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Journal List > Korean J Women Health Nurs > v.25(1) > 1119014

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Lee, Jeon, Park, Lee, Ahn, Lee, and Kim: Influence of Gas Pain, Post-operative Resilience, and Body Temperature Discomfort in Laparoscopic Myomectomy Patients after Thermotherapy
Original Article

Korean Journal of Women Health Nursing 2019; 25(1): 4-18.

Published online: 13 March 2019

DOI: https://doi.org/10.4069/kjwhn.2019.25.1.4

Influence of Gas Pain, Post-operative Resilience, and Body Temperature Discomfort in Laparoscopic Myomectomy Patients after Thermotherapy

JeongAe Lee1, MyoungHwa Jeon2, EunJu Park1, JinAh Lee1, GonMyoung Ahn1, SeungShin Lee3, JiIn Kim4

1Unit Manager, CHA Gagnam Medical Center, Seoul, Korea.

2Team Manager, CHA Gagnam Medical Center, Seoul, Korea.

3Director of Nursing, CHA Bundang Medical Center, Bundang, Korea.

4Professor, Department of Nursing, Daegu Health College, Daegu, Korea.

Corresponding author: Jeong Ae Lee. CHA Gangnam Medical Center, 566 Nonhyeon-ro, Gangnam-gu, Seoul 06135, Korea. Tel: +82-2-3468-3492, Fax: +82-2-567-1286, 67jalee@chamc.co.kr

Received 28 August 2018       Revised 26 November 2018       Accepted 26 February 2019

© 2019 Korean Society of Women Health Nursing

Korean Society of Women Health Nursing

(open-access):

This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

The purpose of this study was to investigate the effects of thermotherapy on gas pain, post-operative resilience, and body temperature discomfort among patients who received laparoscopic myomectomies.

Methods

The experimental group consisted of 62 patients with thermotherapy and the control group consisted of 60 patients. Thermotherapy was applied individually to the experimental group four hours after surgery. The collected data was analyzed using descriptive statistics, t-tests, χ2-tests, and repeated measures of analysis of variance, using IBM SPSS Statistics version 18.

Results

The results showed no significant interaction effect between the group and time of measurement in gas-related pain in the experimental group. For gas-related pain, there was significant difference in right shoulder pain at 24 hours (t=-4.222, p=.000), 48 hours (t=-3.688, p=.000), 72 hours (t=-2.250, p=.028), and left at 24 hours (t=-3.727, p=.000), 48 hours (t=-4.150, p=.000), and 72 hours (t=-2.482, p=.016) and both shoulders at 24 hours (t=-2.722, p=.009) and 48 hours (t=-2.525, p=.014). There was no significant difference in epigastric pain, excluding both epigastric pain at 48 hours (t=2.908, p=.005), 72 hours (t=3.010, p=.004), but there was a significant difference in objective body temperature discomfort (t=2.895, p=.008).

Conclusion

Thermotherapy relieved shoulder gas-related pain and objective body temperature discomfort. It needs to be developed and applied to improve post-operative discomfort in patients with laparoscopic hysterectomies.

Keywords: Gynecological laparoscopy, Thermotherapy, Pain, Recovery, Body temperature

Figures and Tables

kjwhn-25-4-g001
Figure 1

Flow diagram of research process.

NRS=Numeric Rating Scale; TCI=thermal comfort inventory; VAS=visual analogue scale; QoR-40=Quality of Recovery 40.

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Table 1

Homogeneity of General Characteristics, Gas Related Pain and Frequency of Painkiller Use (N=122)

kjwhn-25-4-i001
Variables Exp. (n=62) Cont. (n=60) t/x2 p
n(%) or M±SD n(%) or M±SD
Education level 0.935 .626
High school 4 (6.5) 5 (8.3)
College 50 (80.6) 44 (73.3)
Postgraduate school 8 (12.9) 11 (18.3)
Occupation 6.272 .180
Employee 20 (32.3) 25 (41.7)
Profession 6 (9.7) 12 (20.0)
Housewife 35 (56.5) 23 (38.3)
Student 1 (1.6) -
Marital status 2.998 .392
Married 43 (69.4) 43 (71.7)
Unmarried 17 (27.4) 16 (26.7)
Separation/Divorce 2 (3.2) 1 (1.7)
Religion 3.451 .485
Protestant 17 (27.4) 20 (33.3)
Catholic 8 (12.9) 8 (13.3)
Buddhism 4 (6.5) 7 (11.7)
No religion 33 (53.2) 25 (41.7)
Age (year) 40.8±6.12 39.9±6.71 2.045 .309
Operation time (min) 114.66±52.35 136.23±67.98 2.499 .117
Gas-related pain (at 4 hours)
Epigastric pain (Rt.) 0.55±1.27 0.98±1.72 −1.588 .115
Epigastric pain (Lt.) 0.39±0.87 0.70±1.31 −1.549 .124
Epigastric pain (Both) 1.06±1.76 1.28±1.56 −0.726 .469
Shoulder pain (Rt.) 0.21±0.96 0.17±0.61 −0.295 .768
Shoulder pain (Lt.) 0.11±0.40 0.13±0.56 −0.228 .820
Shoulder pain (Both) 0.15±0.50 0.28±0.99 −0.972 .333
Frequency of Painkiller use (times) 0.48±0.09 0.58±0.15 −0.558 .109
M±SD=mean±standard deviation; Exp.=experimental group; Cont.=control group.

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Table 2

Effects of Thermotherapy on Gas Related Pain (N=122)

kjwhn-25-4-i002
Variables Groups Pretest Posttest 1 Posttest 2 Posttest 3 Posttest 4 Sources F(p) Pretest vs. Posttest 1 Pretest vs. Posttest 2 Pretest vs. Posttest 3 Pretest vs. Posttest 4
M±SD M±SD M±SD M±SD M±SD t(p) t(p) t(p) t(p)
Epigastric pain (Rt.) Exp. (n=62) 0.55±1.27 0.61±1.10 0.76±1.37 0.60±1.01 0.37±0.77 Group 3.137 (.079) −0.439 (.662) −1.176 (.244) −0.293 (.770) 1.156 (.252)
Cont. (n=60) 0.98±1.72 1.00±1.46 1.20±1.50 0.85±1.17 0.46±0.79 Time 5.148 (.002) −0.092 (.927) −1.012 (.316) 0.505 (.616) 1.944 (.057)
t(p) −1.588 (.115) −1.653 (.101) −1.692 (.093) −1.274 (.205) −0.561 (.576) Group×Time 0.605 (.604)
Epigastric pain (Lt.) Exp. (n=62) 0.39±0.87 0.48±1.05 0.63±1.39 0.37±0.81 0.25±0.65 Group 2.762 (.099) −0.695 (.490) −1.318 (.192) 0.145 (.885) 1.266 (.210)
Cont. (n=60) 0.70±1.31 0.77±1.19 0.87±1.15 0.72±1.09 0.42±0.72 Time 4.505 (.003) −0.433 (.666) −1.055 (.296) −0.098 (.922) 1.412 (.163)
t(p) −1.549 (.124) −1.387 (.168) −1.026 (.307) −1.968 (.049) −1.417 (.159) Group×Time 0.150 (.940)
Epigastric pain (Both) Exp. (n=62) 1.06±1.76 0.84±1.30 0.79±1.21 0.42±0.84 0.38±0.82 Group 7.014 (.009) 1.343 (.184) 1.263 (.212) 2.908 (.005) 3.010 (.004)
Cont. (n=60) 1.28±1.56 1.17±1.38 1.37±1.37 1.08±1.16 0.73±0.99 Time 6.584 (.000) 1.412 (.163) 0.520 (.605) 0.864 (.391) 2.274 (.027)
t(p) −0.726 (.469) −1.346 (.181) −2.447 (.016) −3.611 (.000) −2.114 (.037) Group×Time 0.925 (.429)
Shoulder pain (Rt.) Exp. (n=62) 0.21±0.96 0.35±1.17 0.85±1.34 0.31±0.64 0.11±0.32 Group 2.790 (.098) −1.816 (.074) −4.222 (.000) −3.688 (.000) −2.250 (.028)
Cont. (n=60) 0.17±0.61 0.45±1.25 0.93±1.46 0.75±1.09 0.46±0.75 Time 10.393 (.000) −0.868 (.389) −3.115 (.003) −0.740 (.462) 0.736 (.465)
t(p) −0.295 (.768) −3.432 (.666) −0.309 (.758) −2.732 (.007) −3.273 (.001) Group×Time 1.472 (.220)
Shoulder pain (Lt.) Exp. (n=62) 0.11±0.40 0.24±1.30 0.40±1.29 0.32±0.92 0.26±0.65 Group 4.554 (.035) −2.316 (.024) −3.727 (.000) −4.150 (.000) −2.482 (.016)
Cont. (n=60) 0.13±0.56 0.38±0.92 0.82±1.35 0.80±1.19 0.42±0.70 Time 6.423 (.001) −0.740 (.462) −1.652 (.104) −1.608 (.113) −1.417 (.162)
t(p) −0.228 (.820) −0.694 (.489) −1.717 (.089) −2.503 (.014) −1.304 (.195) Group×Time 1.518 (.214)
Shoulder pain (Both) Exp. (n=62) 0.15±0.50 0.29±0.98 0.44±1.00 0.35±0.83 0.10±0.29 Group 8.486 (.004) −1.541 (.129) −2.722 (.009) −2.525 (.014) −0.644 (.522)
Cont. (n=60) 0.28±0.99 0.48±1.01 0.87±1.30 0.75±1.06 0.39±0.67 Time 6.707 (.000) −1.013 (.315) −1.939 (.057) −1.689 (.096) 0.622 (.536)
t(p) −0.972 (.333) −1.066 (.288) −2.048 (.043) −2.285 (.024) −3.134 (.002) Group×Time 0.723 (.543)
M±SD=mean±standard deviation; Pretest=before thermotherapy, 4 hours after surgery; Posttest 1=8 hours after surgery; Posttest 2=24 hours after surgery; Posttest 3=48 hours after surgery; Posttest 4=72 hours after surgery; Exp.=experimental group; Cont.=control group.

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Table 3

Mean Differences in Postoperative Recovery (N=122)

kjwhn-25-4-i003
Variables Exp. (n=62) Cont. (n=60) t p
M±SD M±SD
Physical comfort 46.66±6.32 46.35±7.15 0.255 .799
Emotional state 39.17±4.20 38.40±5.03 0.923 .356
Physical independence 16.54±5.13 17.45±4.77 −1.004 .317
Psychological support 26.96±5.89 25.90±3.11 1.245 .216
Pain 27.46±4.59 28.00±4.32 −0.659 .511
M±SD=mean±standard deviation; Exp.=experimental group; Cont.=control group.

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Table 4

Comparison of Body Temperature Discomfort between Groups (N=122)

kjwhn-25-4-i004
Variable Exp. (n=62) Cont. (n=60) t p
M±SD M±SD
TCI 67.91±8.53 62.15±13.00 2.895 .008
VAS 1.37±1.61 1.75± 2.06 −1.133 .260
M±SD=mean±standard deviation; Exp.=experimental group; Cont.=control group; TCI=thermal comfort inventory; VAS=visual analogue scale.

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Notes

Conflict of Interest The authors declared no conflict of interest.

Author Contributions

  • Data curation: Lee Ja, Jeon M.

  • Formal analysis: Kim J.

  • Investigation: Park E.

  • Methodology: Lee Jb.

  • Project administration: Lee Ja.

  • Resources: Ahn G.

  • Supervision: Lee S, Jeon M.

  • Validation: Kim J.

  • Visualization: Lee Ja.

  • Writing - original draft: Lee Ja, Jeon M.

  • Writing - review & editing: Kim J.

aJeongAe Lee; bJinAh Lee.

Summary Statement

  • • What is already known about this topic?

  • Thermotherapy is a non-pharmaceutical nursing intervention. It is usually used for laparoscopic hysterectomy patients to relieve pain and body temperature discomfort. This method has gained attention because it is very easy to apply and has few side effects.

  • • What this paper adds?

  • Thermotherapy was effective for laparoscopic hysterectomy patients in relieving gas-related pain in the epigastric area and shoulder, as well as reducing body temperature discomfort. However, it was not effective for relief of subjective body temperature discomfort in this study.

  • • Implications for practice, education, and/or policy

  • Thermotherapy is expected to be used as an adjunctive nursing intervention for patients planning to have surgery.

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ORCID iDs

JeongAe Lee
https://orcid.org/0000-0002-5053-1104

MyoungHwa Jeon
https://orcid.org/0000-0002-2259-7771

EunJu Park
https://orcid.org/0000-0003-3995-7224

JinAh Lee
https://orcid.org/0000-0002-3658-6467

GonMyoung Ahn
https://orcid.org/0000-0002-2365-714X

SeungShin Lee
https://orcid.org/0000-0003-1508-5003

JiIn Kim
https://orcid.org/0000-0002-0991-0540

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