Elsa Sanatombi Devi

Effect of Preoperative Education on Postoperative Outcomes Among Patients Undergoing Cardiac Surgery: A Systematic Review and Meta-Analysis

Purpose: The objective of this review was to assess the effect of preoperative education on postoperative outcomes among patients undergoing cardiac surgery. Design: Systematic review and meta‐analysis. Methods: A comprehensive literature search was made on PubMed, CINAHL, Ovid, ProQuest, ScienceDirect, Scopus, Web of Science, and the Cochrane database between 1995 and 2015. Fourteen randomized controlled trials were included. Data analysis was performed with RevMan software and created the Supplementary Appendix using the GRADE approach. Findings: Meta‐analysis showed that preoperative education reduced anxiety scores (standardized mean difference = −0.96, 95% confidence interval: −1.37, −0.54; P < .0001). However, there was no significant effect of preoperative education on pain, depression, and length of hospital stay. There is low‐quality evidence, and reasons for downgrading are due to study design limitations, inconsistency, and imprecision of effect estimates. Conclusions: The results show that preoperative education can effectively decrease anxiety in patients undergoing cardiac surgery.

Lived experiences of patients with chronic obstructive pulmonary diseases (COPD)-qualitative review

Chronic obstructive pulmonary disease (COPD) is a common, debilitating illness of aged population which causes consequential mortality and morbidity. The purpose of the study was to examine the qualitative research focused on lived experiences of COPD patients. Focus of the study was qualitative meta-synthesis on research integration by combining the findings of similar topics from qualitative studies. A comprehensive search for original relevant research studies which are published between 2000 and 2016 was conducted among three scientific data bases of PubMed, Ovid Medline and CINAHL. Data was extracted independently from the included studies by reviewers into the pre-designed structured data extraction forms. The study adopted a summative approach of qualitative content analysis to synthesize the data. The initial search produced 672 studies, after removing the duplicates 494 studies were included for title screen. After removing the non-relevant, non-English and quantitative studies, only ten articles were included for the full text review. Based on the inclusion criteria six relevant articles were included in the final review. The four areas of concern were, feeling incapacitated where breathing difficulty and bulk of carrying portable oxygen systems were the key factors for restricted walking and activities. Social isolation; here the social participation and physical involvement was interpreted as possible for few and was difficult for others. In views on death and dying; thoughts about “suicide” and “why living” and thought about future concerns related to aging, decline in cognitive function and deterioration in health were the major areas discussed.

Psychological impact of cancer diagnosis in newly diagnosed breast cancer patients

Aim: The aim of the study was to examine the impact of cancer diagnosis on the psychological status of women with breast cancer, focusing on anxiety and psychological distress experienced by breast cancer patients. Materials and Method: A descriptive, cross-sectional study was conducted among 80 breast cancer patients after an initial cancer diagnosis by using purposive sampling. The study was conducted in a tertiary care hospital in South India. Data was collected by using Demographic and Clinical proforma, State-Trait Anxiety Inventory and Impact of Event Scale. Sample characteristics were analyzed using descriptive statistics, the influence of anxiety on psychological distress was tested with correlation and a chi-square test was used to test the association between anxiety and distress with demographic and disease-related variables. Results: The sample consisted of 80 women with a mean age of 48.1 years. 96% were married, and 90% of them were housewives. Half of the subjects were educatedupto primary school. 80% were in stage II of cancer with a duration of diagnosis of 2-4 weeks.48% of the subjects were suffering from a moderate range of distress and 16% had severe psychological distress. Similarly, 80% of subjects had moderate to high level of anxiety. Anxiety did not have any influence on psychological distress. And only duration of diagnosis was associated with psychological distress. Conclusion: Results of the study suggest that cancer diagnosis can cause moderate to severe distress in breast cancer patients. Recognizing distress and intervening it on time is pivotal to improve treatment outcomes of women with breast cancer.

Effect of Complementary Therapies in Patients Following Cardiac Surgery: A Narrative Review

Cardiovascular diseases are increasing rapidly and have become a major health problem worldwide. The incidence and prevalence of cardiovascular disease are increasing rapidly, predominantly in the developing countries. Patients with cardiovascular disease who do not respond to routine medical treatment will have to follow cardiac surgical procedures. The objective of this study was to apprise the evidence of the effect of various complementary therapies on postoperative outcomes among patients undergoing cardiac surgery. A comprehensive literature search was made on PubMed-Medline, CINAHL, Science Direct, Scopus, Web of Science, and the Cochrane Library databases for original research studies published between 2000 and 2015. Original articles that reported the effect of complementary therapies in patients undergoing cardiac surgery were included. Twenty-eight studies were analyzed, and they have produced conflicting results. Most of the studies (n = 25) have documented the effects of complementary therapies on improving postoperative outcomes of patients, whereas other studies (n = 3) found no evidence of improvement. Although methods varied considerably, most of the studies included in this review reported positive results. Therefore, there is some evidence that complementary therapies can lead to positive postoperative outcomes. Evidence of the efficacy of complementary therapies in cardiac surgical patients remains inconclusive. Additional research is needed to provide a strong evidence base for the use of complementary therapies to improve postoperative outcomes and recovery in patients undergoing cardiac surgery.

Effectiveness of Acupressure on Chemotherapy Induced Nausea and Vomiting and the functional status among Cancer Patients Receiving Cisplatin as Radiosensitizer Chemotherapy in Kasturba Hospital Manipal

Objective: To investigate the effectiveness of acupressure in reducing CINV, and to find the correlation between functional status and nausea experience. Method: 40 cancer patients receiving cisplatin as radiosensitizer chemotherapy were divided into experimental and control group (n=20 each). Both group received regular antiemetic medication; however the intervention group received finger acupressure to the selected acu-points for nausea and vomiting (Pericardium -6 & Heart -7) for 3 min on each point bilaterally (Total 12 minutes) twice daily for 3 days, starting from second day of chemotherapy. Both group reported nausea and vomiting using Rhodes index of nausea and vomiting. Functional status was assessed using functional status index. Results: Nausea experience was significantly lower in experimental group compared to the control group (P = 0.002) and a significant weak negative correlation was found between the nausea experience and functional status (P = 0 .026). Conclusions: Nausea experience can have significant impact on the functional status of the cancer patients and acupressure can be useful for reducing chemotherapy induced nausea.

Effectiveness of Inflatable Lumbar Support (ILS) for the Prevention of Short Term Backache among Post-operative Female Patients Undergoing Lower Abdominal Surgery Under Spinal Anesthesia

Introduction:Backache strikes nearly 85% of the population at some time of their life. Majority of the backache is due to stress and strain of back muscles, ligaments and tendons. Today the incidence of post-operative backache is increasing and positioning the patient as well as the anesthetic technique of surgery places an important role to develop post- operative backache.1 Objectives:To analyze the effectiveness of lumbar support in preventing post- operative backache as measured by Verbal Descriptive Scale (VDS) and also to find its association between post-operative backache and age, occupation, BMI, type of surgery, position during surgery and also the duration. Method and material:A 10 point Verbal Descriptive Scale pain scale was used to evaluate the post operative backache of both experimental (30) and control group (30). Result:The median of 2nd and 5th day VDS pain score between both the groups were significantly different (Z value is -5.070 in experimental group and - 4.217 in the control group). The median reduction in the VDS pain score between the two groups is statistically significant (Z=-5.028) at p<.05. Conclusion:This study provides empirical evidence to the effectiveness of inflatable lumbar support for the prevention of post-operative backache and is found to have association with BMI.

A Study to assess the Needs of the Family Members of Patients Admitted in Intensive Care Unit and to Compare these with the Nurses’ Perception in Selected Hospitals of Karnataka State

The admission of a patient into a Intensive Care Unit is often a frightening and stressful experience for the family members. The purpose of this study was to assess the needs of the family members of ICU patients and the nurses’ perception of these needs. A descriptive survey was undertaken and data was collected using structured questionnaires from a sample of 75 family members of ICU patients and 75 nurses working in ICUs of Kasturba Hospital, Manipal. The top five needs of the family members identified were: to be assured that the best care is given to my patient, to receive information about the patients progress, to know exactly what is being done for the patient, to know the expected outcome and to have questions answered honestly. The family members identified the Cognitive needs as the most important needs followed by Emotional needs. They gave the least preference to their own Personal or Practical needs. The nurses were able to perceive that the Cognitive needs were the most important to the family members followed by the Emotional needs. The nurses were able to identify 4 out of the top 5 needs of family members. However the mean score of the nurses’ perception of the family members needs were lower than that of the family members needs score (22.91 vs 28.09). Hence it is of crucial importance that the nurses identify the needs of the family members accurately in order to meet these needs.