Analysis of Abdominal Surgery, Pain, and Anxiety: Preoperative Nursing Intervention by Lin and Wang - Article Example

Running Head: PREOPERATIVE NURSING INTERVETION Preoperative Nursing Intervention Name Institution Date A critique of the paper: Lin, L. Y. & Wang, R. H. (2005) Abdominal surgery, pain and anxiety: preoperative nursing intervention. 1.0 Paper context 1.1 Is the title appropriate? The title of the research article is appropriate. This is so, because the paper tackles the pain and anxiety that is observed and experienced by patients prior to abdominal surgery. The paper also addresses how both pain and the anxiety can be managed to lessen the anxiety of the patients both after the surgery and before it is performed (postoperative anxiety/pain and preoperative anxiety/pain) respectively (Burns, & Grove, 2009). 1.2 What was the question research was designed to answer? The research question was designed to answer the question of how preoperative nursing intervention assists in reduction of pain on abdominal surgery that results because of anxiety before the operation is performed and also after the abdominal surgery (Davie & Logan, 2008). 2.0 Research method 2.1 What was the research design used in the study? As Lin & Wang, 2005, explains, the research design that was used is experimental design. This is because the researchers used an experiment to collect the data as from January 2001 up to August 2001. The method was not very appropriate because there was less external validity because this in not like in a real situation and also the design is not very practical. 2.2 Different treatments given to control group and experimental group. The treatment that was given to the control group was only routine care. On the other hand, the intervention group was provided with both preoperative nursing intervention and also routine care. 2.3 Independent Variable The independent variable was the preoperative nursing intervention. According to Davie & Logan, 2008, is the presumed cause and preoperative nursing intervention was the cause that was presumed to reduce the anxiety and pain in the patients before and after abdominal surgery is performed. 2.4 Dependent Variable. The dependant variable was the abdominal surgery, pain and anxiety. This is because Davie & Logan, 2008, explains that dependant variable is the presumed effect and these were the effects that were measured and the researchers had no control over this. 2.5 How was the data collected? From Lin & Wang, 2005, during data collection, there was a questionnaire that got used and contained an anxiety scale, pain attitude scale in addition to Brief Pain Inventory. These were all used in evaluating the results. Interviewing was also used in data collection. The patients were interviewed before the abdominal operation took place. The following information was collected from the patients during the interview; education level, age, job class, marital status, gender and the patient’s height. The patients were also interviewed on if they had or didn’t have diabetes, hypertension or cardiovascular illnesses. Furthermore, they were interviewed regarding their former surgical operations, if they had used analgesics and also about the utmost pain they had ever felt. Finally, the operative and post operative data was collected from the medical records. This data contained the area the surgery was done, the period of the surgery, how long the incision wound was and its direction, the days the patient had nasogastric or the urinary catheter, whether after the surgery PCA was used and the analgesics taken over the first three days after the operation. 3.0 External validity of the study 3.1 Who were the study participants? The study participants were the patients who were having an abdominal surgery. These participants came from a medical centre at Southern Taiwan. 3.2 How was the sample selected? The samples were chosen at random. This was appropriate because choosing the sample randomly gives greater precision of the results since the results are devoid of any bias. 3.3 How many participants were in the study sample? According to Lin & Wang, 2005, the participants in the study sample were 62. This sample size was determined after 18 participants were exempted using the exclusion criteria. Initially, there were 80 participants. The 18 did meet the exclusion criteria and as a result they were eliminated from the study and finally the 62 participants continued with the study. The sum of 30 participants in each group (intervention and control groups) was found to be enough to evaluate the hypothesis of this study. Therefore, the sample size of 62 participants was enough. 3.4 How were the participants allocated into groups? Davie & Logan, 2008 argues that permuted block randomization was used to allocate the participants into either experimental or control group. The participants who did not meet the exclusion criteria and thus met the inclusion criteria were divided into four sub groups. The following were put into consideration during the group allocation; gender and if the patient was to be operated on upper or lower abdomen. The research assistant developed an enveloped which contained paper slips showing the “experimental group” or the control group. After this, patients coming from identical sub-groups were then asked to pick a paper slip from the envelop. This was to determine if an individual would be grouped in either the experimental or the control group. The method was appropriate since it ensured the participants were distributed randomly and hence there was no bias during the grouping. This method ensured that there was a random distribution of patients and that the number in each group would be fairly evenly distributed in terms of gender and surgical area. 3.5 Differences between the intervention group and the control group. According to Lin & Wang, 2005, the participant in the control group exhibited significantly lower pain attitude when compared to the experimental group. Still, the control group just provided with the routine care while the experimental group was provided with routine care in addition to preoperative nursing intervention for pain. 3.6 Difference in patients included and excluded. There are numerous differences between the patients who were dropped from the study and the participants who remained. Those who were excluded from the study had operation being performed on other areas, other than abdomen, were suffering from metastatic cancer and were mentally sick or had cognitive disabilities. Still, those who were dropped were addicted to either opioids, opiates or some strong analgesics or other drugs. Again, if the patient had pain due to some other sicknesses or could not be able to carry out any out-of-bed activity before the abdominal surgery, he or she was dropped from the study. 3.7 Can the study findings be generalized to other settings? It would not be appropriate to generalize the study’s finding to other settings. Davie & Logan, 2008 elaborates that the patients who participated in this study came from the patients who were going through abdominal surgery in one hospital. Consequently, the fact that the participants were taken from one hospital limits the validity of these findings in other settings that are different and have unlike kinds of the operative patients or even to the different hospitals. 4.0 Internal validity 4.1 Define the concept of reliability. Borbasi, Jackson & Langford, 2007 explains that, the concept of reliability is that a measurement is deemed to as being reliable if it demonstrates typically true score, comparable to the error. Exclusively, reliability can be defined in regard to the percentage of true score inconsistency that is captured from the subjects or respondents, comparative to the sum observed variability. The concept of reliability has been demonstrated where the five experts evaluated each and every scale that was used during the study for content importance and correctness. The five patients who met the inclusion criteria were involved in the clarity examination of the items and the word that were found to be confusing or inaccurate were modified according to the responses from the five patients. Thus some of the items were repeated with regard to the recommendations that the experts gave. 4.2 Define the concept of validity According to Borbasi, Jackson & Langford, 2007, Validity concept is used to refer to if the number obtained accurately shows what the user aimed at measuring. Validity is the truthfulness of the inferences that are obtained from the measurement. Validity concept was demonstrated where the two nurses who were gotten from varying study units got trained for data collection. After measuring the anxiety within the patients, pain attitude, and the level of the pain as well as the intervention of pain during day-day activities, the coefficients were 0·98, 0·97, 0·97 and 0·99, respectively. This reflects the truthfulness of the inferences obtained from the measurement (Lin & Wang, 2005). 4.3 Were participants and/or researchers blinded in this study? There is no one who was blinded in this study. This is because the participants and the researchers knew the about the intervention that was to be offered during the study. Due to the lack of blinding in the study, there could have been bias which generally likely to have an effect on the results. 5.0 Results / Data Analysis 5.1 Differences in outcomes between the intervention and control groups. The results indicate that pain interference in experimental group while they were conducting their daily activities was lower than the pain interference that was observed in control group. After the pain preoperative nursing intervention, the control group illustrated higher anxiety levels than the experimental group which demonstrated lower anxiety levels. The results indicate that the participants in the control group exhibited significantly lower pain attitude when compared to the experimental group. 5.2 What type of data analysis was used? Lin & Wang, 2005 explains that, the data was analyzed using SPSS for windows. This method is appropriate since it analyses data accurately and hence the results obtained after the data analysis were precise. Chi-square tests and independent t-tests were also used in testing the differences that were present in the experimental and control groups. This form of analysis is appropriate because it brings out all and precise variations present and hence it brought out clearly and precisely all the possible variations that were present between the experimental and control group. 5.3 Should results be used to inform clinical practice? The results can be used in informing clinical practice because the participants were sampled randomly and hence there could have been no bias which affected the final results. The study therefore contains information devoid of any bias and thus can be useful in informing clinical practice. Moreover, the results demonstrate various differences between the control group and the experimental group. This indicates that the study achieved its objectives and thus the study was viable. The results can also be used in informing of the clinical practice because only the participants who met the inclusion criteria participated in the study and the ones who did not meet the inclusion criteria were exempted from the study. This shows that the results had no negative effects arising from indistinct participants. Finally, the results can be used in clinical practice information because the study made use of both reliability and validity concepts and hence they results were valid and also true. Thus there was no unsuitability in the results (Borbasi, Jackson & Langford, 2007). References Borbasi, S., Jackson, D., & Langford, R. W. (2007). Navigating the maze of nursing research: An interactive learning adventure. Sydney: Elsevier Australia. Burns, N. & Grove, S.K. (2009). The practice of nursing research: Appraisal, synthesis and generation of evidence. Missouri: Saunders Elsevier. Davies, B. & Logan, J. (2008). Reading research: A user-friendly guide for nurses and other health professionals. Canada, Mosby Elsevier. Lin, L.Y & Wang, R.H. (2005). Abdominal surgery, pain and anxiety: Preoperative nursing intervention. Journal of Advanced Nursing, 51(3), 252-260. Read More