Preoperative Nursing Intervention - Assignment Example

Running Head: PREOPERATIVE NURSING INTERVETION Preoperative Nursing Intervention Name Institution Date Lin, L.Y & Wang, R.H. (2005). Abdominal surgery, pain and anxiety: preoperative nursing intervention. Journal of Advanced Nursing, 51(3), 252-260. Context of the paper Q. 1 The title is appropriate because the article addresses the pain and the anxiety that comes before abdominal surgery is performed and how it can be managed to reduce the anxiety to the patients before and after the surgery. Q.2 The research question was designed to answer the effects that come with performing a preoperative nursing intervention for pain on abdominal surgery due to anxiety before the operation as well as the postoperative pain. Research method Q.1 The researchers used experimental design whereby the data was gathered from January 2001 to august 2001. This method is appropriate since the experimental design sets up a casual-and-effect relationship very effectively (Lin, & Wang, 2005). Q.2 The group that was experimental was given routine care as well as preoperative nursing intervention for pain whereas the control group was just given routine care. Q.3 Preoperative nursing intervention is the independent variable since it was controlled by the researcher. Q.4 Abdominal surgery, pain and anxiety is the dependant variable since it is the response that was measured and was not controlled by the researcher. Q.5 The personal data was collected through interviewing whereby the patients were interviewed before the operation was carried and it consisted of the age, gender, height, weight, educational status, job category, marital status, if the patients did or did not have hypertension, diabetes or cardiovascular disease, earlier surgical experiences, the experience in utilizing analgesics as well as greatest intensity of pain that the patient had ever experienced. Both operative and postoperative data was collected from medical records and it consisted of surgery area, time length of operation, length and direction of the incision wound, if PCA was utilized after surgery, dosage of analgesics taken in the initial 3 days following the surgery, and the days with a nasogastric tube or urinary catheter (Suzanne, et al, 2009). A questionnaire was also used in data collection and had an anxiety scale, pain attitude scale, and Brief Pain Inventory. These were used in examining of the results (Lin, & Wang, 2005). External validity of the study Q.1 The study participants were patients who were undertaking abdominal surgery within a medical centre that is locate at Southern Taiwan. Q.2 The samples were selected randomly. Selecting the samples randomly was appropriate since it eliminated any unauthentic casualty and bias as well (Watson, 2008). Q.3 The study sample had 62 participants. A sum of 80 patients has been originally employed. Among the 80 participants, 18 fulfilled exclusion criteria and hence were exempted and thus 62 participants remained. The size of the sample was predetermined through utilizing power analyses founded on the big effect size α of 0·05 and power = 0·80. Thirty (30) participants in every group were established to be sufficient to examine study’s hypothesis and hence the sample size that was used was adequate (Lin, & Wang, 2005). Q.4 Participants were allocated into study groups using the permuted block randomization into either experimental or control group. The participants who were eligible for inclusion were apportioned into four sub groups in regard to their gender and if their area of surgery was to be operated upper or else lower abdomen. A research assistant set up an envelop that had slips of paper indicating the “experimental group” or “control group”. Patients from the same sub-group were requested to take a slip of paper from the envelop to decide if they would fit in the experimental group or control group. This method was appropriate because it made sure that there a random distribution of the patients and also the method ensured that the number in every group would be reasonably fairly distributed in regard to both gender and area of surgery (Lin, & Wang, 2005). Q.5 The difference is that the experimental group one was given routine care as well as preoperative nursing intervention for pain whereas the control group was just given routine care (Lin, & Wang, 2005). Q.6 There is difference in that the patients who were dropped from the experimental research either had metastatic cancer, were being operated on other areas, had cognitive disabilities or have had a mental disease, had addiction in opioids, opiates or powerful analgesics or abused drugs, were experiencing pain because of some other conditions or were not in a position to perform any out-of-bed activities before the surgery. Those who participated in the research did not have or did not experience any of these while those who were dropped suffered either one or more of the above states (Lin, & Wang, 2005). Q.7 The findings cannot be generalized to other settings since they are specific to the experiment sample that was experiment. Maybe the findings would be different after using a different sample. Still, the participants in this study were gotten from patients who were undertaking abdominal surgery within individual hospital. As a result, this can restrict the applicability of the findings to different types of operative patients or to dissimilar hospitals (Watson, 2008). Internal validity Q.1 The concept of reliability is that a measure or experiment is regarded as reliable incase an individual’s score on the identical test give two times is alike. Reliability is the consistency of the measurement or an experiment or the level to which the same measurement or outcome is gotten every time it is done under the same circumstance with the same subjects. It is the repeatability of an experiment or measurement. (Watson, 2008). Reliability concept was demonstrated in that five experts examined all scales for content significance and suitability and some of the items were repeated in accordance to their recommendations. Five patients who fulfilled the sampling criteria were called to evaluate the clarity of the items and imprecise or confusing wording was amended according to their responses. Q.2 The concept of validity is the strength of the research’s conclusions or propositions or the most excellent available estimate to the truth or falsity of a certain conclusion (Watson, 2008). The concept of validity was demonstrated in that two nurses from different unit of the study hospital were trained as data collectors. The intra-class correspondence coefficients among the two nurses in measuring five patients' anxiety, attitude towards pain, the intensity of pain and interference of pain on a daily basis activities were 0·98, 0·97, 0·97 and 0·99, respectively. Cronbach's alpha for the pain attitude scale in the study was 0·92 (Lin, & Wang, 2005). Q.3 Neither the researchers not the participants were blinded in the study. Both parties were aware of the entire process. Bias could have occurred as a result of placebo effects and this is likely to affect the final results of the study since placebo effects might influence the results (Watson, 2008). Results / Data analysis Q.1 The differences between the experimental and controlled group include that the interference of pain in the daily actions within the experimental group was lower when compared to that of the control group. Following the preoperative nursing intervention for pain, the experimental group had lower anxiety levels, 3·03 (2·46) when compared to the control group which illustrated a higher anxiety level, 4·67 (2·53). Pain attitude of the experimental group was considerably bigger when compared to the pain attitude in the control group (Lin, & Wang, 2005). Q.2 SPSS for windows utilized during the statistical analysis of the data. Kolmogorov–Smirnov and box-plot tests indicated that the data was within the hypothesis of normality. Lavene’s test was used to illustrate uniformity of variation between experimental and control groups. Descriptive statistics, which consisted of mean (M), standard deviation (sd) and frequency, were computed. Furthermore, Chi-square tests and independent t-tests were utilized to test the variations between the experimental and control groups. Recurring measures two-way ANOVAs was also utilized in order to test the effects of the intervention. Analyzing data using SPSS for windows yields very accurate results and hence the results that were arrived at, after the data analysis were not erroneous (Watson, 2008). Q.3 The results from this experimental study can be used to inform clinical practice. This is because the efficient methods were used within the entire experimental study. For instance, the experimental method that was used is experimental design which is particularly useful in such a kind of study. This is because this research design allowed the ideal testing of the samples and hence the results arrived at can be used clinical practices. The patients who met the exclusion criteria were not tested and this means that the results that were gotten had no effect from testing people who did not meet the inclusion criteria. Furthermore, those who met the inclusion criteria and were included in the study but also met the exclusion criteria were dropped which means only the patients who were eligible for study were tested. The results can also be used in informing clinical practice since the results indicated differences between the experimental and controlled group. This shows that the study supported its hypothesis and hence arrived at a practical conclusion. The results can be used again because the study fulfilled the concept of reliability and hence this indicates that the tests carried out as well as the measurements that were used were not ambiguous since they illustrated consistency. Moreover, the same factors that were tested in same sample tallied to the best available estimate to the truth of the gotten conclusion and hence this indicates that the results hardly had any errors and thus could be utilized. Finally, the results can be used in informing the clinical practice since they had not been affected by any bias because the method that was used in sampling the participants was random and hence there was no way biasness was present to influence the results. The method of data analysis that was used is also accurate and hence it resulted to error-free results (Watson, 2008).     References Lin, L.Y & Wang, R.H. (2005). Abdominal surgery, pain and anxiety: preoperative nursing intervention. Journal of Advanced Nursing, 51(3), 252-260. Watson, R. (2008). Nursing research: designs and methods. New York: Elsevier Health Sciences. Suzanne, C, et al. (2009). Brunner & Suddarth's Textbook of Medical- Surgical Nursing, Volume. Hong Kong: Lippincott Williams & Wilkins. 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