56 - Surgical Anxiety on Post-operative Pain Among Exploratory-laparotomy Patients
Description: In 2004 the annual volume of major surgery was estimated at 187 million–281 million operations, or approximately one operation annually for every 25 human beings alive (WHO,2008). This is a large and previously unappreciated volume with significant implications for public health. In industrialized countries the rate of major complications has been documented to occur in 3–16% of inpatient surgical procedures, and the death rate 0.4–0.8%. Studies in developing countries suggest a death rate of 5–10% associated with major surgery like Exploratory Laparotomy (Ex-Lap), and the rate of mortality during general anesthesia is reported to be as high as 1 in 150 patients (WHO, 2008). However, identifying patients with anxiety is not considered a priority. An anxious patient may come across as aggressive or demanding, needing constant attention from the nursing staff, or be so nervous and apprehensive that he or she is unable to comprehend even simple instruction (Pritchard, 2009). Health care professionals should be able to identify patients at risk of anxiety to provide effective and supportive care before and after surgery.The study examined (a) difference in pre-operative anxiety and post-operative anxiety (b) comparison on the level of pain as rated by the nurse and as rated by patient themselves (c) relationship between pre-operative anxiety and post-operative pain (d) relationship between post-operative anxiety and post-operative pain. This study utilized a descriptive-correlational research design. The subjects (n=42) were purposively selected over a period of one month. Three instruments were used to gather data. A modified instrument (State Anxiety Scale) was used to measure pre and post-operative anxiety while a standard Numerical Pain Scale together with a modified pain reaction rating scale was used to measure postoperative pain. Both modified instruments obtain 0.70 results when subjected to cronbach’s alpha coefficient test. No significant difference (p-value 0.05; df=41) was noted between pre-operative anxiety and post-operative anxiety. Likewise, no difference (p-value 0.88; df=82) was also obtained on the rating of pain between the nurse and the patient. However, a moderately positive correlation (r-0.40) was found to be statistically significant (p-value 0.03;df=40) on the influence of pre-operative anxiety to post-operative pain while no statistical relationship (0.73;df=40) exists between post-operative anxiety and post-operative pain. Results suggest that patient manifest pre-operative anxiety as well as post-operative anxiety, while pre-operative anxiety has been associated with the post-operative pain however evidence shows that post-operative anxiety was not directly related with post-operative pain. Healthcare provider should consider looking into pre-operative protocol more closely in order to help minimize post-operative pain.