Post-Hospitalization Problems and Nursing Care Needs of Patients who Underwent Thoracolumbar Spine Surgery

Abstract

Introduction Thoracolumbar spine surgery is performed to relieve symptoms like radicular pain and numbness caused by conditions such as disc herniation, lumbar canal stenosis, and spondylolisthesis. Objective: To explore the problems experienced and nursing care needs of patients during home care after thoracolumbar spine surgery. Methods An exploratory study was conducted among 50 patients who underwent thoracolumbar spine surgery in Neurosurgery units, PGIMER, Chandigarh, from July 2018 to September 2020. The problems and nursing care needs were assessed by interviewing the participants telephonically, using an interview schedule comprising of (a) patient profile, (b) clinical variables, and (c) questionnaires to assess physical, psychological, functional, and other problems after discharge. Descriptive statistics (mean, frequency, and percentage) were applied to analyze the data. Results The patients experienced physical problems such as pain, numbness in lower limbs, weakness in limbs, and loss of bladder after discharge. The psychological problems that patients faced were early awakening, sleeplessness, worry about physical dependence on others, stress regarding the family’s role responsibility, and anxiety to return to the job. The common functional issues were difficulty in bathing, difficulty in ambulation, dependence in toileting, and the need for assistance in grooming. Furthermore, other problems perceived by patients were difficulty regarding follow-up in OPD, difficulty in understanding postoperative exercises, lack of understanding of postoperative instructions, and difficulty in carrying out wound dressing. Conclusion The findings of the study provide preliminary evidence that patients experience physical, psychological, and functional problems during their home care after thoracolumbar spine surgery. Hence, it is vital to develop strategies to address the issues by developing need-based nursing care guidelines.

The challenges of nursing care for patients with lumbar discectomy: A qualitative study

“…Dominant routine-based practice in the healthcare system was one of the main challenges of nursing care for patients with lumbar discectomy. In agreement with this finding, a study reported that the difficulties in following medical care services, problems in understanding postoperative exercises and guidelines, and difficulties in wound dressing were among the challenges of nursing care due to routine-based care practice and lack of time to provide patient education (Thapar et al, 2022). Our findings revealed that routinebased practice was associated with ineffective pain management.…”

“…The multiplicity of the physical, mental, and functional complications, problems, and needs of patients with disc surgery (Thapar et al, 2022) their reduced abilities and increased dependence (Fors et al, 2019), and their families' problems in caregiving to them (Rahnama et al, 2017) highlight the importance of quality nursing care services to facilitate their recovery and improve their quality of life (Afshar et al, 2020;Harper & Klineberg, 2019). A study showed that postoperative nursing care services can significantly improve satisfaction with care among patients with disc surgery (Sınmaz & Akansel, 2021).…”