The Effect of Progressive Muscle Relaxation Exercises After Endotracheal Extubation on Vital Signs and Anxiety Level in Open Heart Surgery Patients

Abstract

Objective: The purpose of this study was to examine the effects of the exercises of progressive muscle relaxation (PMR) on vital signs and anxiety level after endotracheal extubation in open heart surgery. Materials and Methods: This study was carried out as quasi-experimental, pre-test, and post-test with a control group. The study recruited 30 experimental and 30 control group open heart surgery patients, who met the inclusion criteria, from a cardiac and vascular surgery clinic of a university hospital. PMR exercises, which were taught before the surgery, were implemented after the surgery in the intensive care unit simultaneously with endotracheal extubation. The vital signs of the patients were monitored for the first 30 min. The anxiety levels were measured after 30 min of extubation with state anxiety inventory. Results: The lower rates of heartbeat, breathing, arterial blood pressure, and anxiety were observed in the experimental group in all measurements (first 30 min after endotracheal extubation), and the differences were statistically significant in favor of the experimental group (p<0.05). Conclusion:The study showed that the relaxation exercises after endotracheal extubation in open heart surgery patients was effective in improving vital signs and reducing anxiety level. Keywords: Open heart surgery, progressive muscle relaxation, endotracheal extubation, anxiety level ÖZ Amaç: Bu çalışma, açık kalp ameliyatı olan hastalarda endotrakeal ekstübasyon sonrası uygulanan progresif gevşeme egzersizlerinin (PGE) yaşam bulgularına ve kaygı düzeyine etkisini belirlemek amacıyla uygulandı. Gereç ve Yöntem: Ön test -son test kontrol grup tasarımlı yarı deneysel bir çalışma olarak planlanan araştırma, bir üniversite hastanesinin kalp ve damar cerrahisi kliniğine açık kalp ameliyatı uygulamak için kabul edilen ve örneklem özelliklerini karşılayan 60 hasta (30 deney, 30 kontrol) ile gerçekleştirildi. Ameliyat öncesi öğretilen PGE, ameliyat sonrası dönemde yoğun bakım ünitesinde endotrakeal ekstübasyonla birlikte uygulanmaya başlandı. Hastaların yaşam bulguları ilk 30 dakika izlendi. Otuzuncu dakikada durumluluk kaygı düzeyi ölçüldü. Bulgular: Endotrakeal ekstübasyon sonrası ilk 30 dakika süresindeki izlemlerinde, deney grubundaki hastaların arter kan basıncı değerleri, nabız hızı, solunum sayısı ve kaygı düzeyleri değerlerinin kontrol grubuna göre daha düşük olduğu ve aralarında deney grubunun lehine anlamlı farklılık olduğu saptandı (p<0,05).

Effect of Jaw Relaxation Technique on Low Back Pain and Selected Vital Signs Among Nursing Staff: A Randomized Controlled Trial

“…A similar study conducted to examine the effect of relaxation therapy revealed significant reduction in systolic and diastolic blood pressure in patients with elevated blood pressure (Soliman & Mohamed, 2013). A recent study conducted to investigate the effect of relaxation technique on vital signs found significant lower rate of pulse, respiration and blood pressure in the experimental group when compared to control group (İbrahimoğlu & Kanan, 2017).…”

Latihan Relaksasi Otot Progresif Dalam Mengatasi Respon Fisik dan Psikologis Pasien Bedah: Literature Review

“…Hemodinamik salah satu parameter respon fisik dan psikologis akibat pengaruh sistem saraf simpatis (15,16,20). Penelitian pada pasien bedah abdomen didapatkan PMR menurunkan nyeri pasca operasi dan terlihat dari hemodinamik pasien pada kelompok intervensi yang lebih rendah dibandingkan kelompok kontrol (15) .…”

“…Dalam penelitian ini didapatkan nyeri pasca operasi abdomen tidak mempunyai korelasi dengan Heart Rate (HR) dan Respiratory Rate (RR) tetapi berhubungan dengan peningkatan mean arterial pressure (MAP) p<0,05. Jurnal Penelitian Kesehatan Suara Forikes ------http://forikes-ejournal.com/index.php/SF Hal ini berbeda dengan penelitian pada pasien bedah jantung terbuka di Turki bahwa penerapan PMR pasca ekstubasi dapat menstabilkan HR, RR, TD, MAP pada grup intervensi dibandingkan dengan grup kontrol (16) . Hal ini sama dengan penelitian lainnya, PMR dan konseling psikologi dapat menurunkan HR dan TD pasien grup intervensi (20) .…”

“…Ansietas merupakan respon psikologi paling banyak diteliti dalam periode perioperatif (11,12,16,18) . Penelitian pada kelompok intervensi mendapatkan PMR 2 kali sehari selama 30 menit dari 48 jam masuk Rumah Sakit sampai sebelum keluar Rumah sakit.…”

“…Hasilnya ansietas grup intervensi pasca operasi turun signifikan (p= 0.017) dan memiliki LOS lebih pendek (12) . Begitupun penelitian di Turki yang melatih PMR pada kelompok intervensi sebelum operasi menggunakan panduan CD (16) . Hasilnya penerapan PMR sesaat setelah ekstubasi selama 30 menit menurunkan ansietas kelompok intervensi (p=0,001) (16) .…”