Pain perception of patients in intensive care unit after cardiac surgery: A qualitative study using Roy's Adaptation Model

Welcome to the third issue of Nursing in Critical Care for this year. In this issue, we cast a spotlight on cardiac intensive care nursing, early mobilization and other clinically relevant topics, which should be of interest to critical care nurses in various settings. Again, the number of submissions to the journal remained high; therefore, the number of papers published is also high and we included 21 papers in this issue.Many of the papers are primarily quantitative in nature, including surveys, randomized controlled trials (RCTs) and scale validation, so we hope our guest editorial from the first issue of this year 1 will help make sense of the statistical results. Nonetheless, the issue also includes a selection of qualitative studies focussing on the experiences of patients, their family and their care providers.We open this issue with commentary papers on two topical issues. In their guest editorial, McEvoy and Tume 2 discuss the importance and implications of undertaking peer reviews for critical care nursing journals, whereas the critical commentary by Sumner and Macwan 3 examines the role of registered nursing associates in critical care. We hope that these papers provide food for thought, and that the first one encourages you to consider becoming a peer reviewer for this and other critical care journals.

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confidence: 99%

Spotlight on cardiac critical care and early mobilisation

Trapani,

Stewart

2024

The effect of eye mask on sleep quality and pain in patients undergoing coronary artery bypass graft surgery: A double‐blind randomized controlled trial

Dagcan Sahin,

Nal,

Gurol Arslan

et al. 2024

BackgroundPain is one of the common postoperative issues that impair recovery and quality of life in patients undergoing coronary artery bypass graft (CABG) surgery. It leads to prolonged recovery and sleep disturbances in patients.AimThis study was conducted to examine the effect of eye mask use on sleep quality and pain in patients undergoing CABG surgery.Study DesignA double‐blind randomized trial design was employed. The study included 60 patients undergoing CABG surgery. They were divided into intervention and control groups through block randomization. Data were collected using a ‘Demographic Characteristics Form’, the ‘Richards‐Campbell Sleep Questionnaire (RCSQ)’ and a ‘Visual Analogue Scale’ (VAS) through face‐to‐face interviews. While patients in the control group received standard care throughout the night, patients in the intervention group received standard care and used eye mask. All patients were followed up for three nights. The CONSORT was used to report the study.ResultsThe main outcome of the study, the RCSQ score, was higher in the intervention group at baseline. The intervention group had higher RCSQ scores than the control group at time 1 and time 2. There were no differences between the groups in the secondary outcome, pain levels. The control group had higher pain scores at time 1 and time 2 than the intervention group.ConclusionThe use of an eye mask after CABG surgery is an effective, safe and simple nursing intervention to improve sleep quality and control pain.Relevance to Clinical PracticeBecause the use of an eye mask is an independent and unique nursing intervention, nurses should be supported and allowed to practise it.

The effect of an open‐heart surgery patient care protocol on post‐sternotomy pain, anxiety and quality of care: A randomized controlled trial

Dağcan Şahin,

Gürol Arslan

2024

BackgroundOpen‐heart surgery patients face many problems because of post‐sternotomy pain. Care protocols can eliminate pain and pain‐related problems by providing holistic care.AimThe aim of this study was to examine the effect of an open‐heart surgery patient care protocol developed in the study on post‐sternotomy pain, anxiety and quality of care.Study DesignThe study was carried out as a double‐blind randomized controlled trial. The sample size was calculated. Considering some attrition, the sample size was increased by 10% for each group, and a total of 68 participants, including 34 in each group, were included in the sample. Data were collected using a ‘Patient Information Form’, a ‘Post‐Sternotomy Pain Follow‐up Form’, the ‘Numeric Rating Scale’, the ‘State Anxiety Inventory’ and the ‘Strategic and Clinical Quality Indicators in Postoperative Pain Management Questionnaire’. The patients in the experimental group were given care in accordance with the protocol, which was developed in the study, on postoperative days 0, 1 and 2.ResultsThe statistical evaluation showed a significant difference between the mean scores of the experimental (F = 7.28; p < .001) and control groups (F = 2.42; p < .05) on the pain assessment scale. It was determined that the number of analgesics used in the experimental group was statistically significantly lower than in the control group. Intra‐group comparisons showed that there was a difference between the mean pre‐test and post‐test state anxiety scale scores of the groups (p < .001). The experimental group had higher mean scores on the Strategic and Clinical Quality Indicators in Postoperative Pain Management Questionnaire than that of the control group (p < .001).ConclusionsThe protocol developed in the study was found to be effective in reducing pain, the use of NSAIDs and opioids, and anxiety levels and increasing the level of quality of care.Relevance to Clinical PracticeThe protocol was original and feasible in that it included independent nursing interventions to improve the quality of care by reducing pain and anxiety. Particularly, the use of protocols in intensive care units was nurses' strongest resource in patient care management. Thus, the protocol, which was prepared for intensive care patients who most frequently experience pain and anxiety, was promising for nurses in improving the quality of care by reducing pain and anxiety. However, it is necessary to conduct further studies involving longitudinal follow‐up in samples and institutions with similar conditions.