Sensations during chest tube removal

Article Abstract:

Nurses are responsible for many patient procedures, and this includes informing the patients of what to expect when a certain procedure is to be performed. This preparation is especially important when the procedure is unpleasant. One such procedure is removal of chest tubes following cardiac surgery. There are no set guidelines on what the patients should be told. This study examined the sensations felt by patients having their chest tubes removed, the usefulness of pain relievers, and demographic variables that would be useful in preparing guidelines for nurses. The study examined chest tube removal in 36 patients who had never had chest tubes previously. Prior to removal, demographic and medical information was obtained and records of any pain relievers given, if any, were noted. Sensations and their intensity were recorded during removal. A burning sensation was the most frequently reported sensation felt (33 percent), followed by pain (29 percent), and a pulling or yanking sensation (20 percent). Intensities, as measured on a vertical visual analog scale, ranged from 8 mm to 100 mm with an average of 51 mm, on a scale of 0 to 100 mm. Sensations and intensities were similar for the different types of chest tubes removed. Eighteen of the patients had been given a pain reliever prior to the procedure and the other 18 were not given any. There were no significant differences between the two groups in sensations felt or their intensities. Women reported pain as a sensation more than men did. Younger patients reported higher intensities of sensation than older patients. Most patients (28) said that just being told the tube was to be removed was sufficient preparation. These results indicate that patients can best be prepared for chest tube removal by a short explanation of the procedure that mentions that they may feel a burning sensation and possibly some pain during the short time it takes to remove the tube. (Consumer Summary produced by Reliance Medical Information, Inc.)

Care and treatment, Evaluation, Practice, Pain, Nursing, Hospital patients, Chest, Chest intubation

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Psychophysiologic aspects of dyspnea in chronic obstructive pulmonary disease: a pilot study

Article Abstract:

Chronic obstructive pulmonary disease (COPD), which is related to diseases such as emphysema, causes long-term changes in lung and heart function. Dyspnea, or labored breathing, frequently accompanies COPD, and stabilization of dyspnea is a frequent goal of COPD treatment. Dyspnea is similar to pain, in that it results from mind-body interactions, and subjective assessment of its severity may be altered by patient anxiety, depression, and somatization (expression of mental state as disturbed body functioning). Changes in blood levels of hormones such as cortisol, which are linked to anxiety, are thought to be related to dyspnea; but this has not been previously studied. Six male patients with COPD were assessed to determine the differences in anxiety, depression, and somatization during times of mild and severe dyspnea. The study found that during times of severe dyspnea, accessory respiratory muscles were more active and the levels of carbon dioxide in the blood increased; both of these symptoms are associated with labored breathing. Patients had higher anxiety levels and higher levels of cortisol. In addition, patients who received the steroid drug prednisone were more depressed during severe dyspnea, and also had higher levels of somatization throughout the study. This study indicates that the treatment of COPD patients should include consideration of the patient's emotional state. (Consumer Summary produced by Reliance Medical Information, Inc.)

Causes of, Complications and side effects, Emphysema, Pulmonary, Emphysema

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Dyspnea during hospitalization for acute phase of illness as recalled by patients with chronic obstructive pulmonary disease

Article Abstract:

Chronic obstructive pulmonary disease is a collection of diseases, including emphysema and asthma. The general course of these diseases is steady deterioration, which occurs through a series of flare-ups and recoveries. Often patients experiencing an exacerbation of the disease require hospitalization. Nursing care for such patients requires an understanding of both the psychologic and physical sides of these diseases. Dyspnea is the subjective sensation of shortness of breath, and as such the patient's experience and not the observer's assessment is the more valid criterion for determining when dyspnea occurs. This mandates a better understanding of the patient's experience. A total of 96 adult patients with chronic bronchitis or emphysema were interviewed about their experiences and feelings of shortness of breath during a period of hospitalization. Although the reports, as expected, were highly individualistic, a general pattern was discerned. The themes recurring among the patient reports included: fear, helplessness, loss of vitality, preoccupation, and legitimacy. Individual patient descriptions of their periods of hospitalization are presented, to sensitize hospital staff to the feelings and perceptions of the patients. (Consumer Summary produced by Reliance Medical Information, Inc.)

Surveys

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