Chest tube insertion following chest trauma or Coronary Artery Bypass Grafting (CABG) surgery is a frequent practice. Patients who undergo chest tube removal experience moderate to severe pain. Patients always described chest tube removal as a painful and frightening experience. Cold application and deep breathing exercise are effective non-pharmacological techniques to reduce pain and anxiety during chest tube removal. The aim of the study was to examine the effect of cold application and breathing exercises technique on pain and anxiety level during chest tube removal. A convenient sample of 120 patients. A quasi experimental design was used (study/control). Surgical intensive care unites at Menoufia University Hospital, Shebin EL-Kome. Visual Analog Scale for Pain (VAS) used to measure pain intensity during chest tube removal. Hamilton Anxiety Scale used to measure the anxiety level during chest tube removal. There was a statistically significant difference between study and control group regarding pain intensity post intervention. There was a statistically significant difference between study and control group regarding anxiety level post intervention. Using cold application and breathing exercise during chest tube removal is an effective practice to reduce pain intensity and anxiety level during chest tube removal. Encourage critical care nurses to develop practice guidelines for pain management during chest tube removal including application of cold and deep breathing exercise as a non pharmacological measure during chest tube removal.
Published in | American Journal of Nursing Science (Volume 6, Issue 4) |
DOI | 10.11648/j.ajns.20170604.12 |
Page(s) | 285-292 |
Creative Commons |
This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited. |
Copyright |
Copyright © The Author(s), 2017. Published by Science Publishing Group |
Chest Tube Removal, Pain, Anxiety, Breathing Exercises, Cold Application
[1] | American Heart and Lung Association. Nursing management of chest drains. Nursing Standard. (2013); 17, 45–54. Available at: http://www.healthline.com/health/chest-tube-insertion#afterward6 |
[2] | Demir Y, Khorshid L. The effect of cold application in combination with standard analgesic administration on pain and anxiety during chest tube removal: A single- blinded, randomized, double-controlled study. Pain Manag Nurs. (2010); 11: 186-96. |
[3] | Cline ME, Herman J, Shaw ER & Morton RD. Standardization of the visual analogue scale. Nursing Research. (1992); 41(6): 378–380. |
[4] | Al-Otaibi, RA., Mokabel, F M. and AL-Ghuneimy Y. The Effect of Cold Application on Pain and Anxiety during chest tube removal. J Am Sci (2013); 9(7): 13-23. |
[5] | Seers, K. and Dawn C. Relaxation techniques for acute pain management: A systematic review. Journal of Advanced Nursing (1998); March. 27 (3): 466 -475. |
[6] | Friesner SA, Curry DM, Moddeman GR. Comparison of two pain management strategies during chest tube removal: relaxation exercise with opioids and opioids alone. Heart Lung (2006); 35 (4): 269-76. |
[7] | Etoch SL, Ulcer S, Codkun O, man L E, K Anatli Y. Cold therapy in migraine patients: Open labels, Non controlled, pilot study. Evidence based Complement Alternat Med. Dec J. (2006); 3(4): 489-93. |
[8] | Broscious SK. Music: an intervention for pain during chest tube removal after open heart surgery. American Journal of Critical Care (1999); 8, 410–415. |
[9] | Houston S, Jesurum J. The quick relaxation technique: Effect on pain associated with chest tube removal. Appl Nurs Res. (1999); 12: 196-205. |
[10] | Hamilton M. (1988). The assessment of anxiety states by rating. Br J Med Psychol. 32: 50–55. |
[11] | Carson MM, Barton DM, Morrison CC & Tribble CG. Managing pain during mediastinal chest tube removal. Heart Lung (1994); 23, 500–505. |
[12] | Scott J, Huskisson E. Vertical or horizontal visual analogue scales. Ann Rheum Dis (2001); 38: 560. |
[13] | Biteman, K., and Dalton, T. Management of procedural pain: Empowering nurses to care for patients through clinical nurse specialist consultation and intervention. Clinical Nurse Specialist (2009); 23 (3): 131–137. |
[14] | Mazloum SR, Abbasi Tehnizi M, Kiannejad A, Gandomkar F. Effect of applying ice bag on pain intensity associated with chest tube removal after cardiac surgery. Horizon Med Sci. (2012); 18: 109-14. |
[15] | Gorgi HM, Nesami BM, Ayyasi M, Ghafari R, Yazdani J. Comparison of ice packs application and relaxation therapy in pain reduction during chest tube removal following cardiac surgery. North Am J Med Sci. (2014); 6: 19-24. |
[16] | National Institutes of Heart Lung & Blood. Reduction of pain intensity after chest tube removal. (2009) Available at http://www.nhlbi.nih.gov/index.htm. |
[17] | Ertug V. Ulker S. The effect of cold application on pain due to chest tube removal. Journal of Clinical Nursing (2012); 21: 784-90. |
[18] | Casey E, Bostanci K, Kuriakose D, McGeary S, Hayes N, Phelan D, Buggy D. The Effect of Cold Application in Combination with Standard Analgesic Administration on Pain and Anxiety during Chest Tube Removal: A Single-Blinded, Randomized, Double- Controlled Study. Pain Management Nursing (2008). 11(3), September: 186–196. |
[19] | Sauls J. The use of ice for pain associated with chest tube removal. Pain Manag Nurs. (2002); 3: 44-52. |
[20] | Rafii F, Mohammadi Fakhar F, Jamshidi Orak R, Inanloo M. Effect of Jaw relaxation on pain intensity of burn dressing. Iran J Critical Care Nurs. (2010); 3: 51–6. |
[21] | Gift, A., Bolgiano, C. and Cunningham J. Effect of Ice back application on pain and anxiety during chest tube removal. Heart Lung (2010). 20 (2): 131-7. |
[22] | Deneuville M, L aureano Filho JR, de Oliveira e Silva ED, Batista CI, Gouveia FM. The influence of cryotherapy on reduction of swelling, pain and trismus after third- molar extraction: a preliminary study. Journal of American Dental Association. (2012) Jun; 1 36(6): 774-8. |
[23] | Hariedy N, Mohammed M, Abd El-Alaziz M and Mohammed L. The Impact of Implementing of Standardized Nursing Care toward Patient with a Chest Tube to Reduce Pulmonary Complications after Thoracotomy. Journal of American Science (2011). 7 (12). |
APA Style
Naglaa Mohamed EL Mokadem, Shimaa EL-Sayed Ibraheem. (2017). Cold Application and Breathing Exercises to Reduce Pain and Anxiety During Chest Tube Removal. American Journal of Nursing Science, 6(4), 285-292. https://doi.org/10.11648/j.ajns.20170604.12
ACS Style
Naglaa Mohamed EL Mokadem; Shimaa EL-Sayed Ibraheem. Cold Application and Breathing Exercises to Reduce Pain and Anxiety During Chest Tube Removal. Am. J. Nurs. Sci. 2017, 6(4), 285-292. doi: 10.11648/j.ajns.20170604.12
AMA Style
Naglaa Mohamed EL Mokadem, Shimaa EL-Sayed Ibraheem. Cold Application and Breathing Exercises to Reduce Pain and Anxiety During Chest Tube Removal. Am J Nurs Sci. 2017;6(4):285-292. doi: 10.11648/j.ajns.20170604.12
@article{10.11648/j.ajns.20170604.12, author = {Naglaa Mohamed EL Mokadem and Shimaa EL-Sayed Ibraheem}, title = {Cold Application and Breathing Exercises to Reduce Pain and Anxiety During Chest Tube Removal}, journal = {American Journal of Nursing Science}, volume = {6}, number = {4}, pages = {285-292}, doi = {10.11648/j.ajns.20170604.12}, url = {https://doi.org/10.11648/j.ajns.20170604.12}, eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajns.20170604.12}, abstract = {Chest tube insertion following chest trauma or Coronary Artery Bypass Grafting (CABG) surgery is a frequent practice. Patients who undergo chest tube removal experience moderate to severe pain. Patients always described chest tube removal as a painful and frightening experience. Cold application and deep breathing exercise are effective non-pharmacological techniques to reduce pain and anxiety during chest tube removal. The aim of the study was to examine the effect of cold application and breathing exercises technique on pain and anxiety level during chest tube removal. A convenient sample of 120 patients. A quasi experimental design was used (study/control). Surgical intensive care unites at Menoufia University Hospital, Shebin EL-Kome. Visual Analog Scale for Pain (VAS) used to measure pain intensity during chest tube removal. Hamilton Anxiety Scale used to measure the anxiety level during chest tube removal. There was a statistically significant difference between study and control group regarding pain intensity post intervention. There was a statistically significant difference between study and control group regarding anxiety level post intervention. Using cold application and breathing exercise during chest tube removal is an effective practice to reduce pain intensity and anxiety level during chest tube removal. Encourage critical care nurses to develop practice guidelines for pain management during chest tube removal including application of cold and deep breathing exercise as a non pharmacological measure during chest tube removal.}, year = {2017} }
TY - JOUR T1 - Cold Application and Breathing Exercises to Reduce Pain and Anxiety During Chest Tube Removal AU - Naglaa Mohamed EL Mokadem AU - Shimaa EL-Sayed Ibraheem Y1 - 2017/07/04 PY - 2017 N1 - https://doi.org/10.11648/j.ajns.20170604.12 DO - 10.11648/j.ajns.20170604.12 T2 - American Journal of Nursing Science JF - American Journal of Nursing Science JO - American Journal of Nursing Science SP - 285 EP - 292 PB - Science Publishing Group SN - 2328-5753 UR - https://doi.org/10.11648/j.ajns.20170604.12 AB - Chest tube insertion following chest trauma or Coronary Artery Bypass Grafting (CABG) surgery is a frequent practice. Patients who undergo chest tube removal experience moderate to severe pain. Patients always described chest tube removal as a painful and frightening experience. Cold application and deep breathing exercise are effective non-pharmacological techniques to reduce pain and anxiety during chest tube removal. The aim of the study was to examine the effect of cold application and breathing exercises technique on pain and anxiety level during chest tube removal. A convenient sample of 120 patients. A quasi experimental design was used (study/control). Surgical intensive care unites at Menoufia University Hospital, Shebin EL-Kome. Visual Analog Scale for Pain (VAS) used to measure pain intensity during chest tube removal. Hamilton Anxiety Scale used to measure the anxiety level during chest tube removal. There was a statistically significant difference between study and control group regarding pain intensity post intervention. There was a statistically significant difference between study and control group regarding anxiety level post intervention. Using cold application and breathing exercise during chest tube removal is an effective practice to reduce pain intensity and anxiety level during chest tube removal. Encourage critical care nurses to develop practice guidelines for pain management during chest tube removal including application of cold and deep breathing exercise as a non pharmacological measure during chest tube removal. VL - 6 IS - 4 ER -