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

Geeta Thapar, M. Dhandapani, Navneet Singla, S. Dhandapani
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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.
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胸腰椎手术患者的住院后问题及护理需求
胸腰椎手术是为了缓解椎间盘突出、腰椎管狭窄、腰椎滑脱等引起的神经根性疼痛和麻木等症状。目的:探讨胸腰椎术后家庭护理中遇到的问题及护理需求。方法对2018年7月至2020年9月在昌迪加尔PGIMER神经外科病房接受胸腰椎手术的50例患者进行探索性研究。通过电话访谈来评估问题和护理需求,访谈时间表包括(a)患者概况,(b)临床变量,(c)出院后身体、心理、功能和其他问题的问卷调查。采用描述性统计(平均值、频率和百分比)对数据进行分析。结果患者出院后出现疼痛、下肢麻木、四肢无力、膀胱失禁等躯体问题。患者面临的心理问题为早醒、失眠、担心身体对他人的依赖、对家庭角色责任的压力、对重返工作岗位的焦虑。常见的功能问题是洗澡困难,行走困难,如厕依赖,需要帮助梳洗。此外,患者感知到的其他问题还包括门诊随访困难、术后运动理解困难、术后指导缺乏理解、难以进行伤口敷料。结论本研究结果为胸腰椎手术后患者在家庭护理中出现生理、心理和功能问题提供了初步证据。因此,通过制定基于需求的护理指南来解决这些问题是至关重要的。
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