Thoracolumbar Spine Surgery: Peri-operative Nursing Care Needs and Quality of Life

Year : 2023 | Volume :01 | Issue : 01 | Page : 13-23
By

Geeta Thapar

Manju Dhandapani

Sivashanmugam Dhandapani

Navneet Singla

  1. Nursing Tutor College of Nursing Government Medical College and Hospital Chandigarh India
  2. Associate Professor Postgraduate Institute of Medical Education and Research (PGIMER) Chandigarh India
  3. Associate Professor Postgraduate Institute of Medical Education and Research (PGIMER) Chandigarh India
  4. Additional Professor Postgraduate Institute of Medical Education and Research (PGIMER) Chandigarh India

Abstract

Aim and Objective: To explore the nursing care needs of the patients after thoracolumbar spine surgery during preoperative, post-operative, home care and to assess the quality of life. Design: An exploratory study. Methods: The study was conducted among 50 patients who had undergone thoracolumbar spine surgery in neurosurgery units of tertiary care hospital from July 2018 to September 2020. The nursing needs were assessed by interviewing participants telephonically using an interview schedule to assess physical, psychological, functional, and other problems and WHOQOL-BREF to assess the quality of life. The data was coded and analyzed using SPSS version 20. Results: The physical problems were pain, numbness, and weakness of limbs. The psychological problems were worry, sleeplessness, dysthymia, and anger. The functional problems were difficulty in toileting and transferring. Patients also reported lack of understanding of the surgical procedure and its outcomes and difficulty in understanding specific instructions. Pain was reduced from 98% to 90% after surgery but was consistently there during the peri-operative period. There was a reduction in numbness after surgery (98% to 68%). The quality of life in psychological and physical domain is more affected as compared to environmental and social domain. More than half of the patients reported quality of life as “neither poor nor good” and 14% reported dissatisfaction with their health. Conclusion: Patients who had undergone thoracolumbar spine surgery experienced various problems during their peri-operative period. Besides physical problems, patients also reported psychological problems and knowledge deficit regarding home care. Physical and psychological domains of quality of life was more affected as compared to environmental and social domains. Impact: There is a need to develop nursing guidelines and nurse-led counselling is necessary to address the many physical and psychological concerns that patients confront throughout their peri-operative time.

Keywords: Thoracolumbar spine surgery, WHOQOL-BREF, peri-operative period, nursing care needs, nurse-led counselling

[This article belongs to International Journal of Orthopedic Nursing and Practices(ijornp)]

How to cite this article: Geeta Thapar, Manju Dhandapani, Sivashanmugam Dhandapani, Navneet Singla. Thoracolumbar Spine Surgery: Peri-operative Nursing Care Needs and Quality of Life. International Journal of Orthopedic Nursing and Practices. 2023; 01(01):13-23.
How to cite this URL: Geeta Thapar, Manju Dhandapani, Sivashanmugam Dhandapani, Navneet Singla. Thoracolumbar Spine Surgery: Peri-operative Nursing Care Needs and Quality of Life. International Journal of Orthopedic Nursing and Practices. 2023; 01(01):13-23. Available from: https://journals.stmjournals.com/ijornp/article=2023/view=115062

References

  1. Alodaibi FA, Fritz JM, Thackeray A, Koppenhaver SL, Hebert JThe fear avoidance model predicts short-term pain and disability following lumbar disc surgery. PLoS ONE.2018; 13 (3): e0193566. doi: org/10.1371/journal.pone.0193566.
  2. Amaral V, Marchi L, Martim H, Amaral R, Nogueira-Neto J, Pierro E, Oliveira L, Coutinho E, Marcelino F, Faulhaber N, Jensen R, Pimenta Influence of psychosocial distress in the results of elective lumbar spine surgery. J Spine Surg. 2017; 3 (3): 371–378. doi: 10.21037/jss.2017.08.05.
  3. Banugo P, Amoako Prehabilitation. BJA Educ. 2017; 17 (12): 401–405. doi: 10.1093/bjaed/mkx032.
  4. Brox JI, Sørensen R, Friis A, Nygaard Ø, Indahl A, Keller A, Ingebrigtsen T, Eriksen HR, Holm I, Koller AK, Riise R, ReikeråsRandomized clinical trial of lumbar instrumented fusion and cognitive intervention and exercises in patients with chronic low back pain and disc degeneration. Spine.2003; 28 (17): 1913–1921. doi: 10.1097/01.BRS.0000083234.62751.7A.
  5. Dhandapani S, Gupta A, Singh J, Sharma BS, Mahapatra AK, Mehta V Spinal dural arterio-venous fistula: clinico-radiological profile and outcome following surgical occlusion in an Indian neurosurgical center. NeurolIndia. 2013; 61 (4): 406–410. doi: 10.4103/0028-3886.117616.
  6. Dhandapani M, Dhandapani S, Agarwal M, Mahapatra A Pain perception following different neurosurgical procedures: a quantitative prospective study. Contemp Nurse. 2016; 52 (4): 477–485. doi: 10.1080/10376178.2016.1222240.
  7. Dydyk AM, Ngnitewe Massa R, Mesfin F Disc Herniation. In: StatPearls. StatPearls Publishing. Available at http://www.ncbi.nlm.nih.gov/books/NBK441822/
  8. Ferrans CE, Zerwic JJ, Wilbur JE, Larson J Conceptual model of health-related quality of life. J Nurs Scholarship. 2005; 37 (4):336–342. doi: 10.1111/j.1547-5069.2005.00058.x.
  9. Fraser SJ, Brown WJ, Whiteford HA, Burton N Impact of nurse-led behavioural counselling to improve metabolic health and physical activity among adults with mental illness. Int J Mental Health Nurs. 2018; 27 (2): 619–630. doi: 10.1111/inm.12343.
  10. Häkkinen A, Kautiainen H, Sintonen H, Ylinen Health related quality of life after lumbar disc surgery: a prospective study of 145 patients. Disabil Rehabil. 2005; 27 (3): 94–100. doi: 10.1080/09638280400007430.
  11. Heider D, Kitze K, Zieger M, Riedel-Heller SG, Angermeyer MHealth-related quality of life in patients after lumbar disc surgery: a longitudinal observational study. Qual Life Res.2007; 16 (9): 1453–1460. doi: 10.1007/s11136-007-9255-8.
  12. Jana A, PaulEpidemiology of low back pain: a literature review. Int J Phys EducSports Health. 2019; 6 (3): 233–237.
  13. Hinkle JL, Cheever KH. Brunner & Suddharth’s Textbook of Medical Surgical Nursing. Volume 2. 13th edition. Philadelphia, PA: Wolters Kluwer; 2014.
  14. Jansson KÅ, Németh G, Granath F, Jönsson B, BlomqvistHealth-related quality of life in patients before and after surgery for a herniated lumbar disc. J Bone Joint Surg Br.2005; 87-B(7): 959–964. doi: 10.1302/0301-620X.87B7.16240.
  15. Kohlboeck G, Greimel KV, Piotrowski WP, Leibetseder M, Krombholz-Reindl M, Neuhofer R, Schmid A, Klinger Prognosis of multifactorial outcome in lumbar discectomy: a prospective longitudinal study investigating patients with disc prolapse. Clin J Pain. 2004; 20 (6): 455–461. doi: 10.1097/00002508-200411000-00011.
  16. Lin EY, Chen PY, Tsai PS, Lo WC, Chiu H Trajectory of health-related quality of life and its determinants in patients who underwent lumbar spine surgery: a 1-year longitudinal study. Qual Life Res. 2018; 27 (9): 2251–2259. doi: 10.1007/s11136-018-1888-2.
  17. Low M, Burgess LC, Wainwright T A critical analysis of the exercise prescription and return to activity advice that is provided in patient information leaflets following lumbar spine surgery. Medicina (Kaunas, Lithuania). 2019; 55 (7): E347. doi: 10.3390/medicina55070347.
  18. Majid N, Lee S, PlummerThe effectiveness of orthopedic patient education in improving patient outcomes: a systematic review protocol. JBI Database Syst Rev Implement Rep.2015; 13 (1): 122–133. doi: 10.11124/jbisrir-2015-1950.
  19. Parker L. Treatment Options for Pain After Back Surgery. [Online]. Spine-Health. Available at https://www.spine-health.com/treatment/back-surgery/treatment-options-pain-after-back-surgery[Accessed on September 17, 2021].
  20. Menendez JY, Omar NB, Chagoya G, Tabibian BE, Elsayed GA, Walters BC, Guthrie BL, Hadley M Patient satisfaction in spine surgery: a systematic review of the literature. Asian Spine J. 2019; 13 (6):1047–1057. doi: 10.31616/asj.2019.0032.
  21. Mohsen SAAE, Ammar SA, Mohammed SEffect of nursing rehabilitation guide on outcomes of patients undergoing lumbar discectomy. IOSR J Nurs Health Sci. 2019; 8 (3): 1–11.
  22. Nicholas MK, George S Psychologically informed interventions for low back pain: an update for physical therapists. Phys Ther. 2011; 91 (5): 765–776. doi: 10.2522/ptj.20100278.
  23. Nickel R, Egle UT, Eysel P, Rompe JD, Zöllner J, Hoffmann S Health-related quality of life and somatization in patients with long-term low back pain: a prospective study with 109 patients. Spine. 2001; 26 (20): 2271–2277.
  24. Papanastassiou I, Anderson R, Barber N, Conover C, Castellvi A Effects of preoperative education on spinal surgery patients. SAS J. 2011; 5 (4): 120–124. doi: 10.1016/j.esas.2011.06.003.
  25. Quack V, Boecker M, Mueller CA, Mainz V, Geiger M, Heinemann AW, Betsch M, El MansyPsychological factors outmatched morphological markers in predicting limitations in activities of daily living and participation in patients with lumbar stenosis. BMC Musculoskelet Disord.2019; 20: Article 557. doi: 10.1186/s12891-019-2918-0.
  26. Scheffel K, Amidei C, Fitzgerald K Motivational interviewing: improving confidence with self-care management in postoperative thoracolumbar spine patients. J Neurosci Nurs. 2019; 51 (3): 113–118. doi: 10.1097/JNN.0000000000000431.
  27. Smith GD, Watson R, Roger D, McRorie E, Hurst N, Luman W, Palmer K Impact of a nurse-led counselling service on quality of life in patients with inflammatory bowel disease. J Adv Nurs. 2002; 38(2): 152–160. doi: 10.1046/j.1365-2648.2002.02159.x.
  28. Solberg TK, Nygaard OP, Sjaavik K, Hofoss D, Ingebrigtsen The risk of “getting worse” after lumbar microdiscectomy. Eur Spine J. 2005; 14 (1): 49–54. doi: 10.1007/s00586-004-0721-5.
  29. Strøm J, Bjerrum MB, Nielsen CV, Thisted CN, Nielsen TL, Laursen M, Jørgensen L Anxiety and depression in spine surgery-a systematic integrative review. Spine J. 2018; 18 (7): 1272–1285. doi: 10.1016/j.spinee.2018.03.017.
  30. Thakur D, Dhandapani M, Ghai S, Mohanty M, Dhandapani Intracranial tumors: a nurse-led intervention for educating and supporting patients and their caregivers. Clin J Oncol Nurs. 2019; 23 (3): 315–323. doi: 10.1188/19.CJON.315-323.
  31. van der Horst AY, Trompetter HR, Pakvis DFM, Kelders SM, Schreurs KMG, Bohlmeijer EBetween hope and fear: a qualitative study on perioperative experiences and coping of patients after lumbar fusion surgery. Int J Orthop Trauma Nurs.2019; 35: 100707. doi: 10.1016/j.ijotn.2019.07.003.
  32. Vlaeyen JWS, Linton SFear-avoidance model of chronic musculoskeletal pain: 12 years on. Pain.2012; 153 (6): 1144–1147. doi: 10.1016/j.pain.2011.12.009.
  33. Wang Y, Gao F, Zou Numbness and weakness recovered at a less extent in patients with lumbar disc herniation after percutaneous endoscopic lumbar discectomy. Pain Res Manage. 2019; 2019: e4642701. doi: 10.1155/2019/4642701.
  34. Weinstein JN, Lurie JD, Tosteson TD, Hanscom B, Tosteson ANA, Blood EA, Birkmeyer NJO, Hilibrand AS, Herkowitz H, Cammisa FP, Albert TJ, Emery SE, Lenke LG, Abdu WA, Longley M, Errico TJ, Hu S Surgical versus nonsurgical treatment for lumbar degenerative spondylolisthesis. NEng J Med. 2007; 356 (22): 2257–2270. doi: /10.1056/NEJMoa070302.
Regular Issue Subscription Original Research
Volume 01
Issue 01
Received May 23, 2023
Accepted July 1, 2023
Published August 7, 2023
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