Miyofasiyal ağrı sendromu olan bireylerde tetik nokta enjeksiyonu sırasında uygulanan inhaler aromaterapinin ağrı, anksiyete, konfor ve kortizol düzeyine etkisi
Yükleniyor...
Tarih
2018
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Ege Üniversitesi, Sağlık Bilimleri Enstitüsü
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Araştırma; miyofasiyal ağrı sendromu (MAS) olan bireylerde tetik nokta enjeksiyonu sırasında uygulanan inhaler aromaterapinin ağrı, anksiyete, konfor ve kortizol düzeyine etkisini incelemek amacıyla plasebo-randomize kontrollü olarak yapılmıştır. Araştırmanın örneklemini; Eylül 2017-Mart 2018 tarihleri arasında Ege Üniversitesi Algoloji Polikliniği'ne başvuran MAS tanısı almış, ilk kez tetik nokta enjeksiyonu yapılacak ve örnekleme alınma kriterlerine uyan 22 aromaterapi, 22 plasebo ve 22 kontrol olmak üzere 66 hasta oluşturmuştur. Miyofasiyal ağrı sendromu olan bireylere tetik nokta enjeksiyonu sırasında; aromaterapi grubuna difüzör ile lavanta yağı, plasebo grubuna kokusuz bebe yağı inhalasyonu uygulanmıştır. Kontrol grubuna rutin tedavi dışında herhangi bir uygulama yapılmamıştır. Araştırma verileri; Birey Tanılama Formu, Görsel Analog Ölçek (Visuel Analog Scale-VAS), Durumluk Kaygı Envanteri, Distress Termometresi, Genel Konfor Ölçeği, Hasta ve Hekim Memnuniyet Skalası ve kortizol için tükürük örneği alınarak yüz yüze görüşme tekniği ile toplanmıştır. Verilerin analizi; bilgisayar ortamında Statistical Package for Social Science (SPSS) paket programı, kortizol değerlerinin analizi ise; Graphpad Prism v7 programı kullanılarak elde edilmiştir. Verilerin değerlendirmesinde numerik verilerin normal dağılıma uygunluğu shapiro-wilk testi ile değerlendirilmiş, tanımlayıcı istatistikler sayı ve yüzde, ölçüm verileri ortalama ve standart sapma değerleri ile gösterilmiştir. Bağımsız örneklerde t testi, tek yönlü varyans analizi, Pearson korelasyon analizi, ki-kare, Kruskal Wallis, Wilcoxon, Friedman ve Mann Whitney U testleri kullanılmıştır. Sonuçlar %95'lik güven aralığında, p<0.05 anlamlılık düzeyinde değerlendirilmiştir. Çalışma sonunda; örneklemi oluşturan hastaların yaş ortalaması 48.8±11.35 olup, %78.8'i kadındır. Hastaların ağrı puan ortalamaları incelendiğinde; aromaterapi grubunda plasebo ve kontrol grubuna göre işlem ortası ve işlem sonrası anlamlı şekilde azalmakta iken plasebo ve kontrol grubunda artmaktadır (p<0.05). Hastaların anksiyete düzeyleri incelendiğinde, aromaterapi grubundaki hastaların işlem sonrası ölçüm medyanının, işlem öncesi ölçüm medyanından anlamlı olarak düşük olduğu (p<0.05), ancak plasebo grubunda ve kontrol grubunda bireylerin işlem öncesi ve sonrası ölçüm durumluk kaygı medyan ölçümleri arasında anlamlı fark bulunmadığı saptanmıştır (p>0.05). Ayrıca aromaterapi grubundaki bireylerin distress termometresi işlem sonrası ölçüm medyan değeri anlamlı olarak düşerken, plasebo ve kontrol grunundaki bireylerin anlamlı olarak artmaktadır. Aromaterapi, plasebo ve kontrol gruplarında genel konfor ölçeği işlem öncesi ve sonrası ölçüm ortalamaları karşılaştırıldığında aromaterapi grubunda işlem sonrası toplam ortalaması anlamlı olarak yüksek iken plasebo ve kontrol gruplarında anlamlı derece düşüktür (p<0.05). Hasta (8.3±1.46) ve hekimin (9.0±0.00) aromaterapi uygulamasından memnuniyet düzeyi yüksek bulunmuştur. Hastaların yaşam bulgularında ise; her üç grubun işlem öncesi ve sonrası vücut sıcaklığı ve satürasyon düzeylerinde anlamlı ilişki saptanmamıştır (p>0.05). Aromaterapi grubunda kontrol grubuna göre, işlem sonrası solunum sayısı, kalp hızı ve diyastolik kan basıncı işlem öncesine göre anlamlı olarak düşükken (p<0.05), sistolik kan basıncında bir anlamlılık saptanmamıştır (p>0.05). Ancak plasebo ve kontrol grubunun işlem sonrası sistolik kan basıncı değerleri anlamlı olarak yüksek bulunmuştur (p<0.05). Aromaterapi, plasebo ve kontrol grupları arasında ve grup içinde işlem öncesi ve işlem sonrası tükürük kortizol sonuçlarında istatistiksel olarak anlamlı bir fark bulunmamaktadır (p>0.05). Bu çalışmanın sonucu olarak; miyofasiyal ağrı sendromu olan bireylerde tetik nokta enjeksiyonu sırasında uygulanan aromaterapinin ağrı şiddetini, anksyete ve stres düzeyini azaltabildiği, konfor düzeyini ve hasta memnuniyetini arttırdığı görülmektedir. Bu olumlu etkiler göz önüne alındığında bağımsız bir hemşirelik müdahalesi olarak kullanılabileceği düşünümektedir.
The study was conducted as a placebo-randomized controlled trial to examine the effects of inhaler aromatherapy administered during trigger point injection on pain, anxiety, comfort and cortisol levels in patients with myofascial pain syndrome (MPS). The sample of the research; Between September 2017 and March 2018, MAS who had applied to the Ege University Algology Polyclinic was diagnosed and 66 patients, including 22 aromatherapy, 22 placebo and 22 controls, were selected for the first injection of the trigger point. During injection of the trigger point for individuals with myofascial pain syndrome; the aromatherapy group with diffuser and lavender oil, odorless baby oil inhalation was applied to the placebo group. The control group was not administered any other routine. Research data; Personal Identification Form, Visual Analogue Scale (VAS), State Anxiety Inventory, Distress Thermometer, General Comfort Scale, Patient and Physician Satisfaction Scale and saliva sample for cortisol were collected by face to face interview technique. In the analysis of the data; Statistical Package for Social Science (SPSS) package program, analysis of cortisol values was obtained by using Graphpad Prism v7 program. In the evaluation of the data, the normal distribution suitability of numerical data was evaluated by shapiro-wilk test, descriptive statistics were shown by number and percentage, mean and standard deviation of measurement data. Independent samples were t test, one way analysis of variance, Pearson correlation analysis, chi-square, Kruskal Wallis, Wilcoxon, Friedman and Mann Whitney U tests. The results were evaluated at 95% confidence interval, p <0.05 significance level. At the end of study; the mean age of the sample patients was 48.8 ± 11.35 and 78.8% were females. When the average pain scores of the patients were examined; in aromatherapy group than in the placebo and control groups, and the process is finished mid-points average of the significantly decreased while it increased in placebo and control groups (p <0.05). When the anxiety levels of the patients were examined, it was found that the last measurement media of the patients in the aromatherapy group were significantly lower than the first measurement median (p <0.05), but there was no significant difference between the first and last measurement state anxiety medians of the individuals in the placebo group and control group (p> 0.05). In addition, the median value of the aromatherapy group was significantly lower after the distress thermometer treatment, while the placebo and control group increased significantly. Compared to the aromatherapy, placebo and control groups, the final total average in the aromatherapy group was significantly higher when compared to the general comfort scale, but significantly lower in the placebo and control groups (p <0.05). Patients (8.3 ± 1:46) and doctors (9.0 ± 0.00) were significantly higher satisfaction level from aromatherapy application. If the vital signs of patients; There was no significant relationship between body temperature and saturation levels of all three groups before and after the procedure (p> 0.05). In the aromatherapy group, respiratory rate, heart rate and diastolic blood pressures were significantly lower than those of the control group (p <0.05), but there was no significant difference in systolic blood pressure (p> 0.05). However systolic blood pressure of the placebo control group after treatment were significantly higher (p <0.05). There was no statistically significant difference between pre- and post-treatment salivary cortisol results between aromatherapy, placebo and control groups and within the group (p> 0.05). As a result of this study; it is observed that aromatherapy administered during trigger point injection in patients with myofascial pain syndrome can decrease pain intensity, anxiety and stress level, increase comfort level and patient satisfaction. Considering these positive effects, it can be used as an independent nursing intervention.
The study was conducted as a placebo-randomized controlled trial to examine the effects of inhaler aromatherapy administered during trigger point injection on pain, anxiety, comfort and cortisol levels in patients with myofascial pain syndrome (MPS). The sample of the research; Between September 2017 and March 2018, MAS who had applied to the Ege University Algology Polyclinic was diagnosed and 66 patients, including 22 aromatherapy, 22 placebo and 22 controls, were selected for the first injection of the trigger point. During injection of the trigger point for individuals with myofascial pain syndrome; the aromatherapy group with diffuser and lavender oil, odorless baby oil inhalation was applied to the placebo group. The control group was not administered any other routine. Research data; Personal Identification Form, Visual Analogue Scale (VAS), State Anxiety Inventory, Distress Thermometer, General Comfort Scale, Patient and Physician Satisfaction Scale and saliva sample for cortisol were collected by face to face interview technique. In the analysis of the data; Statistical Package for Social Science (SPSS) package program, analysis of cortisol values was obtained by using Graphpad Prism v7 program. In the evaluation of the data, the normal distribution suitability of numerical data was evaluated by shapiro-wilk test, descriptive statistics were shown by number and percentage, mean and standard deviation of measurement data. Independent samples were t test, one way analysis of variance, Pearson correlation analysis, chi-square, Kruskal Wallis, Wilcoxon, Friedman and Mann Whitney U tests. The results were evaluated at 95% confidence interval, p <0.05 significance level. At the end of study; the mean age of the sample patients was 48.8 ± 11.35 and 78.8% were females. When the average pain scores of the patients were examined; in aromatherapy group than in the placebo and control groups, and the process is finished mid-points average of the significantly decreased while it increased in placebo and control groups (p <0.05). When the anxiety levels of the patients were examined, it was found that the last measurement media of the patients in the aromatherapy group were significantly lower than the first measurement median (p <0.05), but there was no significant difference between the first and last measurement state anxiety medians of the individuals in the placebo group and control group (p> 0.05). In addition, the median value of the aromatherapy group was significantly lower after the distress thermometer treatment, while the placebo and control group increased significantly. Compared to the aromatherapy, placebo and control groups, the final total average in the aromatherapy group was significantly higher when compared to the general comfort scale, but significantly lower in the placebo and control groups (p <0.05). Patients (8.3 ± 1:46) and doctors (9.0 ± 0.00) were significantly higher satisfaction level from aromatherapy application. If the vital signs of patients; There was no significant relationship between body temperature and saturation levels of all three groups before and after the procedure (p> 0.05). In the aromatherapy group, respiratory rate, heart rate and diastolic blood pressures were significantly lower than those of the control group (p <0.05), but there was no significant difference in systolic blood pressure (p> 0.05). However systolic blood pressure of the placebo control group after treatment were significantly higher (p <0.05). There was no statistically significant difference between pre- and post-treatment salivary cortisol results between aromatherapy, placebo and control groups and within the group (p> 0.05). As a result of this study; it is observed that aromatherapy administered during trigger point injection in patients with myofascial pain syndrome can decrease pain intensity, anxiety and stress level, increase comfort level and patient satisfaction. Considering these positive effects, it can be used as an independent nursing intervention.
Açıklama
Anahtar Kelimeler
Miyofasiyal Ağrı Sendromu, Aromaterapi, Hemşirelik, Ağrı, Anksiyete, Konfor, Kortizol, Myofascial Pain Syndrome, Aromatherapy, Nursing, Pain, Anxiety, Comfort, Cortisol
