Abdominal surgery is recognized as a painful procedure,
1 caused by ischaemia and release of neuropeptides
at the trauma site and throughout the nervous system
and due to the site’s proximity to the diaphragm and cross-innervations in the abdominal area.2–4 Inadequate
pain management following abdominal surgery leads to
complications such as delayed recovery5 and ambulation6;
lack participation in the therapeutic plan; disturbed sleep
and appetite loss; prolonged hospitalization; and dissatisfaction
with, and increased costs of, health-care services.7–9
Pain after surgery is intensely uncomfortable, which
exacerbates the anxiety response and might contribute
to psychological complications.5 Moreover, increased
anxiety activates tension and pain, possibly leading to
delay or cessation of therapeutic procedures.10 Anxiety in
postoperative patients can significantly affect the intensity
of pain and surgical outcomes, and could adversely affect
patient recovery. For instance, it might increase the intubation
time, impair the inflammatory response, increase
cardiovascular workload and change the normal degradation
processes in wound healing.11,12 From the psychological
aspect, postoperative anxiety can cause an increased
sensitivity to noise. It can result in an exaggerated autonomic
response, sensory overload and sleep deprivation
leading to physiological problems, and therefore delayed
self-care after surgery.11 A higher level of pain intensity in
postoperative older patients, longer hospitalization and
poorer ambulation after discharge from the hospital have
all been linked to increased anxiety.13 Hospitalization and
surgery are among the most important causes of anxiety in
older patients.2 Therefore, designing strategies to reduce
pain and anxiety after surgery and provide an environment
conducive to smooth healing and recovery is
needed. Anxiety and pain levels in postsurgical patients
should be assessed so that proactive nursing interventions
are implemented.14
Abdominal surgery is recognized as a painful procedure,1 caused by ischaemia and release of neuropeptidesat the trauma site and throughout the nervous systemand due to the site’s proximity to the diaphragm and cross-innervations in the abdominal area.2–4 Inadequatepain management following abdominal surgery leads tocomplications such as delayed recovery5 and ambulation6;lack participation in the therapeutic plan; disturbed sleepand appetite loss; prolonged hospitalization; and dissatisfactionwith, and increased costs of, health-care services.7–9Pain after surgery is intensely uncomfortable, whichexacerbates the anxiety response and might contributeto psychological complications.5 Moreover, increasedanxiety activates tension and pain, possibly leading todelay or cessation of therapeutic procedures.10 Anxiety inpostoperative patients can significantly affect the intensityof pain and surgical outcomes, and could adversely affectpatient recovery. For instance, it might increase the intubationtime, impair the inflammatory response, increasecardiovascular workload and change the normal degradationprocesses in wound healing.11,12 From the psychologicalaspect, postoperative anxiety can cause an increasedsensitivity to noise. It can result in an exaggerated autonomicresponse, sensory overload and sleep deprivationleading to physiological problems, and therefore delayedself-care after surgery.11 A higher level of pain intensity inpostoperative older patients, longer hospitalization andpoorer ambulation after discharge from the hospital haveall been linked to increased anxiety.13 Hospitalization andsurgery are among the most important causes of anxiety inolder patients.2 Therefore, designing strategies to reducepain and anxiety after surgery and provide an environmentconducive to smooth healing and recovery isneeded. Anxiety and pain levels in postsurgical patientsshould be assessed so that proactive nursing interventionsare implemented.14
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