Abdominal surgery is recognized as a painful procedure,
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. Inadequate
pain management following abdominal surgery leads to
complications such as delayed recovery and ambulation;
lack participation in the therapeutic plan; disturbed sleep
and appetite loss; prolonged hospitalization; and dissatisfaction
with, and increased costs of, health-care services.
Pain after surgery is intensely uncomfortable, which
exacerbates the anxiety response and might contribute
to psychological complications. Moreover, increased
anxiety activates tension and pain, possibly leading to
delay or cessation of therapeutic procedures. 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. 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. 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. 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.