"A Descriptive Study of Patients' Perceptions of Sensations and Distres" by Lois Ann Petermann
 

Date of Award

7-1977

Degree Type

Master's Essay - Restricted

Degree Name

Master of Science in Nursing (MSN)

Department

Nursing

First Advisor

Ruth Stollenwerk

Second Advisor

Mary Jane Schank

Abstract

This study was designed to obtain descriptions of patients' perceptions of the physical sensations and the distress associated with chest tube removal. The study emerged from an underlying commitment to nursing intervention which extends beyond the automatic response of analgesic administration to a patient's complaint of pain. In present day health care, patients are frequently confronted with stressful experiences associated with invasive procedures incorporated into treatment--one of these is chest tube therapy. Although it may not be feasible to change the nature of a physical sensation, it may be possible to alter the pain response by influencing the distress component. Chest tube removal has the potential for inducing pain and distress upon the patient, and an accurate description of physical sensations the patient will experience during this procedure may reduce the distress associated with it.

Thirty adult open-chest surgical patients were interviewed according to a semi-structured interview guide within minutes of experiencing chest tube removal. Sixty percent of the patients labeled the physical sensations associated with chest tube removal to simulate some form of "pulling" or "tugging." The participants' descriptions of their distress varied from "not too bad" to "terrible." Fifteen patients (50%) rated their distress as slight, nine (30%) as moderate, three (10%) as very distressing, two (7%) as just bearable, and one (3%) felt nothing and, therefore, experienced no distress. There did not seem to be any correlation between distress ratings and the time a patient was last medicated for pain. Nineteen (63%) of the thirty patients stated having their chest tubes removed was a totally different sensation from anything they had ever experienced in their past. Twelve patients (40%) received an explanation of the procedure and sixteen patients (53%) received an explanation as to how chest tube removal would feel. The five patients who reported the highest distress ratings received neither an explanation of the procedure nor of the physical sensation they could expect to experience. For the majority of patients (two-thirds), pain inflicted as a result of chest tube removal was over almost immediately upon completion of the procedure.

Assessment and alleviation of pain is of primary concern within the practice of nursing. It is the hope of the researcher that having the results of this study available will enable nurses to provide patients who must undergo chest tube removal with an accurate explanation of what they can expect to experience, and thereby reduce patient distress.

Comments

An Essay Submitted to the Faculty of the Graduate School, Marquette University, in Partial Fulfillment of the Requirements for the Degree of Master of Science in Nursing, Milwaukee, Wisconsin

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