Pengurangan Nyeri dan Cemas dengan Teknik Relaksasi Genggam Jari pada Pasien Pasca Intervensi Koroner Perkutan: Studi Non-randomized Controled Trial
Keywords:
Teknik genggam jari, nyeri, cemas, intervensi koroner perkutan.Abstract
Introduction: Pain and anxiety are problems in patients undergoing Percutaneous Coronary Intervention (PCI) which can be treated with non-pharmacological therapy. However, the fact that this problem still occurs in patients. Various non-pharmacological techniques can be performed, including the finger-holding technique without causing side effects. Purpose: This study aims to evaluate the effectiveness of the finger grip technique in reducing pain and anxiety after removing the transradial sheath after IKP procedures. Methods: Non-randomized clinical trial with a pretest posttest with control group design as the study method, was carried out in March 2023 – May 2023. Participants were patients who were hospitalized with IKP. The study consisted of 18 intervention group participants and 18 control group participants. The intervention group was given non-pharmacological therapy with finger grip relaxation techniques and the control group was given standard nursing care. Pain was measured using the Numerical Rating Scale (NRS) questionnaire and the anxiety variable was measured using the Visual Analog Scale for Anxiety (VAS-A) which has been tested for validity and reliability. Data were analyzed using paired-sample t-tests and independent-sample t-tests to answer the research objectives. Results: There was a decrease in the pain scale from a score of 4.56 (moderate pain) after intervention 2.39 (mild pain) and a reduction in anxiety from a score of 4.17 and after intervention 2.39. The results of the analysis showed that there was a significant effect of the finger grip relaxation technique on reducing pain (p=0.001) and anxiety in patients with PCI (p=0.001). Conclusion: PCI patients after removal of the transradial sheath who experience complications from pain and anxiety and are given the finger-hold relaxation technique, the results are effective, and there is a decrease in pain and anxiety.
Latar Belakang: Nyeri dan cemas menjadi masalah pada pasien yang dilakukan Intervensi Koroner Perkutan (IKP) yang dapat ditangani dengan terapi non-farmakologi. Namun, kenyataan masalah ini masih terjadi pada pasien. Berbagai teknik non-farmakologi yang dapat dilakukan, diantaranya teknik gegngam jari yang tanpa menimbulkan efek samping. Tujuan: Penelitian ini bertujuan mengevaluasi efektifitas teknik genggam jari terhadap pengurangan nyeri dan cemas setelah pelepasan sheath transradial pasca tindakan IKP. Metode: Non-randomized clinical trial dengan rancangan pretest posttest with control group design sebagai metode studi ini, dilaksanakan di pada bulan Maret 2023 – Mei 2023. Partisipan adalah pasien yang dirawat di rumah sakit dengan IKP. Studi terdiri atas 18 partisipan kelompok intervensi dan 18 partisipan kelompok kontrol. Kelompok intervensi diberikan terapi nonfarmakologi teknik relaksasi genggam jari dan kelompok kontrol diberikan asuhan asuhan keperawatan standar. Nyeri diukur menggunakan menggunakan kuesioner Numerik Rating Scale (NRS) dan variabel cemas diukur menggunakan Visual Analog Scale for Anxiety (VAS–A) yang sudah diuji validitas dan reabilitasnya. Data dianalisis menggunakan paired-sample t-test dan independent sample t-test untuk menjawab tujuan penelitian. Hasil: Ditemukan penurunan skala nyeri dari skor 4,56 (nyeri sedang) dan setelah intervensi 2,39 (nyeri ringan) dan pengurangan cemas dari skor 4,17 dan setelah intervensi 2,39. Hasil analisis menunjukkan ada pengaruh secara bermakna efek teknik relakasi genggam jari terhadap penurunan nyeri (p=0,001) dan cemas pada pasien dengan IKP (p=0,001). Simpulan: Pasien IKP setelah pelepasan sheath transradial yang mengalami komplikasi nyeri dan cemas diberikan teknik relaksasi genggam jari diperoleh hasil efektif, terjadi penurunan nyeri dan cemas.
References
Aktürk, E., Kurtoglu, E., Ermis, N., Açikgöz, N., Yagmur, J., Altuntas, M. S., Pekdemir, H., & Özdemir, R. (2014). Comparision of pain levels of transradial versus transfemoral coronary catheterization: a prospective and randomized study. The Anatolian Journal of Cardiology, 14(2), 140.
Aldoori, J. S., & Mohammed, A. I. (2019). Transradial approach for coronary angiography and percutaneos coronary intervention: personal experience. The Egyptian Heart Journal, 71(1), 1–7.
Andarmoyo, S. (2013). Konsep & proses keperawatan nyeri. Ar-Ruzzmedia.
Anggraini, M. S., & Hidayat, A. (2023). Scoping Review The Effect of Finger Grip Relaxation on The Patient’s Anxiety Level Before Operation. Jurnal Kesehatan Pasak Bumi Kalimantan, 5(1), 96–108.
Aoun, J., Hattar, L., Dgayli, K., Wong, G., & Bhat, T. (2019). Update on complications and their management during transradial cardiac catheterization. Expert Review of Cardiovascular Therapy, 17(10), 741–751.
Appukuttan, D., Vinayagavel, M., & Tadepalli, A. (2014). Utility and validity of a single-item visual analog scale for measuring dental anxiety in clinical practice. Journal of Oral Science, 56(2), 151–156. https://doi.org/10.2334/josnusd.56.151
Boitor, M., Martorella, G., Maheu, C., Laizner, A. M., & Gélinas, C. (2018). Effects of massage in reducing the pain and anxiety of the cardiac surgery critically ill—a randomized controlled trial. Pain Medicine, 19(12), 2556–2569.
Chen, W.-L., Liu, G.-J., Yeh, S.-H., Chiang, M.-C., Fu, M.-Y., & Hsieh, Y.-K. (2013). Effect of back massage intervention on anxiety, comfort, and physiologic responses in patients with congestive heart failure. The Journal of Alternative and Complementary Medicine, 19(5), 464–470.
Chiarito, M., Cao, D., Nicolas, J., Roumeliotis, A., Power, D., Chandiramani, R., Sartori, S., Camaj, A., Goel, R., & Claessen, B. E. (2021). Radial versus femoral access for coronary interventions: an updated systematic review and metaâ€analysis of randomized trials. Catheterization and Cardiovascular Interventions, 97(7), 1387–1396.
Deng, Y. (2017). Effects of modified finger exercise on limb pain and numbness after transradial per-cutaneous coronary intervention. Chinese Journal of Nursing, 1456–1458.
Erzincanli, S., & Kasar, K. S. (2021). Effect of hand massage on pain, anxiety, and vital signs in patients before venipuncture procedure: A randomized controlled trial. Pain Management Nursing, 22(3), 356–360.
Feriani, P. (2020). Efektivitas Teknik Relaksasi Benson Dan Terapi Genggam Jari Terhadap Tingkat Kecemasan Pada Pasien Laparatomi Di Ruang Mawar RSUD A. Wahab Sjahranie Samarinda. Borneo Studies and Research, 1(3), 1732–1737.
Hawker, G. A., Mian, S., Kendzerska, T., & French, M. (2011). Measures of adult pain: Visual analog scale for pain (vas pain), numeric rating scale for pain (nrs pain), mcgill pain questionnaire (mpq), shortâ€form mcgill pain questionnaire (sfâ€mpq), chronic pain grade scale (cpgs), short formâ€36 bodily pain scale (sf. Arthritis Care & Research, 63(S11), S240–S252.
Hay, D., & Nesbitt, V. (2019). Management of acute pain. Surgery (Oxford), 37(8), 460–466.
Heidari, F., Rejeh, N., Heravi-Karimooi, M., Tadrisi, S. D., & Vaismoradi, M. (2017). Effect of short-term hand reflexology on anxiety in patients before coronary angiography: A randomized placebo controlled trial. European Journal of Integrative Medicine, 16, 1–7. https://doi.org/https://doi.org/10.1016/j.eujim.2017.09.010
Hill, R. Y. (2010). Nursing from the inside-out: Living and nursing from the highest point of your consciousness. Jones & Bartlett Publishers.
Huriani, E., Olimviani, S. P., & Putra, H. (2021). Handheld Technique Compared to Deep Breathing Technique in Reducing Anxiety Before Cardiac Catheterization. Indonesian Contemporary Nursing Journal, 12–20.
Jolly, S. S., Yusuf, S., Cairns, J., Niemelä, K., Xavier, D., Widimsky, P., Budaj, A., Niemelä, M., Valentin, V., & Lewis, B. S. (2011). Radial versus femoral access for coronary angiography and intervention in patients with acute coronary syndromes (RIVAL): a randomised, parallel group, multicentre trial. The Lancet, 377(9775), 1409–1420.
Lewandowski, P., Zuk, A., Slomski, T., Maciejewski, P., Ramotowski, B., & Budaj, A. (2021). The impact of using a larger forearm artery for percutaneous coronary interventions on hand strength: a randomized controlled trial. Journal of Clinical Medicine, 10(5), 1099.
Ludman, P. F. (2018). Percutaneous Coronary Intervention. Medicine (United Kingdom), 46(9), 547–554. https://doi.org/https://doi.org/10.1016/j.mpmed.2018.06.007
Martorella, G., Boitor, M., Michaud, C., & Gélinas, C. (2014). Feasibility and acceptability of hand massage therapy for pain management of postoperative cardiac surgery patients in the intensive care unit. Heart & Lung, 43(5), 437–444. https://doi.org/https://doi.org/10.1016/j.hrtlng.2014.06.047
Mobini-Bidgoli, M., Taghadosi, M., Gilasi, H., & Farokhian, A. (2017). The effect of hand reflexology on anxiety in patients undergoing coronary angiography: A single-blind randomized controlled trial. Complementary Therapies in Clinical Practice, 27, 31–36.
Neumann, F.-J., Sousa-Uva, M., Ahlsson, A., Alfonso, F., Banning, A. P., Benedetto, U., Byrne, R. A., Collet, J.-P., Falk, V., & Head, S. J. (2019). 2018 ESC/EACTS Guidelines on myocardial revascularization. European Heart Journal, 40(2), 87–165.
Ningrum, N. W., Mahdiyah, D., & Sari, D. P. (2017). Effectiveness of relaxation techniques to decrease handheld Finger pain intensity post cesarean section at Dr. H. Moch. Ansari Saleh hospital in Banjarmasin. 2nd Sari Mulia International Conference on Health and Sciences 2017 (SMICHS 2017)–One Health to Address the Problem of Tropical Infectious Diseases in Indonesia, 188–195.
Oktaviono, Y. H. (2020). Kompilasi Pada Intervensi Koroner Perkutan. Airlangga University Press.
Parellangi, A., Sari, N. K., Loriana, R., & Amaliyah, B. (2016). The Effect Of Giving The Handheld Finger Relaxation On Anxiety Changes To The Patients With Coronary Heart Disease. Journal Research and Analysis: Health Science, September, 1–7.
Rahayu, R. S., Hidayah, N., Muhith, A., & Salim, H. M. (2023). Pengaruh Head of Bed (HOB) terhadap Kenyamanan Pasien dengan Nyeri Punggung Post Percutaneous Coronary Intervention: A Systematic Review. Jurnal Keperawatan, 15(3), 1053–1070.
Sheikhy, F., Tabiee, S., Vagharseyyedin, S. A., & Riyahiinokandeh, G. A. (2018). Effect of foot reflexology massage on feeling of comfort in open heart surgery patients: A clinical trial study. Journal of Gorgan University of Medical Sciences, 20(2), 28–34.
Shin, E. S., & Kim, M.-H. (2018). The effects of hand massage in patients who underwent transradial percutaneous coronary intervention. Journal of Korean Academy of Nursing, 48(4), 465–474.
Silviani, Y. E., Maiseptyasari, R., Fahriani, M., & Putri, S. D. (2021). the Effect of Finger-Grip Relaxation Technique on Reducing Anxiety in Preoperative Caesarean Sectio Patients in the Midwifery Room of Kepahiang Regional Hospital. Indonesian Midwifery and Health Sciences Journal, 5(4), 406–416.
Stuart, G. W. (2016). Prinsip dan Praktik Keperawatan Jiwa Stuart Buku 2: Edisi Indonesia. Elseiver, Singapore.
Sudarti, J. M., & Fauziah, A. (2012). Teori Pengukuran Nyeri dan Nyeri Persalinan. Yogyakarta: Nuha Medika.
Suksatan, W., & Tankumpuan, T. (2022). Mind–Body Interventions in Patients With Heart Failure: State of the Science. Journal of Applied Gerontology, 41(4), 1232–1243.
Tabiee, S., Vagharseyyedin, S. A., Riyahii Nokandeh, G. A., & Sheikhy, F. (2017). The effect of comfort-based care (Reflective massage and education to patient) on comfort in patients undergoing coronary artery bypass grafting. Journal of Surgery and Trauma, 5(3), 44–50.
Tavakol, M., Ashraf, S., & Brener, S. J. (2012). Risks and complications of coronary angiography: a comprehensive review. Global Journal of Health Science, 4(1), 65.
Taylor, K. A., Wiles, J. D., Coleman, D. D., Sharma, R., & Oʼdriscoll, J. M. (2017). Continuous Cardiac Autonomic and Hemodynamic Responses to Isometric Exercise. Medicine and Science in Sports and Exercise, 49(8), 1511–1519.
Umeda, M., Newcomb, L. W., Ellingson, L. D., & Koltyn, K. F. (2010). Examination of the dose–response relationship between pain perception and blood pressure elevations induced by isometric exercise in men and women. Biological Psychology, 85(1), 90–96.
Zhang, K., Hu, P., Zhao, L., Cai, L., & Zhang, Y. (2023). Finger exercise could reduce painfulness and radial artery complications related to coronary artery angiography. Coronary Artery Disease, 10–1097.
Zul’irfan, M., Azhar, B., & Pandini, A. I. (2022). Relaksasi Genggam Jari Berpengaruh terhadap Penurunan Skala Nyeri Pasien Pasca Bedah Fraktur Ekstremitas Bawah. Jurnal Ilmiah Permas: Jurnal Ilmiah STIKES Kendal, 12(4), 887–892.
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