University of Pittsburgh School of Nursing, Pittsburgh, PA.
University of Pittsburgh School of Nursing, Pittsburgh, PA; UPMC-Hillman Cancer Center, Pittsburgh, PA.
J Perianesth Nurs. 2023 Jun;38(3):478-482. doi: 10.1016/j.jopan.2022.08.014. Epub 2023 Jan 10.
The purpose of this study was to investigate the influence of potential co-occurring symptoms, including fatigue, sleep disturbance, anxiety, depressive symptoms, and pain, on the incidence of postdischarge nausea (PDN) measured two days following discharge to home after surgery for breast cancer.
This study used a prospective, cross-sectional, observational design.
The sample was 334 women aged 27 to 88 years of age. Demographic data were collected from the patient and the medical record before surgery. Symptom data were collected 48 hours following surgery using the Patient Reported Outcome Measurement System (PROMIS) and numerical nausea and pain scales.
Eighty-five (25.4%) of study participants reported some nausea two days after discharge. Study participants who experienced PDN frequently described that it occurred after they left the hospital to drive home following their surgery. Unadjusted odds ratios showed the presence of co-occurring symptoms of anxiety, fatigue, sleep disturbance, and pain were all significantly associated with the presence of nausea 48 hours following surgery. Other significant factors associated with (PDN) were history of motion sickness, history of pregnancy-induced nausea, use of opioids, and type of surgery.
Same-day surgery nurses providing postoperative education for women following surgery for breast cancer should explain to patients that nausea may occur after they are discharged, especially those with known motion sickness. In addition, patients should be informed that other symptoms, especially fatigue, sleep disturbance, and anxiety, may co-occur.
本研究旨在探讨潜在共病症状(包括疲劳、睡眠障碍、焦虑、抑郁症状和疼痛)对乳腺癌手术后出院两天内发生的出院后恶心(PDN)的影响。
本研究采用前瞻性、横断面、观察性设计。
样本为 334 名年龄在 27 至 88 岁之间的女性。人口统计学数据在手术前从患者和病历中收集。症状数据在手术后 48 小时使用患者报告的结果测量系统(PROMIS)和数字恶心和疼痛量表收集。
85 名(25.4%)研究参与者在出院后两天报告有一定程度的恶心。经常报告出现 PDN 的研究参与者表示,恶心发生在他们离开医院开车回家后。未经调整的优势比显示,焦虑、疲劳、睡眠障碍和疼痛的共病症状与手术后 48 小时出现恶心明显相关。与(PDN)相关的其他重要因素包括晕车史、妊娠引起的恶心史、阿片类药物的使用和手术类型。
为接受乳腺癌手术的女性提供术后教育的日间手术护士应向患者解释恶心可能在出院后发生,特别是那些已知晕车的患者。此外,应告知患者可能还会出现其他症状,特别是疲劳、睡眠障碍和焦虑。