Comparison of High Frequency Chest Wall Oscillation and Chest Physiotherapy on Pain and Preference Post-Lung Transplant

2.50
Hdl Handle:
http://hdl.handle.net/10755/157052
Category:
Abstract
Type:
Presentation
Title:
Comparison of High Frequency Chest Wall Oscillation and Chest Physiotherapy on Pain and Preference Post-Lung Transplant
Author(s):
Sommer, Susan; Shameem, Zeba; Burchette, Charles; Gawlinski, Anna; Miller, Pamela
Author Details:
Susan Sommer, RN, University of California, Los Angeles Health System, Los Angeles, California, USA, email: spsommer@yahoo.com; Zeba Shameem; Charles Burchette; Anna Gawlinski; Pamela Miller
Abstract:
POSTER PURPOSE: To evaluate the efficacy of chest physiotherapy (CPT) versus high-frequency chest wall oscillation (HFCWO) on measures of patientÆs pain and preference among postoperative lung transplant (LT) recipients in an acute cardiothoracic hospital. BACKGROUND/SIGNIFICANCE:Conventional CPT and HFCWO are used routinely in LT recipients to facilitate the removal of bronchial secretions. To date, no studies have been done that investigate which therapy is more comfortable and less painful for post-LT patients. This is an important clinical question for LT recipients, because patients who have less pain will mobilize secretions more frequently, require fewer medications, and are apt to heal and recover faster. METHOD: In a 2-group experimental study conducted on postoperative day 3, thirty-seven post-LT patients (21 single [SLT], 16 bilateral [BLT], 70% male, mean age, 57 years) were assigned randomly to either CPT first (10 AM and 2 PM) followed by HFCWO (6 PM and 10 PM; n = 18) or vice versa (n = 19). Outcome measure of pain was assessed by the Verbal Numeric Pain Scale (VNPS) and collected before, immediately after, and 15 minutes after treatment. At the end of the treatment sequence, a 4-item patient survey assessed treatment preference regarding pain and effectiveness. Data were analyzed with 2 tests, t tests, and repeated-measures analysis of variance. Open-ended survey responses were analyzed for meaning and themes. RESULTS: Among BLT, patients favored HFCWO over CPT (75% vs 25%); whereas among SLT, CPT was favored (40% vs 55%; P = .07). Most patients reported HFCWO as less painful than CPT (50% vs 38%); 12% reported as equivalent. Across time points, a 3-way interaction was found between the preferred treatment being less painful by survey, treatment method, and VNPS score (F = 3.55, P = .02). Less painful ratings were consistent with VNPS scores during the preferred treatment method. SLT and BLT patients reported preferences toward HFCWO as an effective treatment due to improved airway clearance, longer length of treatment, and comfort. Those who preferred CPT cited the effectiveness of the treatment as more directed and less technical. CONCLUSIONS: The findings of this study indicate BLT patients prefer HFCWO over CPT. Overall, HFCWO was perceived as less painful than CPT. HFCWO may provide targeted clinical benefit in the BLT population. Further investigation is warranted in a multicenter, comparative study to elucidate treatment preferences and pain after LT.
Repository Posting Date:
26-Oct-2011
Date of Publication:
26-Oct-2011
Citation:
2010 National Teaching Institute Research Abstracts. American Journal of Critical Care, 19(3), e15-e28. doi:10.4037/ajcc2010866
Conference Date:
2010
Conference Name:
National Teaching Institute and Critical Care Exposition
Conference Host:
American Association of Critical-Care Nurses
Conference Location:
Washington, D.C., USA
Note:
This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.

Full metadata record

DC FieldValue Language
dc.type.categoryAbstracten_GB
dc.typePresentationen_GB
dc.titleComparison of High Frequency Chest Wall Oscillation and Chest Physiotherapy on Pain and Preference Post-Lung Transplanten_GB
dc.contributor.authorSommer, Susanen_GB
dc.contributor.authorShameem, Zebaen_GB
dc.contributor.authorBurchette, Charlesen_GB
dc.contributor.authorGawlinski, Annaen_GB
dc.contributor.authorMiller, Pamelaen_GB
dc.author.detailsSusan Sommer, RN, University of California, Los Angeles Health System, Los Angeles, California, USA, email: spsommer@yahoo.com; Zeba Shameem; Charles Burchette; Anna Gawlinski; Pamela Milleren_GB
dc.identifier.urihttp://hdl.handle.net/10755/157052-
dc.description.abstractPOSTER PURPOSE: To evaluate the efficacy of chest physiotherapy (CPT) versus high-frequency chest wall oscillation (HFCWO) on measures of patientÆs pain and preference among postoperative lung transplant (LT) recipients in an acute cardiothoracic hospital. BACKGROUND/SIGNIFICANCE:Conventional CPT and HFCWO are used routinely in LT recipients to facilitate the removal of bronchial secretions. To date, no studies have been done that investigate which therapy is more comfortable and less painful for post-LT patients. This is an important clinical question for LT recipients, because patients who have less pain will mobilize secretions more frequently, require fewer medications, and are apt to heal and recover faster. METHOD: In a 2-group experimental study conducted on postoperative day 3, thirty-seven post-LT patients (21 single [SLT], 16 bilateral [BLT], 70% male, mean age, 57 years) were assigned randomly to either CPT first (10 AM and 2 PM) followed by HFCWO (6 PM and 10 PM; n = 18) or vice versa (n = 19). Outcome measure of pain was assessed by the Verbal Numeric Pain Scale (VNPS) and collected before, immediately after, and 15 minutes after treatment. At the end of the treatment sequence, a 4-item patient survey assessed treatment preference regarding pain and effectiveness. Data were analyzed with 2 tests, t tests, and repeated-measures analysis of variance. Open-ended survey responses were analyzed for meaning and themes. RESULTS: Among BLT, patients favored HFCWO over CPT (75% vs 25%); whereas among SLT, CPT was favored (40% vs 55%; P = .07). Most patients reported HFCWO as less painful than CPT (50% vs 38%); 12% reported as equivalent. Across time points, a 3-way interaction was found between the preferred treatment being less painful by survey, treatment method, and VNPS score (F = 3.55, P = .02). Less painful ratings were consistent with VNPS scores during the preferred treatment method. SLT and BLT patients reported preferences toward HFCWO as an effective treatment due to improved airway clearance, longer length of treatment, and comfort. Those who preferred CPT cited the effectiveness of the treatment as more directed and less technical. CONCLUSIONS: The findings of this study indicate BLT patients prefer HFCWO over CPT. Overall, HFCWO was perceived as less painful than CPT. HFCWO may provide targeted clinical benefit in the BLT population. Further investigation is warranted in a multicenter, comparative study to elucidate treatment preferences and pain after LT.en_GB
dc.date.available2011-10-26T19:22:44Z-
dc.date.issued2011-10-26en_GB
dc.date.accessioned2011-10-26T19:22:44Z-
dc.identifier.citation2010 National Teaching Institute Research Abstracts. American Journal of Critical Care, 19(3), e15-e28. doi:10.4037/ajcc2010866en_GB
dc.conference.date2010en_GB
dc.conference.nameNational Teaching Institute and Critical Care Expositionen_GB
dc.conference.hostAmerican Association of Critical-Care Nursesen_GB
dc.conference.locationWashington, D.C., USAen_GB
dc.identifier.citation2010 National Teaching Institute Research Abstracts. American Journal of Critical Care, 19(3), e15-e28. doi:10.4037/ajcc2010866en_GB
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.-
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