Document Type : Original Article
Authors
1 Neurosurgery Ward, Al-Zahra Hospital
2 Department of Adult Nursing, School of Nursing and Midwifery,
3 Department of Neurosurgery, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
Abstract
Background: Today, lumbar herniation discs, a prevalent problem with a sign of lumbar and feet
pain in society. Removal of disk by surgery decrease pain but reduce quality‑of‑life (QOL). In some
cases, lake of following and caring of patient after surgery, herniation disc recurrent. Previous
studies show that patient education and followings is important, therefore, this study aimed to
investigate the effect of continuing care on patient QOL after disc surgery in neurosurgery and very
important person (VIP) ward in Al‑Zahra Hospital. Materials and Methods: This study is a clinical
trial conducted on 64 patients hospitalized in the neurosurgery and VIP wards of Al‑Zahra Hospital,
in Isfahan, Iran, in 2013. The patients were selected by simple sampling method and were randomly
assigned to two groups (study and control). Patients’ response to short form‑36 questionnaire
before and 4 weeks and 3 months after continuing care in study group, and simultaneously, in
the control group. Results: Repeated measures ANOVA showed a significant difference in mean
of physical and psychological dimensions before and 4 weeks and 3 months after intervention in
study group (P < 0.05), but in control group, the difference was not significant (P = 0.8). Pairwise
comparison of mean physical and psychological dimensions at different time points by Fisher’s
least significant difference showed that there was a significant difference in the intervention
group (P < 0.022). But in the control group, there was no significant difference between pairs of
time points (P > 0.18). Conclusion: Continuing care improves dimensions of patients’ QOL, and
it is recommended as a nursing and nonmedical intervention in disc surgery patients.
Keywords
Comparative outcome analyses of differently surgical approaches
to lumbar disc herniation. Coll Antropol 2009;33 Suppl 2:79‑84.
2. Dang L, Liu Z. A review of current treatment for lumbar disc
herniation in children and adolescents. Eur Spine J 2010;19:205‑14.
3. Azizpoor Y, Hemmati F, Sayehmiri K. “Prevalence of life‑time
back pain in Iran”: A systematic review and meta‑analysis. SJKU
2013;18:102‑12.
4. Mousavi SJ, Akbari ME, Mehdian H, Mobini B, Montazeri A,
Akbarnia B, et al. Low back pain in Iran: A growing need to adapt
and implement evidence‑based practice in developing countries.
Spine (Phila Pa 1976) 2011;36:E638‑46.
5. Mirhoseini A. Evaluation of 754 surgically treated lumbar disc
herniation. J Res Med Sci 2003;8:15‑18.
6. Black J, Hokanson JH. Medical Surgical Nursing: Clinical Management
for Positive Outcomes. 8th ed. St. Louis: Evolve, 2008. p. 240.
7. Suzanne CS, Brenda B. Brunner and Suddarth’s Textbook of
Medical Surgical Nursing. 12th ed. Philadelpha: Wolters Kluwer,
2010; p. 332.
8. Glenn JS, Yaker J, Guyer RD, Ohnmeiss DD. Anterior discectomy
and total disc replacement for three patients with multiple recurrent
lumbar disc herniations. Spine J 2011;11:e1‑6.
9. Lee JK, Amorosa L, Cho SK, Weidenbaum M, Kim Y. Recurrent
lumbar disk herniation. J Am Acad Orthop Surg 2010;18:327‑37.
10. Osterman H, Sund R, Seitsalo S, Keskimäki I. Risk of multiple
reoperations after lumbar discectomy: A population‑based study.
Spine (Phila Pa 1976) 2003;28:621‑7.
11. den Boer JJ, Oostendorp RA, Beems T, Munneke M, Oerlemans M,
Evers AW. A systematic review of bio‑psychosocial risk factors for
an unfavourable outcome after lumbar disc surgery. Eur Spine J
2006;15:527‑36.
12. Breivik H, Borchgrevink PC, Allen SM, Rosseland LA, Romundstad L,
Hals EK, et al. Assessment of pain. Br J Anaesth 2008;101:17‑24.
13. Wong M, Tavazzi L. Effect of drug therapy for heart failure on quality
of life. J Clin Hypertens (Greenwich) 2004;6:256‑61.
14. Fayssoux R, Goldfarb NI, Vaccaro AR, Harrop J. Indirect costs
associated with surgery for low back pain – A secondary analysis
of clinical trial data. Popul Health Manag 2010;13:9‑13.
15. Weinstein JN, Lurie JD, Olson PR, Bronner KK, Fisher ES. United
States’ trends and regional variations in lumbar spine surgery:
1992‑2003. Spine (Phila Pa 1976) 2006;31:2707‑14.
16. Hernández MA. Treatment of multiple sclerosis and quality of life.
Rev Neurol 2000;30:1242‑5.
17. King CR, Hinds PS. Quality of Life from Nursing and Patient
Perspectives. 3rd ed. London: Jones and Bartlett Publisher; 2012.
18. Nyatanga L, Dann KL. Empowerment in nursing: The role of
philosophical and psychological factors. J Adv Nurs 2002;3:234‑9.
19. Vég A, Rosenqvist U, Sarkadi A. Variation of patients’ views on Type 2
diabetes management over time. Diabet Med 2007;24:408‑14.
20. Rambod M, Shabani M, Shokrpour N, Rafii F, Mohammadalliha J.
Quality of life of hemodialysis and renal transplantation patients.
Health Care Manag (Frederick) 2011;30:23‑8.
21. Sadeghi S, Zerang FA, Ahmadi F, Karimi Zarchi A, Babatabar HD,
Ebadi A, et al. Effect of applying continuous care model on quality
of life in heart failure patients J Behav Sci 2009;3:9‑13.
22. Ostelo RW, Costa LO, Maher CG, de Vet HC, van Tulder MW.
Rehabilitation after lumbar disc surgery: An update Cochrane
review. Spine (Phila Pa 1976) 2009;34:1839‑48.
23. Last AR, Hulbert K. Chronic low back pain: Evaluation and
management. Am Fam Physician 2009;79:1067‑74.
24. Moyle W. Nurse‑patient relationship: A dichotomy of expectations.
Int J Ment Health Nurs 2003;12:103‑9.
25. Cravene RF, Hirnle CJ. Fundamentals of Nursing Human Health and
Function. 5th ed. Philadelphia Lippincott and Wilkins; 2007.
26. Rafieefar SH, Ahmadzad M, Sharifi M. Comprehensive System of
Patient Educational Health in Islamic Republic of Iran; 2005. 52.
Available from: http://www.behdasht.gov.ir/uploads/1_94_29.pdf.
[Last accessed on 2015 Sep 05].
27. Stuart GE, Laraia M. Principles and Practice of Psychiatric Nursing.
8th ed Canada: Mosby; 2005.
28. Jansson KA, Németh G, Granath F, Blomqvist P. Surgery for
herniation of a lumbar disc in Sweden between 1987 and 1999.
J Bone Joint Surg (Br) 2004;85‑B: 841‑7.
29. Shabani H. Teaching Skills, Teaching Methods and Techniques,
Side. 3. Tehran: SAMT publisher, 200630. Afrooz GH, Motamedi F. Self‑efficacy and mental health of students
in regular and quick‑witted. Iran Psychol 2006; 6(4):56‑60.
31. Baghery H, Memarian R, Alhani F. Survey the effect of group
counseling on quality of life in myocardial infarction patients who
have been refeered to the clinics of Imam Khomeini and Hospitals
in Tehran. J Kalim 2004;6:89‑95.
32. Montazeri A, Goshtasbi A, Vahdaninia M. Translation, reliability and
validity of the SF‑36 standard tools such Farsi. Payesh Quartery,
2006;5(1):49‑56.
33. Kulig K, Beneck GJ, Selkowitz DM, Popovich JM Jr, Ge TT,
Flanagan SP, et al. An intensive, progressive exercise program
reduces disability and improves functional performance in
patients after single‑level lumbar microdiskectomy. Phys Ther
2009;89:1145‑57.
34. Stamfeel M, Post M, Kelder J, Gobee D, Hemel N. Psychometric
properties of Aquqrel: A disease‑specific quality of life questionnaire
for pacemaker patients. J Clin Epidemiol 2001;24:157‑61.
35. Bošković K, Todorović‑Tomašević S, Nada Naumović N, Grajić M,
Knežević A. The quality of life of lumbarradiculopathy patients under
conservative treatment. VOJNOSANITETSKI PREGLED Journal
2009; 66(10): 807‑812
36. Selkowitz DM, Kulig K, Poppert EM, Flanagan SP, Matthews ND,
Beneck GJ, et al. The immediate and long‑term effects of exercise and
patient education on physical, functional, and quality‑of‑life outcome
measures after single‑level lumbar microdiscectomy: A randomized
controlled trial protocol. BMC Musculoskelet Disord 2006;7:70.
37. Sharma M, Chichanovskaya L, Shlemsky V, Petrukhina E.
A Comprehensive study of outcome after lumber discectomy for
lumbar degenerative spine disease at 6 months post‑operative
period. Open Neurosurg J 2013;6:1‑5.
)