Awaludin.
Nurachmah.
, & Novitasari.
The Effect of Smartphone-Based Nursing Therapy to Reducing Post Cardiac Surgery.
JURNAL INFO KESEHATAN, 21.
https://doi.
org/10.
31965/infokes.
Vol21Iss4.
| 636
Jurnal Info Kesehatan Vol.
No.
December 2023, pp.
P-ISSN 0216-504X.
E-ISSN 2620-536X
DOI: 10.
31965/infokes.
Vol21Iss4.
Journal homepage:http://jurnal.
id/index.
php/infokes RESEARCH Open Access The Effect of Smartphone-Based Nursing Therapy to Reducing Post Cardiac Surgery Sidik Awaludin 1a* .
Elly Nurachmah 2b .
Dwi Novitasari 3c School of Nursing.
Faculty of Health Sciences.
Jenderal Soedirman University.
Purwokerto.
Central Java.
Indonesia Faculty of Nursing.
University of Indonesia.
Depok.
West Java.
Indonesia Faculty of Health.
Harapan Bangsa University.
Purwokerto.
Central Java.
Indonesia Email address: abifayza@yahoo.
Email address: ellynur08@yahoo.
Email address: dwinovitasari@uhb.
Received: 9 May 2023 Revised: 29 September 2023 Accepted: 29 September 2023 Abstract The disease that is the number one cause of death in the world today is heart disease.
Actions to overcome the problem of coronary heart disease, one of them with surgery.
Pain is a significant issue at all stages of surgery.
Post-cardiac surgery discomfort should be manageable with smartphone-based nursing care.
The goal of this study was to determine if smartphone-based nursing care may help heart surgery patients feel less pain.
The research design used a quasiexperimental pre- and post-control group design.
The sample size in this study was 46 respondents, which were divided into 23 respondents in the intervention group and 23 respondents in the control group.
The inclusion criteria of this study were cardiac surgery patients on the first day, adult patients receiving paracetamol drip therapy and 1000 mg tablets, and hemodynamic Nursing interventions to deal with pain in this study were carried out using hypnosis and music videos in smartphone-based applications.
Research results showed a post-treatment pain score of 2.
04 in the intervention group and 4.
60 in the control group.
Nursing interventions carried out using videos in smartphone-based applications are able to overcome post-cardiac surgery pain, so pain management using smartphones can be an intervention choice to deal with post-cardiac surgery pain.
Hypnosis and music nursing interventions using videos on smartphone-based applications can be used as nursing therapy to treat pain after cardiac surgery.
Keywords: Cardiac Surgery.
Pain.
Smartphone.
Nursing Therapy.
*Corresponding Author:
Sidik Awaludin School of Nursing.
Faculty of Health Sciences.
Jenderal Soedirman University.
Purwokerto.
Central Java.
Indonesia Email: agungsuharto14@gmail.
AThe Author.
This article is distributed under the terms of the Creative Commons Attribution 4.
International License .
ttp://creativecommons.
org/licenses/by/4.
0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author.
and the source, provide a link to the Creative Commons license, and indicate if changes were made.
The Creative Commons Public Domain Dedication waiver .
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INTRODUCTION
Heart disease remains the world's number-one killer and a major public health concern.
The WHO estimates that 17.
9 million deaths from cardiovascular disease occurred in 2016, which represents 31% of all deaths worldwide.
Heart failure is the leading cause of mortality when compared to other medical diagnoses, and it accounts for the majority of heart disease diagnoses, along with coronary heart disease, hypertensive heart disease, and heart failure (Virani et al.
, 2.
One of the management options for coronary heart disease is surgery (Zipes, 2.
Both elective and cito surgery are stressful events that require special nursing care (Chandrababu et , 2017.
Smeltzer et al.
, 2.
Each stage of cardiac surgery has a major problem, namely The surgical nurse has a role in dealing with every patient's pain complaint so that the patient is free from pain.
Various types of nursing therapy can treat pain, such as hypnosis and Hypnosis nursing therapy is a technique or practice of influencing someone who intentionally enters into a sleep-like state.
In this condition, the hypnotized person can follow orders and accept suggestions without resistance.
Hypnosis is a brief cognitive-behavioral technique without specific side effects.
Hypnosis involves being introduced to procedures that the subject is told to experience imaginatively.
Hypnotic procedures are used to encourage and evaluate responses to suggestions.
In the process of hypnosis, one is guided by a hypnotist to receive suggestions from subjective experience and changes in perception, taste, emotion, thought, and behavior (Awaludin et al.
, 2.
Hypnosis is used by the surgeon to see himself or herself through each of the different parts of the procedure, from start to finish, very easily and pain-free (Awaludin.
Nurachmah, & Novitasari, 2.
Hypnosis affects a person's perception and behavior by means of the suggestibility principles, entering a condition known as transhipnosis.
There is a significant degree of suggestibility in trance, an altered state of consciousness that differs from regular sleep, unconsciousness, and coma.
In 1996, 20 kids were hypnotized by Andrew and Welbury, and they found that in 16 of them who were both hypnotized and under anesthesia at the same time, their sense of pain decreased (Abdeshahi et , 2013.
Eren et al.
, 2.
Since a long time ago, hypnosis has been successfully applied during eye surgery in a number of instances.
Overall, our findings indicate that even though hypnosis in combination with topical anesthetics could not be completely eradicated, patients in the hypnosis group had much better outcomes.
Given the individual variances in hypnotic efficacy and pain sensitivity, pain for all patients may make sense.
In general, a lot of patients in the hypnosis group showed less pain, less fear, and more cooperation (Chen et al.
, 2.
Music therapy is a therapy that uses music or musical elements by a therapist to improve, maintain, or restore physical, mental, emotional, and spiritual health.
Music therapy is a complementary therapy (Comeaux & Steele-Moses, 2.
Music that can be used for the healing process is music that is tailored to your wishes, such as classical music, instrumental music (DevarePhadke & HadiyaParkar, 2.
, and slow music (Amiri et al.
, 2.
Listening to music can affect the physiological functions of a person's body, such as breathing, heart rate, and blood pressure (Awaludin, et al.
, 2020.
Heidari et al.
, 2.
Music relaxes the body, stabilizes the metabolic rate, and fulfills the body's oxygen needs, which affect vital signs such as heart rate, respiratory rate, and blood pressure that are within acceptable ranges (Berman.
Snyder & Frandsen, 2016.
Peate & Evans, 2.
The release of noradrenaline and adrenaline can be decreased by being relaxed.
Reduced levels of the hormone noradrenaline result in lower blood pressure, whereas reduced levels of the hormone adrenaline have the opposite impact on the cardiovascular system, resulting in a reduction in heart rate (Jimynez-Jimynez et al.
, 2.
Listening to therapeutic music for 30Ae35 minutes can reduce anxiety and pain and maintain Awaludin.
Nurachmah.
, & Novitasari.
The Effect of Smartphone-Based Nursing Therapy to Reducing Post Cardiac Surgery.
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org/10.
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hemodynamics within normal limits (Cierci & ynzbayr, 2016.
DevarePhadke & HadiyaParkar, 2.
Providing nursing therapy can be done through smartphone media.
The smartphone app provides useful functions that can be integrated into both conventional and modern maintenance manuals.
Smartphone applications can also be programmed to respond to critical items in self-assessments to automatically detect significant problems (Bauer et al.
, 2020.
Kim et al.
, 2.
Based on this description, to provide nursing services to patients with cardiac surgery in the form of post-cardiac surgery pain management, it is necessary to conduct research on pain interventions in cardiac surgery patients by utilizing the development of smartphone The purpose of this research is to determine the effect of smartphone-based nursing therapy on the pain of cardiac surgery patients.
RESEARCH METHOD
This research is a type of experimental research that used a quasi-experimental pre and post control group design.
The sample size 46 participants.
23 of them were in the intervention group, and 23 of them were in the control group.
The sampling technique used was consecutive The inclusion criteria of this study were first-day cardiac surgery patients, adult patients receiving paracetamol drip therapy and 1000 mg tablets, and hemodynamically stable The nursing therapy provided in this study is hypnosis and music in smartphone Instruments for measuring pain using the Visual Analogue Scale (VAS).
Statistical analysis used the Mann Whitney test.
RESULTS AND DISCUSSION
Table 1.
Distribution of respondents by age.
Group Mean Control Intervention Table 1 shows the average age of respondents in the intervention group was 58 years and the control group was 60 years.
Table 2.
Distribution of respondents by gender.
Male Female Control Intervention Table 2 shows the majority of the gender of the respondents in this study were male.
Group Table 3.
Results of the Pain Scale Mean Difference Test Respondents Between Post-Treatment Groups.
Intervention Control p-value Variable Group Group (Mea.
(Mea.
Pain Scale <0.
*= p-value < 0.
Table 3 shows that the pain scale data between the treatment and control groups after the smartphone-based nursing intervention showed a significant difference .
-value <0.
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The results of the study based on the characteristics of the respondents, according to Table 1 show that the age range in this study was late adulthood and the elderly.
With the increasing age of the elderly, degenerative diseases will arise, increasing the risk factors for coronary heart disease (Noale et al.
, 2.
A similar issue arises with valvular heart disease as well.
According to the findings of research conducted in Brazil, individuals with valvular heart disease were 3 years old on average.
Rheumatic heart disease (RHD) and degenerative valve disease are the most frequent causes.
however, they can happen at any age, depending on the reason (Coffey et al.
, 2021.
Tarasoutchi et al.
, 2.
Increasing age also increases the risk of calcification of the heart valves, causing heart valve dysfunction (Bhatt et al.
, 2.
The majority of respondents in this study were male .
Compared to women, men are more likely to have coronary heart disease.
contrast this with coronary heart disease in women (Virani et al.
, 2.
Men who have unhealthy lifestyles, such as smoking, drinking, and unhealthy diets, are more likely to get heart disease (Khalili et al.
, 2014.
Virani et al.
, 2.
Additionally, it is believed that hormones have a significant role in the prevalence of coronary heart disease.
Estrogen and progesterone, which have an impact on the menstrual cycle and menopause, are the hormones that are involved.
In addition, it is believed that the use of hormonal contraception may have an impact on the prevalence of coronary heart disease (Khan et al.
, 2.
The results of this study showed that the postoperative pain scale on the first day between the treatment and control groups was in the moderate pain category.
On the first day of surgery, the patient received morphine analgesic therapy after regaining consciousness, then was extubated, and the morphine therapy was replaced with paracetamol 1000 mg drip up to H on the second day of operation.
When the patient was moved to the usual treatment room, the paracetamol 1000 mg drip therapy was replaced with tablets, and the dose was reduced to 500 The analgesic therapy given is in accordance with the theoretical concept.
Analgesic therapy given to cardiac surgery patients is in the form of opioid and non-opioid analgesics.
The non-opioid type most often used is paracetamol.
Non-steroidal anti-inflammatory drugs (NSAID.
, metamizole N-methyl-D-aspartate (NMDA) antagonists, alpha-2 agonists, local anesthetics, and gabapentinoids (Yu et al.
, 2.
The analgesic effect is very good when combined with opioid analgesics.
This enables an approximate 4050% dosage decrease of the opioid, which can lessen the likelihood of side effects from usage.
Opioid analgesics are frequently used to relieve postoperative pain, but they have undesirable side effects such as sleepiness and respiratory depression that can prolong the patient's stay in intensive care and postpone extubation.
Due to the possibility of renal damage and bleeding in patients undergoing heart surgery, the use of NSAIDs may be restricted (Bigeleisen & Goehner, 2015.
Keawnantawat et al.
, 2017.
Zubrzycki et al.
, 2.
In this study, video-based smartphone applications were used to deliver nursing interventions for pain management.
The findings of this study are consistent with the idea that smartphones are cellular technologies that offer advantages in the medical field, including standardizing therapy, boosting motivation and adherence to therapeutic programs, providing education, and facilitating quick decisions (Soangra & Lockhart, 2.
, and observing the interventions provided.
Nursing interventions are given to patients according to predetermined nursing therapy videos can be easily accessed and followed by patients via their smartphones (Xu et al.
, 2.
The limitation of this study is that it only combines two nursing interventions to relieve pain post cardiac surgery.
CONCLUSION
Hypnosis and music nursing therapy using videos in smartphone-based applications can significantly overcome post-cardiac surgery pain.
The study's findings are consistent with the Awaludin.
Nurachmah.
, & Novitasari.
The Effect of Smartphone-Based Nursing Therapy to Reducing Post Cardiac Surgery.
JURNAL INFO KESEHATAN, 21.
https://doi.
org/10.
31965/infokes.
Vol21Iss4.
| 640
idea that smartphones are cellular technologies with advantages in the medical field, including standardizing therapy, boosting motivation and adherence to treatment plans, offering education, and facilitating early decision-making.
Patients using cellphones can readily obtain and follow smartphone-based nursing interventions.
REFERENCES