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International Journal of Advances in Nursing Management
Year : 2016, Volume : 4, Issue : 1
First page : ( 87) Last page : ( 90)
Print ISSN : 2347–8632. Online ISSN : 2454–2652.
Article DOI : 10.5958/2454–2652.2016.00019.6

Effects of cold application on pain and anxiety during chest tube removal among post operative cardiac surgery adult patients

Dave Koushal*

Faculty College of Nursing, Dr. Ram Manohar Lohia Hospital, New Delhi

*Corresponding Author's Email: kaushal442@gmail.com

Online published on 23 May, 2016.


A study conducted to assess the effectiveness of cold application on Pain and Anxiety during Chest Tube Removal (CTR) among post operative cardiac surgery adult patients. Pre-test post-test control group experimental design was used. Post operative cardiac surgery adult patient of the selected hospital of Delhi were selected. The study sample was purposive sampling technique with random assignment of subjects into two groups: experimental group and control group. The sample size was 60 i.e. 30 in experimental group and 30 in control group. The control group received usual standard care during chest tube removal whereas experimental group received cold application with gel pack (Temp: 0–20C) after wrapping it with sterile gauze, around chest tube (5cms) for a period of 15 minutes before CTR. The tools used for the study were structured questionnaire to obtain demographic data, standardized Numerical Pain Intensity Scale (NPIS) scale to assess pain, C.D. Speilberger's State Trait Anxiety inventory (STAI) scale to assess anxiety. The obtained data was analysed and interpreted in terms of the objectives of the study using descriptive and inferential statistics. The mean post test pain scores with cold application (1.13 ± 1.31; 0.27 ± 0.44; 0.27 ± 0.44) at zero minute, 15 minute and 30 minute respectively were significantly (< 0.05) lower than the mean pre-test score of 6.10 ± 1.27 in the experimental group without cold application. In control group, pre test mean pain score was 6.57 ± 1.12 as compared to mean post test pain score of 8.57 ± 0.49; 8.73 ± 0.57; 8.63 ± 0.48 at zero minute, 15 minute and 30 minute respectively. It indicates that cold application was effective to reduce pain among post operative cardiac surgery patients while removing chest tube. To evaluate the effectiveness of cold application on anxiety related to chest tube removal, in experimental group the mean post cold application anxiety scores 41.93 ± 2.21 were significantly lower (< 0.05) than the mean anxiety score of 53.47 ± 1.84 before cold application. In addition, the mean anxiety score were 53.31 ± 1.81 before CRT and 57.87 ± 3.21 after CRT among post operative cardiac surgery patient in control group. It indicates that the cold application on chest tube removal was effective in reducing anxiety among post operative cardiac surgery patient. Cold application is simple, cheap, non pharmacological anxiety and pain management strategy ensuring good results.



Cardiothoracic patients, cold application, chest tube removal (CTR), pain score, anxiety score.


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