Cold Application versus Relaxation Technique in Managing Pain and Anxiety for Patient Undergoing Chest Tube Removal

Abstract

Removal of chest tube is considered to be a very painful procedure that has been poorly controlled. Cold application, as anon-pharmacological intervention, has been used successfully in many pain control situations. However, its application to control pain associated with chest tube removal has not been intensively studied. Relaxation is another non-pharmacological technique in pain management keeping in mind that anxiety can cause pain and pain also can cause anxiety. The aim of this study was to assess the effects of cold application versus relaxation technique in managing pain and anxiety associated with chest tube removal after cardiac surgery. Design: Quasi-experimental design as applied to achieve the aim of the study. Setting: this study was conducted in post cardiothoracic intensive care units at Ain Shams University hospital. Subjects: purposive sample of 90 patients divided into three equal groups (30 for each), ice pack, and relaxation technique and control groups. Tools: data were collected through three tools; 1) patients’ assessment sheet; including demographic data, 2) Numerical Scale for measuring pain intensity and 3) Hamilton Anxiety Scale for measuring Anxiety Level. Results: this result showed no significant differences in pain intensity before chest tube removal, but immediately after chest tube removal there was a significant difference between the study groups (cold application and relaxation groups) and control groups. There was no significant difference between the effect relaxation and cold application groups. Conclusion: Regarding the relaxation and cold application methods showed relatively equal effects on reducing the pain owing to chest tube removal in relation to pain and anxiety. Recommendation: The ice packs application and relaxation technique able to reduce the intensity of pain and anxiety level associated with chest tube removal. Therefore it was recommended to be used during chest tube removal.