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Role of a nurse in the care of patients with post-puncture cephalalgia after an operation in spinal anaesthesia
KŘIVKOVÁ, Jana
The objective of this diploma paper was to answer the question whether nursing for patients after an operation in spinal anaesthesia has any effects on the occurrence of post-puncture cephalalgia and on the satisfaction of patients with spinal anaesthesia. The paper is divided into two parts: a theoretical one and a practical research one. The theoretical part sums up the current knowledge of spinal anaesthesia; it provides anatomic and physiological aspects, possible complications and the importance of nursing in this type of anaesthesia. It deals with the syndrome of post-puncture cephalalgia in detail, the mechanism of its origin, typical symptoms, its treatment, and the importance of nursing for patients suffering from this syndrome. With regard to the importance of education in nursing jobs, one chapter of the theoretical part deals with education and educational process. The research part consists of qualitative as well as quantitative surveys. The research was carried out with a group of patients who were hospitalized at the surgical and gynaecological departments of Domažlická nemocnice a.s. (Domažlice Hospital Ltd.) and have undergone an operation in spinal anaesthesia. The quantitative survey was done using a questionnaire that contained 27 questions. Seventy-eight patients, selected at random, took part in this research stage. The objective of the qualitative survey was to find out the following: whether patients were aware of the aspects of spinal anaesthesia, whether they have experienced any complications in relation to the administration of spinal anaesthesia, how have they been informed, and what was their overall satisfaction with spinal anaesthesia. The qualitative part involved 10 patients who had been divided randomly into two groups: a group with ``standard{\crqq} education and a group with above-standard education using a purpose-made brochure. A semi-standardized interview, consisting of 18 questions, was carried of with each patient. The patients in the latter group were also asked additional questions aimed at the benefit of the informative brochure and the completeness of the presented information. The former group was asked whether they would be interested in a brochure focusing on spinal anaesthesia. Based on the results of this survey, the basic research question of the paper can be answered. Nursing does have positive effects on the occurrence of complications and on the satisfaction with spinal anaesthesia. A detailed result analysis shows that patients do not feel any subjective need to be educated by a nurse and they are not interested in the brochure. Most of the patients think they are informed sufficiently and they do not want more information. However, the results of the qualitative survey into the group educated by a nurse show a higher informedness about the method, lower occurrence of complications, higher satisfaction, better observance of recommended regimen measures, and highly reduced level of stress in relation to spinal anaesthesia. The educative brochure was accepted by the educated patients as beneficial and useful. Based on the above-listed results, the informative brochure, being an integral part of this paper, will be introduced as a standard education tool for patients undergoing an operation in spinal anaesthesia at Domažlická nemocnice a.s.
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