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Chapter 1

THE PROBLEM

Introduction

Most patients experience some pain after a surgical procedure. Many factors (it includes

motivational, affective, cognitive and emotional) influence the pain experience. The preoperative

preparation receive by the patient (including information about what to expect, reassurance,

psychological support and teaching specific communication techniques related to pain) is a

significant factor in decreasing anxiety, apprehension and even the amount of postoperative pain

(McDonald & Molony, 2004; Nair & Podichetty, 2004)

Although patients and families are undoubtedly relieved that surgery is over, anxiety

levels may remain high in the immediate postoperative period. Many factors contributed to this

anxiety: pain, being in an unfamiliar environment, inability to control once circumstances or care

for oneself, fear of long-term effects of surgery, fear of complications, fatigue, spiritual distress,

altered role responsibilities, ineffective coping and altered body image are all potential reactions

to the surgical experiences. The nurse the patient and family work through their anxieties by

providing reassurance and information and by spending time listening to and addressing their

concerns (Brunner & Suddarth’s Medical-Surgical Nursing, 2008)

Nursing during the post-operative phase is especially important for the client’s recovery

in terms of pain. Provide psychosocial support to reduced anxiety. The nurse provides support by

actively listening and proving accurate information. It is important to rectify any misperceptions

the client may have.

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In this study, we want to know if psychosocial interactions of the student nurses

significantly affect the recovery of the post-operative patients in terms of pain. Also we

differentiate the magnitude of the chosen factors particularly age, gender and the type of surgery

(includes minor and major). Age and development status affect’s adult’s ability to cope with the

physiologic and psychological of surgery which experiences go along with the person’s aspects

of maturity which allow on how he deal things in his own ability. Gender of an individual is a

great factor in rendering such management because male and female react differently on the

psychosocial interactions depends on their own understanding and perception related to pain.

The type of surgery significantly affects the individual perception and meaning of pain they are

experiencing according to the type of surgery, if it is minor our major.

Empathy is a major component of a satisfactory nurse-patient relationship. This is the

ability to understand and experience the feeling of others as it seems to be your own. It is vital

characteristics a nurse should possess, and this may be somehow generated on how that certain

entity put into realization all the learning acquired of both student and patients.

Statement of the Problem

This study aimed to determined the effect of psychosocial interaction towards the student

nurses on the recovery of post-operative patients in terms of pain at the Brokenshire Integrated

Health Ministries Incorporated.

Specifically, it aims to answer the following questions:

1. What is the profile of the patients in terms of:

a. Age

b. Gender
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c. Type of surgery

• Minor

• Major

2. What are the means responses of the psychosocial interaction towards the student nurses on

the recovery of post-operative patients in terms of pain.

3. To what extend does the recovery of post-operative patients using the pain rating scale.

4. Does the psychosocial interactions significally affects the recovery of the post-operative

patients in terms of pain.

Hypothesis

Ho1: There is no significant relationship between the psychological interactions towards

the student nurses on the recovery of the post-operative patients in terms of pain.

Research framework

This study is based on the Psychosocial Development by Erik Erikson (1902-

1994).Erikson emphasized developmental change throughout the human life span. In Erikson’s

theory, eight stages of development unfold as we go through the life span. Each stage consists of

a crisis that must be faced. According to Erikson, this crisis is not a catastrophe but a turning

point of increased vulnerability and enhanced potential. The more an individual resolves the

crises successfully, the healthier development will be. This study focuses on the stages from
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Identity vs. Confusion to Generativity vs. Stagnation, since we will only include adolescence to

middle adulthood.

Erikson's model of psychosocial development is a very significant, highly regarded and

meaningful concept. Life is a serious of lessons and challenges which help us to grow. Erikson's

wonderful theory helps to tell us why. By this, post operative patients may express their feelings

in terms of pain and how student nurses helps them in their recovery.

Conceptual Framework

Psychological Interactions Post-operative patient’s

recovery in terms of pain.
• Reassurance
• Psychological support
• Providing accurate information
• Rectify any misperception
• Teaching specific communication
Techniques related to pain.

Profile
Age
Gender
Types of surgery
Minor
Major

Figure 1. The schematic Diagram of the Study

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The figure above that shows a schematic diagram of the study on psychological

Interactions of student nurses is considered as independent variable and Post-operative patients

recovery in terms of pain as predictive variables.

It also shows a schematic diagram of psychological Interactions in terms reassurance,

psychological support providing accurate information, rectify any misperception, teaching

specific communication techniques related to pain are considered as the independent variables.

The post-operative patient’s recovery in terms of pain are considered as the predictive variables.

This means that the Post-operative patients recovering would depend on the psychological

interaction of student nurses.

The intervening variable is the profile of post-operative patients at Brokenshire Integrated

Health Ministries Incorporated. This would further classify the post-operative patients who

experience recovery in terms of feeling less pain.

Scope and Limitation

This study involves the post-operative patients at Surgical Ward of Brokenshire

Integrated Health Ministries Incorporated which is located at Brokenshire Heights, Davao City.

This focuses on the effect of psychosocial interactions toward the student nurses on the recovery

of post operative patients from adolescence to the middle adulthood in terms of pain, since they

are capable enough to express their feelings about their situation. A large part of a nursing career

involves both verbal and non-verbal transmission of information to the patient and vice versa.

When considering this idea of nursing and communicating there is also what is called therapeutic

communication in nursing.
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This involves the human element of appropriate emotions in the nursing arena. With

therapeutic communication in nursing, the patient’s emotional state is considered as well as their

feelings. Being sensitive to the needs of a patient especially in terms of pain is very important.

Therapeutic communication in nursing allows for the patient and family to feel like someone

actually cares for him or her in their time of need. This can be fundamental in the

recovery process of a patient. The study will be conducted on Brokenshire Integrated Health

Ministries Incorporated school year 2009-2010.It'sbeyond the capacity of the researchers to

question the honesty of the respondents involved. Also, the researchers will only be dealing with

the appropriate average number of post operative patients since we are expecting that not all

patients are willing to be interviewed.

Significance of the Study

The nursing profession is concerned not only with curing, alleviating or preventing the

disease but it is also involved in how we rendered tender loving care to our patients especially

those who were in emotional stress.

In Promoting psychosocial health, the vital art of providing effective and appropriate

nursing care is the nurse’s ability o conveys understanding, sensitivity and compassion to the

client who has a negative self- concept or who confronts a stressful life event. The nurse

recognizes the impact of low self-esteem or other stressors on the individual client as well as on

the family and support persons.

By proving a supportive environment in which to express feelings by listening attentively

and by offering comfort, the nurse help those affected to develop a healthy self-image or cope
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with stress and to transcend the experience through psychosocial interactions towards the post-

operative patients (Kozier; A. Berman; Snyder, 2004).

The result of the study is beneficial to the nursing students because it serves as basis to

improve their management skills specifically psychosocial interactions to the post-operative

patients as well as to enhance their knowledge to further improve their service to their clients.

This study will enhance the awareness of post-operative patients in the importance of

participating to the student nurses during their psychosocial interactions to know the difference

after their pain feelings emotionally and physically experienced.

Lastly, for future researchers, it serves as a guiding reference to their research inquiries

related to our study. Which will give them a chance for improvement and enhancement to the

student learning.

Definition of Terms

The important terms in this research are defined conceptually and with their

corresponding meaning as they use in the study.

Below are the definitions of the following terms:

Age. Length of somebody or something’s existence: The length of time that somebody or

something has existed, usually express in years. In this study, it refers to the age of post-

operative patients between the age of 18 and above.

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Anxiety. Is a psychological and physiological state characterized by cognitive, somatic,

emotional, and behavioral components (Wikipedia). In this study, it refers to the psychological

and physiological state of the post-operative patients.

Gender. Comprises a range of differences between men and women, extending from the

biological to the social (Wikipedia). In this study, it refers to the male and female post-operative

patients.

Minor surgery. Normally involves little risk, produces few complications and is often performed

in a day surgery. Examples are breast biopsy, removal of tonsils and knee surgery (med-Surg,

2008).

Major surgery. Involves a high degree of risk, it may be complicated or prolonged. Examples are

organ transplant, open heart surgery, and removal of a kidney (med-Surg, 2008).

Pain. Is the unpleasant and aversive feeling common to such experiences as a stubbed toe, a

burnt finger, and iodine in a cut (Wikipedia). In this study, it refers to the unpleasant feeling

physically and emotionally of the post-operative patient after the surgery.

Post-operative patients. In this study, it refers to the patient who are already done from surgery

approximately 2-3 days after.

Psychological interactions. In this study, it refers to the student nurses and post-operative

patients interactions. It includes Reassurance, Psychological support, providing accurate

information, Rectify any misperception, teaching specific communication, Techniques related to

pain.

Psychological support. In this study, it refers to the support of nursing students to the post-

operative depression, nursing student should encourage patients to express anger and other

negative feeling.
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Recovery. The process of recovering from an injury or illness (Wikipedia). In this study, it refers

to the recovery in terms of pain which is less experience by the post-operative patients

approximately 2-3 days after surgery.

Reassurance.

Surgery. Is a medical specialty that uses operative manual and instrumental techniques on a

patient to investigate and/or treat a pathological condition such as disease or injury, to help

improve bodily function or appearance, or sometimes for some other reason (Wikipedia). In this

study, it refers to the surgery happen on the post-operative patients.