Patients Who Had Undergone Spinal Surgery, Research Paper Example

Abstract

The abstract is very detailed and contains pertinent information needed to determine if one wants to read the article. The study was conducted in Taiwan at a medical center that performs spinal surgeries. The purpose of the study was to compare the efficiency of warming methods used on patients post anesthesia. The design is identified as quasi-experimental with a total of 130 participants.  The center that the data was collected from had performed a total of 58, 475 operations in 2008. Between 120-200 of those surgeries were spinals. The participants in the study had to be 18 years of age or older, been under anesthesia during their surgery, not had a fever before the surgery, been in operation between 3-6 hours, operational wound not more than 10-15 cm, and have a tympanic temperature between 34 and 35.5 upon arrival at the center. The findings suggest that the radiant warmer was more efficient than cotton blankets in increasing the patient’s body temperatures. The article was written in 2011 and the references vary in time frame. Some sources were as late as early 1981, while others were as recent as 2006. The rationale for the study was to determine which method of warming post-surgery was more effective. This information can be used to make patients more comfortable after receiving surgery because patient hypothermia is a common phenomenon in medical settings. Also, some facilities do not have forced air warming for patients, for these facilities the radiant warmer is quite effective. There is not efficient information in the abstract to determine variables, design of study, or the population being studied. Just from the abstract information, I could determine that I did not really want to read the article. The sources used are related to the issue of hypothermia. No critical analysis has been made to analyze gaps and limitations.

Theoretical Framework/Design

The study was a quasi-experimental design. It was a longitudinal study that took place over a four month period of time spanning from July through November of 2008. The data was collected from a 3, 447 bed medical referral center in Taiwan. Each patient was informed about the study and was required to give written consent to participate in the study. The participants were divided into two groups. Each group was given three cotton blankets and a comforter. However, one group was provided with a PW81 radiant warmer, with an irradiance of 32 mw/cm2 at 100% heater power mounted 68 cm above the head (including facial area) and neck area. The theoretical framework is not explained in detail. There seems to be a disconnect between the research theory and the problem they present a solution to. I am unsure what type of theory would have been best to use because the goal of the research is unclear. There does not seem to be an independent variable; there are only two groups that both receive the heating source. The target population would be any person having surgery. The design of the study seems to be retrospective because only persons after the study may benefit from the results. There was a baseline of body temperature for the two groups. The baseline temperature was used to determine which heating method warmed the patient fastest. According to the data, the information was collected every 10 minutes until the patient was in recovery. From the information provided in the article, I could not identify any threats to validity. Each participant had to sign consenting to the study. No mention of compensation for participants was stated. Also, no characteristics of data collectors were presented.

Sample

The participants in the study had to be 18 years of age or older, been under anesthesia during their surgery, not had a fever before the surgery, been in operation between 3-6 hours, operational wound not more than 10-15 cm, and have a tympanic temperature between 34 and 35.5 upon arrival at the center. About 70 of the participants were female and 60 were male. The study took place in Taiwan and participants were chosen because they had an upcoming surgery. The sample was one of convenience because they would be in the facility of their own choosing. Participants were randomly placed in groups according to their case numbers. The only information that was revealed about the participants was their sex; no other cultural information was submitted. No evidence was presented to determine if the researcher did a power analysis. All patients were made aware of their rights and all information collected was maintained in the strictest of confidence.

Methods

The researchers had to gain permission from the review board of Chang Gung Memorial Hospital. All patients participating in the study were admitted to the facility 1 day prior to the operation. The researchers visited each patient that would participate in the study. On the day of the operation, each participant was revisited by the researcher.  The patient’s vital signs and temperature were monitored in 10 minute intervals. Each patient was assigned to group B or R according to the last four digits of their case number and researchers followed all guidelines set by the facility human resource department. No intervention protocol was mentioned. The protocol for collecting data was not mentioned. One system for analyzing data was mentioned and it was used throughout the study. There was no mention that the instrument had been tested prior to this study.

Results

Of the 130 participants, more than half of the patients did not have any comorbidities. A two-way analysis of variance and chi-square test were performed to distinguish the differences among the groups. Accordingly, there were no significant differences found in the patient’s body heat as measured by skin heat sensors. No statistical tests were mentioned in the article. Tables and charts are used, but it is difficult to comprehend what is being presented in the article.

Discussion

This was a very interesting article, but it seems the researchers did not have a clear purpose for the study. Initially, it seemed as if they were trying to determine if one particular heat source was more effective than another. However, the results concluded that there was no significant difference in the actual body temperatures of the patients regardless to the type of heating source used. There was a great deal of information presented, which made it very difficult to follow the hypothesis the authors presented (An excess of charts and graphs). Also, the researchers did not state how they came to the conclusion that one form of heat source was better than another. It was not stated if the patients were interviewed and asked if they preferred one source over another or how they concluded that one was better than another. Essentially, they had to only judge of basis of how the patients felt because the heat monitor showed that there was not a difference in body temperatures. Unfortunately, I do not believe this article benefited me. I do not believe it will benefit others in the healthcare field. I would like to see this research repeated for a longer period of time to discern if patients actually feel a difference in their body temperatures using the special heating source. If possible, I would like to see what might happen if patients were given this heat source without being aware that it is supposed to be more efficient than traditional cotton blankets.  I believe they should have focused on how the patients reporting feeling, instead of a measured body temperature. If measuring body temperatures was the only way to determine if the hypothesis was successful, the researchers failed. If they had done this, I believe the results would have been clearer. The information presented seemed to contradict itself in several instances. The article stated that there was no significant difference in the body heats of the patients, but the researchers still concluded that the radiant warmer was more effective. The researchers did mention that a limitation of the study that it was a small sample that was taken in one facility.

References

Hsiu-Ling Yang, et al (2012). The comparison of two recovery room warming methods from hypothermia patients who had undergone spinal surgery. Journal of Nursing Scholarship (44)1, 2-10.