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Original Article

The Effects of Position Change on Low Back Pain, Discomfort, and Bleeding after Transarterial Chemoembolization

Mi-Jeong Yun1, Hye Sook Min2
Korean Journal of Adult Nursing 2014;26(4):424-433.
Published online: August 31, 2014

1Dong-A University Medical Center, Busan

2Department of Nursing, School of Medicine of Dong-A University, Busan, Korea

Corresponding author: Min, Hye Sook Department of Nursing, School of Medicine of Dong-A University, 1 Dongdaesin-dong 3-ga, Seo-gu, Busan 602-812, Korea. Tel: +82-51-240-2872, Fax: +82-51-240-2920, E-mail: hsmin@dau.ac.kr
• Received: March 31, 2014   • Accepted: July 28, 2014

Copyright © 2014 Korean Society of Adult Nursing

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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  • Purpose
    This study was to test the effects of the positional change on low back pain, discomfort, and bleeding complications duringthe periodof bed rest followingtransarterial chemoembolization (TACE).
  • Methods
    There-searchdesign forthis studywas anon-equivalent control groupquasi-experimental design. Theparticipants were 23 patients for the experimental group, and 23 patients for the control group. The experimental group received positional changeof taking the semi-Fowler'sposition and the 30-degree lateral positionalternatively duringthe periodof bed rest after TACE for 4 hoursat one-hour intervals. The control groupmaintainedthesupineposition continuouslyduring theperiod of bed rest after TACE.
  • Results
    There were statisticallysignificant differences in low backpainand discomfort betweenthe experimental andthecontrolgroup after intervention. Andnosignificant difference wasfoundinbleeding complicationbetweentwo groups.
  • Conclusion
    Theresults of thestudysuggest that thepositional change is an effectivenursing intervention to reduce low back painanddiscomfort without increasing the risk of bleeding after TACE.
  • Key Words: Therapeutic chemoembolization; Patient positioning; Low back pain; Discomfort; Hemorrhage
Table 1.
Homogeneity Test for General and Disease-related Characteristics, Dependent Variables at Pretest between Groups (N=46)
Characteristics Categories Exp. (n=23) Cont. (n=23) x2 p
n (%) n (%)
Gender Male 21 (91.4) 19 (82.7) 0.77 .381
Female 2 (8.6) 4 (17.3)
Age (year) 50 ＜ 3 (13.0) 2 (8.6) 0.64 .372
51~60 6 (26.0) 5 (21.7)
61 ＞ 14 (60.8) 16 (69.5)
Education level Middle school ＜ 9 (39.0) 8 (34.6) 0.44 .933
Middle school ≥ 14 (61.0) 15 (65.4)
Occupation Yes 8 (34.8) 7 (30.4) 0.10 .753
No 15 (65.2) 16 (69.6)
Marital status Unmarried 1 (4.3) 0 (0.0) 2.22 .330
Married 19 (82.6) 22 (95.7)
Bereaved 3 (13.0) 1 (4.3)
Religion Yes 8 (34.7) 17 (73.9) 7.19 .066
No 15 (65.2) 6 (26.1)
Monthly income (10,000 won) 200 ＜ 200 ≥ 17 (73.9) 6 (26.1) 17 (73.9) 6 (26.1) 0.82 .846
Experience Yes 18 (78.3) 16 (69.6) 0.45 .502
No 5 (21.7) 7 (30.4)
Pain killer Yes 15 (65.2) 12 (52.2) 0.81 .369
No 8 (34.8) 11 (47.8)
Number of pain killer (DemerolⓇ) No 1 8 (34.8) 9 (39.1) 11 (47.8) 7 (30.4) 4.22 .238
2 ≥ 6 (26.0) 5 (21.7)
Diagnosed (month) 12 ＜ 12 (52.1) 10 (43.4) 5.81 .121
12 ≥ 11 (47.7) 13 (56.4)
Experienced surgery (HCC) Yes 1 (4.3) 1 (4.3) 0.00 1.000
No 23 (95.7) 23 (95.7)
Low back pain   4.96±2.23 3.74±2.36 -1.80 .079
Discomfort   1.83±0.30 1.54±0.21 -3.81 .001 ＜
Bleeding Bleeding area 2.07±6.78 1.16±1.84 -0.62 .537
  Hematoma formation 0 (0.0) 0 (0.0) 0.00 1.000

Exp.=experimental group; Cont.=control group; HCC=hepatocellular carcinoma.

Table 2.
Comparison of Back Pain, Discomfort, Complication of Bleeding over the Time between the Groups (N=46)
Variables Time Exp. (n=23) Con. (n=23) Comparison t or F p
n (%) or M±SD n (%) or M±SD
Back pain Pretest 4.96±2.23 3.74±2.36      
Post 1 hrs 3.57±1.70 5.26±2.63 Group 13.18 <.001
Post 2 hrs 2.65±1.64 5.65±2.64 Time 0.80 .498
Post 4 hrs 2.00±1.54 6.09±2.65 Time×Group 43.51 <.001
Discomfort Pretest 1.83±0.30 1.54±0.21      
Post 1 hrs 1.63±0.32 1.73±0.34 Group 38.62 <.001
Post 2 hrs 1.49±0.37 1.81±0.27 Time 6.54 .014
Post 4 hrs 1.40±0.30 1.89±0.30 Time×Group 9.60 .003
Bleeding area Post 4 hrs 0.10±0.25 0.12±0.17   0.32 .744
Hematoma formation Post 4 hrs 0 (0.0) 0 (0.0)   0.00 1.000
    23 (100.0) 23 (100.0)      

Pretest=two hours after supine.

Post 1hr.=one hour after positional change; Post 2hr.=Two hour after positional change; Post 4hr.=Four hours after positional change.

Exp.=experimental group; Con.=control group.

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    Citations

    Citations to this article as recorded by  
    • The effect of position change on vital signs, back pain and vascular complications following percutaneous coronary intervention
      Selda Mert Boğa, Seher Deniz Öztekin
      Journal of Clinical Nursing.2019; 28(7-8): 1135.     CrossRef
    • The Factors of Pain and Pain Management after Transarterial Chemoembolization in Patients with Hepatocellular Carcinoma
      Se Na Jung, Je In Seon, Kwang Sung Kim
      Asian Oncology Nursing.2017; 17(2): 107.     CrossRef
    • The Effect of Position Change on Discomfort and Bleeding after Liver Biopsy
      Mi-Jeong Yun, Hye Sook Min
      Korean Journal of Adult Nursing.2015; 27(2): 233.     CrossRef

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    Korean J Adult Nurs. 2014;26(4):424-433.   Published online August 31, 2014
    DOI: https://doi.org/10.7475/kjan.2014.26.4.424
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    The Effects of Position Change on Low Back Pain, Discomfort, and Bleeding after Transarterial Chemoembolization
    Korean J Adult Nurs. 2014;26(4):424-433.   Published online August 31, 2014
    DOI: https://doi.org/10.7475/kjan.2014.26.4.424
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    The Effects of Position Change on Low Back Pain, Discomfort, and Bleeding after Transarterial Chemoembolization
    The Effects of Position Change on Low Back Pain, Discomfort, and Bleeding after Transarterial Chemoembolization

    Homogeneity Test for General and Disease-related Characteristics, Dependent Variables at Pretest between Groups (N=46)

    Characteristics Categories Exp. (n=23) Cont. (n=23) x2 p
    n (%) n (%)
    Gender Male 21 (91.4) 19 (82.7) 0.77 .381
    Female 2 (8.6) 4 (17.3)
    Age (year) 50 ＜ 3 (13.0) 2 (8.6) 0.64 .372
    51~60 6 (26.0) 5 (21.7)
    61 ＞ 14 (60.8) 16 (69.5)
    Education level Middle school ＜ 9 (39.0) 8 (34.6) 0.44 .933
    Middle school ≥ 14 (61.0) 15 (65.4)
    Occupation Yes 8 (34.8) 7 (30.4) 0.10 .753
    No 15 (65.2) 16 (69.6)
    Marital status Unmarried 1 (4.3) 0 (0.0) 2.22 .330
    Married 19 (82.6) 22 (95.7)
    Bereaved 3 (13.0) 1 (4.3)
    Religion Yes 8 (34.7) 17 (73.9) 7.19 .066
    No 15 (65.2) 6 (26.1)
    Monthly income (10,000 won) 200 ＜ 200 ≥ 17 (73.9) 6 (26.1) 17 (73.9) 6 (26.1) 0.82 .846
    Experience Yes 18 (78.3) 16 (69.6) 0.45 .502
    No 5 (21.7) 7 (30.4)
    Pain killer Yes 15 (65.2) 12 (52.2) 0.81 .369
    No 8 (34.8) 11 (47.8)
    Number of pain killer (DemerolⓇ) No 1 8 (34.8) 9 (39.1) 11 (47.8) 7 (30.4) 4.22 .238
    2 ≥ 6 (26.0) 5 (21.7)
    Diagnosed (month) 12 ＜ 12 (52.1) 10 (43.4) 5.81 .121
    12 ≥ 11 (47.7) 13 (56.4)
    Experienced surgery (HCC) Yes 1 (4.3) 1 (4.3) 0.00 1.000
    No 23 (95.7) 23 (95.7)
    Low back pain   4.96±2.23 3.74±2.36 -1.80 .079
    Discomfort   1.83±0.30 1.54±0.21 -3.81 .001 ＜
    Bleeding Bleeding area 2.07±6.78 1.16±1.84 -0.62 .537
      Hematoma formation 0 (0.0) 0 (0.0) 0.00 1.000

    Exp.=experimental group; Cont.=control group; HCC=hepatocellular carcinoma.

    Comparison of Back Pain, Discomfort, Complication of Bleeding over the Time between the Groups (N=46)

    Variables Time Exp. (n=23) Con. (n=23) Comparison t or F p
    n (%) or M±SD n (%) or M±SD
    Back pain Pretest 4.96±2.23 3.74±2.36      
    Post 1 hrs 3.57±1.70 5.26±2.63 Group 13.18 <.001
    Post 2 hrs 2.65±1.64 5.65±2.64 Time 0.80 .498
    Post 4 hrs 2.00±1.54 6.09±2.65 Time×Group 43.51 <.001
    Discomfort Pretest 1.83±0.30 1.54±0.21      
    Post 1 hrs 1.63±0.32 1.73±0.34 Group 38.62 <.001
    Post 2 hrs 1.49±0.37 1.81±0.27 Time 6.54 .014
    Post 4 hrs 1.40±0.30 1.89±0.30 Time×Group 9.60 .003
    Bleeding area Post 4 hrs 0.10±0.25 0.12±0.17   0.32 .744
    Hematoma formation Post 4 hrs 0 (0.0) 0 (0.0)   0.00 1.000
        23 (100.0) 23 (100.0)      

    Pretest=two hours after supine.

    Post 1hr.=one hour after positional change; Post 2hr.=Two hour after positional change; Post 4hr.=Four hours after positional change.

    Exp.=experimental group; Con.=control group.
    Table 1. Homogeneity Test for General and Disease-related Characteristics, Dependent Variables at Pretest between Groups (N=46)

    Exp.=experimental group; Cont.=control group; HCC=hepatocellular carcinoma.

    Table 2. Comparison of Back Pain, Discomfort, Complication of Bleeding over the Time between the Groups (N=46)

    Pretest=two hours after supine.

    Post 1hr.=one hour after positional change; Post 2hr.=Two hour after positional change; Post 4hr.=Four hours after positional change.

    Exp.=experimental group; Con.=control group.

    Table 1.

    Table 2.

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