Progresif Gevşeme ve Derin Nefes Egzersizlerinin Cerrahi Bakımda Kullanımı
Özet
Progresif gevşeme egzersizleri ve derin nefes egzersizleri, cerrahi hastaların iyileşme süreçlerinde etkili geleneksel tamamlayıcı tedavi yöntemleridir. Bu teknikler, hastaların ağrı, anksiyete, stres ve uyku bozukluklarını yönetmelerine yardımcı olur. Progresif gevşeme egzersizleri, kasları sırasıyla gerip gevşeterek rahatlama sağlarken, derin nefes egzersizleri parasempatik sinir sistemini uyararak stresin azaltılmasına katkı yapar. Literatür, bu egzersizlerin cerrahi hastalarda anksiyete ve ağrı algısını azalttığını, uyku kalitesini iyileştirdiğini ve genel iyileşmeyi hızlandırdığını göstermektedir. Bu yöntemler, hemşireler tarafından kolayca uygulanabilen, düşük maliyetli ve invaziv olmayan tekniklerdir. Hemşirelerin bu egzersizleri doğru bir şekilde hastalarına öğretmeleri, tedavi sürecine bütünsel bir yaklaşım getirir. Ancak, etkili kullanım için hemşirelerin uygun eğitim alması ve hastaların bireysel ihtiyaçlarına göre egzersizleri uyarlamaları önemlidir. Sonuç olarak, progresif gevşeme ve derin nefes egzersizleri, cerrahi bakımda hasta konforunu artıran ve tedaviye katkı sağlayan tamamlayıcı bir tedavidir.
Progressive relaxation exercises and deep breathing exercises are effective traditional complementary therapies used in the recovery process of surgical patients. These techniques help manage pain, anxiety, stress, and sleep disturbances. Progressive relaxation exercises promotes relaxation by systematically contracting and relaxing muscles, while deep breathing exercises stimulate the parasympathetic nervous system, contributing to stress reduction. Literature shows that these exercises reduce anxiety and pain perception, improve sleep quality, and accelerate overall recovery in surgical patients. These methods are low-cost, non-invasive techniques that can be easily applied by nurses. Nurses teaching these exercises correctly can provide a holistic approach to the treatment process. However, effective use requires nurses to receive appropriate training and to adapt exercises based on individual patient needs. In conclusion, progressive relaxation and deep breathing exercises are complementary therapies in surgical care that enhance patient comfort and contribute to treatment outcomes.
Referanslar
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Referanslar
Hewitt DB, Tsung A, Ejaz A. Patient safety and efficacy within a surgical innovation framework. Laparoscopic Surgery. 2022;6:35. doi: 10.21037/ls-22-36
Chou R, Gordon DB, de Leon-Casasola OA, et al. Management of postoperative pain: A clinical practice guideline from the American pain society, the American Society of Regional Anesthesia and Pain Medicine, and the American Society of Anesthesiologists' committee on regional anesthesia, executive committee, and administrative council. The Journal of Pain. 2016;17(2):131-157. doi:10.1016/j.jpain.2015.12.008
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The National Center for Complementary and Integrative Health (NCCIH). Complementary, alternative, or integrative health: what’s in a name? Available from: https://www.nccih.nih.gov/health/complementary-alternative-or-integrative-health-whats-in-a-name (Accessed 2nd April 2025).
Archana JT, Ankita S, Gopichandran L, et al. Effect of progressive muscle relaxation on sleep quality and fatigue among post valvular heart surgery patients. Journal of Perioperative & Critical Intensive Care Nursing. 2021;7(1):1-8. doi:10.35248/24719870.21.7.162
Hamasaki H. Effects of diaphragmatic breathing on health: A narrative review. Medicines. 2020;7(10):65. doi:10.3390/medicines7100065
Ju W, Ren L, Chen J, et al. Efficacy of relaxation therapy as an effective nursing intervention for post-operative pain relief in patients undergoing abdominal surgery: A systematic review and meta-analysis. Experimental and Therapeutic Medicine. 2019;18(4):2909-2916. doi: 10.3892/etm.2019.7915
Jarrah MI, Hweidi IM, Al-Dolat SA, et al. The effect of slow deep breathing relaxation exercise on pain levels during and post chest tube removal after coronary artery bypass graft surgery. International Journal of Nursing Sciences. 2022;9(2):155-161. doi: 10.1016/j.ijnss.2022.03.001
Norelli SK, Long A, Krepps JM. Relaxation techniques. StatPearls; 2003. Available from: https://www.ncbi.nlm.nih.gov/books/NBK513238/ (Accessed 2nd April 2025).
Kapucu S, Yılmaz Kütmeç C. Kronik hastalıklarda progresif gevşeme egzersizlerinin yararı. Göbeklitepe Journal of Medical Sciences. 2018;32(2):111-114.
Bee SM, Pestka EL, Evans MM. Relaxation therapies. In: Lindquist R, Tracy MF, Snyder M (eds.) Complementary and alternative therapies in nursing. New York: Springer Publishing Company; 2018. p.275-286.
Cooke H. Progressive muscle relaxation. CAM–Cancer Consortium. 2015;1(1):1-6.
McCallie MS, Blum CM, Hood CJ. Progressive muscle relaxation. Journal of Human Behavior in the Social Environment. 2006;13(3):51-66.
Sengupta P. Health impacts of yoga and pranayama: A state-of-the-art review International Journal of Preventive Medicine. 2012;3(7):444-458.
Jerath R, Edry JW, Barnes VA, et al. Physiology of long pranayamic breathing: Neural respiratory elements may provide a mechanism that explains how slow deep breathing shifts the autonomic nervous system. Medical Hypotheses. 2006;67(3):566-571. doi: 10.1016/j.mehy.2006.02.042
Martarelli D, Cocchioni M, Scuri S, et al. Diaphragmatic breathing reduces exercise-induced oxidative stress. Evidence-Based Complementary and Alternative Medicine. 2011;2011:932430. doi: 10.1093/ecam/nep169
Zaccaro A, Piarulli A, Laurino M, et al. How breath-control can change your life: A systematic review on psycho-physiological correlates of slow breathing. Frontiers in Human Neuroscience. 2018;12:353. doi: 10.3389/fnhum.2018.00353
Özhanlı Y, Ayoğlu T. Progresif gevşeme egzersizleri. Özbaş A, Güneş A (edt.) Ağrı yönetiminde ilaç dışı uygulamalar içinde. İstanbul: İstanbul Tıp Kitabevi; 2022. p.229-241.
Cleveland Clinic. Diaphragmatic breathing. Available from: https://my.clevelandclinic.org/health/articles/9445-diaphragmatic-breathing (Accessed 16th April 2025).
Harvard Health Publishing. Learning diaphragmatic breathing. Harvard Medical School. Available from: https://www.health.harvard.edu/healthbeat/learning-diaphragmatic-breathing (Accessed 16th April 2025).
Physiopedia. Diaphragmatic breathing exercises. Available from: https://www.physiopedia.com/Diaphragmatic_Breathing_Exercises (Accessed 16th April 2025).
İskit N. Yoga, yoga terapi, nefes egzersizleri ve gevşeme teknikleri. Turkiye Klinikleri Traditional and Complementary Medicine Special Topics. 2024;5(1):14–20.
Demirsoy N. Gevşeme egzersizleri. Durmaz B (ed) Tedavi Edici Egzersizler içinde. Ankara: Türkiye Klinikleri; 2019. p. 40-46.
Yilmaz M, Bulut Y. The effect of progressive breathing relaxation training on preoperative anxiety and surgical stress response. International Journal of Caring Science. 2020;13(2):1287–1296.
Toussaint L, Nguyen QA, Roettger C, et al. Effectiveness of progressive muscle relaxation, deep breathing, and guided imagery in promoting psychological and physiological states of relaxation. Evidence-Based Complementary and Alternative Medicine. 2021;2021:5924040. doi: 10.1155/2021/5924040
Doan LV, Blitz J. Preoperative assessment and management of patients with pain and anxiety disorders. Current Anesthesiology Reports. 2020;10:28-34. doi: 10.1007/s40140-020-00367-9
Ng SX, Wang W, Shen Q, et al. The effectiveness of preoperative education interventions on improving perioperative outcomes of adult patients undergoing cardiac surgery: A systematic review and meta-analysis. European Journal of Cardiovascular Nursing. 2022;21(6):521-536. doi: 10.1093/eurjcn/zvab123
Abate SM, Chekol YA, Basu B. Global prevalence and determinants of preoperative anxiety among surgical patients: A systematic review and meta-analysis. International Journal of Surgery Open. 2020;25:6-16. doi: 10.1016/j.ijso.2020.05.010
Mulki MMM, Ta’adi TA, Sunarjo L. Effectiveness of deep breath relaxation techniques and music therapy on reducing anxiety level among preoperative patients. International Journal of Nursing Health Services. 2021;4(1):59-65. doi: 10.35654/ijnhs.v4i1.389
Shebl MA, Toraih E, Shebl M, et al. Preoperative anxiety and its impact on surgical outcomes: A systematic review and meta-analysis. Journal of Clinical and Translational Science. 2025;9: e33:1–10. doi: 10.1017/cts.2025.6
Ni K, Zhu J, Ma Z. Preoperative anxiety and postoperative adverse events: A narrative overview. Anesthesiology and Perioperative Science. 2023;1(3):23. doi:10.1007/s44254-023-00019-1
Gu X, Zhang Y, Wei W, et al. Effects of preoperative anxiety on postoperative outcomes and sleep quality in patients undergoing laparoscopic gynecological surgery. Journal of Clinical Medicine. 2023 Feb 24;12(5):1835. doi: 10.3390/jcm12051835
Kassahun WT, Mehdorn M, Wagner TC, et al. The effect of preoperative patient-reported anxiety on morbidity and mortality outcomes in patients undergoing major general surgery. Science Report. 2022;12(1):6312. doi: 10.1038/s41598-022-10302-z
Felix MMDS, Ferreira MBG, Oliveira LFD, et al. Guided imagery relaxation therapy on preoperative anxiety: A randomized clinical trial. Revista Latino-americana de Enfermagem. 2018;26:e3101. doi: 10.1590/1518-8345.2850.3101
Hasanpour-Dehkordi A, Solati K, Tali SS, et al. Effect of progressive muscle relaxation with analgesic on anxiety status and pain in surgical patients. British Journal of Nursing. 2019;28(3):174-178. doi: 10.12968/bjon.2019.28.3.17
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