Effect of Deep Breathing Exercises versus Incentive Spirometry on Pulmonary Complications among Geriatric Patients Undergoing Upper Abdominal Surgery

: Major gastric surgeries are among the most widespread operations in older adults’ patients reached growing rates of postoperative mortality and morbidity. The surgical opening is often approaching the diaphragm with a serious consequence of pulmonary complications which presented with miscellaneous atypical presentations making both diagnosis and management a challenge. The prudent use of therapeutic lung expansion guides like incentive spirometry and deep breathing exercises become imperative to increase lung volume and prevent such life-threatening complications. Here comes the responsibility of gerontological nurses toward facilitating the use of these modalities and factors that decrease geriatric patients’ awareness and hinder their education. Aim: The aim of the current study is to compare the effect of deep breathing exercises versus incentive spirometer on pulmonary complications among geriatric patients undergoing upper abdominal surgeries. Methods: Setting: This study was conducted at two surgical units affiliated to General Alexandria Main University Hospital, Egypt; specialized in upper abdominal surgeries. Subjects: A total of 60 male and female older adults hospitalized to undergo upper gastric surgeries, selected using the consecutive sampling technique, and divided into three groups: two experimental groups (interventional group) and one control group (routine hospital care). Data were collected through five tools: Mini Mental State Examination, Socio-demographic and health profile of the geriatric patients structured interview schedule, Katz activities of daily living scale (six activities of daily living according to three levels of dependency; fully independent, partially dependent, and totally dependent), ARISCAT Risk index (7-independent risk factors), and Melbourne Group Scale (MBG, 8-item checklist). Results: Lung expansion manipulations had statistical significant reduction on the outcrop of pulmonary complications following upper gastric surgeries in geriatric patients, as only 6.7% of those target patients in the study groups presented with these complications on the 6th postoperative day, compared to 60% of their counterparts in the control group. Conclusion: Application of either deep breathing exercises or incentive spirometer proved to be equally influential in diminishing the incidence of pulmonary complications denoting the period following upper gastric surgical operation for elderly subjects. The postoperative pulmonary complications for elderly who underwent these serious surgeries in the deep breathing exercise or incentive spirometer group proved to be lower than those in the matching group with a statistically significant difference between the groups. Recommendations: The pursuit of deep breathing exercises and/or use of incentive spirometer should be established as a routine interventional measure for older adult's patients undergo upper gastric surgeries in clinical settings. Developing of educational classes, posters, or brochures related to importance and steps of lung expansion modalities for both geriatric patients and gerontological nurses should be launched and stepped in the pre and post-operative period.