The Effect of Hand Massage on Pain, Anxiety, Fear and Nausea After Surgery in Children

This study was conducted to determine the effect of hand massage on postoperative anxiety, pain, fear, and nausea and vomiting after pediatric surgery. This is a randomized, controlled experimental study. The sample consisted of 107 sick children who underwent ingunial hernia surgery (control: 55; experimental: 52). Hand massage was applied to the sick children in the experimental group the day before the surgery, on the morning of the surgery and after the surgery.

Due to various diseases throughout their developmental period, children find themselves in an environment where painful procedures are performed that they have not experienced before, and they remain in the hospital due to their illnesses. Surgical procedures constitute a portion of children's hospitalizations. Being exposed to unknown tools and physically painful procedures, being away from the family, and being in a foreign environment are situations that cause the child and family to experience anxiety. Children's anxieties about illness and hospital cause negative consequences such as prolonged recovery time and increased need for pain and sedative medication. Children's fears and anxieties about injuries and medical procedures reduce compliance with the treatment process and cause treatment to be delayed or postponed. Excessive anxiety hinders children's effectiveness in coping with medical treatment and increases uncooperative behavior and negative emotions toward healthcare professionals. Anxiety and pain are considered two common problems experienced by children before and after surgery. Pain causes changes in the brain and makes future pain worse. It slows healing, impairs treatment, and causes medical problems. Untreated pain causes anxiety, depression, irritability, and fatigue. Pain is a common consequence of surgery worldwide, and unrelieved or poorly managed pain is a burden on the child, the healthcare system and society.

Many patients described nausea and vomiting as the most unpleasant surgery-related experience they had in the postoperative period, even more than pain. In particular, prolonged hospital stay leads to re-admission and therefore increased treatment costs. At the same time, it causes the time allocated for nursing care to be prolonged, causing negative reflections on work-time management and therefore on the quality of patient care. Therefore, early detection and prevention of postoperative nausea and vomiting is very important for the satisfaction of the child and family and the quality of care.

In the literature, many non-pharmacological applications such as letting sick children listen to music, virtual reality glasses, and games after surgery have been performed and their effects on parameters such as pain, nausea-vomiting, and anxiety have been examined. Although there are studies examining the relationship between postoperative hand massage and anxiety, pain, fear and nausea in children, they are limited. Therefore, the aim of this study is to determine the effect of hand massage on anxiety, pain, fear and nausea and vomiting in children who have ingunial hernia surgery and are hospitalized in the pediatric surgery clinic.

Eligibility Criteria:
Inclusion Criteria:

* Are between the ages of 7-12,
* Pediatric patients who are scheduled for ingunial hernia surgery,
* Volunteers to participate in the research,
* Those whose families agree to participate in the research
* No communication problems (vision, hearing, mental),
* For patients in the experimental group; All patients who did not have an infectious disease on the hand skin (shingles, fungus, eczema, warts, calluses), local infection (abscess, etc.), open lesion/wound, scar tissue, edema, hematoma, recent fracture or dislocation were included in the sample.

Exclusion Criteria:

* Being outside the 7-12 age range,
* Pediatric patients for whom ingunial hernia surgery is not planned,
* Those who do not volunteer to participate in the research,
* The family does not agree to participate in the research
* Having communication problems
* For patients in the experimental group, patients with infectious diseases, lesions, open wounds, hematomas, fractures-dislocations on the skin of the hands were not included in the study.