Determination Of Daily Life Activities And Anxiety Levels Of Primer And Recurrent Lumbar Disc Herniated Patients
Lumbar disc herniation (LDH) occurs with the displacement of the intervertebral disc and causes symptoms as low back pain, motor weakness and numbness (Luchtmann and Firsching, 2016). It also mostly affects patients’ daily activities negatively and causes difficulties amongphysical functionsdue to pain (Mancuso et al, 2015).In the literature,it was reported that the lifelong prevalence of low back pain varies between 11% and 84%, and LDHwas the first reason for referral to clinic with back pain (Korkut et al., 2015). For the treatment of lumbar disc hernia, conservative treatment is firstly preferred if the patient has only of back pain without any neurological deficits and if there is no pain relief after six weeks of this treatment, surgery becomes the essential treatment (Shin, 2014). It has been reported in the literature that the success of surgical procedures with appropriate indications and techniques can exceed 95% (Loupais et al, 1999).However, it has been also reported that complete recovery was not possible and a recurrent herniated lumbar disc could occurs after lumbar discectomy (Swartz and Trost, 2003; Wera et al, 2008). Because of the disability levels of patients and recurrence of the surgery, patients may have anxiety with high levels (Yeger et al, 2016; Shin, 2014). In order to help patients with their difficulties during daily activities and coping with their anxiety, it is important to explore therole of daily activities in predicting anxiety of patients with LDH.
Objectives: This study aimed to determine the daily life activities and anxiety levels of patients with primer and recurrent lumbar disc hernia.
Methods: This study was carried out in a descriptive study design between 11.04.2016-14.07.2017 on 149 voluntary patients with lumbar disc hernia at a research hospital in Edirne, Turkey. Ethical and institutional permissionswere taken before the study. For data collection, a questionnaire form was created by the researchers consists of socio-demographics and questions to determine the disease status of patients. Their anxiety status was evaluated with using the State-Trait Anxiety Inventory andhigher score showed the higher anxiety. Patients’ daily activity ability status wasevaluated with using the Daily Life Activities Index and higher score showed better daily life activity ability. Patients were informed about this study and after taking their verbal permission; forms were performed in almost 15-20 minutes. Inclusion criteria were; being on the preoperative period, hospitalized for a planned discectomy surgery for the first time or recurrent and beingcooperative.Frequency statistics, Mann-Whitney U and Spearman’s correlation tests were used for statistical analyses.Significance level was taken as 0.05.
Results: The mean age of patients was57.04±13.30 and 64.4% of them were female. It was found that 43.6% of them hadadiscectomy surgery at least once in the past and 65.1% had a conservative treatment before hospitalizing. The mean Daily Life Activities Indexscore of all patients was found 16.15±6.18 (min:10-max:30). Operated patients’ daily life activity abilities were better than non-operated patients and a significant difference was found between daily life activity scores of patients who had a surgery at least once in the past and who had no surgery (p<0.05).The mean State-Trait Anxiety Inventoryscore of all patients was found 39.44±10.64 (min:20-max:77). Anxiety score level of non-operated patients (40.03±11.44) were higher than patients who hada discectomy surgery at least once in the past (38.67±9.56), but any statistically significant difference were found between these groups (p>0.05). A moderate positive correlation was found between daily life activity levels and anxiety levels (r=0.303, p<0.001).
Conclusion: According to the results of this study, it was found that, having a surgery to recover from LDH had a positive affect on patients’ daily life activities. Patients who have a better daily life activity score had higher anxiety levels. This may show us that, they have the fear of losing their activity abilities so that this fear makes their anxiety higher. First time operation makes patients more anxiety. Patients with lumbar disc hernia may have negative perceptions of the surgical treatment and they may carry the fear of recurrence. This may cause their anxiety level to go up.It is recommended to inform patients about the good results of surgery before being operated to lower the anxiety level.
Keywords - Anxiety, daily life activity, lumbar disk hernia, patient care