Mira Dwi Lantasary, Yenny Puspitasari, Agusta Dian Ellina

The Effect of a Combination of 40°C Warm Compress and Handgrip Exercise on Spasm, Pain, and Anxiety in Patients Undergoing Percutaneous Coronary Intervention

Introduction

The effect of a combination of 40°c warm compress and handgrip exercise on spasm, pain, and anxiety in patients undergoing percutaneous coronary intervention. Discover how 40°C warm compresses & handgrip exercise effectively reduce spasm, pain, & anxiety while improving perfusion in PCI patients. A non-pharmacological nursing strategy for better comfort.

Abstract

Background: Percutaneous Coronary Intervention (PCI) is an invasive procedure that often causes spasm, pain, and anxiety in patients, which can affect comfort and the smoothness of the procedure. Non-pharmacological interventions such as warm compresses and handgrip exercise have the potential to improve perfusion and reduce discomfort during the procedure. Purpose: To determine the effect of a combination of a 40°C warm compress and handgrip exercise on reducing spasm, pain, and anxiety, as well as improving perfusion index in patients undergoing Percutaneous Coronary Intervention (PCI). Methods: This study used a quasi-experimental design with a control group. A total of 30 respondents were divided into two groups: 15 in the intervention group and 15 in the control group. The intervention group received a combination of a 40°C warm compress and handgrip exercise, while the control group received standard care. Data were collected using spasm observation sheets, a perfusion index measurement tool, pain scales, and anxiety questionnaires. Data analysis was performed using the Wilcoxon and Mann–Whitney tests. Results: The findings showed that the combination of warm compress and handgrip exercise significantly reduced spasm, pain, and anxiety (p= 0.001< 0.05), and significantly increased the perfusion index (p= 0.000 < 0.05) compared to the control group. Patients in the intervention group demonstrated better physiological and psychological responses during the procedure Conclusion: The combination of a 40°C warm compress and handgrip exercise is an effective non-pharmacological intervention to reduce spasm, pain, and anxiety, while improving perfusion in patients undergoing PCI. This intervention can be recommended as a supportive nursing strategy to enhance patient comfort and procedural outcomes.

Review

This study addresses a clinically important issue concerning patient discomfort during Percutaneous Coronary Intervention (PCI) by investigating a novel combination of a 40°C warm compress and handgrip exercise as a non-pharmacological intervention. The quasi-experimental design, involving 30 patients divided equally into intervention and control groups, aimed to assess the impact on spasm, pain, anxiety, and perfusion index. The findings reported a statistically significant reduction in spasm, pain, and anxiety, alongside a significant increase in the perfusion index within the intervention group, suggesting improved physiological and psychological responses. This supports the authors' conclusion that this combined approach is an effective strategy to enhance patient comfort and potentially procedural outcomes. While the study presents encouraging results for a simple, non-invasive intervention, several methodological aspects warrant closer consideration. The primary limitation, as indicated by the abstract, is the small sample size (N=30), which restricts the generalizability and statistical power of the findings. The quasi-experimental design, without explicit mention of randomization, may introduce potential biases or unmeasured confounding variables, diminishing the robustness of causality claims. Furthermore, details regarding the "standard care" provided to the control group are absent, making it difficult to fully contextualize the comparative benefits. More specific information on the duration and frequency of the warm compress and handgrip exercise, as well as the particular validated tools used for measuring spasm, pain, and anxiety (e.g., specific pain scales, anxiety questionnaires), would enhance the study's reproducibility and credibility. Despite these limitations, the study offers valuable preliminary data advocating for a practical and accessible nursing intervention. The positive outcomes across multiple patient comfort parameters and physiological markers suggest a promising direction for enhancing the patient experience during PCI. To build upon these findings, future research should prioritize conducting larger-scale, multi-center randomized controlled trials to validate the efficacy of this combined intervention across diverse populations and settings. Additionally, a more comprehensive reporting of methodologies, including detailed intervention protocols, specific outcome measures, and a thorough characterization of standard care, would strengthen the evidence base. Investigating the long-term impact on patient satisfaction and recovery, along with a cost-effectiveness analysis, would further cement its potential for widespread clinical adoption.

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