RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES,

KARNATAKA, BANGALORE

SYNOPSIS PROFORMA FOR REGISTRATION OF SUBJECTS

FOR DISSERTATION

MS.JAYASHRI.J.JAVALI
FIRST YEAR M.Sc NURSING
OBSTETRICS AND GYNECOLOGICAL NURSING
2011-2013

V.S.S COLLEGE OF NURSING No78, NAGADEVANAHALLI,

MYSORE RING ROAD,
BANGALORE

1
RAJIV GANDHI UNVERSITY OF HEALTH SCIENCES
KARNATAKA, BENGALURU

PROFORMA FOR REGISTRATION OF SUBJECT FOR SYNOPSIS

1.Name of the Ms. Jayashri.J.Javali

Candidate 1st Year M.Sc Nursing
V.S.S College of Nursing,
And Address
Nagadevanahalli, Kengeri
Bengaluru-560056
Karnataka.

2.Name of the V.S.S College of Nursing,

Institution Nagadevanahalli, Kengeri
Bengaluru -560056
Karnataka.

First Year M.Sc Nursing

3.Course of Study
Obstetrics And Gynecological
and Subject Nursing.

4. Date of
Admission 26/05/2011
Of the course

“A study to assess the effectiveness of

5. Topic of the early ambulation and post operative
Study
recovery among the women has
undergone abdominal hysterectomy in
selected hospital in Bangalore.”

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6. BACKGROUND OF THE STUDY

6.1 INTRODUCTION:
Early ambulation is procedure characterized by a shorter period of
hospitalization or recumbency or by more rapid of mobilization than the normal
practice in the presence of guider or nursing staff or physiotherapist.1

After any surgical interruption or loss of independent mobility can have a

wide ranging effect on all aspects of person’s life. As nurse, researcher or as
therapist a knowledge of methods ,helps available to maintain and/or increase a
persons level of mobility is essential part of being able to help restore him to high
as functional level as is practicable .2

One of the major purposes of the early ambulation process is to help

patients to achieve as high a level of functional independence as possible within
the limit of their particular impairments. Human ambulation or gait is one of the
basic components of independent functional, commonaly affected by either
disease process, injury or by surgery. The desired outcome of most physical
therapy interventions is to either restore or to improve a patient’s ambulatory
status.3

The 1st or 2nd days of minimal movements and gentle turning .Patients
will advised to under go slow mobilization within there limit and depending on
the surgical interventions as well as patient state. Early ambulation arise from the
fact that ,tissue recovery as well as returning of normal day to day functions
would depend on the movements that takes place at the phase of post operative
recovery .Thus knowing what benefits will bring would be useful in being
motivated to do so even with significant of discomfort of this time.4

 Early movements prevent deep vein thrombosis.

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 The mobilization will helps the bowels to move and the gasses to expelled,
thus eliminating the discomfort of abdominal distention, constipation as well as it
improves appetite.
 Early ambulation prevents joint stiffness and contractures.

 Mobilizations paramount important that surgical patients build up their

mental state in order to tackle the slow recovery and gaining functional normalcy.
Thus early ambulation should support a mental stability and early surgical
recovery.4

6.2 THE NEED FOR THE STUDY:

Early ambulation of the patients as soon as possible after surgery is
thought to reduce many complications. The physiotherapy can be categorized as
an important mechanical method. The other mechanical method of prophylaxes
act on the same principle as early mobilization in that they stimulate calf muscles
and put pressure on calf and leg veins, thus discouraging stasis and pooling of
blood in the lower extremities .This intermittent pneumatic leg compression
enhances blood flow in deep veins of extrimites. This method is virtually free of
side effects.5

Early ambulation after abdominal hysterectomy or any other abdominal

surgery has been encourage to prevent complications such as Pneumonia,
pulmonary embolism,atelectasis, deep vein thrombosis ,bladder dysfunctions and
other morbidity related complications ,along with nosocomial infections. Early
ambulation increases ventilation and reduces bronchial secretions in the lungs.6

One of the researcher ‘BUSCJH.E.FISHER AIII’suggested that unless

there were specific contraindications such as shock, extremity disability ,severe
generalized peitonites,heavey bleeding or aninseure wound,ostioporosis and
psychosis cases were mobilized on the 1 st post operative day. The procedure was
generally linked and accepted by all classes of patient’s functional general point
of view .It was obvious that the moral of these patients was excellent and effect of

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this on the pre operative cases was to patients become pretty well able to look
after themselves.7

FACT SHEET – HYSTERECTOMY IN US (2000-04)

In US approximately 600000 hysterectomies are performed each year
procedure is the second most frequently performed major surgical procedure
among reproductive aged women from 2000-2004 on estimated 3.1 million US.
The hysterectomy rate decreased slightly from 5.4/1000 in 2000 to 5.1/1000 in
2004 .The rate of hysterectomy differed from age .Overall rates were highest
among women aged 42-44years and lowest among women aged 50-54years.It is
decreased slightly over the period from 8.9/1000in 2000 and 6.9/1000 in 2004.It
differed by geographic region. The overall rates during study period was highest
from women living in south (6.3/1000) and the lowest for those in North
(4.3/1000).During 2000-2004 the three conditions often associated with
hysterectomy were uterine leimyoma (Fibroid uterus), Endometriosis and Uterine
prolepses.8

COMMUNITY BASED SURVEY:

Women’s organization that operated on community based survey. The
women’s of rural 9.8% of rural women and 5.3% of urban had under gone
hysterectomy compared to rural and urban respectely.Aproximately 1/3rd of all
hysterectomy were in women younger than 35years of age.

In India study on hysterectomy till the last decade have focused per yearly
on clinical out comes with limited analysis of precedence of hysterectomies and
its public health implications, 6-9 in 2008.Study in Haryan is one of the wealthier
study Singh and Aurora to found that 70 women’s in rural sample of 1000 women
had undergone hysterectomy, primarily for heavy menstrual bleeding.
Proximately half (46%) of women underwent hysterectomy reported some of later
complications such as excessive bleeding, fever and pain.9

Recent research in Andhra Pradesh suggests must higher rate of hysterectomy

than in Haryana and in relatively in younger women.2010 study in rural
population found that 45% of 3452 women are reproductive age surveyed had

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already undergone the previously at a median age of 24 years because of acute
pelvic inflammatory diseases, uterine prolapse,UTI and Uterine bleeding.9

6.3 REVIEW OF LITERATURE:

Literature review is standard requisition of scientific research. Reading
and writing the pertinent information of the attempt in research topic. It also
support and explained the resin for the propose topic of research and Avoids
unnecessary duplication explore the feasibility and illuminate the way of New
researcher.

The reviews of literatures are organized as follows.

1. Studies related to early ambulation of postoperative abdominal surgeries.
2. The studies related to postoperative abdominal hysterectomy.

1. THE REVIEWS RELATED TO EARLY AMBULATION AFTER POST

OPERATIVEABDOMINAL SURGERY:

1. DR.MOHANRAJU et.al (2003)

A descriptive study done in GGSM(Gopal gouda santhavary
memorial)Hospital Mysore to assess satisfaction regarding post operative nursing
care among patients undergone abdominal surgeries. The size is 80 patients,
convenient sample technique. The tool used was structural interview
questionnaires schedule comprised of two sections, part 1 consists of background
factors 2,interview schedule on patients level satisfaction .The max.score was 84
and the minor score was 0.The reliability was valued by 5 experts. The was tested
using Karl Person’s method and correlation ,coefficient was r=0.56.The collected
openian were analyzed by using descriptive and inferential statistics.Frequence
and distribution was assess the level of satisfaction regarding nursing care Chi
square test was used to satisfaction and background factors . The study concluded
that satisfaction regarding aspects of post operative nursing care and early
ambulation among patients undergone abdominal surgeries were satisfied on
physiological care.10

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2. ROCHEL (2001)
A descriptive study was conducted in Holy Cross Hospital, Kerala. The
sample was 30 viewed through purposive sampling technique. The tool was
structured interview was made half an hour before the surgery and observation
schedule 6 hrs after surgery. The reliability co-efficient was found to be 0.82. the
statistical analysis included both descriptive and inferential statistics. Frequency
and percentage distribution to assess pre operative, post operative Nursing care.
Chi square used find out the association between level of care and demographic
variables Carl Pearson correlation co-efficient used to find out the relationship
between pre operative care, and post operative complications. The study
concluded and suggested that the nursing care provided to abdominal surgery
patients is adequate in area like need for safety has to be improved. Explanation to
fly members also has to be improved.11

3. E.WILLIAMSON ETC (2003)

A descriptive study was conducted in H.Leemuffitt cancer centre. This
study has been conducted to determine risk of developing a pulmonary embolism
in patients having major abdominal surgery subgroups pre and post operative
cancer and benign subgroups. The method of sample collected was randomized
technique. The total samples of 1374 patients in that 4.4% were diagnosed with
pulmonary embolism. The difference between those with and without cancer
patients was determined. The significant P value is P=0.0006. Finally this study
concluded by determining the rate of post operative pulmonary embolism patients
with cancer who have undergone abdominal surgeries to be 4.4%. This rate
persisted despite vigorous use of SCD’s early ambulation in patients.12

4. GURU NANAK, NIRMAL KAUR (2007)

A Quasi experimental study conducted in Guru Nank medical and
education trust, (Punjab-India). The sample was 30 convenient sampling
technique 15 each experimental and control respectively. The result findings were
non-significant differences of post test performances score between two groups. P
value is P<.001. The effective media to this study was extremely effective media

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to increase level of performance and enhance the early recovery of the patients by
using some of exercises and early mobilization of patients after surgery.13

5. BEERSHEVA ISRAEL (1999-2000)

This experimental was conducted in Soroka medical centre diagnostic
heart catheterization. Early ambulation was performed in 74 patients and
conventional Ambulation was implemented in 24 patients. The main reason for
deferring patients from early ambulation were oozing upon complications of 10
minutes of manual Compression (n=19) difficulties obtained arterial access (n=4)
and hemetoma at the thin of the sheath removal (n=1). The results were assessed
at the time of initial ambulation prior to patients hospital discharge and at one
week follow up, pre discharge assessment was performed 30 and 90 minutes after
ambulation in the Conventional and early ambulation groups respectively. The
extended time for ambulation to discharge in the early ambulation group was
calculated to allow in hospital assessment of bleeding complications at 3, 5, 4, 0,
has after sheath removal.The statistical analysis shows that continuous variables
where analyzed by using student t-test and presented as means positive standard
deviation, and variables expressed as percentage. P value is <0.05. Finally the
study concluded and suggested that early ambulation is feasible and safe in out
patients selected by simple bed side clinical assessment.14

6. In ALFRED HOSPITAL MELBOURNE (2006)

The level 3 evidence based guidelines recommend,1st walk after hip
fracture surgery within 48hrs.Randamised method technique used ,sample of 60
patients,41women and 19 within mean age of 79year.Randamization was either
early ambulation(EA) 1st walk in 1st and 2nd POD or delayed ambulation(DA) after
1st walk an 3rd or 4th POD. Functional level on day7 post surgery, the length of day
and destination at discharge were compered.The result at 1 st week post surgery
patient in the EA group walked further than those in the DA group (p=0.03) and
required less assistance to transfer (P=0.009) and negotiate a sleep (P=0.23)
patients in the EA group were more likely to discharged directly home from act
care than those in DA group and less likely to need high level care. A failed EA
subgroup had significantly more post operative cardiovascular instability and
worse result for all out come measures. And final conclusion was EA after hip
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fracture surgery accelerates functional recovery and associated with more
discharge.15

2. THE STUDIES RELATED TO EARLY AMBULATION AFTER

ABDOMINAL HYSTERECTOMY:

1. RATNA RANGTONGGUL et.al (2005)

A descriptive study conducted in Sringarind Hospital. The study objective to
determine the incidence and magnitude of pain during tee 2 nd post operative day
after abdominal hysterectomy using interviewing method with the background
to encourage the patients to ambulate after 24 hours of surgery. The outcome is
pain and suffering score were evaluated both rest and ambulated patient using
rating scale 0-10 scores. >5 moderate to severe 45 samples. In 2 nd post operative
day after hysterectomy 63% of woman had moderate to severe pain and 67% of
woman were suffer while ambulating. 28% reported oral acetaminophen produces
modest pain relief. The study concluded early mobilized patients are having less
pain and recovery soon as compaired to immobilize patients.16

2. Dr. SUSAN.M.COHEN et. (2011)

A descriptive study was conducted in metropolitan area in US. The study
conducted on hysterectomy patients to describe participants’ response on anxiety
expression hostility and self esteem. The sample included 65 woman aged 23-
70years y randomized sampling techqnic. The study significantly different
negative impact occurring at 1wk and least negative impact at 1year post surgery
F=4.0 and P=0.01. The avoidance subscale was not significantly different across
time. The result has proved that advance in health care have improved morbidity
statistics for patients under gone hysterectomy improved surgical technique by
use of early ambulation. It contributes the reduction of stress and other
complications such as bladder dysfunction and morbidity associated
complications.17

3. IN US(2009)

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 A descriptive study was conducted in Mishra hardy and Kuhn in US. The
sample of 65 women aged 23-70 years those undergone hysterectomy. The study
established tool is to describe participants’ response on anxiety, depression,
hostility, self esteem, sexual functions. Background advanced in health care has
improved morbidity Statistics for patients undergoing hysterectomy and this study
concluded that improved surgical recovery prophylactic antibiotics and early
ambulation have contributed to reduction of complications and to decrease the
morbidity associated diseases. The fatal impact of this study was significantly
different across the time with greatest negative impact occurring at 1 wk and least
negative impact on 1 year post surgery F=4 and p=0.01 and 1 year post
hysterectomy cases F=6.7,P=0.001.18

4. P.D.WILLIAMS, D.M.VALDERRAMA Etc (2008)

An experirimental study conducted in J, Hills Miller Health Centre,
College of Nursing University of Florida. USA. The study object is to determine
on the effect of preparation for masterectomy / hysterectomy on women’s self
care behaviors during immediate post operative period. The sample of 60
women’s. 30 masterectomy and 30 hysterectomies in experimental group and
control group respectively. The independent variables are observed by nurse. The
patient in the group given pre operative instructions performed at significantly
higher level they required neither prompting nor assistance in initiation and
completion of ambulation tasks compare to uninstructed group. Most patients in
uninstructed group did not initiate their tasks despite prompting and physical
assistance by nurse. This is presented at Sigmatheta.Tau international scientific
session. Finally the study concluded that the group applied early ambulation and
excercise in 1st Post Operative Day where initiate their task and early self care,
recovery and discharge compare to uninstructed group.19

PROBLEM STATEMENT:

“A study to assess the effectiveness of early ambulation and post operative

recovery among the women has undergone abdominal hysterectomy in selected
hospital in Bangalore.”

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 6.4 OBJECTIVES:
1. To assess the effectiveness of early ambulation and post operative recovery
among the women undergo abdominal hysterectomy in experimental group and
control group.
2. To associate the effectiveness of early ambulation and post operative recovery
with selected demographical variable among Experimental group and control
group.

6.5 OPERATIONAL DEFINATIONS:

 ASSESS: It refers to an set or to determine the amount or estimate
the value of early ambulation and post operative recovery in patients undergone
abdominal hysterectomy.
 EFFECTIVENESS: It refers to significant increase in the recovery
and activities of daily living, measured from the response of pretest, interventions
and posttest.
 EARLY AMBULATION: It refers to the procedure to accelerate the
ability of the post operated patients to walk or move in a shorter period of
hospitalization in assistance of guider as per doctors’ order.
 HYSTERECTOMY: Hysterectomy is one of the surgical procedure
of removal of whole uterus or a part of it.
 POST OPERATIVE RECOVERY: Refers to restorations of patients
who undergone abdominal hysterectomy surgery, to their normal or near to
normal condition. The post operative recovery has measured in terms of activity
of daily living, functional activities and sense of well being .The activies of daily
living ,functional restorations and sense of well being were defined as followes.

a) Sense of well being scores: Refers to sense of well being of patients who
undergone abdominal hysterectomy surgery as measured by the items in the
interview guides. The sense of recovery ,confidence while walking, improve pain
reduction,sleeping,length of walking and urine flow control etc.

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b)Functional activity scores check after 16hr, 36hr 48hr 72: Refers to
restorations of physiological condition of those patients who undergone
abdominal hysterectomy surgery as measured in terms of observation schedule.
The functional activity included ambulation ,respiratory sounds,obseravation of
bowel sounds ,ability for elimination ,ability to feed and intake of analgesics.

c)Daily activity scores: It refers to restorations of certain actives of patients

undergone abdominal hysterectomy surgery is measured by observational
schedule .The activities of daily living ,includes the care of personal needs of the
patients regarding oral hygiene ,nutritional needs, elimination needs, combing,
dressing and bathing.

6.5 ASSUMPTIONS:
1. The tool would be efficient and represent to comb act the measure
effectiveness of early ambulation and post operative recovery.
2. The patient would co-operative with the researcher and would be willing to
participate effectively in nursing care while mobilization.

6.6 HYPOTHESIS:
H1: There will be a significant difference in the activities of daily living scores in
Relation to early ambulation and post operative recovery among patients
undergone abdominal Hysterectomy surgery in experimental group and control
group.
H2: There will be a significant difference in the functional activity scores in
Relation to early ambulation and post operative recovery among patients
undergone abdominal Hysterectomy surgery in experimental group and control
group
H3: There will be a significant difference in the sense of well being scores in
Relation to early ambulation and post operative recovery among patients
undergone abdominal Hysterectomy surgery in experimental group and control
group

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H4: There will significant difference among selected demographical variable and
actives of daily living scores in relation to early ambulation and post operative
recovery among patients undergone abdominal hysterectomy in Experimental
group .
H5: There will be significant difference among selected variables and functional
activity scores in relation to early ambulation and post-operative recovery among
the patients who had undergone abdominal hysterectomy in experimental group.
H6:There will be significant difference among selected variables and sense of
well being scores in relation to early ambulation and post operative recovery
among patients undergone abdominal hysterectomy in experimental group.

7. MATERIALS AND METHODS OF STUDY:

A) Interview guide- sense of well being.
B) observation schedule to check the activities of daily living and functional

7.1.1 REARCH DESIGN:

Quasi Experiment: Non equivalent control group Time series study.
o1 o2o3o4 x o1I o2I o3I o4 I
7.1.2 SETTING:
The Study is conducted in post operative words of Gynecology in selected
hospital in Bangalore.
7.1.3 VERIABLES:
1.Independent Variable - Early ambulation.
2.Dependent Variable - Post operative recovery
* Activities of daily living
* Physiological- functional well being
* Psychological- sense of well being
3. Demographic variable: age, education, socioeconomic status, source of
knowledge, Exercises, Health variable: type of incision, anesthesia, intake of
analgesics.

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7.1.4 POPULATION:
The target population of this study consists of all patients’ undergone
abdominal hysterectomy in selected hospital in Bangalore.

7.2 METHODS OF DATA COLLECTION:

7.2.1 SAMPLE SIZE:The total sample size for the study is 40, out of 20 patients
are in experimental group and 20 are in control group.
7.2.2 SAMPLE TECHNIQUE:
Convenient sampling technique.

7.2.3 CRITERIA FOR SAMPLE SELECTION:

a)INCLUSIVE CRITERIA:
This study includes,
1. Patient’s with age group of 35-70 Years.
2. Patient’s who are available in government hospital at the time of data
collection.
3. Patient’s who has completed 24 hours of surgery.
4. Patient’s who are willing to participate in the study.
5. Patient’s who understand the verbal communication.
6. Patient’s who undergone first time abdominal surgery .

b) EXCLUSIVE CRITERIA:
1. Patient’s who are unconscious, having surgical complications and
Contraindicated to early
Ambulation.
2. Patient’s who are operated at emergency conditions.
3. Patient’s who are not willing to participate and who are unable to
understand the verbal Language.
4. Patient’s who have doctors order for strict bed rest.
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7.2.4 TOOL FOR DATA COLLECTION:
Section1:Demographic and Health Variables.
Section2: Information regarding Surgery.
Section3: Observation schedule on restoration of activities of daily leaving and

Functional activities.

7.2.5 PLAN FOR DATA ANALYSIS:

The collected data was edited, compiled and analyzed by using descriptive and

inferential statistical analysis.

* DESCRIPTIVE STATISTICS: Mean, median, mode, standard deviation,

Frequency and percentage distribution will be calculated on this study.
* INFERENTIAL STATISTICS: Chi-square test will be used to test the Association
between early ambulation and variables are analyzed by using
‘t’ test, F-ratio.

7.3 DOES THE STUDY REQIRE ANY INVESTIGATION TO BE

CONDECTED ON THE PATIENT OR OTHER HUMAN OR ANIMALS?
IF SO PLEASE DESCRIBE.
No.
7.4 HAS ETHICAL CLEARENCE BEEN OBTAINED FROM YOUR
INSTITUTION?
Yes, the written permission has been obtained from the authorities of
selected hospital prior to the conduct of the study. Written consent will be taken
from the samples prior to the conduct of study.

15
8. BIBLIOGRAPHY:

1.The American journal of surgery related early ambulation; volume 78 Elnest.

2.Occupatioal Therapy and Physical Dysfunction Principal skills and

practice.edition by Anna lurner.Margrate farster .Sybil,Johnson.Page no.225-226.

3.Physical rehabilitation 5th edition .Susan.B’Osullivon

Thomas.J.Schmitz.Jaypees.Page no.335-356.

16
4. Neightengels Nursing times of India journel volume 6 april 2010.

5. The American journal of surgery related to early ambulation after surgen

volume79; Issue 4; pg: 496 – 99.

6. Journal of surgery Pakistan international 15(2);april june 2010.

7. Patients references for Immediate post operative recovery @PDF HCI. Fisher

MDG

8. Fact sheet of hysterectomy in US 2000-2004 article (Pubmed).

9. Community based survey in 2008 volume 27 .recent statergies in india.article

10. Journal of american sciences 2011:7(1) .htt:www.jofamerican sciences.org.

International Journal of gynecological and obstetrics ,vol 55,issues 3,page no.247-

276.

11. Rochal’s reviews on family members openian after early ambulation after

abdominal surgery in kerala 2001.(nursing library).

12. E. Williamson et.al a review on risk of developing pulmonary embolism after

major abdominal surgery in 2003.

13. Guru Nanak,Nirmal Kour et.al conducted study on early recovery after

abdominal surgery in 2007.vol.7.

14. Beersheva Israel, experimental based review after heart catheterization.in

diagnostic research centre; 2000.(pub med).

15. Evidence based recommendations in Alfred hospital,; Melbourne 2006;google

search.

16. .Ratna.Rongtonggul wilaiwan yousule et.A postoperative pain survey after 2nd

POD after abdominal hysterectomy. Vol.20 No.4 oct-Dec 2005.

17. The Journal of obstetrics and gynecology of India; July august 2011, vol 61.

17
18. Comparative/descriptive reviews of evidenced based strategies; 2009; pg: 981

– 82. Google search.

19. P.D.Willums, D.Valderma review on preoperational effects on hysterectomy

Journals

1. Journal of American Sciences; 2011

2. The journal of obstetrics and gynecology of India july-aug 2011.vol

61.

3. The American journal 0f obstetrics and gynecology founded 1869.oct

2011 vol 205.

4. The Nightingale nursing times of India; volume 7 no 1.april 2011.

5. The nightingale nursing times of india; volume 6; no 5, august 2010.

9. Signature of the candidate :Miss.Jayashri.J.Javali

10. Remarks of the guid : This study is important to educate the

post operative Patients undergone
abdominal hysterectomy regarding
Early ambulation and recovery.

11. Name and designation of

11.1 Guide : Mrs. Neesha Clement
Professor,
HOD,ObstetricsandGynecological
nursing

18
11.2 Signature :
11.3 Co- Guide (If Any) : Dr.Geetha

11.4 Head of the department : Mrs.Neesha Clement

Professor,
HOD, obstetrics and gynecological
nursing
11.6 Signature :

12. Principal : I. Clement

12.1 Remarks : The study is relevant,

feasible and appropriate

or the specially
choosen.
12.2 Signature :

19
20
 TARGET POPULATION

Patient who had undergone

abdominal hysterectomy

ACCESSIBLE POPULATION

Patient who had undergone abdominal

surgery in Government hospital, Bangalore

SAMPLE AND SAMPLE SIZE

Patient undergone abdominal

hysterectomys (40) CONVENIENCE
SAMPLE

21
 Control group
Experimental Group
Who did not receive
Who received early early ambulation after
ambulation after hysterectomy– (15)
hysterectomy- (20)

DATA COLLECTION
PROCEDURE
Oberavation check list
Pre test and Interview guide Pre test

Early
ambulation

Post test
Post test

CRITERION
MEASURES

ANALYSIS AND ADL SCORE

INTERPRETATION Functional
restrotion
DescriptiveFindings
and inferential scores
statistucs Sence of well
22 beings
Report thesis
BIBLIOGRAPHY:

1.The American journal of surgery volume 78 related early ambulation

elnest.Occupatioal Therapy and Physical Dysfunction Principal skills and

practice.edition by Anna lurner.Margrate farster .Sybil,Johnson.Page no.225-226.

2.The text book of Obsterics and Gyneocology 2 D.C .Dutta 6 th . edition 2004

Page no 565-567.,Tc,Trice.

3.Physical rehabilitation 5th edition .Susan.B’Osullivon

Thomas.J.Schmitz.Jaypees.Page no.335-356.

4. Neightengels Nursing times of India journel volume 6 apli 2010.

6.Total Laproscopic hysterectomy versus total abdominal hysterectomy Cohart

Review of patients with uterine Neoplsia.JSLS 2005 Jul-Sep9930 page no.277-

286.(Pubmed).

6. The American journal of surgery related to early ambulation after surgen

volume79.

7. Patients references for Immediet post operative recovery @PDF HCI.Fisher

MDG

8.Fact sheet of hysterectomy in US 2000-2004 article (Pubmed).

9.Community based survey in 2008 volume 27 .recent statergies in india.article

10.Journal of american sciences 2011:7(1) .htt:www.jofamerican sciences.org.

11.International Journal of gynecological and obstetrics ,vol 55,issues 3,page

no.247-276.

12.Rochal’s reviews on family members openian after early ambulation after

abdominal surgery in kerala 2001.(nursing library).

23
13.E. Williamson et.al a review on risk of developing pulmonary embolism after

major abdominal surgery in 2003.

14.Guru Nanak,Nirmal Kour et.al conducted study on early recovery after

abdominal surgery in 2007.vol.7.

15.Beersheva Israel,experimental based review after heart catheterization.in 2000.

(pub med).

16.management based protocal based scientific evidence in care of patients

undergone abdominal hysterectomy aprial 2005 page no.494-501.

17. .Ratna.Rongtonggul wilaiwan yousule et.A postoperative pain survy after 2 nd

POD after abdominal hysterectomy. Vol.20 No.4 oct-Dec 2005.

18.Journal of minimally invasive Gynecology vol 12.issue6.2005 page no 494-

502.

19.The journal of obstetrics and gynecology of India.July-Aug 2011,vol 61 page

no 445-446.

20.P.D.Willums ,D.Valderma review on preoperational effects on hysterectomy

and masterectomy.htt//www.find health article.

21.Azzam S,M,Farroha and Hala,S.Y.Hannas corresponding study on abdominal

hysterectomy and mammoplast etc.Indian J,Plast SURG .2008 Jul-Dec. page no.

133-137 (Pubmed).

22.Kaplan.H,Y,Bar Meir .E.Safety of combining abdominoplasty and total

abdominal hysterectomy fifteen cases of reviews of literature. 2005. page

no.54:390-2(Pubmad).

23.S.Enhed for perioperative Sygepleje.Atsnit 3341 Rig hospital.Gynecology

clinical blegdamsvej.9.2100 Kabenhavan .Denmark.

24
24.Efficacy of an assistive interventions for abdominal surgery patients in post

operative care 2006 vol.no 3 page no.191-197.

24.Wogner.L,Carlslund A.M et. Patients and staffs experience following

abdominal hysterectomy in qualitative study on 2004 (Pub med).

25.Christine.A.Heister.MD.Elizebeth.R,Casiano et.al Astudy to compare

complications from vaginal 7(hysterectomy with abdominal hysterectomy in renal

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9. Signature of the candidate :Miss.Jayashri.J.Javali

10. Remarks of the guide : This study is important to

educate the post operative

abdominal hysterectomy patients
regarding early ambulation and
recovery.
11. Name and designation of
11.1 Guide : Mrs. Neesha Clement

26
 Professor,
HOD,ObstetricsandGynecological
nursing
11.2 Signature :
11.3 Co- Guide (If Any) : Dr.

11.4 Head of the department : Mrs.Neesha Clement

Professor,
HOD, obstetrics and gynecological
nursing
11.6 Signature :

12. Principal : I. Clement

12.1 Remarks : The study is relevant,

feasible and appropriate

or the specially
choosen.
12.2 Signature :

27