Semi-Fowler Versus Lateral Positioning for Pain Management in Patients with Cholelithiasis: A Quasi-Experimental Study
DOI:
https://doi.org/10.58184/miki.v4i3.1108Keywords:
cholelithiasis, pain, lateral position, semi-fowler position, non-pharmacological therapyAbstract
Cholelithiasis may cause abdominal pain that affects patients’ comfort and daily activities. In addition to pharmacological therapy, positioning is a simple non-pharmacological nursing intervention that may help reduce pain intensity. The semi-Fowler and lateral positions are commonly used to improve patient comfort; however, their comparative effectiveness in patients with cholelithiasis remains unclear. This study aimed to compare the effectiveness of the semi-Fowler and lateral positions in reducing pain intensity among patients with cholelithiasis. A quasi-experimental study with a two-group pretest–posttest design was conducted in the inpatient ward of RSUD Siti Fatimah Az-Zahra, South Sumatra Province, in May 2026. A total of 34 patients with cholelithiasis were recruited using total sampling and allocated into the semi-Fowler group (n=17) and lateral group (n=17). The semi-Fowler group was positioned with the head of the bed elevated at 30–45°, while the lateral group was positioned in a side-lying posture supported with pillows for 15 minutes. Pain intensity was measured using the Numeric Rating Scale (NRS) before and after the intervention. Data were analyzed using the Wilcoxon Signed-Rank Test and Mann–Whitney U test. The mean pain score decreased from 6.59 ± 1.18 to 3.65 ± 0.93 in the semi-Fowler group and from 6.47 ± 1.01 to 3.53 ± 1.01 in the lateral group. Both groups demonstrated significant reductions in pain intensity (p < 0.001), with no significant difference between the two positions (p = 0.984). Both positions may be considered simple non-pharmacological nursing interventions for pain management in patients with cholelithiasis.
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Avallin, T., Muntlin, Å., Kitson, A., & Jangland, E. (2023). Testing a model for person-centred pain management: A systematic review and synthesis guided by the Fundamentals of Care framework. Journal of Clinical Nursing, 32(19–20), 6811–6831. https://doi.org/10.1111/jocn.16770
Azizah, M. S., & Awaludin, S. (2025). Comparison of the implementation of aromatherapy of peppermint with hand massage on the pain of patients after cholelithiasis surgery: A case study. Jurnal Kedokteran Diponegoro (Diponegoro Medical Journal), 14(3), 151–158. https://doi.org/10.14710/dmj.v14i3.48105
Bourgeois, C., Oyaert, L., Van de Velde, M., Pogatzki-Zahn, E., Freys, S. M., Sauter, A. R., Joshi, G. P., & Dewinter, G. (2024). Pain management after laparoscopic cholecystectomy: A systematic review and procedure-specific postoperative pain management (PROSPECT) recommendations. European Journal of Anaesthesiology, 41(11), 841–855. https://doi.org/10.1097/EJA.0000000000002047
Erdemir, D. S., & Şenturan, L. (2020). The effect of position support during orthopedic surgery on postoperative pain: A randomized controlled trial. Pain Management Nursing, 21(6), 549–555. https://doi.org/10.1016/j.pmn.2020.06.003
Francisco, A. S. P. G., Montemezzo, D., Ribeiro, S. N. dos S., Frata, B., Menegol, N. A., Okubo, R., Sonza, A., & Sanada, L. S. (2021). Positioning effects for procedural pain relief in NICU: Systematic review. Pain Management Nursing, 22(2), 121–132. https://doi.org/10.1016/j.pmn.2020.07.006
Fujita, N., Yasuda, I., Endo, I., Isayama, H., Iwashita, T., Ueki, T., Uemura, K., Umezawa, A., Katanuma, A., Katayose, Y., Suzuki, Y., Shoda, J., Tsuyuguchi, T., Wakai, T., Inui, K., Unno, M., Takeyama, Y., Itoi, T., Koike, K., & Mochida, S. (2023). Evidence-based clinical practice guidelines for cholelithiasis 2021. Journal of Gastroenterology, 58(9), 801–833. https://doi.org/10.1007/s00535-023-02014-6
Kim, H.-J., & Jung, S.-O. (2020). Comparative evaluations of single-item pain-intensity measures in cancer patients: Numeric rating scale vs. verbal rating scale. Journal of Clinical Nursing, 29(15–16), 2945–2952. https://doi.org/10.1111/jocn.15341
Hannigan, C., McHugh Power, J., Lambert, J., & Kelly, M. (2024). The effect of mindfulness-based intervention on cognitively unimpaired older adults’ cognitive function and sleep quality: A systematic review and meta-analysis. Aging & Mental Health, 28(1), 23–35. https://doi.org/10.1080/13607863.2023.2228255
Leung, D. K. Y., Fong, A. P. C., Wong, F. H. C., Liu, T., Wong, G. H. Y., & Lum, T. Y. S. (2024). Nonpharmacological interventions for chronic pain in older adults: A systematic review and meta-analysis. The Gerontologist, 64(6), Article gnae010. https://doi.org/10.1093/geront/gnae010
Liu, M., Ni, R., Huang, S., Yang, X., Lin, Q., Lin, P., & Yang, J. (2023). Efficacy of non-pharmacological interventions in pain relief and opioid consumption after cardiac surgery: A systematic review and Bayesian network meta-analysis. Journal of Clinical Nursing, 32(15–16), 4626–4637. https://doi.org/10.1111/jocn.16482
Nugent, S. M., Lovejoy, T. I., Shull, S., Dobscha, S. K., & Morasco, B. J. (2021). Associations of pain numeric rating scale scores collected during usual care with research-administered patient-reported pain outcomes. Pain Medicine, 22(10), 2235–2241. https://doi.org/10.1093/pm/pnab110
Park, Y. J., & Lee, M. K. (2022). Effects of nurse-led nonpharmacological pain interventions for patients with cancer: A systematic review and meta-analysis. Journal of Nursing Scholarship, 54(4), 422–433. https://doi.org/10.1111/jnu.12750
Patel, H., & Jepsen, J. (2024). Gallstone disease: Common questions and answers. American Family Physician, 109(6), 518–524.
Puspita, T., Prayoga, R., Mulyana, Y., & Widadi, S. Y. (2022). Analysis of nursing care on congestive heart failure disease using semifowler’s position to increase oxygen saturation. Journal of Health Science and Nursing Studies, 1(1). https://doi.org/10.58516/jhsns.v1i1.24
Rahmila, S. S., Melastuti, E., & Amal, A. I. (2025). Pengaruh terapi kombinasi mobilisasi dini dengan aromaterapi lemon terhadap nyeri post operasi pada pasien cholelithiasis. Jurnal Online Keperawatan Indonesia, 8(2), 119–127.
Saragih, I. D., Suarilah, I., Son, N. T., & Lee, B.-O. (2023). Efficacy of non-pharmacological interventions to reduce pain in people with dementia: A systematic review and meta-analysis. Journal of Clinical Nursing, 32(15–16), 5286–5299. https://doi.org/10.1111/jocn.16444
Sauerland, S., & Langenbach, M. R. (2023). Managing symptomatic gallstone disease. BMJ, 383, Article p2624. https://doi.org/10.1136/bmj.p2624
Shenoy, R., Kirkland, P., Hadaya, J. E., Tranfield, M. W., DeVirgilio, M., Russell, M. M., & Maggard-Gibbons, M. (2022). Management of symptomatic cholelithiasis: A systematic review. Systematic Reviews, 11, Article 267. https://doi.org/10.1186/s13643-022-02135-8
Tsegaye, D., Yazew, A., Gedfew, M., Yilak, G., & Yalew, Z. M. (2023). Non-pharmacological pain management practice and associated factors among nurses working at comprehensive specialized hospitals. SAGE Open Nursing, 9, 1–12. https://doi.org/10.1177/23779608231158979
van Veen, S., Drenth, H., Hobbelen, H., Finnema, E., Teunissen, S., & de Graaf, E. (2024). Non-pharmacological interventions feasible in the nursing scope of practice for pain relief in palliative care patients: A systematic review. Palliative Care and Social Practice, 18, Article 26323524231222496. https://doi.org/10.1177/26323524231222496
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