| 1. |
- Brattwall, Metha, 1952, et al.
(författare)
-
Patient assessed health profile: a six-month quality of life questionnaire survey after day surgery.
- 2010
-
Ingår i: Scand J Public Health. - : SAGE Publications. - 1651-1905 .- 1403-4948. ; 38:6, s. 574-579
-
Tidskriftsartikel (refereegranskat)abstract
- AIM: Patient assessed quality of life is one of the principal end-points after day surgery. The aim of the present study was to describe the natural course, differences and timing of final evaluation for three common day surgical procedures; inguinal hernia repair (IHR), arthroscopic procedures (AS); and cosmetic breast augmentation (CBA). Method: A total of 355 patients prospectively completed an extended eight-item EQ-5D questionnaire (pain, mobility, mood, self-care, activities, sleep, sex, need for analgesic), preoperatively and at one, three and six months postoperatively. RESULTS: Pain and mobility problems were frequently reported prior to surgery among IHR and AS patients, while CBA patients had less deviation from normal in the preoperative health profile. The proportions of patients reporting surgery-related deviations were 35%, 20% and 5% at one, three and six months respectively. After one month, 50% of AS patients still suffered subjective discomfort as compared to 13% and 20% of the IHR and CBA patients, respectively. Pain and ambulation problems were the most common symptoms in all groups. Six months after surgery, 94% of IHR, 89% of AS and 97% of CBA patients were fully recovered. CONCLUSIONS: No major morbidity or severe complications were observed and patients' satisfaction was high overall. We found procedure-specific changes in the postoperative health profile after day surgery. AS patients recovered more slowly compared with IHR and CBA patients. We conclude that time for final evaluation differs significantly between procedures.
|
|
| 2. |
- Brattwall, Metha, 1952, et al.
(författare)
-
Patients' assessment of 4-week recovery after ambulatory surgery
- 2011
-
Ingår i: Acta Anaesthesiologica Scandinavica. - : The Acta Anaesthesiologica Scandinavica Foundation. - 0001-5172 .- 1399-6576. ; 55:1, s. 92-98
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Patients’ own assessment of recovery after ambulatory surgery has not been well studied. The aim was to study patients’ self-assessed recovery, the occurrence and time course of post-operative problems in relation to the type of ambulatory surgery.Methods: A questionnaire was filled in by 355 patients at five time points: pre-operative, first day at home, 1, 2 and 4 weeks post-operatively. Consecutive patients who underwent either inguinal hernia repair (IHR), arthroscopic procedures (AS) or cosmetic breast augmentation (CBA) were included.Results: Unplanned return to hospital was rare (3/355). Health care contacts were noted for 9% of the patients during the first week; a total of 70 contacts occurred during the entire period. Pain was the most frequently reported symptom; 40% of the patients reported pain or mobility problems at 1 week, 28% after 2 weeks and 20% after 4 weeks. Pre-operative pain was associated with an increased level of pain during the early post-operative course, in the recovery room and at 1 week post-operatively. IHR was associated with an overall rapid recovery, while AS patients experienced a slower restitution. All AS patients who reported pain after 4 weeks had reported pain problems already pre-operatively. Pain was not present pre-operatively in the CBA group, but was common at 1 and 2 post-operative weeks and was still reported by 11% at 4 weeks.Conclusion: Self-assessed recovery was found to cover several weeks with procedure-specific recovery patterns. Pain and mobility impairment were still frequently reported 4 weeks post-operatively.
|
|
| 3. |
- Brattwall, Metha, 1952, et al.
(författare)
-
Postoperative impact of regular tobacco use, smoking or snuffing, a prospective multi-center study.
- 2010
-
Ingår i: Acta Anaesthesiol Scand. - : Wiley. - 1399-6576 .- 0001-5172. ; 54:3, s. 321-7
-
Tidskriftsartikel (refereegranskat)abstract
- Background: The aim was to study the effects of different tobacco administration routes on pain and post-operative nausea and vomiting (PONV), following three common day surgical procedures: cosmetic breast augmentation (CBA), inguinal hernia repair (IHR) and arthroscopic procedures (AS). We have prospectively investigated the effects of regular tobacco use in ambulatory surgery. Methods: The 355 allocated patients were followed during recovery and the first day at home. Results: Thirty-two percent of the patients used tobacco regularly, 33% of CBA, 27% of IHR and 34% of AS. Pain was well controlled in the post-anesthesia care unit at rest; during ambulation, 37% of all patients reported VAS>3. Tobacco use had no impact on early post-operative pain. Post-operative nausea was experienced by 30% of patients during recovery while in hospital. On day 1, 14% experienced nausea. We found a significant reduction of PONV among tobacco users (smoking and/or snuffing). Smoking or snuffing reduced the risk of PONV by nearly 50% in both genders on the day of surgery and at the first day at home. The reduction of PONV was equal, regardless of tobacco administration routes. Conclusion: We found that regular use of tobacco, both by smoking and snuffing, had a significant effect on PONV during the early post-operative period. Non-tobacco users undergoing breast surgery were found to have the highest risk for PONV. We could not see any influence of nicotine use on post-operative pain. Thus, it seems of value to identify regular tobacco use, not only smoking, as a part of the pre-operative risk assessment.
|
|
| 4. |
- Gunnarsson, Britt-Marie, et al.
(författare)
-
Factors influencing decision making among ambulance nurses in emergency care situations.
- 2009
-
Ingår i: International emergency nursing. - : Elsevier BV. - 1878-013X .- 1755-599X. ; 17:2, s. 83-9
-
Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to investigate which factors that influences decision making among Swedish ambulance nurses in emergency care situations. Nurses in ambulance are sometimes forced to make decisions without adequate information. Data collected from interviews with 14 ambulance nurses was analyzed. The informants described 30 incidents during which they had to make fast decisions. A qualitative content analysis of the text was made, from which different categories were identified. It was found that when nurses are called to an emergency, the extent and degree of difficulty of the incident is decisive for how decisions are made. In addition, the nurses' experience is important for decision making, because the experience factor constitutes a qualitative difference between a novice nurse and a more experienced nurse's influence on decision-making. Furthermore, external factors, such as the uncertainty of a prehospital environment, expectations and pressures from an environment in which one is working while being observed by other people, and collaborating with many different operators, all contribute to making decisions in an urgent situation even more complex. Further studies are needed to understand the complexity of decision making in emergency situations.
|
|
| 5. |
- Kilic, Mert, et al.
(författare)
-
Clinical Performance of a Novel Main-Stream Anaesthetic End-Tidal Gas Monitors during Routine Low Flow Anaesthesia
- 2010
-
Ingår i: Journal of Anesthesia & Clinical Research. - : OMICS Publishing Group. - 2155-6148. ; 1:3
-
Tidskriftsartikel (refereegranskat)abstract
- End-tidal anaesthetic gas concentration monitoring during inhalation anaesthesia has become standard of care. Explorative study comparing the end-tidal anaesthetic gas measured by a new main-stream anaesthetic gas monitor (IRMA, Phasein, Stockholm, Sweden) as compared to standard Datex side-stream monitoring during routine low flow anaesthesia Day surgical centre in StockholmThirty two healthy, ASA 1-2, patients undergoing elective day case anaesthesia with low flow 0.2-0.5 L/min. Simultaneous recording of the end-tidal gas concentration during routine day case anaesthesia with low flow sevoflurane or desflurane anaesthesia. The new monitor was found to be clinically acceptable. The mean bias between IRMA and Datex measures -0.125 vol % (± 0.145, limits of agreement were -0.41 – 0.16). The new main stream gas monitor is clinically acceptable alternative for end-tidal anaesthetic gas monitoring during routine anaesthesia with low flow, 0.2-0.5 L/min.
|
|
| 6. |
- Modin, Marina, et al.
(författare)
-
Postoperative impact of daily life after primary treatment of proximal/distal tibiafracture with Ilizarov external fixation
- 2009
-
Ingår i: JOURNAL OF CLINICAL NURSING. - : Wiley. - 0962-1067 .- 1365-2702. ; 18:24, s. 3498-3506
-
Tidskriftsartikel (refereegranskat)abstract
- Aims and objectives. To describe patients’ experience of the impact of their health-related life situation on their daily life two and four weeks after primary fracture treatment with Ilizarov external fixation. Background. A few studies have been conducted postoperatively focussing on fracture treatment with Ilizarov fixation. Design. A prospective descriptive research design. Method. Patients who had been treated for a proximal/distal tibial fracture were invited to participate in the study. Data were collected with a semi-structured questionnaire where 20 patients described in their own words their situation at home two and four weeks postoperatively. The process used when analysing the data was similar to content analysis. Results. Four key themes were identified: ‘limitations in the home environment’, ‘limitations outside the home’, ‘limitations to social relations’ and ‘experience of having an Ilizarov fixation’. The patient’s life situation was strongly affected during the first postoperative month. This took the form of clear limitations on activities outside the home and a degree of limitation on coping with household chores and personal hygiene. These limitations became less severe after between 2–4 weeks and were very much a consequence of using crutches. Conclusion. This study points to limitations in the patient’s daily life situation in the home. The results from the study make it obvious that the information given to patients prior to discharge, concerning the value of putting weight on the leg, had not been clear or that the patients had not understood it. This had a negative impact on the patient’s daily life after discharge. Further data are needed to uncover the extent of the issue to be able to optimise patient outcomes. Relevance to clinical practice. There is a need for clearer and more active information from the nurse before discharge but also a need to follow up how the information given is understood.
|
|
| 7. |
- Nilsson, Kerstin, et al.
(författare)
-
Nursing students motivation toward their studies : a survey study
- 2008
-
Ingår i: BMC Nursing. - : BioMed Central. - 1472-6955. ; 7
-
Tidskriftsartikel (refereegranskat)abstract
- BackgroundThis study focuses on Swedish nursing students' motivation toward their studies during their three year academic studies. Earlier studies show the importance of motivation for study commitment and result. The aim was to analyze nursing students' estimation of their degree of motivation during different semester during their education and to identify reasons for the degree of motivation.MethodsA questionnaire asking for scoring motivation and what influenced the degree of motivation was distributed to students enrolled in a nursing programme. 315 students who studied at different semesters participated. Analyzes were made by statistical calculation and content analysis.ResultsThe mean motivation score over all semesters was 6.3 (ranked between 0–10) and differed significantly during the semesters with a tendency to lower score during the 5th semester. Students (73/315) with motivation score <4 reported explanations such as negative opinion about the organisation of the programme, attitude towards the studies, life situation and degree of difficulty/demand on studies. Students (234/315) with motivation score >6 reported positive opinions to becoming a nurse (125/234), organization of the programme and attitude to the studies. The mean score value for the motivation ranking differed significantly between male (5.8) and female (6.8) students.ConclusionConclusions to be drawn are that nursing students mainly grade their motivation positive distributed different throughout their entire education. The main motivation factor was becoming a nurse. This study result highlights the need of understanding the students' situation and their need of tutorial support.
|
|
| 8. |
- Warrén-Stomberg, Margareta, et al.
(författare)
-
Acute pain services
- 2003
-
Ingår i: Current Anaesthesia and Critical Care. - : Elsevier. - 0953-7112 .- 1532-2033. ; 14:5-6, s. 211-215
-
Tidskriftsartikel (refereegranskat)abstract
- An interdisciplinary acute pain service (APS) team seems the most attractive clinical organization model for postoperative pain management (POPM) to fulfil the intentions of pain management guidelines in practice. The specific knowledge of anaesthesiologists in the use of drugs and techniques for pain alleviation is of specific importance. Therefore, the anaesthetist is usually the team leader and works together with nurses in the postanaesthesia care unit (PACU), acute pain nurses (APN) and surgical ward nurses. A nurse-based anaesthesiologist supervised type of APS seems in several respects to be a suitable model for POPM in clinical practice.
|
|
| 9. |
- Warrén Stomberg, Margareta, et al.
(författare)
-
Clinical practice and routines for day surgery in Sweden: implications for improvement in nursing interventions.
- 2008
-
Ingår i: Journal of PeriAnesthesia Nursing. - : Elsevier BV. - 1532-8473 .- 1089-9472. ; 23:5, s. 311-20
-
Tidskriftsartikel (refereegranskat)abstract
- The purpose of this study was to examine nursing practice in day surgery settings in Sweden. A questionnaire focusing on the routines of the day surgery process of patients in Sweden was administered. Based on these findings, appropriate nursing interventions are outlined and discussed. Day surgery routines were in accordance with general worldwide practice. The study revealed that nursing involvement was rare in the preoperative routine. In addition, the major part of the recovery process, including assessments of discharge eligibility and information about pain management, was managed by PACU nurses. The nurse follow-up revealed a number of subjective queries and symptoms that, in a seemingly easy way, could have been prevented by further perianesthesia/perioperative patient education. There is an obvious place for nursing interventions when the decision for day surgery is taken. These interventions should focus on providing the patient with information before surgery, preoperative patient health screening, and information/education at discharge. Furthermore, nursing interventions should include quality assurance, such as follow-up calls for the evaluation of care, as well as providing information and coaching for the patient at home.
|
|
| 10. |
- Warrén Stomberg, Margareta
(författare)
-
Guest at Hospice : Time for Consideration
- 2009
-
Ingår i: The American Journal of Hospice and Palliative Medicine. - : Sage Publications. - 1049-9091 .- 1938-2715. ; 26:4, s. 277-280
-
Tidskriftsartikel (refereegranskat)abstract
- This study focuses on daily life situation of terminally ill guests residing at a hospice. In the study, interviews were conducted with 9 such guests. Data were analyzed using a method similar to content analysis. Categories emerged that were related to aspects regarding as external and internal essentials for the well-being of the individual at the hospice. These essentials were as follows: encouragement from the staff, the alleviation of pain, a pleasant and calm atmosphere at the hospice, the significance of visits from relatives, the regret of not being able to take care of oneself, and time to reconcile to one's life. These results not only show the need for close community with both family and staff but also the need for privacy to reflect on life.
|
|
