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Sökning: WFRF:(Arakelian Erebouni)

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  • [1]23Nästa
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1.
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2.
  • Arakelian, Erebouni, 1973-, et al. (författare)
  • Experiences of the Initial Phase Implementation of the STAMINA-Model in Perioperative Context Addressing Environmental Issues Systematically A Qualitative Study
  • 2020
  • Ingår i: International Journal of Environmental Research and Public Health. - MDPI. - 1661-7827 .- 1660-4601. ; 17:9
  • Tidskriftsartikel (refereegranskat)abstract
    • <p>(1) Background: Challenges in perioperative settings put demands on staff working with systematic work environment management. A support model, STAMINA (Structured and Time-effective Approach through Methods for an Inclusive and Active working life), was implemented in a hospital in Sweden, to help staff address environmental issues systematically. The aim was to describe the experiences of the initial phase of implementation of the adapted STAMINA model in perioperative context. (2) Methods: Qualitative individual interviews were held with 14 managers and employees (three men and 11 women). Data were analysed by systematic text condensation. (3) Results: Five themes were identified: Limited knowledge of the model and the implementation process; scepticism, lack of confidence in the model and a passive attitude; the model offered increased participation; the culture in the organization-to understand one's role as employees and managers; and endurance and feedback are key factors for success in the implementation process. (4) Conclusions: Scepticism turned to positive attitude by recognising that the STAMINA model offered increased participation. In order to have successful implementation, the organisational culture must be taken into consideration by giving the employees increased responsibilities and timely feedbacks. Role description, goal definition, feedback, and sticking to one model are key factors for success.</p>
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3.
  • Arakelian, Erebouni, 1973-, et al. (författare)
  • Factors influencing early postoperative recovery after cytoreductive surgery and hyperthermic intraperitoneal chemotherapy
  • 2011
  • Ingår i: European Journal of Surgical Oncology. - 0748-7983 .- 1532-2157. ; 37:10, s. 897-903
  • Tidskriftsartikel (refereegranskat)abstract
    • <p>BACKGROUND:</p> <p>Cytoreductive surgery (CRS) combined with hyperthermic intraperitoneal chemotherapy (HIPEC) can prolong survival in selected patients with peritoneal carcinomatosis (PC). However, there is little data on patients' recovery process after this complex treatment. This study aimed to describe the in-hospital postoperative recovery and factors related to the recovery of patients who undergo CRS and HIPEC.</p> <p>METHOD:</p> <p>A retrospective audit of the electronic health record (EHR) was undertaken for 76 PC patients (42 women, 34 men) treated primarily with CRS and HIPEC between 2005 and 2006 in Sweden.</p> <p>RESULTS:</p> <p>Oral intake, regaining bowel functions and mobilisation usually occurred between 7 and 11 days postoperatively. Patients experienced nausea for up to 13 days postoperatively. Forty-two patients were satisfied with their pain management, which usually took the form of epidural anaesthesia and which continued for about one week post-surgery. Sleep disturbance was observed in 51 patients and psychological problems in 49 patients during the first three postoperative weeks. Tumour burden, stoma formation, use of CPAP, primary diagnosis, and the length of stay in the ICU were factors related to an early recovery process.</p> <p>CONCLUSION:</p> <p>Drinking, eating, regaining bowel functions and mobilisation were re-established within 11 days of CRS and HIPEC. Tumour burden, stoma formation, use of CPAP, primary diagnosis and the length of stay in the ICU all had an impact on postoperative recovery, and should be discussed with the patients preoperatively and taken into consideration in designing an individualised patient care plan, in order to attain a more efficient recovery.</p>
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4.
  • Arakelian, Erebouni, 1973-, et al. (författare)
  • How Anesthesiologists and Nurse Anesthetists Assess and Handle Patients' Perioperative Worries Without a Validated Instrument
  • 2019
  • Ingår i: Journal of Perianesthesia Nursing. - 1089-9472 .- 1532-8473. ; 34:4, s. 810-819
  • Tidskriftsartikel (refereegranskat)abstract
    • <p><strong>PURPOSE:</strong> To study how nurse anesthetists and anesthesiologists assess and handle patients' perioperative anxiety without using a validated instrument.</p><p><strong>DESIGN:</strong> Qualitative study.</p><p><strong>METHODS:</strong> Individual in-depth face-to-face interviews were conducted with nurse anesthetists (n = 9) and anesthesiologists (n = 5) from a university hospital in Sweden. Data were analyzed with thematic analysis according to Braun and Clark.</p><p><strong>FINDINGS:</strong> Two themes were identified: (1) I ask about anxiety, look for visual signs, and observe communication and (2) I handle patients' anxieties individually. In addition to subthemes describing assessment and handling of adults, it appeared that parents played an important role in children's perioperative anxiety.</p><p><strong>CONCLUSIONS:</strong> When not using a validated instrument, assessing perioperative anxiety is commonly based on the anesthesiologist's and nurse anesthetist's experience, knowledge, views, and attitudes. The evaluator's capability of using different strategies in the assessment and handling of perioperative anxiety is important.</p>
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5.
  • Arakelian, Erebouni, et al. (författare)
  • How operating room efficiency is understood in a surgical team : a qualitative study
  • 2011
  • Ingår i: International Journal for Quality in Health Care. - 1353-4505 .- 1464-3677. ; 23:1, s. 100-106
  • Tidskriftsartikel (refereegranskat)abstract
    • <p>Objective. Building surgical teams is one attempt to ensure the health-care system becomes more efficient, but how is 'efficiency'understood or interpreted? The aim was to study how organized surgical team members and their leaders understood operating room efficiency.</p> <p>Design. Qualitative study.</p> <p>Settings. A 1100-bed Swedish university hospital.</p> <p>Participants. Eleven participants, nine team members from the same team and their two leaders were interviewed.</p> <p>Methods. The analysis was performed according to phenomenography, a research approach that aims to discover variationsin peoples' understanding of a henomenon.</p> <p>Results. Seven ways of understanding operating room efficiency were identified: doing one's best from one's prerequisites,enjoying work and adjusting it to the situation, interacting group performing parallel tasks, working with minimal resources to produce desired results, fast work with preserved quality, long-term effects for patient care and a relative concept. When talking about the quality and benefits of delivered care, most team members invoked the patient as the central focus. Despite seven ways of understanding efficiency between the team members, they described their team as efficient. The nurses and assistant nurses were involved in the production and discussed working in a timely manner more than the leaders.</p> <p>Conclusions. The seven ways of understanding operating room efficiency appear to represent both organization-oriented andindividual-oriented understanding of that concept in surgical teams. The patient is in focus and efficiency is understood as maintaining quality of care and measuring benefits of care for the patients.</p>
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6.
  • Arakelian, Erebouni, et al. (författare)
  • I Stay : Swedish Specialist Nurses in the Perioperative Context and Their Reasons to Stay at Their Workplace
  • 2019
  • Ingår i: Journal of Perianesthesia Nursing. - 1089-9472 .- 1532-8473. ; 34:3, s. 633-644
  • Tidskriftsartikel (refereegranskat)abstract
    • <p>Purpose To investigate why nurse anesthetists and operating room nurses choose to stay in the same workplace.</p><p>Design Qualitative design.</p><p>Methods Individual interviews were conducted with 15 nurse specialists from four hospitals in Sweden. Two men and 13 women aged between 43 and 63 participated. Data were analyzed with systematic text condensation according to Malterud.</p><p>Findings Three themes were identified. (1) Organizational stability contributed to low staff turnover, with good spirits between colleagues, representing everyone’s equal value and resulting in a feeling of homelikeness. (2) Sustained development in one’s own profession. (3) A humane head nurse who was at hand, who was a facilitator, who knew staff members, and eliminated obstacles for them.</p><p>Conclusions In a nonhierarchical and stable organization with a head nurse with caritative leadership skills, a welcoming working environment with opportunities for professional development is created. Thus, nurse specialists choose to stay, contributing to organizational development.</p>
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7.
  • Arakelian, Erebouni, 1973-, et al. (författare)
  • I Stay : Swedish Specialist Nurses in the Perioperative Context and Their Reasons to Stay at Their Workplace
  • 2019
  • Ingår i: Journal of Perianesthesia Nursing. - Elsevier. - 1089-9472 .- 1532-8473. ; 34:3, s. 633-644
  • Tidskriftsartikel (refereegranskat)abstract
    • <p><strong>PURPOSE:</strong> To investigate why nurse anesthetists and operating room nurses choose to stay in the same workplace.</p><p><strong>DESIGN:</strong> Qualitative design.</p><p><strong>METHODS:</strong> Individual interviews were conducted with 15 nurse specialists from four hospitals in Sweden. Two men and 13 women aged between 43 and 63 participated. Data were analyzed with systematic text condensation according to Malterud.</p><p><strong>FINDINGS:</strong> Three themes were identified. (1) Organizational stability contributed to low staff turnover, with good spirits between colleagues, representing everyone's equal value and resulting in a feeling of homelikeness. (2) Sustained development in one's own profession. (3) A humane head nurse who was at hand, who was a facilitator, who knew staff members, and eliminated obstacles for them.</p><p><strong>CONCLUSIONS:</strong> In a nonhierarchical and stable organization with a head nurse with caritative leadership skills, a welcoming working environment with opportunities for professional development is created. Thus, nurse specialists choose to stay, contributing to organizational development.</p>
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8.
  • Arakelian, Erebouni, et al. (författare)
  • Job satisfaction or production? How staff and leadership understand operating room efficiency : a qualitative study
  • 2008
  • Ingår i: Acta Anaesthesiologica Scandinavica. - 0001-5172 .- 1399-6576. ; 52:10, s. 1423-1428
  • Tidskriftsartikel (refereegranskat)abstract
    • <p>BACKGROUND: How to increase efficiency in operating departments has been widely studied. However, there is no overall definition of efficiency. Supervisors urging staff to work efficiently may meet strong reactions due to staff believing that demands for efficiency means just stress at work. Differences in how efficiency is understood may constitute an obstacle to supervisors' efforts to promote it. This study aimed to explore how staff and leadership understand operating room efficiency. METHODS: Twenty-one members of staff and supervisors in an operating department in a Swedish county hospital were interviewed. The analysis was performed with a phenomenographic approach that aims to discover the variations in how a phenomenon is understood by a group of people. RESULTS: Six categories were found in the understanding of operation room efficiency: (A) having the right qualifications; (B) enjoying work; (C) planning and having good control and overview; (D) each professional performing the correct tasks; (E) completing a work assignment; and (F) producing as much as possible per time unit. The most significant finding was that most of the nurses and assistant nurses understood efficiency as individual knowledge and experience emphasizing the importance of the work process, whereas the supervisors and physicians understood efficiency in terms of production per time unit or completing an assignment. CONCLUSIONS: The concept 'operating room efficiency' is understood in different ways by leadership and staff members. Supervisors who are aware of this variation will have better prerequisites for defining the concept and for creating a common platform towards becoming efficient.</p>
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9.
  • Arakelian, Erebouni, et al. (författare)
  • Nurses anaesthetists' versus patients' assessment of anxieties in an ambulatory surgery setting.
  • 2019
  • Ingår i: Journal of perioperative practice. - 2515-7949.
  • Tidskriftsartikel (refereegranskat)abstract
    • <p><strong>BACKGROUND:</strong> Failure to assess patients' anxiety perioperatively by means of a validated instrument makes the assessment arbitrary. Studies are lacking about how well nurse anaesthetists estimate patients' preoperative worries.</p><p><strong>PURPOSE:</strong> To compare the nurse anaesthetists' estimations of patients' preoperative anxieties with the patients' own assessment of their anxieties.</p><p><strong>DESIGN:</strong> Quantitative prospective design.</p><p><strong>METHODS:</strong> Eighty-five pairs of patients and nurse anaesthetists in two ambulatory surgery units in a university hospital in Sweden were included. Patients' perioperative anxieties were graded using the Numeric Visual Analogue Anxiety Scale.</p><p><strong>RESULTS:</strong> The nurse anaesthetist overestimated the patients' level of preoperative anxiety in 53% of patients and underestimated patients' anxieties in 31% of the patients. Consensus was seen in 16% of the pairs. In fifty-six pairs (65%), the difference between the estimation of level of patients' anxiety according to Numeric Visual Analogue Anxiety Scale was between -3 (overestimation) and +3 levels (underestimation). Median levels of anxiety were estimated as 3 within the patient group and 4 among the nurse anaesthetists.</p><p><strong>CONCLUSIONS:</strong> Systematic assessment of patients' level of anxiety could lead to identifying patients with severe anxiety levels and to offer more individualised treatment. The patients' own estimation must form the basis for the discussion and treatment.</p>
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10.
  • Arakelian, Erebouni, 1973-, et al. (författare)
  • Older Patients' Worries in Connection With General Anesthesia and Surgery - A Qualitative Study
  • 2018
  • Ingår i: Journal of Perianesthesia Nursing. - ELSEVIER SCIENCE INC. - 1089-9472 .- 1532-8473. ; 33:6, s. 822-833
  • Tidskriftsartikel (refereegranskat)abstract
    • <p>Purpose: To examine anxiety and what older patients worry about related to anesthesia and colorectal surgery, and their perceptions regarding nurses' ability to ease preoperative worry.</p><p>Design: Qualitative individual face-to-face interviews.</p><p>Methods: The study included 18 patients aged between 62 and 91 years with lower abdominal tumors. The study was conducted in two day-surgery wards in Sweden. Interview data were analyzed with Malterud's systematic text condensation.</p><p>Findings: Four themes were identified: (1) losing control of one's body, leaving one's life in someone else's hands, and the feeling that there is no going back, (2) claustrophobia and anticipated pain in an unknown environment, (3) unknown and frightening vocabulary concerning the surgery, and (4) what can happen if something goes wrong.</p><p>Conclusions: Patients worry about a number of things. If preoperative worry could be identified, actions taken to reduce worry could be personalized and patients' own strategies to reduce worries may be helpful for them.</p>
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