| 1. |
- Andersson, Viktor, et al.
(författare)
-
The Impact of Preoperative Patient Anxiety on Postoperative Anxiety and Quality of Recovery After Orthopaedic Surgery
- 2020
-
Ingår i: Journal of Perianesthesia Nursing. - : Elsevier. - 1089-9472 .- 1532-8473. ; 35:3, s. 260-264
-
Tidskriftsartikel (refereegranskat)abstract
- PurposeTo study how preoperative anxiety affects postoperative recovery in orthopaedic surgery based on two specific issues: does preoperative anxiety affect postoperative anxiety, pain, and nausea in the postanesthesia care unit (PACU) and does preoperative anxiety affect the quality of recovery.DesignThis was a nonexperimental quantitative observational study.MethodsPatients (N = 37) were included through consecutive selection. Anxiety, pain, and nausea were measured preoperatively, 30 minutes after arrival at PACU and before discharge from PACU. Three days after discharge, participants completed the Quality of Recovery Questionnaire by telephone.FindingsThere was a significant correlation between preoperative anxiety and anxiety in PACU as well as anxiety, sadness, and depression 3 days after discharge from PACU.ConclusionsPatients who experience preoperative anxiety also experience anxiety in PACU. The quality of recovery 3 days after surgery is also affected by preoperative anxiety. Patients experience continued anxiety as well as sadness and depression.
|
|
| 2. |
- 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. - : Elsevier BV. - 1089-9472 .- 1532-8473. ; 34:4, s. 810-819
-
Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: To study how nurse anesthetists and anesthesiologists assess and handle patients' perioperative anxiety without using a validated instrument.DESIGN: Qualitative study.METHODS: 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.FINDINGS: 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.CONCLUSIONS: 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.
|
|
| 3. |
- 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 BV. - 1089-9472 .- 1532-8473. ; 34:3, s. 633-644
-
Tidskriftsartikel (refereegranskat)abstract
- Purpose To investigate why nurse anesthetists and operating room nurses choose to stay in the same workplace.Design Qualitative design.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.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.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.
|
|
| 4. |
- 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
- 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.Design: Qualitative individual face-to-face interviews.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.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.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.
|
|
| 5. |
- Berg, Katarina, et al.
(författare)
-
The Interaction Between the Patient and Nurse Anesthetist Immediately Before Elective Coronary Artery Bypass Surgery
- 2013
-
Ingår i: Journal of Perianesthesia Nursing. - : WB Saunders. - 1089-9472 .- 1532-8473. ; 28:5, s. 283-290
-
Tidskriftsartikel (refereegranskat)abstract
- Purpose: Establishing a purposive interaction with a patient who is in a vulnerable situation before coronary artery bypass graft (CABG) surgery poses a challenge for the nurse anesthetist. The aim of this study was to identify and describe the interaction between the patient and the nurse anesthetist immediately before elective CABG surgery. less thanbrgreater than less thanbrgreater thanDesign: An observational study using a grounded theory design was used. less thanbrgreater than less thanbrgreater thanMethods: A theoretical selection of patients and nurse anesthetists was made. A total of 11 situations of patient/nurse anesthetist interaction were observed. The data were analyzed using the constant comparative method. Findings:A core category of reassurance emerged from other categories of continuity, confirmation, and control. Continuity was characterized by expedient anesthesia nursing of high quality, confirmation was related to communication in a trusting atmosphere, and control was associated with skilled nursing interventions in the thoracic operating theatre. less thanbrgreater than less thanbrgreater thanConclusions: Reassurance can be achieved through a well-structured anesthesia nursing performance in the thoracic operating theatre, and by focusing on the patient and continuously giving him/her information during the preoperative preparation phase.
|
|
| 6. |
- Bergström, Annika, et al.
(författare)
-
Comfort Theory in Practice-Nurse Anesthetists' Comfort Measures and Interventions in a Preoperative Context
- 2018
-
Ingår i: Journal of Perianesthesia Nursing. - : Elsevier BV. - 1089-9472 .- 1532-8473. ; 33:2, s. 162-171
-
Tidskriftsartikel (refereegranskat)abstract
- Purpose: The Comfort Theory proposes a systematic work approach to respond to patients' holistic needs. The usefulness of the Comfort Theory in the perioperative setting should be investigated. The aim of this study was to describe and analyze the nurse anesthetist's comfort measures in the preoperative context on the basis of the Comfort Theory. Design: Qualitative observational study. Methods: Semi-structured, clinical observation data collection in the preoperative context and deductive thematic analysis. Findings: The nurse anesthetist's comfort measures in the preoperative phase in the operating room department aim to ensure the patient's needs of relief, ease and transcendence in the physical, psycho-spiritual, environmental and socio-cultural contexts. Conclusion: The application of the Comfort Theory to daily work in the preoperative phase is of value for the nurse anesthetist in becoming more aware of the individual holistic needs of the patient and in this way adapting and initiating comfort measures and interventions.
|
|
| 7. |
- Bromfalk, Åsa, 1967-, et al.
(författare)
-
Cardiorespiratory response to sedative premedication in preschool children : a randomized controlled trial comparing midazolam, clonidine, and dexmedetomidine
- 2023
-
Ingår i: Journal of Perianesthesia Nursing. - : Elsevier. - 1089-9472 .- 1532-8473. ; 38:3, s. 454-460
-
Tidskriftsartikel (refereegranskat)abstract
- Purpose: Sedative premedication in children may negatively impact their cardiorespiratory status during the perioperative course, and no clear consensus exists on the optimal premedication treatment for pediatric patients. The objective was to compare the perioperative cardiorespiratory responses to sedation using three different sedative premedication regimens in preschool children scheduled for surgery with total intravenous anesthesia.Design: A single-center randomized controlled trial.Methods: This is a planned secondary analysis of a study conducted at a 200-bed tertiary referral hospital. Ninety children participated in the study. They were aged 2–6 years and scheduled for ear, nose, and throat surgery with propofol/remifentanil anesthesia. Participants were randomly assigned to receive oral midazolam 0.5 mg/kg-1 (MID), oral clonidine 4 mcg/kg–1 (CLO), or intranasal dexmedetomidine 2 mcg/kg-1 (DEX). The main outcome measures were the sedation level, based on the Ramsay Sedation Scale (RSS), and cardiorespiratory status, monitored during the perioperative period.Findings: The final cohort had 83 children (MID, n=27; CLO, n=26; DEX, n=30), with similar intergroup patient characteristics. RSS scores were lower in the MID group than in the CLO and DEX groups before induction and within 30 min postsurgery (P<0.001 and P=0.006, respectively). A negative correlation existed between the RSS and heart rate (HR) (r=-0.570, P<0.001). Before anesthesia induction, the respiratory rate was lowest in the DEX group (MID 21.5±1.7 min–1, CLO 20.6±2.6 min–1, DEX 20.2±1.7 min–1; P=0.042). The HR was lower in the CLO and DEX groups than in the MID group (MID, 102.8±10.0 min–1; CLO, 87.4±9.6 min–1; DEX, 87.6±7.9 min–1; P<0.001). The HR was lower immediately after induction (P=0.009) and intraoperatively (P=0.025) in the CLO and DEX groups than in the MID group.Conclusions: When used as premedication before propofol/remifentanil anesthesia, clonidine and dexmedetomidine provided deeper preoperative sedation compared to midazolam. From a clinical perspective, all three study drugs provided essentially stable cardiovascular and respiratory conditions during the entire perioperative period.
|
|
| 8. |
- Bromfalk, Åsa, 1967-, et al.
(författare)
-
Perioperative staff’s experiences of premedication for children
- 2024
-
Ingår i: Journal of Perianesthesia Nursing. - : Elsevier. - 1089-9472 .- 1532-8473.
-
Tidskriftsartikel (refereegranskat)abstract
- Purpose: Providing perioperative care for children who express anxiety or react with negative anxiety-associated consequences can be a challenge. The use of premedication is established as an important intervention for young children before surgery, yet research into care providers’ experiences of premedication is limited. The aim of this study was to explore perioperative staff’s experiences of premedication for preschool-age children.Design: A descriptive inductive qualitative study was performed based on focus group discussions.Methods: A purposive sample of a team from the operating department with experience in anesthetizing and caring for children in the perioperative period was interviewed in small focus groups: five preoperative and postoperative care nurses, five nurse anesthetists, and five anesthesiologists. The transcribed text was categorized using qualitative content analysis.Findings: The content analysis revealed three themes: a matter of time, do not wake the sleeping bear, and on responsive tiptoes.Conclusions: Care providers must adapt their work to the child’s emotional state of mind and needs, allowing time for the child to trust and accept the premedication and for the premedication to reach its peak effect. Premedication provides light sleep preoperatively, which requires careful treatment of the child to avoid emotional reactions, and the postoperative path is most peaceful when the premedication supports a long duration of sedation. Our findings highlight the need for safety precautions and a permissive and flexible organization with the goal of achieving a smooth and safe journey for the child in the perioperative path.
|
|
| 9. |
- Calebrant, H., et al.
(författare)
-
How the Nurse Anesthetist Decides to Manage Perioperative Fluid Status
- 2016
-
Ingår i: Journal of Perianesthesia Nursing. - Maryland Heights, MO : Elsevier BV. - 1089-9472 .- 1532-8473. ; 31:5, s. 406-414
-
Tidskriftsartikel (refereegranskat)abstract
- Purpose: To determine the factors that affect how nurse anesthetists in a county in Sweden decide how to manage perioperative fluid status. Design: A cross-sectional qualitative study was conducted at two surgical wards in a county hospital. Methods: Sixteen nurse anesthetists were interviewed to explore how nurse anesthetists assess patients' intraoperative fluid requirements and the subsequent measures adopted. Finding: Three categories emerged through content analysis: clinical criteria and the thought process that drives decision making, interdependence in decision making, and uncertainty in decision making. Conclusions: This study revealed differences with regard to fluid management among nurse anesthetists in a county in Sweden. For the assessments and subsequent measures that are carried out to ensure optimal fluid therapy, more research is needed to provide evidence, and evidence-based guidelines need to be developed in Sweden.
|
|
| 10. |
- Clair, Cecilia, et al.
(författare)
-
Strategies to Relieve Patients' Preoperative Anxiety Before Anesthesia : Experiences of Nurse Anesthetists
- 2020
-
Ingår i: Journal of Perianesthesia Nursing. - : Elsevier. - 1089-9472 .- 1532-8473. ; 35:3, s. 314-320
-
Tidskriftsartikel (refereegranskat)abstract
- PurposeTo investigate nurse anesthetists' experiences of strategies that alleviate adult patients' preoperative anxiety before anesthesia administration.DesignThe study has a qualitative approach wherein the data were collected through semistructured interviews. The study included interviews with six active nurse anesthetists with at least 5 years of experience who worked in a hospital in southern Sweden.MethodsCritical incident technology was used to analyze the data.FindingsFour different categories emerged: behavior of nurse anesthetist, preoperatively providing information, diverting attention to create security, and medicine as an alternative.ConclusionsAwareness can increase the use of different strategies by both new and experienced nurse anesthetists, as well as by nurses in preoperative units, which in turn alleviates patient anxiety about anesthesia. This may result in a better perioperative experience for the patient.
|
|
