| 1. |
- Arakelian, Erebouni, 1973-, et al.
(författare)
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How Anesthesiologists and Nurse Anesthetists Assess and Handle Patients' Perioperative Worries Without a Validated Instrument
- 2019
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Ingår i: Journal of Perianesthesia Nursing. - : Elsevier BV. - 1089-9472 .- 1532-8473. ; 34:4, s. 810-819
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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.
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| 2. |
- Arakelian, Erebouni, 1973-, et al.
(författare)
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Older Patients' Worries in Connection With General Anesthesia and Surgery - A Qualitative Study
- 2018
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Ingår i: Journal of Perianesthesia Nursing. - : ELSEVIER SCIENCE INC. - 1089-9472 .- 1532-8473. ; 33:6, s. 822-833
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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.
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| 3. |
- Birkestam, Anderz Mw, et al.
(författare)
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An observational study of ad-hoc anaesthesia teams
- 2020
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Ingår i: Journal of perioperative practice. - : Sage Publications. - 2515-7949 .- 1750-4589. ; 30:4, s. 102-106
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Tidskriftsartikel (refereegranskat)abstract
- Background: Anaesthesia teams are temporarily assembled to cooperate with teams in emergency departments in the immediate management of events compromising patients' airway, ventilation and circulation. Purpose: The aim was to describe a temporary ad-hoc anaesthesia team's performance. Design: An observational study was conducted. Methods: Data, collected with 12 non-participatory observations, were analysed using both an thematic method, and a validated assessment tool, the Team Emergency Assessment Measure. Results: Three themes were identified: (1) flexibility in assuming varying roles, (2) expertise in verbal and non-verbal communication and (3) skills dealing with the challenges of working in unfamiliar dynamic environments. Ninety per cent of anaesthesia teams scored 7.6 (0-10) on the overall assessment according to the Team Emergency Assessment Measure rating. Conclusion: Ad-hoc anaesthesia team members communicated in various ways and the anaesthesia team adapted well to the unpredictable environment in the emergency department.
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| 4. |
- Bixo, Liv, et al.
(författare)
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'Sick and tired' : Patients reported reasons for not participating in clinical psychiatric research
- 2021
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Ingår i: Health Expectations. - : John Wiley & Sons. - 1369-6513 .- 1369-7625. ; 24:S1, s. 20-29
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Tidskriftsartikel (refereegranskat)abstract
- Background: Meaningful and generalizable research depends on patients' willingness to participate. Studies often fail to reach satisfactory representativeness.Objective: This paper aims to investigate reasons for not participating in research among young adult patients with psychiatric illness.Method: A quantitative cross-sectional study was performed based on questionnaires reported on by 51 psychiatric patients (14 males, 35 females and two unspecified) who had previously declined participation in an ongoing research project. Thereafter, a qualitative interview with subsequent content analysis was conducted with ten additional patients (five males, five females).Results: The questionnaires indicate being 'too tired/too sick to participate' as the most common barrier. Lack of time and fear of needles were other common barriers. Lack of trust or belief in the value of research was less inhibitive. In the interviews, disabling psychiatric symptoms were confirmed as the main reason for not participating. Several potential ways to increase participation were identified, such as simplification of procedures and information as well as providing rewards and feedback, and building relationships before asking.Conclusion: This study is unusual as it focuses on the group of young people attending psychiatry outpatient clinics we know very little about - those who do not partake in research. Our results indicate that fatigue and sickness reduce research participation and identify factors that may facilitate enrolment of this important group.
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| 5. |
- Bäckström, Josefin, 1977-, et al.
(författare)
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Health-related quality of life in family members of patients with burns
- 2014
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Ingår i: Journal of Burn Care & Research. - 1559-047X .- 1559-0488. ; 35:3, s. 243-250
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Tidskriftsartikel (refereegranskat)abstract
- A severe burn not only affects the patients, but may also have a great impact on the lives of family members. It is known that family members of patients with burns experience psychological distress, but health-related quality of life (HRQoL) has not been studied in this group. The aim was to study predictors of HRQoL in family members of patients with burns. Forty-four family members of adult patients treated in a burn center, between 2000 and 2007, completed questionnaires during care, and at 3, 6, and 12 months after injury. HRQoL was assessed with the EuroQol 5D (EQ-5D), which consists of the dimensions: mobility, self-care, usual activities, pain, and anxiety/depression. The questionnaire generates an EQ-5D index and a visual analog scale (VAS) score. Overall, the EQ-5D index was similar to that of the general population. A slight improvement in HRQoL was found in the VAS scores and in the anxiety/depression dimension over time. In regression models, HRQoL was primarily predicted by earlier life events, symptoms of post-traumatic stress disorder, and HRQoL, assessed during the patients’ hospitalization. In summary, HRQoL assessed with VAS scores increased slightly during the first year postburn, and early screening for life events and psychological symptoms, and HRQoL might be useful in identifying family members in need of support.
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| 6. |
- Bäckström, Josefin, 1977-, et al.
(författare)
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Identifying the Needs of Family Members in Burn Care : Nurses' Different Approaches
- 2019
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Ingår i: Journal of Burn Care & Research. - : Oxford University Press (OUP). - 1559-047X .- 1559-0488. ; 40:3, s. 336-340
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to explore how nurses in burn care identify family members' needs of support and what support the nurses offer. Family members are an important source of short- and long-term support for burn survivors. Being a family member in burn specific as well as general care can be challenging in several ways. Nurses are recognized as well as positioned in the team for assessing and providing such support; however, little is known about how this is done. This is an explorative study with a qualitative descriptive design. Fourteen semistructured interviews with registered nurses working in national burn centers were recorded digitally, transcribed verbatim, and analyzed using Systematic text condensation. The analysis resulted in four themes reflecting different approaches to assess the needs of family members: Active, Emotional, Passive, and Rejective Approach. Nurses in this study demonstrated different approaches to assessing needs in family members; it is possible that these differences may affect what support family members receive. Therefore, the importance of theoretical education, professional views, and local ward culture should be highlighted in ongoing work in improving care within burn care as well as similar health care contexts.
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| 7. |
- Ekeblad, Frida, et al.
(författare)
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Impact of personality disorders on health-related quality of life one year after burn injury
- 2015
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Ingår i: Disability and Rehabilitation. - : Informa UK Limited. - 0963-8288 .- 1464-5165. ; 37:6, s. 534-540
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: Personality disorders (PDs) are associated with significant distress, disability, and cause great difficulties in life. PDs have been suggested to influence adaptation after major burns, but the potential relationship has not been fully elucidated. This study aimed to describe the prevalence of PDs in 107 patients with major burn injury, and to identify the impact of PDs on perceived patient outcome assessed as health-related quality of life (HRQoL) one year after burn. Methods: One burn-specific instrument (Burn Specific Health Scale-Brief (BSHS-B)) and two generic instruments (EuroQol Five Dimensions and Short Form 36 Health Survey) were used, and Psychiatric Axis I and II disorders were assessed one year post burn. Results: This study identified an above normal prevalence of PDs among individuals afflicted by burn, and participants with PD had a significantly larger lifetime burden of Axis I disorders compared to participants without PD. Participants with PDs scored significantly lower than those without PD in the BSHS-B domain Skin involvement, and the effect of having a PD was related to the subscale Treatment regimens. There was no relationship between the presence of PD and generic HRQoL. Conclusions: An implication of these observations is that special rehabilitation efforts including more tailored interventions must be offered to these patients to ensure that the obstacles they perceive to caring for themselves in this respect are eliminated.
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| 8. |
- Gauffin, Emelie, et al.
(författare)
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Health-related quality of life (EQ-5D) early after injury predicts long-term pain after burn
- 2016
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Ingår i: Burns. - : Elsevier BV. - 0305-4179 .- 1879-1409. ; 42:8, s. 1781-1788
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Tidskriftsartikel (refereegranskat)abstract
- Background: Chronic pain after burn can have severe physical and psychological effects on former patients years after the initial injury. Although the issue of pain after burn has gained increased attention over the past years, prospective, longitudinal studies are scarce. Our aim was to prospectively investigate consecutive burn patients for pain severity over time and to evaluate the prevalence and characteristics of post-burn pain to 2-7 years after the burn. As an additional aim, the effects of burn and individual-related factors, especially health related Quality of Life (HRQoL), were investigated.Method: Sixty-seven consecutive burn patients were assessed during acute care at 3, 6, 12 and 24 months, as well as at 2-7 years post-burn. HRQoL, symptoms of post-traumatic stress disorder (PTSD) and other psychiatric disorders were investigated. During the interviews that took place 2-7 years after the injury (mean 4.6 1.9 years), current chronic post-burn pain was assessed using the Brief Pain Inventory-Short Form (BPI-SF).Results: One-third of the patients still reported pain 2-7 years after the injury. Pain severity and interference with daily life were mainly mild to moderate though they were found to be associated with significantly lower HRQoL. Chronic pain after bum was associated with both burn- and individual-related factors. In logistic regression analysis HRQoL at 3 and 12 months and symptoms of PTSD at 12 months were independent factors in predicting chronic pain after burn.Conclusion: Pain after burn becomes a chronic burden for many former burn patients and decreases HRQoL. A novel finding in this study was that HRQoL assessed early after burn was a predictor for the development of chronic pain. This finding may help to predict future pain problems and serve as an indicator for pain preventive measures.
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| 9. |
- Gauffin, Emelie
(författare)
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Long-term outcome after burn : Pruritus, pain, personality and perceived health
- 2019
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- This thesis investigated the role of burn-specific and individual-related factors for long-term outcome after burn with emphasis on pruritus, pain, personality and perceived health.Consecutive adult patients, admitted to the Uppsala University Burn Center between 2000 and 2009, were included. Patients were assessed during hospitalization, at 3, 6, 12 and 24 months and finally at 2-7 and 10-17 years post-burn.Pruritus was prevalent in half of the patients 2-7 years post-burn. Of the patients with pruritus, half had severe pruritus, which was independently related to full thickness burn and health-related quality of life (HRQoL) at 3 months post-burn. One third scratched to the point of bleeding. Such scratching was independently related to full thickness burns and the personality trait Impulsiveness, but did not necessarily imply more severe pruritus. Results suggest that many patients lack adequate treatment. Pain was prevalent in one third of the patients 2-7 years post-burn. Severity levels generally decreased over time and was at follow-up mostly regarded as mild to moderate. Post-burn pain has a negative effect on HRQoL and at 3 months post-burn, HRQoL was independently related to the reporting of post-burn pain at 2-7 years.Personality trait scores in burn patients deviated little from norm values. Personality traits remained largely stable the first year after burn injury, except for an increase in the trait Stress Susceptibility, which was scored lower during the acute care phase but normalized at 12 months post-burn.In qualitative interviews 10-17 years post-burn, participants reported living a near normal life. The subscales of the burn-specific health scale brief were in general still applicable at this time point. Additional areas playing an important role for post-burn health and outcome were skin-related problems, morphine de-escalation, the importance of work, stress and avoidance, mentality and the healthcare system.Certain subgroups of burn patients are more vulnerable and likely to develop post-burn sequalae and this is dependent on both burn severity and individual characteristics. In general, however, many former burn patients recover well in the long run.
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| 10. |
- Gauffin, Emelie, et al.
(författare)
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Patient perception of long-term burn-specific health and congruence with the Burn Specific Health Scale-Brief
- 2019
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Ingår i: Burns. - : Elsevier BV. - 0305-4179 .- 1879-1409. ; 45:8, s. 1833-1840
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: This qualitative study aims to explore former burn patients’ perception of burn-specific health and investigate how these experiences correspond to the subscales in the Burn Specific Health Scale-Brief (BSHS-B).Method: Respondents were former burn patients, admitted to the Uppsala Burn Centre between 2000 and 2007. A total of 20 respondents with a Total Body Surface Area (TBSA) of 20% or larger, were approached at 10 to 17 years post-burn and interviewed using a semi-structured guide. Data was analyzed using thematic analysis.Results: Despite extensive burn injuries, respondents said they led a close-to-normal life. Their descriptions validated the significance of the existing themes of BSHS-B. Additional themes of importance for post-burn health were skin related problems, morphine de-escalation, the importance of work, stress and avoidance, mentality and the healthcare system.Conclusion: The BSHS-B alone may not be sufficient in providing a comprehensive picture of former burn patients’ self-perceived health in the long-term perspective. Investigating supplementary areas reflecting former patients’ sociocultural and attitudinal environment, as well as personal factors, may be of great importance.
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