| 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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I Stay : Swedish Specialist Nurses in the Perioperative Context and Their Reasons to Stay at Their Workplace
- 2019
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Ingår i: Journal of Perianesthesia Nursing. - : Elsevier BV. - 1089-9472 .- 1532-8473. ; 34:3, s. 633-644
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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.
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| 3. |
- Arakelian, Erebouni, 1973-, et al.
(författare)
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Nurses anaesthetists' versus patients' assessment of anxieties in an ambulatory surgery setting.
- 2019
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Ingår i: Journal of perioperative practice. - : Sage. - 2515-7949 .- 1750-4589. ; 29:12, s. 387-415
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: 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.PURPOSE: To compare the nurse anaesthetists' estimations of patients' preoperative anxieties with the patients' own assessment of their anxieties.DESIGN: Quantitative prospective design.METHODS: 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.RESULTS: 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.CONCLUSIONS: 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.
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| 4. |
- 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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| 5. |
- Arakelian, Erebouni, 1973-, et al.
(författare)
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The meaning of person-centred care in the perioperative nursing context from the patient's perspective : an integrative review
- 2017
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Ingår i: Journal of Clinical Nursing. - : Wiley. - 0962-1067 .- 1365-2702. ; 26:17-18, s. 2527-2544
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Tidskriftsartikel (refereegranskat)abstract
- AIMS AND OBJECTIVES: To determine the meaning of person-centred care from the patient's perspective and in the context of perioperative nursing. BACKGROUND: Person-centred care (PCC) is used but not defined in the perioperative context. The concept indicates an interest in the patient's own experience of health, illness, needs and preferences. As with many terms that are frequently used, there is a tendency for person-centred care to mean different things to different people in different contexts. METHODS: A two-part search strategy was employed; firstly, a computerized database search of PubMed and CINAHL, using Medical Subject Headings and free terms to search articles dating from 2004 to 2014, and secondly, a hand-search of those articles' reference lists was performed. Twenty-three articles were selected and an integrative review was conducted. RESULTS: Four themes were discovered: 'Being recognized as a unique entity and being allowed to be the person you are', 'Being considered important by having one's personal wishes taken into account', 'The presence of a perioperative nurse is calming; prevents feelings of loneliness and promotes wellbeing, which may speed up recovery', and 'Being close to and being touched by the perioperative nurse during surgery'. CONCLUSIONS: PCC means respecting the patient as a unique individual, considering the patient's particularities and wishes, and involving the patient in their own care. PCC also implies having access to one's own nurse who is present both physically and emotionally through the entire perioperative process and who guides the patient and follows up postoperatively, guaranteeing that the patient is not alone. RELEVANCE TO CLINICAL PRACTICE: By having a common understanding of the concept of PCC, the nurse anaesthetists' and theatre nurses' caring actions or concerns will be directed towards the patient', resulting in personalization of care rather than simply defining the concept. This article is protected by copyright. All rights reserved.
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| 6. |
- Jangland, Eva, et al.
(författare)
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Between two roles - Experiences of newly trained nurse practitioners in surgical care in Sweden : A qualitative study using repeated interviews
- 2016
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Ingår i: Nurse Education in Practice. - : Elsevier. - 1471-5953 .- 1873-5223. ; 21, s. 93-99
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Tidskriftsartikel (refereegranskat)abstract
- The position of Nurse Practitioner is a new role in Nordic countries. The transition from a registered nurse to the Nurse Practitioner role has been reported to be a personal challenge. This study, guided by the Nordic theoretical model for use in the education of advanced practice nurses, represents a unique opportunity to describe this transition for newly graduated Nurse Practitioners in an interprofessional surgical care team in Sweden. The aim was to explore how the first Nurse Practitioners in surgical care experienced the transition into a new role and what competences they used in the team. Eight new Nurse Practitioners with parallel work in clinical practice were interviewed twice around the time of their graduation. The qualitative analyses show that the participants integrated several central competences, but the focus in this early stage in their new role was on direct clinical praxis, consultation, cooperation, case management, and coaching. Transition from the role of clinical nurse specialist to nurse practitioner was a challenging process in which the positive response from patients was a driving force for the new Nurse Practitioners. The participants felt prepared for and determined to solve the challenging situations they approached working in the interprofessional team.
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| 7. |
- Leo Swenne, Christine, 1958-, et al.
(författare)
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Perioperative dialogue on postoperative recovery measured by the use of pain medication, psychopharmaceutical agents and length of hospital stay
- 2018
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Ingår i: Nordic journal of nursing research. - : Sage Publications. - 2057-1585 .- 2057-1593. ; 38:4, s. 212-219
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Tidskriftsartikel (refereegranskat)abstract
- The effects of perioperative dialogue have been studied using qualitative methods, describing patient satisfaction with their care. However, they have not been studied in patients with peritoneal carcinomatosis who undergo major surgery, nor with quantitative variables. The aim was to study the use of pain medication and length of hospital stay following cytoreductive surgery and hyperthermic intraperitoneal chemotherapy in patients who received, versus those who did not receive, perioperative dialogue. The study had a quantitative, retrospective and comparative design including 89 audits. Of these, 37 patients received perioperative dialogues, and 52 patients did not (the control group). The result showed that by postoperative day six, patients who received a perioperative dialogue experienced pain less frequently than patients in the control group. However, no differences between the groups were noted with regard to pain medication consumption and length of hospital stay. To ease their worries, all patients in both groups used benzodiazepines. The perioperative dialogue may be studied quantitatively, but it must involve the patient, who is an equal partner in the dialogue. Structured validated self-reporting measures may be used systematically before and after surgery in order to evaluate the perioperative dialogue using quantitative measures.
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| 8. |
- Lögde, Ann, et al.
(författare)
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I am quitting my job : Specialist nurses in perioperative context and their experiences of the process and reasons to quit their job
- 2018
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Ingår i: International Journal for Quality in Health Care. - : Oxford University Press (OUP). - 1353-4505 .- 1464-3677. ; 30:4, s. 313-320
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Tidskriftsartikel (refereegranskat)abstract
- The lack of specialist nurses in operating theatres is a serious problem. The aim of this study was to describe reasons why specialist nurses in perioperative care chose to leave their workplaces and to describe the process from the thought to the decision. Twenty specialist nurses (i.e. anaesthesia, NA, and operating room nurses) from seven university- and county hospitals in Sweden participated in qualitative individual in-depth interviews. Data were analysed by systematic text condensation. We identified four themes of reasons why specialist nurses quitted their jobs: the head nurses' betrayal and dismissive attitude, and not feeling needed; inhumane working conditions leading to the negative health effects; not being free to decide about one's life and family life being more important than work; and, colleagues' diminishing behaviour. Leaving one's job was described as a process and specialist nurses had thought about it for some time. Two main reasons were described; the head nurse manager's dismissive attitude and treatment of their employees and colleagues' mistreatment and colleagues' diminishing behaviour. Increasing knowledge on the role of the head nurse managers in specialist nurses' decision making for leaving their workplace, and creating a friendly, non-violent workplace, may give the opportunity for them to take action before it is too late.
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| 9. |
- Swenne, Christine Leo, 1958-, et al.
(författare)
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Patients' experiences of their everyday life 14 months after cytoreductive surgery and hyperthermic intraperitoneal chemotherapy : a qualitative follow-up study
- 2017
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Ingår i: Scandinavian Journal of Caring Sciences. - : Wiley. - 0283-9318 .- 1471-6712. ; 31:4, s. 904-913
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Patients with peritoneal carcinomatosis treated with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy have a long recovery process.AIM: To describe patients' experiences of their everyday lives after cytoreductive surgery and hyperthermic intraperitoneal chemotherapy.METHOD: A follow-up study with a qualitative, descriptive design. Data were collected by individual, in-depth telephone interviews with 16 patients who had been treated for peritoneal carcinomatosis 14 months earlier at a university hospital in Sweden. The interviews were performed between May and June 2013 and analysed using systematic text condensation.RESULTS: Five themes were identified: (i) finding one's new self and relating to the new situation; (ii) the disease making its presence felt through bodily complications or mental fatigue; (iii) worrying about the return of the disease and passing it on to one's children; (iv) experiencing difficulties contacting various care facilities, not having a clear plan for ongoing rehabilitation; and (v) the need for online support through the Internet and counselling for both patients and their family members.CONCLUSIONS: Despite bodily complications, mental fatigue and worries about the return of the disease, the patient's everyday life was focused on finding his/her new self and adapting to the new circumstances. Difficulties in contacting care facilities and the lack of an ongoing medical and nursing rehabilitation plan called for a need for network support for patients and their families.CLINICAL RELEVANCE: After advanced surgery, patients require a continuous medical and nursing rehabilitation plan, and a platform of support such as meetings via social media and Internet which would connect former patients and their families with future patients and their family members. A contact nurse with specific expertise should design an individual rehabilitation plan and continuously identify the individual needs for long-term support.
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| 10. |
- Swenne, Christine Leo, et al.
(författare)
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Postoperative health and patients' experiences of efficiency and quality of care after cytoreductive surgery and hyperthermic intraperitoneal chemotherapy, two to six months after surgery
- 2015
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Ingår i: European Journal of Oncology Nursing. - : Elsevier BV. - 1462-3889 .- 1532-2122. ; 19:2, s. 191-197
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To study post-discharge health after Cytoreductive Surgery (CRS) and Hyperthermic Intraperitoneal Chemotherapy (HIPEC), and to. analyse patients' experiences of in-hospital efficiency and quality of care. Methods: In-depth individual telephone interviews using an interview guide with open-ended questions were performed with 19 patients with peritoneal carcinomatosis between April and October, 2012. Data were analysed with systematic text condensation. Results: Four themes were identified: 1) Coming home was an essential step in the recovery process and the focus was on getting well physically despite mental stress, uncertainty about the medical rehabilitation plan and the future. 2) Health was affected negatively by postoperative chemotherapy and its side effects. 3) Stoma - a necessary evil affecting the patient's social life. 4) Quality of care and efficiency were defined in patient-centred terms and inter-personal care from the patient's perspectives on Micro level. Despite all, 32% of the patients described being fully recovered and had started to study or work two months after surgery. Conclusions: The study gives insights into some real-life experiences described by patients. The study results can be used to prepare written information, to design a postoperative rehabilitation plan for future patients with Peritoneal Carcinomatosis (PC) and to create a home-page through which patients can receive support from both health care professionals and other fellow patients.
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