| 1. |
- Nilsson, Stefan, 1972, et al.
(författare)
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School-aged children's experiences of postoperative music medicine on pain, distress, and anxiety.
- 2009
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Ingår i: Paediatric anaesthesia. - : Wiley. - 1460-9592 .- 1155-5645. ; 19:12, s. 1184-90
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Tidskriftsartikel (refereegranskat)abstract
- AIM: To test whether postoperative music listening reduces morphine consumption and influence pain, distress, and anxiety after day surgery and to describe the experience of postoperative music listening in school-aged children who had undergone day surgery. BACKGROUND: Music medicine has been proposed to reduce distress, anxiety, and pain. There has been no other study that evaluates effects of music medicine (MusiCure) in children after minor surgery. METHODS: Numbers of participants who required analgesics, individual doses, objective pain scores (Face, Legs, Activity, Cry, Consolability [FLACC]), vital signs, and administration of anti-emetics were documented during postoperative recovery stay. Self-reported pain (Coloured Analogue Scale [CAS]), distress (Facial Affective Scale [FAS]), and anxiety (short State-Trait Anxiety Inventory [STAI]) were recorded before and after surgery. In conjunction with the completed intervention semi-structured qualitative interviews were conducted. RESULTS: Data were recorded from 80 children aged 7-16. Forty participants were randomized to music medicine and another 40 participants to a control group. We found evidence that children in the music group received less morphine in the postoperative care unit, 1/40 compared to 9/40 in the control group. Children's individual FAS scores were reduced but no other significant differences between the two groups concerning FAS, CAS, FLACC, short STAI, and vital signs were shown. Children experienced the music as 'calming and relaxing.' CONCLUSIONS: Music medicine reduced the requirement of morphine and decreased the distress after minor surgery but did not else influence the postoperative care.
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| 2. |
- Nilsson, Ulrica, 1960-, et al.
(författare)
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Stress reduction and analgesia in patients exposed to calming music postoperatively : a randomized controlled trial
- 2005
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Ingår i: European Journal of Anaesthesiology. - 0265-0215 .- 1365-2346. ; 22:2, s. 96-102
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Tidskriftsartikel (refereegranskat)abstract
- Background and objectives: This randomized controlled trial was designed to evaluate, first, whether intra- or postoperative music therapy could influence stress and immune response during and after general anaesthesia and second, if there was a different response between patients exposed to music intra- or postoperatively.Method: Seventy-five patients undergoing open hernia repair as day care surgery were randomly allocated to three groups: intraoperative music, postoperative music and silence (control group). Anaesthesia and postoperative analgesia were standardized and the same surgeon performed all the operations. Stress response was assessed during and after surgery by determining the plasma cortisol and blood glucose levels. Immune function was evaluated by studying immunoglobulin A (IgA) levels. Patients’ postoperative pain, anxiety, blood pressure (BP), heart rate (HR) and oxygen saturation were also studied as stress markers.Results: There was a significantly greater decrease in the level of cortisol in the postoperative music group vs. the control group (206 and 72 mmol L 1 decreases, respectively) after 2 h in the post anaesthesia care unit. The postoperative music group had less anxiety and pain and required less morphine after 1 h compared with the control group. In the postoperative music group the total requirement of morphine was significantly lower than in the control group. The intraoperative music group reported less pain after 1 h in the post anaesthesia care unit. There was no difference in IgA, blood glucose, BP, HR and oxygen saturation between the groups.Conclusion: This study suggests that intraoperative music may decrease postoperative pain, and that postoperative music therapy may reduce anxiety, pain and morphine consumption.
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| 3. |
- Allvin, Renée, 1956-, et al.
(författare)
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Postoperative recovery : a concept analysis
- 2007
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Ingår i: Journal of Advanced Nursing. - Oxford : Blackwell. - 0309-2402 .- 1365-2648. ; 57:5, s. 552-558
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Tidskriftsartikel (refereegranskat)abstract
- Aim. This papaer presents a concept analysis of the phenomeneon postoperative recovery.Background. Each year, millions of patients throughout the world undergo surgical procedures. Although postoperative recovery is commonly used as an outcome of surgery, it is difficult to identify a standard definition.Method. Walker and Avant's concept analysis approach was used. Literature retrieved from MEDLINE and CINAHL databases for english language papers published from 1982 to 2005 was used for the analysis.Findings. The theoretical definition developed points out that postoperative recovery is an energy-requiring process of returning to normality and wholeness. It is defined by comparative standards, achieved by regaining control over physical, psychological, social and habitual functions, and results in a return to preoperative level of independence/dependence in activities of daily living and optimum level of psychological well-being.Conclusion. The concept of postoperative recovery lacks clarity, both in its meaning in relation to postoperative recovery to healthcare professionals in their care for surgical patients, and in the understanding of what researchers in this area really intend to investigate. The theoretical definition we have developed may be useful but needs to be further explored.
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| 4. |
- Allvin, Renee, et al.
(författare)
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Recovery after surgery : A concept analysis
- 2007
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Ingår i: Journal of Advanced Nursing. - : Wiley. - 0309-2402 .- 1365-2648. ; 57:5, s. 552-558
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Tidskriftsartikel (refereegranskat)abstract
- Aim. This paper presents a concept analysis of the phenomenon of postoperative recovery. Background. Each year, millions of patients throughout the world undergo surgical procedures. Although postoperative recovery is commonly used as an outcome of surgery, it is difficult to identify a standard definition. Method. Walker and Avant's concept analysis approach was used. Literature retrieved from MEDLINE and CINAHL databases for English language papers published from 1982 to 2005 was used for the analysis. Findings. The theoretical definition developed points out that postoperative recovery is an energy-requiring process of returning to normality and wholeness. It is defined by comparative standards, achieved by regaining control over physical, psychological, social and habitual functions, and results in a return to preoperative level of independence/dependency in activities of daily living and optimum level of psychological well-being. Conclusion. The concept of postoperative recovery lacks clarity, both in its meaning in relation to postoperative recovery to healthcare professionals in their care for surgical patients, and in the understanding of what researchers in this area really intend to investigate. The theoretical definition we have developed may be useful but needs to be further explored.
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| 5. |
- Berggren, Malin, 1975, et al.
(författare)
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Alternative EBNA1 expression in organ transplant patients.
- 2005
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Ingår i: Journal of medical virology. - : Wiley. - 0146-6615 .- 1096-9071. ; 76:3, s. 378-85
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Tidskriftsartikel (refereegranskat)abstract
- In order to identify patients at risk for developing post-transplant lymphoproliferative disease (PTLD), a sensitive nested RT-PCR method for detection of EBNA1 gene expression in peripheral blood cells was used. EBNA1 expression in peripheral blood samples from 60 organ recipients was analyzed and compared with 24 healthy controls in a retrospective study. Overall, EBNA1-positive samples were detected at least once in 43% of the transplant patients with post-transplant lymphoproliferative disease, in 18% of the other transplant patients and in none of the healthy controls. The odds ratio for EBNA1 expression in patients with post-transplant lymphoproliferative disease was 3.42 (95% CI=1.02-11.54) compared to other transplant recipients. Together with normal EBV Q promoter initiated EBNA1 transcripts, an alternatively spliced form was expressed in peripheral blood cells in the above-mentioned transplant patients. This transcript lacks the U leader exon in the 5'-untranslated region (UTR). We have previously identified and characterized a functional internal ribosome entry site, the EBNA IRES, in the untranslated U leader exon of EBNA1. Transfection experiments with EBNA1 coding plasmids followed by Western blot showed that the EBNA IRES promotes cap-independent translation and increases the EBNA1 protein level. The alternative EBNA1 transcript lacking this function is expressed in the majority of the investigated EBNA1-positive patient samples as well as in some EBV-positive B-cell lines. Alternative splicing in this form gives EBV potential to regulate the translation of EBNA1 by modifying the 5' UTR. These findings indicate a new mechanism for EBNA1 expression in vivo.
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| 6. |
- Falk-Brynhildsen, Karin, 1959-, et al.
(författare)
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Cardiac surgery patients' evaluation of the quality of theatre nurse postoperative follow-up visit
- 2009
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Ingår i: European Journal of Cardiovascular Nursing. - : Oxford University Press (OUP). - 1474-5151 .- 1873-1953. ; 8:2, s. 105-111
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Tidskriftsartikel (refereegranskat)abstract
- Theatre nurses at the Department of Cardiothoracic Surgery in Orebro, Sweden, have since 2001 routinely conducted a follow-up visit to postoperative cardiac patients. A model with a standardized information part and an individual-caring conversation including both a retrospective and a prospective part designed the visit. The purpose of this study was to evaluate the quality of the postoperative follow-up visit conducted by the theatre nurses and find out if the quality was related to gender or type of admission. The method was prospective and explorative, including 74 cardiac surgery patients who had had a postoperative follow-up visit by a theatre nurse in Sweden. The instrument measuring quality, from the patient's perspective, measured the quality of the visit, and consisted of 16 items modified to suit the study. The results showed an overall high quality rating, with statistically significant higher scores for six items between patients who had undergone emergency surgery, in comparison with elective patients. When comparing gender, women had statistically significant higher scores in two items. In conclusion, this postoperative follow-up visit by the theatre nurse was a valuable and useful tool especially for the patients who had undergone emergency surgery. In the follow-up visit the theatre nurse creates a caring relationship by meeting the patient as an individual with his/her own experience and needs for information about the surgery, intra and postoperative care, and recovery.
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| 7. |
- Fredriksson, Ann-Charlotte, et al.
(författare)
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Patients' perception of music versus ordinary sound in a postanaesthesia care unit : a randomised crossover trial
- 2009
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Ingår i: Intensive & Critical Care Nursing. - : Elsevier BV. - 0964-3397 .- 1532-4036. ; 25:4, s. 208-213
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Tidskriftsartikel (refereegranskat)abstract
- We performed an experimental single-blind crossover design study in a postanaesthesia care unit (PACU): (i) to test the hypothesis that patients will experience a higher degree of wellbeing if they listen to music compared to ordinary PACU sounds during their early postoperative care, (ii) to determine if there is a difference over time, and (iii) to evaluate the importance of the acoustic environment and whether patients prefer listening to music during their stay. Two groups received a three-phase intervention: one group (n=23) experienced music-ordinary sound-music and the second group (n=21) experienced ordinary sound-music-ordinary sound. Each period lasted 30 min, and after each period the patients assessed their experience of the sound. The results demonstrated a significant difference (p<0.001) between groups in the proportions of patients reporting that the acoustic environment was of great importance for their wellbeing during the three-phase intervention, and most participants (n=36 versus n=8) noticed that they were exposed to different sounds during the PACU period. The results also revealed that most participants (n=32) preferred listening to music versus listening to ordinary sound (n=3) while in the PACU (p<0.001). These findings promote use of listening to music to establish a healing environment for patients in a postanaesthesia care unit.
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| 8. |
- Idvall, Ewa, et al.
(författare)
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Assessment of recovery after day surgery using a modified version of quality of recovery-40
- 2009
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Ingår i: Acta Anaesthesiologica Scandinavica. - : Wiley. - 0001-5172 .- 1399-6576. ; 53:5, s. 673-677
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Tidskriftsartikel (refereegranskat)abstract
- A recent nationwide survey in Sweden found that day surgery accounts for 43% of all in-hospital procedures.1 Orthopaedic, general, and gynaecological procedures were the most common. About 40% of the day surgery units followed up with telephone calls within 1–2 days, and found pain to be the most common complaint. Quality of recovery had not been systematically evaluated with instruments tested for validity and reliability, and follow-ups beyond 2 days post-operative were not found.Quality of Recovery-40 (QoR-40)2,3 is a 40-item instrument to assess the quality of post-operative recovery. The instrument is divided into five dimensions; emotional state, physical comfort, psychological support, physical independence, and pain. These dimensions represent aspects of good-quality recovery after anaesthesia and surgery. QoR-40 has been used for patients undergoing different surgical procedures and tests for validity and reliability yielded initial support for the instrument. Myles et al.3 concluded that QoR-40 would be a useful outcome measure to assess the impact of changes in health care delivery on quality of care, but anaesthesia and surgery studies have rarely used this approach. Although QoR-40 has not been used exclusively for day surgery patients, some day surgery patients were included when the instrument was developed.2,3 Another study on day surgery patients4 used eight items from QoR-40 relevant to that study. In a systematic review of post-operative recovery outcomes measurements after ambulatory surgery, the QoR-40 was the only instrument that fulfilled the criteria that were set up but was not specifically designed for day surgery and anaesthesia.5 Another systematic review from 2008 also advises to use the QoR-40 in future validation and application studies.6 Day surgery is increasing, and it is important to measure the quality of care and the impact of change. When using an instrument such as QoR-40, each item must be carefully considered for the purpose and context it will be used in, especially when it differs from the original context, both concerning cultural differences between countries and the type of surgical procedure used. Therefore, our study created and used a modified version of the QoR-40 to measure the quality of recovery in day surgery patients. The study aimed to test this modified version in a Swedish context for day surgery patients, to assess the quality of recovery on days 1, 7, and 14 post-operative.
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| 9. |
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| 10. |
- Landgren, Sara, 1980, et al.
(författare)
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Association of Pro-Ghrelin and GHS-R1A Gene Polymorphisms and Haplotypes With Heavy Alcohol Use and Body Mass.
- 2008
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Ingår i: Alcoholism, clinical and experimental research. - : Wiley. - 1530-0277 .- 0145-6008. ; 32:12, s. 2054-2061
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Tidskriftsartikel (refereegranskat)abstract
- Background: Ghrelin, an orexigenic peptide, acts on growth hormone secretagogue receptors (GHS-R1A), expressed in the hypothalamus as well as in important reward nodes such as the ventral tegmental area. Interestingly, ghrelin has been found to activate an important part of the reward systems, i.e., the cholinergic-dopaminergic reward link. Additionally, the rewarding and neurochemical properties of alcohol are, at least in part, mediated via this reward link. There is comorbidity between alcohol dependence and eating disorders. Thus, plasma levels of ghrelin are altered in patients with addictive behaviors such as alcohol and nicotine dependence and in binge eating disorder. This overlap prompted as to investigate the pro-ghrelin and GHS-R1A genes in a haplotype analysis of heavy alcohol-using individuals. Methods: A total of 417 Spanish individuals (abstainers, moderate, and heavy alcohol drinkers) were investigated in a haplotype analysis of the pro-ghrelin and GHS-R1A genes. Tag SNPs were chosen using HapMap data and the Tagger and Haploview softwares. These SNPs were then genotyped using TaqMan Allelic Discrimination. Results: SNP rs2232165 of the GHS-R1A gene was associated with heavy alcohol consumption and SNP rs2948694 of the same gene as well as haplotypes of both the pro-ghrelin and the GHS-R1A genes were associated with body mass in heavy alcohol consuming individuals. Conclusions: The present findings are the first to disclose an association between the pro-ghrelin and GHS-R1A genes and heavy alcohol use, further strengthening the role of the ghrelin system in addictive behaviors and brain reward.
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