Older Patients' Worries in Connection With General Anesthesia and Surgery-A Qualitative Study

The meaning of being conscious during surgery with local or regional anesthesia-A phenomenological hermeneutic study

Background

With increasing prevalence of surgery under local or regional anesthesia, which allows patients to remain conscious during the intraoperative phase, there is a growing need to comprehend the lived experiences associated with this practice.

Objective

This study aimed to illuminate the lived experiences of individuals who remained conscious during surgical intervention under local or regional anesthesia.

Design

A qualitative design was chosen.

Settings

Participants in the present study were recruited from three surgical wards located in central Sweden using a purposive sampling strategy. The surgical disciplines included ear, gynecological, hernioplasty, orthopedic, and vessel surgeries.

Participants

Fourteen narrative interviews were conducted with individuals who had undergone elective surgery while conscious.

Methods

Verbatim transcribed text was analyzed using a phenomenological-hermeneutic method.

Results

The lived experience of being conscious during surgery was marked by feelings of hope alongside a sense of losing one's identity and experiencing destabilization. Structural analysis revealed two themes. The first theme, 'being in the hands of others', encompassed subthemes such as 'entering an unfamiliar environment and procedure,' 'losing foothold and a sense of self-identity,' and 'enduring unexpected or anticipated discomfort.' The second theme, 'managing the inevitable for future health concerns,' involved subthemes such as 'pursuing self-acceptance of the situation,' 'entrusting the professionals while seeking signs of a smooth procedure,' and 'Enhancing own resilience through continuous support.

Conclusions

Beyond the patient's physical well-being during surgery, the OR team should acknowledge the "person" component and focus on their emotional and social needs in this vulnerable situation. The four meta-paradigms of nursing-person, health, environment, and nursing-significantly influence the conscious patient's experience.

Patient or Public Contribution

No patient or public contribution.

Patient experiences during the planned perioperative care pathway: An integrative review

AIMS

This integrative review aimed to synthesize evidence about the patients' experiences during the planned perioperative care pathway.

DESIGN

Integrative review.

DATA SOURCES

Cumulative Index to Nursing and Allied Health Literature (CINAHL), Medline Ovid, Scopus, and American Psychological Association (APA) PsychINFO. Original, peer-reviewed studies published in English between 2012 and 2023 exploring patient experiences during the planned perioperative care pathway were reviewed.

METHODS

This review was guided by the Whittemore and Knafl method and followed PRISMA guidelines to search the literature. Twenty-two articles were selected for the final study.

RESULTS

Three themes emerged: Sharing of information is empowering; interpersonal relationships are valued by patients, and hospital systems and care co-ordination influence the patient experience.

CONCLUSIONS

The quality and consistency of the information patients receive can both support and undermine patient confidence in health professionals. The quality of relationships that participants experience and effective communication with health professionals can support or compromise the quality of the patients' perioperative experience. The nature of the hospital systems and care co-ordination in hospital has implications for the quality of recovery from surgery.

IMPACT

This review evaluates whether national and international health services and organizations, adhering to the WHO guidelines, have developed and implemented intentionally focused perioperative care with the aims to achieving effective and sustainable surgical outcomes through increased patient satisfaction.

NO PATIENT OR PUBLIC CONTRIBUTION

This article is an integrative review and does not include patient or public contribution.

Development and implementation of anxiety management program for women under gynecological surgery with spinal anesthesia: Protocol of action research study

BACKGROUND

Anxiety is the most common health problem and the second leading cause of disability worldwide. Patients undergoing surgery often experience anxiety. It is necessary to use appropriate interventions to achieve the best results. The aim of this study is to develop, implement, and evaluate of anxiety management program for gynecological surgery patients under spinal anesthesia.

MATERIALS AND METHODS

This participatory action research will be conducted through four phases; problem identification, planning, action, and evaluation phases in the Gonbad-e-Kavous Shahada, hospital in northeastern of Iran. These phases will be guided based on the Promoting Action on Research Implementation in Health Services framework. Participants will be included using purposive sampling method. We will use both of qualitative (semi-structured interview, observation) and quantitative (questionnaire) approaches for data collection through the study.

CONCLUSION

For anxiety management of patients, context-based interventions should be performed. Combination of multidimension approach based on health-care providers, patients, and environment will have an effect to solve the problem in the clinical setting.

Patients experience of warmth and coldness in connection with surgery - a phenomenological study

Purpose: The aim was to describe patients' lived experience of warmth and coldness in connection with surgery. Methods: A reflective lifeworld research (RLR) approach founded on phenomenology and the methodological principles of openness, flexibility, and bridling were used. The data consisted of 16 in-depth interviews with patients from four hospitals in Sweden. Results: Warmth and coldness in connection with surgery means an expectation to maintain one´s daily life temperature comfort. When patients' needs of temperature comfort is fulfilled it give a sense of well-being and calmness. Despite the body is covered there are feelings of vulnerability. When patients have the ability to change their own temperature comfort, they feel independent. Conclusion: The individual feeling of temperature comfort could be affected or changed to discomfort during the perioperative context, and an intervention is required to avoid suffering due to the care. An ability to independently influence one´s own temperature comfort can strengthen the patient, whereas the opposite entails suffering in silence. The phenomenon is also related to feelings of confidence about receiving the best care as well as being exposed and vulnerable. When the patient´s need of comfortable temperature is met then feelings of security and sense of well-being emerged.