Evaluation of a Preoperative Clinic for Women With Gynecologic Cancer

Surgical Patient Preoperative Readiness: Translation into French, Cultural Adaptation for Switzerland and Cross-Sectional Exploratory Study in a Tertiary Hospital

PURPOSE

Preoperative evaluation of elective surgery patients traditionally focuses on somatic and organizational aspects of the situation. Patient feelings of readiness, called preoperative readiness (PR), impacts postoperative outcomes, and yet is rarely evaluated. The Preoperative Assessment Tool (PART) is a validated and reliable 15-item questionnaire available in Filipino and English. A reliable tool is essential for evaluating PR within the Swiss health context to offer optimized and comprehensive perioperative care. The aim of this study was to both translate into French and adapt culturally the Preoperative Assessment Tool for Switzerland's francophone population, and to explore patient PR in the preoperative consultation within a Swiss tertiary hospital.

DESIGN

A mixed design with methodologic phases and descriptive study.

METHODS

A mixed design in two phases with a methodologic phase with (1) translation and (2) cultural adaptation for Romandie of the PART, following Wild's 10 steps methodology (n = 11) and (3) a cross-sectional exploratory descriptive study with pilot testing of the translated version in a general elective preoperative consultation in a tertiary hospital in Romandie (N = 88).

FINDINGS

Translation and cultural adaptations are well accepted and understood by the participants (n = 9/11), modifications are accepted by the authors and deemed adequate by the participants (n = 11/11). Time of completion is short (m = 69.06 seconds) and adapted to clinical context. The translated version has a Cronbach (α = 0.85) comparable to the original validated scale (α = 0.86).

CONCLUSIONS

The translation and cultural adaptation for Switzerland of the PART was achieved, and PR was explored. Further psychometric testing of the PART-FrenCH must be conducted to assess fully the tool before its use in a clinical setting. Including PR in preoperative evaluations could enhance patient-centered approaches and lead to improvement in the quality of care.

Importance of Pre-anesthetic Evaluation in Diagnosing Coexisting Asymptomatic Medical Conditions: A Report of Two Cases

The preoperative assessment of patients undergoing surgery, often conducted in pre-anesthesia clinics, plays an important role in ensuring patient safety and optimizing perioperative outcomes. This assessment aids in identifying underlying medical conditions that might otherwise remain asymptomatic until they manifest as complications during or after surgery. Through these two case reports, the importance of pre-anesthesia assessment is highlighted. The first case involves a 67-year-old male whose surgery for lymph node excision was planned. However, during the preoperative assessment, atrial fibrillation and pulmonary hypertension were identified, necessitating further intervention and treatment adjustments before surgery. In the second case, an eight-year-old child with a history of vomiting and abdominal pain planned for tonsillectomy was discovered to have congenital hypothyroidism through a vigilant preoperative evaluation. Timely intervention and consultation with an endocrinologist ensured a safe surgery without complications. These cases emphasize the role of preoperative cardiovascular assessment, the utility of electrocardiograms (ECGs), and the relevance of routine laboratory tests in reducing perioperative mortality. Hence, pre-anesthesia assessments are not mere routine steps; they are essential components of patient care that significantly impact perioperative results.

Effects of Relaxation-Focused Nursing Program in Women with Ovarian Cancer: A Randomized Controlled Trial

BACKGROUND

Surgical treatment is a major cause of hospitalization in ovarian cancer. In this process, physical problems, such as pain and changes in respiratory functions, and psychological problems, such as anxiety and stress, may develop.

AIM

This study aims to investigate the effects of the Relaxation-Focused Nursing Program on pain, anxiety, lung volume, level of knowledge, and nursing care satisfaction in ovarian cancer surgery.

METHOD

A randomized controlled trial in which participants were randomly assigned to either the experimental (preoperative relaxation exercises and education; n = 24) or control (usual nursing care; n =22) groups. The intervention consisted of practicing four sessions of relaxation exercises and education in the hospital for two days before surgery. Data were collected using the Trait and State Anxiety Inventory, Surgical Information Form, and Perioperative Assessment Form. The results were analyzed using the Friedman and Wilcoxon tests.

RESULTS

The findings showed significant reductions in pain (p = .045) and anxiety scores (p < .001). The level of knowledge means scores were higher in the experimental group, but there was no significant difference between mean scores of spirometer volume and care satisfaction.

CONCLUSIONS

The program was more effective than usual nursing care in preoperative anxiety, pain, and level of knowledge. Although there was no difference between the care satisfaction scores of the patients, the reasons for care satisfaction were different in the program. Developing and implementing care that combines stress reduction interventions and preoperative education can improve the preoperative outcomes of patients.

Development, Functioning, and Effectiveness of a Preoperative Risk Assessment Clinic

Lee first described the concept of preoperative assessment testing (PAT) clinic in 1949. An efficiently run clinic is associated with increased cost-effectiveness by lowering preoperative admission time and thus reducing the length of stay and the associated costs. The setup of the PAT clinic should be based on the needs, culture, and resources of the institution. Various models for the setup of PAT clinic have been described, including the concept of a perioperative surgical home, which is a patient-centered model designed to improve health and the delivery of health care and to reduce the cost of care. Although there are several constraints in the development of PAT clinics, with increasing awareness about the usefulness of pre-operative risk assessments, growing bodies of literature, and evidence-based guidelines, these clinics are becoming a medical necessity for the improvement of perioperative care.