Understanding perioperative nursing

Effect of Toys and Preoperative Visit on Reducing Children's Anxiety and their Parents before Surgery and Satisfaction with the Treatment Process

INTRODUCTION

Hospital anxiety and surgery has an unpleasant and disturbing feeling for a child and his/her family. This study aimed to determine the effect of toys and visit in reducing children's anxiety before the surgery and their mothers and satisfaction with the treatment process.

METHODS

This was a quasi-experimental study in posttest design with a control group. 60 children aged 3 to 8 years, who were undergoing ear, nose and throat surgery in Tabriz Amiralmomenin hospital, were chosen, and regarding their age and gender, were recruited into the control or experiment group. For the experiment group, the interventions before surgery were applied. The level of anxiety in children and parents was evaluated by Observation Scale of Behavioral Distress (OSBD-R) and Spielberger State Anxiety Inventory (STAI). The level of parental satisfaction with the treatment process before being discharged from the hospital was evaluated by the process of treatment satisfaction questionnaire (PSQ-18). Data were analyzed by SPSS ver.13.

RESULTS

Mean anxiety scores of the children and mothers in the experimental group were lower than the control group. Mean maternal satisfaction score of the treatment process in the experimental group was higher than the mean scores of the control group. However, in the subscales of general satisfaction, interpersonal behavior, and financial aspects of satisfaction with treatment, no statistical significant difference was found between the experimental and control groups.

CONCLUSION

Based on the findings, providing toys for children and informing the parents about medical information has a major effect in reducing children's and other's anxiety and increasing maternal satisfaction with the treatment process.

Surgery: Between Both Anguish and Joy

Objetivo: describir las categorías que hacen parte de los factores causales de un esquema teórico que emergió durante la investigación: Conviviendo con la ambivalencia en las interacciones de cuidado. Método: cualitativa con enfoque en la teoría fundamentada. Se utilizaron técnicas como la observación, las entrevistas informales y formales a 20 pacientes, 19 auxiliares de enfermería y 8 enfermeras que laboran en diferentes centros quirúrgicos de segundo nivel del Valle de Aburrá. Resultados: se presentan las categorías relacionadas con los sentimientos y las emociones del paciente y del personal de enfermería al ingreso al centro quirúrgico, que hacen parte de los factores causales. Los pacientes desean la normalidad porque sienten molestias no solo físicas sino emocionales, pero también sienten ambivalencia frente al procedimiento quirúrgico. Desde el equipo de enfermería hay una disposición al cuidado porque las enfermeras se identifican en el trabajo para y con seres humanos y se responsabilizan del cuidado del paciente en este periodo. Conclusiones: el equipo de enfermería en cirugía debe estar consciente de la importancia de las dimensiones emocional, social y humana del cuidado y poner especial atención al temor y la ansiedad a los cuales están expuestos los pacientes; por tanto, el cuidado humano en este escenario es vital al ver al otro como un sujeto de atención en su contexto, con sus creencias y valores, aceptándolo tal cual es.

A reflective case study in the obstetric theatre: focusing on the principles of care involved

This article focuses on the principles of care involved in a reflective case study of a patient undergoing a caesarean section. Unplanned caesarean sections are often emotionally charged procedures. Often a mother has had no warning of a surgical intervention for the birth of her child and is understandably both distressed and frightened.

Working Under Pressure

Postoperative services provide an excellent setting to study nursing work due to the patients' needing highly technical, yet highly comforting, care. The current study examined nursing work in postoperative services in an attempt to discern how nursing work is structured. Observations of nursing interactions in a 14-bed postoperative unit of a large Swedish university hospital found that nursing work in this setting is highly intensive and multidimensional. The need to provide nursing interactions that are caring and respectful of patients, while at the same time ensuring a high level of technical capacity, was obvious throughout all stages of patient stays in this unit. Furthermore, although each interaction is necessarily time-limited there is a caring relationship sustained with each patient. There is a pattern of caring that emerges that can be encapsulated as a "contingent routine." Nursing work cannot be broken down into "dimensions of caring." The work is high-pressure and involves, by necessity, multitasking. There are many dimensions of nursing care, but, usually, these are supplied simultaneously.

Older people and hypothermia: the role of the anaesthetic nurse

Older clients are at increased risk during surgical intervention because of age-related system changes and comorbid conditions. However, recent advances in surgical and anaesthetic techniques, together with modern monitoring technology and the proliferation of ambulatory surgery, have reduced mortality in older patients undergoing surgery. Nevertheless, inadvertent hypothermia in older clients remains problematic. Therefore, an understanding of specific diseases prevalent in old age, coupled with a comprehensive knowledge of the physiological impact of ageing in all body systems, underpins the role of the anaesthetic nurse.

Emotional and psychological preoperative preparation in adults

Emotional and psychological surgical preparation plays an important role in many areas of nursing. However, it varies greatly in terms of its perception and delivery. The aim of this article is to familiarize the reader with the concept of emotional and psychological preparation for surgery and to explain how this may be achieved in nursing practice. It highlights that gender, age, and previous experiences are predisposing factors to preoperative anxiety, as is fear of the unknown and fear of harm. It is recommended that information should be given verbally with written supplements and that the patient should be encouraged to ask questions. Diversion therapy such as music, humour and guided imagery have been shown to be effective in reducing patients' preoperative anxiety.

An analysis of perioperative care

Perioperative nursing requires an appreciation of patients' needs throughout the episode of care. This article presents a critical analysis and examination of the perioperative care of a patient undergoing total abdominal hysterectomy. In addition to analysing the efficacy of care delivery in the perioperative setting, we will explore the application of nursing theory and research to everyday practice and the degree to which a hospital's infrastructure facilitates quality care.