Bakgrund: Att opereras sätter patienten i en utsatt situation där personliga och kroppsliga gränser överskrids. Då patienten sövs har hon ännu mindre kontroll över vad som sker och den perioperativa sjuksköterskan blir den som måste bevara hennes värdighet och integritet. På flera intensivvårdsavdelningar kommunicerar personalen med den sövda patienten då de utgår ifrån att hon kan höra och minnas det som sägs även under anestesi. Detta synsätt är till synes inte lika utbrett inom operationsvården. Syfte: Syftet var att beskriva operationssjuksköterskors upplevelser av hur de upprätthåller den sövda patientens integritet och värdighet. Metod: Tre fokusgruppsintervjuer utfördes på två sjukhus i södra Sverige. I studien deltog 12 operationssjuksköterskor med arbetslivserfarenhet från ett halvår upp till 44 år. Intervjuerna spelades in och transkriberades och datan analyserades med kvalitativ innehållsanalys. Resultat: Fyra kategorier med underkategorier identifierades som beskrev operationssjuksköterskans bevarande av den sövda patientens integritet och värdighet. Dessa var: att bevara patientens kroppsliga integritet, att försvara patienten, att ha ett empatiskt förhållningssätt och att följa upp kränkningar mot patienter. Konklusion: Bevarandet av den sövda patientens värdighet och integritet är en komplex fråga, där den kroppsliga integriteten lätt tar överhanden. Implementeringen av ett arbetssätt där den sövda patienten antas kunna uppfatta en del av det som händer på operationssalen skulle kunna leda till att alla delar av värdigheten och integriteten lättare bevaras. Operationssjuksköterskan har en viktig roll i att se till hela människan och hennes behov. Det är många faktorer som påverkar vilka strategier som används av sjuksköterskan och det krävs ett reflekterande förhållningssätt. Organisationen har ett ansvar för att främja arbetsmiljön och teamsamarbetet för att på bästa sätt möjliggöra bevarandet av patientens värdighet och integritet. / Background: Surgery puts the patient in a vulnerable situation where personal and physical limits are exceeded. An anesthetized patient has even less control over what is happening and the perioperative nurse has to maintain the dignity and integrity of the patient. In many intensive care units, the staff communicates with the anesthetized patient assuming she can hear and remember what is said even under sedation. This approach doesn’t seem to be as widespread in surgical care. Objective: The objective was to describe the surgical nurses' experiences of how they maintain the anesthetized patient integrity and dignity. Method: Three focus group interviews were conducted at two hospitals in southern Sweden. The study enrolled 12 operating theatre nurses with work experience from six months up to 44 years. The interviews were recorded and transcribed and the data were analyzed using qualitative content analysis. Results: Four categories with subcategories were identified that described how the operating theatre nurses maintained the integrity and dignity of the anesthetized patient. These were: to preserve the patients’ bodily integrity, defending the patient, to have an empathetic approach and to follow up on violations towards patients. Conclusion: Maintaining the anesthetized patient's dignity and integrity is a complex issue, where bodily integrity often takes precedence. The implementation of an approach where the anesthetized patient is assumed to be able to understand a part of what happens in the operating room could lead to the preservation of the patients’ dignity and integrity as a whole. The operating theatre nurse has an important role to care for the whole person and her needs. There are many factors that influences the strategies used by the nurses that also requires a reflective approach. The organization itself has a responsibility to promote the work environment and team collaboration to best enable the preservation of the patients’ dignity and integrity.

Diss. (sammanfattning) Linköping : Univ., 2003. / Härtill 4 uppsatser.

<p>Sve veća potreba za izvođenjem kolonoskopije u dijagnostičke ili terapijske svrhe nameće potrebu za usavr&scaron;avanjem ove endoskopske procedure. Izvođenje kolonoskopije u op&scaron;toj, intravenskoj anesteziji, moglo bi u značajnoj meri olak&scaron;ati njeno izvođenje, pobolj&scaron;ati podno&scaron;enje ove procedure od strane ispitanika i omogućiti otkrivanje većeg broja pacijenata sa potencijalno malignim bolestima debelog creva. Cilj ispitivanja je bio utvrditi da li primena op&scaron;te intravenske anestezije tokom kolonoskopije povećava broj totalnih kolonoskopija i skraćuje vreme intubacije cekuma, povećava broj viđenih patolo&scaron;kih procesa i smanjuje osećaj bola i učestalost neželjenih reakcija. Primena op&scaron;te intravenske anestezije značajno je povećala broj totalnih kolonoskopija u 94.3% ispitanika u odnosu na 78.7% totalnih kolonoskopija kontrolne grupe i skratila vreme intubacije cekuma, značajno je povećala broj viđenih patolo&scaron;kih promena u 46.7% ispitanika u odnosu na broj viđenih patolo&scaron;kih promena u 28.8% ispitanika kontrolne grupe i značajno je smanjila intenzitet bola i učestalost neželjenih reakcija. U kontrolnoj grupi ispitanika skalom bola nakon kolonoskopije ustanovljen je značajno veći intenzitet bola u poređenju sa ispitanicima ekperimentalne grupe. Na Likertovoj skali zadovoljstva ustanovljena je značajno bolja kontrola bola i lični stav lekara u ekperimentalnoj grupi, dok su poseta ustanovi i procedura, razumevanje procedure, tehnička ve&scaron;tina lekara, lični stav medicinskih sestara i drugog tehničkog osoblja značajno bolje ocenjeni u kontrolnoj grupi. Od svih ispitivanih faktora na zadovoljstvo obe grupe pacijenata značajno su uticali: način izvođenja procedure, bol, uočene patolo&scaron;ke promene i intubacija cekuma. U kontrolnoj grupi ispitanika između skale zadovoljstva i skale bola ustanovljena je značajna negativna korelacija. U kontrolnoj grupi se 80,1% pacijenata izjasnilo da bi ponovnu kolonoskopiju uradili u op&scaron;toj intravenskoj anesteziji u poređenju sa svim pacijentima eksperimentalne grupe koji ne bi menjali način izvođenja ponovne procedure. Primena op&scaron;te intravenske anestezije tokom kolonoskopije povećava broj totalnih kolonoskopija i uočenih patolo&scaron;kih promena, smanjuje učestalost i intenzitet neželjenih reakcija povećavajući zadovoljstvo pacijenata, &scaron;to bi prevashodno moglo imati značaja u skriningu karcinoma debelog creva. Potrebno je pro&scaron;iriti ispitivanje primene op&scaron;te intravenske anestezije u drugim endoskopskim procedurama kako bi bila uvedena u svakodnevnoj kliničkoj praksi.</p> / <p>An increasing need to perform colonoscopy for diagnostic or therapeutic purposes imposed the need for mastering this endoscopic procedure. Performing colonoscopy in general intravenous anesthesia could greatly ease the procedure, make it more comfortable for patients and it could enable detecting a higher number of patients with occult malignant diseases of the colon. The aim of this paper was to determine if the implementation of general intravenous anesthesia during colonoscopy increases the number of total colonoscopies and shortens the time of cecum intubation, increases the number of familiar pathological processes and decreases the sensation of pain as well as the frequency of side reactions. The implementation of general intravenous anesthesia has significantly increased the number of total colonoscopies in 94.3% of examined patients in relation to 78.7% of total colonoscopies of the control group and shortened the time of cecum intubation. It has significantly increased the number of familiar pathological changes in 46.7% of the patients in relation to the number of familiar pathological changes in 28.8% patients of the control group and significantly decreased pain intensity and the frequency of side reactions. A statistically greater pain intensity after colonoscopy was determined by the pain scale in the control group in comparison to the examinees of the experimental group. Likert satisfaction scale has shown that the experiment group assessed pain control and doctors&rsquo; opinion as significantly better, while the institution visits and the procedure, understanding the procedure, doctors&rsquo; technical skills, nurses&rsquo; and technical personnel&rsquo;s personal opinions were assessed as significantly better in the control group. Out of all the examined factors on the satisfaction of both groups, the following ones had a significant inluence: the way the procedure was done, the level of pain, detected pathological changes and cecum intubation. A significanlty negative correlation was determined between the scale of satisfaction and the scale of pain in the control group. 80.1% of the control group patients stated that they would undergo a general anesthesia colonoscopy again in comparison to all the patients of the experimental group who would not change the way the procedure was previously done. The implementation of general intravenous anesthesia in the course of colonoscopy increases the number of total colonoscopies and detected pathological changes, decreases the frequency and intensity of side-effects therefore it enhances patients&#39; sastisfaction, which could play a major role in colon cancer screening. It is necessary to extend the implementation of general intravenous anesthesia in other endoscopic procedures in order to introduce it in everyday clinical practice.</p>