Thesis (M.S.)--University of Wisconsin--Madison, 1980. / Typescript. eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references (leaves 80-84).

Thesis (M.S.)--University of Florida, 2006. / Typescript. Title from title page of source document. Document formatted into pages; contains 34 pages. Includes Vita. Includes bibliographical references.

Thesis (M.S.)--University of Florida, 2004. / Typescript. Title from title page of source document. Document formatted into pages; contains 31 pages. Includes Vita. Includes bibliographical references.

Introduktion: Vi lever i ett mångkulturellt samhälle och det ställer höga krav på operationssjuksköterskans omvårdnad för en hög patientsäkerhet i samband med operation. Syfte: Att undersöka operationssjuksköterskors upplevelser av språkproblem och kulturella aspekter i den perioperativa vården. Metod: Kvalitativ metod med induktiv ansats tillämpades och data samlades in via enskilda intervjuer med 10 operationssjuksköterskor, 8 kvinnor och 2 män, vid tre sjukhus i Mellansverige. En kvalitativ innehållsanalys användes för att bearbeta det insamlade materialet. Resultat: Genom analysen framkom det tre kategorier och åtta subkategorier. De tre  kategorierna var: Operationssjuksköterskan i den mångkulturella vården, Kommunikation och Kommunikationshjälpmedel. I resultatet framkom att hänsyn togs till patientens önskemål så långt det var möjligt om det inte påverkade patientsäkerheten. Operationer i intimare kroppsdelar upplevdes svårare än andra. Operationssjuk-sköterskorna upplevde sig begränsade när de inte kunde kommunicera med patienten. Patienten upplevdes oftast dåligt informerad innan operationen. Det ansågs säkrare att använda en professionell tolk än en anhörig som tolk. Det framkom önskemål från operationssjuksköterskorna om kommunikationshjälpmedel. Konklusion: Studien visade att språkproblem och kulturella aspekter påverkade operationssjuksköterskans perioperativa arbete. Det som upplevdes svårt var både att inhämta och förmedla information som hade betydelse för patientens perioperativa vård och patientsäkerhet. / Introduction: We are living in a multicultural society, which puts great importance on the theatre nurses´ care for patient´s security during surgery. Aim: To investigate the theatre nurses' experiences of language- and cultural issues in the perioperative care. Method: Qualitative method with inductive approach was applied and data was collected through individual interviews with ten surgical nurses, eight women and two men, at three hospitals in the Midwest part of Sweden. A qualitative analysis of the content was used to process the interviews. Results: The analysis resulted in three categories and eight subcategories. The three categories were: Theatre nurse in multicultural health care, Communication and Communication Aids. The result showed that patient's wishes were considered if they did not affect the safety of the patient. Operations in the intimate parts of the body felt harder than others. Theatre nurses felt restricted when they could not communicate with the patient. The patient own personal experience of information prior to the surgery wasn´t satisfactory. It was considered safer to use a professional interpreter than a family member as an interpreter. There were requests from the theatre nurses for communication aids. Conclusion: The study revealed that language- and cultural issues affect the theatre nurse perioperative work. They experienced difficulties in both collecting and disseminating information that had significance for perioperative patient care and patient safety.

Bakgrund: Oro drabbar de flesta patienter inför operation. Det finns många faktorer som påverkar patientens upplevelser av oro både inom vården och det liv patienten befinner sig i. Det är av stor vikt att få en ökad förståelse av hur den preoperativa omvårdnaden kan minska patientens oro och lidande utifrån patientens perspektiv.  Syfte: Att beskriva patientens upplevelse av oro i samband med den preoperativa omvårdnaden.  Metod: En deskriptiv litteraturstudie baserad på kvalitativa artiklar valdes. Tjugo artiklar analyserades med en beskrivande syntes enligt Evans (2002).   Resultat: Det uppkom tre huvud teman och sex subtema; Tema ”Oro som är relaterad till operation” med subteman ”Faktorer som orsakar oro hos patienten innan operation” och ”Väntetidenspåverkan”, tema ”Behov av stöd för att vara delaktig” med subteman ”Individuellt anpassad information” och ”Informationsstöd från vårdpersonal och närstående”, tema ”Behov av trygghet och tillit” med subteman ”Bemötande” och ”Vårdmiljön”.   Slutsats: Upplevelsen av att känna oro innan operation var huvudsakligen ohanterbart och frustrerande på alla aspekter i patientens livsvärld. Med hjälp av ökad förståelse av patientens upplevelser av oro i förhållande till den preoperativa omvårdnaden kan operationssjuksköterskan minska detta lidande som är relaterad till vården. Det är viktigt för operationssjuksköterskan att reflektera över det stöd som patienter är i behov av med en helhetssyn. Nyckelord: preoperativ omvårdnad, upplevelse, lidande, oro, patient, kvalitativ / Background: Anxiety afflicts the majority of patients before an operation. There are many factors which affect the patient's experience of anxiety both within care and the stage of life in which the patient finds himself. It is of great importance to acquire an increased understanding of how pre-operative care can reduce the patient's anxiety and suffering from the patient's perspective.  Aim: To describe the patient's experience of anxiety in relation to pre- operative care.  Method: A descriptive literature study based on qualitative articles was chosen. Twenty articles were analyzed with a descriptive synthesis as according to Evans (2002).  Results: Three main themes and six sub-themes emerged. Theme “Anxiety related to operation” with the sub-theme “Factors which cause anxiety before an operation” and “The effect of waiting”, theme “The need of support to be involved” with the sub-theme “Personalized information” and “Information support from nursing staff and family”, theme “The need of security and trust” with the sub-theme “Personal treatment” and “Care environment”.   Conclusion: The experiencing of feelings of anxiety before an operation could not be addressed and was frustrating in all aspects of the patient's lifeworld. With the help of increased understanding of the patients’ experience of anxiety in relation to the pre-operative care, the operation nurse can reduce this suffering that is related to health care. It is important that the operation nurse reflects over the support the patient needs with a holistic approach. Keywords: preoperative care, experience, suffering, anxiety, patient, qualitative

A cultura da segurança do paciente cirúrgico está em evidência devido ao crescente número de erros e eventos adversos, os quais poderiam ser prevenidos. A avaliação pré-operatória permite que o enfermeiro do Centro Cirúrgico junto com os demais enfermeiros e o anestesiologista, elabore um plano de cuidados para reduzir e prevenir as complicações pós-operatórias. Com os dados obtidos com a avaliação pré-operatória, e as dúvidas dos pacientes esclarecidas, identificam-se as necessidades de cada um, traçando intervenções que buscam solucionar os problemas que possam dificultar o procedimento cirúrgico. Acredita-se que a vivência dos pacientes relacionada aos questionamentos, muitas vezes repetida e dispersa, decorra da coleta efetuada por diversos profissionais envolvidos com as avaliações, da inexistência de um instrumento transdisciplinar de avaliação pré-operatória que na maioria das vezes, está associada uma falha na comunicação entre os profissionais. Objetivo: elaborar e validar um instrumento de avaliação pré-operatória transdisciplinar para garantir a segurança do paciente cirúrgico no período transoperatório. Método: estudo metodológico com técnicas psicométricas baseado na revisão dos guidelines da Associação Brasileira de Enfermeiros de Centro Cirúrgico, Recuperação Anestésica e Centro de Material e Esterilização (SOBECC), Association of periOperative Registered Nurse (AORN), American Society of Anaesthesiologists (ASA) e European Society of Anaesthesiology (ESA), sendo realizado através da etapa de validação de conteúdo de um instrumento de avaliação pré-operatória transdisciplinar. Resultado: o instrumento desenvolvido foi elaborado com base na revisão dos guidelines relevantes das áreas de enfermagem perioperatória e anestesiologia. Foram encontradas semelhanças nos guidelines preconizados pela SOBECC e AORN em quatro categorias. Já os guidelines preconizados pela ASA e ESA eram similares em três categorias. Em relação a validação de conteúdo, o instrumento apresentou índices satisfatórios na validação de conteúdo pelo coeficiente de conteúdo total, variando de 0,83 a 0,99. Recomenda-se a aplicação-piloto informatizada deste instrumento. Conclusão: Nas fases de validação, o instrumento apresentou resultados significativos, tornando-se uma importante ferramenta para garantir a segurança do paciente no período perioperatório. / The safety of the surgical patient is at the forefront of society due to the increasing number of incidents and adverse events that have been extensively documented and could have been otherwise prevented. The preoperative evaluation allows the nurse of the Surgical Center, along with the other nurses and the anesthesiologist, to develop procedures to reduce and prevent postoperative complications. Using the data obtained from the preoperative evaluation and clarifying the doubts of patients, the needs of each patient are identified, tracing interventions that seek to solve the problems that may hinder the surgical procedure. It is believed that the current practice of asking repetitive questions to patients, often exaggerated and dispersed throughout the medical record, results from the uncoordinated actions of several professionals involved in the evaluation and the lack of a transdisciplinary preoperative evaluation instrument, which more often than not leads to miscommunication among professionals. Objective: elaborate and validate a transdisciplinary preoperative evaluation instrument to guarantee the safety of the surgical patient in the transoperative period. Method: a methodological with psychometric techniques study based on the revision of the guidelines of Brazilian Association of Nurses of Surgical Center, Anesthetic Recovery and Material and Sterilization Center (SOBECC), Association of periOperative Registered Nurse (AORN), American Society of Anaesthesiologists (ASA) and European Society of Anaesthesiology (ESA), being carried out through the validation stage of content of a transdisciplinary preoperative evaluation instrument. Result: the developed instrument was elaborated based on the revision of the relevant guidelines of the areas of perioperative nursing and anesthesiology. Similarities were found between the guidelines recommended by SOBECC and AORN in four categories. In turn, the guidelines favored by ASA and ESA were similar in three categories. With regards to content validation, the instrument presented satisfactory contents indexes for coefficient of total content, ranging from 0.83 to 0.99. The pilot application of this computadorized instrument is recommended. Conclusion: In the validation phases, the instrument presented significant results, consisting in an important tool to guarantee patient safety during the perioperative period.

Submitted by Filipe dos Santos (fsantos@pucsp.br) on 2018-04-24T12:27:13Z No. of bitstreams: 1 Grácia Maria Garcia Silva.pdf: 1921629 bytes, checksum: 11acbb31f2a9d74c5cce8f0746ba8a8d (MD5) / Made available in DSpace on 2018-04-24T12:27:14Z (GMT). No. of bitstreams: 1 Grácia Maria Garcia Silva.pdf: 1921629 bytes, checksum: 11acbb31f2a9d74c5cce8f0746ba8a8d (MD5) Previous issue date: 2018-02-28 / The cancellation of surgeries is significant in many hospitals, not only in Brazil. The motifs are repeated in all studies, varying only by orders, and most are avoidable causes. All cancellation creates stress for the patient and burden the institution, also reflecting inefficiency in management. Faced with this reality, in which SUS (Health Unic System) patients are the most impaired, the work proposes a nursing intervention to reduce cancellations of surgeries for these patients. The study, conducted with 159 SUS patients with scheduled elective surgeries, consisted of a nursing consultation and an active search (telephone contact with the patient or family member) 48 hours before the surgery. A retrospective study was also performed on the surgical procedures performed and suspended, by specialty, reason for suspension and source of payment (SUS, Agreement and Particular) from January 2014 to November 2017. The average number of suspensions of research surgeries was 17.0%, above the historical average (10.4%) and the historical average of SUS (14.0%). The rate of suspension when there was contact with the patient or with a relative was 15.3%, lower than the rate when there was no contact (22.0%). As the percentages of patientrelated causes (44.4%) were similar to non-relative ones (55.6%), joint action is recommended between health teams and the institution, in order to reduce cancellation of surgeries / O cancelamento de cirurgias é significativo em muitos hospitais, não apenas do Brasil. Os motivos se repetem em todos os estudos, variando apenas as ordens, e a maioria são causas evitáveis. Todo cancelamento gera stress para o paciente e onera a instituição, refletindo também ineficiência na gestão. Diante desta realidade, na qual os pacientes do SUS são os mais prejudicados, o trabalho propõe uma intervenção de enfermagem para diminuir os cancelamentos das cirurgias para esses pacientes. O estudo, feito com 159 pacientes do SUS com cirurgias eletivas agendadas, foi composto de uma consulta de enfermagem e de uma busca ativa (contato telefônico com o paciente ou familiar), 48 horas antes da cirurgia. Foi feito, também, um estudo retrospectivo sobre as cirurgias agendas, realizadas e suspensas, por especialidade, motivo de suspensão e fonte pagadora (SUS, Convênio e Particular) de janeiro de 2014 a novembro de 2017. A média de suspensões de cirurgias da pesquisa foi de 17,0%, acima da média histórica geral (10,4%) e da média histórica do SUS (14,0%). A taxa de suspensão quando houve o contato com o paciente ou com um familiar foi de 15,3%, inferior à taxa de quando não houve o contato (22,0%). Como os percentuais de causas relativas aos pacientes (44,4%) foram semelhantes aos não relativos (55,6%), recomenda-se uma ação conjunta entre as equipes de saúde e a instituição, de modo a diminuir os cancelamentos de cirurgias

Bakgrund: Preoperativ fasta är nödvändigt innan anestesi för att reducera magsäckens innehåll och därmed minska risken för aspiration. Trots att internationella riktlinjer rekommenderar två timmars fasta för klar vätska är det många sjukhus som fortfarande använder sig av rutinmässig praxis att låta patienter fasta från midnatt. Detta kan innebära en onödigt lång fasta som ger patienten komplikationer i form av sekundära biverkningar och insulinresistens. Syfte: Att undersöka preoperativ omvårdnad i samband med fasta inför kirurgi. Metod: En litteraturstudie med beskrivande design bestående av 14 utvalda originalartiklar från databaserna Pubmed och Cinahl användes. Den teoretiska referensramen för denna studie var Katie Erikssons omvårdnadsteori gällande förståelse av lidande och lidandets drama. Resultat: Många patienter fastade längre än American Society of anesthesiologists (ASAs) rekommenderade riktlinjer. Att fasta längre än två timmar innan operation minskade inte risken för aspiration och gav inte någon mindre volym av magsäckens innehåll hos patienterna. Att ge patienter kolhydratrik dryck innan operation ökade patienternas pre- och postoperativa välbefinnande och innebar inga risker. Slutsats: Genom ett mer flexibelt arbetssätt vid planerad operation kan längden på fastan anpassas efter patientens individuella behov. I samband med planerad kirurgi kan kolhydratrik dryck vara ett bra komplement vid fasta för att minska patientens lidande. Sjuksköterskan är omvårdnadsansvarig och ska arbeta evidensbaserat samt se till patienternas bästa och tillgodose deras behov. Sjuksköterskan kan använda detta som underlag för att minska lidandet i samband med fastan. / Background: Preoperative fasting is necessary before anesthesia to reduce gastric contents and decrease the risk of aspiration. Although international guidelines recommend two hours fasting of liquids, many hospitals still practice nil-by-mouth after midnight. This might give an unnecessarily prolonged fasting which give the patient discomfort and insulin resistance. Aim:  To examine preoperative care in connection with fasting prior to surgery. Method: A literature study with descriptive design based on 14 original articles selected from the databases Pubmed and Cinahl was used. The theoretical frame of reference for this study was Katie Eriksson's nursing theory regarding understanding of suffering and the drama of suffering. Results: Many patients fast longer than American Society of anesthesiologists (ASAs) recommended guidelines. Fasting more than two hours before surgery did not decrease the risk of aspiration and did not decrease the gastric volume. To give patients a high carbohydrate drink before surgery increased the patient's pre- and postoperative comfort. Conclusion: Through a more flexible working method during the planned operation, the length of the fast can be adapted to the patient's individual needs. In conjunction with planned surgery, carbohydrate-rich beverages can be a good complement to fasting to reduce the patient's suffering. The nurse is responsible for nursing care and should work evidence-based and ensure the patients' best and meet their needs. The nurse can use this as a basis for reducing the suffering associated with fasting.

Spirituality and nursing have been intertwined from the beginning of the profession; however, there is little evidence that clearly defines spiritual nursing care and no standardized practices that can be included in the routine preoperative plan of care for patients undergoing invasive surgical procedures. The purpose of this project was to conduct a systematic review of the literature to define spiritual care and identify specific spiritual nursing care interventions. The biopsychosocial model, Narayanasamy's transcultural care practice model, and Watson's theory of human caring provided the theoretical framework for the project. MEDLINE, PubMed, Wiley online library, SCIENCE, WOS, Cochrane, and SciELO databases were searched for the literature review. Keywords and phrases used included spirituality, spiritual nursing care, holistic health practices, inpatient, hospital, and preoperative care. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) II tool was used for data analysis. Interventions found in the literature to be supportive of spirituality included healing presence; providing effective communication; praying with the patient and family or facilitating other religious rituals; using the therapeutic self to be with the patient; listening to and exploring the patients' spiritual perspectives; and showing support and empathy through patient-centered caring, nurturing spirituality, and creating a healing environment. Employing these nursing actions might promote positive social change by contributing to a sense of well-being as patients find meaning and purpose in their illness and life overall, which will promote improved surgical outcomes and better patient satisfaction with care.

<p>Preoperativ stress och oro är vanligt förekommande i dagens sjukvård. Patienter med hög intensitet av preoperativ stress och oro får ofta postoperativa komplikationer såsom längre återhämtningsfas och svårare sårläkning. Syftet med litteraturstudien var att belysa omvårdnadsåtgärder som kan påverka preoperativ stress och oro. Litteraturstudiens resultat bygger på en analys av 16 vetenskapliga artiklar som söktes utifrån litteraturstudiens syfte. Tre omvårdnadsåtgärder som är en del av sjuksköterskeprofessionen eller som finns tillgängliga på vårdavdelningar är information, sjuksköterskans förhållningssätt samt musik. Med hjälp av dessa omvårdnadsåtgärder kan sjuksköterskan hjälpa patienten att reducera preoperativ stress och oro i god tid. Detta resulterar i att patienten upplever trygghet i sin omgivning, slappnar av och blir mottaglig för information. Om intensiteten av stress och oro reduceras preoperativt leder det till kortare sjukhusvistelse och därigenom lägre sjukhuskostnader. För att underlätta sjuksköterskans planering av omvårdnadsåtgärder kan patientdagbok vara till hjälp.<strong> </strong>Det behövs forskning kring sjuksköterskans upplevelse att arbeta utifrån dessa tre omvårdnadsåtgärder.</p>