Socialstyrelsen beskriver en kommande brist på operationssjuksköterskor i Sverige, samtidigt visar statistik av antal ansökningar till specialistutbildningen att färre sjuksköterskor väljer inriktningen operationssjuksköterska. I litteraturen beskrivs operationssjuksköterskans yrke som dolt för utomstående, och det kan vara en orsak till det låga intresset att välja yrket. Syftet med denna pilotstudie var att beskriva sjuksköterskors uppfattningar om operationssjuksköterskans yrke. Studien är genomförd med kvalitativ induktiv ansats som en intervju med öppen ingångsfråga. Data är analyserat med manifest innehållsanalys. I resultatet framkom tre kategorier, Osynligt och lågt värderat, Medlem i teamet och Praktiskt arbete. Resultatet stämmer överens med tidigare utförd forskning. En större studie är av värde för att få en djupare förståelse av skillnader i uppfattningar. Kunskap om uppfattningen kan underlätta rekrytering av operationssjuksköterskor. Specialistkompetens på operationsavdelningarna ökar förutsättningarna för patienter att få en säker perioperativ omvårdad / National Board of Health and Welfare describes an upcoming shortage of perioperative nurses in Sweden, and statistics show that the number of nurses applying to specialized training in the perioperative field is declining. In the literature, the perioperative nursing profession is described as non-visible to people in general, and that may be a reason for the lack of interest in choosing the profession. The purpose of this pilot study is to describe nursesʹ perceptions of the perioperative nursing profession. The study was conducted using qualitative inductive approach as an interview with open entry question. Data was analyzed by manifest content analysis. The results revealed three categories; Invisible and low valued, Member of the team and Practical work. The result is consistent with prior research conducted. A larger study is of value to obtain a deeper understanding of differences in perceptions. Knowledge of these perceptions may facilitate the recruitment of perioperative nurses. Specialized competence at the surgical departments increases the chances for patients to receive a safe perioperative care.

Det är en unik upplevelse att bli opererad med lokalanestesi och vara vaken under ett operativt ingrepp. Patienten överlämnas till vårdpersonalen och är beroende av deras omhändertagande och kunskap. Kontinuerlig information under ingreppet samt ett gott bemötande från personalen kring patienten är avstor vikt för att skapa en trygg miljö och ge god omvårdnad. Syftet med studien var att beskriva patienters upplevelse och känslor av den perioperativa omvårdnaden när de var vakna under ett operativt ingrepp. Fyra intervjuer med konsekutivt utvalda patienter som genomgått operationen på sjukhus i sydvästra Sverige inkluderades i studien. Öppna, övergripande frågor samt följdfrågor användes under intervjuerna. Kvalitativ innehållsanalys användes. Analysen ledde till tre kategorier; tidigare upplevelser av vården, omvårdnad kring operationen samt känslor som uppstod under operationen. Tidigare erfarenhet samt personalens omvårdnad gav trygghet i de aktuella operationerna. Känslorna som uppstod under en vaken operation var både positiva och negativa. Resultatet kan bidra tillvidare utveckling och förbättring av den perioperativa omvårdnaden kring envaken patient. / Being awake during surgery is a unique experience. The patient is handed over to the nursing staff and is dependent on their care and knowledge. Continuous information during surgery and professional care from the nursing staff is important to create a safe environment and provide good healthcare. The aim of the study was to describe the patient’s experience and feelings of the perioperative nursing care when being awake during surgery. Four interviews with consecutively selected patients who had undergone surgery in a hospital in the south west of Sweden were included. Open, general questions and supplementary questions were used during the interviews. Qualitative content analyz was used. The analyz resulted in three categories: past experiences of care, care during the surgery and feelings that occurred during the operation. Previous experience and the care provided by the nurses gave patients the feelings of security. Both negative and positive feeling occurred during surgery. The results may contribute to further development and improvement of the perioperative nursing care on patients that are awake during surgery.

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.

There are many terms used to describe pressure ulcers: pressure sores, decubitus ulcers, bedsores, and pressure necrosis or ischaemic ulcers. Essentially they all describe damage to the patient's skin and underlying tissue. The nursing literature abounds with information about the risk, grading, prevention and treatment of pressure ulcers. These ulcers are a problem in hospital and long term care facilities, and are a major cause of morbidity. In the hospital setting they contribute to an extended length of stay and by doing so 'block' the bed for use by another patient. The ulcers are difficult to treat, are an ongoing cause for pain and discomfort for the patient and can be a strain on hospital finances. Pressure ulcers are not unique to modern times, as they have been discovered on the remains of an Egyptian mummified body (Armstrong & Bortz 2001). This would suggest that the problem dates back to the Pharoahs, and has continued to be a challenging problem throughout the centuries (Bridel 1992). The escalating costs of treating these ulcers today, has brought about an emphasis on the risk factors, prevention and the appropriate interventions, rather than an acceptance of these ulcers as a tolerable ondition (Bridel 1992). In the operating room, nurses are faced with unique challenges when caring for their patients. This is due to difficulty in caring for patients under the influence of the anaesthesia required for surgery, long periods of forced immobility and the inability of the patient to perceive pain and discomfort from the pressure of the hard surface of the operating room table. These problems are increased by nurses' inability to gain access to the patient because of the sterile drapes required to cover the patient for surgery. Armstrong and Bortz (2001) present information from one study in which it is stated that surgical patients have 90% greater chance of developing pressure ulcers than medical patients. One reason for this may be due to the limited information available in regard to the most effective support surface to place on top of the operating room table. This gap in information is problematic for operating room nurses as it limits their ability to select the most effective item of equipment, and determine if the chosen equipment reduces pressure on tissue intra- operatively. The most effective operating room table mattress used and the skills and knowledge of the operating room nurse about the aetiology and prevention of pressure ulcer prevention, are important aspects of nursing care and can influence patient outcomes. The potential for complications to occur may be dependent on single or combined factors such as the patient's age, disease processes, nutritional status and mobility. Preparatory and supportive nursing interventions for surgical procedures based on best available evidence, nursing experience and patient preference, can reduce the incidence of pressure ulcer development in the perioperative environment. This doctoral portfolio contains four separate sections related and linked together by a common theme - pressure ulcer prevention in the perioperative environment. This first section of the portfolio situates the topic and provides a brief overview of the portfolio. The second section is a critical review of the literature pertaining to the most commonly used operating room table mattresses, and the effectiveness of these mattresses in the prevention of pressure ulcer development. This review highlighted a lack of quality research in this area, and while many evaluations have been undertaken to determine the effectiveness of perating room table mattresses, the results are contradictory concerning the patients, exposures and interventions. Because of issues related to the methodological quality of published research in this area a systematic review using meta- analysis was not possible rather a critical review of the research literature is used. The third section of the portfolio reports on a hermeneutic ethnography of the perceived skills and knowledge of nurses in the prevention of pressure ulcer development in the perioperative environment. This study was designed to determine if pressure ulcer prevention forms an aspect of the everyday practice of perioperative nurses. This review has highlighted the need for operating room nurses to review practices when caring for patients in the perioperative environment particularly in respect of pressure ulcer prevention. The fourth and final section of the portfolio summarises the research and provides recommendations for nursing practice and further research in the area of pressure ulcer prevention in the perioperative environment. / Thesis (D.Nurs.)--Department of Clinical Nursing, 2004.

Thesis (Ph. D.)--University of Alabama at Birmingham, 2008. / Title from first page of PDF file (viewed June 5, 2008). Includes bibliographical references (p. 77-87).

Objeto deste estudo é a percepção do enfermeiro sobre a organização do trabalho no ambiente de Centro Cirúrgico e suas repercussões no processo saúde-doença desses profissionais. Os objetivos traçados foram: identificar a percepção dos enfermeiros sobre a organização do trabalho no Centro Cirúrgico do Hospital Universitário Pedro Ernesto, analisar as repercussões no processo saúde-doença dos enfermeiros decorrentes da organização do trabalho no Centro Cirúrgico. O estudo apoiou-se nas concepções da psicodinâmica do trabalho desenvolvida por Dejours, que busca compreender as vivências dialéticas do sofrimento-prazer decorrentes do trabalho e nas estratégias utilizadas pelos trabalhadores para conter, mitigar ou transformar o sofrimento advindo da organização do trabalho. Trata-se de um estudo qualitativo, descritivo, que utilizou como método o materialismo histórico dialético desenvolvido no período de 2006 à 2007. O local de coleta de dados foi o Hospital Universitário Pedro Ernesto e os sujeitos caracterizaram-se em onze enfermeiros que atuavam no Centro Cirúrgico desta instituição. Como técnicas de coleta de dados foram utilizadas a entrevista semi-estruturada e a observação assistemática. Os sujeitos do estudo preencheram um termo de consentimento livre e esclarecido atendendo à Resolução 196/96. Os dados foram analisados à luz da análise de conteúdo, que evidenciou três categorias: as percepções dos enfermeiros sobre o trabalho no Centro Cirúrgico, trabalho material e imaterial, repercussões do trabalho no processo saúde-doença dos enfermeiros. Os resultados apontaram que os enfermeiros consideram seu trabalho como estressante, desgastante e com repercussões na dimensão subjetiva que se sobrepõem às repercussões na dimensão física devido à organização do trabalho instituída no Centro Cirúrgico. O trabalho também foi caracterizado pelos sujeitos como pouco reconhecido e capaz de gerar sentimentos dialéticos de sofrimento e prazer, satisfação e insatisfação, incidindo diretamente processo saúde-doença destes profissionais através de alterações psicossomáticas. / The study is focused on the nurses perception on Labor Organization in the environment of a Surgical Center, as well as its repercussions on these professionals health-illness process. The objectives were: to identify the nurses perception on labor organization in a Surgical Center at Pedro Ernesto University Hospital, to analyse all repercussions on nurses health-illness process generated from labor organization in a Surgical Center. The study was based on Dejours psycodynamics concepts, that try to comprehend dialetic experiences related to suffering-pleasure that come from nurses activities, as well as strategies used by professionals in order to stop, mitigate or change all suffering that comes from their job. This is a qualitative, descriptive study, that used the historical dialetic materialism as method, which was developed from 2006 to 2007. The place for collecting data was Pedro Ernesto University Hospital and the subjects were eleven nurses that were acting at its Surgical Center. In order to produce this study, semi-structured interview and non-systematic observation were used as data collection techniques; all of the participants were free and clear when they filled in a term of agreement, assuring that Ruling 196/96 was fulfilled. All data were analysed through tables in order to characterize the subjects of the study, and for the statements it was used a content analysis that revealed three categories: nurses perception on labor in a Surgical Center, material and non-material work, work repercussions on nurses health-illness process. Results showed that nurses consider their job stressing, tiring and with higher repercussions on the subjective dimension than on physic dimension due to labor organization stablished in a Surgical Center. Subjects also characterized the work as a non-recognized one, capable of generating dialetic feelings, such as suffering and pleasure, satisfaction and unsatisfaction, repercuting directly on these professionals health-illness process through psychossomatic changes.

Objeto deste estudo é a percepção do enfermeiro sobre a organização do trabalho no ambiente de Centro Cirúrgico e suas repercussões no processo saúde-doença desses profissionais. Os objetivos traçados foram: identificar a percepção dos enfermeiros sobre a organização do trabalho no Centro Cirúrgico do Hospital Universitário Pedro Ernesto, analisar as repercussões no processo saúde-doença dos enfermeiros decorrentes da organização do trabalho no Centro Cirúrgico. O estudo apoiou-se nas concepções da psicodinâmica do trabalho desenvolvida por Dejours, que busca compreender as vivências dialéticas do sofrimento-prazer decorrentes do trabalho e nas estratégias utilizadas pelos trabalhadores para conter, mitigar ou transformar o sofrimento advindo da organização do trabalho. Trata-se de um estudo qualitativo, descritivo, que utilizou como método o materialismo histórico dialético desenvolvido no período de 2006 à 2007. O local de coleta de dados foi o Hospital Universitário Pedro Ernesto e os sujeitos caracterizaram-se em onze enfermeiros que atuavam no Centro Cirúrgico desta instituição. Como técnicas de coleta de dados foram utilizadas a entrevista semi-estruturada e a observação assistemática. Os sujeitos do estudo preencheram um termo de consentimento livre e esclarecido atendendo à Resolução 196/96. Os dados foram analisados à luz da análise de conteúdo, que evidenciou três categorias: as percepções dos enfermeiros sobre o trabalho no Centro Cirúrgico, trabalho material e imaterial, repercussões do trabalho no processo saúde-doença dos enfermeiros. Os resultados apontaram que os enfermeiros consideram seu trabalho como estressante, desgastante e com repercussões na dimensão subjetiva que se sobrepõem às repercussões na dimensão física devido à organização do trabalho instituída no Centro Cirúrgico. O trabalho também foi caracterizado pelos sujeitos como pouco reconhecido e capaz de gerar sentimentos dialéticos de sofrimento e prazer, satisfação e insatisfação, incidindo diretamente processo saúde-doença destes profissionais através de alterações psicossomáticas. / The study is focused on the nurses perception on Labor Organization in the environment of a Surgical Center, as well as its repercussions on these professionals health-illness process. The objectives were: to identify the nurses perception on labor organization in a Surgical Center at Pedro Ernesto University Hospital, to analyse all repercussions on nurses health-illness process generated from labor organization in a Surgical Center. The study was based on Dejours psycodynamics concepts, that try to comprehend dialetic experiences related to suffering-pleasure that come from nurses activities, as well as strategies used by professionals in order to stop, mitigate or change all suffering that comes from their job. This is a qualitative, descriptive study, that used the historical dialetic materialism as method, which was developed from 2006 to 2007. The place for collecting data was Pedro Ernesto University Hospital and the subjects were eleven nurses that were acting at its Surgical Center. In order to produce this study, semi-structured interview and non-systematic observation were used as data collection techniques; all of the participants were free and clear when they filled in a term of agreement, assuring that Ruling 196/96 was fulfilled. All data were analysed through tables in order to characterize the subjects of the study, and for the statements it was used a content analysis that revealed three categories: nurses perception on labor in a Surgical Center, material and non-material work, work repercussions on nurses health-illness process. Results showed that nurses consider their job stressing, tiring and with higher repercussions on the subjective dimension than on physic dimension due to labor organization stablished in a Surgical Center. Subjects also characterized the work as a non-recognized one, capable of generating dialetic feelings, such as suffering and pleasure, satisfaction and unsatisfaction, repercuting directly on these professionals health-illness process through psychossomatic changes.

Trata-se de um estudo de abordagem qualitativa sob a perspectiva da sociologia da saúde, que teve como objetivo interpretar a experiência de reabilitação da pessoa com estomia intestinal por adoecimento crônico. Utilizou-se o referencial teórico da sociologia da saúde e o método etnográfico para apreender a experiência de quinze pessoas com estomia intestinal por adoecimento crônico, que foram entrevistadas no domicílio. A coleta de dados ocorreu no período de abril a novembro de 2013, por meio de entrevistas semiestruturadas gravadas em áudio, de observações participantes e das anotações em um diário de campo, cujos dados foram analisados por meio da análise de conteúdo indutiva (CEP/EERP-USP número: 220.269). Os dados foram organizados e decodificados em dois núcleos de sentidos, denominados de \"Lidando com os tratamentos e a estomia intestinal\" e \"A história da doença e os tratamentos na minha vida\". A partir destes, construímos dois núcleos temáticos: \"A experiência de reabilitação da pessoa com estomia intestinal por adoecimento crônico\" e \"Em busca da adaptação às necessidades de mudanças no cotidiano\". No primeiro núcleo temático interpretamos a reflexão dos participantes do estudo em relação à normalidade da vida anterior ao adoecimento crônico intestinal e a estomia, em busca de uma definição sobre si e a sua vida, considerando as dificuldades pessoais, familiares, sociais e terapêuticas enfrentadas, preparando-se para a condição de estomizado intestinal, que se apresenta com os desafios sociais nos espaços privados e públicos. No segundo tema apreendemos a convivência da pessoa com a estomia intestinal e as consequências do adoecimento crônico intestinal, na qual a assistência especializada e o autocuidado possibilitaram enfrentar as dificuldades, os preconceitos e o estigma, que vão sendo vividos e vencidos ao longo do tempo, com o estabelecimento de uma nova normalidade de vida como estomizado intestinal. Com a interpretação da experiência destas pessoas, o significado construído sobre a reabilitação das pessoas com estomia intestinal por condição crônica foi \"processo de superação dos desafios do cotidiano de vida, da deficiência e do estigma\". Acreditamos que este estudo poderá subsidiar a melhoria da assistência especializada a essas pessoas, nos diversos contextos de atendimento à saúde, principalmente no que se refere ao acolhimento, implementação de estratégias e de suporte profissional especializado para possibilitar a reabilitação dessas pessoas, após o tratamento cirúrgico com confecção de estomia intestinal, com atendimento da demanda de suas necessidades / This is a study of qualitative approach from the perspective of the sociology of health, which aimed to interpret the experience of rehabilitation of people with intestinal ostomy due to chronic illness. We used the theoretical framework of the sociology of health and the ethnographic method to grasp the experience of fifteen people with intestinal stoma by chronic illness who were interviewed at home. Data collection occurred in the period from April to November 2013, through semi-structured audio taped interviews, participant observations and notes in a field journal, which data were analyzed using inductive content analysis (CEP/EERP-USP number: 220.269). The data were organized and decoded in two groups of meaning, called \"Dealing with the treatments and the intestinal ostomy\" and \"History of the disease and treatments in my life.\" From these, we constructed two thematic groups: \"The experience of rehabilitation of people with intestinal ostomy due to chronic illness\" and \"In search of adapting to changing needs in daily life.\" In the first thematic nucleus we interpreted the reflection of the participants of the study compared to normal life prior to chronic intestinal disease and ostomy, in search of a definition about themselves and their life, considering personal, familiar, social and therapeutic difficulties faced, preparing for the condition of intestinal ostomy patients, presenting with social challenges in private and public spaces. The second topic we apprehended the person living with intestinal ostomy and consequences of chronic intestinal disease, in which specialized care and self-care made possible face difficulties, prejudice and stigma that are being experienced and matured over time, with the establishment of a new normalcy of life as intestinal ostomy patient. With the interpretation of the experience of these people, the meaning built on the rehabilitation of people with intestinal ostomy for chronic condition was \"process of overcoming the challenges of everyday life, disability and stigma.\" We believe that this study may support specialized assistance to these people, in different contexts of health care, especially regarding to the acceptance, implementation of strategies and specialized professional support to enable the rehabilitation of these people after surgery that created the intestinal ostomy, answering the demand of their needs

A prevenção da hipotermia do paciente cirúrgico é um desafio para o enfermeiro. Na literatura há diferentes medidas que podem ser implementadas para a manutenção da temperatura corporal do paciente no perioperatório, salientamos os sistemas de aquecimento cutâneo. O presente estudo teve como objetivo avaliar as evidências disponíveis na literatura sobre qual é o sistema de aquecimento cutâneo mais eficaz para a prevenção da hipotermia, no paciente submetido à cirurgia cardíaca sem circulação extracorpórea, no período intra-operatório. O método de revisão adotado foi a revisão sistemática. As bases de dados PubMed, Cinahl, Embase, Central e Lilacs foram selecionadas para a busca dos estudos primários. Os descritores controlados e não controlados foram delimitados para cada uma das bases de dados. Dos 1.604 estudos localizados e considerando os critérios de inclusão e exclusão adotados, 25 estudos foram selecionados e oito foram incluídos na revisão sistemática. Dos oito estudos primários incluídos, quatro ensaios clínicos testaram o sistema de ar forçado aquecido e o sistema de circulação de água aquecida, sendo que em um destes estudos, a cobertura elétrica de fibra de carbono também foi estudada. Em dois ensaios clínicos, os autores investigaram o sistema de ar forçado aquecido e o sistema de transferência de energia com dispositivos adesivos. Em um ensaio clínico, o sistema de ar forçado aquecido e o sistema Thermogard foram estudados e um estudo primário investigou o pré-aquecimento, na indução anestésica, com o sistema de ar forçado aquecido. Os resultados evidenciados apontaram que o sistema de circulação de água aquecida é o mais eficaz para a manutenção da temperatura corporal do paciente submetido à revascularização do miocárdio sem circulação extracorpórea em comparação ao sistema de ar forçado aquecido. Em relação aos outros sistemas de aquecimento cutâneo há necessidade de novas pesquisas para determinar a eficácia destes em cirurgia cardíaca. A adoção de medidas para a prevenção da hipotermia é de responsabilidade de todos os profissionais que prestam cuidado ao paciente cirúrgico; entretanto, ressaltamos a atuação do enfermeiro perioperatório. Compete a esse profissional o planejamento e implementação de intervenções direcionadas para a melhoria da qualidade do cuidado de enfermagem e promovam a segurança do paciente. / Hypothermia prevention in surgical patients represents a challenge of nurses. Literature discusses different measures that can be put in practice to maintain patients\' perioperative body temperature, among which we highlight cutaneous warming systems. This study aimed to assess available evidence in literature on the most effective cutaneous warming system for hypothermia prevention in patients submitted to cardiac surgery without extracorporeal circulation, during the intraoperative period. The systematic review method was adopted. The databases PubMed, Cinahl, Embase, Central and Lilacs were selected to seek primary studies. Controlled and non-controlled descriptors were delimited for each of the databases. Out of 1,604 studies that were located, in view of the adopted inclusion and exclusion criteria, 25 were selected and eight included in the systematic review. Out of eight primary studies included, four clinical trials tested the forced-air warming system and the circulating-water garment system. In one of these, the carbon fiber resistive heating blanket was also studied. In two clinical trials, the authors investigated the forced-air warming system and the energy transfer pads system. In one clinical trial, the forced-air warming system and the Thermogard system were studied, and one primary study investigated prewarming during induced anesthesia, using the forcedair warming system. The evidenced results appointed that the circulating-water garment system is the most effective to maintain the body temperature of patients submitted to coronary artery bypass graft surgery without extracorporeal circulation in comparison with the forced-air warming system. As for other cutaneous warming systems, further research is needed to determine their efficacy in case of cardiac surgery. All professionals who deliver care to surgical patients are responsible for the adoption of hypothermia prevention measures; nevertheless, perioperative nurses\' actions are highlighted. These professionals are responsible for planning and putting in practice interventions aimed at improving nursing care quality and enhancing patient safety.

O investimento dessa pesquisa foi colocar em evidência os sentimentos de ansiedade e medo, encontrados em pessoas que se submeteriam à cirurgia de revascularização do miocárdio, por meio da aplicação de uma estratégia de intervenção grupal, na abordagem psicossocial. Os objetivos foram: identificar os níveis de ansiedade e medo nas pessoas que iriam se submeter à cirurgia de revascularização do miocárdio (RM); implementar uma estratégia de orientação grupal na visita pré-operatória, na abordagem psicossocial, para as pessoas que apresentaram medo e ansiedade no pré-operatório de cirurgia de RM; comparar os níveis de ansiedade e medo entre as pessoas que receberam as orientações tradicionais da instituição e aquelas que participaram da estratégia de orientação grupal na visita pré-operatória; apreender o significado das orientações pré-operatórias segundo a percepção das pessoas participantes dos grupos de intervenção. A pesquisa, de natureza quantitativa e qualitativa, foi realizada em um hospital especializado em cardiologia, no município de São Paulo no período de abril a agosto de 2006. Das pessoas abordadas para avaliação (109), 60 participaram efetivamente do estudo, sendo 30 no grupo de intervenção e 30 no grupo controle. Foi realizado um ensaio clínico controlado randomizado. Os dados foram analisados por meio de análise estatística e de análise de conteúdo, segundo Bardin. No grupo de intervenção foram utilizadas dinâmicas grupais para promover um ambiente relaxante e possibilitar aberturas para livre expressão das pessoas participantes. A maioria dos participantes era do sexo masculino, com Ensino Fundamental Incompleto, com nível sócio-econômico médio, com idade média de 62,02 anos. Verificou-se que as pessoas que participaram do grupo de intervenção tiveram redução nos níveis de ansiedade e o medo de forma clínica e estatisticamente significantes. As dinâmicas proporcionaram um momento lúdico e expressivo, além do significado cognitivo/afetivo e relacional, sendo alcançada. a segurança e a tranqüilidade que levaram à redução da ansiedade e do medo. Os resultados indicam que as orientações pré-operatórias realizadas de forma grupal, na abordagem psicossocial, produzem resultados efetivos e, portanto, recomenda-se que essa estratégia seja implementada nas instituições hospitalares / This research is aimed at highlighting the importance of feelings such as anxiety and fear in those who are to undergo myocardial revascularization surgery (RM), and the adoption of a psychosocial approach by which a strategy of group intervention is used. Aiming at identifying the levels of anxiety and fear in those patients, a strategy of group guidance during the pre-surgery round was adopted, using a psychosocial approach, comparing the levels of anxiety and fear in those who received traditional institutional guidance, and those who took part in the group guidance pre-surgical session, and also at comprehending the meaning of the pre-surgical guidance in the perception of the intervention group participants. This research is of a quantitative and qualitative nature, and was conducted in a specialized cardio hospital, in the city of Sao Paulo, in the period between April and August 2006. Out of the 109 people approached for assessment, 60 took an effective participation in the study, of which 30 were in the intervention group and 30 in the control group. A controlled, random clinical rehearsal was performed. The data was analyzed statistically and content wise, in accordance to Bardin. With the intervention group, group dynamics were applied so as to promote a relaxing, friendly environment, and allow for the participants’ free expression. Most of the subjects in this group were male, with incomplete lower education, average socio-economic class, and 62,02 years old on average. It was noted that this group subjects had their levels of anxiety and fear lowered, in a statistically significant manner. The dynamics provided them with more than only a playful, expressive moment; they had a cognitive/affectionate, relational significance, through which security and tranquility were achieved, and, as a result, levels of anxiety and fear were reduced. Results indicate that group pre-surgical guidance in a psychosocial approach produces effective results, and is thus recommended for undertaking in hospital