Många patienter upplever oro inför anestesi och kirurgiska ingrepp. Detta har negativa effekter även på den postoperativa vården. Dagligen träffar anestesisjuksköterskor patienter inför anestesi och gör preoperativa bedömningar. Då forskning tydligt visar på hög grad av oro hos patienter känns det viktigt att granska och belysa detta. Syftet var att granska och sammanfatta forskningsresultat som belyser patienters oro inför anestesi. Detta examensarbete är en integrativ litteraturstudie. Forskning visar att olika interventioner har effekt på patienters oro, både farmakologiska och icke-farmakologiska. Att patienten får tydlig information kring ingrepp och anestesi samt träffar anestesisjuksköterska i god tid innan ingreppet har positiv påverkan på patienters oro. Andra interventioner såsom musikterapi, akupressur och reflexologi har också positiv påverkan på oro.

Background: Hypertension is common, affecting over one billion people worldwide. Importantly, in Sub-Saharan Africa hypertensive disease not only affects the older population group, but is becoming increasingly prevalent in younger patients. In South Africa, over 30% of the adult population has hypertension, making it the single most common cardiovascular risk factor and the predominant contributor to cardiovascular disease and mortality. In non-cardiac surgical patients, elevated blood pressure is the most common perioperative comorbidity encountered with an overall prevalence of 20-25%, and it remains poorly controlled in low and middle-income countries. Furthermore, hypertension in the perioperative setting may adversely affect patient outcome. It thus not only flags possible perioperative challenges to anaesthesiologists, but also identifies patients at risk of long-term morbidity and mortality. Objectives: The primary objective of this study was to determine the prevalence and severity of hypertension in elective adult surgical patients in the Western Cape. Results: The study population included all non-cardiac, non-obstetric, elective surgical patients from seven hospitals in the Western Cape during a one-week period. Hypertension, defined as having had a previous diagnosis of hypertension or meeting the blood pressure criteria of more than 140/90 mmHg, was identified in 51.8% of patients during the preoperative assessment. Significantly, newly diagnosed hypertension was present in 9.6% of all patients presenting for elective surgery. Although 98.1% of the known hypertensive patients were on antihypertensive therapy, 36.9% were inadequately controlled. Numerous reasons exist for this but notably 32% of patients admitted to forgetting to take their medication, making patient factors the most common cause for treatment non-compliance. Conclusion: This study suggests that the perioperative period may be an important opportunity to identify undiagnosed hypertensive patient. The perioperative encounter may have a significant public health implication in facilitating appropriate referral and treatment of hypertension to decrease long-term cardiovascular complications in South Africa.

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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.

Preoperative psychological state is a major issue in day surgery; especially as patients have a short hospital stay. Except for preoperative anxiety, knowledge is sparse about how patients’ experience mood during waiting for day surgery. The overall aim of this thesis was to describe preoperative moods, persons’ experiences of preoperative mood, and the experiences persons´ describe as having an influence on their preoperative waiting. In study І, mixed methods were used. Data from 163 participants were collected through a study-specific questionnaire. In study ІІ, a qualitative method was used. Data from 20 participants were collected through semi-structured interviews. All participants (n=183) were waiting for small or medium surgery within four different specialties’ (I, II). Data were analysed with descriptive statistics and thematic content analysis (І) and inductive content analysis (ІІ). The main finding was that preoperative patients experience a variety of moods, besides anxiety patients may experience a positive mood. Moodinfluencing factors while waiting for day surgery were found. Patients may experience a shifting mood or to not feel calm, while other patients may feel calm, and experience a harmonious mood. Nearly half of the participants felt calm before surgery, as seventy persons (43 %) stated that they felt calm, whereas 91 persons (57%) stated that they did not feel calm (І). Previous negative experiences from health care were confirmed as a trigger for anxiety. Earlier positive experiences, feelings of trust and expectations contribute to a harmonious mood and to feel calm. Regard-less of mood, patients´ experienced feeling hope about regaining health as a help to balance mood (I-II). The findings contribute to knowledge about different preoperative moods and may have implications in improving preoperative care with support strategies that benefits patients’ during waiting for day surgery regardless of psychological state / <p>Alternativ benämning av serie</p><p>Örebro Studies in Care Sciences</p>

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Yes / Objectives: The objectives of this study ware to translate and validate the Amsterdam Preoperative Anxiety and Information Scale into Nigerian Hausa Language to be used in assessing Hausa speaking surgical patients’ preoperative anxiety before undergoing elective surgery. Methods: Forward and backward translation method was adopted to translate APAIS into Hausa Language so as to produce a Hausa version of the scale (APAIS-H). The Hausa version was tested on thirty patients scheduled for elective surgery at Federal Medical Centre, Nguru-Yobe State, Nigeria. The authors performed factor analysis, internal consistency and correlated the translated Hausa version with Spielberger’s State Trait Anxiety Inventory (STAI-State). Findings: The translated Hausa version of the scale produced high internal consistency for the two subscales (Cronbach’s alpha 0.82 for anxiety related to surgery subscale and 0.71 for information desire subscale respectively). APAIS-H correlated well with Spielberger's state Trait Anxiety Inventory STAI-state with a correlation coefficient of (r = 0.81), Conclusion: APAIS-H has been found to be valid and reliable instrument to be used in the assessment of preoperative anxiety in Hausa speaking patients scheduled to undergo surgical operation.

Introduktion: Det är vanligt förekommande med oro i samband med operationer. Vissa riskfaktorer finnskonstaterade, så som brist på information och kvinnligt kön. Anestesisjuksköterskan har en viktig uppgift i attbemöta och identifiera oro i samband med operation, och minskade nivåer av preoperativ oro bidrar till kortareåterhämtningstid och ett minskat lidande. Syfte: Syftet med denna studie var att undersöka faktorer som kan påverka preoperativ oro hos patienter som skagenomgå elektiv kirurgi. Metod: En kvantitativ retrospektiv tvärsnittsstudie genomfördes. Data samlades in genom en webbaserad enkätbestående av demografiska frågor, en skattningsskala för preoperativ oro samt en öppen fråga. Kvantitativ dataanalyserades med SPSS, medan data från den öppna frågan analyserades med manifest innehållsanalys. Totaltanalyserades 111 enkäter. Resultat:Resultatet visar att det inte fanns ett samband mellan ålder och preoperativ oro, samt att kvinnor kände meroro än män inför anestesin. Personer med hög utbildning skattade sig som mer oroliga än personer med lågutbildning, och personer som skattade sig som oroliga sedan tidigare, skattade sig också som mer oroliga införanestesi och kirurgi än andra. Slutsats: Informationsbehovet preoperativt är stort. Personer som är oroliga till vardags löper risk att uppleva höganivåer av oro preoperativt. Vidare forskning krävs för att utveckla en metod som kan identifiera oroliga individer.Genom att identifiera dessa preoperativt kan detta fungera som en prediktor för personer som riskerar att upplevamer preoperativ oro. Denna undersökning kan konstatera att det finns en vinst i att belysa faktorer som kan påverkaden preoperativa upplevelsen då verksamheten kan nyttja informationen till att motverka preoperativ oro.

This thesis begins with a brief review about the role and importance of the small molecules containing fluorine atoms in medicine and imaging. Then, the first part of the thesis will discuss the synthesis, purification and characterization of pentamethine cyanine dyes. The structure identification of the final dyes is done by using 1H NMR, 13C NMR, 19F NMR, and mass spectrometry. The studies performed after full characterization were the determination of optical and physicochemical properties. After these properties were performed, the fluorophores were evaluated to be good candidates for in vivo testing.