No description available.

A multiple baseline study was conducted across five hysterectomy patients between the ages of 30-36. Three patients received a treatment intervention consisting of general and sensory information, muscle relaxation, a cognitive coping technique, and a pre-anesthetic interview. Two yoked, placebo control patients watched a 20-min video· tape about surgery, practiced recovery exercises, and made up stories from TAT cards. Self-report measures taken were the Hospital Stress Rating Scale, a recovery inventory, and postsurgical pain ratings. Physiological measures consisted of pulse, respiration, blood pressure, skin temperature, and blood lactates. Recovery variables were taken on amount of pain medication taken, number ·of days in the hospital, · vomiting, and psychiatric or physical complications. The results indicated that patients in the treatment condition reported less pain and took fewer pain medications after surgery. All other variables indicated little or no change. All patients experienced a decrease in blood lactate levels after the training session. Training time was approximately 1 hour, and thus hospital staff could conduct the training in a reasonable amount of time.

Att kolhydratuppladda är att fylla kroppens muskler med energi, vilken används för att patienten ska klara av kroppens stressrespons i samband med fasta och operation. Kliniskt får patienten dricka näringsdryck innan operation för att kolhydratuppladda. Inför ett kirurgiskt ingrepp genomgår patienten en förändring i vardagen, lämnar hemmet och kommer till en ovan miljö. Att patienten genomgår fasta och upplever en ny situation påverkar patientens välbefinnande negativt, med både hunger, törst och oro och så vidare. I denna litteraturstudie kommer tio artiklar att granskas för att undersöka, effekterna få en preoperativ kolhydratuppladdning fokus i studien ligger på omvårdnad och välbefinnande men den tar även upp effekter som inte är direkt relaterade till omvårdnadsämnet men knyter an till vården. Studien visar, att under rätt förutsättningar hjälper en preoperativ kolhydratuppladdning att minska till exempel preoperativ törst, hunger och oro. Andra positiva effekter som kan ses i studien är mindre postoperativa kräkningar och bättre bibehållen muskelfunktion. Studien är upplagd i tre olika resultatområden primära resultat, sekundära resultat och tertiära resultat. De olika resultatområdena tar upp olika resultat med olika mycket anknytning till omvårdnad. / A carbohydrate-load is essential to charge the muscles of the body with energy so that the patient will be able to withstand the stress-responses of the body due to fasting and operation. This is clinically facilitated by having the patient ingest a nutritional drink in order to load up on carbohydrates. Preparing for a surgical procedure is a significant change of routine for the patient as he/she leaves its usual environment for an unfamiliar one. Having the patient go through fasting and experience a new situation, will affect the patient’s well-being negatively due to hunger, thirst and mental discomfort etc. Ten articles will be included in this literary study in order to study the effects of a pre-operative carbohydrate load. Focus will be put on the care and well-being of the patient, but also effects that are not directly related to nursing sciences, but in patient care in general. The study will show that under the right circumstances a pre-operative carbohydrate build up will reduce pre-operative thirst, hunger, and discomfort. Other beneficial effects learned from the case study are less post-operative vomiting, and improvement in sustained muscle functions. The results from the case study are presented in the categories of primary, secondary and tertiary results, which will be presented with varying relevance to nursing sciences.

Objectives: 1) To examine the effectiveness of Audiovisual (AV) interventions at reducing preoperative anxiety (PA) and its associated outcomes in children undergoing surgery; 2) To assess the psychometric properties of a new scale, the Children’s Perioperative Multidimensional Anxiety Scale (CPMAS); 3) To examine the feasibility and acceptability of a novel tablet-based intervention, Story-Telling Medicine (STM), for reducing children’s PA; 4) To examine the relation between temperament and PA in the surgical context. Methods: A systematic review of studies where the primary outcome was children’s PA was conducted (Study 1). A study of the reliability and validity of the CPMAS were assessed at preoperative assessment (T1), on the day of surgery (T2), and 1 month postoperatively (T3) was also undertaken (Study 2). The feasibility and acceptability of STM were then examined and compared its effect to Usual Care (UC) (Study 3). Finally, children’s temperament was examined using the Colorado Childhood Temperament Inventory at T1 along with the CPMAS assessed at T1 and T2 (Study 4). Results: Fourteen of the 18 studies led to reductions in children’s PA (Study 1). The CPMAS demonstrated good internal consistency, stability and convergent validity across all visits (Study 2). The participant recruitment and study procedures were shown to be feasible and children in the STM group demonstrated greater reductions in CPMAS compared to the UC group (Study 3). Shyness predicted lower PA at T1, while sociability predicted higher PA at T1 and T2 (Study 4). Conclusions: AV interventions appear useful but full-scale RCTs of these treatments are required to pinpoint those that are most effective. The CPMAS is a promising tool for evaluating children’s PA and preliminary evidence suggests that STM is a feasible intervention for reducing children's PA. Finally, our findings highlight the importance of considering individual differences in predicting anxiety in the surgical setting. / Thesis / Doctor of Philosophy (PhD) / Preoperative anxiety affects up to 5 million children in North America annually and is associated with many adverse psychological, behavioural, and health effects. These problems not only produce significant distress for children and families, but can have immediate and long-term effects on a child’s mental health and development. Current methods to reduce preoperative anxiety in children (e.g., medications and psychological preparation programs) are limited by their expense and/or time-intensive nature. In an attempt to reduce children’s preoperative anxiety and its associated negative outcomes, this work examined the usefulness of audiovisual interventions in reducing children’s preoperative anxiety, sought to develop a new instrument to measure children’s preoperative anxiety, tested a new tablet-based application to reduce children’s preoperative anxiety, and examined the relation between children’s temperament and preoperative anxiety. The goal is to improve the surgical experience for children and families, and to reduce psychological and physical problems in children undergoing surgery.

Bakgrund Tidigare studier visar att preoperativ oro och rädsla är vanligt förekommande bland barn. Maktlöshet och känslan av att förlora kontrollen är vanliga känslor hos barn som står inför en operation. Oron och rädslan påverkas också av att barn ofta har svårt att förstå operationsprocessen som de ska genomgå. Därför är det av vikt att öka kunskapen om vad som kan minska dessa känslor och lugna barnen i denna fas. Syfte Syftet med denna litteraturöversikt var att beskriva vad som kan minska barns oro och rädsla i den preoperativa fasen. Metod En strukturerad litteraturöversikt med inslag av den metodologi som används vid systematiska översikter. Resultatet baserades på 16 kvantitativa artiklar som kvalitetsgranskats och analyserats. Resultat I resultatet identifierades två huvudkategorier; information och distraktion, med underkategorierna skärmabaserad information, information i pappersform, informativ lek, musik som distraktion och lek som distraktion. Slutsats Resultatet visar exempel på omvårdnadsåtgärder och interventioner som har visat sig ha god effekt på barns preoperativa oro och rädsla. Information är en väsentlig del av förberedelsen av barn inför operation, och ges i fördel i olika format på ett anpassat sätt. Att distrahera barn genom musik och olika typ av lek är också en effektiv metod för att lugna barn inför operation. / Background Previous studies show that preoperative anxiety and fear is common among children. The feeling of powerlessness and losing control are common feelings in children facing surgery. The anxiety and fear is also affected by the fact that children often have difficulty understanding the surgical process that they are about to undergo. Therefore, it is important to have knowledge of what can reduce these feelings and calm the children in this phase. Aim The aim of this literature review was to describe what can reduce children’s anxiety and fear in the preoperative period. Method A structured literature review with elements of the methodology used in systematic reviews. The result was based on 16 quantitative articles that were quality reviewed and analyzed. Results In the result, two main categories were identified; information and distraction, with the subcategories screen-based information, paper-based information, informative play, music as distraction, and play as distraction. Conclusions The results show examples of nursing measures and interventions that have been shown to have a good effect on children´s preoperative anxiety and fear. Information is an essential part of preparing children for surgery and is preferably provided in various formats in an age-appropriate manner. Distracting children through music and different types of play is also an effective method to calm children before surgery.

Den information som operationssjuksköterskan förmedlar till patienten före, under och efter en elektiv kirurgisk operation kan minska patientens oro och risken för operativa komplikationer. Rätt information kan även minska antalet inställda elektiva kirurgiska ingrepp, förkorta patientens vårdtid samt minska antalet vårdskador och användningen av smärtmedicinering. Ändå är forskningen om vilken information som patienterna önskar i samband med elektiv kirurgi otillräcklig. Syftet med denna studie var därför att sammanställa kunskap om vilken information patienter som skall genomgå elektiv kirurgi har behov av. För att tillmötesgå syftet genomfördes en integrativ litteraturstudie utifrån 15 vetenskapliga artiklar baserade på kvalitativ och kvantitativ metod. Den integrativa litteraturstudien analyserades utifrån kvalitativ metod och strukturerades efter två huvudteman som benämndes heltäckande information samt Personcentrerad information. Resultatet visade att operationsteam och operationssjuksköterskor försökte tillmötesgå patienternas varierade och individuella behov av skriftlig och muntlig information under den preoperativa, operativa och postoperativa perioden i omsorgsvårdsprocessen. Under den preoperativa perioden ville patienterna främst få individualiserade verbala eller skriftliga svar på sina frågor. Under den postoperativa perioden ville patienterna få mer omfattande information än vad som i praktiken gavs. Patienterna ville få en så heltäckande, varierad och individanpassad verbal eller skriftlig information som möjligt. Emellertid förekom skillnader mellan operationsteamets och patienternas önskemål och sätt att tolka information. Patienterna ville få en mer personcentrerad och empatisk förståelse samt fullständig information om operationens långsiktiga resultat. När sådan information inte gavs fullt ut kunde patienterna känna sig otrygga inför operationen och ovissa i egenvården efter operationen. Slutsatsen blev därför att operationssjuksköterskan behöver ge information som tar mer hänsyn till patienternas varierade individuella informationsbehov och mer hänsyn till patienternas behov av psykologisk trygghet före/efter operationen. / The information the surgical nurse communicates to the patient before, during and after an elective surgical operation can reduce the patient's concern and the risk of operative complications. Correct information can also reduce the number of elective surgical procedures canceled, shorten the patient's care time, and reduce the number of medical injuries and the use of pain medication. Nevertheless, there is lacking research on what information patients want in conjunction with elective surgery. The purpose of this study was therefore to compile knowledge about what information patients who are to undergo elective surgery need. To meet the purpose, an integrative literature study was conducted on the basis of 15 scientific articles based on qualitative and quantitative method. The integrative literature study was analyzed using a qualitative method and structured according to two main themes called comprehensive information and person-centered information. The result showed that surgery teams and surgery nurses tried to meet patients' varied and individual needs for written and oral information during the preoperative, operative and postoperative period of the careprocess. During the preoperative period, patients primarily wanted more individualised verbal or written answers to their questions. During the postoperative period, patients wanted more comprehensive information than was provided in practice, and patients wanted as comprehensive, varied and individualized verbal or written information as possible. However, there were differences between the surgical team's and the patients' information preferences, where the patients could want a more person-centered and empathetic understanding as well as complete information about the long-term results of the operation. When such person-centered information was not fully provided, patients could feel insecure before the operation and uncertain in self-care after the operation. The conclusion was therefore that the surgical nurse needs to provide information that takes more account of the patients’ varied individual information needs and more consideration of the patients' sense of psychological security before/after the operation.

The purpose of this research was to critically analyze relevant literature regarding the effects of preoperative education on levels of stress in the pediatric population. The goal of this research is to review and analyze the available literature to determine best practice as it relates to educating the pediatric preoperative patient in order to relieve stress. Research was retrieved from Cumulative Index to Nursing and Allied Health Literature, PsycINFO, and MEDLINE-EBSCOhost databases using keywords pediatric, preoperative, anxiety, stress, fear, children, hospitalized child, education, play therapy, and surgery. Inclusion criteria included research that focused on relieving anxiety or stress in the pediatric surgical patient. Seven research-based articles were found that met the inclusion criteria. Findings indicate surgery is stressful in pediatric patients at all developmental stages. Preoperative education was found to reduce this stress. Verbal, written, and visual means of education all led to a decrease in stress prior to surgery. More research is needed to determine the best developmentally appropriate educational program to relieve stress in the pediatric patient.

No description available.

No description available.

Bakgrund: Bröstcancer är den vanligaste cancerformen hos kvinnor och miljoner diagnostiseras varje år världen över. Det är en dramatisk händelse i en kvinnas liv att drabbas och behandlingen består ofta av strålbehandling, cytostatika och kirurgi. Att behöva kirurgiskt avlägsna hela eller delar av ett bröst kan innebära många tankar och känslor.  Syfte: Syftet med denna studie är att belysa hur patienter med bröstcancer upplever tiden mellan diagnos och operation.  Metod: Detta är en litteraturstudie baserad på 11 kvalitativa vetenskapliga artiklar vilka insamlades via PubMed, CINAHL samt PsycInfo. Samtliga studier kvalitetsgranskades med Statens Beredning för Medicinsk och Social Utvärdering (SBU:s) utarbetade granskningsmall samt analyserades med hjälp av Lundman & Graneheims metod för dataanalys.  Resultat: Efter genomförd resultatanalys upptäcktes flera aspekter av upplevelser som var kopplade till att diagnostiseras med bröstcancer och vänta på operation. Patienternas upplevelser kunde delas in i fem kategorier med tillhörande subkategorier, dessa var; Upplevelser av psykisk belastning, Upplevelser av förändrad kropp- och självbild, Upplevelser kopplat till nära relationer, Att hantera situationen samt Upplevelser av sjukvården och sjuksköterskans roll.  Slutsats: Till största del identifierades negativa känslor under tiden mellan diagnos till operation, men även en del positiva insikter. Med tanke på resultatet i denna studie föreligger det ett behov hos denna patientgrupp av en etablerad kontakt och ett stöd från sjukvården under just denna tid, dock bör detta utgå från den unika patientens behov. / Background: Breast cancer is the most common form of cancer in women and millions are diagnosed each year worldwide. It is a dramatic event in a woman's life to be affected and the treatment often consists of radiation therapy, chemotherapy and surgery. Having to surgically remove all or part of a breast can implicate many thoughts and feelings. Aim: The purpose of this study is to investigate how patients with breast cancer experience the time between diagnosis and surgery. Method: This is a literature study based on 11 qualitative scientific articles which were collected via PubMed, CINAHL and PsycInfo. All studies were quality audited with Statens Beredning för Medicinsk och Social Utvärdering (SBU:s) prepared review template and analyzed using Lundman & Graneheim's method for data analysis. Result: After performing results analysis, several aspects of experiences were discovered that were linked to being diagnosed with breast cancer and waiting for surgery. The patients' experiences could be divided into five categories with associated subcategories, these were; Experiences of mental stress, Experiences of changed body and self-image, Experiences linked to close relationships, Dealing with the situation and Experiences of healthcare and the role of the nurse. Conclusion: Broadly, negative emotions were identified in the period between diagnosis and surgery, but also some positive insights. Given the results of this study, there is a need for established contact and support from healthcare during this particular time for this patient group, however, this should be based on the unique patient's needs.