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Bakgrund: Preoperativ oro är ett vanligt förekommande problem hos patienter som skall genomgå kirurgi. Den medför ett lidande för patienten och en ökad risk för postoperativa komplikationer Syfte: Studien syftade till att beskriva icke-farmakologiska omvårdnadsåtgärder för att lindra patienters preoperativa oro Metod: Studiens design var en litteraturöversikt. Sökningar i databaserna Pubmed och CINAHL genomfördes och resulterade i 23 artiklar som inkluderades i litteraturöversiktens resultat. Resultat: Information med eller utan tillägg av stödjande samtal, informationsvideo, musik och avslappningsövningar lindrar preoperativ oro. Dessutom verkar delaktighet ha betydelse för lindringen men däremot har hemmiljön inte den effekten. Slutsats: De omvårdnadsåtgärder som framkom i resultatet kan vara effektiva verktyg för att lindra patienters preoperativa oro men patienten bör göras delaktig för att maximera effekten. / Background: Preoperative anxiety is a widespread problem amongst patients undergoing surgery. The anxiety brings with it a suffering for the patient and an increased risk of postoperative complications. Purpose: The aim of the study was to describe non-pharmacologic nursing actions that can be used to relieve preoperative anxiety.  Method: The study was designed as a literature review. We conducted a search through the databases Pubmed and CINAHL, from which 23 articles were included in the result of the literature review. Result: Information with or without supportive conversation, informatic videos, music and relaxation techniques relieves preoperative anxiety. Patient participation seems to have a role in relieving preoperative anxiety but the home environment doesn´t have the same role. Conclusion: The nursing actions that emerged as a result of this literature review can be used by nurses as an effective tool to relieve preoperative anxiety and the patient should be allowed to take part in the decision-making.

by Li Ho Cheung, William. / Thesis (M.Phil.)--Chinese University of Hong Kong, 1999. / Includes bibliographical references (leaves 82-88). / Abstracts in English and Chinese. / Abstract --- p.ii / Acknowledgements --- p.vi / Table of Contents --- p.vii / List of Tables --- p.viii / List of Appendices --- p.x / Chapter Chapter 1 : --- Introduction and Literature Review --- p.1 / Chapter Chapter 2 : --- Method --- p.31 / Chapter Chapter 3 : --- Results --- p.48 / Chapter Chapter 4 : --- Discussion --- p.60 / Reference --- p.82 / Appendices --- p.89

BACKGROUND: Preoperative anxiety commonly occurs in young children prior to anesthesia induction. This anxiety is associated with poor post-operative outcomes such as increases in emergence delirium occurrence and post-operative pain. Studies have demonstrated varying effectiveness of interventions such as clowns and video games used to engage and distract children from their anxiety. Anesthesiologists at Lucile Packard Children’s Hospital have designed a new screen-based modality, called the Bedside Entertainment Theatre (BERT), to distract children from their anxiety. OBJECTIVE: The aim of this study is to examine the anxiety-relieving efficacy of BERT against a hand-held electronic tablet, another screen-based form of entertainment used to alleviate preoperative anxiety in children at the hospital. METHODS: Children aged 4-10 undergoing non-emergent outpatient surgery at Lucile Packard Children’s Hospital and their primary caregiver were recruited for the study. Measures were taken at 5 timepoints from children, parents, and clinicians: in the preoperative holding area (T1), at entrance to the OR (T2), at induction (T3), after emergence from anesthesia (T4), and at a 1-week follow up (T5). Primary outcomes were preoperative anxiety, assessed by the modified Yale Preoperative Anxiety Scale (mYPAS) and Child Fear Scale (CFS), and induction compliance, assessed by the Induction Compliance Checklist (ICC). Secondary outcomes were emergence delirium, measured by the Pediatric Anesthesia Emergence Delirium Scale (PAED) and post-operative pain, measured by the Parents’ Post-operative Pain Measure (PPPM) and a Memory Recall Interview. Child covariates were temperament, measured by the Emotionality Activity Sociability Temperament Survey (EAS-TS) and the Children’s Behavior Questionnaire- Very Short Form (CBQ-VSF), and state-trait anxiety, measured by the Child State-Trait Anxiety Inventory (STAIC). Caregiver covariates were state-trait anxiety, measured by the State-Trait Anxiety Inventory (STAI) and caregiver pain catastrophizing about their child, measured by the Pain Catastrophizing Scale- Parent State (PCS-P State). This study is currently ongoing and plans to recruit 60 participants. Parent, child, and clinician satisfaction with usage of either intervention was also assessed. RESULTS: There were no significant differences between mean preoperative anxiety scores of BERT and tablet users at all pre-induction timepoints. There was a significant increase in mean preoperative anxiety scores in BERT users from T1 to T2 and T1 to T3. There was also a significant increase in mean preoperative anxiety scores from T1 to T3 for tablet users. There were no other significant differences in primary and secondary outcomes between interventions. Only post-surgery PCS-P State scores for BERT users correlated with mYPAS scores at T3 (p < 0.05). No other measured covariates correlated with preoperative anxiety scores (p > 0.05). CONCLUSIONS: Although preliminary results do not show differences between the interventions in relieving preoperative anxiety, there may be potential insights gained in how both interventions affect anxiety at different preoperative timepoints. Statistical analysis with the full sample population will be necessary to draw stronger conclusions. / 2018-07-11T00:00:00Z

In response to improving quality patient care, combined with the growing rates of surgical site infections (SSIs) in vascular patients, the need to explore current practice trends with current evidence has been identified. SSIs affect quality patient care and compromise patient safety. Empirical evidence has recommended the use of a chlorhexidine wash preoperatively to reduce SSIs. Despite this recommended practice, vascular patients were not receiving it in their routine plan of care within a hospital organization in southern Ontario. Guided by Lewin's theory of planned change, this project explored how the planning of a chlorhexidine preoperative surgical skin preparation protocol impacted progress toward improved care of vascular patients. The project was designed as a quality improvement project examining approximately 110 vascular surgical procedures over a 1-month period and staff surveys that were provided to staff in the preoperative (n = 88), same day surgery (n = 68), and inpatient (n = 47) units. These data were analyzed and demonstrated a reduction in vascular SSIs from 4.9% pre-implementation to 2.8% 1-month post-implementation. Major themes generated from the staff surveys demonstrated the nursing staff had a good understanding of the content that was presented in the in-service provided. These findings have implications for social change by highlighting the benefits of incorporating evidence in to practice and further informing the preoperative practice in other surgical specialties.

The buffering effect of social support against a range of stress-related health outcomes has been well-documented in a variety of research areas; however, no previous work has examined the applicability of this model to bariatric surgery outcomes. Additionally, based on previous evidence and relevant theoretical work, the stress-buffering effect of social support may show important gender differences. The current study examined stress, depression, social support, and patient gender as predictors of curvilinear weight loss trajectories during the first year following surgery. Data were collected using retrospective chart review. The buffering effects of three types of support were explored using growth curve modeling: structural, emotional, and functional support. On average, patients lost 27% of their total body weight between baseline and the 12 month follow up. Additionally, the current study found partial support for the stress-buffering model of social support among bariatric surgery patients. Overall, emotional and functional support appear be most relevant to weight loss/maintenance in this population; structural support did not predict weight loss or show any significant interactions with stress or depression. However, results varied depending on patient gender and whether patients reported experiencing high levels of stress (significant interaction with emotional support) or depression (significant interaction with functional support). Such findings have important implications for assessment and follow-up care after bariatric surgery, as well as for future research in this area.

<p><strong>Bakgrund: </strong>Tidigare forskning visade att<strong> </strong>ett kirurgiskt ingrepp är en stressfylld upplevelse både fysiskt och psykiskt eftersom kroppens integritet hotas. Preoperativ oro var ett vanligt problem vid elektiv kirurgi. Omvårdnad var ett stöd till medicinsk behandling t.ex. genom information som minskar patientens oro och ängslan samt ökar patientens tolerans för smärta.<strong> Syftet: </strong>Var att beskriva vad patienterna är oroliga för inför elektiv kirurgi samt ge kunskap i vad sjuksköterskan omvårdnadsmässigt kan göra för att minska oron inför elektiv kirurgi. <strong>Metod: </strong>Beskrivande litteraturstudie baserad på fyra kvalitativa och 16 kvantitativa artiklar från år 2001-2008. De sökord som användes var Anaesthesia, Anxiety, Nursing, Preoperative, Presurgery och Surgery. <strong>Resultat: </strong>Fyra centrala fynd framkom; orosmoment, information, musik och akupunktur/ akupressur/värme. Separation från familjen, funktionsoduglighet, att förlora sin självständighet, rädsla för kirurgi och död var alla faktorer som triggar symtom på preoperativ oro. Resultatet visade att musik kan minska oron signifikant. Den omvårdnadsåtgärden kunde tillämpas på flera olika sätt och har visat sig effektiv oavsett vilken musik patienten lyssnar på. Information var viktigt och det bästa var om den individanpassas. <strong></strong></p> / <p><strong>Background: </strong>Previous research has shown that a surgical operation means a lot of stress both physically and mentally since the human integrity is threatened. Preoperative anxiety was a common problem at elective surgery. Caring was a support to medical treatment for example information that decreases the patient anxiety and increases the tolerance for pain. <strong>Aim: </strong>The aim of the research was to describe the preoperative anxiety in elective surgery and to give knowledge in what the nurse can do to decrease this anxiety. <strong>Method: </strong>Descriptive literature review based on four qualitative and 16 quantitative articles from year 2001-2008. The searching words that was used was Anaesthesia, Anxiety, Nursing, Preoperative, Presurgery and Surgery. <strong>Findings: </strong>Four central categories emerged; things patients worries about, information, music and acupuncture/acupressure/heat. Being separated from the family, incapacitation, loss of independence, fear of surgery and death were all things that contribute to preoperative anxiety. The findings showed that music can decrease the anxiety significantly. It can be carried out in different ways and has shown to be effective irrespective of what music the patient is listening to. Information was important and the best thing if it´s adapted to the individual. <strong></strong></p>

<p>The aim of this study was to investigate for how long patients fast before thoracic surgery, plastic surgery and ear, nose and throat surgery, at the University hospital of  Uppsala, and what knowledge patients have about fasting and how they get affected by it. 30 patients were interviewed, 10 patients at each ward, according to a questionnaire. Data processing was performed with SPSS. There was no difference in fasting time for solids between the wards but the mean fasting time was 14 hours. In the thoracic ward patients fasted from liquids considerably longer than in the other wards. The mean fasting time in the thoracic ward was 12 hours compared to six hours in the ear, nose and throat ward and five hours in the plastic surgery ward. Only 27 % (8/30) of the patients knew the reason for fasting before anesthesia. Patients experienced significantly more thirst, nausea and hunger after than before surgery but no difference was seen between men and women. Patients from the thoracic surgery ward experienced more nausea before surgery than the others. The conclusion is that the compliance to the recommendations for preoperative fasting is insufficient and doesn´t comply to the patients needs.</p>

The aim of this study was to investigate for how long patients fast before thoracic surgery, plastic surgery and ear, nose and throat surgery, at the University hospital of  Uppsala, and what knowledge patients have about fasting and how they get affected by it. 30 patients were interviewed, 10 patients at each ward, according to a questionnaire. Data processing was performed with SPSS. There was no difference in fasting time for solids between the wards but the mean fasting time was 14 hours. In the thoracic ward patients fasted from liquids considerably longer than in the other wards. The mean fasting time in the thoracic ward was 12 hours compared to six hours in the ear, nose and throat ward and five hours in the plastic surgery ward. Only 27 % (8/30) of the patients knew the reason for fasting before anesthesia. Patients experienced significantly more thirst, nausea and hunger after than before surgery but no difference was seen between men and women. Patients from the thoracic surgery ward experienced more nausea before surgery than the others. The conclusion is that the compliance to the recommendations for preoperative fasting is insufficient and doesn´t comply to the patients needs.

Bakgrund: Tidigare forskning visade att ett kirurgiskt ingrepp är en stressfylld upplevelse både fysiskt och psykiskt eftersom kroppens integritet hotas. Preoperativ oro var ett vanligt problem vid elektiv kirurgi. Omvårdnad var ett stöd till medicinsk behandling t.ex. genom information som minskar patientens oro och ängslan samt ökar patientens tolerans för smärta. Syftet: Var att beskriva vad patienterna är oroliga för inför elektiv kirurgi samt ge kunskap i vad sjuksköterskan omvårdnadsmässigt kan göra för att minska oron inför elektiv kirurgi. Metod: Beskrivande litteraturstudie baserad på fyra kvalitativa och 16 kvantitativa artiklar från år 2001-2008. De sökord som användes var Anaesthesia, Anxiety, Nursing, Preoperative, Presurgery och Surgery. Resultat: Fyra centrala fynd framkom; orosmoment, information, musik och akupunktur/ akupressur/värme. Separation från familjen, funktionsoduglighet, att förlora sin självständighet, rädsla för kirurgi och död var alla faktorer som triggar symtom på preoperativ oro. Resultatet visade att musik kan minska oron signifikant. Den omvårdnadsåtgärden kunde tillämpas på flera olika sätt och har visat sig effektiv oavsett vilken musik patienten lyssnar på. Information var viktigt och det bästa var om den individanpassas. / Background: Previous research has shown that a surgical operation means a lot of stress both physically and mentally since the human integrity is threatened. Preoperative anxiety was a common problem at elective surgery. Caring was a support to medical treatment for example information that decreases the patient anxiety and increases the tolerance for pain. Aim: The aim of the research was to describe the preoperative anxiety in elective surgery and to give knowledge in what the nurse can do to decrease this anxiety. Method: Descriptive literature review based on four qualitative and 16 quantitative articles from year 2001-2008. The searching words that was used was Anaesthesia, Anxiety, Nursing, Preoperative, Presurgery and Surgery. Findings: Four central categories emerged; things patients worries about, information, music and acupuncture/acupressure/heat. Being separated from the family, incapacitation, loss of independence, fear of surgery and death were all things that contribute to preoperative anxiety. The findings showed that music can decrease the anxiety significantly. It can be carried out in different ways and has shown to be effective irrespective of what music the patient is listening to. Information was important and the best thing if it´s adapted to the individual.