Дисертації з теми "Postoperative care"
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1
Rees, Nancy Wylie. "Nursing management of postoperative pain: perceived care and actual practice." Thesis, Curtin University, 2000. http://hdl.handle.net/20.500.11937/1235.
Анотація:
Postoperative pain management is a major responsibility of nurses who provide care for patients recovering from surgery. In the postsurgical environment, the nurse has a pivotal role in assessing the patient with pain, implementing both doctor and nurseinitiated pain interventions and evaluating the patient's response to pain control treatments. Apart from its humanitarian utility, effective relief of postoperative pain is a critical element of a patient's postoperative recovery. Failure to manage pain effectively in the immediate postoperative period can produce undesirable immediate and longterm physical and psychological consequences that can severely disrupt an individual's quality of life. Despite the availability of multidimensional assessment measures, sophisticated pharmacological therapies and a greater range of complementary pain therapies, postoperative pain remains treated ineffectively by those professionally responsible for its management. In particular, evidence indicates that nurses are poor managers of their patients' postoperative pain. This thesis reports research that was conducted in two stages to explore, describe and analyse how nurses managed their patients' postoperative pain and their perceptions of factors that influenced this practice. A predominantly descriptive design was utilised in Stage 1 of the study to collect data from patients' hospital records and with a demographic questionnaire administered to nurses. This was complemented with interview data from nurses in Stage 2.Previous studies offer limited views of the clinical realities of nursing practice in postoperative pain management. From this perspective, there is a need for research that incorporates these realities to permit analysis of clinical practice and greater understanding therefore of the problem of poor postoperative pain management. The purpose of this study was to provide an illuminative and authentic account of nursing practice in postoperative pain management. For the first part of Stage 1, data were collected retrospectively from nurses' documented accounts of pain assessment and intervention over the first three postoperative days for 100 patients in a major adult acute care teaching hospital. Analysis of nurses' documented responses to patients' reports of postoperative pain revealed that less than one-third of all responses could be considered appropriate for pain management. In particular, nurses failed to provide any pharmacological relief for 53% of patients' reports or severe and excruciating pain. Exploration of the influence of nurses' professional characteristics of education and experience on pain management practice was then undertaken in part 2 of Stage 1 with the use of a demographic questionnaire distributed to 106 nurses who were identified as signatories to the documented responses identified in part 1. Results indicated that length of professional experience accounted for most variations in practice, with older, more experienced nurses managing pain more appropriately than their younger and less experienced colleagues. Irrespective of education or experience, however, nurses failed to respond appropriately to patients reporting excruciating pain.In Stage 2, in-depth interviews were conducted with 8 nurses caring for postoperative patients at the research site. Thematic content analysis revealed four major themes from nurses' perceptions of their practice of postoperative pain management that served to elucidate and enrich the findings of Stage 1 of the research. These were finding out about the patient's pain, making decisions about pain and pain management, individual factors affecting pain management, and interpersonal and organisational factors affecting pain management. This thesis provides an authentic account of nursing practice in postoperative pain management, and contributes understanding and insight into factors that provoke ineffective management of pain after surgery. It has implications for the development of intervention strategies aimed at improving nursing practice, at both individual and organisational levels, and suggests new directions for nursing education and research toward achieving optimum care and eliminating unnecessary pain for patients recovering from surgery.
2
Hines, Sonia Jane. "Aromatherapy for postoperative nausea and vomiting." Thesis, Queensland University of Technology, 2012. https://eprints.qut.edu.au/60245/1/Sonia_Hines_Thesis.pdf.
Анотація:
Background: Postoperative nausea and vomiting is one of the most common adverse reactions to surgery and all types of anaesthesia and despite the wide variety of available antiemetic and anti-nausea treatments, 20-30% of all patients still suffer moderate to severe nausea and vomiting following general anaesthesia. While aromatherapy is well-known and is used personally by nurses, it is less well utilised in the healthcare setting. If aromatherapy is to become an accepted adjunct treatment for postoperative nausea and vomiting, it is imperative that there is both an evidence base to support the use of aromatherapy, and a nursing workforce prepared to utilise it.
Methods: This involved a Cochrane Systematic Review, a Delphi process to modify an existing tool to assess beliefs about aromatherapy to make it more relevant to nursing and midwifery practice, and a survey to test the modified tool in a population of nurses and midwives.
Findings: The systematic review found that aromatherapy with isopropyl alcohol was more effective than placebo for reducing the number of doses of rescue antiemetics required but not more effective than standard antiemetic drugs.
The Delphi panel process showed that the original Beliefs About Aromatherapy Scale was not completely relevant to nursing and midwifery practice. The modified Nurses' Beliefs About Aromatherapy Scale was found to be valid and reliable to measure nurses' and midwives' beliefs about aromatherapy. Factor analysis supported the construct validity of the scale by finding two sub-scales measuring beliefs about the 'usefulness of aromatherapy' and the 'scientific basis of aromatherapy'. Survey respondents were found to have generally positive beliefs about aromatherapy, with more strongly positive beliefs on the 'usefulness of aromatherapy' sub-scale.
Conclusions: From the evidence of the systematic review, the use of isopropyl alcohol vapour inhalation as an adjunct therapy for postoperative nausea and vomiting is unlikely to be harmful and may reduce nausea for some adult patients. It may provide a useful therapeutic option, particularly when the alternative is no treatment at all.
Given the moderately positive beliefs expressed by nurses and midwives particularly about the usefulness of aromatherapy there is potential for this therapy to be implemented and used to improve patient care.
3
Rees, Nancy Wylie. "Nursing Management of Postoperative Pain: Perceived Care and Actual Practice." Curtin University of Technology, Faculty of Education, 2000. http://espace.library.curtin.edu.au:80/R/?func=dbin-jump-full&object_id=12334.
Анотація:
Postoperative pain management is a major responsibility of nurses who provide care for patients recovering from surgery. In the postsurgical environment, the nurse has a pivotal role in assessing the patient with pain, implementing both doctor and nurseinitiated pain interventions and evaluating the patient's response to pain control treatments. Apart from its humanitarian utility, effective relief of postoperative pain is a critical element of a patient's postoperative recovery. Failure to manage pain effectively in the immediate postoperative period can produce undesirable immediate and longterm physical and psychological consequences that can severely disrupt an individual's quality of life. Despite the availability of multidimensional assessment measures, sophisticated pharmacological therapies and a greater range of complementary pain therapies, postoperative pain remains treated ineffectively by those professionally responsible for its management. In particular, evidence indicates that nurses are poor managers of their patients' postoperative pain. This thesis reports research that was conducted in two stages to explore, describe and analyse how nurses managed their patients' postoperative pain and their perceptions of factors that influenced this practice. A predominantly descriptive design was utilised in Stage 1 of the study to collect data from patients' hospital records and with a demographic questionnaire administered to nurses. This was complemented with interview data from nurses in Stage 2.Previous studies offer limited views of the clinical realities of nursing practice in postoperative pain management. From this perspective, there is a need for research that incorporates these realities to permit analysis of clinical practice and greater understanding therefore of the problem of poor postoperative pain management. The purpose of this study was to provide an illuminative and authentic account of nursing practice in postoperative pain management. For the first part of Stage 1, data were collected retrospectively from nurses' documented accounts of pain assessment and intervention over the first three postoperative days for 100 patients in a major adult acute care teaching hospital. Analysis of nurses' documented responses to patients' reports of postoperative pain revealed that less than one-third of all responses could be considered appropriate for pain management. In particular, nurses failed to provide any pharmacological relief for 53% of patients' reports or severe and excruciating pain. Exploration of the influence of nurses' professional characteristics of education and experience on pain management practice was then undertaken in part 2 of Stage 1 with the use of a demographic questionnaire distributed to 106 nurses who were identified as signatories to the documented responses identified in part 1. Results indicated that length of professional experience accounted for most variations in practice, with older, more experienced nurses managing pain more appropriately than their younger and less experienced colleagues. Irrespective of education or experience, however, nurses failed to respond appropriately to patients reporting excruciating pain.
In Stage 2, in-depth interviews were conducted with 8 nurses caring for postoperative patients at the research site. Thematic content analysis revealed four major themes from nurses' perceptions of their practice of postoperative pain management that served to elucidate and enrich the findings of Stage 1 of the research. These were finding out about the patient's pain, making decisions about pain and pain management, individual factors affecting pain management, and interpersonal and organisational factors affecting pain management. This thesis provides an authentic account of nursing practice in postoperative pain management, and contributes understanding and insight into factors that provoke ineffective management of pain after surgery. It has implications for the development of intervention strategies aimed at improving nursing practice, at both individual and organisational levels, and suggests new directions for nursing education and research toward achieving optimum care and eliminating unnecessary pain for patients recovering from surgery.
4
Gustafsson, Tomas, and Benjamin Erkstam. "Patienters upplevelse av postoperativ smärtbehandling : En litteraturstudie." Thesis, Uppsala universitet, Institutionen för folkhälso- och vårdvetenskap, 2019. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-398046.
Анотація:
Bakgrund: Smärta är en subjektiv känsla där varje individ lär sig betydelsen av ordet genom egna erfarenheter. Smärta är något nästan alla upplever efter ett kirurgiskt ingrepp och där otillräcklig smärtlindring i den akuta fasen kan leda till svåra komplikationer vilket skapar lidande för patienten samt stora samhällsekonomiska kostnader. Syfte: Att beskriva patienters upplevelse av postoperativ smärtbehandling. Metod: Litteraturstudie med deskriptiv design av 11 kvalitativa originalartiklar från databaserna PubMed, CINAHL och PsycINFO vars innehåll analyserades i fem steg. Resultat: Patienter var överlag tillfredsställda trots smärta. Det fanns delade åsikter om nyttan av NRS (numerisk skala). Patienter hade en rad föreställningar om läkemedel som ledde dem till att undvika analgetika. Information ansågs vara huvudsakligen hjälpsamt, framför allt skriftlig, dock upplevde patienter att informationen var bristfällig. Attityd, tillit och kommunikation spelade en viktig roll för relationen mellan personal och patient. Patienter som genomgått dagkirurgi och behandlade sin smärta ensamma i hemmet med mycket begränsad kontakt med vårdpersonal, upplevde svårigheter att ta beslut och följa sin smärtbehandlingsplan. Patienter uppskattade att bli inkluderade och delaktiga i sin vård, även om det kunde upplevas som en börda, och tog många egna initiativ och egna strategier under sin behandling, ofta för att slippa använda analgetika. Tidigare erfarenheter var också något som ofta hjälpte patienter i deras smärtbehandling. Slutsats: Patienter var ofta nöjda med sin smärtbehandling trots att de fortfarande upplevde smärta, viktigast för att uppnå detta var en känsla av trygghet. Viktiga faktorer för detta var utförlig skriftlig och upprepad information om smärta, smärtbehandling och analgetika samt ett gott, professionellt, inkluderande och individanpassat bemötande från vårdpersonalen. Brister inom dessa områden ledde till oro och rädsla för det okända, vilket försvårade smärtupplevelsen. Patienter upplevde sällan fullgod smärtlindring.Background: Pain is a subjective feeling where each individual learns the meaning of the word through their own experiences. Pain is something almost everyone experiences after a surgical procedure and where insufficient pain relief in the acute phase can lead to severe complications, which creates suffering for the patient and large socio-economic costs. Aim: To describe patients' experience of postoperative pain management. Method: Literature review with descriptive design of 11 qualitative original articles from the databases PubMed, CINAHL and PsycINFO whose contents were analyzed in five steps. Result: Patients were generally satisfied despite pain. There were different opinions about the benefits of the NRS (numeric rating scale). Patients had a number of conceptions about drugs that led them to avoid analgesics. Information was considered to be mainly helpful, especially written, however patients felt that the information was deficient. Attitude, trust and communication played an important role in the relationship between staff and patient. Patients who underwent day surgery and treated their pain alone in the home with very limited contact with health care professionals experienced difficulties in making decisions and following their pain management plan. Patients appreciated being included and involved in their care, although it could be perceived as a burden, and took many own initiatives and strategies during their treatment, often to avoid using analgesics. Previous experience was also something that often helped patients in their pain management. Conclusion: Patients were often satisfied with their pain management even though they were still experiencing pain, most important to achieve this was a peace of mind. Important factors for this were detailed written and repeated information about pain, pain treatment and analgesics as well as a good, professional, inclusive and individualized response from the care staff. Deficiencies in these areas led to worrying and fear of the unknown, which made the pain experience more difficult. Patients rarely experienced adequate pain relief.
5
Pucher, Philip. "Structural and care process improvement of ward-based postoperative care to optimise surgical outcomes." Thesis, Imperial College London, 2014. http://hdl.handle.net/10044/1/24994.
Анотація:
Much of the variation seen in surgical outcomes can be explained by differences in the quality of management of post-operative complications and ward-based care. The surgical ward round (WR) is critical to determining post-operative care and serves as the primary point of interaction between clinician and patient. Despite this, it is an area not subject to training or assessment at present. This thesis demonstrates the high degree of variability which exists in the conduct of WRs. It establishes the link between suboptimal patient assessment and increased risk of preventable post-operative complications. These place patients not only at risk of short-term deterioration, but result in reduced long-term survival as well. In order to quantify WR quality, a novel assessment tool has been developed and validated within a simulated environment. Ward simulation is a nascent branch of simulation which has been only preliminarily explored to date. A simulation environment was developed to take advantage of the known benefits of simulation such as controllability, reproducibility, and recordability, whilst maintaining a high level of fidelity and realism. An evidence-based curriculum for surgical WR training was designed and implemented in a simulation-based course. By focusing on structured generic processes of patient assessment and management, this resulted in significant improvement of trainee performance in routine WRs. To ensure standardised and optimum management of specific conditions, checklists have proven themselves to be of great value in a number of surgical and medical disciplines. Surgical complications are common, yet their management often suboptimal. As part of this thesis, evidence-based protocols for the management of the six most common complications were designed and validated. The implementation of these in a simulation-based randomised, controlled trial has resulted in greatly increased adherence to evidence-based standards of care, as well as improved communication and clinician performance. This thesis explores the variance currently present in surgical ward rounds, and the potentially grave consequences of this for patient outcomes. To date, WRs have been one of the last areas of surgical care still dependent on the Halstedian principle of experiential learning alone. The tools have now been developed with which to assess, improve, and standardise critical structures and care processes in the assessment and management of the post-operative surgical patient. Future implementation of these and integration into surgical curricula will benefit clinician training, patient care, and surgical outcomes alike.
6
Krstevska, Simic Katerina, and Semmy Josefsson. "Postoperativ återhämtning efter dagkirurgisk operation : Uppföljning via patientens egen mobiltelefon." Thesis, Linköpings universitet, Institutionen för hälsa, medicin och vård, 2021. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-178710.
Анотація:
Bakgrund: Utvecklingen inom kirurgi och anestesi har bidragit till att allt fler operationer utförs dagkirurgiskt då det minskar sjukhusvistelse för patienten och är kostnadseffektivt för vården. Det finns många fördelar med dagkirurgiska ingrepp men nackdelen är att ansvaret för den postoperativa återhämtningen läggs på patient och eventuella anhöriga att bevaka. Det är viktigt att vården förbereder patient och anhöriga inför hemgång med specifik information och instruktioner utifrån patientgrupp för att patienterna ska känna sig trygga. Syfte: Att studera postoperativ återhämtning efter dagkirurgisk operation. Metod: Studien har en randomiserad kontrollerad design. Studien omfattade 565 patienter som randomiserats till en interventions- och kontrollgrupp. Alla inkluderade svarade på Svensk Post-discharge Surgical Recovery Scale preoperativt och dag 28 postoperativt. Interventionsgruppen svarade även på mobilfrågor dag 1 – 14, 21 och 28 postoperativt. Resultat: I resultatet framkom att kvinnor hade sämre återhämtning jämfört med män och att den postoperativa återhämtningen skiljde sig mellan olika operationsgrupper. Ortopedpatienterna behövde längre tid för återhämtning, hade mer smärta, mer behov av vila, sämre rörlighet och behövde mer hjälp med ADL än övriga grupper. Det positiva med resultatet var att alla patienter uppgav lite besvär med illamående och yrsel vilket kan tyda på att patienterna fått bra PONV profylax inför hemgång. Konklusion: Författarna anser att det behövs fler studier som undersöker kvinnors postoperativa återhämtning. Resultatet styrker att ortopediska patienter kan behöva mer uppföljning efter hemgång och att mer specifik information utifrån ingrepp kan höja kvaliteten inom dagkirurgisk vård.
7
Rummel, Robert Mark. "Quality control practices for postoperative eye care in rural Arizona." ScholarWorks, 1994. http://scholarworks.waldenu.edu/hodgkinson/2.
Анотація:
Health care services in the United States are regulated and monitored by federal and state agencies in order to protect the American public. The primary function of these regulating agencies is to assure that any medical procedure or service meets or exceeds the established minimum standards of care. The purpose of this study is to evaluate one aspect of medical care along with its corresponding quality control system.
In the area of eye surgery and postoperative eye care, this investigator encountered several clinical situations in which the quality of medical care has been compromised, increasing the patient's risk of postoperative complications. This study was designed to evaluate how effective the current quality control mechanisms were in recognizing and dealing with a possible breech in the medical quality of care in the postoperative co-management of eye surgery patients in the State of Arizona. General Systems Theory was used as the theoretical base for the study.
The case-study methodology was deemed most appropriate for evaluating the topic of eye surgery co-management. Statistical verification was accomplished by analyzing the standardized data from the case-study checklist.
The results of the study demonstrate that the medical quality control system in Arizona is not enforcing the established minimum standards of quality for eye surgery co-management.
The primary cause of the regulatory agencies suboptimal performance is that the regulatory mechanism is not functioning as a true system. The current disjointed approach to medical quality in Arizona has resulted in (1) inefficient and ineffective mechanisms which enforce minimum standards of care, (2) more than one standard of care for the same medical service, (3) Medicare reimbursement for medical services by unlicensed health care providers, and (4) substandard medical care causing actual harm and increased risk to the patient.
The recommendations offered to rectify the problems identified by this study are based upon applied systems theory. The American health care system seems destined to undergo changes. The recommendations of this study are attempting to mold one aspect of the current methods of providing health care into a true "system of health care."
8
Krug, Jeffrey Bart Litofsky N. Scott Chandrasekhar Anand. "Functional outcome and self-perceived overall health status following surgery to remove primary brain tumor." Diss., Columbia, Mo. : University of Missouri--Columbia, 2008. http://hdl.handle.net/10355/5754.
Анотація:
The entire thesis text is included in the research.pdf file; the official abstract appears in the short.pdf file; a non-technical public abstract appears in the public.pdf file. Title from PDF of title page (University of Missouri--Columbia, viewed on September 25, 2009). Thesis advisors: Dr. N. Scott Litofsky & Dr. Anand Chandrasekhar. Includes bibliographical references.
9
Göransson, Simon, and Henrik Karlsson. "Den muntliga överrapporteringen mellan operation och postoperativ miljö : En observationsstudie av innehållet." Thesis, Linköpings universitet, Avdelningen för omvårdnad, 2019. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-157734.
Анотація:
Bakgrund: För att sjukvården ska kunna upprätthålla patientsäkerheten krävs ett säkert sätt att överföra information mellan skifte av personal. För att kunna inkludera alla viktiga komponenter i en rapport krävs skicklighet i rapportering. Information som missas gör att patienter löper större risk att drabbas för vårdskador. Patienter som genomgår utsätts för sedering eller operativa ingrepp är redan sköra och löper större risk att drabbas av negativa konsekvenser. Syfte: Att undersöka innehållet i den muntliga överrapporteringen mellan anestesisjuksköterskor och postoperativ personal samt granskavad som kan påverka innehållet. Metod: En observationsstudie med kvalitativ och kvantitativ ansats utfördes på en intensivvårdsavdelning och en post-operativ avdelning. Resultat: Sammanställningen av 50 observationer visade att allergier, kirurgiska komplikationer, blodförlust och luftvägshantering var de mest frekventa punkterna som försummades. Innehållet jämfördes sedan med hur nöjda sjuksköterskorna som tog emot rapporten var gällandeinnehåll och struktur. Inga säkra slutsatser kunde dras av förhållandet mellan tid och innehåll, störningsmoment och innehåll, samt uppskattad nöjdhet med rapporten och innehåll. Vart rapporten sker har inverkan i hur stor utsträckning in-och utfarter samt operationsförband rapporteras. Störningsmoment har ingen inverkan på antal parametrar som tas upp. Konklusion: Resultatet visar att viktig information missas i olika utsträckning. Utifrån resultatet på studien dras slutsatsen att det behövs fortsatt forskning för att ge möjligheten att optimera och strukturera rapporterna så innehåll inte missas.Background: If the health care is to maintain the patient security, a safe way to transfer information between staff changes is required. To be able to include all the important components in the report requires great skill. Information that is missed will expose the patient to a greater risk of care damage. Patients that undergo surgery or anaesthesia are already fragile and are at a greater risk of voluminous consequences. Objective: To examine the content of the oral report between the anaesthesia nurse and post-operative nurse, and what causes that could possibly affect the contents of the report. Method: An observation study with qualitative and quantitative method approach was adopted. The setting for the study was an intensive critical care unit and a post anaesthesia unit. Result: The findings in the 50 observations shows that allergies, surgical complications, blood loss and airway management were the most neglected points in the report. The amount of time the observations took were examined along with the content, structure and how satisfied the nurses that received the report were afterwards. No certain conclusions could be shown in the relationship between time and amount of content in the report. Neither was there a relationship between amounts of distraction and decreasing of content. These findings were compared with estimated satisfaction from the nurses that received the report. Where the report is held has impact on how much information about venous access, tubes and bandages is transferred. Disturbance had no effect on the amount of information being reported. Conclusion: The result shows that important information is missed to a certain degree. The study results show that there is still a need for more research to be able to find a way to optimize the oral report and the information transfer.
10
Edberg, Mathias, and Mattias Pedersen. "Patienters upplevelse av postoperativ smärtlindring : En litteraturstudie." Thesis, Uppsala universitet, Institutionen för folkhälso- och vårdvetenskap, 2019. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-373614.
Анотація:
Introduktion: Smärta är en subjektiv känsla som endast den som upplever smärtan kan beskriva, men är något som nästan alla som genomgår ett kirurgiskt ingrepp upplever. Det finns olika typer av smärta och olika sätt att analysera och behandla den på. Bristfällig postoperativ smärtbehandling kan leda till svåra komplikationer och kan medföra stora kostnader för samhället och lidande för patienter. Syfte: I den här studien var syftet att med hjälp av vetenskaplig litteratur beskriva patienters upplevelser av postoperativ smärtlindring. Metod: Studien är gjord som en litteraturstudie med tio vetenskapliga artiklar vilka granskades med hjälp av innehållsanalys. Artiklar söktes via sökmotorerna PubMed och CINAHL. Resultat: Resultatet visade att patienter som var välinformerade om den postoperativa smärtbehandlingen både muntligt och skriftligt före och efter operationen, upplevde att de var mer nöjda med sin postoperativa smärtbehandling. Dessa patienter kände sig tryggare i att tillkalla sjukvårdspersonalen vid smärta och de upplevde att de var förberedda på postoperativ smärta redan innan operationen. Patienterna uppgav att ett bra bemötande från sjukvårdspersonalen hade en positiv inverkan på deras smärtupplevelse. Patienterna lyfte också fram aspekter som kunde förvärra patienternas upplevelse och beskrev då svårigheter att förmedla sin smärta, bristfällig information, ett dåligt bemötande med mera. Slutsats: Majoriteten patienter var nöjda med den postoperativa smärthandlingen men det fanns faktorer som påverkar upplevelsen till det sämre. För att förbättra möjligheten till en god postoperativ smärtbehandling är det viktigt att utveckla en arbetsmiljö för sjukvårdspersonal som tillåter ett gott bemötande och en tydlig kommunikation med patienter både före och efter operation.Introduction: Pain is a complex and subjective experience, it is hard for any other else than the patient to understand it. All patients that undergo surgery will experience some sort of postoperative pain and therefore it is important to understand what pain is and what the patient goes through. Insufficient pain management could lead to postoperative complications that could be life threatening and increases the cost to society. Aim: The aim of this study was to examine the patient’s experiences of postoperative pain management. Methods: This study used a descriptive literature review. The searches were performed in the databases PubMed and CINAHL. Results: Results show that patients who were well-informed both pre- and postoperatively about the pain management were the most satisfied with their experience. Good communication and good treatment heightened the well-being of patients. Negative aspects could be communication difficulties and troubles describing the pain, lack of information and overstrained staff. Conclusion: The majority of patients were satisfied with their postoperative pain management but there were different things that had a negative influence on their experience. Improvements can be made, especially in the staffs’ individual behavior and in the organization as such.
11
Holmqvist, Frida, and Therese Antonsson. "Uppkomst av trycksår i det postoperativa förloppet : En kvantitativ litteraturstudie." Thesis, Uppsala universitet, Sjuksköterskeutbildningar, 2018. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-352521.
Анотація:
ABSTRACT Background: Pressure ulcer is caused by pressure on the same skin area for a certain period of time, which causes a reduced blood circulation in the affected area and causes the tissue to die. Pressure ulcer is a major strain on healthcare, society and a big suffering for the patient. It contributes with high costs, extended care and pain. Aim: The aim was to describe the relationship between postoperative care and the appearance of pressure ulcer. Method: A literature study with 10 quantitative studies was used. Results: The intensive care department has an influence on the onset of pressure ulcers, and most of the pressure ulcers occur postoperatively in patients. The operating time is of no significance, but prolonged surgery may be a risk factor for pressure ulcer postoperatively. The majority of patients developing pressure ulcers in the postoperative process have underlying diseases such as diabetes, heart failure and renal failure. Other risk factors are patients who are older, underweight and have low Bradenpoints. Preventive measures such as air-changing mattresses are of great importance to counteract the onset of pressure ulcers, as well as saving large sums of money. Conclusion: Pressure ulcers are a contributing factor to patients having extended periods of suffering, which at the same time contribute to major costs for society and hospitals. In the postoperative stage, patients are more vulnerable due to reduced mobility and underlying diseases. Preventive measures such as mattresses help reduce the appearance of pressure ulcers and save big sums of money in the end.SAMMANFATTNING Bakgrund: Trycksår uppkommer av att det blir tryck på samma hudområde under en viss tid, vilket leder till att det blir en nedsatt blodcirkulation i det drabbade området och att vävnaden tillslut dör. Trycksår är en stor belastning för sjukvård, samhälle och skapar ett stort lidande för patienten. Tryckskador bidrar med stora kostnader, förlängda vårdtider, smärta samt ett lidande för patienten. Syfte: Syftet var att beskriva sambandet mellan den postoperativa vården och uppkomsten av trycksår.Metod: En litteraturstudie med 10 kvantitativa artiklar. Resultat: Intensivvårdsavdelningen har en påverkan på uppkomsten av trycksår, och större delen av trycksåren uppkommer postoperativt hos patienter som är inneliggande på intensiven. Operationstiden har ingen signifikant betydelse, men en förlängd operation kan vara en riskfaktor för att trycksår uppkommer postoperativt. Majoriteten av patienterna som utvecklar trycksår i det postoperativa förloppet har bakomliggande sjukdomar som diabetes, hjärtsvikt och njursvikt. Andra riskfaktorer är patienter som är äldre, underviktiga och har låga Bradenpoäng. Förebyggande åtgärder som luftväxlande madrass har en stor betydelse för att motverka uppkomsten av trycksår, samt sparar in stora summor pengar. Slutsats: Trycksår är en bidragande faktor till att patienter får förlängda vårdtider med mycket lidande som samtidigt bidrar med stora kostnader för samhälle och sjukhus. I det postoperativa skedet är patienter extra utsatta på grund av nedsatt rörlighet och bakomliggande sjukdomar. Förebyggande åtgärder som madrasser bidrar till minskad uppkomst av trycksår och sparar stora summor pengar i slutändan
12
Nilsson, Ulrica. "The effect of music and music in combination with therapeutic suggestions on postoperative recovery /." Linköping : Univ, 2003. http://www.bibl.liu.se/liupubl/disp/disp2003/med809s.pdf.
13
郭瀅蕙 and Yin-wai Kwok. "Evidence-based preoperative pain education protocol using cognitive behavioral approach for patients undergoing surgeries." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2009. http://hub.hku.hk/bib/B43251237.
14
Kwok, Yin-wai. "Evidence-based preoperative pain education protocol using cognitive behavioral approach for patients undergoing surgeries." Click to view the E-thesis via HKUTO, 2009. http://sunzi.lib.hku.hk/hkuto/record/B43251237.
15
Smith, Fredrik, and Kristoffer Ekelund. "Postoperativ smärtbedömning : Ur ett sjuksköterskeperspektiv." Thesis, University of Skövde, School of Life Sciences, 2009. http://urn.kb.se/resolve?urn=urn:nbn:se:his:diva-3577.
Анотація:
Mycket forskning inom ämnet postoperativ smärta är gjord. Det är ett komplext ämne och studier visar att det förekommer att patienter smärtlindras otillräckligt. Syftet med den här studien var att beskriva vilka metoder sjuksköterskan använder sig av för att bedöma akut postoperativ smärta, och vilka för och nackdelar som finns med de olika metoderna. Vi ansåg att en litteraturstudie var mest lämpad för vår studie och har använt oss av tolv artiklar i resultatet. Där identifierade vi fyra kategorier som beskriver hur sjuksköterskan bedömer postoperativ smärta. (1) Hur patienten ser ut, (2) Kommunikation, (3) Erfarenheter och (4) Smärtskattningsskalor. Ofta vägs flera av dessa kategorier in när sjuksköterskan bedömer smärta. Resultatet visar att sjuksköterskan har en tendens att bedöma smärtan utifrån tidigare erfarenheter och det händer att de ibland undervärderar patientens smärtnivåer. Det framgår också att patientens verbala beskrivning om smärtupplevelsen är den mest tillförlitliga indikatorn i bedömningen av akut postoperativ smärta.
There has been a lot of research conducted on the subject matter of postoperative pain. It’s a complex subject matter with studies showing the presence of inadequate pain relief. The purpose of this study is to describe the methods and tools nurses use to assess acute postoperative pain, and the pros and cons of the various methods. A literature review was conducted and twelve articles where used for the results. Four categories describing how nurses assess postoperative pain were identified. (1) What the patient looks like, (2) Communication, (3) Previous experiences and (4) Pain rating scales. It’s common for multiple categories to be used by nurses assessing pain. Results show nurses have a tendency to assess pain from previous experiences, and in the process sometimes underestimating the patients’ true pain levels. Results also show that the most accurate indicator of a postoperative pain in patients is their own verbal expression of said pain.
16
Pettersson, Maria. "Förebyggande av postoperativ myalgi." Thesis, Halmstad University, School of Social and Health Sciences (HOS), 2010. http://urn.kb.se/resolve?urn=urn:nbn:se:hh:diva-5222.
Анотація:
Succinylcolin är ett icke-depolariserande muskelrelaxantia som används inom anestesisjukvård. En vanlig biverkning är postoperativ myalgi. Varför smärtan uppstår är inte helt klarlagd. Under många år har forskare runt om i världen försökt komma till rätta med problemet utan att helt lyckas.Olika läkemedel och strategier har prövats. En av de viktigaste uppgifter en sjuksköterska har är att förebygga och lindra lidande. Som anestesisjuksköterska finns det möjlighet att påverka den vård som ordineras. Syftet med studien var att undersöka vilka metoder som kan förebygga postoperativ myalgi orsakad av succinylcolin. En litteraturstudie baserad på tio vetenskapliga artiklar genomfördes. Resultatet visade att parecoxib preoperativt samt premedicinering med diklofenakplåster gav det bästa resultatet när det gäller reducerande av myalgi. Med hjälp av dessa så vanliga läkemedel kan onödigt lidande förebyggas och samhällsekonomiska resurser sparas.
17
Myers, Elizabeth C. "Evaluation of a patient-controlled approach to postoperative pain relief." Thesis, Glasgow Caledonian University, 1993. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.335359.
18
Johansson, Felix, and Simon Thunberg. "Föräldrars betydelse i vården av barn med delirium som vårdas inom intensivvårdsmiljö." Thesis, Uppsala universitet, Institutionen för folkhälso- och vårdvetenskap, 2019. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-388845.
Анотація:
Bakgrund: Delirium är en vanligt förekommande komplikation både i barnintensivvården och barnoperationsvården. Det orsakar stort lidande hos de påverkade barnen både emotionellt och fysiskt, samt ökar delirium vårdtiden och orsakar en ökad mortalitet. Syfte: Att presentera vilka omvårdnadsåtgärder som kan förebygga delirium hos barn samt undersöka vad som påverkar vårdrelationen mellan barnet, familjen och sjuksköterskan vid omvårdnad och behandling av delirium i en intensivvårdsmiljö. Metod: Litteraturstudie baserad på kvantitativa studier analyserad med innehållsanalys. Resultat: Analysen resulterade i tre teman: effekten av föräldrars involvering på barn med delirium, övriga effekter av föräldrars involvering i vården av barn och betydelsen för ökad involvering för föräldrarna. Ökad involvering av föräldrarna i den pre och postoperativa vården gav en signifikant förbättring av postoperativt delirium hos barnet, under förutsättning att föräldrarna fått utbildning och blivit förberedda hur de skulle agera. Den ökade involveringen av föräldrar sågs som positivt av både föräldrar och personal. Analysen resulterade inte i några specifika omvårdnadsåtgärder som kan förebygga delirium hos barn. Slutsats: Föräldrar bör få möjligheten att vara så nära sina barn som möjligt och vara involverade i vården på barnintensivvårdsavdelning eller i den pre- och postoperativa vården. För att minska risken att barn drabbas av delirium finns behov av att utbilda och förbereda föräldrarna.Background: Delirium is a common complication at both pediatric intensive care units and pediatric postoperative units and it is causing huge amount of increased suffering for the affected children. Not only the emotional and physical suffering, but also increased time needed to stay in the PICU and increased mortality. Aim: To examine which nursing actions can prevent emergence delirium in children and to examine the importance of the care relationship between the child, the family and the nurse in the care and treatment for delirium. Method: A literature review with a quantitative approach, analyzed with content analysis. Results: The analysis resulted in three themes. The effect of parental involvement on the delirium of children, other effects on the involvement of parents in the care of children and the meaning of the involvement for the parents. The involvement of parents in children pre and postoperative had a significant decrease of delirium and negative behavior under the condition that the parents were prepared and active in their role as a support for their children. The increase parental involvement was viewed as positive from both parents and nurses. Analysis did not find any nursing actions to prevent delirium for children Conclusion: Parents should be able to be as close and involved in the care for their children in a PICU or in the pre and postoperative care as it is possible, and the need to educate and prepare the parents in order to decrease the risk for the children to suffer from delirium.
19
Martinell, Tina. "Tidiga tecken på pankreasanastomosläckage efter kirurgi : en studie om hur dessa kan upptäckas med hjälp av ett bedömningsformulär." Thesis, Röda Korsets Högskola, 2010. http://urn.kb.se/resolve?urn=urn:nbn:se:rkh:diva-81.
Анотація:
Bakgrund: Pankreatikoduodenektomi är den enda kurativa behandlingen av pankreascancer och pankreasanastomosläckage (PAL) är en mycket allvarlig postoperativ komplikation. Metoder för att identifiera detta i ett tidigt skede behöver förbättras. Den postoperativa övervakningen består till stor del av vitalparametrar men sjuksköterskan observerar även andra tecken på försämring. Metod: 32 patienter som genomgått pankreatikoduodenektomi inkluderades i studie. Ett bedömningsformulär innehållande 14 parametrar togs fram och användes för att identifiera vad i sjuksköterskans observationer som kan identifiera tidiga tecken på PAL. Studien hade kvantitativ ansats. Syfte: Att identifiera tidiga tecken på PAL efter pankreatikoduodenektomi med hjälp av ett bedömningsformulär. Resultat: Bedömningsformuläret identifierade normalförloppet efter pankreatikoduodenektomi. Vid jämförelse mellan patienterna som drabbats av PAL och normalförloppet urskildes tre signifikanta skillnader. Patienterna med PAL hade innan det diagnostiserades ökat syrgasbehov, sjuksköterskan bedömde deras allmäntillstånd som dåligt istället för ganska gott och patienternas egenbedömning av allmäntillståndet visade att de mådde sämre för varje dag istället för bättre. Slutsatser: Studien indikerar att ökat syrgasbehov samt sjuksköterskans bedömning och patientens egenbedömning av allmäntillståndet är vägledande för upptäckten av pankreasanastomosläckage.Background: Pancreaticoduodenectomy is the only curative treatment of pancreaticcancer and postoperative pancreatic fistula (POPF) is a very serious complication. Methods to identify this in an early stage must be improved. The postoperative monitoring is largely composed of vital signs, but the nurse also observes other signs of deterioration. Method: 32 patients how underwent pancreaticoduodenectomy were included in the study. An assessment form containing 14 parameters was used to identify what in the nurse's observation that can identify early signs of POPF. The study had a quantitative approach. Objective: To identify early signs of POPF after pancreaticoduodenectomy using anassessment form. Results: The assessment form identified the normal process after pancreaticoduodenectomy. In the comparison between the patients affected by POPF and the normal process, three significant differences were distinguished. The patients with POPF had before it occurred increased oxygen needs, the nurse assessed the general health as poor rather than pretty good and the patients self-assessed the general health worse by the day instead of better. Conclusions: This study indicates that increased oxygen needs and the nurse's assessment and the patient's self-assessment of general health can be indicative for the discovery of POPF.
20
Short, Alison Edna. "Holistic aspects of rehabilitation post-cardiac surgery in the Bonny Method of Guided Imagery and Music /." Electronic version, 2003. http://adt.lib.uts.edu.au/public/adt-NTSM20040910.144144/index.html.
21
Eriksson, Olivia, and Tova Granlöf. "Att belysa hur sjuksköterskor kan arbeta med pre- och postoperativa omvårdnadsinsatser i relation till smärta : En litteraturstudie." Thesis, Högskolan i Halmstad, Akademin för hälsa och välfärd, 2021. http://urn.kb.se/resolve?urn=urn:nbn:se:hh:diva-44146.
Анотація:
Bakgrund: Postoperativ smärta är något som många patienter upplever i samband med kirurgiska ingrepp. Måttlig till intensiv smärta är vanligt förekommande inom hälso- och sjukvården och otillräcklig utbildning och okunskap kan bidra med en rad olika komplikationer efter operation. Syfte: Syftet var att belysa pre- och postoperativa omvårdnadsinsatser i relation till smärta. Metod: En allmän litteraturstudie med induktiv ansats, där sökningar genomfördes i två olika databaser och resulterade i 12 vetenskapliga artiklar med både kvalitativ och kvantitativ metod som granskades och analyserades i fem steg. Resultat: Resultatet består av två kategorier och sex subkategorier. Kategorierna som presenteras i resultatet var Preoperativa omvårdnadsinsatser med subkategorierna premedicinering och vikten av god information till patienten. Postoperativa omvårdnadsinsatser med subkategorierna bedömning av smärta, sjuksköterskans samlade erfarenhet, standardiserade vårdförlopp och mobiliseringens betydelse. I resultatet framkom det att premedicinering, muntlig och skriftlig information samt betydelsen av mobilisering hade viktig roll i den pre- och postoperativa vården och för patientens smärta och lidande. Konklusion: Litteraturstudien visar att riktade omvårdnadsinsatser i pre- och postoperativa skedet kan bidra till en förbättra vård genom att sjuksköterskor får ökad kunskap och utbildning. Vidare sågs ett behov av fortsatt utbildning med fokus på preoperativa korrekt bedömning, behandling och omvårdnad vid smärta i samband med kirurgi.Background: Postoperative pain is a common experience for patients who have hadsurgical intervention. Moderate to intensive pain is a commonly occurring issuewithin the healthcare system and insufficient education and misjudgement can resultin a series of complications post operation. Aim: The aim of this study was tohighlight pre- and postoperative nursing interventions, in relation to pain. Method: Aliterature review with inductive run-up and the searches were made through twodifferent databases resulting in 12 scientific articles, both qualitative and quantitativemethodologies, which were then reviewed and analysed. Result: The result consistsof two themes and six sub-categories. The theme which is presented as part of theresults here-in are Preoperative healthcare measures with the following subcategories: Pre-medication and the Importance of good information to thepatient. Postoperative healthcare measures with the following sub-categories:Assessment of pain, the gathered experiences of the nurse, Standardized careprocesses and Importance of mobilization. The results gathered that premedication,verbal and written information, as well as the significance of mobilization, all had animportant role in the pre- and postoperative healthcare and the pain and suffering ofthe patient. Conclusion: The general literary study shows that targeted nursinginterventions in the pre- and postoperative phase can contribute to improved care bygiving nurses increased knowledge and training. In addition, it was shown that furthertraining focusing on correct preoperative assessments, treatment and care in surgeryrelated pain, is indeed important.
22
Good, Marion Patricia Long. "Comparison of the effects of relaxation and music on postoperative pain." Case Western Reserve University School of Graduate Studies / OhioLINK, 1992. http://rave.ohiolink.edu/etdc/view?acc_num=case1059751996.
23
Åslund, Adelina, and Johanna Rydén. "Åtgärder för att förebygga postoperativ konfusion på somatiska vårdavdelingar." Thesis, Uppsala universitet, Institutionen för folkhälso- och vårdvetenskap, 2021. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-432173.
Анотація:
Bakgrund: Konfusion är ett akut förvirringstillstånd som är vanligt förekommande efter kirurgi där en desorientering av tid, rum, situation eller person sker vilket kan leda till längre vårdtider, ett ökat behov av rehabilitering samt en ökad dödlighet. Detta innebär dels ett lidande för patienten, men även en ökad belastning på vården med ökade kostnader på grund av den längre vårdtiden. Genom att förebygga postoperativ konfusion skulle de negativa konsekvenserna kunna förhindras och patientens lidande därmed minska. Syfte: Syftet med studien var att identifiera vilka icke-farmakologiska åtgärder som beskrivs i vetenskaplig litteratur för att förebygga postoperativ konfusion på somatiska vårdavdelningar. Metod: En deskriptiv litteraturstudie som baserats på tio kvantitativa originalartiklar publicerade år 2015–2020. Databaserna som användes var PubMed och Cinahl. Artiklarnas kvalitet granskades och de sammanställda artiklarnas resultat analyserades och resultatet delades in teman och kategorier för ge en bättre överblick inom området. Resultat: Som förebyggande åtgärder för postoperativ konfusion identifierades i det sammanvägda resultatet fem teman. Dessa var kunskap, orientering, miljö, basal omvårdnad och smärta. Inom temana identifierades även kategorier där kommunikation, utbildning av personal samt ett nära samarbete med närstående visades vara en viktig del i att förebygga postoperativ konfusion på somatiska vårdavdelningar. Slutsats: Med icke-farmakologiska förebyggande åtgärder riktade mot kunskap, orientering, miljö, basal omvårdnad och smärta kunde fler fall av postoperativ konfusion förebyggas. Genom detta kunde därmed även patientens lidande och belastningen på vården minskas.Background: Delirium is an acute state of confusion that is common post surgery where a disorientation of time, situation and person occurs which can lead to longer length of stay, an increased need for rehabilitation and an increased mortality. This leads to suffering for the patient but also an increased burden on healthcare. By preventing postoperative delirium the negative consequences could be avoided and the suffering of the patient thereby decrease. Aim: The aim of this study was to identify non-pharmacological measures that are described in scientific literature to prevent postoperative delirium in somatic wards. Methods: A descriptive literature study based on ten quantitative peer reviewed articles published between 2015–2020. The databases that were used were Pubmed and Cinahl. The compiled results were evaluated and the compiled results were analyzed and then categorized into themes to give a better overview of the field. Results: As preventive measures for postoperative delirium five themes were identified in the result. These were knowledge, orientation, environment, nursing care and pain. Within these themes categories were also identified and communication, staff education and a close cooperation with relatives were an important part in preventing postoperative delirium in somatic wards. Conclusion: With non-pharmacological preventive measures aimed towards knowledge, orientation, environment, nursing care and pain more cases of postoperative delirium could be prevented. These preventive measures could thereby decrease the patients suffering and the burden on healthcare.
24
Soop, Mattias. "Effects of perioperative nutrition on insulin action in postoperative metabolism /." Stockholm, 2003. http://diss.kib.ki.se/2003/91-7349-529-8/.
25
Schmieding, Sally Renee. "Effect of written information of wound healing and self care practices in postoperative patients." Thesis, The University of Arizona, 1988. http://hdl.handle.net/10150/276827.
Анотація:
An experimental design was employed to determine the knowledge gained through use of written Wound Healing Fact Sheets. The study sample consisted of 30 postoperative patients recruited from the accessible population of abdominal and chest surgery patients. Subjects were randomly assigned to experimental and control groups. Experimental subjects were interviewed, received the Fact Sheets and underwent knowledge testing prior to discharge and by telephone approximately one week after discharge. Control subjects did not receive the Fact Sheets but were interviewed and tested identically to the experimental group. Low equivalent reliabilities were demonstrated through use of the KR-20 for the knowledge test. Content validity was established by a panel of three experts. A t-test computed between pre and post test mean scores identified a significant difference in knowledge gained by experimental versus control subjects. Low reliability weakens the significance of this result.
26
Olsson, Daniel, and Andrea Olsson. "Symptom patienter upplever efter dagkirurgi till följd av anestesi." Thesis, Uppsala universitet, Institutionen för folkhälso- och vårdvetenskap, 2015. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-253992.
Анотація:
Ambulatory surgery is common and develops alongside surgery and anesthetic methods. Time admitted is short and aftercare takes place in the home environment. Objective: The aim of the study was to investigate which symptoms patients experience after ambulatory surgery related to anesthesia. Furthermore how strongly symptoms affect the patient. Symptoms appear as a result of anesthesia and surgery and can therefore be interpreted as nursing induced suffering. Method: Participants were recruited at ambulatory clinics at a Swedish university hospital spring, 2015. Prior to the study permission was granted from the clinic managers. The study is a quantitative descriptive longitudinal study. Data collection forms were administered and data collection was performed by phone. Incisional pain, headache, neck pain, hoarseness, postoperative sore throat, nausea, drowsiness, post-discharge urine retention and numbness were requested parameters. Answers were evaluated as; none-existing, mild, moderate and severe. Data was measured at 48 hours and postoperative day seven. Result: The study included 67 participants. The various symptoms were all apparent to some extent by some of the participants at 48 hours. Concerning headache, neck pain, hoarseness, sore throat, nausea, urine retention and numbness most were symptom free. Incisional pain and drowsiness however affected the participants noticeably. Seven days after surgery there was an overall improvement throughout the parameters. Although incisional pain and drowsiness also lessened some participants still evaluated their experience moderate to severe. Conclusion: The majority of the day surgery patients were content with their care, in our study 97% were satisfied. There was an improvement within the experienced symptoms after seven days compared to after 48 hours. There is room for improvement concerning pain management and time for recovery in the home environment as drowsiness was still an evident issue.Dagkirurgi är vanligt och drivs framåt av utvecklingen inom kirurgi och anestesi. Vårdtiden är kort och mycket av eftervården sker i hemmet. Syfte: Syftet var att undersöka vilka symptom patienter upplever efter genomgången dagkirurgi relaterat till anestesi. Vidare undersöks hur starkt olika symptom påverkar patienten. Symptom efter anestesi och kirurgi uppkommer till följd av omvårdnaden och kan därför tolkas som ett vårdlidande. Metod: Deltagare har rekryterats från dagkirurgiska avdelningar vid ett mellansvenskt universitetssjukhus våren 2015. Tillstånd inhämtades före studien från verksamhetschefer. Studien är en beskrivande kvantitativ longitudinell studie och data har samlats in med frågeformulär där svaren delgivits via telefon. Parametrarna smärta i operationsområde, huvudvärk, smärta i nacke, heshet, smärta i svalg, illamående, trötthet, urinretention samt känselbortfall har efterfrågats. Svaren har delgivits på en skala som graderats i nivåer från; inte alls, mild, måttlig och svår. Mättillfällen var efter 48 timmar samt sju dagar postoperativt. Resultat: Studien har 67 deltagare. Efter 48 timmar upplevdes de olika symptomen alltid av någon deltagare, men vid huvudvärk, smärta i nacke, heshet, smärta i svalg, illamående, urinretention samt känselbortfall var de flesta symptomfria. Smärta i operationsområdet och trötthet påverkade dock patienterna påtagligt. Efter sju dagar upplevdes förbättring i alla parametrar. Smärta i operationsområdet samt trötthet minskade, men upplevdes fortfarande av vissa som måttlig och svår. Slutsats: De flesta dagkirurgiska patienterna är nöjda med sin vård, 97% i vår studie. En förbättring i upplevda symptom finns efter sju dagar jämfört med efter 48 timmar. Förbättringspotential finns inom smärtlindring och vidare bör utrymme för återhämtning finnas då trötthet visat sig vara förekommande
27
Broström, Britt, and Marianne Ernstsson. "Postoperativ smärta: Metoder för bedömning och omvårdnadsåtgärder : En litteraturöversikt." Thesis, Högskolan Dalarna, Omvårdnad, 2016. http://urn.kb.se/resolve?urn=urn:nbn:se:du-24236.
Анотація:
Bakgrund: Postoperativ smärta är ofta underbehandlad. Det finns flera orsaker till varför det är viktigt med en god smärtlindring efter operation. Dels lindring av den akuta smärtan men även för att förebygga komplikationer och långvarig smärta. Syfte: Att beskriva sjuksköterskans bedömning av och omvårdnadsåtgärder vid postoperativ smärta hos vuxna patienter. Metod: En litteraturöversikt baserad på 16 artiklar, publicerade mellan år 2010-2016. Artiklarna hittades i databaserna PubMed, CINAHL och Web of Science. Resultat: Sjuksköterskans förhållningssätt samt tid för att skapa en relation med patienten, är en förutsättning för korrekt smärtbedömning. Förutom administrering av analgetika finns det omvårdnadsåtgärder som kan lindra smärta som sjuksköterskan kan använda sig av, till exempel lägesändringar eller att ge information. Slutsats: Det finns flera faktorer som påverkar sjuksköterskans smärtbedömning, varav patientens delaktighet och sjuksköterskans förhållningssätt är viktiga komponenter. Även omvårdnadsåtgärder kan lindra smärta.Background: Postoperative pain is often undertreated. There are several reasons why it is important with good pain relief after surgery. Ease of the acute pain but also to prevent complications and long lasting pain. Aim: To describe the nurse´s assessment and nursing care of postoperative pain in adults. Methods: Literature review based on 16 articles, published between 2010- 2016. The articles were found in the databases PubMed, CINAHL and Web of Science. Results: The nurse´s attitude and time for creating a relationship with the patient, is a prerequisite for correct pain assessment. Apart from administration of analgesics, there is nursing care that can relieve pain, which the nurse can use, for example change position or give information. Conclusion: There are many factors that influence the nurse´s pain assessment, where the patient´s participation and the nurse´s attitude are important components. Also nursing care can ease pain.
28
Whalan, Comus John. "Mechanisms of post-operative sepsis and renal impairment in obstructive jaundice /." Title page, abstract, contents and introduction only, 1998. http://web4.library.adelaide.edu.au/theses/09MD/09mdw552.pdf.
29
Gebhardt, Pamela Gipe. "Reliability and validity of the Interchange of Gases Assessment Tool for monitoring the respiratory status of patients in the postanesthetic care unit." Thesis, The University of Arizona, 1989. http://hdl.handle.net/10150/144669.
Анотація:
The purpose of this descriptive study was to evaluate, through clinical testing, the interrater reliability and concurrent validity of the Interchange of Gases Assessment Tool (IGAST) for monitoring the respiratory status of patients in the Postanesthesia Care Unit. The IGAST was used to assess the respiratory status of 20 patients over three time periods (60 data samples). Findings indicated that interrater reliability of the IGAST was acceptable for clinical use in the PACU. The IGAST received a mean interrater reliability rating of 98% in the PACU setting. Results of the mean dimension scores supported the patients' readiness for discharge. Chart audit revealed that the IGAST had concurrent validity since charted information and rated IGAST items were congruent. Further findings suggested that nurses using the IGAST document the respiratory status of patients more completely and more consistently than nurses using narrative documentation.
30
Atkinson, Jo-An Maree. "Post-operative scar management : the use of paper tape to prevent hypertrophic scarring in surgical incisions /." [St. Lucia, Qld.], 2005. http://www.library.uq.edu.au/pdfserve.php?image=thesisabs/absthe18705.pdf.
31
Au, Ho-yeung, and 歐浩洋. "The efficacy and clinical safety of various analgesic combinations forpost-operative dental pain: a systematicreview." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2013. http://hub.hku.hk/bib/B50639572.
Анотація:
Background
Various analgesics are available for post-operative pain after third molar surgery. Combinations of different classes of analgesics may improve the overall efficacy of pain control as they covers different pain pathways. A great variation of combinations and dosages of analgesics have been suggested in the literature, yet it was still unclear what combination(s) and dosages were the most effective for acute post-operative dental pain. A systematic review of randomized clinical trials would help clinicians to make clinical judgment of which analgesic combination(s) would be the best for their patients for acute post-operative dental pain in terms of efficacy and safety.
Aim
To conduct a systematic review of randomized clinical trials to answer the clinical question “which analgesic combination and dosage is potentially the most effective and safe for acute post-operative dental pain control?”
Methods
A structured systematic literature search, with predefined inclusion and exclusion criteria, of the relevant computer databases and journals was performed. The search and the evaluations of articles were done by 2 independent reviewers in 3 rounds. Studies that fulfilled the pre-set criteria were included to enter the final review. The analgesic efficacy of the analgesic combinations reported in the included studies were presented by the objective pain measurements, sum of pain intensity at 6 hours (SPID6) and total pain relief at 6 hours (TOTPAR6). The SPID6 and TOTPAR6 of various combinations were adjusted after deducting from the effect of placebos of the respective studies. The adverse effects of the different analgesic combinations were also presented.
Results
There were 13 studies with 2843 subjects included in the final review. Eight groups of drug combinations with 13 different dosages were reported. The efficacies of the reported analgesic combinations have SPID6 scores ranged from 1.46 to 6.44 and TOTPAR6 scores ranged from 3.24 – 10.3. Among the analgesic combinations, ibuprofen 400mg + oxycodone HCL 5mg had the highest adjusted SPID6 (6.44), and a very higher adjusted TOTPAR6 (9.31), representing its efficacy could be superior to the other different analgesic combinations reported in this study. Nausea was the most common adverse effect of the analgesic combinations, with prevalence ranged from 0-55%. Most of the common adverse effects were related to the use of opioids in the combination. Three combinations of different dosages containing ibuprofen and caffeine were reported with the lowest prevalence of adverse effect.
Conclusions
This systematic review of randomized clinical trials has presented the efficacy and adverse effects of the various analgesic combinations for acute post-operative dental pain control. We have identified ibuprofen 400mg with oxycodone 5mg was more effective when compared to the other 12 combinations. Nausea was the most common adverse effects in an analgesic combination containing an opioid. Ibuprofen 200mg with caffeine 100mg or 200mg has a reasonable analgesic effect with fewer side effects when compared to the other analgesic combinations.published_or_final_version
Dental Surgery
Master
Master of Dental Surgery
32
Larsson, Sandra, and Ellen Oscarsson. "Patienters upplevelser av sin återhämtning på vårdavdelningen efter att ha genomgått avancerad tumörkirurgi." Thesis, Uppsala universitet, Institutionen för kirurgiska vetenskaper, 2020. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-417115.
Анотація:
ABSTRACT Background: Patients that have undergone cytoreductive surgery (CRS) with or without hyperthermic intraperitoneal chemotherapy (HIPEC) are a patient group with many complex nursing care needs, the recovery process is often long and challenging. However, there is no research on the patients experiences of the recovery on the ward. Aim: The aim was to describe how patients that have undergone CRS with or without HIPEC experiences the postoperative recovery at the ward, and if the nursing care they receive matches their individual needs. Method: A qualitative study with semi-structured interviews were conducted with seven patients on one gynecological- and one surgical ward. Data was analysed with qualitative content analysis. Result: Two categories were identified: A time filled with physical challenges but gradually returning to normal and A roller coaster of thoughts and emotions. The result showed both physical and mental challenges during the recovery process on the ward. The patients described nausea, tiredness and initially difficulties with mobilisation. They also shared feelings of concern, frustration and missing their relatives. The nursing staff had an important role in creating a safe environment during the treatment period by showing support, providing information and offering conversations. Conclusion: The result of the study shows that patients who have undergone CRS with or without HIPEC experiences both physical and mental challenges during the recovery process on the ward. Through support, information and conversations the nursing staff can meet the patient’s individual needs and in that way, optimize the recovery. By ensuring a high level of competence among the nursing staff, the safety of the patients can be guaranteed and good nursing can be carried out.
33
Cheng, Tan-ning, and 鄭丹寧. "An evidence-based guideline on preoperative warming of patients undergo general anesthesia to reduce postoperative hypothermia." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2013. http://hdl.handle.net/10722/193046.
Анотація:
Operating theatre is a cold environment and hypothermia (core body temperature lower than 36C) is prevalent among patients undergoing operations. Possible causes of this adverse condition include anesthetic effect, body part exposure, blood loss, and the low room temperature in the theatre. Hypothermia can impair wound healing, decrease drug metabolism, increase oxygen consumption, which in turn causing respiratory distress, bradycardia as well as atrial fibrillation. In extreme cases, it can be lethal.
Numerous research studies have explored ways of interventions and new technologies to maintain normal body temperature of patients during operations. However, perhaps without proper translation to clinical practice, the rate of postoperative hypothermia still remains high in many hospital setting.
The objectives of this thesis are to systematically review the current literature on the effectiveness of preoperative warming on reducing postoperative hypothermia of patients undergoing general anesthesia. Data from the relevant literature is extracted for setting up a table of evidence. Also, quality assessment is performed. An evidence-based practice guideline for preoperative warming is developed and its feasibility and transferability to the target patients is examined. The purpose of the guideline is to provide better care for patients undergoing general anesthesia.
In this thesis, preoperative forced air warming is proposed. The target setting is the operating theatre department and day surgery centre in a local public acute hospital. The target population is patients who undergo general anesthesia. Data is extracted from six articles. The implementation potential of the proposed guideline is high, because of the high transferability, feasibility and cost-effective ratio. An evidence-based practice guideline is developed based on the evidence. Well-designed implementation and evaluation plan are developed for the implementation of the proposed guideline.published_or_final_version
Nursing Studies
Master
Master of Nursing
34
Neuling, Sandra J. "Psychosocial needs and responses in breast cancer recovery /." Title page, contents and abstract only, 1989. http://web4.library.adelaide.edu.au/theses/09PH/09phn487.pdf.
Анотація:
Thesis (Ph. D.)--Dept. of Psychology, University of Adelaide, 1991.Typescript (Photocopy). Includes two papers co-authored by the author as appendix D. Includes bibliographical references (leaves 397-425).
35
Stupples, Caroline Elizabeth. "Enhancing recovery in non-critical care emergency bowel resection." Thesis, University of Northampton, 2016. http://nectar.northampton.ac.uk/8829/.
36
Hales, Majella. "Postoperative antifibrinolytic drugs to control haemorrhage." Thesis, Queensland University of Technology, 2002.
37
Zeitz, Kathryn. "Post-operative observations, ritualised or vital in the detection of post-operative complications." Title page, contents and abstract only, 2003. http://web4.library.adelaide.edu.au/theses/09PH/09phz483.pdf.
Анотація:
Copy of author's previously published work inserted. Includes bibliographical references (leaves 273-283). Aims to identify if the current practice of post-operative vital sign collection detects complications in the first 24 hours after the patient has returned to the general ward setting using a combination of methods within a triangulated approach to data collection.
38
Chen, Wen-Lin. "Nurses' and parents' attitudes toward pain management and parental participation in postoperative care of children." Thesis, Queensland University of Technology, 2005. https://eprints.qut.edu.au/16127/1/Wen-Lin_Chen_Thesis.pdf.
Анотація:
Over the last 25 years, inadequate pain management for postoperative children continues to be reported in the literature. Inadequate postoperative pain management leads to detrimental physiological and psychological effects, and lengthens children's hospitalisation. Parental participation can improve the quality of care in hospital and after discharge. Both pain management and parental participation are influenced by the attitudes of nurses and parents. However, only little attention has been paid to this field particularly in Taiwan.
The purpose of the present study was: firstly, to understand nurses' and parents' attitudes toward pain management and parental participation in postoperative child care. Secondly, to explore the personal factors affecting their attitudes to pain management and parental participation. The third purpose was to compare nurses' and parents' attitudes toward pain management and parental participation in postoperative care of children in Taiwan. A descriptive, cross sectional design was used to survey paediatric nurses (n=63) and parents (n=133) of children from 0 to 17 years old who had undergone surgery in three Taiwan teaching hospitals.
The findings indicate that misconceptions about pain medications were found in both parents and nurses. Both parents and nurses held neutral to positive attitudes towards parental participation and postoperative pain management. Both parents and nurses who had higher education levels had more positive attitudes toward the use of pain medication. Parents who were younger, had a higher education level, had previous experience of caring for their child during hospitalisation, had previous experience with their child having surgery and who had younger children, had more positive attitudes toward parental participation. Nurses who had more working experience with children had more positive attitudes toward parental participation. Nurses and parents all had higher agreement in using non-pharmacological methods for children's postoperative pain relief. Nurses had more agreement than the parents in the subscale of "parent-professional collaboration" and another five items in the PPAS questionnaire which included parents being allowed to change simple dressings, restrain their child, and feed their baby; parents being informed; and enhanced professional-patient relationship with parental involvement. Parents had more positive attitudes than nurses to the subscale of "parent presence" and the parents were more in favour than nurses of the provision of facilities such as free meals or parking fees.
Improvement in the quality of children's pain management requires more education to enhance nurses' and parents' knowledge and attitudes toward children's pain management and parental participation. Additional programs are needed that target nurses with less paediatric experience as well as older parents to develop more positive attitudes to parental participation. Paediatric nurses need to be aware and satisfy parents' desire to be present during their child's hospitalisation, as well as help parents to clarify their misconceptions about side effects and tolerance of analgesics utilisation.
39
Chen, Wen-Lin. "Nurses' and Parents' Attitudes toward Pain Management and Parental Participation in Postoperative Care of Children." Queensland University of Technology, 2005. http://eprints.qut.edu.au/16127/.
Анотація:
Over the last 25 years, inadequate pain management for postoperative children continues to be reported in the literature. Inadequate postoperative pain management leads to detrimental physiological and psychological effects, and lengthens children's hospitalisation. Parental participation can improve the quality of care in hospital and after discharge. Both pain management and parental participation are influenced by the attitudes of nurses and parents. However, only little attention has been paid to this field particularly in Taiwan. The purpose of the present study was: firstly, to understand nurses' and parents' attitudes toward pain management and parental participation in postoperative child care. Secondly, to explore the personal factors affecting their attitudes to pain management and parental participation. The third purpose was to compare nurses' and parents' attitudes toward pain management and parental participation in postoperative care of children in Taiwan. A descriptive, cross sectional design was used to survey paediatric nurses (n=63) and parents (n=133) of children from 0 to 17 years old who had undergone surgery in three Taiwan teaching hospitals. The findings indicate that misconceptions about pain medications were found in both parents and nurses. Both parents and nurses held neutral to positive attitudes towards parental participation and postoperative pain management. Both parents and nurses who had higher education levels had more positive attitudes toward the use of pain medication. Parents who were younger, had a higher education level, had previous experience of caring for their child during hospitalisation, had previous experience with their child having surgery and who had younger children, had more positive attitudes toward parental participation. Nurses who had more working experience with children had more positive attitudes toward parental participation. Nurses and parents all had higher agreement in using non-pharmacological methods for children's postoperative pain relief. Nurses had more agreement than the parents in the subscale of "parent-professional collaboration" and another five items in the PPAS questionnaire which included parents being allowed to change simple dressings, restrain their child, and feed their baby; parents being informed; and enhanced professional-patient relationship with parental involvement. Parents had more positive attitudes than nurses to the subscale of "parent presence" and the parents were more in favour than nurses of the provision of facilities such as free meals or parking fees. Improvement in the quality of children's pain management requires more education to enhance nurses' and parents' knowledge and attitudes toward children's pain management and parental participation. Additional programs are needed that target nurses with less paediatric experience as well as older parents to develop more positive attitudes to parental participation. Paediatric nurses need to be aware and satisfy parents' desire to be present during their child's hospitalisation, as well as help parents to clarify their misconceptions about side effects and tolerance of analgesics utilisation.
40
Hansson, Malin, and Isabelle Wolnievik. "Att förebygga akut konfusion hos patienter som har genomgått kirurgi : - en kvantitativ litteraturstudie." Thesis, Uppsala universitet, Institutionen för folkhälso- och vårdvetenskap, 2020. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-409023.
Анотація:
Bakgrund: Akut konfusion är ett vanligt tillstånd hos patienter som genomgått kirurgi och innebär att patientens kognitiva förmåga är nedsatt. Forskning visar att patienter som drabbas av akut konfusion efter ett kirurgiskt ingrepp har högre mortalitet och resulterar i ett lidande för patienten med allvarliga komplikationer. Syfte: Syftet med litteraturöversikten var att sammanfatta olika omvårdnadsinterventioner som förebygger akut konfusion hos patienter som genomgått kirurgi. Metod: Litteraturöversikt med deskriptiv design där resultatet grundar sig på 10 kvantitativa originalartiklar. Resultat: Resultatet visade att en användning av screeningverktyg, anpassning av omvårdnadsmiljön och en medverkan av närstående kunde förebygga utvecklingen av akut konfusion hos patienter som genomgått kirurgi. Slutsats: Effektiva screeningsverktyg och rätt omvårdnadsåtgärder i kombination med närståendes medverkan är avgörande preventionsfaktorer för akut konfusion hos patienter som genomgått kirurgi. Sjuksköterskan har en avgörande roll i det patientnära arbetet eftersom det är här som rätt åtgärder måste sättas in – på så vis kan akut konfusion förebyggas och minska lidandet för patienten. Tillståndet bör därför uppmärksammas och förebyggas med hjälp av sjuksköterskans kompetens och omvårdnad.Background: Delirium is one of the most common postoperative complications and results in impaired cognitive function for the patient. It has been established from research that delirious patients had a higher risk for mortality, pathophysiological consequences and negative postoperative outcomes which can cause distress for the patient. Intention: The aim of this study was to survey nursing interventions that prevent delirium for patients who underwent surgery. Method: Quantitative literature review with a descriptive design, where the result is based on ten quantitative original articles. Results: The results show that use of clinical assessment tools for nurses, adaptation of the nursing environment and involvement of family members helped to prevent the development of delirium. Conclusion: Proper nursing assessment tools, adaptation of the nursing environment and involvement of family members helped prevent delirium. Nurses play a vital role in the patientcentered care as it is here warning signs needs to be identified – knowledge of this subject should therefore be studied. This helps to improve the quality of the nursing care, prevents delirium and reduces unnecessary suffering for the patients.
41
Idvall, Ewa. "Development of strategic and clinical quality indicators in postoperative pain management /." Doctoral thesis, Linköping : Univ, 2001. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-5158.
42
Wells, Larry Kevin. "Efficacy of Ibuprofen and Ibuprofen/Acetaminophen on Postoperative Pain in Symptomatic Necrotic Teeth." The Ohio State University, 2010. http://rave.ohiolink.edu/etdc/view?acc_num=osu1283354429.
43
Karlsson, Hanna, and Linn Lundebo. "Nursing care of patients with postoperative pain : an observation study at Kilimanjaro Christian Medical Centre, Tanzania." Thesis, Röda Korsets Högskola, 2010. http://urn.kb.se/resolve?urn=urn:nbn:se:rkh:diva-74.
Анотація:
Some cultures regard pain as a natural part of life compared with the Western culture which believes that pain is something unnatural and that has to be eliminated. Transcultural nursing is a way to learn about and provide culturally fitting and meaningful care to people with different cultures. Tanzania suffers from a lack of qualified health workers due to an increased burden of disease and this affects the quality and supply of effective health services. It has been seen that it is common for patients to get inadequate pain treatment and this results in many different complications. The aim of the study was to describe the nursing care of patients with postoperative pain at a rural hospital in Tanzania. The study was implemented at the Kilimanjaro Christian Medical Centre in Moshi. A qualitative participating observation study with an ethnographic approach was used to collect the data. The data was analyzed by content analysis and resulted in three themes: 1. The role of the nurse, 2. Pain management, and 3. Meeting the patient. The conclusion was that the nursing care around patients with postoperative pain showed an extended collaboration between the nurses and other health care professionals as well as with the patients’ parents. The study further showed that the atmosphere around the patients was positive and calm and that the nurses assessed pain by measuring vital signs and facial expressions.
44
Monti, Elisa. "Valutazione dell'efficacia del protocollo riabilitativo nel Fast-Track dell'artroprotesi totale d'anca vs "Standard care"." Bachelor's thesis, Alma Mater Studiorum - Università di Bologna, 2019. http://amslaurea.unibo.it/19333/.
Анотація:
BACKGROUND: Il protocollo Fast-track nell’artroprotesi d’anca è costituito da un intervento educativo collettivo pre-ricovero, da controllo adeguato delle perdite ematiche e del dolore pre- peri- e post-operatorio e dall’intervento riabilitativo accelerato ed intensivo. La presente tesi si inserisce all’interno di uno studio randomizzato controllato in aperto, prospettico. L’obiettivo dello studio effettuato presso l’Istituto Ortopedico Rizzoli è quello di valutare se, rispetto alla normale pratica clinica, l’applicazione del protocollo Fast-track riduce i tempi di ospedalizzazione e consente la ripresa precoce e ottimale delle funzionalità e delle principali attività di vita quotidiana.
METODI: La popolazione è costituita da 33 pazienti affetti da artrosi primaria dell’anca con indicazione ad intervento di artroprotesi totale con tecnica mini-invasiva. 17 persone vengono reclutate per il protocollo Fast-track e 16 persone per il protocollo standard. Le persone vengono valutate in termini di riduzione dei tempi di recupero secondo la scala ILOA e di raggiungimento degli esiti funzionali secondo le scale WOMAC, HHS e NRS, nel pre-operatorio, alla dimissione ed ai controlli ambulatoriali fino a 6 settimane post-operatorie.
RISULTATI: Dallo studio si evince una significatività statistica per diverse misure di outcome: la durata della degenza, il dolore in seconda e in terza giornata post-operatorie, gli esiti funzionali rappresentati da scala ILOA, HHS e WOMAC a 6 settimane post-intervento.
CONCLUSIONI: I risultati dello studio confermano che l’applicazione del protocollo Fast-track nella chirurgia di artroprotesi totale d’anca è in grado di far ottenere una ripresa precoce e ottimale delle funzionalità e delle principali attività di vita quotidiana.
Risulta però necessario uno sviluppo, in collaborazione con il paziente, nel piano di cura e di riabilitazione post-dimissione con lo scopo di andare incontro ai bisogni individuali della persona e alle sue preferenze.
45
Holmér, Pettersson Pia. "Pain treatment after surgery : with special reference to patient-controlled analgesia, early extubation and the use of paracetamol /." Stockholm, 2004. http://diss.kib.ki.se/2004/91-7140-134-2.
46
Jin, Hao, and 金昊. "Postoperative strategies to improve the benefit of cochlear implantation in a Cantonese-speaking population." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2003. http://hub.hku.hk/bib/B29488357.
47
Munkhammar, Emelie, and Susanne Pettersson. "Komplementära behandlingsmetoder och dess effekter på postoperativ smärta." Thesis, Högskolan Väst, Avd för vårdvetenskap på grundnivå, 2013. http://urn.kb.se/resolve?urn=urn:nbn:se:hv:diva-5889.
48
Larocque, Catherine. "Are We on the Same Page About Skin-to-Skin Care? A Descriptive Correlational Study Exploring Skin-to-Skin Care for Postoperative NICU Infants." Thesis, Université d'Ottawa / University of Ottawa, 2020. http://hdl.handle.net/10393/41079.
Анотація:
Family-centered care (FCC) is considered the gold standard for care delivery in the Neonatal Intensive Care Unit (NICU). However, there are challenges with the implementation of FCC in practice and there is limited literature about how to tailor this approach for specialized NICU populations.
To explore FCC for surgical neonates in the NICU, the concept was explored using Roger’s evolutionary concept analysis. Results illustrate that FCC in the NICU is a philosophy or care, rather than a set of interventions. The subsequent cross-sectional descriptive exploratory study showed that the surgical infants in our sample (n=11) received a limited amount of skin-to-skin care (median 0 mins/day) and parents reported challenges to being involved in their infant’s care.
This thesis supports the challenges with the implementation of FCC in practice and both the need to consider multiple perspectives and the need for broader systemic change in order to support a FCC philosophy.
49
Gustafsson, Moa, and Sofia Larsson. "Transkutan nervstimulering som smärtlindring efter thoraxkirurgi." Thesis, Uppsala universitet, Institutionen för folkhälso- och vårdvetenskap, 2020. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-426854.
Анотація:
ABSTRACTBackground: Thoracic surgery includes surgical diseases in the thorax and is dominated by coronary artery surgery. Pain after heart surgery is often most intense three to four days after the surgery. The pain treatment has improved over the last 20-30 years. Despite this, 30-50% report unbearable postoperative pain. Pain can in many cases be relieved by non- pharmacological methods such as Transcutaneous Electric Nerve Stimulation (TENS). TENS activates the body's own pain-relieving mechanisms by stimulating peripheral nerves. Aim: The aim of this study was to explore whether TENS has an effect on postoperative pain after thoracic surgery and to describe obstacles and opportunities for TENS as a pain management method. Method: The study has a descriptive design. The method of the study is a quantitative literature review that included 11 articles. The database PubMed was used to find articles. Result: TENS had a positive effect on self-estimated pain and reduced the consumption of analgesics after thoracic surgery. The few articles that included obstacles and opportunities showed that nurses perceived using TENS moderately difficult. Furthermore, they did not show any side effects. Conclusion: TENS as a pain management method after thoracic surgery relieves pain and reduces the consumption of analgesics, which could lead to less suffering for the individual, reduced burden on healthcare and a lower social cost.
50
Svärd, Elin, and Anna-Karin Vilhelmsson. "Intensivvårdssjuksköterskans omvårdnadsåtgärder för att förebygga luftvägskomplikationer hos den postoperativa patienten." Thesis, Högskolan i Gävle, Avdelningen för hälso- och vårdvetenskap, 2018. http://urn.kb.se/resolve?urn=urn:nbn:se:hig:diva-26655.
Анотація:
Bakgrund: Postoperativa luftvägskomplikationer är vanligt förekommande och ökar risken för både morbiditet och mortalitet samt ökar kostnaderna för samhället. Olika omvårdnadsåtgärder finns för att förebygga postoperativa luftvägskomplikationer. Syfte: Syftet med studien var att beskriva hur intensivvårdssjuksköterskor definierar begreppet postoperativa luftvägskomplikationer, samt deras omvårdnadsåtgärder för att förebygga dessa komplikationer hos den postoperativa patienten Metod: Studien genomfördes med en beskrivande design med kvalitativ ansats. Tio intensivvårdssjuksköterskor intervjuades med hjälp av semistrukturerade intervjuer. Resultat: Det framkom fem huvudkategorier i resultatet: Definition av begreppet postoperativa luftvägskomplikationer, Att välja omvårdnadsåtgärder, Att ge förebyggande omvårdnad, Att bedöma patientens individuella behov och Att se hinder till att ge omvårdnadsåtgärder. Intensivvårdssjuksköterskorna beskrev att det inte finns några rutiner eller riktlinjer att följa gällande förebyggandet av postoperativa luftvägskomplikationer. De beskrev också att patientens individuella behov ligger till grund för valet av omvårdnadsåtgärder för att förebygga postoperativa luftvägs-komplikationer. Intensivvårdssjuksköterskorna beskrev även olika råd om egenvård som de ger patienterna med syfte att förebygga postoperativa luftvägskomplikationer, bland annat att uppmana dem till att hosta och djupandas och att instruera dem att blåsa i PEEP-ventil*. Slutsats: Studiens resultat belyser avsaknaden av rutiner och känslan av att de postoperativa patienterna är en åsidosatt patientgrupp inom intensivvården samt att intensivvårdssjuksköterskorna saknar tiden till att kunna vårda denna patientgrupp optimalt. Rutiner bör upprättas för att intensivvårdssjuksköterskorna ska veta vilka omvårdnadsåtgärder som behöver sättas in för att förebygga postoperativa luftvägskomplikationer. Nyckelord: Intensivvårdssjuksköterska, omvårdnadsåtgärder, postoperativa luftvägskomplikationer, prevention. *PEEP- PEEP betyder Positive End Expiratory Pressure (positivt slutexpiratoriskt tryck). PEEP-ventil = Ventil som patienten andas ut emot, som gör att respirationscykeln startar och slutar med ett positivt tryck i luftvägarna (Gulbrandsen & Stubberud, 2009).Background: Postoperative respiratory complications are common and can be associated with an increase of mortality, morbidity and costs for society. There are different kinds of nursing actions to prevent postoperative pulmonary complications. Aim: The aim of this study was to describe how intensive care nurses define postoperative respiratory complications, and what kind of nursing actions they perform to prevent these complications among the postoperative patients. Method: The study was performed through a descriptive design with qualitative approach. Semistructured interviews with ten intensive care nurses were conducted. Result: Five categories appeared in the result: Definition of the concept postoperative respiratory complications, To choose nursing actions, To perform preventive care, To assess the patient´s individual needs and To see obstacles to perform nursing actions. The intensive care nurses described that there are no routines to follow in preventing respiratory complications for the postoperative patient. The intensive care nurses also described that they see to the patientens´ individual needs to prevent postoperative respiratory complications and that they give them different self-care advices in order to prevent postoperative respiratory complications, for instance tell the patient to cough, take deep breaths and instruct them how to use a PEEP-tube*. Conclusion: The result of this study showed that there is a lack of routines and that the these patients are breachede within the intensive care and also that the intensive care nurses experience a lack of time to givet hese patientes optimal care. Routines should be established so that intensive care nurses know what kind of nursing action to choose in order to prevent postoperative pulmonary complications. Key words: Intensive care nurse, nursing actions, postoperative respiratory complications, prevention. *PEEP- PEEP means Positive End Expiratory Pressure. PEEP-tube = Ventilator/tube in which the patient exhales against to make the cycle of respiration start and end onto a positive pressure in the respiratory system (Gulbrandsen & Stubberud, 2009).