Day surgery: patients' felt abandoned during the preoperative wait
Day surgery: patients' felt abandoned during the preoperative wait
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DOI：
10.1111/j.1365-2702.2008.02374.x
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发表时间：
2008-09-01
影响因子：
4.2
通讯作者：
Wright, Kerrie
中科院分区：
文献类型：
--
作者：
Gilmartin, Jo;Wright, Kerrie
背景日间手术的迅速发展促进了外科护理干预的转变。不断发展的证据基础在影响护士主导的预评估、信息提供、疼痛管理和术后干预方面发挥了重要作用。然而，文献的特点是一些缺陷：从入院到出院的患者经验的关注不足，引起的焦虑和患者的潜在需求没有很好地阐明。本文的目的是描述和解释病人的经验，当代手术。这种解释学现象学方法集中在20名成年患者的经验。数据收集采用非结构化访谈。通过使用现象学的方法确定四个流行的主题来解释成绩单。调查结果。强调了从数据中出现的主题，从准备过程中的赋权感，到遇到的恐惧和术前等待区的遗弃感，再到恢复动力。研究表明，大多数患者在术前阶段感到被遗弃，护士没有认识到持续心理支持的重要性。因此，在日间手术中加强提供情感支持和以人为本的护理至关重要。还需要注意的是，环境因素会影响患者的焦虑，术前促进音乐的使用可以减少焦虑，增加幸福感。至关重要的是，卫生专业人员需要促进以人为本，并在整个手术过程中保持护理的连续性。使用动态的人际交往技巧，如积极倾听、“保持”、“遏制”和协调，以减少术前期间的焦虑和遗弃感。此外，对患者表现出的口头话语、副语言和非语言线索保持警惕。需要仔细解释有关程序时间安排方面的拖延的具体情况。
Background. The rapid expansion in day surgery has facilitated a shift in surgical nursing intervention. The evolving evidence base has a major part to play in influencing nurse-led preassessment, information provision, pain management and postoperative intervention. However, the literature is characterised by a number of deficits: poor attention to patient experience from admission to discharge, anxieties evoked and the potential needs of patients are not well articulated.Aim. The purpose of this paper is to describe and interpret patients' experiences of contemporary day surgery.Method. This hermeneutic phenomenological approach focused on the experience of 20 adult patients. Data was collected by using unstructured interviews. The transcripts were interpreted through the identification of four prevalent themes using the phenomenological method. Findings. The themes that emerged from the data are emphasised, ranging from the feeling of empowerment during preparation, through apprehensions encountered and the feeling of abandonment in the preoperative waiting area, to recovery dynamics.Conclusion. The study demonstrates that the majority of the patients felt abandoned in the preoperative stage and nurses did not recognise the importance of ongoing psychological support. Therefore, it is crucial to strengthen the provision of emotional support and person-centred care in a day surgery context. There is also a need to be aware that environmental factors can impact on patient anxiety, promoting the use of music preoperatively can reduce anxiety and increase well-being.Relevance for clinical practice. Crucially health professionals need to facilitate person-centred and continuity of care throughout the day surgery experience. Using dynamic interpersonal skills, such as active listening 'holding' 'containment' and attunement to reduce anxiety and feelings of abandonment in the preoperative period. Moreover, being alert to verbal utterances, para-language and non-verbal cues demonstrated by the patient. Specific information about delays regarding the timing of procedures needs to be carefully explained.