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Heath C, Bavich P, Sommerfield A, von Ungern-Sternberg BS. Kids Voices, the perioperative experience of emergency surgery from children's perspectives: A qualitative study. PATIENT EDUCATION AND COUNSELING 2023; 110:107674. [PMID: 36848717 DOI: 10.1016/j.pec.2023.107674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 02/07/2023] [Accepted: 02/11/2023] [Indexed: 06/18/2023]
Abstract
OBJECTIVE The study aimed to better understand children's emergency perioperative experience, a little researched topic. Current literature shows discrepancies between child and adult perceptions for the same healthcare experience. Acquisition of knowledge from the child's perspective can be utilized to improve perioperative care. METHOD This qualitative study included children (4-15 years) undergoing emergency surgery requiring general anesthesia for manipulation under anesthesia (MUA) and appendicectomy. Recruitment was opportunistic with the aim to recruit a minimum of 50 per surgical subgroup, with 109 children interviewed via telephone postoperatively. Data analysis was performed using qualitative content analysis. Participants varied in terms of age, gender, diagnosis and previous perioperative experience. RESULTS Qualitative content analysis found three overarching themes in association with the perioperative process: (1) fearful/apprehensive, (2) perception of powerlessness and (3) perception of trust and security. Two overarching themes were found from data relevant to the perioperative environment: (1) poor adaptation of the care environment to the children's needs and (2) positive adaptation of the care environment to the children's needs. CONCLUSION AND PRACTICE IMPLICATIONS The themes identified provide valuable insight into children's perioperative experience. Findings are of value to stakeholders in healthcare and are expected to inform strategies to optimize the quality of healthcare.
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Affiliation(s)
- Chloe Heath
- Department of Anaesthesia and Pain Medicine, Perth Children's Hospital, Perth, WA, Australia; Perioperative Medicine Team, Telethon Kids Institute, Perth, WA, Australia
| | - Paige Bavich
- Department of Anaesthesia and Pain Medicine, Perth Children's Hospital, Perth, WA, Australia
| | - Aine Sommerfield
- Department of Anaesthesia and Pain Medicine, Perth Children's Hospital, Perth, WA, Australia; Perioperative Medicine Team, Telethon Kids Institute, Perth, WA, Australia
| | - Britta S von Ungern-Sternberg
- Department of Anaesthesia and Pain Medicine, Perth Children's Hospital, Perth, WA, Australia; Perioperative Medicine Team, Telethon Kids Institute, Perth, WA, Australia; Division of Emergency Medicine, Anaesthesia and Pain Medicine, Medical School, The University of Western Australia, Perth, WA, Australia.
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Kimball H, Cobham VE, Sanders M, Douglas T. Procedural anxiety among children and adolescents with cystic fibrosis and their parents. Pediatr Pulmonol 2023. [PMID: 37097054 DOI: 10.1002/ppul.26419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 03/13/2023] [Accepted: 04/10/2023] [Indexed: 04/26/2023]
Abstract
BACKGROUND Procedural anxiety involves acute distress around medical procedures and may lead to avoidance or resistance behaviors that interfere with effective cystic fibrosis (CF) care and health outcomes. While individuals with CF commonly endure uncomfortable and/or distressing medical procedures, procedural anxiety among children and adolescents with CF has received little research attention. This study investigated the prevalence and correlates of procedural anxiety among individuals with CF aged 6-18 and their parents. METHOD Eighty-nine parents of children with CF completed surveys examining child procedural anxiety, anxiety, and health behaviors (including treatment adherence); and parent vicarious procedural anxiety. RESULTS Seventy-five percent of participants rated at least one CF-related procedure as "extremely" anxiety-inducing for their child. Parental vicarious procedural anxiety was reported in 80.9% of participants. Procedural anxiety significantly correlated with child anxiety, treatment-resistive behaviors, and parent-vicarious procedural anxiety. Procedural anxiety was associated with younger age and frequency of distressing procedures, but not with forced expiratory volume in 1 s, body mass index, hospitalizations, or exposure to general anesthesia. CONCLUSION Procedural anxiety is common among children, adolescents, and caregivers, and is associated with child anxiety and treatment resistance, emphasizing the importance of screening and interventions for procedural anxiety as part of routine CF care from early childhood. Implications for screening and intervention are discussed.
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Affiliation(s)
- Hayley Kimball
- School of Psychology, The University of Queensland, St Lucia, Brisbane, Queensland, Australia
- Children's Hospital Foundation, Brisbane, Queensland, Australia
| | - Vanessa E Cobham
- School of Psychology, The University of Queensland, St Lucia, Brisbane, Queensland, Australia
- Child and Youth Mental Health Service (CYMHS), Children's Health Queensland Hospital and Health Service, Brisbane, Queensland, Australia
| | - Matthew Sanders
- School of Psychology, The University of Queensland, St Lucia, Brisbane, Queensland, Australia
| | - Tonia Douglas
- Cystic Fibrosis Service, Queensland Children's Hospital, Brisbane, Queensland, Australia
- School of Medicine Clinical Unit, The University of Queensland, Herston, Brisbane, Queensland, Australia
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3
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Yun R, Hess O, Kennedy K, Stricker PA, Blake L, Caruso TJ. Assessing pediatric perioperative affect: A concise review of research and clinically relevant scales. Paediatr Anaesth 2023; 33:243-249. [PMID: 36178764 DOI: 10.1111/pan.14568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 09/08/2022] [Accepted: 09/25/2022] [Indexed: 02/07/2023]
Abstract
Perioperative anxiety and distress are common in pediatric patients undergoing general anesthesia and increase the risk for immediate and long-term postoperative complications. This concise review outlines key research and clinically-relevant scales that measure pediatric perioperative affect. Strengths and weaknesses of each scale are highlighted. A literature review identified 11 articles with the following inclusion criteria: patients less than or equal to 18 years, perioperative anxiety or distress, and original studies with reliability or validity data. Although robust research-based assessment tools to measure anxiety have been developed, such as the Modified Yale Preoperative Anxiety Scale, they are too complex and time-consuming to complete by clinicians also providing anesthesia. Clinically-based anxiety measurement scales tend to be easier to use, however they require further testing before widespread standard utilization. The HRAD ± scale (Happy, Relaxed, Anxious, Distressed, with a yes/no answer to cooperation) may be a promising observational anxiety scale that is efficient and includes an assessment of compliance. Further studies are needed to refine a clinically-relevant anxiety assessment tool and appraise interventions that reduce perioperative distress.
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Affiliation(s)
- Romy Yun
- Department of Anesthesiology, Perioperative and Pain Medicine, Division of Pediatric Anesthesiology, Stanford University School of Medicine, Lucile Packard Children's Hospital Stanford, Stanford, California, USA
| | - Olivia Hess
- Stanford School of Medicine, Stanford, California, USA
| | | | - Paul A Stricker
- Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Lindsay Blake
- University of Arkansas for Medical Sciences Library, Little Rock, Arkansas, USA
| | - Thomas J Caruso
- Department of Anesthesiology, Perioperative and Pain Medicine, Division of Pediatric Anesthesiology, Stanford University School of Medicine, Lucile Packard Children's Hospital Stanford, Stanford, California, USA
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4
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Kleye I, Sundler AJ, Karlsson K, Darcy L, Hedén L. Positive effects of a child-centered intervention on children's fear and pain during needle procedures. PAEDIATRIC & NEONATAL PAIN 2023; 5:23-30. [PMID: 36911787 PMCID: PMC9997124 DOI: 10.1002/pne2.12095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 12/07/2022] [Accepted: 01/19/2023] [Indexed: 02/09/2023]
Abstract
To examine whether children experience less fear or pain using a child-centered intervention and if there were differences between the intervention group and the control group regarding heart rate, time required for the procedure, success rate for the cannula insertion, and patient satisfaction. A controlled single-center case study of observational design, with one control and one intervention group. Child self-reported fear or pain levels did not reveal any differences for those receiving the intervention compared with controls. However, according to a behavioral observation measure with the Procedure Behavior Check List, effects of the intervention were lower distress in relation to fear and pain during the cannula insertion. The time it took to perform the cannula insertion also decreased significantly in the intervention group. More children in the intervention group reported that they were satisfied with the needle procedure compared with the children in the control group. The child-centered intervention provides reduced observed distress related to fear and pain in children undergoing a cannula insertion and reduced total time by more than 50%. This study found that child involvement in care strengthen their ability to manage a needle procedure.
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Affiliation(s)
- Ida Kleye
- Faculty of Caring Science Work Life and Social Welfare, University of Borås Boras Sweden
| | - Annelie J Sundler
- Faculty of Caring Science Work Life and Social Welfare, University of Borås Boras Sweden
| | - Katarina Karlsson
- Faculty of Caring Science Work Life and Social Welfare, University of Borås Boras Sweden
| | - Laura Darcy
- Faculty of Caring Science Work Life and Social Welfare, University of Borås Boras Sweden
| | - Lena Hedén
- Faculty of Caring Science Work Life and Social Welfare, University of Borås Boras Sweden
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5
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Alderson P, Cohen M, Davies B, Elliott MJ, Johnson M, Lotteria A, Mendizabal R, Stockton E, Stylianou M, Sutcliffe K, Wellesley H. The involvement and autonomy of young children undergoing elective paediatric cardiac surgery: a qualitative study. J Cardiothorac Surg 2022; 17:136. [PMID: 35641980 PMCID: PMC9153234 DOI: 10.1186/s13019-022-01889-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 05/19/2022] [Indexed: 11/10/2022] Open
Abstract
Background Standards generally reported in the literature about informing children and respecting their consent or refusal before elective heart surgery may differ from actual practice. This research aims to summarize the main themes in the literature about paediatric anaesthesia and compare these with research findings on how health professionals counsel young children before elective heart surgery, respect their consent or refusal, and maintain patient-centred care.
Methods This qualitative research involved: literature reviews about children’s consent to surgery and major interventions; observations of wards, clinics and medical meetings in two paediatric cardiology departments, October 2019 to February 2020; audio-recorded semi-structured interviews with 45 hospital staff, including 5 anaesthetists, and related experts, November 2019 to April 2021; interviews with 16 families, with children aged 6- to 15-years and their parents shortly after elective heart surgery, and some months later (reported in other papers); thematic data analysis; and research reports on how different professions contribute to children’s informed decisions for heart surgery.
Results The medical, ethics and English legal literature tend to assume legal minors cannot refuse major recommended treatment, and cannot consent until they are 12 years or older. Little is said about informing pre-competent children. If children resist, some anaesthetists rely on sedation and distraction, and avoid much informed discussion, aiming to reduce peri-operative anxiety. However, interviewees reported informing young children, and respecting their consent or refusal before elective surgery. They may delay elective surgery and provide further information and support, aiming to reduce fear and promote trust. Six years of age was commonly cited as the threshold for respecting consent to heart transplantation. Conclusion Differing views about younger children’s competence, anxiety and best interests support different reactions to children’s consent and refusal before elective heart surgery. This paper reports the zero-restraint policy followed for over a decade in at least one leading surgery centre. The related law and literature need to be updated, to take more account of evidence of actual practice.
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Affiliation(s)
- Priscilla Alderson
- Social Research Institute, University College London, 18 Woburn Square, London, WC1H 0NR, UK.
| | - Marc Cohen
- Great Ormond Street Hospital for Children NHS Trust, London, UK
| | - Ben Davies
- Royal Children's Hospital, Melbourne, Australia
| | | | - Mae Johnson
- Great Ormond Street Hospital for Children NHS Trust, London, UK
| | | | - Rosa Mendizabal
- Social Research Institute, University College London, 18 Woburn Square, London, WC1H 0NR, UK
| | - Emma Stockton
- Great Ormond Street Hospital for Children NHS Trust, London, UK
| | | | - Katy Sutcliffe
- Social Research Institute, University College London, 18 Woburn Square, London, WC1H 0NR, UK
| | - Hugo Wellesley
- Great Ormond Street Hospital for Children NHS Trust, London, UK
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Lööf G, Lönnqvist P. Role of information and preparation for improvement of pediatric perioperative care. Paediatr Anaesth 2022; 32:600-608. [PMID: 35167154 PMCID: PMC9311830 DOI: 10.1111/pan.14419] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 01/25/2022] [Accepted: 02/08/2022] [Indexed: 11/26/2022]
Abstract
The perioperative period is a significant and stressful experience that may cause negative consequences in children, both in a short-term and long-term perspective. Despite a wide base of evidence stating the importance of adequate preparation to reduce anxiety, improve coping, cooperation and enhance recovery, many children continue to report that they feel unprepared for their perioperative experience. To secure children's right to request and need for preparation, the content, format, and availability of existing programs need to be scrutinized. Preparation programs in perioperative care must change from simply providing information to embracing the importance of children's need to process the information provided in order to learn and understand. Interactive web-based technology can function as a significant resource for preparation of children for perioperative procedures. By changing perspective from children's need for information to their need for learning and by developing preparation programs including adequate educational principles, web-based technology can be used to its fullest advantage as a healthcare learning and preparation resource.
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Affiliation(s)
- Gunilla Lööf
- Paediatric Perioperative Medicine and Intensive CareKarolinska University HospitalStockholmSweden,Department of Learning, Informatics, Management and EthicsKarolinska InstitutetStockholmSweden
| | - Per‐Arne Lönnqvist
- Paediatric Perioperative Medicine and Intensive CareKarolinska University HospitalStockholmSweden,Department of Physiology and PharmacologyKarolinska InstitutetStockholmSweden
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Yang Y, Zhang M, Sun Y, Peng Z, Zheng X, Zheng J. Effects of advance exposure to an animated surgery-related picture book on preoperative anxiety and anesthesia induction in preschool children: a randomized controlled trial. BMC Pediatr 2022; 22:92. [PMID: 35164741 PMCID: PMC8843029 DOI: 10.1186/s12887-022-03136-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2021] [Accepted: 01/24/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Our aim was to investigate whether early surgical preparation by reading an animated picture book about procedure-related events could reduce the preoperative anxiety in preschoolers. METHODS 131 patients, aged 3-6 years and underwent elective minor surgery were randomized either to a control or a picture book group. Both groups received general information about surgery and anesthesia in pre-anesthesia clinic. Patients in study group also received a surgery-depicting picture book for them to read at home a week earlier before surgery. Child anxiety was evaluated with the modified Yale Preoperative Anxiety Scale Short Form in six observing time points before anesthesia induction, and the compliance of anesthesia induction was assessed with the Induction Compliance Checklist (ICC). RESULTS There were significantly lower anxiety scores in picture book group than in control group at the time of ready for intravenous cannulation in operating room [51.9 (23.6) vs. 67.2 (22.0); mean difference 15.3; 95% confidence interval (CI) 6.4-24.1; P = 0.001] and at the time of pre-anesthesia visit [27.8 (7.6) vs. 33.2 (13.6); mean difference 5.3; 95%CI 0.93-9.8; P = 0.018]. No significant differences of anxiety levels were found between two groups at other observed time points: in the anesthesia outpatient clinic, in the holding area, at separation from parent to operating room (OR), and on entrance to OR (P = 0.584, 0.335, 0.228, 0.137, respectively). The percentage of children with poor induction compliance (i.e., ICC ≥ 6) was higher in control group compared with that in picture book group [38% vs.21%; odds ratio(95%CI): 0.78(0.61-0.99); P = 0.041]. CONCLUSIONS Home-reading an animated picture book to get familiar with the perioperative events earlier prior to surgery could effectively reduce the preoperative anxiety level and increase the compliance during the induction of anesthesia in preschool children. TRIAL REGISTRATION ChiCTR2000033583, 06/06/2020 www.chictr.org.cn .
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Affiliation(s)
- Yanyan Yang
- Department of Anesthesiology, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Mazhong Zhang
- Department of Anesthesiology, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Ying Sun
- Department of Anesthesiology, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
| | - Zhezhe Peng
- Department of Anesthesiology, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Xiaosu Zheng
- Department of Anesthesiology, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Jijian Zheng
- Department of Anesthesiology, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
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8
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Bell E, Dodd M, Sommerfield D, Sommerfield A, von Ungern-Sternberg BS. Kids voices: Exploring children's perspective of tonsillectomy surgery. Paediatr Anaesth 2021; 31:1368-1370. [PMID: 34478177 DOI: 10.1111/pan.14288] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Revised: 08/27/2021] [Accepted: 08/28/2021] [Indexed: 11/30/2022]
Affiliation(s)
- Emily Bell
- Department of Anaesthesia and Pain Management, Perth Children's Hospital, Nedlands, Australia.,Perioperative Medicine Team, Telethon Kids Institute, Nedlands, Australia
| | - Megan Dodd
- Department of Anaesthesia and Pain Management, Perth Children's Hospital, Nedlands, Australia.,Perioperative Medicine Team, Telethon Kids Institute, Nedlands, Australia
| | - David Sommerfield
- Department of Anaesthesia and Pain Management, Perth Children's Hospital, Nedlands, Australia.,Perioperative Medicine Team, Telethon Kids Institute, Nedlands, Australia.,Division of Emergency Medicine, Anaesthesia and Pain Medicine, The University of Western Australia, Perth, Australia
| | - Aine Sommerfield
- Department of Anaesthesia and Pain Management, Perth Children's Hospital, Nedlands, Australia.,Perioperative Medicine Team, Telethon Kids Institute, Nedlands, Australia
| | - Britta S von Ungern-Sternberg
- Department of Anaesthesia and Pain Management, Perth Children's Hospital, Nedlands, Australia.,Perioperative Medicine Team, Telethon Kids Institute, Nedlands, Australia.,Division of Emergency Medicine, Anaesthesia and Pain Medicine, The University of Western Australia, Perth, Australia
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Andersson L, Almerud Österberg S, Johansson P, Knutsson S. The interplay between children, their parents and anaesthesia staff during the child's anaesthesia - An observational study. J Clin Nurs 2021; 31:2240-2251. [PMID: 34523185 DOI: 10.1111/jocn.16042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 08/24/2021] [Accepted: 08/27/2021] [Indexed: 12/01/2022]
Abstract
AIMS AND OBJECTIVES To interpret and understand the interplay between children, their parents, and anaesthetic staff to gain a greater understanding of children being anaesthetised. BACKGROUND Anaesthesia induction is a stressful procedure for the child and parents in the technologically advanced environment in the operating room (OR). Anaesthesia staff are a key resource for ensuring safety and interplays, but the meeting is often short, intensive, and can affect the child and the parent. DESIGN A qualitative observational design with a hermeneutic approach. METHODS Twenty-seven non-participant observations were conducted and videotaped when children were being anaesthetised. The SRQR checklist was used. RESULTS The result is presented as a theatre play with three headings; the scene, the actors, and the plot. The scene was not designed for the child or the parent's comfort and could lead to anxiety and insecurity. Four themes described the interplays: The need to be inviting and to be invited, The need for varying compliance, The need for mutual dependence, and The need to give and to receive emotional support. The plot could lead to uncertainty, and the interplay could change between being caring and uncaring depending on the actors. CONCLUSIONS The technologically advanced environment in the OR constituted an emotional obstacle, but the anaesthesia staff themselves can be a powerful resource creating a caring environment. The outcome of the plot may depend on the anaesthesia staff's bearing. RELEVANCE TO CLINICAL PRACTICE A caring approach in the OR requires a willingness from the anaesthesia staff to invite the child to participate and find a balance between helping the parents to find their place in the OR and support them in supporting their child. The findings can start reflections in the unit on how to create a more caring environment.
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Affiliation(s)
- Lisbet Andersson
- Faculty of Health and Caring Science Linnaeus University, Växjö, Sweden
| | - Sofia Almerud Österberg
- Department of Anesthesiology, Faculty of Health and Caring Science Linnaeus University and Kronoberg County Council, Växjö, Sweden
| | - Pauline Johansson
- Faculty of Health and Caring Science Linnaeus University, Växjö, Sweden
| | - Susanne Knutsson
- Faculty of Health and Caring Science Linnaeus University, Växjö, Sweden
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Andersson L, Almerud Österberg S, Årestedt K, Johansson P. Nurse anesthetist attitudes towards parental presence during anesthesia induction- a nationwide survey. J Adv Nurs 2021; 78:1020-1030. [PMID: 34462946 DOI: 10.1111/jan.15031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 07/14/2021] [Accepted: 08/18/2021] [Indexed: 11/30/2022]
Abstract
AIMS To describe nurse anesthetists' attitudes towards the importance of parental presence during their child's anaesthesia induction and to explore associating factors. DESIGN A cross-sectional design. METHODS Nurse anesthetists from 55 Swedish hospitals were asked to participate (n = 1,285). A total of 809 completed the questionnaire, Families' Importance in Nursing Care-Nurses' Attitudes (FINC-NA) during 2018. Data were analysed by descriptive statistics and multiple linear regression analysis. RESULTS Nurse anesthetists generally had a positive attitude towards the importance of parental presence. They reported a more positive attitude in family as a resource in nursing care (median = 40) followed by family as a conversational partner (median = 25), family not as a burden (median = 17) and family as its own resource (median = 13). Multiple linear regression analyses showed that working in a district hospital, working only with children, having routines/memorandum about parental presence, being a woman, allowing both parents to be present in their child's anaesthesia and greater experience of children's anesthesia, were associated with a more positive attitude. CONCLUSION This nationwide survey contributes important knowledge for understanding nurse anesthetists' attitudes and the result shows that nurse anesthetists generally have a positive attitude towards the importance of parents. Areas of improvement were, however, identified; the nurses tend to not value family as its own resource and family as a conversational partner highly. IMPACT Nurse anesthetists have a crucial role in children's anesthesia care since the quality of parental presence experience depends on a positive attitude from the nurses. Parental involvement is important to establish a child-centered anaesthesia care, which should be highlighted in the education of nurse anesthetists. Parental involvement should also be addressed in healthcare policies and routines should be established.
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Affiliation(s)
- Lisbet Andersson
- Faculty of Health and Caring Science, Linnaeus University, Växjö, Sweden
| | - Sofia Almerud Österberg
- Faculty of Health and Caring Science, Linnaeus University, Växjö, Sweden.,Department of Anesthesiology, Kronoberg County Council, Växjö, Sweden
| | - Kristofer Årestedt
- Faculty of Health and Caring Science, Linnaeus University, Växjö, Sweden.,The Research Section, Region Kalmar County, Kalmar, Sweden
| | - Pauline Johansson
- Faculty of Health and Caring Science, Linnaeus University, Växjö, Sweden
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