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I'm afraid! Children's experiences of being anesthetized
Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.ORCID iD: 0000-0002-8264-9078
University of Borås, Sweden.
Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.ORCID iD: 0000-0001-7139-3524
Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.ORCID iD: 0000-0002-2602-0101
2020 (English)In: Pediatric Anaesthesia, ISSN 1155-5645, E-ISSN 1460-9592, Vol. 30, no 9, p. 998-1005Article in journal (Refereed) Published
Abstract [en]

Introduction Children experience anesthetization as stressful, and many preoperative measures have been tested for reducing their anxiety. There is, however, little research about children's own experiences and thoughts about being anesthetized. Aims The aim of the present study was thus to explain and understand the meaning of being anesthetized as experienced by children. Methods A qualitative lifeworld hermeneutic approach was used. Data were collected through nonparticipant video observations, field notes, and interviews. The participants were children (n = 28) aged 4-13 years who required general elective minor surgery performed in four Swedish hospitals. Results The four interpreted themes describe the children's experiences of being anesthetized: Being powerless, Striving for control, Experiencing an ambiguous comprehensibility, and Seeking security. The children struggled with anxiety as a result of their inability to protect themselves from perceived external threats while being anesthetized. In order to meet their needs, it would be beneficial for them to receive appropriate information in a calm, supportive, and protective environment. Conclusion The reasons for children experiencing anxiety when being anesthetized are multifaceted, and this study highlights the importance of listening to each child's own voice and striving to create an individually adapted caring and safe environment with as much protection as possible.

Place, publisher, year, edition, pages
John Wiley & Sons, 2020. Vol. 30, no 9, p. 998-1005
Keywords [en]
anesthesia, anxiety, child, experiences, lifeworld hermeneutic
National Category
Nursing
Research subject
Health and Caring Sciences, Nursing
Identifiers
URN: urn:nbn:se:lnu:diva-97176DOI: 10.1111/pan.13931ISI: 000542138100001PubMedID: 32463955Scopus ID: 2-s2.0-85087131658OAI: oai:DiVA.org:lnu-97176DiVA, id: diva2:1454400
Available from: 2020-07-16 Created: 2020-07-16 Last updated: 2022-07-08Bibliographically approved
In thesis
1. Med dig vid min sida: -det vårdande mötets betydelse när barn genomgår anestesi i en högteknologisk operationsmiljö
Open this publication in new window or tab >>Med dig vid min sida: -det vårdande mötets betydelse när barn genomgår anestesi i en högteknologisk operationsmiljö
2022 (Swedish)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Aim: The overall aim of this thesis was to contribute with knowledge of and gain a greater understanding of the encounter between children, parents, and anesthesia staff in a high-technological surgical environment.

Methods: This thesis is based on four studies with descriptive, interpretive and cross-sectional designs. Study I includes 28 children with a focus on the meaning of being anesthetized. Data were collected with non-participant video observations, field notes, and interviews. Data were analyzed using a lifeworld hermeneutical approach according to Dahlberg et al. Study II includes six parents with a focus on the meaning of being a parent at one’s child’s first anesthesia in day surgery. The data analysis was carried out with a phenomenological perspective according to Giorgi’s human science method. Study III includes 809 questionnaires completed by nurse anesthetists about the importance of Families’ in Nursing Care (FINC-NA). Data were analyzed with descriptive statistics and multiple linear regression analysis. Finally, study IV includes 27 non-participant observations when children are being anesthetised. The data analysis was carried out with an observational design with a hermeneutic approach grounded in the philosophy of Gadamer and further described by Ericsson et al.

Results: The children’s experiences of being anesthetized are: like being powerless, striving for control, experiencing ambiguous comprehensibility, and they are seeking security. They struggle with anxiety as a result of their inability to protect themselves. Their parents experience ambivalence between worry and relief, and a feeling of losing control. They need to be prepared, be present, and have emotional support. The nurse anesthetists generally had a positive attitude towards the importance of parental presence. Working in a district hospital, working only with children, having routines, being a woman, and allowing both parents to be present and greather experience of children’s anesthesia were associated with a more positive attitude. However, the operating room is not designed for children or the parent’s comfort during the child’s anesthesia induction, and there is a need to be inviting and to be invited, a need for varying compliance, there is a need for mutual dependence, and a need to give and receive emotional support.

Conclusions: The reasons children experience anxiety are multifaceted. It is thus essential to listen to the voice of each child and each parent, support them, strive to create an individually adopted caring with so much protection as possible, and see parents as a resource and a conversational partner. The caring encounter is essential when children undergo anesthesia in a high-technical surgical environment. The anesthesia staff can be a powerful resource depending on their demeanour.

Place, publisher, year, edition, pages
Växjö: Linnaeus University Press, 2022. p. 104
Series
Linnaeus University Dissertations ; 444
National Category
Nursing
Research subject
Health and Caring Sciences, Nursing
Identifiers
urn:nbn:se:lnu:diva-111177 (URN)9789189460812 (ISBN)9789189460829 (ISBN)
Public defence
2022-05-13, Weber, Hus K, Växjö, 13:00
Opponent
Supervisors
Available from: 2022-04-07 Created: 2022-04-05 Last updated: 2024-05-28Bibliographically approved

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Andersson, LisbetJohansson, PaulineAlmerud Österberg, Sofia

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