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Värmebevarande insatser utifrån patientens och operationsteamets perspektiv
Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.ORCID iD: 0000-0002-5932-6078
2021 (Swedish)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Aim: The overall aim was to map and describe experiences of heat conservationmeasures (HCM) for the patient in connection with surgery from the patientʼsand the surgical teamʼs perspectives. The four studies aimed to: determinewhether nurse anesthetists have access to, knowledge of, and adhere torecommended guidelines to maintain normal body temperature during theperioperative period (I), describe the patientʼs lived experience of warmth andcoldness in connection with surgery (II), describe the nurse anesthetistʼsperceptions of heat conservation measures in connection with surgery (III),describe the surgical team memberʼs experience of communication regardingheat conservation measures during surgery (IV).

Methods: The four studies had both descriptive and explorative designs.Participants included the head of department and nurse anesthetists atoperating departments in Sweden (I), 16 patients (II), 19 nurse anesthetists(III), and 29 surgical team members (IV). Data were collected via twoquestionnaires (I), individual interviews (II, III, IV), and narratives (IV). Datawere analyzed by descriptive statistics and content analysis (I), reflectivelifeworld research (II), phenomenography (III), and deductive content analysis(IV).

Results: There are two sides to the same coin when it comes to HCM. One sideis temperature comfort and the other side is body temperature and temperaturemeasurement. Patients expect that their individual needs for temperaturecomfort will be fulfilled and when it is, they felt calmness and well-being. Thereis, however, an interdependence between the patient, the surgical team, andteam members. Patients do not dare to speak up about their needs and adapt tothe HCM they have been provided. The nurse anesthetist is dependent on thedialogue with the patient to be able to provide the right HCM and also on teammembersʼ communication and attitude towards HCM. The surgical team is inturn dependent on each other’s competencies when communicating aboutHCM which often happens in several small team constellations and sparinglyin the whole surgical team. Overall, there is a lack of a common guidelines,knowledge of HCM and especially redistribution, and full access to HCM.

Conclusion: It is of importance to reach the patientʼs individual needs to avoidsuffering and promote well-being and patient safety. The nurse anesthetistʼsgoal is to protect the patient by avoiding heat loss and maintaining normal bodytemperature. There is a need to highlight the patient’s role in the surgical team, whose goal is to provide the patient with the best care, there might however, bedifferent perspectives on HCM. Furthermore, the surgical team needs supportfrom their organizational management regarding the right preconditions asaccess to HCM and a common platform for education to provide HCM, toincrease patient safety during surgery.

Place, publisher, year, edition, pages
Växjö: Linnaeus University Press, 2021. , p. 134
Series
Linnaeus University Dissertations ; 424
National Category
Nursing
Research subject
Health and Caring Sciences, Nursing
Identifiers
URN: urn:nbn:se:lnu:diva-107854ISBN: 9789189460164 (print)ISBN: 9789189460171 (electronic)OAI: oai:DiVA.org:lnu-107854DiVA, id: diva2:1610089
Public defence
2021-09-01, Via Zoom, 10:00 (Swedish)
Opponent
Supervisors
Available from: 2021-11-10 Created: 2021-11-10 Last updated: 2025-05-14Bibliographically approved
List of papers
1. The nurse anesthetists' adherence to Swedish national recommendations to maintain normothermia in patients during surgery
Open this publication in new window or tab >>The nurse anesthetists' adherence to Swedish national recommendations to maintain normothermia in patients during surgery
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2017 (English)In: Journal of Perianesthesia Nursing, ISSN 1089-9472, E-ISSN 1532-8473, Vol. 32, no 5, p. 409-418Article in journal (Refereed) Published
Abstract [en]

Purpose

The aim of this study was to determine if nurse anesthetists (NAs) have access, knowledge, and adhere to recommended guidelines to maintain normal body temperature during the perioperative period.

Design

A descriptive survey design.

Methods

Questionnaires were sent to heads of the department (n = 56) and NAs in the operating departments in Sweden.

Finding

The level of access to the recommendations is high, but only one third of the operating departments have included the recommendations in their own local guidelines. The NAs' adherence was low, between 5% and 67%, and their knowledge levels were 57% to 60%.

Conclusions

A high level of knowledge, access, and adherence are important for the organization of operating departments to prevent barriers against implementation of new recommendations or guidelines. There are needs for education about patients' heat loss due to redistribution and clear recommendations.

Place, publisher, year, edition, pages
Elsevier, 2017
Keywords
Adherence, Nurse anesthetist, Perioperative hypothermia, Recommendations
National Category
Nursing
Research subject
Health and Caring Sciences, Nursing
Identifiers
urn:nbn:se:lnu:diva-50034 (URN)10.1016/j.jopan.2016.03.006 (DOI)000412599200004 ()28938976 (PubMedID)2-s2.0-85009275397 (Scopus ID)
Available from: 2017-03-27 Created: 2017-03-27 Last updated: 2025-05-14Bibliographically approved
2. Patients experience of warmth and coldness in connection with surgery – a phenomenological study
Open this publication in new window or tab >>Patients experience of warmth and coldness in connection with surgery – a phenomenological study
2021 (English)In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 16, no 1, article id 1858540Article in journal (Refereed) Published
Abstract [en]

Purpose: The aim was to describe patients' lived experience of warmth and coldness in connection with surgery.

Methods: A reflective lifeworld research (RLR) approach founded on phenomenology and the methodological principles of openness, flexibility, and bridling were used. The data consisted of 16 in-depth interviews with patients from four hospitals in Sweden.

Results: Warmth and coldness in connection with surgery means an expectation to maintain one ' s daily life temperature comfort. When patients' needs of temperature comfort is fulfilled it give a sense of well-being and calmness. Despite the body is covered there are feelings of vulnerability. When patients have the ability to change their own temperature comfort, they feel independent.

Conclusion: The individual feeling of temperature comfort could be affected or changed to discomfort during the perioperative context, and an intervention is required to avoid suffering due to the care. An ability to independently influence one ' s own temperature comfort can strengthen the patient, whereas the opposite entails suffering in silence. The phenomenon is also related to feelings of confidence about receiving the best care as well as being exposed and vulnerable. When the patient ' s need of comfortable temperature is met then feelings of security and sense of well-being emerged.

Place, publisher, year, edition, pages
Taylor & Francis Group, 2021
Keywords
Comfort, experience, hypothermia, patient, perioperative, refelective lifeworld research, surgery, temperature, warming
National Category
Nursing
Research subject
Health and Caring Sciences, Nursing
Identifiers
urn:nbn:se:lnu:diva-99679 (URN)10.1080/17482631.2020.1858540 (DOI)000598245200001 ()33308102 (PubMedID)2-s2.0-85097520964 (Scopus ID)
Available from: 2020-12-23 Created: 2020-12-23 Last updated: 2025-05-14Bibliographically approved

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Citation style
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