Preparing patients to undergo surgery.
ABSTRACT Pre-operative preparation is vital to patient safety and a key nursing role. Careful preparation can minimise anxiety, and therefore physical effects, and ensure patients arrive in the operating department ready for surgery. This involves a range of procedures, including ensuring patients understand the operation, and are able to give informed consent, unless this is not possible due to age or mental capacity.
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ABSTRACT: Patients waiting for coronary angiography are often anxious and worried, experiencing considerable emotional problems before the procedure, which can result in an increase in blood pressure (BP), heart rate, respiratory rate and the myocardial oxygen demand. Such maladaptive responses may not only increase the patients need for sedative drugs, but also could increase the length of post angiography hospitalization. Therefore, it is important to implement some supportive actions to decrease the patients' anxiety and to stabilize their vital signs before coronary angiography. This study aimed to investigate the effects of a multimodal preparation package on vital signs of patients undergoing coronary angiography. A matched trial was conducted on 66 patients waiting for coronary angiography. Patients were assigned in intervention (n = 33) and control (n = 33) groups. A multimodal preparation package was implemented in intervention group, two hours before angiography. The data collection instrument consisted of questions on demographic characteristics and a table for recording the patients' vital signs including systolic BP (SBP) and diastolic BP (DBP), heart rate, respiratory rate and body temperature. Vital signs were measured three times, the day before angiography, 30 minutes before and 30 minutes after the angiography, using a thermometer and a monitoring device. Data analysis was performed using the Kolmogo-Smirnov test, t test and Mann-Whitney U test. From the total number of 66 patients, the 63.3% were male and married. No significant differences were observed between the mean of SBP and DBP and also the heart rate in the intervention and control groups, on the day before angiography. However, the mean SBP and DBP and heart rate of the intervention group were significantly lower compared to the control group, both 30 minutes before and 30 minutes after angiography. The intervention did not significantly change the respiration rate and temperature in the intervention group. The study showed that preparation package was effective in decreasing SBP and DBP, as well as heart rate. Therefore, using multimodal comprehensive preparation packages, such as the package used in the present report, is suggested.
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ABSTRACT: Abstract Surgical intervention; is defined as “controlled trauma” that can change patient’s normal physiological functions. It’s a stimulus that starts the process of coping with surgical intervention for individuals and causes adaptive or maladaptive behaviour. Various emotional reactions occur in patient who had surgery or in his/her relatives. Anxiety/concern/worry is one of the most common psychiatric disorders that accompany physical illnesses. Medical developments reduced time of staying at hospital by increasing elective and one-day surgery but caused skipping of patients’ psychological treatment. It is necessary to evaluate psycho-social condition and coping mechanisms, to take necessary precautions to provide psychological support, to determine educational requirements of patients and their relatives and to provide education for patients in preoperative and postoperative period by nurses. Researches show that in patients who were prepared well for surgery in terms of psychology; anxiety reduced, less anaesthetic substance is need of during surgery, less analgesic drug is used in postoperative period, the vital signs are regulated in a short time, corticosteroid hormones that are produce as a reaction to stress are less produced, the patient can be cope better with the surgery trauma, the complications are less developed (infection etc.), the patients are healed fastly and are discharged early. Hence, in this article the subject of psychological approach which is a important step in preoperative and postoperative preparation is discussed.