Klemetti Seija, Suominen Tarja
University of Turku, Department of Nursing Science, Turku, Finland.
Int J Nurs Pract. 2008 Feb;14(1):47-56. doi: 10.1111/j.1440-172X.2007.00666.x.
The purpose of this descriptive study was to examine how preoperative fasting and postoperative termination of the fast was experienced in ambulatory surgery by child patients and their mothers. The target group consisted of children (n = 12, age 2-10 years) who had undergone tonsillectomy/adenoidectomy, and their mothers. In the interviews, the mothers were asked to describe the problems connected with their child's preoperative fast and postoperative termination of the fast, as well as the things that went well in the process. Content analysis was carried out inductively. Preoperatively, the children were thirsty and anxious, but understood the fasting situation well. In some cases, there were conflicts between the child and his/her parent if fasting was prolonged. Parents also had doubts about their ability to implement the child's fast. Postoperatively, children had pains in their throats and stomachs, suffered from nausea, and had difficulty taking in nutrition and medication. Parents had worries about their child's home care, such as food intake and administration of pain medication. The possibility of postoperative bleeding and exacerbation of the child's condition was also worrying for the parents. The most evident result of the study was that parents need more information before their child's operation. Preparing the child for the operation by giving him/her nutrition as long as permitted enhances postoperative recovery and improves parents' control over the ambulatory surgical experience. Nurses should take a more active part in children's perioperative fasting and preoperative preparation of children and their parents. In further research, experimental studies should be designed in order to receive more evidence-based information for clinical practice.
这项描述性研究的目的是考察儿童患者及其母亲在门诊手术中对术前禁食和术后禁食结束的体验。目标群体包括接受扁桃体切除术/腺样体切除术的儿童(n = 12,年龄2至10岁)及其母亲。在访谈中,母亲们被要求描述与孩子术前禁食和术后禁食结束相关的问题,以及过程中进展顺利的事情。采用归纳法进行内容分析。术前,孩子们口渴且焦虑,但对禁食情况理解良好。在某些情况下,如果禁食时间延长,孩子和父母之间会产生冲突。父母们也对自己执行孩子禁食的能力表示怀疑。术后,孩子们喉咙和胃部疼痛,感到恶心,在摄入营养和药物方面存在困难。父母们担心孩子的家庭护理,如食物摄入和止痛药物的服用。孩子术后出血和病情加重的可能性也让父母们担忧。该研究最明显结果是,父母在孩子手术前需要更多信息。在允许的情况下尽可能长时间给孩子提供营养来为手术做准备,可促进术后恢复并增强父母对门诊手术体验的掌控。护士应在儿童围手术期禁食以及儿童及其父母的术前准备方面发挥更积极的作用。在进一步研究中,应设计实验性研究,以便为临床实践获取更多基于证据的信息。