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局部或区域麻醉下手术中意识清醒的意义——一项现象学诠释学研究

The meaning of being conscious during surgery with local or regional anesthesia-A phenomenological hermeneutic study.

作者信息

Häggström Marie, Brodin Kerstin

机构信息

Mid Sweden University Department of Health Sciences, Sweden.

出版信息

Int J Nurs Stud Adv. 2024 Jul 5;7:100224. doi: 10.1016/j.ijnsa.2024.100224. eCollection 2024 Dec.

Abstract

BACKGROUND

With increasing prevalence of surgery under local or regional anesthesia, which allows patients to remain conscious during the intraoperative phase, there is a growing need to comprehend the lived experiences associated with this practice.

OBJECTIVE

This study aimed to illuminate the lived experiences of individuals who remained conscious during surgical intervention under local or regional anesthesia.

DESIGN

A qualitative design was chosen.

SETTINGS

Participants in the present study were recruited from three surgical wards located in central Sweden using a purposive sampling strategy. The surgical disciplines included ear, gynecological, hernioplasty, orthopedic, and vessel surgeries.

PARTICIPANTS

Fourteen narrative interviews were conducted with individuals who had undergone elective surgery while conscious

METHODS

Verbatim transcribed text was analyzed using a phenomenological-hermeneutic method.

RESULTS

The lived experience of being conscious during surgery was marked by feelings of hope alongside a sense of losing one's identity and experiencing destabilization. Structural analysis revealed two themes. The first theme, 'being in the hands of others', encompassed subthemes such as 'entering an unfamiliar environment and procedure,' 'losing foothold and a sense of self-identity,' and 'enduring unexpected or anticipated discomfort.' The second theme, 'managing the inevitable for future health concerns,' involved subthemes such as 'pursuing self-acceptance of the situation,' 'entrusting the professionals while seeking signs of a smooth procedure,' and 'Enhancing own resilience through continuous support.

CONCLUSIONS

Beyond the patient's physical well-being during surgery, the OR team should acknowledge the "person" component and focus on their emotional and social needs in this vulnerable situation. The four meta-paradigms of nursing-person, health, environment, and nursing-significantly influence the conscious patient's experience.

PATIENT OR PUBLIC CONTRIBUTION

No patient or public contribution.

摘要

背景

随着局部或区域麻醉下手术的普及,这类手术允许患者在术中保持清醒,因此越来越需要了解与此相关的实际体验。

目的

本研究旨在阐明在局部或区域麻醉下手术时保持清醒的个体的实际体验。

设计

采用质性研究设计。

地点

本研究的参与者通过目的抽样策略从瑞典中部的三个外科病房招募。手术科室包括耳科、妇科、疝修补术、骨科和血管外科手术。

参与者

对14名在清醒状态下接受择期手术的个体进行了叙事访谈。

方法

使用现象学诠释学方法对逐字转录的文本进行分析。

结果

手术中保持清醒的实际体验以希望感为特征,同时伴有身份丧失感和不稳定感。结构分析揭示了两个主题。第一个主题“置身他人掌控之中”包括“进入陌生环境和手术过程”、“失去立足点和自我认同感”以及“忍受意外或预期的不适”等子主题。第二个主题“为未来健康问题应对不可避免之事”涉及“寻求对现状的自我接纳”、“信任专业人员并寻找手术顺利的迹象”以及“通过持续支持增强自身恢复力”等子主题。

结论

除了关注患者手术期间的身体健康外,手术室团队还应认识到“人”这一要素,并在这种脆弱情况下关注他们的情感和社会需求。护理的四个元范式——人、健康、环境和护理——对清醒患者的体验有重大影响。

患者或公众贡献

无患者或公众参与。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b973/11305001/240fee4f22ef/gr1.jpg

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