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Patientens upplevelse av oavsiktlig vakenhet i generell anestesi: En systematisk integrativ litteraturstudie
Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
2019 (Swedish)Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesisAlternative title
The patient's experience of awareness during general anesthesia : A systematic integrative literature review (English)
Abstract [sv]

Bakgrund: Awareness, oavsiktlig vakenhet, är en ovanlig men allvarlig komplikation vid generell anestesi. Awarenessupplevelsen kan vara traumatisk för patienterna och resultera i långvarig ohälsa. Patienterna har rätt till god vård och anestesisjuksköterskan är ansvarig för att patienterna är adekvat sövda under hela sin anestesi. Syfte: Att belysa patientens upplevelse av awareness under generell anestesi samt vilka konsekvenser det kan resultera i för patienten  Metod: En systematisk integrativ litteraturstudie genomfördes. Litteratursökningar gjordes i databaserna Cinahl, PubMed och PsycINFO. 36 kvalitativa och kvantitativa studier identifierades och analyserades med tematisk syntes. Resultat: Fyra övergripande analytiska teman framkom. Dessa var sensoriska intryck, existentiella känslor, påkalla uppmärksamhet och psykisk ohälsa. De tre första temana berör patientens upplevelse i samband med awareness och det sista temat berör vilka konsekvenser denna upplevelse kunde få för patienterna.  I samband med awareness kunde patienterna uppleva olika sensoriska intryck som hörsel, syn, känsel, smärta och paralys. Dessa upplevelser kunde medföra existentiella känslor som rädsla, oro, ångest, panik och hjälplöshet. Flera patienter beskrev hur de försökte påkalla personalens uppmärksamhet. Upplevelsen av awareness var för en del patienter en traumatisk upplevelse som kunde medföra kortvarig eller långvarig psykisk ohälsa av varierande omfattning. Det kunde även medföra psykosociala konsekvenser med försämrade relationer till närstående och hälso- och sjukvården med följden att patienten ej kunde genomföra rekommenderad behandling. Slutsats: Att uppleva awareness kan innebära ett lidande för patienten. En ökad kunskap om awareness medvetandegör behovet av att förebygga awareness och ökar anestesisjuksköterskans möjlighet att identifiera och stötta patienter som drabbats. 

Abstract [en]

Background: Awareness, (e.g. unintentional wakefullness) is an unusual but serious complication during general anesthesia. The awareness experience can be traumatic for the patients and result in long-term illness. The patients are entitled to good care and the anesthetist nurse is responsible for ensuring that the patients are adequately anesthetized throughout their anesthesia. Aim: The aim was to illustrate the patient’s perception of awareness during general anesthesia and the consequences this may have for the patient.   Method: A systematic integrative literature study was conducted. Literature searches were made in the databases CINAHL, PubMed and PsycINFO. 36 qualitative and quantitative studies were identified and analyzed with thematic synthesis. Result: Four comprehensive analytical themes emerged. These were Sensory impressions, existential feelings, calling for attention and mental illness. The first three themes concern the patient’s experience in relation to awareness and the last theme concerns what consequences this experience could have for the patients. In conjunction with awareness patients could experience different sensory impressions such as hearing, sight, feeling, pain and paralysis. These experiences could cause existential feelings such as fear, anxiety, panic and helplessness. Several patients described how they tried to call on the staff’s attention. The experience of awareness was for some patients a traumatic experience that could cause short-term or longterm psychological sequele of varying degrees. It could also result in psychosocial consequences with deteriorated relationships with both relatives and health care, with the result that the patient could not carry out recommended treatment.  Conclusion: Experiencing awareness may mean a suffering for the patient. An increased knowledge about awareness acknowledges the need to prevent it and increases the ability of the nurse to identify and support patients who are affected.

Place, publisher, year, edition, pages
2019. , p. 82
Keywords [en]
Awareness, anesthesia, intraoperative complications, experience, mental illness
Keywords [sv]
Oavsiktlig vakenhet, awareness, anestesi, intraoperativa komplikationer, upplevelse, psykisk ohälsa
National Category
Health Sciences
Identifiers
URN: urn:nbn:se:lnu:diva-82379OAI: oai:DiVA.org:lnu-82379DiVA, id: diva2:1312934
Subject / course
Vårdvetenskap
Educational program
Specialist Nursing Programme, with Specialism in Anaesthetic Care, 60 credits
Supervisors
Examiners
Available from: 2019-05-02 Created: 2019-04-30 Last updated: 2019-05-02Bibliographically approved

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Patientens upplevelse av oavsiktlig vakenhet i generell anestesi(785 kB)33 downloads
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