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An intraoperative caring model: the 'awake' patient's need for a genuine caring encounter
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.
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.ORCID iD: 0000-0002-2602-0101
2013 (English)In: Clinical Nursing Studies, ISSN 2324-7940, Vol. 1, no 4, 23-35 p.Article in journal (Refereed) Published
Abstract [en]

Anaesthesia nursing care during regional anaesthesia is characterized by the encounter between the ‘awake’ patient’s own lifeworld and the nurse anaesthetist’s knowledge in theory and in practice. This study aims to present an intraoperative caring model from the patient’s perspective that will facilitate nurse anaesthetists’ (NA) practice to enhance and support the ‘awake’ patient’s intraoperative well-being during surgery under regional anaesthesia. The model is underpinned by a synthesis based on interviews with patients, a philosophical reflection using Merleau-Ponty’s philosophy, and video recordings from orthopaedic surgeries under regional anaesthesia. The model can be used as a tool to encounter awake patients’ existential needs in the intraoperative situation and to further enlighten NAs about the possible impact of their proximity, interaction and communication behaviour in the delivery of intraoperative nursing care. The model can help NAs to access, understand and learn through lived experiences, thereby deepening their professional caring skills. The model is a way to get research knowledge ready for use by NAs to reflect on what gaps need to be filled between what nurses know (research) and do (practice).

Place, publisher, year, edition, pages
2013. Vol. 1, no 4, 23-35 p.
Keyword [en]
Anaesthesia care, Caring science, Intraoperative caring model, Regional anaesthesia
National Category
Nursing
Research subject
Health and Caring Sciences, Caring Science
Identifiers
URN: urn:nbn:se:lnu:diva-30683DOI: 10.5430/cns.v1n4p23OAI: oai:DiVA.org:lnu-30683DiVA: diva2:666611
Available from: 2013-11-23 Created: 2013-11-23 Last updated: 2016-11-18Bibliographically approved
In thesis
1. Att vara vaken under operation i regional anestesi: Från patienters upplevelser till en vårdande modell
Open this publication in new window or tab >>Att vara vaken under operation i regional anestesi: Från patienters upplevelser till en vårdande modell
2013 (Swedish)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Aim: The overall aim of the thesis was to describe the experiences of awake patients during surgery under regional anesthesia. In addition, the aim was to develop a model for intraoperative care that can support and enhance patients’ well-being during the intraoperative period.

 

Methods: Study I was a patient interview study guided by a reflective lifeworld approach. In study II a philosophical reflection of the findings from study I was carried out. In study III a hermeneutic approach inspired by Ricoeur and Gadamer was used in order to interpret video recorded material. In study IV a hermeneutic approach inspired by Gadamer was used to synthesize the findings in studies I-III transformed into an intraoperative caring model. 

Overall main findings: The analysis shows that being awake during surgery can be compared with walking a tightrope because of ambiguous feelings. The proximity and presence of the nurse anesthetist (NA) anchors the patient in the present and strengthens the patient’s feeling of trust. The temporary disruption in the relationship between the body and the world due to regional anesthesia means that the patient’s being in the world is exposed to revolutionary experiences. Gaps between the patient’s experiences and the situation can be bridged over when the NA acts as the patient’s bodily extension and links the patient as a subject to the world in the intraoperative situation. From the patient’s perspective this calls for the NA’s proximity and genuine presence in the ‘intraoperative caring space’. When the NA’s performance of his/her professional duties clashes with the patient’s existential being in the intraoperative situation the need of present presence from the NA is crucial.

Conclusions: The findings contribute to knowledge development about intraoperative care and raise awareness that care for the awake patient cannot be performed on formal routines that might disregard the uniqueness of each patient’s situation. The model can be used as a tool to encounter awake patients’ existential needs in the intraoperative situation and to further enlighten NAs about the possible impact of their proximity, interaction and communication behavior in the delivery of intraoperative nursing care.

Place, publisher, year, edition, pages
Växjö: Linnaeus University Press, 2013
Series
Linnaeus University Dissertations, 157/2013
Keyword
anesthesia care, hermeneutics, intraoperative caring model, patient’s experiences, patient-nurse interaction, phenomenology, philosophy, reflective lifeworld research, regional anesthesia, video recording
National Category
Nursing
Research subject
Health and Caring Sciences, Caring Science
Identifiers
urn:nbn:se:lnu:diva-30684 (URN)978-91-87427-65-7 (ISBN)
Public defence
2013-12-13, Myrdal, Hus K, Växjö, 10:30 (Swedish)
Opponent
Supervisors
Available from: 2013-11-25 Created: 2013-11-23 Last updated: 2014-05-09Bibliographically approved

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Karlsson, Ann-ChristinEkebergh, MargarethaLarsson Mauléon, AnnikaAlmerud Österberg, Sofia
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