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  • 1.
    Andersson, Susanne
    et al.
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Svanström, Rune
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Ek, Kristina
    University of Skövde, Health and Education.
    Rosén, Helena
    Health Sciences, University of Lund, Lund.
    Berglund, Mia
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    'The challenge to take charge of life with long-term illness': Nurses' experiences of supporting patients' learning with the didactic model2015In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 24, no 23-24, p. 3409-3416Article in journal (Refereed)
  • 2.
    Rosén, Helena
    University of Skövde, School of Life Sciences.
    Patients' experiences of symptoms, discomfort and their impact on daily living following day surgery2011Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    The frequency of day surgery continues to increase worldwide. However, knowledge of the patients experiences of symptoms and discomfort beyond the first 72 hours postoperatively remains almost nonexistent.  The overall aim of this study was to describe patients' experiences of symptoms and discomforts and their impact on daily living. A prospective design was used to survey 298 patients’ symptoms and discomforts as well as their impact on daily living up to three months after a day surgery in a community hospital in Sweden.  A review of previous research, published between 1992 and 2008 was completed (Paper I).  The first analysis of data was descriptive and correlational; focusing on patients' perception of pain, return to normal activities and daily function over time (Paper II).  The second analysis was descriptive, focusing on patients' experiences and perceived causes of persisting discomfort following day surgery (Paper III).  The third analysis was qualitative, using thematic analysis of two cases (Paper IV) to examine symptom experience, components of symptom management strategies and symptom status outcomes as well as influencing factors related to person, health and illness and environment domains. Paper II: On a Numerical rating scale (NRS) (0-10) 55% (n=127) of patients rated their worst pain as >4 at 48 hours, 43% (n=91) at seven days and 34% (n=26) at three months after surgery.  Pain interfered at NRS >4 with work at 48 hours and seven days, then subsided, but still reported at three months.  Worst pain at 48 hours correlated significantly with return to normal activity within seven days.  Paper III: Varying types of discomforts was reported by 118 patients at 48 hours, 110 at seven days and 46 at three months after surgery.   

    Perceived causes of discomfort at three months were: type of surgery, insufficient access to provider or information and incorrect or suboptimal treatment.  Paper IV: Contextual domains, Symptom Experiences, Symptom Management strategies and Symptom Status Outcomes, were used to illustrate the postoperative situation following day surgery.  Concluding; despite extensive efforts, such as pain management guidelines, people may suffer for a long period after day surgery.

  • 3.
    Rosén, Helena I.
    et al.
    University of Skövde, School of Life Sciences.
    Bergh, Ingrid H. E.
    University of Skövde, School of Life Sciences.
    Lundman, Berit M.
    University of Skövde, School of Life Sciences.
    Mårtensson, Lena B.
    University of Skövde, School of Life Sciences.
    Patients' experiences and perceived causes of persisting discomfort following day surgery2010In: BMC Nursing, ISSN 1472-6955, E-ISSN 1472-6955, Vol. 9, p. artikelnummer 16-Article in journal (Refereed)
    Abstract [en]

    Background: The aim of this study was to describe patients’ experiences and perceived causes of persisting discomfort following day surgery. Earlier research has mainly covered symptoms and signs during a recovery period of up to one month, and not dealt with patients’ perceptions of what causes persisting, longer-term discomfort. Methods: This study is a part from a study carried out during the period May 2006 to May 2007 with a total of 298 day surgery patients. Answers were completed by 118 patients at 48 hours, 110 at seven days and 46 at three months to one open-ended question related to discomfort after day surgery constructed as follows: If you are stillexperiencing discomfort related to the surgery, what is the reason, in your opinion? Data was processed, quantitatively and qualitatively. Descriptive, inferential, correlation and content analyses were performed. Results: The results suggest that patients suffer from remaining discomfort e.g. pain and wound problem, with effects on daily life following day surgery up to three months. Among patients’ perceptions of factors leading to discomfort may be wrongful or suboptimal treatment, type of surgery or insufficient access to provider/information. Conclusions: The results have important implications for preventing and managing discomfort at home followingday surgery, and for nursing interventions to help patients handle the recovery period better.

  • 4.
    Rosén, Helena I.
    et al.
    University of Skövde, School of Health and Education.
    Bergh, Ingrid H. E.
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Schwartz-Barcott, Donna
    Nursing College, University of Rhode island, Kingstown, RI.
    Mårtensson, Lena B.
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    The Recovery Process After Day Surgery Within the Symptom Management Theory2014In: Nursing Forum, ISSN 1744-6198, Vol. 49, no 2, p. 100-109Article in journal (Refereed)
    Abstract [en]

    Purpose: The aim was to illustrate two cases in a postoperative situation following day surgery within the framework of the symptom management theory. Method: Template analysis using the symptom management theory. Result: Neither the woman nor the man was able to return to their normal activities, health status or functional status, within a week. Conclusion: The results illustrate how a postoperative situation may involve personal suffering up to 3 months. Practical Implication: To obtain an outcome following day surgery, as optimal as possible, improving clinical practices and routines, such as discharge criteria, guidelines, and care pathways, is necessary. © 2014 Wiley Periodicals, Inc.

  • 5.
    Rosén, Helena I.
    et al.
    University of Skövde, School of Life Sciences.
    Bergh, Ingrid H.
    University of Skövde, School of Life Sciences.
    Odén, Anders
    Mårtensson, Lena B.
    University of Skövde, School of Life Sciences.
    Patients´ Experiences of Pain Following Day Surgery - At 48 Hours, Seven Days and Three Months2011In: Open Nursing Journal, ISSN 1874-4346, E-ISSN 1874-4346, Vol. 5, p. 52-59Article in journal (Refereed)
    Abstract [en]

    Recent studies indicate that patients experience pain after day surgery for a longer period than previously known. This requires verification. This was a prospective, descriptive correlational study. A convenience sample of 298 day surgery patients undergoing various surgical procedures was asked to report pain intensity and its interference with daily function 48 hours, seven days and three months after day surgery. Correlation and regression analyses were performed. On a NRS, 55% (n=230) reported pain (≥4) 48 hours after surgery, as did 43% (n=213) at seven days. Pain interfered with normal activities at ≥4 NRS at 48 hours and at seven days, after which it decreased.

  • 6.
    Rosén, Helena
    et al.
    University of Skövde, School of Life Sciences.
    Lauzon Clabo, Laurie M.
    College of Nursing, University of Rhode Island, United States.
    Mårtensson, Lena
    University of Skövde, School of Life Sciences.
    Symptoms following day surgery: a review of the literature2009In: Journal of Advanced Perioperative Care, ISSN 1470-5664, Vol. 4, no 1, p. 7-18Article, review/survey (Refereed)
    Abstract [en]

    Aim: The purpose of this paper is to provide a broad-based overview of the current literature regarding patients’ experiences of symptoms following day surgery. Background: The advent of new anaesthetic and anti-emetic agents, advanced surgical techniques and the need for reduced costs for inpatient hospital services, has resulted in about 70% of all surgical procedures being undertaken as day surgery (Mattila et al 2005, Qureshi et al 2006) in many countries such as the United Kingdom (UK) (Aylin et al 2005) and Europe, Australia and North America (Jarrett 2001). As more and more types of surgery, including increasingly complex procedures, are undertaken as day surgery and with the expansion of day surgery for patients who are older, frail or who have multiple co-morbidities, there is a need to expand the knowledge base regarding patients’ symptom experience at home following day surgery. In particular, there is a need to examine the patients’ experience of symptoms longitudinally and to examine the impact of these on the return to activities of daily living (Gudex et al 2006). Method: Nursing and health care papers published in English between 1992 and April 2008 were sought, using the Cumulative Index of Nursing and Allied Health Literature (CINAHL) database. Thirty six papers were selected and critiqued. A checklist was used to review the included studies for their type of method and the way they were designed and implemented (Goodman 1993). Findings: The wide range of studies reviewed provided further understanding of incidence, intensity and duration of symptoms experienced by patients after day surgery. Patients almost invariably report that pain and other symptoms were at their peak up to 24 hours after discharge and frequently persisted for six days or more. However, a clear picture of the symptom experience following day surgery failed to emerge because methodological differences make comparison across studies difficult. While there has been little exploration of the symptom experience longitudinally, those studies that have examined symptoms over time suggest that the patient's experience of them does have a significant impact on their ability to function in their normal social and work roles for a prolonged period of time following day surgery. In the studies reviewed when day surgery patients´ activity levels were reduced postoperatively, return to usual activity was delayed and activities of daily living were reported as difficult to manage. Conclusion: This review demonstrates that patients' experience of symptoms in the recovery period at home following day surgery is more profound than clinicians expect, lasts for a longer period and interferes with the ability to return to normal activities. However there are still gaps in knowledge particularly concerning the extent to which patients continue to experience symptoms after six days and beyond. Further research needs to explore multidimensional perspectives on symptoms together with an additional and more thorough evaluation of the impact of symptoms on daily living. Recommendations: Further research regarding these gaps in knowledge is necessary in order to develop a deeper understanding of patients’ symptom experience following day surgery and to develop appropriate assessment and intervention strategies for this population. The perioperative nurse with his or her specialised knowledge is well suited to face these challenges.

     

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