Volume 16, Issue 3 (June 2022)
Qom Univ Med Sci J 2022, 16(3): 200-211 |
Back to browse issues page
Research code: 1772
Ethics code: IR.SKUMS.REC.1397.329
Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
Ghanbari-Afra L, Zaheri A, Mehraban A, Delaram M, Deris F. Harmful Stressors in the Post-anesthesia Care Ward in 2017: Comparison of the Views of Patients and Nurses. Qom Univ Med Sci J 2022; 16 (3) :200-211
URL: http://journal.muq.ac.ir/article-1-3436-en.html
URL: http://journal.muq.ac.ir/article-1-3436-en.html
1- Trauma Nursing Research Center, Faculty of Nursing and Midwifery, Kashan University of Medical Sciences, Kashan, Iran.
2- Department of Anesthesia, School of Paramedical, Shahrekord University of Medical Sciences, Shahrekord, Iran. ,zaheriazita69@gmail.com
3- Department of Anesthesia, School of Paramedical, Shahrekord University of Medical Sciences, Shahrekord, Iran.
4- Department of Nusing and Midwifery, Facult of Midwifery, Shahrekord University of Medical Sciences, Shahrekord, Iran.
5- Department of Statistics and Epidemiology, Faculty of Statistics, Shahrekord University of Medical Sciences, Shahrekord, Iran.
2- Department of Anesthesia, School of Paramedical, Shahrekord University of Medical Sciences, Shahrekord, Iran. ,
3- Department of Anesthesia, School of Paramedical, Shahrekord University of Medical Sciences, Shahrekord, Iran.
4- Department of Nusing and Midwifery, Facult of Midwifery, Shahrekord University of Medical Sciences, Shahrekord, Iran.
5- Department of Statistics and Epidemiology, Faculty of Statistics, Shahrekord University of Medical Sciences, Shahrekord, Iran.
Full-Text [PDF 5016 kb]
(180 Downloads)
| Abstract (HTML) (524 Views)
Full-Text: (244 Views)
Introduction
The Post-Anesthesia Care Unit (PACU) is a vital part to monitor and care for patients recovering from the immediate physiological effects of anesthesia and surgery. Recovery after anesthesia is usually done under the supervision of an anesthesiologist by responsible nurses and trained staff. In this unit, patients are in need of maintaining their airways and experience hemodynamic instability. Proper care in PACUs can ensure the safety of patients and significantly reduce unwanted events and deaths after surgery and anesthesia. This unit is potentially a stressful place. The stressors are mainly the stimuli that trigger a stress response. The stress response is a physiological reaction that occurs due to the perception of incompatible and terrifying situations. Proper identification of stressors, psychological support, and implementation of immediate psychological interventions by nurses for hospitalized patients can significantly improve the patient outcomes such as improvement of vital signs and reduction of pain, anxiety, complications, and length of hospital stay, and cause patient satisfaction. If the nurses cannot accurately perceive the stressors of patients, they will not be able to provide effective care to them. Having knowledge of the patient’s stressors can help nurses play an effective role in the patient’s recovery process by modifying the stressors thought appropriate interventions.
According to the results of previous studies and considering the environmental and cultural conditions and the abilities of staff, there are considerable differences between the perceptions of patients and nurses about the stressors in hospitals which need further research. However, we found no study in this field. Therefore, this study aims to compare the perceptions of patients and nurses about the existing stressors in PACUs of hospitals in Shahrekord, Iran.
Methods
This descriptive cross-sectional study was conducted in 2018. All nurses/head nurses in the PACUs of Kashani and Hajar hospitals affiliated to the Kudestan University of Medical Sciences were selected were selected using a census method. For the patients in the PACUs of these hospitals, the sample size was determined 384 using the formula. The instrument used in this study was a researcher-made questionnaire with two sections; the first section was a demographic form for nurses (age, gender, marital status, educational level, position and type of work shift) and patients (age, gender, marital status, educational level). The second part measures the stressors in the PACUs, which was adapted from Ganong’s modified intensive care unit environmental stressor scale. Data were analyzed in SPSS software, version 19 software using descriptive statistics including frequency, percentage, mean and standard deviation and inferential statistics including chi-square test, independent t-test, and analysis of variance. The significance level was set at 0.05.
Results
The mean age was 45.41±28.14 years in patients and 33.92±5.77 years in nurses. In patients, about 70% were female, 76% were married, and about 43/2% had a diploma. IN nurses, 60% were female, 63.3% were married, and about 93/3% were working as a nurse, and 93/3% had a rotating shift work. There was no significant difference in the total score of PACU environment stressor scale between patients and nurses. The mean total score of PACU environmental stressor scale for patients had no significant relationship with their gender, educational level, marital status, and age. The mean total score of stressor scale for nurses had no significant relationship with their age, gender, work shift, job position, and marital status.
Discussion
The perceptions of nurses and patients about top ten stressors in the PACUs were almost similar. It seems that nurses need more training for assessing and eliminating the PACU environment stressors in patients which can help them provide high quality patient care and meet the needs of patients in PACUs. Early psychological interventions can also help patients discharged following surgery and anesthesia and are at unstable conditions to get rid of these stressful experiences.
Ethical Considerations
Compliance with ethical guidelines
This article is taken from the research project approved by Shahrekord University of Medical Sciences.
Funding
This article has received the code of ethics with the number IR.SKUMS.REC.1395.320 under the financial support of the Research Vice-chancellor of the Faculty of Nursing and Midwifery, Shahrekord University of Medical Sciences.
Authors contributions
This study was designed and compiled by Azita Zaheri and Leila Ghanbari-Afra. The samples were collected by Asma Mehraban and Masoume Delaram. Data analysis was done by Fatemeh Deris, and the present manuscript was prepared and edited by Azita Zaheri and Leila Ghanbari-Afra, and the present text has been approved by all the authors.
Conflicts of interest
There is no conflict of interest between the authors.
Acknowledgements
We would like to express our thanks and appreciation to the efforts of the esteemed research assistant of Shahrekord University of Medical Sciences, nursing directors and nurses of Ayatollah Kashani and Hajar hospitals who helped us in conducting this research.
The Post-Anesthesia Care Unit (PACU) is a vital part to monitor and care for patients recovering from the immediate physiological effects of anesthesia and surgery. Recovery after anesthesia is usually done under the supervision of an anesthesiologist by responsible nurses and trained staff. In this unit, patients are in need of maintaining their airways and experience hemodynamic instability. Proper care in PACUs can ensure the safety of patients and significantly reduce unwanted events and deaths after surgery and anesthesia. This unit is potentially a stressful place. The stressors are mainly the stimuli that trigger a stress response. The stress response is a physiological reaction that occurs due to the perception of incompatible and terrifying situations. Proper identification of stressors, psychological support, and implementation of immediate psychological interventions by nurses for hospitalized patients can significantly improve the patient outcomes such as improvement of vital signs and reduction of pain, anxiety, complications, and length of hospital stay, and cause patient satisfaction. If the nurses cannot accurately perceive the stressors of patients, they will not be able to provide effective care to them. Having knowledge of the patient’s stressors can help nurses play an effective role in the patient’s recovery process by modifying the stressors thought appropriate interventions.
According to the results of previous studies and considering the environmental and cultural conditions and the abilities of staff, there are considerable differences between the perceptions of patients and nurses about the stressors in hospitals which need further research. However, we found no study in this field. Therefore, this study aims to compare the perceptions of patients and nurses about the existing stressors in PACUs of hospitals in Shahrekord, Iran.
Methods
This descriptive cross-sectional study was conducted in 2018. All nurses/head nurses in the PACUs of Kashani and Hajar hospitals affiliated to the Kudestan University of Medical Sciences were selected were selected using a census method. For the patients in the PACUs of these hospitals, the sample size was determined 384 using the formula. The instrument used in this study was a researcher-made questionnaire with two sections; the first section was a demographic form for nurses (age, gender, marital status, educational level, position and type of work shift) and patients (age, gender, marital status, educational level). The second part measures the stressors in the PACUs, which was adapted from Ganong’s modified intensive care unit environmental stressor scale. Data were analyzed in SPSS software, version 19 software using descriptive statistics including frequency, percentage, mean and standard deviation and inferential statistics including chi-square test, independent t-test, and analysis of variance. The significance level was set at 0.05.
Results
The mean age was 45.41±28.14 years in patients and 33.92±5.77 years in nurses. In patients, about 70% were female, 76% were married, and about 43/2% had a diploma. IN nurses, 60% were female, 63.3% were married, and about 93/3% were working as a nurse, and 93/3% had a rotating shift work. There was no significant difference in the total score of PACU environment stressor scale between patients and nurses. The mean total score of PACU environmental stressor scale for patients had no significant relationship with their gender, educational level, marital status, and age. The mean total score of stressor scale for nurses had no significant relationship with their age, gender, work shift, job position, and marital status.
Discussion
The perceptions of nurses and patients about top ten stressors in the PACUs were almost similar. It seems that nurses need more training for assessing and eliminating the PACU environment stressors in patients which can help them provide high quality patient care and meet the needs of patients in PACUs. Early psychological interventions can also help patients discharged following surgery and anesthesia and are at unstable conditions to get rid of these stressful experiences.
Ethical Considerations
Compliance with ethical guidelines
This article is taken from the research project approved by Shahrekord University of Medical Sciences.
Funding
This article has received the code of ethics with the number IR.SKUMS.REC.1395.320 under the financial support of the Research Vice-chancellor of the Faculty of Nursing and Midwifery, Shahrekord University of Medical Sciences.
Authors contributions
This study was designed and compiled by Azita Zaheri and Leila Ghanbari-Afra. The samples were collected by Asma Mehraban and Masoume Delaram. Data analysis was done by Fatemeh Deris, and the present manuscript was prepared and edited by Azita Zaheri and Leila Ghanbari-Afra, and the present text has been approved by all the authors.
Conflicts of interest
There is no conflict of interest between the authors.
Acknowledgements
We would like to express our thanks and appreciation to the efforts of the esteemed research assistant of Shahrekord University of Medical Sciences, nursing directors and nurses of Ayatollah Kashani and Hajar hospitals who helped us in conducting this research.
Type of Study: Original Article |
Subject:
پرستاری-جراحی-ویژه-کودکان
Received: 2022/04/5 | Accepted: 2022/06/21 | Published: 2022/07/1
Received: 2022/04/5 | Accepted: 2022/06/21 | Published: 2022/07/1
References
1. Dang D, Johantgen ME, Pronovost PJ, Jenckes MW, Bass EB. Postoperative complications: does intensive care unit staff nursing make a difference? Heart & Lung. 2002; 31(3):219-28. DOI: 10.1067/mhl.2002.122838 [DOI:10.1067/mhl.2002.122838] [PMID] [DOI:10.1067/mhl.2002.122838]
2. Stoelting RK, Miller RD. Basics of anesthesia. London: Churchill Livingstone; 2007. [Link]
3. Kluger M, Bullock M. Recovery room incidents: a review of 419 reports from the Anaesthetic Incident Monitoring Study (AIMS). Anaesthesia. 2002; 57(11):1060-6. [DOI:10.1046/j.1365-2044.2002.02865.x] [PMID] [DOI:10.1046/j.1365-2044.2002.02865.x]
4. LaPierre E, Ritchey K, Newhouse R. Barriers to research use in the PACU. J Perianesth Nurs . 2004; 19(2):78-83.1 [DOI:10.1016/j.jopan.2004.01.001] [PMID] [DOI:10.1016/j.jopan.2004.01.001]
5. Pardo MC. Miller's Basics of anesthesia. Amsterdam: Elsevier; 2022. [Link]
6. Hines R, Barash PG, Watrous G, O'Connor T. Complications occurring in the postanesthesia care unit: a survey. Anesth Analg. 1992; 74(4):503-9. [DOI:10.1213/00000539-199204000-00006] [PMID] [DOI:10.1213/00000539-199204000-00006]
7. Tarrac SE. A description of intraoperative and postanesthesia complication rates. J Perianesth Nurs. 2006; 21(2):88-96. [DOI:10.1016/j.jopan.2006.01.006] [PMID] [DOI:10.1016/j.jopan.2006.01.006]
8. Rosa BÂ, Rodrigues RCM, Gallani MCBJ, Spana TM, Pereira CGdS. Estressores em unidade de terapia intensiva: versão brasileira do The Environmental Stressor Questionnaire. Rev Esc Enferm USP. 2010; 44(3):627-35. [DOI:10.1590/S0080-62342010000300011] [PMID] [DOI:10.1590/S0080-62342010000300011]
9. Wenham T, Pittard A. Intensive care unit environment. Continuing Education in Anaesthesia. Crit Care & Pain. 2009; 9(6):178-83. [DOI:10.1093/bjaceaccp/mkp036] [DOI:10.1093/bjaceaccp/mkp036]
10. Langer EJ, Janis IL, Wolfer JA. Reduction of psychological stress in surgical patients. J Exp Soc Psychol. 1975; 11(2):155-65. [DOI:10.1016/S0022-1031(75)80018-7] [DOI:10.1016/S0022-1031(75)80018-7]
11. So HM, Chan DSK. Perception of stressors by patients and nurses of critical care units in Hong Kong. Int J of Nur Stud. 2004; 41(1):77-84. [DOI:10.1016/S0020-7489(03)00082-8] [DOI:10.1016/S0020-7489(03)00082-8]
12. Papathanassoglou ED. Psychological support and outcomes for ICU patients. Nurs Crit Care. 2010; 15(3):118-28. [DOI:10.1111/j.1478-5153.2009.00383.x] [PMID] [DOI:10.1111/j.1478-5153.2009.00383.x]
13. Peris A, Bonizzoli M, Iozzelli D, Migliaccio ML, Zagli G, Bacchereti A, et al. Early intra-intensive care unit psychological intervention promotes recovery from post traumatic stress disorders, anxiety and depression symptoms in critically ill patients. Crit Care. 2011; 15(1):R41. [DOI:10.1186/cc10003] [PMID] [PMCID] [DOI:10.1186/cc10003]
14. Cornock MA. Stress and the intensive care patient: perceptions of patients and nurses. J Adv Nurs. 1998; 27(3):518-27. [DOI:10.1046/j.1365-2648.1998.00555.x] [PMID] [DOI:10.1046/j.1365-2648.1998.00555.x]
15. Landstrom M, Rehn I-M, Frisman GH. Perceptions of registered and enrolled nurses on thirst in mechanically ventilated adult patients in intensive care units-A phenomenographic study. Intensive & Crit Care Nurs. 2009; 25(3):133-9. [DOI:10.1016/j.iccn.2009.03.001] [PMID] [DOI:10.1016/j.iccn.2009.03.001]
16. Azizi-Fini I, Adib-Hajbaghery M, Ahmadi R, Fallahi F. Traumatic stressors in the intensive care unit: Viewpoints of patients and nurses. Trauma Mon. 2017; 22(5). [Link] [DOI:10.5812/traumamon.37631]
17. Yava A, Tosun N, Ünver V, Çiçek H. Patient and nurse perceptions of stressors in the intensive care unit. Stress Health. 2011; 27(2):e36-47. [DOI:10.1002/smi.1333] [PMID] [DOI:10.1002/smi.1333]
18. Cochran J, Ganong LH. A comparison of nurses' and patients' perceptions of intensive care unit stressors. J Adv Nurs . 1989; 14(12):1038-43. [DOI:10.1111/j.1365-2648.1989.tb01515.x] [PMID] [DOI:10.1111/j.1365-2648.1989.tb01515.x]
19. Moghaddasian S, Dizaji SL, Mahmoudi M. Nurses empathy and family needs in the intensive care units. J Caring Sci. 2013; 2(3):197. [DOI: 10.5681/jcs.2013.024]
20. Kaur M, Patidar AB, Kaur J, Sharma SK. A comparative study of the patients' and staff nurses' perception of environmental stressors in ICU at a tertiary care hospital in Punjab, India. Int J Nurs Educ. 2013; 5(2):114. [DOI:10.5958/j.0974-9357.5.2.075] [DOI:10.5958/j.0974-9357.5.2.075]
21. van de Leur JP, van der Schans CP, Loef BG, Deelman BG, Geertzen JH, Zwaveling JH. Discomfort and factual recollection in intensive care unit patients. Crit Care. 2004; 8(6):1-7. [DOI:10.1186/cc2976] [PMID] [PMCID] [DOI:10.1186/cc2976]
22. Novaes MFP, Knobel E, Bork A, Pavao O, Nogueira-Martins L, Bosi Ferraz M. Stressors in ICU: perception of the patient, relatives and health care team. Intensive Care Med. 1999; 25(12):1421-6. [DOI:10.1007/s001340051091] [PMID] [DOI:10.1007/s001340051091]
23. Payen J-F, Gélinas C. Measuring pain in non-verbal critically ill patients: which pain instrument? Crit Care. 2014; 18(5):1-2. [DOI:10.1186/s13054-014-0554-5] [PMID] [PMCID] [DOI:10.1186/s13054-014-0554-5]
Send email to the article author
| Rights and permissions | |
 |
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
Owned by Qom University of Medical Sciences
Published by Qom University of Medical Sciences Press
eISSN: 2008-1375
pISSN: 1735-7799
Email: journal[at]muq.ac.ir
j.mua.ac[at]gmail.com
