Effect of psychological care given to the women who underwent hysterectomy before and after the surgery on depressive symptoms, anxiety and the body image levels.

This study was conducted for the purpose of evaluating the effect of the psychological care given to women before and after hysterectomy surgery on depression levels, anxiety and body image. This experimental study was conducted in the gynecological oncology surgery clinic of Samsun Education and Research Hospital in Turkey between the dates of January 2018 and June 2018. Those who meet the sample selection criterion and agreed to participation to the study among the women who were admitted to the clinic for hysterectomy were assigned randomly to the experimental and control groups. 42 women in total including 21 women in each of experimental and control groups formed the sample of the study. The effect of the psychological care was evaluated through Beck Depression Inventory (BDI), State-Trait Anxiety Inventory (STAI) and Body Catherix Scale (BCS). The evaluation measurements were conducted as pre-test, post-test and follow-up (2-months post-test). The BDI and STAI scores of the women who receive psychological care have decreased and their BPS scores have increased. On the contrary, BDI and STAI scores of the women who receive psychological care in the experimental group have increased and their BCS scores have decreased. These findings show that psychological care has positive effects on depressive symptoms, anxiety and the body image in the women who underwent hysterectomy.IMPACT STATEMENTWhat is already known on this subject? Having a hysterectomy impacts a woman's life in a significant manner. As such, deciding to undergo a hysterectomy is a difficult process for women, especially from a psychological perspective. Following a hysterectomy, women commonly experience changes in body perception, such as perceiving the body as different, feeling disabled, feeling hollow, believing they are different than other women and feeling that their body is attracting notice. The literature reports that women perceive themselves as different, alienated, impaired and changed after a hysterectomy and that they have difficulty making contact with the environment; furthermore, the more changes in body perception increase, the more depression increases.What the results of this study add? This study revealed that psychological care given to women before and after undergoing a hysterectomy decreases anxiety and increases positive body perception. For this reason, psychological care for women undergoing hysterectomies should be part of routine nursing care and should be started upon the hospitalisation of the patient.What are the implications of these findings for clinical practice and/or further research? The findings of this study indicate that after a hysterectomy, women experience not only physiological disease symptoms but also psychological problems. Therefore, women who have undergone or will undergo a hysterectomy also have psychological needs. Further study is suggested to determine what can be done with a professional team to meet the demands for psychological care.

[The influence of nasal packing on the quality of life in the early postoperative period following septoplastic surgery]. / Vliianie tamponady nosa na kachestvo zhizni v rannem posleoperatsionnom periode posle septoplastiki.

The objective of the present study was to evaluate the influence of anterior nasal packing on the physical health condition and the quality of life of the patients in the early postoperative period following septoplastic surgery and to propose an alternative to the anterior nasal packing procedure. The study included 90 patients divided into three groups. Those of the first group underwent endoscopic septoplasty, the patients of the second group were managed by standard septoplastic surgery, and the patients of group 3 were given treatment with the use of modified septoplasty including the application of a fibrin sealant as an alternative to nasal tampons. It was shown that anterior nasal packing exerts the undesirable influence on the quality of life during the early postoperative period following septoplastic surgery whereas the use of the modified technique based on the application of a fibrin sealant as an alternative therapeutic modality significantly enhances the effectiveness of the treatment.

The Effect of Nasal Packing Removal on Patients Anxiety.

AIM: We aimed to investigate the effect of removal of merocel nasal packings on patients anxiety after septoplasty using Hamilton Anxiety Scale. MATERIAL AND METHODS: Total amount of 50 patients who had septoplasty operation in the Department of Ear, Nose and Throat Clinic of our hospital were enrolled to the study. Patients anxiety determined using Hamilton Anxiety Scale. The patients anxiety levels were measured before 24 hours before the operation (Group 1), 48 hours after operation before nasal packing removal (Group 2) and 60 minutes after nasal packing removal (Group 3). RESULTS: Patients were evaluated according to the Hamilton Anxiety Scale; in Group 1 15.3 ± 7.2, 19.3 ± 7 in Group 2, 14.6 ± 6,5 in Group 3 was measured. CONCLUSION: There was no statistically significant difference between Groups 1 and 3. There is a statistically significant difference on patients anxiety levels 48 hours after operation before nasal packing removal (p<0.001). There is an statistically significant increase of patients anxiety before packing removal. We recommend using soluble packings or sewing techniques without nasal packings after septoplasty because of patient comfort after operation.

Developing biographies: the experiences of children, young people and their parents of living with a long-term condition.

This article reports on data from a qualitative interview study that sought to understand the experiences, choices and actions of children and young people undergoing surgery for a long-term condition and that of their parents. Using the concept of biography the article examines how the biographies of children, young people and their parents can be influenced by surgery and the ongoing management of a long-term continence condition. This article challenges previous work that characterises the presence of a condition from birth as a continuous and normal part of the illness experiences of these patients. Although this may be the case in some instances, children, young people and their parents can experience diverse and changing experiences associated with ongoing condition management as well as surgery. Biographical continuity, enrichment and disruption are all relevant concepts for such patients living with a long-term continence condition. These can be influenced by their previous experiences of their condition, their expectations, and dynamics with parents, including changes associated with development and the increasing independence of young people.

Patients' perspectives on timing of urinary catheter removal after surgery.

UNLABELLED: A prolonged catheter duration is a major risk factor for catheter-associated urinary tract infection, with bacteriuria increasing by 5% per day (Gokula et al, 2004). AIM: In this study, the authors explored patients' perceptions of the care process relating to peri-operative catheterisation to identify patient factors that encourage early removal. METHOD: Semi-structured interviews, incorporating a grounded theory approach, were performed on three men and seven women during 2010. Interviews were transcribed and analysed using constant comparative method and thematic framework analysis. RESULTS: Catheter duration ranged 1-10 days. Main themes elicited included: lack of understanding of the purpose and catheterisation process; loss of patient autonomy and dignity; and impact of environmental factors. CONCLUSION: Lack of knowledge of the catheterisation process among participants led to fears and concerns that may have contributed to delayed catheter removal. Changes to patient care that are likely to reduce catheter duration include ensuring the provision of pre-operative information, greater patient involvement in catheter removal decisions, and provision of easily accessible toilet facilities.

Information needs of Chinese surgical patients on discharge:a comparison of patients' and nurses' perceptions.

AIMS: This paper is a report of a descriptive study of Chinese abdominal surgical patients' and nurses' perceptions of discharge information needs. BACKGROUND: Discharge from hospital poses a potential threat to surgical patients' lives because they have to cope in daily life with the consequences of the illness and surgery. Recent studies indicate that nurses often underestimate or inappropriately perceive patients' discharge information needs. Few studies have examined the discharge information needs of patients who have undergone abdominal surgery, and research in Asian populations is particularly scarce. METHODS: A descriptive qualitative study was conducted in 2008. Semi-structured interviews were performed with a convenience sample of 16 patients who had undergone an abdominal surgery and their 16 nurses in a regional general hospital in Hong Kong. RESULTS: Results of content analysis indicated that to both the surgical patients and their nurses, three similar categories of information needs on discharge were health concerns upon discharge, addressing patients' information needs, and obstacles that hindered information seeking. Specific needs related to finance, knowledge of illness, psychological support and role of diet and traditional Chinese medicine perceived as important by the patients were underestimated by the surgical nurses and revealed important issues in providing holistic and culture-specific nursing care for surgical patients upon discharge. CONCLUSION: Surgical patients' information needs on finance, illness condition, psychological support and cultural practices were found not to be accurately and adequately understood by their nurses. Nurses should give culturally specific and appropriate predischarge education in terms of promotion of recovery from surgery, health maintenance practice and psychological support.

Primary caregiver stress in caring for a living-related liver transplantation recipient during the postoperative stage.

AIM: The aim of this study was to explore the stress experienced by the primary family caregiver of the living-related liver transplantation patient during the postoperative stage. BACKGROUND: Living-related liver transplantation is a treatment choice for end-stage liver disease patients who face a shortage of available donated livers. Research suggests that the caregiver of the liver transplant recipient experiences tremendous stress because a family member is on the waiting list. Nevertheless, there are limited studies that investigate the caregiver experience of stress during this surgery. METHOD: This qualitative study used face-to-face semi-structured interviews to understand the subjective experiences of study participants. The study participants were drawn from a tertiary medical centre in northern Taiwan. During the data collection period (October 2007 to May 2008), 6 of the 12 caregivers agreed to participate in this study (N = 6), all of whom were female and, except for one participant, were the wives of the recipients. RESULTS: Participant stress was caused by the gap between expectations and primary caregiving experiences. In particular, the five themes that were identified: (a) unstable sentiment towards liver transplantation; (b) entanglement of burden; (c) non-synchronized family interaction; (d) distance from the healthcare professional; and (e) concern about the protector role function. CONCLUSIONS: The stress of primary caregivers of living-related liver transplantation is related to the gap between expectations and primary caregiving experiences. The immediate postoperative stage is a critical one for health professionals to provide intervention and management.

Live kidney donors - assessment and follow up.

BACKGROUND: Live kidney donation has increased steadily over the past decade, both in Australia and internationally. In some centres more than 50% of patients receiving a kidney transplant do so from a living related or unrelated donor. Live nondirected or altruistic donation has become more popular, as have paired exchange programs. General practitioners may be involved in pre-donation counselling and the assessment and follow up of otherwise healthy kidney donors. OBJECTIVE: This overview outlines the clinical pathway and considerations required pre- and post-live kidney donation and highlights some of the uncertainties of donor nephrectomy. DISCUSSION: Live donation requires comprehensive physical, psychological and immunological assessment of the donor-recipient pair. Assessment requires an integrated approach that incorporates the skills of a number of clinicians and allied health practitioners. General practitioners have a crucial role in the counselling, assessment and follow up of live kidney donors.

Helping your patient after breast reconstruction.

Autologous reconstruction--building a "breast" from the patient's own tissues--poses multiple challenges. Find out how to help her overcome them.

Marital quality predicts hospital stay following coronary artery bypass surgery for women but not men.

This study examined how two indices of spouse support, one relatively general and chronic (perceived overall marital quality), and one relatively situation-specific and acute (spouse support while in the hospital), separately and in interaction with patient gender, predict postoperative length of stays following major (coronary bypass) surgery. In a sample of 226 male and 70 female patients drawn from three hospitals in the San Diego area, California, the results indicated that marital quality, in combination with patient gender, predicted postoperative lengths of stay, such that relatively poor marital relationships elevated risk for longer stays for female but not male patients. Lengths of stay for female patients with higher quality marital relationships were similar to those of male patients (regardless of marital quality). These results were not attributable to any assessed preoperative differences in patient health and were independent of perceptions of spouse support received while in the hospital, which did not independently predict patients' lengths of stay.

[Adipositas - new aspects in internistic care before and after bariatric surgery]. / Adipositas ­ Neue Aspekte in der internistischen Betreuung vor und nach bariatrischer Chirurgie.

Indication for bariatric or metabolic surgery depends primarily on body mass index. Recent study results however suggest, that other markers are more reliable predictors of metabolic success. A revision of indication criteria is therefore necessary especially for surgical therapy of type 2 diabetes mellitus. Postoperative management should include screening for postbariatric hypoglycemia and bone density. Furthermore psychologic surveillance is recommended.

Effects of dialogue and therapeutic touch on preoperative and postoperative experiences of breast cancer surgery: an exploratory study.

PURPOSE/OBJECTIVES: To obtain preliminary data and determine the feasibility of a large-scale experimental study to test the efficacy of the Rogerian Science of Unitary Human Beings-based intervention of dialogue and therapeutic touch (TT) on pre- and postoperative anxiety and mood and postoperative pain from breast cancer surgery. DESIGN: Experimental. SETTING: Mid-Atlantic region; ambulatory. SAMPLE: 29 Caucasian and 2 African American English-speaking women with positive breast cancer biopsy (experimental, n = 14; control, n = 17), ranging in age from 31-84 years old (F = 55.6). METHODS: Treatments administered in subjects' homes within seven days prior to surgery and 24 hours after hospital discharge. Experimental treatment consisted of 10 minutes of TT and 20 minutes of dialogue. Control treatment consisted of 10 minutes of quiet time and 20 minutes of dialogue. Data (Spielberger State-Trait Anxiety Inventory. Affects Balance Scale, and Visual Analog Scale-Pain) were collected at the conclusion of each home visit. MAIN RESEARCH VARIABLES: Anxiety, mood, and pain. FINDINGS: The experimental group had lower preoperative state anxiety than the control groups (p = 0.008). No difference was found for preoperative mood. No differences were found for any postoperative measure. CONCLUSIONS: A large-scale study of dialogue and TT would require changes in design and recruitment strategies. IMPLICATIONS FOR NURSING PRACTICE: Nurses may provide more comprehensive care by incorporating dialogue and TT or quiet time into their pre- and postoperative care. Additional research, however, is recommended to determine the differential effects of dialogue, TT, and quiet time on women's experiences with breast cancer prior to incorporating these noninvasive modalities into clinical practice.

Acoustic neuroma: suggestions for helping the patient adapt after translabyrinthine surgery.

An acoustic neuroma is a benign, slow growing tumor which arises from the eighth cranial nerve and produces a variety of symptoms. The translabyrinthine approach is one of the most common surgical procedures employed to remove an acoustic neuroma. Surgical removal may result in frustrating alterations to which the individual must adapt. Patient education can prepare the patient for these alterations and facilitate adaptation.

Self-perceptions about having an ostomy: a postoperative analysis.

The aim of this study is to identify the self-perceptions of patients at different postoperative phases and settings. The case study involves two ostomy patients: a young woman with a temporary ileostomy, and an older man with a permanent colostomy. Both patients were interviewed while still in the hospital on the third, fifth, and seventh postoperative days, and on the second day of the first and third months after discharge. Four major factors were identified after the patients were analyzed: social support, health and life expectations, physical suffering, and self-care. Family support predominated the social support category for both patients. The results showed that the patients' perceptions about having an ostomy were not influenced by the type of ostomy (i.e., whether the ostomy was temporary or permanent in the in-hospital phase). However, these results/perceptions, primarily those related to health and life expectancy and self-care, changed early in the study. We believe it is important for the healthcare team to know the perceptions patients have about their ostomies and themselves postoperatively. This, in turn, may contribute to systematic and personalized care based on specific patients' demands that vary at different stages of treatment and, most certainly, in different cultures.

Nursing intervention for pre-operative anxiety.

Surgical nursing is changing as the type of surgical procedures being performed are becoming more complex and the time for delivering nursing care is reducing. This has resulted in condensing the acute physical care required into a few hours, often to the detriment of other aspects of nursing intervention such as pre- and post-operative anxiety management. A pre-operative psychological care plan for use in a modern, dynamic, surgical arena is briefly outlined as no such strategy currently exists.

Overcoming the top 10 tracheotomy self-care learning barriers.

Multispecialty inpatient units are the norm in today's acute care settings. Since few units have the luxury of seasoned otorhinolaryngology (ORL) nurses, care of the postoperative patient with a tracheotomy, including discharge teaching and planning are left to the generalists. Generalist nurses and new ORL nurses may find themselves experiencing fear and anxiety along with the tracheotomy patients they care for and teach. Experienced ORL nurses are continually challenged to find ways to share their expertise with patients and less experienced nurses in effective ways. This article presents a unique approach to preparing nurses to teach self-tracheotomy care to their patients. Medical-surgical staff nurses attended a 90-minute inservice program presenting actual clinical scenarios of temporarily learning-impaired patients with tracheotomies, and were asked to role play effective interventions. The program content is designed to address the reluctance of inexperienced, busy nurses to confront learning barriers and motivate patients to accomplish early postoperative involvement in tracheotomy self care. The widespread nature of the challenges faced by nurses and patients regarding tracheotomy care has been confirmed by discussions with colleagues on a national level. It has been confirmed further by the first author's clinical experiences in a wide variety of health care settings. Recommended nursing actions and responses to learning barriers presented here are based on expert opinion and clinical experience.