A systematic review of qualitative studies: patients' experiences of preoperative communication.

AIM: This article reports on a systematic review of qualitative studies on patients' experiences of preoperative communication with healthcare professionals. BACKGROUND: Communication is critical for providing efficient care to patients. It is especially important for patients waiting for surgery, as they experience a variety of unknowns before the procedure. Through communication with healthcare professionals, patients gain a better understanding of the surgery and the issues related to their life after the surgery. Thus, the preoperative communication between healthcare professionals and patients is a significant topic for review. DESIGN: Systematic review. METHODS: Six electronic databases (CINAHL, Cochrane Library, Embase, Medline, PsycINFO and PUBMED) were systematically searched. Qualitative studies of patients' experiences before surgery were purposely selected for synthesis. Key themes and concepts were extracted and synthesised. RESULTS: Eleven studies on patients' experiences before surgery were identified. Four main themes relating to patients' experiences of preoperative communication with healthcare professionals were identified from all 11 articles. These themes were as follows: need for information, involving relatives, need for control and healthcare professionalism. CONCLUSIONS: Patients' experience of preoperative communication with healthcare professionals showed different needs and feelings for communication. Healthcare professionals need to have adequate knowledge, skills and positive attitudes to help patients through the journey of this critical life event. RELEVANCE TO CLINICAL PRACTICE: Patients' sensitivity and their different needs for communication may contribute to future advances in the training of healthcare professionals with regard to their communication knowledge and skills. They may also affect the allocation of resources for patients waiting for surgery and educating related professionals about their knowledge and skills of communication and their attitudes. Adequate space for meeting simultaneously with patients and their relatives and extra human resources and tools for the assessment of individuals' need for communication are also required.

Morphology and stability of CO2-in-water foams with nonionic hydrocarbon surfactants.

The morphologies, stabilities, and viscosities of high-pressure carbon dioxide-in-water (C/W) foams (emulsions) formed with branched nonionic hydrocarbon surfactants were investigated by in situ optical microscopy and capillary rheology. Over two dozen hydrocarbon surfactants were shown to stabilize C/W foams with Sauter mean bubble diameters as low as 1 to 2 microm. Coalescence of the C/W foam bubbles was rare for bubbles larger than about 0.5 microm over a 60 h time frame, and Ostwald ripening became very slow. By better blocking of the CO(2) and water phases with branched and double-tailed surfactants, the interfacial tension decreases, the surface pressure increases, and the C/W foams become very stable. For branched surfactants with propylene oxide middle groups, the stabilities were markedly lower for air/water foams and decane-water emulsions. The greater stability of the C/W foams to coalescence may be attributed to a smaller capillary pressure, lower drainage rates, and a sufficient surface pressure and thus limiting surface elasticity, plus small film sizes, to hinder spatial and surface density fluctuations that lead to coalescence. Unexpectedly, the foams were stable even when the surfactant favored the CO(2) phase over the water phase, in violation of Bancroft's rule. This unusual behavior is influenced by the low drainage rate, which makes Marangoni stabilization of less consequence and the strong tendency of emerging holes in the lamella to close as a result of surfactant tail flocculation in CO(2). The high distribution coefficient toward CO(2) versus water is of significant practical interest for mobility control in CO(2) sequestration and enhanced oil recovery by foam formation.