ABSTRACT
Perioperative nurses traditionally have helped patients cope with the adversities of surgery through preoperative instruction. The authors conducted a study to determine whether an efficacy-enhancing preoperative teaching protocol was effective in increasing preoperative self-efficacy in patients scheduled to undergo laparoscopic cholecystectomy procedures with general anesthesia. The subjects were 60 surgical patients in a 156-bed community hospital located in the midwestern United States. Analysis of covariance indicated there were no significant differences between groups after controlling for preoperative self-efficacy. Further research is needed to determine whether an efficacy-enhancing teaching protocol can improve selected short- and long-term outcomes in surgical patients.
Subject(s)
Cholecystectomy, Laparoscopic , Patient Education as Topic/methods , Self Concept , Adolescent , Adult , Aged , Aged, 80 and over , Cholecystectomy, Laparoscopic/adverse effects , Cholecystectomy, Laparoscopic/nursing , Cholecystectomy, Laparoscopic/psychology , Humans , Middle Aged , Midwestern United States , Models, Psychological , Perioperative Nursing , Preoperative CareABSTRACT
Lack of standardization in formulas for calculating absenteeism impeded comparison among institutions and comparison to rates reported for the health care industry. Even though illness related benefits, replacement costs for absent employees and attendance incentives absorbed scarce financial resources, more than 40% of hospitals had no standard for excessive absence. Directors of nursing were concerned about staffing and the possibility that employees were tiring to the point of becoming ill. Among directors, concern about absenteeism was greatest in urban hospitals of 100-200 beds.
Subject(s)
Absenteeism , Nursing Staff, Hospital/supply & distribution , Acute Disease/nursing , Employee Discipline , Humans , Nurse Administrators , Organizational PolicyABSTRACT
Nurses conduct preoperative teaching to help patients cope with the adversities of surgery. Self-efficacy can predict an individual's behavior in aversive situations (eg, surgery); therefore, assessing patients' self-efficacy is one way perioperative nurses can plan patient care and help patients through the surgical experience. This study expands on the results of a previous evaluation of a preoperative self-efficacy scale. The content and face validity of the revised 15-item scale used in this study were assessed before the instrument was administered to preoperative patients. Evidence supports the validity of the multidimensional instrument. Internal consistency estimates > or = .84 support the subscales' reliability.
Subject(s)
Perioperative Nursing , Preoperative Care/nursing , Self Care/psychology , Self-Assessment , Surgical Procedures, Operative/psychology , Adult , Aged , Aged, 80 and over , Evaluation Studies as Topic , Female , Humans , Knee Prosthesis/nursing , Knee Prosthesis/psychology , Male , Middle Aged , Patient Education as Topic , Postoperative Period , Reproducibility of Results , Surveys and Questionnaires/standardsABSTRACT
Self-efficacy has been validated as a predictor of an individual's behavior in aversive situations. Traditionally, nurses have conducted preoperative instruction to help patients cope with the adversities of surgery. Assessing patients' self-efficacy is an additional way to assist them through the experience of surgery and plan their care. This study developed and tested an instrument to measure self-efficacy in adult preoperative patients. The instrument consists of two subscales: a 16-item efficacy expectation subscale and a 16-item outcome expectation subscale. The instrument was administered to 200 surgical patients to obtain descriptions of item characteristics, internal consistency reliability, and beginning construct validity. Evidence supports the validity and reliability of both self-efficacy subscales. The revised instrument can assist perioperative nurses in assessing preoperative patients' self-efficacy.
Subject(s)
Adaptation, Psychological , Self-Assessment , Surgical Procedures, Operative/psychology , Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Operating Room Nursing , Psychometrics , Reproducibility of Results , Surgical Procedures, Operative/nursing , Surveys and Questionnaires/standardsABSTRACT
Preoperative instruction has been found to decrease postoperative complications; however, the mechanisms through which preoperative instruction exerts its effects remain unknown. In this study, the relationship between preoperative self-efficacy and postoperative behaviors was investigated. Subjects were 68 cholecystectomy patients. Subjects' scores on the efficacy expectations subscale were related significantly to postoperative deep breathing, ambulation, and recall of expected events; scores on the outcome expectations subscale were related significantly to postoperative requests for pain medication. Self-efficacy theory provided a link between self perceptions and behavior and may be the mechanism through which preoperative instruction exerts its effects.
Subject(s)
Cholecystectomy/nursing , Patient Education as Topic/standards , Postoperative Care/psychology , Preoperative Care/standards , Self Care/standards , Adult , Aged , Cholecystectomy/psychology , Health Behavior , Humans , Middle Aged , Nursing Evaluation Research , Preoperative Care/psychology , Self Care/psychologyABSTRACT
These investigators describe the characteristics of nurse anesthesia research reported in the AANA Journal in 1975-1976 and 1985-1986 and compare nurse anesthesia research to overall nursing research as reported by Brown, Tanner and Padrick. The amount of nurse anesthesia research remained stable, with an even greater focus on clinical practice than in nursing research overall. The 1980's research, as in all nursing, was more theoretically oriented than the 1970's studies. Nurse anesthesia research designs were mainly descriptive, with a trend toward explanatory and prospective. As in all nursing research, convenience samples of hospitalized individuals were most common. More pronounced in nurse anesthesia research than in nursing overall were deficiencies in reporting of reliability and validity of data, psychometric evaluation of instruments and use of statistics. Trends toward CRNA authorship and addressing ethical concerns were identified. Recommendations included increased emphasis on methodological studies, conceptual links and statistical analysis; extension to topics of nursing education and administration and characteristics of nurses; and replication of studies.