Design of a Nursing Intervention Program to Prevent Adolescents' Perioperative Anxiety

Marcia Pestana-Santos, Adriana Pestana-Santos, Inês Esteves Martins, Margarida Reis Santos, Lurdes Lomba
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Abstract

Introduction Adolescents undergoing surgery have expressed a willingness to obtain information about their surgery and to be involved in the decisions about their health care process. Around 80% of adolescents experience anxiety before undergoing surgery. On the basis of the adolescents' shared experiences, areas of possible nursing intervention have been identified to prevent anxiety and the multitude of adverse effects associated with it. The purpose of this study is to present a nursing intervention program to prevent perioperative anxiety in adolescents (3P2A) designed based on the first phase of the complex intervention's framework. Methods The design of this program followed the updated guidance for developing complex interventions issued by the Medical Research Council and the National Institute for Health Research. Five Portuguese nurses, experts in perioperative nursing, and pediatric specialists evaluated and validated the final version of this program. Results The nursing intervention program to prevent perioperative anxiety in adolescents (3P2A) consists of three phases that correspond to the preoperative, intraoperative, and postoperative periods. The first phase includes conducting a preoperative nursing consultation to identify stressors, providing written and verbal information about the surgery, and applying nonpharmacological interventions to reduce anxiety. In the intraoperative period, nonpharmacological interventions are implemented in the anesthetic induction room immediately before the adolescent falls asleep. Finally, the postoperative period comprises a nursing visit to identify postoperative complications and promote the adolescents' well-being. Discussion The program is structured with specific interventions to be implemented in each of the perioperative periods. Because of its flexibility, it may be fully or partially implemented considering the identified needs, priorities, and resources when caring for an adolescent with anxiety during the perioperative period.
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预防青少年围手术期焦虑的护理干预方案设计
引言接受手术的青少年表示愿意获得有关他们手术的信息,并参与有关他们医疗保健过程的决策。大约80%的青少年在接受手术前会感到焦虑。根据青少年的共同经历,已经确定了可能的护理干预领域,以预防焦虑及其相关的多种不良影响。本研究的目的是提出一个基于复杂干预框架的第一阶段设计的预防青少年围手术期焦虑的护理干预计划(3P2A)。方法该项目的设计遵循了医学研究委员会和国家卫生研究所发布的关于制定复杂干预措施的最新指南。五名葡萄牙护士、围手术期护理专家和儿科专家对该计划的最终版本进行了评估和验证。结果预防青少年围手术期焦虑的护理干预计划(3P2A)包括三个阶段,分别对应于术前、术中和术后阶段。第一阶段包括进行术前护理咨询,以确定压力源,提供有关手术的书面和口头信息,并应用非药物干预措施来减少焦虑。在术中阶段,在青少年入睡前立即在麻醉诱导室进行非药物干预。最后,术后阶段包括一次护理访问,以确定术后并发症并促进青少年的健康。讨论该计划的结构包括在每个围手术期实施的具体干预措施。由于其灵活性,在围手术期照顾焦虑青少年时,考虑到已确定的需求、优先事项和资源,可以完全或部分实施。
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