局部或区域麻醉手术中意识清醒的意义--现象学诠释学研究

IF 3.1 Q1 NURSING International Journal of Nursing Studies Advances Pub Date : 2024-07-05 DOI:10.1016/j.ijnsa.2024.100224

Marie Häggström, Kerstin Brodin

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引用次数: 0

摘要

背景随着局部麻醉或区域麻醉下手术的日益普及，患者在术中阶段可以保持清醒，因此越来越有必要了解与这种做法相关的生活经历。方法采用现象学--语言学方法对逐字转录的文本进行分析。结果在手术过程中清醒的生活体验的特点是希望感与失去身份和经历不稳定的感觉并存。结构分析揭示了两个主题。第一个主题是 "掌握在他人手中"，包括 "进入一个陌生的环境和程序"、"失去立足点和自我认同感 "以及 "忍受意料之外或预料之中的不适 "等子主题。第二个主题是 "处理不可避免的未来健康问题"，其中包括 "追求对现状的自我接受"、"信任专业人士，同时寻求手术顺利进行的迹象 "和 "通过持续支持增强自身复原力 "等副主题。护理的四个元范式--人、健康、环境和护理--对有意识的患者的体验有重大影响。患者或公众的贡献没有患者或公众的贡献

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The meaning of being conscious during surgery with local or regional anesthesia–A phenomenological hermeneutic study

Background

With increasing prevalence of surgery under local or regional anesthesia, which allows patients to remain conscious during the intraoperative phase, there is a growing need to comprehend the lived experiences associated with this practice.

Objective

This study aimed to illuminate the lived experiences of individuals who remained conscious during surgical intervention under local or regional anesthesia.

Design

A qualitative design was chosen.

Setting(s)

Participants in the present study were recruited from three surgical wards located in central Sweden using a purposive sampling strategy. The surgical disciplines included ear, gynecological, hernioplasty, orthopedic, and vessel surgeries.

Participants

Fourteen narrative interviews were conducted with individuals who had undergone elective surgery while conscious.

Methods

Verbatim transcribed text was analyzed using a phenomenological-hermeneutic method.

Results

The lived experience of being conscious during surgery was marked by feelings of hope alongside a sense of losing one's identity and experiencing destabilization. Structural analysis revealed two themes. The first theme, 'being in the hands of others', encompassed subthemes such as 'entering an unfamiliar environment and procedure,' 'losing foothold and a sense of self-identity,' and 'enduring unexpected or anticipated discomfort.' The second theme, 'managing the inevitable for future health concerns,' involved subthemes such as 'pursuing self-acceptance of the situation,' 'entrusting the professionals while seeking signs of a smooth procedure,' and 'Enhancing own resilience through continuous support.

Conclusions

Beyond the patient's physical well-being during surgery, the OR team should acknowledge the "person" component and focus on their emotional and social needs in this vulnerable situation. The four meta-paradigms of nursing—person, health, environment, and nursing—significantly influence the conscious patient's experience.