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  • Nurses’ Views on How to Best Design a Program to Prevent Adolescents’ Anxiety in the Perioperative Period. A Qualitative Study
    Publication . Pestana-Santos, Marcia; Pestana-Santos, Adriana; Cabral, Ivone Evangelista; Reis Santos, Margarida; Lomba, Lurdes
    Purpose: To describe the nurses' views for consideration when designing a program to prevent adolescents' anxiety in the perioperative period. Design: A qualitative descriptive case study using focus group and thematic analysis was conducted. Methods: Three face-to-face focus group interviews were conducted in October and November 2019 in the pediatric department of a university hospital. A purposive criterion method was applied to achieve a sample of 19 pediatric nurse specialists. Data were organized and systematized in the professional software for qualitative and mixed methods data analysis software (MAXQDA) and treated through the thematic analysis method. The COREQ checklist was used to report data collection, analysis, and results. Findings: Four major themes and 14 subthemes regarding the perioperative period were generated. The first, adolescent evaluation, included the knowledge evaluation about procedures, signs and symptoms, and desire to be engaged in care. The second, caring adolescents and parents, means that nurses must be ready to care for both, use the opportunities to implement the nursing interventions, and manage physical teen space to accommodate adolescents in the ward. The third, nurses' challenges in the perioperative period, comprise the lack of time and trained nurses to work with adolescents, and the absence of prior adolescents' preparation and postoperative feedback. The fourth, nursing consultation, consists in promoting interdisciplinarity, developing the nursing interventions, and the main content to be included in the program's design. Conclusions: Given the challenges experienced by nurses when caring for adolescents in the perioperative period, nurses suggested a systematized assessment of the adolescent at an early stage of the perioperative caring process. Added to this is the nurse’s readiness for the adolescent and parents, as well as the existence of trained nurses to evaluate adolescents and to implement non-pharmacological interventions in the perioperative period. A nursing consultation emerges as the most suitable solution to include in a program to prepare adolescents for the surgical procedure and help them to manage anxiety. This kind of intervention should begin in the preoperative period, preferably after the decision on the need for the procedure.
  • Ansiedade perioperatória em adolescentes: manifestações e necessidades de controlo. Revisão integrativa
    Publication . Pestana-Santos, Márcia; Reis Santos, Margarida; Pestana-Santos, Adriana; Pinto, Cláudia; Lomba, Lurdes
    Background: In a phase of development as complex as adolescence, the surgical experience is a great challenge. While there is some knowledge about manifestations of anxiety in children, less is known about manifestations of anxiety in adolescents. Likewise, the knowledge about adolescents needs for control of anxiety in the perioperative period is missing. Aims: To synthesize the existing research on the manifestations of anxiety in adolescents in the perioperative period and to identify the adolescents needs for control of anxiety in the perioperative period. Methods: An integrative review was conducted using a literature search in five different health databases. Only original studies related to the study topic were included. A six-step method was used to develop the revision and to analyze the results. Results: Of the 251 articles initially selected, only five met the inclusion criteria. A total of 114 adolescents from five different countries were represented. The manifestations of anxiety were grouped in psychological, social and physical. These manifestations were mostly related with fear of surgery, how would they deal with pain, body image change, anxiety itself and the separation from their friends. The needs were ‘to be informed’ and ‘to be involved in the decisions about their own care process’. Conclusions: The adolescents have manifestations of anxiety and specific needs to deal with perioperative anxiety, which need to be taken into account in the planning of perioperative care. Further research is needed to promote the development of an evidence-based program tailored to answer to the adolescent’s needs and to minimize their manifestations of anxiety in the perioperative period.