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- Non-pharmacological interventions used during the perioperative period to prevent anxiety in adolescentsPublication . Pestana-Santos, Marcia; Reis Santos, Margarida; Cardoso, Daniela; Lomba, LurdesObjective: The objective of this review is to map the range of non-pharmacological interventions used during the perioperative period to prevent anxiety in adolescents. Introduction: Evidence shows that 80% of adolescents report having experienced significant anxiety in the perioperative period. Non-pharmacological interventions implemented in the perioperative period are recommended as a resource to help to control anticipatory, separation and perioperative anxiety and fear related to surgical procedures in adolescents. Inclusion criteria: This review will consider studies that focus on adolescents aged 10 to 19 who have undergone a surgical procedure, regardless of the type of surgery, and participated in non-pharmacological interventions aimed to prevent anxiety in the perioperative period. The intervention may be provided by any healthcare professional. Studies related to non-pharmacological interventions associated with hospitalization in a non-surgical context will be excluded. Methods: The methodology will follow the JBI recommendations for scoping reviews. Any published and unpublished sources of information will be considered. Studies published in English, Spanish and Portuguese will be included, with no geographical or cultural limitations. Duplicates will be removed and two independent reviewers will screen the abstracts and assess the full text of selected studies, based on the inclusion criteria. The results of study selection will be presented in a Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) flow diagram for scoping reviews. Data synthesis will be presented in a narrative summary to provide a description of the existing evidence.
- Nurses’ Views on How to Best Design a Program to Prevent Adolescents’ Anxiety in the Perioperative Period. A Qualitative StudyPublication . Pestana-Santos, Marcia; Pestana-Santos, Adriana; Cabral, Ivone Evangelista; Reis Santos, Margarida; Lomba, LurdesPurpose: 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 integrativaPublication . Pestana-Santos, Márcia; Reis Santos, Margarida; Pestana-Santos, Adriana; Pinto, Cláudia; Lomba, LurdesBackground: 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.
- More+ oral health with ProSorriso ProgramPublication . Bica, Isabel; Cunha, Madalena; Reis Santos, Margarida; Costa, José; Costa, PatríciaINTRODUCTION AND OBJECTIVE. The proactive involvement of health and education professionals with a focus on development transition groups is an important pillar for achieving the oral health goals for 2020 established by the World Health Organization and require reinforcement of actions for health promotion and prevention of oral diseases. Thus, it is justi+ed to develop a program of oral health promotion in schools, such as ProSorriso (Costa, 2014), in order to evaluate the e9ectiveness of the Program. METHODS. Quasi-experimental study, with measures’ application before and after the implementation of the ProSorriso Program, in 200 adolescents, aged between 11-16 years (mean of 13.21±1.014 years). This Program is developed in three phases: diagnosis, intervention and evaluation of the oral health of adolescents. The application of the Questionnaires of Eating Habits, Oral Hygiene and Oral Health Knowledge, as well as mouth observation according to WHO criteria (1997), occurred before and after participation in the program. RESULTS. Adolescents improved their oral health after active participation in ProSorriso, presenting fewer decayed teeth and more +lled teeth. Their dental plaque bio+lm also improved with signi+cant bene+ts for adolescents who bene+ted from the Program interventions (t = 7.389; p = .000). Adolescents’ knowledge about oral health and nutrition enhanced signi+cantly after participation in the ProSorriso Program (t = -6.510; p = .000); (t = 2.523; p = .012). CONCLUSIONS. Adolescents improved their health status, eating habits, hygiene and oral health knowledge, recognizing the e9ectiveness of the implementation of the ProSorriso Program as a determinant of adolescents present and future health.
- Neuman Systems Model in perioperative nursing care for adolescents with juvenile idiopathic scoliosisPublication . Pestana-Santos, Márcia; Reis Santos, Margarida; Cabral, Ivone Evangelista; Sousa, Paula Cristina; Lomba, Maria de Lurdes Lopes de FreitasObjective: To implement the nursing process, based on the Neuman Systems Model and the International Classification of Nursing Practice terminology, in the care of an adolescent who underwent corrective surgery for juvenile idiopathic scoliosis. Method: This is a qualitative study of the type of single case, with triangulation of data collection techniques (formal clinical interview, notes in a field diary and medical record information), developed with a 17-year-old adolescent and indication for corrective surgery. The empirical materials generated with the interviews carried out at admission and at discharge, observation and medical record information were treated with categorical content analysis. Results: The categories of personal condition, anxiety, selfconcept, meaningful people, facilitating health resources, school, free time and leisure were recurrent. Diagnoses were defined with a focus on Anxiety, Knowledge on pain management (control) and Willingness (or readiness) to learn, associating them with the respective nursing interventions. Conclusion: The Model contributed to assess and recognize surgery stressors for the adolescent and to theoretically base the nursing process. The classification allowed systematizing nursing care records, elements of clinical practice, unifying vocabulary and codes.
- Nonpharmacological interventions used in the perioperative period to prevent anxiety in adolescents: a scoping reviewPublication . Pestana-Santos, Márcia; Pires, Rita; Goncalves, Andreia; Parola, Vitor; Reis Santos, Margarida; Lomba, LurdesObjective: The objective of this scoping review was to examine and map the range of nonpharmacological interventions used in the perioperative period to prevent anxiety in adolescents. Introduction: Undergoing surgery involves experiencing fears and uncertainties that lead to an increase in anxiety levels. The interventions used to prevent anxiety in the perioperative period in adolescents must be appropriate to their developmental stage. Inclusion criteria: Studies involving adolescents (10 to 19 years of age) undergoing any type of surgical procedure and specifying any nonpharmacological interventions administered to prevent anxiety, implemented in the perioperative period, were included in this review. Methods: A comprehensive search strategy using multiple databases was employed to find relevant studies. The databases search included MEDLINE via PubMed; CINAHL Plus with Full Text via EBSCO; Cochrane Central Register of Controlled Trials; LILACS; Scopus; Library, Information Science and Technology Abstracts; PsycINFO; JBI Connectþ; and Cochrane Database of Systematic Reviews. Sources of unpublished studies and gray literature were TDX – Tesis Doctorals en Xarxa (Spain); RCAAP – Reposito´ rio Cientı´fico de Acesso Aberto de Portugal; OpenGrey – System for Information on Grey Literature in Europe; and MedNar. Studies published in English, Spanish, or Portuguese were included. There was no date restriction, or geographical or cultural limitation applied to the search. The relevant studies and their reported outcomes were organized and analyzed. Results: The database search yielded 1438 articles, and three additional records were added after hand searching. Title, abstract, and full-text review identified 11 papers that met the inclusion criteria. The final data set represented 947 participants. The data were analyzed according to the type of nonpharmacological intervention, population, concept (outcome measured and tool used), context (physical location; preoperative vs. postoperative), frequency and duration of the intervention, and which professional team member implemented the intervention. Eight nonpharmacological interventions were identified, applied either in the preoperative or postoperative context. The nurses were the main professionals administering the nonpharmacological interventions to the adolescents. Conclusions: A variety of nonpharmacological interventions were used in the perioperative period to prevent anxiety in adolescents. The most common interventions were music/musicotherapy and hypnosis/guided imagery. However, other interventions such as therapeutic play, preoperative preparation program, mothers’ presence during the anesthesia induction, distraction, relaxation training, massage therapy, and reading were also identified. These interventions were used alone or in a combination of two interventions, either preoperatively or postoperatively. The adolescents in the early stage (10 to 14 years) were the most studied group and the adolescents in the late stage (17 to 19 years) were the least studied. Future research should focus on the implementation of nonpharmacological interventions in the perioperative period involving adolescents, particularly late adolescents. A systematic review on the effect of nonpharmacological interventions for anxiety management in adolescents in the perioperative period should be conducted.