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    Patients' experience of mood while waiting for day surgery. Svensson Margita,Nilsson Ulrica,Svantesson Mia Journal of clinical nursing AIMS AND OBJECTIVES:The aim was to describe the moods experienced by people waiting for day surgery. BACKGROUND:Except for anxiety, there is a lack of knowledge about the moods experienced by patients while waiting for day surgery, as well as the impact of mood during the perioperative period. Preoperative anxiety is common and has multiple negative effects. A deeper knowledge of preoperative moods and how they are experienced is needed and may be useful for improving perioperative care. DESIGN:Qualitative descriptive design. METHODS:Qualitative semi-structured interviews (n = 20) with adults waiting for day surgery in a Swedish university hospital. Data were analysed with inductive content analysis. RESULTS:The informants described a variety of moods and mood-influencing reasons. The main category that emerged was, 'feeling hope about regaining health as a help to balance mood' regardless of mood. This category was abstracted from the generic categories 'experiencing a harmonious mood' and 'experiencing a shifting mood'. The subcategories were 'feeling calm and at ease despite concerns and fear,' 'experiencing expectation,' 'feeling trust and confidence,' 'shifting between expectancy and anxiety,' 'feeling vulnerable and exposed, and 'feeling uncertainty'. CONCLUSIONS:The findings contribute to the knowledge about that regardless of mood, feeling hope about regaining health may help patients to balance their mood during the waiting period. RELEVANCE TO CLINICAL PRACTICE:The results can have implications with respect to developing and improving preoperative care, such as having clinicians extend offers of individual assistance and information during the waiting period to patients experiencing shifting mood. Instilling hopefulness in patients who are waiting for day surgery by means of clinical staff attitudes and interactions may help patients to develop healthy coping strategies and thereby improve their physical and emotional well-being. 10.1111/jocn.13304
    Optimize patient outcomes among females undergoing gynecological surgery: A randomized controlled trial. Johnson Kari,Razo Sherry,Smith Jeannie,Cain Alex,Soper Kathi Applied nursing research : ANR BACKGROUND:Optimizing early education in gynecological procedures utilizing an Enhanced Recovery after Surgery (ERAS) program and a bundle concept may optimize patient outcomes after surgery. PURPOSE:Evaluate whether an ERAS bundle compared to standard education can affect length of stay, 30 day readmission, and patient satisfaction among patients undergoing gynecologic surgery. DESIGN:Prospective, comparative, randomized design SETTING: 28 bed Medical Surgical Unit SAMPLE/INTERVENTION: 50 patients undergoing hysterectomy, 25 who received post-operative evidence based bundle/standard education, and 25 who received standard education packet. Bundle components included 1) early mobilization, 2) early transition to oral pain medication, 3) early feeding, and 4) chewing gum. A follow-up phone call was made in two to three days following discharge for both groups utilizing teach-back. RESULTS:84% (n = 21) patients in the bundle group were discharged in one day. There were no 30 day readmissions for both groups. Twenty two (88%) participants met the bundle components 100% of the time. For the indicator "walking helped with recovery" 100% (n = 25) responded "very good to excellent" for bundle group and 96% (n = 24) responded "very good to excellent" for standard group. Twenty three (92%) of the bundle group felt that that overall nursing care received was very good to excellent and 24 (96%) of the general group felt that overall nursing care received was very good to excellent. CONCLUSION:Optimizing peri-operative education using a bundle approach to provide evidence based interventions can minimize risk and enhance early recovery for females undergoing gynecological surgery. 10.1016/j.apnr.2018.12.005
    Factors influencing day surgery patients' quality of postoperative recovery and satisfaction with recovery: a narrative review. Jaensson Maria,Dahlberg Karuna,Nilsson Ulrica Perioperative medicine (London, England) The aim of healthcare services is to provide a high quality of care. One way to ensure that this aim has been fulfilled is to assess patients' satisfaction with their care. Although satisfaction is a complex concept, it is an important outcome in perioperative care. The objective of this paper is to discuss and reflect on factors that can affect patients' quality of postoperative recovery and satisfaction with recovery after day surgery. Involving patients in shared decision-making (SDM) and providing sufficient preoperative and postoperative information can improve their satisfaction. It is important to assess whether patients experience poor recovery, which can be both distressing and dissatisfying. We suggest that patients' age, sex, mental health status, and health literacy (HL) skills should be assessed preoperatively, since these factors seem to have a negative impact on patients' postoperative recovery. Identifying factors that have a negative impact on patients' quality of postoperative recovery and satisfaction with recovery after day surgery will assist healthcare professionals in supporting vulnerable patients, such as those with limited HL and poor mental health. Treating patients with respect and dignity and providing SDM can increase their quality of postoperative recovery and satisfaction with recovery. 10.1186/s13741-019-0115-1