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Dahlberg, K., Brady, J. M., Jaensson, M., Nilsson, U. & Odom-Forren, J. (2019). Education, Competency and the Role of the PACU Nurse: Results from an international survey. In: : . Paper presented at 5th International Conference for PeriAnaesthesia Nurses (ICPAN 2019), Cancun, Mexico, November 5-8, 2019.
Open this publication in new window or tab >>Education, Competency and the Role of the PACU Nurse: Results from an international survey
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2019 (English)Conference paper, Oral presentation with published abstract (Refereed)
National Category
Nursing
Identifiers
urn:nbn:se:oru:diva-77937 (URN)
Conference
5th International Conference for PeriAnaesthesia Nurses (ICPAN 2019), Cancun, Mexico, November 5-8, 2019
Available from: 2019-11-18 Created: 2019-11-18 Last updated: 2019-11-18Bibliographically approved
Jaensson, M., Dahlberg, K. & Nilsson, U. (2019). Factors influencing day surgery patients’ quality of postoperative recovery and satisfaction with recovery: A narrative review. Perioperative Medicine, 8, Article ID 3.
Open this publication in new window or tab >>Factors influencing day surgery patients’ quality of postoperative recovery and satisfaction with recovery: A narrative review
2019 (English)In: Perioperative Medicine, ISSN 0908-6919, E-ISSN 2047-0525, Vol. 8, article id 3Article, review/survey (Refereed) Published
Abstract [en]

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.

Place, publisher, year, edition, pages
BioMed Central, 2019
Keywords
Ambulatory surgical procedures, Postoperative period, Preoperative period, Patient satisfaction, Quality of healthcare
National Category
Health Care Service and Management, Health Policy and Services and Health Economy Surgery
Identifiers
urn:nbn:se:oru:diva-74137 (URN)10.1186/s13741-019-0115-1 (DOI)000470006900001 ()31139359 (PubMedID)
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare, 2013–4765Swedish Research Council, 2015–02273
Available from: 2019-05-09 Created: 2019-05-09 Last updated: 2019-06-20Bibliographically approved
Dahlberg, K., Jaensson, M., Eriksson, M., Nilsson, U. & Odencrants, S. (2019). Holding it together – patients’ perspectives on postoperative recovery when using an e-assessed follow-up. In: : . Paper presented at 5th International Conference for PeriAnaesthesia Nurses (ICPAN 2019), Cancun, Mexico, November 5-8, 2019.
Open this publication in new window or tab >>Holding it together – patients’ perspectives on postoperative recovery when using an e-assessed follow-up
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2019 (English)Conference paper, Oral presentation with published abstract (Refereed)
Abstract [en]

Background: Today the majority of surgeries are performed as day surgery. After surgery patients are responsible for their own recovery and self-care is a central part of postoperative recovery after day surgery.

Aim: To explore patients’ experience of postoperative recovery after day surgery when using a mobile phone application (app) for follow-up.

Design: Qualitative interview study with a descriptive and explorative design.

Settings: Four day surgery units in different parts of Sweden.

Participants: Eighteen participants who had undergone day surgery, ≥18 years of age and used a mobile app for follow-up on postoperative recovery after day surgery. Participants were purposively selected.

Methods: Interviews were individual and semi-structured. Thematic analysis as described by Braun and Clarke (2006) was used to analyze the data.

Findings: From the data two themes and six subthemes emerged: 1) Give it all you´ve got, with the subthemes Believing in own capacity, Being prepared and Taking action, 2) The importance of feeling safe and sound, with the subthemes Feeling safe and reassured, Not being acknowledged and Not being left alone. The first theme, Give it all you´ve got, describes how participants themselves act and contribute to improve their recovery. The second theme, The importance of feeling safe and sound, describes the importance of support from next of kind and health care during patients postoperative recovery.

Conclusions: Recovery after day surgery is a complex process, in which the patients need to prepare for and manage their recovery. This study highlights the importance of own preparation as crucial for a smooth recovery. Also, to have an easy way to get in contact with health care after day surgery, such as using digital follow up, may be a counteract for feeling left alone after surgery.

Implications for perianaesthesia nurses and future research

In perianesthesia nursing it is important to acknowledge patients need for support during postoperative recovery. It is also important to support patients in their preparation for surgery since this preparation has an impact on how the postoperative recovery is experienced. Further studies should explore how perianesthesia nurses can support patients to improve the pre-recovery phase in order to optimize postoperative recovery.

National Category
Nursing
Identifiers
urn:nbn:se:oru:diva-77936 (URN)
Conference
5th International Conference for PeriAnaesthesia Nurses (ICPAN 2019), Cancun, Mexico, November 5-8, 2019
Available from: 2019-11-18 Created: 2019-11-18 Last updated: 2019-11-18Bibliographically approved
Dahlberg, K., Jaensson, M. & Nilsson, U. (2019). “Let the patient decide” – person-centered postoperative follow-up contacts, initiated via a phone app after day surgery: secondary analysis of a randomized controlled trial. International Journal of Surgery, 33-37
Open this publication in new window or tab >>“Let the patient decide” – person-centered postoperative follow-up contacts, initiated via a phone app after day surgery: secondary analysis of a randomized controlled trial
2019 (English)In: International Journal of Surgery, ISSN 1743-9191, E-ISSN 1743-9159, p. 33-37Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Patients undergoing day surgery are expected to manage their recovery on their own. Follow-up routines differ, but many patients have expressed a need for more professional support during recovery. The aim of this study was to describe how many follow-up contacts were initiated, and when and why, via a digital solution. Also, we wanted to compare postoperative recovery and characteristics between patients requesting, and patients not requesting, contact.

MATERIALS AND METHODS: This was a secondary analysis of a multicenter, two-group, parallel randomized controlled trial. Participants used a digital solution called "Recovery Assessment by Phone Points (RAPP)" for initiating follow-up contacts after day surgery. The quality of postoperative recovery was measured with the Swedish web-version of Quality of Recovery.

RESULTS: Of 494 patients, 84 (17%) initiated contact via RAPP. The most common reasons for initiating contact were related to the surgical wound and pain. Contacts were initiated across the 14-day assessment period, with 62% (62/100) in the first postoperative week. The RAPP contact group had significantly poorer postoperative recovery on days 1-14 compared to those not requesting contact via RAPP (p < 0.001). There was a significantly higher proportion of patients who had undergone general anesthesia in the RAPP contact group (85% [71/84]) compared to the non-RAPP contact group (71% [291/410]), p = 0.003.

CONCLUSION: Letting the patient decide him/herself whether, and when, contact and support is needed during the postoperative period, is possible and does not increase the frequency of contacts. This study investigates a digital solution, RAPP, as one example of a person-centered approach that can be implemented in day surgery follow-up.

Place, publisher, year, edition, pages
Elsevier, 2019
Keywords
Ambulatory surgery, Follow-up, eHealth
National Category
Health Care Service and Management, Health Policy and Services and Health Economy Surgery
Identifiers
urn:nbn:se:oru:diva-70268 (URN)10.1016/j.ijsu.2018.11.022 (DOI)000455016300005 ()30503602 (PubMedID)2-s2.0-85057781234 (Scopus ID)
Funder
Swedish Research Council, 2015-02273Forte, Swedish Research Council for Health, Working Life and Welfare, 2013-4765
Available from: 2018-11-22 Created: 2018-11-22 Last updated: 2019-03-26Bibliographically approved
Nilsson, U., Dahlberg, K. & Jaensson, M. (2019). Low Preoperative Mental and Physical Health is Associated with Poorer Postoperative Recovery in Patients Undergoing Day Surgery: A Secondary Analysis from a Randomized Controlled Study. World Journal of Surgery, 43(8), 1949-1956
Open this publication in new window or tab >>Low Preoperative Mental and Physical Health is Associated with Poorer Postoperative Recovery in Patients Undergoing Day Surgery: A Secondary Analysis from a Randomized Controlled Study
2019 (English)In: World Journal of Surgery, ISSN 0364-2313, E-ISSN 1432-2323, Vol. 43, no 8, p. 1949-1956Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Day surgical procedures are increasing both in Sweden and internationally. Day surgery patients prepare for and handle their recovery on their own at home. The aim of this study was to investigate patients' preoperative mental and physical health and its association with the quality of their recovery after day surgery.

METHOD: This was a secondary analysis of a randomized controlled trial. Data were collected at four-day surgery units in Sweden. Health-related quality of life was measured using the Short Form 36 (SF-36) Health Survey, and postoperative recovery was assessed using the Swedish web version of the Quality of Recovery (SwQoR) scale.

RESULT: This study included 756-day surgery patients. A low, compared with a high, preoperative mental component score was associated with poorer recovery as shown by responses to 21/24 and 22/24 SwQoR items, respectively, on postoperative days (PODs) 7 and 14. A low compared with a high preoperative physical component score was associated with poorer recovery in 18/24 SwQoR items on POD 7 and 13/24 on POD 14.

CONCLUSION: A clear message from this study is for surgeons, anaesthetists and nurses to consider the fact that postoperative recovery largely depends on patients' preoperative mental and psychical status. A serious attempt must be made, as a part of the routine preoperative assessment, to assess and document not only the physical but also the mental status of patients undergoing anaesthesia and surgery.

TRIAL REGISTRATION: Clinicaltrials.gov Identifier: NCT0249219.

Place, publisher, year, edition, pages
Springer, 2019
National Category
Surgery
Identifiers
urn:nbn:se:oru:diva-73538 (URN)10.1007/s00268-019-04995-z (DOI)000473525500010 ()30937487 (PubMedID)2-s2.0-85068542993 (Scopus ID)
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare, 2013-4765Swedish Research Council, 2015-02273
Available from: 2019-04-08 Created: 2019-04-08 Last updated: 2019-08-08Bibliographically approved
Nilsson, U., Dahlberg, K. & Jaensson, M. (2019). Low Preoperative Mental Health can lead to Poorer Postoperative Recovery in Patients Undergoing Day Surgery. In: : . Paper presented at SFAI-veckan, Gothenburg, Sweden, September 11-13, 2019.
Open this publication in new window or tab >>Low Preoperative Mental Health can lead to Poorer Postoperative Recovery in Patients Undergoing Day Surgery
2019 (English)Conference paper, Poster (with or without abstract) (Refereed)
National Category
Nursing
Identifiers
urn:nbn:se:oru:diva-76196 (URN)
Conference
SFAI-veckan, Gothenburg, Sweden, September 11-13, 2019
Available from: 2019-09-10 Created: 2019-09-10 Last updated: 2019-09-10Bibliographically approved
Nilsson, U., Jaensson, M., Dahlberg, K. & Hugelius, K. (2019). Postoperative recovery after general and regional anesthesia in patients undergoing day surgery: A mixed methods study. Journal of Perianesthesia Nursing, 34(3), 517-528
Open this publication in new window or tab >>Postoperative recovery after general and regional anesthesia in patients undergoing day surgery: A mixed methods study
2019 (English)In: Journal of Perianesthesia Nursing, ISSN 1089-9472, E-ISSN 1532-8473, Vol. 34, no 3, p. 517-528Article in journal (Refereed) Published
Abstract [en]

Purpose: To investigate differences and describe experiences of postoperative recovery after day surgery between patients undergoing general anesthesia (GA) versus regional anesthesia (RA).

Design: A mixed methods design.

Methods: Day surgery patients (N = 401) were included. Postoperative recovery was assessed daily for 14 days using the Swedish Web Version of the Quality of Recovery questionnaire included in a mobile application. In addition, qualitative interviews were completed with 20 day surgery patients. Quantitative and qualitative data were first analyzed separately and then merged.

Findings: There were significant differences in Swedish Web Version of the Quality of Recovery between GA and RA on days 1 to 13 (P < .05). These findings could not be confirmed in the qualitative findings, except for psychological issues as well as tiredness and fatigue. Unexpected issues contributed to a greater extent to the theme not feeling well Pain in the surgical wound was overall the biggest problem.

Conclusions: There seems to be a poorer recovery after GA compared with RA. Tiredness or fatigue is present also after minor surgery in RA. Unexpected issues affect recovery negatively, and therefore should be addressed by health care.

Place, publisher, year, edition, pages
Elsevier, 2019
Keywords
day surgery, fatigue, mixed methods, patient experience, patient-reported outcomes, postoperative
National Category
Nursing
Identifiers
urn:nbn:se:oru:diva-68568 (URN)10.1016/j.jopan.2018.08.003 (DOI)000469462400009 ()30470465 (PubMedID)2-s2.0-85057033263 (Scopus ID)
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare, 2013-4765Swedish Research Council, 2015-02273
Available from: 2018-08-24 Created: 2018-08-24 Last updated: 2019-06-18Bibliographically approved
Wångdahl, J., Dahlberg, K., Jaensson, M. & Nilsson, U. (2019). Psychometric validation of Swedish and Arabic versions of two Health literacy questionnaires, eHEALS and HLS-EU-Q16, for use in a Swedish context: A study protocol. BMJ Open, 9(9), Article ID e029668.
Open this publication in new window or tab >>Psychometric validation of Swedish and Arabic versions of two Health literacy questionnaires, eHEALS and HLS-EU-Q16, for use in a Swedish context: A study protocol
2019 (English)In: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 9, no 9, article id e029668Article in journal (Refereed) Published
Abstract [en]

INTRODUCTION: Equity in health and access to healthcare regardless of gender, ethnicity or social position is a major political issue worldwide. Regardless of an individual's knowledge, motivation and competence, individuals are expected to be engaged and take responsibility of their own care. Migrants have been identified as a vulnerable population in healthcare, and an explanation for the inequity in health and in healthcare is limited health literacy. Furthermore, with increasing digitalisation in healthcare, it also puts demand on the individual to have digital or electronic health (eHealth) literacy.The overall aim of this study is to conduct a psychometric evaluation of the Swedish and Arabic versions of HLS-EU-Q16 and eHEALS and to compare Arabic and Swedish speakers' Health literacy and eHealth literacy levels in Sweden.

METHODS AND ANALYSIS: This is a prospective, psychometric evaluation study with the intent of including 300 Arabic-speaking and 300 Swedish-speaking participants. Questionnaires: The Health Literacy Survey European Questionnaire (HLS-EU-Q16) includes 16 items measuring perceived personal skills of finding, understanding, judging and applying health information to maintain and improve their health. The eHealth literacy scale (eHEALS) is an 8-item scale measuring health literacy skills in relation to online information and applications.This study will be conducted in four phases. Phase 1: Translation of HLS-EU-Q16 and eHEALS from English to Swedish and Arabic versions following the principles of translation of questionnaires. Phase 2: Content validity testing of eHEALS, including face validity and interpretability, conducted with five Arabic and five Swedish-speaking participants. Phase 3: Psychometric testing including construct validity, reliability, feasibility and floor ceiling effects. Phase 4: Distribution and comparison of eHealth and HLS-EU-Q16 analysed with χ2 and Fisher's exact test as appropriate. To assess associations between HLS-EU-Q16, eHEALS and demographic variables, binary logistic regression analyses will be performed.

ETHICS AND DISSEMINATION: The project has been approved by the regional ethical review board in Stockholm, Sweden (2019/5:1) and will follow the principles outlined in the 1964 Helsinki Declaration and its later amendments. Results from this study will be disseminated in peer-reviewed journals, scientific conferences and social media.

Place, publisher, year, edition, pages
BMJ Publishing Group Ltd, 2019
Keywords
eHealth, health literacy, psychmetric evaluation
National Category
Health Care Service and Management, Health Policy and Services and Health Economy
Identifiers
urn:nbn:se:oru:diva-76197 (URN)10.1136/bmjopen-2019-029668 (DOI)31530602 (PubMedID)
Available from: 2019-09-10 Created: 2019-09-10 Last updated: 2019-09-23Bibliographically approved
Dahlberg, K., Jaensson, M. & Nilsson, U. (2019). RAPP - digital uppföljning efter dagkirurgi. Svensk Kirurgi, 77(1), 37-39
Open this publication in new window or tab >>RAPP - digital uppföljning efter dagkirurgi
2019 (Swedish)In: Svensk Kirurgi, ISSN 0346-847X, Vol. 77, no 1, p. 37-39Article in journal (Other academic) Published
Place, publisher, year, edition, pages
Stockholm: Svensk kirurgisk förening, 2019
National Category
Surgery
Identifiers
urn:nbn:se:oru:diva-76460 (URN)
Available from: 2019-09-16 Created: 2019-09-16 Last updated: 2019-09-17Bibliographically approved
Falk-Brynhildsen, K., Jaensson, M., Bridgid, G. & Nilsson, U. (2019). Swedish operating room nurses and nurse anesthetists' perceptions of competence and self-efficacy. Journal of Perianesthesia Nursing, 34(4), 842-850
Open this publication in new window or tab >>Swedish operating room nurses and nurse anesthetists' perceptions of competence and self-efficacy
2019 (English)In: Journal of Perianesthesia Nursing, ISSN 1089-9472, E-ISSN 1532-8473, Vol. 34, no 4, p. 842-850Article in journal (Refereed) Published
Abstract [en]

Purpose: To compare perceived competence and self-efficacy (SE) among Swedish operating room (OR) nurses and registered nurse anesthetists (RNAs), and to evaluate the relationship between SE and competence, gender, age, and years of experience.

Design: Comparative cross-sectional survey.

Methods: Two validated questionnaires, Perceived Perioperative Competence Scale-Revised and General Self-Efficacy Scale, were sent to members of the Swedish Association of Health Professionals (n = 2,902).

Findings: The response rate was 39% (n = 1,033). OR nurses showed significantly higher scores on Perceived Perioperative Competence Scale-Revised subscale foundational knowledge and leadership as well as General Self-Efficacy Scale scores compared with RNAs. The RNA group showed significantly higher empathy scores compared with OR nurses. Among the OR nurses professional development made the strongest contribution to SE and proficiency among the RNAs.

Conclusions: These results suggest that there are differences in perceived competence and SE between OR nurses and RNAs. Gender may be an independent factor affecting SE.

Place, publisher, year, edition, pages
Elsevier, 2019
Keywords
perceived competence, operating room, perioperative nursing, self-efficacy
National Category
Nursing
Identifiers
urn:nbn:se:oru:diva-69422 (URN)10.1016/j.jopan.2018.09.015 (DOI)000477975200024 ()30738727 (PubMedID)2-s2.0-85061049228 (Scopus ID)
Available from: 2018-10-08 Created: 2018-10-08 Last updated: 2019-08-14Bibliographically approved
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ORCID iD: ORCID iD iconorcid.org/0000-0001-7574-6745

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