Swan BA.
AHSR FHSR Annu Meet Abstr Book. 1996; 13: 194-5.
School of Nursing, University of Pennsylvania, Philadelphia 191014, USA.
RESEARCH OBJECTIVE: Despite the widespread development of ambulatory surgery, there has been little critical evaluation of patient outcomes following ambulatory surgery and the relationship of the change and growth in ambulatory surgery nursing practice on patient outcomes. The purpose of the study was to examine the relationship of patient perceived nurse caring behaviors to symptom distress and functional status in adult ambulatory surgical patients. STUDY POPULATION: A consecutive sample of 126 consenting adults, ages 18 to 64 years and conversant in English, who had elective ambulatory surgery with regional or general anesthesia, or monitored anesthesia care (intraventous sedation) were recruited to the study from an urban academic medical center, a suburban community hospital, and a suburban teaching hospital. STUDY DESIGN: A non-experimental, prospective, single cohort design that encompassed one preoperative and three postoperative time periods was used to answer the study questions. Following informed consent, routine demographic data was collected from the patient interview and obtained from the medical record. Measurements of symptom distress and functional status were obtained through four verbal interviews - one preoperative in person interview and three postoperative telephone interviews. Measurements of patient perceived nurse caring behaviors were obtained for the preoperative evaluation visit and postoperative recovery period. Symptom distress was measured with the General Symptom Distress Scale (GSDS) (Lalonde, 1987). The Functional Status Questionnaire (FSQ) (Jette et al., 1986) was used to measure functional status, and patient perceived nurse caring behaviors were measured using the Caring Behaviors Inventory (CBI) (Wolf, Giardino, Osborne, & Ambrose, 1994). Comorbidity was categorized according to the American Society of Anesthesiologists' (ASA) Physical Status classification. PRINCIPAL FINDINGS: Symptom distress remained significantly increased until the seventh day post surgery, particularly in the ASA physical status classification III group. Subjects experienced low levels of functional status including intermediate activities of daily living, social activity, social interaction, and role function during the first seven days post surgery, particularly in the ASA physical status classification III group. Symptom distress was inversely related to functional status preoperatively and continued until the seventh day post surgery. In general, symptom distress accounted for a significant amount of the variance in functional status not accounted for by ASA physical status classification. Postoperative patient perceived nurse caring behaviors explained ten percent of the variance in symptom distress post surgery, that was not accounted for by ASA physical status classification or preoperative symptom distress. These behaviors explained between seven percent and 15.6 percent of the variance in functional status following ambulatory surgery, that was not accounted for by ASA physical status classification or preoperative functional status. CONCLUSIONS: This examination of symptom distress and functional status in adults following ambulatory surgery, and the role patient perceived nurse caring behaviors plays, extends current empirical knowledge about the relationships between these three variables. Further, the study findings enhance our understanding of postoperative home recovery in ambulatory surgery adults. RELEVANCE TO CLINICAL PRACTICE, HEALTH CARE DELIVERY AND POLICY: This research established a link between nurse caring behaviors and patient outcomes. With this knowledge, nursing interventions during the preoperative and postoperative periods can be planned and evaluated. These nursing interventions may add to the clinically relevant question of whether positive patient outcomes can be predicted before the patient leaves the ambulatory surgery recovery room. For example, assessment of patient and caregiver home readiness, allows nurses to more efficiently intervene with patients and their caregivers while they are still in the hospital.
Publication Types:
Keywords:
- Activities of Daily Living
- Adult
- Ambulatory Surgical Procedures
- Anesthesia
- Anesthesia, General
- Behavior
- Caregivers
- Comorbidity
- Empathy
- Evaluation Studies
- Humans
- Longitudinal Studies
- Nurses
- Postoperative Period
- Stress, Psychological
- Surgical Procedures, Elective
- rehabilitation
- surgery
- hsrmtgs
Other ID:
UI: 102222418
From Meeting Abstracts