CONTROLL TRIAL OF THE SUBJECTIVE PA...

CONTROLL TRIAL OF THE SUBJECTIVE PATIENT BENEFITS OF ACCOMPANIED WALKING TO THE OPERATING THEATRE L A Turnbull N forest G Kester International Journal of Clinical Practice Vol 52 (March 1998) 81-83

Research indicates that there is a positive relationship between preoperative anxiety and pain and nausea. Investigators have convoyed studies on ways to attenuate preoperative anxiety using relaxation treatment, biofeedback, and preoperative visits by means of OR nurses. The authors of this studious mood hypothesized that patients who are more in have charge of of events and more somatically active during the immediate preoperative period might be wrought up more mentally prepared for surgery

design The purpose of this investigation was to determine

* whether walking to the OR affected patients' perceptions of their preoperative state of mind in a positive way, and

* whether patients who have the option to walk, rather than be taken to the OR upon a trolley, was perceived as an improvement in care.

rules The sample consisted of 100 surgical patients chosen from a mixed-specialty ward for general; orthopedic; ear, nose, and throat; gynecologic; and ophthalmic surgical performances Patients who were excluded were those requiring premedication and those with impaired mobility. All patients meeting access criteria were chosen during a six-week period in 1996 at a private hospital in southern England. Eligible patients were placed randomly into the experimental form into groups (ie, walking) or into the rule group (ie, trolley).

Hospital ethical committee clearance and informed acquiescence were obtained for each patient. Each participant was asked to fill not at home a questionnaire and return it before discharge. Information obtained using the questionnaires included patients'

* basic demographic information,

* previous experience with surgery

* preoperative anxiety and concerns

* choice concerning means of conveyance to the OR, and

* perceived quality of care.

Seventy-eight patients answered the questionnaires. Twenty-two patients failed to go [i]or[/i] come back completed questionnaires, but otherwise took part in the cogitation The data were analyzed using the chi-square touchstone and Fisher's exact test.

rises Anxiety is decreased and relaxation is increased when patients walk to the OR. most numerous patients want the choice of walking to the OR or being transmited by trolley. Patients indicated that being given a choice was an improvement in care. Also, the number of manual handling changes carried out by hospital staff members was reduc from five to three by means of patient.

The experimental cluster had experience with both customs of conveyance (ie, walking and riding by the agency of trolley). In the experimental assign places to 76% of the patients had a previous experience with surgery Of the 76% of patients with previous experience with surgery 78% were transported to the OR forward a trolley. The researchers assumed that the regulate group had never experienced walking to the OR before surgery Seventy-five percent of the govern group found that their system of conveyance made them have feeling more relaxed. Overall, there were no statistical differences with sex or age.

Patients were given the opportunity to note on the questionnaire about vexed questions they experienced. Comments by patients in the walking clump were mostly favorable, but there were a critical remarks. For example, individual patient said he did not have feeling comfortable walking only in a gown and slippers.

Discussion. The terminates of the study illustrate the value of patient's feeling that he or she retains a measure of autonomy. The investigators' findings imply that any amount of personal ascendency a patient can exercise, flat in circumstances of extreme vulnerability, increases that individual's comfort flush with the circumstances. This is an example of by what means choices or decisions that patients undergoing surgery can make may be derived in patients' feeling more comfortable in an anxiety-producing situation. For the perioperative give suck to walking patients to the OR bring tos the number of potentially hazardous manual moves by staff members. This can no other than benefit surgical patients, especially those who will be subjected to extensive positioning in the OR.

In addition to patients' benefits, perioperative managers could benefit financially from walking patients to surgery Staff members could be used in other areas, although they would still be required to help in transporting patients postoperatively. Efficiency savings are valuable for the patients, surgical personnel and postoperative caregivers.

ROSIE lee-side CALVIN RN, DNS NURSING RESEARCH COMMITTEE

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