Background
Perioperative experience can be very distressing in adolescence if not managed properly by healthcare professionals. In the clinical context, the emotional expression of the adolescent is less spontaneous, which makes the assessment of anxiety, pain or even the desire to be involved in the perioperative process, difficult. Listening to their perioperative experiences will permit an understanding of their difficulties and expectations, regardless of the surgical intervention undergone.
Aim
To explore the adolescents’ perioperative experiences in relation to inpatient and outpatient elective surgery.
Methods
Qualitative exploratory study, with thematic analysis approach. A purposive sample of 40 adolescents aged 14–18 years and in the perioperative period, from two paediatric surgery settings in a university hospital, was questioned from January to July 2020. Data were collected using a semi‐structured interview and analysed inductively with qualitative thematic analysis.
Results
The data yielded one major theme, five themes, and 14 sub‐themes. The major theme, Adolescent in perioperative period, included the five themes: (1) emotional and psychological aspects; (2) physical aspects; (3) social aspects; (4) organizational aspects; (5) previous surgical experience. Adolescents expressed fear of the unknown, anxiety, difficulty in pain control, and feelings of autonomy loss. Issues related to withdrawal from school and friends is also a focus of adolescent concern during the perioperative period. Despite showing satisfaction with the way they were cared for, they complained about the lack of pre‐ and post‐operative preparation.
Conclusion
There are aspects that should be considered when caring for adolescents in perioperative period. As far as possible, programmes to prevent adolescents’ anxiety in perioperative period should be designed in a holistic perspective, with aim at the psychological, physical, sociocultural, and organisational aspects.
Introduction
Adolescents undergoing surgery have expressed a willingness to obtain information about their surgery and to be involved in the decisions about their health care process. Around 80% of adolescents experience anxiety before undergoing surgery. On the basis of the adolescents' shared experiences, areas of possible nursing intervention have been identified to prevent anxiety and the multitude of adverse effects associated with it. The purpose of this study is to present a nursing intervention program to prevent perioperative anxiety in adolescents (3P2A) designed based on the first phase of the complex intervention's framework.
Methods
The design of this program followed the updated guidance for developing complex interventions issued by the Medical Research Council and the National Institute for Health Research. Five Portuguese nurses, experts in perioperative nursing, and pediatric specialists evaluated and validated the final version of this program.
Results
The nursing intervention program to prevent perioperative anxiety in adolescents (3P2A) consists of three phases that correspond to the preoperative, intraoperative, and postoperative periods. The first phase includes conducting a preoperative nursing consultation to identify stressors, providing written and verbal information about the surgery, and applying nonpharmacological interventions to reduce anxiety. In the intraoperative period, nonpharmacological interventions are implemented in the anesthetic induction room immediately before the adolescent falls asleep. Finally, the postoperative period comprises a nursing visit to identify postoperative complications and promote the adolescents' well-being.
Discussion
The program is structured with specific interventions to be implemented in each of the perioperative periods. Because of its flexibility, it may be fully or partially implemented considering the identified needs, priorities, and resources when caring for an adolescent with anxiety during the perioperative period.
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