OBJECTIVES: to analyze the relationship between preoperative emotional state and the prevalence and intensity of postoperative pain and to explore predictors of postoperative pain. METHOD: observational retrospective study undertaken among 127 adult patients of orthopedic and trauma surgery. Postoperative pain was assessed with the verbal numeric scale and with five variables of emotional state: anxiety, sweating, stress, fear, and crying. The Chi-squared test, Student's t test or ANOVA and a multivariate logistic regression analysis were used for the statistical analysis. RESULTS: the prevalence of immediate postoperative pain was 28%. Anxiety was the most common emotional factor (72%) and a predictive risk factor for moderate to severe postoperative pain (OR: 4.60, 95% CI 1.38 to 15.3, p<0.05, AUC: 0.72, 95% CI: 0.62 to 0.83). Age exerted a protective effect (OR 0.96, 95% CI: 0.94-0.99, p<0.01). CONCLUSION: preoperative anxiety and age are predictors of postoperative pain in patients undergoing orthopedic and trauma surgery.

Background:Knowing the organizational factors that predict burnout in perioperative nurses is paramount for improving the care of patients and promoting nurses’ psychosocial well-being and health.Objective:To determine the influence of organizational factors of the perioperative nurse's work environment on the three burnout dimensions: emotional exhaustion, despersonalization, and personal accomplishment.Method:A cross-sectional study was conducted among 136 nurses in a perioperative care unit at a university hospital in Barcelona, Spain. Data were collected using a demographic data form, and the Spanish versions of the Practice Environment Scale of the Nursing Work Index and Maslach Burnout Inventory.Results:Findings showed emotional exhaustion in 43% (56) of nurses, depersonalization in 21% (28), and reduced personal accomplisment in 53% (69). The degree of general burnout was moderate.The work environment was considered unfavourable as only one factor of five was favourable (Nursing foundations of quality care). Multiple regression analyses showed three organizational factors were associated with all three dimensions of burnout: “Nurse manager ability, leadership, and support of nurses”; “Staffing and resources adequacy”; and “Nursing foundations of quality care”.Conclusions:In this study three organizational factors played a significant role in predicting burnout among perioperative nurses. We recommend hospital management implement policies to improve these organizational factors. Promoting positive leadership styles, providing necessary resources, and creating a positive climate in the work environment could increase psychosocial wellbeing and decrease burnout among perioperative nurses.

Objective: to investigate how the perioperative work environment affects work dissatisfaction, professional exhaustion and the perception of the quality of care about the intention of abandoning the work of perioperative nurses. Method: cross-sectional study with 130 nurses working in the surgical area of a high-tech Spanish public university hospital. The scale of the nursing practice environment, Maslach’s exhaustion inventory, the questions about job satisfaction, the perception of the care quality and intention to abandon work to collect data were used. Descriptive, inferential and logistic regression statistics were made. Results: in general, 20% of perioperative nurses would want to quit their work. The dimension of the work environment of staff and resources, dissatisfaction and emotional exhaustion in nurses were factors that indicated the intention of perioperative nurses to abandon work. Conclusion: the implementation of strategies for the retention of perioperative nurses should be considered, improving the factors that indicate how the work environment, especially the allocation of personnel and resources, dissatisfaction and emotional exhaustion. Creating positive work environments based on magnetic values can be a key strategy.

Objetivo: investigar a segurança e a satisfação de pacientes e sua relação com os cuidados dos enfermeiros no perioperatório. Método: estudo multinível, transversal, correlacional, realizado com 105 enfermeiros da área cirúrgica e 150 pacientes operados em um hospital terciário espanhol. Para os enfermeiros foram coletadas as variáveis sociodemográficas, a percepção do ambiente de trabalho, o desgaste profissional e a satisfação no trabalho. Para os pacientes, a segurança de eventos adversos e nível de satisfação, por meio de registros e questionários. Utilizou-se análise multinível, univariada e multivariada. Resultados: satisfação no trabalho, compromisso profissional e participação em questões hospitalares foram preditores negativos para eventos adversos relacionados ao paciente, enquanto o cuidado do enfermeiro no pós-operatório foi um preditor positivo. Conclusão: observa-se aumento dos eventos adversos quando os enfermeiros têm insatisfação no trabalho, menor compromisso profissional e baixa disponibilidade para participar nos assuntos de sua unidade. Por outro lado, os eventos adversos diminuem quando os enfermeiros realizam os cuidados no pós-operatório. A satisfação foi boa e não houve associação com as características do cuidado dos enfermeiros. Recomenda-se melhorar esses preditores para aumentar a segurança de pacientes cirúrgicos.

Objective:Although numerous studies have assessed patient satisfaction in diverse settings, in the realm of nursing surgical care, standardization of measurement for patient experience and satisfaction is lacking. Therefore, the aim of this study was to assess the satisfaction of surgical patients with perioperative nursing care.Method:A descriptive cross-sectional survey was conducted. Sociodemographic characteristics and clinical data were recorded. Patient satisfaction was measured with a modified version of the La Monica–Oberst Patient Satisfaction Scale (LOPSS-12).Results:150 patients (73 women, 49% and 77 men; 51%) completed the survey. The mean age was 63 years (standard deviation, 16 years). The mean overall satisfaction score on the La Monica–Oberst Patient Satisfaction Scale was 3.17 (standard deviation, 0.21). The scale showed adequate content validity (Lawshe’s Content Validity Index was 0.76) and moderate reliability (Cronbach’s alpha = 0.70). Two variables—patient sex and the presence of comorbidities—were significantly associated with overall satisfaction: men and patients with comorbidities were more satisfied with the care received. Patients with university studies were significantly more likely than patients with less education to consider nurses “impatient,” but also considered the nurses’ advice to be “useful.” Patients with hospital-acquired complications were more likely to perceive nurses to be “more interested in completing tasks than in listening,” although they also felt that nurses worked “conscientiously.”Conclusion:Overall, patient satisfaction with perioperative nursing care was good. This study identified several areas of nursing care in need of improvement, particularly the need to spend more time with patients and to keep them better informed about the perioperative process. The modified La Monica–Oberst Patient Satisfaction Scale is suitable for measuring surgical patient satisfaction with perioperative nursing care. The findings presented here may be of value to nursing administrators, educators, and nursing care providers to improve patient satisfaction and to develop strategies to prevent patient dissatisfaction.

Communication failures were a leading cause of sentinel events in the operation room due to frequently the communication breakdown occurs between physicians and nurses. This study explored the perspectives of surgical teams (nurses, physicians, and anaesthesiologists) on interprofessional collaboration and improvement strategies. A surgical team comprising eight perioperative nurses, four surgeons, and four anaesthesiologists from a university-affiliated hospital participated in this qualitative and phenomenological research from December 2018 to April 2019. Data were collected in in-depth interviews and were used in a thematic analysis according to Colaizzi to extract themes and categorised codes with the ATLAS.ti software. The result is presented in three generic categories: Barrier-like disruptive behaviours and lack of coordination of care; consequences by safety threats to the patient; overcoming barriers by shared decision making among professionals, flattened hierarchies, and teamwork/communication training. The conclusion is that different teams’ perspectives can facilitate genuine reflection, discussion, and implementation of targeted interventions to improve operating room interprofessional collaboration and overcome barriers and their consequences. Currently, there is a need to change towards interprofessional collaboration for optimal patient outcomes and to ensure all professionals’ expectations are met.

(1) Background: Healthcare professionals´ clinical practice, their care of patients and the clinical decision-making process may be influenced by ethical and moral sensitivity. However, such outcomes have been scarcely studied in physical therapists. This study aimed to explore ethical sensitivity and moral sensitivity in practicing physical therapists, and to compare both variables by gender. (2) Methods: Cross-sectional study. 75 physical therapists (58.7% women; average age = 34.56 (8.68) years) were asked to fill in questionnaires measuring ethical sensitivity (Ethical Sensitivity Scale Questionnaire) and moral sensitivity (Revised-Moral Sensitivity Questionnaire). (3) Results: The sample showed high ethical sensitivity (116.14 ± 15.87 over 140) and high moral sensitivity (40.58 ± 5.36 over 54). When comparing by gender, women reported significantly higher ethical sensitivity than men (p = 0.043), as well as higher scores in the following dimensions: Caring by connecting with others (p = 0.012) and Working with interpersonal and group differences (p = 0.028). However, no differences were found in moral sensitivity (p = 0.243). (4) Conclusion: Physical therapists showed high levels of ethical and moral sensitivity, whilst women reported higher ethical sensitivity than men. Understanding physical therapists´ ethical and moral sensitivity is essential to design and implement integrated education programs directed to improve the quality of care of patients in their daily clinical practice.

(1) Background: The COVID-19 pandemic has led to an increase in the complexity of caregiving, resulting in challenging situations for perioperative nurses. These situations have prompted nurses to assess their personal and professional lives. The aim of this study was to explore the experiences of perioperative nurses during the first wave of the COVID-19 pandemic, with a specific focus on analyzing moral breakdowns and ethical dilemmas triggered by this situation. (2) Methods: A qualitative design guided by a hermeneutical approach was employed. Semi-structured interviews were conducted with 24 perioperative nurses. The interviews were transcribed and thematically analysed following the Consolidated Criteria for Reporting Qualitative Research (COREQ) guidelines. (3) Results: The findings revealed three main categories and ten subcategories. These categories included the context in which moral breakdowns emerged, the ethical dilemmas triggered by these breakdowns, and the consequences of facing these dilemmas. (4) Conclusions: During the first wave of COVID-19, perioperative nurses encountered moral and ethical challenges, referred to as moral breakdowns, in critical settings. These challenges presented significant obstacles and negatively impacted professional responsibility and well-being. Future studies should focus on identifying ethical dilemmas during critical periods and developing strategies to enhance collaboration among colleagues and provide comprehensive support.