Care for the elderly: a challenge in the anaesthesia context
Anaesthesia care involves bioscience and technical knowledge. Provision of anaesthesia care for elderly surgical patients can be a significant challenge when promoting patient comfort, safety, and satisfaction in a high-tech context with time constraints. Many patients in anaesthesia care are old an...
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| description | Anaesthesia care involves bioscience and technical knowledge. Provision
of anaesthesia care for elderly surgical patients can be a significant
challenge when promoting patient comfort, safety, and satisfaction in a
high-tech context with time constraints. Many patients in anaesthesia
care are old and frail and have multiple illnesses and other problems,
such as delicate skin, malnutrition, and pain. All this must be accounted
for when caring for the elderly. Extra time in anaesthesia care is
required to prepare elderly surgical patients for anaesthesia and
surgery. And surgical patients have limited opportunities to influence
their situations while in anaesthesia and surgery.
So the overall aim of the research was to obtain insight into what
anaesthesia care means in the lifeworld of anaesthesia - through accounts
of experiences of nurse anaesthetists (NAs) and elderly patients.
Research objectives were to: qualitatively identify and describe ways in
which new NAs experience and perceive anaesthesia (I), describe the
essence of the problematic anaesthesia-care situation phenomenon (as it
relates to NAs) that involves elderly patients (II), illuminate what it
means for a nurse anaesthetist to be in a problematic anaesthesia care
situation (III), and illuminate what it means for elderly patients to be
in intra-anaesthesia care and surgical situations (IV).
The research takes a phenomenological approach to facilitate
understanding of human beings (nurse anaesthetists and elderly patients)
in a specific context (anaesthesia care). Three analysis methods were
used in an effort to find congruence between research. questions and
methods: phenomenography (I), descriptive phenomenology (II), and
interpretive phenomenology (III and IV).
In study I, nine newly graduated nurse anaesthetists had one month of
clinical experience when they responded to four open-ended questions. The
questions dealt with their views on anaesthesia care, and they provided
clinical examples that further clarified their written answers. In
studies II and III, seven experienced nurse anaesthetists were
interviewed. Their narrations focused on concrete experiences in
problematic anaesthesia care situations. In study IV, seven elderly
patients (ages 61-79) were interviewed within six months after they had
had hip replacement surgery or femur fracture surgery with regional
anaesthesia. All participants were told that participations were
voluntary and that they could withdraw from the studies at |
| format | Dissertation |
| fullrecord | <record><control><sourceid>swepub_D8T</sourceid><recordid>TN_cdi_swepub_primary_oai_swepub_ki_se_617632</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>oai_swepub_ki_se_617632</sourcerecordid><originalsourceid>FETCH-LOGICAL-b2652-1e3788df163ad9fff0a3c284d28bd0e887854835bf6108a0e90936d709ad39ba3</originalsourceid><addsrcrecordid>eNp1jk1LxDAQhgPiQVdv_oD-AAuTpE0mx6V-wsJe1GuYbCa2WG3Jrsr-ewP2uqd5GZ5n5j0Tl05a2YAChxfipqPMVZpydei54jFyHo9X4jzRuOfrZa7E68P9S_dUb7aPz916UwdlWlVL1hYxJmk0RZdSAtI7hU1UGCIwosW2Qd2GZCQgATtw2kQLjqJ2gfRK1P939788fwc_5-GT8tFPNPhl9VESeyOt0arw9iQ_zfxFedcPP7xIEow0vlRUUMzbk-bd8Lb2U3734dB7AFVe_QGyEVj2</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>dissertation</recordtype></control><display><type>dissertation</type><title>Care for the elderly: a challenge in the anaesthesia context</title><source>SWEPUB Freely available online</source><creator>Larsson Mauleon, Annika</creator><creatorcontrib>Larsson Mauleon, Annika ; Institutionen för klinisk neurovetenskap, arbetsterapi och äldrevårdsforskning (NEUROTEC) ; Department of Clinical Neuroscience, Occupational Therapy and Elderly Care Research (NEUROTEC) ; Karolinska Institutet</creatorcontrib><description>Anaesthesia care involves bioscience and technical knowledge. Provision
of anaesthesia care for elderly surgical patients can be a significant
challenge when promoting patient comfort, safety, and satisfaction in a
high-tech context with time constraints. Many patients in anaesthesia
care are old and frail and have multiple illnesses and other problems,
such as delicate skin, malnutrition, and pain. All this must be accounted
for when caring for the elderly. Extra time in anaesthesia care is
required to prepare elderly surgical patients for anaesthesia and
surgery. And surgical patients have limited opportunities to influence
their situations while in anaesthesia and surgery.
So the overall aim of the research was to obtain insight into what
anaesthesia care means in the lifeworld of anaesthesia - through accounts
of experiences of nurse anaesthetists (NAs) and elderly patients.
Research objectives were to: qualitatively identify and describe ways in
which new NAs experience and perceive anaesthesia (I), describe the
essence of the problematic anaesthesia-care situation phenomenon (as it
relates to NAs) that involves elderly patients (II), illuminate what it
means for a nurse anaesthetist to be in a problematic anaesthesia care
situation (III), and illuminate what it means for elderly patients to be
in intra-anaesthesia care and surgical situations (IV).
The research takes a phenomenological approach to facilitate
understanding of human beings (nurse anaesthetists and elderly patients)
in a specific context (anaesthesia care). Three analysis methods were
used in an effort to find congruence between research. questions and
methods: phenomenography (I), descriptive phenomenology (II), and
interpretive phenomenology (III and IV).
In study I, nine newly graduated nurse anaesthetists had one month of
clinical experience when they responded to four open-ended questions. The
questions dealt with their views on anaesthesia care, and they provided
clinical examples that further clarified their written answers. In
studies II and III, seven experienced nurse anaesthetists were
interviewed. Their narrations focused on concrete experiences in
problematic anaesthesia care situations. In study IV, seven elderly
patients (ages 61-79) were interviewed within six months after they had
had hip replacement surgery or femur fracture surgery with regional
anaesthesia. All participants were told that participations were
voluntary and that they could withdraw from the studies at any time.
The results show three ways of approaching anaesthesia care. Two ways
were patient centred, while the third emphasised demands on efficiency.
The favoured approach (patient centred) was selected because of each
newly graduated nurse anaesthetist's understanding of care-giving in an
anaesthesia situation. This meant that similar situations could be
approached differently (I). Unforeseen situations were an inevitable part
of anaesthesia care and proved to be problematic because they could not
be predicted. They were accentuated in acute anaesthesia care situations
with little time to come to terms with what was happening. Re-lived
memories from former unpleasant situations affected and reshaped the
present anaesthesia care situations. In addition, conflicting views of
values were problematic in anaesthesia care (II). Being in problematic
anaesthesia care sit uations was experienced as highly morally demanding
when involving elderly patients and raised moral distress that evolved
from the experience of being prevented from acting on one's legal and
moral duties. In addition,, moral distress occurred when they felt that
they weren't authorised to use their professional expertise or when
others did not authorise them to use it (III). Elderly patients comfort
and well-being were shown to be substantially challenged in anaesthesia
care and surgery. The cognitive and emotional experience of time made
some waiting and pain episodes in anaesthesia care to be experienced as
endless. Severe pain could preoccupy to them to such an extent that they
could not co-operate with the team, e.g., they could not communicate.
Lost control of their bodies made the elderly sense a distance with
themselves and made the anaesthesia care and surgery situation seem
unreal. Sensing distrust created situations in which the elderly felt
unsafe, so they felt that they had to be on their guards (IV).
The research illuminates anaesthesia care from two perspectives. The
results describe what anaesthesia care means and its consequences from
the perspective of care providers (NAs) and what anaesthesia means from
the perspective of care recipients (elderly patients). The research
points out consequences of unforeseen problems and consequences for
different approaches to anaesthesia care. Problematic anaesthesia care
situations, i.e., experiences of difficult situations that require
solutions seemed to be an inevitable in anaesthesia care and effect
anaesthesia care-giving and conditions for receiving anaesthesia care.
Further, the importance of recognising the experience of temporality as
linear and nonchronological was put forward through NAs' recollections
and elderly patients' experiences of pain and waiting. The research
describes the need to articulate NAs' legal and professional authority in
relation to given practice mandates. It also gives an account of elderly
patient' needs to be understood - from an insider perspective - to help
overcome challenges such as pain and wait in anaesthesia care and
surgical situations. Finally, the research calls for further study of the
experience of time in relation to care providers and patients in
anaesthesia care as well as more research about moral distress and its
consequences in anaesthesia care.</description><identifier>ISBN: 9171402098</identifier><identifier>ISBN: 9789171402097</identifier><language>eng</language><subject>Anaesthesia care, anaesthesia nursing, elderly patients, intra-operative care, moral distress, nurse anaesthetists, paradigm case, patient experiences, problematic care, phenomenology ; MEDICAL AND HEALTH SCIENCES ; MEDICIN OCH HÄLSOVETENSKAP</subject><creationdate>2005</creationdate><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,311,552,780,885,4052</link.rule.ids><linktorsrc>$$Uhttp://hdl.handle.net/10616/37820$$EView_record_in_Swedish_Publication_Index_(SWEPUB)$$FView_record_in_$$GSwedish_Publication_Index_(SWEPUB)$$Hfree_for_read</linktorsrc><backlink>$$Uhttps://urn.kb.se/resolve?urn=urn:nbn:se:bth-00276$$DView record from Swedish Publication Index$$Hfree_for_read</backlink><backlink>$$Uhttp://hdl.handle.net/10616/37820$$DView record from Swedish Publication Index$$Hfree_for_read</backlink></links><search><creatorcontrib>Larsson Mauleon, Annika</creatorcontrib><creatorcontrib>Institutionen för klinisk neurovetenskap, arbetsterapi och äldrevårdsforskning (NEUROTEC)</creatorcontrib><creatorcontrib>Department of Clinical Neuroscience, Occupational Therapy and Elderly Care Research (NEUROTEC)</creatorcontrib><creatorcontrib>Karolinska Institutet</creatorcontrib><title>Care for the elderly: a challenge in the anaesthesia context</title><description>Anaesthesia care involves bioscience and technical knowledge. Provision
of anaesthesia care for elderly surgical patients can be a significant
challenge when promoting patient comfort, safety, and satisfaction in a
high-tech context with time constraints. Many patients in anaesthesia
care are old and frail and have multiple illnesses and other problems,
such as delicate skin, malnutrition, and pain. All this must be accounted
for when caring for the elderly. Extra time in anaesthesia care is
required to prepare elderly surgical patients for anaesthesia and
surgery. And surgical patients have limited opportunities to influence
their situations while in anaesthesia and surgery.
So the overall aim of the research was to obtain insight into what
anaesthesia care means in the lifeworld of anaesthesia - through accounts
of experiences of nurse anaesthetists (NAs) and elderly patients.
Research objectives were to: qualitatively identify and describe ways in
which new NAs experience and perceive anaesthesia (I), describe the
essence of the problematic anaesthesia-care situation phenomenon (as it
relates to NAs) that involves elderly patients (II), illuminate what it
means for a nurse anaesthetist to be in a problematic anaesthesia care
situation (III), and illuminate what it means for elderly patients to be
in intra-anaesthesia care and surgical situations (IV).
The research takes a phenomenological approach to facilitate
understanding of human beings (nurse anaesthetists and elderly patients)
in a specific context (anaesthesia care). Three analysis methods were
used in an effort to find congruence between research. questions and
methods: phenomenography (I), descriptive phenomenology (II), and
interpretive phenomenology (III and IV).
In study I, nine newly graduated nurse anaesthetists had one month of
clinical experience when they responded to four open-ended questions. The
questions dealt with their views on anaesthesia care, and they provided
clinical examples that further clarified their written answers. In
studies II and III, seven experienced nurse anaesthetists were
interviewed. Their narrations focused on concrete experiences in
problematic anaesthesia care situations. In study IV, seven elderly
patients (ages 61-79) were interviewed within six months after they had
had hip replacement surgery or femur fracture surgery with regional
anaesthesia. All participants were told that participations were
voluntary and that they could withdraw from the studies at any time.
The results show three ways of approaching anaesthesia care. Two ways
were patient centred, while the third emphasised demands on efficiency.
The favoured approach (patient centred) was selected because of each
newly graduated nurse anaesthetist's understanding of care-giving in an
anaesthesia situation. This meant that similar situations could be
approached differently (I). Unforeseen situations were an inevitable part
of anaesthesia care and proved to be problematic because they could not
be predicted. They were accentuated in acute anaesthesia care situations
with little time to come to terms with what was happening. Re-lived
memories from former unpleasant situations affected and reshaped the
present anaesthesia care situations. In addition, conflicting views of
values were problematic in anaesthesia care (II). Being in problematic
anaesthesia care sit uations was experienced as highly morally demanding
when involving elderly patients and raised moral distress that evolved
from the experience of being prevented from acting on one's legal and
moral duties. In addition,, moral distress occurred when they felt that
they weren't authorised to use their professional expertise or when
others did not authorise them to use it (III). Elderly patients comfort
and well-being were shown to be substantially challenged in anaesthesia
care and surgery. The cognitive and emotional experience of time made
some waiting and pain episodes in anaesthesia care to be experienced as
endless. Severe pain could preoccupy to them to such an extent that they
could not co-operate with the team, e.g., they could not communicate.
Lost control of their bodies made the elderly sense a distance with
themselves and made the anaesthesia care and surgery situation seem
unreal. Sensing distrust created situations in which the elderly felt
unsafe, so they felt that they had to be on their guards (IV).
The research illuminates anaesthesia care from two perspectives. The
results describe what anaesthesia care means and its consequences from
the perspective of care providers (NAs) and what anaesthesia means from
the perspective of care recipients (elderly patients). The research
points out consequences of unforeseen problems and consequences for
different approaches to anaesthesia care. Problematic anaesthesia care
situations, i.e., experiences of difficult situations that require
solutions seemed to be an inevitable in anaesthesia care and effect
anaesthesia care-giving and conditions for receiving anaesthesia care.
Further, the importance of recognising the experience of temporality as
linear and nonchronological was put forward through NAs' recollections
and elderly patients' experiences of pain and waiting. The research
describes the need to articulate NAs' legal and professional authority in
relation to given practice mandates. It also gives an account of elderly
patient' needs to be understood - from an insider perspective - to help
overcome challenges such as pain and wait in anaesthesia care and
surgical situations. Finally, the research calls for further study of the
experience of time in relation to care providers and patients in
anaesthesia care as well as more research about moral distress and its
consequences in anaesthesia care.</description><subject>Anaesthesia care, anaesthesia nursing, elderly patients, intra-operative care, moral distress, nurse anaesthetists, paradigm case, patient experiences, problematic care, phenomenology</subject><subject>MEDICAL AND HEALTH SCIENCES</subject><subject>MEDICIN OCH HÄLSOVETENSKAP</subject><isbn>9171402098</isbn><isbn>9789171402097</isbn><fulltext>true</fulltext><rsrctype>dissertation</rsrctype><creationdate>2005</creationdate><recordtype>dissertation</recordtype><sourceid>D8T</sourceid><recordid>eNp1jk1LxDAQhgPiQVdv_oD-AAuTpE0mx6V-wsJe1GuYbCa2WG3Jrsr-ewP2uqd5GZ5n5j0Tl05a2YAChxfipqPMVZpydei54jFyHo9X4jzRuOfrZa7E68P9S_dUb7aPz916UwdlWlVL1hYxJmk0RZdSAtI7hU1UGCIwosW2Qd2GZCQgATtw2kQLjqJ2gfRK1P939788fwc_5-GT8tFPNPhl9VESeyOt0arw9iQ_zfxFedcPP7xIEow0vlRUUMzbk-bd8Lb2U3734dB7AFVe_QGyEVj2</recordid><startdate>2005</startdate><enddate>2005</enddate><creator>Larsson Mauleon, Annika</creator><scope>ADTPV</scope><scope>DBVSS</scope><scope>DF3</scope><scope>D8T</scope><scope>DSNTI</scope></search><sort><creationdate>2005</creationdate><title>Care for the elderly</title><author>Larsson Mauleon, Annika</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-b2652-1e3788df163ad9fff0a3c284d28bd0e887854835bf6108a0e90936d709ad39ba3</frbrgroupid><rsrctype>dissertations</rsrctype><prefilter>dissertations</prefilter><language>eng</language><creationdate>2005</creationdate><topic>Anaesthesia care, anaesthesia nursing, elderly patients, intra-operative care, moral distress, nurse anaesthetists, paradigm case, patient experiences, problematic care, phenomenology</topic><topic>MEDICAL AND HEALTH SCIENCES</topic><topic>MEDICIN OCH HÄLSOVETENSKAP</topic><toplevel>online_resources</toplevel><creatorcontrib>Larsson Mauleon, Annika</creatorcontrib><creatorcontrib>Institutionen för klinisk neurovetenskap, arbetsterapi och äldrevårdsforskning (NEUROTEC)</creatorcontrib><creatorcontrib>Department of Clinical Neuroscience, Occupational Therapy and Elderly Care Research (NEUROTEC)</creatorcontrib><creatorcontrib>Karolinska Institutet</creatorcontrib><collection>SwePub</collection><collection>SwePub Thesis</collection><collection>SWEPUB Blekinge Tekniska Högskola</collection><collection>SWEPUB Freely available online</collection><collection>SwePub Thesis full text</collection></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext_linktorsrc</fulltext></delivery><addata><au>Larsson Mauleon, Annika</au><aucorp>Institutionen för klinisk neurovetenskap, arbetsterapi och äldrevårdsforskning (NEUROTEC)</aucorp><aucorp>Department of Clinical Neuroscience, Occupational Therapy and Elderly Care Research (NEUROTEC)</aucorp><aucorp>Karolinska Institutet</aucorp><format>dissertation</format><genre>dissertation</genre><ristype>THES</ristype><btitle>Care for the elderly: a challenge in the anaesthesia context</btitle><date>2005</date><risdate>2005</risdate><isbn>9171402098</isbn><isbn>9789171402097</isbn><abstract>Anaesthesia care involves bioscience and technical knowledge. Provision
of anaesthesia care for elderly surgical patients can be a significant
challenge when promoting patient comfort, safety, and satisfaction in a
high-tech context with time constraints. Many patients in anaesthesia
care are old and frail and have multiple illnesses and other problems,
such as delicate skin, malnutrition, and pain. All this must be accounted
for when caring for the elderly. Extra time in anaesthesia care is
required to prepare elderly surgical patients for anaesthesia and
surgery. And surgical patients have limited opportunities to influence
their situations while in anaesthesia and surgery.
So the overall aim of the research was to obtain insight into what
anaesthesia care means in the lifeworld of anaesthesia - through accounts
of experiences of nurse anaesthetists (NAs) and elderly patients.
Research objectives were to: qualitatively identify and describe ways in
which new NAs experience and perceive anaesthesia (I), describe the
essence of the problematic anaesthesia-care situation phenomenon (as it
relates to NAs) that involves elderly patients (II), illuminate what it
means for a nurse anaesthetist to be in a problematic anaesthesia care
situation (III), and illuminate what it means for elderly patients to be
in intra-anaesthesia care and surgical situations (IV).
The research takes a phenomenological approach to facilitate
understanding of human beings (nurse anaesthetists and elderly patients)
in a specific context (anaesthesia care). Three analysis methods were
used in an effort to find congruence between research. questions and
methods: phenomenography (I), descriptive phenomenology (II), and
interpretive phenomenology (III and IV).
In study I, nine newly graduated nurse anaesthetists had one month of
clinical experience when they responded to four open-ended questions. The
questions dealt with their views on anaesthesia care, and they provided
clinical examples that further clarified their written answers. In
studies II and III, seven experienced nurse anaesthetists were
interviewed. Their narrations focused on concrete experiences in
problematic anaesthesia care situations. In study IV, seven elderly
patients (ages 61-79) were interviewed within six months after they had
had hip replacement surgery or femur fracture surgery with regional
anaesthesia. All participants were told that participations were
voluntary and that they could withdraw from the studies at any time.
The results show three ways of approaching anaesthesia care. Two ways
were patient centred, while the third emphasised demands on efficiency.
The favoured approach (patient centred) was selected because of each
newly graduated nurse anaesthetist's understanding of care-giving in an
anaesthesia situation. This meant that similar situations could be
approached differently (I). Unforeseen situations were an inevitable part
of anaesthesia care and proved to be problematic because they could not
be predicted. They were accentuated in acute anaesthesia care situations
with little time to come to terms with what was happening. Re-lived
memories from former unpleasant situations affected and reshaped the
present anaesthesia care situations. In addition, conflicting views of
values were problematic in anaesthesia care (II). Being in problematic
anaesthesia care sit uations was experienced as highly morally demanding
when involving elderly patients and raised moral distress that evolved
from the experience of being prevented from acting on one's legal and
moral duties. In addition,, moral distress occurred when they felt that
they weren't authorised to use their professional expertise or when
others did not authorise them to use it (III). Elderly patients comfort
and well-being were shown to be substantially challenged in anaesthesia
care and surgery. The cognitive and emotional experience of time made
some waiting and pain episodes in anaesthesia care to be experienced as
endless. Severe pain could preoccupy to them to such an extent that they
could not co-operate with the team, e.g., they could not communicate.
Lost control of their bodies made the elderly sense a distance with
themselves and made the anaesthesia care and surgery situation seem
unreal. Sensing distrust created situations in which the elderly felt
unsafe, so they felt that they had to be on their guards (IV).
The research illuminates anaesthesia care from two perspectives. The
results describe what anaesthesia care means and its consequences from
the perspective of care providers (NAs) and what anaesthesia means from
the perspective of care recipients (elderly patients). The research
points out consequences of unforeseen problems and consequences for
different approaches to anaesthesia care. Problematic anaesthesia care
situations, i.e., experiences of difficult situations that require
solutions seemed to be an inevitable in anaesthesia care and effect
anaesthesia care-giving and conditions for receiving anaesthesia care.
Further, the importance of recognising the experience of temporality as
linear and nonchronological was put forward through NAs' recollections
and elderly patients' experiences of pain and waiting. The research
describes the need to articulate NAs' legal and professional authority in
relation to given practice mandates. It also gives an account of elderly
patient' needs to be understood - from an insider perspective - to help
overcome challenges such as pain and wait in anaesthesia care and
surgical situations. Finally, the research calls for further study of the
experience of time in relation to care providers and patients in
anaesthesia care as well as more research about moral distress and its
consequences in anaesthesia care.</abstract><oa>free_for_read</oa></addata></record> |
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| subjects | Anaesthesia care, anaesthesia nursing, elderly patients, intra-operative care, moral distress, nurse anaesthetists, paradigm case, patient experiences, problematic care, phenomenology MEDICAL AND HEALTH SCIENCES MEDICIN OCH HÄLSOVETENSKAP |
| title | Care for the elderly: a challenge in the anaesthesia context |
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