131 Concerns of The Unheard: A Qualitative Systematic Review on The Preoperative Concerns of General Surgery Patients

Abstract Aim Preoperative care is important for patients and healthcare professionals (HCPs), and greatly influences patients’ postoperative outcomes. This review aims to provide an in-depth understanding of the concerns general surgery patients have in the preoperative period and discover solutions to improve their care. Method CINAHL, Medline, PsycINFO, and Web of Science were searched, and articles related to patients’ preoperative concerns were included. Key quotes were extracted, coded, and thematically analyzed according to Thomas and Harden’s methodology. Results Three themes were generated from the 27 included articles; lead-up to surgery, the postoperative recovery process, and HCP care provision. Patients were uncertain and concerned about the impact the surgery or disease may have on them while they waited for their surgery to occur. Additionally, perceived inadequate provision of care by patients led to them doubting their HCPs’ ability, heightening their preoperative anxiety. Lastly, postoperative recovery processes were often unclear, leading to increased distress as patients wonder if they could recover from the disease and/or surgery. Conclusions Unresolved preoperative concerns increase patients’ anxiety and uncertainty, negatively affecting their postoperative recovery. A combination of individualized preoperative education and complementary therapy can be implemented by HCPs to alleviate these concerns, leading to better postoperative outcomes.

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A Review of Sludge-to-Energy Recovery Methods

Energies ◽

10.3390/en12010060 ◽

2018 ◽

Vol 12 (1) ◽

pp. 60 ◽

Cited By ~ 40

Author(s):

Jumoke Oladejo ◽

Kaiqi Shi ◽

Xiang Luo ◽

Gang Yang ◽

Tao Wu

Keyword(s):

Sewage Sludge ◽

Energy Recovery ◽

Recovery Process ◽

Metal Pollutants ◽

Recovery Processes ◽

Recent Developments ◽

Cost Competitiveness ◽

Treatment Facilities ◽

Heavy Metal Pollutants ◽

The Impact

The increasing volume of sewage sludge from wastewater treatment facilities is becoming a prominent concern globally. The disposal of this sludge is particularly challenging and poses severe environmental hazards due to the high content of organic, toxic and heavy metal pollutants among its constituents. This study presents a simple review of four sewage to energy recovery routes (anaerobic digestion, combustion, pyrolysis and gasification) with emphasis on recent developments in research, as well as benefits and limitations of the technology for ensuring cost and environmentally viable sewage to energy pathway. This study focusses on the review of various commercially viable sludge conversion processes and technologies used for energy recovery from sewage sludge. This was done via in-depth process descriptions gathered from literatures and simplified schematic depiction of such energy recovery processes when utilised for sludge. Specifically, the impact of fuel properties and its effect on the recovery process were discussed to indicate the current challenges and recent scientific research undertaken to resolve these challenges and improve the operational, environmental and cost competitiveness of these technologies.

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Is extra care housing in England care-neutral?

Journal of Assistive Technologies ◽

10.1108/jat-12-2013-0040 ◽

2015 ◽

Vol 9 (1) ◽

pp. 3-20 ◽

Cited By ~ 1

Author(s):

Ruth Mayagoitia ◽

Els Van Boxstael ◽

Hedieh Wojgani ◽

Fay Wright ◽

Julienne Hanson ◽

...

Keyword(s):

Design Methodology ◽

Care Staff ◽

Original Research ◽

Care Provision ◽

Policy Makers ◽

Content Type ◽

Care Integration ◽

Provision Of Care ◽

The Impact ◽

Extra Care Housing

Purpose – Extra care housing (ECH) is housing for older people that aims to provide flexible care while fostering independence. The purpose of this paper is to examine the impact that some of the successes and failures in improving accessibility during remodelling had on care provision, in order to offer advice to social housing providers planning to remodel existing properties into ECH. Design/methodology/approach – The data consisted of an inventory of accessibility features and assistive technology (AT) items in flats and common areas. The data were drawn from ten ECH schemes in different regions of England. Findings – Most of the AT found was low-technology supporting independence, such as grabbers; some was specific to care provision, such as hoists. Even after remodelling, the design and layout of most buildings did not fully comply with accessibility standards, leading to increased provision of care for some tenants: a care-negative situation. Research limitations/implications – This multidisciplinary, original research on remodelling into ECH presents successful examples of accessibility, AT and care integration that required active tenant involvement and creative design input from care staff, architects and builders who were AT and accessibility aware. It is argued that for new and remodelled ECH buildings to be care-neutral, designers need to work towards the most inclusive model of ECH. Originality/value – This is original research that has produced guidance for builders, developers, policy makers and other stake holders.

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Implementation of an Enhanced Recovery After Spine Surgery program at a large cancer center: a preliminary analysis

Journal of Neurosurgery Spine ◽

10.3171/2018.4.spine171317 ◽

2018 ◽

Vol 29 (5) ◽

pp. 588-598 ◽

Cited By ~ 24

Author(s):

Roxana M. Grasu ◽

Juan P. Cata ◽

Anh Q. Dang ◽

Claudio E. Tatsui ◽

Laurence D. Rhines ◽

...

Keyword(s):

Spine Surgery ◽

Enhanced Recovery ◽

Recovery Process ◽

Postoperative Recovery ◽

Opioid Consumption ◽

Pelvic Surgery ◽

Cancer Center ◽

Team Approach ◽

Pain Scores ◽

The Impact

OBJECTIVEEnhanced Recovery After Surgery (ERAS) programs follow a multimodal, multidisciplinary perioperative care approach that combines evidence-based perioperative strategies to accelerate the functional recovery process and improve surgical outcomes. Despite increasing evidence that supports the use of ERAS programs in gastrointestinal and pelvic surgery, data regarding the development of ERAS programs in spine surgery are scarce. To evaluate the impact of an Enhanced Recovery After Spine Surgery (ERSS) program in a US academic cancer center, the authors introduced such a program and hypothesized that ERSS would have a significant influence on meaningful clinical measures of postoperative recovery, such as pain management, postoperative length of stay (LOS), and complications.METHODSA multimodal, multidisciplinary, continuously evolving team approach was used to develop an ERAS program for all patients undergoing spine surgery for metastatic tumors at The University of Texas MD Anderson Cancer Center from April 2015 through September 2016. This study describes the introduction of that ERSS program and compares 41 patients who participated in ERSS with a retrospective cohort of 56 patients who underwent surgery before implementation of the program. The primary objectives were to assess the effect of an ERSS program on immediate postoperative pain scores and in-hospital opioid consumption. The secondary objectives included assessing the effect of ERSS on postoperative in-hospital LOS, 30-day readmission rates, and 30-day postoperative complications.RESULTSThe ERSS group showed a trend toward better pain scores and decreased opioid consumption compared with the pre-ERSS group. There were no significant differences in LOS, 30-day readmission rate, or 30-day complication rate observed between the two groups.RESULTSAn ERSS program is feasible and potentially effective on perioperative pain control and opioid consumption, and can expedite recovery in oncological spine surgery patients. Larger-scale research on well-defined postoperative recovery outcomes is needed.

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The impact of coronavirus 2019 on general surgery residency: A national survey of program directors

Annals of Medicine and Surgery ◽

10.1016/j.amsu.2021.102285 ◽

2021 ◽

Vol 65 ◽

pp. 102285

Author(s):

Maxwell F. Kilcoyne ◽

Garrett N. Coyan ◽

Edgar Aranda-Michel ◽

Arman Kilic ◽

Victor O. Morell ◽

...

Keyword(s):

National Survey ◽

General Surgery ◽

Program Directors ◽

General Surgery Residency ◽

The Impact

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Telemedicine Experience of General Surgery Trainees: Impact on Patient Care and Education

The American Surgeon ◽

10.1177/00031348211023402 ◽

2021 ◽

pp. 000313482110234

Author(s):

Brandon J Nakashima ◽

Navpreet Kaur ◽

Chelsey Wongjirad ◽

Kenji Inaba ◽

Mohd Raashid Sheikh

Keyword(s):

Patient Care ◽

Surgical Training ◽

General Surgery ◽

Southern California ◽

University Of Southern California ◽

General Surgery Residency ◽

Surgical Training Program ◽

Current Utilization ◽

Surgery Resident ◽

The Impact

Objective The COVID-19 pandemic has had a significant impact on patient care, including the increased utilization of contact-free clinic visits using telemedicine. We looked to assess current utilization of, experience with, and opinions regarding telemedicine by general surgery residents at an academic university–based surgical training program. Design A response-anonymous 19-question survey was electronically distributed to all general surgery residents at a single academic university–based general surgery residency program. Setting University of Southern California (USC) general surgery residency participants: Voluntarily participating general surgery residents at the University of Southern California. Results The response rate from USC general surgery residents was 100%. A majority of residents (76%) had utilized either video- or telephone-based visits during their careers. No resident had undergone formal training to provide telemedicine, although most residents indicated a desire for training (57.1%) and acknowledged that telemedicine should be a part of surgical training (75.6%). A wide variety of opinions regarding the educational experience of residents participating in telemedicine visits was elicited. Conclusions The COVID-19 pandemic brought telemedicine to the forefront as an integral part of future patient care, including for surgical patients. Additional investigations into nationwide telemedicine exposure and practice among United States general surgery residencies is imperative, and the impact of the implementation of telemedicine curricula on general surgery resident telemedicine utilization, comfort with telemedicine technology, and patient outcomes are further warranted. Competencies Practice-based learning, systems-based practice, interpersonal and communication skills

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Examining the Impact of COVID-19 Restrictions on the Operative Volumes of US General Surgery Residents

Surgery ◽

10.1016/j.surg.2021.06.003 ◽

2021 ◽

Author(s):

Allison M. Ammann ◽

Alexander R. Cortez ◽

Dennis M. Vaysburg ◽

Leah K. Winer ◽

Jeffrey J. Sussman ◽

...

Keyword(s):

General Surgery ◽

The Impact

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Does grandparental child-care provision affect number, satisfaction and with whom leisure activities are done?

Ageing and Society ◽

10.1017/s0144686x2100009x ◽

2021 ◽

pp. 1-23

Author(s):

Merih Ates ◽

Valeria Bordone ◽

Bruno Arpino

Keyword(s):

Child Care ◽

Fixed Effects ◽

Leisure Activities ◽

Care Provision ◽

Care Giving ◽

The Family ◽

Role Enhancement ◽

Number Frequency ◽

Rich Information ◽

The Impact

Abstract This study investigates the impact of non-intensive and intensive supplementary grandparental child care on grandparents’ involvement in leisure activities. Three aspects of leisure activities are investigated: the number/frequency of activities, with whom they are carried out and the subjective satisfaction with them. Beside the possibility of a cumulation effect, the literature suggests that providing grandparental child care might compete with other activities, especially for women. Thus, we consider role enhancement and role strain theories to derive our hypotheses. We use longitudinal data from the German Ageing Survey (DEAS) which contains rich information on the leisure activities of people aged 40 and older. To account for selection into the provision of grandparental child care, we use a within-unit estimation approach (fixed-effects panel models). Our results show that both grandfathers and grandmothers tend to engage in more leisure activities when they provide grandparental child care. While care-giving grandfathers become more likely to engage in activities with family members without changing their engagement outside the family, we found no effect for women in this respect. Nevertheless, grandparental child-care provision modifies satisfaction with leisure activities only for women, reducing it, independently from with whom leisure activities are carried out. These findings suggest that a higher quantity of leisure activities does not necessarily imply higher quality.

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A journey to a new stable state—further development of the postoperative recovery concept from day surgical perspective: a qualitative study

BMJ Open ◽

10.1136/bmjopen-2020-037755 ◽

2020 ◽

Vol 10 (9) ◽

pp. e037755

Author(s):

Ulrica Nilsson ◽

Maria Jaensson ◽

Karin Hugelius ◽

Erebouni Arakelian ◽

Karuna Dahlberg

Keyword(s):

Stable State ◽

Recovery Process ◽

Well Being ◽

Day Surgery ◽

Physical Symptoms ◽

Postoperative Recovery ◽

Four Dimensions ◽

Adult Participants ◽

Starting Point ◽

Patients Experience

ObjectiveThis study aims to further develop the concept analysis by Allvin et al in 2007 and Lundmark et al in 2016 from the perspective of day-surgery patients. Also, to describe how patients experience postoperative recovery in relation to the identified dimensions and subdimensions and to interpret the findings in order to get a deeper understanding of the concept postoperative recovery.DesignDescriptive qualitative design with a theoretical thematic analysis.SettingSix day-surgery departments in Sweden.ParticipantsThirty-eight adult participants who had undergone day surgery in Sweden. Participants were purposively selected.ResultsFour dimensions—physical, psychological, social and habitual—were confirmed. A total of eight subdimensions were also confirmed, two from Allvin et al’s study and six from Lundmark et al’s study. Recovery included physical symptoms and challenges coping with and regaining control over symptoms and bodily functions. Both positive and negative emotions were present, and strategies on how to handle emotions and achieve well-being were established. Patients became dependent on others. They coped with and adapted to the recovery process and gradually stabilised, reaching a new stable state.ConclusionPostoperative recovery was described as a process with a clear starting point, and as a dynamic and individual process leading to an experience of a new stable state. The recovery process included physical symptoms, emotions and social and habitual consequences that challenges them. To follow-up and measure all four dimensions of postoperative recovery in order to support and understand the process of postoperative recovery is, therefore, recommended.

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Examining the impact of psychological distress on short-term postoperative outcomes after elective endovascular aneurysm repair (EVAR)

Journal of Psychosomatic Research ◽

10.1016/j.jpsychores.2021.110367 ◽

2021 ◽

Vol 142 ◽

pp. 110367

Author(s):

Yarrow Scantling-Birch ◽

Guy Martin ◽

Sathyan Balaji ◽

Jacqueline Trant ◽

Ian Nordon ◽

...

Keyword(s):

Psychological Distress ◽

Endovascular Aneurysm Repair ◽

Postoperative Outcomes ◽

Short Term ◽

Aneurysm Repair ◽

The Impact

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A Multiple Stakeholder Perspective for Evaluating Community-Based Dementia Care

Innovation in Aging ◽

10.1093/geroni/igaa057.197 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 60-61

Author(s):

Johan Suen

Keyword(s):

Dementia Care ◽

Structural Constraints ◽

Care Provision ◽

Care Providers ◽

Structured Interviews ◽

Community Based ◽

Relational Factors ◽

Care Relationships ◽

The Individual ◽

The Impact

Abstract For holistic interventions and research on dementia, it is fundamental to understand care experiences from the perspectives of carers, care recipients, and care professionals. While research on care dyads and triads have highlighted the effects of communication and interactional aspects on care relationships, there is a lack of knowledge on how individual-contextual and relational factors shape the provision and receipt of care in terms of decision-making processes, resource allocation, and expectations of care outcomes. Thus, this paper sheds light on (i) how carers negotiate care provision with other important life domains such as employment, household/family roles and conflicts, as well as their own health problems, life goals, values, and aspirations for ageing; (ii) how older adults with dementia perceive support and those who provide it; (iii) the structural constraints faced by care professionals in delivering a team-based mode of dementia care; and, taken together, (iv) how community-based dementia care is impeded by barriers at the individual, relational, and institutional levels. Findings were derived from semi-structured interviews and observational data from fieldwork conducted with 20 persons with dementia (median age = 82), 20 of their carers (median age = 60), and 4 professional care providers. All respondents were clients and staff of a multidisciplinary and community-based dementia care system in Singapore. Our analysis indicates the impact of dementia care is strongly mediated by the interplay between institutional/familial contexts of care provision and the various ‘orientations’ to cognitive impairment and seeking support, which we characterised as ‘denial/acceptance’, ‘obligated’, ‘overprotective’, and ‘precariously vulnerable’.

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