scholarly journals FASTING IN ELECTIVE SURGICAL PATIENTS: COMPARISON AMONG THE TIME PRESCRIBED, PERFORMED AND RECOMMENDED ON PERIOPERATIVE CARE PROTOCOLS

Author(s):  
Saionara Cristina FRANCISCO ◽  
Sandra Teixeira BATISTA ◽  
Geórgia das Graças PENA

Background: Prolonged preoperative fasting may impair nutritional status of the patient and their recovery. In contrast, some studies show that fasting abbreviation can improve the response to trauma and decrease the length of hospital stay. Aim: Investigate whether the prescribed perioperative fasting time and practiced by patients is in compliance with current multimodal protocols and identify the main factors associated. Methods: Cross-sectional study with 65 patients undergoing elective surgery of the digestive tract or abdominal wall. We investigated the fasting time in the perioperative period, hunger and thirst reports, physical status, diabetes diagnosis, type of surgery and anesthesia. Results: The patients were between 19 and 87 years, mostly female (73.8%). The most performed procedure was cholecystectomy (47.69%) and general anesthesia the most used (89.23%). The most common approach was to start fasting from midnight for liquids and solids, and most of the patients received grade II (64.6%) to the physical state. The real fasting average time was 16 h (9.5-41.58) was higher than prescribed (11 h, 6.58 -26.75). The patients submitted to surgery in the afternoon were in more fasting time than those who did in the morning (p<0.001). The intensity of hunger and thirst increased in postoperative fasting period (p=0.010 and 0.027). The average period of postoperative fasting was 18.25 h (3.33-91.83) and only 23.07% restarted feeding on the same day. Conclusion: Patients were fasted for prolonged time, higher even than the prescribed time and intensity of the signs of discomfort such as hunger and thirst increased over time. To better recovery and the patient's well-being, it is necessary to establish a preoperative fasting abbreviation protocol.

2017 ◽  
Vol 2017 ◽  
pp. 1-8 ◽  
Author(s):  
George Njoroge ◽  
Lucy Kivuti-Bitok ◽  
Samuel Kimani

Background. Preoperative fasting (POF) is physiologically and precautionary important during anesthesia and surgery. POF from midnight has been practiced despite the recommended shorter practice. Objective. Assessing preoperative fasting among adult patients scheduled for elective surgery at Kenyatta National Hospital (KNH). Methods. A descriptive cross-sectional study involving 65 surgical patients. A questionnaire of mixed questions on demographics, reasons, source of instructions, opinion on instructions, time, premedication practices, outcome, and complains on NPO was used. Analysis was quantitatively done with SPSS v. 22. Ethical approval was obtained from KNH-UoN ERC. Results. Of the respondents 93.8% lacked knowledge on the correct reasons for POF and felt that the instructions were unclear and less important <50%. POF instructions were administered by nurses 80%, anesthetists 15%, and surgeons 5%. Most of respondents (73.8%) fasted > 15 hours. The POF outcomes were rated moderately challenging as follows: prolonged wait for surgery 44.6%, thirst 43.1%, hunger 36.9%, and anxiety 29.2%. Conclusion. Nurses are critical in providing POF instructions and care, and patient knowledge level is a mirror reflection of the quality of interventions. This underscores the need to build capacity for nurses and strengthen the health system to offer individualized preoperative interventions as well as monitoring and clinical auditing of fasting practices.


Mastology ◽  
2020 ◽  
Vol 30 ◽  
Author(s):  
Aline Fernanda Fontinele Murici ◽  
Ângela Ferreira Barros

Objective: To evaluate which stage of breast reconstruction promotes improved quality of life for women treated for breast cancer, and to verify the socioeconomic and clinical factors associated with better quality of life. Methods: A cross-sectional study was conducted with 70 women treated for breast cancer in the perioperative period of late breast reconstruction in the Federal District. To assess quality of life, the Functional Assessment of Cancer Therapy — Breast (FACT-B) instrument was used. Results: Half of the women were under 50 years old. Tumor removal surgery had occurred on average 5.4 years ago. Women with axillary dissection had greater impairment in the physical well-being domain (p=0.001) and the breast cancer subscale (p=0.016). Among women who had undergone surgery more than one year previously, there were higher domains of emotional (p=0.006) and functional (p=0.003) well-being. Women who underwent breast reconstruction had higher values in the social/family well-being (p<0.001), emotional well-being (p=0.001), functional well-being (p=0.001), and breast cancer subscale (p=0.005) domains; and on the FACT-B score (p<0.001), right after the first stage. Conclusions: Breast reconstruction favored better quality of life from the first stage, suggesting that this therapeutic modality should be offered promptly, whenever possible, and guaranteed for all women treated for breast cancer.


2022 ◽  
Author(s):  
Zhi-jian Sun ◽  
Xu Sun ◽  
Yan Huo ◽  
Meng Mi ◽  
Gui-ling Peng ◽  
...  

Abstract BackgroundLong-term fasting for elective surgery has been proven unnecessary based on established guidelines. Instead, preoperative carbohydrate loading 2 hours before surgery and recommencing oral nutrition intake as soon as possible after surgery is recommended. This study was performed to analyze the compliance with and effect of abbreviated perioperative fasting management in patients undergoing surgical repair of fresh fractures based on current guidelines.MethodsPatients with fresh fractures were consecutively enrolled from May 2019 to July 2019 at our hospital. A carbohydrate-enriched beverage was recommended up to 2 hours before surgery for all surgical patients except those with contraindications. Postoperatively, oral clear liquids were allowed once the patients had regained full consciousness, and solid food was allowed 1 to 2 hours later according to the patients’ willingness. The perioperative fasting time was recorded and the patients’ subjective comfort with respect to thirst and hunger was assessed using an interview-assisted questionnaire.ResultsIn total, 306 patients were enrolled in this study. The compliance rate of preoperative carbohydrate loading was 71.6%, and 93.5% of patients began ingestion of oral liquids within 2 hours after surgery. The median (interquartile range) preoperative fasting time for liquids and solids was 8 (5.2–12.9) and 19 (15.7–22) hours, respectively. The median postoperative fasting time for liquids and solids was 1 (0.5–1.9) and 2.8 (2.2–3.5) hours, respectively. A total of 70.3% and 74.2% of patients reported no thirst or hunger during the perioperative period. Logistic regression analysis showed that the preoperative fasting time for liquids was an independent risk factor for perioperative hunger. No adverse events such as aspiration pneumonia or gastroesophageal reflux were observed.ConclusionsIn this study of a real clinical practice setting, abbreviated perioperative fasting management was carried out with high compliance in patients with fresh fractures. The preoperative fasting time should be further shortened to further improve patients’ subjective comfort.


Rev Rene ◽  
2021 ◽  
Vol 22 ◽  
pp. e61347
Author(s):  
Larissa Silva Bergantini ◽  
Sueli Mutsumi Tsukuda Ichisato ◽  
Mariana Salvadego Águila Nunes ◽  
Carlos Alexandre Molena Fernandes

Objective: to verify the preoperative fasting time in children undergoing elective surgical procedures. Methods: cross-sectional study, carried out with information obtained from 20 children’s medical records, submitted to descriptive and inferential statistical analysis. Results: the median fasting time was 8.03 hours. The shortest time recorded was 7 hours and 45 minutes and the longest 17 hours and 30 minutes. School children had the longest pre-anesthetic fasting time. In 16 cases, fasting after midnight was prescribed. There was no statistically significant difference between fasting time and the variables age groups and surgical specialties. No correlation was found between the child’s age and fasting time. Conclusion: the median fasting time was shorter than that found in other studies. The patients fasted for longer intervals than recommended. Fasting time was not related to age group, surgical specialty, and age of the child.


GeroPsych ◽  
2017 ◽  
Vol 30 (2) ◽  
pp. 61-70 ◽  
Author(s):  
Lia Oberhauser ◽  
Andreas B. Neubauer ◽  
Eva-Marie Kessler

Abstract. Conflict avoidance increases across the adult lifespan. This cross-sectional study looks at conflict avoidance as part of a mechanism to regulate belongingness needs ( Sheldon, 2011 ). We assumed that older adults perceive more threats to their belongingness when they contemplate their future, and that they preventively react with avoidance coping. We set up a model predicting conflict avoidance that included perceptions of future nonbelonging, termed anticipated loneliness, and other predictors including sociodemographics, indicators of subjective well-being and perceived social support (N = 331, aged 40–87). Anticipated loneliness predicted conflict avoidance above all other predictors and partially mediated the age-association of conflict avoidance. Results suggest that belongingness regulation accounts may deepen our understanding of conflict avoidance in the second half of life.


2020 ◽  
Vol 1 (1) ◽  
Author(s):  
Mory Sanoh

Introduction : A chronic condition like diabetes interferes with an individual's well-being, and if some of their needs are not met because of the disease, their quality of life is reduced. In this context, therapeutic education constitutes a basic element in the management of diabetes.Materials and Methods : A cross-sectional study by self-administered questionnaire and interviews which were carried out with all type 1 and type 2 diabetics, consultants at the level of the Tit Mélil Primary Health Care establishment, in 2019 and who benefited from or not therapeutic education, with or without complications.Result : The study included 50 diabetic patients, surveys show us that type 1 diabetic patients were 13 (26%). And type 2.37 (74%). Regarding the organization of care, 74% of patients say they are under treatment with oral antidiabetics, 10% oral antidiabetics and insulins, 6% insulin therapy and others under diet. Speaking of Food, 76.5% of diabetics know the importance and know what foods to avoid.Conclusion : TVE is possible, it will result in a change in the structure of programs and new educational training for caregivers.


2017 ◽  
Vol 8 (1) ◽  
pp. 10
Author(s):  
Narendra Kumar Singh ◽  
Nishant Goyal

Background: Schizophrenia is associated with a high familial, social and economic burden. Schizophrenia is also associated with a high level of disability which may create impediments on the social and economic areas of the patients as well as on their respective family networks. Families with schizophrenia may encounter problems such as impairment of health and well being of other family members, restriction of social activities of the family members and shrinking of support from the social network. Aims: The present study examined the difference in perceived social support and burden of care between the male and female caregivers of patients with schizophrenia. Methods: This was a cross-sectional study examining the difference in perceived social support and burden of care between the male and female caregivers of patients with schizophrenia. The sample consisted of 60 (30 male and 30 female) caregivers of the patients with the diagnosis of schizophrenia as per ICD-10-DCR. Results and Conclusion: This study revealed that male caregivers perceived more social support and less burden of care as compared to female caregivers. Key words: Gender, social support, burden


2020 ◽  
Author(s):  
Diana Raj ◽  
Norliza Ahmad ◽  
Nor Afiah Mohd. Zulkefli ◽  
Zalilah Mohd Shariff

BACKGROUND Excessive screen time is detrimental to the child’s health. However, screen time situation among Malaysian children is poorly understood. OBJECTIVE This study aims to identify the prevalence and determinants of screen time among children under five years old using the latest WHO guidelines. METHODS A cross sectional design was used to randomly select 489 children from nine government health clinics. Total screen time and factors were assessed using validated self-administered questionnaires and analyzed using multiple logistic regression. RESULTS Results show an overall prevalence of 91.4% with a median of 3.00 hours (IQR: 1.36-5.04). Majority of children watched television (66%), followed by mobile phones (30%) and computers (4%). The determinants of screen time were Malay ethnicity, (AOR 3.56, 95% CI: 1.65-7.68), parental age of 30 years or more (AOR 3.12, 95% CI: 1.58-6.16), parental screen time exceeding 2 hours a day (AOR 2.42, 95% CI: 1.24-4.73), parent’s moderate self-efficacy to influence child’s physical activity (AOR 2.29, 95% CI: 1.01-5.20) and parent’s positive perception on influence of screen time on child’s cognitive well-being (AOR 1.15, 95% CI:1.01-1.32). CONCLUSIONS Parents played an important role in determining their child’s screen time. Future interventions that focus on the parents may ensure age appropriate screen time for their children.


2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 589-589
Author(s):  
Laura Samuel ◽  
Laken Roberts ◽  
Danielle Boyce ◽  
Melissa Hladek ◽  
Sarah LaFave ◽  
...  

Abstract Lower income and financial strain (i.e. difficulty making ends meet) are associated with worse aging biomarkers, but evidence among nationally representative samples is limited. This cross-sectional study tested whether income to poverty ratio (analyzed separately for those &lt;500% vs. ≥500% poverty threshold) and financial strain are associated with biomarkers of aging among NHATS participants aged ≥65 years (n=4,648), adjusting for age, race/ethnicity, gender, smoking, BMI, and diabetes diagnosis for hemoglobin A1c. Sampling weights were applied. Among those with incomes &lt;500% poverty, higher income was associated with lower hemoglobin A1c (b= -0.0196, p=0.007), CMV (b= -0.0689, p&lt;0.001) and CRP (b= -0.0428, p=0.012). Among those with incomes ≥500%, higher income was associated with lower IL-6 (b= -0.0001, p=0.023) and lower CMV (b= -0.0001, p&lt;0.001). Financial strain was not associated with biomarkers. Income is more strongly associated with biomarkers among the lower income group, calling for special attention to this vulnerable population.


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