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  • 1.
    Karlsson, Ann-Christin
    et al.
    Blekinge Institute of Technology, School of Health Science.
    Ekeberg, Margaretha
    Larsson Mauleon, Annika
    Almerud Österberg, Sofia
    Is that My Leg? Patients' Experiences of Being Awake During Regional Anesthesia and Surgery2012In: Journal of Perianesthesia Nursing, ISSN 1089-9472, E-ISSN 1532-8473, Vol. 27, no 3, p. 155-164Article in journal (Refereed)
    Abstract [en]

    Most knee or hip replacement surgery is performed under regional anesthesia, when patients are awake. Previous research has primarily focused on patients' experiences during general anesthesia. The aim of this study was to uncover the meaning of being awake during regional anesthesia and surgery Nine interviews with patients undergoing knee or hip replacement surgery comprise the data. The phenomenological analysis shows that being awake during surgery can be compared with walking a tightrope because of ambiguous feelings. Four interrelated constituents farther elucidated the patients' experiences: balancing between proximity and distance in the operating theater balancing between having control and being left out, my partly inaccessible body handled by others, and the Significant role of the carer Anesthesia providers and perioperative nurses need to understand the awake patients' intraoperative experiences to support and confirm them when they can no longer experience or have full access to their body.

  • 2.
    Karlsson, Ann-Christin
    et al.
    Blekinge Institute of Technology, School of Health Science.
    Ekeberg, Margaretha
    Larsson Mauleon, Annika
    Blekinge Institute of Technology, School of Health Science.
    Almerud Österberg, Sofia
    Only a whisper away. A philosophical view of the awake patient's situation during regional anaesthetics and surgery2012In: Nursing Philosophy, ISSN 1466-7681, E-ISSN 1466-769X, Vol. 13, no 4, p. 257-265Article in journal (Refereed)
    Abstract [en]

    In this study the awake patient's intraoperative situation and experiences during regional anaesthetics and surgery are reflected upon by using the work of the French philosopher Maurice Merleau-Ponty. Merleau-Ponty's phenomenological idea of the body as being at the centre of the world highlights the patient's embodied position and bestows significance onto the body as a whole, as a lived body. A case, based on the findings from a previous interview study, is presented as a contextual starting point where a patient goes from having a familiar body recognized as her own to having a partially anaesthetized body experienced as an unknown object. The intraoperative caring space is described in this context as the mutual ground where the awake patient and the nurse anaesthetist (NA) can interact to create meaning. The NA can act as the patient's bodily extension to bridge the gap between the patient's experiences and the situation. This calls for the NA's proximity and genuine presence in order to meet and understand the patient's awake experiences. Learning from the patient's situatedness gives information that is valuable for NAs to share with patients who are less experienced with this contextual situation. The challenge for the NA is not to perform routine-based care, but to acknowledge every patient's lifeworld and uniqueness thus enabling the patient to move easily along the mindbodyworld continuum. The core of intraoperative care is to provide support and promote well-being of awake patients in the intraoperative environment. The use of a philosophical perspective is relevant for nurses who work in an intraoperative setting where patients undergo regional anaesthetics. This study shows how nursing research using phenomenological philosophy can help uncover new meanings known only to the patients living the experience.

  • 3.
    Karlsson, Ann-Christin
    et al.
    Blekinge Institute of Technology, School of Health Science.
    Ekebergh, Margaretha
    Larsson Mauléon, Annika
    Almerud Österberg, Sofia
    An intraoperative caring model – the ‘awake’ patient’s need for a genuine caring encounter2013In: Clinical Nursing Studies, ISSN 2324-7940, Vol. 1, no 4, p. 23-35Article in journal (Refereed)
    Abstract [en]

    Anaesthesia nursing care during regional anaesthesia is characterized by the encounter between the ‘awake’ patient’s own lifeworld and the nurse anaesthetist’s knowledge in theory and in practice. This study aims to present an intraoperative caring model from the patient’s perspective that will facilitate nurse anaesthetists’ (NA) practice to enhance and support the ‘awake’ patient’s intraoperative well-being during surgery under regional anaesthesia. The model is underpinned by a synthesis based on interviews with patients, a philosophical reflection using Merleau-Ponty’s philosophy, and video recordings from orthopaedic surgeries under regional anaesthesia. The model can be used as a tool to encounter awake patients’ existential needs in the intraoperative situation and to further enlighten NAs about the possible impact of their proximity, interaction and communication behaviour in the delivery of intraoperative nursing care. The model can help NAs to access, understand and learn through lived experiences, thereby deepening their professional caring skills. The model is a way to get research knowledge ready for use by NAs to reflect on what gaps need to be filled between what nurses know (research) and do (practice).

  • 4.
    Karlsson, Ann-Christin
    et al.
    Blekinge Institute of Technology, School of Health Science.
    Ekebergh, Margaretha
    Larsson Mauléon, Annika
    Blekinge Institute of Technology, School of Health Science.
    Almerud Österberg, Sofia
    Patient-Nurse Anesthetist Interaction During Regional Anesthesia and Surgery Based on Video Recordings2013In: Journal of Perianesthesia Nursing, ISSN 1089-9472, E-ISSN 1532-8473, Vol. 28, no 5, p. 260-270Article in journal (Refereed)
    Abstract [en]

    Purpose: The purpose of this study was to interpret and describe the patient-nurse anesthetist (NA) interaction during regional anesthesia. Design: Video recordings conducted during orthopedic surgery at a surgical clinic in Sweden formed the basis for the study, in which three patients and three NAs participated. Methods: A hermeneutic analysis was conducted on the data. Finding: The findings of the analysis demonstrated that the NA was in either ‘‘present’’ presence or ‘‘absent’’ presence in the awake patient’s visual field during surgery. The NA’s professional actions at times dominated the patient’s existential being in the intraoperative situation. The findings conveyed insights about the patient-NA interaction that open up possibilities for nurses to understand and reflect upon their own practice in an expanded way. Conclusions: Using video recordings for reflections enables development of professional skills that positively influence the care quality for patients during regional anesthesia.

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