Experiencia sobre la visita prequirúrgicauna revisión de evidencias

  1. Alberto Gálvez Toro 1
  2. Candela Bonill de la Nieves 2
  3. Cristina Torres Luzón 2
  4. María Rodríguez Bailón
  5. Mª Luisa Ayudarte Larios 2
  1. 1 Coordinador de Investigación. Fundación Index (Granada, España)
  2. 2 Becarios de Investigación: IV Programa de Jóvenes Investigadores, Fundación Index (Granada, España).
Revista:
Evidentia: Revista de enfermería basada en la evidencia

ISSN: 1697-638X

Año de publicación: 2006

Volumen: 3

Número: 8

Tipo: Artículo

DIALNET GOOGLE SCHOLAR lock_openAcceso abierto editor

Otras publicaciones en: Evidentia: Revista de enfermería basada en la evidencia

Resumen

Antecedents: The hypothesis that the pre-surgical visit has effects over the anxiety measured for the surgical patient exists. Other benefits are quoted. Although it is possible to find random surveys in which a slight reduction of the anxiety is observed, the conditions under which this fact has occurred and the possibilities of implementation in our environment are not known. Objectives: (1) Evaluation of the conditions under which the pre-surgical visit has been implemented in our environment, in order to establish the minimum conditions for the success of the intervention, and to facilitate the development of protocols and programs of implementation. (2) Knowledge of the experience that the nurses in our environment have about the pre-surgical visit. Search strategy: Searches in CUIDENplus (CUIDEN and CUIDEN evidencia) were made attending to open not methodological but thematic criteria. Natural language was used in an exhaustive search for all the text fields of the documents (title, key words and abstract), delimited by the field language (=Spanish) and the type of publication (=article). The words used were: visit, surgery, operative, pre-operative and surgical (complete and truncated word). Criteria of selection, tabulation and data analysis: The evaluation of findings was made attending to a double criterion, methodological and of degree of utility. Two instruments were used: the classification of evidences of quantitative hierarchy from the EBWG, whose gold standard is the clinical random tests, and the classification of quantitative hierarchized evidences in terms of their utility. All the surveys were evaluated by at least two reviewers. The process of revision was made as follows: (a) a reviewer analyzed a survey, (b) the group coordinator reviewed it again as a second reviewer, (c) the double review and the comments from the reviewers were sent to the rest of reviewers. The whole work was made by consensus, although the group coordinator was used as pivot. No quantitative synthesis was made during the data analysis. Each study was analyzed independently to give answer to each of the questions posed in this revision. Main results. The analysis of the results shows that none of them obtains a degree of recommendation A of its evidences, that is, there is no case in which the existence of an adequate level of evidence to recommend the interventions analyzed could be stated. From the point of view of utility, the clinical professional can obtain relevant information to take decisions or to implement future effective interventions based on the lack of effectiveness, the experiences or the impressions of the researchers. Three types of pre-surgical visits have been identified: Type I or informative, Type II or therapeutic and Type III or anxiolytic. Conclusions of the reviewers. Using the data of this revision, the systematic pre-surgical visit can not be recommended for every patient having a programmed surgery. Taking into account the experience of the nurses of our environment, once the necessary resources have been considered, we recommend the informative visit or Type I and the therapeutic visit or Type II. It seems clear that a connection between the satisfaction of the patient and the informative visit exists. The visit makes the patient perceive a greater quality of the service; it makes him sense a more individualized attention. The training, the advice, the recommendations or the preparation in the self-care, might have beneficial effects over the post-operative results for selected patients and/or in cases of well defined problems. It is possible that minimum interventions in visits of Type II might allow obtaining favourable post-operational results measured in the patient (self-cares,adhesion to the treatment, prevention of adverse effects). In the future, the specific contents of the therapeutic visit centred in concrete and well defined problems should be explored. It becomes necessary to reorient the research towards the measurement of results in controlled interventions of nursing related to self-cares.

Referencias bibliográficas

  • -Alonso Trujillo, Javier, Pineda Olvera, Juan, González Díaz, Héctor E, Aguire Onofre, José de Jesús y Resendiz Rivas, Jorge Eduardo. Efectividad de un programa de salud aplicado a pacientes apendicectomizados. Desarrollo Científ Enferm. 2005 jun; 13(5):132-135. [Enlace]
  • -Aparcero Bernet, Luis Alfonso, Núñez García, A, Ramos Fernández, G, Olcina Santoja, R, Romero Sánchez, M, Bozzo Fernández, A, Muñoz Luna, L, Barea Monchón, A y López Moraleda, I. La visita entrevista prequirúrgica: intervención de Enfermería e instrumento para la calidad. Enfuro. 2003 oct-dic; 88:9-13.
  • -Arán Catalán, Rosa María, Díez Delgaso, Celia, Marimon, Mercè, Freixa, F y Borull, Conchita. Efecto de la visita preoperatoria de las enfermeras quirúrgicas a los pacientes que van a ser intervenidos. Enferm Clínica. 1996 mar-abr; 6(2):57-62.
  • -Blanca Gutiérrez, Joaquín Jesús. La educación pre-operatoria: análisis de contenidos y de su influencia en la recuperación del paciente. Inquietudes, 2005; XI (31):34-35. [Enlace]
  • -Cuñado Barrio, Ascensión, Legarre Gil, M Jesús, Ruiz Castón, Josefa, Silveira de la Torre, Jesús, Caballero Martínez, Luis y García López, Fernando. Efecto de una "visita enfermera" estructurada e individualizada en la ansiedad de los pacientes quirúrgicos. Ensayo clínico aleatorizado. Enferm Clínica. 1999 may-jun; 9(3):98-104.
  • -Gálvez Toro, Alberto. Clasificación de las Evidencias por su Diseño y Utilidad. La investigación secundaria cualitativa. Index Enferm (Gran). 2003 invierno. Año XII(43):45-49. Revisión, artículo. [Enlace]
  • -Gastón Etayo, M Rosario y Rojo Miñón, Emilia. Estudio prospectivo de la ansiedad en los pacientes intervenidos en cirugía torácica y valoración de la visita preanestésica de enfermería. Oiñarri. 1995 mar; 2:12-15.
  • -Gómez Escrig, Pilar, Sánchez Ortiz, Pilar y Moro Baizán, Mª José. Atención personalizada al enfermo en quirófano. Enfermera perioperatoria. Impulso. 1997 oct; 82:21-25.
  • -Hernández Rodríguez, José Enrique, Díaz Hernández, Maximino, Chacón Ferreras, Rodrigo y Udaeta Valdivieso, Beatriz. Influencia de la visita preoperatoria en la evolución postoperatoria. Enferm Científ. 1996 sep-oct; 174-175:34-37.
  • -Hurtado Vázquez Ivonne, y Espino Villafuerte, Maria Elena. Disminución de la ansiedad del paciente quirúrgico a través de la intervención de enfermería. Desarrollo Científ Enferm. 2004 mar; 12(2):47-50. [Enlace]
  • -López Martín, M Beatriz. Evaluación de la influencia de la visita preoperatoria en la disminución de ansiedad perioperatoria de los pacientes intervenidos de artroscopia y ligamentoplastía de rodilla Info-tr@um@ 2005; 6:14-26.
  • -McDonald S, Hetrick S, Green S. Educación prequirúrgica para el reemplazo de cadera o de rodilla (Revisión Cochrane traducida). En: La Biblioteca Cochrane Plus, 2005 Número 4. Oxford: Update Software Ltd. Disponible en: http://www.update-software.com. (Traducida de The Cochrane Library, 2005 Issue 4. Chichester, UK: John Wiley & Sons, Ltd.). Fecha de la modificación más reciente: 23 de noviembre de 2003. [Enlace]
  • -Mas Rubio, Dolors y Comas Trullàs, Lluisa. Efecto de la visita al paciente de la enfermera quirofanista en la fase preoperatoria. Enferm Clínica. 1998 jul-ago; 8(4):156-160.
  • -Sánchez del Charco, MC, Palenzuela Serrano, J, Ruiz Darabia, P, Almendros Álvarez, C, Rodríguez Úbeda, C, Gil García, E, Moreno Galán, JD, Caballero Gómez, L, Soler Rojas, G y Santalla Sánchez, JF. Valoración preoperatoria. Atención integral al paciente quirúrgico. Rev AE ATS Urol. 1992 jul-sep; 44:15-22.
  • -Shuldham, Caroline. A review of the impact of pre-operative education on recovery from surgery. International Journal of Nursing Studies, 1999; 36:171-177.
  • -Trujillo Abad, Ana María, Checa Ruiz, María Antonia y Góngora Abad, María Rosa. Visita preanestésica. Enferm Científ. 1998 mar-abr; 192-193:33-35.
Fuente de los datos: Dialnet