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

Ano de publicación: 2006

Volume: 3

Número: 8

Tipo: Artigo

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Outras publicacións en: Evidentia: Revista de enfermería basada en la evidencia

Resumo

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.

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Fonte de datos: Dialnet