Den här studien visar att det finns ett stort behov av att utföra mer djupgående och specificerade studier. Det betyder att de ska fokusera på en typ av operation, liknande uppföljningstid och undersöka om postoperativ smärta kan reduceras genom åtgärder riktat mot smärtkatastrofiering. Det involverar både medicinska- och omvårdnadsåtgärder som ska utvärder effekten.
Studien kunde inte bidra till några direkta kliniska implikationer inom vården men det finns mycket att studera vidare inom. Eftersom den här studien pekar på att smärtkatastrofiering har ett samband till postoperativ smärta är det relevant att anestesisjuksköterskan är medveten om dess påverkan. Det kan förhoppningsvis skapa ett intresse att forska vidare inom området och särskilt utvärdera omvårdnadsstrategier för att minska postoperativ smärta.
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perioperativa processen. Omvårdaden blir därför väldigt viktig och utrymme skapas för att angripa den psykologiska aspekten av smärta och genom omvårdandsåtgärder motverka den. De åtgärderna skulle kunna vara delaktiga i minskningen av postoperativ smärta och
katastrofiering. Det skulle behövas en utökad personcentrerad och evidensbaserad preoperativ bedömning där psykologiska faktorer är delaktiga i identifieringen av patienter med risk för postoperativ smärta. Smärthanteringen av patienter som ska opereras behöver vara mer individanpassad och inte enbart följa standardiserade riktlinjer. Det skulle behövas rutiner som anpassar smärtlindringen och omvårdnaden ut efter patientens smärtkatastrofiering. Anestesisjuksköterskestudenter skulle kunna gynnas av att studera preoperativa faktorer som kan påverka den postoperativa smärtan. Det skulle ge studenter en ökad förståelse kring patienters individuella förutsättningar inför operationen för att sedan vara med och implementera kunskapen på operationsavdelningar. Vårdgivaren har ett ansvar att skapa utrymme för denna typ av implementeringar och utvecklingen av den perioperativa vården. En personcentrering för att förebygga postoperativ smärta skulle kunna minska onödigt vårdlidande.
39
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Bilagor
Bilaga A
Sökstrategin som användes i de fyra databaserna för att hitta de valda artiklarna. Varje Nummer (Nr) är en sökning med efterföljande information kring den.
Pubmed: Valda kriterier i databasen: Adult, engelska
Nr Sökord Antal träffar Lästa titlar Lästa abstracts Antal granskad e i fulltext Inkludera artiklar Artikelnu mmer #1 Postoper ative pain 66220 0 0 0 0 #2 Pain catastrop hizing 2097 0 0 0 0 #3 Postsurgi cal pain 1189 0 0 0 0 #4 acute 501180 0 0 0 0 #5 #1 OR #3 AND #2 AND #4 56 56 45 30 11 2-6, 9- 10, 12- 15, 18-21
54 Nr Sökord Antal träffar Lästa titlar Lästa Abstract Antal granskad e i fulltext Inkludera de artiklar Artikelnu mmer #1 Postoper ative pain 15721 0 0 0 0 #2 Pain catastrop hizing 1743 0 0 0 0 #3 Postsurgi cal pain 542 0 0 0 0 #4 acute 208,624 0 0 0 0 #5 #1 OR #4 and #2 AND #3 50 50 35 15 2 1 (2- 6),7, (9- 10), 15) (18-21)
PsycInfo: Valda kriterier i databasen Adult, peer reviewed, engelska