Med dig vid min sida : -det vårdande mötets betydelse när barn genomgår anestesi i en högteknologisk operationsmiljö

Sammanfattning: Aim: The overall aim of this thesis was to contribute with knowledge of and gain a greater understanding of the encounter between children, parents, and anesthesia staff in a high-technological surgical environment.Methods: This thesis is based on four studies with descriptive, interpretive and cross-sectional designs. Study I includes 28 children with a focus on the meaning of being anesthetized. Data were collected with non-participant video observations, field notes, and interviews. Data were analyzed using a lifeworld hermeneutical approach according to Dahlberg et al. Study II includes six parents with a focus on the meaning of being a parent at one’s child’s first anesthesia in day surgery. The data analysis was carried out with a phenomenological perspective according to Giorgi’s human science method. Study III includes 809 questionnaires completed by nurse anesthetists about the importance of Families’ in Nursing Care (FINC-NA). Data were analyzed with descriptive statistics and multiple linear regression analysis. Finally, study IV includes 27 non-participant observations when children are being anesthetised. The data analysis was carried out with an observational design with a hermeneutic approach grounded in the philosophy of Gadamer and further described by Ericsson et al.Results: The children’s experiences of being anesthetized are: like being powerless, striving for control, experiencing ambiguous comprehensibility, and they are seeking security. They struggle with anxiety as a result of their inability to protect themselves. Their parents experience ambivalence between worry and relief, and a feeling of losing control. They need to be prepared, be present, and have emotional support. The nurse anesthetists generally had a positive attitude towards the importance of parental presence. Working in a district hospital, working only with children, having routines, being a woman, and allowing both parents to be present and greather experience of children’s anesthesia were associated with a more positive attitude. However, the operating room is not designed for children or the parent’s comfort during the child’s anesthesia induction, and there is a need to be inviting and to be invited, a need for varying compliance, there is a need for mutual dependence, and a need to give and receive emotional support.Conclusions: The reasons children experience anxiety are multifaceted. It is thus essential to listen to the voice of each child and each parent, support them, strive to create an individually adopted caring with so much protection as possible, and see parents as a resource and a conversational partner. The caring encounter is essential when children undergo anesthesia in a high-technical surgical environment. The anesthesia staff can be a powerful resource depending on their demeanour.