Mr TONIO PACE - Commonwealth Nurses€¦ · Mr TONIO PACE Undergoing ... •Tonsillitis - tonsils...
Transcript of Mr TONIO PACE - Commonwealth Nurses€¦ · Mr TONIO PACE Undergoing ... •Tonsillitis - tonsils...
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Inaugural Commonwealth Nurses Conference
Our health: our common wealth 10-11 March 2012 London UK
In collaboration with the 9th CNF Europe Region Conference
Supported by the Royal College of Nursing UK
Mr TONIO PACE
Undergoing tonsillectomy: experiences of parents and children in Malta
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Undergoing Tonsillectomy:
Experiences of
Parents and Children in Malta
Tonio Pace
Nursing Officer Mater Dei Hospital - Malta
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Introduction
1.About Malta
2.Tonsils & Tonsillectomies
3.Methodology
4.Findings
5.Discussion/Recommendations
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The Tonsils
• Made up of lymphatic tissue and are located at the
back of the mouth.
• Part of the lymphatic system, which is responsible for
fighting infection.
• Tonsillitis - tonsils become inflamed and cause fever,
sore throat, dysphagia and swelling of the lymph
nodes in the neck (Medical University of South Carolina, 2006).
• Recurrent acute infection or chronic inflammations are
indications for surgery.
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Tonsillectomy
• A common surgical procedure on children (Hellier, Knight, Hern and Waddell, 1999).
• It often entails an overnight stay in hospital as the
tonsils are removed under GA.
• In Malta, tonsillectomy is a relatively common
surgical intervention (+/- 400) yearly.
• Possibility of serious complications such as a post
tonsil bleed and/or pain, nausea and vomiting (Drake-Lee and Stokes,1998).
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Aim of the Study
• To investigate the experiences of parents and
children undergoing tonsillectomy.
• To find out how parents and children were prepared
for admission to hospital.
• To inquire about the main events that parents and
children experienced during the perioperative phase.
• To elicit the views of parents and children regarding
their discharge from hospital.
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Methodology
• Descriptive Exploratory Study
• Permission obtained from Local University Research
Ethics Board
• Sample: 10 parents and 10 children from the E.N.T
ward undergoing tonsillectomy
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Methodology
• A survey research design was used, where one was
aimed at the parents while another for children
• Consent signed by each parent
• Tool piloted on four parents and four children
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Findings
• Doctors viewed as the source who gave information.
• Nurses did not give information about surgery.
• Parents and children felt welcomed by staff.
• Ward environment although clean, but not child
friendly.
• Visiting hours need readjusting for children.
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Findings
• Parents need to tell their children about
hospitalization and surgery.
• Parents urged to accompany child to theatre.
• Child recalled being awaken by the parent.
• Parent being with the child showed a psychological
benefit.
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Findings
• Parents need to be well informed prior to discharge.
• Parents and children were eager to return home.
• Most children referred negatively to their hospital
experience.
• When children are well prepared and are allowed
to play, they view it less negatively.
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Discussion
• Nurses tend to let the doctor give the information.
• Admission and stay in hospital was a positive one.
• Good rapport between all parties is vital for the
child’s care.
• Medical jargon not suitable for lay people.
• Parents need to be left to decide on whether they
should accompany their child to theatre or not.
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Discussion
• Children get frustrated due to long waiting times and
hunger before surgery.
• All children reacted differently after surgery.
• Parents felt that their presence was beneficial.
• Parents who did not complain may have not, so as
not to compromise their child’s care.
• Children in hospital seem to have mostly missed their
immediate family member.
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Recommendations
• Information should be available and adaptable for
children.
• A theatre nurse can visit child a day before surgery
and/or introduce short tours to operating theatres.
• Section of ward to be adapted for children
providing toys, books, etc.
• Visiting hours for children need to be revised.
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Recommendations
• Awareness on parental participation.
• Discharge planning - both verbal and written.
• Staff need to listen more to parent/child's worries.
Further Research
• A larger study for further insight;
– On child’s views on the information needed,
– On whether long waiting affects the child psychologically,
– On nurses on how they should deal with children in a
mixed aged ward.