Brazilian Journal of Anesthesiology
https://app.periodikos.com.br/journal/rba/article/doi/10.1590/S0034-70942005000400005
Brazilian Journal of Anesthesiology
Scientific Article

Avaliação do atendimento anestésico da criança e do adolescente em um hospital universitário

Evaluation of the anesthetic management of children and adolescents in a teaching hospital

Andressa Simões Aguiar; Norma Sueli Pinheiro Módolo; Yara Marcondes Machado Castiglia; Bruno Augusto Moura Bruschi

http://dx.doi.org/10.1590/S0034-70942005000400005 Braz J Anesthesiol, vol.55, n4, p.405-420, 2005
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Resumo

JUSTIFICATIVA E OBJETIVOS: Qualidade em anestesia e na satisfação dos pacientes têm tido acentuado destaque. O objetivo foi avaliar o atendimento anestésico de crianças e adolescentes, entrevistando seus responsáveis. MÉTODO: Foram entrevistados 230 responsáveis por crianças e adolescentes submetidos à anestesia no período compreendido entre abril e dezembro de 2003. Realizou-se entrevista na visita pós-operatória através de questionário com quatro itens: identificação das crianças e de adolescentes e seus responsáveis (item 1); esclarecimentos na visita pré-anestésica (item 2), quanto à anestesia (item 3) e à recuperação pós-anestésica (SRPA) (item 4), determinando-se quem dera as informações aos entrevistados e se houvera complicação no pós-anestésico. O responsável atribuiu nota de 0 a 10 ao Serviço de Anestesiologia. RESULTADOS: A pesquisa foi respondida pela mãe em 189 (82,2%) casos. A maioria dos entrevistados, 114 (75,6%), tinha entre 20 e 39 anos, era casada (148 a 64,3%) e 140 (60,9%) não tinham ocupação. Para 89%, o anestesiologista se identificou; para 37% e 77,4%, esclareceu sobre importância e tempo do jejum; 82%, sobre anemia; 90%, alergia; 46,8%, importância da SRPA; 42,2%, tempo de permanência; 72,9%, estado de saúde de sua criança. Não houve apreensões para 49%, 58% e 58%, respectivamente, no pré, intra e pós-anestésico. Gostariam de ter estado com sua criança/adolescente na chegada à SRPA 78,9%. Foram relacionadas preocupações no período pré, intra e pós-anestésico com o sexo e a idade do paciente - não ter tido nenhuma preocupação - maioria dos entrevistados - e com a escolaridade do entrevistado - quanto mais completa, menor foi o número e a variedade das preocupações relatadas. As notas atribuídas ao Serviço de Anestesiologia tiveram maior freqüência entre 7 e 10 (97,4%). CONCLUSÕES: Considera-se que o Serviço de Anestesiologia desenvolve bom trabalho, apesar de falhas na comunicação, que são de solução simples e dependem mais da vontade do serviço que de seu conhecimento científico.

Palavras-chave

ANESTESIA

Abstract

BACKGROUND AND OBJECTIVES: Anesthetic quality and patients' satisfaction has been increasingly praised. Our objective was to evaluate anesthetic management of children and adolescents in our Hospital, by interviewing parents and/or tutors. METHODS: 230 parents or tutors of children and adolescents submitted to anesthesia in the period April-December 2003 were interviewed during the postoperative visit through a four-item questionnaire: children and adolescents and their parents or tutors identification (item 1); explanations during preanesthetic evaluation (item 2) about anesthesia (item 3) and post-anesthetic recovery (PACU) (item 4). Person informing respondents was identified and the presence of post-anesthetic complications made known. Respondents have scored the Anesthesiology Department from 0 to 10. RESULTS: Survey was answered by mothers in 189 (82.2%) of cases. Most respondents (114, 75.6%) were aged 20 to 39 years, were married (148, 64.3%), and 140 (60.9%) had no job. Anesthesiologists have introduced themselves to 89%; for 37% and 77.4% they have explained the importance and duration the fasting period; 82% were informed about anemia; 90% were informed about allergy; 46.8% were informed about PACU importance; 42.2% were explained about length of stay; 72.9% were informed about the health status of their children. There have been no concerns for 49%, 58% and 58%, respectively about pre, intra and post-anesthetic period; 78.9% would like to have been with their children at PACU arrival. Pre, intra and post-anesthetic concerns were related to patients' age and gender - no concern whatsoever for most respondents - and to respondents' education - the better the education the lower the number and diversity of reported concerns. Scores to the Anesthesiology department were mostly between 7 and 10 (97.4%). CONCLUSIONS: The Anesthesiology Department provides satisfactory services, in spite of communication failures, which are easy to solve and depend more on Department's willingness than on scientific knowledge.

Keywords

ANESTHESIA

Referencias

Lee JA. The anaesthetic out-patient clinic. Anaesthesia. 1949;4:164-74.

Machado PRD. Relação médico-paciente em Anestesiologia: Melhor Momento. .

Machado PRD. Qualidade em anestesia: Uma visão do paciente. .

Kain ZN, Mayes LC, Caramico LA. Preoperative preparation in children: a cross-sectional study. J Clin Anesth. 1996;8:508-514.

Kain ZN, Caramico LA, Mayes L. Preoperative preparation programs in children: a comparative examination. Anesth Analg. 1998;87:1249-1255.

Hatava P, Olsson GL, Lagerkranser M. Preoperative physicological preparation for children undergoing ENT operation: a comparison of two methods. Paediatr Anaesth. 2000;10:477-486.

Bellew M, Atkinson KR, Dixon G. The introduction of a paediatric anaesthesia information leaflet: an audit of its impact on parental anxiety and satisfaction. Paediatr Anaesth. 2002;12:124-130.

Koinig H. Preparing parents for their child's surgery: preoperative parental information and education. Paed Anaesth. 2002;12:107-109.

Tait AR, Voepel-Lewis T, Munro HM. Parents preferences for participation in decisions made regarding their child's anaesthetic care. Paediatr Anaesth. 2001;11:283-290.

Kopp VJ, Shafer A. Anesthesiologists and perioperative communication. Anesthesiology. 2000;93:548-555.

Hepner DL, Bader AM. The perioperative physician and professionalism: the two must go together!. Anesth Analg. 2001;93:1088-1090.

Lopes CA, Machado PRA, Castiglia YMM. O que pensa o paciente sobre o binômio anestesiologista-anestesia. Rev Bras Anestesiol. 1993;43:335-340.

Hadjistavropoulos HD, Dobson J, Boisvert JA. Information provision, patient involvement and emotional support: prospective areas for improving anesthetic care. Can J Anesth. 2001;48:864-870.

Klock PA, Roizen MF. More and better-educating the patient about the anesthesiologist's role as perioperative physician. Anesth Analg. 1996;83:671-672.

Jeske HC, Lederer W, Lorenz I. The impact of business cards on physician recognition following general anesthesia. Anesth Analg. 2001;93:1262-1264.

Chan CS, Molassiotis A. The effects of an educational programme on the anxiety and satisfaction level of parents having parent present induction and visitation in a postanesthesia care unit. Paediatr Anaesth. 2002;12:131-139.

Cote CH. Pre-operative preparation. Balliere's Clin Anesthesiol: Paed Anaesth. 1996;10:605-626.

Stiles WB, Putnam SM, James SA. Dimensions of patient and physician roles in medical screening interviews. Soc Sci Med. 1979;13A:335-341.

Fung D, Cohen M. Measurement of patient satisfaction. Anesth Analg. 1999;89:255.

Kotiniemi LH, Ryhanen PT, Moilanen IK. Behavioural changes in children following day-case surgery: a 4 - week follow-up of 551 children. Anaesthesia. 1997;52:970-976.

McCann ME, Kain ZN. The management of preoperative anxiety in children: an update. Anesth Analg. 2001;93:98-105.

Kain ZN, Mayes LC, O'Connor TZ. Preoperative anxiety in children: Predictors and outcomes. Arch Pediatr Adolesc Med. 1996;150:1238-1245.

Kain Z, Sevarino F, Rinder C. The preoperative behavioral stress response: does it exist?. Anesthesiology. 1999;91:A742.

Ader R, Cohen N, Felten D. Psychoneuroimmunology: interactions between the nervous system and the ummune system. Lancet. 1995;345:99-103.

Holzman RS. Morbidity and mortality in pediatric anesthesia. Pediatr Clin North Am. 1994;41:239-256.

Meursing AEE, Bezstarosti-VanEdden . Working with parents. Balliére's Clin Anesthesiol. 1996;10:627-631.

Sikich N, Carr AS, Lerman J. Parental perceptions expectations and preferences for the postanaesthetic recovery of children. Paediatr Anaesth. 1997;7:139-142.

Dawson KP, Mogridge N. Parental perceptions of paediatric inpatient care. N Z Med J. 1991;104:12-13.

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