Experience of anaesthesia nurses of perioperative communication in hip fracture patients with
dementia
Sammanfattning
Background: Perioperative care in hip fracture patients with dementia can be complex. There is
currently little scientific evidence on how care should be undertaken.
Aims: The aim of the study was to describe the experience of anaesthesia nurses of the difficulties
that emerge in care situations and how communication with patients can be maintained in the
perioperative setting of hip fracture surgery.
Methods: Individual interviews were conducted with ten anaesthesia nurses (5 men and 5 women).
The interviews were carried out at a university hospital in Gothenburg (Sweden), and the data were
analysed using qualitative content analysis.
Findings: Three main response categories were discerned: ‘Communication’, ‘Dementia as a special
issue’ and ‘Practical issues’. Dementia was viewed as one of the most difficult and shifting diseases
an individual may suffer from. Time must be allocated to communicate clearly and patiently, to
meticulously plan and carry out care while providing distinct information to enable patient
participation. Establishing a mental bridgehead by confirming the patients' perceptions/feelings
significantly reduced distress in a majority of the patients. A holistic and respectful approach was
deemed mandatory at all times. Patients are sometimes dependent on recognition, so that small
personal items brought close to the patient during surgery can calm the patient. State-of-the-art
analgesia and anxiolytic medications are mandatory.
Conclusions: Perioperative problems can be overcome with patience, empathy and profound
knowledge of how patients with dementia respond prior to surgery. Our results may serve as a
source for future care and provide information about hospital settings for better perioperative care in
patients with dementia. Published by arrangement with John Wiley & Sons.