Observational Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Psychiatry. Apr 19, 2024; 14(4): 553-562
Published online Apr 19, 2024. doi: 10.5498/wjp.v14.i4.553
Nurse anesthetists’ perceptions and experiences of managing emergence delirium: A qualitative study
Yi Xin, Fu-Cai Lin, Chen Huang, Bin He, Ya-Ling Yan, Shuo Wang, Guang-Ming Zhang, Rui Li
Yi Xin, Fu-Cai Lin, Bin He, Ya-Ling Yan, Wuxi Medical College, Jiangnan University, Wuxi 214122, Jiangsu Province, China
Chen Huang, Shuo Wang, Guang-Ming Zhang, Department of Anesthesiology, Tongren Hospital Shanghai Jiao Tong University School of Medicine, Shanghai 200335, China
Rui Li, Department of Nursing, Tongren Hospital Shanghai Jiao Tong University School of Medicine, Shanghai 200335, China
Co-first authors: Yi Xin and Fu-Cai Lin.
Co-corresponding authors: Rui Li and Guang-Ming Zhang.
Author contributions: Xin Y, Lin FC, Zhang GM, and Li R contributed to the research design and thesis writing; Xin Y, Lin FC, and Huang C collected and analyzed the data; Xin Y, He B, Wang S, and Yan YL contributed to the data collection; Zhang GM and Li R overall supervise the study; and all authors contributed to the article and approved the submitted version. The reasons for designating Xin Y and Lin FC as co-first authors are twofold: Firstly, both co-first authors jointly contributed to experimental design, data collection, and analysis, playing a crucial role in ensuring the reliability and validity of the research. Secondly, both co-first authors collaborated in writing and revising the research paper, thereby enhancing the overall quality of the manuscript. The reasons for designating Li R and Zhang GM as co-corresponding authors are threefold: Firstly, they possess expertise in the fields of anesthesiology and nursing, providing crucial professional support and advice for the research. Secondly, they serve as leaders and mentors within the research team, playing significant organizational and guidance roles throughout the entire research project. Lastly, their contributions to the review and revision of this manuscript are equal. In summary, the co-first authors and co-corresponding authors of this study, by analyzing and presenting the research content from multiple professional perspectives, ensured the breadth and depth of the research findings.
Institutional review board statement: The study was reviewed and approved by the Jiangnan University Medical Ethics Committee (Approval No. JNU20230301IRB16).
Informed consent statement: All study participants or their legal guardians provided informed written consent prior to study enrollment.
Conflict-of-interest statement: There are no conflicts of interest to report.
Data sharing statement: No additional data are available.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Rui Li, MSc, Chief Nurse, Department of Nursing, Tongren Hospital Shanghai Jiao Tong University School of Medicine, No. 1111 Xianxia Road, Changning District, Shanghai 200335, China. 18616365160@163.com
Received: January 12, 2024
Peer-review started: January 12, 2024
First decision: January 30, 2024
Revised: February 2, 2024
Accepted: March 19, 2024
Article in press: March 19, 2024
Published online: April 19, 2024
Processing time: 96 Days and 0.2 Hours
Abstract
BACKGROUND

This study employs a descriptive phenomenological approach to investigate the challenges anesthesia nurses face in managing emergence delirium (ED), a common and complex postoperative complication in the post-anesthesia care unit. The role of nurses in managing ED is critical, yet research on their understanding and management strategies for ED is lacking.

AIM

To investigate anesthetic nurses’ cognition and management experiences of ED in hopes of developing a standardized management protocol.

METHODS

This study employed a descriptive phenomenological approach from qualitative research methodologies. Purposeful sampling was utilized to select 12 anesthetic nurses from a tertiary hospital in Shanghai as research subjects. Semi-structured interviews were conducted, and the data were organized and analyzed using Colaizzi’s seven-step analysis method, from which the final themes were extracted.

RESULTS

After analyzing the interview content, four main themes and eight subthemes were distilled: Inefficient cognition hinders the identification of ED (conceptual ambiguity, empirical identification), managing diversity and challenges (patient-centered safe care, low level of medical-nursing collaboration), work responsibilities and pressure coexist (heavy work responsibilities, occupational risks and stress), demand for high-quality management (expecting the construction of predictive assessment tools and prevention strategies, and pursuing standardized management processes to enhance management effectiveness).

CONCLUSION

Nursing managers should prioritize the needs and suggestions of nurses in order to enhance their nursing capabilities and provide guidance for standardized management processes.

Keywords: Anesthetic nurse; Emergence delirium; Postoperative complications; Cognition; Disease management; Qualitative research

Core Tip: This study employs a descriptive phenomenological approach to investigate the challenges anesthesia nurses face in managing emergence delirium (ED), a common and complex postoperative complication in the post-anesthesia care unit. The role of nurses in managing delirium is critical, yet research on their understanding and management strategies for ED is lacking. The findings indicate that anesthesia nurses have insufficient knowledge about ED but acknowledge the necessity for further education and have proposed numerous proactive management strategies. The study also underscores the need for management to prioritize nurse welfare to foster the growth of a high-quality care team.