ATENCIÓN DE ENFERMERÍA PERIOPERATORIA PARA ADOLESCENTES: REVISIÓN DEL ALCANCE

Araújo, Layane Cristina; Oliveira, Danielle Mendonça; Garcia, Taysa de Fátima; Poveda, Vanessa de Brito; Silva, Liliane de Lourdes Teixeira

doi:10.1590/1980-265X-TCE-2024-0157en

person Layane Cristina Araújo

Study design · Data collection · Data analysis and interpretation · Discussion of results · Writing and/or critical review of content · Final review and approval of the final version

schoolUniversidade Federal de São João del Rei. Divinópolis, Minas Gerais, Brasil.

0000-0002-1105-3234

person Danielle Mendonça Oliveira

Study design · Data collection · Data analysis and interpretation · Discussion of results · Writing and/or critical review of content · Final review and approval of the final version

schoolUniversidade Federal de São João del Rei. Divinópolis, Minas Gerais, Brasil.

0009-0006-0139-4138

person Taysa de Fátima Garcia

Study design · Data collection · Data analysis and interpretation · Discussion of results · Writing and/or critical review of content · Final review and approval of the final version

schoolUniversidade Federal de Minas Gerais, Escola de Enfermagem, Departamento de Enfermagem Básica. Belo Horizonte, Minas Gerais, Brasil.

0000-0002-1191-9587

person Vanessa de Brito Poveda

Study design · Data collection · Data analysis and interpretation · Discussion of results · Writing and/or critical review of content · Final review and approval of the final version

schoolUniversidade de São Paulo, Escola de Enfermagem, Programa de Pós-Graduação em Enfermagem na Saúde do Adulto. São Paulo, São Paulo, Brasil.

0000-0002-5839-7253

person Liliane de Lourdes Teixeira Silva

Study design · Data collection · Data analysis and interpretation · Discussion of results · Writing and/or critical review of content · Final review and approval of the final version

schoolUniversidade Federal de São João Del Rei, Grupo de Atuação Docente Saúde do Adulto e Idoso. Divinópolis, Minas Gerais, Brasil.

0000-0002-3429-3310

personCORRESPONDING AUTHOR Liliane de Lourdes Teixeira Silva.
emaillilanets@ufsj.edu.br

CONFLICT OF INTEREST

There is no conflict of interest.

EDITORS

Associated Editors: Gisele Cristina Manfrini, Maria Lígia Bellaguarda

Editor-in-chief: Elisiane Lorenzini.

Databases

Search strategies

Virtual Health Library

(Adolescente OR Adolescent OR Adolescência OR Adolescence OR Teenager) AND ("Cirurgia Geral" OR "General Surgery" OR "Cirugía General" OR "Chirurgiegénérale" OR Cirurgia OR "Centros Cirúrgicos" OR Surgicenters OR "Centros Quirúrgicos" OR "Dispensaires de petitechirurgie" OR "Sala de Recuperação" OR "Recovery Room" OR "Sala de Recuperación" OR "Salle de réveil" OR Surgery) AND ("Enfermagem Perioperatória" OR "Enfermagem Cirúrgica" OR "Perioperative Nursing" OR "Enfermería Perioperatoria" OR "Soins infirmiers périopératoires" OR "Surgical Nursing").

PubMed, Cochrane, Scopus, Web of Science:

(Adolescent OR Adolescence OR Teenager) AND ("General Surgery" OR Surgicenters OR "Recovery Room" OR Surgery) AND ("Perioperative Nursing" OR "Surgical Nursing").

Author	Study design	Age group	Main results and indications
Yaegashi C, et al¹⁵	Descriptive, retrospective and observational	0-1: 82 1-5: 418 6-10: 170 > 10: 113	A high percentage of children admitted to the PACU were still drowsy, requiring continuous observation. Moreover, 14% of the population assessed presented complications such as desaturation, agitation, pain, nausea and vomiting, and laryngospasm. The study portrayed the importance of a multidisciplinary team in patient care, adoption of pain control, nausea/vomiting, and the need for contact with parents until anesthetic induction.
Avila MAG, et al¹⁷	Randomized parallel controlled clinical trial	06 to 14	Providing perioperative guidance with and without the use of comic books was able to reduce parental anxiety, but when provided on the day of surgery, it had no impact on the anxiety of children and adolescents. The study recommended that preoperative preparation be carried out at the time of scheduling the surgery.
Rızalar S, et al¹⁸	Multicenter study	06 to14	Early postoperative feeding in children undergoing appendectomy affected the occurrence of the first flatus and feces evacuation, the length of hospital stay and the level of hunger, thirst and pain. It was suggested that nurses together with the multidisciplinary team incorporate evidence found and affirm the development of early feeding protocols together with the team.
Santos, MP²⁸	Case study	17	In developing a nursing care plan, it was possible to identify intra, inter and extra personal factors that allowed planning the care and prevention levels proposed by Neuman, expanding nursing vision to holism and well-being. Pain, anxiety and risk of neurological injury were the most recurrent stressors.
Martinelli, AM³²	Case study	13	Perioperative nursing care promotes recovery and reduces hospital stay. The postoperative period was uneventful, with patients being discharged six days after surgery without complications. Investing in the care plan enables patients to return to daily activities sooner.
Balakas K, et al¹⁹	Theoretical guide	0 to 18	A care guide for neuroatypical patients and challenging behaviors was created. It was suggested to maintain the room ambiance, reduce waiting times, have a reference professional, and improve communication among the team. In addition, it was recommended to include the family in care, administer medications before arrival at the hospital, identify the rooms of patients with challenging behaviors, and use People First Language.
Busen N, et al³²	Theoretical guide	Not specified	The guide highlighted ensuring patient safety, planning and management of perioperative care with educational interventions that can reduce anxiety among family members and adolescents during surgical preparation. It provided recommendations for clinical approach to adolescents according to their age and application of informed consent.
Bray L, et al²⁰	Theoretical guide	Not specified	Theoretical guide for children and young people with ostomies that addressed preparation for placement of the device, through games, photo albums, storyboard construction and living diary. The use of serious games was encouraged as an alternative to individualize care.
YOO JB, et al²¹	Post hoc nonequivalent control design	Children and adolescents (no age specified) (n:76)	The study demonstrated that providing visual information about the anesthesia recovery room and maintaining the presence of a family member in this unit was effective in reducing anxiety, delirium and pain in children and adolescents upon awakening from anesthesia. It is recommended that nursing staff follow this approach.
Fina K²⁹	Case report	13	Holistic perioperative nursing care for children and their families should consider assessing spiritual needs and identifying interventions that help patients and families achieve spiritual comfort, such as the use of therapeutic listening and facilitated access to the practice of religious rites and rituals according to beliefs.
Sampaio CEP, et al²²	Systematic review	Not specified	Anxiety is one of the predominant feelings in patients undergoing surgery, which directly impacts the care provided. Nursing should act through actions that guide patients and are capable of mitigating the emotional burden. The review recognized the importance of family support and interaction with support groups to reduce anxiety.
Santos MP, et al¹⁴	Integrative review	Not specified	The review identified the psychological, social and physical manifestations related to perioperative care in adolescents. It indicated their desire to obtain information about the surgery and to be leading actors in their care, in addition to involving their parents in this process. It highlighted the need to expand studies on the subject.
Lima FM, et al²³	Qualitative-quantitative study	10-19	Adolescents waited for surgery in the corridor of the surgical center, which negatively impacted their experience. They complained of embarrassment due to the surgical attire used, and more than half of participants classified the surgical procedure as unpleasant. The study indicated that the attire should be readjusted and that it is essential for nurses to assist adolescents through contact prior to surgery to understand patients’ needs.
Gray literature
Santos MP¹⁴	Case study, systematic review	Not specified	The study developed a perioperative anxiety prevention system called 3P2A following the first phase of the Medical Research Council’s complex interventions model. Reviews and original research were conducted, such as case studies and qualitative assessments that addressed: adolescents’ perception of the perioperative period; nurses’ performance aimed at adolescents; and the use of non-pharmacological interventions such as Integrative and Complementary Practices as a way to reduce adolescent anxiety. From this, a model was created to be applied in the pre-, trans-, and post-operative periods to be tested in future research.
Pereira MJASN³⁰	Systematic literature review with a quantitative approach	11 to 15 years	Guided imagery, relaxation training, and music therapy were shown to be tools for reducing anxiety in adolescents preparing for surgery. The results support the need for nurses to be trained to provide individually tailored information to adolescents, and it is imperative that healthcare disciplines collaborate to design effective perioperative education programs.
Sardinha P²⁴	Project methodology	Not specified	The computerized system for the preparation of anesthetic drugs can prevent errors related to anesthetic therapy and should be encouraged in the routine of the Surgical Center.
Aciolly P²⁵	Methodological study	Not specified	Methodological study aimed at creating an instrument to be used in pediatric perioperative nursing care.
D`Oliveira DAE²⁶	Project Methodology.	Not specified	The lack of structure to receive parents/significant others is a gap in perioperative care, in addition to the lack of knowledge of this right or the presence of fears/concern about entering the service. The presence of parents/significant others increases parental satisfaction, reduces parental anxiety in the preoperative period and in the waiting room, increases confidence in perioperative care, reduces children’s anxiety and represents a link with the child/young person.
Canejo I²⁷	Project Methodology.	Not specified	Having a companion until anesthesia induction gave the companions peace of mind. Patients reported that the presence of a family member was important because they felt safer, calmer and more comfortable. The fact that they could take their favorite toy with them also helped.

Standard	Advances	Gaps	Evidence for practice	Research recommendation
Interventions¹⁶^-³³	Strategies such as preoperative visit, serious game, comic book, integrative practices.	Appropriate time to apply the strategy to obtain desired results in controlling fear and anxiety.	The use of interaction strategies increases understanding of the surgical period and involves the adolescent in self-care.	Randomized clinical trials that test interventions at different time points.
Common preoperative feelings among adolescents ¹⁶^,²¹^-²⁶	Reinforcement of the need for a companion/significant other in the perioperative period.	The institutions’ routines do not allow people to enter during anesthetic induction and in the PACU.	The presence of parents or a significant other reduces post-surgical delirium and favors post-anesthetic recovery.	Establish protocols that allow companions to enter until the moment of anesthetic induction.
Similar treatment for pediatric and adolescent patients ²⁹^-³¹	Individualizing care provides significant results in the perioperative period.	Lack of professional preparation to deal with neuroatypical and transsexual adolescents.	Strategies to individualize care according to the adolescents’ profile contribute to greater involvement in surgical self-care.	Investigate groups of children and adolescents separately.