title: Experience of anaesthesia nurses of perioperative communication in hip fracture patients with dementia.
abstract: BACKGROUND
  Perioperative care in hip fracture patients with dementia can be complex. There is currently little scientific evidence on how care should be undertaken.
  
  
  OBJECTIVE
  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.
  
  
  RESULTS
  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.
authors: Department of Orthopedics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
authors: Ferid
authors: F
authors: Krupic
authors: Unit of Orthopedics, Department of Clinical Sciences, Danderyd Hospital, Karolinska Institutet, Stockholm, Sweden.
authors: Thomas
authors: T
authors: Eisler
authors: Unit of Orthopedics, Department of Clinical Sciences, Danderyd Hospital, Karolinska Institutet, Stockholm, Sweden.
authors: Olof
authors: O
authors: Sköldenberg
authors: Sahlgrenska Academy, Institute of Health and Care Sciences, University of Gothenburg, Gothenburg, Sweden.
authors: Nabi
authors: N
authors: Fatahi
mesh_terms: D003142:Communication; D003704:Dementia / Q000150:complications*; D006620:Hip Fractures / Q000150:complications / Q000523:psychology* / Q000601:surgery; D006801:Humans; D009719:Nurse Anesthetists / Q000523:psychology*; D009723:Nurse-Patient Relations; D059035:Perioperative Period
keywords: communication; dementia; hip fracture; nursing; perioperative care