Journal of Perianesthesia Nursing最新文献

{"title":"Variability in Postoperative Voiding Practices Across Gynecologic Services: Opportunities for Standardized Protocols in Outpatient Care.","authors":"Chantel Galang, Eden Chang, Mary Dumlao, Ashley Mulhausen, Tyler Calma, M Jonathon Solnik","doi":"10.1016/j.jopan.2026.09.019","DOIUrl":"https://doi.org/10.1016/j.jopan.2026.09.019","url":null,"abstract":"<p><strong>Purpose: </strong>Delayed trial of void (TOV) after outpatient gynecologic surgery can prolong recovery and delay discharge. Despite its importance, no standardized voiding protocol exists, leading to inconsistent practices across general gynecology (GYNE), urogynecology (UROGYNE), and gynecologic oncology (GYNEONC) services. This project characterized variation in postoperative TOV management and identified factors associated with time to first void to inform future standardized, risk-stratified protocol development.</p><p><strong>Design: </strong>A single-center retrospective review of outpatient gynecologic surgery was conducted using quality improvement methodology.</p><p><strong>Methods: </strong>Patients undergoing outpatient gynecologic procedures at a tertiary hospital between August 2023 and August 2024 were included (n = 185). Descriptive statistics compared patient characteristics, operative factors, and postoperative bladder management practices. Multivariable linear regression evaluated time to first void, adjusting for age and body mass index (BMI). Secondary outcomes included post-anesthesia care unit (PACU) length of stay, retrofill practices, and physician-directed voiding criteria. Exploratory sensitivity analyses using nested linear models evaluated the influence of operative duration, intraoperative narcotic administration, and retrofill volumes.</p><p><strong>Findings: </strong>Postoperative bladder management varied across services, including retrofill practices, voiding criteria, post-void residual thresholds, and the number of permitted voiding attempts. After adjustment for age and BMI, time to first void attempt was 44.7 minutes longer in GYNE patients and 57.8 minutes longer in GYNEONC patients than in UROGYNE patients. Further adjustment for operative duration and intraoperative narcotic administration attenuated between-service differences, suggesting that operative complexity accounted for part, but not all, of the observed variation; most variance in time to first void remained unexplained. PACU length of stay was similarly prolonged across all services (GYNE 306.7 ± 140.6 minutes, GYNEONC 314.8 ± 136.1 minutes, UROGYNE 303.9 ± 109.5 minutes) despite differences in TOV timing.</p><p><strong>Conclusions: </strong>Substantial variation in postoperative TOV management existed across outpatient gynecologic surgical services. Although differences in time to first void were partially explained by operative duration and intraoperative narcotic administration, meaningful variability persisted in retrofill practices, void timing, and physician-directed voiding criteria. These findings support prospective evaluation of a risk-stratified, evidence-informed TOV protocol using patient-centered outcomes.</p>","PeriodicalId":49028,"journal":{"name":"Journal of Perianesthesia Nursing","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149326637","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Feasibility Trial Examining Acupressure Wristbands in Ambulatory Surgery Patients at Risk for Post-Discharge Nausea and Vomiting.","authors":"Aya Tagami, Shaunattonie Henry, Michael McGillion, Kalpana Nair, Sandra L Carroll","doi":"10.1016/j.jopan.2026.09.021","DOIUrl":"https://doi.org/10.1016/j.jopan.2026.09.021","url":null,"abstract":"<p><strong>Purpose: </strong>Postoperative nausea and vomiting (NV) can lead to complications like pain and bleeding. In ambulatory surgery patients, post-discharge NV impacts 40% to 80% of patients undergoing laparoscopically assisted vaginal hysterectomy (LAVH). Pericardium 6 (PC6) acupressure may prevent postoperative NV in hospital, but little is known regarding its effect on post-discharge NV. The purpose of this study was to examine the feasibility of a trial to test the effects of bilateral PC6 acupressure wristbands plus usual care versus placebo plus usual care on post-discharge NV.</p><p><strong>Design: </strong>A parallel-arm feasibility randomized controlled trial was employed.</p><p><strong>Methods: </strong>Primary outcomes included rates of consent, randomization, intervention/placebo delivery, continuous wristband wear, and retention. Twenty participants undergoing ambulatory LAVH were randomized to either a) usual post-discharge NV care plus bilateral PC6 acupressure wristbands, or b) usual care with bilateral placebo wristbands. Wristbands were placed on arrival to the recovery room and worn until 24 hours after discharge. Follow-up calls were made to gather outcome data.</p><p><strong>Findings: </strong>Three a priori criteria for feasibility success were met: rates of randomization, continuous wear, and retention.</p><p><strong>Conclusions: </strong>It was feasible to conduct a trial where a registered nurse delivered acupressure wristbands versus placebo wristbands to patients in the recovery room following LAVH under general anesthesia. Post-discharge symptom management is an important component of nursing practice. If acupressure wristbands are found to be effective at preventing post-discharge NV in larger trials, registered nurses are well-positioned to educate patients about a cost-effective intervention with minimal risk of side effects.</p>","PeriodicalId":49028,"journal":{"name":"Journal of Perianesthesia Nursing","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149301554","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perianesthesia Nursing Considerations for the Patient with Placenta Accreta Spectrum.","authors":"Melanie Chichester, Nancy Homan, Abbey Austin, Valerie Rappa","doi":"10.1016/j.jopan.2026.08.010","DOIUrl":"https://doi.org/10.1016/j.jopan.2026.08.010","url":null,"abstract":"<p><p>Pregnant patients with Placenta Accreta Spectrum (PAS) require complex care. Coordination and communication across the interdisciplinary team are vital for optimal outcomes. Familiarizing the perianesthesia nurse with concepts specific to this diagnosis greatly impacts mother-baby-family unit and can significantly reduce the risk of maternal morbidity. As the patient with PAS may require care outside the obstetric department, it is imperative to ensure the perianesthesia nurse has the requisite knowledge to serve as the hub of the interdisciplinary team. The purpose of this article is to review current information regarding patients with a diagnosis of PAS and to provide evidence-based interventions for holistic perianesthesia nursing care.</p>","PeriodicalId":49028,"journal":{"name":"Journal of Perianesthesia Nursing","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149276133","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Deep Cervical Lymphaticovenous Anastomosis (LVA) for Alzheimer's Disease: A Case Report.","authors":"Xiu Liang, Conghui Jiang, Hairong Zhug, Ying Sun, Shumin Tu, Jiamin Kang","doi":"10.1016/j.jopan.2026.08.005","DOIUrl":"https://doi.org/10.1016/j.jopan.2026.08.005","url":null,"abstract":"<p><p>This case report describes the short-term observed clinical course of a 65-year-old patient with Alzheimer's disease (AD) who underwent deep cervical lymphaticovenous anastomosis (LVA) under general anesthesia, and summarizes the perianesthesia nursing care provided before, during, and after anesthesia. Neuropsychological assessments showed limited changes in cognitive scores at 1 month after surgery, including a 1-point increase in MMSE and a 1-point decrease in ADAS-Cog, while ADCS-ADL declined. The NPI score decreased from 21 preoperatively to 0 on postoperative day 3 and remained lower than baseline, with a score of 2 at 1 month. Given the single-case design, short follow-up period, and lack of a control condition, these observations should be interpreted cautiously and cannot establish treatment efficacy. Deep cervical LVA may warrant further investigation as an exploratory surgical approach for AD, and perianesthesia nursing care may support perioperative safety, recovery, and complication prevention in this context. Further controlled studies with longer follow-up are needed.</p>","PeriodicalId":49028,"journal":{"name":"Journal of Perianesthesia Nursing","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149220788","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nursing Students' Approach to Child Patients Who Have Undergone Surgery: A Qualitative Study.","authors":"Aydın Nart, Meltem Aslan, Bengisu Akoğlu, Sedef Alataş Demirtaş","doi":"10.1016/j.jopan.2026.09.020","DOIUrl":"https://doi.org/10.1016/j.jopan.2026.09.020","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to explore nursing students' experiences and challenges during their clinical practice with pediatric patients who had undergone surgery, with particular attention to the meanings they attributed to these experiences.</p><p><strong>Design: </strong>A qualitative study using reflexive thematic analysis.</p><p><strong>Methods: </strong>Semi-structured interviews were conducted with 20 undergraduate nursing students studying at a foundation university in Türkiye. Interviews lasted approximately 15 to 20 minutes and focused on students' clinical experiences, emotional responses, communication processes, perceived challenges, and educational needs in pediatric surgical care. The interviews were audio-recorded, transcribed verbatim, and analyzed using reflexive thematic analysis following Braun and Clarke's approach with the support of MAXQDA 2022.</p><p><strong>Findings: </strong>The analysis identified six interrelated themes reflecting students' experiences in pediatric surgical care, including professional satisfaction through witnessing recovery, challenges in pain and fear management, communication strategies adapted to developmental level, the theory-practice gap, ethical dilemmas, and emotional burden. Students reported that observing children's recovery was motivating, while managing pain, fear, and family anxiety posed significant challenges.</p><p><strong>Conclusions: </strong>Nursing students' experiences in pediatric surgical settings reflect both learning opportunities and contextual challenges that shape their professional development. The findings highlight the importance of structured, practice-based educational strategies focusing on pain and fear management, developmentally appropriate communication, family-centered care, ethical decision-making, and emotional support for students.</p>","PeriodicalId":49028,"journal":{"name":"Journal of Perianesthesia Nursing","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149229183","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preoperative Anxiety Among Hospitalized Pediatric Patients with CHD: A Qualitative Study From the Perspectives of Health Care Professionals and Parents.","authors":"Qinglan Li, Ruijie Yanglan, Jingran Yang, Yu Wang, Shu Peng, Wantong Yao, Jingjing Zhang, Fang Ma","doi":"10.1016/j.jopan.2026.09.017","DOIUrl":"https://doi.org/10.1016/j.jopan.2026.09.017","url":null,"abstract":"<p><strong>Purpose: </strong>Preoperative anxiety commonly occurs in children with congenital heart disease(CHD), undermining their psychological function and postoperative recovery. Targeted anxiety interventions require a systematic understanding of children's preoperative stress. As key caregivers, parents and health care professionals(HCPs) undrepin intervention development; therefore, this study aimed to explore how parents and HCPs perceive preoperative anxiety in pediatric patients with CHD within the Chinese cutural and social context.</p><p><strong>Design: </strong>This studyadopted a descripitive phenomenological qualitative approach.</p><p><strong>Methods: </strong>. Between January and April 2026, semi-structured interviews were conducted with 23 parents of pediatric patients with CHD and nine HCPs in a tertiary hospital in Kunming. Interview data were managed via NVivo 12.0 and analyzed through thematic analysis.</p><p><strong>Findings: </strong>(1) Existence versus non-existence of preoperative anxiety, (2) Preoperative anxiety due to children and parental factors, (3) Diverse manifestations of preoperative anxiety, and (4) Ways of coping with Preoperative Anxiety.</p><p><strong>Conclusions: </strong>Anxiety in pediatric patients with CHD is sometimes suppressed or overlooked. It is crucial to improve the ability of parents and HCPs to identify pediatric anxiety and encourage children to express their emotions. Surgery-related information should be delivered to children in age-appropriate and comprehensible language. Given the communal nature of family emotions, parental negative emotions also require attention, and unnecessary parent-child separation should be minimized. Among the management strategies for preoperative anxiety, pharmacological interventions exert rapid effects, while non-pharmacological interventions are more favored due to the absence of adverse reactions. Influenced by the Confucian culture of \"forbearance\", some parents tend to ignore their children's anxious emotions, highlighting the importance of educating parents about the value of appropriate support.</p>","PeriodicalId":49028,"journal":{"name":"Journal of Perianesthesia Nursing","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149217225","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementing a Parental Anxiety Reduction Protocol (PARP) in the Perioperative Period.","authors":"Kailey Beckett, Grace Flaherty, Kendra Thompson, Cynthia Dabney, Kenneth Wofford, Lauren Freedman, Karla Maldonado","doi":"10.1016/j.jopan.2026.09.007","DOIUrl":"https://doi.org/10.1016/j.jopan.2026.09.007","url":null,"abstract":"<p><strong>Purpose: </strong>Parents and children often experience anxiety when a child undergoes a surgical procedure. Parental anxiety may influence the child's perioperative experience and has been associated with increased child anxiety, which is linked to adverse postoperative outcomes, including an increased incidence of postoperative delirium, higher pain scores, and a greater need for intraoperative analgesia. The effects of untreated preoperative anxiety may extend beyond the immediate perioperative period and contribute to maladaptive behaviors at home. The purpose of this project was to implement and evaluate a structured protocol designed to reduce parental anxiety during the pediatric perioperative period.</p><p><strong>Design: </strong>An evidence-based quality improvement project guided by the Knowledge-to-Action model was conducted over a 3-month period at a Level I pediatric trauma hospital. The project targeted parents of children aged 2 to 10 years undergoing outpatient surgical procedures.</p><p><strong>Methods: </strong>A Parental Anxiety Reduction Protocol was developed using three evidence-based interventions implemented across the perioperative continuum. The protocol included an educational pamphlet provided to parents at registration, play therapy for children in the preoperative setting, and a meditation video provided to parents during the intraoperative phase. Parental anxiety was measured before and after implementation of the protocol using the State-Trait Anxiety Inventory-6 (STAI-6). Pre- and postintervention anxiety scores were statistically analyzed to evaluate the effectiveness of the protocol.</p><p><strong>Findings: </strong>Implementation of the Parental Anxiety Reduction Protocol resulted in a statistically significant reduction in parental anxiety scores. Postintervention STAI-6 scores were significantly lower than preintervention scores (P < .001), demonstrating that the multimodal perioperative intervention was effective in reducing parental anxiety.</p><p><strong>Conclusions: </strong>A structured, evidence-based perioperative protocol incorporating parental education, pediatric play therapy, and parental meditation significantly reduced parental anxiety among parents of children undergoing outpatient surgery. Reducing parental anxiety may also help mitigate pediatric perioperative anxiety and contribute to improved perioperative experiences and outcomes for children and their families.</p>","PeriodicalId":49028,"journal":{"name":"Journal of Perianesthesia Nursing","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149196523","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Postoperative Delirium in Pediatric Surgery Patients: Prevalence, Risk Factors, and Parental Anxiety.","authors":"Esra Durmayüksel, Özlem İbrahimoğlu, Hülya Saray Kılıç, Aslı Akdeniz Kudubeş, Sümeyye Meryem Soyalan Cebeci","doi":"10.1016/j.jopan.2026.09.015","DOIUrl":"https://doi.org/10.1016/j.jopan.2026.09.015","url":null,"abstract":"<p><strong>Purpose: </strong>This study aims to determine the prevalence and risk factors of postoperative delirium in pediatric surgical patients and its relationship with parental anxiety and the time the parent is taken to the child's care.</p><p><strong>Design: </strong>This is a descriptive and cross-sectional study.</p><p><strong>Methods: </strong>This study was conducted with 127 pediatric patients and their parents in Turkey between August 2023 and August 2024. Data were collected using the Parent Information Form, the short form of the State-Trait Anxiety Inventory for parents, and the Ramsay Sedation Scale and Cornell Pediatric Delirium Rating Scale-Revised for children.</p><p><strong>Findings: </strong>The prevalence of postoperative delirium in children was 69.3%. Among parents, 79.5% experienced state anxiety and 21.3% experienced trait anxiety. Parents were reunited with their children an average of 13.42 ± 8.73 minutes after surgery, and a significant association was found between the timing of this reunion and the presence of delirium. Children whose parents were reunited later exhibited higher delirium rates.</p><p><strong>Conclusions: </strong>Postoperative delirium is highly prevalent among pediatric surgical patients and is influenced not only by biological factors but also by psychosocial and familial dynamics. Earlier parent-child reunification was associated with a lower prevalence of postoperative delirium in this study, highlighting the potential relevance of family-centered care in the early postoperative period. Strengthening family-centered nursing care and developing evidence-based interventions targeting early parental involvement are crucial for improving postoperative outcomes in children.</p><p><strong>Application to practice: </strong>Surgical nurses should strengthen their systematic observation skills and integrate family-centered care principles into practice to ensure early recognition of postoperative delirium and support holistic recovery in pediatric patients.</p>","PeriodicalId":49028,"journal":{"name":"Journal of Perianesthesia Nursing","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149185391","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nurses' Experiences and Perspectives on Perioperative Care During Neonatal Circumcision: A Qualitative Study.","authors":"Meltem Aslan, Aydın Nart, Bengisu Akoğlu","doi":"10.1016/j.jopan.2026.09.016","DOIUrl":"https://doi.org/10.1016/j.jopan.2026.09.016","url":null,"abstract":"<p><strong>Purpose: </strong>To explore nurses' knowledge, experiences and perceptions of perioperative care related to neonatal circumcision and to identify implications for nursing practice and care standardization.</p><p><strong>Design: </strong>A qualitative descriptive study.</p><p><strong>Methods: </strong>Twenty-eight nurses working in neonatal care settings and involved in neonatal circumcision care were recruited using snowball sampling. Data were collected through face-to-face, semi-structured in-depth interviews and analyzed using Braun and Clarke's reflexive thematic analysis. Reporting followed the Consolidated Criteria for Reporting Qualitative Research.</p><p><strong>Findings: </strong>Five themes were identified: (1) knowledge and training needs, (2) clinical assessment of circumcision timing, (3) postoperative nursing care and family education, (4) interprofessional collaboration and nursing roles in perioperative care, and (5) policy and protocol needs. Nurses described variation in clinical practices and highlighted challenges related to pain assessment, bleeding and complication monitoring, and family education. Clinical experience was perceived as an important contributor to competence. Participants also emphasized the importance of coordinated perioperative care and greater standardization of neonatal circumcision practices.</p><p><strong>Conclusions: </strong>Nurses have important roles throughout neonatal circumcision care, particularly in clinical assessment, pain and complication monitoring, family education, and interprofessional coordination. Practice-oriented education, standardized perioperative care protocols, and strengthened interdisciplinary communication may contribute to safer and more consistent neonatal circumcision care.</p>","PeriodicalId":49028,"journal":{"name":"Journal of Perianesthesia Nursing","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149185269","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association Between Relative Plasma Hyperosmolality and Postoperative Delirium Following Cardiac Surgery: A Post Hoc Analysis.","authors":"Helena Claesson Lingehall, Staffan Svenmarker, Micael Appelblad, Yngve Gustafson, Birgitta Olofsson","doi":"10.1016/j.jopan.2026.09.008","DOIUrl":"https://doi.org/10.1016/j.jopan.2026.09.008","url":null,"abstract":"<p><strong>Purpose: </strong>To determine whether relative plasma hyperosmolality is independently associated with postoperative delirium (POD) and to explore the relationship between the cumulative number of concurrent perioperative variables and POD in patients aged greater than or equal to 65 years undergoing cardiac surgery.</p><p><strong>Design: </strong>Post hoc analysis.</p><p><strong>Methods: </strong>This post hoc analysis of a randomized controlled trial included 195 consecutive patients enrolled between March 2019 and June 2020 at a tertiary hospital in Sweden. The incidence of POD was 36% (70/195). POD was assessed preoperatively and postoperatively on days 1 and 3, based on the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Plasma osmolality was measured on five occasions and coordinated with POD assessments. Potential perioperative variables associated with POD were analyzed using a multivariable logistic regression model.</p><p><strong>Findings: </strong>The main findings indicate that relative hyperosmolality on the third postoperative day may represent a biochemical factor independently associated with the development of POD, and the presence of more than two concurrent perioperative factors, which may increase the likelihood of POD eightfold.</p><p><strong>Conclusions: </strong>Relative plasma hyperosmolality may be associated with POD after cardiac surgery. The accumulation of concurrent perioperative variables also appears important and supports further investigation of multicomponent prevention strategies. Multicenter studies are needed to confirm these findings.</p>","PeriodicalId":49028,"journal":{"name":"Journal of Perianesthesia Nursing","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149117251","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}