Perioperative thirst: an analysis from the perspective of the Symptom Management Theory

Abstract

A theoretical study aimed to analyze the existing knowledge in the literature on the perioperative thirst symptom from the perspective of Symptom Management Theory, and supplemented with the experience of the study group and thirst research. Thirst is described as a very intense symptom occurring in the perioperative period, and for this reason it cannot be ignored. The Symptom Management Theory is adequate for understanding the thirst symptom and is a deductive theory, focused on the domains of the Person, Environment and Health / Illness Status, as well as on the dimensions of Experience, Management Strategies and Symptom Outcomes. Using the theory leads us to consider perioperative thirst in its multifactorial aspects, analyzing the interrelation of its domains and dimensions in order to draw attention to this symptom that has been insufficiently valued, recorded and treated in clinical practice.

The use of mentholated popsicle to reduce thirst during preoperative fasting: A randomised controlled trial

“…These observations were similar to studies conducted in other countries (Abebe et al, ; Aguilar‐Nascimento et al, ; Francisco et al, ; Gul et al, ). Thirst in these patients is not only due to the duration of fasting, but can also be influenced by anxiety, medication type and age, for example (Arai et al, ; Conchon et al, ; Leiper, ). It is possible that our results were influenced by the duration of fasting (longer fasting might lead to higher level of thirst), but these are exactly the patients that could benefit from the intervention and are our target population.…”

“…Thirst is a multifactorial symptom that can be stimulated by the necessity of hydration, necessity of normalisation of blood volume and plasma osmolarity, or can be initiated by various personal and cultural characteristics of an individual, such as palatability of ingested liquids and food habits (Leiper, 2005;Stevenson, Mahmut, & Roone, 2015). In addition, thirst can be affected by processes related to health and disease, environment, and life experiences, all of which might influence on how a person perceives and reacts to the symptom (Conchon, Nascimento, Fonseca, & Aroni, 2015). Factors that can affect the intensity and discomfort from thirst include fasting, anxiety, medications, and age, among others (Arai, Stotts, & Puntillo, 2013;Conchon et al, 2015;Leiper, 2005).…”

Developing and validating the Perioperative Thirst Discomfort Scale

“…Variability in individual perception regarding fasting, thirst, and gastric fullness has been investigated, since it is influenced by personal characteristics, as well as motivational and affective factors (22) . Thirst is also affected by physiological, environmental and health-disease process factors, being considered a multifactorial symptom (2,22) . EDESP seeks to evaluate these individual differences in thirst perception as it allows for discriminating the intensity of the discomfort caused by its different attributes, and which the scales that exclusively measure the intensity of thirst cannot differentiate.…”

“…When not quenched by water intake, thirst becomes an unpleasant feeling so imperative that it can outweigh all the others (2) . Surgical patients are part of a group at high risk of developing both osmotic and hypovolemic thirst (1,3) .…”

“…Surgical patients are part of a group at high risk of developing both osmotic and hypovolemic thirst (1,3) . In the perioperative period, patients are exposed to several factors predisposing to the thirst symptom, such as prolonged preoperative fasting, anesthetic-surgical medications, orotracheal intubation and blood loss (1)(2)(3)(4) . When the confluence of these factors are added to anxiety, irritability, stress and fear of anesthesia and surgery (2,(4)(5) , it results in thirst being one of the most distressing aspects for the patient.…”