Unpacking the Broad Landscape of Intraoperative Stressors for Clinical Personnel: A Mixed-Methods Systematic Review

Abstract

Ahreum Lee,1 Mastaneh Torkamani-Azar,2 Bin Zheng,3 Roman Bednarik4 1Samsung Electronics Co. Ltd., Suwon, Gyeonggi-do, Republic of Korea; 2University of Eastern Finland, Kuopio, Finland; 3Department of Surgery, University of Alberta, Edmonton, Canada; 4University of Eastern Finland, Joensuu, FinlandCorrespondence: Roman Bednarik, University of Eastern Finland, Joensuu, Finland, Email [email protected]: The main goals of this mixed-methods systematic review are to identify what types of intraoperative stressors for operating room personnel have been reported in collected studies and examine the characteristics of each intraoperative stressor.Methods: With a systematic literature search, we retrieved empirical studies examining intraoperative stress published between 2010 and 2020. To synthesize findings, we applied two approaches. First, a textual narrative synthesis was employed to summarize key study information of the selected studies by focusing on surgical platforms and study participants. Second, a thematic synthesis was employed to identify and characterize intraoperative stressors and their subtypes.Results: Ninety-four studies were included in the review. Regarding the surgical platforms, the selected studies mainly focused on minimally invasive surgery and few studies examined issues around robotic surgery. Most studies examined intra-operative stress from surgeons’ perspectives but rarely considered other clinical personnel such as nurses and anesthetists. Among seven identified stressors, technical factors were the most frequently examined followed by individual, operating room environmental, interpersonal, temporal, patient, and organizational factors.Conclusion: By presenting stressors as multifaceted elements affecting collaboration and interaction between multidisciplinary team members in the operating room, we discuss the potential interactions between stressors which should be further investigated to build a safe and efficient environment for operating room personnel.Keywords: intraoperative stressors, team dynamics, communication and teamwork in health care, medical devices and technologies

Keywords

• intraoperative stressors
• team dynamics
• communication and teamwork in health care
• medical devices and technologies