Understanding Frailty in Surgical Care: A Phenomenological Study of Newly Graduated Nurses’ Perspectives and Clinical Approaches

Öz

This study aimed to explore newly graduated nurses’ perceptions and clinical approaches toward frailty in surgical patients and to identify their educational requirements and structural support needs for professional development in this area. A phenomenological qualitative design was used. In-depth, face-to-face interviews were conducted with 16 newly graduated nurses working in four surgical specialties (orthopedics, general surgery, cardiovascular surgery, and neurosurgery) across five tertiary hospitals in hospitals in İstanbul. Interviews were audio-recorded, transcribed verbatim, and analyzed using interpretative phenomenological analysis to identify themes and subthemes. Data were collected between April and July 2025. Six themes were identified: (1) perceptions and definitions of frailty, (2) recognition of frailty’s clinical importance, (3) care needs of frail patients, (4) clinical complexity and adaptive (non-standardized) practice, (5) institutional gaps in frailty management, and (6) educational and workforce support needs. Participants often understood frailty in lay terms rather than clinical ones, yet recognized its impact on delayed recovery, higher complication risk, and psychosocial vulnerability.  Newly graduated nurses perceive frailty as a notable determinant of surgical outcomes but lack the knowledge, tools, and institutional support to address it systematically. Incorporating frailty-focused education into undergraduate curricula and orientation programs may enhance early identification. Standardized screening and multidisciplinary collaboration are needed to strengthen frailty-sensitive nursing practice and improve outcomes for surgical patients.

Anahtar Kelimeler

• Frailty
• Newly graduated
• Perioperative care
• Qualitative research
• Surgical nursing.

Etik Beyan

Ethical approval for the study was obtained from the Yeditepe University Ethics Committee prior to data collection (Date: 14 March 2025, Approval no: E.83321821-805.02.03-586).

Cerrahi Bakımda Kırılganlığı Anlamak: Yeni Mezun Hemşirelerin Bakış Açıları ve Klinik Yaklaşımlarına Dair Fenomenolojik Bir Çalışma

Öz

Bu çalışma, yeni mezun hemşirelerin cerrahi hastalarda kırılganlığa ilişkin algılarını ve klinik yaklaşımlarını araştırmayı ve bu alandaki mesleki gelişimleri için eğitim gereksinimlerini ve yapısal destek ihtiyaçlarını belirlemeyi amaçlamıştır. Fenomenolojik nitel bir tasarım kullanılmıştır. İstabul ilindeki beş üçüncü basamak hastanede, dört cerrahi alanında (ortopedi, genel cerrahi, kardiyovasküler cerrahi ve nöroşirürji) çalışan 16 yeni mezun hemşire ile derinlemesine yüz yüze görüşmeler yapılmıştır. Görüşmeler ses kaydı alınarak, yazıya dökülmüş ve temaları ve alt temaları belirlemek için yorumlayıcı fenomenolojik analiz kullanılarak analiz edilmiştir. Veriler Nisan ve Temmuz 2025 tarihleri ​​arasında toplanmıştır. Altı tema belirlenmiştir: (1) kırılganlık algıları ve tanımları, (2) kırılganlığın klinik öneminin tanınması, (3) kırılgan hastaların bakım ihtiyaçları, (4) klinik karmaşıklık ve uyarlanabilir (standartlaştırılmamış) uygulama, (5) kırılganlık yönetiminde kurumsal eksiklikler ve (6) eğitim ve iş gücü desteği ihtiyaçları. Katılımcılar genellikle kırılganlığı klinik terimlerden ziyade genel kullanımdaki haliyle algıladıklarını, ancak iyileşmenin gecikmesi, komplikasyon riskinin artması ve psikososyal kırılganlık üzerindeki etkisini fark ettiklerini bildirmişti. Yeni mezun hemşireler kırılganlığı cerrahi sonuçların önemli bir belirleyicisi olarak görmekle beraber, bunu sistematik olarak ele almak için gerekli bilgiye, araçlara ve kurumsal desteğe sahip olmadıklarını ifade etmişlerdi. Kırılganlığa odaklı eğitimin lisans müfredatına ve oryantasyon programlarına entegre edilmesi, erken tanılanmasını güçlendirebilir. Kırılganlığa duyarlı cerrahi hemşireliği uygulamalarını güçlendirmek ve cerrahi hastaları için sonuçları iyileştirmek için standartlaştırılmış tarama ve çok disiplinli işbirliğine ihtiyaç bulunmaktadır.

Anahtar Kelimeler

• Kırılganlık
• Yeni mezun
• Perioperatif bakım
• Kalitatif araştırma
• Cerrahi hemşireliği.

Kaynakça

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