Journal of advanced nursing
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This paper explores one facet of a therapeutic relationship with a woman suffering from inoperable cervical cancer. The psychotherapy sessions were conducted in both hospital and the family home and continued on a weekly basis until final termination immediately prior to the woman's death. Through a "suspense structure' case study narrative, the writer, a nurse psychotherapist, describes the way in which the humanities, art and poetry can provide a means through which to understand seemingly incomprehensible feelings related to reviewing past events as a preparation for death. ⋯ The author proposes that engagement in a therapeutic relationship with a dying person presents the worker with parallel struggles manifesting in elementary feelings which require discernment. The central recommendation of this paper is that the rich symbolic language and metaphors, redolent in art and poetry, be harnessed as a potent therapeutic tool. Throughout the discussion, the terms counselling and psychotherapy are used interchangeably.
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This paper explores the concept of humour by exposing it to the analytical framework of Walker and Avant. The paper then seeks to examine the benefit humour has in child and parent health education. Whilst the author argues that the framework utilized to analyse the concept is positivistic in nature, emphasis is given to the value of humour and the various meanings ascribed to it in the real world. ⋯ The findings of this small study indicated that whilst humour is delicate and may be inappropriate in certain settings it appears to have a positive correlation with information giving and reduced anxiety levels amongst parents of hospitalized children when used appropriately. The analytical components of the concept were examined carefully and it appeared that the tool used to analyse the concept was successful in that the theoretical framework was directly related to practice, however, the framework also highlighted the delicate nature of the concept and the dangers of inappropriate use. The paper argues, however, that humour does play a part in the delivery of skilled, sensitive and competent care and the need for nurse education to address this is paramount.
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Postoperative patients differ in their response to pain and opioids. It is therefore important that nurses offer other options as adjuvants to medication. Relaxation and music may reduce pain by interrupting the postoperative cycle of pain, muscle tension and sympathetic activity. ⋯ However, the between-study differences in surgical procedures, experimental techniques, activities during testing, measurement of pain, and amount of practice make comparisons difficult. Furthermore, within studies, the problems of inadequate sample size, lack of random assignment, no assurance of pretest equivalence, delayed post-test administration and no control for opiates at the time of testing reduces the validity of the studies' conclusions. Randomized controlled studies of the types of relaxation and music that are most helpful to postoperative patients should be explored in various contexts.
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Randomized Controlled Trial Clinical Trial
Effects of critical care unit noise on the subjective quality of sleep.
Nurse researchers have provided evidence that hospital critical care unit (CCU) noise may put patients at risk for sleep problems. Technological advances in this setting have been described as contributing to this problem. Although data on the negative effects of CCU noise on physiological sleep are available, less attention has been given to self-reports of the subjective quality of sleep following exposure to this stressor. ⋯ Data on the quality of dreams yielded no difference between groups. The results provide support for the hypothesis that CCU sound levels impact negatively on subjective sleep. It was recommended, now that CCU sound levels were isolated in the laboratory as a potential stressor, that future research should attempt to replicate this study in a hospital CCU.