Research in nursing & health
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Current trauma triage protocols lack sensitivity to occult injuries in older persons, resulting in unacceptable undertriage rates. We identified crash scene information that could be used by emergency personnel to identify the need for trauma center care in older persons injured in motor vehicle crashes. ⋯ CART analysis of 26 crash scene variables resulted in two classification trees from which triage decision rules were stated for persons with severe and moderate injuries. Sensitivity and specificity of the rules were 95.15% and 76.47% for severe injury and 83.1% and 81.5% for moderate injury.
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Randomized Controlled Trial
Effects of preoperative therapeutic play on outcomes of school-age children undergoing day surgery.
The purpose of this study was to examine the effects of therapeutic play on outcomes of children undergoing day surgery. Two hundred and three children admitted for day surgery were invited to participate in a randomized controlled trial. ⋯ No significant differences were found between the two groups in postoperative pain. The study provides some evidence that therapeutic play is effective in pre- as opposed to postsurgical management of children.
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Because persons with cognitive impairment often cannot self-report pain, it is imperative to develop instruments that use observable indicators. The purpose of this study was to develop and test the psychometric properties of the Discomfort Behavior Scale (DBS), which is comprised of 17 items from the Minimum Data Set (MDS). ⋯ The items are tau equivalent, allowing unity weighting and simple summation to create scale scores, and the internal consistency was good. The DBS has potential to be useful in studies of efforts to improve pain management in cognitively impaired residents of nursing homes.
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The purpose of this study was to develop and psychometrically test the Social Capital Scale for families of children with special health care needs. Researchers have suggested a link between social capital and health, however, psychometrically tested measures of social capital are not described in the literature. ⋯ Five subscales provide insight into family strengths and areas for improvement related to their investment in relationships that support health. Use of the SCS will contribute to the establishment of consensus and precision in communication about social capital's utility and measurement in the population of families of children with special health care needs.
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Among older, long-term breast cancer survivors, symptoms from previous treatment can generate uncertainty about whether they represent co-morbid conditions, recurrence, or normal aging. This uncertainty can result in emotional distress and thoughts of recurrence. Communication with health care providers may help women reduce uncertainty and improve both emotional and cognitive well-being. ⋯ Symptoms, age, and uncertainty had the strongest influence on well-being, regardless of race. There was an unexpected positive association between patient-provider communication and thoughts of recurrence. Descriptive analysis revealed that 52% of women were unable to achieve their desired decision-making role with health care providers.