The Nursing clinics of North America
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The following conclusions can be made based on review of the evidence: There is limited but positive evidence that select physical modalities are effective in managing chronic pain associated with specific conditions experienced by adults and older individuals. Overall, studies have provided the most support for the modality of therapeutic exercise. Different physical modalities have similar magnitudes of effects on chronic pain. ⋯ Healthcare professionals must be knowledgeable about the strength of evidence underlying the use of physical modalities for the management of chronic pain. Based on the limited research evidence available (especially related to assistive devices, orthotics, and thermal modalities), it often is difficult to accept or exclude select modalities as having a potential role in chronic pain management for adults and older individuals. Improved research methodologies are needed to address physical modality effectiveness better.
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Nurs. Clin. North Am. · Sep 2003
ReviewComplementary and alternative therapies: what is their place in the management of chronic pain?
Nurses have used complementary therapies for many years to relieve anxiety, promote comfort, and reduce or alleviate pain. The therapies described in this article are examples of the many therapies available for nurses to consider when planning care for patients with chronic pain. The increasing body of scientific knowledge is providing more guidance about the efficacy of specific therapies. ⋯ Evaluating the effectiveness of the complementary therapy to promote comfort in patients with chronic pain is essential. Obtaining this information is not only critical to the care of a particular patient, but these data will assist nurses in learning more about specific therapies. Most importantly, nurses need to pursue research to further the scientific basis for many of the complementary therapies.
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Nurs. Clin. North Am. · Jun 2003
ReviewTechnology and the environment: supportive resource or barrier for people with developmental disabilities?
Findings from needs assessments and abandonment studies point to issues with health care providers, particularly in their ability to listen to the needs of the consumer and important others regarding AT-EI. Professionals need to listen to what people are telling them or, in many cases, what they are not telling them. Actions and nonverbal messages can speak very loudly. ⋯ This includes referring individuals with developmental disabilities to people and groups that know how to get AT-EI, how to fund it, and how to troubleshoot it, and linking them to other people with disabilities who are sharing strategies in person and on-line. It also includes focusing beyond basic self-care and considers AT-EI strategies that enable a person to participate in high meaning activities and roles in the home and the community. Participation in activities identified as highly meaningful and important to the person, such as participating in a religious community, networking with other people on-line, gardening, or being a member of a community group, to name a few, can positively contribute to health, wellness, and quality of life; the challenge is to create and adapt the environment (social, physical, and societal) to support participation choices and control.
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Nurs. Clin. North Am. · Mar 2003
ReviewManaging geriatric psychiatric emergencies: delirium and dementia.
As the population ages, nurses in various clinical settings must identify high-risk groups that are vulnerable to delirium and dementia. They also must be able to provide psychosocial and pharmacologic interventions that promote comfort and safety for patients and their families experiencing these distressful medical conditions. Efforts to facilitate healthy resolution and restore the patient and caregivers to an optimal level of functioning must be priorities.
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Sleep is a complex behavior; adequate sleep is essential for healthy functioning and even for survival. Poor sleep quality and insufficient sleep have been linked to increased risk for various illnesses, as well as with an increased prevalence of excessive daytime sleepiness and reduced quality of life. ⋯ Routine health examinations that include questions about sleep habits, daytime sleepiness, and problems with sleep at night can help to educate people about the importance of good sleep habits. They provide a way to identify sleep disorders so that appropriate therapies can be instituted or proper referrals to a sleep specialist can be given.