Applied nursing research : ANR
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This study describes the process pediatric nurses used to assess pain in 0- to 12-month-old infants. Qualitative analyses of open-ended interviews with 40 pediatric nurses with from 1 to 20 years of experience produced an infant pain assessment model. This model explicates a "principle of consolability" and describes how nurses apply this principle, using comfort measures, in assessing pain of preverbal infants. Because this model makes processes involved in infant pain assessment explicit, it can be useful in teaching nursing students or novice pediatric nurses and in formulating hypotheses for further study.
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Comparative Study
Delirium: comparison of four predictive models in hospitalized critically ill elderly patients.
Delirium, a cognitive and behavioral disorder affecting more than one third of all hospitalized elderly patients, is often misdiagnosed or unrecognized by caregivers, leading to higher patient morbidity and mortality rates. Prediction of the disorder, based on known predisposing and precipitating risk factors, can be used to target susceptible patients for prevention and early intervention. Predictive models need to be evaluated for clinical application and predictive value. ⋯ A final multivariate model, derived from all variables, exhibited a sensitivity of 100% and specificity of 90% in predicting delirium in this study. Further studies are needed to substantiate these results. Then, identified risk factors can be incorporated into delirium prevention protocols for use by nurses at the bedside.
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Randomized Controlled Trial Clinical Trial
Ameliorating adults' acute pain during phlebotomy with a distraction intervention.
This study evaluated the effectiveness of a distraction intervention on subjects' perceptions of pain. During phlebotomy, 96 adults received either usual care or used a kaleidoscope as a distraction. ⋯ Statistical analyses revealed significantly lower perceptions of experienced pain among subjects using the kaleidoscope and concurrent validity for using the FACES Pain Scale with adults. Because the distraction intervention is effective, inexpensive, and easy to implement, its routine use during phlebotomy is recommended.
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Although early identification of pregnant women who are at risk for severe preeclampsia may help reduce maternal-perinatal sequelae, an adequate screening test for this disorder has not been described. The purpose of this study was to determine if a group of women (n = 57) who developed severe preeclampsia had a higher midtrimester mean arterial pressure (MAP-2) than a matched group of women (n = 57) who remained normotensive throughout pregnancy and the puerperium. It was found that women who developed severe preeclampsia had a significantly higher MAP-2 than normotensive women and significantly more preeclamptic subjects had an MAP-2 > or = 85 mmHg than did control subjects. Thus, an elevated MAP-2 may help identify women who are at risk for the development of severe preeclampsia.