Applied nursing research : ANR
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Knowledge of the nature, meaning, and impact of suffering from the perspective of people with rheumatoid arthritis is needed to determine what nursing interventions are most helpful in reducing suffering. Grounded theory was used to identify the nature of suffering in 14 people with rheumatoid arthritis. Suffering was found to be a process directed toward regaining normalcy and consisted of three phases: disintegration of self; the shattered self; and reconstruction of self. ⋯ Finding meaning through positive life changes was an outcome of suffering. The informants' differentiation between pain and suffering also was examined. The provision of comfort measures along with a caring and empathetic attitude were identified as helpful nursing interventions in reducing suffering.
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Comparative Study
Predictive validity of the Braden Scale and nurse perception in identifying pressure ulcer risk.
Before the implementation of the Braden Scale, an institutional study was conducted to determine the cut-off point at which patients would be at risk for developing a pressure ulcer. Nurses' perception of patient risk for pressure ulcer development also was compared with the Braden Scale. One hundred and three subjects hospitalized for a minimum of 7 days and randomly selected from routine hospital admissions were rated with the Braden Scale, and skin assessments were made three times per week for up to 2 weeks starting 24 to 48 hours after admission. ⋯ Results of the t test demonstrated the Braden Scale score is the most highly significant finding (p = .0038) to predict pressure ulcer positive and pressure ulcer negative groups. For this study, the Braden Scale cut-off point was set at 17 with a sensitivity of .59 and a specificity of .59. Clinical implementation of the Braden Scale must be combined with frequent and thorough skin assessment practices because some patients will develop pressure ulcers even though the tool does not predict the patients to be at risk.
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Randomized Controlled Trial Clinical Trial
Effects of intraoperative progress reports on anxiety levels of surgical patients' family members.
A three-group quasi-experimental posttest-only design was used to examine the effectiveness of intraoperative progress reports by comparing family members' state-anxiety score, mean arterial pressure level (MAP), and heart rate during elective surgical procedures. Control-group family members (n = 50) received usual care. ⋯ Family members in the experimental group reported lower state-anxiety scores (p < .001) and had significantly lower MAP levels (p < .001) and heart rates (p < .01) compared with the control and attention groups. Progress reports appear to be a beneficial independent nursing intervention for reducing anxiety in family members during the intraoperative waiting period.
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Comparative Study
Patterns of patient-controlled analgesia and intramuscular analgesia.
Effective management of acute pain is a major nursing goal. The purpose of this study was to identify patient patterns in intravenous patient-controlled analgesia (PCA) and intramuscular (IM) analgesia for patients after surgery. ⋯ Patterns of the use of PCA and IM analgesia were identified. These provide additional information for the development of pain management protocols.