Journal of clinical nursing
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Review
Allostasis and allostatic load: expanding the discourse on stress and cardiovascular disease.
The aim of this discursive paper is to introduce allostasis and allostatic load, which are relatively new concepts proposed to explain physiological responses to stress, and to suggest ways in which allostasis theory can be applied to the development of clinical interventions to increase resilience for producing better health outcome. ⋯ Clinical practice should be based on a solid theoretical foundation to improve health outcomes. Strategies to manage stress and increase resilience along with clinical interventions to manage the physiological responses to chronic stress are necessary to assist in preventing and controlling the detrimental effects of chronic disease on human life.
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To provide an analysis of the scope of nursing practice and inter-professional role responsibility for ventilatory decision-making in Australian and New Zealand (ANZ) intensive care units (ICU). ⋯ The results of this survey suggest, within the ANZ context, nurses participate actively in ventilation and weaning decisions. In addition, the results support an association between the education profile and skill-mix of nurses and the level of collaborative practice in ICU. Relevance to clinical practice. Mechanical ventilation may result in significant complications if not applied appropriately. Collaborative practice that encourages nursing input into decision-making may improve patient outcomes and reduce complications.
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In a sample of patients who underwent instrumented spinal fusions for chronic low back pain (CLBP), the purposes of this study were: to determine the amount of pain patients experienced and to determine the impact of length of time since surgery, use of pain medication and their outlook on the future on these pain intensity scores. ⋯ A high percentage of patients with CLBP continue to experience pain 1-8 years after spinal fusion. A positive outlook towards the future seems to be associated with less pain in these patients. Relevance to clinical practice. Patients who continue to experience pain and have a more negative outlook on the future may benefit from psychoeducational interventions that teach them how to better cope with their pain.
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The aim of this research was to identify the needs and coping strategies of individuals with Huntington disease and their family members/carers and to ascertain the extent to which they were supported by the type of specialised service provided in this unit. ⋯ It is helpful to allow patients control over timing and frequency of contact with professionals. Improving understanding of the condition in the public and health professionals may enable patients to access a greater range of social activities.
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To arrive at an expert consensus in relation to health promotion and health education constructs as they apply to nursing practice, education and policy. ⋯ This study provides a hitherto previously absent expert consensus on the current position of health promotion and health education, in nursing and predictions for their future course. Its findings represent an important step for nurses as they seek to become increasingly active and influential within wider health promotion and health education arenas. Relevance to clinical practice. Delphi studies do not necessarily offer indisputable fact. This study, however, with its strong consensus on the majority of original statements is a good indicator as to how nursing experts currently view health promotion and health education constructs. Expert consensus offers a useful form of measure against current and future clinical practice and helps to build a firm foundation for change. Nurses, then, are advised here to refer to the findings presented, that they remain contextually and conceptually clear, as they embark on current and future health promotion-related activities.