Clinical nursing research
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Secondary analysis of data collected for a grounded theory study of family surrogate decision-making processes at the end of life was undertaken to describe participants' perceptions of the needs of family decision makers as expressed through their advice to others. Data were analyzed using the constant comparative method of grounded theory, resulting in identification of the major categories and their properties describing surrogates' recommendations. ⋯ Those who were able to see that another's wishes were honored experienced satisfaction. Advice from experienced surrogates offers nurses both direct guidance to help them meet surrogates' needs and insight to assist them in coaching surrogates in the performance of this critical role.
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Clinical nursing research · Aug 2004
Use of a numeric visual analog anxiety scale among patients undergoing colorectal surgery.
The aim of this study was to evaluate the utility of a Numeric Visual Analog Anxiety Scale (NVAAS) as a potentially accurate and efficient way to determine presurgery anxiety among patients undergoing colorectal surgery. A secondary aim was to determine the relationship between NVAAS ratings of anxiety and postsurgery pain. Thirty-six patients scheduled for colorectal surgery were asked to rate their state anxiety on the NVAAS and to complete the State-Trait Anxiety Inventory (STAI). ⋯ The NVAAS measure of presurgery anxiety also correlated significantly with STAI-trait anxiety (0.46, p <.005) and postsurgery Visual Analog Scale pain ratings (0.35, p <.038). The NVAAS appears to be a valid and sensitive measure of anxiety among patients undergoing colorectal surgery. The NVAAS also has the advantage of being convenient and easy to use at bedside, increasing its clinical utility in medical nursing care.
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Clinical nursing research · Aug 2004
Comparative StudyAn exploration of seniors' ability to report pain.
The purpose of this study was to evaluate the ability of a group of elderly residents to use self-report methods to measure their pain in an accurate fashion. Using a comparative descriptive design, completion rates of three pain assessment tools and the self-report skills of a sample of 130 long-term care residents with varying levels of cognitive impairment were evaluated. The majority of residents with mild to moderate cognitive impairment were able to complete at least one of the verbal pain assessment tools, with the Present Pain Intensity and Numerical Rating Scales being the preferred choices for use in clinical settings. However, the Faces Pain Scale appeared to be more challenging for residents to complete, suggesting that it requires further testing before it can be recommended for clinical use.
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Clinical nursing research · Feb 2004
Salivary cortisol as indicators of pain in preterm infants: a pilot study.
Assessment and management of pain in preterm infants is critical and complicated. The addition of salivary cortisol measurement may improve the specificity of assessment and guide care to alleviate pain. The purpose of this study was fourfold: (a) assess the feasibility of a method of saliva collection in premature infants, (b) assess reliability of a method of measuring salivary cortisol in response to heelstick, (c) identify relationships between salivary cortisol and a measure of pain behavior (using CRIES) following heelstick, and (d) identify peak response times for elevations of salivary cortisol following heelstick in preterm infants. ⋯ Samples were collected without use of stimulants. Sample means supported peak and trough patterns previously described in the literature. Behavioral measures of pain did not correlate well with peak cortisol levels.
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Clinical nursing research · Nov 2003
Patient and nurse-related implications of remote cardiac telemetry.
The purposes of this study were (a) to determine the frequency of rhythm disturbance events among patients on remote cardiac telemetry, (b) to identify how many of these events were detected by the telemetry nurses, and (c) to explore the impact of managing telemetry on nurses' workload This prospective observational study took place in a nine-bed Coronary Respiratory Care Unit (CRCU) in a tertiary Canadian University Hospital. No lethal arrhythmias were detected during 420 hours of observation. There were a high number of remote telemetry warning arrhythmias, the vast majority of which were artifact (80.2%). ⋯ Nurses detected between 60% to 100% of valid warning alarms. Remote cardiac telemetry without a dedicated monitor-watcher places unnecessary demand on CRCU nurses' time because the vast majority of arrhythmia alarms are inconsequential. The addition of monitoring remote telemetry to the CRCU nurse's workload has the potential to negatively influence the care provided to CRCU patients.