The Permanente journal
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The Permanente journal · Jan 2015
Randomized Controlled TrialEffect of Structured Touch and Guided Imagery for Pain and Anxiety in Elective Joint Replacement Patients--A Randomized Controlled Trial: M-TIJRP.
Postoperative management of pain after total joint arthroplasty remains a challenge despite advancements in analgesics. Evidence shows that complementary modalities with mind-body and tactile-based approaches are valid and effective adjuncts to reduce pain and anxiety postoperatively. ⋯ The benefit of M may be because of the specifically structured sequence of touch by competent caring, trained providers.
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The Permanente journal · Jan 2015
Efficacy and utility of phone call follow-up after pediatric general surgery versus traditional clinic follow-up.
Typical follow-up for surgical procedures consists of an interim history and brief focused physical examination. These appointments occupy clinic resources, require a time investment by the family, and rarely identify problems. Previous studies have demonstrated the safety of a postoperative phone call. ⋯ Postoperative phone call follow-up is an effective tool that improves patient and physician efficiency and satisfaction.
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The Permanente journal · Jan 2014
Randomized Controlled TrialEffect of transcendental meditation on employee stress, depression, and burnout: a randomized controlled study.
Workplace stress and burnout are pervasive problems, affecting employee performance and personal health. ⋯ The Transcendental Meditation program was effective in reducing psychological distress in teachers and support staff working in a therapeutic school for students with behavioral problems. These findings have important implications for employees’ job performance as well as their mental and physical health.
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The Emergency Department (ED) is the place where people most frequently seek urgent care. For patients living with chronic disease or malignancy who may be in a crisis, this visit may be pivotal in determining the patients' trajectory. There is a large movement in education of emergency medicine physicians, hospitalists, and intensivists from acute aggressive interventions to patient-goal assessment, recognizing last stages of life and prioritizing symptom management. ⋯ This article will summarize the following: identification of patients who may need palliation, discussing prognosis, eliciting goals of care and directives, symptom management in the ED, and making plans for further care. These efforts have been shown to improve outcomes and to decrease length of stay and cost. The focus of this article is relieving "patient" symptoms and family distress, honoring the patient's goals of care, and assisting in transition to a noncurative approach and placement where this may be accomplished.