Nursing research
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Randomized Controlled Trial Clinical Trial
Use of transcutaneous electrical nerve stimulation for postoperative pain.
This study examined the effects of transcutaneous electrical nerve stimulation (TENS) on incisional pain caused by the procedure of cleaning and packing an abdominal surgical wound. Seventy-five subjects (mean age 56.9 years) were randomly assigned to one of three intervention groups: TENS, placebo-TENS, or no-treatment control. ⋯ Subjects who received TENS reported a significantly lower level of pain after dressing change than did those subjects who received either placebo-TENS or no-treatment. Drug administration variables did not contribute significantly to level of reported pain.
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The purpose of this study was to describe interactional styles used by nurse practitioners and physicians in their attempts to influence patients' decision making. The ethical concepts of paternalism, maternalism, and shared decision making (operationalized as command, consequence, and concordance, respectively) formed the conceptual framework for the analysis of the interactions. ⋯ Tests of a priori hypotheses using hierarchical log-linear modeling yielded the following significant results: Males and physicians in solo practice used more command statements and fewer consequence statements than females and nurse practitioners in solo practice, who used fewer command statements and more consequence statements. All groups used more command/consequence statements than concordance statements.
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Comparative Study
Progression of labor pain in primiparas and multiparas.
The purpose of this study was to systematically describe the dimensions of pain during the progression of labor in primiparas and multiparas. Fifty primiparas and 88 multiparas were assessed for pain when the cervix was dilated 2-4 cm, 5-7 cm, and 8-10 cm. The sensory component of in-labor pain was more severe than the affective component for both primiparas and multiparas throughout labor and delivery except during Stage III when primiparas reported more intense affective pain. Primiparas reported more intense sensory pain in Stages I and III and more intense affective pain in all three stages of labor than the multiparas even though they consumed significantly more pain medications than the multiparas.
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The majority of diabetics in this country use disposable syringes and needle units for their insulin injections. Health care providers have traditionally recommended that these disposable syringes be discarded after each use to reduce the possibility of infection; manufacturer's instructions also state that the disposable syringes are to be used once and then discarded. Despite the limited research in this area, many American diabetic teaching programs have recently adopted a policy of encouraging ambulatory diabetics to reuse their syringes. ⋯ Four syringes were found to be contaminated with normal skin flora. No pathogenic organisms were isolated. In addition, 15.1% of the subjects did not clean their hands or the site prior to the injection.
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A statewide survey of nurses in perinatal centers was conducted to assess the prevalence of do-not-resuscitate (DNR) policies in neonatal intensive care units (NICUs) and to examine factors influencing nurses in those centers in their compliance with DNR orders. Three nurses in each of 10 perinatal centers were asked to complete a questionnaire on DNR policies and nurses' compliance and to respond to four hypothetical clinical situations. ⋯ Nurses' intention to resuscitate despite a DNR order varied, depending on the description of the infant. Multiple regression analyses showed that subjective norms (beta = .41 to .82) rather than attitudes (beta = .17 to .39) exerted a more powerful influence on nurses' decisions not to resuscitate.