Pflege
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The objective of this article is to present a literature review of German and English literature concerning sleep disturbances of critically ill adults in intensive care units. It represents mainly nursing research-based studies which focused on characteristics and possible causes of sleep disturbances. The literature revealed that patients suffer from moderate to severe sleep deprivation characterized by a decrease of total sleep length and quality, and by sleep fragmentation. ⋯ Nurses have an important role to play in recognizing and assessing factors that contribute to sleep deprivation and in intervening to reduce the effects of sleep deprivation. The research studies in this review represent the positivistic scientific perspective where sleep deprivation research has been objectified and controlled. A broader, more indepth understanding is needed, however, so that the subjective view of critically ill persons can be represented.
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The aim of this interdisciplinary project was the improvement of postoperative pain management on surgery wards of an university hospital: Pain medication should be enlarged with the possibility to administer an opium-medication i.v. (non only s.c.) when needed (VAS > 3), which has been tested on two wards. The study shows the resulting changes of the intervention for patients and nurses. For recording, there has been patient questionnaires and document analysis before and after the new possibility to administer medication, and a nurses opinion survey. ⋯ The enlargement to administer pain medication and asking/registering pain intensity regularly, created more sensitivity for the patient's pain-experience among nurses, and this lead to better use of the prescribed pain medication and to better pain management overall. Further quality-improvement in post-operative pain relief seems possible by continuing on that way in the future.
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The study assessed the individual quality of life of people with schizophrenia who live in the supported group homes. Forty residents in seven group homes were interviewed using The Schedule for the Evaluation of Individual Quality of Life: A Direct Weighting Procedure Instrument (SEIQoL-DW). The SEIQoL-DW assesses the individualised QoL using semi-structured interview technique. ⋯ The individual nature of QoL was reflected in differences in QoL-areas defined, differences in levels of satisfaction, and differences in the relative importance of each LQ-area to individuals. The measures were generally acceptable, with all respondents showing great interest and being able of completing the SEIQoL-DW. This study showed also that instruments such as the SEIQoL-DW might have a therapeutic application for people with psychiatric disorders.
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This experimental study was designed to investigate the influence of a cognitive behavioural technique on elective abdominal-surgical and orthopaedic patients at seven different time points within the first 72 postoperative hours. It examines the effect of deep breathing relaxation on the anxiety, distress, and incisional pain levels of postoperative surgical patients. The results show that the cognitive behavioural technique positively affects postoperative perception of pain, energy level, relaxed state and strain within the experimental group. ⋯ Postoperatively, patients from the experimental group in both surgical areas used more opioids than patients from the control group. Preoperatively assessed personality factors did not differ between both groups. Overall the findings suggest that the implementation of a deep breathing relaxation technique positively influences the postoperative course of elective abdominal-surgical and orthopaedic patients.
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Comparative Study
[Perception of symptom distress in lung cancer patients: I. Agreement between patients and their caregiving relatives].
This paper employs a comparative descriptive design to compare primary family caregivers' assessment of lung cancer patients' symptom distress with patients' own perceptions of symptom distress in the home setting. The second part describes the results of the qualitative component of this research. ⋯ No significant differences in ratings were found for 10 of the 13 symptoms assessed. Therefore, when the patient is unable to provide a self-report of symptom distress, health-care professionals may seriously consider family caregivers' assessments of patients' symptom distress to be reasonable estimates for at least 10 of the 13 symptoms on the SDS.