Pflege
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Having an ill child that is being treated in a pediatric intensive care unit (PICU) is tremendously stressful for the parents, both physically and emotionally. To help them cope with the circumstances they find themselves in, parents often develop expectations which are addressed to the team of the PICU, and which they find important to be fulfilled. Many of these expectations are culturally shaped. ⋯ Their own expectations were reflected in the six subcategories: "Knowing that the child is receiving good care", "Being with the child", "Being involved", "Experiencing care for oneself and one's child", "Being informed" and "Experiencing continuity". These results are congruent with prior research reported in the international literature. Having a desire for a continuous medical support and the clear separation of roles between physicians and nurses are new findings from this investigation which have not been described previously.
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In the modern hospice movement and in Palliative Care, helping severely ill and dying patients to have a "good end of life" and a "good death" has high priority. The concept of a "good death" reflects the corresponding ideal of a "good dying". This concept analy-sis aimed at clarifying the current understanding of the characteristics of a "good death" as well as at presenting a coherent theoretical and ideational basis. The meaning of an ideal death as a point of reference and leitmotif in structuring palliative and hospice care, the theoretical background, and the components of a "good death" will be described in this article.
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Comparative Study
[Translation of the Richmond Agitation-Sedation Scale (RASS) for use in German Swiss intensive care units].
In intensive care units, patients are sedated to reduce the stress caused by illness and/or treatments such as artificial respiration. Regular assessment of the degree of sedation as part of the goal-directed therapy has been recommended as a standard of care. The Swiss Society of Intensive Care Medicine requires all accredited Swiss intensive care units to periodically document the degree of sedation by means of a sedation scale as part of the minimal data set (MDSi). ⋯ The iterative translation of the RASS for use in Swiss intensive care units described in this article is an example of interdisciplinary teamwork. Translation of clinical assessment tools for clinical use should be carried out as carefully and stringently as the development of research tools. Based on the experience gained in the described project we recommend the following points to consider when translating clinical assessment tools: a) referring to literature not only on the subject of translation but also on the process of translation itself, b) involving professional translators as language experts, and c) consulting the author(s) of the original version.
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A medial incision is a common surgical technique to obtain access to the abdomen. Thereby, the muscles involved in movement are manipulated, leading to post-operative restrictions in mobility and pain determined by movement. The aim of this pilot study was to assess the impact of a pre-operative training session using the Viv-Arte model, which is based on kinesthetic mobilisation principles. ⋯ There were no significant differences in the two groups related to the objectives. It is possible that the study groups or the operationalisation were not appropriate for testing the effects of the intervention. It seems important to continue to develop instruments that are appropriate for measuring the effect of mobility-related interventions.
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People with cognitive impairment and consecutive communication disturbance are, due to their illness, a very vulnerable group of patients. They are particularly at risk that their pain is not well assessed and therefore often not treated adequately. Insufficient pain management however impacts health status and decreases cognitive functioning and the patients' quality of life. ⋯ First results showed that pain was individually assessed with the patients in each shift and that pain was treated both with and without medication. Nurses paid more attention to pain assessment and improved their practice of structured assessments in patients with severe cognitive impairment. We therefore recommend applying both the standard and the pain assessment instrument BESD with cognitively impaired patients.