Pflege
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This article reports the second part of a comprehensive study examining patient satisfaction with nursing care in ambulatory patients of a Swiss emergency department. A descriptive cross-sectional study examined patient satisfaction, using a revised version of the questionnaire
in a convenience sample of 114 patients. The occurrence and intensity of anxiety, insecurity, worry, pain, dyspnoea, nausea, thirst and hunger, and their correlation with patient satisfaction were analyzed. ⋯ Patients who suffered from the states or symptoms described above and reported receiving ineffective nursing interventions showed significantly lower patient satisfaction scores than patients not suffering from these states or symptoms. Statistically significant correlations were found between worry, pain, anxiety and patient satisfaction. The results of both studies (part 1+2) (Müller-Staub, Meer, Briner, Probst & Needham, 2008) are discussed, conclusions drawn and implications for practice and research presented. -
Critically ill patients are at a particular risk for developing pressure ulcers. Yet until now, no sufficiently specific, validated pressure ulcer risk assessment instruments exist for critically ill patients. In a prospective study of 698 patients of medical intensive care unit (ICU), we therefore analyzed if the Waterlow scale is suitable for pressure ulcer risk assessment in the ICU. ⋯ Sensitivity and specificity reached their maximal values of 64.6% and 48.8%, respectively, at a comparably high cut-off of 30 points on the Waterlow scale (positive and negative likelihood ratio being 1.26 and 0.73, respectively). The area under the curve (AUC) was 0.59 in the receiver-operator-characteristic curve. Adding intensive care related parameters to the scale yielded some degree of improvement (AUC 0.69), but the development of ICU specific pressure ulcer risk scales still seems to be necessary to allow reliable pressure ulcer risk assessment in the ICU.
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Delirium is an acute decline in attention and cognition. To make a diagnosis, there are two classification systems: the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) and the International Classification of Diseases (ICD-10). While the core criteria are similar in both systems, ICD-10 requires three additional criteria to make a diagnosis: disturbed psychomotor behaviour and sleep-wake-cycle and emotional disturbances. ⋯ While the DOS is a classical observation instrument, the CAM requires a structured interview, similar to the Mini-Mental State Exam by Folstein. Both the DOS and CAM instruments were scientifically translated into German. This article will present the translated versions of both DOS and CAM, report their use in a Swiss population of patients at risk for delirium and provide the theoretical background of diagnosing delirium with the criteria of the DSM-IV and ICD-10.
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Due to demographic change and increase of dementia there is an obvious need of voluntary hospice helpers who support dementia patients. The aim of this qualitative study was to describe the experience and challenges of hospice volunteers supporting dementia patients. The results were taken into account in the development of a training course. ⋯ They empathetically support dementia patients without expecting anything in return and they benefit from their work with dying people ("to put one's own interests last"). Voluntary hospice helpers offer important support for dementia patients but their role in the interdisciplinary team has to be defined. Training courses are useful to improve interaction and reflection skills.