Pflege
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The "Non-Communicating Children's Pain Checklist Revised" (NCCPC-R) is designed for pain assessment with cognitively impaired children and adolescents, who cannot express pain consciously and adequately, either verbally or non-verbally. The aim of this methodological pilot study is to collect information about the psychometric properties of the German language NCCPC-R version. Professional caregivers of 24 children and adolescents, hospitalised in a rehabilitation centre in the German speaking part of Switzerland, collected 187 measurements in episodes without pain and 62 measurements in episodes with pain. ⋯ At a cut-off-point score of 5 the sensitivity of the NCCPC-R is 84% and specificity is 78%. Considering the small sample, it can be assumed that the German language NCCPC-R version's performance in the examined aspects of reliability and forms of validity is adequate to be suitable for pain assessment by cognitively impaired children and adolescents. Further studies to examine the psychometric properties of the instrument are recommended.
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Review
[Pain prevalence and patient preferences concerning pain management in the emergency department].
Pain is one of the most common problems for patients who present to the Emergency Department (ED), thus a timely and effective pain management intervention is essential for quality patient care. A comprehensive literature review was undertaken in an effort to document the prevalence of pain and to increase knowledge about patients' preferences regarding pain management in emergency situations. Results indicated that the prevalence of pain is high and pain management, including treatment, is often unsatisfactory in the ED. ⋯ Relationships between sociodemographic factors and patient preferences could not clearly be elicited from the literature. A weakness is that the reviewed studies were descriptive and published primarily in the United States in the last five years. There is a need for further research in this area, particularly studies that investigate patients' preferences regarding pain management in European EDs.
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In intensive care units (ICU), patients in life-threatening situations are hospitalized. While the health status of these patients is often severely compromised, therapeutic interventions include endo-tracheal intubation with artificial ventilation, sedation, and analgesia which restrict their ability to communicate. These patients become additional vulnerable since their pains may not been adequately identified. ⋯ In most of the instruments, the validity was tested only superficially and no detailed reports regarding the application in everyday practice were given. However, the studied instruments includes algorithm as a significant component which enable decision making of the health care providers in order to execute stepwise pain management interventions. In conclusion, a need for further research to disclose pain indicators in sedated and artificial ventilated ICU-patients, continuous development of instruments and their validation in clinical practice is obvious.
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Review
[Literature review of back massage and similar techniques to promote sleep in elderly people].
Insomnia is a frequent problem among elderly people. As a consequence, sedative hypnotic drugs are prescribed very often that can lead to problematic effects. As an alternative to sedative hypnotic drugs nurses use relaxing interventions to promote sleep. ⋯ The results indicate that these interventions promote relaxation and sleep and that they are perceived as very pleasant by the elderly. However; they do not explain in detail the reasons for effects these and the role of touch. This review shows that further research (RCTs) is necessary to determine the effects of back massage and "Atemstimulierende Einreibung" on relaxation and sleep.
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Work schedules impact significantly on the health and well-being of health care professionals. The prevailing schedules can place the care providers 'at risk both psychologically and physically as well as in their social and private sphere. The added burden of daily activities in intensive care units (ICUs) intensifies these effects. ⋯ To assess the health impact of the work schedules, a method was developed which considers the most important health relevant dimensions of the work schedules for a global estimate. Finally, the most extreme groups regarding the health impact of the working schedules were compared regarding their organizational context using non-parametric and parametric tests. The findings show that the working schedules in ICUs could be considerably improved, particularly regarding duration and density of working hours as well as regarding supportive structures of the hospitals.