British journal of nursing (Mark Allen Publishing)
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Sickle cell disease (SCD) is one of the world's commonest hereditary disorders. Painful episodes are the overriding manifestation. SCD pain is largely opioid-sensitive and, in severe cases, adult patients warranting hospitalization often need parenteral opioids. ⋯ Patients identified that realization of PCA's full potential is being limited by ineffective analgesic regimens, analgesic side effects and technical shortcomings. Patients found the main disadvantages of PCA to relate to nursing care issues including restrictions placed upon patients' ability to exercise choice and much reduced direct nurse contact. The implications for nursing practice and management involve addressing these patients' concerns through staff training, improving patient-staff communication, inputting resources and further research.
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It is recognized that parents' presence during their child's hospitalization is of benefit to the parents and the child. However, the level of parental involvement in their child's care may be influenced by many factors, such as the amount of support nurses provide for parents. This article reports on two themes from the findings of a larger study on parental involvement in children's postoperative pain management - parental support and parents' satisfaction with their child's postoperative pain management. ⋯ This article reports on the issues of parent support from the results of the survey, and on satisfaction relating to their child's postoperative pain management from the parent interviews. The findings demonstrated that nurses perceived that parents were receiving more support from them than that which parents felt they were receiving. Parents were more satisfied with their child's pain management and children received more analgesia when they were cared for by a lower grade nurse.
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This article, the last in the series, focuses on future international research, education, policy and practice issues that centre around the concept of hope. While a growing literature is accumulating, it needs to be acknowledged that the area of hope and hope inspiration remains under-researched and is consequently not well understood. ⋯ If the goal is to conduct interdisciplinary research across countries and to gain a global understanding of hope, then greater resources are needed. There is a need to prepare nurses and other healthcare professionals to deal with the challenge of enhancing and maintaining hope in those that they care for in their practice, as well as in themselves.