The Canadian nurse
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Improving pain management practices can decrease adverse complications and improve patient outcomes. This in turn will result in the more efficient use of health care resources. ⋯ They often rely on their patients' reported levels of satisfaction as an outcome measure for success of a program. Most often, informal methods are used to gather information on satisfaction with care.
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With more and more people choosing to die at home, palliative care is an increasingly important field. The challenge for those of us working in the field is to develop a comprehensive system of care that will provide high quality, in-home support. Such support involves a large network of formal and informal caregivers--family members, caregiving friends, homemakers and a variety of health care providers--who collaborate together and with the individual to provide holistic care. Thus, co-ordination, collaboration and communication are essential if this network is to meet the physical, psychological, social and spiritual needs of the dying and their families.
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Seniors take three times as many drugs as the general population and are the group most vulnerable to the adverse effects of drug therapy. For this reason, it is extremely important that they receive support to help them understand and manage their medications. To highlight the major problems in managing medication, determine the risk factors and prevent overdosing of psychotropic drugs in seniors, the authors carried out a study of 549 senior rural residents living at home. ⋯ Close to half the respondents (42.6%) reported occasionally forgetting whether they had taken their medication. The findings also indicate that the respondents' sex, their perception of their personal state of health, the population density, and the depression index are all major variables that significantly relate to use of psychotropic drugs. All of the findings identify the specific needs of seniors and suggest a focus for nursing intervention.
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The Canadian health care system serves an increasingly ethnically diverse clientele, especially in major urban centres. Sustained inflows of immigrants demand that social and health care services partially revise their mission to help these newcomers maintain their health following arrival in Canada, since their health generally tends to deteriorate over time. This poses a special challenge for women who have immigrated recently, because their health is often jeopardized by vulnerability linked to their socioeconomic status. ⋯ These views are similar to North American concepts. Research could confirm the similarities and differences between immigrant women and host populations. Nursing interventions would support culturally appropriate comprehensive action that addresses the individual, family, community and social aspects.
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This portion of a study, first published last month, examines the various aspects of dying (including the dying person's needs); looks introspectively at the spiritual aspect of death; and analyzes the behavior and attitudes of care-giving staff, their values, motivations and needs. While dying people may have unpredictable attitudes and behavior, nurses need to maintain an attitude of caring and communication in their interventions. Important to consider when nursing the dying are subjects such as: establishing a helping relationship; appropriate communication; and self-knowledge and preconceived notions. Criticism most often directed at palliative care suggests that curative and palliative care should be integrated; should abandon their reserved territories (such as care units); and should develop an association that goes beyond the terminal phase.