Journal of nursing scholarship : an official publication of Sigma Theta Tau International Honor Society of Nursing
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To report an integrative review about sleep patterns, factors that influence sleep, and sleep interventions in acutely ill hospitalized adults; discuss methodological challenges associated with studying sleep in this population; and propose future research. ⋯ More systematic research is needed to determine correlates of sleep disturbance in acutely ill hospitalized adults. Such studies can help investigators to identify patients who are most at risk for sleep disturbance and to provide the theoretical and conceptual bases for sleep-promoting interventions. Methodological challenges include characteristics of acute care patients and hospital environments, as well as the complexity of measuring sleep.
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To discuss the need for a shift in focus from intuitive to more analytic ways of examining both the process and outcomes of professional decisions based on "best evidence." ⋯ A systematic approach to decision making in health care is needed, so that both health professionals and patients have a means for knowing the basis of decisions about treatment.
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To describe families' decision-making processes, both cognitive and affective, regarding end-of-life treatments for nursing home residents with moderately severe to very severe dementia. ⋯ Family members had poignant, unresolved emotional needs stemming from their loved one's illness and nursing home placement. Participants were unprepared to make end-of-life treatment decisions and lacked the informational and emotional support of a consistent provider to help with decisions. Family members need assistance in processing difficult and painful emotions, understanding the trajectory of disease, what decisions might impede a natural death, and comfort or palliative care options.
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To describe the perceptions of nurses regarding do-not-resuscitate (DNR) decisions in critical care settings. ⋯ Documentation of a comprehensive patient treatment plan and awareness of the rationale for DNR designation are strategies suggested to help achieve desire patient care goals in critical care settings.
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To understand nurses' experiences of caring for dying patients who have "air hunger." When air hunger occurs in people who are close to death, it often triggers increasing panic and breathlessness. Describing this phenomenon is an initial step toward a more informed and consistent response to air-hungry patients. ⋯ The three themes provide a framework for a new vision of "doing everything" for a dying person who suffers from air hunger. Care encompasses knowing what to do as well as how to stay present during suffering.