Articles: adult.
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Traumatic hernia of the abdominal wall is a rare entity. A large proportion of reported cases are in children with a particular type of injury, i.e. from a handlebar injury. In adults, the presentation can vary substantially and the diagnosis is difficult. We present two cases in adults, with widely varying presentations and management. ⋯ Following blunt abdominal trauma, particularly high-velocity injuries, a high index of suspicion must be reserved for parietal wall swellings, as missed hernias in this setting have a high risk of strangulation. Computed tomography is the best aid to diagnosis. Management of each case needs to be individualized.
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We assessed the quality of life of ICU survivors using SF-36 at 4 months after ICU discharge and investigated any correlation of PCS and MCS with age, illness severity and hospital or ICU length of stay. We examined the relationship between these variables, persisting physical and psychological symptoms and the perceived benefit of individual patients of follow-up. ⋯ Younger age and prolonged hospital stay are associated with lower mental or physical quality of life and may be targets for rehabilitation. Patients with persisting symptoms at 4 months view follow-up as beneficial and a simple screening questionnaire may identify those likely to attend outpatient services.
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Manualized reminiscence and life review therapies are supported as an evidence-based, effective treatment for depression among older adults, but this therapeutic approach is usually individually administered and has rarely been applied in palliative care settings. We combined mutual reminiscence and life review with engagement in meaningful activity and examined the efficacy of this family-based dyadic intervention to decrease caregiving stress and increase family communication. Seventeen individuals living with chronic, life-limiting illnesses in the community and their family caregivers received three home visits with a master's-level interventionist. ⋯ All participants in the intervention group initiated a Legacy Project and reported that Legacy activities improved family communication. Participation in Legacy creation also resulted in increased positive emotional experiences in patient and caregiver groups. These results are illustrated through careful examination of three case studies.
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Int J Evid Based Healthc · Dec 2008
Systematic review of the effectiveness of nursing interventions in reducing or relieving post-operative pain.
Objectives The primary objective of this systematic review was to assess the effectiveness of nursing interventions for the relief/reduction of post-operative pain when compared with either standard care or other nursing interventions. Inclusion criteria Types of studies This review included randomised controlled trials (RCTs) and other quasi-randomised experimental research designs. Types of participants Adults treated for post-operative pain in an acute care hospital. ⋯ When there are two similarly effective interventions nurses need to weigh the possible positive and negative of the intervention including side effects, risk of adverse events, cost and patient preference. Other considerations include variations in patients' past pain experiences, type of surgery, many different analgesics. Although there were no controlled trials to support assessment and documentation, professionally and legally, documentation is required.
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Rev Bras Ter Intensiva · Dec 2008
Evaluation of extracurricular internships in the adult's intensive care units.
Students of Salvador - BA, Brazil were trained in critical care medicine by accomplishing extracurricular internships. This study aims to detect changes in attitude and interest of students who concluded these internships as well as the most frequent activities developed. ⋯ This study showed that internships in adult intensive care units of Salvador (BA), Brazil provided students with greater assurance to evaluate critical patients, increased their interest to follow an intensivist physician career and allowed contact with the main procedures and topics related to critical care medicine.