共查询到20条相似文献，搜索用时 730 毫秒
1.
Tom Schoeman Krishnaswamy Sundararajan Svatka Micik Pooja Sarada Suzanne Edwards Alexis Poole Marianne Chapman 《Australian critical care》2018,31(6):382-389
Background
There is rising prevalence of post-traumatic-stress-disorder (PTSD) in patients and their relatives after ICU discharge. The impact of ICU diaries on PTSD in relatives of critically ill patients in Australia has not been fully evaluated.Objectives
To determine if relatives of an Australian critically ill population were interested in using ICU diaries. To determine the prevalence and impact of ICU diaries upon symptoms of PTSD, depression and anxiety in relatives of an Australian critically ill population.Methods design
Prospective, observational, exploratory study.Setting
Royal Adelaide Hospital (RAH), Adelaide, Australia.Participants
One hundred and eight consecutive patients, staying >48 h in a level 3 ICU were identified. A survey using DASS-21, IES-R questionnaires was performed on admission followed by a repeat survey 90 days post discharge from ICU. An IES-R score >33 was used to define severe PTSD symptoms. A comparison between subjects who did and did not complete their diaries was performed.Results
Forty subjects refused to participate, eight were excluded, and sixty family members were included for analysis, thirty-six of whom completed diaries. There was no statistically significant difference between PTSD symptom scores at follow-up controlling for useful diary completion (complete – see methods) and PTSD at baseline. There was a statistically significant association between PTSD and unemployment, controlling for PTSD at baseline (P value = 0.0045). Family members had significantly higher odds of PTSD at baseline compared to 3 month follow up (P value = 0.0092, Odds Ratio = 3.3, 95% CI: 1.3, 8.2). This was independent of the completeness of the diaries and adjusted for clustering on subject. Family members with incomplete diaries were less likely to report depressive symptoms at baseline (P value = 0.0218, estimate = ?4.6, 95% CI: ?8.5, ?0.7). Diary completion was not indicative of the likelihood of family members to report PTSD symptoms (P value = 0.5468, estimate = ?1.6, 95% CI: ?6.8, 3.6).Conclusion
ICU diaries were often not completed and completion did not appear to be related to the incidence of stress, anxiety, depression and PTSD symptoms in the families of patients in the ICU. This may be because Australian families are generally not interested in maintaining a diary. 相似文献2.
C. López-López A. Arranz-Esteban M.V. Martinez-Ureta M.C. Sánchez-Rascón C. Morales-Sánchez M. Chico-Fernández 《Enfermería intensiva / Sociedad Espa?ola de Enfermería Intensiva y Unidades Coronarias》2018,29(2):64-71
Objective
To analyse the influence of psychotropic substance use on the level of pain in patients with severe trauma.Design
Longitudinal analytical study.Scope
Intensive Care Unit (ICU) of Trauma and Emergencies.Patients
severe trauma, non-communicative and mechanical ventilation > 48 hours. Two groups of patients were created: users and non-users of psychotropic substances according to medical records.Interventions
Measurement of pain level at baseline and during mobilization, using the Pain Indicator Behaviour Scale.Variables
demographic characteristics, pain score, sedation level and type and dose of analgesia and sedation.Results
Sample of 84 patients, 42 in each group. The pain level in both groups, during mobilisation, showed significant differences p = 0.011, with a mean of 3.11 (2.40) for the user group and 1.83 (2.14) for the non-user group. A relative risk of 2.5 CI (1,014-6,163) was found to have moderate / severe pain in the user group compared to the non-user group. The mean dose of analgesia and continuous sedation was significantly higher in the user group: P=.032 and P=.004 respectively. There was no difference in bolus dose of analgesia and sedation with P=.624 and P=.690 respectively.Conclusions
Patients with a history of consumption of psychoactive substances show higher levels of pain and experience a higher risk of this being moderate/severe compared to non-users despite receiving higher doses of analgesia and sedation infusion. Key words: pain, multiple trauma, drug users. 相似文献3.
Jessica Gonçalves Juliana Hotta Ansai Fernando Arturo Arriagada Masse Francisco Assis Carvalho Vale Anielle Cristhine de Medeiros Takahashi Larissa Pires de Andrade 《Revista brasileira de fisioterapia (S?o Carlos (S?o Paulo, Brazil))》2018,22(5):417-423
Background
A dual-task tool with a challenging and daily secondary task, which involves executive functions, could facilitate the screening for risk of falls in older people with mild cognitive impairment or mild Alzheimer's disease.Objective
To verify if a motor-cognitive dual-task test could predict falls in older people with mild cognitive impairment or mild Alzheimer's disease, and to establish cutoff scores for the tool for both groups.Methods
A prospective study was conducted with community-dwelling older adults, including 40 with mild cognitive impairment and 38 with mild Alzheimer's disease. The dual-task test consisted of the Timed up and Go Test associated with a motor-cognitive task using a phone to call. Falls were recorded during six months by calendar and monthly telephone calls and the participants were categorized as fallers or non-fallers.Results
In the Mild cognitive impairment Group, fallers presented higher values in time (35.2 s), number of steps (33.7 steps) and motor task cost (116%) on dual-task compared to non-fallers. Time, number of steps and motor task cost were significantly associated with falls in people with mild cognitive impairment. Multivariate analysis identified higher number of steps spent on the test to be independently associated with falls. A time greater than 23.88 s (sensitivity = 80%; specificity = 61%) and a number of steps over 29.50 (sensitivity = 65%; specificity = 83%) indicated prediction of risk of falls in the Mild cognitive impairment Group. Among people with Alzheimer's disease, no differences in dual-task between fallers and non-fallers were found and no variable of the tool was able to predict falls.Conclusion
The dual-task predicts falls only in older people with mild cognitive impairment. 相似文献4.
Stamatis S. Makrygiannis Despina Rizikou Nikolaos G. Patsourakos Manolis Lampakis Anastasia Margariti Olga S. Ampartzidou Konstantinos Sakellaridis Paraskevi Tselioti Athanasios Pipilis Athanasios A. Prekates 《Australian critical care》2018,31(5):274-277
Background
Data regarding new onset atrial fibrillation (nAF) in general, non-cardiac, intensive care unit (ICU) patients are limited. However, it has been suggested that nAF is associated with worse clinical outcome in these patients.Objective
The purpose of the present work was to study the prognostic impact of nAF, in this setting.Methods
We prospectively studied all patients admitted to a single ICU for a period of 12 months. Patients admitted for brief post-operative monitoring, patients with chronic, intermittent atrial fibrillation and atrial fibrillation present upon admission, were excluded. Death during ICU stay (ICUD) was the pre-specified study end-point. Length of stay (LOS) for survivors was also reported. A number of factors related to the occurrence of nAF and the present disease were recorded for each patient.Results
The study population was comprised of 133 patients. Twenty (15%) of them manifested nAF. The end-point of ICUD was observed in 27.1% of the patients. The median LOS reported was 8 days. Patients with nAF seemed to have significantly worse prognosis, compared to those who did not manifest nAF (OR = 3.35, 95%CI:1.26–8.92; P = 0.016). Additionally, nAF patients appear to require significantly extended LOS (P = 0.01). Nevertheless, when the effect of nAF on ICUD was adjusted for sepsis, there was no statistically significant difference between those that manifested nAF and the rest of the patients.Conclusion
Patients suffering nAF seem to have worse prognosis during ICU stay. However, a direct impact of nAF on mortality was not documented. 相似文献5.
Joanne Molloy Naomi Pratt Ravindranath Tiruvoipati Cameron Green Virginia Plummer 《Australian critical care》2018,31(1):42-46
Background
The Rapid Response Call (RRC) is a system designed to escalate care to a specialised team in response to the detection of patient deterioration. To date, there have been few studies which have explored the relationship between time of day of RRC and patient outcome.Objective
To examine the relationship between the time of RRC activations and patient outcome.Method
All adult inpatients with a RRC in non-critical care wards of a metropolitan Australian hospital in 2012 were retrospectively reviewed. RRCs occurring between 18:00–07:59 were defined as ‘out of hours’.Results
There were 892 RRC during the study period. RRCs out of hours were associated with a higher rate of ICU admissions immediately after the RRC (19.4% vs. 12.3%, p < 0.001). Patients experiencing an out-of-hours RRC were more likely to have an in-hospital cardiopulmonary arrest (OR = 1.7, p < 0.04). In-hospital mortality rate was significantly higher for patients with out-of-hours RRCs (35.5% vs. 25.0%, p = 0.014). After adjusting for confounders out-of-hours RRC were independently associated with increased need for ICU admissions and in-hospital mortality.Conclusion
The diurnal timing of RRCs appears to have significant implications for patient mortality and morbidity, patient outcomes are worse if RRC occurs out of hours. This finding has implications for staffing and resource allocation. 相似文献6.
Fereshteh Pourkazemi Claire E. Hiller Jacqueline Raymond Deborah Black Elizabeth J. Nightingale Kathryn M. Refshauge 《Physiotherapy》2018,104(4):430-437
Objective
To explore and identify the predictors of ankle sprain after an index (first) lateral ankle sprain.Design
Prospective cohort study, Level of evidence II.Setting
Musculoskeletal research laboratory at the University of Sydney.Participants
A sample of convenience (70 controls, 30 with an index sprain) was recruited.Methods
Potential predictors of ankle sprain were measured including: demographic measures, perceived ankle instability, ankle joint ligamentous laxity, passive range of ankle motion, balance, proprioception, motor planning and control, and inversion/eversion peak power. Participants were followed up monthly and the number of ankle sprains was recorded over 12 months.Results
Ninety-six participants completed the study; 10 participants sustained an ankle sprain. A combination of 10 predictors including: a recent index sprain, younger age, greater height and weight, perceived instability, increased laxity, impaired balance, and greater inversion/eversion peak power explained 27 to 56% of the variance in occurrence of ankle sprain (χ211,95 = 30.67, p = 0.001). The regression model correctly classified 90% of cases. The strongest independent predictors were history of an index sprain (odds ratio (OR) = 8.23, 95% confidence interval (CI) = 1.66 to 40.72) and younger age (OR = 8.41, 95%CI = 1.48 to 47.96).Conclusion
A recent index ankle sprain and younger age were the only independent predictors of ankle sprain. The combination of greater height or weight, feeling of instability, peak power and impaired balance predicted the occurrence of ankle sprain in almost 90% of participants. These findings could form the basis for intervention targeted at reducing recurrence of sprain after an index sprain. 相似文献7.
J. Broderick C. Mc Grath K. Cullen D. Talbot J. Gilmor M. Baily-Scanlan T. O’Dwyer 《Physiotherapy》2018,104(2):248-250
Objectives
To explore the influence of obesity on outcomes of exercise capacity and disease impact in patients with chronic obstructive pulmonary disease (COPD) in response to pulmonary rehabilitation (PR) and to compare outcomes to those of normal weight and overweight counterparts.Design
Secondary data analysis of clinical database.Setting
St. James’s Hospital, Dublin, Ireland.Participants
155 participants with a primary diagnosis of COPD who completed a PR programme between 2012 and 2014.Main Outcome Measures
Exercise capacity evaluated using the Six Minute Walk Test (6MWT) and the COPD Assessment Test (CAT) evaluated disease impact.Results
Walking distance in the 6MWT improved significantly [mean difference of 55 m (95% CI: 42 to 68; p < 0.001)] and similarly [F(2, 92) = 1.434, p = 0.24] across all BMI categories, although the level of improvement reached clinical significance in the normal/underweight and overweight categories only. Disease impact on the CAT score improved across all body mass index (BMI) classifications by 2.3 points (95% CI: 0.9 to 3.6; p < 0.050) which reached clinical significance and did not vary across BMI categories [F(2, 80) = 0.534, p = 0.58].Conclusion
Exercise capacity and self-report disease impact of individuals with COPD improved similarly in response to PR irrespective of BMI. 相似文献8.
G.F. Carvalho C.S. Almeida L.L. Florencio C.F. Pinheiro F. Dach M.E. Bigal D. Bevilaqua-Grossi 《Physiotherapy》2018,104(4):424-429
Objective
To assess the prevalence of falls and fear of falling in patients with migraine compared with controls.Design
Cross-sectional.Setting
Tertiary headache clinic.Participants
This study consisted of 105 controls and 105 consecutive patients diagnosed with migraine with aura (MA, n = 35), migraine without aura (MO, n = 35) and chronic migraine (CM, n = 35).Main outcome measures
Patients were interviewed using a questionnaire containing questions about the history of falls and impairment in balance, and completed the International Falls Efficacy Scale (FES-I). Groups were contrasted using Student’s t-test and analysis of variance, and prevalence ratios were estimated.Results
Falls and self-reported impairment in balance are more prevalent in patients with migraine (54% and 69%, respectively) than in controls (2% and 2%, respectively). In particular, patients with CM and MA reported a greater mean number of falls during the previous year {CM 1.4 [standard deviation (SD) 2.2]; MA 2.2 (SD 2.3)} compared with patients with MO [0.5 (SD 1.0); P < 0.04] and controls [0.05 (SD 0.2); P < 0.002]. The prevalence ratio of falls was greater in patients with MA (7.2; P < 0.002) and CM (4.5; P < 0.002) compared with controls. Patients with migraine experienced a high level of concern about falls during their daily activities compared with controls (29.8 vs 20.1 points in the FES-I questionnaire; P<0.0001).Conclusions
The balance impairment of patients with migraine may have a functional impact. Migraine is associated with risk of falling, and patients exhibit a higher prevalence of impairment in balance, falls and fear of falling. 相似文献9.
Question
What is the effectiveness and what are the adverse effects.Design
Systematic review with meta-analysis.Participants
Patients with shoulder or upper extremity pain or dysfunction.Intervention
Trigger point dry needling (TDN) compared to control, another intervention or another needling technique.Outcome measures
Primary outcome measures included shoulder or upper limb pain, shoulder or upper limb dysfunction.Results
Eleven randomized trials involving 496 participants were appraised. There was very low evidence that trigger point dry needling of the shoulder region is effective for reducing pain and improving function in the short term. There is some evidence that needling both active and latent trigger points is more effective than needling an active trigger point alone for pain immediately and 1-week after treatment (SMD = ?0.74, 95%CI = ?1.2 to ?0.3; and SMD = ?1.0, 95%CI = ?1.52 to ?0.59).Conclusion
There is very low evidence to support the use of TDN in the shoulder region for treating patients with upper extremity pain or dysfunction. Two studies reported adverse effects to TDN interventions. Most common adverse effects included bruising, bleeding, and pain during or after treatment. Future studies are likely to change the estimates of the effectiveness of TDN for patients with upper extremity pain or dysfunction.PROSPERO: CRD42016045639. 相似文献
10.
11.
T.O. Smith M. Mansfield J. Dainty G. Hilton C.J.V. Mann C.M. Sackley 《Physiotherapy》2018,104(1):80-90
Objectives
To determine whether physical activity measured using the Physical Activity Scale for the Elderly (PASE), changes during the initial 24 months post-total hip (THR) or knee replacement (TKR), and how this compares to a matched non-arthroplasty cohort.Design
Case-controlled study analysis of a prospectively collected dataset.Setting
USA community-based.Participants
116 people post-THR, 105 people post-TKR compared to 663 people who had not undergone THR or TKR, or had hip or knee osteoarthritis. Cohorts were age-, gender- and BMI-matched.Main outcome measures
Physical activity assessed using the 12-item PASE at 12 and 24 months post operatively.Results
There was no significant difference in total PASE score between pre-operative to 12 months (mean: 136 vs 135 points; p = 0.860) or 24 months following THR (mean: 136 vs 132 points; p = 0.950). Whilst there was no significant difference in total PASE score from pre-operative to 12 months post-TKR (126 vs 121 points; p = 0.930), by 24 months people following TKR reported significantly greater physical activity (126 vs 142 points; p = 0.040). There was no statistically significant difference in physical activity between the normative matched and THR (p ≥ 0.140) or TKR (p ≥ 0.060) cohorts at 12 or 24 months post joint replacement.Conclusions
Physical activity is not appreciably different to pre-operative levels at 12 or 24 months post-THR, but was greater at 24 months following TKR. Health promotion strategies are needed to encourage greater physical activity participation following joint replacement, and particularly targeting those who undergo THR. 相似文献12.
Objectives
To investigate how a virtual cultural simulation experience and guided reflection influenced physiotherapy students’ intrapersonal and interpersonal cultural empathy, and to explore students’ satisfaction with the learning experience.Design
Three research arms within a single cohort: 1) pre-test post-test investigation of intrapersonal cultural empathy; 2) quasi-experimental investigation of interpersonal cultural empathy; 3) post-test measurement of satisfaction.Setting
An Australian university.Participants
Bachelor and Master physiotherapy students, response rate 98% (162/165).Interventions
A self-directed online virtual simulation in which the student assumed the role of a patient who has been hospitalised in a developing country. Students were then guided to reflect on the experience via online questions.Main outcome measures
The primary measure was the Comprehensive State Empathy Scale (CSES) of intrapersonal cultural empathy. Secondary measures were the Theory of Planned Behaviour:Cultural Competence Questionnaire (TPB:CCQ) of interpersonal cultural empathy; and the Satisfaction with Cultural Simulation Experience Scale (SCSES).Results
Intrapersonal cultural empathy improved after the virtual simulation, shown in overall CSES scores [pre-test: 95 (81–109) vs post-test: 106 (89–117); median difference 11; P = <0.001]. For the TPB:CCQ, the post-simulation (‘intervention’) group demonstrated greater ‘Perceived Behavioural Control’ interpersonal empathy compared to the presimulation (‘control’) group [4.41 (0.54) vs 4.59 (0.53); mean difference = 0.19; 95% confidence interval = 0.01 to 0.36; P = 0.020]. Satisfaction with the experience was high (mean SCSES score = 40/56 (71%)).Conclusions
A virtual cultural simulation experience and guided reflection led to significant increases in students’ intrapersonal cultural empathy, with some influence on interpersonal cultural empathy. Students were highly satisfied with this learning experience. 相似文献13.
Matthew Hao Lee Biswadev Mitra Jiun Kae Pui Mark Fitzgerald 《Australian critical care》2018,31(4):199-203
Background
Traumatic brain injury (TBI) is a significant public health issue. Assessing pupil reactivity is a crucial aspect of its management and the pupillometer has been shown to be a more objective tool compared to the standard penlight. Its use, however, is not widespread.Objective
To investigate the paucity in uptake, we examined the frequency of use of pupillometers (NeurOptics®NPi-100?) amongst Intensive Care Unit (ICU) doctors and nurses, evaluated its user-friendliness and explored barriers to its use.Design
An online cross-sectional survey.Methods
Surveys were distributed five months after the introduction of pupillometers (in May 2015) to ICU doctors and nurses working in a quaternary referral centre providing state services for trauma. The survey included sections on: questions on demographics and experience, methods of conventional pupillary assessment in patients with TBI, experience of using the pupillometer, and questions on barriers to its use. Responses were collated as discrete variables and summarised using counts and proportions. Comparisons among proportions were undertaken using the chi-squared test and reported with 95% confidence intervals.Results
A total of 79 responses were recorded, predominantly 94.9% (n = 75) from nursing staff. A total of 50 (63.3%) responders were using the pupillometers, with a mean frequency-of-use rating of 4.67 out of 10 and a mean user-friendliness rating of 6.28 out of 10. There was no association between frequency of use and user-friendliness (p = 0.36). The main identified barriers to its use included a lack of education with regards to its use, a perceived lack of clinical significance, a lack of standardisation of documenting findings, and difficulties with access to disposable patient shields (Smartguards).Conclusions
There was good adoption of the technology in the early phases of ICU implementation with user-friendliness rated favourably. In this paper we identify barriers to use and discuss possible solutions to increase clinical utility. 相似文献14.
Background
The unipedal balance test (UBT) is widely used with older adults, but interpreting performance on the test requires the availability of normative values.Objective
To use meta-analysis to provide normative values for the UBT for adults ≥ 60 years.Data sources
Electronic searches of PubMed, CINAHL, and Scopus as well as hand searches.Study selection
Inclusion required that articles provided means and standard deviations for UBT time for strata including at least 30 participants without pathology.Study appraisal and synthesis
The two authors independently abstracted information on UBT procedures and performance. The Comprehensive Meta Analysis (3.0) program (random effects model) was used to consolidate UBT data from 23 articles. A custom six component (14 point) checklist was used to rate article quality.Results
Meta-analysis showed the mean UBT time for 13,454 tested individuals to be 26.9 seconds. Times were longer for individuals who were younger, male, and allowed longer test durations (e.g. ≥ 120 seconds vs 30 seconds).Limitations
Although the UBT norms presented herein provide a better estimate of normal performance than individual studies, differences between studies in age and gender strata and test durations limit the generalizability of some of the normative values generated using meta-analysis. 相似文献15.
Objectives
To pilot the methods for a randomized controlled trial (RCT) to investigate whether the treatment effect of Mechanical Diagnosis and Therapy (MDT) is enhanced with the LUMOback.Design
Assessor blinded RCT with 3 and 6-week follow-ups.Setting
An outpatient clinic.Participants
Primary eligibility criteria were: a directional preference of lumbar extension, ≥18 years of age, and non-specific low back pain lasting for ≥1 month.Interventions
The MDT group undertook extension exercises (10 reps/3 hour) and postural correction using a lumbar roll at home. The MDT + LUMOback group also wore the LUMOback daily, providing a vibration alert in a slouched posture.Main outcome measures
The Global Rating of Change Scale (GRCS) (0–6), recruitment rate per month, treatment sessions, compliance rate of wearing the LUMOback, participants’ adherence with treatment, dropout rate and the stage of the MDT program at six weeks.Results
Twenty-two participants were included for 20 months (a recruitment rate of 1.1 patient/month). Dropout rate was 9%. The mean (SD) of the GRCS of the MDT and MDT + LUMOback groups were 4.7 (0.8) and 4.7 (0.5) at the 3-week follow-up and were both 4.9 (0.5) at the 6-week follow-up. The patients undertook a mean of 6.7 sessions for six weeks and exercises with mean of 3.7 set/day in each group. The mean compliance rate of wearing the LUMOback was 88%. Nobody was discharged from the intervention with full recovery within six weeks.Conclusions
Data indicated a promising method for the full RCT, but a rationale for the full RCT was not justified.Clinical Trial Registration number: UMIN000018380. 相似文献
16.
Naoki Akazawa Kazuhiro Harada Naomi Okawa Kimiyuki Tamura Atsushi Hayase Hideki Moriyama 《Physiotherapy》2018,104(4):438-445
Objective
To examine the relationships between muscle mass, intramuscular adipose and fibrous tissues of the quadriceps, and gait independence in chronic stroke survivors.Design
Cross-sectional study.Setting
Hospital-based research.Participants
Seventeen chronic stroke survivors who were unable to walk independently (non-independent walker group) and 11 chronic stroke survivors who were able to walk independently (independent walker group) participated in this study. In addition, 25 healthy older adults (healthy group) were enrolled.Interventions
None.Main outcome measures
The muscle mass and intramuscular adipose and fibrous tissues of the rectus femoris and vastus intermedius were assessed based on muscle thickness and echo intensity of ultrasound images, respectively.Results
The thicknesses of the rectus femoris and vastus intermedius on the paretic and non-paretic sides in the non-independent walker group were significantly lower than those in the healthy group (mean difference ?0.5 to ?0.2 cm; P < 0.001–0.037). The paretic side in the non-independent walker group had significantly higher rectus femoris and vastus intermedius echo intensity compared with the healthy group (mean difference 15.8–17.4; P = 0.007–0.025). The thickness of the rectus femoris on the non-paretic side was significantly lower in the independent walker group than in the healthy group (mean difference ?0.3 cm; P = 0.001).Conclusions
These results suggest that chronic stroke survivors who are unable to walk independently are likely to experience secondary changes in skeletal muscle on both the paretic and non-paretic sides. 相似文献17.
Background
Compassion satisfaction and compassion fatigue influence nurses’ intention to stay or leave nursing. Identification of compassion satisfaction or fatigue in critical care nurses is important in this high turnover workforce.Objectives
The aim of this study was to examine factors predicting and contributing to compassion satisfaction and compassion fatigue experienced by critical care nurses in Australian intensive care units.Methods
A self-reported cross-sectional survey using an established tool collected data from critical care nurses of two adult Australian intensive care units.Results
Overall, these critical care nurses reported what Professional Quality of Life Scale guidelines designated as ‘average’ levels of compassion satisfaction and burnout, and ‘low’ levels of Secondary Traumatic Stress (STS). Compared to Site B, nurses at Site A had significantly higher compassion satisfaction (p = 0.008) and lower STS scores (p = 0.025), with site significantly predictive for compassion satisfaction (p < 0.024) and STS (p < 0.002). Nurses with postgraduate qualifications had significantly higher compassion satisfaction scores (p = 0.027), and compassion satisfaction significantly increased with increasing duration of practice (p = 0.042) as a nurse and in their current ICU (p = 0.038). Burnout scores significantly reduced with increasing age, years of tenure and practice; burnout was predicted by lower years of tenure (p < 0.016).Conclusion
These critical care nurses revealed profiles that, whilst not in crisis, fell short of the ideal high compassion satisfaction and moderate/low fatigue. More recent tenure flags those potentially at higher risk of compassion fatigue, whilst the better scores associated with postgraduate education and from one site need further exploration. Further research should develop understanding and interventions to enhance compassion satisfaction and support retention of this crucial nursing workforce. 相似文献18.
Lotta Johansson Berit Lindahl Susanne Knutsson Mikael Ögren Kerstin Persson Waye Mona Ringdal 《Australian critical care》2018,31(2):59-70
Background
Currently, it is well known that the sound environment in intensive care units (ICU) is substandard. Therefore, there is a need of interventions investigating possible improvements. Unfortunately, there are many challenges to consider in the design and performance of clinical intervention studies including sound measurements and clinical outcomes.Objectives
(1) explore whether it is possible to implement a full-scale intervention study in the ICU concerning sound levels and their impact on the development of ICU delirium; (2) discuss methodological challenges and solutions for the forthcoming study; (3) conduct an analysis of the presence of ICU delirium in the study group; and (4) describe the sound pattern in the intervention rooms.Methods
A quasi-randomized clinical trial design was chosen. The intervention consisted of a refurbished two-bed ICU patient room (experimental) with a new suspended wall-to-wall ceiling and a low frequency absorber. An identical two-bed room (control) remained unchanged. Inclusion criteria: Patients >18 years old with ICU lengths of stay (LoS) >48 h. The final study group consisted of 31 patients: six from the rebuilt experimental room and 25 from the control room. Methodological problems and possible solutions were continuously identified and documented.Results
Undertaking a full-scale intervention study with continuous measurements of acoustic data in an ICU is possible. However, this feasibility study demonstrated some aspects to consider before start. The randomization process and the sound measurement procedure must be developed. Furthermore, proper education and training are needed for determining ICU delirium.Conclusion
This study raises a number of points that may be helpful for future complex interventions in an ICU. For a full-scale study to be completed a continuously updated cost calculation is necessary. Furthermore, representatives from the clinic need to be involved in all stages during the project. 相似文献19.
Tatiane Calve Douglas Vicente Russo Júnior Ana Maria Forti Barela 《Revista brasileira de fisioterapia (S?o Carlos (S?o Paulo, Brazil))》2018,22(1):64-69
Background
Exercises that could prevent gait impairment of older adults should be implemented in such a way that practitioners can keep motivation and adherence independent of older adults fitness levels.Objective
This study describes how younger and older adults use a non-pedal tricycle to transport their bodies along a pathway.Methods
Nine younger (24 ± 4.9 y) and nine older (66 ± 4.0 y) adults participated in this study. They moved along a straight pathway at a self-selected comfortable speed with reflective markers on their main lower limb landmarks. A computerized gait analysis system with infrared cameras was used to obtain kinematic data to calculate spatial-temporal parameters and lower limb angles.Results
Overall, participants from both groups were able to perform the task moving at a similar mean speed, with similar stride length and ankle joint excursion. Older adults had higher cadence (mean difference of 17 steps/min; 95% CI = 0.99–1.15) and hip excursion (mean difference of 12°; 95% CI = 28–33), longer stance duration (mean difference of 3.4%; 95% CI = 56.2–59.5), and lower knee excursion (mean difference of 6°; 95% CI = 47.9–53.8) than younger adults.Conclusion
Older adults were able to transport their body with a non-pedal tricycle with more hip and less knee excursion than younger adults. Professionals that work with the older population should look at and take into consideration the use of non-pedal tricycles in exercise protocols and investigate the long-term impacts. 相似文献20.
Christina Aggar Jacqueline G. Bloomfield Astrid Frotjold Tamsin H.T. Thomas Fung Koo 《Collegian (Royal College of Nursing, Australia)》2018,25(1):105-111