Effect of educational program on pediatric nurses' knowledge and practice regarding selected nonpharmacological techniques to relive pain in neonates

BackgroundNewborn infants have an increased sensitivity to pain and are more reactive to pain than older children and adults. Nurses play a crucial role in assessing pain, implementing and evaluating interventions to minimize neonatal pain using available resources especially nonpharmacologic techniques.Aim of the studyto develop and apply an educational program on pediatric nurses regarding selected nonpharmacologic techniques to relieve pain in neonates.Research designA pre/post quasi-experimental research design was utilized in the present study. The study was carried out at Minia University for Obstetric and Pediatric and General Hospitals at neonatal care units. A convenient sample of 41 nurses was included in this study. Educational program for nurses was done through using the following data collection tools 1) Pre-designed questionnaire sheet, 2) Observation checklists sheet and 3) Educational and training program.ResultsIt was revealed that there was an obvious increase in the total mean scores of knowledge and practice in post and follow up program phase compared with pretest phase, with a very highly significant difference (p < 0.001).ConclusionThe education program had a significant impact on pediatric nurses' knowledge and practices regarding selected nonpharmacologic techniques to relieve pain in neonates.RecommendationsA continuous training and educational program should be planned and offered on regular basis for nurses regarding nonpharmacologic techniques to relieve pain in neonates.     

Effect of the labour roadmap on anxiety,labour pain,sense of control,and gestational outcomes in primiparas

Background and purposeThe pain and uncertainty of the labour process can lead to anxiety. Birth ball exercises are one of the pain relief methods for the labour process. This study aimed to explore the outcomes of the use of the labour roadmap with birth balls in primiparas.Materials and methodsThis randomized controlled trial involved Chinese women between the gestational ages of 37–42 weeks who were randomly assigned to the experimental or control group. The outcomes of labour pain, anxiety, and self-control were collected using the Short-Form McGill Pain Questionnaire, visual analogue scale-anxiety, and Labor Agentry Scale, respectively.ResultsThe study found improvements in anxiety, pain, and self-control (P < 0.05), as well as the duration of the first stage of labour (P < 0.05) in the intervention group, but there were no significant differences in the duration of the second and third stages of labour, volume of bleeding, or the 1-min Apgar score between the two groups (P = 0.09, 0.07, 0.06, 0.63, respectively).ConclusionThe labour roadmap was effective for improving self-control, reducing pain and anxiety during labour, and accelerating the first stage of labour.     

非药物分娩镇痛的应用现状及研究进展

【摘要】 分娩疼痛是一种内脏性疼痛,是导致围产期母婴不良妊娠结局的原因之一,其强度及镇痛措施的效果与产妇的生理因素、心理因素及社会因素相关。非药物分娩镇痛措施为产妇提供心理支持和生理调节技术以达到分娩镇痛、促进自然分娩的目的。其对产程及母婴影响小、安全性高、依从性好、经济易行,适用范围广,有利于促进产程进展,减少产科和麻醉干预措施,改善妊娠结局。本文就国内外常用的非药物分娩镇痛方法的应用现状及研究进展进行综述。     

The effect of nonpharmacological training on delirium identification and intervention strategies of intensive care nurses

ObjectiveThis study aims to investigate the effect of nonpharmacological intervention training on delirium recognition and the intervention strategies of intensive care (ICU) nurses.MethodThis is a quasi-experimental study conducted using a pretest–posttest design. The study sample included a total of 95 patients staying in the medical ICU of a university hospital and 19 nurses working in these units. The data were collected using the Patient and Nurse Introduction, Confusion Assessment Method for the ICU, and Delirium Risk Factors, and Non-pharmacological Interventions in Delirium Prevention Forms.ResultsDelirium was identified in 26.5% and 20.9% of the patients in the pre- and posttraining phase, respectively. Patients with delirium had a longer duration of stay in the ICU, lower mean Glasgow Coma Scale score and a higher number of medications in daily treatment (p < 0.05). The risk of delirium increased 8.5-fold by physical restriction and 3.4-fold by the presence of hypo/hypernatremia. The delirium recognition rate of nurses increased from 7.7% to 33.3% in the post-training phase.ConclusionOur study results show that training can increase the efficiency of ICU nurses in the management of delirium.     

难治性胃食管反流病的非药物治疗进展

胃食管反流病(GERD)是一种常见的上消化道疾病。目前质子泵抑制剂(PPI)是治疗该病的首选药物,但约40%GERD患者经规范治疗后疗效不佳,即难治性GERD,且易合并不同程度的精神心理症状,严重降低患者生活质量。因此积极探索一些非药物治疗手段成为近年来rGERD相关研究的热点。本文就生活方式的调整、穴位刺激、膈肌生物反馈、内镜下治疗、外科手术等rGERD非药物治疗方法进展做一综述。     

胃食管反流病的非药物治疗现状与新进展

胃食管反流病（GERD）是一种常见的上消化道疾病,约40%GERD患者经药物规范治疗后疗效不佳,根据患者的具体情况针对性的治疗方法显得愈发重要,积极探索一些非药物治疗手段成为近年来GERD相关研究的热点。本文通过总结回顾5年国内外的文献,比较各种非药物治疗的优缺点,包括生活方式的调整,穴位刺激,膈肌生物反馈,内镜下治疗,外科手术等非药物治疗方法进展做一综述。     

Gentle remedies: Restoring faith in the first step of nonpharmacological infant mental health care for the prevention and treatment of “disruptive behavior”

Parents and healthcare providers are reported to be “desperate” for solutions for dealing with temper tantrums and other extreme “disruptive behaviors.” Reports state that at least 10,000 and as many as 20,000 infants under the age of two in 2014 were prescribed drugs such as risperidone, quetiapine, and other antipsychotic medications, suggesting that parents may have lost faith in their inner abilities to create an environment for their infant. Dr. Maria Montessori, concluded from her work that the nervous troubles of many “difficult” children can be traced to one of the most “harmful forms of repressive action” an adult can take, that of “interference” with or interrupting a child's self-chosen activity. This paper explores alternatives to adult interruption that begins with shushing crying infants and may extend to demanding medications with the intention of stopping behaviors. It discusses a tiered infant mental health care system in which conservative care, the first tier or step can be restored with nonpharmacological gentle remedies. Gentle remedies are neither better than nor are they a replacement for pharmaceutical drugs, the fourth and last step of the tiered system due to their known short term and potential long-term risks. The gentle remedies first step approach begins with parents engaging in environment and lifestyle management. Examples of other gentle remedies discussed for use in helping infants to discharge stress and frustration include lullabies, hot water bottles, infant massage education, oatmeal baths and other herbal simples, and Bach Flower Remedies.