Relatives of stroke patients--their experiences and needs in hospital

This study explores the experiences and needs of relatives of hospitalized stroke patients. In semi-structured interviews, 17 relatives of stroke patients were asked about their experiences during the hospitalization period. The interviews were analysed by thematic content analysis. The findings indicate that the experiences of the relatives change during the hospitalization period, and that they are influenced by four factors: the individual character of the relatives, the position of the patient, the people in the relatives' social environment and the hospital situation. Four categories of needs were also found: the need for information, communication, support and accessibility.     

前移护理干预对颅内动脉瘤破裂早期行夹闭术患者预后的影响

目的探讨前移护理干预对颅内动脉瘤破裂早期行夹闭术患者预后的影响。方法随机将32例颅内动脉瘤破裂早期手术患者分为干预组和对照组各16例,干预组患者实行围手术期预见性护理干预,对照组实行神经外科常规护理。观察2组患者术后再次出血、脑血管痉挛、消化道出血、电解质紊乱及肺部感染的例数。出院时按格拉斯哥(GCS)标准评价疗效。结果干预组患者再次出血、脑血管痉挛、消化道出血、电解质紊乱及肺部感染发生率明显低于对照组;干预组患者GCS评分与对照组相比明显升高。结论预见性护理干预对颅内动脉瘤破裂早期手术患者的预后及并发症的预防有明显的协同作用,降低了死亡率和致残率,患者预后更好。     

Staff and patient perceptions of a community urinary catheter service

Urinary catheters are used extensively throughout healthcare for various reasons including management of urinary tract dysfunction. The purpose of this study was to simultaneously explore both catheter user experience and staff perception of catheter services within community urinary catheter care. A questionnaire was conducted to investigate the views of community nursing staff. During the same time period, patients were interviewed about (a) catheter‐care standards and adherence to guidelines, (b) patients' feelings towards their catheter and (c) potential improvements to catheter practices and design. Sixty‐nine staff were surveyed. Although 97% of staff indicated they used local guidelines, in up to 62% of cases findings suggested practices in sending urine samples for culture did not comply with guidelines. Then, 75% of staff were satisfied with catheter care, but weaknesses were identified in handover processes, communication between staff and patients, and excessive documentation. Staff results were compared with the findings from interviews of 29 long‐term urinary catheter users, demonstrating a higher level of satisfaction with catheter care among patients (86%). Patients and staff agreed that generally the impacts of their catheter on personal hygiene, sense of independence, sense of dignity and of patient happiness, were neutral (neither positive nor negative). However, regarding improvements to catheter practices and catheter design, 73% of staff but only 45% of patients suggested improvements in service, while 76% of patients but only 49% of staff suggested improvement in design. The study reveals general satisfaction with community catheter care, but indicates areas of potential improvements regarding communication, documentation and catheter design. When compared to patient responses, staff overall had a less positive view of patients perception of their relationship with their catheter.     

The lived experience of the diabetes nurse specialist regular check-ups, as narrated by patients with type 2 diabetes

Aim. The aim was to elucidate the lived experience of regular diabetes nurse specialist check‐ups among patients with type 2 diabetes. Background. Diabetes care with diabetes nurse‐led clinics in primary care has been established in Sweden since the 1980s. Information about patients’ lived experience of these regular check‐ups is important in the further development of diabetes nursing in primary care. Methods. Narrative interviews were conducted with 10 women and 10 men with type 2 diabetes regarding their lived experience in everyday life and the regular check‐ups by the diabetes nurse specialist. A phenomenological‐hermeneutic method inspired by Ricoeur was used in the analysis. Results. Patients’– with type 2 diabetes – lived experience of regular check‐ups showed an overall positive influence on the patients’ way of living with the disease by underpinning and developing their understanding and management of daily life. This influence was interpreted as an interlinked chain comprising the following elements; being confirmed, being guided within the disease process, becoming confident and independent and being relieved. Every link contained a positive influence from being dependent‐independent, autonomous and a feeling of freedom in patients striving for an everyday life with a disease under control. Relevance to clinical practice. The development of diabetes‐nurse‐led clinics from the perspective of the patient must consider the patient's individual need for support and continuity with the diabetes nurse specialist. Consultations with collaborative partnership and specific expertise that is easy to access implied autonomous disease self‐management in terms of patients’ own control of the disease over time. In view of the increasing number of patients with diabetes, this could positively impact the availability of diabetes nursing care.     

‘Patients' experiences of seeing their obesity in CT images allow for an active self‐care: a qualitative study’

Medical images are primarily used to ensure an accurate diagnosis and make treatment possible. They are more rarely used for explanation or information to or education of patients. This study investigates patients' experiences of being shown and given an explanation of their obesity disease using CT images. Twelve patients participated: >30 BMI kg/m², age between 34 and 65, and mixed sexes, seven women and five men. Patients said that seeing their own images made them more aware of and more involved in their disease, enabling them to carry out more active self‐care. The deeper involvement offered them a new approach to their body and helped them to make decisions on treatment to reduce their weight.     

Experiences of wake and light therapy in patients with depression: A qualitative study

Wake therapy can reduce depressive symptoms within days, and response rates are high. To sustain the effect, it is often combined with light therapy. Few studies have focussed on factors related to patients′ adherence to the regime, and none has used qualitative methods to examine their experience of these combined interventions. Therefore, the aim of the present study was to illuminate patients' experiences with wake and light therapy and factors related to adherence. Thirteen inpatients with depression were included. They participated in an intervention consisting of three wake therapies during the first week, 30 min of daily light treatment for the entire 9 weeks, and ongoing psychoeducation regarding good sleep hygiene. Patients kept a diary, and individual semistructured interviews were conducted. Data were analysed using qualitative content analysis. The participants' overall experience with the treatment was positive. Some experienced a remarkable and rapid antidepressant effect, whereas others described more long‐term benefits (e.g. improved sleep and diurnal rhythm). Yet recovery was fragile, and patients were only cautiously optimistic. Social support was important for maintaining the motivation to stay awake and receive daily light therapy. Overall, participants found the treatment worthwhile and would recommend it to others with depression. The study revealed a lack of knowledge among participants about the connection between regular sleep patterns and depression. In conclusion, this study provides insight into patients' experiences, and knowledge that can contribute to guidelines for future adherence‐promoting organization of wake and light therapy.     

Parents' experiences of midwife-managed care following the loss of a baby in a previous pregnancy

AIMS OF THE STUDY: This article reports on research that explored the impact of the Special Delivery Service, a midwife-managed intervention, developed as an addition to routine care to support and educate high-risk pregnant women and their partners subsequent to the death of a baby in a previous pregnancy. BACKGROUND: Approximately 40,000 families suffer the trauma of a neonatal death* annually in the USA, while statistics for Canada and Australia give similar numbers relative to population. Since many more babies die than those accounted for in these statistics, through stillbirth, miscarriage and Sudden Infant Death Syndrome, more than the above-cited 2% of childbearing couples will face the trauma of the loss of a baby. RATIONALE: The resultant threat that this situation may pose to the health of the mother has been extensively documented in the literature. However, despite the recent growth in knowledge about the impact of perinatal loss and bereavement, few interventions are specifically designed to support Australian and Canadian women and their partners during a pregnancy following the loss of a baby. METHODOLOGY: This phenomenological study explored women's and their partners' experiences of grief and loss and the support offered to them through the Special Delivery Service programme. RESULTS & DISCUSSION: In the face of funding and organizational changes to both the Australian and Canadian health care systems that have eliminated or reduced some services, this research reinforced the need for individualized, compassionate midwifery care and the urgent need for genuinely empathic and supportive health care services for these women and their partners. It also emphasized the need for couples to be informed and supported so that gender differences in grieving do not become a divisive element in the relationship. CONCLUSIONS: The findings have implications for both nurses and midwives in their practice in countries where optimum care of this vulnerable population is not routinely available. The research supports midwife-managed models of care to ensure women and their families are appropriately supported in crisis. The findings provide insight also into the diverse grief response among couples and the difficulties experienced in a pregnancy following the loss of a baby.     

连续护理模式对脑卒中合并气管切开患者出院后生活质量的效果研究

目的评价连续护理模式对提高脑卒中合并气管切开患者出院后生活质量的效果。方法将211例脑卒中合并气管切开的患者随机分为观察组和对照组。两组患者住院期间均给予常规护理,观察组在此基础上实施出院后连续护理干预。出院3个月后对两组患者生活质量及气管套管相关知识掌握情况进行比较。结果 3个月后观察组患者生活质量及气管切开知识掌握情况明显优于对照组,差异具有统计学意义(P0.01或P0.05)。结论连续护理模式有助于提高脑卒中合并气管切开出院患者的生活质量水平及相关护理知识水平。