The effect of Reiki on pain and anxiety in women with abdominal hysterectomies: a quasi-experimental pilot study

The purpose of this pilot study was to compare reports of pain and levels of state anxiety in 2 groups of women after abdominal hysterectomy. A quasi-experimental design was used in which the experimental group (n = 10) received traditional nursing care plus three 30-minute sessions of Reiki, while the control group (n = 12) received traditional nursing care. The results indicated that the experimental group reported less pain and requested fewer analgesics than the control group. Also, the experimental group reported less state anxiety than the control group on discharge at 72 hours postoperation. The authors recommend replication of this study with a similar population, such as women who require nonemergency cesarian section deliveries.     

Abdominal surgery, pain and anxiety: preoperative nursing intervention

AIM: This paper reports a study examining the effects of preoperative nursing intervention for pain on abdominal surgery preoperative anxiety and attitude to pain, and postoperative pain. METHOD: In a randomized controlled study conducted between January and August 2001, patients undergoing abdominal surgery in a medical center in southern Taiwan were randomly assigned to an experimental (n = 32) or control group (n = 30). The experimental group received routine care and preoperative nursing intervention for pain, while the control group received routine care only. A structured questionnaire including an anxiety scale, pain attitude scale, and Brief Pain Inventory was used to assess the results. RESULTS: Participants in the experimental group experienced a significant decrease in preoperative anxiety and a significant improvement in preoperative pain attitude. They also had statistically significantly lower postoperative pain intensity for 4 hours after surgery and lower highest pain intensity within the first 24 hours after surgery. Perceived pain interference during position changes, deep breathing/coughing, and moments of emotion in the experimental group was statistically significantly lower than that of the control group in the same situations. The experimental group also started out-of-bed activities 1.5 days earlier. CONCLUSION: Preoperative nursing intervention for pain has positive effects for patients undergoing abdominal surgery. The intervention used in this study could serve as a guide for nurses to improve the pain care of these patients.     

Sexual behaviour of nursing home residents: staff perceptions and responses

AIMS: This paper presents the results of a study that investigated nursing home staff perceptions of affectionate and sexual behaviour of residents. BACKGROUND: Despite growing recognition of the importance of sexual expression among residents and a increasing willingness to discuss the topic, sexual activity for nursing home residents remains an ignored component of life satisfaction. Even when 'sexuality' has been included as part of a resident's plan of care, this may not mean that attention has been paid to maintaining that aspect of their life. Thus, nursing homes can mark the end of many types of freedom for older people. Given that intimate basic care is performed by others and often by members of the opposite sex, loss of sexual freedom may also occur. METHOD: A grounded theory approach was used to study staff working in nursing homes in Australia and Sweden. Data were generated through interviews and nominal groups with nursing home staff. Thirty women volunteered to be interviewed, and 18 others were involved in the three nominal group discussions; a further five participants were involved as key informants. FINDINGS: Staff perceptions and responses to residents' sexual behaviour were found to be influenced by their own level of comfort related to sexuality issues, and the ethos within the organization where they worked. The conceptual paradigm was termed 'Guarding Discomfort' and specified the ways in which staff guard against sexuality discomfort as well as the ways their behaviour fits within different types of organizations. CONCLUSION: Both staff and nursing home managers need to work toward developing a home environment that is supportive of residents' sexuality rights, that permits sexuality expression and promotes a culture where all people concerned are comfortable with sexuality issues.     

早期康复护理对脑卒中失语症患者言语功能恢复的影响

目的探讨脑卒中失语症早期综合康复护理的方法和效果。方法将75例脑卒中失语症患者随机分为早期康复护理组、延期康复护理组与对照组各25例,对照组接受神经内科的常规治疗和护理,早期、延期康复护理组在此基础上予以心理护理和健康教育。采用中国康复研究中心汉语标准失语症检查量表（CRRCAE）在康复护理前后对3组患者进行评分,并进行比较。结果康复干预后CRRCAE各项评分,早期康复护理组、延期康复护理组在听理解、复述、口语表达、朗读、阅读方面与对照组比较差异显著。早期康复护理组在听力理解、复述、口语表达、朗读、阅读方面与延期康复护理组比较差异显著。结论综合康复护理对脑卒中失语症患者言语功能的恢复有促进作用,早期介入康复护理效果更明显。     

A descriptive analysis of experienced nurses' clinical reasoning during a planning task

A Think Aloud (TA) method was employed to collect verbal data from seven clinical nurses as they reviewed a written case study and formulated a plan of care. Protocol Analysis (PA) of the verbal data resulted in a visual representation of each subject's plan of care and provided information regarding the clinical data that subjects used to plan care. The results demonstrated that frequently problems and interventions were inextricably linked and considered in unison rather than during separate steps of a planning process. This finding has implications relative to the current practice within both nursing education and nursing service of focusing on problems and interventions separately when planning care.     

Conceptions of pain among Somali women

AIM: This paper reports a study of a group of Somali mothers' views on pain, the causes of pain, pain behaviour and pain treatment concerning themselves and their family members. BACKGROUND: Both the meaning of pain and pain behaviour are associated with values in a patient's social and cultural context. Culture also provides models for how to treat and relieve pain. Several studies report a lack of cultural sensitivity and competence among healthcare professionals, resulting in lower quality of and less access to health care and pain treatment for minority groups. However, the majority of the scientific literature on pain and culture concerns adults in the United States of America. METHOD: Focused conversational interviews were carried out with a convenience sample of nine Somalia women living in Sweden in order to describe and explore their conceptions of pain. Qualitative content analysis was conducted through meaning condensation. The data were collected in 2002-2003. FINDINGS: The women expressed a number of different ideas about definitions and causes of pain. Somalis, especially men, are expected to be stoic about pain. The women had different strategies for communicating about and relieving pain. Children from the ages of 6-8 years upwards were expected to control their pain expression. Respondents used both formal and informal care to relieve pain. For some of the women, consulting a psychologist was not a culturally acceptable way of seeking pain relief. CONCLUSIONS: Nurses must strive for increased cultural competence and explore ways to make healthcare services sensitive to culturally diverse groups. Nurses have an educational role in educating parents and children about pain and the importance of sufficient pain relief. All healthcare providers should be aware of their own cultural values and the risk of stereotyping people.     

早期康复护理对脑卒中失语症患者言语功能恢复的影响

目的 探讨脑卒中失语症早期综合康复护理的方法和效果.方法 将75例脑卒中失语症患者随机分为早期康复护理组、延期康复护理组与对照组各25例,对照组接受神经内科的常规治疗和护理,早期、延期康复护理组在此基础上予以心理护理和健康教育.采用中国康复研究中心汉语标准失语症检查量表(CRRCAE)在康复护理前后对3组患者进行评分,并进行比较.结果 康复干预后CRRCAE各项评分,早期康复护理组、延期康复护理组在听理解、复述、口语表达、朗读、阅读方面与对照组比较差异显著.早期康复护理组在听力理解、复述、口语表达、朗读、阅读方面与延期康复护理组比较差异显著.结论 综合康复护理对脑卒中失语症患者言语功能的恢复有促进作用,早期介入康复护理效果更明显.     

A comparison of massage effects on labor pain using the McGill Pain Questionnaire

The purpose of this study was to describe the characteristics of pain during labor with and without massage. Sixty primiparas in labor were randomly assigned to either a massage or control group and tested using the self-reported Short-Form McGill Pain Questionnaire (SF-MPQ) at 3 phases of cervical dilation: phase 1 dilation (3-4 cm), phase 2 dilation (5-7 cm), and phase 3 dilation (8-10 cm). The massage group received standard nursing care and massage intervention, whereas the control group received standard nursing care only. The results of this study showed: (1) In both groups, as cervical dilation increased, there were significant increases in pain intensity as measured by SF-MPQ; (2) massage lessened pain intensity at phase 1 and phase 2, but there were no significant differences between the groups at phase 3; (3) the most frequently selected five sensory words chosen by both groups were similar at phases 1 and 2- (a) sore, (b) sharp, (c) heavy, (d) throbbing, and (e) cramping, while of the 4 affective classes, "fearful" and "tiring-exhausting" were the most used by participants to describe the affective dimension. The results of this study indicate that, although massage cannot change the characteristics of pain experienced by women in labor, it can effectively decrease labor pain intensity at phase 1 and phase 2 of cervical dilation during labor. Nurses and caregivers could consider using massage to help laboring women through the labor pain.     

Good nursing care to ICU patients on the edge of life

Critically ill patients are admitted to intensive care units (ICUs) to receive advanced technological and medical treatment. Some patients seem not to benefit from the treatment, and sometimes questions are raised as to whether treatment should be withheld or withdrawn. This study was conducted using ICU nurses' experiences with the aim of acquiring a deepened understanding of what good nursing care is for these patients. The study was performed at an adult ICU in Norway, where 14 ICU female nurses were included as participants. The research design was based on interpretative phenomenology and data was collected by group interviews inspired by focus-group methodology. The participants were divided into two groups and each group was interviewed four times. Colaizzi's model was used in the process of analysis. The results show that good nursing care depended on several basic conditions: continuity, knowledge, competence and cooperation, and included clear goals to give appropriate life-saving -- or end-of-life treatment and care. Cornerstones in good nursing care were nurses' verbal communication and nurses' use of their hands. The study emphasises several consequences for future ICU nursing practice and education to enhance good nursing care to patients on the edge of life.     

Establishment of a Somali doula program at a large metropolitan hospital

To meet the unique cultural needs of Somali childbearing women in the United States, a doula support program was implemented at a major midwestern teaching hospital in the spring of 2002. To date, 123 Somali women who have been served by a Somali doula have given birth to live infants at this hospital. Cesarean birth rates in Somali women who had a doula present at birth were lower than the cesarean birth rate for Somali women not attended by a doula. Surveys with the nursing staff indicate that the nurses who have worked with a doula 3 or more times felt more confident caring for Somali women than nurses who have not worked with a doula at least 3 times. Patient feedback indicates positive attitudes about the doula service. Further research needs and suggestions for establishing such a program in other institutions are included.     

Some surprising similarities in the clinical reasoning of'expert' and 'novice' orthopaedic nurses: report of a study using verbal protocols and protocol analyses

This paper reports on an Australian study of 'expert' and 'novice' orthopaedic nursing practitioners' clinical reasoning Concurrent and retrospective verbal reports of patient assessment and care planning in real 'everyday' practice situations were collected from nine pairs of 'expert' and 'novice' orthopaedic nurses Verbal protocol analyses revealed that the experts used the same level of concepts as novices, that their clinical reasoning was as physically orientated as that of novices, and that the implicit constructions of nursing in the reasonings of both experts and novices were consistent with a 'medical model' of health care The research design, limitations and findings are discussed     

Verbal abuse of nursing and midwifery students in clinical settings in Turkey

This phenomenological study describes nursing and midwifery students' experiences with and perceptions of verbal abuse in clinical settings in Turkey. Purposive sampling and, within this technique, typical case sampling were used to capture the students' most typical experiences of verbal abuse. Four categories with 10 themes describing verbal abuse experiences emerged from interviews. The abusive behavior originated from clinical instructors, agency nurses and midwives, physicians, patients, and patients' families. Abuse included health care professionals' exhibiting condescending attitudes toward and making derogatory comments about nursing higher education, refusing to share clinical knowledge and skills with students, belittling students' approaches to patient care, and humiliating and treating students as health care professionals of lesser value. During their clinical education, students were both vulnerable to and the targets of significant verbal abuse from those in supervisory positions. The students were vulnerable to verbal abuse because they were outsiders, left alone to tend to their own learning needs, inexperienced in patient care, and unsure of their rights. Measures should be taken to eliminate verbal abuse not only because of its obvious injustice, but also because it impedes the professionalization of nursing. Faculty and students should be prepared for the possibility of verbal abuse so they can respond assertively.     

Examination of Knowledge About and Nursing Interventions for the Care of Patients in Pain of Nurses Who Work at Çukurova University Medical Faculty Balcali Hospital

Pain is a concept that goes back into distant history and is something that is faced by every person in different degrees and at different times in their lives. A definition of pain, adopted by the International Association for the Study of Pain and the American Pain Society, is: “an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage.” Although pain is one of the most common reasons for needing health care, it is not well understood and continues to be one of the most important health problems today. The pain experience is dynamic, and the nurse is responsible for understanding this. Nurses need to cooperate with the patient and other members of the health care team to be able to control pain. Nurses are ethically responsible for the management and easing of pain. This study was conducted to investigate what nurses know about the care of patients in pain and what nursing actions are used. There were 198 nurses working day shift at Çukurova University Balcali Hospital who were included. The data were collected using a questionnaire that described the nurses and measured the nurses' knowledge about care. The mean age of the nurses was 30.89 years, they had a mean 12.0 years of experience in the profession, 52.0% did not have experience with chronic pain, 42.4% stated that they frequently encountered patients in pain, 70.2% had received education about pain in school, 88.4% had not received education about pain outside of school and did not read about pain in journals, 88.9% used pharmacologic management, 85.4% evaluated patients' pain based on verbal statements, 96.5% knew the important points in the use of opioid analgesics, and 3% knew pain theory. As a result of this study, it is seen that nurses have inadequate knowledge about care of patients in pain and pain control methods. After evaluation of the conclusions, they will be used in education to increase the quality of the nursing care.     

The spiritual dimensions of care in military nursing practice

Spirituality has been the subject of numerous journal articles and books in recent years. Research into this topic has been conducted in many spheres of nursing practice with the notable exception of military nursing. This article goes a small way to addressing the apparent lack of research into spirituality in a military nursing setting by summarizing the findings of one study into this significant area of nursing care. The findings are derived from a mixed method quantitative/qualitative study of registered nurses in the Royal Australian Air Force. The major finding indicated that two distinct concepts of "family" define the way in which this small group of nurses perceive, assess and implement care for the spiritual needs of their patients. These concepts comprise a traditional family structure and an extended military family structure that includes the person's unit and comrades-in-arms.     

心理护理干预对输卵管结扎术妇女心理状态及疼痛状况的影响

目的:探讨心理护理干预对输卵管结扎术妇女心理状态及疼痛状况的影响.方法:将我院妇科施行输卵管结扎术850例妇女随机分为观察组450例和对照组400例.对照组给予常规护理;观察组在常规护理基础上,根据其不同心理问题进行护理干预.结果:观察组与对照组比较,心理状态及对疼痛的反应等方面差异均有统计学意义(P＜0.05).结论:心理护理干预对消除输卵管结扎术妇女心理障碍、降低疼痛级别具有积极作用,值得临床推广应用.