Investigation into the Communication that Takes Place Between Nurses and Patients During Chemotherapy

This study used the medium of videotaping to investigate the verbal and nonverbal communication that takes place between nurses and patients during chemotherapy administration. Eight chemotherapy sessions were video recorded and then analyzed for emerging themes. In addition, the videotapes were used in a reflective process with nurses. The findings showed that nurses were efficient in communicating about the physical and medical care of patients but were hesitant in exploring emotional issues. This study highlights the focus on physical symptoms and side effects by nurses in this setting. It also supports the need for further education and training in psychosocial assessment during chemotherapy administration.     

The nature and severity of distress among rehabilitation hospital patients

The purpose of this study was to assess the nature and severity of psychological symptoms of distress as reported by patients in a rehabilitation setting. We used the Symptom Checklist 90—Revised (SCL-90-R) to differentiate between levels of distress among our sample of 104 rehabilitation patients and the norms for adult psychiatric and normal populations. The study also attempted to determine if the levels of distress differed among four diagnostic groups (amputees,n=21; brain injury,n=23; cerebrovascular accident group,n=24; and mixed diagnostic group,n=36). Results indicated that our sample differed significantly in the anticipated direction from nonpatient and outpatient psychiatric norms. Our findings did not support the use of the SCL-90-R as a single-criterion screening device. However, our findings confirmed that the SCL-90-R has considerable utility in rehabilitation settings as a research instrument for measuring group differences.     

External injury documentation in major trauma victims is inadequate: Grounds for routine photography in the emergency department?

Objective: There is no widely accepted measure of clinical documentation quality in the ED. The present study creates a measure for comparing the quality of clinical documentation of external injuries with autopsy reports. This is used to discuss the advantages and disadvantages of introducing routine photography to improve clinical documentation of injuries. Methods: This retrospective case series addressed all non‐surviving major trauma patients (Injury Severity Score ≥15) presenting to St. Vincent's Hospital ED, Sydney, within the 5 year period from 1 July 2002 to 30 June 2007. Comparison between clinical and autopsy documentation of external injuries was completed for each major trauma patient. Results: Of the 48 major trauma patients, there were an average of 11.6 injuries missed in documentation per patient (P < 0.001, 95% CI 8.6–14.6). ED documentation recorded on average 29% (95% CI 26%?32%) of the external injuries that appeared in the autopsy report. We call this percentage the external injury documentation rate. The external injury documentation rate was influenced by injury count and body region, but was not influenced by age, sex, severity (using the Abbreviated Injury Scale and Injury Severity Score), or whether the clinician used a trauma survey or standard progress notes or not, and there was no visible trend over time. Conclusion: Clinical documentation of external injuries in major trauma is poor. This is presumably because of many factors, including time pressures and high‐stress environments. A possible strategy to improve this documentation is routine photography, which should offer both clinical and legal benefits.