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- Adriansson, C, et al.
(author)
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The use of topical anaesthesia at children's minor lacerations : an experimental study
- 2004
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In: International Emergency Nursing. - : Elsevier Ltd. - 1755-599X .- 1878-013X. ; 12:2, s. 74-84
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Journal article (peer-reviewed)abstract
- Background: In a great many situations within health care and treatment, children are subjected to unnecessary pain and suffering. When local anaesthetics is to be administered the child can experience this as incomprehensible especially when the nursing staff assures the child that no pain would be felt, only to discover soon after, that it actually did hurt at the moment of anaesthetic infiltration. The soothing of pain during the suturing of wounds in emergency wards can be reduced, ensuring that unnecessary pain in the cafe-and-treatment process is mot meted out to children. In order to prevent this (subjection to unnecessary pain), and by improving accepted practice, it was interesting to investigate whether children felt pain at the time of infiltration anaesthesia following the initial topical anaesthesia. Aim: The aim of the present study was to investigate the effects of introductory topical anaesthesia using Xylocain solution dropped in the wound prior to a definitive infiltration-anaesthesia. An experimental, prospective design was used where children were included in either an experimental group or a control group. The experimental group (n=10) were given a Xylocain solution while the control group (n=10) received physiological Sodium solution. Data collection for the study was made by making VAS estimates and by interviews. Result: The study shows that a certain alleviation of pain does occur when using Xylocain but no statistically significant difference exists between the two groups. Irrespective of whether the children received an introductory topical anaesthesia with Xylocain or Sodium solution at the time of infiltration anaesthesia, they expressed pain in connection with infiltration. The study also shows that many children express fear and anxiety. Conclusion: Current research highlights the difficulties involved in offering children a really satisfactory form of pain relief in connection with infiltration anaesthesia and suturing of wounds. It is urgent to throw more light on children’s pain, both from a nursing and from a medical point of view. No statistically significant difference was found in children’s reported pain, after treatment with Xylocain but the solution can have a positive effect at the time of the infiltration jab, but a larger study needs to be done in order to establish this firmly.
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- Egerod, I., et al.
(author)
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The patient experience of intensive care: A meta-synthesis of Nordic studies
- 2015
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In: International Journal of Nursing Studies. - : Elsevier BV. - 0020-7489 .- 1873-491X. ; 52:8, s. 1354-1361
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Journal article (peer-reviewed)abstract
- Background: Sedation practices in the intensive care unit have evolved from deep sedation and paralysis toward lighter sedation and better pain management. The new paradigm of sedation has enabled early mobilization and optimized mechanical ventilator weaning. Intensive care units in the Nordic countries have been particularly close to goals of lighter or no sedation and a more humane approach to intensive care. Objectives: The aim of our study was to systematically review and reinterpret newer Nordic studies of the patient experience of intensive care to obtain a contemporary description of human suffering during life-threatening illness. Design: We conducted a meta-synthesis in which we collected, assessed, and analyzed published qualitative studies with the goal of synthesizing these findings into a new whole. Analysis was based on the scientific approach of Gadamerian hermeneutics. Methods: We performed a literature search of qualitative studies of the patient experience of intensive care based on Nordic publications in 2000-2013. We searched the following databases: PubMed, CINAHL, Scopus, and PsycINFO. Each original paper was assessed by all authors using the Critical Appraisal Skills Program instrument for qualitative research. We included 22 studies, all of which provided direct patient quotes. Results: The overarching theme was identified as: The patient experience when existence itself is at stake. We constructed an organizing framework for analysis using the main perspectives represented in the included studies: body, mind, relationships, and ICU-environment. Final analysis and interpretation resulted in the unfolding of four themes: existing in liminality, existing in unboundedness, existing in mystery, and existing on the threshold. Conclusions: Our main finding was that human suffering during intensive care is still evident although sedation is lighter and the environment is more humane. Our interpretation suggested that patients with life-threatening illness descend into a liminal state, where they face the choice of life or death. Caring nurses and family members play an important role in assisting the patient to transition back to life. (C) 2015 Elsevier Ltd. All rights reserved.
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- Eriksson, Thomas, et al.
(author)
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The experiences of patients and their families of visiting during whilst in an intensive care unit : A hermeneutic interview study
- 2011
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In: Intensive & Critical Care Nursing. - : Elsevier. - 0964-3397 .- 1532-4036. ; 27:2, s. 60-67
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Journal article (peer-reviewed)abstract
- Aim The aim of this study was to interpret and understand the meanings of the lived experiences of visiting of patients in an ICU and their families. Method The research design was hermeneutic, based on interviews. This study includes 12 interviews with seven patients and five relatives who had been in an ICU. The interview text was interpreted in a Gadamerian manner as different plays with actors and plots. Findings Patients’ narratives could be divided into two parts; recall of real life and unreal life experiences, the unreal being more common. Relatives’ narratives are described as being on stage and being backstage, i.e. in the room with the patient and outside it. Conclusion The final interpretation elucidated the experience of visiting as the sudden shift between being present in real life vs. being present in the real life of unreality. It was a process whereby the patient and the family build a new understanding of life that creates a new form of interplay within the family. The pre-critical illness life is no longer there – a new life has begun. To support patients and their families in this process of change a family-centred care perspective is necessary.
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- Granberg Axèll, Anetth, et al.
(author)
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Intensive care unit syndrome/delirium is associated with anemia, drug therapy and duration of ventilation treatment.
- 2002
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In: Acta Anaesthesiologica Scandinavica. - : Wiley. - 0001-5172. ; 46:6, s. 726-731
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Journal article (peer-reviewed)abstract
- BACKGROUND: We have performed a prospective qualitative investigation of the ICU syndrome/delirium; the main parts of which have recently been published. The aim of the present study was to explore the relationship between the ICU syndrome/delirium and age, gender, length of ventilator treatment, length of stay and severity of disease, as well as factors related to arterial oxygenation and the amount of drugs used for sedation/analgesia. METHODS: Nineteen mechanically ventilated patients who had stayed in the ICU for more than 36 h were closely observed during their stay, and interviewed in depth twice after discharge. Demographic, administrative and medical data were collected as a part of the observation study. RESULTS: Patients with severe delirium had significantly lower hemoglobin concentrations than those with moderate or no delirium (P=0.033). Patients suffering from severe delirium spent significantly longer time on the ventilator and at the ICU, and were treated with significantly higher daily doses of both fentanyl (P=0.011) and midazolam (P=0.011) in comparison with those reporting only moderate or no symptoms of delirium. There were no significant differences in the Therapeutic Intervention Scoring System scores, reflecting the degree of illness, between patients with and without delirium. CONCLUSION: The development of the ICU syndrome/delirium seems to be associated with decreased hemoglobin concentrations and extended times on the ventilator. Prolonged ICU stays and treatment with higher doses of sedatives and opioids in patients with delirium appear to be secondary phenomena rather than causes.
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- Levenstam, Anna-Karin, et al.
(author)
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Changes in patients' need of nursing care reflected in the Zebra system.
- 2002
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In: Journal of Nursing Management. - : Hindawi Limited. - 1365-2834 .- 0966-0429. ; 10:4, s. 191-199
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Journal article (peer-reviewed)abstract
- During 1995-97, many head nurses stated that they had perceived an increase in patients' need of nursing care. A questionnaire was designed to determine the reasons for this. The purpose of the investigation was to answer two questions, 'What were the reasons for head nurses perception of an increase in patients need of nursing care from 1995 to May 1997?' and, 'Does patient classification in the Zebra system reflect the underlying changes in patients' need of nursing care? The results show that there are several reasons behind changes in the patients need of nursing care. The main reasons are a decreased general level of health among patients and that treatments are more time-consuming. After comparing statistics concerning patient classification with the answers received from the questionnaire, a good level of agreement could be seen in these.
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| 8. |
- Lindwall, Lillemor, et al.
(author)
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Den talande kroppen
- 2001
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In: Vård i Norden, 21 (4), 16-20.
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Journal article (peer-reviewed)
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| 10. |
- Sterud, T., et al.
(author)
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A systematic review of working conditions and occupational health among immigrants in Europe and Canada
- 2018
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In: BMC Public Health. - : Springer Science and Business Media LLC. - 1471-2458. ; 18:1
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Research review (peer-reviewed)abstract
- Background: A systematic attempt to summarize the literature that examines working conditions and occupational health among immigrant in Europe and Canada.Methods: We established inclusion criteria, searched systematically for articles included in the Medline, Embase and Social Sciences Citation Index databases in the period 2000–2016 and checked the reference lists of all included papers.Results: Eighty-two studies were included in this review; 90% were cross-sectional and 80% were based on self-report. Work injuries were consistently found to be more prevalent among immigrants in studies from different countries and in studies with different designs. The prevalence of perceived discrimination or bullying was found to be consistently higher among immigrant workers than among natives. In general, however, we found that the evidence that immigrant workers are more likely to be exposed to physical or chemical hazards and poor psychosocial working conditions is very limited. A few Scandinavian studies support the idea that occupational factors may partly contribute to the higher risk of sick leave or disability pension observed among immigrants. However, the evidence for working conditions as a potential mediator of the associations between immigrant status and poor general health and mental distress was very limited.Conclusion: Some indicators suggest that immigrant workers in Europe and Canada experience poorer working conditions and occupational health than do native workers. However, the ability to draw conclusions is limited by the large gaps in the available data, heterogeneity of immigrant working populations, and the lack of prospectively designed cohort studies.
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