Utilisation of palliative/ end-of-life care practice recommendations in the burn intensive care unit of a Ghanaian tertiary healthcare facility: An observational study.

BACKGROUND: The need to integrate palliative/end-of-life care across healthcare systems is critical considering the increasing prevalence of health-related suffering. In burn care, however, a general lack of practice recommendations persists. Our burn unit developed practice recommendations to be implemented and this study aimed to examine the components of the practice recommendations that were utilised and aspects that were not to guide further training and collaborative efforts. METHODS: We employed a prospective clinical observation approach and chart review to ascertain the utilisation of the recommendations over a 3-year period for all burn patients. We formulated a set of trigger parametres based on existing literature and burn care staff consultation in our unit. Additionally, a checklist based on the practice recommendations was created to record the observations and chart review findings. All records were entered into a secure form on Google Forms following which we employed descriptive statistics in the form of counts and percentages to analyse the data. RESULTS: Of the 170 burn patients admitted, 66 (39%) persons died. Although several aspects of each practice recommendation were observed, post-bereavement support and collaboration across teams are still limited. Additionally, though the practice recommendations were comprehensive to support holistic care, a preponderance of delivering physical care was noted. The components of the practice recommendations that were not utilised include undertaking comprehensive assessment to identify and resolve patient needs (such as spiritual and psychosocial needs), supporting family members across the injury trajectory, involvement of a palliative care team member, and post-bereavement support for family members, and burn care staff. The components that were not utilised could have undoubtedly helped to achieve a comprehensive approach to care with greater family and palliative care input. CONCLUSION: We find a great need to equip burn care staff with general palliative care skills. Also, ongoing collaboration/ partnership between the burn care and palliative care teams need to be strengthened. Active family engagement, identifying, and resolving other patient needs beyond the physical aspect also needs further attention to ensure a comprehensive approach to end of life care in the burn unit.

The comfort perception in the critically ill patient from the Kolcaba theoretical model.

BACKGROUND: The stay in a critical care unit (CCU) has a serious impact on physical condition causing numerous discomfort factors such as pain or difficulty in communicating. All of these are associated with possible sequelae following discharge from the Intensive Care Unit (ICU) named post-ICU syndrome. The Kolcaba Comfort Theory allows, from a holistic approach, to identify care needs from the patient's perspective using instruments such as the General Comfort Questionnaire (GCQ). OBJECTIVES: To determine the comfort level of patients admitted to the CCU using the GCQ of Kolcaba and to identify the discomfort factors. METHODS: Cross-sectional descriptive observational prospective study. POPULATION: 580 patients admitted to adult CCU of two high complexity hospitals from June 2015 to March 2020 with stay ≥24 h were interviewed. Descriptive analysis, Student's t-test and ANOVA and multivariate analysis were performed using SPSS v26 and STATA v16. RESULTS: The mean age was 52,62 (16,21), 357 (61,6%) were male and 434 (74,8%) were believers. The type of admission was planned in 322 (55,5%) and the most prevalent reason for admission was surgical 486 (83,8%). The median pain score (NRS) was 3,00 [0-4] and severity score (APACHE II) was 13,26 (5,89), the median length of stay was 4,00 [2-7] days. The mean comfort level was 3,02 (0,31) showing the highest value Reanimation 3.02 (0.30) and the lowest Trauma and Emergency Unit 2.95 (0.38). Statistically significant differences were found between the units in the comfort level of patients >65 years of age (p = 0.029). The Relief comfort type obtained the lowest mean 2.81 (0.33) and the physical context 2.75 (0.41) in the three units. In the multivariate analysis, statistically significant differences were found between the comfort level and the pain level: no pain (p = 0,000) OR 4,361 CI [2,184-8,707], mild pain (p = 0,000) OR 4,007 CI [2,068-7,763], moderate pain (p = 0,007) OR 2,803 CI [1,328-5,913], and the APACHE II score equal to or greater than 10 (p = 0,000) OR 0,472 CI [0,316-0,705]. CONCLUSIONS: The comfort level showed high scores in all three units. The physical and environmental contexts and the relief comfort type negatively affected the perception of comfort. The variables that explained comfort were pain and severity of illness. The evaluation of comfort from the patient's perspective through the GCQ could be considered an indicator of quality of nursing interventions.

Surviving indoor heat stress in United States: A comprehensive review exploring the impact of overheating on the thermal comfort, health, and social economic factors of occupants.

In the face of escalating global climate change and the increasing frequency of extreme heat events, the mitigation of building overheating has become an urgent priority. This comprehensive review converges insights from building science and public health domains to offer a thorough understanding of the multifaceted impacts of indoor overheating on occupants. The paper addresses a significant research gap by offering a holistic exploration of indoor overheating of residential buildings and its consequences, with a specific focus on the United States, an economically diverse nation that has been underrepresented in the literature. The review illuminates the effects of overheating on thermal comfort, health, and socio-economic aspects within the built environment. It emphasizes associated repercussions, including heightened cooling energy consumption, increased peak electricity demand, and elevated vulnerability, leading to exacerbated heat-related mortality and morbidity rates, especially among disadvantaged groups. The study concludes that vulnerabilities to these impacts are intricately tied to regional climatic conditions, highlighting the inadequacy of a one-size-fits-all approach. Tailored interventions for each climate zone are deemed necessary, considering the consistent occurrence of indoor temperatures surpassing outdoor levels, known as superheating, which poses distinct challenges. The research underscores the urgency of addressing indoor overheating as a critical facet of public health, acknowledging direct socioeconomic repercussions. It advocates for further research to inform comprehensive policies that safeguard public health across diverse indoor environments.

The impact of spiritual care delivered by nurses on patients' comfort: A propensity score matched cohort utilizing electronic health record data.

BACKGROUND: Spiritual care has been associated with better health outcomes. Despite increasing evidence of the benefits of spiritual care for older patients coping with illness and aggressive treatment, the role of spirituality is not well understood and implemented. Nurses, as frontline holistic healthcare providers, are in a position to address patients' spiritual needs and support them in finding meaning in life. This study aimed to identify spiritual care by analyzing nursing data and to compare the psychological and physical comfort between older chronically ill patients who received spiritual care versus those who did not receive spiritual care. MATERIAL AND METHODS: A propensity score matched cohort utilizing nursing care plan data was used to construct balanced groups based on patient characteristics at admission. 45 older patients (≥65 years) with chronic illnesses received spiritual care with measured psychological or physical comfort and 90 matched controls. To ensure the robustness of our results, two sensitivity analyses were performed. Group comparisons were performed to assess the average treatment effect of spiritual care on psychological and physical comfort outcomes. RESULTS: The mean psychological comfort was 4.3 (SD = 0.5) for spiritual care receivers and 3.9 (SD = 0.9) for non-receivers. Regression analysis showed that spiritual care was associated with better psychological comfort (estimate = 0.479, std. error = 0.225, p = 0.041). While its effect on physical comfort was not statistically significant (estimate = -0.265, std. error = 0.234, p = 0.261). This study provides suggestive evidence of the positive impact of nurses' spiritual care in improving psychological comfort for older patients with chronic illnesses. CONCLUSION: Using interoperable nursing data, our findings suggest that spiritual care improves psychological comfort in older patients facing illness. This finding suggests that nurses may integrate spiritual care into their usual care to support patients experiencing distress.

The effect of structured supportive approach based on Kolcaba's comfort theory applied to parents of children with cerebral palsy on child's comfort, quality of life, and parent's self-efficacy: A randomised controlled trial.

AIM: This study aims to assess how a structured supportive approach applied to the parents of children living with cerebral palsy according to how the Theory of Comfort affects the child's comfort, quality of life, and parent's self-efficacy. DESIGN: A single-blind, randomised, controlled experimental trial. METHODS: The study was conducted with parents of children with cerebral palsy aged between 8 and 16 years who presented to the rehabilitation centers between October 2021 and November 2022. The sample consisted of a total of 73 parents from the experimental (n = 35) and control (n = 38) groups. While a care programme based on the Theory of Comfort was applied to the intervention group, the practises included in the routines of the centres were applied to the control group. The researcher collected data using the Comfort Behaviours Checklist (CBCL), the Parent Form of the Quality-of-Life Scale for Children (QoLC), and the Self-Efficacy Scale. RESULTS: The children in the intervention group had significantly higher CBCL and QoLC mean scores and the parents in the intervention group had significantly higher self-efficacy mean scores of parents when compared to the control group. CONCLUSIONS: The structured supportive approach based on the Theory of Comfort enhanced children's comfort and quality of life and increased parents' self-efficacy. RELEVANCE TO CLINICAL PRACTICE: It is recommended to implement the structured supportive approach applied according to the Theory of Comfort with the parents of children with cerebral palsy in special training and rehabilitation centres. Paediatric nurses can perform preventive and rehabilitative nursing management with a holistic approach to meet the needs of children with cerebral palsy and their families.

The effect of guided imagery applied on geriatric orthopaedic patients on preoperative anxiety and comfort.

BACKGROUND: This study was designed to examine the effect of guided imagery applied to geriatric orthopaedic patients on preoperative anxiety and comfort. METHODS: This study was conducted as a randomized controlled trial. The population of the study consisted of geriatric patients treated in the orthopaedics and traumatology clinic of a university hospital. The sample consisted of 80 patients, including the experimental group (n = 40) and the control group (n = 40). Personal Descriptive Form, The State-Trait Anxiety Inventory (STAI) and General Comfort Scale were used as data collection tools. RESULTS: After the guided imagery application, it was determined that the anxiety of the experimental group decreased statistically significantly, and their comfort improved (P < 0.05). CONCLUSION: After the imagery, it was determined that the patients in the experimental group had a decrease in their anxiety level and an improvement in their comfort. Since it is a low-cost and easily accessible method, applying imagery in the preoperative period is recommended.

The impact of using P6 acupressure on the nausea, vomiting, and comfort of myocardial infarction patients: A randomized, single-blind, placebo-controlled clinical trial.

Background: Nausea and vomiting are two common symptoms in myocardial infarction patients. This study aims to determine the impact of p6 acupressure on nausea, vomiting, comfort, and the need for anti-vomiting drugs in myocardial infarction (MI) patients. Methods: This research involved 90 patients with acute heart attacks experiencing persistent nausea despite taking anti-vomiting drugs. They were divided into three groups: acupressure, placebo, and control. The acupressure group wore a wristband with a button, the placebo group had a similar wristband without a button, and the control group received no wristband. Data on nausea severity, comfort, frequency of nausea, vomiting, and retching was collected before and after the intervention at different time points. The study also assessed the use of anti-vomiting drugs within 24 h of the intervention. Results: The patients in the acupressure group, compared to those in the placebo and control groups, experienced significantly lower severity of nausea, frequency of vomiting, nausea, and retching and a substantially higher level of comfort level during the two, four, and 6 h after the start of the intervention (P < 0.05). However, no significant difference between the placebo and control groups was observed (P > 0.05). During the 24 h after the start of the intervention, administration of anti-vomiting drugs to the acupressure group was significantly less than that done in the placebo and control groups (P < 0.05). Conclusions: The results illustrated that p6 acupressure reduces nausea, vomiting, and retching and increases the comfort level in myocardial infarction patients.

Bi2O3/Gd2O3 Meta-Aerogel with Leaf-Inspired Nanotrap Array Enables Efficient X-Ray Absorption.

The increasing utilization of X-rays has generated a growing need for efficient shielding materials. However, the existing Pb-based materials suffer from a narrow X-ray absorbing range, high weight, and rigidity. Inspired by the natural leaf, which can efficiently absorb light through chlorophyll and carotenoids in confined cells, we engineer ultralight and superelastic nanofibrous Bi2O3/Gd2O3 meta-aerogels (BGAs) with X-ray nanotrap arrays by manipulating the 3D confined assembly of 1D Bi2O3 and Gd2O3 nanofibers. The BGAs can synergistically absorb X-ray photons from complementary energy ranges into the nanotraps and induce cyclic collisions with Bi2O3 and Gd2O3 nanofibers, maximizing the effective X-ray attenuation. The meta-aerogel exhibits the integrated performance of efficient X-ray shielding efficiency (60-83%, 16-90 keV), ultralow density (10 mg cm-3), and superelasticity. The production of these meta-aerogels presents an avenue for the development of next-generation X-ray protective materials and the resolution of X-ray imaging systems.

Effects of monensin in supplements for beef cattle in tropical grazing systems during the rainy season.

Two experiments were carried out to evaluate the effect of monensin in supplements for grazing heifers. In experiment I, treatments consisted of protein supplements (low intake - 0.5 kg/animal/day and high intake - 1.0 kg/animal/day) associated or not with monensin. Animal performance, nutrient intake, and digestibility were evaluated. Forty crossbred heifers with an initial body weight (BW) of 213.8 ± 4.5 kg were used. There was no difference in average daily gain between treatments (average of 0.588 kg/animal/day). There was no interaction between monensin and supplements for intake parameters and digestibility. Dry matter (DM) intake was equal between treatments (~ 2% of BW). However, there was a reduction in pasture intake with the high-intake supplement. In experiment II, treatments consisted of two types of supplements (protein or mineral) associated or not with monensin. The variables analyzed were productive performance, ingestive behavior, and thermal comfort, evaluated through the index of thermal stress for cows (ITSC). Forty crossbred heifers with a BW of 159.2 ± 1.3 kg were used. The type of supplement did not influence the performance of the animals. However, monensin promoted greater weight gain in the animals (110 g/animal/day). There was an interaction effect between supplementation and monensin addition on behavioral activities, except for idle time. The inclusion of monensin in the protein supplement reduced the grazing time. The ITSC value influenced the activities of ingestive behavior, and the increase of this index reduced the grazing time in all treatments. Forage quality influences the response to monensin use, and the addition of monensin in supplements for grazing cattle during the rainy season is recommended for forages with high CP content.

The effect of back massage with frankincense and myrrh oil before the cardiac electrophysiological procedure on back pain intensity and comfort: A single-blind randomized controlled trial.

CONTEXT: Back pain is one of the most common problems experienced by patients after the cardiac electrophysiological study procedure. In addition, limitation of movement after the procedure negatively affects the comfort and satisfaction of patients. OBJECTIVES: The aim of this study was to determine the effect of back massage with frankincense and myrrh oil on back pain severity and comfort in patients who were to undergo cardiac electrophysiological study. METHODS: This is a randomized controlled study with a pretest-posttest design. This study was conducted from October 2020 to March 2021, at the angio unit of a heart hospital at a university in Turkey. The study was completed with 30 patients in each group, a total of 90 people. Data were collected using a patient information form, a Visual Analogue Scale (VAS) and the General Comfort Questionnaire (GCQ). The intervention group and the placebo group received back massage with frankincense and myrrh essential oil and with jojoba fixed oil respectively. No intervention was applied to the control group. RESULTS: There was no statistically significant difference between the post-procedure VAS values according to the groups. Except for sociocultural comfort, there were significant differences between the groups in terms of GCQ total scores and subscales at the first and last follow-up. CONCLUSIONS: Back massage with frankincense and myrrh oil increased overall comfort, physical comfort, the psychospiritual comfort. Additional research with a rigorous design is needed to determine its effect on pain.

[The effects of hypnosis by virtual reality on tolerance to flexible bronchoscopy]. / Effets de l'hypnose par réalité virtuelle sur la tolérance de la bronchoscopie flexible.

INTRODUCTION: Patients often perceive flexible bronchoscopy as an unpleasant procedure. The aim of this study was to investigate the effect of virtual reality (VR) hypnosis on tolerance to flexible bronchoscopy. MATERIALS AND METHODS: We conducted a prospective, randomized, controlled, monocentric study comparing flexible bronchoscopy with VR-induced hypnosis to the usual procedure. Patient tolerance was evaluated using a visual analogue scale (VAS), the state-trait anxiety inventory (STAI) before and after the procedure and, finally, willingness to repeat the examination under the same conditions (WTR). RESULTS: Among the 70 patients included, 34 were randomized to the VR hypnosis group and 36 to the control group. There was no difference between the 2 groups in terms of modification of the pre-/post-bronchoscopy VAS for anxiety, pain, cough, choking, nausea and overall discomfort, or modification of the STAI score and WTR. Subgroup analysis among patients who were more anxious before the procedure revealed a trend toward reduced anxiety in the VR hypnosis group. CONCLUSION: This study did not observe any effect of VR hypnosis on the tolerance of patients during routine flexible bronchoscopy. However, VR hypnosis may be beneficial in patients with higher anxiety score before bronchoscopy, a hypothesis that needs to be confirmed by further studies with a larger number of subjects.

RFID trial: localization of non-palpable breast lesions using radiofrequency identification tags or wire.

BACKGROUND: Breast cancer is the most frequently diagnosed cancer and the leading cause of cancer death in women. Approximately 50% of breast cancers are discovered at an early stage in patients for whom conservative surgery is indicated. Intraoperative localization of non-palpable breast lesions is generally accomplished using a hook wire to mark the area of concern under ultrasound or stereotactic localization. But this technique has several drawbacks (painful, stressful…). We propose the use of a wire-free breast lesion system using miniature radiofrequency identification (RFID) tags. This technique could improve patient comfort and surgical comfort for surgeons. We therefore propose a study to assess the interest of introducing the RFID localization technique at the Jean PERRIN comprehensive cancer center. METHODS: This is a single-center prospective trial designed to assess the interest in introducing the RFID localization technique at the Jean Perrin center. It aims to show the superiority of the RFID technique in terms of patient tolerance compared to the gold-standard (hook wire). A sequential inclusion in time will be performed: 20 inclusions in the gold-standard group, then 20 patients in the RFID group before repeating the inclusion scheme. Any patient requiring preoperative localization will receive a senology consultation. The RFID tag will be placed during this consultation. The hook wire localization will be done the day before the surgery. Patients will fill out a Hospital Anxiety and Depression scale (HAD) questionnaire at the time of inclusion. They will then fill out a satisfaction questionnaire in 2 steps: during the placement of the device (RFID tag or hook wire) or during the postoperative consultation at 1 month. Radiologists and surgeons will fill out a questionnaire to evaluate the localization technique, respectively after the localization and surgery procedures. DISCUSSION: The RFID study is the first study in France which specifically assesses the interest of the RFID localization in terms of patients comfort. Patient comfort is one of the key elements to take into consideration when managing patients in oncology and new technologies such as RFID tags could improve it. TRIAL REGISTRATION: ClinicalTrials.gov ID; NCT04750889 registered on February 11, 2021.

Emergency Clinicians' Comfort Levels in Caring for Transgender Patients.

Objective: Transgender individuals report negative experiences in emergency department settings, but little is known about emergency clinicians' barriers to treating transgender patients. The purpose of this study was to explore emergency clinicians' experiences with transgender patients to better understand their comfort with caring for this population. Methods: We conducted a cross-sectional survey of emergency clinicians in an integrated health system in the Midwest. To assess the relationship between each independent variable and the outcome variables (i.e., comfort level generally and comfort level asking transgender patients about their body parts specifically), Mann-Whitney U test or Kruskal-Wallis analysis of variance was conducted for categorical independent variables and Pearson correlations were conducted for continuous independent variables. Results: Most participants (90.1%) were comfortable caring for transgender patients, whereas two-thirds (67.9%) were comfortable asking transgender patients about body parts. Although none of the independent variables was associated with increased clinician comfort level caring for transgender patients in general, White clinicians and those who were unsure how to ask patients about their gender identity or transgender-specific care they had received were less comfortable asking about body parts. Conclusion: Having skills to communicate with transgender patients was associated with emergency clinicians' comfort levels. In addition to offering traditional classroom-based didactics about transgender health care, providing opportunities for clinical rotations that allow clinicians-in-training to treat, and perhaps more importantly, learn from transgender patients will likely be higher yield in bolstering clinician confidence in serving this patient population.

Neuromuscular electrical stimulation in garments optimized for compliance.

PURPOSE: Physical inactivity is associated with muscle atrophy and venous thromboembolism, which may be prevented by neuromuscular electrical stimulation (NMES). This study aimed to investigate the effect on discomfort, current amplitude and energy consumption when varying the frequency and phase duration of low-intensity NMES (LI-NMES) via a sock with knitting-integrated transverse textile electrodes (TTE). METHODS: On eleven healthy participants (four females), calf-NMES via a TTE sock was applied with increasing intensity (mA) until ankle-plantar flexion at which point outcomes were compared when testing frequencies 1, 3, 10 and 36 Hz and phase durations 75, 150, 200, 300 and 400 µs. Discomfort was assessed with a numerical rating scale (NRS, 0-10) and energy consumption was calculated and expressed in milli-Joule (mJ). Significance set to p ≤ 0.05. RESULTS: 1 Hz yielded a median (inter-quartile range) NRS of 2.4 (1.0-3.4), significantly lower than both 3 Hz with NRS 2.8 (1.8-4.2), and 10 Hz with NRS 3.4 (1.4-5.4) (both p ≤ .014). Each increase in tested frequency resulted in significantly higher energy consumption, e.g. 0.6 mJ (0.5-0.8) for 1 Hz vs 14.9 mJ (12.3-21.2) for 36 Hz (p = .003). Longer phase durations had no significant effect on discomfort despite generally requiring significantly lower current amplitudes. Phase durations 150, 200 and 400 µs required significantly lower energy consumption compared to 75 µs (all p ≤ .037). CONCLUSION: LI-NMES applied via a TTE sock produces a relevant plantar flexion of the ankle with the best comfort and lowest energy consumption using 1 Hz and phase durations 150, 200 or 400 µs.

[Discussion on "sugar needle - comfortable acupuncture and moxibustion"].

The cases of feeling comfort during acupuncture and moxibustion treatment in literature were summarized and its biological basis was explored. A simple classification of comfort was made, and the importance of obtaining comfort in acupuncture treatment was pointed out. Considering the pursuit of less pain and harmlessness in modern clinical treatment, sugar needle should be advocated and popularized in current clinical practice of acupuncture and moxibustion.

The effect of mandala art therapy on the comfort and resilience levels of mothers who have children with special needs: A randomized controlled study.

BACKGROUND: The study was conducted in order to determine the effect of mandala therapy applied to mothers who have children with special needs on the mothers' comfort and resilience levels. METHODS: The study was conducted as a randomized controlled study at a special education school in Turkey. The study sample consisted of 51 mothers (24 mothers in the experimental group and 27 mothers in the control group) who had children with special needs. A 16-h mandala therapy was applied to the mothers in the experimental group. Identifying Information Form, General Comfort Questionnaire and Adult Resilience Scale were used as data collection tools. RESULTS: According to the regression analysis performed in order to explain the difference between the first and third measurements of General Comfort Questionnaire, mandala art therapy was found to be effective, and the model established was determined to be statistically significant. It was also determined that the change that occurred between the third and first measurements performed in order to identify the change in the general comfort levels of the individuals was higher in the experimental group in comparison to the control group (P < 0.05). It was seen that the mothers' mean scores obtained from the Adult Resilience Scale total scale and its subscales significantly increased in the second and third measurements (P < 0.05) but that the increase in the mean scores of the control group was not significant (P > 0.05). CONCLUSIONS: Mandala Art Therapy is a method that improves the comfort levels and resilience of mothers who have children with special needs. It might be beneficial for mothers to perform these applications at special education schools in collaboration with nurses.

The effect of guided imagery on postoperative pain and comfort of geriatric orthopaedic patients: a randomized controlled trial.

BACKGROUND: The purpose of this study is to investigate the effects of guided imagery on postoperative pain and comfort in geriatric orthopedics patients. METHODS: This study was carried out with a randomized-controlled true experimental design. The population of the study included geriatric patients receiving treatment at the orthopedics and traumatology inpatient clinic of a university hospital. Based on random selection, the sample consisted of total of 102 patients, including 40 patients in the experimental group and 40 in the control group. The data were collected using a Personal Information Form, the Visual Analog Scale, and the General Comfort Questionnaire. RESULTS: After the guided imagery intervention, the pain levels of the experimental group significantly decreased compared to their baseline pain levels (t = 4.002, P = 0.00). Their perceived comfort was also significantly improved (t = -5.428, P = 0.00). Although the perceived comfort of the control group decreased, this decrease was not statistically significant (t = 0.698, P = 0.489). CONCLUSION: It is recommended that guided imagery, which is an inexpensive and accessible method, be integrated into the nursing care process to reduce the pain and increase the comfort of geriatric orthopedics patients.

Effects of comfort nursing on pain and quality of life in children undergoing tonsillectomy.

OBJECTIVE: To observe the effect of comfort nursing on pain, quality of life, and nutritional status in children undergoing tonsillectomy. METHODS: In this retrospective study, a total of 114 children who underwent tonsillectomy in Chun'an Hospital of Traditional Chinese Medicine were divided into a research group and a control group according to the nursing methods, with 57 cases in each group. The control group received routine nursing care, and the research group received additional comfort nursing. We compared the pain level (assessed by visual analogue scale (VAS) scale), quality of life (assessed by Generic Quality of Life Inventory-74 (GQOLI-74)), relevant clinical indicators (postoperative swallowing recovery time, wake-up time, and hospital stay), nutrition indicators (total blood protein and albumin), sleep quality (assessed by Pittsburgh Sleep Quality Index (PAQI)), nursing satisfaction, and postoperative complications between the two groups. RESULTS: After postoperative nursing, the VAS scores and PSQI scores were significantly decreased (both P<0.05), and the GQOLI-74 scores were significantly increased (P<0.05) in both groups. The postoperative swallowing recovery time, wake-up time, and hospital stay in the research group were significantly shorter than those in the control group (all P<0.05). The levels of total serum protein and albumin in the research group were significantly higher than those in the control group (both P<0.05). The research group showed a significantly higher satisfaction rate and lower incidence of complications as compared with the control group (both P<0.05). The results of the logistic regression analysis showed that postoperative upper respiratory infection and the degree of tonsillar embedment were independent risk factors for hemorrhage after tonsillectomy (P<0.05). CONCLUSION: In children undergoing tonsillectomy, providing comfort nursing can significantly reduce pain and improve their quality of life.

Psychometric validation of the Kolcaba General Comfort Questionnaire in critically ill patients.

BACKGROUND: There is a lack of validated tools to measure comfort in critically ill patients. OBJECTIVE: The objective of this study was to evaluate the psychometric properties of the General Comfort Questionnaire (GCQ) in patients admitted to intensive care units (ICUs). METHODOLOGY: A total of 580 patients were recruited, randomising the sample into two homogeneous subgroups of 290 patients for exploratory factor analysis and confirmatory factor analysis, respectively. The GCQ was used to assess patient comfort. Reliability, structural validity, and criterion validity were analysed. RESULTS: The final version included 28 of the 48 items from the original version of the GCQ. This tool was named the Comfort Questionnaire (CQ)-ICU, maintaining all types and contexts of the Kolcaba theory. The resulting factorial structure included seven factors: psychological context, need for information, physical context, sociocultural context, emotional support, spirituality, and environmental context. A Kaiser-Meyer-Olkin value of 0.785 was obtained, with Bartlett's sphericity test (0.000) being significant, and the total variance explained was 49.750%. The Cronbach's alpha was 0.807, with subscale values ranging from 0.788 to 0.418. Regarding convergent validity, high positive correlations were obtained between the factors and the GCQ score, the CQ-ICU score, and the criterion item GCQ31: "I am content". In terms of divergent validity, correlations were low with the APACHE II scale and with the NRS-O except for physical context (-0.267). CONCLUSION: The Spanish version of the CQ-ICU is a valid and reliable tool to assess comfort in an ICU population 24 h after admission. Although the resulting multidimensional structure does not replicate the Kolcaba Comfort Model, all types and contexts of the Kolcaba theory are included. Therefore, this tool enables an individualised and holistic evaluation of comfort needs.

O conforto em oncologia: significados para a enfermagem e pacientes em tratamento oncológico / Comfort in oncology: meanings for nursing and patients undergoing cancer treatment / Confort en oncología: significados para enfermería y pacientes en tratamiento oncológico

Objetivo: analisar o conforto enquanto componente do cuidado de Enfermagem com base em conceitos teóricos disponíveis na literatura científica de enfermagem, relatos de pacientes em tratamento oncológico e profissionais de Enfermagem. Métodos: Pesquisa descritiva e exploratória com abordagem qualitativa, desenvolvida com pacientes internados e profissionais da equipe de Enfermagem de uma unidade de internação oncológica de um hospital filantrópico em Salvador. A coleta de dados ocorreu nos meses de novembro e dezembro de 2020, através de entrevistas semiestruturadas e, a análise dos mesmos realizada através da técnica de análise de conteúdo de Bardin. Resultados: O conforto foi conceituado pelos participantes como bem-estar, acolhimento e atendimento às necessidades humanas básicas, sendo resultado do cuidado de Enfermagem numa perspectiva holística. Conclusão: Dentre as necessidades humanas básicas, a de conforto, muitas vezes comprometida no processo terapêutico, deve receber a devida atenção por parte da Enfermagem. Logo, é essencial identificar os desconfortos trazidos pelo adoecimento e manifestos pelos pacientes, buscando estratégias de cuidados para restabelecer a condição de conforto, bem como buscar manter o conforto existente. (AU)

Objective: to analyze comfort as a component of nursing care based on theoretical concepts available in the scientific nursing literature, reports of patients undergoing cancer treatment and nursing professionals. Methods: Descriptive and exploratory research with a qualitative approach, developed with hospitalized patients and professionals from the nursing staff of an oncology inpatient unit of a philanthropic hospital in Salvador. Data collection took place in November and December 2020, through semi-structured interviews, and their analysis was performed using Bardin's content analysis technique. Results: Comfort was conceptualized by the participants as well-being, welcoming and meeting basic human needs, resulting from nursing care in a holistic perspective. Conclusion: Among the basic human needs, comfort, often compromised in the therapeutic process, should receive due attention from Nursing. Therefore, it is essential to identify the discomforts caused by the illness and manifested by patients, seeking care strategies to reestablish the condition of comfort, as well as seeking to maintain the existing comfort. (AU)

Objetivo: analizar la comodidad como componente del cuidado de enfermería a partir de conceptos teóricos disponibles en la literatura científica de enfermería, relatos de pacientes en tratamiento oncológico y profesionales de enfermería. Métodos: Investigación descriptiva y exploratoria con abordaje cualitativo, desarrollada con pacientes hospitalizados y profesionales del personal de enfermería de una unidad de internación de oncología de un hospital filantrópico de Salvador. La recolección de datos se realizó en noviembre y diciembre de 2020, a través de entrevistas semiestructuradas, y su análisis se realizó mediante la técnica de análisis de contenido de Bardin. Resultados: La comodidad fue conceptualizada por los participantes como bienestar, acogida y satisfacción de las necesidades humanas básicas, resultado del cuidado de enfermería en una perspectiva holística. Conclusión: Entre las necesidades humanas básicas, la comodidad, muchas veces comprometida en el proceso terapéutico, debe recibir la debida atención por parte de Enfermería. Por tanto, es fundamental identificar los malestares provocados por la enfermedad y manifestados por los pacientes, buscando estrategias de atención para restablecer la condición de confort, así como buscando mantener el confort existente. (AU)