Identifying personal health-related resources of women with breast cancer for nursing: An integrative review.

Personal health-related resources are essential for women with breast cancer, as these help them to maintain their own health and well-being during different phases of their illness. The purpose of this integrative review was to identify, describe and synthetise what personal health-related resources have already been identified for this patient group. We carried out an integrative review to find papers that focused on personal health-related resources for women with breast cancer aged 18-64 years. The search covered 1 January 2005 to 31 May 2021 and was carried out using the CINAHL, PubMed, PsycINFO, Web of Science and Cochrane Library databases. It was limited to peer-reviewed scientific papers with abstracts published in English and 23 papers met the inclusion criteria. The data were analysed using content analysis. Personal health-related resources for women with breast cancer consisted of three different, but inherently interconnected, categories of personal strengths, person-centred cancer care and social support from and involvement in their cultural community. Personal health-related resources for women with breast cancer were multifaceted. Women need nursing support to identify and use these resources and future studies are needed to strengthen how they are measured.

Is it time for a comprehensive approach in older home care clients' care planning in Finland?

BACKGROUND: Home-care services require access to high quality information. Apart from the provision of right-time organised planning of care and to document information about clients' needs, in home care, the care planning is intended to facilitate continuity and individual nursing through nursing documentation of the assessment of the client. AIMS: The aim was to describe the contents of older (+75 years) home-care clients' electronic care and service plans and to evaluate how the clients' resources have been taken into account. DESIGN AND METHODS: The data were collected from the care and service plans (n = 437) of home-care services during July 2010. The data were analysed by quantitative methods and by thematic content analysis. RESULTS: Based on the analysis, medication was the most reported component in all plans (92.7%); other commonly reported components were self-care (85.4%) and coping (78.0%). Components within respiratory, follow-up treatment, life cycle and health behaviour were forgotten. Most of the care and service plans were designed from the home-care professionals' point of view but the plans lacked the perspective of older clients. CONCLUSION: To be able to promote older home clients' ability to live at home, home-care planning needs to be individually designed and must take into account clients' needs and their perspectives regarding meaningful activities and social relationships. In addition, there is a need to develop a more comprehensive care planning system, based on the clients' individual needs and standards of care planning.

Music intervention study in abdominal surgery patients: challenges of an intervention study in clinical practice.

Evidence-based nursing requires carefully designed interventions. This paper discusses methodological issues and explores practical solutions in the use of music intervention in pain management among adults after major abdominal surgery. There is a need to study nursing interventions that develop and test the effects of interventions to advanced clinical nursing knowledge and practice. There are challenges in carrying out intervention studies in clinical settings because of several interacting components and the length and complexity of the causal chains linking intervention with outcome. Intervention study is time-consuming and requires both researchers and participants' commitment to the study. Interdisciplinary and multiprofessional collaboration is also paramount. In this study, patients were allocated into the music group, in which patients listened to music 30 minutes at a time, or the control group, in which patients did not listen to any music during the same period.

The impact of listening to music on analgesic use and length of hospital stay while recovering from laparotomy.

Postoperative pain management is based on the use of analgesics; however, music may alleviate pain either by direct analgesic effects or by relaxing and distracting the mind from pain and unpleasant feelings. Conflicting results have been presented about how listening to music affects analgesic use and length of hospital stay after surgery. We assessed the effect of music listening on analgesic use, length of hospital stay, and adverse effects in adult patients having laparotomy, using a prospective design with two parallel groups. Patients undergoing elective abdominal surgery (n = 168) were assigned to either a music group (n = 83) operated on odd weeks or a control group (n = 85) operated on even weeks. The music group listened to music 7 times for 30 minutes at a time during the first 3 postoperative days. The control group did not listen to the music. The hypotheses that patients in the music group will need less analgesic, have a shorter length of hospital stay, and experience less adverse effects than those in the control group were not supported by the data, although patients recovering from surgery enjoyed listening to music. Music listening may enhance quality of hospital stay and recovery in patients undergoing major abdominal surgery and could be a useful tool to relieve the patient's pain experience.

Views of midwives about ethical aspects of participation in placental perfusion studies.

BACKGROUND: Little is known regarding the role of the midwife in recruiting mothers to participate in scientific research. OBJECTIVE: To describe ethical aspects of participation of midwives in placental perfusion studies. DESIGN: Qualitative study involving thematic interviews and thematic content analysis. SETTING: Two university hospitals in Finland in 2008-2009. PARTICIPANTS: Midwives (n=20) who had been involved in recruiting mothers for a placental perfusion study. FINDINGS: Midwives felt that the situation, when inviting the mothers to donate their placentas, was restless and hasty because of the considerable number of tasks required during a birth. For recruitment, they explained how they tried their best to find a quiet opportunity to provide information about the placental perfusion study, so that the mother could take her time reading the written information. During a birth, it was difficult to give information to the mother in such a way that she would truly understand. Information for the mother was planned to be provided in an equal, dialogic conversation, with the subject of research introduced by the midwife. Placental perfusion studies as carried out in this setting were not seen to have any risks for the mothers, and midwives were under less strain in this study than in other medical research projects. The midwives considered it normal to use placentas in scientific research, and did not see any associated ethical problems. In their opinion, the use of placentas was acceptable and even desirable, provided that the mother was informed about the research and gave voluntary informed consent. CONCLUSIONS AND IMPLICATIONS FOR PRACTISE: Recruitment must be taken into account in management of the ward, and should be planned so that no recruitment is undertaken during medical procedures. Midwives need more education about the research including the important aspects of the creation of general knowledge about substances which may harm the fetus. Dialogue is needed between the mother and the midwife to ensure genuine informed consent.

Effects of listening to music on pain intensity and pain distress after surgery: an intervention.

AIMS: To evaluate the effects of music listening on pain intensity and pain distress on the first and second postoperative days in abdominal surgery patients and the long-term effects of music on the third postoperative day. BACKGROUND: Music has been found to relieve pain intensity in surgery patients. There are only a few studies on music intervention in abdominal surgery. Music intervention studies assessing multidimensional pain such as pain intensity and pain distress are also scarce. DESIGN: Prospective clinical study with two parallel groups. METHODS: Patients undergoing elective abdominal surgery (n = 168) were divided into either a music group (n = 83) or a control group (n = 85). Patients assessed pain intensity and pain distress in bed rest, during deep breathing and in shifting position once in the evening of the operation day and on the first and second postoperative days in the morning, at noon and in the evening. On the third postoperative day, the patients assessed their pain intensity and pain distress only once. RESULTS: In the music group, the patients' pain intensity and pain distress in bed rest, during deep breathing and in shifting position were significantly lower on the second postoperative day compared with control group of patients. On the third postoperative day, when long-term effects of music on pain intensity and pain distress were assessed, there were no significant differences between music and control groups. CONCLUSION: This study demonstrates that the use of music alleviates pain intensity and pain distress in bed rest, during deep breathing and in shifting position after abdominal surgery on the second postoperative day. Music intervention is safe, inexpensive and easily used to improve the healing environment for abdominal surgery patients. RELEVANCE TO CLINICAL PRACTICE: Music intervention should be offered as an adjunct alternative to pharmacological pain relief after abdominal surgery in nursing practice.

Music as a nursing intervention: effects of music listening on blood pressure, heart rate, and respiratory rate in abdominal surgery patients.

Contradictory results have been presented on how music listening affects patients' blood pressure, heart rate, and respiratory rate. The aim of the present study was to evaluate the effects of music listening on blood pressure, heart rate, and respiratory rate on operation day, and on the first, second, and third postoperative days in abdominal surgery patients. Using a quasi-experimental pretest-post-test design, 168 abdominal surgery patients were assigned every second week to the music group (n=83) or to the control group (n=85) for 25 months. In the music group, the respiratory rate was significantly lower after intervention on both the first and second postoperative days compared with the control group. A significant reduction in systolic blood pressure was demonstrated in the group that received music compared with the control group on both the first and second postoperative days. Evaluation of the long-term effects of music on physiological factors showed that the respiratory rate in the music group was significantly lower compared with the control group. Nurses should offer music listening to surgery patients because of its potential benefit.

Imagery-induced relaxation in children's postoperative pain relief: a randomized pilot study.

This study aimed to test the efficacy of imagery and relaxation in hospitalized children's postoperative pain relief. Sixty children aged 8-12 years who had undergone appendectomy or upper/lower limb surgery and had been randomly assigned to the experimental group (n(1) = 30) listened to an imagery trip CD, whereas those in the control group (n(2) = 30) received standard care. An investigator-developed questionnaire was used, and the intensity of pain was assessed using a visual analogue scale: before (Phase 1), immediately after (Phase 2), and 1 hour after (Phase 3) intervention or standard care. The children in the experimental group reported having significantly less pain (p < .001) than the control children based on a comparison of VAS pain scores in Phases 1 and 2. There were no significant differences in nurse-assessed pain scores. The type and time of operation were related to pain intensity in children. The nurses underestimated the pain of pediatric patients. The imagery trip CD can be used to reduce children's postoperative pain in a hospital setting, although its effect is short-lasting.

Increasing nurses' knowledge and behavior changes in nonpharmacological pain management for children in China.

This study implemented pain education for Chinese nurses using a pre-post test design and compared their use of nonpharmacological methods in children's postoperative pain management. Results show that nurses' use of most of these methods for pain relief increased significantly, which helped to improve the quality of care for children. This study enriches nurses' knowledge in children's pain management and develops evidence for practice by demonstrating the need for hospitals to provide continuous pain education to nurses.

Children's perceptions on the implementation of methods for their postoperative pain alleviation: an interview study.

The purpose of this study was to reveal the 8-12-year-old children's perceptions on the use of methods for pediatric postoperative pain alleviation by themselves, their parents and nurses. Face-to-face structured interviews were conducted with 59 subjects who had undergone surgical procedures in three provincial hospitals in Fujian Province, China in 2004. Content analysis and descriptive statistics were used to analyse the data. According to the children's perceptions, they commonly used rest/sleeping, a physical method (positioning) and a strategy of emotional support (requiring presence of their parents); their parents frequently used helping with daily activities and all strategies of emotional support; the nurses mostly used a strategy of emotional support (comforting) and a physical method (positioning). Children's suggestions mainly concerned the application of non-pharmacological methods, especially presence of caregivers. In conclusion, pain-relieving methods were not sufficiently used although children suffered from intense postoperative pain, which calls for health-care providers' future attention.

Chinese parent's use of nonpharmacological methods in children's postoperative pain relief.

Parental participation in paediatric postoperative care is common in China. However, the knowledge is limited on what methods parents use to relieve their children's postoperative pain in hospital. The purpose of this study was to describe what nonpharmacological methods parents use to relieve their children's postoperative pain and factors related to this. A previously validated Scandinavian questionnaire survey was conducted in five provincial hospitals in Fujian, China, in 2004. Parents (n = 206) whose children had undergone operation were asked to complete questionnaires concerning nonpharmacological methods for children's pain relief. The response rate was 88%. Results show that the most commonly used methods by parents were emotional support strategies, helping with daily activities, distraction and imagery. Breathing technique was the method used least frequently. Fathers and parents who were older, more educated, employed and with earlier hospitalization experience with their children used pain alleviation methods more frequently than mothers and parents without these characteristics. Moreover, parents used some methods more frequently with boys, younger children, as well as children admitted for selective operations, with longer duration of hospitalization and with moderate or severe pain. Parents utilized various nonpharmacological methods for children's pain relief, especially those easy to use. This study may serve to focus healthcare providers' efforts on educating parents with respect to various nonpharmacological pain alleviation methods available for postoperative pain. Furthermore, this study provides parents an opportunity to be aware of their role in their children's pain management.

Hospitalized children's descriptions of their experiences with postsurgical pain relieving methods.

The purpose of this study was to describe children's (aged 8-12 yr) experiences with postsurgical pain relieving methods, and their suggestions to nurses and parents concerning the implementation of pain relief measures in the hospital. The data were collected by interviewing children (N = 52) who were inpatients on a pediatric surgical ward in the university hospital of Finland. Content analysis was used to analyze the data. The children rated the intensity of pain on a visual analogue scale. The results indicated that all of the children used at least one self-initiated pain relieving method (e.g. distraction, resting/sleeping), in addition to receiving assistance in pain relief from nurses (e.g. giving pain killers, helping with daily activities) and parents (e.g. distraction, presence). The children also provided suggestions, especially as it relates to nurses (e.g. creating a more comfortable environment), regarding the implementation of effective surgical pain relief. However, some cognitive-behavioral and physical methods were identified that should be implemented more frequently in clinical practice. Furthermore, most children reported their worst pain to be severe or moderate, which indicates that pain management in hospitalized children should be more aggressive.

Parents' roles in using non-pharmacological methods in their child's postoperative pain alleviation.

Increasingly nowadays, parents participate more fully in the care of their hospitalized children. The purpose of this study was to describe parents' utilization of selected non-pharmacological methods in relieving their hospitalized child's (aged 8-12 years) postoperative pain, and factors related to this function. Data were collected by a questionnaire survey completed by parents (n=192) with a child hospitalized on a paediatric surgical ward in the five university hospitals of Finland. The response rate was 90%. Results indicated that non-pharmacological methods, such as emotional support and helping with daily activities, were well utilized whereas cognitive-behavioural and physical methods were less frequently used strategies. Certain background factors specific to the parents and their hospitalized children were significantly related to the non-pharmacological methods used by the parents. The hospitalized child's gender, the time of the surgical procedure, and the parents' assessments of their child's pain intensity, were especially significantly related to many of these strategies. The findings of this study could be used in clinical practice to improve guidance provided to parents regarding interventions for children's pain relief.