Effect of Guided Imagery on Patient Comfort, Vital Signs, Pain, Anxiety, and Satisfaction in Cancer Patients Undergoing Port Catheterization With Local Anesthesia: A Prospective Randomized Controlled Study.

BACKGROUND: Port catheter placement is usually an operation performed under local anesthesia. Being conscious during the interventions performed with local anesthesia can lead to anxiety and stress. OBJECTIVE: The aim of this study was to determine the effect of guided imagery performed before and during the procedure on vital signs and comfort, pain, anxiety, and satisfaction levels in patients with cancer undergoing port catheterization with local anesthesia. METHODS: A total of 80 patients were included in the study. Patients in the intervention group received standard treatment and nursing care, as well as a guided imagery intervention once before and once during the procedure. Patients in the control group received only standard treatment and nursing care. RESULTS: Patients in the guided imagery group reported lower pain and anxiety scores, higher patient satisfaction, and increased comfort compared with patients in the control group. Patients in the guided imagery group showed significantly lower respiratory rate and heart rate than the control group by the end of the procedure. There was no significant difference in blood pressure. CONCLUSION: Practicing guided imagery before and during a procedure performed under local anesthesia reduced cancer patients' pain, increased patient satisfaction and comfort, and had a positive effect on their respiratory and heart rates. IMPLICATIONS FOR PRACTICE: We recommend guided imagery as a practical, low-cost complementary therapy for patients receiving local anesthesia.

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)

Effects of warm or cold compresses applied to the legs during hemodialysis on cramps, fatigue, and patient comfort: A placebo-controlled randomized trial.

INTRODUCTION: Muscle cramps and fatigue are common complications in hemodialysis patients and have been associated with reduced patient comfort. Among the complementary therapies advocated for the management of these complications have been the application of warm or cold compresses to the extremities during a hemodialysis treatment. In this study, we compared the effects of warm or cold compresses application on cramping, fatigue, and patient comfort. METHODS: This placebo-controlled randomized trial was done in 69 patients, who were stratified and randomly allocated to three treatment arms. Two of the three groups included an intervention; application of either warm (n = 23) or cold (n = 23) compresses to the extremities during dialysis. The third group served as a placebo control (n = 23). The study period comprised 12 hemodialysis sessions. One week after the completion of the intervention, a follow-up dialysis session was also evaluated. Data were collected at baseline (t0 ), during each of 12 intervention sessions (t1 -t12 ), and at the follow-up session t13 . Cramps, fatigue, and patient comfort were evaluated using the Cramp Episode Follow-up Chart, Piper's Fatigue Scale, and the Hemodialysis Comfort Scale, respectively. RESULTS: In both the intervention and follow-up sessions, cramping and fatigue were lower, and comfort was higher in each of the intervention groups compared to placebo controls Application of warm compresses was superior to use of cold compresses. DISCUSSION: Both warm and cold compress administration reduced muscle cramps, fatigue, and hemodialysis comfort in hemodialysis patients.

Enfermagem e cuidados paliativos em idosos / Nursing and palliative care for older adults / Enfermería y cuidados paliativos en ancianos

Objetivo: Ressaltar os principais aspectos relacionados ao papel da Enfermagem frente aos cuidados paliativos em idosos. Método: Revisão integrativa considerando artigos publicados de 2015 a 2021 em qualquer idioma e disponíveis nas bases acessadas via Portal de Periódicos Capes, a partir dos descritores indexados DeCS/MeSH: aged, palliative care, nurse, quality of life; patient comfort. Resultados: Inicialmente foram identificados 558 trabalhos publicados e após aplicação dos critérios de inclusão e exclusão a amostra foi composta por 20 artigos selecionados. Conclusão: Com a realização deste estudo, foi possível concluir que os cuidados paliativos do paciente idoso terminal devem ser planejados de forma personalizada para possibilitar o apoio humanizado e acatar as necessidades de cada paciente. O enfermeiro é um dos pilares mais importantes entre o paciente e a família, realiza o cuidado profissional e pode oferecer um cuidado integral. (AU).

Objective: To discuss aspects related to Nursing in the application of palliative care for older patients. Method: Literature review for articles published from 2015 to 2021, based on the descriptors indexed in the DeCS / MeSH: aged, palliative care, nurse, quality of life; patient comfort. Results: Initially, 558 articles were found and after applying inclusion / exclusion criteria, the sample consisted of 20 articles. Conclusion: This study allows us to conclude that the palliative care of the terminally ill elderly patient must be planned in a personalized way to enable humanized support and meets the needs of each patient. The nurse is one of the most important pillars between the patient and the family, performs professional care and can offer comprehensive care. (AU).

Objetivo: discutir aspectos relacionados con la Enfermería en la aplicación de los cuidados paliativos al paciente anciano. Método: revisión de la literatura de los artículos publicados de 2015 a 2021, con base en los descriptores indexados en el DeCS / MeSH: anciano, cuidados paliativos, enfermero, calidad de vida; comodidad del paciente. Resultados: Inicialmente se encontraron 558 artículos y luego de aplicar los criterios de inclusión / exclusión, la muestra estuvo conformada por 20 artículos. Conclusión: Este estudio permite concluir que los cuidados paliativos del anciano en fase terminal deben planificarse de forma personalizada para posibilitar un acompañamiento humanizado y atender las necesidades de cada paciente. La enfermera es uno de los pilares más importantes entre el paciente y la familia, realiza una atención profesional y puede ofrecer una atención integral. (AU).

Massagem terapêutica / intervenção de enfermagem na promoção do conforto da pessoa com doença / Therapeutic massage: nursing intervention in promoting the comfort of the person with the disease

A pessoa com doença oncológica pode vivenciar sintomas tais como dor, ansiedade, fadiga e distress que comprometem o seu estado de conforto. A massagem terapêutica surge na literatura como uma intervenção que pode ser utilizada pelos enfermeiros no alívio de sintomas e na melhoria do conforto destes doentes. Este relatório insere-se no no âmbito do 12º Curso de Mestrado em Enfermagem na área de Especialização em Enfermagem Médico-Cirúrgica, na veretente oncológica. Descreve o percurso de estágio desenvolvido, analisando de forma crítica e reflexiva o contributo das aprendizagens na aquisição de competências de enfermeiro especialista. Este trabalho foi desenvolvido segundo a metodologia de projeto centrando-se na necessidade de dar visibilidade às intervenções não farmacológicas implementadas pelos enfermeiros na promoção do conforto da pessoa com doença oncológica. Foram mobilizados os conhecimentos adquiridos em cada contexto de estágio e os contributos de uma revisão scoping que permitiram implementar um programa de massagem terapêutica com o objetivo de avaliar a eficácia da massagem na promoção do conforto da pessoa com doença oncológia. Após a massagem verificou-se um alívio dos sisntomas reportados pelos participantes e o conforto foi melhorado. A implementação deste projeto deu visibiliadde ao conforto como um resultado sensível aos cuidados de enfermagem, contribuindo para a melhoria da qualidade dos cuidados prestados à pessoa com doença oncológia numa Unidade de Hospital de Dia.

Oncology patients often report pain, anxiety, fatigue and distress, as key symptoms contributing to an overall feeling of discomfort. Based on published literature, massage is a drug-free intervention performed by nurses, that can be used to relieve patient's symptoms and improve overall wel-being. In this Master´s thesis, written for the 12th program for the Masters of Science in Medical-Surgical Nursing in Oncology, I have explored how massage can contribute to the comfort of oncology patients. This work was developed according to the project methodology, focusing on the need to give visibility to the non-pharmacological interventions implemented by nurses in promoting the comfort of oncology patients. Internships were carried out to acquire skills as a specialist nurse. The knowledge and the contributions of multiple internships allowed the implementation of a therapeutic massage program in a Day Hospital Unit. After a critical reflection on this subject, we conclude that the use of massage therapy results in the relief of patient-reported symptoms and in the improvement in overall comfort. This project promotes the idea that massage therapy performed in Day Hospital Units contributes to the improvement of quality of care provided by nurses to oncology patients.

Promoção do conforto na pessoa em processo cirúrgico: intervenção do enfermeiro de reabilitação / Promoting comfort in people undergoing surgery: rehabilitation nurse intervention

Perante o aumento exponencial de cirurgias realizadas, surge a necessidade de criar conhecimento e evidência científica sobre a intervenção especializada junto desta população específica. As complicações pós-operatórias são a maior causa de morbilidade, mortalidade e institucionalização prolongada com aumentos inerentes de custos económicos. Estas complicações podem ser de diversas etiologias e estar dependentes de diversos fatores de risco associados. As intervenções do enfermeiro especialista em enfermagem de reabilitação à pessoa em processo cirúrgico promovem diagnósticos precoces e ações preventivas, assegurando a manutenção da funcionalidade e a prevenção de complicações. Esta atuação especializada possibilita manter ou recuperar independência, controlando e minimizando efeitos das complicações associadas. O conforto é a condição experimentada pelas pessoas que recebem as medidas de conforto, é a experiência imediata e holística de ser fortalecido através da satisfação das necessidades dos três tipos de conforto ­ alívio, tranquilidade e transcendência, nas dimensões física, psico-espiritual, social e ambiental. Para o âmbito do presente relatório, foi realizada uma revisão narrativa da literatura, recorrendo ao método PI(C)O partindo da seguinte questão: "Quais as intervenções de enfermagem de reabilitação (Intervention), na promoção do conforto (Outcomes), na pessoa em processo cirúrgico (Population)?" O presente relatório permitiu desenvolver conhecimento e competências aos níveis do processo cirúrgico, complicações pós-operatórias e respetiva intervenção do enfermeiro especialista em enfermagem de reabilitação. No decorrer do processo de aquisição das competências comuns e específicas do enfermeiro especialista, foi fundamentada a intervenção especializada como promotora de conforto apoiada na Teoria do Conforto de Kolcaba. O enfermeiro especialista em enfermagem de reabilitação ao abordar o conforto na sua intervenção, deve esperar resultados realistas assentes nessas dimensões, obtendo os respetivos níveis de conforto. O conforto e as suas necessidades são mutáveis e consideram-se interdependentes dos programas de enfermagem de reabilitação e vice-versa.

Given the exponential increase in the number of surgeries performed, there is a need to create knowledge and scientific evidence on the specialised intervention for this specific population. Postoperative complications are a major cause of morbidity, mortality, and prolonged institutionalisation with inherent increases in economic costs. These complications may have different etiologies and be dependent on several associated risk factors. The interventions of the nurse specialist in rehabilitation to patients undergoing surgery promote early diagnosis and preventive actions, ensuring the maintenance of functionality and the prevention of complications. This specialised action allows maintaining or regaining independence, controlling and minimising the effects of the associated complications. Comfort is the condition experienced by people who receive comfort measures, it is the immediate and holistic experience of being strengthened through the satisfaction of the needs of the three types of comfort - relief, tranquillity and transcendence, in the physical, psycho-spiritual, social and environmental dimensions. To address this topic, a narrative literature review was conducted using the PI(C)O method based on the following question: "What are the interventions of rehabilitation nursing (Intervention), in the promotion of comfort (Outcomes), in people undergoing surgery (Population)?" During the process of acquisition of common and specific competencies of the specialist nurse, the specialised intervention was based on Kolcaba's Comfort Theory as a promoter of comfort. The specialist nurse in rehabilitation, when addressing comfort in his intervention, should expect realistic results based on these dimensions, obtaining the respective levels of comfort. Comfort and its needs are changeable and are considered interdependent on rehabilitation nursing programs, and vice-versa.

Ética, ontologia y epistemología del cuidado de enfermería para con el paciente con enfermedad renal / Ethics, ontology and epistemology of nursing care for patients with kidney disease / Ética, ontologia e epistemologia dos cuidados de enfermagem para o paciente com doença renal

Los ensayos y escritos relacionados con el cuidado del paciente renal a través de los años se han enfocado a la calidad de vida, estilos de afrontamiento, satisfacción o percepciones que experimentan los pacientes durante su enfermedad. El presente articulo pretende reconocer que el cuidado de enfermería para con el paciente renal es un aspecto fundamental que proporciona al profesional la comprensión de la realidad del paciente y contribuye de manera positiva a comprender la realidad de enfermería como disciplina; enmarcadas en algunas posiciones que permiten garantizar su significado. Estas posiciones son la ética, la ontología y la epistemología. La ética se logra cuando el profesional de enfermería consigue proteger y respetar la dignidad humana del paciente renal que reciben atención de salud, la ontología se ocupa de reflexionar acerca de las concepciones de la realidad y sus relaciones centrando su finalidad en la búsqueda de la salud, del bienestar, la independencia y la trascendencia del paciente renal y la epistemología consiste en mostrar, de manera holística, la evolución del conocimiento de la enfermería para brindar un cuidado de excelencia al paciente renal.

Abstract Over the years, essays and writings related to kidney patient care have focused on quality of life, coping styles, satisfaction, or perceptions experienced by patients during their illness. This article aims to recognize that nursing care for kidney patients is a fundamental aspect that provides the professional with an understanding of the patient's reality and contributes positively to understanding the reality of nursing as a discipline framed in some positions that guarantee their meaning. These positions are ethics, ontology, and epistemology. Ethics is achieved when the nursing professional manages to protect and respect the human dignity of kidney patients who receive health care. Ontology deals with reflecting on the conceptions of reality and their relationships, focusing its purpose on the search for health, well-being, independence, and transcendence of kidney patients. And epistemology consists of showing, in a holistic way, the evolution of nursing knowledge to provide excellent care to kidney patients.

Resumo: Ensaios e escritos relacionados com os cuidados aos pacientes renais ao longo dos anos têmse focado na qualidade de vida, estilos de enfrentamento, satisfação ou percepções que os pacientes experimentam durante a sua doença. Este artigo tem como objetivo reconhecer que o cuidado de enfermagem para o doente renal é um aspecto fundamental que proporciona ao profissional uma compreensão da realidade do doente e contribui positivamente para a compreensão da realidade da enfermagem como disciplina; emoldurado em algumas posições que permitem garantir seu significado. Estas posições são ética, ontologia e epistemología. A ética é alcançada quando o profissional de enfermagem consegue proteger e respeitar a dignidade humana do paciente renal que recebe cuidados de saúde, a ontologia se preocupa em refletir sobre as concepções da realidade e as suas relações centrando o seu propósito na procura de saúde, bem-estar, independência e transcendência do paciente renal e epistemologia consiste em mostrar, holisticamente, a evolução do conhecimento de enfermagem para prestar um excelente cuidado ao paciente renal.

Patient Comfort with Various Local Infiltration Anesthetics for Minor Oculoplastic Surgery: A Systematic Review and Network Meta-Analysis.

BACKGROUND: Although local anesthetics have been extensively studied, limited evidence is available regarding the optimal solution for maximizing patient comfort in minor oculoplastic procedures. OBJECTIVES: To determine the optimal anesthetic solution for local infiltration in minor oculoplastic surgeries to maximize patient comfort. METHODS: This systematic review with network meta-analysis of prospective studies was conducted to understand the efficacy of different local anesthetics in combination to maximize patient comfort. The study was designed according to the Cochrane Handbook for Systematic Reviews of Interventions. The population comprised patients receiving local infiltration anesthesia in minor oculoplastic surgeries. Various anesthetics with adjuvants were compared with respect to injection pain, operative bleeding, and complications. Random-effects model was performed. The primary outcome of injection pain was measured using the visual analog scale (VAS) or a preference question (which intervention was the least painful). Other outcomes were operative bleeding and complications, which were evaluated with a similar preference question. RESULTS: Eleven randomized controlled trials (RCTs) of 521 patients (917 eyes) were included. The network meta-analysis revealed that "bicarbonate-buffered lidocaine with epinephrine" led to a significant decrease in injection pain (preference question) compared to "prilocaine with felypressin" and "lidocaine with epinephrine," whereas no significant differences were detected in the analysis of injection pain measured using the VAS. CONCLUSIONS: "Bicarbonate-buffered lidocaine with epinephrine" may be the optimal anesthetic solution for local infiltration in minor oculoplastic surgeries due to reduced injection pain, operative bleeding, and postoperative swelling. However, this should be interpreted cautiously as the confidence in the evidence was very low. THE CLINICAL TRIAL REGISTRATION NUMBER: CRD42021260332 (PROSPERO).

El concepto del confort en el cuidado de enfermería / The Concept of Comfort in Nursing Care

Introducción: Para enfermería, el confort es un objetivo de cuidado en los múltiples escenarios del actuar disciplinario, lleva a la formulación de teorías con perspectiva holística y logra aplicar el confort desde una mirada física, psicoespiritual, ambiental y social. Objetivo: Identificar los atributos del concepto confort entendido por enfermería en los diferentes escenarios de cuidado. Métodos: Revisión integrativa, con estrategia de búsqueda: "Confort" AND "Nursing", en las bases de datos Scopus, Google Académico, BVS, EBSCO, Cochrane, Ovid y Medline. Los criterios de elegibilidad fueron: estudios primarios, a texto completo, publicados entre 2009-2019, en español, inglés y portugués. Se utilizó el diagrama prisma para el análisis crítico de diseños experimentales, revisiones y cualitativos, se emplearon las plantillas del Critical Appraisal Skills Programme (Caspe). Para los demás diseños se aplicaron las listas de chequeo del Joanna Briggs Institute, quedaron incluidos 16 artículos. Conclusión: El confort está ligado a temas que enmarcan la realidad física, social, psíquica y ambiental de la persona, determinado por los atributos: 1. Alivio físico del dolor mediante intervenciones farmacológicas y de elementos externos en contacto con el cuerpo. 2. Soporte social con cercanía de los familiares, lo que facilita la adaptación al ambiente hospitalario y reduce la ansiedad. 3. Relaciones con el personal sanitario de acompañamiento y acceso a información sobre la condición del paciente. 4. Ambiente adaptado para favorecer la recuperación y alivio. 5. Descanso que incluye reposo y sueño, generando alivio; y 6. Salud mental con alivio de ansiedad, estrés y adecuada recuperación mental(AU)

Introduction: For nursing, comfort is a care-related objective in the multiple settings of professional performance; it leads to the formulation of theories with a holistic perspective and manages to be applied from a physical, psychospiritual, environmental and social point of view. Objective: To identify the attributes of the concept of comfort understood by nursing in different care settings. Methods: Integrative review carried out in the Scopus, Google Scholar, VHL, EBSCO, Cochrane, Ovid and Medline databases, using the following search strategy: "Comfort" AND "Nursing". The eligibility criteria considered primary studies, full texts, published between 2009 and 2019, in Spanish, English or Portuguese. The PRISMA diagram was used for the critical analysis of experimental, review and qualitative studies, using the templates of the Critical Appraisal Skills Program (Caspe). For the other designs, the checklists of the Joanna Briggs Institute were applied and sixteen articles were included. Conclusion: Comfort is related to issues that enclose the physical, social, psychic and environmental reality of a person, determined by the following attributes: physical relief of pain through pharmacological interventions and external elements in contact with the body; social support with the closeness of family members, which facilitates adaptation to the hospital environment and reduces anxiety; relationships with the accompanying health personnel and access to information on the patient's condition; an adapted environment to favor recovery and relief; rest including sleep and generating relief; and mental health with relief of anxiety, stress and adequate mental recovery(AU)

A Comparison in Patient Comfort Using Conventional Syringe and Needleless Jet Anesthesia Technique in Periodontal Surgery-A Split-Mouth Randomized Clinical Trial.

Background and Objectives: Periodontal surgery requires local anesthetic coverage to alleviate patient discomfort. Needles and injections can engender feelings of fear and anxiety in individuals. This study aimed to assess the level of comfort and anxiety in patients during the administration of local anesthesia using needleless jet anesthesia (JA) when compared to a conventional syringe (CS) in periodontal surgery. Method and Materials: 60 sites were designated for injection in a split-mouth design in 30 subjects who required periodontal surgery. Local anesthesia was administered in two appointments scheduled one week apart using either a JA system or a CS. The Visual Analogue Scale (VAS), Verbal Rating Scale (VRS), and Beck's anxiety inventory were used to report the pain and anxiety levels while injecting local anesthesia. Statistical analysis of the results was performed using the Shapiro-Wilks test and Paired t-test. Results: Patients reported greater comfort with JA. The VAS and VRS values were statistically significant-(p = 0.003) and (p = 0.001), respectively. Patients showed fear and were nervous about receiving a local anesthetic using a CS. A few subjects experienced lingering pain with the CS, whereas greater comfort and no lingering soreness were reported post-operatively at the site of JA administration. Conclusions: This study provides the first comprehensive assessment of using JA for periodontal surgical procedures. Lower pain scores were consistently observed with the use of jet injectors. Patients were at ease and reported lesser anxiety and greater comfort with jet injectors, making it ideally suited for providing local anesthesia in periodontal surgery.

Bismuth/petroleum gauze plus high density polyethylene vs. bismuth/petroleum gauze: A comparison of donor site healing and patient comfort.

INTRODUCTION: Skin grafting continues to be a fundamental component of burn treatment and inherently, a donor site must be created and treated. Burn surgeons agree that specific dressings may have a significant affect on donor site healing, but we have no consensus as to which dressing provides maximum benefit. METHODS: Retrospective analysis of prospectively collected data from an observational, within-patient controlled assessment of a practice pattern intervention. The project compared donor sites treated with high-density polyethylene plus an overlying layer of bismuth/petroleum gauze to donor sites treated with bismuth/petroleum gauze alone. The primary endpoint was patient reported pain using a standard visual analog scale from 0 (no pain) to 10 (worst possible pain). A 2-point reduction in pain was considered clinically significant. Healing was defined as complete detachment of the dressings and> 95% wound re-epitheliazation. RESULTS: A total of 30 patients were observed and analyzed. Both dressings were associated with a mean pain rating of 6 out of 10 (STD= ± 2) and a median pain rating of 6 out of 10 (range = 0-10). Additionally, both dressings were associated with a mean healing time of 20 days (SEM=1.1). The subjective dressing preference showed that a majority of patients had no preference between the two modalities (n = 20). However, when an actual preference was stated (n = 10), bismuth/petroleum gauze alone was preferred by 9 out of 10 patients. CONCLUSION: Clinically and subjectively, we found no discernible differences between the 2 dressing regimens. Thus, bismuth/petroleum gauze alone is the more cost effective dressing choice. Our burn center continues to use bismuth/petroleum gauze alone as its standard of care for donor site dressings and will continue to try to define the optimal donor site dressing.

Effect of Music on Fatigue, Comfort, and Vital Signs in Patients After Liver Transplant Surgery: A Randomized Controlled Trial.

This randomized controlled clinical trial was conducted to determine the effect of music therapy on fatigue, comfort and vital signs of the liver transplant patients. The study sample comprised 120 adult patients (60 in the experimental and 60 in the control group) who met the inclusion criteria and agreed to participate in the study. In the experimental group, the researcher performed music therapy. After applying music therapy once to patients for 30 minutes, their fatigue, comfort, and vital signs were evaluated. No treatment was performed in the control group. According to music therapy follow-ups after liver transplantation, mean scores of fatigue levels were lower, comfort levels were higher, and vital signs were normal, with a statistical significance in the experimental group compared with the control group in all measurements before and after music therapy (P < .001). The study should be repeated using different parameters.

Comprometimento e promoção do sono em unidades de terapia intensiva: revisão integrativa / Comprometimiento y promoción del sueño en unidades de cuidados intensivos: revisión integradora / Sleep impairment and sleep promotion in intensive care units: an integrative review

Resumo Objetivo: Identificar, nas bases de dados científicas, as evidências que comprometem o sono e as intervenções de enfermagem promotoras do sono em Unidades de Terapia Intensiva. Métodos: Revisão integrativa da literatura, realizada nas bases de dados MEDLINE, CINAHL e Cochrane Database of Systematic Reviews, para responder às questões norteadoras do estudo, de acordo com o formato PICo, nos meses de maio e junho de 2019. Os idiomas considerados foram o inglês, português e espanhol. Resultados: Identificou-se 110 estudos e 12 foram considerados elegíveis para a revisão. A análise reporta que o comprometimento do sono é multicausal, sendo este influenciado sobretudo por desconforto ambiental e físico do paciente. As intervenções de enfermagem, tais como a gestão do ambiente, no âmbito do ruído e da luminosidade, o agrupamento da prestação de cuidados, o controle da dor e da ansiedade do paciente internado, são fundamentais para a qualidade do sono. Conclusão: A produção científica evidencia que as intervenções de Enfermagem identificadas, sobretudo no âmbito da promoção do conforto ambiental e físico do paciente, contribuem para a qualidade do sono em Unidades de Terapia Intensiva, contudo a promoção do conforto psicoespiritual e social do paciente ainda é superficial, tendo em conta o foco e as prioridades nesta tipologia de internamento.

Resumen Objetivo: Identificar, en bases de datos científicas, las evidencias que comprometen el sueño y las intervenciones de enfermería para promover el sueño en unidades de cuidados intensivos. Métodos: Revisión integradora de literatura, realizada en las bases de datos MEDLINE, CINAHL y Cochrane Database of Systematic Reviews para responder las preguntas orientadoras del estudio, de acuerdo con el formato PICO, en los meses de mayo y junio de 2019. Los idiomas considerados fueron inglés, portugués y español. Resultados: Se identificaron 110 estudios y 12 fueron considerados elegibles para la revisión. El análisis reporta que el comprometimiento del sueño es multicausal y lo que más influye en el sueño es la incomodidad ambiental y física del paciente. Las intervenciones de enfermería, tales como el manejo del ambiente respecto al ruido y a la luminosidad, el agrupamiento de la prestación de cuidados y el control del dolor y de la ansiedad del paciente internado, son fundamentales para la calidad del sueño. Conclusión: La producción científica evidencia que las intervenciones de enfermería identificadas, sobre todo respecto a la promoción del bienestar ambiental y físico del paciente, contribuyen con la calidad del sueño en unidades de cuidados intensivos. No obstante, la promoción del bienestar piscoespiritual y social del paciente aún es superficial, teniendo en cuenta dónde se centra la atención y cuáles son las prioridades en este tipo de internación.

Abstract Objective: To identify, in the scientific databases, evidence of factors that impair sleep and nursing interventions to promote sleep in Intensive Care Units. Methods: An integrative literature review was conducted across the databases MEDLINE and CINAHL and the Cochrane Database of Systematic Reviews between May and June 2019 using the PICO framework, seeking to answer the guiding questions of the study. The languages included in the literature review were English, Portuguese, and Spanish. Results: One hundred and ten studies were identified, twelve of which were considered eligible for review. The analysis of the articles found that sleep impairment is multicausal, being influenced mainly by the patient's environmental and physical discomfort. Nursing interventions, such as environmental management of noise and light, grouping of care procedures, and control of pain and anxiety in the hospitalized patient, are fundamental for sleep quality. Conclusion: The academic literature shows that the nursing interventions identified, particularly those that promote the patient's environmental and physical comfort, contribute to the quality of sleep in Intensive Care Units. However, promotion of the patient's psychospiritual and social comfort is still lacking, given the focus and priorities of this type of hospitalization.

Evaluation of the effect of nutrition-related visual education on the comfort of patients receiving hemodialysis therapy / Avaliação do efeito da educação visual relacionada com a nutrição no conforto dos doentes que recebem terapia de hemodiálise

RESUMO Objetivo O objetivo deste estudo foi avaliar o efeito da educação visual no conforto dos pacientes que recebem terapia de hemodiálise. Métodos Foi utilizado um projeto de estudo aleatório em um ambiente controlado. Este estudo foi realizado com 90 pacientes hemodialisados crônicos em dois centros de diálise, sendo que 45 pacientes pertenciam ao grupo de intervenção e os outros 45 pacientes perterciam ao grupo de controle. Formulário de dados do paciente, escala de conforto de hemodiálise - Versão II, escala de controle de fluidos do paciente de hemodiálise, escala de conhecimento dietético e escala de comportamentos dietéticos foram os documentos usados. No grupo de intervenção, foram conduzidas três entrevistas. Na primeira entrevista, a educação visual foi aplicada e reaplicada após 15 dias. No grupo de controle, duas entrevistas foram realizadas e nenhuma intervenção foi feita. Resultados Descobriu-se que o programa de treinamento tem um amplo efeito sobre o conforto e relaxamento físico do paciente, assim como relaxamento psicoespiritual, transcendência psicoespiritual, transcendência ambiental e relaxamento sociocultural. Além disso, foi notado um efeito moderado sobre o alívio físico no grupo de intervenção no terceiro mês. Dessa maneira, foi determinado que o programa de educação visual aplicado teve um amplo efeito no controle de fluidos, conhecimento de dieta e comportamento do grupo de intervenção. Conclusão Verificou-se que a educação visual tem um efeito positivo no estado de conforto, no conhecimento dietético e no comportamento dietético dos pacientes submetidos à terapia de hemodiálise

ABSTRACT Objective This study aimed to evaluate the effect of visual education on the comfort of patients receiving hemodialysis therapy. Methods A randomized controlled study design was used. This study was conducted in two dialysis centers with 90 chronic hemodialysis patients. A Patient introduction form, Hemodialysis Comfort Scale-Version II, Hemodialysis Patient Fluid Control Scale, Scale for Dietary Knowledge, and Scale for Dietary Behaviors were used. In the intervention group, three interviews were conducted. In the first interview, visual education was applied, and reinforcement education ensued after 15 days. In the control group, two interviews were conducted, and no intervention was performed. Results The training program was found to have a significant effect on comfort, physical and psychospiritual ease, psychospiritual and environmental transcendence, and sociocultural ease, and a moderate effect on physical relief in the intervention group in the third month. It was determined that the visual education program applied had a large effect size on fluid control, diet knowledge, and behaviors in the intervention group. Conclusion Visual education was found to have a positive effect on the comfort status, dietary knowledge, and dietary behavior of patients receiving hemodialysis therapy.

Effect on autonomic nervous activity of applying hot towels for 10 s to the back during bed baths.

BACKGROUND: Bed baths are a daily nursing activity to maintain patients' hygiene. Those may provide not only comfort but also relaxation. Notably, applying a hot towel to the skin for 10 s (AHT10s) during bed baths helped to reduce the risk of skin tears and provided comfort and warmth in previous studies. However, it is still unclear whether autonomic nervous system is affected by bed baths. Thus, this study investigated the effect on the autonomic nervous activity of applying hot towels for 10 s to the back during bed baths. METHODS: This crossover study had 50 participants (25 men and women each; average age 22.2 ± 1.6 years; average body mass index 21.4 ± 2.2 kg/m2) who took bed baths with and without (control condition: CON) AHT10s on their back. Skin temperature, heart rate variability (HRV), and blood pressure (BP) were measured. Subjective evaluations and the State-Trait Anxiety Inventory in Japanese were also performed. RESULTS: A significant interaction of time and bed bath type on skin surface temperature was observed (p < .001). Regarding the means of skin surface temperature at each measurement time point, those for AHT10s were significantly higher than those for CON. Although the total state-anxiety score significantly decreased in both the bed bath types after intervention, the mean values of comfort and warmth were higher for bed baths with AHT10s than for CON (p < .05) during bed baths; AHT10s was significantly higher in warmth than CON after 15 min (p = .032). The interaction and main effects of time on HRV and BP and that of bed bath type were not significant. CONCLUSION: Bed baths that involved AHT10s caused participants to maintain a higher skin temperature and warmer feeling than under the wiping-only condition; they also provided comfort during the interventions. However, the bed baths with AHT10s did not allow participants to reach a relaxed state; moreover, there was no change in autonomic nerve activity. This may be due to participants' increased anxiety from skin exposure and the intervention being limited to one part of the body.

The effect of a stress ball on stress, vital signs and patient comfort in hemodialysis patients: A randomized controlled trial.

OBJECTIVE: In this study, an investigation was made of the effect of the use of a stress ball, a method of distraction-attracting the attention elsewhere - on stress, vital signs andcomfort levels in hemodialysis patients. METHODS: This randomized, controlled experimental study, between July 2019 and September 2019 was carried out in a dialysis unit in the inner regions of Turkey. The study was conducted with 45 patients (23 experiments, 22 controls) who were receiving hemodialysis treatment. The experimental group were asked to squeeze a stress ball for approximately 10-15 min throughout eight successive dialysis sessions. The data were obtained with an Individual Description Form, the Distress Thermometer and the Hemodialysis Comfort Scale. RESULTS: At the end of the study, no significant difference was found in the vital signs and comfort levels of the experimental and control groups (p > 0.05). However, while the stress score of the experimental group decreased significantly, the stress score of the control groups increased (p < 0.05). CONCLUSION: This study shows that although the use of the stress ball did not affect vital signs and comfort in hemodialysis patients, it had a positive effect on stress.

Cuidados de enfermagem no manejo da dor em pacientes adultos e idosos em cuidados paliativos / Atención de enfermería en el manejo del dolor en pacientes adultos y de ancianos en cuidados paliativos / Nursing care in pain management in adult and elderly patients in palliative care

Objetivo: Identificar os cuidados de enfermagem no manejo da dor de pacientes adultos e idosos em cuidados paliativos. Método: Foi realizada uma revisão integrativa da literatura, de artigos nacionais e internacionais, que abordaram o tema "cuidados de enfermagem no manejo da dor de pacientes em cuidados paliativos", publicados no período de 2009 a 2019, em três bases de dados. Foram encontrados oito artigos que atenderam os critérios de inclusão e exclusão. Resultados: A partir da análise dos artigos, foram elaboradas duas categorias: a investigação da dor pela equipe de enfermagem em pacientes em cuidados paliativos e intervenções para o alívio da dor em pacientes em cuidados paliativos. Conclusão: Evidenciou-se a importância do vínculo entre o profissional e o paciente/família, no manejo da dor, além da assistência de forma holística. O pequeno número de estudos sobre o tema foi uma limitação para a pesquisa, ressaltando, assim, a necessidade de mais pesquisas nesta temática(AU)

Objective: To identify nursing care in pain management of adult and elderly patients in palliative care. Method: This is an integrative literature review of national and international articles which addressed the "nursing care in pain management of patients under palliative care" published between 2009 to 2019 onto three databases. Eight papers that met the inclusion and exclusion criteria ere found. Results: From the analysis of the articles, two categories were elaborated: The investigation of pain by the nursing team in patients under palliative care; and Interventions for pain relief in patients under palliative care. Conclusion: Results evidenced the importance of the bond between the professional and the patient / family in the management of pain, as well as a holistic care. The small number of studies on the topic was a limitation for this study, thus emphasizing the need for more research on this topic(AU)

Objetivo: Identificar los cuidados de enfermería en el manejo del dolor de pacientes adultos y ancianos en cuidados paliativos. Método: se realizó una revisión integral de la literatura, de artículos nacionales e internacionales, que abordó el tema "atención de enfermería en el manejo del dolor de pacientes en cuidados paliativos" publicado en el período de 2009 a 2019, en tres bases de datos. Se encontraron ocho artículos que cumplían los criterios de inclusión y exclusión. Resultado: A partir del análisis de los artículos, se elaboraron dos categorías: la investigación del dolor por parte del equipo de enfermería en pacientes en cuidados paliativos e intervenciones para el alivio del dolor en pacientes en cuidados paliativos. Conclusión: Se evidenció la importancia del vínculo entre el profesional y el paciente/familia en el manejo del dolor, además de la atención integral. El pequeño número de estudios sobre el tema fue una limitación para la investigación, enfatizando así la necesidad de más investigación sobre este tema.(AU)

[Humanize Death in a Time of Sanitary Crisis: Accompanied Die, Farewell and Receive Spiritual Care]. / Humanizar la Muerte en Tiempos de Crisis Sanitaria: Morir Acompañado, Despedirse y Recibir Atención Espiritual.

The crisis in the health system caused by COVID-19 has left some important humanitarian deficits on how to care for the sick in their last days of life. The humanization of the dying process has been affected in three fundamental aspects, each of which constitutes a medical and ethical duty necessary. In this study, I analyze why dying accompanied, with the possibility of saying goodbye and receiving spiritual assistance, constitutes a specific triad of care and natural obligations that should not be overlooked - even in times of health crisis - if we do not want to see human dignity violated and violated some fundamental rights derived from it.

Comfort and religious-spiritual coping of intensive care patients' relatives.

OBJECTIVES: To identify the level of comfort and religious-spiritual coping of family members of intensive care unit patients and to analyse the sociodemographic/clinical variables that influence this association. METHODS: Cross-sectional study on the adult and paediatric intensive care units of two public hospitals in the state of São Paulo, between January and September 2016. Participants were divided into two groups: adult (n = 96) and paediatric (n = 70). We used the religious-spiritual coping brief (RSC-Brief) and the comfort scale for relatives of people in critical states of health (ECONF). RESULTS: Comfort was low in both groups and the family members used limited strategies in the RSC-Brief. The multiple linear regression analysis indicated that the variable length of hospitalization (ß = 0.69; p < 0.01) influenced comfort and was also associated with the RSC-Brief (ß = -0.18; p < 0.01). CONCLUSION: Family members' comfort was low in both groups. It increased with the hospitalisation time of the patients' relative and tended to decrease with the severity of the disease.