Pain experiences of traumatically injured patients in a critical care setting.

BACKGROUND: Little is known about the acute pain experiences of traumatically injured critically ill patients. OBJECTIVES: To describe pain experiences of traumatically injured adults during the first 72 hours of hospitalization. METHODS: Thirty multiply injured adults at a level I trauma center participated in the study. Pain was measured by using the McGill Pain Questionnaire and a visual analog scale. Subjects completed pain measures while at rest in a supine recumbent position and after a turn onto the side. RESULTS: The typical subject was 37 years old, had 4 major blunt trauma injuries, and had received the equivalent of 55.9 mg of morphine during the 24 hours before data collection. Mean at-rest scores were 26.5 on the pain-rating index, 2 on the present pain intensity index, and 34.6 on the visual analog scale. Immediately after the turn, mean scores on the visual analog scale increased from 25 to 48.1 (P = .002). Other pain scores after the turn did not differ significantly from at-rest values. Subjects who turned had lower scores on the visual analog scale at rest (P = .02) and less anxiety (P = .02) than did those who refused to turn. Ninety-six percent reported pain in the injured areas, and 36% reported pain related to biomedical devices. No relationship was found among reported pain and demographic, treatment, or clinical variables. CONCLUSIONS: Additional research is needed on pain at rest and during commonly performed procedures and on improved methods for pain relief in traumatically injured critically ill patients.

Computer-mediated support group use among parents of children with cancer--an exploratory study.

This study describes aspects of computer group use as a vehicle for self-help by parents of children with cancer. Using an electronic mail system, data were gathered from 73 parents who had participated in online support groups. Most participants were Caucasian, well educated, and reported annual incomes of more than $50,000. The perceived benefits of the computer group involvement were getting information, sharing experiences, receiving general support, venting feelings, gaining accessibility, and using writing. The disadvantages included "noise," negative emotions, large volume of mail, and lack of physical contact and proximity. The findings indicate that computer group use is more common in parents with relatively high socioeconomic status. There are certain advantages and disadvantages of computer group use that need to be recognized and addressed by health professionals and users.

Integrating cancer risk assessment into a community health nursing course.

BACKGROUND: Because the state of Maryland has the fourth highest cancer death rate among the states and the District of Columbia, a community-based hospital identified the need to develop a cancer prevention, screening, and education program for the community at large and the employees. Subsequently, as a prerequisite for graduation, Community Health Nursing Students (CHN) conducted a project with the goal of assessing hospital employee cancer risk status and presenting a hospital-based cancer education program. METHOD: Data regarding employee cancer risk status were gathered using a modified 31-item cancer-risk-assessment guide; risk factors for cancers of the lung, colon-rectum, skin, prostate, breast, and cervix were identified. RESULTS: Overall, the employees were at a high to moderate risk of developing cancers of the cervix, followed by cancers of the skin and breast, and at lowest risk of developing cancer of the lung, followed by cancers of the prostate and colon-rectum. CONCLUSION: The findings provided baseline data for the development of employee-focused cancer education and screening programs.

Mentoring: the ultimate professional relationship.

Mentoring plays a significant role in business, industry, government, education, and healthcare. Mentoring relationships help promote the individual's professional growth and development. Such development involves knowledge and skill acquisition, which is facilitated by interaction with other, more experienced and proficient professionals. The Belcher-Sibbald Continuum of Learning describes the relationship among the concepts of role modeling, networking, preceptoring, and mentoring. Each concept is defined and described as a unique relationship which promotes professional growth and development. In addition, three mentoring/networking relationships in the context of the wound care community are presented to provide insight into this type of relationship.

Instruction in the techniques and concept of supportive care in oncology.

Cancer education merits a coordinated, vertical curriculum and an integrated planning strategy. It has become clear that it is as important to teach the techniques of supportive care in oncology as it is to teach the concepts of cancer biology, pathology, epidemiology, prevention, detection and aggressive treatments. Our aim is to determine whether the medical school and nursing school curricula give the students an introduction to the concepts of supportive care of the cancer patient. The spectrum of such supportive care encompasses a wide range of issues working towards a common goal of providing overall comfort with an emphasis on quality of life, and runs parallel with specific therapeutic strategies and associated problems. Do the graduate medical student and nursing student understand that cancer management is multidisciplinary and team-based? That the approach to pain management not only includes the administration of pain medications, but should also evaluate pain assessment and anesthetic, neurosurgical and behavioral approaches? That nausea and vomiting associated with chemotherapy can be ameliorated to a certain extent? That infections are common but algorithms exist for prevention and therapy? That certain metabolic complications are unique to cancer patients? That transfusions are vital procedures in patients with neoplasms undergoing aggressive treatments but are associated with certain risks and complications? That there are serious psychosocial, ethical and legal needs to be considered? To address these issues, the American Cancer Society Professors of Clinical Oncology, the American Cancer Society Professors of Oncology Nursing and the United States Cancer Center Directors were surveyed.(ABSTRACT TRUNCATED AT 250 WORDS)

Nursing aspects of quality of life enhancement in cancer patients.

The evolution of cancer care from a focus on length of survival to quality of life is presented as a frame-work for the nurse's evolving role in the domain. Nurses have roles as clinicians, managers, researchers, teachers, and change agent/consultants and as such their impact on the specific factors affecting the quality of life of persons with cancer can be substantial. Patients are unique in their response to cancer and its treatment, as well as in their perspective as to what constitutes quality of life. The nurse's interventions must reflect and incorporate this uniqueness so that patients can be helped to live their lives fully and as they wish.

Spirituality and sense of well-being in persons with AIDS.

The nurse is in a position to look holistically at PWAs to diagnose spiritual distress with the same sensitivity and skill as that used to diagnose physical and psychosocial problems. Caring for these persons requires holistic planning and intervening as well, with an awareness of the effect of spirituality on well-being.