RESUMO
Stroke patients can experience a variety of pain. Many stroke patients have co-morbidities such as osteoporosis, arthritis or diabetes causing diabetic neuropathy. As well as pain from other long term conditions, stroke patients can experience central post-stroke pain, headaches, and musculoskeletal issues such as hypertonia, contractures, spasticity, and subluxations. These stroke patients can also have communication difficulties in the form of expressive dysphasia and/or global aphasia. Communication difficulties can result in these patients not expressing their pain and therefore not having it assessed, leading to inadequate pain relief that could impact their rehabilitation and recovery. By implementing an observational measurement of pain such as the Abbey pain scale, patients with communication difficulties can have their pain assessed and recorded. Initially 30% of patients on the acute stroke ward did not have their pain assessed and adequately recorded and 15% of patients had inadequate pain relief. The patient was assessed if they were in pain and therefore not receiving adequate pain relief by measuring their pain on the Abbey pain scale. After introducing the Abbey pain scale and creating a nurse advocate, an improvement was shown such that only 5% of patients did not have their pain recorded and all had adequate pain relief.
RESUMO
Recent developments in medical curricula have led to marked changes in the teaching of gross (topographical) anatomy. This has resulted from the belief that anatomy is largely "content-driven" and not "skills- based". This presentation describes and evaluates, primarily from the perspective of medical students, different methods of teaching anatomy and includes the "teaching" of such skills as: team skills, relating their dissecting room experience to the study of pathology and to the clinic, relating their experience to medical humanities issues such as their responses to death. The assessment of attitudes was conducted by employing Thurstone and Chave attitude analyses and also a matrix questionnaire that evaluated different methods of teaching anatomy in relation to an array of potential course aims/learning outcomes. Comparisons were made with the attitudes of professional anatomists working in Europe. The findings show that: Medical students and professional anatomists differ little in their evaluation of the importance of anatomy and of the relationships between teaching methods and course aims/learning outcomes; Medical students believe that anatomy is very important to clinical medicine (before entering their medical course, after completing their anatomy courses, and towards the end of their medical training at university); Medical students would prefer that anatomy is taught practically (via dissection, use of prosection, with living and radiological anatomy) than theoretically (via didactic teaching, models, CAL). Because of anatomy's perceived clinical importance, because of the preference for practical teaching and learning, and because both professional anatomists and medical students do not believe that anatomy contributes greatly to other basic sciences, it is suggested that anatomy ought to be a "stand-alone" component in a medical curriculum (AU)
No disponible
