Journal of advanced nursing
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This review aims to document the effectiveness of relaxation techniques, when used alone for the management of acute pain, after surgery and during procedures. A systematic review of randomized controlled trials (RCTs) was undertaken. Seven studies involving 362 patients were eligible for this review. ⋯ However, this was not conclusive and many of both the positive and the negative studies suffered from methodological inadequacies. Well designed and executed randomized controlled trials are needed before the clinical use of relaxation in acute pain management can be firmly underpinned by good quality research evidence. Until this evidence is available we recommend that the clinical use of relaxation in acute pain settings is carefully evaluated and not used as the main treatment for the management of acute pain.
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The literature often suggests and assumes that children are under-medicated postoperatively. A review of the literature leads to the conclusion that only a few studies answer the question of whether children's pain is relieved insufficiently. The lack of consensus on expected pain intensity after surgery and caution about prescribing analgesics could explain why analgesics are often prescribed on a pro re nata (prn) basis. ⋯ In some situations, nurses under-estimate the child's pain, while in others, nurses' attitudes, beliefs and knowledge regarding pain relief strategies play an important role. On the basis of this review of the literature standard prescription of pain medication instead of prn is recommended. Furthermore, research on the incidence and prevalence of pain in children and on the effectiveness of analgesic administration postoperatively is warranted.
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The aim of this paper is to present an overview of the literature on the factors influencing decision-making in the nursing care of children in pain. To that effect published and unpublished references were reviewed. The most frequently cited factors influencing the assessment and management of pain in children are summarized and discussed. Finally recommendations are made where further research is warranted.
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The emergency nurse practitioner (ENP) is a rapidly developing role within emergency health care provision in the United Kingdom (UK). This paper explores some of the available literature concerning the development of the role in the context of major accident and emergency departments. The professional and legal implications of this shift in role boundaries are discussed. ⋯ The relative plethora of rigorous evaluation studies of ENP role effectiveness in North America, is contrasted with the current paucity of empirical data available in the UK. A number of methodological issues concerning the evaluation of ENP services are identified. The need for research in this area, alongside a programme of continuing local audit to guide and inform evidence-based practice, is emphasized.
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By examining the relationship between the cultural construction of female sexuality and the lack of potential for many young heterosexual women to be truly sexually healthy this paper submits that messages for women within HIV prevention programmes can be confused, confining and at times dangerous to women's health and well-being. It is suggested that these messages also reinforce a traditional, biologically determined medical understanding of female sexuality that does not take note of social or culturally based research or commentary on female experience or female desire, but rather confines many women to sexual restrictions, doing little to empower women to prevent sexual risk-taking. ⋯ This allows for a framework for the study of sexuality that relates it to other social phenomena, particularly economic, political and social structures (Foucault 1979); in other words, a study of the 'social construction' of sexuality. This paper suggests that health care professionals need to develop an awareness of the diversities within female sexuality and gain insight into their own values and assumptions about female sexuality if these are not to inhibit effective approaches and interventions in the areas of HIV and sexual health.