Heart & lung : the journal of critical care
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Comparative Study
Predictors of successful heart failure self-care maintenance in the first three months after hospitalization.
The objective of this study was to replicate a prior study of predictors of self-care in heart failure (HF). ⋯ Elderly men and those with fewer comorbid illnesses were most successful at HF self-care.
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Wound care (WC) is an important part of treatment for hospitalized patients with wounds. There is a paucity of data about the type or amount of pain patients experience during WC. ⋯ Patients experience pain and distress with WC. Some behaviors and words consistently describe WC pain. Further work is warranted to refine pain assessment and management in patients undergoing WC procedures.
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The literature supports nursing interventions to maximize communication in mechanically ventilated patients, yet limited research exists on patients' perceptions of the helpfulness of health care practitioner interventions to enhance communication. In addition, the level of frustration experienced by these patients has not been reported. Thus, further research is necessary to examine patients' perspectives of the helpfulness of health care practitioner interventions that enhance communication of the mechanically ventilated patient. ⋯ Mechanically ventilated patients experience a high level of frustration when communicating their needs, and health care providers have a significant impact on the mechanically ventilated patient's experience. Further research is needed to explore and measure methods of facilitating communication that increase patient satisfaction, reduce patient anxiety, and obtain optimal pain management.
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The study's objective was to examine the effect of body position on oxygen consumption (Vo(2)) and hemodynamics. Although gravity-dependent hemodynamic and pulmonary consequences are well documented, less is known about the effect of body positions on VO(2) and hemodynamics, which is of importance in critical care. ⋯ These results yield further insight into how the adverse and beneficial effects of body positioning as a therapeutic intervention may be mediated through gravitational stress and myocardial mechanics. Such an understanding is crucial when prescribing body positioning to enhance oxygenation in the patient in the intensive care unit and to minimize its adverse effects.
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The inability to speak during mechanical ventilation is recognized as a terrifying and isolating experience that is related to feelings of panic, insecurity, anger, worry, fear, sleep disturbances, and stress among critically ill patients. Alternative methods of communicating with temporarily nonspeaking patients in the intensive care unit (ICU) have received little study. Although electronic voice output communication aids (VOCAs) are available for disabled children and adults, the effectiveness of VOCA systems with adult medical ICU patients who may have multisystem illness, prolonged intubation, and longer ICU stays has not been explored. ⋯ This study showed that use of VOCAs is possible with selected critically ill adults and may contribute to greater ease of communication during respiratory tract intubation particularly with family members. Further clinical research using control or comparison groups is needed.