Scandinavian journal of caring sciences
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Clarification of the concept self-harm is needed in order to enable research and theory development and facilitate the development and evaluation of medical interventions and nursing care for individuals who self-harm. This study presents such a conceptual analysis. Articles from 1997 to 2007 were sought from the Medline, PubMed, Cinahl, and PsychINFO search engines by entering the search words 'self-harm', 'self-harming', and 'psychiatric care'. 25 medicine and 23 nursing science articles were chosen for inclusion and analysed. ⋯ Accordingly, inter-professional collaboration and postgraduate education is needed in order to provide better care and treatment for self-harm patients. Furthermore, better understanding is needed to help enable health care personnel understand why individuals self-harm. The conceptual analysis presented in this study may be helpful as regards theory development within this still rather unexplored field.
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To assess pain in older persons with severe dementia is a challenge due to reduced self-report capacity. Recently, the development and psychometric property testing of the Mobilization-Observation-Behaviour-Intensity-Dementia (MOBID) Pain Scale was described using video-recording. The purpose of this article was to present the further development of this instrument. In MOBID-2 Pain Scale, the assessment of inferred pain intensity is based on patient's pain behaviours in connection with standardized, guided movements of different body parts (Part 1). In addition, MOBID-2 includes the observation of pain behaviours related to internal organs, head and skin registered on pain drawings and monitored over time (Part 2). ⋯ On the basis of pain behaviours, standardized movements and pain drawings, MOBID-2 Pain Scale was shown to be sufficiently reliable, valid and time-effective for nurses to assess pain in patients with severe dementia.
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Pain assessment of premature infants continue to be ineffective. The problem may be partly because of misconceptions or lack of knowledge in the assessment of pain in children. ⋯ On average nurses' attitudes were positive towards the pain assessment in neonatal intensive care. However, there were some gaps in the knowledge concerning the respondents' perceptions of the items, which is a challenge to nursing and nursing education.
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The representation of end users' perspectives in healthcare decisions requires involvement of their surrogates when the end users, i.e. certain patients, elderly people, children and people with disabilities, are unable to present their views. ⋯ This systematic review has revealed that the involvement of surrogates is an additional vital way to represent end users' perspectives in healthcare decisions where for a range of reasons their opinions are unable to be effectively ascertained. However, because of the heterogeneity of surrogates and end users, the selection of appropriate surrogates and deploying surrogate decisions require particularly careful consideration of their value in individual cases; thus, subsequent decision-making must be reviewed on a case-to-case basis to seek to ensure that the best interests, needs and wishes of the end user are fully and accurately represented.
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Despite decades of research and the availability of effective analgesic approaches, many patients continue to experience moderate to severe pain after surgery. Greater research efforts are needed to identify the factors that impede effective pain management. Despite the fact that a variety of research and clinical studies on all aspects of pain have been conducted in many countries, the factors affecting pain management have not been completely identified. ⋯ The conclusion embraces implications for clinical practice to improve the knowledge of nurses and nursing manager and insight in postoperative pain management. Clearly, programmes for change must address not only knowledge improvement, but also the wider complex influences on barriers to pain management.