Scandinavian journal of caring sciences
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Parents are expected to alleviate their children's pain at home after day surgery, and the methods of pain alleviation should be taught to the parents by the hospital staff. However, the lack of information related to children's pain alleviation has been pointed out in several studies. ⋯ Both the content, the methods of providing and the timing of discharge instruction need to be developed in children's day surgery. Special attention should be paid to written instructions, which should be given to the parents prior to the day of the child's surgery. Further research is needed to explore the skills of hospital staff in advising the parents and other factors explaining children's postoperative pain at home.
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Multicenter Study Clinical Trial Controlled Clinical Trial
Effects of 'pain-advisers': district nurses' opinions regarding their own knowledge, management and documentation of patients in chronic pain.
This study investigated whether district nurses' opinions changed after the education and introduction of district nurses as 'pain-advisers' at primary health care centres (PHCCs) regarding working conditions and satisfaction with pain control management at their PHCCs, their own knowledge of pain control and satisfaction with their own pain control management, pain assessment and nursing documentation of patients with chronic pain conditions. A study area (SA) with five PHCCs and a control area (CA) with seven PHCCs were selected. In the SA, 28 and in the CA, 25 district nurses answered a questionnaire both before and after the introduction of the 'pain-advisers' into the SA. ⋯ According to the district nurses in the SA, several statistically significant improvements were achieved after the introduction of the 'pain-advisers'; more district nurses reported that pain policies or other written information were now available at their PHCCs, that they were more satisfied with present overall routines at their PHCCs, that a better pain control was applied at their PHCCs regarding patients with leg ulcers, that they themselves to a greater extent performed individual pain assessments of the patients and that they more often used pain visual analogue scales to assess the patients' pain and to evaluate the results of the pain treatment. They also reported an increased satisfaction with their own nursing documentation. Although much remains to be done, it must be acknowledged that the 'pain-advisers', with relatively small resources, managed to make significant improvements.
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To evaluate and improve the quality of care provided, it is of vital importance to investigate the quality of care in the context of health care. Patient satisfaction is a significant indicator of the quality of care. Consequently, quality work includes investigations that map out patient satisfaction with nursing care. ⋯ The bulk of the literature included in the study came from the UK, Sweden and the USA. This means that the results should be applicable to health care in the western world. An important implication for future research is to continue to elucidate the factors that influence satisfaction with nursing care, as seen from the patient's perspective.
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This paper reports on the evaluation stage of an action research project on interprofessional collaboration in discharge planning. Findings from interviews with health care professionals working in the acute sector had revealed concerns about discharge planning and multidisciplinary teamwork. In the United Kingdom the National Health Service (NHS) Plan has reinforced the need for an integrated approach to health care. ⋯ Methods of evaluation used were: (i) stakeholder interviews, (ii) interprofessional audit and (iii) analysis of the variances from the integrated care pathway. The evaluation revealed that although integrated care pathways led to improved outcomes for the health care trust there was little evidence to suggest that interprofessional relationships and communication were enhanced. Furthermore, key factors in discharge delays appeared to be organizational rather than professional.
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It is increasingly common that cancer patients are cared for at home at the end of life, with help from advanced home care teams. This may have positive implications for cancer patients and their families, but it may also be burdensome to the family caregivers with implications for their health and well-being. This qualitative study was therefore initiated to prospectively explore how family caregivers reason about their expectations of providing end-of-life care at home for relatives with cancer, enrolled in advanced palliative home care units. ⋯ Professional support is described as expected primarily for care-related tasks, although hopes may be expressed about support in other areas. The distinction between resources described as existing in theory and those used in practice also are apparent in analysis of the interviews. If home care is to be a positive alternative to hospital care, individual expectations should be considered when planning supportive care.