Nursing research
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Several pain observation scales have been developed to accurately assess and manage pain in older adults with severe cognitive impairments, communication difficulties, or both. ⋯ As different methods of evaluating reliability and validity were used, and different aims (e.g., type of pain) were pursued, the available scales cannot be compared easily. Nevertheless, a few are promising, given preliminary results. These should be examined further on psychometric properties and usefulness in different populations because optimal pain assessment is necessary for efficient and effective pain treatment.
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Multicenter Study Comparative Study
Anesthesia staffing and anesthetic complications during cesarean delivery: a retrospective analysis.
Obstetrical anesthesia services may be provided by Certified Registered Nurse Anesthetists (CRNAs), anesthesiologists, or a combination of the two providers. Research is needed to assist hospitals and anesthesia groups in making cost-effective staffing choices. ⋯ There is no difference in rates of complications between the two types of staffing models. As a result, hospitals and anesthesiology groups may safely examine other variables, such as provider availability and costs, when staffing for obstetrical anesthesia. Further study is needed to validate the use of ICD-9-CM codes for anesthesia complications as an indicator of quality.
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More patients are receiving healthcare services from nurse practitioners (NPs) and physician assistants (PAs). These providers are likely to be confronted with a variety of ethical issues as they balance quality care with their patients' rising cost concerns. However, very little is known about the ethical conflicts and causes of these conflicts experienced by these clinicians in their daily practice. ⋯ NPs and PAs are experiencing ethical conflict often associated with their perceived professional obligations to advocate for patients. Being well-prepared in ethics and having sufficient professional independence help clinicians balance the ethical complexities and demands of meeting patients' needs within a constrained healthcare system.
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Correctional nurses function in a high stress environment due to the nature of their clients and the primacy of environmental security. Job stress and satisfaction are theorized relational concepts that influence intent to stay and turnover as described in the anticipated turnover model. An increased understanding of the nature and sources of stress and satisfaction provides necessary information about correctional nursing. ⋯ Stress levels and the top two sources of stress were essentially the same for both groups of correctional nurses. Sources of satisfaction are ranked similarly but subscale and overall scores indicate that the nurses in the replication study were more dissatisfied. Findings validate the theoretical proposition in the anticipated turnover model that job stress is a major predictor variable in explaining job satisfaction.
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Family caregivers of stroke survivors experience a variety of negative social, emotional, and health-related outcomes as a result of providing care. ⋯ The revised 15-item BCOS has evidence of satisfactory reliability and validity in family caregivers of stroke survivors. The BCOS is a valuable measure in research and can be used to identify priority areas for nursing interventions designed to improve caregivers' outcomes.