Nursing research
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Randomized Controlled Trial
Matching doses of distraction with child risk for distress during a medical procedure: a randomized clinical trial.
Parents often want to provide support to their children during medical procedures, but not all parents are effective in providing distraction after brief training. ⋯ Some parents may need additional training in providing distraction to their children during procedures, and some children at medium and high risk for distress may need professional support. Parents should be asked about their preferences in acting as the distraction coach and, if willing, be provided as much training and support as possible in the clinical situation.
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Caring for relatives with schizophrenia is complicated and has been associated with burden. Caregivers may also experience satisfaction, but these outcomes have not been simultaneously studied in family caregivers of relatives with schizophrenia. ⋯ Caring for family members with schizophrenia is burdensome but can also be a source of satisfaction. Correlates of caregiver burden appeared to be somewhat distinct from those of caregiver satisfaction. Further research on negative and positive aspects of caregiving is warranted to broaden the understanding of caregiving experiences and design therapeutic interventions to mitigate caregiver burden and enhance the sense of satisfaction with caregiving.
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Significant alterations in autonomic nervous system (ANS) function, vasomotor reactivity, and cerebral blood flow may develop from damage to brain ANS regulatory areas in heart failure (HF). This preferentially right-sided injury occurs largely in autonomic structures perfused by the middle cerebral artery. Indications of altered, asymmetrical perfusion raise the potential for further neural damage. ⋯ Diminished cerebral blood flow velocity and altered vasomotor reactivity were associated with HF, changes being preferentially on the right side; the asymmetry was more pronounced during CO2 and orthostatic challenges. The impaired blood flow regulation may contribute to the lateralized brain pathology in ANS areas, undermining autonomic control in HF.
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The three-component model of organization commitment has typically been studied using a variable-centered rather than a person-centered approach, preventing a more complete understanding of how these forms of commitment are felt and expressed as a whole. ⋯ Healthcare organizations often foster commitment by using continuance commitment-enhancing strategies (e.g., offer high salaries and attractive benefits) that may inadvertently introduce behavioral risk. This work suggests the importance of changing the context in which continuance commitment occurs by strengthening the other two components.
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Valid and reliable instruments are needed to measure communication interaction behaviors between nurses and mechanically ventilated intensive care unit patients who are without oral speech. ⋯ Preliminary results suggest that the revised CIBI has good face validity and shows good interrater reliability for many of the behaviors, but further refinement is needed. The use of dual raters with adjudication of discrepancies is the recommended method of administration for the revised CIBI.