Pflege
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In intensive care units (ICU), patients in life-threatening situations are hospitalized. While the health status of these patients is often severely compromised, therapeutic interventions include endo-tracheal intubation with artificial ventilation, sedation, and analgesia which restrict their ability to communicate. These patients become additional vulnerable since their pains may not been adequately identified. ⋯ In most of the instruments, the validity was tested only superficially and no detailed reports regarding the application in everyday practice were given. However, the studied instruments includes algorithm as a significant component which enable decision making of the health care providers in order to execute stepwise pain management interventions. In conclusion, a need for further research to disclose pain indicators in sedated and artificial ventilated ICU-patients, continuous development of instruments and their validation in clinical practice is obvious.
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Review
[Literature review of back massage and similar techniques to promote sleep in elderly people].
Insomnia is a frequent problem among elderly people. As a consequence, sedative hypnotic drugs are prescribed very often that can lead to problematic effects. As an alternative to sedative hypnotic drugs nurses use relaxing interventions to promote sleep. ⋯ The results indicate that these interventions promote relaxation and sleep and that they are perceived as very pleasant by the elderly. However; they do not explain in detail the reasons for effects these and the role of touch. This review shows that further research (RCTs) is necessary to determine the effects of back massage and "Atemstimulierende Einreibung" on relaxation and sleep.
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The objective of this article is to present a literature review of German and English literature concerning sleep disturbances of critically ill adults in intensive care units. It represents mainly nursing research-based studies which focused on characteristics and possible causes of sleep disturbances. The literature revealed that patients suffer from moderate to severe sleep deprivation characterized by a decrease of total sleep length and quality, and by sleep fragmentation. ⋯ Nurses have an important role to play in recognizing and assessing factors that contribute to sleep deprivation and in intervening to reduce the effects of sleep deprivation. The research studies in this review represent the positivistic scientific perspective where sleep deprivation research has been objectified and controlled. A broader, more indepth understanding is needed, however, so that the subjective view of critically ill persons can be represented.