Articles: aged.
-
J Pain Symptom Manage · Jun 2009
Randomized Controlled TrialThe effect of pain question phrasing on older adult pain information.
The aim of this study was to test how practitioners' pain communication affected the pain information provided by older adults. A post-test only, double-blind experiment was used to test how the phrasing of practitioners' pain questions-open-ended and without social desirability bias; closed-ended and without social desirability bias; or open-ended and with social desirability bias-affected the pain information provided by 312 community-living older adults with osteoarthritis pain. Older adults were randomly assigned to one of the three pain phrasing conditions to watch and orally respond to a computer-displayed videotape of a practitioner asking about their pain. ⋯ Older adults described significantly more pain information in response to the open-ended question without social desirability. The two follow-up questions elicited significant additional information for all three groups, but did not compensate for the initial reduced pain information from the closed-ended and social desirability-biased groups. Initial use of an open-ended pain question without social desirability bias and use of follow-up questions significantly increase the amount of important pain information provided by older adults with osteoarthritis pain.
-
Randomized Controlled Trial Comparative Study
Sedation with propofol for interventional endoscopy by trained nurses in high-risk octogenarians: a prospective, randomized, controlled study.
Sedation with the short-acting anesthetic agent propofol has shown several advantages, particularly in interventional endoscopy. So far, however, there are no valid data on the safety of nurse-administered propofol sedation (NAPS) during interventional endoscopy in elderly high-risk patients. ⋯ NAPS during interventional endoscopy is as safe as midazolam/pethidine sedation even in high-risk patients aged > 80 years.
-
Randomized Controlled Trial
A Phase II randomised controlled trial assessing the feasibility, acceptability and potential effectiveness of dignity therapy for older people in care homes: study protocol.
Although most older people living in nursing homes die there, there is a dearth of robust evaluations of interventions to improve their end-of-life care. Residents usually have multiple health problems making them heavily reliant on staff for their care, which can erode their sense of dignity. Dignity Therapy has been developed to help promote dignity and reduce distress. It comprises a recorded interview, which is transcribed, edited then returned to the patient, who can bequeath it to people of their choosing. Piloting has suggested that Dignity Therapy is beneficial to people dying of cancer and their families. The aims of this study are to assess the feasibility, acceptability and potential effectiveness of Dignity Therapy to reduce psychological and spiritual distress in older people reaching the end of life in care homes, and to pilot the methods for a Phase III RCT. ⋯ Dignity Therapy is brief, can be done at the bedside and could help both patients and their families. This detailed exploratory research shows if it is feasible to offer Dignity Therapy to residents of care homes, whether it is acceptable to them, their families and care home staff, if it is likely to be effective, and determine whether a Phase III RCT is desirable.
-
Randomized Controlled Trial
Older adult pain communication and the Brief Pain Inventory Short Form.
A randomized control group design with 106 community-dwelling older adults was used to test how completing the Brief Pain Inventory Short Form (BPI-SF) affected the osteoarthritis pain information reported by older adults responding to an open-ended pain question. The treatment group responded to the BPI-SF and then to the open-ended pain question. The control group responded first to the open-ended pain question, and then to the BPI-SF. ⋯ Responding to the BPI-SF did not assist older adults to describe additional pain information when responding to an open-ended pain question, but responding to an open-ended pain question did significantly increase the amount of functional pain interference reported on the BPI-SF. Practitioners and researchers should be aware of the potential difference in BPI-SF functional pain interference response depending on whether pain is discussed before or after administering the BPI-SF. Discussing pain before completing the BPI-SF might prompt older adults to think more about how pain interferes with their daily life.
-
Randomized Controlled Trial
Effects of extreme hemodilution during cardiac surgery on cognitive function in the elderly.
Strategies for neuroprotection including hypothermia and hemodilution have been routinely practiced since the inception of cardiopulmonary bypass. Yet postoperative neurocognitive deficits that diminish the quality of life of cardiac surgery patients are frequent. Because there is uncertainty regarding the impact of hemodilution on perioperative organ function, the authors hypothesized that extreme hemodilution during cardiac surgery would increase the frequency and severity of postoperative neurocognitive deficits. ⋯ In this prospective, randomized study of hemodilution during cardiac surgery with cardiopulmonary bypass in adults, the authors report an early termination of the study because of an increase in adverse events. They also observed greater neurocognitive impairment among older patients receiving extreme hemodilution.