Articles: patients.
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Outcomes research plays a key role in defining the effects of medical care in critical care. Last year Critical Care published a number of papers that evaluated patient-centered and policy-relevant outcomes. ⋯ We further analyze the literature, assessing outcomes such as quality of life and the psychological burden associated with critical care. We also reviewed processes of care, and studies looking at cost analysis of treatment associated with critical care.
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Scand J Trauma Resus · Jan 2013
ReviewConfusion with cerebral perfusion pressure in a literature review of current guidelines and survey of clinical practise.
Cerebral perfusion pressure (CPP) is defined as the difference between the mean arterial pressure (MAP) and the intracranial pressure (ICP). However, since patients with traumatic brain injury (TBI) are usually treated with head elevation, the recorded CPP values depends on the zero level used for calibration of the arterial blood pressure. Although international guidelines suggest that target values of optimal CPP are within the range of 50 - 70 mmHg in patients with TBI, the calibration of blood pressure, which directly influences CPP, is not described in the guidelines.The aim of this study was to review the literature used to support the CPP recommendations from the Brain Trauma Foundation, and to survey common clinical practice with respect to MAP, CPP targets and head elevation in European centres treating TBI patients. ⋯ The evidence behind the recommended CPP thresholds shows no consistency on how blood pressure is calibrated and clinical practice for MAP measurements and CPP target values seems to be highly variable. Until a consensus is reached on how to measure CPP, confusion will prevail.
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Dimens Crit Care Nurs · Jan 2013
ReviewLiterature review: patients' and health care providers' perceptions of stressors in critical care units.
The purpose of this article was to provide a historical review and analysis of the research literature focusing on patients', nurses', and health care providers' perceptions of stressors in the critical care setting. A narrative historical literature review method was used. ⋯ Several studies investigated perceptions of stressors using the Environmental Stressors Questionnaire and the findings did not show any significant changes of stress perception over time since 1989 until the present. There is a need to further investigate stress perceptions in the health care setting using a mixed qualitative and quantitative approach to provide a more precise description of stressors and stress perceptions in the critical care setting.
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Palliative medicine · Dec 2012
ReviewUsing observation as a data collection method to help understand patient and professional roles and actions in palliative care settings.
Observational research methods are important for understanding people's actions, roles and behaviour. However, these techniques are underused generally in healthcare research, including research in the palliative care field. ⋯ Qualitative observational data collection methods can contribute to theoretical and conceptual development and the explanation of social processes in palliative care. In particular this contribution to understanding care structures and processes should improve understanding of patients' experiences of their care journey and thus impact on care outcomes.
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Early diagnosis and intervention for people with dementia is increasingly considered a priority, but practitioners are concerned with the effects of earlier diagnosis and interventions on patients and caregivers. This systematic review evaluates the qualitative evidence about how people accommodate and adapt to the diagnosis of dementia and its immediate consequences, to guide practice. ⋯ There is an extensive body of qualitative literature on the experiences of community-dwelling individuals with dementia on receiving and adapting to a diagnosis of dementia. We present a thematic analysis that could be useful to professionals working with people with dementia. We suggest that research emphasis should shift towards the development and evaluation of interventions, particularly those providing support after diagnosis.