Axone (Dartmouth, N.S.)最新文献

In some centres, patients who require a lumbar discectomy are successfully discharged the day of surgery. With the ongoing pressure to provide safe care for patients within certain bed limitations, this option was considered. Using a continuous quality improvement method, a prospective review of patients undergoing a single-level lumbar discectomy was monitored. Based on pre-set criteria, patients were included or excluded in the day surgery protocol and both groups were monitored. A large component of nursing education was provided for all patients, and will be highlighted. Data retrieved for both groups included demographics, length of operation, length in recovery room, length of hospital stay required, and the re-admission rate. There were 47 patients monitored over 11 months. Of the 34 patients entered in the protocol, seven required an overnight length of stay. The reasons for the extended length admission will be described. Of the 13 patients excluded from the protocol, one did not require an overnight stay. Following review of the data, the criteria for inclusion of patients into the protocol has been altered and patients can safely proceed with day surgery for lumbar discectomy.

The purpose of this study was to conduct focus group interviews to obtain information for development of a needs assessment questionnaire. Four focus groups were conducted with 10 people with multiple sclerosis (MS) and five significant others. A facilitator from the learning services department at the hospital conducted the interviews guided by questions developed by the researcher. The focus group interviews were audiotaped and transcribed. The researcher analyzed the transcribed interviews. Content analysis was used to analyze the transcribed data creating categories from key words and phrases as they appeared. The findings were grouped by themes. The results highlighted the participants' experiences and needs regarding physical changes; sources of assistance; unmet needs; psychological, employment, leisure, and informational needs. A comparison of themes developed from the focus groups and in the literature captured categories for questionnaire development. One new theme, leisure, was not found in the literature and was incorporated based on the findings of this study. The final categories for questionnaire development were: physical, health, psychological, financial, employment/meaningful daytime activity and leisure, accessibility and information. A survey questionnaire was developed from the focus group data using the phraseology of the participants.

Families face a difficult decision when choosing whether or not to have surgery for their infant with isolated craniosynostosis. While the skull deformity may not affect the child's physical health, growth, or development, it may have psychosocial impacts on a child's social-emotional development, self-esteem, and interpersonal interactions. Parents are challenged to balance surgical risks with potentially positive effects on their child's psychosocial health. The purpose of this research study was to explore parental decision-making related to surgery for isolated craniosynostosis, and to identify strategies that facilitate their decision-making. A thematic content analysis of focus group interview data revealed four themes that encapsulated the process of parental decision-making. The decision for some parents was agonizing. However, others found the decision relatively straightforward. In all cases, parents spent time thinking and gathering information. Certain critical events helped parents make their decision. Parents identified a number of strategies that would be helpful to the decision-making process.

Subarachnoid hemorrhage (SAH) often results in devastating neurological deficits requiring hospitalization and loss of independence. This is often a difficult time for patients and their families who are struggling to cope with this sudden illness. Current treatment options include surgical clipping of the aneurysm or endovascular obliteration using Guglielmi Detachable Coils. Our purpose in writing this paper will be to review the factors that determine the choice of treatment, and to discuss how nurses can provide our patients and families with the support and teaching needed during this difficult time.

The focus of this paper is to present an inductively derived substantive theory, "Negotiating Uncertainty". The theory details the most salient concerns of families who had a close relative who had suffered a severe TBI and how they dealt with the experience during the uncertain trajectory of illness that followed coma. This study was conducted in two acute care neurosurgical units in Level 1 trauma facilities in Toronto, Canada, using the grounded theory research method. There were a total of 36 participants in the study: 11 individuals who were injured and 25 close family members. Supporting data is provided to permit the reader to hear the issues of family members first-hand and to evaluate the recommendations for practice, education, and research.

The meaning of the experience of being told you or a family member have/has a serious brain tumor was revealed during a descriptive research study conducted to determine preoperative education needs. Eighteen patients and 15 family members participated immediately following the office visit with the neurosurgeon and/or on admission to hospital, for a total of 29 interviews and 13 questionnaires. Twenty-four interviews were conducted with 13 patients and 11 family members in the pre-discharge phase of the research. The key themes of hearing the news, education needs and information needs were identified through content analysis of transcribed interviews and questionnaire data. Patients and family members portrayed experiences, revealed emotions related to hearing the news, and shared ways of coping. Interviews with patients and their family members that contained clear narratives were identified. From these interviews, three sets of narratives were selected. Each of the narratives was analyzed to determine how the patients and their key family members articulated and made sense of the diagnosis and surgical treatment of a skull base tumor. The themes of a sense of comfort, the known is better than the unknown, waiting for news of the surgical outcome, and quality of recovery emerged from the analysis. Lessons learned about the individuality of patients' and family members' needs and approaches to support effective coping were identified.