scholarly journals Enhancing the Communication of Suddenly Speechless Critical Care Patients

2016 ◽  
Vol 25 (3) ◽  
pp. e40-e47 ◽  
Author(s):  
Carmen S. Rodriguez ◽  
Meredeth Rowe ◽  
Loris Thomas ◽  
Jonathan Shuster ◽  
Brent Koeppel ◽  
...  

Background Sudden speechlessness is common in critically ill patients who are intubated or have had surgery for head and neck cancer. Sudden inability to speak poses challenges for hospitalized patients because strategies to facilitate communication are often limited and unreliable. Objective To determine the impact of a technology-based communication intervention on patients’ perception of communication difficulty, satisfaction with communication methods, and frustration with communication. Methods A quasi-experimental, 4-cohort (control and intervention) repeated-measures design was used. Data were collected daily for up to 10 days. Patients in adult critical care units were followed up as they were transferred to other units within the institutions selected for the study. The impact of a technology-based communication system (intervention) was compared with usual care (control). Patients’ communication outcomes pertinent to communication with nursing staff that were evaluated included perception of communication ease, satisfaction with methods used for communication, and frustration with communication. Results Compared with participants in the control group, participants in the intervention group reported lower mean frustration levels (−2.68; SE, 0.17; 95% CI, −3.02 to −2.34; P < .001) and higher mean satisfaction levels (0.59; SE, 0.16; 95% CI, 0.27 to 0.91; P < .001) with use of the communication intervention. Participants in the intervention group reported a consistent increase in perception of communication ease during the hospital stay. Conclusions The results facilitated evaluation of a bedside technology-based communication intervention tailored to the needs of suddenly speechless critically ill patients.

Author(s):  
María-José Cantero ◽  
Raquel Bañuls ◽  
Paz Viguer

There is clear agreement about the importance of promoting emotional intelligence in school through programs integrated in the academic curriculum. The objective of this study is to analyze the impact of the EDI program on the emotional intelligence trait and on general academic performance, as well as mathematics and language performance. The participants were 5th grade elementary school students between 10 and 11 years old. A quasi-experimental repeated-measures design was used, with a comparison group and four assessment points. The results showed, on the one hand, the effectiveness of a two-year intervention in improving emotional intelligence and, on the other hand, its positive influence on academic performance in general, and specifically on mathematics and language performance. In the non-intervention group, general academic performance and language performance declined. The results are discussed, and recommendations are made for future interventions.


Author(s):  
Claudia Consuelo Torres Contreras ◽  
Astrid Nathalia Páez-Esteban ◽  
Mayerli Katherine Rincon-Romero ◽  
Raquel Rivera Carvajal ◽  
Marisela Márquez Herrera ◽  
...  

ABSTRACT Objective: To determine the effectiveness of a nursing intervention for delirium prevention in critically ill patients. Method: A quasi-experimental study was conducted with a non-equivalent control group and with evaluation before and after the intervention. 157 Patients were part of the intervention group and 134 of the control group. Patients were followed-up until they were discharged from the ICU or died. The incidence of delirium in both groups was compared. Additionally, the effect measures were adjusted for the propensity score. Results: The incidence and incidence rate of delirium in the control group were 20.1% and 33.1 per 1000 person-days (CI 95% 22.7 to 48.3) and in the intervention group was 0.6% and 0.64 per 1000 person-days (CI 95% 0.22 to 11.09), respectively. The crude Hazard Ratio was 0.06 (CI 95% 0,008 to 0,45) and adjusted 0.07 (CI 95% 0,009 to 0,60). The number needed to be treated was six. Conclusion: Low incidence of delirium in critically ill patients intervened demonstrated the effectiveness of interventions. The average intervention time was 4 days with a 15-minutes dedication for each patient.


2011 ◽  
Vol 107 (7) ◽  
pp. 1056-1061 ◽  
Author(s):  
Miriam Theilla ◽  
Betty Schwartz ◽  
Yael Zimra ◽  
Haim Shapiro ◽  
Ronit Anbar ◽  
...  

n-3 Fatty acids are recognised as influencing both wound healing and immunity. We assessed the impact of a fish oil- and micronutrient-enriched formula (study formula) on the healing of pressure ulcers and on immune function in critically ill patients in an intensive care unit. A total of forty patients with pressure ulcers and receiving nutritional support were enrolled (intervention group, n 20, received study formula; and a control group, n 20, received an isoenergetic formula). Total and differential leucocyte count and percentage of adhesion molecule positive granulocyte and lymphocyte cells (CD11a, CD11b, CD18 and CD49b) were measured on days 0, 7 and 14. Percentage of positive lymphocytes for CD54, CD49b, CD49d and CD8 were also measured on days 0, 7 and 14. The state of pressure ulcers was assessed by using the pressure ulcer scale for healing tool score on days 7, 14 and 28 of treatment. No between-group differences in patient demographics, anthropometry or diagnostic class were observed. Patients who received the study formula showed significant increases in the percentage of positive CD18 and CD11a lymphocytes and of CD49b granulocytes as compared to controls (P < 0·05). While the severity of pressure ulcers was not significantly different between the two groups on admission, severity increased significantly over time for the control group (P < 0·05), but not for the study group. The present study suggests that a fish oil- and micronutrient-enriched formula may prevent worsening of pressure ulcers and that this effect may be mediated by an effect on adhesion molecule expression.


2021 ◽  
pp. 014303432110250
Author(s):  
Celeste Simões ◽  
Anabela C. Santos ◽  
Paula Lebre ◽  
João R. Daniel ◽  
Cátia Branquinho ◽  
...  

Resilience is an individual’s ability to adapt successfully to and persevere during and after significant challenges. Resilience programmes based on a socioemotional learning approach have been associated with an increase in protextive factors (e.g., prosocial competencies), improvements in physical and mental health, and a decrease in internalised and externalised symptoms. The present study aimed to evaluate the impact of the RESCUR curriculum implemented in Portuguese schools on students’ academic, behavioural, and socioemotional outcomes, based on child and teacher reports. Participants included 1,084 children (53.2% male) aged 3-15 ( M = 7.24, SD = 2.31). A quasi-experimental study compared outcomes for an experimental intervention group (AIG) with a waiting list control group (WG). The results showed the RESCUR programme decreased mental health difficulties while increasing both prosocial behaviours and well-being. In addition, academic performance increased for those in preschool after implementation. Both teachers and children consistently reported positive behavioural changes in resilience-related competencies after implementing RESCUR. Our findings contribute to the recent research on the potential of RESCUR to address key socioemotional competencies and improve relevant protextive factors. Study limitations and future recommendations are addressed.


Author(s):  
Alexandra Jayne Nelson ◽  
Brian W Johnston ◽  
Alicia Achiaa Charlotte Waite ◽  
Gedeon Lemma ◽  
Ingeborg Dorothea Welters

Background. Atrial fibrillation (AF) is the most common cardiac arrhythmia in critically ill patients. There is a paucity of data assessing the impact of anticoagulation strategies on clinical outcomes for general critical care patients with AF. Our aim was to assess the existing literature to evaluate the effectiveness of anticoagulation strategies used in critical care for AF. Methodology. A systematic literature search was conducted using MEDLINE, EMBASE, CENTRAL and PubMed databases. Studies reporting anticoagulation strategies for AF in adults admitted to a general critical care setting were assessed for inclusion. Results. Four studies were selected for data extraction. A total of 44087 patients were identified with AF, of which 17.8-49.4% received anticoagulation. The reported incidence of thromboembolic events was 0-1.4% for anticoagulated patients, and 0-1.3% in non-anticoagulated patients. Major bleeding events were reported in three studies and occurred in 7.2-8.6% of the anticoagulated patients and up to 7.1% of the non-anticoagulated patients. Conclusions. There was an increased incidence of major bleeding events in anticoagulated patients with AF in critical care compared to non-anticoagulated patients. There was no significant difference in the incidence of reported thromboembolic events within studies, between patients who did and did not receive anticoagulation. However, the outcomes reported within studies were not standardised, therefore, the generalisability of our results to the general critical care population remains unclear. Further data is required to facilitate an evidence-based assessment of the risks and benefits of anticoagulation for critically ill patients with AF.


F1000Research ◽  
2021 ◽  
Vol 10 ◽  
pp. 929
Author(s):  
Nouran Hesham El-Sherazy ◽  
Naglaa Samir Bazan ◽  
Sara Mahmoud Shaheen ◽  
Nagwa A. Sabri

Background Antioxidants show nephroprotective effect against vancomycin associated nephrotoxicity (VAN) in animals. This study aimed to assess the ascorbic acid nephro-protective role against VAN clinically. Methods Forty-one critically ill patients were randomly assigned to one of two groups: intervention group (vancomycin IV plus ascorbic acid, n=21) or control group (vancomycin IV only, n=20). Primary outcomes were the incidence of VAN and the absolute change in creatinine parameters, while mortality rate was the secondary outcome. Nephrotoxicity was defined as an increase in serum creatinine (S.cr) by at least 0.5 mg/dL or 50% of baseline for at least two successive measurements. This study is registered at Clinicaltrials.gov (NCT03921099), April 2019. Results Mean absolute S.cr increase was significant when compared between both groups, P-value = 0.036, where S.cr increased by 0.05(0.12) and 0.34(0.55) mg/dL in the intervention and control groups, respectively. Mean absolute Cr.cl decline was significant when compared between both groups, P-value = 0.04, where Cr.cl was decreased by 5.9(17.8) and 22.3(30.4) ml/min in the intervention and control groups, respectively. Incidence of VAN was 1/21(4.7%) versus 5/20(25%) in the intervention and control groups, respectively (RR: 0.19; CI: 0.024–1.49; P-value = 0.093). Mortality was higher in the control group; however, it was not statistically significant, P-value = 0.141. Conclusion Co-administration of ascorbic acid with vancomycin preserved renal function and reduced the absolute risk of VAN by 20.3%, however, the reduction in VAN incidence didn’t reach statistical significance level. Further large multicenter prospective trials are recommended.


Author(s):  
Diana Paricio ◽  
Maria F. Rodrigo ◽  
Paz Viguer ◽  
Marina Herrera

The Positive Youth Development (PYD) approach identifies adolescents as resources to be empowered rather than problems to be solved. All adolescents have strengths and will fully develop when these strengths are integrated with healthy resources in the diverse environments where they live and interact. The objective of this study was twofold: (1) to present the Positive Development Program for Adolescents living in rural areas (DPAR Program) and (2) to pilot test the intervention program. The DPAR program was evaluated using a repeated-measures design before and after the intervention, with an intervention group and a control group. The sample consisted of 176 adolescents between 11 and 15 years old (M = 12.89, SD = 0.90) who belonged to two high schools with similar characteristics located in rural settings. A mixed-design analysis of variance was performed for each dependent variable. Results showed a significant increase in most of the study variables (self-esteem, self-efficacy, group identity, empathy, relational skills, assertiveness, and conflict resolution) and a significant decrease in alexithymia, as well as better academic performance. All this evidence indicates that the DPAR program is effective in promoting positive adolescent development and addresses the lack of programs based on the PYD approach in rural areas.


2019 ◽  
Vol 10 (4) ◽  
pp. 11
Author(s):  
Eman Abdel Fattah Hassan ◽  
Hoda Wahid Amer

Objective: To evaluate the impact of regular chest percussion on outcome measures for infants with pneumonia.Methods: A two-group pre-post quasi-experimental design was conducted in the Pediatrics Medical Unit at Abu Elrish Children’s Hospital, Cairo University. The experiment involved 100 infants fifty (control group) followed the hospital routine care and other fifty applied regular chest percussion (intervention group). Chest condition was assessed subjectively and objectively throughout five days before and after the regular chest percussion using Pediatrics Respiratory Severity Scales. Physiological measurements of infant’s respiratory rate, heart rate, and temperature and oxygen saturation were assessed. All research ethics were applied.Results: The mean of Pediatric Respiratory Severity Score (PRSS), temperature, respiration, heart rate and oxygen saturation among infants was statistically improved throughout the intervention days than the control group 1st, 2nd, 3rd and 4th days post the regular chest percussion at a significance level as p < .05.Conclusions: The regular chest percussion had a significant improvement in the respiratory health conditions for infants with bacterial pneumonia. This study recommends regular chest percussion that should be applied in medicine and intensive care units. Further researches must be done to add more evidence -based practices regarding the effect of chest percussion for children with pneumonia.


2016 ◽  
Vol 50 (5) ◽  
pp. 823-830 ◽  
Author(s):  
Patrícia de Oliveira Salgado ◽  
Ludmila Christiane Rosa da Silva ◽  
Priscila Marinho Aleixo Silva ◽  
Tânia Couto Machado Chianca

Abstract OBJECTIVE To evaluate the effects of physical methods of reducing body temperature (ice pack and warm compression) in critically ill patients with fever. METHOD A randomized clinical trial involving 102 adult patients with tympanic temperature ≥ 38.3°C of an infectious focus, and randomized into three groups: Intervention I - ice pack associated with antipyretic; Intervention II - warm compress associated with antipyretic; and Control - antipyretic. Tympanic temperature was measured at 15 minute intervals for 3 hours. The effect of the interventions was evaluated through the Mann-Whitney test and Survival Analysis. "Effect size" calculation was carried out. RESULTS Patients in the intervention groups I and II presented greater reduction in body temperature. The group of patients receiving intervention I presented tympanic temperature below 38.3°C at 45 minutes of monitoring, while the value for control group was lower than 38.3°C starting at 60 minutes, and those who received intervention II had values lower than 38.3°C at 75 minutes of monitoring. CONCLUSION No statistically significant difference was found between the interventions, but with the intervention group I patients showed greater reduction in tympanic temperature compared to the other groups. Brazilian Registry of Clinical Trials: RBR-2k3kbq


2014 ◽  
Vol 16 (1) ◽  
pp. 17-28 ◽  
Author(s):  
Martin Campbell

Purpose – The purpose of this paper is to measure nurses’ knowledge about Adult Support and Protection (Scotland) Act 2007 before and after a one-day training course using participants’ favoured methods of training activities. Design/methodology/approach – A repeated measures design was used to evaluate the impact of a one-day Adult Support and Protection training on pre-training knowledge of community nurses across one NHS area. Participants’ favoured methods of training activities were used in the training. Participants were community nurses working in learning disability, mental health, older people's services, acute services, substance misuse, and accident and emergency. All completed a training needs analysis and training preferences study. Individual and group scores on an Adult Support and Protection knowledge questionnaire were analysed pre- and post-training. Findings – There was a statistically significant increase in scores post-training (Wilcoxon's signed-ranks test). Individual increases ranged from 2.5 to 27.5 per cent, with a mean score of 15 per cent. Evaluation of the impact of nationally approved Adult Support and Protection training is needed and training should take account of participants’ existing knowledge and preferred methods of training delivery to improve the transfer of learning into practice. Research limitations/implications – Participants were self-selecting. Existing knowledge was not controlled for in the sample. No longitudinal follow up to measure retention of any improvements in knowledge. No control group. Training methods used were based on the expressed preferences of 40 nursing staff, but only 18 of these staff participated in the training day. Originality/value – There is a dearth of research in evaluating the impact of the adult protection training on staff knowledge and understanding. Designing training activities and content to take account of participant preferences, and areas where knowledge is weakest may enhance the effectiveness of training in this area. This research was funded as a Queens Nursing Institute Community Project. It builds on a pilot project


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