ABSTRACT
Long-term care of the elderly and the disabled rests on a vast network of informal caregivers. This qualitative study examined the effects of caregiving on the health and wellbeing of a small, non-representative sample of urban women caregivers. These 11 informants participated in two interviews. Health was conceptualized in a holistic manner, consistent with the view of the World Health Organization and Health Canada. The caregiving experience, as described in this study, was life changing and consuming. Analysis revealed that the domain of caregiving could be captured by three dominant themes: loss and grieving; adapting and coping; and the short- and long-term impact. The consistency in the findings and policy recommendations of studies of informal caregiving begs the question: when will caregivers finally be heard?
Subject(s)
Adaptation, Psychological , Caregivers/psychology , Grief , Home Nursing/psychology , Social Support , Adult , Aged , Anecdotes as Topic , Canada , Female , Health Status , Home Nursing/economics , Home Nursing/methods , Humans , Interpersonal Relations , Middle Aged , Spirituality , Stress, Psychological , Surveys and Questionnaires , Time FactorsABSTRACT
The principles and philosophy of palliative care can be implemented successfully in secure forensic environments. While incarcerated, many inmates will suffer from a variety of life-limiting illnesses requiring palliative care. There are a number of resources available for the development and implementation of programs within secure forensic environments.
Subject(s)
Forensic Psychiatry , Palliative Care/organization & administration , Prisoners , Prisons/organization & administration , Psychiatric Nursing , England , Forensic Psychiatry/methods , Health Services Accessibility , Humans , Psychiatric Nursing/methods , Security MeasuresABSTRACT
Anxiety is an important component of children's pain and is routinely assessed in pain research. Two forms of the State-Trait Anxiety Inventory have been used frequently by researchers investigating children's pain and state anxiety (form C-1 and Y-1). We were unable to find psychometric information about this tool when used with a population of hospitalized children. Therefore, we undertook to assess reliability and validity, and identify problem items using data from 881 hospitalized children (aged 5-18 years) whom we had tested. Considering results of all analyses together, we concluded that the tools lack validity and reliability, and contain many problem items that are in need of revision.
Subject(s)
Adaptation, Psychological , Anxiety/diagnosis , Child, Hospitalized/psychology , Adolescent , Child , Child, Preschool , Diagnostic Techniques and Procedures/psychology , Evaluation Studies as Topic , Female , Humans , Male , Psychological Tests , Therapeutics/psychologyABSTRACT
Early childhood experiences with painful injections may lead to anxiety and fear. These reactions need not develop if steps are taken to reduce the pain associated with injections. The purpose of this study was to assess the efficacy of a refrigerant topical anesthetic in reducing injection pain in preschool children experiencing routine diphtheria-pertussis-tetanus (DPT) immunizations. This double-blind placebo-controlled study was conducted in community health clinics in conjunction with ongoing immunization programs. Ninety subjects, aged 4-5.5 years, were randomly assigned to one of three groups: (a) refrigerant topical anesthetic; (b) placebo topical spray; and (c) no-spray control. Pain was measured subjectively using a four-point visual analogue scale. Both the refrigerant topical anesthetic spray and the placebo spray significantly reduced injection pain. Age was found to be an important factor influencing pain response in this study. Parental anxiety was not a significant factor influencing pain response. In addition, parents were not good at predicting their child's pain. The results of the study support the use of an intervention, such as refrigerant topical anesthetic, as a practical, simple, and effective treatment strategy for reduction of short-term painful procedures like injections.
Subject(s)
Anesthetics, Local/therapeutic use , Injections/adverse effects , Pain Management , Administration, Topical , Anxiety , Child, Preschool , Diphtheria-Tetanus-Pertussis Vaccine/administration & dosage , Diphtheria-Tetanus-Pertussis Vaccine/therapeutic use , Double-Blind Method , Female , Humans , Male , Organic Chemicals , Pain/etiology , Parents/psychology , Treatment OutcomeSubject(s)
Anesthetics, Local , Lidocaine , Pain/prevention & control , Prilocaine , Punctures , Child , Drug Combinations , Humans , Lidocaine, Prilocaine Drug Combination , NeedlesSubject(s)
Curriculum , Education, Nursing, Baccalaureate/standards , Adult , Employment , Female , Humans , Male , Middle Aged , Students, NursingABSTRACT
Several aspects of venipuncture technique were evaluated to assess their relationship to reported pain. Subjects were 514 children aged 5-17 who had venipuncture performed by a technician in a hospital outpatient laboratory. A research assistant timed the duration of venipuncture and then obtained visual analogue pain scores from the children following venipuncture. Blood volume obtained from venipuncture was also measured. The technician who performed the procedure, amount of blood drawn, and time required to complete the venipuncture did not contribute to the prediction of children's pain. Age and anxiety, which were treated as covariates, were significant predictors of pain. The distribution of pain experienced by children was positively skewed and about one-third of children were above the mean pain score. From the results of this study, venipuncture pain can be recommended for the study of issues in children's pain. Further, the findings recommend the development and utilization of interventions to reduce children's venipuncture pain.
Subject(s)
Bloodletting , Pain/etiology , Psychology, Child , Adolescent , Bloodletting/methods , Bloodletting/psychology , Child , Child, Preschool , Evaluation Studies as Topic , Female , Humans , Male , Medical Laboratory Personnel , Outpatients , Pain/diagnosis , Pain Measurement , Risk FactorsABSTRACT
A cross-sectional descriptive design was utilized to explore expected, experienced and recalled pain, and anxiety. Subjects were 138 children (5-17 yr) who were attending an outpatient laboratory for venipuncture. They reported state anxiety and expected visual analogue scale pain prior to having venipuncture. Following venipuncture, they reported sensory and affective pain. Two months afterward, subjects were contacted and asked to recall sensory and affective pain from the venipuncture. Analysis of data determined that children's recall of pain was quite good although better for affective pain than sensory pain. Prediction accuracy for pain was not good. From analysis it was determined that overestimation of pain was related to anxiety but not to greater experienced pain. Four patterns of responses were identified when prediction and recall accuracy were further examined. These patterns were designated as realism, irrelevance, over-reaction and denial. It was suggested that these patterns of response may provide clues about avoidance and coping behavior for children's pain. In general, the results of this study did not support previous research. It was demonstrated that various statistical techniques which have been employed in research on this topic have influenced the interpretation of pain prediction and recall data.
Subject(s)
Bloodletting/psychology , Mental Recall , Pain/psychology , Set, Psychology , Adolescent , Child , Child, Preschool , Cross-Sectional Studies , Female , Humans , Male , Pain MeasurementABSTRACT
Examined venipuncture pain and anxiety among 90 male and 90 female children and adolescents (5 to 17 years) who were attending a hospital laboratory. The purpose of the study was to assess sex differences in pain. Ss reported state anxiety and expected pain prior to having venipuncture and sensory and affective pain following venipuncture. Analysis of data determined that male and female were alike regarding age, state anxiety, expected pain, and perceived sensory and affective venipuncture pain. From analysis of pain estimation errors, it was found that males were significantly more likely to underestimate pain and females were significantly more likely to overestimate pain. These findings were discussed in terms of implications for coping research and for clinical practice.
Subject(s)
Anxiety/psychology , Bloodletting/psychology , Gender Identity , Pain Measurement , Adolescent , Arousal , Child , Child, Preschool , Female , Humans , Male , Personality DevelopmentABSTRACT
A cross-sectional study of venipuncture pain and anxiety was conducted with 180 consecutively referred children and their parents. Analysis indicated that younger children report more venipuncture pain than older children. Anxiety was related to both age and pain. As well, anxiety was lowest among children with no previous venipuncture experience and among those with the greatest experience.
Subject(s)
Child Development , Pain/psychology , Sick Role , Adolescent , Bloodletting/psychology , Child , Child, Preschool , Cross-Sectional Studies , Female , Humans , Male , Pain Measurement , Sensory ThresholdsSubject(s)
Gender Identity , Pain/psychology , Adolescent , Adult , Aged , Aged, 80 and over , Child, Preschool , Female , Humans , Male , Middle Aged , Pain/epidemiology , Pain/nursing , Pain Measurement , Sex FactorsABSTRACT
Studies have shown that women report more pain than men when pain is induced in the laboratory. As sex differences in perceived pain have not been established with clinical or endogenous pain, research was undertaken to compare reported pain of males and females arising from one of three sources. Two groups of adults and one group of children were studied. Analysis indicated no sex differences in reported clinical or endogenous pain for children or adults.
