ABSTRACT
BACKGROUND: Pain management of vaso-occlusive crises is a fundamental priority in the lifelong care of children and adolescents with sickle cell disease. AIM: This study examined nurses' attitudes towards caring for children with sickle cell disease (SCD) and SCD pain management in those with vaso-occlusive pain. METHOD: A structured, self-reporting survey was provided to a convenience sample of 298 nurses across 10 hospitals serving Jordan's northern and middle regions. Descriptive and inferential statistics were applied for data analysis. RESULTS: Most nurses (77%) perceived their experience caring for children with SCD as positive. Many nurses (65%) felt frustrated about caring for these children during painful episodes. Participants identified workload and inadequate time as limiting their ability to address the analgesic needs of children with SCD. Receiving structured education specialized in pain management and more years of experience in nursing significantly predicted less hesitancy in administering opioid-based analgesia. CONCLUSIONS: The results of this study provided further insight into factors that potentially contribute to vaso-occlusive pain crises frequently being poorly managed and inadequately addressed among pediatric patients. Nurses' attitudes and understanding of SCD pain management must be addressed to advance the clinical practice of managing pain in children with SCD.
Subject(s)
Analgesia , Anemia, Sickle Cell , Nurses , Adolescent , Humans , Child , Cross-Sectional Studies , Jordan , Analgesics/therapeutic use , Pain/drug therapy , Pain/etiology , Anemia, Sickle Cell/complications , Anemia, Sickle Cell/drug therapyABSTRACT
OBJECTIVES: To obtain feasibility data on a self-management program to improve adherence with positive airway pressure (PAP) in individuals with newly diagnosed obstructive sleep apnea. METHODS: A mixed-methods design assessed program effectiveness and participants' opinions on program ease-of-use. Structured interviews with the treatment group occurred one week and one month after initiation of PAP therapy. RESULTS: Participants (n = 14) completing the study demonstrated 64% adherence versus 58% of the controls. Ease of use was demonstrated. CONCLUSIONS: The PAP self-management program demonstrated ease of use and was found somewhat effective in improving PAP adherence. PRACTICE IMPLICATIONS: The book was useful in assisting participants by validating information obtained from their providers and developing an understanding of the consequences of not using PAP.
Subject(s)
Continuous Positive Airway Pressure/methods , Self-Management/methods , Sleep Apnea, Obstructive/therapy , Adult , Aged , Books , Feasibility Studies , Female , Humans , Male , Middle Aged , Patient Compliance , Treatment OutcomeABSTRACT
PURPOSE: To compare and contrast the Heise "ecological model of gender-based violence" with factors related to "intimate partner violence" (IPV) in Jordan. METHODS: Findings of empirical studies examining IPV against Jordanian women were analyzed using the Heise ecological model (1998). CONCLUSION: Factors identified in the literature were generally consistent with the ecological model. However, the literature on IPV in Jordan rarely examined the role of community-level factors in the exosystem and sociopolitical factors in the macrosystem. Consequently, little is known about how these exosystem and macrosystem factors affect IPV in Jordan. The Heise model was then adapted to reflect identified factors in the Jordanian cultural context. PRACTICAL IMPLICATION: More research aimed at uncovering barriers to identification and treatment of IPV targeting the exosystem and macrosystem is needed.
Subject(s)
Intimate Partner Violence/ethnology , Humans , Jordan/ethnologyABSTRACT
PURPOSE/OBJECTIVES: To describe common practices and shared meanings of sleep-wake disturbances in individuals with newly diagnosed non-small cell lung cancer (NSCLC) before treatment and evaluate their preexisting sleep disturbances. RESEARCH APPROACH: Open-ended interviews of patients newly diagnosed with lung cancer. SETTING: A Veterans Administration hospital and a comprehensive cancer center in the northeastern United States. PARTICIPANTS: 26 patients newly diagnosed with NSCLC who chose chemotherapy treatment. METHODOLOGIC APPROACH: Interpretive phenomenology based on Heideggarian hermeneutics. MAIN RESEARCH VARIABLES: Meaning of diagnosis on life experiences and sleep practices. FINDINGS: Participants described four related themes: (a) the diagnosis as devastating yet not surprising, (b) treatment as hope for more time, (c) keeping life normal, and (d) sleep patterns as long lived. CONCLUSIONS: Although participants did not complain about sleep difficulties, they described a history of sleep disturbances and poor sleep hygiene. Participants focused their trust on the treatment, giving them more time to follow their priorities and ignoring the effects of sleep deprivation on their quality of life. INTERPRETATION: Healthcare professionals may design interventions to encourage keeping life as normal as possible, focusing on improving sleep, which may ultimately prolong patients' lives.
