ABSTRACT
BACKGROUND: The Glasgow Coma Scale (GCS) is one of the methods that has validity for evaluating the consciousness levels of patients in the literature and is accepted by health authorities. AIM: The purpose of this study was to evaluate the inter-rater reliability of GCS in intensive care patients receiving palliative care. STUDY DESIGN: A prospective cross sectional observational study. The study was conducted in a general intensive care unit with 20 beds with patients receiving palliative care. In the unit, 18 nurses worked in two shifts, day and night. Each patient's primary palliative care nurse and two additional researchers were given one minute to independently record the patient's GCS total and subscale scores. All observations were completed within 5 min as there could be significant changes in the patient's GCS score during observations. RESULTS: A total of 258 assessments were completed. For the GCS total scoring, a moderate agreement was found between palliative care nurses and the first researcher-observer (49.0%) and also between palliative care nurses and the second researcher-observer (47.7%). In addition, there was a substantial agreement between the first and second researchers (78.9%) and also between all observers (61.5%) (all p = .001). CONCLUSIONS: Although there was a near-perfect agreement between the two researcher-observers, we found only moderate agreement among all observers (palliative care nurses and two researcher-observers) in the evaluation of GCS total and subscale scores. RELEVANCE TO CLINICAL PRACTICE: We found that lack of knowledge and training on the standardized use of GCS is still a problem for palliative and intensive care units. Because of the diversity of patients requiring GCS assessment in palliative care units, refresher training programs and hands-on workshops on consciousness assessment should be organized regularly for more experienced nurses.
ABSTRACT
PURPOSE: To evaluate the effect of occupational therapy on anxiety, depression, and psychological well-being in older adults. METHODS: This study is a single-blind, randomized-controlled prospective experimental study conducted with 84 older adult individuals, 41 in the intervention group and 43 in the control group, in a nursing home. Occupational therapy was applied to the patients in the intervention group, and all patients were followed for a week. In the study, data were collected using the Participant Information Form, Geriatric Anxiety Scale, Psychological Well-Being Scale, and Geriatric Depression Scale. RESULTS: The mean age of the participants was 68 years in the intervention group and 70 years in the control group. While 65.9% of the participants in the experimental group were male, 65.1% of the control group was male. The post-test anxiety scores of the participants were lower in the intervention group than in the control group (7.0 ± 4.2 vs. 16.7 ± 10.9) (p < 0.001). The post-test psychological well-being scores of the participants were higher in the intervention group than in the control group (47.9 ± 6.8 vs. 38.4 ± 6.5) (p < 0.001). There was no statistically significant difference between the depression scores of the intervention group and the control group (6.9 ± 3.7 vs. 6.2 ± 5.4) (p = 0.468). CONCLUSIONS: In this study, it was determined that after occupational therapy was applied to older adults, their anxiety decreased and their psychological well-being increased, while there was no statistically significant difference in their depression levels. Occupational therapy, with a focus on decreasing anxiety, is a potential approach that can improve older adults' health, psychological well-being, and coping skills. GOV ID: NCT05576558.
