RESUMEN
Purpose. Hyaluronidase is an enzyme that temporarily liquefies the interstitial barrier, allowing easy dispersal of local anaesthetic through cleavage of tissue planes. This prospective, blinded, randomised controlled study investigates the utility of adding hyaluronidase to local anaesthetic in the setting of carpal tunnel release. Methods. 70 consecutive carpal tunnel release patients were recruited and randomised into a control group only receiving local anaesthetic and a hyaluronidase group receiving both hyaluronidase and local anaesthetic. Pain scores were rated using the visual analogue scale (VAS) by patients immediately after local anaesthetic injection and again immediately after the carpal tunnel release. Results. Preoperative VAS scores, taken after local anaesthetic injection, were greater than postoperative VAS scores. Postoperative VAS scores were significantly lower in the hyaluronidase group and tourniquet times were significantly shorter in the hyaluronidase group. Conclusion. Hyaluronidase addition to local anaesthetic in carpal tunnel release resulted in significant reductions in operative time and pain immediately after operation.
RESUMEN
OBJECTIVE: To determine the prevalence and types of complementary and alternative medications (CAMs) used by menopausal women living in South-East Queensland, Australia; and profile the women who are using CAMs through sociodemographic characteristics, self-rated health status, lifestyle and preventative health strategies. METHOD: This study was a secondary data analysis of data collected by postal questionnaire from 886 women aged 48-67 years participating in the Queensland Midlife Women's Health Study. The outcome measure was CAM use, distinguished by three categories: herbal therapies, phytoestrogens and nutritional intake (supplements and healthy eating). RESULTS: The overall prevalence of CAM use among mid-life Australian women was 82% which included therapeutic techniques (83%), nutritional supplements (66.8%), phytoestrogens (55.8%), herbal therapies (41.3%), Evening Primrose oil (34%) and vitamin E (28.8%). CAM users, when compared to non-users, were more likely to be previous (p < 0.05) but not current users (p < 0.05) of hormone therapy (HT), higher educated (p < 0.05), low to middle income earners (p < 0.001) and have participated in self-breast examination (p < 0.01). They were also more likely to report good general health (p < 0.05) and improved physical functioning without limitations due to health (p < 0.05). CAM users were less likely to be aged over 55 years (p < 0.05) and smoke more than 20 cigarettes per day (p < 0.001). CONCLUSIONS/IMPLICATIONS FOR HEALTH RESEARCH: As prevalence of current CAM use in this population group is considerably higher than HT use, health education programs to assist mid-life women to understand the scientific evidence (or lack of it) for their efficacy is recommended.
Asunto(s)
Terapias Complementarias/estadística & datos numéricos , Estado de Salud , Estilo de Vida , Menopausia , Distribución por Edad , Anciano , Australia/epidemiología , Autoexamen de Mamas/estadística & datos numéricos , Estudios Transversales , Escolaridad , Femenino , Terapia de Reemplazo de Hormonas , Humanos , Persona de Mediana Edad , Fenómenos Fisiológicos de la Nutrición , Fitoestrógenos , Prevalencia , Fumar/epidemiología , Factores Socioeconómicos , Encuestas y CuestionariosRESUMEN
Cancer pain continues to be an important focus of health research and intervention development. The continuing shift of cancer care to the community increases the family caregiver's role in pain management and highlights the need to understand family experiences and also family barriers to effective pain management. This paper presents the findings of an Australian study exploring attitudinal barriers to effective pain management amongst 75 family caregivers of people with cancer attending an outpatient clinic. Approximately 75% of the caregivers demonstrated concerns or were unsure about addiction, a belief likely to impact on the use of prescribed opioids in the home. Caregivers demonstrated similar levels of concern about side-effects or whether the presence of pain indicated disease progression. These findings support research in other populations and are further evidence of the need to include family caregivers, along with patients, in intervention studies aimed at reducing the impact of these barriers on effective pain management.
Asunto(s)
Analgésicos Opioides/uso terapéutico , Neoplasias/psicología , Dolor/prevención & control , Adulto , Anciano , Anciano de 80 o más Años , Analgésicos Opioides/efectos adversos , Actitud Frente a la Salud , Australia , Cuidadores/psicología , Tolerancia a Medicamentos , Familia/psicología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Dolor/psicología , Cuidados Paliativos/métodosRESUMEN
Significant pain continues to be reported by many hospitalized patients despite the numerous and varied educational programs developed and implemented to improve pain management. A theoretically based Peer Intervention Program was designed from a predictive model to address nurses' beliefs, attitudes, subjective norms, self-efficacy, perceived control and intentions in the management of pain with p.r.n. (as required) narcotic analgesia. The pilot study of this program utilized a quasi-experimental pre-post test design with a patient intervention, nurse and patient intervention and control conditions consisting of 24, 18 and 19 nurses, respectively. One week after the intervention, significant differences were found between the nurse and patient condition and the two other conditions in beliefs, self-efficacy, perceived control, positive trend in attitudes, subjective norms and intentions. The most positive aspects of the program were supportive interactive discussions with peers and an awareness and understanding of beliefs and attitudes and their roles in behavior.
Asunto(s)
Analgésicos Opioides/uso terapéutico , Conocimientos, Actitudes y Práctica en Salud , Personal de Enfermería en Hospital/educación , Dolor/enfermería , Enfermería Perioperatoria/normas , Adulto , Análisis de Varianza , Actitud del Personal de Salud , Femenino , Humanos , Masculino , Dolor/tratamiento farmacológico , Grupo Paritario , Enfermería Perioperatoria/educación , Poder Psicológico , Evaluación de Programas y Proyectos de Salud , AutoimagenRESUMEN
A statewide cross-sectional survey was conducted in Australia to identify the determinants of registered nurses' intention to administer opioids to patients with pain. Attitudes, subjective norms and perceived control, the key determinants of the Theory of Planned Behavior, were found to independently predict nurses' intention to administer opioids to these patients. Perceived control was the strongest predictor. Nurses reported positive overall attitudes towards opioids and their use in pain management. However, many negative attitudes were identified; for example, administering the least amount of opioid and encouraging patients to have non-opioids rather than opioids for pain relief. The findings related to specific attitudes and normative pressures provide insight into registered nurses' management of pain for hospitalized patients and the direction for educational interventions to improve registered nurses' administration of opioids for pain management.