A new tool for real-time pain assessment in experimental and clinical environments.

Pain measurement largely depends on the ability to rate personal subjective pain. Nevertheless, pain scales can be difficult to use during medical procedures. We hypothesized that pain can be expressed intuitively and in real-time by squeezing a pressure sensitive device. We developed such a device called "Painmouse(®)" and tested it on healthy volunteers and patients in two separate studies: Sixteen male participants rated different painful heat stimuli via Painmouse(®) and a Visual Analog Scale (VAS). Retest was done one week later. Participants clearly distinguished four distinct pain levels using both methods. Values from the first and second sessions were comparable. Thereafter, we tested the Painmouse(®) by asking twelve female and male leg- ulcer patients to continuously squeeze it during the whole length of their wound-dressing change. Patients rated each step of dressing change on an 11-point numeric rating scale. Painmouse(®) ratings were highest for the wound cleaning and debridement step. Application of the new dressing was not evaluated as very painful. On the other hand, numeric scale ratings did not differentiate between dressing change steps. We conclude that the Painmouse(®) enables pain assessment even under difficult clinical circumstances, such as during a medical treatment in elderly patients.

[The contibution of concept development to nursing knowledge? The example of transitoriness]. / Wissensvermehrung durch Konzeptentwicklung? Das Beispiel Vergänglichkeit.

To provide nursing practice with evidence, it is important to understand nursing phenomena in detail. Therefore, good descriptions including the identification of characteristics and attributes of nursing phenomena on various levels of abstraction, i. e., concepts, are needed. In this article the significance of concept development for nursing science will be demonstrated by drawing on the example of 'transitoriness'. The evolutionary concept analysis proposed by Rodgers (2000) is introduced in more detail. Drawing on transitoriness, the phenomenon is presented with the help of the evolutionary concept analysis by Rodgers (2000). The phenomenon's characteristics and attributes are identified, as well as potential areas of application. Moreover, areas are outlined, in which interventions for nursing practice can be developed, implemented and evaluated. Thus, nursing practice is updated to include new findings and innovation. Through concept analysis nursing phenomena can be described in more detail, enhanced or broadened for use in nursing practice. Such structured processes as concept analysis can be employed successfully for other nursing phenomena. Concept analyses can lead to the identification of tasks for the respective scientific discipline and professionals. Thus, concept analyses can lead to the concretisation of tasks in nursing.

[Skin care and skin protection in preterm babies]. / Hautpflege und Hautschutz beim unreifen Frühgeborenen. Eine systematische Literaturübersicht.

UNLABELLED: The skin of preterm infants is anatomically and physiologically premature. This quality of the skin as well as the need for intensive monitoring and treatment/care represent additional stress factors for the integrity of the babies' skin. The babies have an increased vulnerability and risk of skin injuries. Therefore, during the first two to three weeks of life observation of the premature skin is of utmost importance. Ritualistic activities have to be questioned. This is particularly true for infants who are born before 28 weeks of pregnancy. This systematic literature review investigates the effectiveness of nursing interventions in the skin care and protection of the premature infants born earlier than the 32nd week of pregnancy. A systematic literature-search in different databases addressed the following topics: Skin-assessment, selection and use of adhesives, skin care with emollients, and body cleaning (wash interval). Despite certain methodological problems with some of the studies included in this review the following results can be formulated: Based on altered infant behaviour and the skin's continuously high population of germs the interval of bathing should be enhanced to four days. During the first two to four weeks of life the application of sun flower oil is recommended. It has a disinfecting effect and is relatively cheap. Potential preventive or protective dressings of the skin are recommended. Similarly both the utilisation of a valid skin assessment instrument and of preventive measures are inevitable. CONCLUSION: Evidence-based knowledge of the needs and care of premature skin could reduce complications during the neonatal phase and therefore health care costs. The implementation of a standardised, evidence-based skin care guideline could raise the health professionals' awareness in of skin care needs in this vulnerable patient group.

[Dialogal phenomenology in the context of nursing science, a critical examination of a rather unknown research method]. / Dialogische Phänomenologie im Rahmen der Pflegewissenschaft - Eine kritische Auseinandersetzung mit einer wenig bekannten Forschungsmethode.

Dialogal Phenomenology is an interpretive research method which in the German speaking world is relatively unknown in nursing science. It is based on the core concepts of Husserlian Phenomenology. First, in this article the method of Dialogal Phenomenology is being presented. Subsequently an exercise of about one year duration is reported. In this exercise two nurse scientists and two nursing experts examined - in an exemplary application of the method - the scientific potential of this method, its practicability and its potential relevance for reflexive nursing practice. As soon as the research team realised how the method is being practised and what its potential benefit for nursing practice is it terminated the exercise. The critical examination of the research method showed that it has great epistemological potential. However, its application under the given circumstances proved challenging.

Adjustment process in Iranian women with breast cancer.

Breast cancer is a devastating event for a woman. Physical changes and psychological problems, treatment to improve the patient's condition, and increased survival rates compared with other cancers manifest the importance of quality of life in these patients. This quality of life is affected by how the patients adjust to their situation. Hence, to understand adjustment to breast cancer, this research aimed to investigate the experience from the patients' perspective and how they interact with others and interpret their experiences in adjusting to the disease. A qualitative research approach based on grounded theory was used. The data were the result of 45 interviews with patients in different phases of their illness trajectory during 1 year, 6 interviews with families, and 10 observation sessions. The main categories that emerged were perceived threat to live, religious aspects, supportive dimensions, will to recover, increase in endurance, barriers to efforts leading to health, living with the disease with tolerance, and inhibitors and facilitators of tolerance. These main categories were understood as passages to reach evolutionary peaceful coexistence. Adjustment to breast cancer has positive evolutional process, and its direction is toward better adjustment. By positive mental reconstruction, the patients feel that they can live with their disease.

Compassion in jewish, christian and secular nursing. A systematic comparison of a key concept of nursing (part I).

BACKGROUND: The topos of the Compassionate God is a dominant motive of the Jewish and Christian traditions. It is relevant for nursing because it asks the nurse to imitate God so as to become God-like. Also, to think that God suffers with the suffering believers is thought to give comfort to them. Because in the western world the topos of the Compassionate God represents the basis of the ethics of compassion/caring, this piece of basic research is important for clinical practice. This study explores to what extent Jewish and Christian nursing adhered to the biblical topos of the Compassionate God at different periods and in different cultural contexts. METHOD: A mixed methods approach was used. It included variations of hermeneutical text analysis as used in historical, philosophical, theological, science of religion, and nursing research. RESULTS: The analysis of the literary sources shows that the topos of the Compassionate God was interpreted differently in different cultural contexts. However, at all times it directed religious and secular nursing. Since the beginning of the 21(st) century it builds the core of "compassionate caring" as propagated by North American nursing science. CONCLUSIONS: The topos of the Compassionate God laid the foundation of the tradition of the ethics of compassion in nursing. More research is required to learn whether it also plays a role in Islamic nursing.

["Getting through"--a difficult nursing concept]. / "Auf die Zähne beissen": Ein schwieriger Begriff in der Pflege.

This analysis of the research literature related to the nursing concept "enduring" was carried out on the background of the demand for evidence based nursing. The aim was to test with an exemplary concept to what extent this request is feasible and meaningful, if related to a concept describing patients' subjective experience. The state of the art of research literature on enduring contains a variety of problematic aspects: conceptual, theoretical, linguistic as well as problems originating in nursing's moral tradition. These have important implications for the application of the concept in nursing practice.

Religious dimensions of suffering from and coping with cancer: a comparative study of Jewish and Christian patients.

INTRODUCTION: The major aim of this research was to study religious coping styles among Christian and Jewish patients suffering from cancer. In addition, the empirical results were compared with the Jewish and Christian traditions of suffering. SAMPLE: A total of 100 Jewish and Christian cancer patients in Switzerland and in Israel consented to being interviewed about their religious coping styles. METHODS: For the collection and analysis of data, a grounded theory approach was applied. For the comparison of the empirical data with the traditional Jewish and Christian scriptures, content analysis and hermeneutics were used. RESULTS: The analysis shows that patients of both religious used the same five coping strategies. This research demonstrates that for most patients -- though not for all -- religiousness has great potential as a resource to help them coping in positive ways with cancer. CONCLUSION: This resource should be utilized for the patients' benefit and further studied.

[Covenant or contract? A reflection on two paradigms of the nursing relationship]. / Bündnis oder Vertrag? Eine Reflexion über zwei Paradigmen der pflegenden Beziehung.

This article contains a critical reflexion about two paradigms upon which nurse-patient relationships can be based: the traditional covenant, rooting in religion and ethics and the business-orientated contract. The motive for this reflexion lies in the present economic, scientific and societal context of nursing practice, which threatens traditional nursing values. It leads to an inflation of the covenant paradigm in favour of the contract paradigm, which implies greater efficiency. Following the description of the two paradigms the way they determine nursing relationships is being compared. On the basis of this confrontation the contract as basis of the nursing relationship is discarded. Finally, questions concerning the future positioning of nursing and of nursing science in terms of the foundation and of the profile of the nurse-patient relationship are asked.