Nasal Tube Securement: Randomized Controlled Trial in Pediatric Hospitalized Patients.

PURPOSE: The aim of this study was to compare accidental dislodgement rates of nasal gastric tubes secured with standard methods or a nasal tube securement device in pediatric patients. DESIGN: A randomized controlled trial was conducted. METHODS: Participants ( n = 43) were randomized into standard securement or nasal tube securement device using block randomization to control for age and diagnosis. Surveys were collected from staff and caregivers on device ease of use and satisfaction. RESULTS: There were a similar number of tube dislodgements for patients in the nasal tube securement device group ( n = 6) and the standard practice group ( n = 7). The median hospital length of stay was higher for the standard practice group (13 days vs. 9 days). CONCLUSION: Use of the nasal tube securement device did not significantly decrease the rate of tube dislodgements compared with standard practice. CLINICAL RELEVANCE TO REHABILITATION NURSING: The study provides information for pediatric rehabilitation nurses in choosing securement options for nasal gastric tubes.

Comparison of Attachments in Real-World and Virtual-World Relationships.

OBJECTIVE: The burgeoning of online social networks raises questions about the quality and value of these interpersonal relationships. The present study employed an established measure of attachment security to compare the nature of individuals' attachments in virtual-world relationships with those in real-world relationships and also examined the relative strength of attachments in the two types of relationships. METHOD: Participants were 125 volunteers recruited online who had established relationships in Second Life, a popular virtual world. Participants consented and completed all measures anonymously online. RESULTS: The findings indicate that equally strong attachments are formed in virtual- and real-world relationships; there is modest correspondence in the quality of attachment in the two types of relationship; the strength of attachments in the virtual world is influenced by capacity to immerse oneself in fantasy; duration of the relationship is correlated with strength of attachment in both worlds; and emotional well-being relates to strength of attachment in real-world relationships and lower attachment anxiety in virtual-world relationships. CONCLUSIONS: The value of attachment relationships in virtual worlds calls for further investigation. Moreover, consistent with the growing employment of telemedicine, the potential for clinical interventions in virtual worlds merits consideration.

Avatar therapy: where technology, symbols, culture, and connection collide.

The topic of "e-therapy" is of great research and clinical interest in 2012. This article presents a case study that examines several elements of psychotherapy, as administered in the "Second Life" virtual environment. In this case, psychotherapy took place primarily via text messaging between two avatars (client and therapist) who "sat" in a virtual office. The therapist resided in the United States and provided therapy to an individual from a developing nation who was currently residing in another more developed Middle Eastern country for work and to escape political atrocities being committed in his home country. This case example raises many issues that could be explored, including the ethics of providing such therapy, cultural competence, technological details, and providing therapy across national lines. However, due to the complicated and multifaceted nature of providing therapy in a virtual environment, this case presentation focuses on technical issues, such as the basics of providing therapy in Second Life. Given that the patient in this case used multiple avatars (cartoon-like representations of himself) in therapy, the topic of the avatar as the expression of internal representations and conflicts is also examined. This case report also discusses the patient's presenting problems and elements of the therapeutic alliance such as transference and countertransference. Finally, suggestions for future research are made. The author posits that mental health professionals can now reach at-risk patients (e.g., refugees residing in other countries) whom they were not previously able to treat and suggests that mental health practitioners may have an ethical duty to research and provide these kinds of services so that certain underserved populations may be treated. (Journal of Psychiatric Practice 2012;18:451-459).