Nurses' knowledge of pain in the elderly.

The purpose of this study was to investigate nurses' knowledge of pain and pain management with respect to elderly persons. Registered nurses at several general hospitals and nursing homes were surveyed by questionnaire concerning their knowledge of pain management in the elderly. The findings indicated a significant knowledge deficit in this area. There were also significant differences in knowledge levels between general hospital nurses and those working in nursing homes. We conclude that more education about pain management in elderly patients is needed for nurses. This deficit needs to be addressed in both undergraduate nursing programs and hospital in-service courses. Presently, the majority of patients entering hospitals are aged 65 years and over. Hence, nurses in all areas of care, not just specifically those working in aged care facilities, need a sound knowledge of pain management of the elderly to facilitate compassionate and effective nursing care.

Changes in health status of elderly patients following hip replacement surgery.

This study investigated changes in health status following a total hip replacement among a convenience sample of 22 male and 23 female patients, all of whom had been suffering from hip dysfunction and associated arthritic pain and impaired mobility. Subjects were pretested in an orthopedic pre-admission clinic with the Arthritis Impact Measurement Scales questionnaire and were posttested with the same instrument 3 1/2 months after the initial contact and subsequent to hip replacement surgery. Analysis of pretest and posttest mean differences showed significant improvement in scores for pain and physical activity. No significant changes were demonstrated in the psychological and social domains of health status.

Nurses' perceptions of the value of nursing research for practice.

Nurses' perceptions of whether nursing research is a valuable guide for clinical practice were investigated by a questionnaire survey. The non-random sample of 410 medical-surgical and psychiatric nurses working in hospitals and community mental health centres were also asked whether they applied research findings to their practice, and whether they participated in research and read nursing research journals. The study found that most nurses believed that nursing research is important for advancing clinical care but few applied research findings to their practice, participated in research or regularly read research journals. There were no significant differences in the value attributed to research by nurses from different educational backgrounds or different clinical settings. In the respondents' opinion, their education in nursing research was well covered in 16% of basic hospital courses and 56% of tertiary courses.

Relaxation and the relief of cancer pain.

Progressive muscle relaxation combined with guided imagery has the potential to promote relief of cancer pain. The techniques appear to produce a relaxation response that may break the pain-muscle-tension-anxiety cycle and facilitate pain relief through a calming effect. The techniques can be taught by nurses and readily learned by patients. The techniques provide a self-care strategy that, to a limited extent, shifts the locus of control from clinician to patient.

Coping strategies of caregivers of family members with dementia.

Data derived from a national sample of 89 caregivers of non-institutionalized family members with dementia were examined in order to identify the specific coping strategies caregivers utilized and whether the identified strategies were associated with negative or positive outcomes. Results from this study indicated that caregivers predominantly used problem-focused strategies. Further analysis demonstrated that employing more positive coping strategies did not necessarily result in a reduced sense of burden.

The use of relaxation for the promotion of comfort and pain relief in persons with advanced cancer.

The efficacy of a relaxation technique involving deep breathing, muscle relaxation, and imagery was tested as a nursing intervention for the promotion of comfort and pain relief in hospitalized oncology patients. The intervention was implemented in accordance with Orem's self-care approach to nursing practice. Sixty-seven new admissions to an oncology ward were randomly assigned to receive relaxation training by audio tapes, live relaxation training by nurses, or no relaxation training. Relaxation training was conducted twice weekly over a period of three weeks. All subjects were pretested and post-tested with the McGill Pain Questionnaire and Visual Analogue Scale for pain. Analgesic medication was monitored throughout the study. Data analysis showed significant reductions in subjective pain ratings by subjects receiving relaxation training. There was also a significant reduction in non-opiate p.r.n. analgesic intake which suggested a reduced incidence of breakthrough pain.

Toxic shock associated with tampon usage.

A case of a 30-year-old woman who developed fever, diarrhoea and vomiting during the third and fourth days of menstruation, during which she was using tampons, is presented. The patient was admitted to hospital on the fifth day in shock , semicomatose, and with a generalized erythroderma. A presumptive diagnosis of toxic shock syndrome was made. Aggressive resuscitative and antibiotic therapy achieved a favourable outcome. An unused tampon from the same packet grew a Staphylococcus aureus of the same antibiogram and phage type as that isolated from the vaginal culture.

Ureteric stone. When do we need to intervene?

This paper reports the experience of one urologist reviewing a series of 210 patients with ureteric stone over a 12-year period. The study suggests that with care and patience, more than three quarters of these calculi will pass without surgical intervention. The importance of stone size and site as giving the best prognosis of expected outcome is demonstrated, and it is suggested that the classical indications for operation should be reviewed.