In this case study, we investigated the efficacy of mirror therapy and online counseling in the management of phantom limb pain. The patient was a 28-year-old woman who experienced phantom limb pain after a traumatic transhumeral amputation three and a half months before initiating therapy. After a 40-minute educational session with a nurse researcher experienced in pain management and surgical nursing, the patient practiced mirror therapy at home for four weeks and kept in contact with the nurse using a mobile chat application. The patient scored the intensity of her pain before and after each practice session on a 0-to-10 numeric pain scale. The first week was difficult for her because of tiredness and the pain. In the second week she experienced less pain during the day than at night but claimed to feel much better than before. In the fourth week, she reported having difficulty sleeping, but she stated that her pain had decreased. The intensity of the pain didn't change following mirror therapy in the first week; however, her average pain score was 1.15 points lower after mirror therapy in the second week (from 4.57 to 3.42), and 1.57 points lower in the third and fourth weeks (from 5.42 to 3.85 and 4.85 to 3.28). Online counseling for mirror therapy is easy, economical, and time-saving for patient and nurse alike. However, physical and physiological problems experienced during this process may reduce the effectiveness of the therapy, highlighting the importance of a multidisciplinary approach to phantom limb pain management, which may include care from a psychologist, massage therapist, physiotherapist, and specialist in alternative therapies for relaxation, in addition to the surgeon and the nurse.
Aim The respiratory tract is the main transmission way of the SARS-CoV-2 virus and nurses who care for COVID-19 patients in intensive care units (ICUs) are required to constantly use personal protective equipment (PPE) during their daily work. This study aimed to examine the PPE-related skin changes experienced by the nurses working in pandemic ICU during the COVID-19 pandemic. Methods Using a descriptive phenomenological approach, semi-structured interviews were conducted between November 1st and December 25th, 2020, in the pandemic ICU of a training and research hospital in Usak, Turkey. The nurses who worked in the pandemic ICU for at least one week and experienced skin changes due to PPE use were included. Individual interviews were carried out online through video conferencing. Colaizzi's method was used in data analysis by using the ATLAS.ti 8.0. Results The main themes were main causes of PPE-related skin changes, its location along with secondary adverse effects, symptomatology, prevention, and therapeutic interventions used for curing PPE-related skin changes. Nurses mostly reported PPE-related skin changes behind their ears, over their nose, cheeks and jaw due to wearing N95 masks and on the forehead due to wearing face shields. Wearing PPE at least 2 hours, the type/quality of PPE, and being dehydrated were identified as the common causes. Conclusion This study provides a deeper understanding into the PPE-related skin change experiences of pandemic ICU nurses and the importance of the quality of the PPE used. It is recommended to enable shortened working shifts and ergonomic PPE materials for ICU nurses.
SummaryObjectives: In the last two decades, mirror therapy has become a frequently used method of managing phantom limb pain (PLP). However, the role of nurses in mirror therapy has not yet been well defined. This study examined the effect of mirror therapy on the management of PLP, and discusses the importance of mirror therapy in the nursing care of amputee patients. Methods: This quasi-experimental study was conducted in the pain management department of a university hospital and a prosthesis clinic in İstanbul, Turkey, with 15 amputee patients who had PLP. Forty minutes of practical mirror therapy training was given to the patients and they were asked to practice at home for 4 weeks. Patients were asked to record the severity of their PLP before and after the therapy each day using 0-10 Numeric Pain Intensity Scale. Results: Mirror therapy practiced for 4 weeks provided a significant decrease in severity of PLP. There was no significant relationship between the effect of mirror therapy and demographic, amputation or PLP-related characteristics. Patients who were not using prosthesis had greater benefit from mirror therapy. Conclusion: Mirror therapy can be used as an adjunct to medical and surgical treatment of PLP. It is a method that patients can practice independently, enhancing self-control over phantom pain. As mirror therapy is a safe, economical, and easy-to-use treatment method, it should be considered in the nursing care plan for patients with PLP.
ÖZETÇocuklarda cerrahi süreç, kendileri ve aileleri için genelde hoş olmayan ve zor deneyimleri içermektedir. Bu süreçteki çocuk, anksiyete ve stresi oldukça yoğun yaşar. Diğer taraftan çocuk hastalar, ameliyat sürecine doğrudan etki eden oldukça karmaşık konuma sahiptir. Çünkü çocuk hastanın bakımı sadece rutin cerrahi bakım prosedürünü ve ameliyathanedeki hasta bakımını içermez. Bunların yanı sıra, çocuk hava yolunu, anatomi ve fizyolojisini, çocuk gelişimini bilmeyi, çocuk ile ailenin bakımını üstlenebilmeyi gerektirir. Bu derleme, cerrahide çocuk hastalara ilişkin göz önünde bulundurulması gereken farklılıkları ve ameliyat süresince dikkate alınması gereken bakımları sunmak amacıyla hazırlanmıştır. (Gün cel Pe di at ri 2013; 11: 128-33) Anah tar ke li me ler: Cerrahi, çocuk, perioperatif bakım SUM MARYA child's surgical period usually contains unpleasant and difficult experiences, for the child and the parents. The child in this period experiences greater anxiety and distress. On the other hand, pediatric patients have complex states that directly effects their perioperative care during. Because their perioperative care includes not only the knowledge of general surgical procedure and care of a patient in the operating room. It also includes the specific understanding of a child's airway, anatomy and physiology, the understanding of child development and care of the child and family. This review is prepared to present these differences of the pediatric surgical patients and the care during their perioperative period. (Jo ur nal of Cur rent Pe di at rics 2013; 11: 128-33)
IntroductionSeveral studies have shown that physical activity (PA) levels and sedentary behaviour (SB) are independent risk factors for many health-related issues. However, there is scarce evidence supporting the relationship between SB and urinary incontinence (UI) in community-dwelling older adults, and no information on any possible association in institutionalised older adults. Stage I of this project has the main objective of determining the prevalence of UI and its associated factors in nursing home (NH) residents, as well as analysing the association between UI (and its types) and SB. Stage II aims to investigate the incidence and predictive factors of functional and continence decline, falls, hospitalisations, mortality and the impact of the COVID-19 pandemic among NH residents.Methods and analysisStage I is an observational, multicentre, cross-sectional study with mixed methodology that aims to explore the current status of several health-related outcomes in NH residents of Osona (Barcelona, Spain). The prevalence ratio will be used as an association measure and multivariate analysis will be undertaken using Poisson regression with robust variance. Stage II is a 2-year longitudinal study that aims to analyse functional and continence decline, incidence of falls, hospitalisations, mortality and the impact of the COVID-19 pandemic on these outcomes. A survival analysis using the actuarial method for functional decline and continence, evaluated every 6 months, and the Kaplan-Meier method for falls, hospitalisations and deaths, and Cox regression for multivariate analysis will be undertaken.Ethics and disseminationThe study received the following approvals: University of Vic - Central University of Catalonia Ethics and Research Committee (92/2019 and 109/2020), Clinical Research Ethics Committee of the Osona Foundation for Health Research and Education (FORES) (code 2020118/PR249). Study results will be disseminated at conferences, meetings and through peer-reviewed journals.Trial registration numberNCT04297904.
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