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Biomedical subjects

S Warden

Publications and source records attributed to S Warden.

12 recordsLinked to original sources

Nurses' clinical decision-making regarding the management of pain.

Effective pain management remains an elusive goal within the profession of nursing. While considerable improvement has occurred, patients continue to experience inappropriate levels of pain. To date, research has focused on objective factors that influence pain management. Few studies have examined attitudinal factors that may influence nurses' decision-making. This quasi-experiment was based on preliminary data showing that nurses' preconceived notions regarding certain patient groups influenced their management of pain. An intervention was tested for its' effect on nurses' preconceived notions regarding specific patient groups. A significant difference in a positive direction was found. Nurses were more willing to spend time and energy managing pain across all patient groups following the intervention.

Adult↗

Nurses' clinical decision-making regarding the management of pain.

Effective pain management remains an elusive goal within the profession of nursing. While considerable improvement has occurred, patients continue to experience inappropriate levels of pain. To date, research has focused on objective factors that influence pain management. Few studies have examined attitudinal factors that may influence nurses' decision-making. This quasi-experiment was based on preliminary data showing that nurses' preconceived notions regarding certain patient groups influenced their management of pain. An intervention was tested for its' effect on nurses' preconceived notions regarding specific patient groups. A significant difference in a positive direction was found. Nurses were more willing to spend time and energy managing pain across all patient groups following the intervention.

Adult↗

Barriers to change: a pain management project.

Although considerable effort has been directed toward improving the management of acute pain, ineffective pain management practices remain in many institutions across this country. While educational efforts have increased health care providers' knowledge regarding the management of pain, a concomitant change in practice has not occurred. This project was designed to examine barriers to the effective management of pain encountered in acute care settings. A repeated case study of attempts to change was conducted in six institutions located in the southeastern United States. Results identified seven major barriers to pain management: lack of knowledge, non-facilitative attitudes, inconsistent leadership, poor working relationships, cultural and religious biases, physicians' fears of legal repercussions and a lack of resources.

Acute Disease↗

Elderly hospice patients' perspective on pain management.

The literature reports that 70% of cancer patients with advanced disease experience pain. Even with increased emphasis on research and education, problems with effective pain management are still evident. Hospice patients' knowledge and attitudes about pain may contribute to this complex problem. To gain an understanding of hospice patients' perspective on the management of pain, 57 hospice patients were asked to describe their knowledge of pain management and their attitudes toward controlling pain. Results showed non-facilitative attitudes and gaps in knowledge that may contribute to ineffective pain management among hospice patients.

Aged↗

Sexual abuse of adults with learning disabilities.

This paper reports a clinical study of reported or disclosed sexual abuse of adults with learning disabilities. The findings support the results of a recent survey [V. Turk & H. Brown (1993) Sexual abuse of adults with learning disabilities: results of a two-year incidence survey. Mental Handicap Research 6, 193-216] but some differences were found, particularly with regard to sex of the survivors. The study also illustrates more than previous studies a link between sexual abuse and sexualized and inappropriate sexual behaviour and other challenging behaviours in men with learning disabilities.

Adolescent↗

Nursing knowledge: acute postoperative pain management in the elderly.

1. The inadequate management of acute postoperative pain among adults is well documented. Studies have shown that 75% or more of hospitalized adult patients following surgery suffer moderate or intense pain even with the use of analgesics. Also, physicians under-prescribe narcotic analgesics and nurses administer less than the patient could receive. 2. Nurses' ineffective approaches to the management of pain have been attributed to inappropriate fears of addiction and respiratory depression, rigid attitudes regarding what constitutes adequate pain relief, and misunderstandings about the physiologic and psychologic components of pain. 3. The results of this study support McCaffery's (1989) finding that nurses do not understand the effective use of narcotics in relation to pain management.

Adult↗

Quality assurance: is it professional insurance?

Quality assurance (QA) is being hailed as a 'new frontier' of nursing. Its diffusion into nursing theory and practice in the United Kingdom is outlined. QA is not an alien import; favourable preconditions already existed. The systems-reasoning of the nursing process, which sprawned a plethora of models, each geared to the 'orderly' progression of stages, objectives and process, is resonant with the values and measurement techniques of QA. A major limitation of QA is that it downplays the organizational complexity of hospitals. Although QA is projected as being in the service of clients, its major impetus is concerned with professional self-defence, as regards other professions, the state and litigious clients. Further, QA enlisted by nursing strongly reproduces the ethos and logic of the dominant medical model; patients are 'objectified' as the technical products of production. The 'medical gaze' is now being joined with the 'nursing gaze'.

Consumer Behavior↗

Bilateral testicular rupture: report of a case with an unusual presentation.

A case of bilateral testicular rupture after blunt trauma is presented. It is unusual in that the patient presented with a unilateral retractile testis with pain. The contralateral testis was asymptomatic but was found to be ruptured at exploration. The objectives of preservation of testicular function and prevention of misdiagnosis and undiagnosed cases are reiterated. Early exploration of all blunt trauma to the scrotum and testis is advocated. The surgical management of the ruptured testis is reviewed with regard to orchiectomy, primary closure, closure with portion of tunica vaginalis and decompression of the contused testis.

Adult↗

The effect of a mock trial on nursing students' ability to make clinically sound legal judgments.

In an attempt to enhance nursing students' abilities to make legally sound clinical judgments, a mock trial experience was developed and evaluated. Using a quasi-experimental design, students' learning was assessed using scenarios derived from actual cases involving nurses. Satisfaction with a traditional learning approach was compared to learning through attendance at a mock trial. A significant difference was found in learning before and after the trial (t = 2.26, P < 0.05), and students preferred the mock trial experience to traditional classroom presentations.

Clinical Competence↗

Elderly people's knowledge of and attitudes to pain management.

Pain is a frequent complaint of elderly people in hospitals and in the community, yet it is often not managed effectively. Barriers to effective management have included fear of narcotic addiction, inadequate assessment of pain, and attitudes of health professionals. Attempts have been made to improve the knowledge and attitudes of health-care professionals. This study examined the attitudes and knowledge of acute pain and pain management among well elderly people in rural and urban settings in the southeastern USA in order to identify possible barriers to effective pain management. Questionnaires on knowledge and attitudes towards pain and pain management were given to 62 rural and 63 urban well elderly people aged 65 years and older. Findings demonstrate a lack of knowledge as well as the presence of non-facilitative attitudes about pain and pain management.

Acute Disease↗