Newshan & Schuller-Civitella (2003) demonstrated that TT is safe and effective to be implemented on hospitalized patients. A large-scale study was conducted during 1998 and 2000 on 605 patients who received TT at St. John’s Riverside Hospital. Qualitative data revealed that 48% patients (n=259) with pain experienced the reduced pain suffering; 48% patients (n=254) were found to have physiological response relating to relaxation; 90%(n=83) patients found TT very helpful or helpful by using Patient satisfactory survey. Only 12% (n=605) patients reported no change; in addition, 20% fell into sleep during sessions. However, the lack of predominated time for TT treatment and a compare group; the self-admitted questionnaire and the convenience sample at the single holistic department cannot be generalized to a particular disease.
Busch et. al.,(2012) undertook a randomized two-group study to examine the effects of therapeutic touch (TT) on burn patients’ index of anxiety, pain, salivary cortisol and pain medication under a non-academic setting. A final number of 19 patients received TT (N=8) and nursing presence (N=11), data measured on day1, 2, 5 and 10 after administration, revealing that the anxiety of pain in TT-group was lower on day 10 and they received less morphine than NP-group on day1 and 2 but not statistically significant. However, the higher cortisol level occurred in TT group before changing dressing on day2, suggesting the higher anxiety level instead of pain as explained by author. Limitations of this study including the high attribute rate, the lack of control group and the incomplete datasets would weaken the power of this study. Their qualitative data from the random interview with 6 nurses showed that combining nur...
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...54 participants were randomly allocated to TT intervention group, nursing companion group and standard group. TT was given on 7 consecutive days for 20 minutes each day. Due to the high withdraw rate, finally 42 women completed study and only 16 received the consecutive 7-days treatments. Statistically difference was shown in TT group of lower anxiety level compared to presence and standard care group (p=0.27) on the first three days’ intervention; there was no significant difference referring to mean symptom score, regardless of subjective data from participants reported better sleep after treatment. Author hypnotized that the short period treatment and the insufficient measurement would result in the non-significant change of symptom relief. Further, high dropout rate, the inability to blind participants, small sample size undermined the reliability of this study.
In this essay, the author
- Explains that newshan & schuller-civitella (2003) demonstrated that tt is safe and effective to be implemented on hospitalized patients.
- Explains that busch et. al. conducted a randomized two-group study to examine the effects of therapeutic touch on burn patients' index of anxiety, pain, salivary cortisol and pain medication. the high attribute rate, lack of control group and incomplete datasets would weaken the power of this study.
- Explains that hawranik et.al. used a randomized three-group experimental trial to examine tt's effectiveness in decreasing disruptive behaviors among cognitively impaired older patients with dementia.
- Describes a quasi-experimental study that explored the effects of tt on anxiety level, vital signs and cardiac dysrhythmia among women experiencing cardiac catheterization.
- Explains that a double-blind rct examined the physiologic effects of tt on the level of hemoglobin and hematocrit level among healthy students with anemia.
- Explains that tt may be of value as an adjunctive measure in lowering anxiety level and reducing withdrew symptoms for chemical dependency among pregnant inpatients.
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- painexplanatory essayIn addition, to keep a patient comfortable, pain control promotes recovery and may reduce risk of developing certain complications after surgery. Through the use of guided imagery and other pain management strategies, the patients can achieve better pain control and improved functioning and will enjoy a better quality of life (Dobson & Byrne, 2014). Also, the inability to escape from pain may create a sense of helplessness and even hopelessness, which may predispose the patient to a more chronic depression. According to Wells, Pasero, and McCarffery (2008), around the clock dosing is recommended during this early post-surgical period to prevent severe pain and control continuous pain.
In this essay, the author
- Describes how toby-finn, a 21-year-old college student, was presented to the emergency department with severe abdominal pain. he was diagnosed with ischemic necrosis of small bowel.
- Explains that nurse molly, who is continuing the care in the medical surgical unit, noted that toby-finn and his brother, toto are anxious. she initiated a therapeutic communication, and encouraged both the patient and the brother to verbalize their feelings and concerns.
- Explains that pain is a complex and subjective phenomenon that involves biological, psychological, social, and cultural factors. each individual responds differently to pain because everyone has different pain thresholds and tolerances.
- Explains that the distinction between acute and chronic pain relies on a single continuum of time with some interval. acute pain is defined as pain of recent onset and probable limited duration.
- Explains that chronic pain is occurring when pain signals keep firing in the nervous system for weeks, months, and even years. it is sustained by factors that are both pathological and physically remote from the originating cause.
- Explains how pain receptors are activated by noxious insults to peripheral tissues, such as skin, dental pulp, meninges, and internal organs. the thalamus organizes the information and sends it to the sensory cortex.
- Explains that since pain is a subjective experience, there is no test that can measure and locate pain with precision. however, nurses can work with the patient to identify the cause and symptoms of the pain.
- Explains that the acute phase response includes numerous protein changes, including increases in the complement system, fibrinogen, serum amyloid, and acute phases. these complex changes are induced by inflammation-associated cytokines.
- Explains that doctors prescribe opioids or narcotic medications such as morphine, dilaudid, vicodin, or percocet after surgery. opioids are powerful medications that can help manage pain.
- Explains that to overcome the pain after surgery does not mean taking more prescription pain medication. other ways to relieve pain include relaxation and guided imaginary. cognitive behavioral therapies have shown promise in changing pain perception and coping patterns.
- Explains that pain control promotes recovery and may reduce risk of complications after surgery. the inability to escape from pain may create a sense of helplessness and hopelessness.
1144 wordsRead More - What Is The Gate Control Theory Of Pain?explanatory essayThere are four specific concepts that need to be addressed while caring for a patient with pain. Beneficence can be defined as preventing harm, guarding the rights of the patients by doing what is best for the patient (Bernhofer, 2011, p. 2). Most of the health care professionals entered into this profession because they want to do ‘good’ for the patient .Uncontrolled pain can lead to complications and potentiates the onset of chronic pain. Nurses need to make assessment and recognition of pain as their priority “to do good and prevent harm” to the patients. The nurse needs to act as an advocate among their team members and work towards a common goal of identifying and treating the patient’s pain. If nurses fail to do so and withholding the
In this essay, the author
- Explains the four concepts that need to be addressed while caring for a patient with pain. beneficence can be defined as preventing harm, guarding the rights of the patients by doing what is best for the patient.
- Explains that the principle of justice in ethics is violated when nurses are withholding or not administering the treatments of pain based on age, sex, race, and religion.
- Explains that nursing is a unique function to help the individual sick or healthy by providing appropriate nursing care to promote health and recovery from illness.
- Explains that self-care is a concept essential to nursing where patient identifies his problem and learn strategies to overcome the situation to improve his quality of life.
- Explains that modelfigure 1 is a schematic model that depicts the visual demonstration of concepts and the theory in the theoretical framework.
- Describes the gate control theory of pain and its elements. the rectangle shape represents the brain and nociceptors where process, action, and functions are insinuated.
- Explains how the theoretical framework model describes how a person perceives pain. nociceptors are stimulated by an internal or external stimuli, and pain perception takes place when this stimulus travels through l fibers and s fibres to the spinal cord.
838 wordsRead More - The Efficacy of Patient-Controlled Analgesiaopinionated essayThe practice of patient-controlled analgesia (PCA) has been around for approximately four decades now. During this time there have been improvements to the technology and the understanding of how to use this form of patient pain control; however, there continues to be concern related to the safety and efficacy of PCA. As this analysis proceeds it will briefly explain what PCA is and how it is used, then delve into the benefits and the safety issues surrounding PCA use as it pertains to the patient and the nurse. Some of the benefits of PCA include improved pain management, improved use of nursing resources, increased patient satisfaction, and reduced pulmonary issues (Hicks, Sikirica, Nelson, Schein & Cousins, 2008). Some of the safety issues surrounding PCA use include infusion pump programing errors, basal infusion dosing, and proxy errors when using PCA by proxy (Ladak, Chan, Easty, & Chagpar, 2007). Therefore, the purpose of this report is to examine the benefits and risks of patient-controlled analgesia and how it relates to nursing practice.
In this essay, the author
- Explains the benefits of patient-controlled analgesia (pca) and the safety issues surrounding it.
- Explains that patient-controlled analgesia by way of an infusion pump allows patients experiencing moderate to severe pain to administer their own pain medication.
- Explains that pca improves pain management by allowing patients to administer their own analgesia via an infusion pump, thus avoiding the peaks and troughs of medication levels associated with intermittent, nurse-administrated medications.
- Opines that proper time management of nursing resources is essential in effective, efficient, and ethical treatment of patients.
- Opines that increased patient satisfaction is another benefit in the use of pca. there have been multiple studies conducted that show high patient-satisfaction with it compared to other conventional forms of medication administration.
- Explains that pca infusion pump usage reduces pulmonary incidents by preventing excessive sedated patients from administering medication that could lead to opioid-induced respiratory distress.
- Opines that although there appears to be significant benefits to the use of pca infusion pumps, there are significant safety issues that can cause severe harm and potentially even death.
- Explains that a nurse mistakenly changed the concentration of analgesic medication to 0.3mg/ml, resulting in respiratory arrest.
- Analyzes a five-year study involving more than 800 facilities and over 900,000 medication errors that found 9,571 of those errors were associated with pca.
- Explains that basal or background infusion of opioids are associated with increased risk of respiratory depression and should be used with caution.
- Explains that pca by proxy removes a fundamental safeguard built into the procedure. the inherent safety feature is that when the patient is well-sedated or sleeping, they are not pushing the button.
- Opines that patient-controlled analgesia has many benefits and safety issues, but are the risks associated with nursing medication errors, basal infusions, and pca by proxy worth the risk?
- Opines that the inherent risks associated with pca do not outweigh the potential benefits received from its use.
- Cites chumbley, lynch, gilson, nishida, sembar, m. c., spencer, p. j, & west, d. f.
- Explains that pca by proxy: taking the patient out of patient-controlled analgesia. nursing 2012 critical care, 7(2), 25-29.
- Analyzes hicks, sikirica, nelson, schein, j. r., and cousins. medication errors involving patient-controlled analgesia.
- Explains that surgical nurses' perceptions of patient-controlled analgesia are based on king, s., and walsh, k.
- Explains ladak, chan, easty, & chagpar, how to select the right patient-controlled analgesia (pca) device.
- Compares postoperative pain management using two patient-controlled analgesia methods: nursing perspective. journal of advanced nursing, 65(7), 1370-1380.
- Explains wuhrman, cooney, dunwoody, eksterowicz, merkel, s., and oakes, l.
1438 wordsRead More - The Importance Of Pain Managementexplanatory essayWhen helping to relieve a pain that the patient states they have, it can help them to recover more quickly, and enables them to do activities that may have been prevented while they were in pain. In the article it states, that with adequate pain management, it would in turn decrease the length of stay, lower readmission rates, earlier overall recovery, improved quality of life, and decrease the costs for the patient and within the healthcare system (Glowacki, 2015). Due to her condition worsening while in the hospital by developing pressure ulcers, this caused a longer stay for the patient which in turn, cost the hospital more money and prevented the patient from getting better to get discharged. One organization, like the American Pain Society, are helping to come up with better ways of educating healthcare professionals to assess a patient’s pain. Healthcare professionals need to be well educated with the following: recognizing patient’s perception of pain, previous experiences with pain, spiritual and religious beliefs, and sociocultural components (Glowacki, 2015). A change also needs to be implemented to improve pain assessment, and to prevent any lapse in administration of pain medication, which can in turn increase the pain or lead to uncontrolled pain. (Glowacki,
In this essay, the author
- Describes their first encounter with a patient who had stage ii bed sores on her buttocks, which made her dependent on the nurse. she was in pain and needed someone to vouch for her.
- Explains how mccaffery's article states that pain is whatever the experiencing person says it is, and exists whenever they say it does. the american pain society is educating healthcare professionals to assess a patient’s pain.
- Explains that they use basic knowledge, experience, and intuition to take care of their patient and improve their nursing care. this is considered personal knowing, as having a sense of reason to connect deeper with the patient.
- Explains that the nurse had to monitor the patient to ensure that narcotics were given appropriately and monitor for potential side effects and severe adverse effects.
1024 wordsRead More - The Importance Of Pain Assessment And Managementexplanatory essayThe core skill that was involved in the last clinical placement was regarding pain assessment and management. Pain was defined as an unpleasant experience from the sensory and emotional aspects that usually involved the tissue damage in the body (Fields, 2007). Pain was classified into acute or chronic. Acute pain was a direct biological response to inflammation, tissue damage, or disease. Acute pain usually lasted less than one month. Acute pain was usually accompanied by anxiety and emotional distress. Chronic pain comprised of pain that lasted longer than a month following the healing of a tissue injury. Chronic pain persisted or recurred for three months or longer. Chronic pain was either continuous or intermittent (Frey, 2005). Pain caused by tissue damage, was called as nociceptive pain, and pain caused by nerve damage, that was named as neuropathic pain. Pain that was affected by psychological factors was known as psychogenic pain. The origin of psychogenic pain was either in tissue damage or nerve damage, relevant to the factors as fear, depression, stress, or anxiety. Pain assessment was essential to be carried out as the basis to frame out pain management interventions. The main focus of pain assessment was to express pain in terms of intensity, nature, location, duration and aggravating or easing factors. These lead to an exact template to carry out pain assessment in patients with acute and chronic pain (Fink, 2000, p.236). Pain management was an interdisciplinary approach, comprised of all interventions that were applicable to ease pain and also to alleviate the cause of the pain (Schonbeck and Uretsky, 2013). The rationale in selecting the core skill , which was pain assessment and management, was due to the impor...
In this essay, the author
- Explains that pain assessment was essential to be carried out as the basis to frame out pain management interventions in patients with acute and chronic pain.
- Explains that physiotherapists were well-trained with application of pain assessment tools in clinical settings according to the clinical conditions and target populations.
- Explains that the physiotherapist assessed and documented the critical components of the pain assessment process by determining location of pain, aggravating factors, and easing factors.
- Describes mpq as a multidimentional assessment tool that covered sensory, affective, evaluative, and miscellaneous aspects of pain.
- Explains that wbfprs was easy to be utilised, as it required minimal instruction and cost-effectiveness. both scales were cartoon-based and are understandable.
1107 wordsRead More - Safe Pain Managementopinionated essayEducating nurses about safe pain management will help prevent under treatment of pain and the resulting harmful effects. Using the appropriate assessment tools for assessing pain in the cognitively intact adults and cognitively impaired adults is vital, otherwise pain may be underestimated or
In this essay, the author
- Opines that educating nurses about safe pain management will help prevent under treatment of pain and the resulting harmful effects.
44 wordsRead More - Pca Nurse Executive Summaryanalytical essayThis was a meta-analysis evaluating the outcome on the patient satisfaction survey scores, the amount of intake of medication vs PCA usage, adverse effects and the visual analog scale which is a numerical pain rating system measured characteristics of a person experiencing pain. Data collected from Cochrane Central Register for controlled trials, Medline and Embase by authors extracted data from randomized controlled trials. RCT’s are the high quality trials for defining the relationship between the cause and effect which can provide the development of effective quality evidence based practice for the best patient outcome when performing nursing interventions.
In this essay, the author
- Explains that pca pumps are programmable opioid pain management devices for self delivery of pain medication. the theory was designed based on the research that if patients had more efficacy in post-operative pain, this would reduce adverse effect and increase better patient satisfaction.
- Evaluates the effectiveness and safety of pca nurses given opioids for post operative pain control as a better patient outcome and improvement of nursing intervention
- Describes a meta-analysis evaluating the outcome on the patient satisfaction survey scores, the amount of medication intake vs pca usage, adverse effects and the visual analog scale.
- Explains that 1687 subjects in the control group and 1725 subjects that received pca out of 49 studies assessed had lower vas with a 95% confidence interval.
223 wordsRead More - 123explanatory essayThe role of autophagy poses as a highly conserved catabolic phenomena where cells undergoing stress develop a cytoplasmic crescent shaped phagophore that matures into an autophagosome. The autophagosome is involved in engulfing damaged organelles and long lived proteins in order to replenish the cellular energy content and building blocks for biosynthesis. The autophagy phenomenon always occurs to maintain the cellular homeostasis. But, under stress there is triggering of this autophagy event beyond its basal level. The most important breakthrough in our understanding of the molecular pathway of autophagy came from yeast genetic analysis where 35 Atg (Autophagy-related) genes were identified. Various types of Cellular stress sparks an autophagy initiation response by phagophore nucleation which coverges in inactication of stress sensor mTOR (mammalian target of rapamycin).The phosphatidylinositol 3-kinase (PI3K)-mTOR pathway is stimulated upon binding of growth factors (Estrogen like growth factor, EGF; Growth factor, GF) to its cognate receptors (Estrogen like growth factor receptor, EGFR; Growth factor receptor, GFR) on plasma membrane thereby phosphorylating the receptor tyrosine moieties .This results in activation of PI3K which inturn activates Akt. Next, activated Akt phosphorylates and inactivates tuberous sclerosis complex (TSC) 1/2 which finally inhibits the mTOR complex. Changes in intracellular ATP/AMP level leads to activation of energy sensor AMPK which goes onto activate TSC 1/2.Induction of genotoxic stress also leads to AMPK activation. Ultimately mTOR inhibition causes hypo-phosphorylation of Atg13, which subsequently binds to Atg1 (mammalian homolog of Ulk1) via Atg17. Consequently, Atg1 dynamically engages At...
In this essay, the author
- Explains that autophagy is a highly conserved catabolic phenomenon where cells undergoing stress develop an cytoplasmic crescent shaped phagophore that matures into an
- Explains that the phagophore elongates and undergoes maturation guided by class iii phosphoinositide -3-kinases.
- Explains that p62/sqstm1 acts as a cognate adaptor molecule toward lc3 recognition during phagophore elongation. autophagy and autophagic cell death should not be confused.
831 wordsRead More - 123analytical essayThe importance of knowing the changes in the body of children and youth is more than clear when it is known that a fifth man spends his life as a child (Kolarov, 2005). Period of growth and development is a stressful period in which should be young adapt to changes experienced and beginning to emerge from 10-12. years of age in girls, 12-14. years of age in boys, while rapid growth and emergence comes from 11-14. year to 15-21. The boys, with girls between 8-15. The years of age, provided that there is the possibility of precocious puberty and delayed puberty, during which occur earlier or later growth and development. Longer period of time emphasizes that the postural disorders in children continues to increase, as evidenced by a growing body of research showing that the percentage of school-age children and adolescents with postural disorders exceeds over 60% (Radislavljevic, Koturović and Aranđelović 1982, Jovovich, 1999). Krsmanovic and Bigović (2006) reported that 53% of respondents have violated posture, as some authors point out that more than 70% of school children has some physical disorders, and certain problems that result from lack of movement (Ristic, Markovic and purple 2002; Velitčenko , 1993). Kovac (2000) points out kyphosis, lordosis and scoliosis, the most common deformities of the spine in a child's age, and a review of the problems of early diagnosis, interdisciplinary problems of diagnosis and treatment. The assumptions are that a number of factors affecting the occurrence of postural disorders. Vasic (2008) concludes that the deformity of the spine in school children is usually caused by poor posture, sjedelačkog lifestyle, reduced physical activity, and improper seating. Also, according to body weight and b...
In this essay, the author
- Explains the importance of knowing the changes in the body of children and youth.
- Analyzes the relationship between postural disorders and anthropometric characteristics, such as poor lordosis, weak abdominal muscles, and deformities in the sagittal plane.
647 wordsRead More - 123argumentative essayOn April 10, 2014, I went to a concert, which was my second time to watch a classical concert. The concert hall of this one was different from Recital hall, which I attended last time. Voertman hall has around 350 seats, which is more than Recital hall, so the space is also bigger than Recital hall. All the seats are not stepped, and Voertman has sound-isolated walls which ensures audience are not bothered by outside noises and a large stage. However, it does not have speaker because this concert hall is for chamber music and small ensemble performance. All music of this concert was related with piano. On that day, there were not too much audience in the seats. Only around 15 people which contains friends of performers dressed casually watch the concert. They talked about the music that will performed that night. The light turn off suddenly, and one Korean performer who dressed professionally walk to the stage. She bowed to us, and audience applauded to her for a while, which means the concert started.
In this essay, the author
- Explains that voertman has sound-isolated walls and a large stage, which ensures audience are not bothered by outside noises. all music of this concert was related with piano.
- Explains that the concert only had four pieces, all of which are for the piano. the first piece was originally written for organ, and it was transformed for piano in 1923.
- Compares mozart's piano concerto in d minor and string quartet in c major. the first and third movements had fast tempos and cadenzas.
- Analyzes how the tempo and dynamic changes between movements gave audience lively senses. the cadenzas in the first and third movements showed virtuosity of performers.
527 wordsRead More