WOCN

Il percorso della persona con ulcera: Indagine quali-tativa mista sequenziale sul vissuto e sul significato di essere portatore di un'ulcera di difficile guarigione Riassunto Obiettivo: Esplorare la storia di malattia dei pazienti affetti da un'ulcera di difficile guarigione, afferenti a due ambulatori per la cura delle ulcere a gestione infermieristica. Materiali e metodi: Studio misto sequenziale esplicativo. La prima fase si è realizzata tramite un'intervita strutturata per indagine della storia di malattia. Dopo successiva selezione alcuni pazienti sono stati sotto-posti ad un'intervista semi-strutturata in profondità. Risultati: Nei 57 utenti coinvolti nell'intervista strutturata è emerso che all'insorgenza dell'ulcera il 67,68% (n=38) ha ricorso ad un sanitario entro i 15 giorni successivi. Il primo professionista è stato per il 64,9% (n=37) dei casi, il medico di famiglia e il 60,71% (n=34) si è rivolto per la prima volta all'ambulatorio infer-...

Objective/purpose: Psychosocial adjustment, coping, and quality of life for persons with a venous ulcer and a history of intravenous drug use were examined. Design: A cross-sectional design was used. Setting and subjects: Data were collected in an urban outpatient clinic. All eligible persons were asked to participate. Thirty-two patients agreed to participate, providing an 89% response rate. The mean age

PURPOSE: Negative pressure therapy has been accepted as a valuable adjunct for wound closure in adults; however reports on its effectiveness in young children and neonates are limited. The purpose of the study was to evaluate the effectiveness and safety of negative pressure ...

In this paper, a designing process and implementation details of an intelligent Bluetooth-enabled robot car are described. The robot car is wirelessly remote controlled via Bluetooth. In addition, a comparative analysis of the different kinds of sensors, which are useful in robot cars, is provided. Moreover, a review of the wireless robot car remote controlling systems is provided.

... studies with a clearly defined theoretical framework designed to measure the effect of various facilitation efforts by intermediaries on RU (and by ... Wallin L, Rudberg A, Gunningberg L. Staff experiences in implementing guidelines for Kangaroo Mother Care a qualitative study. ...

Use of telehealth in wound care continues to expand as technology is enhanced and clinicians become more familiar with use of the new technology as a supplement to usual care. This article describes the Telehealth Wound Care Program implemented at Mount Sinai Hospital Home Health Agency and Mount Sinai Hospital Wound Care Center. Results of the wound care provided for one patient are included in the case study described in this article. The authors note the many benefits of telehealth as an adjunct to usual therapy in wound care.

A group of 3 WOC nurses and a nurse researcher, in partnership with the author of the Bates Wound Assessment Tool (BWAT), sought to validate wound photographs depicting each characteristic of the instrument. The BWAT contains 13 items that assess wound size, depth, edges, undermining, necrotic tissue type, amount of necrotic, granulation and epithelialization tissue, exudate type and amount, surrounding skin color, edema, and induration. These are rated using a modified Likert scale; a score of 1 indicates the healthiest and 5 indicates the most unhealthy attribute for each characteristic. In 2001, the PSST was revised and renamed the Bates-Jensen Wound Assessment Tool to reflect the global use of the tool with wound types beyond pressure ulcers. Phase 1 involved the selection of digitalized wound photographs for 11 of the BWAT wound characteristics by the researchers. The photographs needed to be of high resolution and good quality for eventual publication and validated by the original BWAT author as being representative of the intended characteristic. In phase 2, a face-to-face validation exercise was completed to include, edit, or exclude these photographs. Corrections were made; additional photographs were obtained for the remaining characteristics and to replace those not validated. Phase 3 involved an electronic survey that achieved validation online. Phase 2 participants consisted of 15 WOC nurses with a mean of 11.5 years of experience with wounds. Phase 3 had 8 WOC nurses and 1 master's prepared wound care specialist, with approximately 10 years of experience. One third of participants in each phase were familiar with the BWAT. In a separate exercise to rate photographs that would be used for testing the implementation of the pictorial guide, 7 WOC nurses and 2 RNs who used the BWAT regularly and 2 researchers participated in a face-to-face discussion. A total of 214 photographs were reviewed in this study. Seventy-three percent (n = 55) of the photographs for the pictorial guide were endorsed in phase 2, and 100% (n = 53) in phase 3 to demonstrate the 65 BWAT characteristics. In addition, photographs that could be used for a competency exercise and for pre- and posttests were also rated by the panels. The photographic content of the BWAT pictorial guide has been validated by a small group of wound care experts. The purpose of the exercise was to create a visual learning aid to enhance the education around wound assessment and as a resource for nurses in practice. Now published in a pocket guide format, it is a standardized way to teach BWAT wound assessment skills in a consistent format.

Obesity has become the number one health problem in the United States. The patients who is obese and undergoing a surgical procedure that results in the formation of fecal or urinary diversion requires advanced skills of a multidisciplinary healthcare team. Patients who are obese carry a high risk of wound and cardiopulmonary complications and often present a serious challenge in terms of stoma creation and management. The purpose of this article is to examine the risk factors that face the patient who is obese and undergoing stoma surgery, the challenges of stoma creation, and the resultant stoma management problems.

To compare health and lifestyle factors of people with and without urinary incontinence (UI). A postal survey was undertaken that represents the first of a 3-stage project designed to evaluate the health interventions of primary health care teams and continence advisory services on patient outcomes related to UI. Two random samples of adult populations (N = 12,529) were included, generated from the family physician patient registers within 2 health authorities in England. Data were collected using a structured questionnaire that queried demography, perceived health status, activities of daily living, self-care, and use of local health and social services. Information was also collected on past and present continence status. Structured questionnaires and a cover letter were mailed to the target population. Two reminders were sent to nonresponders to maximize the response rate. The main measures relate to factors associated with UI: mobility, sleep, childbirth, smoking, diet, body mass index, and accommodation. Significantly more women than men had UI (P < .0001). Respondents with UI were older than those who were continent (P < .0001). Women with UI were significantly more likely to have a greater number of pregnancies (P < .0001), were more likely to have given birth to a baby weighing more than 9 lb (P < .01), and to have had more than 4 children (P = .01) compared with women who were continent. People with UI were less likely to be single and more likely to be widowed than those who were continent (P < .0001). People who lived alone and who had UI were also significantly less likely to have a relative or friend that they could depend on for help than those who were continent (P < .001). UI was also found to be significantly associated with impaired mobility (P < .0001) and sleeping difficulties (P < .0001). No meaningful differences were found between diet and UI, although significantly more people with UI had higher mean body mass index, were obese, or reported that they felt too heavy for their height when compared with people who were continent (P < .0001). No association was found in the present study with smoking or ethnicity and UI. Key health and lifestyle factors associated with UI included age, gender, childbirth, mobility, sleep patterns, obesity, living alone, and access to help. These factors should be assessed when planning and implementing health care for persons with UI. Attention to these associated factors may prove useful in identifying new cases or people at risk of developing UI when screening people as part of routine health checks. This, in turn, could assist with targeting effective and efficient health care but may also contribute to prevention for some people.

The aim of this study was to evaluate how relatives of patients with an ostomy rated the various aspects of care, how they perceived the quality of the care provided, and how they ranked their involvement in the care. Patients' satisfaction was also sought, particularly their perception of relatives' involvement. Descriptive cross-sectional. The study comprised a colostomy group (32 pairs) and an ileostomy group (28 pairs). All patients attended a stoma outpatient clinic. Quality of care was assessed using the identity-oriented dimension of the validated questionnaire Qualityof Care from the Patient's Perspective. Questionnaires were mailed to patients and their relatives. Relatives and patients in both study groups considered most topics covered by the questionnaire to be important. Half of the patients with an ileostomy and their relatives and approximately 30% of those in the colostomy group were dissatisfied with the information they received, however. Moreover, a greater proportion (41-89%) of the patients were unhappy with the opportunities they were offered to participate in the decision-making process. Patients with an ileostomy and their relatives tended to be more dissatisfied with the quality of care than the colostomy group, but the difference was not statistically significant. The topics covered by the questionnaire were considered important to both patients and their relatives. Information and counseling offered by the ET nurses and the colorectal surgeons were judged to be unsatisfactory, indicating the need for frequently assessing and improving general standards of quality of care.

The objective of this review is to determine the effects of clamping short-term indwelling urethral catheters before removal on the incidence of urinary tract infection, time to first void, voiding dysfunction, incidence of recatheterization, and the length of hospital stay. Published and unpublished randomized and quasi-randomized controlled trials, completed between January 1966 and July 2004, in English and other languages that compared the effects of clamping short-term indwelling urethral catheters, were systematically reviewed using multiple electronic databases. Determination of eligibility of trials for inclusion in the review, assessment of methodological quality, and data extraction were undertaken independently by 2 reviewers. Relative risks for dichotomous data and a weighted mean difference for continuous data were calculated with 95% confidence intervals. Where synthesis was inappropriate, a narrative overview has been undertaken. Three trials that investigated the effect of clamping the indwelling urethral catheter compared to free drainage before removal were eligible for inclusion. Two trials reported no significant difference in the incidence of urinary tract infection (UTI), number of patients who developed urinary retention or required recatheterization, and the length of hospital stay between the 2 groups. Another reported that the postvoid residual urine volume for patients who did not receive reconditioning of the bladder increased from 4.25 mL at baseline to 42.25 mL after removal of the indwelling urethral catheter, whereas the residual urine volume for patients who received reconditioning increased from 17.25 mL at baseline to 22 mL at follow-up. The evidence for clamping indwelling urethral catheters before removal remains equivocal. Given the current state of evidence, procedures relating to clamping of indwelling urinary catheters should not be initiated. Until stronger evidence becomes available, however, practices relating to clamping indwelling urethral catheters will continue to be dictated by local preferences and cost factors.