605 resultados para family nursing


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Over the past forty years, significant research has been conducted on the epidemiology of late onset dementia. Less is known however, about the prevalence, incidence and burden of illness of early onset dementia (occurring prior to 65 years of age). The purpose of this narrative review is to examine existing literature regarding the experiences and implications of living with early onset dementia for patients, caregivers, and family members. The following questions were addressed: (1) What is the impact of early onset dementia on patients, families and carers? and; (2) What are the needs of patients with early onset dementia and their family and carers? Key findings form this review are presented.

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Background More than 60% of new strokes each year are "mild" in severity and this proportion is expected to rise in the years to come. Within our current health care system those with "mild" stroke are typically discharged home within days, without further referral to health or rehabilitation services other than advice to see their family physician. Those with mild stroke often have limited access to support from health professionals with stroke-specific knowledge who would typically provide critical information on topics such as secondary stroke prevention, community reintegration, medication counselling and problem solving with regard to specific concerns that arise. Isolation and lack of knowledge may lead to a worsening of health problems including stroke recurrence and unnecessary and costly health care utilization. The purpose of this study is to assess the effectiveness, for individuals who experience a first "mild" stroke, of a sustainable, low cost, multimodal support intervention (comprising information, education and telephone support) - "WE CALL" compared to a passive intervention (providing the name and phone number of a resource person available if they feel the need to) - "YOU CALL", on two primary outcomes: unplanned-use of health services for negative events and quality of life. Method/Design We will recruit 384 adults who meet inclusion criteria for a first mild stroke across six Canadian sites. Baseline measures will be taken within the first month after stroke onset. Participants will be stratified according to comorbidity level and randomised to one of two groups: YOU CALL or WE CALL. Both interventions will be offered over a six months period. Primary outcomes include unplanned use of heath services for negative event (frequency calendar) and quality of life (EQ-5D and Quality of Life Index). Secondary outcomes include participation level (LIFE-H), depression (Beck Depression Inventory II) and use of health services for health promotion or prevention (frequency calendar). Blind assessors will gather data at mid-intervention, end of intervention and one year follow up. Discussion If effective, this multimodal intervention could be delivered in both urban and rural environments. For example, existing infrastructure such as regional stroke centers and existing secondary stroke prevention clinics, make this intervention, if effective, deliverable and sustainable.

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Nursing is fundamental to the care of stroke patients. From the acute setting all the way to rehabilitation and community reintegration, nursing is there. Having well-educated and highly skilled nurses to monitor and care for stroke patients is crucial. Equally important is the collaboration of colleagues at a national level to facilitate and disseminate research and best practice guidelines across Canada. The National Stroke Nursing Council aims to fill this role. Stroke nurses from across Canada were invited to a national forum in 2005, hosted by the Canadian Stroke Network. The focus of this forum was to elucidate issues of concern to nurses across the stroke care continuum in relation to a Canadian Stroke Strategy. Subsequent to this forum, a cadre of nurses, after undergoing a rigorous screening process, were selected to form the inaugural National Stroke Nursing Council (NSNC). With ongoing support from the Canadian Stroke Network, the mandate of the NSNC is to promote leadership, communication, advocacy, education and nursing research in the field of stroke.

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Background: Prediction of outcome after stroke is important for triage decisions, prognostic estimates for family and for appropriate resource utilization. Prognostication must be timely and simply applied. Several scales have shown good prognostic value. In Calgary, the Orpington Prognostic Score (OPS) has been used to predict outcome as an aid to rehabilitation triage. However, the OPS has not been assessed at one week for predictive capability. Methods: Among patients admitted to a sub-acute stroke unit, OPS from the first week were examined to determine if any correlation existed between final disposition after rehabilitation and first week score. The predictive validity of the OPS at one week was compared to National Institute of Health Stroke Scale (NIHSS) score at 24 hours using logistic regression and receiver operator characteristics analysis. The primary outcome was final disposition after discharge from the stroke unit if the patient went directly home, or died, or from the inpatient rehabilitation unit. Results: The first week OPS was highly predictive of final disposition. However, no major advantage in using the first week OPS was observed when compared to 24h NIHSS score. Both scales were equally predictive of final disposition of stroke patients, post rehabilitation. Conclusion: The first week OPS can be used to predict final outcome. The NIHSS at 24h provides the same prognostic information.

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Brain cells control everything we do - from speaking to walking to breathing. The brain needs a steady supply of blood and oxygen to function properly. Without this vital steady supply of blood, brain cells don't get enough nutrients and oxygen to do their job, and a stroke or 'brain attack' occurs. The human brain is divided into regions that control various motor (movement) and sensory (the senses) functions. Damage from stroke to a specific region may affect the functions it controls. This causes symptoms such as paralysis (loss of movement), difficulty speaking, or loss of coordination. The left side of the brain controls motor and sensory functions on the right side of the body. The left side is also responsible for scientific functions, understanding written and spoken language, number skills and reasoning. The right side of the brain controls motor and sensory functions on the left side of the body. It also controls artistic functions, such as music, art awareness, and insight. If an artery inside the brain or leading to the brain becomes temporarily blocked, the flow of blood to an area of the brain slows or stops. The lack of blood can cause temporary symptoms such as weakness, numbness, problems with speech, dizziness, or loss of vision.

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The Foothills Medical Centre in Calgary, AB, Canada, is a tertiarycare referral center for southern Alberta and southeastern British Columbia. The Calgary Stroke Program, which serves a population of 1.5 million people and a geographic territory of more than 114,233 square kilometers (44,622 square miles), annually offers acute and follow-up care to more than 1,000 people with stroke. Leading the team of healthcare professionals dedicated to providing excellence in stroke patient care is a stroke nurse practitioner (SNP). The nurse practitioner role in Canada, as in many healthcare settings, was initially developed in response to cutbacks in medical residency programs and increasing acuity levels of hospitalized patients (Irvine et al., 2000). This article describes the development of the SNP role and its impact on system and process changes and patient care and outcomes in an acute stroke program in the Calgary Health Region.

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The aim of this study was to develop an Internet-based self-directed training program for Australian healthcare workers to facilitate learning and competence in delivery of a proven intervention for caregivers of people with dementia: The New York University Caregiver Intervention (NYUCI). The NYUCI is a nonpharmacological, multicomponent intervention for spousal caregivers. It is aimed at maintaining well-being by increasing social support and decreasing family discord, thereby delaying or avoiding nursing home placement of the person with dementia. Training in the NYUCI in the United States has, until now, been conducted in person to trainee practitioners. The Internet-based intervention was developed simultaneously for trainees in the U.S. and Australia. In Australia, due to population geography, community healthcare workers, who provide support to older adult caregivers of people with dementia, live and work in many regional and rural areas. Therefore, it was especially important to have online training available to make it possible to realize the health and economic benefits of using an existing evidence-based intervention. This study aimed to transfer knowledge of training in, and delivery of, the NYUCI for an Australian context and consumers. This article details the considerations given to contextual differences and to learners’ skillset differences in translating the NYUCI for Australia.

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This project aimed to identify current Language Literacy and Numeracy (LLN) and Inclusive Teaching and Learning Practices in a TAFE Diploma of Nursing (Enrolled/Division 2 Nursing). The key purpose of the study was to make recommendations for improving inclusive teaching practice and learning outcomes of students and for reducing student attrition, thereby increasing the employability of graduates in the health industry subsequent to course completion.

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This chapter reviews recent changes in family law related to domestic violence and the research on their impact in Australia.

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The concept nursing grand rounds (NGR) has been reported in the nursing literature since the 1960s. Many of the reported initiatives are based on a presentation forum in the manner of medical grand rounds, as an approach to undergraduate education, or as a means to monitor patients. Among the points of difference in the design of the pilot project undertaken in a busy surgical ward to investigate the effectiveness of NGR in increasing nurses work satisfaction was the inclusion of the nursing librarian as an integral part of the NGR team and processes which previously has not reported in the literature. The nursing librarian’s role was to search the literature and find the best evidence on the predetermined patient topic prior to the NGR to enable the nurse presenting to integrate the research findings into the presentation of the patient. The nursing librarian attended each NGR and commented where appropriate on the level of evidence. Nurses discussed current practice and the impact the retrieved literature would have on patient care comparing best practice with current practice. Outcomes of this project include in some cases change in practice, change in culture where NGRs are now embedded into ward culture, NGR extended to other wards, enthusiasm for EBP, the initiation of a “super searcher” model where the nursing librarian is more of a consultant and develops the searching skills of nominated nurses who become the resource on the ward.

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Background: The critical care context presents important opportunities for nurses to deliver skilled, comprehensive care to patients at the end of life and their families. Limited research has identified the actual end-of-life care practices of critical care nurses. Objective: To identify the end-of-life care practices of critical care nurses. Design: A national cross-sectional online survey. Methods: The survey was distributed to members of an Australian critical care nursing association and 392 critical care nurses (response rate 25%) completed the survey. Exploratory factor analysis using principal axis factoring with oblique rotation was undertaken on survey responses to identify the domains of end-of-life care practice. Descriptive statistics were calculated for individual survey items. Results: Exploratory factor analysis identified six domains of end-of-life care practice: information sharing, environmental modification, emotional support, patient and family centred decision-making, symptom management and spiritual support. Descriptive statistics identified a high level of engagement in information sharing and environmental modification practices and less frequent engagement in items from the emotional support and symptom management practice areas. Conclusions: The findings of this study identified domains of end-of-life care practice, and critical care nurse engagement in these practices. The findings highlight future training and practice development opportunities, including the need for experiential learning targeting the emotional support practice domain. Further research is needed to enhance knowledge of symptom management practices during the provision of end-of-life care to inform and improve practice in this area.