151 resultados para Abdominal Pain
Resumo:
Objective: To investigate Candida species and Staphylococcus aureus and the development of 'nipple and breast thrush' among breastfeeding women. Design: Prospective longitudinal cohort study. Setting: Two hospitals in Melbourne, Australia (one public, one private) with follow-up in the community. Participants: 360 nulliparous women recruited at 36 weeks' gestation from November 2009 to June 2011. Participants were followed up six times: in hospital, at home weekly until 4 weeks postpartum and by telephone at 8 weeks. Main outcome measures: Case definition 'nipple and breast thrush': burning nipple pain and breast pain (not related to mastitis); detection of Candida spp (using culture and PCR) in the mother's vagina, nipple or breast milk or in the baby's mouth; detection of S aureus in the mother' nipple or breast milk. Results: Women with the case definition of nipple/ breast thrush were more likely to have Candida spp in nipple/breast milk/baby oral samples (54%) compared to other women (36%, p=0.014). S aureus was common in nipple/breast milk/baby samples of women with these symptoms as well as women without these symptoms (82% vs 79%) (p=0.597). Time-to-event analysis examined predictors of nipple/breast thrush up to and including the time of data collection. Candida in nipple/breast milk/baby predicted incidence of the case definition (rate ratio (RR) 1.87 (95% CI 1.10 to 3.16, p=0.018). We do not have evidence that S aureus colonisation was a predictor of these symptoms (RR 1.53, 95% CI 0.88 to 2.64, p=0.13). Nipple damage was also a predictor of these symptoms, RR 2.30 (95% CI 1.19 to 4.43, p=0.012). In the multivariate model, with all three predictors, the RRs were very similar to the univariate RRs. This indicates that Candida and nipple damage are independent predictors of our case definition.
Resumo:
Background:
Objectives:
The purpose was to assess the quality of pain management in a cohort of Danish postoperative patients by examining their pain experience, beliefs about pain and pain treatment, and relationships between pain intensity, its effect on function, and pharmacological pain management.
Methods:
The American Pain Society’s Patient Outcome Questionnaire was administered to a consecutive cohort of Danish patients who had undergone gastrointestinal, gynaecological, orthopaedic or urological surgery within 24 and 72 h of surgery.
Results:
Findings indicated uncontrolled pain in 45.5% of patients. These patients reported moderate to severe intensity average pain in the previous 24 h, however, 88.4% of the cohort overall stated they were satisfied or very satisfied with pain treatment. Patients who experienced severe pain only received 50% of available strong opioids, 73.3% of available weak opioids, 100% of available non-steroidal antiinflammatory drugs (NSAIDS) and paracetamol. Further, analgesics prescribed to be administered at fixed intervals were administered 99% of the time; in contrast, all Pro Re Nata (PRN) orders irrespective of analgesic categories, were administered only 25% of the time.
Conclusions:
A number of patients experienced significant pain postoperatively. Although multi-modal analgesics were available, analgesic administration practices did not consistently reflect management responsive to patient needs. Despite this, patients were largely satisfied with the care received suggesting the need for further research to understand how patients perceive the efficacy of pain management.
Resumo:
Pain affects peoples' well-being and quality of life and is one of the most common symptoms experienced by people receiving haemodialysis (HD).
Objectives
To explore how Thai people receiving HD perceive pain, the effect of pain on their lives, and how they cope with and manage pain.
Methods
Purposive sampling was used to recruit participants from two Thai outpatient haemodialysis facilities in Songkhla province. Face-to-face, in-depth individual interviews using open-ended questions were conducted during January and February 2012. The interviews were audio-recorded and transcribed verbatim. Data were analysed using Ritchie and Spencer's Framework method.
Findings
Twenty people receiving HD participated in the study: age range 23–77 years; 10 were females. Three main types of pain emerged: physical pain, which occurred when needles were inserted during HD treatment and vascular access operations; psychological pain due to unfulfilled hopes and dreams and changes in family roles; and social pain. Perception of pain was influenced by the general populations' perceptions of chronic kidney disease. Participants used two main coping styles to manage pain: health-adjustment and health-behaviour styles. These two coping styles encompassed four specific coping strategies: religion, spirituality, accepting pain associated with HD treatment, and social support. Coping styles and strategies were influenced by Thai culture.
Conclusion
The study elicited information that could help nursing staff understand how Thai people manage pain and the importance of cultural beliefs to their pain experience and coping strategies, which in turn can help nurses plan appropriate pain management.
Resumo:
The objective of the study was to explore patient participation in the context of pain management during a hospital admission for a cardiac surgical intervention of patients with cardiovascular disease. This is a single-institution study, with a case-study design. The unit of analysis was a cardiothoracic ward of a major metropolitan, tertiary referral hospital in Melbourne, Australia. Multiple methods of data collection were used including preadmission and predischarge patient interviews (n=98), naturalistic observations (n=48), and focus group interviews (n=2).
Resumo:
ABSTRACT
Background:
Aim:
To undertake a randomised controlled pilot study comparing the efficacy of Arnica and Hirudoid creams in treating bruising and pain following post-needling infiltration.
Methods:
One dialysis centre of 40 patients over a 12-month period. Following infiltration, and at the five subsequent dialysis treatments, pain was measured using the Abbey pain scale and size of the bruise was recorded.
Results:
Eleven cases of infiltration were recorded consisting of seven males (64%) and four females (36%) who had a mean age of 78 years (SD=9). Access for eight patients was via arteriovenous fistula and for three patients via arteriovenous graft. Eight patients experienced bruising and two patients reported mild pain post-infiltration but there were no differences found between the effect of Arnica or Hirudoid in treating either symptom.
Conclusion:
This pilot study was unable to detect any differences in the effect of Arnica and Hirudoid on pain or bruising. The study demonstrated that a larger, multicentre trial would be required to power a study and that a non-interventional control group should be added.
Resumo:
To assess whether changes in measures of fat distribution and body size during early life are associated with blood pressure at 36 months of age.
Resumo:
Evidence from clinical practice and the extant literature suggests that post-operative pain assessment and treatment is often suboptimal. Poor pain management is likely to persist until pain management practices become consistent with guidelines developed from the best available scientific evidence. This work will address the priority in healthcare of improving the quality of pain management by standardising evidence-based care processes through the incorporation of an algorithm derived from best evidence into clinical practice. In this paper, the methodology for the creation and implementation of such an algorithm that will focus, in the first instance, on patients who have undergone total hip or knee replacement is described.
