Music listening: its effects in creating a healing environment

Older adults face challenges in function, cognition, and isolation as they age. Nurses are responsible for providing a healing environment to promote health and well-being. Music listening is an intervention that could be used to facilitate a healing environment. This article provides examples of evidence that music can improve the healing environment for older adults, both physiologically and psychologically. Music can connect individuals with their emotions and bring about a sense of self-awareness that improves the quality of life for older adults. Music is a safe, inexpensive, and easy-to-use intervention that nurses can implement independently to help older adults cope with pain, acute confusion, and functional deficits. Examples of ways nurses can use music to provide a healing environment are also included.     

Paining Out: An Integrative Pain Therapy Model

This article describes and evaluates an integrative pain therapy model as a beneficial form of pain-management for chronic pain. The author based his model on cognitive-behavioral modalities, progressive relaxation combined with art therapy, sensory awareness combined with indirect clinical hypnosis, formal clinical hypnosis and self-hypnosis. Those techniques were applied in small group settings to systematically alter pain perception, pain interpretations and response to pain for the group participants’ benefit. As a result, the group participants gained a greater sense of control over the pain, eased or abolished the pain, and decreased the stress, anxiety and depression associated with chronic pain. The techniques used were synthesized into ten group therapy sessions. A small data sample suggests that the model has clinical utility and maintained its benefits in a 6- to12-month follow-up.

The Use of Hypnosis in the Treatment of Dissociative Patients

A frequent need of adult patients who were traumatized in childhood is to recall and work through those experiences which have been blocked out of awareness but continue to exert negative influences. Hypnosis is an effective resource with such patients. This article discusses the early developments of hypnosis. It describes components of the trance state which makes it a useful resource with trauma patients as well as an effective therapeutic process and technique. Two case studies are presented to demonstrate some applications of hypnosis with sexually traumatized patients.     

Assessments of patients with a 5-category or a 3-category practical classification system: validaty and practicality

In order to implement preventive programs to prevent back pain in nurses, assessments of the degree of passivity and mobility of patients is imperative. After all, the load in health care ergonomics, is often the patient. The degree of cooperation or resistance determines the load on the back for the nurses and the necessity of the use of lifting devices like patient lifters or sliding sheets. These assessments must be done in both a practical and a reliable way. For this purpose a 3-category and a 5- category system to assess the degree of patient mobility and passivity was developed and tested. The results are presented on the poster.     

Outcome of an interdisciplinary pain management program in a rehabilitation clinic

The Chronic Pain Section at Reykjalundur has 33 beds for patients with various chronic pain problems. About 200 patients are treated annually. For 3 years, 158 patients were enrolled in a random study focusing on increasing the patients' functioning and eliminating analgesic drugs through an interdisciplinary rehabilitation program. Patients answered a questionnaire at admission, before discharge from the clinic and about one year after discharge. The follow-up was done with a mailed questionnaire. The focus was on the patients' functioning rather than absence of pain. The program's duration was 7 weeks. The first 2 weeks were utilized for evaluation, information and education (pain school). Pain relieving drugs were gradually withdrawn but anti-inflammatory drugs were used when indicated. Cognitive behavioral therapy was applied in an increasing number of cases over the 3 year period by specially trained nurses and a psychiatrist. Pain, anxiety and depression were self-evaluated on a numeric rating scale (NRS). About 50% of the patients had a history of pain for more than 5 years. Low back pain was the most common diagnosis (48.1%) and 28.5% had post-traumatic pain. A significant reduction in pain, anxiety and depression was found both at discharge (p < 0.0001) and at follow-up (p < 0.001). Before entering the program, only 18.4% of the patients were able to work whereas 48.1% returned to work after discharge and 59.2% were working at follow-up.     

Concern, Caution, and Care: HIV Risk Perception among Hospital Nurses

Nurses routinely confront uncertainties surrounding the risk of occupationally transmitted HIV, particularly in the context of hospital AIDS care. Nurses respond to their perception of this HIV risk with a mixture of concern, caution, and care. This study empirically examines HIV risk perception based on a survey of hospital nurses in U.S. cities with high HIV seroprevalence rates. There is variation in the degree to which hospital nurses worry about HIV at work, despite widespread use of universal precautions. Occupational HIV risk perception is associated with knowledge of workplace transmission vectors, comfort with AIDS patients, AIDS care experience, and working conditions. Results show that nurses on AIDS care units are more habituated to HIV risk, whereas those with less AIDS care knowledge, tolerance, and experience are more concerned about HIV Consequently, nurses who worry less about being infected with HIV are more willing to perform AIDS care, predict plans to continue AIDS care in the future, and report more equal treatment of people with AIDS. Supportive workplaces which reduce stress and emotional exhaustion, together with enhanced and improved training for hospital nurses, may temper provider concerns and improve the continuity and quality of care.     

Teaching hospitalized patients with serious, persistent mental illness.

1. Although patient teaching is an important nursing function, minimal research was found related to education of patients with schizophrenia. Teaching psychiatric patients about illness, treatment, and rehabilitation has not received the same attention in psychiatric nursing as it has in other nursing specialties. 2. Eighty percent of the patients who participated in patient education classes would recommend the program to others. Treatment teams reported that some patients asked more questions about their treatment and became more active in ward groups following the classes. 3. The use of nurses as patient educators facilitates professional nursing practice and effectively ensures that patients' general physical health and psychiatric education needs are systematically addressed.     

How to work with elderly patients on a general psychiatric unit

Currently, there are specialized geropsychiatric units being used for elderly psychiatric inpatients. However, these units are not always available to the growing elderly population. The general inpatient psychiatric unit seems to be well suited for treating the medical and mental illness of elderly psychiatric patients (Billig, 1989; Conwell, 1989; Liptzin, 1987). As identified earlier, nurses may not be enthusiastic about adding this population to their unit. Our society is youth-oriented and the elderly tend to be viewed as slow, needy, and sick. It is essential for nurses to explore their own feelings regarding aging and what it means to be old. If the nurse has not dealt with issues such as her own mortality and that of her parents and close friends, it may be difficult for her to understand and work with the elderly. The ability to understand the feelings of another and to communicate this understanding has been identified as a crucial variable related to positive therapeutic outcome (Kirk, 1982). Inservice programs and groups that give the staff opportunities to explore their attitudes and feelings toward the elderly may result in more effective therapeutic interventions (Farley, 1983). To many elderly patients, nurses are seen as supportive figures, interpreters of the unknown, and potential allies who have an empathic regard for them (Davis, 1968). The nurse can use these impressions to initiate interventions. This, along with coming to terms with one's own feelings about aging, can result in a greater understanding of these patients. This article has given a very brief overview of the many issues related to the care of the elderly psychiatric inpatient.(ABSTRACT TRUNCATED AT 250 WORDS)     

Chronic pain in older adults

Despite the sophisticated pharmaceutical agents and technologies available today, many people, including older adults, continue to experience chronic pain. Inadequately treated chronic pain can seriously affect one's quality of life. Health care providers are only beginning to understand the structural and functional changes that occur in older adults with chronic pain, but recent research suggests that nurses and other health professionals need to become aware of the unique needs of older adults who live with chronic pain. When health professionals lack specific knowledge of pain management in older adults, patients may suffer needlessly.     

Spouse-aided Therapy and Psychiatric Nursing: A Preliminary Report

The training of psychiatric nurses as behavioural nurse therapists has been successfully established in the U.K. by Marks et al. However, their approach has a number of theoretical and practical limitations, such as a rigid adherence to an illness model of psychiatric disorder. This paper describes and evaluates an approach to the training of psychiatric nurses based on systems theory. Four nurses were trained in the use of Spouse-aided Therapy, a time-limited, goal-orientated outpatient approach to the treatment of married psychiatric patients with persisting psychological disorders. Patients' spouses are involved throughout therapy, with the aim of making full use of resources within marriage which may facilitate patients' recovery. Questionnaire and anecdotal data from 12 patients showed a mean fall of 30% in patients' symptoms and a mean fall of 20% in marital dissatisfaction after therapy. The pattern of results supported a systems theory interpretation of outcome.     

'You cannot get enough of them!’ The rise (and fall) of complementary therapies in British nursing practice in the 1980s and 1990s

This paper examines the emerging use of complementary therapies in British nursing practice at the end of the twentieth century. Many nurses turned to complementary therapies as a means to provide a closer therapeutic relationship with their patients and this paper will establish how nurses were informed and empowered. The paper places complementary practices in the context of nursing developments in the closing decades of the twentieth century and concludes that the extent of the supporting networks that encouraged nurses to incorporate these therapies into their work was more significant than has been previously recognised and exemplifies a distinct period in the history of modern nursing.     

Counseling clients with genital herpes

The epidemic of genital herpes requires nurses to diagnose and treat human responses to this health problem (American Nurses' Association, 1980). It also creates many opportunities for nurses, particularly in the realm of counseling and education. Given the changing epidemiology of genital herpes and the psychosocial consequences, nurses need to keep abreast of new information so that they may assist people to live with the disease and teach the prevention of transmission of the disease. Recent information about mild and asymptomatic cases of herpes infections has serious implications for counseling and education of persons with genital herpes. The emergence of this "silent" dimension of herpes infections means more difficulty in diagnosis and treatment. All persons with genital herpes should be assessed for their physical and psychological responses to the disease and information should be given to combat misconceptions, to alleviate fear, and aid in preventing transmission. The most significant implication of mild or asymptomatic herpes is the greater risk of transmission. The public needs to be informed about the practice of "safer sex" as a routine measure to prevent herpes, as well as AIDS and other STDs. Given the widespread and epidemic proportions of herpes, persons should be counseled to use condoms whenever they engage in sexual activity with a partner. In addition, correct use of condoms must be taught. Nurses have an important role to play in counseling clients with genital herpes and in preventing the disease.     

Sex differences in observers' reactions to a nurse's use of touch

We tested the notion that male and female observers would have different reactions to the use of touch by a nurse towards a patient in a hospital situation. If males are socialized to favor autonomy and independence and females to favor nurturance and caring, it was assumed that male subjects would rate a nurse as less supportive and competent if a nurse touched a patient. The results (based on reactions to photographs manipulating the level of physical contact that occurred between a nurse and a patient) were generally consistent with these predictions. While the subjects' sex moderated reactions to the nurse-initiated touch, there was an overall pattern for observers to react more favorably to the nurse who used touch compared to no touch in interacting with a patient. The results suggest that nurses and health professionals who use touch in interacting with patients may be judged in part by the attitudes of males and females about the use of touch.     

Primary care update for mental health nurses: evidence-based guidelines for nursing assessment, intervention, and follow up

Physical health comorbidities are often undiagnosed or undertreated in individuals with severe and persistent mental illness. Mental health nurses are in an ideal position to identify, refer, and monitor treatment of these comorbidities. National evidence-based practice guidelines provide key information about common physical health comorbidities that mental health nurses can readily use in their everyday practice.     

Cytochrome P450 testing for better psychiatric care

Genotyping for CYP2D6 and CYP2C19 variations is emerging as a potentially useful clinical tool to help mental health professionals prescribe psychiatric medications for their patients. Cytochrome P450 testing uses a blood sample to determine an individual's required dosage of identified drugs that are metabolized by the two enzymes. To provide care for patients and families, nurses should be able to demonstrate identified essential nursing competencies related to genetics and genomics, which include an understanding of cytochrome P450 testing. As patient advocates, nurses are expected to understand how to identify patients most likely to benefit from CYP2D6 and CYP2C19 testing, how to ensure informed consent for such testing, and how to educate patients about testing and test results.     

Highlights from a Study of Abuse of Patients in Nursing Homes

This article reports some major findings from a random sample survey of nurses and nurses aides in 32 long-term care facilities. After defining key terms, we review the literature in an attempt to establish what is currently known about patient maltreatment in nursing homes. Next, data from the survey are presented to profile the staff and to describe difficulties in nursing home work. Findings on the extent and correlates of physical and psychological abuse of patients are then reported. The article concludes with recommendations to reduce abuse of patients.     

Discrepancies in pain presentation caused by adverse psychosocial conditions as compared to pain due to high physical workload?

Disorders in the musculoskeletal system have been associated with a high physical workload as well as psychosocial and individual factors. It is however not obvious which of these factors that is most important to prevent. Musculoskeletal disorders in neck and upper extremity was assessed by interview and clinical examination in 79 teachers and 93 assisting nurses, all females. Psychosocial work environment was assessed by questionnaire. The physical workload was recorded by technical measurements of postures, movements and muscular load, in 9 teachers and 12 nurses. The physical workload was lower among the teachers, but they had a more demanding psychosocial work environment. Among the nurses, but not in the teachers, the neck-shoulder disorders were associated with a high body mass index (BMI). The teachers reported neck-shoulder complaints to a higher extent than the nurses, but had much lower prevalence of diagnoses in the clinical examination (12% vs. 25%; POR 0.3 CI 0.1 - 1.2; adjusted for age and BMI). The results suggest that adverse psychosocial conditions among the teachers give rise to a different kind of pain in the neck-shoulder region than from physical overload, troublesome but not as severe as the one afflicting the nurses.     

An international validation study of the care thermometer: a tool supporting the quality of ergonomic policies in health care

Occupational back pain among nurses leads to high costs and personal suffering for nurses. It is difficult to assess the success of such initiatives and to monitor results in a practical way. Such a practical monitoring and web-based instrument was developed. This Care Thermometer (CT) allows the users to assess the current situation in their facility today, and, with regular use, it can help to track progress over time. The Care Thermometer is a further step in the development of the TilThermometer, a validated assessment tool that is used on a large, national scale in The Netherlands. The claims of the newly developed Care Thermometer are ambitious and an international validation study was performed in four countries: the UK, USA, Germany and the Netherlands. The instrument appears to be sufficiently valid, useful and practical. There are however some points to keep in mind when interpreting the results of the CT. Especially a careful, punctual and stringent data collection phase is crucial for accurate and useful results. Some recommendations to further improve the practical use both for the design of the instrument and the process of data-collection and -entering are given.     

Static load in the nursing profession; the silent killer?

Traditionally back pain in the nursing profession is associated with heavy lifting of patients. Although there is a strong relationship between heavy loads on the spine and lifting patients, literature indicates that there is a major factor that should not be underestimated: static load. Static load can be defined as the result of static, not moving, not dynamic, working positions. For example when a caregiver is washing a patient on a bed which is too low, her back is in a static (bended) stooped position up to several minutes. Exposure to static load is an underestimated silent killer of nurses musculoskeletal system . There is evidence from this cross-sectional study that static load can be reduced by a combination of introducing the right equipment, creating awareness and education.