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Illness Trajectory (illness + trajectory)
Selected AbstractsComparison of ventilator-dependent child reports of health-related quality of life with parent reports and normative populationsJOURNAL OF ADVANCED NURSING, Issue 1 2007Jane Noyes Abstract Title. Comparison of ventilator-dependent child reports of health-related quality of life with parent reports and normative populations Aims., This paper is a report of the first study of ventilator-dependent child and parent ratings of health-related quality of life using a validated instrument, which was undertaken as part of a case study of costs and consequences. Background., Advances in medical care and technologies such as the ventilator have extended childhood illness trajectories beyond our current range of knowledge and experience. These advances and their effects reinforce the need for further research to determine health-related quality of life as an outcome of ventilator-dependency in childhood. Methods., The KINDL was administered to ventilator-dependent children aged 4,18 years and parents as part of an in-depth case study. Twenty-seven parents and 17 children (including 17 child-parent pairs) completed questionnaires. Data were collected between 2001 and 2004. Findings were compared with normative values derived from a representative sample of children of a similar age in the general population. Results., Ventilator-dependent children reported significantly lower overall health-related quality of life, and significantly lower scores on all domains except about their friends, compared with school children, and chronically ill children in respect of their disease. Parents and children rated children's overall health-related quality of life the same but parents reported significantly lower scores for their child's disease and relationships with friends. There was a positive correlation between children and parents in all areas apart from self-esteem and school. Conclusions., Both child and parent perspectives are needed to understand the impact of ventilator-dependency and associated co-morbidity on the child. As new interventions and models of service delivery emerge it will be important for nurses to understand the impact on the child by evaluating physical, emotional and social consequences. [source] The effect of a pulmonary rehabilitation programme on older patients with chronic pulmonary diseaseJOURNAL OF CLINICAL NURSING, Issue 1 2008Kim Ae Kyung RN Aim., The aim of this study was to answer the question: is there an effect on the respiratory capacity and activity tolerance of older patients with chronic obstructive pulmonary disease who participate in a pulmonary rehabilitation programme? Background., Pulmonary rehabilitation is now an integral part of chronic obstructive pulmonary disease management. Evidence supports the positive effects of breath training and exercising training on quality of life, exercise tolerance and improved physical condition of individual with chronic obstructive pulmonary disease. Limited empirical documentation exists to support the effectiveness of a nurse managed rehabilitation programme for older patients with chronic obstructive pulmonary disease. The study was done to evaluate the effects of pulmonary rehabilitation provided by nurses on the pulmonary function, gas exchange and exercise tolerance in older patients with chronic obstructive pulmonary disease. Design., A one group pre-test,post-test design was used to evaluate the effects of a pulmonary rehabilitation programme. Method., The sample consisted of 20 patients with chronic obstructive pulmonary disease who participated in a pulmonary rehabilitation programme including breathing exercises, upper-limb exercises and inspiratory muscle training. Results., The findings indicated improvement in exercise performance and a decrease in dyspnea after participation in the pulmonary rehabilitation programme. Relevance to clinical practice., The clinical nurse can make a significant impact on the illness trajectory and quality of life for patients with chronic obstructive pulmonary disease. The nurse has a critical role in helping patient with chronic obstructive pulmonary disease learn to cope, adjust and adapt to life with a chronic illness. Active nurse involvement with a patient in a pulmonary rehabilitation programme can assist in the identification of factors that motivate the patient, help in establishing realistic out comes expectations and provide patient teaching opportunities. The nurse can assist the patient to develop skills of self-awareness regarding particular symptoms, self-monitoring and health status change identification. [source] Following the path of ICU survivors: a quality-improvement activityNURSING IN CRITICAL CARE, Issue 4 2003Wendy Chaboyer Summary ,,Recent interest in continuity of care has meant that the illness trajectory experienced by intensive care unit (ICU) patients has received more attention ,,Using continuous quality improvement as a framework, this paper describes information obtained during a 3-year period relating to ICU patients' long-term experiences after being discharged from hospital ,,This information identified that most participants had been discharged home but that many experienced problems with mobility, disability and fatigue. Changes in employment status and the need for financial assistance were noted ,,As a result of the information provided by this activity, clinical practice has changed and a number of formal research studies have been undertaken [source] Helping at the bedside: Spouses' preferences for helping critically ill patientsRESEARCH IN NURSING & HEALTH, Issue 5 2004Deborah Eldredge Abstract Spouses of patients in intensive care units (ICU) need to be close and helpful to ill partners. According to adult attachment theory, emotional responses may be related to preferences for closeness and helpfulness, and according to control theory optimism also may influence spouses' emotional responses. Spouses' goals and helping behaviors were assessed in 88 spouses of ICU patients. Using a repeated-measures design, the relationships of closeness, helpfulness, and optimism to emotional outcomes were assessed. Preferences for closeness and helpfulness were strongly related, and together with optimism, predicted spouses' mood at some point of the illness trajectory. Spouses who were over-involved with partners' care requirements were at greater risk for emotional distress. Results suggest that closeness and helpfulness are integrated concepts, and that attachment dimensions of a relationship and optimism are useful for understanding spouses' emotional responses to critical illness. © 2004 Wiley Periodicals, Inc. Res Nurs Health 27:307,321, 2004 [source] | ||||||||||