A historical overview of pressure ulcer literature of the past 35 years.

This article discusses a study of publications on pressure ulcers from 1965 to 1999 using the information available in Medline. Results show that .06% of all articles relate to pressure ulcers.

Relevance of the diagnosis 'stage 1 pressure ulcer': an empirical study of the clinical course of stage 1 ulcers in acute care and long-term care hospital populations.

Stage 1 pressure ulcers are difficult to diagnose. Several prevalence studies have shown that almost half of the pressure ulcers identified are stage 1. The present study investigated the importance of stage 1.

The impact of assessing the prevalence of pressure ulcers on the willingness of health care institutions to plan and implement activities to reduce the prevalence.

Background: In 1998, 89 health care institutions (hospitals, nursing homes, residential homes, and community care institutions) participated in the first Dutch National Pressure Ulcer Prevalence Study.

Aim: Based on the innovation-decision process for individuals (Rogers 1995), the effect of their participation was investigated at different levels in the institutions [prevalence assessment coordinator, director, ward management (enrolled) nurses, and the pressure ulcer committee].

Method: A mail questionnaire was developed and filled out by 54 coordinators of the participating health care institutions.

Prevalence, risk factors and prevention of pressure ulcers in Dutch intensive care units. Results of a cross-sectional survey.

Objective: Evaluating the prevalence, risk factors and prevention of pressure ulcers in Dutch intensive care units (ICUs).

Design: Cross-sectional design.

Setting: ICUs of acute care hospitals that participated in the 1998 and 1999 national prevalence surveys.

Risk assessment scales for pressure ulcers: a theoretical, methodological, and clinical perspective.

Several instruments have been devised to measure risk of developing pressure ulcers. In this article, the value of risk assessment scales is explored and discussed from a theoretical, methodological, and clinical perspective. The first part of the article focuses on the validity of such scales from the first two perspectives.

Self-care and quality of life in patients with advanced heart failure: the effect of a supportive educational intervention.

Objective: The goal of this study was to determine the effects of a supportive educational nursing intervention on self-care abilities, self-care behavior, and quality of life of patients with advanced heart failure.

Design: The study design was an experimental, random assignment.

Setting: The study was located at the University Hospital in Maastricht, The Netherlands.

Quality of life in older patients with systolic and diastolic heart failure.

Aims: To get insight into the quality of life of a clinical practice sample of patients with heart failure that are admitted to the hospital. Secondly to determine differences between patients with systolic and diastolic dysfunction and finally to describe factors relating to quality of life.

Methods: Three dimensions of quality of life (functional capabilities, symptoms and psychosocial adjustment to illness) were assessed during interviews of 186 patients with chronic heart failure.

The effect of paracetamol, fentanyl, and systematic assessments on children's pain after tonsillectomy and adenoidectomy.

Various clinical protocols are used to manage early postoperative tonsillectomy and/or adenoidectomy (T&A) pain in children. Although believed to be effective, these protocols are not evidenced-based. Therefore, a double-blind, randomized, placebo controlled (2 x 2) factorial design was used (1) to evaluate the effectiveness of 2 pain protocols used interchangeably to manage early postoperative T&A pain and (2) to investigate whether nurses' systematic pain assessments improve pain management.

Validity and reliability of the braden scale and the influence of other risk factors: a multi-centre prospective study.

The Braden scale is one of the most intensively studied risk assessment scales used in identifying the risk of developing pressure sores. However, not all studies show that the sensitivity and specificity of this scale is sufficient. This study, therefore, investigated whether adding new risk factors can enhance the sensitivity and specificity of the Braden scale.

The development of a national registration form to measure the prevalence of pressure ulcers in The Netherlands.

To gain insight into the prevalence of pressure ulcers in Dutch healthcare institutions, a national registration form to measure the prevalence of pressure ulcers annually in different healthcare settings was developed based on a literature study and responses from a Delphi panel. The reliability and the feasibility of the form devised were tested in a pilot study conducted in a university hospital, a nursing home, and in a home healthcare setting. Interrater reliability of the grading system varied between the institutions from 0.

Factors related to fatigue; priority of interventions to reduce or eliminate fatigue and the exploration of a multidisciplinary research model for further study of fatigue.

A growing interest in the health problem presented by fatigue, both in clinical practice and research, coupled with a decreasing number of reported studies on fatigue in the last decade, make an updated and systematic review of factors related to fatigue necessary. A search of the literature, comprising 53 studies, was therefore undertaken to explore the following research questions: Which significantly social-demographic, cure-related, and care-related factors are significantly correlated with fatigue? And which nursing interventions need priority in experimental research to reduce or eliminate fatigue? Reported factors related to fatigue in analysed studies show that the correlations between the specific cure- and care-related factors and fatigue are similar among the various investigated (patient) populations. This result supports the concept of the non-specific character of fatigue.

Effects of education and support on self-care and resource utilization in patients with heart failure.

Aims: To test the effect of education and support by a nurse on self-care and resource utilization in patients with heart failure.

Methods: A total of 179 patients (mean age 73, 58% male, NYHA III-IV) hospitalized with heart failure were evaluated prospectively. Patients were randomized to the study intervention or to 'care as usual'.

Evidence-based nursing practice: both state of the art in general and specific to pressure sores.

The importance of research-based practice in nursing has been frequently stressed, and a number of nursing studies have been conducted whose results enable nursing to improve knowledge and practice. This study reports a literature review in which the current status of knowledge and research utilization with regard to pressure sores is described. This review first gives an overview of studies on knowledge utilization in general and shows that the spontaneous diffusion of knowledge is inappropriate.

The effects of primary nursing on work-related factors.

This study investigates the effects of a primary nursing care delivery system on some work-related factors of nurses in long-stay psychiatric care settings. In a quasi-experimental research design a cohort of 176 nurses was followed for 2.5 years.

Developing a supportive-educative program for patients with advanced heart failure within Orem's general theory of nursing.

Recovery from heart failure and coping with the effects of this serious condition has a major impact on the self-care demand of patients with heart failure. To prevent potential self-care deficits, education and support are important issues in nursing care. The purpose of this article is to describe the development of a supportive-educative program that is designed to enhance self-care abilities of patients with heart failure.

DUFS and DEFS: development, reliability and validity of the Dutch Fatigue Scale and the Dutch Exertion Fatigue Scale.

The purpose of this study among patients with chronic heart failure (n = 138) was to develop and test both the Dutch Fatigue Scale (DUFS) and the Dutch Exertion Fatigue Scale (DEFS). Psychometric testing of these scales included measurement of internal consistency, construct validity and criterion-related validity. Statistical analyses of both scales showed sufficient reliability and validity.

Differences in pain assessment and decisions regarding the administration of analgesics between novices, intermediates and experts in pediatric nursing.

This article describes a study examining the influence of expertise on nurses' pain assessments and decisions regarding pharmacological interventions in children. In an experimental design, novices (n = 271), intermediates (n = 222), and experts (n = 202) in pediatric nursing, various cases were presented. Each case consisted of a combination of a vignette and a video.

Effects of specialized community nursing care in patients with chronic obstructive pulmonary disease.

Objective: To investigate the effects of specialized respiratory home nursing care after discharge from a pulmonary rehabilitation center.

Design: Pretest-posttest control group design. Patients in the experimental group were visited by a nurse who specializes in respiratory care, whereas the control group received care from nurses who did not specialize in respiratory care.

Are children given insufficient pain-relieving medication postoperatively?

The literature often suggests and assumes that children are under-medicated postoperatively. A review of the literature leads to the conclusion that only a few studies answer the question of whether children's pain is relieved insufficiently. The lack of consensus on expected pain intensity after surgery and caution about prescribing analgesics could explain why analgesics are often prescribed on a pro re nata (prn) basis.

[Education and guidance of a patient with chronic heart failure. A case study].

The number of patients with heart failure is growing. To optimize care for these patients in hospital and at home, a supportive-educative intervention is developed. The intervention is guided by a standard nursing care plan which is developed from literature, existing standard nursing care plans, and interviews with nurses.

The effectiveness of massage in preventing pressure sores: a literature review.

The prevention of pressure sores is a major concern of rehabilitation nurses. Through the years, several methods have been used to prevent pressure sores. One of the most commonly used methods is massage of bony prominences and pressure areas.