Volume 31, Issue 1 ,2009

Caring for families: Double binds in neuroscience nursing
Only $15.00

Order Now


Abstract

Despite the proliferation of literature related to nurse-family relationships, little is known about such relationships in acute care neuroscience environments. A grounded theory study illuminated the experiences of nurses caring for families of patients with acquired brain injuries in the context of acute care hospital environments. Nurses, working in pressure-cooker-like environments, tried to meet information and emotional needs of families. During data analysis, a communication pattern emerged that impacted on nurses’ experiences and relationships with families. This communication pattern, known as a double bind, contributed to a pattern of nursing that emerged and offers an explanation for the behaviours of the nurses in coping with family members. Nurses felt “damned if they did and damned if they didn’t”. To provide family-centred care, we need to fully understand the experiences of nurses caring for these families. This paper describes the concept of double bind and its application to neuroscience nursing.

Le soin aux familles: double contrainte en soins infirmiers en sciences neurologiques

Résumé

Malgré la prolifération d’écrits sur la relation infirmière famille, on en sait peu sur les relations dans un environnement de soins aigus en sciences neurologiques. Une théorie ancrée a guidé l’expérience d’infirmières soignant des familles de clients avec des traumatismes crâniens, dans le contexte d’un environnement de soins aigus en milieu hospitalier. Des infirmières qui travaillaient dans un environnement sous pression ont tenté de rencontrer les besoins émotionnels et d’information des familles. Durant l’analyse des données, une tendance de communication a émergé et offre une explication sur le coping des infirmières et de leurs comportements avec les membres de la famille. Les infirmières se sentaient dans une impasse « damned if they did and damned if they didn’t ». Nous avons besoin de bien comprendre l’expérience des infirmières qui soignent ces familles pour prodiguer un soin centré sur la famille. Cet article décrit le concept de double contrainte et son application en soins infirmiers en sciences neurologiques.



The efficacy of 5-HT3 receptor antagonists for the prevention of postoperative vomiting following craniotomy: Two studies in children and young adults
Only $15.00

Order Now

By Susan M. Neufeld and Christine V. Newburn-Cook


Abstract

The purpose of this meta-analysis was to estimate the efficacy of prophylactic administration of 5-HT3 receptor antagonists for postoperative vomiting (POV) in pediatric craniotomy patients at 24 hours. By updating a previously published systematic literature search, we found a recently published pediatric study to combine with the one already identified. The two published randomized placebo-controlled trials were combined for a total of 135 participants aged 2 to 20 (79 treatment and 56 controls). The only study drug was ondansetron. The combined relative risk (RR) of vomiting was not statistically significant in the treatment group compared to the control group (RR = 0.77; 95% CI: 0.50–1.19). There was also no evidence of efficacy for ondansetron in reducing the use of rescue antiemetics in the treatment group compared to the control group (RR = .71; 95% CI: 0.34–1.49). While combining these randomized placebo-controlled trials did not show efficacy for ondansetron in preventing POV in craniotomy patients aged 2 to 20, a clinically significant effect cannot be excluded, as even the combined sample size remained small. Thus, there is no current evidence for or against this class of drugs for preventing POV in children after craniotomy, and clinical decision-making must be based on studies in other populations and clinical experience. Ongoing assessment of nausea and vomiting and ongoing evaluation of the effectiveness of treatments in individual children and young adults remains an essential part of perianesthesia and postoperative neuroscience nursing.