av Maria Sandhaug og Åse Mygland
Rehabilitation after traumatic brain injury – why use standardized outcome measures in the clinic?Engelsk sammendrag
A traumatic brain injury can be defined as an injury caused by an external trauma – a condition which affect nearly 9,500 people in Norway every year. The most important causes related to traumatic brain injury are traffic accidents, violence, and sports accidents in which 10% of the injuries are so severe that long term and specialized rehabilitation is necessary. The average age of those victimized by traumatic brain injury is approx. 30 years.
Brain injury rehabilitation concerns assessment measures of different areas of function. There is a range of country-specific interventions and treatments reflecting the different traditions of healthcare in Europe. The injury profile is often complex, and it may thus be difficult to evaluate the effect of the treatment. To match this diversity of treatment modalities, a wide range of outcome measures are used to evaluate the efficacy of intervention or treatment. Standardized outcome measures can be used to chart areas of attention in regard to individualized treatment, patient prognosis, and effect of treatment. Use of these measures may lead to the establishment of a common language among experts and contribute to research and development. As such, standardized outcome measures are well established internationally, but practical matters concerning organisation and utility in the everyday clinic are not so well documented. Do these measures in fact reflect a correct image of the clinic? Are they too demanding on resources in a busy everyday clinic? There is a need for a national standard for a group of valid outcome measures in rehabilitation medicine. The purpose of this article is to discuss the utility and benefits of implementing standardized outcome measures in clinical rehabilitation practice.
av Ingrid Poulsen og Mette Rosendal Darmer
av Vibeke Rischel og Alice Slot
Cat-ch-Ing, what does it catch? A discussion of the audit instrument Cat-ch-IngEngelsk sammendrag
Auditing records is a necessity in quality improvement in nursing. The Cat-ch-Ing instrument is Auditing records is a necessity in quality improvement in nursing. The Cat-ch-Ing instrument is developed for auditing nursing records based on the VIPS-model.
In a sample of 66 audits, this study explores the correlation between the total score, the quantitative and the qualitative score when using the Cat-ch-Ing instrument. Furthermore, the article explores the transparency of the total score, and discusses the applicability of the instrument. It was found that a high total score in Cat-ch-Ing was dependant of the presence of a care-plan and a discharge note in the record. Results of audit using the Cat-ch-Ing instrument ought not to be compared since the contents of the total score lack transparency. We recommend that Cat-ch-Ing is further developed before being used systematically in Denmark. This development should focus especially on the elimination of systematic bias, weighting between variables and integration of Danish legal demands towards nursing documentation.
av Kari Martinsen
The spontaneous flash of an idea and its meaning for life and workEngelsk sammendrag
In the practical work of a clinical nurse as well as in general research activity, the sudden flash In the practical work of a clinical nurse as well as in general research activity, the sudden flash of an idea („innfall“) can be a liberating and creative influence. Such an intuitive idea may have a decisive impact by throwing an illuminating and critical light on the work of the practical nurse and that of the researcher alike. Indeed, I will maintain that the sudden flash of ideas influences all creative thinking, all scientific discoveries, as well as our own daily lives. A spontaneous flash of an idea is something that suddenly enters one’s mind, a notion not thought of previously. You have to catch it in its flight and fly into creativity on its wings. It cannot be planned for or constructed. However, it is possible to establish conditions and prepare room for flash ideas to occur – it will not come without such preparations. It further requires courage to open up for, take on, pursue and explore such a spontaneous notion, since it may require changes in one’s way of thinking and working. The point of orientation for the following discussion will be (the Danish theologian and philosopher) K.E Løgstrup’s thoughts on the sudden flash of an idea („innfallet“).
av Kristina Holmegaard Thygesen og Bente Appel Esbensen
Disease related problems in everyday life in patients with lung cancer – part IEngelsk sammendrag
At present, patients with lung cancer live longer than before with the cancer disease and its At present, patients with lung cancer live longer than before with the cancer disease and its treatments. Consequently, they are to a higher degree suffering from the disease, the treatment, and side effects. The purpose of this investigation was to reveal the problems affecting the everyday life of the lung cancer patient, and to consider possible differences in male and female patients with lung cancer perception of these problems. The investigation was based on a survey using a questionnaire including 35 patients with lung cancer. In total, 74 % of the patients had known their diagnosis less than 12 months. All patients had experienced breathing difficulties in everyday life. The everyday life of men was affected by a higher variety of problems compared to that of women. In general, everyday life of the lung cancer patients was affected by numerous socio-cultural, psychological, mental, and existential problems, and they therefore need specific attendance and interventions to improve their situations.
av Jakob Ibsen Vedtofte
Patients’ satisfaction with anaesthesia and perioperative courseEngelsk sammendrag
Aim of this part of the investigation was to uncover the patients’ satisfaction with anaesthesia and operation. The interviews in this proportion of the investigation were part of a clinical trial with investigation of depth of anaesthesia monitoring, and the interviews one week after surgery served to investigate any difference in the patients’ satisfaction with the treatment. The student nurse-anaesthetists in four hospitals contributed each with two procedures, one with monitoring and one without.
The investigation included 25 student-nurse anaesthetists and 50 patients.
The investigation showed that 33 patients were completely satisfied with the anaesthesia. The rest, 17 patients were less satisfied with the anaesthesia. Most of the dissatisfaction dealt with the postoperative course where slow recovery, nausea, vomiting, and pain after surgery were the three most common. The perioperative course was also commonly commented with remarks about reception, communication, and induction of anaesthesia whereas preanaesthetic complaints were unusual.
av Katrine Juhl Petersen
The blue patientEngelsk sammendrag
„The blue patient“ describes one of the three categories „white“, „blue“, and „red“into which all patients are divided upon arrival at the emergency room. Patients in the blue category are supposed to receive treatment within three hours, whereas the „red“ group requires immediate treatment, and the „white“ is the least acute. The blue patient category forms the basis of this qualitative survey of the individual patient-experience of care and nursing at the emergency room. The purpose is to achieve a better insight into the expectations and experience of the patient when meeting the nurse personnel. The survey is based on interviews with nine patients after treatment at the emergency room. The answers have been analysed on the basis of a phenomenal and hermeneutic methodical perspective. The conclusion of the survey is that nursing care is of the utmost importance for the patient’s wellbeing and feeling of safety during the course of treatment. Furthermore, there is a strong connection between the nursing skills of the personnel and the ability of the patients to handle crises situations.
av Gitte Sylvester Jensen
When the body awakens
av Annemette Lundmark Jensen
Breast feeding – indicator of a good motherhood?Engelsk sammendrag
The Danish health system recommends full breast feeding for 6 months, in order to prevent the infant from catching diseases.
Breast feeding a child labels the mother as a normal and good mother whereas the opposite is the case of a mother not breast feeding her child. This mother stands the risk of being stigmatized as an abnormal and not very good mother.
An anthropological literature study indicates that motherhood and feelings related to motherhood are very much created in the socio-cultural context of which the mother is a part. The many different ideals of today’s women and the roles they may play, therefore influence the way these women consider and give priority to breast feeding, and not all roles suit a breast feeding mother.
If the health system continues its heavy focusing on preventing diseases for the child, the risk is creationing a different kind of diseases and suffering for women who do not breast feed their children.