Bladder dysfunction may occur in acute stroke patients and as a consequence the risk of urinary retention, incontinence and urinary tract infections increases. The literature is sparse regarding occurrence of bladder dysfunction in acute stroke and if catheterization should be performed to prevent bladder overdistension in acute stroke thrombolysis. The aim of this study was to investigate the safety of implementing a new selective and “watchful waiting strategy” for intermittent catheterization during acute stroke thrombolysis. From November 2018 to June 2019, we conducted a prospective cohort study before and after implementing (in March 2019) a selective and watchful waiting strategy for intermittent catheterization. Data were collected on nurse-administered registration forms for ischemic stroke patients treated with thrombolysis. In both periods urogenital complications were registered. We found no significant differences between period 1 (before) and 2 (after) in the occurrence of urinary tract infections and/or macroscopic urogenital bleeding episodes. However, for developing blood in the 24hour urine analysis we found a significant reduction in period 2 compared to period 1, 8 (23%) vs 3 (7%) respectively. Applying a selective and watchful waiting strategy towards urinary catheterization in acute ischemic stroke patients treated with intravenous thrombolysis did not increase the risk of urogenital complications, and the discomfort associated with catheterization was limited to fewer patients.
Relatives may play a very important role in the perioperative setting, but their experience of participation has not previously been investigated. Therefore, the aim of this qualitative study was to investigate relatives’ feelings, experiences, and needs in the perioperative setting. Fifteen semi-structured interviews with relatives were conducted. Data were analyzed according to Kvale and Brinkman’s method of meaning condensation. The findings showed that relatives had difficulties finding their role on the day of surgery and felt frustrated, anxious, and vulnerable. They felt invisible in the hospital setting and lacked information, which made choices, preparation, and participation difficult. Relatives struggling to support patients are at risk of getting ill themselves if they are not offered guidance. The study concludes that relatives need information that is different from that given to patients as well as they need acceptance and care from healthcare professionals. Furthermore, decisions about relatives’ participation should be made before the day of surgery and continuously in collaboration between patients, relatives, and healthcare professionals.
Type 2 diabetes requires continuous self-management, and remote technology such as telehealth makes it possible to increase diabetes self-management support. The aim of this study is to assess the feasibility of telephone health counselling provided by a diabetes specialist nurse, describe the participants’ sociodemographic and clinical characteristics, and identify the topics raised by the participants in the counselling. Further, we wish to assess and compare the stages of behavioural change within diet and physical activity as self-reported by the participants and assessed by the diabetes specialist nurse. The nurse applied a problem-solving model using principles from Motivational Interviewing and assessed the participants’ stage of behavioural change based on the Transtheoretical model. Participants received five telephone calls addressing self-management behaviour. We collected sociodemographic and clinical data, stages of change in diet and physical activity, and practical aspects of the telephone counselling. The majority of participants completed the programme. Telephone health counselling during daytime provided by a diabetes specialist nurse is feasible, despite most participants being of working age. The issues raised were relevant to diabetes self-management. Interestingly, the patients assessed their stage of change in diet and physical activity as poorer than the diabetes specialist nurse did.
Background: Chest drains (chest tubes and pigtail catheters) may induce pain during and after insertion. Objective: To investigate patient-reported pain in patients with chest drains. Methods: A cross-sectional questionnaire study. On the day after chest drain insertion, patients described their present pain and recalled the pain during and 1-2 hours after insertion. Pain intensity (VAS) was recorded during insertion. The following was recorded 1-2 hours and one day after insertion: pain intensity at rest (VAS, Likert) and during physical activity (Likert scale), site, location (superficial or deep), duration and the character of pain. Results: Patients were consecutively included (49 with chest tube and 82 with pigtail catheter). Chest tubes caused moderate pain intensity at all measured points; pigtail catheters caused light pain. The duration of pain predominantly lasted > 1minute or was constant, and the character of pain was shooting and tender. Significantly higher pain intensity was seen in women than in men, and during physical activity than at rest. Conclusion: To increase the quality of care concerning pain management in patients with chest drain, we suggest an increased attention to pain intensity, duration and description of pain, especially in patients with chest tubes, in women and during physical activity.
In this essay I want to share reflections on a broad understanding of vulnerability ending with consideration of the mutual vulnerability of patients and nurses. Patients’ vulnerability is a key issue in nursing aiming at protecting the patient towards harm. However, attention has also been paid to the vulnerability of the nurse in recent years. From the perspective of vulnerability in a broader sense, exploration of vulnerability in healthcare shows the importance of the phenomenon and the meaning in relation to the life world. Deduced from literature on vulnerability a definition captures the complexity of objective versus subjective vulnerability. This show how the external judgment of people’s vulnerability may influence their internal perception of being vulnerable. In healthcare dependency may increase the patient’s vulnerability. This is caused by the need for help from the nurse that makes the patient open for supporting, and thereby also open for harming encounters. The nurse’s vulnerability lies in her or his engagement in emphatic caring for the patient. If failing to provide proper care, the nurse’s existence as a good nurse is threatened. This is further extended if the patient turns against the nurse. Elaboration on the mutual vulnerability of patients and nurses opens for enhanced understanding of the phenomenon and related phenomena that may reduce harm.
2-2020, årgang 10
Nordisk Sygeplejeforskning – Nordic Nursing Research is a scientifically and peer-reviewed level-one journal. The journal publishes scientific articles and essays. Nordic Nursing Research addresses researchers within the fields of nursing science and health, teachers in the health education, nurses in clinical practice and other professionals.
The journal publishes articles in Norwegian, Danish, Swedish and English.
Nordisk Sygeplejeforskning – Nordic Nursing Research er et vitenskapelig og fagfellevurdert tidsskrift på nivå 1. Tidsskriftet publiserer vitenskapelige artikler og essays, og henvender seg til forskere innen sykepleievitenskap og helsefag, undervisere, sykepleiere i klinisk praksis og andre fagprofesjonelle.
Tidsskriftet publiserer artikler på norsk, dansk, svensk og engelsk.
Pia Dreyer (PhD), Aarhus Universitetshospital
National editor Denmark
Elizabeth Rosted (PhD) Sjællands Universitetshospital, Roskilde
National editor Norway
Heidi Jerpseth (Postdoktorstipendiat), Høgskolen i Oslo og Akershus
Nina Falsen Krohn
Typeset: Type-it AS
ISSN online: 1892-2686
The journal is owned jointly by Dansk Selskab for Sygeplejeforskning and Norsk Selskab for Sykepleieforskning NSF and published by Universitetsforlaget.
© Universitetsforlaget 2020 / Scandinavian University Press