RESUMEN
INTRODUCTION: Electrical injuries exhibit significant acute and long-term sequelae. Amputation and neurological deficits are common in electrical injury survivors. There is a paucity of information on the long-term outcomes of this population. Therefore, this study examines the long-term outcomes of electrical injuries by comparing them to fire/flame injuries. METHODS: Data from the Burn Model System National Database collected between 1996 and 2015 was examined. Demographic and clinical characteristics for adult burn survivors with electrical and fire/flame injuries were compared. Satisfaction With Life Scale (SWLS), Short Form-12 Physical Composite Score (SF-12 PCS), Short Form-12 Mental Composite Score (SF-12 MCS), and employment status were examined at 24 months post-injury. Linear and logistic regression models were used to assess differences in outcome measures between groups, controlling for demographic and clinical variables. RESULTS: A total of 1147 adult burn survivors (111 with electrical injuries; 1036 with fire/flame injuries) were included in this study. Persons with electrical injuries were more likely to be male and injured at work (p<0.001). SF-12 PCS scores were significantly worse for survivors with electrical injuries at 24 months post-injury than survivors with fire/flame injuries (p<0.01). Those with electrical injuries were nearly half as likely to be employed at 24 months post-injury than those with fire/flame injuries (p=0.002). There were no significant differences in SWLS and SF-12 MCS between groups. CONCLUSIONS: Adult survivors with electrical injuries reported worse physical health and were less likely to be employed at 24 months post-injury compared to survivors with fire/flame injuries. A more detailed understanding of return to work barriers and work accommodations is merited for the electrical injury population. Furthermore, the results of this study should inform future resource allocation for the physical health and employment needs of this population.
Asunto(s)
Quemaduras por Electricidad/fisiopatología , Empleo/estadística & datos numéricos , Estado de Salud , Traumatismos Ocupacionales/fisiopatología , Adulto , Amputación Quirúrgica/estadística & datos numéricos , Superficie Corporal , Quemaduras/fisiopatología , Quemaduras/psicología , Quemaduras por Electricidad/psicología , Estudios de Casos y Controles , Traumatismos por Electricidad/fisiopatología , Traumatismos por Electricidad/psicología , Femenino , Incendios , Humanos , Tiempo de Internación/estadística & datos numéricos , Modelos Lineales , Modelos Logísticos , Masculino , Persona de Mediana Edad , Traumatismos Ocupacionales/psicología , Enfermedades del Sistema Nervioso Periférico/etiología , Satisfacción Personal , Calidad de Vida , Estudios Retrospectivos , Reinserción al TrabajoRESUMEN
INTRODUCTION: Burns affecting the head and neck (H&N) can lead to significant changes in appearance. It is postulated that such injuries have a negative impact on patients' social functioning, quality of life, physical health, and satisfaction with appearance, but there has been little investigation of these effects using patient reported outcome measures. This study evaluates the effect of H&N burns on long-term patient reported outcomes compared to patients who sustained burns to other areas. METHODS: Data from the National Institute on Disability, Independent Living, and Rehabilitation Research Burn Model System National Database collected between 1996 and 2015 were used to investigate differences in outcomes between those with and without H&N burns. Demographic and clinical characteristics for adult burn survivors with and without H&N burns were compared. The following patient-reported outcome measures, collected at 6, 12, and 24 months after injury, were examined: satisfaction with life (SWL), community integration questionnaire (CIQ), satisfaction with appearance (SWAP), short form-12 physical component score (SF-12 PCS), and short form-12 mental component score (SF-12 MCS). Mixed regression model analyses were used to examine the associations between H&N burns and each outcome measure, controlling for medical and demographic characteristics. RESULTS: A total of 697 adults (373 with H&N burns; 324 without H&N burns) were included in the analyses. Over 75% of H&N injuries resulted from a fire/flame burn and those with H&N burns had significantly larger burn size (p<0.001). In the mixed model regression analyses, SWAP and SF-12 MCS were significantly worse for adults with H&N burns compared to those with non-H&N burns (p<0.01). There were no significant differences between SWL, CIQ, and SF-12 PCS. CONCLUSIONS: Survivors with H&N burns demonstrated community integration, physical health, and satisfaction with life outcomes similar to those of survivors with non-H&N burns. Scores in these domains improved over time. However, survivors with H&N burns demonstrated worse satisfaction with their appearance. These results suggest that strategies to address satisfaction with appearance, such as reconstructive surgery, cognitive behavior therapy, and social skills training, are an area of need for survivors with H&N burns.
Asunto(s)
Quemaduras/psicología , Traumatismos Craneocerebrales/psicología , Traumatismos del Cuello/psicología , Calidad de Vida , Adulto , Quemaduras/fisiopatología , Quemaduras/rehabilitación , Traumatismos Craneocerebrales/fisiopatología , Traumatismos Craneocerebrales/rehabilitación , Traumatismos Faciales/fisiopatología , Traumatismos Faciales/psicología , Traumatismos Faciales/rehabilitación , Femenino , Humanos , Masculino , Persona de Mediana Edad , Traumatismos del Cuello/fisiopatología , Traumatismos del Cuello/rehabilitación , Medición de Resultados Informados por el Paciente , Satisfacción del Paciente , Apariencia Física , Integración Social , SobrevivientesRESUMEN
Adults with Congenital Heart Disease (CHD) are a new and growing population of clients who pose a challenge to both medicine and nursing. An analysis of the literature has resulted in the development of a new conceptual framework utilizing the concept analysis of Quality of Life and Husted and Husted's ethical decision making in nursing in the care of the adult with CHD. Additionally, application of Husted and Husted's theory will be explored with a critical care case study.
Asunto(s)
Ética en Enfermería , Cardiopatías Congénitas/enfermería , Cardiopatías Congénitas/psicología , Modelos de Enfermería , Teoría de Enfermería , Calidad de Vida , Adulto , Factores de Edad , Cuidados Críticos/métodos , Cuidados Críticos/psicología , Técnicas de Apoyo para la Decisión , Humanos , Masculino , Persona de Mediana Edad , Relaciones Enfermero-Paciente , Evaluación en Enfermería/métodosRESUMEN
Critical care nursing in Nicaragua is vastly different than critical care practiced in the United States. The current status of critical care nursing in Nicaragua is challenging at best. Medical personnel do not have access to arterial blood gases, blood cultures, and capillary blood glucose monitoring. The strengths and challenges present in Nicaraguan critical care has made the nursing staff rely on keen and astute nursing assessment of their patients. Due to the lack of technology in Nicaragua, creativity and improvising are a must in caring for a critically ill patient. However, the concerns and issues facing the nurses in Nicaragua are very similar to those experienced by critical care nurses in the United States. Critical care nursing in Nicaragua is indeed true nursing at its finest.
Asunto(s)
Cuidados Críticos/métodos , Cuidados Críticos/organización & administración , Especialidades de Enfermería/métodos , Especialidades de Enfermería/organización & administración , Humanos , Ciencia del Laboratorio Clínico , Nicaragua , Evaluación en Enfermería/métodos , Especialidades de Enfermería/educación , Enfermería TransculturalRESUMEN
Water fluoridation was instituted as a public health measure more than 50 years ago to help limit dental caries. However, with the advent of fluoridated dentifrices, fluoridated infant formulas, and commercially prepared beverages with fluoridated water, the incidence of dental fluorosis is increasing. Health care professionals need to understand the history of water fluoridation, examine the benefits and complications of fluoride, and, if need be, take an informed political stance on an issue that is affecting large numbers among our pediatric population.
Asunto(s)
Fluoruración/efectos adversos , Salud Pública , Preescolar , Fluoruración/legislación & jurisprudencia , Fluoruración/estadística & datos numéricos , Intoxicación por Flúor/etiología , Intoxicación por Flúor/prevención & control , Fluorosis Dental/etiología , Humanos , Necesidades Nutricionales , Enfermería Pediátrica , Estados UnidosRESUMEN
Administration of vitamin E, vitamin C, and allopurinol to reduce reperfusion-induced injury remains controversial. Clinical trials are being conducted, and the results are promising. No adverse side effects have been reported with the short-term use of these drugs. The cost of the pre-operative medication is approximately $5 per week, which favors its use. The ability of nurses to be effective advocates of patients receiving these drugs is vital. What appears to be a trivial medication regimen may save myocardial cells and promote an uncomplicated postoperative period.