Григорій Епік

Епік Григорій Данилович (1901–1937) – український письменник, кіносценарист, перекладач і публіцист

Withdrawal symptoms in children after long-term administration of sedatives and/or analgesics: A literature review. "Assessment remains troublesome"

Background: Prolonged administration of benzodiazepines and/or opioids to children in a pediatric intensive care unit (PICU) may induce physiological dependence and withdrawal symptoms. Objective: We reviewed the literature for relevant contributions on the nature of these withdrawal symptoms and on availability of valid scoring systems to assess the extent of symptoms. Methods: The databases PubMed, CINAHL, and Psychinfo (1980-June 2006) were searched using relevant key terms. Results: Symptoms of benzodiazepine and opioid withdrawal can be classified in two groups: central nervous system effects and autonomic dysfunction. However, symptoms of the two types show a large overlap for benzodiazepine and opioid withdrawal. Symptoms of gastrointestinal dysfunction in the PICU population have been described for opioid withdrawal only. Six assessment tools for withdrawal symptoms are used in children. Four of these have been validated for neonates only. Two instruments are available to specifically determine withdrawal symptoms in the PICU: the Sedation Withdrawal Score (SWS) and the Opioid Benzodiazepine Withdrawal Scale (OBWS). The OBWS is the only available assessment tool with prospective validation; however, the sensitivity is low. Conclusions: Withdrawal symptoms for benzodiazepines and opioids largely overlap. A sufficiently sensitive instrument for assessing withdrawal symptoms in PICU patients needs to be developed

A method to develop a nursing intervention: the contribution of qualitative studies to the process

Aim of the paper. To describe how to develop a patient-centred nursing intervention (NI). Background. The stimulus for scrutinizing methods and techniques to develop a NI was a research project concerning the contribution of information and support to the sexual adaptation of women with gynaecological cancer. Within this project, a NI for sexual teaching (ST) was developed because the literature review revealed no tested NI for this purpose. How patients experience and perceive received information influences the usefulness and efficacy of a teaching intervention. Qualitative methods provide insight and understanding of patients' experience. Consequently, qualitative methods are appropriate to use when developing interventions that aim to influence patients' situations through the provision of information. Method. Previously reported approaches for developing an intervention did not match the goals and underlying premises identified for the intervention under development. An alternative method, consisting of a design phase and a testing phase, was developed. The goal of the design phase was to develop a working definition of the intervention and to formulate recommendations for carrying out the intervention. Written guidelines provided concrete examples of the topics to discuss and how to discuss them. During the design phase, a qualitative study was conducted to describe the lived-experience of the phenomenon that the information should influence, namely sexuality after treatment for gynaecological cancer. In the testing phase, a different type of qualitative study took place. The patients' experience of receiving information and the nurses' experience of providing it were investigated in order to refine the proposed intervention, to identify the results patients hope to achieve (or achieved) and to explore the underlying theoretical explanation of the intervention. During the testing phase, the feasibility and acceptability of the modified intervention were both established. Conclusion. Even when the starting point is advice from care-givers, an intervention can be developed that is in harmony with the patient perspective when qualitative studies are part of the process

Health and Social Needs of Traumatized Refugees and Asylum Seekers: An Exploratory Study

The purpose of this study was to describe the care needs of adult traumatized refugees and asylum seekers. DESIGN AND METHODS.  A mixed-methods design was used. A survey was conducted using the Camberwell Assessment of Need (CAN) among 30 patients. Semistructured in-depth interviews were subsequently conducted with eight of these patients. FINDINGS.  Key themes among refugees are loneliness and grief. Refugees are in severe psychological distress. They also encounter all kinds of practical problems that influence their quality of life. Furthermore, many of them suffer from serious psychiatric and trauma-related problems. PRACTICE IMPLICATIONS.  The results of this explorative study can contribute to the quality of care for traumatized refugees

Educational intervention for patients with head and neck cancer in the discharge phase

The consequences of head and neck cancer (HNC) treatment have great impact on patients' lives. Despite the importance of preparing patients for the period after discharge, patients frequently experience a lack of information. Aims of the study were to develop a nurse-led educational intervention to provide information during a discharge interview and to investigate the effects of the intervention on informational needs and satisfaction with information in HNC patients

Development and testing of an analytic rubric for a master's course systematic review of the literature : A cross-sectional study

Background: Conducting grading of systematic reviews in master's level programs of health sciences education is a complex process. Students conduct systematic reviews under the supervision of course faculty in seminar groups where both draft version and definite version of the literature review are graded/assessed. The aim of this study was to develop a systematic review of the literature rubric (SRL-rubric) for the evaluation of systematic reviews in the course of SRL in a master's Program of Health Care Sciences and to investigate students and faculty experiences with and the usability of the SRL-rubric. Methods: The SRL-rubric was developed using a seven-step approach. Usability was investigated with cross-sectional survey. Results: The SRL-rubric included nine categories and five proficiency levels. Fifty-Two of 59 students and all six faculty members at Utrecht University Program of Health Care Sciences completed the survey. Students rated the ease of working with the rubric with an average 6.6 (10-point scale). Faculty ratings ranged from 7 to 9. Problems were identified with distinction among cells describing proficiency levels and final grading. Discussion: A structured process focused on the requisite actions to develop the SRL-rubric. It was useful in writing and grading systematic reviews. However, some students indicated that they missed specific feedback and suggestions describing how to improve their weaknesses. Further development and research is needed to enhance grading reliability of SLR-rubric and to establish content validity and maintain consistency with criteria for conducting and reporting reviews,