Nurses Caring for Patients at the End of Life in Intensive Care Unit : A Literature Review

This article explored nurses caring for patients at the end of life in the Intensive Care Unit (ICU). A literature review was conducted by analyzing 56 scholar papers including research articles, thesis/dissertation, and books which met the inclusion criteria. Data were searched through PubMed, ProQuest, Wiley Online Library and Science Direct. Searches used combination of following keywords: ‘ICU nurse’, combined with ‘caring’, ‘end of life’, ‘end of life care’. The result of the analysis presented the need of the patients and their families at the end of life, the nurses’ goals of caring at the end of life, the nurses’ role, problems and barriers in caring at the end of life in the ICU. Culture and religion have an influence in caring for patients at the end of life. The knowledge from this literature review can be guided the nurses to develop an effective caring model at the end of life in the ICU

Thai Adolescents and Social Responsibility: Overcoming Violence in Schools and Creating Peace

There is a need to understand the nature of adolescent violent behavior across cultures as well as to learn more about adolescent’s social responsibility toward violence. Purpose: To describe social responsibility of adolescents toward violence and explain the aspects of adolescent’s social responsibility in Thailand. Design and Methods: Focus group and qualitative individual interviews (N=18) were conducted with 18 participants, including 10 adolescent students, 4 teachers, and 4 parents, to assess their perceptions and behavior on social responsibility and violent behavior. Thematic analysis was conducted in three phases to code transcribed interview data and identify themes of social responsibility toward violence. Findings: Violence has become recognized globally as a critical social problem that requires vital attention. The present study found that it is valuable that adolescent students could cultivate social responsibility toward violence. In this research, the social responsibility was categorized into 4 aspects: 1) Being influenced by others and feeling out of control; 2) Being frustrated with diffusion of responsibility for promoting non-violence; 3) Not accepting responsibility for escalating behavior; and 4) Seeing the larger picture and developing trust. Conclusions: Adolescents’ social responsibility should be promoted through collaborative social support between home and school. This was accepted among the participants as the way to reach the culturally-valued superior moral rank of social responsibility. The concerted collaboration to attain the highest value of social responsibility has the potential to solve issues of violence and latent violence as well as contribute towards a peaceful society. Key words: adolescence, violence, social responsibility, school mental health promotio

Nurse Involvement in End of Life Decision Making in the Intensive Care Unit: A Literature Review

This article reviews the evidence related to nurse involvement in the end of life (EOL) decision making in the Intensive Care Unit (ICU). This study was conducted by analyzing 53 scholarly papers which met the inclusion criteria. Data were searched through CINAHL, Science Direct, ProQuest, Wiley Online Library, and PubMed. The keywords used were “ICU Nurse”, combined with “end of life”, “decision making” and “end of life decision making”. The databases of PubMed, ProQuest, CINAHL, Wiley Online, Ovid, and Science Direct were used to search for the relevant articles. The results of the analysis present the definition of end of life decision making, type of end of life decision making, persons involved in end of life decision making in the ICU, process of end of life decision making in the ICU, a nurse’s role in end of life decision making, and factors influencing end of life decision making in the ICU. The results of this study are important to develop an understanding regarding nurse involvement in end of life decision making in the ICU

The lived experience of family caregivers caring for patients dependent on life-sustaining technologies

Purpose: The purpose of this study was to describe the meaning of the lived experience of family caregivers caring for their loved ones who were dependent upon life-sustaining technologies while in the hospital. Methods: This study followed van Manen's hermeneutic phenomenological approach to generate and analyze data to describe the experience of ten family caregivers who met the following inclusion criteria: a family member who participated actively in caring for the loved one who was dependent upon technologies for human care. Data were collected using individual in-depth interviews. The interview transcriptions were analyzed using van Manen's phenomenological approach, while Lincoln and Guba's criteria were used to establish trustworthiness of the study. Findings: Four thematic categories structured the meaning of the experience: Being an invisible person; supporting patients' wholeness; struggling to trust technologies for human care; and living in uncertainty. These thematic categories were reflective of Van Manen's four lived worlds of body, relation, space, and time. Conclusion: Understanding the experience of family caregivers challenges nurses to express their technological competencies in caring more fully in their human care. Locsin's theory of Technological Competency as Caring in Nursing was used to explain and describe the meaning of the experiences of family caregivers caring for patients who were dependent upon technologies for human care, and foster nursing practice as caring in nursing

Laser Induced Modification and Integration of Glasses

Glasses have been widely used as substrates in new technologies especially flat panel displays (FPD), organic light-emitting diode (OLED) lighting, and lab-on-a-chip (LOC) applications. They are inexpensive, chemically inert with excellent optical, mechanical and thermal properties. In addition, they are biocompatible, and some compositions possess bioactive properties which are highly desirable in biomedical applications. This dissertation seeks to develop fundamental understanding of feature formation mechanisms and changes in morphology, structural, and mechanical properties of glasses induced by lasers in both high (a femtosecond laser) and low (a continuous wave laser) intensity regimes, and to investigate novel processes for modification and integration of glasses. Due to its nonlinear absorption capability in glasses, a femtosecond laser is used to generate internal features inside glass. Their morphology, structure, and mechanical properties such as modulus, hardness, ductility, and fracture toughness are experimentally characterized. Fundamental understanding of the feature formation and these property changes is developed through differential interference contrast (DIC) microscopy, spatially resolved Raman spectroscopy, spatially resolved nanoindentation, and predictive numerical simulations. The improved understanding lays ground work to investigate novel processes of transmission welding (TW) and single step channeling (SSC) in glasses. Joining or sealing of glasses in FPD, OLED, and LOC applications are currently based on adhesives. They are susceptible to moisture permeability and require high curing temperatures of entire parts for a long period of time. TW is investigated and the mechanism of joint formation is analyzed. A numerical model, developed to predict the welding widths, demonstrates the inverse teardrop-shaped absorption volume like the experimental weld seam geometry. Using indentation fracture analysis, the joint is determined to have better mechanical properties than the base material. Fabrication of microfluidic networks in LOC using traditional lithographic processes, or other hybrid processes is cumbersome because they involve multiple steps. SSC is investigated, and numerical models are also developed and experimentally validated to predict the channel lengths resulting from different laser and focusing parameters. The understanding of the channel formation mechanism, and the channel length variation corresponding to the working parameters is developed. TW has the potential to achieve a reliable, highly localized sealing process while SSC has the potential to simplify LOC designs requiring no adhesive for FPD and biomedical industry, respectively. Reduction of the risk of early failure for load-bearing biomedical implants could be achieved by coating bioactive glass onto bioinert metallic substrates. High bioactivity of bioactive glass accelerates the bone-bonding time. Coatings of 45S5 Bioglass, which has the highest rate of bioactivity by plasma spraying and enameling usually fail due to its significant crystallization and weak adhesion to the substrates. Double layer coating by a continuous wave (CW) laser is investigated to produce a dense bond coat having a strong adhesion and a porous top coat having high bioactivity. The morphology and microstructure of the resultant laser coatings are experimentally characterized. A mixed interfacial layer is found at the glass-titanium interface indicating a relatively strong chemical bonding. The top coat is examined revealing a porous structure with low crystallinity. A numerical model is developed to aid in understanding laser sintering mechanisms and is validated experimentally to predict the overall porosity and crystallinity of laser coating

Anxiety and Physiological Responses in Patients with First Myocardial Infarction

Abstract—Myocardial infarction (MI) is a leading cause of mortality and morbidity in many countries. MI in patients tends to be followed by anxiety that may contribute to developing complications. The first experience of MI was found as one factor that influences anxiety in patients. Severe and untreated anxiety has negative impacts on physiological responses as a rapid response to an infarction. Moreover, the assessment and treatment of anxiety in hospitals are commonly less undervalued. The purpose of this study was to examine the anxiety levels and physiological responses among first MI patients. This study was a descriptive study with 60 first MI patients who were admitted to ICCU of Sanglah Hospital, Bali, Indonesia. Subjects were asked to complete the anxiety instrument using the 6-item State Anxiety Inventory and Trait Anxiety Inventory. Blood pressure, heart rate, and respiration rate were assessed as clinical physiological responses of anxiety. The results revealed that more than half of the subjects were found to have moderate state anxiety (53.3%) and 48.3% showed moderate trait anxiety. 35% of patients in their first experience of MI showed a high level of state anxiety. Also, there was a statistically significant correlation between physiological responses and anxiety, however, not in systolic blood pressure. A significant number of patients with first MI were assessed as having high and moderate levels of anxiety. Thus, these results might be taken as evidence to early evaluate the anxiety of MI patients to prevent further complications

Core Competencies in Vocational Welder Worker: Based on Thai Welding Industry Participator Perceptions

Abstract: A core competency facilitates the identification of training needs and guides the design of a professional development program. Thus, this research was to explore and examine the core competencies in vocational welder worker based on Thai welding industry participator perceptions. To synthesize core competencies first used the focus group technique with 17 experts to identify their perspectives on core competencies in vocational welder worker. After that competencies questionnaire survey was developed to collect data from a participator sample consist of , 206 welding industry participators. Research methods were applied to collect quantitative data using questionnaires, forms, interviews, discussion groups and workshops. The resulting analysis revealed that the main elements of the competencies in vocational welder worker could be divided into three core competencies categories, namely: 1) The knowledge and skills generally: Basic skills and Information technology skills 2) The knowledge and skills specific: Process of connection and control, Welding process design, Metal structuring, The selection of proper welding process, Welding control, Inspection and testing process piece, Drawing and design product, Handmade sheet metal product, Produce and control manufacturing, and Pipe installation 3) The attitude: Personalities and human relation