Katastrofeøvelse som lærings-arena for sykepleierstudenter?

Rapporten omhandler en studie om studenterfaringer med katastrofeøvelse som læringsarena for sykepleierstudenter på andre studieår, der sykepleie til akutt og kritisk syke pasienter er tema. Hensikten med studien var å undersøke hvilke opplevelser og erfaringer studentene fikk ved å delta som helsepersonell i katastrofeøvelsen, og om dette er en aktuell læringsarena for andre års sykepleierstudenter. For å videreutvikle kvalitet fra katastrofeøvelsen som læringsarena, trengs kunnskap basert på studenters erfaringer. Metode: Studien er beskrivende, med tematisk analyse av studentenes logger og hva de reflekterte over etter øvelsen. Logger ble skrevet i slutten av øvelsesdagen. Debriefingen ble gjort etter at loggene var skrevet. Utvalget bestod av 29 studenter på andre studieår i sykepleie og som hadde deltatt på katastrofeøvelsen. Det ble anvendt tematisk analyse av logger som svar på åpne spørsmål, om sykepleierstudentenes forventninger, forberedthet som læreforutsetning, umiddelbare opplevelser av læringsarenaen og læringsutbytter. Tematisk analyse skal gi kunnskap om hva som er tema og hva som karakteriserer tema som tas opp i datamateriale (Graneheim og Lundman, 2004). Resultater: Overbyggende tema var katastrofeøvelse som læringsarena. Analysen førte til fem deltema: 1. Forberedelser, 2. Kunnskap, 3. Forventninger, 4. Trygghet, 5. Læringsutbytter. Konklusjon: Katastrofeøvelsen i sin helhet var en positiv opplevelse for studentene. Deres tilbakemeldinger er entydige og viser at de ønsker å delta på katastrofeøvelser som ledd i utdanningsprosessen

Cytokine-mediated crosstalk between cancer stem cells and their inflammatory niche from the colorectal precancerous adenoma stage to the cancerous stage: Mechanisms and clinical implications

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Exploring links between industrialization, urbanization, and Chinese inflammatory bowel disease

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Genetic and Non-genetic Factors Associated With Constipation in Cancer Patients Receiving Opioids

Acknowledgments. We are grateful to all the researchers involved in The European Pharmacogenetic Opioid Study (EPOS) and to Gunnhild Jakobsen who organized the collection of data.Peer reviewedPublisher PD

Health care providers underestimate symptom intensities of cancer patients: A multicenter European study

<p>Abstract</p> <p>Background</p> <p>Many patients with advanced cancer depend upon health care providers for symptom assessment. The extent of agreement between patient and provider symptom assessments and the association of agreement with demographic- and disease-related factors was examined.</p> <p>Methods</p> <p>This cross-sectional study included 1933 patient-health care provider dyads, from 11 European countries. Patients reported symptoms by using the four-point scales of the European Organization of Research and Treatment of Cancer Core Quality of Life Questionnaire (EORTC QLQ-C30) version 3, and providers used corresponding four-point categorical scales. Level of agreement was addressed at the group level (Wilcoxon Signed-Rank test), by difference scores (provider score minus patient score), at the individual level (Intraclass Correlation Coefficients, ICCs) and visually by Bland-Altman plots. Absolute numbers and chi-square tests were used to investigate the relationship between agreement and demographic-, as well as disease-related factors.</p> <p>Results</p> <p>The prevalence of symptoms assessed as moderate or severe by patients and providers, respectively, were for pain (67 vs.47%), fatigue (71 vs. 54%), generalized weakness (65 vs. 47%), anorexia (47 vs. 25%), depression (31 vs. 17%), constipation (45 vs. 30%), poor sleep (32 vs. 21%), dyspnea (30 vs. 16%), nausea (27 vs. 14%), vomiting (14 vs. 6%) and diarrhea (14 vs. 6%). Symptom scores were identical or differed by only one response category in the majority of patient-provider assessment pairs (79-93%). Providers underestimated the symptom in approximately one of ten patients and overestimated in 1% of patients. Agreement at the individual level was moderate (ICC 0.38 to 0.59). Patients with low Karnofsky Performance Status, high Mini Mental State-score, hospitalized, recently diagnosed or undergoing opioid titration were at increased risk of symptom underestimation by providers (all p < 0.001). Also, the agreement was significantly associated with drug abuse (p = 0.024), provider profession (p < 0.001), cancer diagnosis (p < 0.001) and country (p < 0.001).</p> <p>Conclusions</p> <p>Considerable numbers of health care providers underestimated symptom intensities. Clinicians in cancer care should be aware of the factors characterizing patients at risk of symptom underestimation.</p