ISSN:1071-5754    

出版商:OVID    

年代:2001

数据来源: OVID

ISSN:1071-5754    

出版商:OVID    

年代:2001

数据来源: OVID

ISSN:1071-5754    

出版商:OVID    

年代:2001

数据来源: OVID

ISSN:1071-5754    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

Despite our best efforts, chronic wounds continue to confound us. Cases of patients with diabetes who have wounds are particularly perplexing and challenging to manage. The diagnosis and treatment of osteomyelitis in this population are of great interest to clinicians. Much of wound care is based on tradition and expert opinion. The current focus is on evidence-based practice. The purpose of this critical literature review is to determine the best evidence for diagnosing osteomyelitis as a basis for providing appropriate therapy to patients with diabetes and foot ulcers. Treatments vary greatly in terms of time, cost, and invasiveness depending on the accuracy of the diagnosis. The choice of oral versus parenteral antibiotics, the length of the treatment, and decisions about surgical intervention or aggressive debridement are based on correctly differentiating osteomyelitis from soft tissue infection, osteoarthropathy, and other conditions. It is difficult to differentiate soft tissue infection from bone infection in the patient with diabetes and neuropathic bone disease. The precision of available tools for diagnosing osteomyelitis in patients with diabetes and foot ulcers is widely debated. A gold standard as a reference test for clinical trials and treatment decisions has not been consistently used in published research studies. Without a reference test that is reliable and valid, the conclusions regarding effectiveness of diagnostic modalities and antibiotic treatment regimens are questionable.

ISSN:1071-5754    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

Use of telehealth in wound care continues to expand as technology is enhanced and clinicians become more familiar with use of the new technology as a supplement to usual care. This article describes the Telehealth Wound Care Program implemented at Mount Sinai Hospital Home Health Agency and Mount Sinai Hospital Wound Care Center. Results of the wound care provided for one patient are included in the case study described in this article. The authors note the many benefits of telehealth as an adjunct to usual therapy in wound care.

ISSN:1071-5754    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

PurposePractical aspects and impact on daily life of short bowel syndrome (SBS) and an ostomy were explored in people with SBS. Interest was focused on nutrition and excretion, ostomy problems, associated medical and surgical problems, socioeconomic situation, and social and leisure activities.Subjects and SettingSix subjects (range, 38–68 years) with Crohn's disease were included from the University Short Bowel Clinic at Sahlgrenska University Hospital, Gothenburg, Sweden. Average disease duration was 25 years, and mean small intestinal length was 107 cm; 4 subjects were receiving parenteral nutrition at home.MethodsSubjects were interviewed in their homes using a semistructured interview divided into the areas of focus. Data were transcribed by shorthand and were rewritten into the computer the same day. A questionnaire on nutrition and excretion was answered by the subjects in writing and mailed to the interviewer.ResultsThe most significant observation was the limited ability to act spontaneously, because all daily activities involved considerable planning. Three subjects said they had never accepted the ostomy; the others would not return to their pre-stoma lifestyle. The 2 subjects with a colostomy described special emptying patterns that caused limitations in social life that had not been reported previously. Fistulas were reported as having been the most trying part of the disease. Three subjects worked part time, which was of utmost importance for quality of life. Fatigue influenced social and leisure activities.ConclusionPeople with SBS are bothered by a number of demanding problems in various aspects of life. Therefore, a team approach toward care is critical to allow for coordination of action toward the various needs. It also seems unlikely that standard instruments of quality of life can capture the complicated situations with which these subjects live. It appears that coping mechanisms also need to be considered.

ISSN:1071-5754    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

Selecting continence products for an individual patient or hospital contract is often a daunting task. This article describes the evaluation process developed for a program of government-funded multicenter evaluations of continence products established in the United Kingdom to provide an evidence base for product selection. The essential requirements of an evaluation are discussed, together with the methodologic and statistical issues that such evaluations present. The strengths and limitations of multicenter trials are examined and suggestions are made regarding other areas of nursing in which this approach could be usefully adopted.

ISSN:1071-5754    

出版商:OVID    

年代:2001

数据来源: OVID

ISSN:1071-5754    

出版商:OVID    

年代:2001

数据来源: OVID

ISSN:1071-5754    

出版商:OVID    

年代:2001

数据来源: OVID