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Gan HY, Liu HC, Huang HP, He M. The Prevalence and Risk Factors for Postoperative Thirst: A Systematic Review and Meta-analysis. J Perianesth Nurs 2024:S1089-9472(24)00043-1. [PMID: 38935010 DOI: 10.1016/j.jopan.2024.01.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2023] [Revised: 01/24/2024] [Accepted: 01/30/2024] [Indexed: 06/28/2024]
Abstract
PURPOSE Thirst is a symptom of dehydration and one of the main complications affecting postoperative outcomes and comfort. Persistent water scarcity can have a detrimental effect on the cognitive function and psychology of patients. However, the current evidence about the prevalence and risk factors for postoperative thirst is not fully understood. Therefore, this study aims to investigate the prevalence and risk factors of postoperative thirst and provide guidance for clinical practice. DESIGN Systematic review and meta-analysis. METHODS We searched PubMed, Cochrane Library, Web of Science, Embase, Clinicaltrials.gov, China National Knowledge Infrastructure, and Wanfang Database. Eligible studies were evaluated using the Agency for Healthcare Research and Quality. The collected data were pooled and analyzed using Stata15.0. FINDINGS A total of 11 cross-sectional studies were included involving 20,612 patients. Eight studies reported prevalence and the pooled prevalence of postoperative thirst was 76.8% (95% confidence interval [CI]: 0.664 to 0.858). Five studies contributed to meta-syntheses of risk factors for postoperative thirst. The results indicated that sex (odds ratio [OR] = 1.44, 95% CI = 1.13 to 1.84, I2 = 80.2%, P = .006), anesthesia drug (OR = 1.48, 95% CI = 1.06 to 2.06, I2 = 94.8%, P < .001), surgical type (OR = 0.66, 95% CI = 0.49 to 0.9, I2 = 77.9%, P = .004) were statistically associated with postoperative thirst. CONCLUSIONS Our study shows a high prevalence of postoperative thirst. Sex, anesthesia drug, and surgical type are risk factors that influence postoperative thirst. Nurses and other health care professionals should routinely assess the postoperative thirst of patients and perform targeted interventions to alleviate their distressing symptoms and improve the quality of care.
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Affiliation(s)
- Hao-Yue Gan
- School of Nursing, North Sichuan Medical College, Nanchong, Sichuan, China; Operating Room of Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Mianyang, Sichuan, China
| | - Hang-Cheng Liu
- School of Nursing, North Sichuan Medical College, Nanchong, Sichuan, China
| | - Hua-Ping Huang
- Nursing Department of Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Mianyang, Sichuan, China
| | - Mei He
- President Office of Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Mianyang, Sichuan, China.
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2
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Wang R, Wang L, Liu T, Peng C. Effects of menthol on thirst during surgery patients fasting: A systematic review and meta-analysis of randomized controlled studies. Int J Nurs Pract 2024; 30:e13191. [PMID: 37582491 DOI: 10.1111/ijn.13191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2022] [Revised: 07/13/2023] [Accepted: 07/28/2023] [Indexed: 08/17/2023]
Abstract
AIMS We aim to analyse the effect of menthol on thirst intensity and thirst comfort in surgical patients. BACKGROUND Menthol has achieved good results in quenching thirst in patients in intensive care units, but its safety and reliability in perioperative fasting patients are unknown. DESIGN A systematic review with meta-analysis of intervention studies was performed. DATA SOURCES We used Chinese and English databases from their dates of inception to May 2022. Literature was retrieved from PubMed, Web of Science, Cochrane Library, Embase, CINHAL, SinoMed, CNKI, Wanfang and VIP database. REVIEW METHODS Two reviewers independently examined the records according to the eligibility criteria and extracted the data of each included study. RESULTS A total of seven studies were identified in this review, which included 537 surgical patients. Overall, menthol reduced thirst intensity in surgical patients and decreased thirst discomfort. Further subgroup analysis revealed that the menthol intervention significantly improved thirst intensity in surgical patients during preoperative and postoperative fasting periods. The Egger's tests showed no significant bias (p = 0.113 and 0.553, thirst intensity and thirst discomfort, respectively). CONCLUSION Menthol intervention effectively improved thirst intensity and thirst discomfort during fasting in surgical patients, but more large-scale, multicentre randomized controlled trials are required to confirm these findings further.
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Affiliation(s)
- Ran Wang
- Department of Anesthesia and Surgery, Xuanwu Hospital of Capital Medical University, Beijing, People's Republic of China
| | - Lin Wang
- Department of Anesthesia and Surgery, Xuanwu Hospital of Capital Medical University, Beijing, People's Republic of China
| | - Ting Liu
- Department of Anesthesia and Surgery, Xuanwu Hospital of Capital Medical University, Beijing, People's Republic of China
| | - Cao Peng
- Department of Anesthesia and Surgery, Xuanwu Hospital of Capital Medical University, Beijing, People's Republic of China
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3
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Çelik SŞ, Mert S, Arslan HN. The Effect of Cold Oral Applications in the Management of Postoperative Thirst: A Systematic Review. J Perianesth Nurs 2024:S1089-9472(23)01064-X. [PMID: 38556965 DOI: 10.1016/j.jopan.2023.11.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Revised: 11/16/2023] [Accepted: 11/28/2023] [Indexed: 04/02/2024]
Abstract
PURPOSE Thirst is one of the most bothersome symptoms experienced by surgical patients. Effective thirst intervention and management in the Post Anesthesia Care Unit (PACU) and hospital wards is critical because patients are less sedated and more aware than in the past. There is a need to review the literature on the identification and management of thirst in the inpatient and PACU settings. The aim of this systematic review was to examine the available evidence on the effectiveness of oral cold applications on thirst in postoperative patients. DESIGN This was a systematic review study. Articles in PUBMED, Web of Science, ScienceDirect, TÜBİTAK-ULAKBİM, and TRDizin databases between January 2008 and January 2023 that included oral cold applications to relieve the thirst of patients in the postoperative period were included. METHODS The PICOT-SD (Patients Interventions Comparison Outcome Time-Study Design) method was used as an eligibility criterion for inclusion in the study. The eligibility criteria included that the articles were written in English-Turkish and within the target dates, the studies included nursing interventions, the primary outcome of the studies was thirst, and the study sample included postoperative patients. The risk of bias was assessed using the RoB2 tool developed by Cochrane. FINDINGS A total of 254 articles were retrieved from the databases using the specified keywords. 244 articles did not meet the study criteria: 30 were excluded because they were not interventional studies, 61 were not conducted in a postoperative population, 56 were duplicates, and 79 were not on a related topic. A total of 10 studies consisting of randomized controlled trials and quasi-experimental articles met the criteria for our review. Oral cold applications effectively reduced the thirst rate of postoperative patients and improved their health-related quality of life. The intervention has also been shown to reduce other anesthesia-related complications. CONCLUSIONS This systematic review concluded that cold oral applications have promising effects on thirst, dry mouth, and health-related quality of life. Cold oral applications are cost-effective and suitable for large-scale health care applications.
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Affiliation(s)
| | - Sabiha Mert
- Istanbul Galata University, Vocational School, Anesthesia Program, Istanbul, Turkey
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4
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Bayrambey R, Akkuş Y. Evaluation of thirst severity, death anxiety, and complementary and supportive therapy use as predictors of urinary incontinence-related quality of life in older adults. Eur Geriatr Med 2024; 15:269-277. [PMID: 38007407 DOI: 10.1007/s41999-023-00892-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 10/24/2023] [Indexed: 11/27/2023]
Abstract
PURPOSE This correlational survey study aimed to evaluate thirst severity, death anxiety, and the use of complementary and supportive therapy as predictors of urinary incontinence-related quality of life in older adults. METHODS The study included 368 participants aged 60 or older. Data were collected by face-to-face interviews using a participant information form, the International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF), Visual Analog Scale for thirst severity, Death Anxiety Scale, a modified version of the Mini Mental State Examination, and questions about their use of complementary and supportive therapies. RESULTS The participants had a mean age of 70.5 ± 6.9 years (54.9% female). Mean ICIQ-SF score was significantly correlated with daytime frequency of urine leakage and thirst severity score. Multiple linear regression analysis indicated that thirst severity was a significant predictor of urinary incontinence-related quality of life. Most of the older adults said they had never used complementary or supportive therapies for urinary incontinence. CONCLUSION Thirst severity should be assessed in older adults with urinary incontinence in addition to other factors that may affect ICIQ-SF scores.
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Affiliation(s)
- Rabia Bayrambey
- Faculty of Health Science, Nursing Department, Kafkas University, 36100, Kars, Turkey.
| | - Yeliz Akkuş
- Faculty of Health Science, Nursing Department, Kafkas University, 36100, Kars, Turkey
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5
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Phelan C, Hammond L, Thorpe C, Allcroft P, O'Loughlin M. A Novel Approach to Managing Thirst and Dry Mouth in Palliative Care: A Prospective Randomized Cross-Over Trial. J Pain Symptom Manage 2023; 66:587-594.e2. [PMID: 37562697 DOI: 10.1016/j.jpainsymman.2023.08.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 07/30/2023] [Accepted: 08/03/2023] [Indexed: 08/12/2023]
Abstract
CONTEXT Thirst and xerostomia are significant and highly distressing symptoms experienced by patients receiving palliative and end-of-life care. OBJECTIVES Determine a reduction of thirst intensity and perceptions of dry mouth on a numerical scale following both the experimental intervention (mini mint ice cubes) and control (plain ice chips). METHODS Cross-over Randomized Controlled Trial (RCT) to assess the effectiveness of novel intervention in the treatment of dry mouth and the sensation of thirst in palliative care patients. RESULTS Patients rated the severity of their symptoms of dry mouth and thirst using a numeric rating scale (NRS). On commencing the study and preintervention, all patients suffered severe dry mouth and thirst (≥5/10). Mint and plain ice cubes produced improvement of symptoms immediately after interventions. Results from dry mouth ratings show, a decrease of 1.6 points for plain ice cubes (P < 0.0001), on average, ratings for mint ice cubes decreased 3.7 (P < 0.0001). For the sensation of thirst, the plain ice cube intervention group rating decreased 1.7 points (P < 0.006), ratings for mint ice cubes decreased 3.4 points (P < 0.0001). The average decrease in dry mouth and thirst intensity scores from preintervention to postintervention were significantly greater for mint ice cubes (P < 0.05) and 86.6% of patients preferred mint ice cubes. CONCLUSION This trial found that while usual mouth care and the intervention were both able to reduce the intensity of dry mouth and the sensation of thirst, the mint intervention had a greater response.
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Affiliation(s)
- Caroline Phelan
- Research Centre for Palliative Care (C.P., L.H., C.T., P.A., M.O.), Death and Dying, College of Nursing and Health Sciences, Flinders University, Bedford Park, Australia.
| | - Lauren Hammond
- Research Centre for Palliative Care (C.P., L.H., C.T., P.A., M.O.), Death and Dying, College of Nursing and Health Sciences, Flinders University, Bedford Park, Australia
| | - Courtney Thorpe
- Research Centre for Palliative Care (C.P., L.H., C.T., P.A., M.O.), Death and Dying, College of Nursing and Health Sciences, Flinders University, Bedford Park, Australia
| | - Peter Allcroft
- Research Centre for Palliative Care (C.P., L.H., C.T., P.A., M.O.), Death and Dying, College of Nursing and Health Sciences, Flinders University, Bedford Park, Australia; Southern Adelaide Local Health Network (P.A., M.O.), Southern Adelaide Palliative Services, Bedford Park, Australia
| | - Muireann O'Loughlin
- Research Centre for Palliative Care (C.P., L.H., C.T., P.A., M.O.), Death and Dying, College of Nursing and Health Sciences, Flinders University, Bedford Park, Australia; Southern Adelaide Local Health Network (P.A., M.O.), Southern Adelaide Palliative Services, Bedford Park, Australia
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6
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Çiftçi B, Yıldız GN, Avşar G, Köse S, Aydın E, Doğan S, Çelik Ş. Development of the Thirst Discomfort Scale: A Validity and Reliability Study. Am J Crit Care 2023; 32:176-183. [PMID: 37121897 DOI: 10.4037/ajcc2023954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
BACKGROUND Thirst is a sensation associated with a dry mouth and the desire or craving to drink water. Surgical patients are among those hospitalized individuals who are at high risk of developing both osmotic and hypovolemic thirst. OBJECTIVES To develop a new measurement tool for evaluating the thirst-related discomfort of surgical patients and to assess its validity and reliability. METHODS The study population consisted of patients admitted to the surgical clinics of a research hospital in Turkey between January and March 2022. The new measurement tool was developed in several stages: a pilot implementation phase with 51 patients and the main implementation phase with 198 patients. Data were collected by means of face-to-face interviews with patients. Exploratory factor and confirmatory factor analyses were performed using IBM SPSS Statistics, version 22, and IBM SPSS Amos. RESULTS The final Thirst Discomfort Scale consisted of 12 items in 3 subdimensions. The Cronbach α values of the scale subdimensions ranged from 0.787 to 0.848, and the Cronbach α value for the scale as a whole was 0.886. The scale explained 66.237% of the total variance of the data. CONCLUSION The Thirst Discomfort Scale consisting of 12 items and 3 subdimensions is a valid and reliable measurement tool for evaluating thirst-related discomfort of surgical patients.
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Affiliation(s)
- Bahar Çiftçi
- Bahar Çiftçi is an assistant professor, Department of Fundamentals of Nursing, Atatürk University, Atateknokent, Erzurum, Turkey
| | - Güzel Nur Yıldız
- Güzel Nur Yıldız is an instructor, Department of Dialysis, Muş Alparslan University, Muş, Turkey
| | - Gülçin Avşar
- Gülçin Avşar is an associate professor, Department of Fundamentals of Nursing, Atatürk University, Atateknokent, Erzurum, Turkey
| | - Sema Köse
- Sema Köse is an instructor, Department of Nursing, Erzincan Binali Yıldırım University, Erzincan, Turkey
| | - Esra Aydın
- Esra Aydın is an instructor, Department of Dialysis, Gümüşhane University, Gümüşhane, Turkey
| | - Sevgi Doğan
- Sevgi Doğan is a research assistant, Department of Fundamentals of Nursing, Atatürk University, Erzurum, Turkey
| | - Şeymanur Çelik
- Şeymanur Çelik is a research assistant, Department of Fundamentals of Nursing, Atatürk University, Erzurum, Turkey
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7
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Lin R, Li H, Chen L, He J. Prevalence of and risk factors for thirst in the intensive care unit: An observational study. J Clin Nurs 2023; 32:465-476. [PMID: 35199411 PMCID: PMC10078651 DOI: 10.1111/jocn.16257] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 01/13/2022] [Accepted: 02/08/2022] [Indexed: 01/17/2023]
Abstract
AIM AND OBJECTIVES This study investigated the incidence of thirst and contributing factors in intensive care unit (ICU) patients by analysing differences in physiologic, psychological, and disease- and environment-related parameters in ICU patients with vs without thirst. BACKGROUND Little is known about the factors that influence thirst, and there are no standardised methods for identifying at-risk patients in the ICU. Previous studies generalised the risk of thirst in ICU patients because of a lack of data on relevant variables. Here, we examined the factors contributing to thirst based on symptom management theory. DESIGN Prospective descriptive design. METHODS Physiologic, psychological, disease-related and environment-related data were collected for 301 patients from 4 ICUs (medical, surgical, cardiac and emergency ICUs) of a hospital from 15 December 2017-10 July 2019 through a screening interview, questionnaires and from electronic medical records. The data were analysed with descriptive statistics, the t-test and chi-squared test, and by logistic regression. Binary stepwise logistic regression was used to identify thirst-associated factors. The findings are reported according to the STROBE checklist for cross-sectional studies. RESULTS In total, 210/301 (69.8%) ICU patients experienced thirst. Risk factors were nil per os order (odds ratio [OR] = 4.10, 95% confidence interval [CI]: 1.44-11.69), surgery (OR = 2.96, 95% CI: 1.11-7.93), high glucose (OR = 3.36, 95% CI: 1.01-11.17) and greater disease severity (OR = 1.13, 95% CI: 1.02-1.24). CONCLUSION Thirst is common in ICU patients. Timely detection of patients' thirst and identification of those at high risk by ICU nurses can ensure the implementation of effective and safe interventions. RELEVANCE TO CLINICAL PRACTICE The results of this study highlight the need to evaluate thirst symptoms in patients with severe disease and develop relief strategies for fasting, perioperative, and hyperglycaemic patients and others who are at high risk of thirst.
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Affiliation(s)
- Rong Lin
- Research Center for Nursing Theory and Practice, Fujian Provincial Hospital, Fuzhou, China.,The School of Nursing, Fujian Medical University, Fuzhou, China.,Department of Nursing, Fujian Provincial Hospital, Shengli Clinical Medical College of Fujian Medical University, Fuzhou, China
| | - Hong Li
- Research Center for Nursing Theory and Practice, Fujian Provincial Hospital, Fuzhou, China.,The School of Nursing, Fujian Medical University, Fuzhou, China.,Department of Nursing, Fujian Provincial Hospital, Shengli Clinical Medical College of Fujian Medical University, Fuzhou, China
| | - Lili Chen
- Research Center for Nursing Theory and Practice, Fujian Provincial Hospital, Fuzhou, China.,The School of Nursing, Fujian Medical University, Fuzhou, China
| | - Jinyi He
- Intensive Care Unit, Fujian Provincial Hospital, Fuzhou, China
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8
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Flim M, Rustøen T, Blackwood B, Spronk P. Thirst in adult patients in the intensive care unit: protocol for a scoping review. BMJ Open 2022; 12:e063006. [PMID: 36446463 PMCID: PMC9710361 DOI: 10.1136/bmjopen-2022-063006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
INTRODUCTION Thirst is one of the most bothersome symptoms experienced by intensive care unit (ICU) patients. Effective diagnosis and management of thirst in the ICU is essential, particularly as patients are less sedated than previously and more aware of this problem. Currently, no overview of publications on thirst identification and management in ICU patients exists. The scoping review will address the broad question 'What is known about thirst as a symptom in adult critically ill patients?' It aims to provide an overview of the causes and risk factors, diagnosis and measurement, the symptom dimensions and its interaction with other symptoms, and thirst management. METHODS AND ANALYSIS The review will follow the Joanna Briggs Institute methodology framework to guide the process and will be reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews. Methods include: defining the review questions, eligibility criteria, concepts of interest and context; and outlining the search strategy, study selection process, data extraction and analysis. PubMed, MEDLINE, EMBASE and CINAHL will be searched from inception to April 2022. ETHICS AND DISSEMINATION Ethical approval is not required, as the scoping review will synthesise information from available publications. The scoping review will be submitted for publication to a scientific journal, presented at relevant conferences and disseminated as part of future workshops with ICU support groups and the critical care professional community.
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Affiliation(s)
- Marleen Flim
- Intensive Care, Gelre Ziekenhuizen, Apeldoorn, The Netherlands
- Expertise centre for Intensive Care Rehabilitation Apeldoorn (ExpIRA), Apeldoorn, The Netherlands
| | - Tone Rustøen
- Institute of Health and Society, Faculty of Medicine, University of Oslo, Norway, Oslo, Norway
- Department of Research and Development, Division of Emergencies and Critical Care, Oslo universitetssykehus Ulleval, Oslo, Norway
| | - Bronagh Blackwood
- Wellcome-Wolfson Institute for Experimental Medicine, Queen's University Belfast, Belfast, UK
| | - Peter Spronk
- Intensive Care, Gelre Ziekenhuizen, Apeldoorn, The Netherlands
- Expertise centre for Intensive Care Rehabilitation Apeldoorn (ExpIRA), Apeldoorn, The Netherlands
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9
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Halm MA. Managing Thirst in the Critically Ill. Am J Crit Care 2022; 31:161-165. [PMID: 35229147 DOI: 10.4037/ajcc2022475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Affiliation(s)
- Margo A. Halm
- Margo A. Halm is associate chief nurse executive, nursing research and evidence-based practice, VA Portland HealthCare System, Portland, Oregon
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10
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Effects of a spray-based oropharyngeal moisturising programme for patients following endotracheal extubation after cardiac surgery: A randomised, controlled three-arm trial. Int J Nurs Stud 2022; 130:104214. [DOI: 10.1016/j.ijnurstu.2022.104214] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2021] [Revised: 02/22/2022] [Accepted: 02/23/2022] [Indexed: 01/18/2023]
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11
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Neto AM, Gomes TS, Pertel M, Vieira LAVP, Pacheco EBAV. An overview of plastic straw policies in the Americas. MARINE POLLUTION BULLETIN 2021; 172:112813. [PMID: 34371344 DOI: 10.1016/j.marpolbul.2021.112813] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 06/28/2021] [Accepted: 08/01/2021] [Indexed: 06/13/2023]
Abstract
Although plastic straws account for a small fraction of urban residue, they are also found in marine and coastal waste, raising concerns in the community and resulting in policies to curb or ban improper disposal. These policies are still little documented and discussed in the scientific literature. This review article aims at surveying, categorizing and analyzing existing regulations on the American continent (North, Central and South America and the Caribbean). The regulations were analyzed in terms of straw bans; obligations regarding the type of raw material used in manufacturing; accessibility-related exceptions to bans; and the adoption of environmental education measures. A total of 363 regulations enacted in 62.8% of American countries were examined, 37% of which need technical standards to support their requirements. In Central America and the Caribbean, it is primarily the regulations that provide environmental education. Locations with a strong beach tourism economy have enacted plastic straw regulations.
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Affiliation(s)
- Arnaldo Mailes Neto
- Escola Politécnica, Engenharia Ambiental, Av. Athos da Silveira Ramos 149, Centro de Tecnologia, Bloco A, CEP 21941-909 Ilha do Fundão, Rio de Janeiro, Brazil
| | - Thiago Santiago Gomes
- Instituto de Macromoléculas Professora Eloisa Mano/Programa em Ciência e Tecnologia de Polímeros, Avenida Horácio Macedo 2.030, Centro de Tecnologia, Bloco J, Universidade Federal do Rio de Janeiro, CEP 21941-598, Brazil
| | - Mônica Pertel
- Escola Politécnica, Engenharia Ambiental, Av. Athos da Silveira Ramos 149, Centro de Tecnologia, Bloco A, CEP 21941-909 Ilha do Fundão, Rio de Janeiro, Brazil; Escola Politécnica/Programa de Engenharia Ambiental, Av. Athos da Silveira Ramos 149, Centro de Tecnologia, Bloco A, CEP 21941-909 Ilha do Fundão, Rio de Janeiro, Brazil
| | - Louise A V P Vieira
- Faculdade de Direito, Universidade Federal Fluminense, Rua Presidente Pedreira 62, Ingá, Niterói CEP 24210-510 Brazil
| | - Elen B A V Pacheco
- Instituto de Macromoléculas Professora Eloisa Mano/Programa em Ciência e Tecnologia de Polímeros, Avenida Horácio Macedo 2.030, Centro de Tecnologia, Bloco J, Universidade Federal do Rio de Janeiro, CEP 21941-598, Brazil; Escola Politécnica/Programa de Engenharia Ambiental, Av. Athos da Silveira Ramos 149, Centro de Tecnologia, Bloco A, CEP 21941-909 Ilha do Fundão, Rio de Janeiro, Brazil.
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12
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Flim M, Hofhuis J, Spronk P, Jaarsma T. Measuring thirst distress of patients in the intensive care unit. Nurs Crit Care 2021; 27:576-582. [PMID: 34612559 DOI: 10.1111/nicc.12719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 08/17/2021] [Accepted: 09/15/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Thirst is one of the most intense and distressing symptoms experienced by patients in the intensive care unit (ICU), and no validated measurement tools exist. Validating a thirst measurement tool for the ICU population could be a first step in gaining a better understanding of thirst in ICU patients and aid the development and implementation of strategies regarding the prevention and control of thirst. AIM The objective of this study was to determine the validity and reliability of the "Thirst distress scale for patients with heart failure (TDS-HF)" in measuring thirst distress in adult ICU patients. METHODS Content validity was established by an expert panel consisting of ICU nurses, intensivists and five ICU patients. Concurrent validity, known-groups validity and internal consistency were determined in a consecutive sample of 56 awake and oriented ICU patients with a median age of 70 years (IQR: 57-74). RESULTS Content validity of the TDS-HF in the ICU population was low, with item-content validity indexes between 0.25 and 0.75. Concurrent validity was high as Spearman's correlation between TDS-HF and the numeric rating score (0-10) for thirst distress was 0.71. Internal consistency was high (Cronbach's alpha 0.78). When comparing groups, only higher blood urea nitrogen was significantly related to higher scores on the TDS-HF (P = .003). CONCLUSION The TDS-HF has high concurrent validity and reliability in measuring thirst distress in ICU patients. Nevertheless, questions remain regarding the applicability and content validity of the scale, which should be further explored before the TDS-HF can be used in the ICU. RELEVANCE FOR CLINICAL PRACTICE The TDS-HF can be used to explore thirst distress and to evaluate interventions. Individual items of the scale can be used to explore the nature of thirst distress in individual patients.
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Affiliation(s)
- Marleen Flim
- Department of Intensive Care Medicine, Gelre Hospitals, Apeldoorn, The Netherlands.,Expertise center for Intensive care Rehabilitation Apeldoorn, Apeldoorn, The Netherlands
| | - José Hofhuis
- Department of Intensive Care Medicine, Gelre Hospitals, Apeldoorn, The Netherlands.,Expertise center for Intensive care Rehabilitation Apeldoorn, Apeldoorn, The Netherlands
| | - Peter Spronk
- Department of Intensive Care Medicine, Gelre Hospitals, Apeldoorn, The Netherlands.,Expertise center for Intensive care Rehabilitation Apeldoorn, Apeldoorn, The Netherlands
| | - Tiny Jaarsma
- Utrecht University, Utrecht, The Netherlands.,Clinical Health Sciences, Nursing Sciences, University Medical Center Utrecht, Utrecht, The Netherlands.,Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
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13
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Lee CW, Liu ST, Cheng YJ, Chiu CT, Hsu YF, Chao A. Prevalence, risk factors, and optimized management of moderate-to-severe thirst in the post-anesthesia care unit. Sci Rep 2020; 10:16183. [PMID: 32999369 PMCID: PMC7527446 DOI: 10.1038/s41598-020-73235-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Accepted: 09/12/2020] [Indexed: 11/12/2022] Open
Abstract
Post-operative thirst is common and may cause intense patient discomfort. The aims of this retrospective study conducted in a high-volume post-anesthesia care unit (PACU) were as follows: (1) to examine the prevalence of moderate-to-severe post-operative thirst—defined as a numerical rating scale (NRS) score of 4 or higher, (2) to identify the main risk factors for moderate-to-severe post-operative thirst, and (3) to maximize the efficacy and safety of thirst management through a quality improvement program. During a 1-month quality improvement program conducted in August 2018, a total of 1211 adult patients admitted to our PACU were examined. Moderate-to-severe thirst was identified in 675 cases (55.8%). The use of glycopyrrolate during anesthesia was associated with moderate-to-severe thirst (71.7% versus 66.4%, respectively, p = 0.047; adjusted odds ratio: 1.46, p = 0.013). Following a safety assessment, ice cubes, room temperature water, or an oral moisturizer were offered to patients. A generalized estimating equation model revealed that ice cubes were the most effective means for thirst management—resulting in an estimated thirst intensity reduction of 0.93 NRS points at each 15-min interval assessment (p < 0.001)—followed by room temperature water (− 0.92/time-point, p < 0.001) and the oral moisturizer (− 0.60/time-point; p < 0.001). Patient satisfaction (rated from 1 [definitely dissatisfied] to 5 [very satisfied]) followed a similar pattern (ice cubes: 4.22 ± 0.58; room temperature water: 4.08 ± 0.55; oral moisturizer: 3.90 ± 0.55, p < 0.001). The use of glycopyrrolate—an anticholinergic agent that reduces salivary secretion—was the main independent risk factor for moderate-to-severe post-operative thirst. Our findings may provide clues towards an optimized management of thirst in the immediate post-operative period.
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Affiliation(s)
- Chia-Wei Lee
- Department of Anesthesiology, National Taiwan University Hospital, Taipei, 10002, Taiwan
| | - Shih-Ting Liu
- Department of Nursing, National Taiwan University Cancer Center, Taipei, 10672, Taiwan
| | - Ya-Jung Cheng
- Department of Anesthesiology, National Taiwan University Hospital, Taipei, 10002, Taiwan
| | - Ching-Tang Chiu
- Department of Anesthesiology, National Taiwan University Hospital, Taipei, 10002, Taiwan
| | - Yu-Fen Hsu
- Department of Anesthesiology, National Taiwan University Hospital, Taipei, 10002, Taiwan
| | - Anne Chao
- Department of Anesthesiology, National Taiwan University Hospital, Taipei, 10002, Taiwan.
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Souza Júnior EVD, Silva CDS, Lapa PS, Trindade LES, Filho BFDS, Sawada NO. Influence of Sexuality on the Health of the Elderly in Process of Dementia: Integrative Review. AQUICHAN 2020. [DOI: 10.5294/aqui.2020.20.1.6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Objective: this work sought to inquire on the influence of sexuality on the health of the elderly during dementia. Materials and Methods: this was an integrative review. A careful search was conducted in nine databases; however, only five databases provided articles fulfilling the scope of the study: Medline, Lilacs, BDENF, Scopus, and Web of Science (WoS). The health science descriptors (DeCS) were adopted: “sexualidad”, “demencia” and “anciano”, and the descriptors cataloged in the Medical Subject Headings (MeSH): “sexuality”, “dementia” and “aged”. After applying the inclusion criteria, eight articles were selected to comprise the study sample. Results: the practice of sexuality influences upon the health of the elderly with dementia with some beneficial effects, given that it provides, especially, better perception of quality of life and wellbeing. Nevertheless, it cannot be generalized due to methodological insufficiency evidenced in the studies found to construct this review. Conclusions: due to the limitation of studies addressing the theme and the methodological insufficiency of those included in this review, it is necessary to conduct research that shows in depth the influence of sexuality on this population, given that it can be constituted as another approach for the promotion and protection of health in the elderly with dementia.
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Evaluation of a Safety Protocol for the Management of Thirst in the Postoperative Period. J Perianesth Nurs 2019; 35:193-197. [PMID: 31864832 DOI: 10.1016/j.jopan.2019.07.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2019] [Revised: 07/25/2019] [Accepted: 07/25/2019] [Indexed: 11/23/2022]
Abstract
PURPOSE To associate medications, anesthetic techniques, and clinical conditions that interfere in the time of patient approval in the safety protocol for thirst management. DESIGN A quantitative, analytical, and longitudinal study conducted in Southern Brazil. METHODS A nonprobabilistic sample, of 203 adult patients in the immediate postoperative period, evaluated every 15 minutes for 1 hour. FINDINGS A general prevalence of thirst of 67.7%, and mean intensity of 6.38. Fentanyl, morphine, rocuronium, and sevoflurane increased lack of approval in the protocol within 30 minutes (P < .05). General anesthesia (P < .0001) and level of consciousness (95.4%) presented the highest nonapproval rates. CONCLUSIONS Anesthetics and general anesthesia delayed protocol approval; however, after 30 minutes, 75.4% of patients had been approved. Level of consciousness was the main criterion of disapproval. The protocol identified crucial clinical conditions that made it impossible for the patient to receive thirst relief strategies and demonstrated that thirst can be satiated precociously with safety.
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Zengin N, Ören B, Üstündag H. The relationship between stressors and intensive care unit experiences. Nurs Crit Care 2019; 25:109-116. [PMID: 31407452 DOI: 10.1111/nicc.12465] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2018] [Revised: 06/12/2019] [Accepted: 06/20/2019] [Indexed: 12/13/2022]
Abstract
BACKGROUND Patients in intensive care units (ICUs) face many physical and psychological stressors because of the environment of these units and their own critical conditions and experience stress in various degrees. Each stressor may affect patients' experiences in ICUs differently. AIM AND OBJECTIVES This study aimed to examine the relationship between stressors and patients' experiences in an ICU. METHODS This descriptive, cross-sectional study was conducted between September 2014 and June 2015 in a university hospital and included 116 patients who were admitted to the general ICU for at least 24 hours. Data were collected using the Intensive Care Experience Scale and a questionnaire that included questions about socio-demographic and disease-related characteristics of patients and their stressors. RESULTS The mean age of the patients was 57.81 ± 13.81 years, and the mean duration of ICU stay was 2.28 ± 3.88 days. There was a moderate positive relation between the stressors noise (r = .534; P < .01), thirst (r = .438; P < .01), loneliness (r = .410; P < .01), and pain (r = .404; P < .01) and the subscale frightening experiences. However, there was a moderate, negative relation between the stressors inability to speak (r = -.444; P < .01), surrounding speeches (r = -.458; P < .01), equipment noise (r = -.490; P < .01), and physical exercise (r = -.546; P < .01) and the subscale satisfaction with care. CONCLUSIONS The patients associated stressors with satisfaction and frightening experiences in the early period of their discharge from the ICU. As stressors increases, so do frightening experiences, and satisfaction with care is affected negatively. RELEVANCE TO CLINICAL PRACTICE Currently, stressors to which patients discharged from ICU are exposed during their admission to wards are not evaluated in practice. This study is important in that it can help health professionals be aware of effects of stressors on patients in the early period of their discharge.
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Affiliation(s)
- Neriman Zengin
- Faculty of Health Sciences, Department of Midwifery, University of Health Science, Istanbul, Turkey
| | - Besey Ören
- Faculty of Health Sciences, Department of Midwifery, University of Health Science, Istanbul, Turkey
| | - Hülya Üstündag
- Faculty of Health Sciences, Department of Nursing, İstanbul Bilgi University, Istanbul, Turkey
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Pica in end-stage chronic kidney disease: Literature review. Nefrologia 2018; 39:115-123. [PMID: 30360922 DOI: 10.1016/j.nefro.2018.08.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2018] [Revised: 07/18/2018] [Accepted: 08/25/2018] [Indexed: 01/19/2023] Open
Abstract
Pica is an individual entity in the patient with chronic kidney disease (CKD), which phenomenon has not been widely studied despite the high reported prevalence. Moreover, pica complications (anemia, altered electrolytes, poor absorption of micro and macronutrients and malnutrition) could be exacerbated in CKD and limit the quality of renal replacement therapy. The intake of non-caloric and non-nutritional substances could be harmful and cause effects on satiety and metabolic / electrolyte imbalance and modify the biocompatibility of micronutrients, toxins and pathogens worsening health status. In daily practice, pica could be under-reported because patient's shame to recognize it, or fear that such behavior influences their treatment. Additionally, clinicians who not investigate the presence of pica or its complications contribute to the lack of information about the magnitude and relevance of this problem in CKD.
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Pierotti I, Fracarolli IFL, Fonseca LF, Aroni P. Evaluation of the intensity and discomfort of perioperative thirst. ESCOLA ANNA NERY 2018. [DOI: 10.1590/2177-9465-ean-2017-0375] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/26/2023] Open
Abstract
Abstract Objective: To evaluate the intensity and discomfort of perioperative thirst and related factors during anesthesia recovery. Method: This is a quantitative, cross-sectional, descriptive study. Results: Of the 203 participants, 182 (89.6%) reported they were thirsty. The mean intensity of thirst was 6.9 measured using a verbal numerical scale of 0 to 10 and discomfort was 7.3 on a scale of 0 to 14. All attributes evaluated by the scale were cited including dry mouth and desire to drink water (87.3%), dry lips (79.1%), thick tongue feeling (43.4%), thick saliva (56.5%), dry throat (75.2%) and bad taste in the mouth (63.1%). There was a positive correlation between the intensity of thirst and discomfort assessed by the scale (Spearman coefficient: 0.474; p-value: <0.05). No correlation was found between age, length of fasting and use of opioids with the intensity of thirst and discomfort. Conclusion and implication in the clinical practice: Discomfort arising from the attributes of thirst is evidenced as the intensity of thirst increases.
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