Contribution of multidisciplinary team to pain management

A multidisciplinary team nursing model in the treatment of patients undergoing transapical mitral valve clamping: a prospective study

Background

As a new surgical method for older adults with cardiac insufficiency, transapical mitral valve clamp surgery requires the cooperation of practitioners across multiple disciplines to ensure appropriate treatment and nursing care. This study aimed to explore the utility of a multidisciplinary team nursing model in the clinical treatment and nursing care of patients undergoing transapical mitral valve clamping.

Methods

Our sample of ten patients included four men (40%) and six women (60%), with a mean age of 71.4 ± 5.2 years. The multidisciplinary team comprised nurses that specialized in severe illness, cardiac health, rehabilitation, psychology, nutrition, and pain. The team engaged in comprehensive discussions regarding problems specific to the patients undergoing transapical mitral valve surgery, allowing them to formulate individualized nursing measures and implement precise policies.

Results

No serious postoperative complications occurred in any of the ten patients included in this study, and a significant improvement was noted in the cardiac status of all the patients. Color ultrasound findings at discharge indicated that the degree of reflux of all the patients was ≤2+. Among the ten patients, the Activity of Daily Living Scale scores at discharge were significantly higher than before the operation (69.0 ± 4.6 vs. 55.0 ± 5.8). In addition, the 6-min walking test results at discharge were significantly better than those observed before the operation (318.0 ± 21.7 m vs. 295.2 ± 18.4 m).

Conclusions

Utilization of a multidisciplinary team allows nurses across various specialties to provide more comprehensive and systematic care for patients undergoing a mitral valve clamping operation, thus promoting patient recovery.

A contribution to the debate on tinnitus definition

Tinnitus is generally defined as an auditory perception in the absence of environmental sound stimulation. However, this definition is quite incomplete as it omits an essential aspect, the patient's point of view. This point of view constitutes, first and foremost, a global and unified lived experience, which is not only sensory (localization, loudness, pitch and tone), but also cognitive (thoughts, attentiveness, behaviors) and emotional (discomfort, suffering). This experience can be lived in a very unpleasant way and consequently have a very negative impact on quality of life. This article proposes and justifies a new definition for tinnitus elaborated by a group of French clinicians and researchers, which is more in line with its phenomenology. It also provides a minimum knowledge base, including possibilities for clinical care, hoping to eradicate all misinformation, misconceptions and inappropriate attitudes or practices toward this condition. Here is the short version of our definition: Tinnitus is an auditory sensation without an external sound stimulation or meaning, which can be lived as an unpleasant experience, possibly impacting quality of life.

Multi-disciplinary interpretations of pain in older patients on medical units

The aim of this study was to assess the knowledge and attitudes of the health care team caring for older patients on acute medical wards. Pain is probably the most distressing symptom experienced by hospital patients. Pain management has traditionally been seen as part of the anaesthetist's role, within the UK, establishment of acute pain teams was a response to the report 'pain after surgery' which cemented the link between pain and surgery. However, in 2004-2005, 63% of admissions to general medicine in the UK were individuals in the 60+ age group suggesting that older people are significant users of general medicine services. Treatment of pain is multi-disciplinary and effective pain management should be a universal response by health care professionals and non-professionals. A questionnaire was distributed to all nurses; registered and non-registered, junior doctors who worked on the acute medical wards, all physiotherapists and all pharmacists in the hospital. There were varying levels of pain management education identified across the professional groups and, whilst there is a reasonable level of pain knowledge both general and specific to the older person, there is still a need to improve the knowledge and attitudes of all health care professional groups caring for older patients in pain on acute medical wards.