Personalizing automated driving speed to enhance user experience and performance in intermediate-level automated driving

In the context of high-level driving automation (SAE levels 4-5), several studies have shown that a personalized automated driving style, i.e., mimicking that of the human behind the wheel, can improve his experience. The objective of this simulator study was to examine the potential transfer of these benefits in the context of intermediate-level driving automation (SAE levels 2-3), focusing on driving speed personalization. In the first phase of the study, the driving speed of 52 participants was recorded. In the second phase, the same participants were driven by an automated car on a highway twice, and sometimes had to takeover during the drive because of a stationary vehicle on the lane. On these two drives, the automated car drove either at the same speed as them (personalized) or 20 km/h faster. The results showed that using a personalized speed driving style led to higher comfort, and that this effect was fully mediated by automated driving perceived safety. Although driving speed predicted automated driving perceived safety, this effect was actually moderated by trust in automated cars. Regarding takeover performance, the results showed that the brake use and maximum force were lower with the personalized speed driving style, leading to lower resulting maximum negative longitudinal acceleration and speed variability. Overall, the results of this study suggest that the benefits of automated driving style personalization in terms of speed extend to SAE levels 2-3. In addition to the experience benefits, this personalization approach could also improve traffic flow and safety.

The effectiveness of the therapeutic toys on the comfort level and vital signs of the neonates during intravenous cannula insertion (Comfiestudy): A randomized controlled trial

PURPOSE

This study was planned to determine the effect of the therapeutic toy used during IV cannula insertion on the comfort level, crying time and vital signs of neonates.

METHODS

The sample (n = 38) was randomized to the Control and the Comfie Groups. Vital signs were measured before, during, and after the IV cannula insertion. Comfort levels and the duration of crying were measured during the insertion.

RESULTS

Neonates in the Comfie Group had lower pulse and higher saturation levels during the insertion, and they had lower respiration rates and pulse but higher oxygen saturation levels at the post 1st-5th minute. They were more comfortable than the neonates in the control group.

DISCUSSION

The result of this research reveals that therapeutic toys applied during the IV cannula insertion in neonates increase the comfort level and stabilize the vital signs.

APPLICATION TO PRACTICE

The use of toys during IV cannula insertion could be an effective nonpharmacological method to improve outcomes.

Transient pain and discomfort when wearing high-heeled shoes

In the dynamic world of fashion, high-heeled footwear is revered as a symbol of style, luxury and sophistication. Yet, beneath the facade of elegance of classy footwear lies the harsh reality of discomfort and pain. Thus, this study aims to investigate the influence of wearing high-heeled shoes on the sensation of pain across different body regions over a period of 6 h. It involved fifty female participants, all habitual wearers of high-heeled shoes, aged between 20 and 30 years. Each participant kept a record of their perceptions of pain and discomfort every hour for a total of 6 h using a 0-10 pain scale with 0 indicating no pain and 10 indicating severe pain. The findings reveal a progressive rise in pain throughout wear, with the most intense pain reported in the back, calcaneus, and metatarsals. The analysis shows that after approximately 3.5 h, participants experience significant increases in pain levels. However, the relationship between heel height and pain is not linear. It appears that a heel height of 7.5 cm is the threshold where overall body pain becomes significant. The study suggests that a duration of 3.5 h of wear and a heel height of 7.5 cm serve as critical points to decrease overall body pain. Moreover, beyond this heel height, knee pain diminishes compared to other body areas possibly due to the shift towards a more neutral posture. The study findings, coupled with the recommendations, can assist footwear designers in crafting not only stylish but also comfortable shoes.

The influencing factors of hearing protection device usage among noise-exposed workers in Guangdong Province: a structural equation modeling-based survey

BACKGROUND

There are numerous complex barriers and facilitators to continuously wearing hearing protection devices (HPDs) for noise-exposed workers. Therefore, the present study aimed to investigate the relationship between HPD wearing behavior and hearing protection knowledge and attitude, HPD wearing comfort, and work-related factors.

METHOD

A cross-sectional study was conducted with 524 noise-exposed workers in manufacturing enterprises in Guangdong Province, China. Data were collected on hearing protection knowledge and attitudes, HPD wearing comfort and behavior, and work-related factors through a questionnaire. Using structural equation modeling (SEM), we tested the association among the study variables.

RESULTS

Among the total workers, 69.47% wore HPD continuously, and the attitudes of hearing protection (26.17 ± 2.958) and total HPD wearing comfort (60.13 ± 8.924) were satisfactory, while hearing protection knowledge (3.54 ± 1.552) was not enough. SEM revealed that hearing protection knowledge had direct effects on attitudes (β = 0.333, p < 0.01) and HPD wearing behavior (β = 0.239, p < 0.01), and the direct effect of total HPD wearing comfort on behavior was β = 0.157 (p < 0.01). The direct effect also existed between work shifts and behavior (β=-0.107, p < 0.05). Indirect relationships mainly existed between other work-related factors, hearing protection attitudes, and HPD wearing behavior through knowledge. Meanwhile, work operation had a direct and negative effect on attitudes (β=-0.146, p < 0.05), and it can also indirectly and positively affect attitudes through knowledge (β = 0.08, p < 0.05).

CONCLUSION

The behavior of wearing HPD was influenced by hearing protection knowledge, comfort in wearing HPD, and work-related factors. The results showed that to improve the compliance of noise-exposed workers wearing HPD continuously when exposed to noise, the HPD wearing comfort and work-related factors must be taken into consideration. In addition, we evaluated HPD wearing comfort in physical and functional dimensions, and this study initially verified the availability of the questionnaire scale of HPD wearing comfort.

The hemostatic and comforting effects of oral adhesive bandages in tooth extraction: a randomized controlled clinical study

OBJECTIVES

To compare oral adhesive bandages with the classic compression method and evaluate the clinical efficacy of this wound dressing material in improving postoperative comfort, wound healing, and hemostasis in tooth extraction.

MATERIALS AND METHODS

The study was designed as a randomized controlled clinical trial. A total of 120 patients were recruited and randomly assigned to the study group and the control group. In the study group, oral adhesive bandages were used as wound dressing. In the control group, patients bit on cotton balls and gauze, as usual. Hemorrhage, comfort, and healing levels were evaluated at postoperative 1 h, 24 h, and 7 days. The adhesion time of the oral adhesive bandages was also recorded.

RESULTS

The average adhesion time of the oral adhesive bandages was 26.6 h. At postoperative 1 and 24 h, the hemostatic levels of the oral adhesive bandage group were significantly higher than those of the control group. The oral adhesive bandage group also reported significantly higher comfort scores than the control group. Both groups had similar healing levels and side effects. But the mean score for wound healing was slightly higher in the oral adhesive bandage group.

CONCLUSIONS

Oral adhesive bandages were more effective than cotton balls and gauze in providing hemostatic and comfort effects on extraction wounds.

CLINICAL RELEVANCE

Oral adhesive bandages possess clinical value in the management of extraction wounds.

Establishing a plan to improve pediatric patient comfort during PIV insertions and blood specimen collection: a quality improvement effort

HIGHLIGHTS

Patient comfort during peripheral intravenous (PIV) insertion and specimen collection was increased. The authors extended the contingency plan implemented for PICC insertion to include PIV insertion and specimen collection. The authors met their goals by using quality improvement methodology. Prioritizing patient comfort often requires institutional culture change.

BACKGROUND

Needle procedures can cause pain and distress, especially in pediatric patients.1 Retrospective data collected at a freestanding pediatric facility revealed that approximately 30% of pediatric patients were not demonstrating sufficient levels of comfort during peripheral intravenous (PIV) catheter insertion and specimen collection (lab draws) even after successful implementation of comfort measures by the vascular access team (VAT) in an adjacent procedure (eg peripherally inserted central catheter placement). The current quality improvement project was implemented to support adaptation and expansion of previous lessons learned to PIVs and lab draws specifically.

DESIGN AND METHODS

The VAT used the Pediatric Sedation State Scale,2 a standardized assessment tool integrated into the electronic medical record, to assess procedural comfort during PIVs and lab draws from February 2021 through April 2023. A total of 24 134 patients aged 0 to 18 years were included in the data collection. Interventions were delivered concurrently and included (1) reeducation/ongoing support for implementation of the Comfort Promise3 measures, (2) the creation and implementation of advanced comfort options, and (3) culture change.

AIMS AND OBJECTIVES

The goal of the interventions was to improve the percentage of pediatric patients achieving adequate levels of comfort beginning at 68% in year 1 to 90% in year 2.

RESULTS

From February 2021 to April 2023, the VAT team was able to improve procedural comfort scores from 68% to 90% of pediatric patients with adequate comfort for lab draws and/or PIV insertions.

CONCLUSIONS

While standard comfort measures are a good first step in pain management during needle procedures, they are not sufficient for every pediatric patient. Nitrous, sedation, and the use of anxiolytics and analgesics can play an important role in reducing pain and anxiety during needle procedures and should be considered for patients not achieving adequate levels of comfort with standard comfort measures.

Effects of a music-based intervention on psychophysiological outcomes of patients undergoing medical imaging procedures: A systematic review and meta-analysis

INTRODUCTION

Musical intervention (MI) is a valuable strategy for addressing the psychological and emotional challenges faced by patients undergoing imaging procedures. This study explores MI's impact on psychophysiological outcomes during imaging procedures, detailing the sound repertoire and technical characteristics employed in MI.

METHODS

A systematic review (SR) and meta-analysis (MA) were conducted. Electronic database searches of PubMed, Web-of-Science, and Scopus were performed encompassing original randomised research and quasi-experimental articles published until June 2023.

RESULTS

Thirteen articles were included in this SR, scoring between 23 and 68 on the Joanna Briggs Institute (JBI) Checklist. Four articles were included to perform a MA concerning anxiety and heart rate (HR) outcomes. Most studies utilised digital playlists as the medium for MI. Headphones were commonly used, with an average volume of 50-60 dB and a musical frequency of 60-80 beats/min. While authors generally preferred selecting musical genres for the repertoire, two articles specifically chose Johann Pachelbel's "Canon in D major" as their musical theme. In terms of psychological parameters, the experimental groups exhibited lower anxiety values than the control groups, with further reductions after MI. However, MA shows that this trend is only marginally significant. Patient comfort and overall examination experience showed improvement with MI. Regarding physiological parameters, HR, especially in the final phase of the examination, was significantly lower in the experimental group compared to the control group.

CONCLUSION

Across multiple studies, MI demonstrated the ability to reduce anxiety and HR. However, no specific music repertoire emerged as the most effective.

IMPLICATIONS FOR PRACTICE

MI arises as a painless, reliable, low-cost, and side-effect-free strategy, presenting imaging departments with a practical means to enhance patient comfort and mitigate anxiety and stress during medical procedures.

The effect of structured supportive approach based on Kolcaba's comfort theory applied to parents of children with cerebral palsy on child's comfort, quality of life, and parent's self-efficacy: A randomised controlled trial

AIM

This study aims to assess how a structured supportive approach applied to the parents of children living with cerebral palsy according to how the Theory of Comfort affects the child's comfort, quality of life, and parent's self-efficacy.

DESIGN

A single-blind, randomised, controlled experimental trial.

METHODS

The study was conducted with parents of children with cerebral palsy aged between 8 and 16 years who presented to the rehabilitation centers between October 2021 and November 2022. The sample consisted of a total of 73 parents from the experimental (n = 35) and control (n = 38) groups. While a care programme based on the Theory of Comfort was applied to the intervention group, the practises included in the routines of the centres were applied to the control group. The researcher collected data using the Comfort Behaviours Checklist (CBCL), the Parent Form of the Quality-of-Life Scale for Children (QoLC), and the Self-Efficacy Scale.

RESULTS

The children in the intervention group had significantly higher CBCL and QoLC mean scores and the parents in the intervention group had significantly higher self-efficacy mean scores of parents when compared to the control group.

CONCLUSIONS

The structured supportive approach based on the Theory of Comfort enhanced children's comfort and quality of life and increased parents' self-efficacy.

RELEVANCE TO CLINICAL PRACTICE

It is recommended to implement the structured supportive approach applied according to the Theory of Comfort with the parents of children with cerebral palsy in special training and rehabilitation centres. Paediatric nurses can perform preventive and rehabilitative nursing management with a holistic approach to meet the needs of children with cerebral palsy and their families.

Functional evaluation of a novel fibreglass-reinforced polyamide custom dynamic AFO for foot drop patients: A pilot study

BACKGROUND

Ankle-foot orthoses (AFOs) are orthopaedic devices often prescribed to treat foot drop. For patients who are not satisfied with off-the-shelf solutions, custom AFOs personalized to the patient's lower limb anatomy are required. Dynamic AFOs provide stability while allowing for physiological ankle mobility in the stance phase of walking.

RESEARCH QUESTION

Can a morphology-based dynamic custom AFO made of fiberglass-reinforced polyamide restore a quasi-normal gait pattern and improve comfort in patients with foot drop?

METHODS

In this pilot study, the legs and feet of ten foot drop patients (age=64.9 ± 11.4 years; BMI=26.2 ± 2.1 kg/m2) were scanned using a Kinect-based 3D scanner. A custom AFO was designed and produced for each patient using a fiberglass-reinforced polyamide through selective laser sintering. To assess kinematics, skin markers were placed on relevant bony landmarks according to a validated protocol. Each patient was instructed to walk at a self-selected comfortable speed under three conditions: wearing the custom AFO, wearing an off-the-shelf orthosis (Codivilla spring), and without any AFO (shod condition). Muscle activation in the tibialis anterior, gastrocnemius, rectus femoris and biceps femoris muscles in both legs was recorded using wireless sEMG sensors. The comfort and of each AFO was evaluated using a Visual Analogue Scale.

RESULTS

The custom AFO resulted in significant increase of stride length and walking speed compared to the shod condition. Except for the hip joint, which exhibited greater maximum flexion and reduced range of motion, the kinematic parameters of all other joints were similar to those observed in a healthy control population. Furthermore, the custom AFO received significantly higher comfort scores compared to the Codivilla spring.

SIGNIFICANCE

This study has provided evidence supporting the effectiveness of custom orthotic solutions in restoring lower limb kinematics and improving the perceived comfort in foot drop patients compared to off-the-shelf solutions.

The role of vision in sensory integration models for predicting motion perception and sickness

Users of automated vehicles will engage in other activities and take their eyes off the road, making them prone to motion sickness. To resolve this, the current paper validates models predicting sickness in response to motion and visual conditions. We validate published models of vestibular and visual sensory integration that have been used for predicting motion sickness through sensory conflict. We use naturalistic driving data and laboratory motion (and vection) paradigms, such as sinusoidal translation and rotation at different frequencies, Earth-Vertical Axis Rotation, Off-Vertical Axis Rotation, Centrifugation, Somatogravic Illusion, and Pseudo-Coriolis, to evaluate different models for both motion perception and motion sickness. We investigate the effects of visual motion perception in terms of rotational velocity (visual flow) and verticality. According to our findings, the SVCI model, a 6DOF model based on the Subjective Vertical Conflict (SVC) theory, with visual rotational velocity input is effective at estimating motion sickness. However, it does not correctly replicate motion perception in paradigms such as roll-tilt perception during centrifuge, pitch perception during somatogravic illusion, and pitch perception during pseudo-Coriolis motions. On the other hand, the Multi-Sensory Observer Model (MSOM) accurately models motion perception in all considered paradigms, but does not effectively capture the frequency sensitivity of motion sickness, and the effects of vision on sickness. For both models (SVCI and MSOM), the visual perception of rotational velocity strongly affects sickness and perception. Visual verticality perception does not (yet) contribute to sickness prediction, and contributes to perception prediction only for the somatogravic illusion. In conclusion, the SVCI model with visual rotation velocity feedback is the current preferred option to design vehicle control algorithms for motion sickness reduction, while the MSOM best predicts perception. A unified model that jointly captures perception and motion sickness remains to be developed.

Predictors of sleep quality components in patients undergoing transarterial chemoembolisation: a cross-sectional study

PURPOSE

Patients undergoing transarterial chemoembolisation experience postembolisation symptoms and interferences affecting sleep quality, which require intervention. The study aimed to identify the predictors of sleep quality components in patients undergoing transarterial chemoembolisation.

METHODS

This study included two groups of participants: 50 patients undergoing transarterial chemoembolisation and 45 nurses caring for them. Data were collected from September to November 2022 using a structured questionnaire, and analysed using descriptive statistics, the t-test, analysis of variance, Spearman's rank correlation, and multiple regression analysis using the SPSS 27.0 program (IBM Corp., Armonk, NY, USA).

RESULTS

The mean sleep quality score was 40.28±14.10. Heat sensation (t=-2.08, p=.043) and fatigue (t=-4.47, p<.001) predicted sleep fragmentation in 38.6% of the patients. Abdominal pain (t=-2.54, p=.014), vomiting (t=-2.21, p=.032), and the expected fatigue by the nurses (t=2.68, p=.014) predicted sleep length in 41.7% of patients. Abdominal pain (t=-2.05, p=.046) explained 42.9% of sleep depth.

CONCLUSION

Based on the predictors of sleep quality components obtained in this study, strategies to improve sleep quality tailored to patients undergoing transarterial chemoembolisation should be developed. This study highlighted the need to bridge the gap between patients' and nurses' expected fatigue and its contribution to sleep fragmentation and sleep length. It also highlighted the importance of noncontact temperature measurement, controlling vomiting, and pain relief for improving sleep length in patients undergoing transarterial chemoembolisation.

A dry polymer nanocomposite transcutaneous electrode for functional electrical stimulation

BACKGROUND

Functional electrical stimulation (FES) can be used in rehabilitation to aid or improve function in people with paralysis. In clinical settings, it is common practice to use transcutaneous electrodes to apply the electrical stimulation, since they are non-invasive, and can be easily applied and repositioned as necessary. However, the current electrode options available for transcutaneous FES are limited and can have practical disadvantages, such as the need for a wet interface with the skin for better comfort and performance. Hence, we were motivated to develop a dry stimulation electrode which could perform equivalently or better than existing commercially available options.

METHODS

We manufactured a thin-film dry polymer nanocomposite electrode, characterized it, and tested its performance for stimulation purposes with thirteen healthy individuals. We compared its functionality in terms of stimulation-induced muscle torque and comfort level against two other types of transcutaneous electrodes: self-adhesive hydrogel and carbon rubber. Each electrode type was also tested using three different stimulators and different intensity levels of stimulation.

RESULTS

We found the proposed dry polymer nanocomposite electrode to be functional for stimulation, as there was no statistically significant difference between its performance to the other standard electrodes. Namely, the proposed dry electrode had comparable muscle torque generated and comfort level as the self-adhesive hydrogel and carbon rubber electrodes. From all combinations of electrode type and stimulators tested, the dry polymer nanocomposite electrode with the MyndSearch stimulator had the most comfortable average rating.

CONCLUSIONS

The dry polymer nanocomposite electrode is a durable and flexible alternative to existing self-adhesive hydrogel and carbon rubber electrodes, which can be used without the addition of a wet interfacing agent (i.e., water or gel) to perform as well as the current electrodes used for stimulation purposes.

Bowel preparation protocol for hospitalized patients ages 50 years or older: A randomized controlled trial

BACKGROUND

The incidence and mortality rate of colorectal cancer progressively increase with age and become particularly prominent after the age of 50 years. Therefore, the population that is ≥ 50 years in age requires long-term and regular colonoscopies. Uncomfortable bowel preparation is the main reason preventing patients from undergoing regular colonoscopies. The standard bowel preparation regimen of 4-L polyethylene glycol (PEG) is effective but poorly tolerated.

AIM

To investigate an effective and comfortable bowel preparation regimen for hospitalized patients ≥ 50 years in age.

METHODS

Patients were randomly assigned to group 1 (2-L PEG + 30-mL lactulose + a low-residue diet) or group 2 (4-L PEG). Adequate bowel preparation was defined as a Boston bowel preparation scale (BBPS) score of ≥ 6, with a score of ≥ 2 for each segment. Non-inferiority was prespecified with a margin of 10%. Additionally, the degree of comfort was assessed based on the comfort questionnaire.

RESULTS

The proportion of patients with a BBPS score of ≥ 6 in group 1 was not significantly different from that in group 2, as demonstrated by intention-to-treat (91.2% vs 91.0%, P = 0.953) and per-protocol (91.8% vs 91.0%, P = 0.802) analyses. Furthermore, in patients ≥ 75 years in age, the proportion of BBPS scores of ≥ 6 in group 1 was not significantly different from that in group 2 (90.9% vs 97.0%, P = 0.716). Group 1 had higher comfort scores (8.85 ± 1.162 vs 7.59 ± 1.735, P < 0.001), longer sleep duration (6.86 ± 1.204 h vs 5.80 ± 1.730 h, P < 0.001), and fewer awakenings (1.42 ± 1.183 vs 2.04 ± 1.835, P = 0.026) than group 2.

CONCLUSION

For hospitalized patients ≥ 50 years in age, the bowel preparation regimen comprising 2-L PEG + 30-mL lactulose + a low-residue diet produced a cleanse that was as effective as the 4-L PEG regimen and even provided better comfort.

Is it getting hot in here? The effects of VR headset microclimate temperature on perceived thermal discomfort, VR sickness, and skin temperature

Thermal discomfort is a driver of negative user experiences with modern VR headsets since they are similar to head-worn gaming computers. Here, we examined the effect of microclimate temperature (MCT; i.e., the air between headset and user) and the effect of standing and seated use on thermal discomfort for a goggle style headset. Users played VR games across three 48-min sessions with different thermal profiles ranging between 28°-43 °C. Perceived thermal and weight discomfort were rated by participants every 12-min. Thermal, but not weight comfort declined during the study period as MCT increased. Users sweat more and had greater forehead temperatures while standing with the lowest thermal profile, suggesting thermal management is more critical for active experiences. Overall, this study recommends MCT should be kept below 36 °C. Finally design for thermal comfort should be tailored to the individual, experience duration and activity level.

Effect of Sexual Health Education of Mothers on Their Comfort and Intention to Discuss Sex-Related Topics with Adolescent Girls: A Controlled Intervention Study

Sex education is one of the most challenging topics for mothers. Therefore, we examined the effect of sexual health education of mothers on their comfort and intention to discuss sex-related topics with adolescent girls. In this controlled intervention study, 160 mothers of 13- to 16-year-old girls were randomly assigned to either the intervention or control groups. The intervention group underwent sexual health training, while the control group received routine care. Paired t-test, chi-square, analysis of covariance, and multivariate analysis of covariance were used for the analysis of data. There was a significant increase in mean parents' comfort in discussing sex topics in the intervention group compared to the control group (p < .001). The intervention group had spoken with their child to a higher extent than the control group in all 13 items of parents' Intention index for discussing sex topics with the child (except for delivery and menstruation) (p < .05).There was no significant difference between groups for the mean age appropriate for discussing sex topics with the child, Sense of Competence as well as its dimensions, such as self-efficacy and satisfaction. Mean pre-to-post scores of sense of Competence in child rearing (p = .04) and self-efficacy (p = .037) significantly increased in the intervention groups, while they were not significant in the control group. Sexual health education was effective in the feeling of interest and comfort of mothers to discuss sex topics. Therefore, counseling services on mothers' speech interactions are recommended to promote adolescent girl's sexual health.

Australian, Irish, and Swedish women's comfort levels when breastfeeding in public

BACKGROUND

Despite a flux of global initiatives to increase and sustain breastfeeding rates, challenges persist. The decision to commence and sustain breastfeeding is influenced by multiple, complex factors. Feelings of social embarrassment, shame, fear of judgement, and lack of confidence when breastfeeding in public, compound women's decisions to breastfeed and may result in formula feeding or early cessation of breastfeeding. A greater understanding of where and how women feel most comfortable when breastfeeding in public can assist in designing interventions to support the initiation and continuation of breastfeeding.

METHODS

A cross-sectional survey was conducted with women living in Australia (n = 10,910), Sweden (n = 1,520), and Ireland (n = 1,835), who were currently breastfeeding or who had breastfed within the previous two years. Our aim was to explore where, and how often women breastfeed in public and to compare their levels of comfort when breastfeeding in public. Data were collected in 2018 using an anonymous online survey over a four-week period in Ireland, Australia, and Sweden, and were analyzed using SPSS Version 25.

RESULTS

Most respondents were highly educated, with over 70% in each country reporting having a university or college degree. Observing women breastfeeding in public was more commonly reported to be a weekly or daily occurrence in Sweden (24.5%) and Australia (28%), than in Ireland (13.3%). Women in the participating countries reported breastfeeding in public most commonly whenever their babies needed feeding. Very few women never or rarely breastfed publicly. Coffee shops/cafes, restaurants, and parks were the most popular locations. In all three countries, partners were reported to be very supportive of breastfeeding in public, which enhanced breastfeeding women's comfort levels. When asked to score out of a maximum comfort level of 10, women reported higher mean levels of comfort when breastfeeding in front of strangers (Ireland M = 7.33, Australia M = 6.58, Sweden M = 6.75) than with those known to them, particularly in front of their father-in-law (Ireland M = 5.44, Australia M = 5.76, Sweden M = 6.66 out of 10), who scored lowest in terms of women's comfort levels.

CONCLUSION

This study offers important insights into the experiences and comfort levels of women breastfeeding in public. Limitations include the anonymous nature of the surveys, thus preventing follow-up, and variances in terminology used to describe locations across the three settings. Recommendations are made for research to determine the relationships between the frequency of breastfeeding in public and breastfeeding women's perceived comfort levels, the influence of family members' perceptions of breastfeeding in public and women's experiences, and the experience of women who feel uncomfortable while breastfeeding in public, with a view to developing support measures.

Translation and validation of the Comfort Behaviors Checklist in hospitalized children with chronic diseases

BACKGROUND

Different tools have been developed to measure patients' comfort. This study aims to translate, validate, and apply the Comfort Behaviors Checklist to hospitalized children with chronic diseases.

METHODS

Validity and reliability are assessed using face and content validity, construct validity (known-groups technique and Principal Component Analysis), internal consistency, and inter-rater reliability. The study takes place in a children's hospital in Iran, involving 220 children aged 4 to 6.

RESULTS

The Comfort Behaviors Checklist demonstrates acceptable face and content validity. Construct validity is supported by the lack of correlation between behavioral comfort scores in known groups. The Principal Component analysis results in five components, explaining 70.39% of the total variation. The checklist exhibits acceptable reliability, with a total Cronbach's alpha coefficient of 0.86 and an intraclass correlation coefficient of 0.835.

CONCLUSION

The Comfort Behavior Checklist is a valid and reliable tool for assessing the level of comfort in Iranian children with chronic diseases.

Blood biochemical, hormonal, and hematological responses of native sheep submitted to different environmental conditions

The aim of this study was to evaluate the biochemical, hormonal, and hematological blood responses of native sheep subjected to five temperatures (20°, 24°, 28°, 32°, and 36 °C), using 24 sheep of the following breeds: Santa Inês (SI), Morada Nova (MN), Soinga (SO) and no defined racial pattern (NDRP), kept in collective pens inside the climatic chamber. The experimental design was completely randomized, in a 5 × 4 factorial scheme (5 temperatures and 4 breeds) with 6 animals of each breed at each temperature. There was interaction for urea (P < .0001), glucose (P < .0001), cholesterol (P < .0001), and magnesium (P < .0001) as a function of breed and air temperature. Urea (P = .001), glucose (P < .0001), triglycerides (P = .033), cholesterol (P = .004), and magnesium (P < .0001) showed differences according to breed. It was observed that T4 (P < .0001) and cortisol (P < .0001) showed an interaction between breed and temperature, while T4 (P = .001) and cortisol (P = .001) an effect of breed. The highest magnesium concentration was observed in MN, and the lowest was in NDRP, SO, and SI, which are statistically similar, and SI and NDRP are statistically similar. The hormones showed a significant effect (P < .0001) for temperature, where cortisol increased, and thyroid hormones decreased with increasing temperature. Temperatures of 32° and 36 °C contribute to changes in blood, hormone, and hematological biochemical responses of native sheep.

Securing direct stakeholder feedback to inform clinical research in serious mental illness: Results of a patient and family perspectives survey

Mental illness research routinely includes unfamiliar or potentially frightening procedures like lumbar puncture (LP), contributing to low enrollment and retention. Previous studies related to LP acceptance have focused on older individuals, and little information on participant preferences for educational materials is available. We developed an online survey assessing existing knowledge, comfort and concerns, and preferences for educational materials in the context of our clinical study on schizophrenia spectrum conditions (SSCs). We found that participants were generally knowledgeable and interested in engaging with clinical SSC research. Frequency of engagement with research publications differed significantly by participant groups and age. Comfort levels were consistently highest for study procedures other than LP, though surprisingly the average number of informational needs per procedure was not significantly different for LP compared to other procedures. Preferences for format and source of educational materials varied across participant groups and age. Our results suggest that younger individuals with an SSC diagnosis are likely to have limited exposure to information, and proactively providing accessible and accurate educational materials may improve positive perceptions of LP. Providing content in a range of formats and sources will ensure that participants and their support networks have access to their preferred resources.

The impact of using P6 acupressure on the nausea, vomiting, and comfort of myocardial infarction patients: A randomized, single-blind, placebo-controlled clinical trial

Background

Nausea and vomiting are two common symptoms in myocardial infarction patients. This study aims to determine the impact of p6 acupressure on nausea, vomiting, comfort, and the need for anti-vomiting drugs in myocardial infarction (MI) patients.

Methods

This research involved 90 patients with acute heart attacks experiencing persistent nausea despite taking anti-vomiting drugs. They were divided into three groups: acupressure, placebo, and control. The acupressure group wore a wristband with a button, the placebo group had a similar wristband without a button, and the control group received no wristband. Data on nausea severity, comfort, frequency of nausea, vomiting, and retching was collected before and after the intervention at different time points. The study also assessed the use of anti-vomiting drugs within 24 h of the intervention.

Results

The patients in the acupressure group, compared to those in the placebo and control groups, experienced significantly lower severity of nausea, frequency of vomiting, nausea, and retching and a substantially higher level of comfort level during the two, four, and 6 h after the start of the intervention (P < 0.05). However, no significant difference between the placebo and control groups was observed (P > 0.05). During the 24 h after the start of the intervention, administration of anti-vomiting drugs to the acupressure group was significantly less than that done in the placebo and control groups (P < 0.05).

Conclusions

The results illustrated that p6 acupressure reduces nausea, vomiting, and retching and increases the comfort level in myocardial infarction patients.

Prefer what you like? Evaluation and preference of cycling infrastructures in a bicycle simulator

PROBLEM

Previous research on cyclists' route evaluations and preferences already identified influencing factors and relevant evaluation criteria, but studies mostly focused on selected aspects like safety or comfort. This study examined the evaluation of routes more comprehensively considering five evaluation criteria, and further aims to compare the evaluation with the preference of routes. For this, we used the experimental approach of a bicycle simulator.

METHOD

Our participants cycled route segments that varied in certain route characteristics. Each segment was rated in total and on five criteria generated in a previous study, namely Mental Comfort, Interaction, Environment, Ease of Use, and Physical Comfort. At the end, all route segments were ranked according to their quality.

RESULTS

Results showed that separated paths were rated the best, while busy footpaths and uphill segments were rated the worst. Interestingly, interacting with pedestrians was described to be more attention-demanding but not as mentally uncomfortable as interacting with motor traffic. The evaluation and preference of routes mostly went hand in hand but differed for the footpath, which was ranked better than it was rated. Results further indicated that gradient has such a strong impact on the physical comfort of a route that it even influenced the overall evaluation.

DISCUSSION

Our findings suggest that the evaluation and preference of routes is influenced by the degree of separation, traffic volume, the type of the road user that the cyclists may need to interact with, but most importantly, it is influenced by the interaction of these three aspects.

PRACTICAL IMPLICATIONS

The five criteria we used can reliably assess the evaluation and preference of routes. They help to differentiate the reason for negative evaluation of routes. This differentiation is crucial to improve cycling routes, as different causes for dissatisfaction among cyclists require different consequences.

Factors influencing nasal airway pressure and comfort in high-flow nasal cannula oxygen therapy: a volunteer study

BACKGROUND

High-flow nasal cannula (HFNC) oxygen therapy is essentially a constant-flow, noninvasive respiratory support system similar to a noninvasive ventilator operating in constant-flow mode. The clinical outcome of HFNC oxygen therapy is strongly associated with the pressure generated by high-flow gas and the patient's comfort level. This study was performed to explore the relevant factors affecting pressure and comfort of HFNC oxygen therapy in vivo.

METHODS

Thirty-five healthy volunteers were enrolled in the trial. They underwent placement of nasal cannulas of various inner diameters (3, 4 or 5 mm) and treatment with different HFNC devices [HFT-300 (Weishengkang Medical Technology Co., Ltd., Jiangsu China) or H-80 M (BMC Medical Co., Ltd., Beijing China)],and the nasal airway pressure and comfort were assessed. Multiple linear regression was used to determine predictors of airway pressure.

RESULTS

Multiple linear regression showed that the end-expiratory pressure was associated with the flow rate, sex, height, and cannula size. The end-expiratory pressure increased by 0.6 cmH2O per 1-mm increase in cannula diameter, decreased by 0.3 cmH2O per 10-cm increase in participant height (with a 0.35 cmH2O decrease for men), and increased by 1 cmH2O when the flow rate increased by 10 L/min (R2 = 0.75, P < 0.05 for all variables in model). In addition, the pressure generated by the H-80 M device was higher than that generated by the HFT-300 device (P < 0.05). Discomfort manifested as difficulty in expiration, and its severity increased as the cannula diameter increased; however there was no significant difference in comfort between the two HFNC devices (P > 0.05).

CONCLUSION

In volunteers undergoing HFNC oxygen therapy, the nasal cannula diameter, flow rate, sex, height, and device model can affect the nasal airway pressure, and the nasal catheter diameter and flow rate can affect comfort. These factors should be given close attention in clinical practice.

TRIAL REGISTRATION

ChiCTR2300068313 (date of first registration: 14 February 2023,  https://www.chictr.org.cn ).

Women's perspectives of nitrous oxide for labour and procedural analgesia: A prospective clinical audit and cross-sectional study. "It's the best thing"

PROBLEM

There is limited data regarding dose and duration of nitrous oxide use by women in peripartum care. Experiences of using nitrous in Australian settings have not previously been explored BACKGROUND: More than 1:2 women use nitrous oxide analgesia during labour and birth, despite this, there are limited published data on nitrous oxide use for labour or procedural analgesia in Australia.

AIM

To explore the use of nitrous oxide during labour and birth or procedural care.

METHODS

A two-phased sequential design was used; clinical audit (n = 183) and cross-sectional survey (n = 137) approaches supported data collection. Quantitative data were analysed using descriptive and inferential statistics, qualitative data underwent content analysis.

FINDINGS

Nitrous oxide was used by primiparous and multiparous women evenly. Duration of labour-use ranged from < 15 min (10.9%) to > 5 h (10.8%), with equal representation between > 50% concentration (43%) and < 50% (43%). At audit, 75% found nitrous useful; postpartum maternal satisfaction scores remained high, mean indicators were 75%. More multiparous women found nitrous oxide useful than primiparous (95%vs80%,p = 0.009). There was no association between perceived usefulness and whether women were in spontaneous, augmented or induced labour; regardless of concentrations reached. Three key themes described women's perspectives of physical and psycho-emotional effects and challenges.

DISCUSSION

Nitrous oxide plays an important role in the provision of analgesia during procedural or labour and birth care. Service provision, parent and professional education, and future service design will benefit from these novel findings confirming the utility and acceptability of nitrous oxide use in contemporary maternity care.

Individualised analgesia, sedation, delirium and comfort management strategies in the ICU: a narrative review

This group is a product of the collaboration agreement signed by SOMIAMA (Sociedad de Medicina Intensiva de Madrid) and SAR MADRID (Sociedad de Anestesiología, Reanimación y Terapéutica del Dolor de Madrid) under which the organisations agreed to create joint working groups to improve critical patient care. Pain, discomfort, agitation, and delirium cause suffering, delay discharge, and can lead to serious complications in patients admitted to medical and surgical critical care units and post-anaesthesia care units. The main objectives in this type of unit include: Ensuring the comfort of patients suffering or recovering from a critical illness.Avoiding complications associated with the measures, particularly pharmacological, taken to ensure that comfort.

Clinical performance and Willingness To Pay for soft toric contact lenses in low and moderate astigmats

PURPOSE

To determine clinical performance and the 'Willingness To Pay' for toric vs. spherical soft contact lenses in an astigmatic population.

METHODS

In the clinical study, subjects with binocular low to moderate astigmatism (-0.75DC to -1.50DC) wore pairs of soft toric (Biofinity toric) and spherical (Biofinity) contact lenses in random sequence. Visual acuity (high and low contrast, monocular and binocular), subjective comfort and subjective vision were recorded. In the economics study, first subjects who had participated in the clinical study were presented with a series of randomised economic scenarios in order to determine their Willingness To Pay a premium (i.e. an increase) for toric lenses. Then, a similar set of scenarios were presented to a much larger group of online respondents and again, Willingness To Pay was established.

RESULTS

For the four measures of visual acuity, the Biofinity toric lens out-performed the Biofinity spherical lens by 0.6 to 1.1 lines.. Subjective vision performance was statistically significantly better with the toric lens for the distance task only. Comfort scores were not significantly different. Similar findings for Willingness To Pay were established for the clinical subjects and for the online respondents. The Willingness To Pay premium (additional fee) for a monthly supply of toric lenses (over spherical lenses) was between £13 and £16, if a toric lens provides better vision and similar comfort, as shown in the clinical study.

CONCLUSION

Consumers are willing to pay a monthly premium of around 50% to benefit from the typical experience of better vision and similar comfort for toric vs. spherical lenses. The level of additional cost for toric lenses compared to their spherical equivalents is less than this in the market, so eye care professionals should consider that toric lenses are delivering a greater clinical return than anticipated by wearers for the relatively small increase in price.

Problems Experienced by the Mothers in Post-Cesarean Period: A Narrative Review

Cesarean delivery rates have been increasing which leads to a rise the problems experienced. After cesarean deliveries important problems for the mother and baby may be seen. The most common problems in the mothers after cesarean delivery are; bleeding, infection, fatigue, sleep disorders, breast problems, self-care issues, and sense of inadequacy in care of the newborn. The method used in this study was narrative review. A literature review was conducted by searching the materials published in databases including Web of Science, PubMed, Google Scholar search engine and, the WHO website. Pain, maternal death, breastfeeding problems, worsened sleep quality and comfort, anxiety, delayed recovery, prolonged hospitalization and infection rates in the cesarean deliveries are higher than in vaginal deliveries. Nurses can facilitate adaptation to the role of motherhood and prevent risky situations by evaluating mothers' care needs and providing proper interventions and support. Nurses should not only focus on the physical care needs of the mother and baby; they should also ensure the physical and psychosocial adaptation of family members in the face of role changes.

Effect of Yakson touch and mother's voice on pain and comfort level during nasal CPAP application in Turkey: A randomized controlled study

PURPOSE

This study was conducted to evaluate the effects of Yakson touch and mother's voice on pain and comfort levels of preterm infants during nasal CPAP application.

DESIGN AND METHODS

The study was conducted as a randomized experimental study with a control group. It included 124 premature infants (mother's voice group = 31, Yakson touch group = 31, mother's voice+ Yakson touch group= 31, control group = 31) of 28-37 weeks of age who had nasal CPAP application in the NICU of a state hospital in souteastern Turkey between April 2019 and August 2020. While the infants in the experimental group received mother's voice, Yakson touch, and mother's voice+ Yakson touch procedures before, during and after nasal CPAP application, the infants in the control group received nasal CPAP application without extra intervention. "Newborn Infant Pain Scale (NIPS)" and "Premature Infant Comfort Scale (PICS)" were used to collect data.

RESULTS

Further analysis revealed that the Yakson Touch was the most beneficial intervention for reducing NIPS scores and PICS scores during and after nasal CPAP application in the experimental groups, followed by mother's voice + Yakson touch and lastly mother's voice.

CONCLUSION

Yakson touch and mother's voice+Yakson touch methods, are effective in neonatal pain and comfort management during and after the nasal CPAP application.

Development and Psychometric Validation of Patient-Reported Outcome Measures (PROMs BCC-20) for Assessing Comfort during Chemotherapy in Breast Cancer Patients

OBJECTIVE

The study aims to develop and psychometric validate Patient-Reported Outcomes Measures for Assessing Comfort during Chemotherapy in Breast Cancer Patients (PROMs BCC-20).

METHODS

This study was conducted in two phases: 1) items were developed from the literature review and in-depth interviews, and 2) Exploratory factor analysis (EFA), Confirmatory factor analysis (CFA), and concurrent validity were performed to evaluate construct validity. The participants were cancer stage I-IIIC, adult females, performance status was assessed by Eastern Cooperative Oncology Group (ECOG) score ≤ 2 after receiving the second cycle of adjuvant chemotherapy and selected by purposive sampling method. For each group of EFA and CFA was 250 participants.

RESULT

Five hundred breast cancer patients during adjuvant chemotherapy were recruited from three tertiary cancer centers. A succession of EFA using principal axis factoring with Promax rotation revealed four dimensions yielded a seven factors solution, explaining a 60.07 percent variance. CFA contains 20 items with five factors; 1) social function, four items; 2) digestive function, three items; 3) emotional function, six items; 4) environmental function, three items; and 5) sleep quality, four items via maximum likelihood with bootstrapping indicated a good fit model (SRMR = 0.045, RMSEA = 0.040, CFI = 0.947, and TLI = 0.935). The Cronbach's alpha of 0.86 demonstrated strong internal consistency reliability. Pearson's correlation coefficient showed acceptable criterion validity.

CONCLUSION

The PROMS BCC-20 provides good psychometric properties and practical patients' direct reports of comfort in breast cancer patients during chemotherapy. The PROMs BCC-20 should be standardized for comfort measurement and tailor-made nursing care to provide patient satisfaction and good nursing outcomes.

The effect of Reiki on fatigue and comfort in hemodialysis patients

OBJECTIVE

This prospective, single-blind, randomized parallel controlled study was conducted to determine the effects of distant Reiki on the fatigue and comfort levels of patients undergoing hemodialysis (HD) treatment.

METHODS

The study was conducted in a private dialysis center located in one of the metropolises of Turkey between October 2020 and September 2021. Sixty-two patients receiving HD treatment were randomly allocated to intervention (n = 31) and control (n = 31) groups. Distant Reiki was administered to the patients in the intervention group three times a week for four weeks. Distant Reiki sessions were held the night before the patient's hemodialysis day and lasted approximately 36-40 min. The patients in the control group were administered routine treatment under the institutional policy without any further intervention. Data were collected using the Fatigue Severity Scale (FSS) and General Comfort Questionnaire (GCQ). Measurements were performed before Reiki was applied, after Reiki was applied (the first day after the 12th session), and four weeks after the last measurement in order to assess whether Reiki has a long-term effect. The data obtained were assessed using Shapiro Wilk, Repeated Measures, Student's t, Pearson chi-square, Likelihood Ratio chi-square, and Fisher Exact chi-square tests.

RESULTS

The patients in the intervention and control groups were statistically similar in terms of their descriptive characteristics (p>0.05). The intervention group's fatigue score decreased from 5.42 (SD=1.20) to 3.44 (SD=1.00) immediately after the intervention and 3.21 (SD=0.86) four weeks after the intervention. In the control group, these values were 4.50 (SD=1.29), 4.70 (SD=1.22), and 4.65 (SD=1.02), respectively (p<0.05). The general comfort total score of the intervention group increased from 2.86 (SD=0.30) to 3.03 (SD=0.20) immediately after the intervention and 2.98 (SD=0.22) four weeks after the intervention. In the control group, these values were 2.71 (SD=0.33), 2.63 (SD=0.23), and 2.59 (SD=0.30), respectively (p<0.05).

CONCLUSION

This research has shown that distant Reiki, as one of the non-pharmacological methods, positively affects the fatigue severity and comfort level of patients receiving HD treatment.

Assessment of Comfort during Less Invasive Surfactant Administration in Very Preterm Infants: A Multicenter Study

INTRODUCTION

This study was set up to investigate if and to what extent non-pharmacological analgesia is able to provide comfort to very preterm infants (VPI) during less invasive surfactant administration (LISA).

METHODS

This was a prospective non-randomized multicenter observational study performed in level IV NICUs. Inborn VPI with a gestational age between 220/7 and 316/7 weeks, signs of respiratory distress syndrome, and the need for surfactant replacement were included. Non-pharmacological analgesia was performed in all infants during LISA. In case of failure of the first LISA attempt, additional analgosedation could be administered. COMFORTneo scores during LISA were assessed.

RESULTS

113 VPI with a mean gestational age of 27 weeks (+/- 2.3 weeks) and mean birth weight of 946 g (+/- 33 g) were included. LISA was successful at the first laryngoscopy attempt in 81%. COMFORTneo scores were highest during laryngoscopy. At this time point, non-pharmacological analgesia provided adequate comfort in 61% of the infants. 74.4% of lower gestational aged infants (i.e., 220-266 weeks) were within the comfort zone during laryngoscopy compared to 51.6% of higher gestational aged infants (i.e., 270-320 weeks) (p = 0.016). The time point of surfactant administration did not influence the COMFORTneo scores during the LISA procedure.

CONCLUSION

Non-pharmacological analgesia provided comfort in as much as 61% of the included VPI during LISA. Further research is needed to both develop strategies to identify infants who, despite receiving non-pharmacological analgesia, are at high risk for experiencing discomfort during LISA and define patient-tailored dosage and choice of analgosedative drugs.

Mood regulates the physiological response to whole-body vibration at low intensity

In the present study we evaluated the relationship between human vibrational comfort and psychophysiological processes. We exposed twenty-one participants to three levels of whole-body vibration at low intensity inside a full-scale mock-up of a ship cabin. Autonomic Nervous System (ANS) activity, mood and well-being state during each level of vibration exposure were measured. We found that a positive affective state determined greater changes in ANS activity in response to vibration variations compared to a negative affective condition. Furthermore, we found that variations of the vibration intensity did not always determine variations of the comfort experience at physiological and psychological level. The relevance of our findings is a challenge for comfort design research showing a gap between guidelines for comfort design and evidence based on psychophysiological responses to environmental stimulation.

[Progress of research on evaluation indicators and standards about high-speed train comfort]

The rapid development of high-speed railway in China has proposed higher requests for the comfort level of high-speed trains. However, there is no internationally unified evaluation criterion for high-speed train comfort currently, which therefore substantially affects the comparability and standardization of research results for high-speed train comfort. This paper systematically reviews the research literature about evaluation indicators and standards related to high-speed train comfort, and finds that there is currently no unified definition, evaluation indicators, as well as evaluation criterion for high-speed train comfort. Most current evaluation criteria are based on a single indicator. Some indicators are simultaneously developed by different apartments and differ between each other, and there is no comprehensive indicator or criteria for high-speed train comfort, restricting the comparison of high-speed train comfort across regions. It is recommended that the administrative department of high-speed railroad in China should organize experts to establish a unified definition of high-speed train comfort, comprehensive evaluation indicators and relevant judgment criteria for high-speed train comfort, in face of the rapid development and globalization of high-speed trains.

Challenges to the new soft contact lens wearer and strategies for clinical management

Soft contact lens discontinuations have a dramatic impact on the overall success of this form of vision correction, and evidence suggests that the reasons for contact lens cessation are different for new wearers than for established lens users. In descending order, these relate to vision, discomfort, handling, inconvenience/loss of interest, ocular health and cost. This paper considers the background and underlying evidence for these causes of soft lens discontinuation in new wearers, and presents clinical management strategies to minimise this phenomenon. Such measures can reasonably be expected to significantly reduce the number of contact lens discontinuations leading to happier patients, increased satisfaction for eye care professionals (ECPs), and greater success for both individual practices and the contact lens industry more broadly.

Patient and therapeutic radiographer experiences of comfort during the radiotherapy pathway: A qualitative study

INTRODUCTION

There is little research regarding the experiences of patient comfort and how it is best managed in radiotherapy. The aim of this study was to explore the experiences of patient and therapeutic radiographer views of comfort during radiotherapy.

METHODS

This qualitative study involved semi-structured interviews, with cancer patients (n = 25) and therapeutic radiographers (n = 25), conducted between January-July 2019. Patients were recruited from one radiotherapy clinic and therapeutic radiographers were recruited from across the United Kingdom via specialist interest groups and social media. Interviews were audio-recorded and transcribed verbatim. Thematic analysis was used to analyse the data separately between both groups and shared themes were identified.

RESULTS

Four themes were identified of which two themes were shared among both the patients and therapeutic radiographer. Emotional Health was a shared theme highlighting experiences such as stress, vulnerability and privacy. The second shared theme, Positioning and Immobilisation Experiences, concerned how patients' experience being physically positioned and using immobilisation for accurate radiotherapy. The theme Information and Communication Experience was derived from patients highlighting concerns over sharing and provision of information and ways of communication. The last theme, Environmental Experience, emerged from the patient interviews and related to the first impressions of the radiotherapy environment such as reception or treatment rooms and how this effects the overall feelings of comfort.

CONCLUSION

This qualitative study has provided the shared voice of patients and therapeutic radiographers and their experiences of comfort during radiotherapy. These shared experiences emphasise the importance of considering comfort holistically and not just from a physical context. This information can be used by therapeutic radiographers to better understand their patients experiences and needs to provide better comfort during radiotherapy to improve patients' outcomes.

IMPLICATIONS FOR PRACTICE

The clinical implications of our study can encourage Therapeutic Radiographers to provide holistic care for their patients throughout the pathway and specifically to comfort patients while they are having treatment. In the short term this could be via simple adaptions to practice while in the long term, research is needed to develop comfort interventions for patients receiving radiotherapy.

The effect of using illustrated materials for communication on the anxiety and comfort of cardiac surgery patients receiving mechanical ventilator support: A randomized controlled trial

BACKGROUND

Using illustrated communication materials with patients receiving mechanical ventilation support increases patient satisfaction and reduces communication difficulties. However, there are no randomized controlled clinical studies showing the effect of the use of these materials on patient care outcomes.

OBJECTIVE

To determine the effect of using illustrated communication materials on the anxiety and comfort levels of patients receiving mechanical ventilation support.

METHODS

In this controlled clinical trial, patients were randomly assigned to either the intervention group that used illustrated communication materials or the control group that used routine communication methods. In the first minute of contact with patients in the intensive care unit, then at 30 min and 60 min, patients' numerical pain-rating scale scores, hemodynamic values, and face-anxiety scale scores were recorded. Satisfaction with communication and perianesthesia comfort scale scores were obtained the day after operation.

RESULTS

After 30 min of communication, the percentage of face-anxiety points difference decreased in the intervention group (-14.16) compared to the control group (-6.11), and the difference was statistically significant (p < 0.05). In terms of perceived comfort during postoperative mechanical ventilation, the mean score of the patients in the intervention group (106.10) was higher than the control group (88.53), and the difference was statistically significant (p < 0.05). Furthermore, 90% of the patients in the intervention group and 30% of the patients in the control group were satisfied with the communication method used, and the difference between the groups was statistically significant.

CONCLUSION

Using illustrated communication materials reduces anxiety and increases patient satisfaction and comfort levels. In communicating with intubated patients, the use of illustrated communication materials is recommended.

Effect of menthol lozenges after extubation on thirst, nausea, physiological parameters, and comfort in cardiovascular surgery patients: A randomized controlled trial

OBJECTIVES

To determine the effect of post-extubation oral menthol lozenges on thirst, nausea, physiological parameters, and comfort level in patients undergoing cardiovascular surgery.

RESEARCH METHODOLOGY/DESIGN

The study was a single-centre, randomized controlled trial.

SETTING

This study included 119 patients undergoing coronary artery bypass graft surgery in a training and research hospital. Patients in the intervention group (n = 59) received menthol lozenges at 30, 60, and 90 min after extubation. Patients in the control group (n = 60) received standard care and treatment.

MAIN OUTCOME MEASURES

The primary outcome of the study was the change in post-extubation thirst assessed by Visual Analogue Scale after using menthol lozenges compared to baseline. Secondary outcomes were changes in post-extubation physiological parameters and nausea severity assessed by Visual Analogue Scale compared to baseline, and comfort level assessed with Shortened General Comfort Questionnaire.

RESULTS

Between-group comparisons showed that the intervention group had significantly lower thirst scores at all time points and nausea at the first assessment (p < 0.05) and significantly higher comfort scores (p < 0.05) than the control group. There were no significant differences between the groups in physiological parameters at baseline or any of the postoperative assessments (p > 0.05).

CONCLUSION

In patients undergoing coronary artery bypass graft surgery, the use of menthol lozenges effectively increased comfort level by reducing post-extubation thirst and nausea, but had no effect on physiological parameters.

IMPLICATIONS FOR CLINICAL PRACTICE

Nurses should be vigilant for complaints such as thirst, nausea, and discomfort in patients after extubation. Nurses' administration of menthol lozenges to patients may help reduce post-extubation thirst, nausea, and discomfort.

Dense 3D pressure discomfort threshold (PDT) map of the human head, face and neck: A new method for mapping human sensitivity

When designing wearables that interface with the human head, face and neck, designers and engineers consider human senses, ergonomics and comfort. A dense 3D pressure discomfort threshold map could be helpful, but does not exist yet. Differences in pressure discomfort threshold for areas of the head, neck and face were recorded, to create a 3D pressure discomfort threshold map. Between 126 and 146 landmarks were placed on the left side of the head, face and neck of twenty-eight healthy participants (gender balanced). The positions of the landmarks were specified using an EEG 10-20 system-based landmark-grid on the head and a self-developed grid on the face and neck. A 3D scan was made to capture the head geometry and landmark coordinates. In a randomised order, pressure was applied on each landmark with a force gauge until the participant indicated experiencing discomfort. By interpolating all collected pressure discomfort thresholds based on their corresponding 3D coordinates, a dense 3D pressure discomfort threshold map was made. A relatively low-pressure discomfort threshold was found in areas around the nose, neck front, mouth, chin-jaw, cheek and cheekbone, possibly due to the proximate or direct location of nerves, blood veins and soft (muscular) tissue. Medium pressure discomfort was found in the neck back, forehead and temple regions. High pressure discomfort threshold was found in the back of the head and scalp, where skin is relatively thin and closely supported by bone, making these regions interesting for mounting or resting head, face and neck related equipment upon.

Helmet CPAP bundle: A narrative review of practical aspects and nursing interventions to improve patient's comfort

BACKGROUND

The application of Continuous Positive Airway Pressure (CPAP) with a helmet is increasing around the world, both inside and outside of the intensive care unit. Current published literature focus's on indications, contraindications and efficiency of Helmet CPAP in differing clinical scenarios. Few reports, summarising the available knowledge concerning technical characteristics and nursing interventions to improve patient's comfort, are available.

AIM

To identify the crucial technical aspects in managing patients undergoing Helmet-CPAP, and what nursing interventions may increase comfort.

METHODS

A narrative literature review of primary research published 2002 onwards. The search strategy comprised an electronic search of three bibliographic databases (Pubmed, Embase, CINAHL).

RESULTS

Twenty-three studies met the inclusion criteria and were included in the review. Research primarily originated from Italy. Nine key themes emerged from the review: gas flow management, noise reduction, impact of gas flow and HME filters on delivered FiO₂, filtration of exhaled gas / environmental protection, PEEP monitoring, airway pressure monitoring, active humidification of gas flow, helmet fixation and tips to implement awake prone position during Helmet-CPAP.

CONCLUSIONS

A Helmet-CPAP check-list has been made of nine key interventions based on the available evidence regarding system set up, monitoring and management. Implementation of this check-list may help nurses and physicians to increase the comfort of patients treated with Helmet CPAP and enhance their compliance with long-term treatment.

Exploring outcomes from an innovative, pediatric-focused intervention with undergraduate nursing students

BACKGROUND

To adapt to COVID-19 restrictions, a virtual pediatric skills day was developed to provide nursing students with practical experience prior to entering the pediatric clinical setting. Student assessment before and after participation indicate a virtual skills day is helpful in building student confidence prior to pediatric clinicals.

METHODS

This mixed-method study involved a cross-sectional approach with a six-item survey administered before and immediately after the virtual pediatric skills day intervention to undergraduate junior nursing students. Outcome measures included comfort and preparation for pediatrics and families of pediatric patients.

FINDINGS

After exploring outcomes from 93 students complete pre and post intervention measures, we addressed comfort themes including excited, nervous, and readiness while preparedness themes highlighted concerns with parental interactions, upset children, and COVID-19 restrictions.

DISCUSSION

It is beneficial for nursing students to have clinical experiences with children prior to visiting a pediatric clinical setting. Such experiences decrease student stress and anxiety and allow meaningful opportunities to occur.

Validation of a moving base driving simulator for motion sickness research

Increasing levels of vehicle automation are envisioned to allow drivers to engage in other activities but are also likely to increase the incidence of Carsickness or Motion Sickness (MS). Ideally, MS is studied in a safe and controlled environment, such as a driving simulator. However, only few studies address the suitability of driving simulators to assess MS. In this study, we validate a moving base driving simulator for MS research by comparing the symptoms and time course of MS between a real-road driving scenario and a rendition of this scenario in a driving simulator, using a within-subjects design. 25 participants took part as passengers in an experiment with alternating sections (slaloming, stop-and-go) with normal and provocative driving styles. Participants performed Sudoku puzzles (eyes-off-road) during both scenarios and reported MIsery SCale (MISC) scores at 30 s intervals. Motion Sickness Assessment Questionnaire (MSAQ) scores were collected upon completion of either scenario. Overall, the results indicate that MS was more severe in the car than in the simulator. Nevertheless, significant correlations were found between individual MS in the car and simulator for 3 out of 4 MSAQ symptom categories (0.48 < r < 0.73, p < 0.02), with a strong overall correlation (r = 0.57, p = 0.004). MS onset times were similar between the car and the simulator, and sickness fluctuations as a result of driving style showed a similar pattern between scenarios, albeit more pronounced in the car. Based on observed similarities in MS, we conclude these simulator results to have relative validity. We attribute the observed reduction of MS severity in the simulator to the downscaling of the motion by the Motion Cueing Algorithm (MCA). These results suggest that, at least in eyes-off-road conditions, findings on MS from simulator studies may generalize to real vehicles after application of a conversion factor. This conversion factor is likely to depend on simulator and MCA characteristics.

Evaluating the effective pressure applied by a valgus knee orthosis in individuals with medial knee osteoarthritis based on the dose-response relationship

BACKGROUND

There is evidence that valgus knee orthosis improves clinical and biomechanical outcomes in individuals with medial knee osteoarthritis (MKOA). It is unclear whether variations in pressure application by orthosis straps can affect the biomechanical outcomes. This study aimed to determine the dose-response relationship between different orthosis straps tensions and changes in knee adduction moment (KAM) parameters in individuals with MKOA.

METHOD

Twenty-four individuals with symptomatic MKOA were enrolled in this quasi-experimental study. Five tension conditions in orthosis straps were tested in 20-mmHg increments, from 0 (no pressure) to 100 (maximal pressure) mmHg. Patients were asked to adjust the orthosis strap tension based on their perceived comfort. After each condition, a 3D gait analysis was performed, and KAM parameters were calculated. The participants also reported their satisfaction with knee orthosis adjustment for each pressure condition.

RESULTS

With successive increases in strap tension from 40 to 80 mmHg, the first peak, second peak, and angular impulse of KAM decreased nonlinearly (from 6 % to 25 %). Increasing the orthosis strap tension to 100 mmHg significantly decreased (P < 0.05) the participants' satisfaction level. The effective dosages (IC₅₀) of pressure for the first peak, second peak, and angular impulse of KAM as responses were 58, 65, and 69 mmHg, respectively.

CONCLUSION

The KAM decline was not linear as the strap pressure increased. Patients were dissatisfied with orthosis adjustment when strap tension was above 80 mmHg. The optimum dosage of pressure on the knee joint's lateral side for adjusting an orthosis' strap tension is approximately 69 mmHg.

Standards for passenger comfort in automated vehicles: Acceleration and jerk

A prime concern for automated vehicles is motion comfort, as an uncomfortable ride may reduce acceptance of the technology amongst the general population. However, it is not clear how transient motions typical for travelling by car affect the experience of comfort. Here, we determine the relation between properties of vehicle motions (i.e., acceleration and jerk) and discomfort empirically, and we evaluate the ability of normative models to account for the data. 23 participants were placed in a moving-base driving simulator and presented sinusoidial and triangular motion pulses with various peak accelerations (A_max0.4 - 2 ms^-2) and jerks (J_max0.5 - 15 ms^-3), designed to recreate typical vehicle accelerations. Participants provided discomfort judgments on absolute 'Verbal Qualifiers' and relative 'Magnitude Estimates' associated with these motions. The data show that discomfort increases with acceleration amplitude, and that the strength of this effect depends on the direction of motion. We furthermore find that higher jerks (shorter duration pulses) are considered more comfortable, and that triangular pulses are more comfortable than sinusoidal pulses. ME responses decrease (i.e., reduced discomfort) with increasing pulse duration. Evaluations of normative models of vibration and shock (ISO 2631), and perceived motion intensity provide mixed results. The vibration model could not account for the data well. Reasonable agreement between predictions and observations were found for the shock model and perceived intensity model, which emphasize the role of acceleration. We present novel statistical models that describe motion comfort as a function of acceleration, jerk, and direction. The present findings are essential to develop motion planning algorithms aimed at maximizing comfort.

Effects of increased recirculation air rate and aircraft cabin occupancy on passengers' health and well-being - Results from a randomized controlled trial

BACKGROUND

Aircraft cabins are special environments. Passengers sit in close proximity in a space with low pressure that they cannot leave. The cabin is ventilated with a mixture of outside and recirculated air. The volume of outside air impacts the carbon footprint of flying. Higher recirculation air rates could be considered to save energy and divert less kerosene from producing thrust.

OBJECTIVES

To investigate whether higher recirculation air rates in aircraft cabins negatively affect passengers' health and well-being and if occupancy plays a role in this.

METHODS

In a 2 (occupancy: full and half-occupied) X 4 (ventilation regime) factorial design with stratified randomization, participants were exposed in an aircraft segment in a low-pressure tube during a 4-h simulated flight. Ventilation regimes consisted of increasing proportions of recirculated air up to a maximum CO₂ concentration of 4200 ppm. Participants rated comfort, health symptoms, and sleepiness multiple times. Heart rate (variability), as stress marker, was measured continuously.

RESULTS

559 persons representative of flight passengers regarding age (M = 42.7, SD = 15.9) and sex (283 men) participated. ANCOVA results showed hardly any effect of both factors on self-reported health symptoms, strong main effects of occupancy on comfort measures, and interaction effects for sleepiness and physiological stress parameters: Participants in the half-occupied cabin hardly reacted to increased recirculation air rates and show overall more favorable responses. Participants in the fully occupied cabin reported higher sleepiness and had stress reactions when the recirculation air rate was high.

DISCUSSION

This large-scale RCT shows the importance of occupancy, a previously neglected factor in indoor air research. The proximity of other people seems to increase stress and exacerbate reactions to air quality. Further studies on causal pathways are needed to determine if recirculation air rates can be increased to reduce the carbon footprint of flying without detrimental effects on passengers.

The Effect of Modified Epley Maneuver Implementation on the Anxiety and Comfort Levels of Patients with Posterior Canal Bening Paroxysmal Positional Vertigo: A Prospective Study

To evaluate the effects of the modified Epley maneuver during Posterior Canal Benign Paroxysmal Positional Vertigo (BPPV) on patients' anxiety and comfort levels. The study, organized as a prospective, worked with 72 patients who were diagnosed with Posterior Canal BPPV through Dix-Hallpike maneuver. The data for the study was collected through Descriptive Characteristics Form, General Comfort Questionnaire Short Form, and Beck Anxiety Inventory. It was found that that 63.9% of the patients experienced average-level anxiety before the implementation of the Epley maneuver and received a total of 3.07 ± .37 (1-6) from the General Comfort Questionnaire. Before applying the modified Epley maneuver and I and IV When the score changes after the week were examined, it was determined that there was a statistically significant difference in all scale scores, as comfort levels increased, anxiety levels decreased. Anxiety was identified as the most important predictor of patients' comfort level before and after the implementation of the modified Epley maneuver. In light of these findings, it can be said that modified Epley maneuver can safely be used to increase the comfort of patients with Posterior Canal BPPV. Considering that patients with BPPV can consult to emergency rooms, family clinics along with polyclinics, it is recommended to organize regular trainings on BPPV and the implementation of the Epley maneuver. It is believed that evaluation of BPPV patients for their anxiety and offer support when needed is important for the prognosis and patients' comfort.

The effect of seating recline on sleep quality, comfort and pressure distribution in moving autonomous vehicles

The revolution of technologically advanced vehicles with a high level of automation involves a profound transformation. The focus of most research in this area has been on the use of travel time for different use cases. Sleeping is one of the most time-consuming activities in everyone's life; therefore, this has been described as one of the most desired use cases for fully automated vehicles. In order to identify the best conditions to allow sleep and improve sleep quality while travelling in such vehicles, two studies were performed: a sleep study and a pressure distribution study, the results of which are included in this document. The focus of both studies was on two seat positions: reclined (60° backrest recline) and flat (87° backrest recline). In the sleep study, forty participants had the opportunity to sleep during a 90-min drive in order to evaluate long-term comfort and subjective sleep quantity and quality. Although both positions resulted in generally similar results in terms of sleep and comfort, some significant differences were identified. Karolinska Sleepiness Scale results showed that sleepiness increased in the reclined position, whereas it decreased in the flat position. Moreover, the self-reported parameter Wake After Sleep Onset was higher in the reclined position. In the pressure distribution study, it was possible to identify specific seat prototype limitations indicating inadequate support, which was related to discomfort detected during the sleep study. As a conclusion, the comparison between the reclined and flat positions showed indications that, in moving fully automated vehicles, the flat seat position is the most comfortable and effective for sleeping.

The effect of three different methods applied during peripheral vascular access in prematures on pain and comfort levels

PURPOSE

This research was carried out to determine the influence of kangaroo care, fetal position, and swaddling on pain and comfort levels in preterm infants during peripheral vascular access.

DESIGN AND METHODS

The study was conducted as a randomized experimental study with a control group. It included 148 premature infants (kangaroo group = 37, swaddling group = 37, fetal position = 37, control group = 37) of 32-37 weeks of age who had peripheral vascular access in the NICU of a state hospital in eastern Turkey between December 2019 and June 2020. While the infants in the experimental group received kangaroo care, fetal position, and swaddling procedures during and after peripheral vascular access, the infants in the control group received conventional peripheral vascular access without extra intervention. "Newborn Infant Pain Scale (NIPS)" and "Premature Infant Comfort Scale (PICS)" were used to collect data. Data were analyzed using percentile, chi-square and ANOVA tests.

RESULTS

Further analysis revealed that the fetal position was the most beneficial intervention for reducing NIPS scores and boosting PICS scores during and after peripheral vascular access in the experimental groups, followed by kangaroo care and lastly swaddling.

CONCLUSION

It was discovered that kangaroo care, fetal position, and swaddling were useful in lowering discomfort and boosting comfort levels in premature infants during and after peripheral vascular access.

PRACTICE IMPLICATIONS

Kangaroo care, fetal position and swaddling methods can be used in clinical practice in order to reduce the pain level and increase the comfort level during and after peripheral vascular access in prematures.

The Effect of Several Factors on the Patient's Satisfaction with the Complete Dentures and the Correlation with the Adaptation Period

OBJECTIVE

A great number of patients are completely satisfied with a regular denture, on the other hand, numerous patients are still not satisfied with their denture functions despite proper denture manufacture in relation to prosthetic standards.

AIM

To estimate the parameters of satisfaction for patients to improve the health care quality of patients and evaluate the effect of the adaptation period.

MATERIALS AND METHODS

A total of 136 patients who participated in this study were patients with complete dentures (CD), after placement of the CD, the patients were asked some questions (about esthetics, phonetics, comfort, quality of fit, and the masticatory efficiency) and the satisfaction of patients was evaluated by using Likert's scale, then recorded four readings, first at the placement visit, second after 1 month, third after 45 days, and last after 2 months.

RESULTS

The female patients' satisfaction related to phonetics was about 37.8% at the placement visit, but about 91.2% after 2 months; the male patients' satisfaction related to phonetics was about 44% at the placement visit, then 94.6% after 2 months; the female patients' satisfaction as related to esthetics was about 56.6% at the placement visit, but was about 89.8% after 2 months; the male patients' satisfaction as related to esthetics was about 68% at the placement visit, but about 89.4% after 2 months.

CONCLUSION

The satisfaction of the patient with their CD is affected by many factors such as phonetics, esthetics, comfort levels, the quality of fitness of the denture, and the mastication. The differences between gender in satisfaction in all parameters were non-significant, that is, p > 0.001. The adaptation period has an effect on the satisfaction rate of the completely edentulous patient with their CD.

The Effect of Listening to the Recitation of the Surah Al-Inshirah on Labor Pain, Anxiety and Comfort in Muslim Women: A Randomized Controlled Study

This study aimed to identify whether listening to the recitation of the Surah Al-Inshirah (94th Chapter of the Holy Qur'an) during labor had any effect on women's pain, anxiety and comfort levels. Designed as a randomized controlled trial, the study was performed with the participation of 126 pregnant Muslim women. The study showed that listening to the recitation of the Surah Al-Inshirah during labor had positive effects on the women's pain, anxiety and comfort levels. In this respect, it is recommended that based on individuals' religious beliefs, spiritual elements such as surahs, prayers and hymns be integrated into the midwifery care offered during labor.

The effect of hydroxypropyl-guar nanoemulsion on signs and symptoms of dry eye

PURPOSE

To examine the effect of hydroxypropyl-guar nanoemulsion (HP-Guar nanoemulsion, Alcon Laboratories Ltd, Fort Worth, TX, USA) versus saline (0.9% sodium chloride; Pfizer Inc., Bentley WA Australia) on the comfort and tear film properties of people with dry eye disease both in the short-term (up to 2 h post-drop instillation) and longer-term (after 4 weeks of 4-times daily use), and to examine the effect on tear inflammatory markers after 4 weeks.

METHODS

This was a prospective, investigator-masked, randomised, cross-over dispensing study. Twenty participants with dry eye disease (5 males: 15 females) with average age 46.9 ± 14.4 (range 26 to 70) years were randomized to either HP-Guar nanoemulsion, or saline eye drops. Ocular symptoms, lipid layer thickness, tear evaporation, tear osmolarity and non-invasive break-up time were measured pre-drop instillation, 1 h and 2 h post-eye drop instillation, and after 4-weeks of 4-times daily drop use. Tear inflammatory mediators were measured pre-drop instillation and after 4-weeks. After 4-weeks, patients had a 4-week washout period and then crossed over to the alternate drop.

RESULTS

With HP-Guar nanoemulsion, participants reported less grittiness/burning/stinging 1 h post eye drop instillation compared to baseline (79.5 ± 23.3 vs. 66.8 ± 27.7, p = 0.02); less dryness 1 h and 2 h post eye drop instillation compared to baseline (77.8 ± 23.0 and 76.2 ± 23.7 vs. 61.0 ± 27.1 respectively, p < 0.01 for both); and greater overall satisfaction 1 h post drop instillation and after 4 weeks of daily use compared to baseline (80.4 ± 21.6 and 83.4 ± 16.6 vs. 68.6 ± 26.0 respectively, p ≤ 0.011 for both). With saline, participants reported less dryness after 4 weeks of daily use compared to baseline (74.2 ± 23.8 vs. 60.2 ± 24.0, p < 0.01). For HP-Guar nanoemulsion, average lipid layer thickness was significantly thicker 2 h post drop-instillation (79.5 ± 21.7 nm) compared to baseline (63.7 ± 18.9 nm) and the 4-week assessment (62.4 ± 23.1 nm, p < 0.01 for both). For saline, average lipid layer thickness was significantly thicker at 1 h and 2 h post eye drop instillation (76.0 ± 23.8 nm and 80.4 ± 24.8 nm) compared to baseline (61.0 ± 15.6 nm, p < 0.01 for both). There was no difference in inflammatory mediators or other tear variables between drops or visits.

CONCLUSION

HP-Guar nanoemulsion was more effective for improving a range of subjective dry eye symptoms both in the short and long-term compared to saline. Both HP-Guar nanoemulsion and saline transiently increased lipid layer thickness.

Effects of quadratus lumborum block on perioperative multimodal analgesia and postoperative outcomes in patients undergoing radical prostatectomy

BACKGROUND

This study aimed to investigate the effects of ultrasound-guided quadratus lumborum block (QLB) on perioperative multimodal analgesia and postoperative outcomes in patients undergoing radical prostatectomy.

METHODS

A total of 80 patients undergoing radical prostatectomy were randomly divided into two groups: general anaesthesia with QLB (QLB group; n = 40) and general anaesthesia with sham QLB (normal saline [NS] group; n = 40). QLB or sham QLB was performed before the induction of anaesthesia. Sufentanil was intravenously administered for postoperative analgesia. The primary outcome was the pain score (measured using a numerical rating scale [NRS]) at different time points within 48 h postoperatively. Secondary outcomes included the cumulative dose of sufentanil within 48 h postoperatively, subjective comfort, grip strength, first time of exhaustion, first fluid intake time, time to get out of bed, length of postoperative hospital stay and overall satisfaction. The SPSS software, version 17.0, was used for all statistical analyses.

RESULTS

Postoperative NRS at rest was significantly lower at 2 h (1.7 ± 1.1 versus 3.0 ± 2.1), 4 h (1.8 ± 1.2 versus 4.1 ± 2.3), 6 h (1.9 ± 2 versus 4.4 ± 2) and 12 h (3.5 ± 2.3 versus 5 ± 3.3) and was also lower when coughing at 2 h (2.3 ± 1.1 versus 4 ± 2.1), 4 h (2.3 ± 1. 1 versus 4.3 ± 2) and 6 h (2.4 ± 1.1 versus 5.9 ± 2.3) in the QLB than that in the NS group. The cumulative dose of sufentanil was significantly lower in the QLB than that in the NS group at 4 h, 6 h, 12 h, 24 h and 48 h. The nausea score was significantly lower in the QLB group at 24 h postoperatively, and the first time of exhaustion and time to get out of bed were significantly shorter (P < 0.05). The overall satisfaction score was significantly higher in the QLB than in the NS group (4 ± 0.7 versus 2.6 ± 0.9).

CONCLUSION

Ultrasound-guided bilateral QLB can provide effective postoperative analgesia for patients undergoing radical prostatectomy, reduce the need for sufentanil, facilitate comfort and improve postoperative outcomes. QLB can be a good component of multimodal analgesia.

TRIAL REGISTRATION

The clinical trial is registered in the Chinese Clinical Trial Registry (ChiCTR). Current Controlled Trials: ChiCTR1900022009 . the date of registration:2019/03/20.