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Preterm infants in the neonatal intensive care unit are exposed to various painful procedures; thus, different non-pharmacological pain control techniques are used to alleviate pain. The aim of this study is to determine the effect of Yakson and Gentle Human Touch (GHT) methods during endotracheal suctioning on pain, comfort, and physiological parameters response in preterm infants. A randomised controlled crossover trial. This study was conducted in the neonatal intensive care unit between July 2022 and June 2023. Thirty infants were included in this study based on inclusion criteria. The samples randomly received a sequence of suctioning with Yakson and GHT and routine care. Neonatal Pain Agitation and Sedation Scale (N-PASS) and COMFORTneo were used to collect the data. The pain and comfort scores of preterm infants who received GHT and Yakson touch during and after endotracheal suctioning were statistically significantly lower than the infants in the routine care (p < 0.001). It was determined that the difference was in favour of the Yakson group (p < 0.001). The infants who received GHT and Yakson application had lower heart rates and higher oxygen saturation levels after the application compared to the control group (p < 0.001). The application of Yakson and GHT during endotracheal aspiration in preterm infants has been found to be effective in pain and comfort management, as well as in the regulation of physiological parameters.

Evidence is growing that people can benefit from palliative care earlier in their illness, say Scott Murray and colleagues, but care must be tailored to different conditions

Recent literature emphasizes the importance of comfort in the design of exosuits and other assistive devices that physically augment humans; however, there is little quantitative data to aid designers in determining what level of force makes users uncomfortable. To help close this knowledge gap, we characterized human comfort limits when applying forces to the shoulders, thigh and shank. Our objectives were: (i) characterize the comfort limits for multiple healthy participants, (ii) characterize comfort limits across days, and (iii) determine if comfort limits change when forces are applied at higher vs. lower rates. We performed an experiment (N = 10) to quantify maximum tolerable force pulling down on the shoulders, and axially along the thigh and shank; we termed this force the comfort limit. We applied a series of forces of increasing magnitude, using a robotic actuator, to soft sleeves around their thigh and shank, and to a harness on their shoulders. Participants were instructed to press an off-switch, immediately removing the force, when they felt uncomfortable such that they did not want to feel a higher level of force. On average, participants exhibited comfort limits of ~0.9-1.3 times body weight on each segment: 621±245 N (shoulders), 867±296 N (thigh), 702±220 N (shank), which were above force levels applied by exosuits in prior literature. However, individual participant comfort limits varied greatly (~250-1200 N). Average comfort limits increased over multiple days (p<3e-5), as users habituated, from ~550-700 N on the first day to ~650-950 N on the fourth. Specifically, comfort limits increased 20%, 35% and 22% for the shoulders, thigh and shank, respectively. Finally, participants generally tolerated higher force when it was applied more rapidly. These results provide initial benchmarks for exosuit designers and end-users, and pave the way for exploring comfort limits over larger time scales, within larger samples and in different populations.

Background Comfort, anxiety, and pain significantly impact the quality of life and treatment adherence in cancer patients undergoing chemotherapy. Virtual reality (VR) technology offers a novel non-pharmacological intervention to address these primary concerns. While vital signs provide objective physiological data, they are considered secondary outcomes that may reflect changes in patients’ subjective experiences. Objective This study aims to evaluate the effectiveness of smartphone-based virtual reality relaxation (SVR) interventions on improving comfort and reducing anxiety and pain (primary outcomes) in patients with cancer undergoing chemotherapy. Additionally, it assesses the impact on blood pressure and pulse rate (secondary outcomes). Methods This prospective, two-arm, randomized controlled trial involved 99 cancer patients undergoing chemotherapy who were randomized into the SVR group ( n  = 50) and control group ( n  = 49) from March to May 2023. The SVR group received a 10-min immersive VR experience featuring 360-degree natural scenery videos with relaxing sounds, while participants in the control group received standard care and guided imagery leaflets. The primary outcomes—comfort, anxiety, and pain—were evaluated at various time points: comfort was assessed at baseline and post-chemotherapy, while anxiety and pain were assessed at four stages (pre-chemotherapy, pre-VR, immediate post-intervention, and post-chemotherapy). Secondary outcomes included vital signs (blood pressure and pulse rate), which were assessed at the same four stages. Cybersickness symptoms were examined post-chemotherapy. Data analysis involved independent t tests, linear regression, and Generalized Estimating Equations (GEE). Results Among 99 randomized patients, the SVR group reported significantly higher comfort levels ( p  = 0.01; Cohen’s d  = 0.4), reduced anxiety ( p  = 0.01; Cohen’s d  = 0.50), and pain ( p  = 0.015; Cohen’s d  = 0.35) compared to the control group. No significant differences were found in heart rate ( p  = 0.92), systolic blood pressure ( p  = 0.36), or diastolic blood pressure ( p  = 0.95). The majority of participants (66–96%) in the SVR group did not report cybersickness symptoms. Conclusions SVR shows promise as an intervention for improving comfort and reducing anxiety and pain in cancer patients undergoing chemotherapy. Healthcare providers at chemotherapy centers should consider incorporating VR devices and curated content into patient care routines. Trial registration ClinicalTrials.gov: NCT05756465, registered on January 22, 2023.

Background Due to the deterioration in comfort experienced after cesarean section, mothers go through troubled hours, have problems with breastfeeding, and cannot even meet their own and their baby’s needs. This study was conducted to determine the effect of neuro-linguistic programming on mothers’ comfort levels following cesarean section in the postpartum period. Methods This study was performed from 1 January to 1 September 2023 as a prospective randomized controlled single-blind clinical trial with 100 participants (50 experimental, 50 control). The research data were collected using the Personal Information Form and the Postpartum Comfort Scale. The dependent samples t test and independent samples t test were used in the analysis of research data as well as numbers, percentages, and means. Analysis of covariance (ANCOVA) was used to evaluate the effect of the NLP more accurately by controlling the pre-test scores. Results There were statistically significant differences between the mean pretest and posttest postpartum comfort scale scores, physical comfort scores, psycho-spiritual comfort scores, and sociocultural comfort scores of mothers in the intervention group. In this regard, mothers in the intervention group had higher mean postpartum comfort scale scores, physical comfort scores, psycho-spiritual comfort scores, and sociocultural comfort scores in the posttest phase than in the pretest phase. Conclusions This study revealed that neuro-linguistic programming enhanced the postpartum comfort levels of mothers who underwent cesarean delivery. In this context, it is recommended that nurses and midwives enhance participants’ comfort through the use of neuro-linguistic programming techniques in care processes. Trial registration NCT05646537.

Background . The relationship among comfort, perceived social support, and hope should still be further explored. Clarifying the relationship between the aforementioned variables can enable clinical staff to implement tailored and effective intervention strategies for enhancing the management and quality of care of patients with ischemic stroke. Aim . This study aims to investigate the relationship between comfort, perceived social support, and hope in hospitalized patients with acute ischemic stroke and to explore the mediating effect of perceived social support on comfort and hope. Methods . A correlational cross‐sectional study was performed using an online questionnaire. The study was conducted from January to August 2023 among 572 patients with acute ischemic stroke, and finally 534 valid questionnaires were included in the analysis. The general information questionnaire, Modified Barthel Index, Shortened General Comfort Questionnaire, Perceived Social Support Scale, and Herth Hope Index were utilized for investigation. Mediation analysis was performed by structural equation modelling. Indirect effects were evaluated through bootstrapping. Data analysis was performed using the statistical program packages, namely, SPSS 29.0 and AMOS 24.0 . Results . The comfort, perceived social support, and hope scores of patients with acute ischemic stroke were 94.1 (11.92), 72.74 (10.26), and 40.55 (4.99), respectively. The participants’ hope was positively related to comfort ( r  = 0.531, p < 0.001) and perceived social support ( r  = 0.589, p < 0.001). Perceived social support exerts a partial mediating role between comfort and hope, and the mediating effect was 0.159 (95% CI [0.117, 0.210]), accounting for 25.0% of the total effect. Conclusion . We reported that comfort—directly and indirectly—exerts a positive impact on hope. Particularly, perceived social support enhances the impact of comfort on hope; perceived social support mediates the relationship between comfort and hope. Clinical staff should correctly understand the relationship among the three variables; they should effects targeted strategies to enhance patient comfort and social support, thereby increasing the hope level among ischemic stroke patients and bolstering confidence in disease management. Implications for Nursing Management . This study demonstrates that comfort and perceived social support serve as protective factors for hope among ischemic stroke patients. This observation provides evidence supporting the optimization of management for ischemic stroke patients from the perspectives of the cognitive adaptation theory and comfort theory. The findings of this study contribute to a more optimal understanding among clinical caregivers regarding the mechanisms underlying the relationship between comfort, social support, and hope, and it facilitates the adoption of effective intervention strategies for promoting the psychological management of ischemic stroke patients and enhancing patient care quality.

Background The high-flow nasal cannula (HFNC) delivers up to 60 l/min of humidified air/oxygen blend at a temperature close to that of the human body. In this study, we tested whether higher temperature and flow decrease patient comfort. In more severe patients, instead, we hypothesized that higher flow might be associated with improved comfort. Methods A prospective, randomized, cross-over study was performed on 40 acute hypoxemic respiratory failure (AHRF) patients (PaO 2 /FiO 2  ≤ 300 + pulmonary infiltrates + exclusion of cardiogenic edema) supported by HFNC. The primary outcome was the assessment of patient comfort during HFNC delivery at increasing flow and temperature. Two flows (30 and 60 l/min), each combined with two temperatures (31 and 37 °C), were randomly applied for 20 min (four steps per patient), leaving clinical FiO 2 unchanged. Toward the end of each step, the following were recorded: comfort by Visual Numerical Scale ranging between 1 (extreme discomfort) and 5 (very comfortable), together with respiratory parameters. A subgroup of more severe patients was defined by clinical FiO 2  ≥ 45%. Results Patient comfort was reported as significantly higher during steps at the lower temperature (31 °C) in comparison to 37 °C, with the HFNC set at both 30 and 60 l/min ( p  < 0.0001). Higher flow, however, was not associated with poorer comfort. In the subgroup of patients with clinical FiO 2  ≥ 45%, both lower temperature (31 °C) and higher HFNC flow (60 l/min) led to higher comfort ( p  < 0.01). Conclusions HFNC temperature seems to significantly impact the comfort of AHRF patients: for equal flow, lower temperature could be more comfortable. Higher flow does not decrease patient comfort; at variance, it improves comfort in the more severely hypoxemic patient.

The aims were twofold: (a) to map tools documented in the literature to evaluate comfort among patients undergoing high flow nasal cannula (HFNC) treatment; and (b) to assess if the retrieved tools have been validated for this purpose. A scoping review, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews (PRISMA-ScR). In July 2023, PubMed, Scopus, CINAHL and Cochrane Library were consulted. Studies assessing comfort in adult, paediatric, and neonatal patients undergoing HFNC were included. Seventy-four articles were included, among which nine (12.2 %) investigated comfort as the primary aim. Twenty-five different tools were found, classifiable into 14 types, mostly unidimensional and originating from those measuring pain. The most widely used was the Visual Analogic Scale (n = 27, 35.6 %) followed by the Numerical Rating Scale (n = 11, 14.5 %) and less defined generic tools (n = 10, 13.2 %) with different metrics (e.g. 0–5, 0–10, 0–100). Only the General Comfort Questionnaire and the Comfort Scale were specifically validated for the assessment of comfort among adults and children, respectively. Although the comfort of patients undergoing HFNC is widely investigated in the literature, there is a scarcity of tools specifically validated in this field. Those used have been validated mainly to assess pain, suggesting the need to inform patients to prevent confusion while measuring comfort during HFNC and to develop more research in the field. Comfort assessment is an important aspect of nursing care. Given the lack of validation studies in the field, efforts in research are recommended.

BackgroundIn Turkey, paediatric emergency departments often lack the specialised environments required for invasive procedures on neonates. Given their developmental vulnerability, it is crucial to use interventions that reduce discomfort and support physiological stability. This study introduces the portable therapeutic baby nest (PTBN), designed to provide developmentally supportive care aligned with the principles of the Newborn Individualized Developmental Care and Assessment Program.MethodsThis two-phase study included 80 term neonates (40 per group). First, the PTBN was developed from February to April 2022. Second, its effectiveness was evaluated through a randomized controlled trial conducted from May to September 2022. The experimental group underwent venous blood sampling in the PTBN, and the control group on a standard stretcher. All procedures were video-recorded and assessed by two blinded nurses using the Physiological Parameter Monitoring Form, COMFORTneo and Neonatal Infant Pain Scale (NIPS).ResultsBaseline characteristics were similar across groups (p>0.05). During and after sampling, the PTBN group had significantly lower heart and respiratory rates, higher oxygen saturation and lower NIPS and COMFORTneo scores compared with controls (p<0.05).ConclusionThe PTBN improved physiological stability, comfort and pain outcomes during venous sampling in neonates.Trial registration numberNCT05442619.

Prone positioning for whole-breast irradiation (WBI) reduces dose to organs at risk, but reduces set-up speed, precision, and comfort. We aimed to improve these problems by placing patients in prone crawl position on a newly developed crawl couch (CrC). A group of 10 right-sided breast cancer patients requiring WBI were randomized in this cross-over trial, comparing the CrC to a standard prone breastboard (BB). Laterolateral (LL), craniocaudal (CC) and anterioposterior (AP) set-up errors were evaluated with cone beam CT. Comfort, preference and set-up time (SUT) were assessed. Forty left and right-sided breast cancer patients served as a validation group. For BB versus CrC, AP, LL and CC mean patient shifts were − 0.8 ± 2.8, 0.2 ± 11.7 and − 0.6 ± 4.4 versus − 0.2 ± 3.3, − 0.8 ± 2.5 and − 1.9 ± 5.7 mm. LL shift spread was reduced significantly. Nine out of 10 patients preferred the CrC. SUT did not differ significantly. The validation group had mean patient shifts of 1.7 ± 2.9 (AP), 0.2 ± 3.6 (LL) and − 0.2 ± 3.3 (CC) mm. Mean SUT in the validation group was 1 min longer (P < 0.05) than the comparative group. Median SUT was 3 min in all groups. The CrC improved precision and comfort compared to BB. Set-up errors compare favourably to other prone-WBI trials and rival supine positioning.