This review explores adverse surgical outcomes for patients who experience hypothermia in the peri-operative period. Findings of the literature review highlight the need to establish a standard definition of hypothermia. Furthermore, the literature supports the full implementation of the National Institute for Health and Care Excellence guidance on ‘The Management of Inadvertent Perioperative Hypothermia in Adults’. A total of 18 studies were critically appraised to determine their rigour, reliability and validity. A discussion of the findings from the studies has taken into account the inferences drawn from the appraisal. Evaluation of the quality of the evidence has been used to evaluate which findings could apply to clinical practice. While there were variations in study quality, the evidence supports
developing an effective strategy for preventing hypothermia in the peri- operative period.
Mindfulness for older adults with chronic low back pain
Guidelines for the management of pain in older adults highlight that not only is chronic pain physically debilitating, but associated issues such as depression, anxiety and social isolation should be addressed. To this end, a biopsychosocial approach is paramount
to the successful management of chronic low back pain (CLBP) in the older adult (Abdullah et al 2013) (Schofield et al 2019). Aims A narrative literature review was undertaken to search for, retrieve and assess the literature exploring the efficacy and safety of mindfulness practice in the management of the older adult with CLBP and to consider how the evidence may inform local clinical practice. Methods A comprehensive and systematic search of the literature was undertaken. Three databases were accessed: Cinahl, PsychInfo, Medline using the search terms: mindfulness, mbsr, mindfulness-based stress reduction, mindfulness intervention, older adults, elderly, geriatric, ageing, seniors, older people, chronic low back pain, clbp. Results All three RCTs focused on community- dwelling older adults with CLBP and used adapted forms of the MBSR programme developed by Kat-Zinn at the University of Massachusetts. All three studies cite Moroneas the principal researcher and author, but they are different studies thus justifying including them in the literature review. Conclusions MBSR appears feasible and effective for older adults coping with CLBP, as demonstrated in the Morone et al (2008) study, but particularly in the Morone et al (2016) study. Pain reduction was sustained at the 6 month follow-up in the Morone et al (2106) study, suggesting that mindfulness may be effective in the long-term.