Revista Científica de la Sociedad de Enfermería Neurológica (English ed.)最新文献

Background

Femoral artery access site complications are uncommon but likely to become more frequent with the increased use of endovascular procedures in stroke patients.

Aims

This study aims to describe the clinical, diagnosis and treatment features of a consecutive case series of femoral artery pseudoaneurysms (FAP).

Methods

A retrospective case series was performed for consecutive patients diagnosed with FAP at our institution between January 2016 and January 2020. Variables regarding patient demographics, endovascular procedural features and PAF description, diagnosis, treatment and outcomes were included.

Results

We identified a total of 9 cases in a 5-year period; six happened after acute endovascular therapy for stroke, 2 after diagnostic arteriography and 1 after subarachnoid hemorrhage related ruptured aneurysm embolization. Most patients experienced local symptoms but in 3 cases the PAF was incidentally discovered during the stroke diagnostic study. Only 1 of the patients experienced severe anemia related to the PAF. Regarding treatment, local compression and patient rest was enough in 2 cases, thrombine percutaneous injection was used in 3 patients and open surgery in 3. Nurse reports included evaluation of the groin status (pain, lump, bruise) prior to the PAF diagnosis in six patients.

Conclusions

The clinical presentation of FAP after endovascular procedure is heterogeneous and its diagnosis and management may be challenging. Systematic assessment of the groin after EP in stroke patients could help in prompt diagnosis and treatment of this complication.

Background

Dysphagia has a high prevalence with associated complications, such as respiratory infections and recurrent institutionalizations, factors associated with the burden of malnutrition and dehydration that negatively affects the patient's quality of life and entails added health costs.

Objective

To assess the knowledge of a group of Portuguese nurses regarding dysphagia and perform the cross-cultural adaptation of the questionnaire used.

Methods

Cross-sectional descriptive study based on an online self-ministered questionnaire sent to nurses, regardless of the length of professional experience and area of clinical practice. Data treatment was performed using the IMB SPSS computer software, and the open responses were treated using the QDA Miner Lite.

Results

241 nurses were enrolled between May and June 2021, of which 192 (79.6%) were female, with an age of 37.8 ± 8.3 years and a length of service of 14.4 ± 8.5 years. Overall knowledge of dysphagia was high (80.1%). Participants were dissatisfied with their knowledge and expressed a need for further training, mainly in therapeutic intervention.

Conclusions

It is essential to understand why nurses still consider themselves to lack knowledge despite higher levels of knowledge. Future research should explore these aspects. These findings corroborate the gap between the nurses’ perceived knowledge and their actual knowledge about dysphagia, which may influence practice by influencing the decision-making process. Due to its high prevalence and complications, this gap may translate into increased patient safety risks.

Introduction

Stroke is a time-dependent pathology which requires a rapid and universal neurological assessment tool. Since October 2021, following training of nursing staff, the NIHSS scale has been implemented in order to increase comparability, concordance and improve communication with the medical team.

Objectives

1. To examine the concordance among scores of the NIHSS scale implemented by nursing staff and medical team in Neurology Service of the Ramón y Cajal Hospital. 2. To describe the subjective perception of using the NIHSS scale from the nursing staff in the Neurology Service of the Ramón y Cajal Hospital.

Method

Cross-sectional observational study that included 100 patients distributed in two periods of three months each in the Stroke Unit of the Ramón y Cajal Hospital. The NIHSS scale scores given by nursing and neurology were collected, as well as the discordant items of each assessment. Statistical analyzes included frequencies, percentages, Cronbach's alpha and the Intraclass Correlation Coefficient. A survey was conducted among the 22 professionals to assess the degree of acceptance.

Results

A high concordance (68% and 70% in each period) was achieved between the nursing and neurology. A total of 94% of professionals reported to get used to the NIHSS scale.

Conclusions

The implementation of the NIHSS scale is a clear opportunity for improvement in the stroke unit, facilitating communication between nursing and neurology teams, due to agreement between scores and increasing quality of medical care.

Spasticity plus syndrome (SSP) is a clinical diagnosis based on the presence of a compendium of symptoms that has been suggested recently in patients with demyelinating disease. Using this diagnosis might help to avoid polimedication and to offer a better symptomatology management in long-term patients.

Objective

The aim of this study is to retrospectively analyze the number of cases compatible with a SSP diagnostic in our nurse clinical-consultancy.

Methodology

We analyzed a time-window from 2002 till 2022 and we included cases compatible with SSP at those 2 time-points as well as the number of symptomatic treatments prescribed also in both time-points.

Results

All cases in the databased were compatible with SSP and also associated pain (90%), rigidity (83.3%), fatigue (75%) and bladder problems (43.3%). An increase in symptomatic treatments was stated (from 1.4 to 3.9 at the end of the temporal window of analysis), and THC:CBD was prescribed in 88.9% of them. There was no correlation between number of symptoms at the beginning and number of symptomatic treatments at the end of the time-window. No correlation either was found between number of symptomatic treatments and physical disability.

Conclusions

SSP is relatively easy to be diagnosed in our consultancy and it should be more frequently stated as it will offer the opportunity to individual management of symptoms and treatments for our patients that could impact their quality of life in the long-term.

The new coronavirus disease 2019 (COVID-19) outbreak has rapidly spread throughout the world, becoming a serious public health problem. COVID-19, in addition to respiratory symptoms, has neurotropic characteristics that can impact the nervous system. We present a 22-year-old female who developed diplopia and numbness of her limbs eight days after affecting by COVID-19 and she showed a left-sided outward gaze palsy without any history of previous a specific illness or medication. Supratentorial, infratentorial, and cervical cord enhancing plaques confirmed an acute demyelinating process in favor of Acute disseminated encephalomyelitis (ADEM). Her oligoclonal bands (OCB) were positive as well. As a result, a provisional diagnosis of ADEM was made. Her condition improved dramatically after starting corticosteroids and rituximab.

Objective

To determine the relationship of perceived social support with clinical variables, the profile of activities of daily living and quality of life in patients diagnosed with myasthenia gravis living in Spain and Latin America.

Methods

Observational, cross-sectional study. Subjects diagnosed with myasthenia gravis were recruited from associations, foundations and social media in the first quarter of 2022. The Medical Outcomes Study (MOS-SSS), the Myasthenia gravis activities of daily living profile (MG-ADL) and the 15-item Myasthenia Gravis Quality of Life scale revised (MG-QOL15R-S) instruments were included.

Results

Mean time to diagnosis (t = 2,38; P < .05), history of thymoma (χ2 = 5.18; P < .05), MG-ADL global score (t = 4.29; P < .001), and MG-QOL15R-S global score (t = 7.67; P < .001) were related to perceived social support in MG subjects. We also found that MOS-SSS score correlated significantly with MG-ADL (r = −0.15; P < .001) and MG-QOL15R-S (r = −0.27; P < .001) scores.

Conclusions

A history of thymoma reduces the likelihood of high perceived social support, and diagnosis of the disease at less than two years has been associated with a higher frequency of high perceived social support. In addition, high perceived social support is expected to correlate with high quality of life and lower severity of myasthenia gravis symptoms.