Journal of Neuroscience Nursing最新文献

Abstract: BACKGROUND: Multidisciplinary teamwork is essential in delivering holistic care to critically ill populations, including ventilated neurosurgery patients. Although it is considered a safe and feasible aspect of patient care, mobilization is often missed in this population because of negative healthcare provider perceptions regarding barriers and patient safety. Nurse-led teamwork has been suggested to overcome these barriers and to achieve earlier mobilization for patients, as well as positive provider perceptions, which may affect the culture and frequency of mobilization on neurointensive care units. Quantitative studies analyzing multidisciplinary teamwork perceptions to mobilize ventilated neurosurgery patients with or without a nurse-led protocol have not been previously conducted. Analyzing such perceptions may provide insight to team-related barriers related to missed mobility. This pilot quasi-experimental study aimed to determine whether the use of a nurse-led mobility protocol affects teamwork perceptions when mobilizing ventilated neurosurgery patients. METHODS: A sample of multidisciplinary teams, composed of nurses, patient care technicians, and respiratory therapists, mobilized ventilated neurosurgery patients according to either standard of care (for the control group) or a nurse-led mobility protocol (for the interventional group). Teamwork perceptions were measured via the reliable and valid Nursing Teamwork Survey tool. RESULTS: Linear mixed model analyses revealed that multidisciplinary teams in the nurse-led mobility protocol group had significantly higher levels of overall perceived teamwork than those in the control group, t3 = -3.296, P = .038. Such differences were also noted for teamwork variables of team leadership and mutual trust. CONCLUSION: Nurse-led mobility protocols should be considered to increase teamwork when performing multidisciplinary teamwork-based mobility for ventilated neurosurgery patients. Future studies should continue to evaluate teamwork perceptions after nurse-led mobility.

Abstract: BACKGROUND: Parkinson disease (PD), a neurodegenerative disease characterized by motor and nonmotor symptoms, can affect the daily activities of individuals. This study was conducted to determine nonmotor symptom burden in patients with PD and to reveal the relationship of nonmotor symptom burden with activities of daily living and fear of falling. METHODS: This cross-sectional and correlational study was carried out with 309 patients given a diagnosis of PD. The data were collected using a personal information form, the Non-Motor Symptoms Scale, the Katz Activities of Daily Living Scale, and the Fear of Falling Questionnaire. RESULTS: Whereas 70.2% of the patients had very high nonmotor symptom severity levels, 33.7% were semidependent or dependent in terms of performing their activities of daily living. The fear of falling was experienced by 32.7% of the patients. A statistically significant inverse relationship was found between the mean Non-Motor Symptoms Scale scores of the patients and their mean Katz Activities of Daily Living Scale and Fear of Falling Questionnaire scores ( P < .05). Nonmotor symptom burden independently explained 66% of the total variance in the performance of activities of daily living and 69% of the total variance in fear of falling ( P < .01). CONCLUSION: Nonmotor symptom burden in PD patients is a significant determinant for participation in activities of daily living and fear of falling. Nurses should approach patients with PD with a focus not only on assessing motor symptoms but also on assessing nonmotor symptoms.

Abstract: BACKGROUND: Multiple sclerosis (MS) is an immune-mediated disease that affects the central nervous system, and is potentially disabling. Women experience MS more frequently than men at a 3:1 ratio. Current literature suggests that women may experience health, social determinants of health, and disability differentially, and there is a gap in the research examining how gender intersects with MS. METHODS: Interviews were conducted with 23 women with MS. van Manen's hermeneutic phenomenology was used to inform and analyze the data to understand the nature and meaning of health and well-being for participants. RESULTS: A key theme of "enhancing wholeness for women with MS" emerged from the data, which suggests that women with MS view themselves as healthy and "whole" despite living with MS. Supporting factors for physical, mental, and social well-being include the ability to enact human agency within social structures such as with employment or seeking care with MS clinics. The findings informed the development of a figure that depicts the supporting factors of health and well-being for women living with MS. CONCLUSION: The health and well-being of women with MS may be optimally supported by nurses and interdisciplinary healthcare teams through careful consideration as to how agency is enacted within social structures, for example, MS clinics, employment, and social support systems, as well as considerations for social determinants of health.

Abstract: BACKGROUND: Pain management and good sleep are essential for patients after surgical procedures. This study aimed to evaluate the effects of footbath on postoperative pain severity and sleep quality levels of patients who have undergone degenerative lumbar spine surgery. METHODS: Sixty patients were randomly assigned to the footbath intervention group or the control group. The intervention was a 20-minute footbath in 42°C water before patients fell asleep on the evening of the surgery day. On the morning of the surgery day and the morning of postoperative day, the patient's pain severity and sleep quality scores were obtained using the visual analog scale and the Visual Analog Sleep Scale. RESULTS: There was no significant difference between the pain severity scores of the study groups ( P > .05). The sleep quality level of the intervention group was statistically significantly higher than that of the control group ( P < .05). CONCLUSION: Consequently, a footbath is effective in increasing sleep quality levels of patients who have undergone degenerative lumbar spine surgery. It may be used as a simple and practical nonpharmacological nursing strategy for improving patients' sleep quality.