Axone (Dartmouth, N.S.)最新文献

Negotiating is the core variable or central concern of families who have a close relative in a state of post-comatose unawareness or minimal responsiveness following a severe traumatic brain injury. Family members negotiate with each other, with members of the health care team, and with others such as insurance agents, case managers, and representatives of the justice system on behalf of the injured individual. Family members also negotiate the intricacies of the health care system. These are the findings of a 16-month grounded theory study conducted on two acute neurosurgical units in Toronto, with 25 family members from 11 families who had a close family member who suffered a severe traumatic brain injury and who was in a state of post-comatose unawareness or minimal responsiveness. An extensive review of the scholarly literature related to family research methodology and family research related to families following the brain injury of a family member is also provided in this paper.

The scholarly literature related to quality of life (QoL) is reviewed. Specific contributions by neurosciences nursing related to quality of life for patients and family caregivers is presented in the areas of stroke, neuro-oncology, traumatic brain injury, multiple sclerosis, and epilepsy. QoL information is important, as it is used in decisions concerning treatment and interventions for patients and their family members who are living with neurological conditions and their consequences.

The awake craniotomy procedure has become the gold standard for tumour resection in eligible patients. In this paper, the awake craniotomy procedure is reviewed, including the advantages of the procedure over the standard craniotomy procedure. The role of the neuroscience nurse in awake craniotomies is highlighted.

In this paper we described our approach to the development of the role of a nurse within a stroke and cognition ambulatory clinic at Baycrest. In developing this approach we integrated Baycrest's commitment to clients and family-focused care, our focus on interdisciplinary collaborative practice, the position of the post-rehabilitation clinic in the continuum of care, the clinical experience of the nurse and director, and the relevant scholarly literature. The role of the nurses in the stroke and cognition clinic includes assessment, interdisciplinary care planning, client/family support, and knowledge transfer.

A high percentage of individuals who have suffered a stroke will be cared for at home, primarily by aging spouses and/or relatives. Providing care to a family member with a chronic or life-threatening condition can be both emotionally rewarding and distressing for the care provider. The objective of this research was to test the factors associated with caregiver experiences. The findings of a convenience sample of 48 caregivers indicated that the higher the amount of caregiver burden, the greater the lifestyle impact and emotional distress for the caregiver. Caregiver satisfaction was not found to be associated with emotional well-being. The amount of support, both instrumental and social, did not improve the emotional well-being of the caregiver. The caregiver's sense of mastery was found to moderate the relationship between lifestyle impact and emotional well-being and also between caregiver satisfaction and emotional well-being.

Mary Glover was a Head Nurse at St. Paul's Hospital in Vancouver. She was killed in a plane crash more than 25 years ago. Yet, through this neuroscience nurse's passion for her specialty, we share in her legacy through the annual Mary Glover Lecture, which was established by her parents after her death. The first Mary Glover Lecturer was Pamela Mitchell, a well-known neuroscience nurse from the School of Nursing at the University of Washington. She is leaving a multifaceted legacy through her research on intracranial pressure and quality of care as well as her books and her mentorship. Jessie Young has left a legacy as the founder and first president of the Canadian Association of Neuroscience Nurses (CANN). CANN is leaving a legacy with many firsts among Canadian nursing specialty organizations. Leaving a legacy is not just about donating money or writing a famous book. For most of us, our legacy comes in the little everyday things of life. Ask yourself, what is the legacy that you are leaving as a neuroscience nurse and as an individual?

Approximately 84% of all stroke patients with hemiplegia will experience shoulder injury and pain. The importance of maintaining proper posture while positioning and transferring a stroke patient is key to decreasing risk for shoulder injury. Shoulder subluxation injury post-stroke is a consequence of sustained hemiplegia and spasticity. Current research evidence suggests that using therapies such as gentle range of motion and functional electrical stimulation may reduce and prevent shoulder subluxation and hemiplegic shoulder pain. However, physiotherapists are currently the only professionals who can implement such therapies. Considering that stroke care provided by neuroscience nurses includes transferring, positioning and assisting in activities of daily living, it is clear that nurses are an important part of the therapy process. Therefore, the question is: "What is the role of the neuroscience nurse in the reduction and prevention of shoulder pain post-stroke?" The purposes of this paper are to i) discuss the causes of shoulder subluxation and related pain post-stroke, ii) review current best practice in prevention and treatment of shoulder subluxation, and iii) explore ways in which the acute neuroscience nurse can prevent or reduce shoulder subluxation in the hemiplegic stroke patient.

Stroke is the fourth leading cause of death in Canada and, each year, approximately 50,000 Canadians will suffer a stroke with a range of severities from mild, short duration symptoms to significant long-term disability or death. Of these 50,000 patients, at least 20,000 are hospitalized. Earlier this year, a core set of evidence-based performance indicators were identified by a national consensus panel that may be used to determine the quality of care provided to stroke patients in hospital during the acute phase of illness. Nurses play a critical role in stroke care across the continuum and recently published stroke assessment guidelines for nurses clearly describe key approaches to assessment and/or screening of stroke survivors. Many of the nursing assessments and/or screening actions recommended in the guidelines have direct or indirect associations with the recent performance indicators. This article describes where those relationships exist and the role nurses may play in determining overall performance for acute stroke patient care delivery during the hospitalization phase of the stroke continuum of care.

Distinguishing between true and quasi-experimental studies and the benefits of one group, within subjects designs: a discussion of the research design used in: Self-efficacy of staff nurses for health promotion counselling of patients at risk for stroke.

The effect of nurses' confidence to counsel patients at risk of stroke in selected health promotion areas: smoking cessation, exercise and nutrition was examined. Bandura's (1986) self-efficacy and Knowles' adult learning theories provided the theoretical underpinnings for the study. This was a quasi-experimental design in which neuroscience nurses (N = 23) from a quaternary hospital completed questionnaires prior to, immediately after, and 2 months post completion of a self-directed learning manual (SDL). The researcher-designed manual was designed to enhance learning about the risk factors for stroke and the importance of stroke prevention. Along with reflective activities and pre-post test, strategies for counseling high-risk, stroke-prone individuals in the areas of smoking cessation, exercise, and nutrition were also integrated. The Health Promotion Counseling Self-Efficacy Scale (Tresolini, Saluja, and Stritter, 1995), consisting of 10 self-efficacy subscales relating to self-confidence in knowledge and ability to counsel in health promotion areas, was used to capture the nurses' self-report of self-efficacy. Using a 5-point Likert Scale, nurses also rated their amount of agreement or disagreement about health promotion counseling in practice. Overall, self-efficacy levels for both knowledge and counseling increased significantly (p < .01) from pre-to immediately post completion of the manual, and decreased slightly at two-month follow-up. This pattern was evident in all health promotion areas measured except for knowledge in exercise (p = .015). Nurses' attitudes about aspects of health promotion practices correlated significantly (p < 05) at two-month follow-up with all health promotion areas. Results of this study support the usefulness of a self-directed learning manual as a teaching strategy for health promotion counseling of individuals at risk of stroke.