Axone (Dartmouth, N.S.)最新文献

The shift towards patient-centred care is the priority in health care today. Providing quality care that is highly efficient and patient-friendly while also being cost-effective is a difficult, but not impossible task. Since 1996, awake, image-guided day surgery for resection of brain tumors has been performed at Toronto Western Hospital in an attempt to combine the concept of patient-centred care with responsible resource allocation. Nurses can play a vital role in facilitating a shift in outpatient neurosurgery towards a more patient-care focused environment. By providing information and education to patients and families, nurses have enormous potential to improve satisfaction and outcomes for patients undergoing these procedures. Thoroughly preparing patients for their surgery and helping them manage their care post-operatively are the keys to decreased complications and re-admission. This would undoubtedly improve cost-effectiveness for the system while simultaneously improving the patients' quality of life.

Gamma Knife surgery (GKS) is a minimally invasive neurosurgical procedure used to treat a variety of cranial lesions and disorders. Gamma Knife surgery technology and conditions treated are discussed in this paper. The patient experiences during the treatment phases are also reviewed. The incision-free technology was introduced by Lars Leksell and Bjorn Larson in 1967 in Europe, and has been available in the United States since 1987 (Ganz, 1997). Gamma Knife surgery has expanded internationally with over 170 sites worldwide treating over 250,000 patients using focused beams of Cobalt-60 radiation. Winnipeg's Health Sciences Centre opened the first Canadian Gamma Knife centre in November 2003.

Until recently, the effects of a minor head injury have been minimalized by health care workers. Few resources have been available to individuals who experienced a mild traumatic brain injury who were discharged from hospital emergency services. Recognizing the needs of these individuals and their families, health care workers in Nova Scotia, including nurses, have developed a specific program of rehabilitation for patients who have suffered mild brain injuries.

Valuing and promoting quality of life after stroke is an essential component of practice for neuroscience nurses and other clinicians working in rehabilitation settings. Although some research studies have addressed factors that contribute to quality of life post-stroke, the majority of studies have focused on stroke survivors, not their spouses. Additionally, little attention has been given to family strengths associated with quality of life. In this paper, the investigator presents the findings of a recent descriptive, correlational study that was based on the conceptual framework of the Developmental Model of Health and Nursing (DMHN) (Allen & Warner, 2002; Ford-Gilboe, 2002a). This was the first study to examine the relationships among hope, family health promoting activity, and quality of life. The study was conducted with a convenience sample of 40 stroke survivors with moderate to severe functional impairments and their spouses. Participants had completed a rehabilitation program. Spouses' employment status, number of supports, and functional independence at discharge were common predictors of quality of life for both partners. However, hope was found to contribute to quality of life of stroke survivors, but not their spouses. The different patterns of findings are discussed and the key implications for clinical and research practice are addressed.

The rehabilitative care of persons suffering long-lasting effects of brain injury is a significant challenge for nurses as they are the health professionals who usually spend the most time with them. Historically in Germany, the term "apallic syndrome" has been commonly used for what Plum and Posner (1980) termed the persistent vegetative state. When persons are diagnosed as being in a persistent vegetative state, that is awake but not aware, for more than six months, they seldom receive active therapy except what nurses or families may provide. Stimulation programs have been advocated for these persons, but there is still no reliable evidence as to their effectiveness, and the conceptual basis of the two main types of programs has been poorly understood. The multisensory stimulation approach, such as the Coma Recovery Program or Coma Arousal Therapy, is based on behaviourism with the belief that intensive stimulation provided to all senses will enhance synaptic reinnervation and stimulate the reticular activating system to increase brain tone. In contrast, the sensory regulation approach is based on information processing and mediation of reaction to sensory information with emphasis on enhancing selective attention by regulating the environment rather than providing high degrees of stimulation. What both approaches have in common is the belief that the person in a persistent vegetative state may, at some level, be able to perceive and begin to process information and that external stimulation may enhance that process. Nurses interacting with persons in persistent vegetative state are encouraged to think about how they can regulate sensory input to enhance meaning and facilitate information processing for these persons.