Axone (Dartmouth, N.S.)最新文献

Little research is currently available related to pain management by neuroscience nurses. However, due to concerns about the potential for altering neurological status, some neurosurgery patients may not receive optimal pain management. This paper describes findings from a pain related survey which was distributed during the Canadian Association of Neuroscience Nurses June 1998 national conference. The survey was intended to assess Canadian neuroscience nurses pain management knowledge and to explore pain management techniques after intracranial surgery. While 60% of respondents answered four pain assessment and management case study related questions correctly, some respondents rated pain differently when it was expressed by a smiling or grimacing patient. The most common methods for pain control after intracranial surgery included intermittent codeine and/or morphine, often by intramuscular injection. Findings from this study suggest that some neuroscience nurses require further education about pain management and that many patients do not receive optimal pain management after intracranial surgery.

Continuous intrathecal baclofen infusion (CIBI) is a relatively new treatment modality for severe spasticity of spinal cord origin. Literature review suggests relief of severe spasms and rigidity is proven with CIBI, in patients with spinal cord injury and multiple sclerosis, while ongoing research exists for patients with acquired brain injury and cerebral palsy. Criteria for patient selection, the screening trial process, an outline of the surgical procedure, and generalities of maintenance therapies, will be reviewed broadly as per literature, as well as specifically to the Vancouver experience with adults. Additionally, reported patient outcomes and implications for nursing will be shared.

The patient population which has the most to gain from comprehensive stroke education is the one which has experienced a stroke with minimal deficit and carries an increased risk for experiencing a second more severe stroke. This is the patient population the author selected, yet little published information is available. Given that in Canada stroke carries the third highest rate of mortality and the highest risk of morbidity there is a role for an advanced practice nurse to develop and deliver a comprehensive stroke education program for this population. This is of special significance given the understanding that stroke is considered to be one of the most preventable diseases. The practice environment for this patient population is shifting out of the hospital and into the community. The learning needs and issues as well as the identification of appropriate patient focussed outcomes needs to be examined. A comprehensive plan for the delivery of patient focussed education which includes content, setting, and timing for this target population needs to be developed, piloted and reported on. Nurses have been identified as appropriate for delivering patient education. An advanced practice nurse is poised to address this need and develop a model for others to incorporate in their practice.

Continuous intrathecal baclofen infusion (CIBI) is a relatively new treatment modality for severe spasticity of spinal cord origin. Literature review suggests relief of severe spasms and rigidity is proven with CIBI, in patients with spinal cord injury and multiple sclerosis, while ongoing research exists for patients with acquired brain injury and cerebral palsy. Criteria for patient selection, the screening trial process, an outline of the surgical procedure, and generalities of maintenance therapies, will be reviewed broadly as per literature, as well as specifically to the Vancouver experience with adults. Additionally, reported patient outcomes and implications for nursing will be shared.

The ability to cope with major stressors and adversity in our lives is as individual as the human experience. An unpredictable disease such as Multiple Sclerosis (MS) can demand major adjustments to one's lifestyle, employment, and personal relationships. Why is it that some sail smoothly through major upheaval in all of these realms despite the acquisition of significant physical disability while others are immobilized by seemingly trivial disruptions in their routine. How can we, as health professionals, assist those who are coping in a non-adaptive manner, to identify and implement more effective strategies. Does focused counseling early in the disease promote effective coping? Existing literature reviews coping with chronic illness, detailing the tools and strategies which individuals may use to manage stressors. This paper will build on this foundation of knowledge. How well you are determines how well you cope. The emphasis will be on "premorbid" personality traits which may be critical to coping. The author will critically examine the practicality of utilizing existing assessment tools for those at differing stages of MS and offer assessment guidelines for nurses working both with newly diagnosed and well-established disease. Suggestions for counseling techniques which may promote effective coping behaviors will be offered. How an individual copes with a chronic illness such as MS has implications for that person's family, social network and society at large. Those who become overwhelmed by a disease such as MS will stop working earlier, utilize more healthcare resources, and rate themselves as having poor quality of life. Nurses and other health professionals who have regular contact with those with MS may be able to influence this scenario.

Little has been written about the transition experiences of persons with epilepsy and their families. The results of the survey presented in this report support the notion that transition from pediatric to adult care for persons with chronic illness can be very painful. The sadness produced by the ending of close relationships, and fear and uncertainty about the future are commonly experienced emotions at this time. Careful assessment and planning by the entire team coupled with cooperative efforts between adult and pediatric care providers are necessary to ensure a smooth and seamless transition from pediatric to adult epilepsy care.