The Journal of neuroscience nursing : journal of the American Association of Neuroscience Nurses最新文献

Abstract:

Background: Stress impacts the quality of life for stroke survivors (SS) and support persons (SPs) during recovery, negatively affecting both individuals in the stroke dyad (SD). While mindfulness-based interventions (MBIs) can improve well-being, their complexity and time demands are significant barriers for implementation in the stroke community. Tailoring MBI to the needs of SS and SP (modified-MBI) shows promise in improving stress and quality of life for both members of the SD throughout long-term recovery. METHODS: The A Mindful Approach to Managing Stress (A-MAMS) intervention enrolled 58 participants to assess the feasibility and acceptability of an 8-week virtual asynchronous m-MBI. Enrollment, retention, lesson, and homework completion rates were measured. End-of-study feedback survey (EOS) data was also collected. RESULTS: The A-MAMS intervention demonstrated high feasibility (enrollment rate=96.7%; attendance rate=98.3%) and acceptability (lesson and homework completion rates=97.8% and 98.8%, retention rate=89.7%). A total of 52 participants (30 SS and 22 SP; 15 SD members) completed all course components and EOS. The EOS feedback indicated 96.2% found the intervention helpful for stress management and would recommend it. No significant dyadic effect was identified. CONCLUSION: This remotely delivered m-MBI was feasible and acceptable for adult SS and SP. These findings support the utility of tailored, accessible mindfulness interventions for the SD, laying a foundation for future research on their implementation and impact.

Background: Stroke is a leading cause of death and disability worldwide, with timely intervention being critical to minimizing long-term disability. Delays in hospital arrival frequently result in patients missing the therapeutic window for effective treatment. This study aimed to explore the factors contributing to delayed hospital arrival in acute stroke patients. METHODS: This cross-sectional study was conducted at a tertiary care hospital in the Arabian Gulf region, from February to November 2024. It included adults with computed tomography/magnetic resonance imaging-confirmed stroke, classified as early or late arrivers. Data collected included demographics, socioeconomic status, stroke symptoms and onset, risk factors, transportation method, post-stroke destination, and awareness of the emergency number and Alteplase (ALT). The National Institutes of Health Stroke Scale score at onset was recorded. RESULTS: Among 195 stroke patients, 46.15% arrived late. Significant differences between early and late arrivers were observed in employment, income, and stroke symptoms. Early arrivers had higher rates of limb weakness, facial weakness, and dysarthria/aphasia, whereas headache and vertigo were more common in late arrivers. Early arrivers were more likely to live with family or friends, be aware of ALT, and know the emergency number ( P = 0.001, <0.001, <0.001, respectively). Knowledge of ALT [odds ratio (OR) = 5.63, 95% CI = 2.1-13.81] predicted early arrival, while headache (OR = 0.21, 95% CI = 0.04-0.97) and vertigo (OR = 0.17, 95% CI = 0.03-0.80) predicted delays. CONCLUSION: Lack of knowledge about ALT and unusual stroke symptoms is a potential barrier to early arrival within the therapeutic window. Strenuous efforts must be directed towards such barriers to achieve optimal care for patients with acute stroke.

BACKGROUND: Parkinson disease (PD) is the second most prevalent neurodegenerative condition and has a profound impact on patients' quality of life. Effective management requires active self-care, in which health literacy (HL) plays a critical role by enabling patients to acquire, interpret, and apply knowledge about their condition. This review aimed to map the existing literature on HL in PD and assess its impact on disease management. METHODS: A scoping review was conducted in accordance with Joanna Briggs Institute guidelines and reported following Preferred Reporting Items for Systematic Reviews and Meta-analysis extension for Scoping Review. Relevant studies were identified through systematic searches of 7 major databases. Eligibility criteria were structured using the Population-Concept-Context framework. RESULTS: Sixteen studies were included, most published between 2016 and 2024 and predominantly from high-income countries. The studies investigated key HL dimensions, including knowledge of motor and nonmotor symptoms, medication management, and patient-provider communication. Findings revealed substantial gaps in functional HL, particularly in recognizing nonmotor symptoms and understanding pharmacological regimens, while interactive and critical HL were rarely assessed. Across studies, age, education level, and disease duration consistently influenced HL levels. Importantly, no standardized or personalized HL interventions for PD were identified. CONCLUSIONS: HL in PD remains underdeveloped, with current research largely focused on functional HL and limited exploration of interactive or critical domains. Integrating HL assessment into routine care and developing nursing-led, personalized interventions may improve self-care, treatment adherence, and long-term outcomes for people with PD. Future research should prioritize validated measurement tools, multimodal interventions, and studies in diverse populations to address existing gaps.

Abstract: Diabetes mellitus affects millions of people and is a significant public health concern. Neurologically, hearing occurs with intact outer, middle, and inner ear functioning, with brain recognition and decoding. Hearing impairments are underrecognized and contribute to safety issues and poor quality of life. CONTENT: This article identifies how diabetes contributes to neurological changes that manifest as impaired hearing and balance. A pathophysiological review of the auditory pathway and ongoing theories of diabetes-related changes in the auditory nerves and blood vessels results in impaired hearing and balance. SUMMARY: Neuroscience nurses benefit from understanding how uncontrolled diabetes and nerve destruction impact communication, quality of life, and safety. Diabetic neuropathy does not exist in isolation and hearing loss often goes unappreciated.

Abstract: BACKGROUND: Before implementing an educational intervention, there is a need to establish baseline knowledge levels such that the outcome of said intervention can be fairly evaluated. Before developing a structured nursing educational intervention, we aimed to assess nursing knowledge, nursing confidence regarding that knowledge, and the accuracy of the knowledge. METHODS: We distributed a 50-item validated neurological assessment test (NAT) questionnaire to 70 nurses working at a teaching hospital in Kenya. There were no personal identifiers collected and the NAT was made available in both electronic and paper formats to facilitate responses. RESULTS: The 64 nurses who returned the questionnaire had median knowledge scores of 22% (14% to 32%); median confidence scores of 61% (37% to 87%); and median accuracy scores of 38% (31.3% to 45.6%). There was a strong association between confidence and knowledge ( r2 =0.66; P <0.0001); and between knowledge and accuracy ( r2 =0.35; P <0.0001); but not between confidence accuracy ( r2 =0.03; P =0.112). CONCLUSION: The NAT questionnaire was useful in assessing baseline confidence levels, knowledge, and accuracy of that knowledge. Nurses in this sample had moderate to high confidence that extended beyond the accuracy of their knowledge base. There is a need for targeted international educational interventions to improve neuroscience nursing knowledge.

Background: Advanced practice providers (APPs) play a critical role in neuroscience patient care and system-level leadership. Despite their growing presence, the practice of neuroscience APPs throughout the United States is underexplored. This study aims to describe the current practice for neuroscience APPs in the United States. METHODS: An online survey was developed using the 2006 American Association of Neuroscience Nurses advanced practice survey as a starting point. The peer-tested survey used snowball recruitment, with an initial email to American Association of Neuroscience Nurses members or customers who identified as APPs (n = 4950). The survey was open to any neuroscience APP. The survey collected demographic, current practice, and system-level role data. RESULTS: A total of 350 respondents completed the survey. Respondent roles were nurse practitioner (76.6%), clinical nurse specialist (20.9%), and physician assistant (2.6%). Most worked in hospital settings (83.1%) and practiced in inpatient (56.3%) or ambulatory (31.1%) settings, with the southern region of the United States (31.1%) having the highest representation. Common practice elements included patient evaluation, management, procedures (intraventricular catheters, intracranial monitoring devices), and billing and coding practices across roles. CONCLUSION: This survey highlights the diverse roles and practice contributions of neuroscience APPs. Findings underscore the need for standardized practice measures and further research to define and optimize APP integration into neuroscience care. The results provide insights into opportunities to support the development and recognition of neuroscience APPs' impact on patient outcomes and health care systems.