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

Abstract: BACKGROUND: Patients with brain tumors continue to exhibit a lower quality of life than the general population, even after an extended period after surgery. Therefore, this study aimed to assess the postoperative quality of life of patients with brain tumors in South Korea and explore its determinants. METHODS: This study used a descriptive correlational design and collected data using questionnaires and electronic medical records. The collected data included the participants' characteristics, anxiety and depression levels, uncertainty, social support, and quality of life. Data analysis was performed using SPSS 29.0, with descriptive statistics, Pearson correlation analysis, and multiple regression analysis. RESULTS: Of the 117 subjects, 84 (71.8%) had benign tumors, and 33 (28.2%) had malignant tumors, with an average postoperative duration of 42.7 (51.0) months. Thirty-four participants (29%) reported experiencing depression, whereas the average uncertainty score was 91.8 (12.0) points. The average quality-of-life score was 67.52 (20.31) points, indicating a lower quality of life compared with the general population. Lower average monthly income (β = 0.174, P = .044), higher depression levels (β = -0.413, P < .001), and greater uncertainty (β = -0.230, P = .025) were associated with reduced quality of life. In terms of social support, family support was linked to quality of life but did not have a significant influence ( P = .780), whereas healthcare provider support significantly affected quality of life ( P = .015). CONCLUSION: This study highlights the persistent decline in the postoperative quality of life of patients with brain tumors due to depression and uncertainty, emphasizing the need for healthcare provider support. Clarifying these challenges, it may serve as a basis for developing nursing interventions to enhance survivors' long-term quality of life.

Abstract: BACKGROUND: Changes in pupil reactivity secondary to cerebral mass effect are traditionally linked to compression of the oculomotor nerve by the uncus or by horizontal midbrain displacement. The neurological pupil index (NPi) is a metric to assess the pupillary light reflex. This study explores the relationship of midline shift, cisternal, and sulcal effacement or ventricular compression in patients with a new finding of abnormal pupillary light reflex. METHODS: This retrospective study identified adult patients with serial pupillometer readings between 2018 and 2023 who had a baseline head computed tomography (CT) scan, subsequent new-onset NPi worsening from normal to abnormal, and a repeat CT scan within 2 hours of the NPi changes. Those with NPi worsening were compared with those with no NPi change. RESULTS: Among 77 patients (27 with NPi worsening, 50 without), those with NPi worsening exhibited a higher incidence of midline shift on the repeat CT. Regression models revealed a significant correlation between midline shift change and abnormal NPi ( r = 0.2260, P < .001). However, NPi worsening was not linked to changes in ventricular compression, nor sulcal or cisternal effacement. CONCLUSION: Midline shift, rather than cisternal or sulcal effacement, is associated with abnormal NPi values.

Abstract: BACKGROUND: Certified stroke treatment centers are classified based on their available resources to treat stroke including an Acute Stroke Ready Hospital (ASRH), a primary stroke center (PSC), a Thrombectomy-Capable Stroke Center (TCSC), and comprehensive stroke centers (CSCs). These hospitals all provide varying levels of care with CSCs being the most able to treat all types and complexities of stroke. This undergraduate nursing-led study explored the public's preference for treatment at different certified stroke treatment centers. METHODS: This study was a prospective nonrandomized observational survey of English-speaking adults at a plasma donation center in the Southwest United States. Subjects completed a 2-minute survey asking whether they would drive to the hospital or call 911 during a suspected stroke, and at which type of hospital they would prefer to be treated. RESULTS: Of 249 respondents, 204 (81.9%) indicated that they would call 911 for hospital transport, and 45 (18.1%) would drive their family member to a hospital. Most respondents (95/248, 38.3%) would prefer treatment at a PSC, 90 (36.3%) preferred an ASRH, 52 (21.0%) preferred a CSC, and 11 (4.4%) preferred a TCSC. There was no association between transportation preference and hospital preference dichotomized as CSC or PSC versus ASRH or TCSC (χ 2 = 0.021, P = .885), nor CSC versus other (χ 2 = 0.944, P = .331). CONCLUSION : Most respondents did not select CSC as the preferred treatment site, and 1 in 5 would drive rather than call 911. This indicates a knowledge gap regarding stroke center classification that warrants increased education.

Abstract: BACKGROUND: The objective of this study is to investigate the clinical effectiveness of the combination of multimodal exercise (MME) with supportive music and imagery in the management of poststroke mood disorders (PSMD). METHODS: A total of 200 PSMD patients treated in the neurology department of a tertiary hospital in Jiangsu Province were enrolled. They were assigned to either a control group or the observation group using a random number table at a 1:1 ratio, with 100 patients in each group. The control group received conventional nursing care, and the observation group received both MME and music and imagery in addition to the conventional nursing interventions. The scores of the 10-item Kessler Psychological Distress Scale (K10), Hospital Anxiety and Depression Scale (HADS), and Well-being Index Scale (WBIS) were recorded before and 3, 6, and 9 months after the interventions and compared between the 2 groups. RESULTS: Changes in K10, HADS, and WBIS scores significantly differed between the 2 groups after interventions (all P < .05) and among different time points (all P < .05). There were interactions between the time points of the K10, HADS, and WBIS assessments and the intervention methods in both groups ( P < .05). The improvements in anxiety or depression and psychological distress in the observation group were significantly superior to those in the control group. CONCLUSION: MME combined with music and imagery can effectively improve anxiety and depression, reduce symptoms of psychological distress, and improve well-being in PSMD patients.

Abstract: BACKGROUND: Better self-management of chronic diseases may benefit patient functional status, medication effectiveness, lifestyle, and psychosocial health. Self-efficacy, disease perception, social support, anxiety, and depression are determinants of self-management behaviors in individuals with chronic illnesses. There remains a gap in the empirical exploration of the influence of these factors on self-management behaviors in young Chinese stroke survivors. This study examined how these factors affect specific self-management behaviors. METHODS: Validated instruments were used to evaluate patient self-efficacy, disease perception, social support, anxiety, and depression in a cross-sectional study. Structural equation modeling was used to examine the hypothesis. RESULTS: Self-efficacy and social support showed a positive correlation with self-management (0.421 and 0.446, respectively; P < .001). Disease perception, anxiety, and depression were negatively correlated with self-management (-0.158 and -0.336, respectively; P < .05). The structural equation model fit the data very well; social support had a direct positive effect on self-management ( t = 3.002, P < .05) and self-efficacy ( t = 5.773, P < .001). However, the presence of social support had a positive impact on reducing anxiety and depression ( t = -5.046, P < .001). Furthermore, self-efficacy positively affected self-management ( t = 1.226, P < .05), whereas anxiety and depression ( t = -1.190, P < .05) and disease perception ( t = -1.068, P < .05) had adverse effects on self-management. CONCLUSION: Medical staff and caregivers can improve patient self-management by helping them recognize the disease, reducing negative perceptions, communicating more for better understanding and care, intervening in anxiety and depression, and promoting mental health. This is especially important for young stroke patients.

Abstract: BACKGROUND: Epilepsy centers and epilepsy monitoring units (EMUs) specialize in the care of individuals with epilepsy, often requiring patients to undergo evaluations that may increase their risk of injury or status epilepticus. The National Association of Epilepsy Centers has established an accreditation framework for these centers, which includes epilepsy-specific training for nurses in level 3 and 4 facilities. The American Association of Neuroscience Nurses (AANN) launched a certificate program for the seizure and epilepsy healthcare professional, addressing this educational requirement. This study assessed the effects of the AANN epilepsy certificate on nursing knowledge and self-reported confidence in delivering care in an EMU. METHODS: This prospective cohort study involved 39 neuroscience nurses who completed a 20-item knowledge assessment and self-reported measures of knowledge and confidence using a Likert scale before and after completing the AANN epilepsy certificate, followed by 2 additional evaluations. RESULTS: The mean scores on the epilepsy knowledge check increased from 12.3 to 16.1 (P < .001). This improvement in knowledge was correlated with the highest terminal degree attained (P = .046), but not with years of experience, time spent in neurology, pediatric nurse certification, or the frequency of work in the EMU. In addition, self-reported confidence scores rose from 19.0 to 22.1 (P < .001). Based on chart review of the 2 months before and after completion of the modules, the time from seizure identification to seizure treatment decreased from a mean of 6.5 to 4 minutes. CONCLUSION: The completion of the AANN certificate program enhanced the epilepsy-related knowledge and confidence of neuroscience nurses. These educational modules help to meet accreditation requirements for epilepsy centers and provide substantial benefits for nurses.