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

Abstract: BACKGROUND: Neuroscience nurses play a pivotal role in identifying nutritional risk factors, monitoring patients, and initiating interventions to optimize recovery outcomes. Patients with moderate to severe acquired brain injury (ABI) are at risk of undernutrition during subacute rehabilitation, yet prevalence is rarely described using recent diagnostic criteria. This study aimed to explore the Global Leadership Initiative on Malnutrition (GLIM) criteria in routinely collected clinical data and to describe undernutrition in patients with ABI at admission and discharge from in-hospital rehabilitation. METHODS: A quantitative descriptive study was conducted using nutritional data extracted from electronic health records stored in a clinical database. The analysis focused on GLIM criteria, including low body mass index (BMI), disease-related inflammation, and the risk of reduced food intake. RESULTS: A total of 2,645 patients were included. A low BMI was observed in 10% of 2,465 patients at admission and in 8% of 2,147 patients at discharge. Inflammation was present in 82% of 912 patients at admission and 71% of 420 at discharge. Reduced intake was noted in 61% of 1,745 patients at admission and 26% of 1,550 at discharge. Many patients did not meet the required combination of phenotypic and etiologic criteria for GLIM-defined malnutrition. CONCLUSION: Potential undernutrition, according to individual GLIM criteria, varied significantly at admission, with "low BMI" showing the lowest prevalence. This may indicate a substantial long-term nutritional risk among patients who appear well-nourished based on BMI. Furthermore, the lack of comprehensive data on individual criteria suggests that routinely collected clinical data may be insufficient for accurately assessing malnutrition.

Background: Multiple sclerosis (MS) is a neurological disease that manifests differently in men and women, including variations in clinical progression and symptoms. Despite the relevance of these differences, research exploring disparities in sexuality and relationships remains limited. Therefore, this study aimed to identify differences between men and women in alterations in sexual function and relationship adjustment in a Spanish sample of people with MS.

Methods: A descriptive cross-sectional study was conducted involving 208 adults recruited through 13 Spanish MS associations. An electronic form was used to collect sociodemographic and sexuality-related variables. The Multiple Sclerosis Intimacy and Sexuality Questionnaire-15 and the Dyadic Adjustment Scale-13 were also included in the data collection process.

Results: Men with MS reported greater concerns about sexually satisfying their partner (P < 0.001) and more frequent feelings of sexual insecurity (P = 0.001) than women. Differences in sexual function were also observed in physiological aspects, with erectile dysfunction being more prevalent in men than vaginal lubrication difficulties in women (P = 0.031). Regarding relationship adjustment, no significant differences were identified (P = 0.816). However, a significant correlation was found between relationship adjustment and alterations in sexual function in men (P = 0.038).

Conclusions: The results of this study point to meaningful differences between men and women with MS in how sexual function is experienced, with men reporting greater concerns related to both physiological (erectile dysfunction) and psychological (worries about satisfying their partner and insecurity) difficulties. Regarding relationship adjustment, overall levels were similar between groups; however, poorer sexual function was significantly associated with worse adjustment only among men. These specific differences should be taken into account when addressing sexuality in clinical care, as considering these disparities may contribute to more comprehensive, personalized, and effective interventions for people with MS.

Background: Despite more than 30 years of public health campaigns, critical gaps persist in community stroke symptom recognition and awareness of the importance of calling 9-1-1. Underserved communities experience disproportionately higher risk of stroke and poorer outcomes, and they have lower reported knowledge of stroke symptoms and are less likely to receive acute time-sensitive treatments. This quality improvement initiative outlines a pathway for stroke centers to address these disparities through reproducible and customizable pop-up health awareness events that also fulfill regulatory requirements.

Methods: The nurse leaders of 2 hospital stroke programs serving the same city in California developed a collaborative stroke awareness event at an urban farmers' market in a high-risk, underserved neighborhood. Volunteers conducted a brief intervention in the form of a survey to engage participants and share information.

Results: The event successfully engaged a diverse audience and fostered partnerships at a pop-up offering on one Sunday morning in May. A total of 128 community members participated, and 113 surveys were included in the final analysis. Pre-intervention, 42% of participants confidently recognized stroke symptoms, which increased to 88% postintervention (P<0.0001). Participants' confidence in recognizing the importance of calling 9-1-1 increased from 22% preintervention to 93% postintervention (P <0.0001).

Conclusion: An event plan for offering stroke awareness information enabled the facilitating hospitals to effectively share critical health information and gain insights into the communities served. The survey responses suggested significant improvement in stroke awareness within a limited timeframe. The collaborative event also succeeded in fostering relationships across organizations, departments, and between health care and the community.

Introduction: A global aging population seeking resolution of pain and functional decline from degenerative spine conditions is leading to an increasing number of spine surgeries. The recovery process is complex with many cognitive and physical actions performed by the patient, which can be conceptualized as patient work. Shaped by the dynamic patient work system (PWS), patient work is the time and effort patients complete at home and across health settings to meet their health goals. Our aim was to define factors in the PWS that influence the patient work of older adults' recovery during the hospital and posthospitalization phases as well as by discharge location after spine surgery.METHODS: Secondary data analysis (28 interviews) using deductive and inductive qualitative content analysis methods was used to describe PWS influencing factors. The Systems Engineering Initiative for Patient Safety 2.0 human factors framework (person, organization, task, tools and technology, and internal and external environments) guided independent (3 members) coding, codebook evolution, and team deductive analysis. Care phase and discharge location were further analyzed using team inductive analysis.RESULTS: In nearly all components, factor differences were present between discharge to home or skilled nursing facility or inpatient rehabilitation. These differences included pain severity, mobility, unexpected experiences, education not meeting their needs, the level of problem-solving required, and types of benchmarks to their goal of recovery.CONCLUSIONS: Our findings show that regardless of discharge disposition, older adults experience uncertainty and different needs during recovery that often generate invisible work in navigating the recovery process. Participants describe significant work to clarify any uncertainty and meet their recovery needs. Nursing has a pivotal role to further investigate strategies to help patients achieve their recovery goals.

Background: Foreign accent syndrome (FAS) is a rare speech disorder characterized by the unintended emergence of a foreign-sounding accent. While the precise pathophysiology of this syndrome has not been identified, FAS is thought to result from disruptions in pitch, inflection, stress, and articulation, leading listeners to perceive a foreign accent. It is most commonly associated with stroke, but can also result from traumatic brain injury, demyelinating disease, or neoplasm.

Methods: We present the case of a 59-year-old, right-handed, native English-speaking female from West Virginia who developed FAS secondary to a right frontotemporal meningioma. Clinical assessment, imaging, and surgical records were reviewed to evaluate the etiology and course of her speech disturbance.

Results: Despite a complete and uncomplicated safe surgical resection, the speech disorder persisted. This outcome contrasts with other reported cases in which FAS resolved following treatment of the underlying lesion, suggesting potential irreversible disruption to the brain's speech networks.

Conclusion: This case highlights the complexity of FAS and contributes to the growing evidence that the disorder may result from disruption of distributed cortical and subcortical speech networks, rather than a single anatomical site. Furthermore, it highlights the possibility of persistent deficits even after successful treatment of the underlying structural lesion. These findings emphasize the importance of early recognition, supportive communication strategies, and multidisciplinary care planning, particularly by bedside nurses and Advanced Practice Registered Nurses, to address both the neurologic and psychosocial impacts of persistent speech disturbances like FAS.

Background: The aim of this study is to develop a standardized training content system for newly recruited nurses in neurology departments based on the Competency-based Education (CBE) model, thereby supporting the systematic professional development of early-career nursing personnel. METHODS: Preliminary training indicators at all levels were formulated using a literature review, situational analysis, expert panel consultations, and the CBE framework. The modified Delphi method was used to refine and finalize the content system. RESULTS: Ten experts participated in the modified Delphi consultation. Both rounds of surveys achieved a 100% effective response rate. The expert authority coefficient was 0.920, and Kendall's coefficient of concordance ranged from 0.159 to 0.300 ( P <0.05). All coefficients of variation were below 0.25, and the coefficient of importance exceeded 40%. The finalized training content system included 3 primary indicators, 12 secondary indicators, and 82 tertiary indicators. CONCLUSION: The resulting training content system demonstrated scientific rigor and reliability, incorporating the specific competencies required in neurology nursing. It offers a practical framework for standardizing the orientation and training of newly recruited nurses, thereby contributing to the enhancement of overall nursing competence within the specialty.