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

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.

Abstract: 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.

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.

Abstract: INTRODUCTION: In pediatric epilepsy monitoring units (EMU), nurses are essential in assessing seizure activity and neurological status. One critical element of neurological evaluation is the pupillary light reflex (PLR), traditionally assessed manually with low interrater reliability. Quantitative pupillometry offers a more accurate and reliable method for evaluating PLR, yet its use in EMUs has not been well described. The objective is to describe the implementation of quantitative pupillometry in a pediatric EMU through a nurse-led initiative. METHODS: A collaborative effort between nursing and physician leadership introduced the NPi-200 pupillometer in a pediatric EMU. Nurses received hands-on training, and a standardized electronic order was developed to integrate the tool into clinical workflows. Accessibility issues were addressed by relocating the device to a central nursing station. RESULTS: Over the pilot period, 40 patients underwent pupillometry assessments, with 88% yielding complete data. No adverse events occurred. Nurses reported the device was easy to use and successfully incorporated it into their routine care, even for children with developmental delay. CONCLUSION: Pupillometry can be effectively and safely implemented in the pediatric EMU setting through a nurse-driven process. This initiative demonstrated high usability, safety, and integration into clinical practice, supporting its broader use for neurological monitoring in epilepsy care.

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.