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: Sleep disorders are common and various in persons with multiple sclerosis (PwMS). However, their assessment and management remain in the background compared with motor symptoms. This study was conducted to better understand sleep disorders in PwMS and to analyze sleep problems and their predictive symptoms. METHODS: This cross-sectional design study was conducted with 136 PwMS. Data were collected using a participant identification form, Pittsburgh Sleep Quality Index, Insomnia Severity Index, Epworth Sleepiness Scale, and Stop-Bang Test. In data analysis, 1-way analysis of variance, t test and Pearson correlation, and multiple regression analysis were used. RESULTS: The study found that 51.5% of the participants have poor sleep quality, 36.8% have insomnia, 24.3% have excessive daytime sleepiness, and 19.9% were at risk of obstructive sleep apnea. Symptoms of forgetfulness (β = 0.199), depression (β = 0.223), pain (β = 0.278), and increased urinary frequency at night (β = 0.236) explain approximately 40% of the change in sleep quality score; difficulty swallowing (β = 0.218), depression (β = 0.253), and pain (β = 0.313) symptoms explain 33% of the change in insomnia score; fatigue (β = 0.292) and anxiety (β = 0.409) symptoms explain 32% of the change in sleepiness score. CONCLUSIONS: PwMS start to experience sleep disorders in the early stages of the disease, some characteristics affect sleep disorders, and the symptoms they experience explain sleep disorders at significant rates. Sleep disorders should be evaluated by nurses and interdisciplinary healthcare teams from the early stages of multiple sclerosis with different aspects and to include predictive symptoms in the interventions to be implemented to reduce sleep disorders.

Abstract: BACKGROUND: Planned tracheal extubation failure is a common occurrence among patients in the neurosurgical intensive care unit (NICU) because of the complex nature of neurocritical injuries, and the failure could result in a poor prognosis. METHODS: We observed and recorded the patients with tracheal intubation in the NICU of a hospital in Shanghai from June 2021 to December 2022 and analyzed data from planned tracheal extubation, categorizing patients by success or failure, and compared outcomes between the two groups while investigating contributing factors. RESULTS: A total of 156 patients were included, 133 (85.3%) of whom were successfully extubated and 23 (14.7%) were not. The results of logistic regression analysis demonstrated that the Glasgow Coma Scale score before extubation (OR, 0.643; 95% CI, 0.444-0.931; P = .020) and the frequency of respiratory secretions suctioning before tracheal extubation (OR, 0.098; 95% CI, 0.027-0.354; P < .001) were independent risk factors for extubation failure. We also found that the extubation failure group experienced a significantly longer ICU stay and incurred higher hospitalization costs. CONCLUSIONS: Poor Glasgow Coma Scale scores and a high frequency of respiratory secretions suctioning before tracheal extubation were the main factors contributing to tracheal extubation failure in NICU patients. To avoid tracheal extubation failure and adverse outcomes, these two factors should be carefully assessed before tracheal extubation.