Pub Date : 2006-12-01DOI: 10.1097/01376517-200612000-00008
S. Barker-Collo, C. Cartwright, J. Read
This article examines the narratives of 16 individuals diagnosed with multiple sclerosis (MS). Before diagnosis, the participants had experienced disparate and transient symptoms. Diagnosis itself involved numerous tests and health practitioners, varied responses to the diagnosis, an inability to assimilate information about the disease, and a view of MS as being the lesser of two evils. Immediately after diagnosis, participants revealed concerns about the unpredictable progression of the disease. Patient narratives reflected both negative and positive aspects of living with a chronic illness, such as shifting roles, discrimination, reevaluation of priorities, reinvestment in the family, and positive lifestyle changes. All aspects of the narratives revealed fear and anxiety in relation to the unknown.
{"title":"Into the unknown: the experiences of individuals living with multiple sclerosis.","authors":"S. Barker-Collo, C. Cartwright, J. Read","doi":"10.1097/01376517-200612000-00008","DOIUrl":"https://doi.org/10.1097/01376517-200612000-00008","url":null,"abstract":"This article examines the narratives of 16 individuals diagnosed with multiple sclerosis (MS). Before diagnosis, the participants had experienced disparate and transient symptoms. Diagnosis itself involved numerous tests and health practitioners, varied responses to the diagnosis, an inability to assimilate information about the disease, and a view of MS as being the lesser of two evils. Immediately after diagnosis, participants revealed concerns about the unpredictable progression of the disease. Patient narratives reflected both negative and positive aspects of living with a chronic illness, such as shifting roles, discrimination, reevaluation of priorities, reinvestment in the family, and positive lifestyle changes. All aspects of the narratives revealed fear and anxiety in relation to the unknown.","PeriodicalId":94240,"journal":{"name":"The Journal of neuroscience nursing : journal of the American Association of Neuroscience Nurses","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2006-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74035095","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2006-12-01DOI: 10.1097/01376517-200612000-00001
J. Haymore
{"title":"Stroke center certification: a beginning, not an end.","authors":"J. Haymore","doi":"10.1097/01376517-200612000-00001","DOIUrl":"https://doi.org/10.1097/01376517-200612000-00001","url":null,"abstract":"","PeriodicalId":94240,"journal":{"name":"The Journal of neuroscience nursing : journal of the American Association of Neuroscience Nurses","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2006-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81180353","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2006-10-01DOI: 10.1097/01376517-200610000-00006
C. White, L. Poissant, Geneviève Côté-Leblanc, S. Wood-Dauphinee
This study examined the health-related quality of life (HRQL) and overall quality of life (QOL) of family caregivers of stroke survivors to determine changes over time and to identify QOL predictors. Caregivers were interviewed after 1.5 and 2 years of caregiving. The scores on the mental subscales were significantly lower than on the age- and sex-matched population norms. The most important predictors of QOL were the stroke survivor's behavioral disturbances and reintegration into normal patterns of living. Caregivers who reported fewer stroke-survivor behavioral disturbances and well-adjusted reintegration also reported a higher personal QOL. These results highlight the impact of a stroke on the caregiver's HRQL and QOL, even after 2 years, and the importance of interventions for caregivers.
{"title":"Long-term caregiving after stroke: the impact on caregivers' quality of life.","authors":"C. White, L. Poissant, Geneviève Côté-Leblanc, S. Wood-Dauphinee","doi":"10.1097/01376517-200610000-00006","DOIUrl":"https://doi.org/10.1097/01376517-200610000-00006","url":null,"abstract":"This study examined the health-related quality of life (HRQL) and overall quality of life (QOL) of family caregivers of stroke survivors to determine changes over time and to identify QOL predictors. Caregivers were interviewed after 1.5 and 2 years of caregiving. The scores on the mental subscales were significantly lower than on the age- and sex-matched population norms. The most important predictors of QOL were the stroke survivor's behavioral disturbances and reintegration into normal patterns of living. Caregivers who reported fewer stroke-survivor behavioral disturbances and well-adjusted reintegration also reported a higher personal QOL. These results highlight the impact of a stroke on the caregiver's HRQL and QOL, even after 2 years, and the importance of interventions for caregivers.","PeriodicalId":94240,"journal":{"name":"The Journal of neuroscience nursing : journal of the American Association of Neuroscience Nurses","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2006-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85993217","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2006-06-01DOI: 10.1097/01376517-200606000-00001
C. Stewart‐Amidei
{"title":"Of hurricanes and other disasters.","authors":"C. Stewart‐Amidei","doi":"10.1097/01376517-200606000-00001","DOIUrl":"https://doi.org/10.1097/01376517-200606000-00001","url":null,"abstract":"","PeriodicalId":94240,"journal":{"name":"The Journal of neuroscience nursing : journal of the American Association of Neuroscience Nurses","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2006-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81674820","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2006-04-01DOI: 10.1097/01376517-200604000-00001
C. Stewart‐Amidei
{"title":"Getting older, getting better.","authors":"C. Stewart‐Amidei","doi":"10.1097/01376517-200604000-00001","DOIUrl":"https://doi.org/10.1097/01376517-200604000-00001","url":null,"abstract":"","PeriodicalId":94240,"journal":{"name":"The Journal of neuroscience nursing : journal of the American Association of Neuroscience Nurses","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2006-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78318912","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2006-04-01DOI: 10.1097/01376517-200604000-00006
L. Bunting-Perry
Parkinson's disease (PD) is a chronic, progressive neurological disease affecting 1.5 million Americans. The modern success of pharmacology and deep-brain stimulation surgery to treat the motor symptoms of tremor, rigidity, and bradykinesia provide PD patients with longer lives and increased motor functioning. However, in the moderate and advanced stages of disease, the therapeutic benefits of pharmacology diminish and motor symptoms are more complicated to treat. The nonmotor symptoms of PD receive little attention in clinical settings, although they can lead to disability and caregiver burden. The Center to Advance Palliative Care advocates applying the principles of palliative care to chronic disease. Likewise, the World Health Organization has redefined palliative care to include life-threatening illness. The Parkinson's Disease Model of Care (PDMC) takes the precepts of palliative care and presents a model for the neuroscience nurse to use in individual care planning across the trajectory of disease. The PDMC guides the nurse in providing relief from suffering for PD patients and their families, from diagnosis through bereavement, with an emphasis on advance care planning.
{"title":"Palliative care in Parkinson's disease: implications for neuroscience nursing.","authors":"L. Bunting-Perry","doi":"10.1097/01376517-200604000-00006","DOIUrl":"https://doi.org/10.1097/01376517-200604000-00006","url":null,"abstract":"Parkinson's disease (PD) is a chronic, progressive neurological disease affecting 1.5 million Americans. The modern success of pharmacology and deep-brain stimulation surgery to treat the motor symptoms of tremor, rigidity, and bradykinesia provide PD patients with longer lives and increased motor functioning. However, in the moderate and advanced stages of disease, the therapeutic benefits of pharmacology diminish and motor symptoms are more complicated to treat. The nonmotor symptoms of PD receive little attention in clinical settings, although they can lead to disability and caregiver burden. The Center to Advance Palliative Care advocates applying the principles of palliative care to chronic disease. Likewise, the World Health Organization has redefined palliative care to include life-threatening illness. The Parkinson's Disease Model of Care (PDMC) takes the precepts of palliative care and presents a model for the neuroscience nurse to use in individual care planning across the trajectory of disease. The PDMC guides the nurse in providing relief from suffering for PD patients and their families, from diagnosis through bereavement, with an emphasis on advance care planning.","PeriodicalId":94240,"journal":{"name":"The Journal of neuroscience nursing : journal of the American Association of Neuroscience Nurses","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2006-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85770812","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2006-04-01DOI: 10.1097/01376517-200604000-00002
B. Ridley, P. Rawlins
Practitioners from around the country who have extensive experience in intrathecal baclofen (ITB) therapy gathered in early 2004 to develop best-practice guidelines for ITB therapy. Discussion focused on the idea that ITB therapy is a program rather than a procedure. Key recommendations were made in areas including team coordination, patient selection and goals, patient education, patient screening, implant technique, long-term management, individualized dosing options, ongoing evaluation of patient response, appraisal of the integrity of the catheter and infusion system, and appropriate practice resources.
{"title":"Intrathecal baclofen therapy: ten steps toward best practice.","authors":"B. Ridley, P. Rawlins","doi":"10.1097/01376517-200604000-00002","DOIUrl":"https://doi.org/10.1097/01376517-200604000-00002","url":null,"abstract":"Practitioners from around the country who have extensive experience in intrathecal baclofen (ITB) therapy gathered in early 2004 to develop best-practice guidelines for ITB therapy. Discussion focused on the idea that ITB therapy is a program rather than a procedure. Key recommendations were made in areas including team coordination, patient selection and goals, patient education, patient screening, implant technique, long-term management, individualized dosing options, ongoing evaluation of patient response, appraisal of the integrity of the catheter and infusion system, and appropriate practice resources.","PeriodicalId":94240,"journal":{"name":"The Journal of neuroscience nursing : journal of the American Association of Neuroscience Nurses","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2006-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80539191","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2006-01-01DOI: 10.1097/01376517-200609000-00001
C. Stewart‐Amidei
Will reading habit influence your life? Many say yes. Reading attack from the back is a good habit; you can develop this habit to be such interesting way. Yeah, reading habit will not only make you have any favourite activity. It will be one of guidance of your life. When reading has become a habit, you will not make it as disturbing activities or as boring activity. You can gain many benefits and importances of reading.
{"title":"Attack back!","authors":"C. Stewart‐Amidei","doi":"10.1097/01376517-200609000-00001","DOIUrl":"https://doi.org/10.1097/01376517-200609000-00001","url":null,"abstract":"Will reading habit influence your life? Many say yes. Reading attack from the back is a good habit; you can develop this habit to be such interesting way. Yeah, reading habit will not only make you have any favourite activity. It will be one of guidance of your life. When reading has become a habit, you will not make it as disturbing activities or as boring activity. You can gain many benefits and importances of reading.","PeriodicalId":94240,"journal":{"name":"The Journal of neuroscience nursing : journal of the American Association of Neuroscience Nurses","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2006-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78419679","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2006-01-01DOI: 10.1097/01376517-200602000-00001
C. Stewart‐Amidei
Practice guidelines have garnered a great deal of attention in health care. Institutions, practice lines, professional organizations, specialty groups, and even advocacy groups are producing practice guidelines and promoting their use. Practice guideline development is a timeconsuming and sometimes daunting task. Aside from being trendy, why do we bother with practice guidelines? Practice guidelines were originally proposed as a way to standardize care across geographic boundaries. After all, nursing care should not differ from Alaska to Florida. Guidelines are especially useful for common diseases, such as asthma, or common problems, such as deep-vein thrombosis. The AHCPR series of guidelines is a good example. Guidelines such as these are usually developed from review of the evidence base as well as from expert consensus. These tools are helpful in guiding overall management, enhancing safety, minimizing unnecessary tests and treatments, and promoting cost and time savings. Care can be streamlined and standardized, and we can avoid re-inventing the proverbial wheel. The most important reason we have practice guidelines is to identify the standard of care. Guidelines say, “This is how it should be done.” In turn, guidelines serve as the benchmark to which we compare our practice. Another reason practice guidelines exist is to protect overlapping interests. Identifying responsibilities and scope of practice through guidelines serves to enhance collaboration in care and promote a multidisciplinary approach to difficult problems. This is particularly important in the most challenging of neuroscience problems. In order to develop practice guidelines, it is necessary to critically analyze our practice. We ask questions about how we do what we do, whether it is enough, whether it is safe, and whether it has a scientific basis. Such critical analysis improves quality of care, which in itself is worth the effort it takes to develop a guideline. Developing consensus also promotes communication and collaboration among professionals. To make guidelines useful, we must first understand why they exist. Second, we must use them. Guidelines that are not put into everyday practice are of no benefit. Third, we must critically analyze guidelines in use and update them when necessary. Changes in treatment options, new technology, and environmental changes all may prompt us to update practice guidelines, keeping in mind the reasons we have guidelines in the first place. Next, as nursing professionals, we must share the guidelines we develop as a way of promoting excellence in care. Consider sharing your practice guidelines with our readers. Know your professional organization’s practice guidelines, become involved in developing and revising them, and propose suggestions for new guidelines. You should find practice guidelines useful and not a bother at all.
{"title":"Why bother with practice guidelines?","authors":"C. Stewart‐Amidei","doi":"10.1097/01376517-200602000-00001","DOIUrl":"https://doi.org/10.1097/01376517-200602000-00001","url":null,"abstract":"Practice guidelines have garnered a great deal of attention in health care. Institutions, practice lines, professional organizations, specialty groups, and even advocacy groups are producing practice guidelines and promoting their use. Practice guideline development is a timeconsuming and sometimes daunting task. Aside from being trendy, why do we bother with practice guidelines? Practice guidelines were originally proposed as a way to standardize care across geographic boundaries. After all, nursing care should not differ from Alaska to Florida. Guidelines are especially useful for common diseases, such as asthma, or common problems, such as deep-vein thrombosis. The AHCPR series of guidelines is a good example. Guidelines such as these are usually developed from review of the evidence base as well as from expert consensus. These tools are helpful in guiding overall management, enhancing safety, minimizing unnecessary tests and treatments, and promoting cost and time savings. Care can be streamlined and standardized, and we can avoid re-inventing the proverbial wheel. The most important reason we have practice guidelines is to identify the standard of care. Guidelines say, “This is how it should be done.” In turn, guidelines serve as the benchmark to which we compare our practice. Another reason practice guidelines exist is to protect overlapping interests. Identifying responsibilities and scope of practice through guidelines serves to enhance collaboration in care and promote a multidisciplinary approach to difficult problems. This is particularly important in the most challenging of neuroscience problems. In order to develop practice guidelines, it is necessary to critically analyze our practice. We ask questions about how we do what we do, whether it is enough, whether it is safe, and whether it has a scientific basis. Such critical analysis improves quality of care, which in itself is worth the effort it takes to develop a guideline. Developing consensus also promotes communication and collaboration among professionals. To make guidelines useful, we must first understand why they exist. Second, we must use them. Guidelines that are not put into everyday practice are of no benefit. Third, we must critically analyze guidelines in use and update them when necessary. Changes in treatment options, new technology, and environmental changes all may prompt us to update practice guidelines, keeping in mind the reasons we have guidelines in the first place. Next, as nursing professionals, we must share the guidelines we develop as a way of promoting excellence in care. Consider sharing your practice guidelines with our readers. Know your professional organization’s practice guidelines, become involved in developing and revising them, and propose suggestions for new guidelines. You should find practice guidelines useful and not a bother at all.","PeriodicalId":94240,"journal":{"name":"The Journal of neuroscience nursing : journal of the American Association of Neuroscience Nurses","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2006-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79343809","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2005-12-01DOI: 10.1097/01376517-200512000-00003
L. Sauerbeck, J. Khoury, D. Woo, B. Kissela, C. Moomaw, J. Broderick
Smoking is an independent risk factor for stroke. The purpose of this prospective study was to determine whether significant changes in smoking behavior occurred in a cohort of stroke patients who were educated about risk reduction during their initial recovery period. Participants or their proxies were then contacted at 3 months for a follow-up interview, during which their current location, smoking status, and functional outcome were recorded. Of 405 participants interviewed, 112 were current smokers at the time of stroke. Participants younger than 65 years and Blacks were more likely to be smokers. At 3 months, 48 (43%) of the baseline smokers had quit smoking compared with an estimated rate of 28% previously reported in the literature. The number of participants who smoked > 20 cigarettes per day was 31 at baseline versus 7 at 3 months. This change of behavior was independent of baseline characteristics and the level of poststroke disability. Risk-reduction education provides stroke survivors with the information needed to change their lifestyles. Further research is needed to determine whether this behavior continues beyond 3 months and to determine why some stroke survivors continue to smoke.
{"title":"Smoking cessation after stroke: education and its effect on behavior.","authors":"L. Sauerbeck, J. Khoury, D. Woo, B. Kissela, C. Moomaw, J. Broderick","doi":"10.1097/01376517-200512000-00003","DOIUrl":"https://doi.org/10.1097/01376517-200512000-00003","url":null,"abstract":"Smoking is an independent risk factor for stroke. The purpose of this prospective study was to determine whether significant changes in smoking behavior occurred in a cohort of stroke patients who were educated about risk reduction during their initial recovery period. Participants or their proxies were then contacted at 3 months for a follow-up interview, during which their current location, smoking status, and functional outcome were recorded. Of 405 participants interviewed, 112 were current smokers at the time of stroke. Participants younger than 65 years and Blacks were more likely to be smokers. At 3 months, 48 (43%) of the baseline smokers had quit smoking compared with an estimated rate of 28% previously reported in the literature. The number of participants who smoked > 20 cigarettes per day was 31 at baseline versus 7 at 3 months. This change of behavior was independent of baseline characteristics and the level of poststroke disability. Risk-reduction education provides stroke survivors with the information needed to change their lifestyles. Further research is needed to determine whether this behavior continues beyond 3 months and to determine why some stroke survivors continue to smoke.","PeriodicalId":94240,"journal":{"name":"The Journal of neuroscience nursing : journal of the American Association of Neuroscience Nurses","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2005-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76392480","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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