| 1. |
- Elf, Kristin, et al.
(författare)
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Electroencephalographic Patterns During Common Nursing Interventions in Neurointensive Care : A Descriptive Pilot Study
- 2019
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Ingår i: Journal of Neuroscience Nursing. - 0888-0395 .- 1945-2810. ; 51:1, s. 10-15
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Tidskriftsartikel (refereegranskat)abstract
- Background: Many patients with neurological insults requiring neurointensive care have an increased risk of acute symptomatic seizures. Various nursing interventions performed when caring for these patients may elicitpathological cerebral electrical activity including seizures and stimulus-induced rhythmic, periodic, or ictal discharges (SIRPIDs). The aim was to explore changes in electroencephalogram (EEG) due to neurointensive care nursing interventions.Methods: A convenience sample was recruited between November 2015 and April 2016, consisting of 12 adult patients with impaired consciousness due to a neurosurgical condition. Continuous EEG and simultaneous video recordings of nursing interventions were collected 48 continuous hours for each patient. Two analysts categorized the video recordings for common nursing interventions, and a neurophysiologist analyzed the EEGs.Results: In total, 976 nursing interventions were observed. Epileptiform activity was observed in 4 patients (33%), during 1 nursing intervention episode each (0.4%). The 4 observed episodes of epileptiform activity occurred during multiple simultaneous nursing interventions (n = 3) and hygienic interventions (n = 1). Stimulus-induced rhythmic, periodic, or ictal discharges were observed in 1patient (8%), in 1 single nursing intervention (0.1%). The observed SIRPID soccurred during repositioning of thepatient. All patients had muscle artifacts, during 353 nursing interventions (36.3%). The duration of nursing interventions was longer for those with simultaneous muscle artifacts (median, 116 seconds) than those without muscle artifacts, epileptiform activity, or SIRPIDs (median, 89.0 seconds). With regard to epileptiform activityand SIRPIDs, the median durations of the nursing interventions were 1158 and 289 seconds, respectively.Conclusion: The results of this pilot study indicate that muscle artifacts seem prevalent during nursing interventions and may be a sign of stress. Nurses should be aware of the risk of inducing stress by performing regular nursing interventions in daily practice, consider shorter or fewer interventions at a time in sensitive patients, and administer sedation accordingly. Considering that this was a pilot study, more research that investigates correlations between EEG patterns and nursing interventions in larger samples is needed.
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| 2. |
- Engström, Åsa, et al.
(författare)
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Transition as experienced by close relatives of people with traumatic brain injury
- 2011
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Ingår i: Journal of Neuroscience Nursing. - 0888-0395 .- 1945-2810. ; 43:5, s. 253-260
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Tidskriftsartikel (refereegranskat)abstract
- When someone is afflicted by a traumatic brain injury (TBI), it entails a sudden change in the lives of their close relatives. Relatives provide the primary support system for the person with TBI, and new living patterns have to be developed by the family to achieve balance in the new situation. There is an absence of studies focusing on the process of transition for people living close to a person with TBI, especially in a long-term relationship. The aim of this study, therefore, was to describe such transitions experienced by the close relatives of people with TBI. Five close relatives, all women, who lived with or close to a person with TBI in the northern part of Sweden, were interviewed. The data were analyzed in accordance with the qualitative interpretive method and performed in a series of steps to arrive at a description of the transition. The findings of the analysis are presented in 4 categories: the starting point of the transitions, transitions in pattern of daily life, transitions in relationship, and transitions in social life. The transitions of daily life for close relatives began suddenly as the person with TBI was injured unexpectedly. The relatives could feel lonely as former friends were gone or avoided them. How the person with TBI was met by other people strongly affected how the close relatives felt. Although they struggled to lessen the dependence of the person with TBI on them, they also felt anxious about how things would be if close relatives were no longer there for that person. The findings are discussed with reference to works by the philosophers Buber, Le´vinas, and Lo¨ gstrup and theories of transition.
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| 3. |
- Eriksson, Helene, et al.
(författare)
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Ethical Dilemmas Around the Dying Patient With Stroke: A Qualitative Interview Study With Team Members on Stroke Units in Sweden
- 2014
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Ingår i: Journal of Neuroscience Nursing. - : Lippincott, Williams andamp; Wilkins. - 0888-0395 .- 1945-2810. ; 46:3, s. 162-170
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Tidskriftsartikel (refereegranskat)abstract
- In Sweden, individuals affected by severe stroke are treated in specialized stroke units. In these units, patients are attended by a multiprofessional team with a focus on care in the acute phase of stroke, rehabilitation phase, and palliative phase. Caring for patients with such a large variety in condition and symptoms might be an extra challenge for the team. Today, there is a lack of knowledge in team experiences of the dilemmas that appear and the consequences that emerge. Therefore, the purpose of this article was to study ethical dilemmas, different approaches, and what consequences they had among healthcare professionals working with the dying patients with stroke in acute stroke units. Forty-one healthcare professionals working in a stroke team were interviewed either in focus groups or individually. The data were transcribed verbatim and analyzed using content analysis. The ethical dilemmas that appeared were depending on nondecisions about palliative care or discontinuation of treatments. The lack of decision made the team members act based on their own individual skills, because of the absence of common communication tools. When a decision was made, the healthcare professionals had problems holding to the decision. The devised and applied plans could be revalued, which was described as a setback to nondecisions again. The underlying problem and theme was communication barriers, a consequence related to the absence of common skills and consensus among the value system. This study highlights the importance of palliative care knowledge and skills, even for patients experiencing severe stroke. To make a decision and to hold on to that is a presupposition in creating a credible care plan. However, implementing a common set of values based on palliative care with symptom control and quality of life might minimize the risk of the communication barrier that may arise and increases the ability to create a healthcare that is meaningful and dignified.
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| 4. |
- Garmy, Pernilla, 1973-, et al.
(författare)
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Adolescents' lived experience of epilepsy
- 2003
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Ingår i: Journal of Neuroscience Nursing. - 0888-0395 .- 1945-2810. ; 35:1, s. 40-49
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Tidskriftsartikel (refereegranskat)abstract
- To improve the well-being of adolescents with epilepsy, research is needed on how adolescents cope. In this study, Lazarus' model of stress and coping and Antonovsky's Theory of Sense of Coherence were used as the theoretical framework. The aim was to describe the lived experience of adolescents with epilepsy and their coping skills. The participants were 13-19 years old with an epilepsy diagnosis but without mental retardation or cerebral palsy. The study was performed in southern Sweden at the pediatric department of a university hospital. Semistructured and open-ended interviews were conducted with 13 adolescents. The transcripts were analyzed with manifest and latent content analysis. All the adolescents had developed strategies to cope with the emotional strains caused by epilepsy. They experienced strains from the seizures, limitation of leisure activities, side effects of medication, and feelings of being different. The coping strategies described were finding support, being in control, and experimenting.
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| 5. |
- Hickisch, Annika, 1953-, et al.
(författare)
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Swedish Translation and Reliability of the Full Outline of Unresponsiveness Score
- 2016
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Ingår i: Journal of Neuroscience Nursing. - Philadelphia, USA : Lippincott Williams & Wilkins. - 0888-0395 .- 1945-2810. ; 48:4, s. 195-205
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Tidskriftsartikel (refereegranskat)abstract
- Background: It is important for patient safety that the patient's level of consciousness is assessed and documented in a structured and reliable manner. The Full Outline of Unresponsiveness (FOUR) score measures the level of consciousness more comprehensively than the coma scales that are commonly used in Sweden. Therefore, there was a need to translate the FOUR score into Swedish and to evaluate its use in a Swedish healthcare context.Objectives: The aim of this study was to translate the FOUR score into Swedish and to evaluate the reliability of the Swedish version compared with the reliability of the Glasgow Coma Scale (GCS).Methods: The English version of the FOUR score was translated into Swedish and evaluated in terms of interrater reliability and internal consistency on fictitious patient cases with an advanced high-fidelity patient simulator. Two nurses rated 30 patient cases with the FOUR score and the GCS. Interrater reliability for items was determined by quadratic-weighted kappa and for the total score by intraclass correlation coefficient. Internal consistency was calculated with Cronbach's alpha.Results: The fourth version of the Swedish translation reached consensus in the expert panel. The back-translation was approved by the author of the original FOUR score. Interrater reliability of the Swedish version of the FOUR score was excellent; the weighted kappa was 0.94-1, and intraclass correlation coefficient = .99 (95% CI [0.97, 0.99]), and these were equal to the reliability of the GCS. Cronbach's alpha showed a high degree of internal consistency for the FOUR score (α = .92 for rater A and .91 for rater B), which was slightly higher than that for the GCS.Conclusions: The Swedish version of the FOUR score is equivalent to the original English version and has shown excellent reliability using fictitious patient cases with an advanced patient simulator.
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| 6. |
- Isaksson, Ann-Kristin, 1961-, et al.
(författare)
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From symptom to diagnosis : illness experiences of multiple sclerosis patients.
- 2006
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Ingår i: Journal of Neuroscience Nursing. - : Ovid Technologies (Wolters Kluwer Health). - 0888-0395 .- 1945-2810. ; 38:4, s. 229-237
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Tidskriftsartikel (refereegranskat)abstract
- This interview study describes 61 multiple sclerosis (MS) patients' conceptions of the disease before they were diagnosed and their experiences of the initial symptoms and the diagnosis. Qualitative content analysis was applied. The patients' perception of MS was in most cases disablement and death, but some narrated a more nuanced image of MS. The experiences of the initial symptoms and the diagnosis were stressful. The patients became and remained vulnerable through diagnosis. They managed the situation in a variety of ways to acquire strength. Nurses who encounter MS patients require specialized knowledge to understand the vulnerability of these patients and to provide support.
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| 7. |
- Isaksson, Ann-Kristin, 1961-, et al.
(författare)
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Managing chronic sorrow : experiences of patients with multiple sclerosis
- 2008
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Ingår i: Journal of Neuroscience Nursing. - : American Association of Neuroscience Nurses. - 1945-2810 .- 0888-0395. ; 40:3, s. 180-191
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Tidskriftsartikel (refereegranskat)abstract
- The goals of this study were to describe the ways in which patients with multiple sclerosis (MS) manage chronic sorrow and to apply this information to the theoretical model of chronic sorrow. This descriptive study involved 38 participants with MS who were experiencing chronic sorrow. Using the theoretical model of chronic sorrow, we applied content analysis to participants' accounts of how they attempted to manage this sorrow. The findings showed that discomfort resulted from ineffective management of chronic sorrow, reflecting the vulnerability these patients experience and the lack of understanding of their needs and appropriate support from family, friends, and healthcare personnel. In some cases, however, the losses and emotional distress caused by MS were managed effectively, which led to increased comfort through personal growth and a greater appreciation of life, greater confidence, and hope for the future. The theoretical model was valuable in helping to describe participants' patterns of managing chronic sorrow. Healthcare personnel should acknowledge chronic sorrow as one aspect of psychological distress in MS. Knowledge of patients' experiences of chronic sorrow should be included in the education for neuroscience nurses. Furthermore, it is necessary to develop support interventions for patients with chronic sorrow and their families.
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| 8. |
- Jumisko, Eija, et al.
(författare)
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The meaning of living with traumatic brain injury in people with moderate or severe traumatic brain injury
- 2005
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Ingår i: Journal of Neuroscience Nursing. - : Ovid Technologies (Wolters Kluwer Health). - 0888-0395 .- 1945-2810. ; 37:1, s. 42-50
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Tidskriftsartikel (refereegranskat)abstract
- A traumatic brain injury (TBI) extensively affects the injured person's daily life. Research based on the perspectives of people with TBI can increase understanding of the challenges they face and the possibility of supporting them in managing their lives. The aim of this study was to elucidate the meaning of living with TBI as narrated by the people with moderate or severe TBI. The data were collected by means of qualitative research interviews with 12 participants who had lived with TBI for 4-13 years. A phenomenological hermeneutic method was used to interpret the transcribed interviews. The study showed that people with TBI had lost their way and struggled to achieve a new normalcy. Losing one's way included experiences of waking up to unknown, missing relationships and experiencing the body as an enemy. Participants' struggles to attain a new normalcy included searching for an explanation, recovering the self, wishing to be met with respect, and finding a new way of living. Living with TBI seems to mean living with a perpetually altered body that changed the whole life and caused deep suffering, where feelings of shame and dignity competed with each other. Participants seem to be quite alone in their suffering and need more support from healthcare professionals.
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| 9. |
- Kitzmüller, Gabriele, et al.
(författare)
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The Long-Term Experience of Family Life After Stroke
- 2012
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Ingår i: Journal of Neuroscience Nursing. - : American Association of Neuroscience Nurses. - 0888-0395 .- 1945-2810. ; 44:1, s. E1-E13
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Tidskriftsartikel (refereegranskat)abstract
- Stroke is a life-threatening and disabling illness known to have a significant impact on families. The purpose of this study was to illuminate the long-term experience of family life after stroke of stroke survivors and their spouses and children, particularly regarding marital and parent-child relationships. Thirty-seven narrative interviews were conducted with stroke survivors and their spouses and adult children who were minors at onset of the illness. A qualitative approach inspired by Gadamer's hermeneutic and van Manen's phenomenological understanding of lived experience was used. The analysis revealed four themes: the family as a lifebuoy, absent presence, broken foundations, and finding a new marital path. Lack of communication and altered roles and relationships endangered marital equilibrium and parent-child relationships after stroke. This study highlighted the need for professional family support as families were unprepared for the life changes that occurred. Nurses and other healthcare workers should examine family relationships and communication patterns and view the family as a unit composed of unique persons with different needs. Further research on the experiences of stroke survivors' children seems urgent.
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| 10. |
- Liedström, Elisabeth, 1952-, et al.
(författare)
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Quality of life in spite of an unpredictable future : the next of kin of patients with multiple sclerosis
- 2010
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Ingår i: Journal of Neuroscience Nursing. - Philadelphia, USA : Lippincott Williams & Wilkins. - 0888-0395 .- 1945-2810. ; 42:6, s. 331-341
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Tidskriftsartikel (refereegranskat)abstract
- The aim of the study was to describe the quality of life of the next of kin of patients diagnosed as having multiple sclerosis (MS). Forty-four next of kin were interviewed and thereafter answered the Subjective Quality of Life questionnaire. The next of kin's quality of life emerged as good in terms of both external conditions and interpersonal relationships in both the interviews and the Subjective Quality of Life. In the interviews, most of the next of kin indicated a trusting and secure relationship with the cohabiting partner, but others described a strained situation with an unsatisfactory married/cohabiting life. There was worry about a worsening of the relationship in the future. In addition, the next of kin spoke of a decrease in freedom, self-actualization, and security, also of a more negative general mood and negative emotional experiences. The results of the questionnaire showed that a sense of engagement in life, having energy, self-actualization, self-assuredness, self-acceptance, security, and general mood were significantly correlated with quality of life as a whole. The study confirms that MS is a disease affecting the whole family, and the next of kin were living in uncertainty, facing an unpredictable future. The nurses could start family support groups and help the next of kin to look after their own health, giving advice on health-promoting behavior to make it possible for the person with MS to live at home even if the illness becomes worse.
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