| 1. |
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| 2. |
- Ahlström, Gerd
(författare)
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Personal assistance for patients living with a severe neurological disorder.
- 2006
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Ingår i: Journal of Neuroscience Nursing. - 0888-0395. ; 38:3, s. 183-193
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Tidskriftsartikel (refereegranskat)abstract
- Patients with neurological diseases increasingly are being cared for at home. The purpose of this study was to describe stressful everyday experiences in connection with neurological disorders, to learn how people cope with such experiences, and gain knowledge about coping resources. Twenty-seven persons receiving personal assistance were interviewed twice at home. The 54 interviews were subjected to inductive content analysis. The persons encountered many problems in everyday life and usually handled them by means of acceptance, avoidance, practical problem solving, and reappraisal. Dependence on personal assistance gave rise to a sense of helplessness, but it was also the major coping resource. Nurses can improve home care by giving instruction and guidance to persons working as personal assistants.
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| 3. |
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| 4. |
- Eklund, Pernilla, 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. ; 35:1, s. 9-40
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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. |
- 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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| 6. |
- 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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| 7. |
- 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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| 8. |
- Garmy, Pernilla, 1973-, et al.
(författare)
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Adolescents' lived experience of epilepsy
- 2003
-
Ingår i: Journal of Neuroscience Nursing. - 0888-0395 .- 1945-2810. ; 35:1, s. 40-49
-
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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| 9. |
- Hagell, Peter, et al.
(författare)
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Apomorphine in the treatment of Parkinson's disease
- 2001
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Ingår i: Journal of Neuroscience Nursing. - 0888-0395. ; 33:1, s. 21-38
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Tidskriftsartikel (refereegranskat)abstract
- Apomorphine is a potent, nonselective, direct-acting dopamine-receptor agonist. Given subcutaneously, it has a rapid onset of antiparkinsonian action qualitatively comparable to that of levodopa. Despite its long history, it was not until peripheral dopaminergic side effects could be controlled by oral domperidone that the clinical usefulness of apomorphine in Parkinson's disease began to be investigated thoroughly in the mid-1980s. Although several routes have been tried, subcutaneous administration, either as intermittent injections or continuous infusion, is so far the best and most applied in the treatment of advanced, fluctuating Parkinson's disease. Clinical trials have shown stable efficacy with markedly reduced time spent in "off" phases as well as, for infusion therapy, reduced levodopa requirements. In the most successful cases, motor fluctuations disappear and the need for oral medication is eliminated. Adverse events are usually mild and dominated by cutaneous reactions. Neuropsychiatric side effects occur, but the influence of apomorphine on these remains controversial. Controlled long-term clinical trials are highly warranted to reveal the full potentials of this treatment. Careful patient selection and follow-up, where the specialized movement disorder nurse has a crucial role, are paramount for a successful long-term outcome. Apomorphine warrants a wider application in the treatment of advanced Parkinson's disease and should be tried before more invasive interventions are considered.
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| 10. |
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| 11. |
- Hagell, Peter
(författare)
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Compliance and noncompliance in neuroscience
- 2000
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Ingår i: Journal of Neuroscience Nursing. - 0888-0395. ; 32:3, s. 182-182
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Tidskriftsartikel (refereegranskat)abstract
- Among the responses to this month's question, the most common strategy for motivating compliance is providing information. This finding is also supported with the example from Australia, where stoke sufferers are highly compliant with any intervention aimed at prevention of future strokes. In this case, the high level of compliance and (probably) motivation can be explained by the fact that stroke is potentially fatal and highly disabling. Other important issues also were identified in the responses: (a) patients' trust and belief in healthcare professionals in terms of providing information and motivation, and (b) a lack of motivation in some patients who simply do not want to comply and prefer a certain level of seizure activity or other impairments and disabilities over the potential side effects of the treatment. This raises another question that goes beyond the concept of compliance and noncompliance: How does the system comply to the patient? I will leave this topic open, and I welcome comments for a future round of discussion here at Global Views.
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| 12. |
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| 13. |
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| 14. |
- Hagell, Peter, et al.
(författare)
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Pain management
- 1999
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Ingår i: Journal of Neuroscience Nursing. - 0888-0395. ; 31:8, s. 251-251
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Tidskriftsartikel (refereegranskat)
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| 15. |
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| 16. |
- Hagell, Peter
(författare)
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Restorative neurology in movement disorders
- 2000
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Ingår i: Journal of Neuroscience Nursing. - 0888-0395. ; 32:5, s. 256-256
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Tidskriftsartikel (refereegranskat)abstract
- Cell replacement for restoration of neurological functions in patients with movement disorders has been investigated for more than 15 years. Initial attempts used autologous adrenal medulla grafts implanted into the denervated striatum of patients with Parkinson's disease (PD). This approach was soon abandoned in favor of intrastriatal implantation of human embryonic mesencephalic tissue, rich in dopaminergic neurons. Available data from grafted PD patients show long-term (up to 10 years) graft survival and clinical benefits. The pattern and magnitude of symptomatic relief following transplantation, however, are incomplete and the outcome varies among patients. The need for large amounts of human embryonic tissue has to be circumvented and a better understanding of the relationship between graft placement and symptomatic recovery is necessary before this procedure can be offered to larger groups of patients. Clinical trials in Huntington's disease have so far shown inconclusive results. Neural cell replacement therapy is still an experimental procedure, but has the potential to become a future restorative treatment in PD and other movement disorders.
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| 17. |
- Hagell, Peter
(författare)
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Should boxing be banned?
- 2000
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Ingår i: Journal of Neuroscience Nursing. - 0888-0395. ; 32:2, s. 126-126
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Tidskriftsartikel (refereegranskat)abstract
- Should boxing be banned? Do the ever-so-obvious risks outweigh everyone's freedom to choose whether to expose oneself to these risks by taking up the sport? On an official level, the RCN in the UK has taken its stand--it does not! So has also the British Medical Association (BMA)--it does! With few exceptions, the responding nurses from Europe, America, and Australia in this month's column seem to agree with the official nursing standpoint in the UK, also emphasizing the importance that any person's choice not only should be free, but also informed. In the United States, where boxing perhaps has its strongest tradition and deepest roots, the whole issue hardly seems to be one of much realistic debate at all. In Australia, however, the debate seems to be similar to that in the UK. What would a total ban on boxing lead to? No more boxing and no more neurological consequences due to boxing? Doubtfully, boxing would probably continue anywhere where there is an interest for it, and a ban might actually increase the attraction to the sport for some people. In this scenario there is also a risk that the safety precautions would be seriously compromised. This month's question exemplifies an area in which it is very important for nurses to make a stand, on a personal as well as on a collective level. As indicated by several of this month's replies, the issue is probably not merely about boxing but also about to what extent people's choices should be controlled by bans and where the line should be drawn. To what extent are people competent to make their own decisions and where/when/how should "big brother" (in this case as represented by, among others, nursing as a profession) be allowed to step in? Anyone who has any further contributions or comments on this issue is welcome to contact me!
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| 18. |
- Hagell, Peter
(författare)
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Timed tests in the clinical assessment of motor function in Parkinson's disease
- 2000
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Ingår i: Journal of Neuroscience Nursing. - 0888-0395. ; 32:6, s. 331-331
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Tidskriftsartikel (refereegranskat)abstract
- The clinical evaluation section of the Core Assessment Program for Intracerebral Transplantations (CAPIT) for Parkinson's disease (PD) was developed to standardize the clinical evaluation in cell transplantation trials, but also has been used in other therapeutic trials for PD. An important part of the CAPIT protocol is the standardized timed tests of motor function. In a recent revision of CAPIT, the Core Assessment Program for Surgical Interventional Therapies in Parkinson's Disease (CAPSIT-PD), the timed tests have been modified. There are some practical considerations that need attention when timed tests are used. They should be performed under the same circumstances with the patient in a defined condition and according to the same instructions from one time to another. Also, the examiner should not assist the patient, either directly or indirectly, by cueing. In addition to quantification of motor function as an outcome measure in therapeutic trials and other clinical research, timed tests also can be used for determining dopaminergic responsiveness in differential diagnosis of parkinsonism. Our experience is that timed tests are valuable quantitative and objective measures in scientific as well as clinical assessments of PD. Practical guidelines for and examples of these areas of use are provided.
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| 19. |
- 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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| 20. |
- 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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| 21. |
- 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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| 22. |
- 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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| 23. |
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| 24. |
- 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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| 25. |
- Liedström, Elisabeth, 1952-, et al.
(författare)
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Chronic sorrow in next of kin of patients with multiple sclerosis
- 2008
-
Ingår i: The Journal of neuroscience nursing. - London : Lippincott Williams & Wilkins. - 0888-0395. ; 40:5, s. 304-311
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Tidskriftsartikel (refereegranskat)abstract
- The well-being of patients' next of kin can be an important factor with regard to the care and rehabilitation of patients with multiple sclerosis (MS). The aim of this qualitative study was to explore the presence and meaning of chronic sorrow in a group of next of kin of patients with MS. Using a semistructured interview guide as a basis, 44 next of kin were interviewed. The results showed that 35 (80%) of the participants were considered to have chronic sorrow based on predetermined criteria. Three main themes characterized the meaning of chronic sorrow: loss of security, loss of sense of community in family life, and loss of joy and recreation. This study indicates that nurses need to devote greater attention to the well-being of next of kin, offering support programs to help them cope with chronic sorrow.
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| 26. |
- 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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| 27. |
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| 28. |
- Nyholm, Lena, et al.
(författare)
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Predictive Factors That May Contribute to Secondary Insults With Nursing Interventions in Adults With Traumatic Brain Injury
- 2017
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Ingår i: Journal of Neuroscience Nursing. - 0888-0395 .- 1945-2810. ; 49:1, s. 49-55
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Tidskriftsartikel (refereegranskat)abstract
- Background: Nursing interventions pose risks and benefits to patients with traumatic brain injury at a neurointensive care unit. Objectives: The aim of this study was to investigate the risk of inducing high intracranial pressure (ICP) related to interventions and whether intracranial compliance, baseline ICP, or autoregulation could be used as predictors. Methods: The study had a quantitative, prospective, observational design. Twenty-eight patients with TBI were included, and 67 interventions were observed. The definition of a secondary ICP insult was ICP of 20 mm Hg or greater for 5 minutes or more within a continuous 10-minute period. Results: Secondary ICP insults related to nursing interventions occurred in 6 patients (21%) and 8 occasions (12%). Patients with baseline ICP of 15 mm Hg or greater had 4.7 times higher risk of developing an insult. The predictor with the best combination of sensitivity and specificity was baseline ICP. Conclusions: Baseline ICP of 15 mm Hg or greater was the most important factor to determine the risk of secondary ICP insult related to nursing intervention.
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| 29. |
- Nyholm, Lena, 1973-, et al.
(författare)
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Secondary insults related to nursing interventions in neurointensive care : a descriptive pilot study
- 2014
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Ingår i: Journal of Neuroscience Nursing. - 0888-0395 .- 1945-2810. ; 46:5, s. 285-291
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Tidskriftsartikel (refereegranskat)abstract
- The patients at a neurointensive care unit are frequently cared for in many ways, day and night. The aim of this study was to investigate the amount of secondary insults related to oral care, repositioning, endotracheal suctioning, hygienic measures, and simultaneous interventions at a neurointensive care unit with standardized care and maximum attention on avoiding secondary insults. The definition of a secondary insult was intracranial pressure > 20 mm Hg, cerebral perfusion pressure < 60 mm Hg and systolic blood pressure < 100 mm Hg for 5 minutes or more in a 10-minute period starting from when the nursing intervention began. The insult minutes did not have to be consecutive. The study included 18 patients, seven women and 11 men, aged 36-76 years with different neurosurgical diagnoses. The total number of nursing interventions analyzed was 1,717. The most common kind of secondary insults after a nursing measure was high intracranial pressure (n = 93) followed by low cerebral perfusion pressure (n = 43) and low systolic blood pressure (n = 14). Repositioning (n = 39) and simultaneous interventions (n = 32) were the nursing interventions causing most secondary insults. There were substantial variations between the patients; only one patient had no secondary insult. There were, overall, a limited number of secondary insults related to nursing interventions when a standardized management protocol system was applied to reduce the occurrence of secondary insults. Patients with an increased risk of secondary insults should be recognized, and their care and treatment should be carefully planned and performed to avoid secondary insults.
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| 30. |
- Prendergast, Virginia, et al.
(författare)
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Effects of a standard versus comprehensive oral care protocol among intubated neuroscience ICU patients : results of a randomized controlled trial
- 2012
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Ingår i: Journal of Neuroscience Nursing. - : Lippincott Williams & Wilkins. - 0888-0395 .- 1945-2810. ; 44:3, s. 134-146
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Tidskriftsartikel (refereegranskat)abstract
- The purpose of the study was to compare changes in oral health during intubation until 48 hours after extubation in neuroscience intensive care unit (ICU) patients enrolled in a standard or a comprehensive oral care protocol. The effects of manual toothbrushing (standard group, n = 31) were compared with those of tongue scraping, electric toothbrushing, and moisturizing (comprehensive group, n = 25) in intubated patients in a neuroscience ICU in a 2-year randomized clinical trial. Oral health was evaluated based on the Oral Assessment Guide (OAG) on enrollment, the day of extubation, and 48 hours after extubation. There were no significant differences in the frequency of the oral care protocol. Protocol compliance exceeded 91% in both groups. The total OAG score and all eight categories significantly deteriorated (Friedman test, p < .001, Bonferroni corrected) in the standard oral care group and did not return to baseline after extubation. Large effect sizes were present at all three points in this group. The total OAG score deteriorated during intubation within the comprehensive protocol group (Friedman test, p < .004) but returned to baseline status after extubation. In four categories, the ratings on tongue, mucous membranes, gingiva, and teeth did not deteriorate significantly over time. Published oral care protocols are substandard in promoting and maintaining oral health in intubated patients. A comprehensive oral care protocol, using a tongue scraper, an electrical toothbrush, and pharmacological moisturizers, was more effective for oral hygiene throughout intubation and after extubation than manual toothbrushing alone.
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| 31. |
- Prendergast, Virginia, et al.
(författare)
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Effects of a standard versus comprehensive oral care protocol among intubated neuroscience ICU patients : results of a randomized controlled trial
- 2012
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Ingår i: Journal of Neuroscience Nursing. - : Lippincott Williams and Wilkins Ltd.. - 0888-0395 .- 1945-2810. ; 44:3, s. 134-146
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Tidskriftsartikel (refereegranskat)abstract
- The purpose of the study was to compare changes in oral health during intubation until 48 hours after extubation in neuroscience intensive care unit (ICU) patients enrolled in a standard or a comprehensive oral care protocol. The effects of manual toothbrushing (standard group, n = 31) were compared with those of tongue scraping, electric toothbrushing, and moisturizing (comprehensive group, n = 25) in intubated patients in a neuroscience ICU in a 2-year randomized clinical trial. Oral health was evaluated based on the Oral Assessment Guide (OAG) on enrollment, the day of extubation, and 48 hours after extubation. There were no significant differences in the frequency of the oral care protocol. Protocol compliance exceeded 91% in both groups. The total OAG score and all eight categories significantly deteriorated (Friedman test, p < .001, Bonferroni corrected) in the standard oral care group and did not return to baseline after extubation. Large effect sizes were present at all three points in this group. Thetotal OAG score deteriorated during intubation within the comprehensive protocol group (Friedman test, p < .004) but returned to baseline status after extubation. In four categories, the ratings on tongue, mucous membranes, gingiva, and teeth did not deteriorate significantly over time. Published oral care protocols are substandard in promoting and maintaining oral health in intubated patients. A comprehensive oral care protocol, using a tongue scraper, an electrical toothbrush, and pharmacological moisturizers, was more effective for oral hygiene throughout intubation and after extubation than manual toothbrushing alone.
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| 32. |
- Räty, Lena, 1948-, et al.
(författare)
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Epilepsy patients' Conceptions of Epilepsy as a Phenomenon
- 2009
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Ingår i: Journal of Neuroscience Nursing. - Philadelphia, USA : Lippincott Williams & Wilkins. - 0888-0395 .- 1945-2810. ; 41:4, s. 201-210
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Tidskriftsartikel (refereegranskat)abstract
- This study addressed epilepsy patients' conceptions of epilepsy as a phenomenon and emotions related to those conceptions. Nineteen outpatients were interviewed, and data were analyzed according to the phenomenographical methodology. Patients described epilepsy in six qualitatively different ways: Epilepsy is (a) an illness related to physical disturbances, (b) a condition related to physical disturbances, (c) a mental disturbance related to lack of mental capacity, (d) a handicap related to psychological and/or social aspects, (e) an identity related to being an epileptic, and (f) a punishment. The emotions confidence, happiness, hope, and annoyance were related to epilepsy as an illness or a condition, whereas shame, fear, sorrow, and guilt were related to the other four categories. This study indicated that, to patients, the phenomenon of epilepsy is above all a psychosocial nature and in that dimension closely related to negative emotions.
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| 33. |
- Silén, Marit, 1979-, et al.
(författare)
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Workplace Distress and Ethical Dilemmas in Neuroscience Nursing
- 2008
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Ingår i: Journal of Neuroscience Nursing. - 0888-0395 .- 1945-2810. ; 40:4, s. 222-231
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Tidskriftsartikel (refereegranskat)abstract
- This study concerns Swedish nurses' experiences of workplace stress and the occurrence of ethical dilemmas in a neurological setting. Qualitative interviews were conducted with 21 nurses. The interview results were subjected to qualitative latent content analysis and sorted into 4 content areas: workplace distress, ethical dilemmas, managing distress and ethical dilemmas, and quality of nursing. Common workplace stressors were high workload and lack of influence. These were perceived to have negative consequences for the quality of nursing. Ethical dilemmas mainly concerned decision making on initiation or withdrawal of treatment, which was experienced as a troublesome situation where conflicts could arise. The nurses managed the distress and ethical dilemmas by accepting and adjusting to the situation and seeking support from colleagues. They also endeavored to gain new strength in their private lives.
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| 34. |
- Sjöström, AC, et al.
(författare)
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Parkinson-plus patients--an unknown group with severe symptoms
- 2002
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Ingår i: The Journal of neuroscience nursing : journal of the American Association of Neuroscience Nurses. - : Ovid Technologies (Wolters Kluwer Health). - 0888-0395. ; 34:6, s. 314-9
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Tidskriftsartikel (refereegranskat)
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| 35. |
- Skoglund, Karin, et al.
(författare)
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Monitoring and Sedation Differences in the Management of Severe Head Injury and Subarachnoid Hemorrhage Among Neurocritical Care Centers
- 2013
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Ingår i: Journal of Neuroscience Nursing. - 0888-0395 .- 1945-2810. ; 45:6, s. 360-368
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Tidskriftsartikel (refereegranskat)abstract
- Background: The emergence of specialized neurocritical care (NCC) centers has been associated with an improved survival of patients with severe traumatic brain injury or subarachnoid hemorrhage. However, there are no established guidelines on sedation strategy or the frequency of evaluating the level of consciousness using the neurological wake-up test (NWT) in sedated NCC patients. Objectives: The aim was to compare the (1) monitoring techniques, (2) sedation principles, and (3) the use of the NWT in patients with severe traumatic brain injury or subarachnoid hemorrhage in 16 NCC centers. Method: A systematic survey of all 16 centers providing NCC in Scandinavia was performed using a questionnaire regarding the routine primary choice of sedative and analgesic compounds, monitoring techniques, and the frequency of the NWT, sent to the director of each center during 1999, 2004, and 2009. Results: The response rate was 100%. Except for one center in 1999, all included centers routinely used monitoring of intracranial and cerebral perfusion pressure. In contrast, newer monitoring techniques such as microdialysis, jugular bulb oximetry, and brain tissue oxygenation were infrequently used throughout the survey period. Approximately half of the NCC centers used propofol infusion as the primary sedative, whereas the remaining centers used midazolam infusion, and there was a marked variation in the choice of analgesia in each evaluated year. The NWT was never used in 50% of centers and six times daily in one center from 1999 to 2009. Most differences among the NCC centers remained unchanged over the evaluated 10-year period. Discussion: Although Scandinavian countries have similar healthcare systems, there were marked differences among the participating NCC centers in the choice of monitoring tools and sedatives and the routine use of the NWT. These differences likely reflect different clinical management traditions and a lack of evidence-based guidelines in routine NCC.
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| 36. |
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| 37. |
- Westergren, Albert, 1967-, et al.
(författare)
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Measurement properties of the 12-item Short-Form Health Survey in stroke
- 2014
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Ingår i: Journal of Neuroscience Nursing. - 0888-0395 .- 1945-2810. ; 46:1, s. 34-45
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Tidskriftsartikel (refereegranskat)abstract
- Background: The 12-item Short-Form Health Survey (SF-12) was developed to measure perceived physical and mental health. Some studies of the psychometric properties, using classical test theory, of the SF-12 provide support for its use in patients with stroke, but it has not been scrutinized using recommended modern test theory approaches such as the Rasch measurement model among stroke survivors.Objectives: This study sought to explore the measurement properties of the SF-12 physical and mental health scales among people with stroke using the Rasch measurement model.Design: A cross-sectional design was used in this study.Methods: All patients discharged from a dedicated stroke unit in southern Sweden during 6 months were asked to participate 6 months later. Of 120 stroke survivors, 89 (74%) agreed to participate. Rasch analysis was used to assess the measurement properties of the SF-12 physical and mental component summary scores (PCS-12 and MCS-12, respectively).Results: For the PCS-12, we identified problems with targeting, overall and item-level fit, representing local response dependency, and multidimensionality. For the MCS-12, there were problems related to targeting (the persons felt better than the scale could conceptualize) and response categories that did not function as expected. However, MCS-12 items displayed reasonable model fit without indications of multidimensionality but with signs of local response dependency.Conclusion: The measurement properties of the MCS-12 in stroke appear reasonable unless milder mental health problems are of interest, whereas those of the PCS-12 are less acceptable. Given the interdependence between MCS-12 and PCS-12 that is inherent with the standard SF-12 scoring algorithm, such data should be interpreted with caution.
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| 38. |
- Westergren, Albert, et al.
(författare)
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Measurement properties of the 12-item Short-Form Health Survey in stroke
- 2014
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Ingår i: Journal of Neuroscience Nursing. - : Lippincott Williams and Wilkins Ltd.. - 0888-0395. ; 46:1, s. 34-45
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Tidskriftsartikel (refereegranskat)abstract
- Background: The 12-item Short-Form Health Survey (SF-12) was developed to measure perceived physical and mental health. Some studies of the psychometric properties, using classical test theory, of the SF-12 provide support for its use in patients with stroke, but it has not been scrutinized using recommended modern test theory approaches such as the Rasch measurement model among stroke survivors. Objectives: This study sought to explore the measurement properties of the SF-12 physical and mental health scales among people with stroke using the Rasch measurement model. Design: A cross-sectional design was used in this study. Methods: All patients discharged from a dedicated stroke unit in southern Sweden during 6 months were asked to participate 6 months later. Of 120 stroke survivors, 89 (74%) agreed to participate. Rasch analysis was used to assess the measurement properties of the SF-12 physical and mental component summary scores (PCS-12 and MCS-12, respectively). Results: For the PCS-12, we identifiedproblems with targeting, overall and item-level fit, representing local response dependency, and multidimensionality. For the MCS-12, there were problems related to targeting (the persons felt better than the scale could conceptualize) and response categories that did not function as expected. However, MCS-12 items displayed reasonable model fit without indications of multidimensionality but with signs of local response dependency. Conclusion: The measurement properties of the MCS-12 in stroke appear reasonable unless milder mental health problems are of interest, whereas those of the PCS-12 are less acceptable. Given the interdependence between MCS-12 and PCS-12 that is inherent with the standard SF-12 scoring algorithm, such data should be interpreted with caution.
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