The Journal of neuroscience nursing : journal of the American Association of Neuroscience Nurses
-
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. ⋯ 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.
-
The Canadian Neurological Scale (CNS), a validated stroke assessment tool, was implemented for the neurological assessment of patients with stroke. The purpose of this study was to explore nurses' values and perceptions of best-practice guidelines (BPGs) and the CNS assessment, to evaluate the effect of a workshop and implementation process on nurses' self-efficacy for CNS use, to determine whether the workshop and implementation process met the needs of the nurses, and to evaluate the accuracy and appropriateness of CNS assessment documentation. Nurses reported moderate-to-strong awareness and use of BPGs and expressed the belief that BPGs were valuable; however, they had some difficulty accessing BPGs. ⋯ A chart audit demonstrated that only 69% of patients appropriate for the CNS assessment were assessed with this tool. Although nurses are aware of BPGs, translating these changes into practice takes time and may require BPG modification to best fit the needs of the areas in which they will be used. When choosing a validated stroke assessment tool, clinicians must consider how often the tool will be used for assessments, particularly in the acute phase.
-
Epidural hematomas (EDHs) account for 10% of fatal injuries in patients with head trauma. Up to 35% of patients suffering EDHs develop secondary brain injury within days after the initial trauma. ⋯ This case study presents a patient who developed an EDH following severe head trauma with signs and symptoms of secondary brain injury; intravascular temperature modulation was used to treat the secondary injury for a prolonged period of 13 days. The patient showed a complete neurologic recovery with return to work 6 months after her injury.
-
Understanding chronic pain complicating disability: finding meaning through focus group methodology.
Although extensive literature exists on the experiences of people living with chronic nonmalignant pain as a primary condition, little is known about the phenomenon of pain as it is experienced by the person with a chronic disabling condition. This focus group study explored the experience of disability-related pain among 32 people with multiple sclerosis (MS) living in the community. Thematic analysis of transcripts revealed 4 broad conceptualizations of the experience of living with chronic MS-related pain. ⋯ The participants shared how MS had transformed their worlds into ones in which pain and discomfort had become a normal part of everyday life, requiring careful negotiation and planning to undertake activities and prevent exacerbation. It is vital that healthcare providers give people with MS opportunities to talk about pain and pain-related concerns, validate their experiences, and provide interventions that enable self-management. Clinicians are encouraged to challenge their own meanings and expectations about disability-related pain so that therapeutic interventions can be facilitated.
-
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. ⋯ 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.