J Am Acad Nurse Prac
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J Am Acad Nurse Prac · Jun 2005
Review Case ReportsFrom mechanisms to management: translating the neuropathic pain consensus recommendations into clinical practice.
Chronic neuropathic pain poses a treatment challenge, and is associated with significant psychologic distress, physical disability, and impaired functioning, which impact the activities of daily living. Efforts to provide relief are often inadequate and/or require polypharmacy. This has spurred interest among researchers and clinicians alike to develop early, intensive treatments that target the molecular and cellular mechanisms involved in pain transduction, transmission, and modulation, or ideally, that prevent neuropathic pain from occurring in the first place. ⋯ In this regard, several potential agents (eg, NMDA and AMPA/kainate antagonists) are in phase 2 and 3 clinical trials. In the interim, evolving data and evidence-based neuropathic treatment recommendations provide guidance for selecting first- and second-line medications that alone or in combination offer acceptable neuropathic pain control and allow clinicians to bridge the gap between current knowledge and its application in the clinical setting. Hopefully, as basic and clinical science progresses, further treatment advances and management tools will be found to improve the care of patients who live with neuropathic pain.
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J Am Acad Nurse Prac · Jun 2005
Tandem practice model: a model for physician-nurse practitioner collaboration in a specialty practice, neurosurgery.
To describe the benefits of a physician-nurse practitioner (NP) collaborative practice model, specifically that of a tandem practice model, using a neurosurgeon and a primary care NP in the clinic and inpatient setting. ⋯ Patients seen in a specialty practice, particularly that of neurosurgery, often have little understanding of their problem and may be frightened or confused because of their perceptions of the unknown. Providing care to such specialized patient populations in a constantly changing healthcare environment may prove demanding to the specialist. The introduction of a primary care NP into such specialty settings offers patients, their families, consultants, and staff members an additional resource for evaluation, intervention, education, and communication, improving the continuity and comprehensiveness of care to challenging patient populations. This model is an option for physician specialists interested in augmenting their practice and provides further resources for meeting the holistic needs of selected patient populations regardless of the setting.
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J Am Acad Nurse Prac · Jun 2005
"It's about time": College women's perceptions of gynecologic health.
To examine college women's perceptions of gynecologic health, with a particular emphasis on healthcare decision making. Women's perceptions of health promotion efforts that would influence gynecologic health were also examined. ⋯ Three themes were identified: (dis)connecting with their changing bodies, experiencing the healthcare encounter, and making healthcare decisions. Results suggest that college can be "the time" when college women begin to think about and act on decisions about gynecologic health. Implications for practice By acknowledging college women's multidimensional definitions of health and knowledge of healthy behaviors, advanced practice nurses can assist women in developing strategies for enacting these definitions and integrating desired healthy behaviors into their busy college lives.