The Journal of neuroscience nursing : journal of the American Association of Neuroscience Nurses最新文献

{"title":"Factors Affecting Functional Improvement in the Initial Months of Recovery After Stroke: A Pilot Study.","authors":"Mary C Forgea, Carla Jungquist, Jeanne Langan, Chin-Shang Li, Christina Zaccarini, Rebecca A Lorenz","doi":"10.1097/JNN.0000000000000828","DOIUrl":"https://doi.org/10.1097/JNN.0000000000000828","url":null,"abstract":"<p><strong>Abstract: </strong>BACKGROUND: The purpose of this study is to examine factors affecting functional improvement among survivors of stroke during the initial months of stroke recovery. METHODS: A 1-group repeated measures sequential mixed methods design was used. Quantitative longitudinal data were collected on admission, discharge, and postdischarge from the inpatient rehabilitation unit to evaluate the change in patient engagement and the relationship between environmental, personal, and behavioral factors, and functional independence. Semistructured interviews were conducted up to 6 months postdischarge. RESULTS: The sample included 27 participants with a mean age of 64.67 (SD = 13.56). There was a significant increase in patient engagement from admission to discharge (P < .0001), followed by a nonsignificant decrease from discharge to follow-up (P = .36). The change in functional improvement from admission to discharge was significant (P < .0001). Stroke severity was the only significant predictor of functional improvement (P = .008). There was a significant but weak negative correlation between Patient Health Engagement scale (PHE-s®) total score and sleep disturbance (r = -0.344, P = .008) and sleep disturbance and self-efficacy (r = -0.362, P = .005). There was a moderate positive correlation between PHE-s total score and self-efficacy (r = 0.662, P < .001). Five participants participated in follow-up interviews. The 5 main themes that emerged from interview data were (1) feeling happy to be home, (2) wishing recovery was quicker, (3) living with disability, (4) overcoming obstacles, and (5) social support. CONCLUSION: This pilot study provides insight into the experiences of survivors of stroke during rehabilitation and recovery. The results of this study indicate a need for additional support (eg, transportation, social/emotional) for survivors of stroke after discharge from the rehabilitation unit. Further research to investigate the barriers and facilitators of recovery for survivors of stroke after discharge and the development of interventions aimed at improving sustainable recovery outcomes is needed.</p>","PeriodicalId":94240,"journal":{"name":"The Journal of neuroscience nursing : journal of the American Association of Neuroscience Nurses","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143560311","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}

{"title":"AANN 2024: Reflecting on a Year of Growth and Impact.","authors":"Kimberly S Meyer, Erin Fecske","doi":"10.1097/JNN.0000000000000827","DOIUrl":"https://doi.org/10.1097/JNN.0000000000000827","url":null,"abstract":"","PeriodicalId":94240,"journal":{"name":"The Journal of neuroscience nursing : journal of the American Association of Neuroscience Nurses","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143559836","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}

{"title":"Development and Psychometric Testing of a Tool to Measure Nursing Care Intensity for Stroke Patients.","authors":"Amalia Ferrara, Paolo Iovino, Valentina Magni, Maria Rosa Dibuono, Tiziana Brunelli, Rosaria Mastrorocco, Cinzia Favilla, Silvia Giacomelli, Pio Cerchia, Laura Rasero","doi":"10.1097/JNN.0000000000000825","DOIUrl":"https://doi.org/10.1097/JNN.0000000000000825","url":null,"abstract":"<p><strong>Abstract: </strong>BACKGROUND: Nurses play a crucial role in the care of stroke patients improving health outcomes. However, stroke nursing care is complex, and an instrument available to monitor the patient dependence over time and an efficient management of care would be beneficial for the stroke care units. The purpose of this study is to develop and psychometrically test an instrument to measure nursing care intensity for patients admitted to stroke units. METHODS: A 3-step process was implemented. First, item generation was performed based on an established theory. Second, content validity was assessed on the generated pool of items, and finally, the instrument was tested on a sample of 1200 stroke patients at admission and discharge time points, to test its psychometric properties. RESULTS: Item generation was driven by the theory of Roper-Logan-Tierney, and a total of 13 items were derived. Content validity led to the elimination of 5 items. The final instrument, the Chart of Nursing Assessment in Stroke (STROKE-CNA), was made of 8 items. Confirmatory factor analysis had a supportive fit (root mean square error of approximation = 0.077, comparative fit index = 0.99), indicating structural validity. Scores of the instrument at admission were significantly lower than at discharge (P < .001, Cohen d = 1.42), indicating longitudinal validity. The changes in STROKE-CNA scores between admission and discharge were positively correlated with the corresponding changes in scores on the Scandinavia Stroke Scale (r = 0.57, P < .001), confirming adequate responsiveness. The STROKE-CNA scores were negatively correlated with age (admission: r = -0.22, P < .001; discharge: r = -0.28, P < .001), indicating convergent validity. Internal consistency was adequate at 0.93, and interrater reliability was optimal, with Cohen kappa ranging between 0.61 and 0.99. CONCLUSIONS: The STROKE-CNA has promising validity and reliability when used for assessing nursing care complexity of patients admitted to stroke units.</p>","PeriodicalId":94240,"journal":{"name":"The Journal of neuroscience nursing : journal of the American Association of Neuroscience Nurses","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143528103","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}

{"title":"Stroke Risk Prediction and Diabetes Management in Multiethnic Rural Communities.","authors":"Sheena Ramazanu, Agani Afaya, Ang Seng Hock Martin, Priya Baby","doi":"10.1097/JNN.0000000000000823","DOIUrl":"https://doi.org/10.1097/JNN.0000000000000823","url":null,"abstract":"","PeriodicalId":94240,"journal":{"name":"The Journal of neuroscience nursing : journal of the American Association of Neuroscience Nurses","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143443056","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}

{"title":"Comparing Tenecteplase and Alteplase for Acute Ischemic Stroke.","authors":"Chen-Chen Tu, Hanqi Kelly Mao, Jennifer L Wessol","doi":"10.1097/JNN.0000000000000821","DOIUrl":"https://doi.org/10.1097/JNN.0000000000000821","url":null,"abstract":"<p><strong>Abstract: </strong>BACKGROUND: Acute ischemic stroke (AIS) is a leading cause of mortality and disability. Patients who receive thrombolytic therapy promptly tend to have better outcomes. Although alteplase (tPA) is the standard Food and Drug Administration-approved thrombolytic for AIS treatment, recent American Heart Association guidelines suggest that tenecteplase (TNK) can be used as an alternative. This project compares the cost-effectiveness and clinical outcomes of TNK versus tPA in AIS treatment. Key outcomes include door-to-needle time, length of stay, National Institutes of Health Stroke Scale scores, and the incidence of hemorrhagic conversion events. METHODS: The project involved retrospective analysis through medical chart reviews at a thrombectomy-capable stroke center in a Pacific Northwest community hospital. Data were collected from 175 AIS patients treated with either tPA (82) or TNK (93) between March 2022 and December 2023. Patients eligible for thrombolytic therapy received tPA before March 15, 2023, with TNK used thereafter. Selection criteria adhered to American Heart Association guidelines and clinicians' judgment. RESULTS: Although door-to-needle times were similar (P = .20), excluding outliers revealed a significant difference favoring TNK (P = .04). No significant group differences were observed for demographics, National Institutes of Health Stroke Scale scores, length of stay, or post-intracerebral hemorrhage rates. Tenecteplase use resulted in over $40 000 in medication savings during the project period. CONCLUSION: Tenecteplase offers comparable safety and efficacy to tPA for treating AIS, with the added benefit of cost savings. Although clinical outcomes did not significantly differ between the 2 drugs, TNK's reduced cost and ease of administration make it an attractive option, particularly in resource-limited settings. These results support the current organizational treatment protocol favoring TNK.</p>","PeriodicalId":94240,"journal":{"name":"The Journal of neuroscience nursing : journal of the American Association of Neuroscience Nurses","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143401184","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}

{"title":"Can Multiple Sclerosis-Related Symptoms Determine Sleep Disorders?","authors":"Ayyüce Tuba Koçak, Ayşe Uçar, Selda Arslan, Ali Ulvi Uca","doi":"10.1097/JNN.0000000000000801","DOIUrl":"10.1097/JNN.0000000000000801","url":null,"abstract":"<p><strong>Abstract: </strong>BACKGROUND: Sleep disorders are common and various in persons with multiple sclerosis (PwMS). However, their assessment and management remain in the background compared with motor symptoms. This study was conducted to better understand sleep disorders in PwMS and to analyze sleep problems and their predictive symptoms. METHODS: This cross-sectional design study was conducted with 136 PwMS. Data were collected using a participant identification form, Pittsburgh Sleep Quality Index, Insomnia Severity Index, Epworth Sleepiness Scale, and Stop-Bang Test. In data analysis, 1-way analysis of variance, t test and Pearson correlation, and multiple regression analysis were used. RESULTS: The study found that 51.5% of the participants have poor sleep quality, 36.8% have insomnia, 24.3% have excessive daytime sleepiness, and 19.9% were at risk of obstructive sleep apnea. Symptoms of forgetfulness (β = 0.199), depression (β = 0.223), pain (β = 0.278), and increased urinary frequency at night (β = 0.236) explain approximately 40% of the change in sleep quality score; difficulty swallowing (β = 0.218), depression (β = 0.253), and pain (β = 0.313) symptoms explain 33% of the change in insomnia score; fatigue (β = 0.292) and anxiety (β = 0.409) symptoms explain 32% of the change in sleepiness score. CONCLUSIONS: PwMS start to experience sleep disorders in the early stages of the disease, some characteristics affect sleep disorders, and the symptoms they experience explain sleep disorders at significant rates. Sleep disorders should be evaluated by nurses and interdisciplinary healthcare teams from the early stages of multiple sclerosis with different aspects and to include predictive symptoms in the interventions to be implemented to reduce sleep disorders.</p>","PeriodicalId":94240,"journal":{"name":"The Journal of neuroscience nursing : journal of the American Association of Neuroscience Nurses","volume":" ","pages":"9-14"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142776143","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}

{"title":"Analysis of Factors and Clinical Outcomes of Planned Tracheal Extubation Failure in Neurosurgical Intensive Care Unit Patients.","authors":"Haotian Wu, Jinsong Shen, Yan Xu","doi":"10.1097/JNN.0000000000000796","DOIUrl":"10.1097/JNN.0000000000000796","url":null,"abstract":"<p><strong>Abstract: </strong>BACKGROUND: Planned tracheal extubation failure is a common occurrence among patients in the neurosurgical intensive care unit (NICU) because of the complex nature of neurocritical injuries, and the failure could result in a poor prognosis. METHODS: We observed and recorded the patients with tracheal intubation in the NICU of a hospital in Shanghai from June 2021 to December 2022 and analyzed data from planned tracheal extubation, categorizing patients by success or failure, and compared outcomes between the two groups while investigating contributing factors. RESULTS: A total of 156 patients were included, 133 (85.3%) of whom were successfully extubated and 23 (14.7%) were not. The results of logistic regression analysis demonstrated that the Glasgow Coma Scale score before extubation (OR, 0.643; 95% CI, 0.444-0.931; P = .020) and the frequency of respiratory secretions suctioning before tracheal extubation (OR, 0.098; 95% CI, 0.027-0.354; P < .001) were independent risk factors for extubation failure. We also found that the extubation failure group experienced a significantly longer ICU stay and incurred higher hospitalization costs. CONCLUSIONS: Poor Glasgow Coma Scale scores and a high frequency of respiratory secretions suctioning before tracheal extubation were the main factors contributing to tracheal extubation failure in NICU patients. To avoid tracheal extubation failure and adverse outcomes, these two factors should be carefully assessed before tracheal extubation.</p>","PeriodicalId":94240,"journal":{"name":"The Journal of neuroscience nursing : journal of the American Association of Neuroscience Nurses","volume":" ","pages":"26-30"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142484780","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}

{"title":"Assessing Adherence to Posttraumatic Stress Disorder Screening in Young Stroke Survivors.","authors":"Caitlin Palmisano, Madelyn O'Neal, Mary Ann Bautista, Carol A O'Neil, Suzanna Fitzpatrick","doi":"10.1097/JNN.0000000000000808","DOIUrl":"10.1097/JNN.0000000000000808","url":null,"abstract":"<p><strong>Abstract: </strong>Background: Over 795 000 US people per year experience a stroke, and 10% are younger than 50 years. After a stroke, posttraumatic stress disorder (PTSD) affects 10% to 30% of those patients and may compromise a survivor's secondary prevention compliance. At an inner-city clinic in Maryland where up to 300 young adult stroke survivors are followed, zero patients were screened for PTSD. A quality improvement project was implemented to screen for PTSD in a young adult stroke survivor clinic and to provide them with psychotherapy referrals and follow-up. Methods: Over 15 weeks in the fall of 2023, all patients presenting to the young adult stroke survivor clinic were screened for PTSD using the Posttraumatic Stress Disorder Checklist-5 validated screening tool. Providers and medical staff were all educated on the tool before implementation. Results: During the 15-week implementation period, 72 patients presented to the clinic. Posttraumatic stress disorder screening was completed for 88.9% (64/72). Of those, 32.8% (21/64) completed the Posttraumatic Stress Disorder Checklist-5 via the electronic health record, and 67.2% (43/64) completed it by in-person screening. Of the 64 patients screened, 12 patients screened positive for PTSD (18.8%, 12/64). Among those screening positive, 75% (9/12) were given a referral for psychotherapy. Conclusions: Literature reports that PTSD compromises stroke survivors' ability to optimize their health after a stroke. Screening identifies those experiencing symptoms of PTSD, providing an opportunity for referral and treatment. Results show that routine care of young stroke survivors can effectively include screening for PTSD.</p>","PeriodicalId":94240,"journal":{"name":"The Journal of neuroscience nursing : journal of the American Association of Neuroscience Nurses","volume":" ","pages":"31-36"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142741738","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}

{"title":"A Comprehensive Unit-Based Safety Program to Enhance the Safe Management of Children in an Epilepsy Monitoring Unit.","authors":"Haiqin Wang, Hui Gan, Qin Zhou, Li Dai","doi":"10.1097/JNN.0000000000000806","DOIUrl":"10.1097/JNN.0000000000000806","url":null,"abstract":"<p><strong>Abstract: </strong>BACKGROUND: The epilepsy monitoring unit (EMU) is an independent unit for video electroencephalogram monitoring of epilepsy patients, with the aim of capturing typical seizure events. Because of the uncontrolled seizure frequency, there may be safety risks for patients, such as falling, trauma, aspiration, status epilepticus, and sudden unexpected death in epilepsy. This study aims to evaluate the application effect of comprehensive safety projects on safety management in a pediatric EMU. METHODS: From June 2022 to May 2024, a preevaluation and postevaluation study was conducted at the EMU of a tertiary grade A children's specialized hospital in China. The intervention group carried out a unit-based comprehensive safety project, including nurse safety culture training, establishing a normalized mechanism for safety improvement, and developing evidence-based safety prevention strategies. RESULTS: The response time of paroxysmal events in the intervention group was shorter than that in the control group ( P < .05). The scores of implementation of safety precautions and emergency measures in the intervention group were higher than those in the control group ( P < .05). The nursing-related complications in the intervention group were lower than those in the control group ( P < .05). CONCLUSION: The comprehensive unit-based safety project management mode can effectively improve the quality of EMU nursing care for children and reduce nursing-related complications.</p>","PeriodicalId":94240,"journal":{"name":"The Journal of neuroscience nursing : journal of the American Association of Neuroscience Nurses","volume":" ","pages":"51-55"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142840703","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}

{"title":"Development and Evaluation of a Care Needs Scale for Parents of Children With Tourette Syndrome.","authors":"Yu-Jing Zhang, Mei-Yin Lee, Huei-Shyong Wang, Yue-Cune Chang","doi":"10.1097/JNN.0000000000000804","DOIUrl":"10.1097/JNN.0000000000000804","url":null,"abstract":"<p><strong>Abstract: </strong>BACKGROUND: Tourette syndrome (TS) is a chronic neurodevelopmental disorder that begins in school-age children. Although TS is not life-threatening, the tics and comorbidities can impact a child's physical and mental health, as well as interpersonal interactions. Understanding the care needs of parents of children with TS is essential for providing healthcare services that effectively support these children. The aim of the study was to develop and evaluate the psychometric properties of the care needs scale for parents of children with TS (CNS-PCTS) in Taiwan. METHODS: This study used a methodological design. The scale was developed by preliminarily identifying relevant items and dimensions through a systematic review of the literature. A pilot test with 30 participants and exploratory factor analysis (EFA) confirmed the subscales and items pertaining to the care needs of the parents. Data analysis included content validity, item analysis, internal consistency, test-retest reliability, and EFA. The Chinese version of the Pittsburgh Sleep Quality Index was adopted to assess the discriminant validity of the CNS-PCTS. RESULTS: Two hundred fifty-six parents of children with TS completed the scale. The scale-level content validity index was 0.92. The EFA revealed that the CNS-PCTS consisted of 13 items, with the factor loadings ranging from 0.656 to 0.83, and covered 3 factors: getting information about TS, assisting children in social engagement, and obtaining parenting support. The discriminant validity showed a positive correlation between the Chinese version of the Pittsburgh Sleep Quality Index and the CNS-PCTS. Cronbach's α coefficients of the subscales ranged from 0.89 to 0.94, and the intraclass correlation coefficient was 0.94. CONCLUSION: The CNS-PCTS demonstrated satisfactory psychometric properties. It helps health professionals understand parents' care needs and assess the effectiveness of interventions. Confirmatory factor analysis can be performed in future studies to provide more rigorous validity.</p>","PeriodicalId":94240,"journal":{"name":"The Journal of neuroscience nursing : journal of the American Association of Neuroscience Nurses","volume":" ","pages":"15-20"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142607875","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}