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

{"title":"Relationship Between Sleep Quality and Constipation Severity in Patients With Parkinson Disease: A Cross-sectional Study.","authors":"Tomoko Doi, Ikumi Honda, Maki Nakajima, Miharu Tamaoki, Masaaki Hirayama","doi":"10.1097/JNN.0000000000000733","DOIUrl":"10.1097/JNN.0000000000000733","url":null,"abstract":"<p><strong>Abstract: </strong>BACKGROUND: Constipation in patients with Parkinson disease (PD) adversely affects motor symptoms, making defecation management critical. Sleep disturbance is another common complaint in patients with PD (PWP). Associations between sleep disturbances and constipation have been reported in recent studies on PD. If improving sleep quality is useful for managing constipation in PWP, it might serve as a new method of constipation management that is less physically and mentally distressing than laxatives. This study aimed to examine the relationship between sleep quality and constipation severity in PWP. METHODS: We administered a questionnaire on sleep and constipation to 1048 PWP. Constipation severity was assessed using Constipation Assessment Scale Japanese version 2 (CAS). General sleep quality was estimated using the Japanese versions of the Pittsburgh Sleep Quality Index (PSQI) and Athens Insomnia Scale. Sleep quality due to PD-specific nighttime problems was estimated using the Parkinson's Disease Sleep Scale-2 Japanese version (PDSS-2). We conducted a multiple regression analysis using the forced entry method to identify the variables that influenced CAS. RESULTS: We analyzed 350 PWP. Overall, 94.9% of PWP had constipation symptoms. The percentages of PWP with poor sleep were as follows: PSQI, 74.7%; Athens Insomnia Scale, 69.8%; and PDSS-2, 73.8%. Furthermore, 17.6% of the patients with constipation and 35.3% with sleep problems did not consult a healthcare provider. Multivariate analysis revealed that CAS was significantly associated only with PDSS-2 (standardized partial regression coefficient, 0.217; 95% confidence interval, 0.030-0.111). CONCLUSION: Poor sleep quality, related to PD-specific nighttime problems, was found be associated with worsening constipation severity. Nursing activities that help PWP with PD-specific nighttime problems have a more comfortable night's sleep would be key to alleviating constipation severity.</p>","PeriodicalId":94240,"journal":{"name":"The Journal of neuroscience nursing : journal of the American Association of Neuroscience Nurses","volume":"55 6","pages":"211-216"},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71490815","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":"Implementation of an Interprofessional Mobility Program in a Neurosurgical Intensive Care Unit.","authors":"","doi":"10.1097/JNN.0000000000000738","DOIUrl":"10.1097/JNN.0000000000000738","url":null,"abstract":"","PeriodicalId":94240,"journal":{"name":"The Journal of neuroscience nursing : journal of the American Association of Neuroscience Nurses","volume":"55 6","pages":"E6"},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71490812","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":"Predictors of Healthcare Utilization in Family Caregivers of Persons With a Primary Malignant Brain Tumor.","authors":"Isabella Goldberg, Paula Sherwood, Susan M Sereika, Heidi S Donovan, Jason Weimer, Jan Drappatz, Florien Boele, Xiaojun Shi, Ashlee Loughan","doi":"10.1097/JNN.0000000000000732","DOIUrl":"10.1097/JNN.0000000000000732","url":null,"abstract":"<p><strong>Abstract: </strong>BACKGROUND: Negative physical health results from the emotional stress of providing care to a family member with a primary malignant brain tumor; however, the downstream effects on caregivers' healthcare utilization (HCU) are unknown. This analysis examined associations between caregivers' emotional health and markers of HCU during the 6 months after patients' diagnoses. METHODS: Caregivers' self-report HCU data from a longitudinal study with 116 neuro-oncology caregivers were analyzed. Healthcare utilization was operationalized as number of prescription medications, reporting visits to primary care providers (PCPs), nature of PCP visit, number of comorbid conditions, and change in comorbid conditions. Potential predictors were caregivers' depressive symptoms (Center for Epidemiologic Studies-Depression Scale), hours providing care per day, mastery (Pearlin and Schooler), and burden (Caregiver Reaction Assessment). Logistic mixed effects modeling were used. RESULTS : Caregivers with higher levels of depressive symptoms ( P < .01), anxiety ( P = .02), burden related to schedule ( P = .02), and abandonment ( P < .01) were more likely to report worsening comorbid conditions. Those with higher mastery ( P = .02) were less likely to report worsening comorbid conditions. Caregivers who had a PCP visit and reported higher burden related to feelings of self-esteem ( P = .03) were more likely to report an illness-related visit. CONCLUSION : Findings suggest a relationship between neuro-oncology caregivers' emotional health and their HCU. Data highlight the importance of caregivers' PCPs identifying caregivers at risk for deteriorating health and increased HCU and intervene to ensure caregivers' self-care.</p>","PeriodicalId":94240,"journal":{"name":"The Journal of neuroscience nursing : journal of the American Association of Neuroscience Nurses","volume":" ","pages":"222-227"},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10754244/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41109777","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Length of Stay Does Not Predict Change in Epilepsy Monitoring Unit Comfort Questionnaire Scores.","authors":"Jacqueline Solis, Jade Marshall, Emerson Nairon, Sonia Joseph, Maxine Adegbola, DaiWai M Olson","doi":"10.1097/JNN.0000000000000727","DOIUrl":"10.1097/JNN.0000000000000727","url":null,"abstract":"<p><strong>Abstract: </strong>BACKGROUND: The epilepsy monitoring unit (EMU) is a clinical setting designed to help diagnose and analyze the nature behind a patient's seizures in a hospitalized unit. Patients admitted to an EMU may experience sleep deprivation, withdrawal of antiepileptic medications, and the use of a continuous electroencephalogram. The purpose of this study was to explore change in patient comfort during an EMU admission. METHODS: The Epilepsy Monitoring Unit Comfort Questionnaire (EMUCQ) was used to evaluate the initial stress level of EMU patients on their date of admission versus their fourth day on the unit. RESULTS: The average EMUCQ score from the admission date was 196.6 (26.28), whereas the mean EMUCQ score on the fourth day was 197.8 (24.79). The P value of .802 and t value of 0.25 indicated that the scores were not statistically significantly different. CONCLUSION: Although some scores indicated there was a large change between baseline and follow-up, these scores could not be readily attributed to the patient's length of stay in the unit. Future studies should examine the role of specific variables hypothesized to impact comfort in the EMU.</p>","PeriodicalId":94240,"journal":{"name":"The Journal of neuroscience nursing : journal of the American Association of Neuroscience Nurses","volume":"55 6","pages":"217-221"},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71490814","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":"In Research, Failure Is Not an Option-It Is an Expectation.","authors":"DaiWai M Olson","doi":"10.1097/JNN.0000000000000734","DOIUrl":"10.1097/JNN.0000000000000734","url":null,"abstract":"","PeriodicalId":94240,"journal":{"name":"The Journal of neuroscience nursing : journal of the American Association of Neuroscience Nurses","volume":"55 6","pages":"187"},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71490813","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":"Use of Stroke Alert Sticker in the Field Decreases Time to Acute Interventions for Ischemic Stroke Patients.","authors":"Nicolle W Davis, Meghan Bailey, Jeannette M Hester, Gabriel Bonnell, Anna Khanna, Christina Wilson, Jason Jones, Michael Cowart, Amita Singh","doi":"10.1097/JNN.0000000000000728","DOIUrl":"10.1097/JNN.0000000000000728","url":null,"abstract":"<p><strong>Abstract: </strong>BACKGROUND: Stroke is a medical emergency requiring timely intervention to optimize patient outcomes. The only treatments currently Food and Drug Administration approved for acute stroke are intravenous (IV) thrombolytics, which require obtaining specific medical history to be administered safely. This medical history may be overlooked in the prehospital setting or lost during patient handoff between emergency medical services (EMS) personnel and hospital staff, delaying treatment. We evaluated whether utilization of a \"stroke alert sticker\" by EMS to capture key information in the field would decrease door-to-needle (DTN) time. METHODS: Bright-orange \"stroke alert stickers\" were disseminated to our local EMS agency to be placed on all suspected stroke patients in the field prompting documentation of key elements needed for timely treatment decisions. The \"stroke alert sticker\" included time last known well, contact information, presenting symptoms, and relevant medications. We evaluated the impact of the \"stroke alert sticker\" on acute stroke metrics, including DTN time. RESULTS: The project included 220 consecutive stroke alert patients brought to our comprehensive stroke center by a single EMS agency from May 2021 through February 2022. Twenty-one patients were treated with an IV thrombolytic. Overall \"stroke alert sticker\" use compliance was 40%; for the subgroup of patients who were given an IV thrombolytic, the \"stroke alert sticker\" was used 60% of the time. In patients who received an IV thrombolytic, prehospital EMS notification was 100% with \"stroke alert sticker\" use, compared with 75% without (P = .13). In addition, with \"stroke alert sticker\" utilization, DTN time was reduced by 20 minutes (31 [11] minutes with sticker vs 51 [21] minutes without, P = .04). CONCLUSION: Utilization of the \"stroke alert sticker\" significantly improved DTN times compared with patients without the sticker. This evidence supports continued use of the \"stroke alert sticker\" to improve DTN times and patient outcomes.</p>","PeriodicalId":94240,"journal":{"name":"The Journal of neuroscience nursing : journal of the American Association of Neuroscience Nurses","volume":"55 6","pages":"194-198"},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71490816","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":"Implementation of an Interprofessional Mobility Program in a Neurosurgical Intensive Care Unit.","authors":"Katie Broadway, Cristina M Nuila","doi":"10.1097/JNN.0000000000000729","DOIUrl":"10.1097/JNN.0000000000000729","url":null,"abstract":"<p><strong>Abstract: </strong>BACKGROUND: Emerging research suggests the need for implementation of mobility protocols and consistent evaluation of the impact on patient outcomes. Standardized mobility guidelines may be a solution for promoting nurse-driven mobility efforts and influencing a shift in the culture of mobility among nursing teams. In a 36-bed neurosurgical intensive care unit, 2 key areas of opportunity were identified related to patient mobility: strengthening of frontline nursing engagement in mobility and accuracy of documented early and safe mobilization. METHODS: Using a plan-do-study-act performance improvement framework, an interprofessional team developed a comprehensive early patient mobility program. Defined criteria and mobility rounds assisted in identifying the patient's functional ability and level of assistance. Nursing staff received education in case study format to enhance understanding and improve practical application of the phases of mobility. Chart reviews served as continuous assessment of documented mobilizations within the appropriate phases of mobility, and surveys evaluated staff perceptions of program success. RESULTS: On a rating scale of 1 to 5, clinicians reported a rating of 4.32 in overall observation that patients are safely mobilized earlier and more frequently and 4.48 on overall improvement in the neurosurgical intensive care unit culture of mobility. CONCLUSION: An interprofessional mobility program focusing on safe and early mobilization may improve overall culture, confidence, and empowerment of the frontline clinicians.</p>","PeriodicalId":94240,"journal":{"name":"The Journal of neuroscience nursing : journal of the American Association of Neuroscience Nurses","volume":" ","pages":"205-210"},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41144704","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 Retrospective Analysis of Ischemic Stroke Patients Supports That Very Early Mobilization Within 24 Hours After Intravenous Alteplase Is Safe and Possibly Beneficial.","authors":"Lisa Yanase, Diane Clark, Elizabeth Baraban, Tamela Stuchiner","doi":"10.1097/JNN.0000000000000731","DOIUrl":"10.1097/JNN.0000000000000731","url":null,"abstract":"<p><strong>Abstract: </strong>BACKGROUND: Stroke care guidelines recommend early mobilization of acute ischemic stroke patients, but there are sparse data regarding early mobilization of stroke patients receiving thrombolytic therapy. We developed the Providence Early Mobility for Stroke (PEMS) protocol to mobilize patients to their highest individual tolerance within 24 hours of stroke admission in 2010, and it has been in continuous use at our primary and comprehensive stroke centers for over a decade. In this study, we evaluated the PEMS protocol in all patients treated with intravenous alteplase without endovascular treatment. METHODS : This retrospective study includes 318 acute ischemic stroke patients treated with alteplase who were admitted to 2 urban stroke centers between January 2013 and December of 2017 and were mobilized with the PEMS protocol within 24 hours of receiving alteplase. Safety of PEMS was assessed by change in National Institutes of Health Stroke Scale at 24 hours by time first mobilized. Using multivariate and logistic regression models, we analyzed time first mobilized and 90-day modified Rankin scale (mRS). RESULTS : Median time first mobilized was 9 hours from administration of alteplase. For every hour delay in mobilization, the odds of being slightly or moderately disabled (mRS, 2-3) at 90 days increased by 7% (adjusted odds ratio, 1.07; P = .004), and the odds of being severely disabled or dead (mRS, 4-6) at 90 days increased by 7% (adjusted odds ratio, 1.07; P = .02). In addition, for every hour delay in mobilization, 24-hour National Institutes of Health Stroke Scale increased by 1.8%. DISCUSSION: Our results support that the PEMS protocol is safe, and possibly beneficial, for acute ischemic stroke patients treated with intravenous alteplase. Our protocol differs from other very early mobility protocols because it does not prescribe a \"dose\" of activity. Instead, each patient was mobilized to his/her individual highest degree as soon as it was safe to do so.</p>","PeriodicalId":94240,"journal":{"name":"The Journal of neuroscience nursing : journal of the American Association of Neuroscience Nurses","volume":" ","pages":"188-193"},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41184695","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":"Reflections on Patient Care Technicians Obtaining Pupillometer Readings in a Neuroscience Intensive Care Unit.","authors":"Donald Stout,&nbsp;James Dullaway,&nbsp;Hannah McMahan,&nbsp;Blake A Daniel,&nbsp;DaiWai M Olson","doi":"10.1097/JNN.0000000000000676","DOIUrl":"https://doi.org/10.1097/JNN.0000000000000676","url":null,"abstract":"R ELEC IO N T he ability to trend physiologic measures is one of many ways that nurses contribute to successful patient outcomes. For patients with acquired brain injury, even subtle changes in patient conditions may herald significant neurological decline. As such, neuroscience nurses spend a large portion of their time inmonitoring and assessing patients for subtle changes. Quantitative pupillometry (QP) is relatively new to many neurological and neurosurgical care units. The adoption of QP in our neuroscience intensive care unit (NSICU) is enhanced by partnering with our patient care technician (PCT) team to obtain QP readings. This reflections article describes our experiences in promoting the PCT role to obtain QP readings.","PeriodicalId":94240,"journal":{"name":"The Journal of neuroscience nursing : journal of the American Association of Neuroscience Nurses","volume":" ","pages":"245-246"},"PeriodicalIF":2.3,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40338350","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":"Low-to-Moderate Risk Transient Ischemic Attack Patients can be Safely Discharged from the Emergency Department to a Nurse Practitioner-Led Clinic.","authors":"","doi":"10.1097/JNN.0000000000000683","DOIUrl":"https://doi.org/10.1097/JNN.0000000000000683","url":null,"abstract":"","PeriodicalId":94240,"journal":{"name":"The Journal of neuroscience nursing : journal of the American Association of Neuroscience Nurses","volume":" ","pages":"E6"},"PeriodicalIF":2.3,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40452261","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}