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

{"title":"Associations of Delirium to Posthospital Outcomes After Acute Stroke: A Scoping Review.","authors":"Bethany C Young, Bethany A Rhoten","doi":"10.1097/JNN.0000000000000736","DOIUrl":"10.1097/JNN.0000000000000736","url":null,"abstract":"<p><strong>Abstract: </strong>Background: Delirium is a common and distressing manifestation of acute brain dysfunction that is associated with poor outcomes in various critically ill patient populations. Although patients with acute stroke experience delirium, understanding of delirium in this population is limited. The purpose of this scoping review is to describe existing evidence about delirium and associations with posthospital outcomes after acute stroke. Methods: Arksey and O'Malley's 5-stage framework was used to perform a scoping review. PubMed, CINAHL, and EMBASE electronic databases were searched. Outcome domains of interest included mortality, cognitive function, physical function, mental health, and quality of life. Full-text, peer-reviewed articles with adult stroke sample populations (acute ischemic stroke, intracerebral hemorrhage, subarachnoid hemorrhage) were included. Results: Nineteen articles, involving 5611 unique patients, were included. Most sample populations included patients with either acute ischemic stroke or intracerebral hemorrhage. Heterogeneous research aims, methods, and outcome measures limit the ability to compare specific findings across studies. However, included studies suggest higher mortality at 12 months, worse cognition, and greater functional impairment in patients who have experienced acute stroke and delirium. Limited information regarding associations of delirium with posthospital mental health outcomes and quality of life precluded the ability to analyze these relationships and warrants further investigation. Conclusion: This review suggests concerning findings about associations of delirium to posthospital outcomes after acute stroke. Better characterization of delirium after acute stroke and analysis of its impact on long-term outcomes are needed.</p>","PeriodicalId":94240,"journal":{"name":"The Journal of neuroscience nursing : journal of the American Association of Neuroscience Nurses","volume":" ","pages":"12-19"},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41184696","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":"Letter to the Editor: Elusive Evidence.","authors":"Maureen Lall, Norma McNair, Elizabeth Kozub, Cathy Cartwright, Wendy R Trueblood Miller, Beth Hundt","doi":"10.1097/JNN.0000000000000740","DOIUrl":"10.1097/JNN.0000000000000740","url":null,"abstract":"","PeriodicalId":94240,"journal":{"name":"The Journal of neuroscience nursing : journal of the American Association of Neuroscience Nurses","volume":" ","pages":"2-3"},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139050033","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":"Predictive Factors of Apathy in Stroke Survivors During the Recovery Period.","authors":"Pao-Chen Wang, Hsiang-Chu Pai","doi":"10.1097/JNN.0000000000000737","DOIUrl":"10.1097/JNN.0000000000000737","url":null,"abstract":"<p><strong>Abstract: </strong>BACKGROUND: Apathy may be an important predictor of depression and significantly negatively affect the quality of life and functional recovery of stroke survivors. However, the evidence reflects the inconsistent findings of studies on the impact of individual-related variables on apathy in patients with stroke. OBJECTIVES: This study examines the relationships among stroke survivors' individual characteristics, background variables, disease-related variables, and apathy; furthermore, we identify predictors of apathy. METHODS: In this cross-sectional correlational study, the participants were recruited from a medical university hospital. Three measurement tools were used: individual and background variables, the modified Rankin Scale, and the Apathy Evaluation Scale. Hierarchical multiple regression analysis was used to identify the predictors of apathy. RESULTS: Participants included 100 stroke survivors with a mean age of 59.9 (12.1) years. The prevalence of apathy among stroke survivors was 27%. Stroke survivors' economic sources (β = 0.430, P = .001), perceived family support (β = -0.163, P = .048), and modified Rankin Scale (β = 0.283, P = .001) accounted for 43.7% of the variance in survivor apathy. CONCLUSION: The results of this study clarified which individual characteristics, background variables, and disease-related variables are key predictors of apathy in patients with stroke.</p>","PeriodicalId":94240,"journal":{"name":"The Journal of neuroscience nursing : journal of the American Association of Neuroscience Nurses","volume":" ","pages":"25-30"},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138178387","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":"Restraints in Neurosurgery Departments: An Underrated Risk, a Perfect Storm.","authors":"Deborah Maselli","doi":"10.1097/JNN.0000000000000735","DOIUrl":"10.1097/JNN.0000000000000735","url":null,"abstract":"","PeriodicalId":94240,"journal":{"name":"The Journal of neuroscience nursing : journal of the American Association of Neuroscience Nurses","volume":" ","pages":"4-5"},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41184697","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":"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,&nbsp;Diane Clark,&nbsp;Elizabeth Baraban,&nbsp;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":"Implementation of an Interprofessional Mobility Program in a Neurosurgical Intensive Care Unit.","authors":"Katie Broadway,&nbsp;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 Scoping Review of the Incidence, Predictors, and Outcomes of Delirium Among Critically Ill Stroke Patients.","authors":"","doi":"10.1097/JNN.0000000000000655","DOIUrl":"https://doi.org/10.1097/JNN.0000000000000655","url":null,"abstract":"","PeriodicalId":94240,"journal":{"name":"The Journal of neuroscience nursing : journal of the American Association of Neuroscience Nurses","volume":"82 1","pages":"E3"},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77072116","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 Person-Centered Approach to Understanding Stroke Survivor and Family Caregiver Emotional Health.","authors":"","doi":"10.1097/JNN.0000000000000644","DOIUrl":"https://doi.org/10.1097/JNN.0000000000000644","url":null,"abstract":"","PeriodicalId":94240,"journal":{"name":"The Journal of neuroscience nursing : journal of the American Association of Neuroscience Nurses","volume":"11 1","pages":"E2"},"PeriodicalIF":0.0,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80633539","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":"What can I do?","authors":"C. Stewart‐Amidei","doi":"10.1017/9781108900997.013","DOIUrl":"https://doi.org/10.1017/9781108900997.013","url":null,"abstract":"Often the people we work among see themselves as poor. We have the privilege of letting them know that they are not poor in God’s eyes but are valued and valuable. This is a transformation that can inspire communities to make positive changes for themselves. Changes that can also mobilise communities for mission, as they recognise the gifts and abilities that God has given them to share his good news with their neighbours.","PeriodicalId":94240,"journal":{"name":"The Journal of neuroscience nursing : journal of the American Association of Neuroscience Nurses","volume":"42 1","pages":"3"},"PeriodicalIF":0.0,"publicationDate":"2021-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75513527","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}