Heart disease: from living to living well

Aysha Mendes, Editor, British Journal of Cardiac Nursing, aysha.freelance@gmail.com, discusses support for patients living with heart disease.

Equipment needs for premature babies in special care or intensive care

Neonates who require additional care, be it in a special care baby unit, neonatal intensive care unit or just on the labour ward, may need specific equipment to allow the team to care for them accurately and safely. This article outlines some of the specific types of equipment which may be needed.

Sleep disturbances in Parkinson's disease are associated with central parkinsonian pain

Introduction

Sleep disturbances and pain are common non-motor symptoms in Parkinson’s disease (PD). This study aimed to explore the association between these two symptoms in a cohort of patients with PD.

Materials and methods

The Parkinson’s Disease Sleep Scale (PDSS-2) was used to identify sleep disturbances in a series of 229 PD patients. The identification and characterization of pain was performed by a semi-structured interview and by the application of the Ford classification and the Brief Pain Inventory (BPI). The Unified Parkinson’s Disease Rating Scale-III, Hoehn & Yahr (H&Y), and Schwab and England Independence Scale were used to assess motor symptoms and functional independence in off and on conditions. The Hospital Anxiety and Depression Scale (HADS) and SF-36 were applied to screen for anxiety and depression and to evaluate the quality of life. Non-parametric tests were used for group comparisons and logistic regressions were applied to explore predictors of sleep disturbances.

Results

Seventy-five (33%) patients had clinically relevant sleep disturbances (PDSS-2≥18) and 162 patients (71%) reported pain. Of those with pain, 38 (24%) had central parkinsonian pain. PD patients with sleep disturbances experienced more pain and had more severe motor symptoms, lower functional independence, more anxiety and depression symptoms, and worst quality of life. Among patients with pain, central parkinsonian pain was the subtype of pain with the highest odds of sleep disturbances, even when taking into account motor symptoms (H&Y off), motor fluctuations, intensity of pain (BPI), and symptoms of anxiety and depression (HADS).

Conclusions

The association between pain and sleep disturbances in PD appears to be dependent on subtype of pain. The close relationship between central parkinsonian pain and sleep disturbances in PD raises the possibility of common pathophysiological mechanisms. A better understanding of the relationship between sleep disturbances and central parkinsonian pain may contribute to the development of new care strategies in PD patients.

Heart failure: support at the end of life

Aysha Mendes, Editor, British Journal of Cardiac Nursing, begins a series on cardiology with a look at attitudes to and guidelines on providing end-of-life care for people with heart failure.

Alternatives to (antipsychotic) medication in people with dementia

Aysha Mendes, Freelance Journalist, specialising in healthcare, psychology and nursing, looks at ways of caring for people with dementia without the use of antipsychotic drugs.

Avoiding hospital readmission of a person with dementia

People with dementia can be confused or distressed by hospital admission, which can then impact on their physical health. Aysha Mendes considers ways to reduce distress and enhance wellbeing.

When a person with dementia is leaving hospital

People with dementia can find change particularly difficult. Aysha Mendes looks at how to minimise distress experienced by these patients when they leave the ward to return home or move to a new care setting.

Collaborating with the carers of dementia patients in the acute setting

Aysha Mendes, Freelance Journalist, specialising in health, psychology and nursing, discusses how nurses can build positive relationships with the carers of people with dementia.