Improving the quality of life for multiple sclerosis patients using the nurse-based home visiting model

Effectiveness of Standardized Nursing Terminologies for Nursing Practice and Healthcare Outcomes: A Systematic Review

PURPOSE

This review evaluates the effectiveness of using standardized terminologies in nursing.

METHODS

A systematic literature review was performed via PubMed, Web of Science, CINAHL, and OVID databases for articles published between January 1973 and September 2020. The Effective Public Health Practice Project's Quality Assessment Tool for Quantitative Studies was used to assess the quality of all included studies.

RESULTS

Fourteen studies were selected for data extraction and analysis, which included a total of 24,243 patients and 99 nurses. Of the studies that met the inclusion criteria, the quality of five were of high quality, one was of moderate quality, and eight was of weak quality. All articles were summarized according to two themes: the identification of common outcomes or interventions, and the validation or evaluation of the effectiveness of standard nursing terminology sets.

CONCLUSION

Standardized terminologies in nursing help nurses to implement care plans according to nursing procedures, supervise changes in patients' sensitive indicators, improve patients' health outcomes, and contribute to evidence-based nursing practices and global data resource sharing.

IMPLICATIONS FOR NURSING PRACTICE

Standardized nursing terminologies have positive effects on clinical practice, are essential for enriching nurses' knowledge, and alter nurses' attitudes regarding education and guidance, which promotes the clinical application of these terminologies.

Healthcare resource utilization and costs for multiple sclerosis management in the Campania region of Italy: Comparison between centre-based and local service healthcare delivery

Background

Multiple sclerosis (MS) requires multidisciplinary management. We evaluated differences in healthcare resource utilization and costs between Federico II and Vanvitelli MS Centres of Naples (Italy), representative of centralised (i.e., MS Care Unit) and local service-based models of multidisciplinary care, respectively.

Methods

We included MS patients continuously seen at the same local healthcare services and MS Centre (Federico II = 187; Vanvitelli = 90) from 2015 to 2017. Healthcare resources for MS treatment and management were collected and costs were calculated. Adherence was estimated as the rate of medication possession ratio (MPR) during 3-years of follow-up. Mixed-effect linear regression models were used to estimate differences in all outcomes between Federico II and Vanvitelli.

Results

Patients at Federico II had more consultations within the MS centre (p<0.001), blood tests (p<0.001), and psychological/cognitive evaluations (p = 0.040). Patients at Vanvitelli had more consultations at local services (p<0.001). Adherence was not-significantly lower at Vanvitelli (p = 0.060), compared with Federico II. Costs for MS treatment and management were 10.6% lower at Vanvitelli (12417.08±8448.32EUR) (95%CI = -19.0/-2.7%;p = 0.007), compared with Federico II (15318.57±10919.59EUR).

Discussion

Healthcare services were more complete (and expensive) at the Federico II centralised MS Care Unit, compared with the Vanvitelli local service-based organizational model. Future research should evaluate whether better integration between MS Centres and local services can lead to improved MS management and lower costs.

e-Health and multiple sclerosis: An update

e-Health (or digital healthcare) is becoming increasingly relevant in multiple sclerosis (MS) clinical management. We aim to review and discuss current status and future perspective of e-health in people with multiple sclerosis (pwMS). The first part of this review describes how information on MS can be conveyed through the Web and digital media. The second part illustrates recent advances in digital technology that can improve clinical management and in motor and cognitive rehabilitation of pwMS. Finally, this review advocates future development of the "digital case manager" as a new figure to coordinate clinical management and care of pwMS. The digital revolution is changing the medical approach to MS in terms of information conveying and sharing, rehabilitation, and healthcare management.

Depression and perceived social support among Saudi patients with multiple sclerosis

PURPOSE

To examine the association between depression level and perceived social support among patients with multiple sclerosis (MS) in Saudi Arabia.

DESIGN AND METHODS

A cross-sectional, descriptive, correlational design was used with 140 patients. A self-reporting questionnaires were used.

FINDINGS

The age range of the participants was 18-59 years (mean 34.3 years, SD 7.69). The mean score for reported depression was 27.5 which is considered as moderate level of depression. The mean score of the Multidimensional Scale of Perceived Social Support (MSPSS) was 45.3 (SD = 16.2). Patients with MS who received higher level of social support exhibits lower level of depression.

PRACTICE IMPLICATIONS

Aside from addressing physiological needs, healthcare providers must ensure that patients with MS receive positive social support to decrease level of depression.

Validity and Reliability of the Turkish Version of the Monitoring My Multiple Sclerosis Scale

INTRODUCTION

This research was conducted to adapt the Monitoring My Multiple Sclerosis (MMMS) scale, which is a scale used for self-evaluation by multiple sclerosis (MS) patients of their own health and quality of life, to Turkish and to determine the psychometric properties of the scale.

METHODS

The methodological research was conducted in the outpatient MS clinic of a university hospital between January and September 2013. The sample in this study consisted of 140 patients aged above 18 who had a diagnosis of definite MS. Patients who experienced attacks in the previous month or had any serious medical problems other than MS were not included in the group. The linguistic validity of MMMS was tested by a backward-forward translation method and an expert panel. Reliability analysis was performed using test-retest correlations, item-total correlations, and internal consistency analysis. Confirmatory factor analysis and concurrent validity were used to determine the construct validity. The Multiple Sclerosis Quality of Life-54 instrument was used to determine concurrent validity and the Expanded Disability Status Scale, Hospital Anxiety and Depression Scale, and Mini Mental State Examination were used for further determination of the construct validity.

RESULTS

We determined that the scale consisted of four factors with loadings ranging from 0.49 to 0.79. The correlation coefficients of the scale were determined to be between 0.47 and 0.76 for item-total score and between 0.60 and 0.81 for items and subscale scores. Cronbach's alpha coefficient was determined to be 0.94 for the entire scale and between 0.64 and 0.89 for the subscales. Test-retest correlations were significant. Correlations between MMMS and other scales were also found to be significant.

CONCLUSION

The Turkish MMMS provides adequate validity and reliability for assessing the impact of MS on quality of life and health status in patients.

Measuring carer burden in informal carers of patients with long-term conditions

INTRODUCTION

The aim of this literature review is to identify the most common tools used to measure burden in carers of people with Parkinson's disease (PD), heart failure (HF), multiple sclerosis (MS) and chronic obstructive pulmonary disease (COPD).

METHOD

Databases such as Medline, PsycINFO, CINAHL and Academic Search Complete were searched. Studies in which carer burden was measured were included.

RESULTS

Zarit Burden Inventory and Caregiver Reaction Assessment were most commonly used to measure carer burden, regardless of the chronic condition. A wide range of other instruments were also used.

CONCLUSIONS

Even though a range of tools are available, further improvements are necessary in order to enable healthcare professionals to identify carers experiencing high burden.

Impact of nursing diagnoses on patient and organisational outcomes: a systematic literature review

AIMS AND OBJECTIVES

To investigate the impact of nursing diagnoses on patient and organisational outcomes in any field of health care where nurses are involved.

BACKGROUND

In healthcare systems, descriptions of patient complexity and outcomes and payment criteria are primarily based on medical diagnoses and procedures. Other aspects of patient care are rarely considered. Nursing diagnoses are believed to be related to healthcare outcomes, but comprehensive evidence for this association is missing.

DESIGN

Systematic literature review.

METHODS

The search was conducted in PubMed, CINAHL and Scopus databases without year or language limitations. The studies were categorised according to their methodological quality (low, good or high) and classified based on their levels of evidence on a scale of 1 (strongest evidence) to 5 (weakest evidence).

RESULTS

Seventeen of 3426 potentially relevant studies met the eligibility criteria. Eleven studies were classified as low, five as good and one as high quality. The levels of evidence were rated as 2 for one study, three for two studies, four for nine studies and five for five studies. Nursing diagnoses were found to predict patient (quality of life, mortality) and organisational (length of hospital stay, hospital charges, amount of nursing care, discharge dispositions) outcomes. Patient care plans based on nursing diagnoses improved sleep quality, quality of life and glycaemic control. When added to information from disease-based classification systems (e.g. diagnosis-related groups), nursing diagnoses improved the predictions of the above outcomes.

CONCLUSIONS

Nursing diagnoses have a great potential to predict patient and organisational outcomes. High-quality research is required to better investigate the existence and strength of these relationships.

RELEVANCE TO CLINICAL PRACTICE

The systematic use of nursing diagnoses in clinical practice, as well as the sharing of high-quality nursing data in large databases, may provide a considerable boost to the contribution of nursing to healthcare outcomes.