Neurology Ward Research Articles

Perceived Social Isolation Among Patients With Multiple Sclerosis Suffering From Disease-Induced Pain and Disability.

Patients with multiple sclerosis (MS) face a wide range of symptoms, including physical disability, imbalance, motor disorders, and acute and chronic pain. The psychosocial consequences of these symptoms may limit social well-being and quality of life in these patients. The aim of the study was to assess self-perceived social isolation among patients with MS and its relationship with pain intensity and disability status. This cross-sectional study was conducted on 200 patients with MS referred to neurology wards and clinics, the MS Association, and rehabilitation centers. Data collection tools used included a demographic information form, Numeric Pain Rating Scale, Expanded Disability Status Scale, and Social Isolation Questionnaire. The mean scores of 4.66 ( SD = 1.15) for disability and 4.18 ( SD = 2.22) for pain intensity both indicated moderate levels of both. Of the sample, 21.5% (43 patients) reported no pain, 22.5% ( n = 45) reported mild pain, 35% ( n = 70) reported moderate pain, and 21% ( n = 42) reported intense pain. The average social isolation score was 63.52 ( SD = 3.32), which is higher than the theoretical average. Of the sample, 44.5% reported low social isolation, whereas 55.5% indicated high social isolation. Gender, duration of MS, economic status, disability status, and pain intensity were all found to be significantly associated with social isolation in patients with MS (all p s < .05). Based on the findings, comprehensive support plans are necessary to improve psychosocial well-being, social life, and quality of life in patients with MS.

Long-term use of rituximab increases T cell count in MS patients.

Rituximab has been used to treat MS patients in Iceland for over a decade. However, long-term effect of rituximab on leukocyte populations has not yet been elucidated. By retrospective analysis of flow cytometric data from 349 patients visiting the neurological ward at The National University Hospital of Iceland from 2012 to 2023 for rituximab treatment, the long-term effect of rituximab and whether the effect was dose dependent (1000mg vs 500mg) was evaluated. No difference was detected in efficacy of B cell depletion in patients treated with 500mg as an initial dose of rituximab when compared to 1000mg. Long-term use of rituximab led to an increase in T cell count (p=0,0015) in patients receiving 3-8 doses of rituximab (1.5-8 years of treatment). The increase occurred in both CD4+ (p=0,0028) and CD8+ T cells (p=0,0015) and led to a decrease in the CD4/CD8 ratio (p=0,004). The most notable difference lies in reshaping the balance between näive and effector CD8+ T cells. The clinical implications of long-term treatment with rituximab and its effect on the T cell pool needs to be explored further. Since no difference in B cell depletion was detected between the two patient groups, 1000mg as an initial dose might be excessive, suggesting a personalized dosing regimen might have therapeutic and financial advantages.

“Not me!” a qualitative, vignette-based study of nurses’ and physicians’ reactions to spiritual distress on neuro-oncological units

PurposePeople with primary malignant brain tumors experience serious health-related suffering caused by limited prognosis and high symptom burden. Consequently, neuro-oncological healthcare workers can be affected emotionally in a negative way. The aim of this study was to analyze the attitudes and behavior of nurses and physicians when confronted with spiritual distress in these patients.MethodsNeurospirit-DE is a qualitative vignette–based, multicenter, cross-sectional online survey that was conducted in Bavaria, Germany. Reflexive thematic analysis was used for data analysis.ResultsA total of 143 nurses and physicians working in neurological and neurosurgical wards in 46 hospitals participated in the survey. The participants questioned if the ability to provide spiritual care can be learned or is a natural skill. Spiritual care as a responsibility of the whole team was highlighted, and the staff reflected on the appropriate way of involving spiritual care experts. The main limitations to spiritual care were a lack of time and not viewing spiritual engagement as part of the professional role. Some were able to personally benefit from spiritual conversations with patients, but many participants criticized the perceived emotional burden while expressing the imminent need for specific training and team reflection.ConclusionsMost neuro-oncological nurses and physicians perceive spiritual care as part of their duty and know how to alleviate the patient’s spiritual distress. Nonetheless, validation of spiritual assessment tools for neuro-oncology and standardized documentation of patients’ distress, shared interprofessional training, and reflection on the professional and personal challenges faced when confronted with spiritual care in neuro-oncology require further improvement and training.

Evaluation of Sleep EEG Changes in Paediatric Patients with Language Dysfunction: A Follow Up Study

Abstract Background Several case reports and studies have described an association between sleep epileptiform discharges and language dysfunctions. This has been partly confirmed in studies that have investigated the effect of this epileptiform discharges on neurocognitive function. Objectives To screen for sleep-potentiated epileptiform discharges in children with language dysfunction (language delay or regression) and to evaluate the effect of treatment of these epileptiform discharges on language dysfunction. Methods The study was conducted on 93 children with language delay or language regression. Patients were recruited from the pediatric neurology clinic, pediatric outpatient clinic, phoniatrics outpatient clinic and the inpatient neurology ward at the Ain Shams University Children’s hospital, Cairo, Egypt in the period between February 2020 and November 2021. A 90- minute sleep electroencephalography, intelligence quotient level and language age were done for all patients included in the study. Children who had an active electroencephalography with uncontrolled clinical seizures or persistently epileptogenic activity without clinical seizures received treatment according to type of activity then after 6 months they were subjected to follow up electroencephalographyand assessment of intelligence quotient level and language age. Results The enrolled patients were divided into two groups: Group (1) including 28 (30%) patients with either or both of epileptogenic activity and clinical seizures and group (2) including 65 (70%) patients without either epileptogenic activity or clinicalseizures. We found 24 (85.7 %) children in group 1 had clinical seizures with median age of onset 2.5 years (range from 1-8 years). Further in the first group, 21 (85.7 %) of children showed presence ofepileptogenic activity with 10 (47.6 %) of children showed spike and slow wave, 6 (28.6 %) showed sharp wave, 3 (14.3 %) showed continuous spike and wave during slow wave sleep (CSWS), 2 (9.5 %) children showed sharp and slow wave. In our study, levetiracetam was given as first line treatment in patients with active seizures. An add-on therapy was given in patients who were not controlled on one antiepileptic drug. A follow up 90 minutes sleep electroencephalography was done and showed a highly significant reduction in epileptogenic activity with a p value of &amp;lt; 0.001. A follow up language test and intelligence quotient level score were done and showed a highly significant improvement with p value of (0.001 and 0.009) respectively. Conclusion Epileptiform activities with or without epilepsy in children may alter normal language function. Treatment of these epileptogenic activity affect improvement of this language dysfunction. Trial registration: ClinicalTrials.gov I.D: NCT05487521.

Educational Intervention Effect on Nurses’ Knowledge of Glasgow Coma Scale for Neurological Patient Assessment in Tertiary Hospitals in Edo State, Nigeria

Context: Nigeria reports increasing cases of neurological patients requiring close monitoring using the Glasgow Coma Scale (GCS). Although nurses are key health personnel managing these patients, evidence suggests they lack knowledge of the GCS and neurological assessment. Aim: This study assessed the effect of an educational intervention on nurses' knowledge of GCS for neurological patients’ assessment in selected tertiary hospitals in Edo State, Nigeria. Methods: This is a quasi-experimental, non-equivalent control group, pre-post-test research design. The sample consisted of 98 nurses purposely selected from the neurological wards of the selected hospitals. A researcher-developed self-report questionnaire with a reliability Cronbach's alpha index of 0.832. Data analysis used descriptive and inferential statistics at the 5% significance level. Results: Knowledge of GCS increased from a (0%) pre-test to 29(60.4%) very good knowledge level post-test one and 15(31.3%) post-test two, whereas the control group had 0% throughout the three periods. Significant differences (p 0.000) over the assessment times were found in the intervention group. The post hoc test revealed statistically significant differences between pre-test versus post-test one/and post-test two. A chi-square analysis of association showed no association between socio-demographic characteristics and level of knowledge on GCS among participants pre and post-intervention for both study groups (p&gt;0.05). Conclusion: This study has convincingly demonstrated the effectiveness of the developed educational intervention package in improving nurses' knowledge of the GCS. The self-instructional format offers an appealing approach to promoting self-directed learning among nurses. This approach can empower nurses to confidently assess patients using the GCS, interpret scores accurately, and apply their knowledge in clinical practice.

An Analysis of Drug-Related Problems in the Neurology Ward of a Tertiary Teaching Hospital: A Cross-Sectional Study.

Background and objective Drugs that act on the central nervous system have a high potential to cause drug-related problems (DRPs). A clinical pharmacist aided by collaborative efforts within an interdisciplinary healthcare team can prevent, detect, and resolve DRPs, thereby contributing to the promotion of medication safety and improving the quality of life of individuals under care.This study aimed to assess DRPs identified in the neurology ward of a tertiary hospital from February 2016 to November 2019. Methods This was a descriptive study with a cross-sectional and retrospective design involving secondary data collected from pharmaceutical care (PC) records. Student's t-tests, Pearson correlation coefficients, Poisson models, and logistic regression models were used to analyze the associations between age, number and type of medications, duration of hospitalization, and the occurrence of DRPs. Results A total of 130 patients were included in the study, and a total of 266 DRPs were detected, with 93 patients experiencing more than one DRP and 37 not presenting any DRPs. Necessity-related DRPs were the most prevalent (46.6%) type, followed by safety-related DRPs (28.6%). The prevalence of safety-related DRPs was higher in individuals older than 60 years (p<0.001). Conclusions Of note, 84.6% of the interventions suggested by pharmacists to resolve DRPswere accepted by the healthcare team. The high number of DRPs found underscores the importance of the clinical role of the pharmacist and interprofessional collaboration in the care of neurological patients, especially in the pharmaceutical follow-up of elderly individuals.

A case of neuro-Behcet's disease complicated with intra-cardiac thrombosis

Intra-cardiac thrombus is an unusual and rare complication of Behcet’s (BD) with poor prognosis. A 32-year-old man with a history of mouth and genital ulcers since 12 years ago was admitted to the neurology ward with complaints of headache and fever. Two years ago, the patient suffered from hydrocephalus due to cerebral vein thrombosis and a cerebral shunt was implanted for him. The patient was diagnosed with BD and was treated with glucocorticoids and cytotoxic drugs. During current hospitalization, with the diagnosis of shunt infection, the patient was treated with broad-spectrum antibiotics and the shunt was removed. On the 10th day of hospitalization, he developed cough and palpitation without dyspnea. Echocardiography showed a 2.5 × 4.7 mm mass in the right ventricle, tricuspid regurgitation and pulmonary arterial pressure of 32 mmHg. On computed tomography of the chest, the lung parenchyma was normal, but extension of the thrombus into the main pulmonary artery was reported.

Epidural Blood Patch in Subdural Hematoma Due to Spontaneous Intracranial Hypotention: A Case Report and Literature Review

Spontaneous intracranial hypotension (SIH) is an orthostatic headache syndrome with variable symptoms and complications which is often misdiagnosed at initial manifestations. SIH results from spontaneous CSF leakage leading to brain sag. The typical findings on cranial MR imaging consist of subdural fluid collections, enhancement of the pachymeninges, engorgement of venous structures, pituitary hyperemia, and sagging of the brain. Subdural hematoma may occur as a result of tearing of bridging veins and usually develop into chronic subdural hematoma. The majority of patients with SDH due to SIH have chronic DSH and, therefore, rarely present with neurological deficits. Evacuation of SDH may be performed for large SDH with ME (mass effects), or when dilated or asymmetric pupil is present. However in most cases, evacuation of the hematoma is not necessary and may result in worsened outcomes. The epidural blood patch (EBP) is a treatment of choice. Fortunately, most of these subdural hematomas can be handled with treatment directed at the underlying spinal CSF leak without the need for surgery. We report the case of 42-year-old man with the chief complaint of orthostatic headache. He was admitted to neurology ward and after imaging studies, it was found that he has bilateral subdural hematoma. Due to the lack of history of trauma, underlying disease, and coagulation disorder, and considering the imaging findings, the patient was referred to the pain department to perform an epidural blood patch. After performing the epidural blood patch, the patient's pain was relieved immediately, and during a three-month follow-up period, the epidural hematoma was completely absorbed. Spontaneous intracranial hypotension (SIH) is a highly misdiagnosed and underdiagnosed disorder and requires a high index of suspicion for diagnosis. During the last decades, a much larger number of spontaneous cases are identified. Literature is a bit confusing, with some authors recommending evacuation of subdural fluid in cases of deteriorating consciousness and few others recommending EBP first even in patients with comatose state but epidural patch is often an important part of treatment.

HbA1c and Pulsatility Index in Middle Cerebral Artery of Patients with Acute Thrombotic Stroke

Highlights:1. The findings of this study indicate that clinicians should remain vigilant, as effective glycemic control, reflected by optimal HbA1c levels, does not necessarily correlate with favorable distal cerebrovascular resistance, as measured by pulsatility index (PI).2. This study recommends that patients with acute thrombotic stroke undergo a comprehensive examination to ensure an accurate diagnosis and appropriate treatment. Abstract Stroke is the second leading cause of death and disability in the world. Diabetes mellitus is a risk factor for stroke with an increase in blood viscosity associated with hyperglycemia, and HbA1c is a well-established biomarker primarily used for the long-term monitoring of glycemic control in patients with diabetes mellitus. The Pulsatility index (PI) parameter of Trans Cranial Doppler (TCD) can measure blood vessel resistance. This study was to prove the correlation between HbA1c and PI in Middle Cerebral Artery (MCA) of acute thrombotic stroke patients. A cross-sectional study was conducted to thrombotic stroke patients treated at the neurological ward of Dr. Soetomo General Academic Hospital, Surabaya, Indonesia from March 2019 to April 2020 who met the inclusion and exclusion criteria. Data were obtained from medical records. Statistical analysis was performed using Spearman test for numerical data and Chi-square for categorical data with a significant value of p &lt;0.05. There were 32 subjects who met the inclusion and exclusion criteria. A total of 24 subjects (75%) were males and 8 (25%) females with a mean age of 56.41±13.22 years. PI MCA results were abnormal in 14 subjects (43.75%) with an average of 1.8±0.97 and PI MCA was normal in 18 subjects (56.25%) with an average of 0.87±0.15. The average HbA1c was 6.55±1.9%. There was no statistically significant association observed between HbA1c and PI in MCA examination (r=0.07; p=0.73). In conclusion, the findings of this study indicate the lack of correlation between pulsatility index and HbA1c in patients with acute ischemic stroke. This underscores the importance of comprehensive cerebrovascular evaluation regardless of HbA1c status.

Variability and flexibility of diagnostic procedures as exemplified by speech-language diagnosis of patients in the neurology department of Szpital Czerniakowski sp. z o.o. in Warsaw

The text describes the variability and flexibility of speech-language diagnostic procedures which are adjusted to special needs of patients of neurological ward. The authors use tools that have been specifically developed by them. The diagnostic procedure includes: case history, short conversation, the speech-language abilities assessment (creating and understanding of verbal messages), preliminary assessment of speech abilities using deliberately prepared words and sentences, non-verbal capacities evaluation, primary functions assessment. The authors share the clinical and experimental approach to the speech-language diagnosis and justify the designated procedure for the preliminary speech-language diagnosis. They also underscore thec omplexity of the connections between biopsychic and environmental factors that can influence the process of speech-language diagnosis process.

Quality of life in nurses from neurological wards: The mediating role of burnout

In recent years, nurses experienced higher workloads which has an adverse impact on their quality of life (QoL), particularly in nurses from neurological wards as they are exposed to additional stressors due to physical and psychological strains. This study analyzed the relationship between psychological morbidity, burnout, social support, career duration, and QoL in nurses from neurological wards, including the indirect effect of burnout. A total of 92 nurses were assessed on social support, psychological distress, burnout, and QoL. Pearson’s correlations and a path analysis were conducted to analyze the relationship among variables. The results showed that burnout had an indirect effect in the relationship between psychological morbidity/satisfaction with social support and mental QoL. Physical QoL showed an indirect effect in the relationship between career duration/psychological morbidity and mental QoL. Satisfaction with social support had a direct effect on mental QoL, although career duration directly impacted physical QoL. Interventions on burnout and physical QoL are crucial to promote nurses’ mental QoL, particularly nurses with longer careers. Programs of occupational health should address stress management to promote nurses’ engagement, since hospitals and nursing homes are excellent settings to offer these types of programs on a regular basis.

Dysphagia screening among stroke patients in a tertiary hospital: a best practice implementation project.

The study aimed to promote nurses' compliance with best practices for dysphagia screening in patients with stroke. Dysphagia can significantly increase the risk of complications, especially aspiration pneumonia, leading to increased risk of disability, death, and high medical expenses. Dysphagia screening can reduce aspiration risk and is recommended as a crucial step in dysphagia management; however, not all patients with stroke undergo dysphagia screening in the neurology ward. The JBI Evidence Implementation Framework was used in this study. A baseline audit was conducted by interviewing 22 nurses and reviewing 48 medical records to evaluate current practice against best practice recommendations. The JBI Getting Research into Practice (GRiP) tool was used to identify barriers and strategies for practice change. A follow-up audit of 19 nurses and 48 medical records was conducted after implementation of improvement strategies. The follow-up audit results showed improvement in three criteria compared with the baseline audit: for Criterion 1, compliance increased by 27.3%, rising from 72.7% to 100%; for Criteria 3 and 4, compliance increased by 77.1%, rising from 20.8% to 97.9%. The difference in nurses' knowledge, attitude, and behavior scores for dysphagia screening between the baseline and follow-up audits was statistically significant (all p < 0.05). The project showed improvements in evidence-based practice in the dysphagia screening of stroke patients in a neurology ward. However, more work needs to be done to ensure the sustainability of best practices, such as regular training for nurses, supervision from managers, and regular audits of dysphagia screening.

Clinical audit on management of suspected meningoencephalitis patients at lady reading Hospital, Peshawar

Objective: The purpose of this study was to observe management and empiric treatment of meningitis/encephalitis without doing initial investigation CSF-RE or delaying it, at Department of Emergency Medicine, General Medicine and Neurology wards. Method: It is an observational retrospective study this study was carried out at the General medicine, Neurology and Emergency units from July 2023 to Dec 2023.Total of 54 patients were included. Before conduction of study Ethical Review Committee permission was sought to access patient Data. We studied their hospital stored data on HMIS such as admission Date, start of empiric antibiotics, CT Scans, Blood Culture and CSF-REs. Results: 98% of patients were started on empiric Antibiotics without doing CSF-RE/LP on initial presentation at the hospital. In 64% patients CSF-RE was delayed and subsequently performed. In 34% CSF-RE was never carried out. Conclusion: We did presentations, Information campaigns, to follow standard Guidelines for Suspected meningitis /encephalitis to limit potential side effects, Development of Resistance to Antibiotics and to limit treatment costs.

The Interrelationship of Benefit Finding, Demoralization, and Stigma among Patients with Parkinson's Disease and Their Caregivers.

Parkinson's disease (PD) is a debilitating neurodegenerative disease with a relentlessly progressive course of illness. This study aimed to assess the dyadic dynamics of benefit finding (BF), demoralization, and stigma on the depression severity of PD patients and their caregivers. This study used a cross-sectional design with purposive sampling. In total, 120 PD patients and 120 caregivers were recruited from the neurological ward or neurological outpatient clinic of a medical center in Taiwan from October 2021 to September 2022. PD patients and their caregivers were enrolled and assessed using the Mini International Neuropsychiatric Interview, the Benefit Finding scale, Demoralization Scale, Stigma Subscale of the Explanatory Model Interview Catalogue, and Taiwanese Depression Questionnaire. Among the 120 patients and 120 caregivers that successfully completed the study, 41.7% (N = 50) and 60% (N = 72) were female, respectively. The most common psychiatric diagnoses of both the PD patients (17.5%) and their caregivers (13.3%) were depressive disorders. Using structural equation modeling, we found that the stigma, BF, and demoralization of PD patients might contribute to their depression severity. Demoralization and stigma of PD patients' caregivers might also contribute to the depression severity of PD patients. Caregivers' BF and demoralization were significantly linked with their depression severity. PD patients' BF degree and their caregivers' BF degree had significant interactive effects. Both patients' and their caregivers' stigma levels had significant interactive effects. Clinicians should be aware of and manage these contributing factors between PD patients and their caregivers in order to prevent them from exacerbating each other's depression.

Exploring nurses' difficulties and strategies when caring for patients with dementia in a neurological ward.

Nurses in neurological wards face numerous challenges when caring for patients with dementia, particularly those who also present other acute illnesses. However, studies focusing on this area are limited. This study aimed to explore the difficulties and strategies in caring for patients with dementia among nurses working in a neurological ward. A qualitative descriptive design was adopted. Twelve nurses from a neurology ward participated in individual semi-structured interviews. The data collected through these interviews were subjected to qualitative content analysis. Two main themes emerged from the analysis: (i) various shortcomings and concerns, which include subthemes: insufficient support, worry about patient safety, inadequate care ability of the caregiver, and insufficient self-competence, and (ii) unique clinical strategies, which include subthemes: cooperate with the caregiver, improve self-competence in dementia care, and employ meticulous resorts. The findings highlighted the nurses' dedication to minimizing patient risks and utilizing available resources as well as stakeholders to provide optimal care. To enhance patient care quality, it is essential to support nurses by addressing care-related barriers, offering continuous education, and establishing care pathways.

Psychiatry training in Hungary, difficulties and advantages

Introduction While in theory our training program is quite satisfactory, in practise it often falls short. The first two years give a more general knowledge, including spending time at internal, ICU and neurological wards as well as attending a month-long course about communication, palliative care and basic legal principals important in healthcare. The second three years provide the opportunity to engage in profession-related rotations, like psychotherapy, psychiatric rehabilitation and addictology.Objectives The design in itself is clear, but the supervision for its enactment is insufficient. This leads to regional differences between the four faculties of our country, not everyone is able to partake in the supposedly mandatory rotations (mostly because of shortcomings in staff ) and the organization of our theoretical education varies greatly in each region to the point of non-existence in one area, since the COVID-19 pandemic started. The personal supervision of each psychiatry trainee also leaves much to be desired both on professional and – in psychiatry very important – mental levels. Competence and responsibility limits are often vague, and, especially in country hospitals, to much is expected of the resident (i.e. doing a nightshift alone, without direct supervision).MethodsIt is a positive thing that in theory there are standards in place, the problem is that they are more viewed as guidelines, than demands to be met. Nevertheless, some of the faculties provide well-organized education (even subdivided per year of training) and/or take rotations outside of the ‘home ward’ seriously. The opportunity to gain a basic knowledge in psychotherapy is also beneficial and a good aspect of our training. Easily accessible or even obligatory participation in psychotherapy for ourselves during our training however, is lacking.Results The decreasing number of psychiatry trainees sadly is a worldwide trend and Hungary is no exception. This poses more difficulties, i.e. making it harder to let a resident go on ‘outside’ rotations, especially from wards already struggling with staff shortages. Because of the latter, there is also little time to teach the trainees appropriately and pay them the attention they need.ConclusionsAll in all, there is much potential in our training program and its standards, also leaving room for substantial improvement in realizing the practical aspects. The decline in numbers of psychiatry trainees is worrisome and calls for more general intervention on a European or even global level.Disclosure of InterestNone Declared

The burden and psychosocial impact on immediate caregivers of patients with spinal cord injury in a tertiary health facility, Edo State, Nigeria

ABSTRACT Objective: This study aimed to assess the burden and psychosocial impact of spinal cord injury on the immediate caregivers at a tertiary health facility in Benin City, Edo State. Materials and Methods: A descriptive cross-sectional survey design was adopted among 73 family caregivers in the neurological ward of a tertiary health facility using a structured questionnaire as instrument of data collection. Data collected were analyzed using descriptive statistics and multiple logistic regression. Results: Findings revealed that an overall mean of 2.73 indicates that the burden on the caregivers was moderate with a moderate psychological impact (m = 2.88) and a high sociological impact (m = 3.12). Factors affecting the caregiving provided by immediate caregivers include social and household responsibilities (94.5%), financial situation (89.0%), family support (83.6%), and health status of the caregiver (80.8%). Age (odds ratio [OR] = 5.67, 95% confidence interval [CI]: 1.23–27.17, P = 0.027), education (OR = 3.75, 95% CI: 1.05–13.39, P = 0.041), and “others” (spouses, siblings, friends, or extended family members) (OR = 3.167, 95% CI: 1.583–6.337, P = 0.001) were predictors for high psychological impact while education (OR = 0.074; 95% CI: 0.015–0.370, P = 0.001) and caregiving role (OR = 3.167; 95% CI: 0. 1.583–6.337, P = 0.001) high sociological impact. Conclusion: Majority of the caregivers experience moderate burden, moderate psychological impact, and high sociological impact. Understanding these factors is essential for developing targeted interventions and support services to address the unique needs of caregivers and mitigate the burden of caregiving on their psychosocial health.

The Relevance of Differential Assessment Between Campimetry Deficit and Neglect in Hospitalized Neurologic Patients

Background: This study investigates the clinical impact of visual system diseases and neuropsychological deficits on individualized rehabilitation programs for hospitalized neurologic patients. This study aimed to evaluate the clinical impact of visual system diseases and neuropsychological deficits on individualized rehabilitation programs for hospitalized neurologic patients. Methods: An observational study was conducted on adult inpatients with neurologic disorders who were admitted to the neurology ward between February 2022 and January 2023. These patients underwent comprehensive multidisciplinary assessments as well as clinical orthoptic evaluations. We collected data pertaining to demographics, medical history, diagnoses, and rehabilitation reports. All participants met specific eligibility criteria, including age, cognitive status, and clinical stability. Results: Initially, 120 patients, 68 ±13 years old, were included in the full cohort. Subsequently, after excluding patients with low interview reliability, those lacking campimetry defects, or those solely presenting neglect, a final cohort of 7 patients remained for qualitative analysis. This final group exhibited a broad age range, predominantly had vascular diagnoses, and experienced prolonged hospital stays. These patients were notable for the presence of campimetry disorders and frequently faced challenges associated with spatial neglect. Conclusions: Visual system diseases and neuropsychological deficits significantly impact the planning and execution of rehabilitation programs for hospitalized neurologic patients. A multidisciplinary approach, with the orthoptist's expertise, is essential to address visual impairments, improving the quality of life and functional outcomes of stroke survivors.

Nursing care of a 69-year-old patient after a stroke staying in the neurological ward

The presented work focuses on the description of issues related to ischemic stroke and the presentation of the patient's care process after this incident. The first part is a clinical description of the disease, and the second part is a case report of a patient after an ischemic stroke staying in a neurological ward.&#x0D; The work also includes a description of the course of hospitalization, nursing problems, nursing interventions undertaken and evaluations of nursing activities.

Effects of a Nurse-Led Cognitive Behavioral Intervention for Parents of Children With Epilepsy

BackgroundThis study aimed to evaluate the effects of a nurse-led cognitive behavioral intervention for parents of children with epilepsy (CWE). MethodsThe study recruited 238 CWE from the neurology ward of Xiangya Hospital from March 2019 to August 2022. According to the interventions after discharge, the children and their parents were randomly divided into 117 parent-child dyads in the intervention group and 121 parent-child dyads in the control group. The seizure severity and treatment compliance in CWE as well as the parents’ psychological states and satisfaction with the care provided by nurses were compared before and after intervention. ResultsThe follow-up six months after discharge showed that the seizure frequency among CWE in the intervention group was significantly less than the controls (P = 0.048). Compared with the controls, the intervention group also reported fewer symptoms of anxiety and depression, better sleep quality, and more positive attitudes toward epilepsy, as well as higher nursing satisfaction (P < 0.001). The correlation analysis indicated the correlation of CWE’s seizure severity was correlated with the compliance, parents' psychological states, and parents' satisfaction with the care provided by nurses. ConclusionsThe adoption of the nurse-led cognitive behavioral intervention on parents of CWE can improve the parents’ mental health status and their satisfaction with the nurses, which can have a positive association with the seizure severity of CWE. In light of this information, this nursing intervention may be a new method for the long-term disease management of CWE.