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专科护士在多发性硬化症中痉挛及相关症状检测中的作用。

The role of specialist nurses in detecting spasticity and related symptoms in multiple sclerosis.

机构信息

Unidad de Neuroinmunología- Esclerosis múltiple, Hospital Clínic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), |Universitat de Barcelona, Barcelona, Spain.

Hospital Universitari Mútua de Terrassa, Terrassa, Barcelona, Spain.

出版信息

J Clin Nurs. 2023 Jul;32(13-14):3496-3503. doi: 10.1111/jocn.16421. Epub 2022 Jul 7.


DOI:10.1111/jocn.16421
PMID:35799407
Abstract

BACKGROUND: Spasticity is a frequent symptom of multiple sclerosis (MS), which may negatively influence daily living activities (ADL). OBJECTIVES: To (1) explore the feasibility to conduct a structured interview by specialist nurses about limitations in ADL; (2) determine the percentage of people with MS (PwMS) with limitations in ADL related to spasticity; (3) to assess the knowledge about spasticity and describe its clinical features. DESIGN: Observational, cross-sectional, multicentre study in 16 MS units of Catalonia (Spain). Participants were recruited from the outpatient facility and day-care hospital between July 2018 and June 2019 and met the following criteria: (1) age 18 or older, (2) diagnosis of MS according to McDonald criteria 2010 and (3) no clinical relapse in previous 30 days. METHODS: Specialist nurses conducted a structured interview divided in two parts: the assessment of (1) limitations in the ADL and (2) the presence of spasticity and associated symptoms. The usefulness of this intervention was requested. This study met the STROBE reporting guidelines checklist for observational studies. RESULTS: Three hundred sixty eight pwMS (244 women) with a mean age of 46 years and a median Expanded Disability Status Scale score of 2.5 (range, 0-8.5) were included. 262 (71%) pwMS had limitations in the ADL, and spasticity was reported as the most limiting symptom in 59 (23%). As a result of the interview, spasticity was observed in 199 (76%) participants; 47 (24%) of them were unaware that they had spasticity and 102 (51%) would not have reported it spontaneously. The level of the interview satisfaction was high (90%). CONCLUSIONS: Spasticity is a complex and limiting symptom in MS. The structured interview conducted by specialist nurses is feasible and has good acceptance. PATIENT CONTRIBUTION: Specialist nurses can be proactive in MS clinical assessment, which may help to detect symptoms with negative impact on quality of life.

摘要

背景:痉挛是多发性硬化症(MS)的常见症状,可能会对日常生活活动(ADL)产生负面影响。

目的:(1)探索由专科护士进行 ADL 受限情况结构化访谈的可行性;(2)确定存在与痉挛相关的 ADL 受限的 MS 患者(PwMS)的比例;(3)评估对痉挛的了解程度并描述其临床特征。

设计:在西班牙加泰罗尼亚的 16 个 MS 单位进行的观察性、横断面、多中心研究。参与者从 2018 年 7 月至 2019 年 6 月在门诊和日间医院招募,符合以下标准:(1)年龄在 18 岁或以上;(2)根据 2010 年 McDonald 标准诊断为 MS;(3)在过去 30 天内无临床复发。

方法:专科护士进行了一项结构化访谈,分为两部分:(1)评估 ADL 受限情况,(2)评估痉挛的存在及其相关症状。要求评估这种干预措施的有用性。本研究符合观察性研究的 STROBE 报告指南检查表。

结果:纳入了 368 名 PwMS(244 名女性),平均年龄为 46 岁,扩展残疾状况量表评分中位数为 2.5(范围,0-8.5)。262 名(71%)PwMS 存在 ADL 受限,痉挛被报告为最受限的症状,占 59 例(23%)。通过访谈发现,199 名(76%)参与者存在痉挛;其中 47 名(24%)不知道自己患有痉挛,102 名(51%)不会自发报告。访谈满意度水平较高(90%)。

结论:痉挛是 MS 的一种复杂且受限的症状。由专科护士进行的结构化访谈是可行的,且具有良好的可接受性。

患者贡献:专科护士可以积极主动地进行 MS 临床评估,这可能有助于发现对生活质量产生负面影响的症状。

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