Sairanen Ilkka, Virtanen Heli, Hämäläinen Päivi, Suhonen Riitta
University of Turku, Department of Nursing Science, Turku, Finland.
Turku University Hospital, Finland.
Int J Nurs Stud Adv. 2023 Dec 15;6:100172. doi: 10.1016/j.ijnsa.2023.100172. eCollection 2024 Jun.
Patient stress is often overlooked in the care of patients with neurological problems. Nursing theorists have previously heralded stress assessment through conceptual clarification, while clinical nurses in the health care system hold an ideal position for implementation of assessment and coordination of support. Integrated with a hospital assessment and support scheme, recognition of stress as a target of systematic assessment can lead to improved clinical outcomes.
The aim of the study was to describe and compare patient-reported outcome measures suitable for assessment of the stress response as symptoms in neurological patients.
This study is an integrative review and concept development of patient stress based on qualitative and quantitative analysis of available self-reporting instruments.
Instruments were retreived with a systematic search from PubMed, CINAHL, PsychINFO and Web of Science reference databases on August 2, 2021. Search terms associated with the concept of stress symptoms were used. Instrument inclusion was done with the guidance of authoritative symptom inventories, with partial confirmation by a second author to mitigate bias. In the analysis, the instruments included in the review were quantitatively described and compared. Insights from the instrument composition led to clarification of our concept of stress response to further refine the list of instruments suitable for self-assessment of the stress status. This study was not registered.
Based on the inclusion criteria, 23 patient-reported outcome measures extending over a variety of stress concepts were included. The similarity of items among the instruments implied a symptom cluster delineated by 59 common symptom subclasses that were grouped together in a re-classification of instrument items. A comparative quantitative analysis prompted us to distinguish the concept of stress response from antecedent, consequent, and related concepts as a manifestation of mental, somatic, and behavioral domains. Ten instruments with items covering the three domains, each with unique qualities regarding number of items, measured spread, and letter count were described.
Within an organizational framework, effective allotment among types of support can be founded on the patient's stress status and the stressors. The stress status manifests itself as a set of measurable symptoms. Optimal instruments for use in systematic clinical assessment of neurological patients' stress status should satisfy the suggested specification of the stress response with a minimal number of items and concise wording. Finding and including the relevant instruments for analysis were the main limitation of the study.
Stress of neurological patients needs to be assessed and addressed. We ranked 10 suitable instruments that can be useful in the assessment.
在神经系统疾病患者的护理中，患者的压力常常被忽视。护理理论家此前通过概念澄清倡导压力评估，而医疗保健系统中的临床护士在实施评估和协调支持方面处于理想位置。将压力识别为系统评估的目标，并与医院评估和支持计划相结合，可改善临床结果。
本研究的目的是描述和比较适合评估神经系统疾病患者压力反应症状的患者报告结局指标。
本研究是基于对现有自我报告工具的定性和定量分析，对患者压力进行的综合综述和概念发展。
2021年8月2日，通过系统检索PubMed、CINAHL、PsychINFO和Web of Science参考数据库获取相关工具。使用了与压力症状概念相关的检索词。在权威症状清单的指导下纳入工具，并由第二作者进行部分确认以减少偏差。在分析中，对纳入综述的工具进行了定量描述和比较。工具构成的见解促使我们澄清压力反应的概念，以进一步完善适合自我评估压力状态的工具列表。本研究未注册。
根据纳入标准，纳入了23项涵盖多种压力概念的患者报告结局指标。工具之间项目的相似性意味着由59个常见症状子类描绘的症状群，这些子类在工具项目的重新分类中被归为一组。比较性定量分析促使我们将压力反应的概念与先行、后续和相关概念区分开来，将其作为心理、躯体和行为领域的一种表现。描述了10项涵盖这三个领域的工具，每项工具在项目数量、测量范围和字母计数方面都有独特之处。
在一个组织框架内，可根据患者的压力状态和压力源在各类支持之间进行有效分配。压力状态表现为一组可测量的症状。用于神经系统疾病患者压力状态系统临床评估的最佳工具应满足压力反应的建议规范，项目数量最少且措辞简洁。寻找并纳入相关工具进行分析是本研究的主要局限。
神经系统疾病患者的压力需要评估和解决。我们对10种适用于评估的工具进行了排名。
