The multiple sclerosis nurse as patient educator.

Patient education is an important part of neuroscience nursing. New treatments, such as beta interferon self-injections, have challenged nurses. The purpose of this study was to analyze the patient education given by 35 Finnish nurses who work with patients who have multiple sclerosis. The content and didactic solutions of patient education, evaluation of patients' learning skills, and learning outcomes were analyzed. Also, successful and unsuccessful patient education experiences are described. The results showed that patient teaching is based on individual and unstructured approaches. The role of the patient is important, and there is need for more systematic evaluation of learning outcomes. Results from teaching of beta interferon self-injections are similar. In general, more systematic research in this area is required.

Elements of empowerment and MS patients.

Elements of empowerment are: cognitive, experiential, ethical, social, biophysiological, functional and economic. Empirical data from 64 Finnish multiple sclerosis patients were collected. Based on the data, the social element is the most dominating element of empowerment. Patient-center research in nursing care of MS patients should be done to facilitate MS patients abilities toward empowerment.

[Intermittent self-catheterization in multiple sclerosis]. / Hoitotyöllä elämän laatua toistokatetrointi hyvinvoinnin osatekijänä.

Intermittent self-catheterization was taught to 70 patients with multiple sclerosis (MS) between 1.9.1989 and 31.1.1992 in Masku Neurological Rehabilitation Centre. All of them were interviewed in April 1992. Altogether 62 (89%) returned the questionnaires. The aims of the study were 1) to define the compliance of the patients to the treatment, and 2) to assess the effect of the catheterization on the quality of life of the patients. The conceptual framework used for the study was self care concept. Bladder symptoms had been present for seven years (mean) and the average time after the diagnosis of MS was ten years. Twenty eight (28) patients discontinued the treatment after having catheterized for 11 months in average. The main reason (50%) for discontinuation was normalization of the bladder function. The patients reported reduction in urgency symptoms, incontinence of urine and difficulties in emptying the bladder. All these changes were statistically significant. The number of urinary infections was slightly increased (not reaching statistical significance). However, the infections caused less subjective discomfort during the treatment than before it. The urinary symptoms interfered with the personal activities of the patients in a variety of ways. As many as 79% of the respondents reported that their quality of life was improved by the intermittent self-catheterization. The treatment allowed the patients to resume their personal, social -- and in some cases occupational--activities of daily living. Significant improvement was reported in f.e. family life, marital relationships, sexual life and the quality of night sleep.