Nursing practices on sexual health for people with neurological disorders: A narrative review.

AIMS: To identify and describe nursing practices on the sexual health of people with neurological disorders. DESIGN: Narrative review. METHODS: Data were extracted from 1 January 2002, to 20 May 2021. Inclusion criteria were nursing practices, sexual health and people with neurological disorders. The main outcome measures were: context of nursing practice implementation (assumptions, knowledge, strategies and skills), facilitators of and barriers to addressing and treating the sexual health of people with neurological disorders, and benefits of nursing practices in sexual health. PRISMA reporting guidelines were used. DATA SOURCES: PubMed, Embase, ScienceDirect and CINAHL. RESULTS: In total, 926 articles were identified and nine were included. The involvement of nurses was recommended in most studies. Assumptions about the impact of neurology on sexuality and nurse's role in sexual healthcare, biopsychosocial knowledge, and skills (ethical, interpersonal, and technical) were highlighted. We found that the modes of knowledge proposed by Carper were mobilized in an unequal way. Sexual difficulties were the key focus and eroticization concerns were not addressed in any of the articles. CONCLUSION: Several studies advocate nursing intervention; however, few accurately present, detail and evaluate sexual health nursing practices of patients with neurological pathologies. Literature describes practices structured around disorders rather than the potentials, fails to address the brake of eroticism and provides little information on the results of interventions. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: Developing teaching programs on sexual health in nursing programs may be necessary if nurses are to support a diverse range of patients in an inclusive and positive manner. These programs should highlight the domain-specific knowledge that is mobilized. IMPACT: Sexual health is a fundamental human right. Alterations in the nervous system have shown to affect sexual health, however, it is not often discussed among patients with neurological disorders, who are rarely provided with sexual health counselling. Our findings may impact healthcare professionals engaged in care with these patients. REPORTING METHOD: PRISMA. No patient or public contribution.

Le savoir expérientiel : exploration épistémologique d'une expression répandue dans le domaine de la santé.

Among the different forms of knowledge, experiential knowledge is widely used in certain activities in the field of health. Most often connected to patients, it is also discussed in relation to health professionals, but less frequently. This article offers some points of reference and clarifies what underlies experiential knowledge. These points of reference are based on definitions of experience and knowledge, as well as work on the type of knowledge created by experience. An exploration of the contexts in which “experiential knowledge” has emerged and the focus of the disciplines that discuss it finds few epistemological connections between knowledge and experience. In the humanities and social sciences, experiential knowledge is most often connected to patients or adults in educational situations. With regard to nursing knowledge, the analysis of Carper and Lechasseur’s work on the nature of nursing knowledge reveals how the characteristics of experience are integrated into their typologies, particularly when it comes to artistic and personal knowledge. The explicit absence of experience in these typologies is then questioned with regard to the scientific imperatives that nursing science, at this particular period in its construction, is determined to promote.

La construction d'une problématique de recherche : de l'histoire d'une femme atteinte de sclérose en plaques à une recherche en sciences infirmières dans le domaine de la santé sexuelle.

The problematic, an essential step in the scientific research process, includes different components that must be articulated in the same temporality, hence its complexity. There is no consensus on definitions and a relatively short description of construction modalities in the literature. The problematization process is an intellectual, reflexive, questioning, documentation, and choice process aimed at moving from an idea or subject to a specific research question to be answered. The construction of the problem makes it possible in particular to specify the theoretical, methodological, and analytical orientation of the research. This step is an essential step which positions research in a continuum of disciplinary knowledge, and in this case, in the history of nursing knowledge. The objective of this article is to show, using a concrete example, how the analysis of clinical observations allows the development of a nursing research problem that integrates a project and then a research program. The clinical situation concerns the sexual health of women with multiple sclerosis. Beyond personal experience and the narrative of a singular, reinterpreted approach, it is a twofold movement to illustrate concretely, based on a situation and empirical observations, abstract elements and to transform them with the support of theoretical knowledge into communicable and transferable information useful in the construction of the research problem. The presentation of the invisible history of the construction of this problem can have an impact on teaching but also reflects the conceptual framework drawn from nursing sciences and mobilizable in this context of care. Through this example, it is therefore necessary to illustrate, through a retrospective analysis, the construction of nursing knowledge both on research methods and on theoretical models useful for care.

[Constructing a research problem: From the story of a female patient with multiple sclerosis to a nursing research project on sexual health]. / La construction d'une problématique de recherche : de l'histoire d'une femme atteinte de sclérose en plaques à une recherche en sciences infirmières dans le domaine de la santé sexuelle.

The research problem, an essential step in the scientific research process, comprises different components that should be combined within the same time frame, hence its complexity. There is no consensus regarding its definition, and the ways in which it can be constructed have received little attention in the literature. Forming a research problem is an intellectual and reflective process that involves questioning, documentation, and choices aimed at moving from an idea or subject to a specific research question. In particular, the construction of the research problem makes it possible to define the theoretical, methodological, and analytical orientation of the research. This is an essential step that positions research within a continuum of disciplinary knowledge, and in this case, within the history of nursing knowledge. The aim of this article is to show, using a concrete example from nursing practice, how analyzing clinical observations can enable the formation of a research problem for a single project and then a whole research program. The clinical situation described here concerns the sexual health of female patients suffering from multiple sclerosis. Alongside detailing personal experience and the individual approach taken, reinterpreted, this involves concretely illustrating abstract elements, in a twofold process, drawing upon a particular situation and empirical observations, and using theoretical knowledge to transform these elements into communicable and transferable information that can be used to construct a research problem. Bringing to light the invisible story behind the construction of a research problem can be beneficial for learning, but also reveals the conceptual framework drawn from the field of nursing, which can be applied to a care setting. The example presented in this paper illustrates how nursing knowledge can be created through the use of research methods and theoretical models, and how these can then be used in nursing.

[Family caregivers of young patients suffering from chronic neurological diseases during the transition from neuropediatrics to adult neurology: An observational study of the burden felt by the primary family caregiver.] / Les aidants familiaux de jeunes patients atteints de maladies neurologiques chroniques lors de la transition entre secteur pédiatrique et prise en charge en milieu adulte : étude observationnelle de l?aidant familial principal.

Introduction / Context: The transition of young patients from pediatric to adult departments is a critical period with high risks of interruption of the care circuits, thus justifying the implementation of transition programs. This period is also difficult for caregivers, more particularly the main family caregiver. This study addresses the impact of this transition upon the family caregivers of young adults suffering from chronic neurological diseases. OBJECTIVES: To identify the main family caregivers, their profile, and to evaluate their implication and feelings in terms of burden at the time of the transition. METHODS: A questionnaire, which included a modified version of the Zarit Burden Interview, was sent to the families of young patients who had recently moved to the adult neurology department. RESULTS: Twenty-nine of the forty families contacted replied: the main caregiver is usually the mother (86.6%), the mean age is 51.8, 65% had kept their professional occupation, and 21% had quit. The burden scale showed that 65.5% felt little or no burden. DISCUSSION AND CONCLUSION: This limited feeling of burden may be explained by the fact that the majority of patients did not have a motor/intellectual disability. The burden scale we used was originally created for caregivers of elderly patients (often their children), and may not be suitable for assessing children's parents. More specific scales should be considered.

[Improving the sexual quality of life of people with multiple sclerosis]. / Améliorer la sexualité des personnes atteintes de sclérose en plaques.

Helping people with a chronic disease with regard to their sexual wellbeing is part of the nurse's role. In order to be able to offer this support the nurse requires training and needs to work in collaboration with medical staff. The approach consists in assessing the disorders linked to the disease or its treatment which affect the patient's sexual quality of life, advising on potential solutions using medication or mechanical devices and providing the patient with personalised guidance.

[Nursing consultation for sexual problems in multiple sclerosis]. / Vers une consultation infirmière en neurosexologie.

Patients with multiple sclerosis often complain of sexual problems. Nurses in a neurology department have decided to explore the sexual health of these patients. They also intend to assess the need for a neurosexuality nurse consultation.

Validation of the French version of the Multiple Sclerosis Intimacy and Sexuality Questionnaire 15 Tools which help nurse for assessing the effect of perceived multiple sclerosis symptoms on sexual activity and satisfaction.

AIM: To validate a French version of the Multiple Sclerosis Intimacy and Sexuality Questionnaire 15 which examines patients' perception of the effect of multiple sclerosis symptoms on their sexual activity. METHODS: After completing a translation/re-translation process to ensure linguistic and content validity, the Multiple Sclerosis Intimacy and Sexuality Questionnaire 15 French (MSISQ-15Fr) was completed by patients with multiple sclerosis. The validity of the construction, reliability, stability and reproducibility of the translation was evaluated. EXPLANATORY MIXED OBSERVATIONAL STUDY: Validation of a French assessment tool for sexual disorders (borrowed theoretical framework): the Multiple Sclerosis Intimacy and Sexuality Questionnaire 15 (MSISQ 15) RESULTS: The normed χ2 was 1.21, the root mean square error of approximation was 0.046 [0.00; 0.07], the comparative fit index was 0.974, and the standardized root mean square was 0.065. The calculated Cronbach's coefficients indicated strong internal coherence, and the intraclass correlation coefficient was satisfactory at 0.9. Translations of the Multiple Sclerosis Intimacy and Sexuality Questionnaire 15 (MSISQ-15) have already been validated in five languages. This French version is valid, stable and reproducible. It provides French-speaking nurses an accessible and appropriate tool that will enable them to play an active role in the sexual health strategy recommended by the World Health Organization.

Multidrug-resistant bacteria transmitted through high-density EEG in ICU.

PURPOSE: Prevention of multidrug resistant (MDR) bacterial contamination remains a major challenge in ICUs. Many hospital outbreaks involving MDR transmitted through environmental contamination have been reported. Bedside high-density EEG allow for dynamic cognitive evaluation in brain-injured patients and is used more and more frequently in clinical practice to evaluate brain function and predict outcome in severely neurologically impaired patients. Unfortunately, the material used for this procedure is not entirely disposable. METHOD: We performed a systematic analysis of MDR bacterial contamination in patients contaminated in our ICU using specific bacteriological methods. RESULTS: We report a proven case of cross-contamination of an extended-spectrum beta-lactamase (ESBL)-producing Klebsiella pneumoniae strain, and a possible case of cross-contamination of a carbapenem-resistant Acinetobacter baumannii strain. CONCLUSION: Cross-contamination of MDR bacteria is possible through high-density EEG material. However, appropriate procedures can decrease this risk.