ABSTRACT
The number of patients receiving injectable medications has increased significantly during the past few years. Today, patients with hepatitis, rheumatoid arthritis, and multiple sclerosis are added to the list of those, namely diabetics, who have been instructed in self-administration of injectable medications. Currently, some of these medications create significant skin site reactions, and patients tend to discontinue the medications without informing the healthcare provider. Determining the problem and developing a research study that provides evidence to demonstrate methods to help patients adhere to agreed-upon treatment modalities can be accomplished within the clinical practice setting. This study provided a method to decrease skin reactions with interferon 1-b injections for multiple sclerosis patients and has been continued as a method with other like medications.
Subject(s)
Adjuvants, Immunologic/administration & dosage , Injections, Intramuscular/methods , Interferon-beta/administration & dosage , Multiple Sclerosis , Patient Compliance , Self Administration/methods , Adjuvants, Immunologic/adverse effects , Adult , Air , Clinical Nursing Research , Clinical Protocols , Cross-Over Studies , Erythema/chemically induced , Erythema/diagnosis , Erythema/prevention & control , Evidence-Based Medicine , Female , Humans , Injections, Intramuscular/adverse effects , Injections, Intramuscular/psychology , Interferon beta-1b , Interferon-beta/adverse effects , Male , Middle Aged , Multiple Sclerosis/drug therapy , Multiple Sclerosis/psychology , Nurse's Role , Nursing Assessment , Nursing Methodology Research , Patient Compliance/psychology , Patient Education as Topic , Self Administration/adverse effects , Self Administration/psychology , Skin Temperature , Surveys and QuestionnairesABSTRACT
Persons with multiple sclerosis require extensive management of the physiologic and psychologic sequelae of their chronic disease process. Sexual intimacy is affected by many of these disease effects, which impacts them in diverse ways. Many persons with multiple sclerosis do not discuss sexual intimacy with their health care provider because they assume it is an expected part of the disease and nothing can help, or they are too embarrassed to admit to problems at a very young age. Since this is a disease that usually occurs between 20 and 40 years of age, sexual intimacy is affected from many perspectives. Collaboration is essential in the plan of care between the client, family, and the health care provider.
Subject(s)
Coitus , Health Knowledge, Attitudes, Practice , Multiple Sclerosis/nursing , Nurse's Role , Sex Counseling/organization & administration , Sexual Dysfunction, Physiological/nursing , Aged , Evidence-Based Medicine , Female , Humans , Male , Middle Aged , Multiple Sclerosis/complications , Nurse Clinicians/organization & administration , Nursing Methodology Research , Patient Education as Topic , Practice Guidelines as Topic , Sex Factors , Sexual Dysfunction, Physiological/etiologyABSTRACT
As we gain a better understanding of narratives presented by both normally aging adults and those with cognitive deficits, we are able to communicate more effectively. We can select more interactive ways to help construct meaning with individuals who appear to have lost the ability to communicate. We can listen for formulaic expressions or colloquial speech, furnish beginnings, echo details, add to endings. We can recall what we were told in an earlier conversation and reintroduce the topic so that the speaker with Alzheimer disease (AD) can recognize information and expand it instead of being asked to recall it. By using the repetition technique of quilting narrative, nurses can help family members see that the person with AD is trying to signal some part of a life event, which helps convey to others who he or she is.
Subject(s)
Alzheimer Disease/complications , Communication Disorders/etiology , Communication Disorders/rehabilitation , Narration , Aged , HumansABSTRACT
As the elderly population in our country continues to increase, it is imperative that the bedside practitioner be keenly aware of the factors that affect pharmacokinetics and pharmacodynamics of medication administration. Refining the admission interview process to obtain accurate medication information--including alternative and OTC drugs--will help to decrease the incidence of drug interactions and ADR in the acute care setting. Appropriate monitoring of pharmacologic effects and organ function will allow the practitioner to better treat the elderly client with as few medications as possible.