Barbara Grabowska-Fudala

Caregiving burden and its determinants in Polish caregivers of stroke survivors.

Introduction Despite the growing body of literature on the consequences of providing non-professional care to stroke survivors, the determinants of caregiving burden are still not fully recognized. Identification of significant determinants can facilitate caregiver intervention programs. The aim of this study was to evaluate the level of burden borne by caregivers of stroke patients and to identify the most important determinants of burden at 6 months after hospitalization. Material and methods Data were collected from 150 pairs of stroke patients/caregivers. Caregiver burden was assessed on the Caregiver Burden scale (CB). Several characteristics were measured as potential predictors of the burden. Special attention was paid to the caregivers sense of coherence (SOC) and anxiety. Regression analysis was employed to test the hypothesized relationships between these variables and the burden. Results Forty-seven percentage of the caregivers reported a substantial burden (severe or moderate). Caregiver SOC (p < 0.001), anxiety (p < 0.001) and the patients’ functional status (p < 0.001) were the most important predictors of the overall burden and the most consistent predictors of the majority of aspects included in the CB scale. Caregiver health, patients gender, time spent caregiving and social support were also factors related to the burden. The identified predictors explained 67% of the variance in the overall burden. Conclusions Clinicians and other professionals should focus on the coping abilities of caregivers, their emotional state and the level of patients’ dependency, as these are the vital and modifiable factors affecting caregiver burden following stroke.

Northwick Park Dependency Score — a New Scale for Use in Nursing Practice

Introduction. Evaluation of functional limitations in patients with ischemic stroke is essential in planning suitable nursing care. The main aim of all nursing procedures taken is to ensure the safety of patients, to provide the best, individualized care fulfilling patients’ needs and to support recovery process, considering the necessary number of nursing staff and time needed for these procedures. A tool helpful in the process of diagnosis and planning care is the Northwick Park Dependency Score — NPDS. Aim. The aim of the present study is to describe the Polish version of this scale and to assess its usefulness by comparing the NPDS with the Barthel Index — considered the “golden standard” for assessing patient’s disability and dependency. Material and Methods. The study included 100 elderly ischemic stroke patients aged 60 to 99 years (mean 76.1, SD 9.07). To assess patient’s dependency and thus the need of nursing care, the NPDS Scale was used. Functional status of patients was assessed with the Barthel Index, and the neurological state using the NIHSS. Results. Most items in NPDS, are similar to the items of the BI. However, the NPDS includes additional important questions regarding cognitive functions, communication and behavioral dysfunctions. It allows to estimate the number of nursing staff and their scope of competences necessary for providing care as well as time needed for particular nursing activities. There is a strong correlation between individual modules in the NPSD and the BI sales (r ≈ 0.90). Nevertheless, these are not interchangeable. The high correlation coefficient confirms the validity of the Polish version of the NPDS. Conclusions. NPDS is a simple and useful tool in nursing care allowing to plan the activities based on objective indicators. Despite many similarities it is not a substitute for the popular Barthel Scale. Therefore, the NPDS should be promoted in the nursing environment as a possible work tool. (JNNN 2018;7(1):4–11)

Course of Care of a Multiple Sclerosis Patient in the Context of Pharmacotherapy

Multiple sclerosis (SM) is an incurable, advancing, demyelinating illness with inflammatory background. It constitutes the most frequent cause of disability among young people, between 20 and 40 years of age. Despite the identification of multiple factors causing the disease, its pathomechanism has not been yet completely discovered. For this reason, finding an effective cure for multiple sclerosis continues to present a challenge (for modern scientists). The currently available treatment for SM aims to halt its progress and to minimalize complications related to the disease. The goal of the work was to provide an overview of the therapies currently available to those suffering from SM. Selecting an appropriate form of treatment and medication as well as preparing the patient and continuation of monitoring during the therapy constitute important elements of conducting an effective SM therapy. ( JNNN 2015;4(3):130–137)