Michelle Hyczy de Siqueira Tosin

Diagnósticos de Enfermagem sobre alterações urinárias na doença de Parkinson

Objetivo: Analisar os Diagnosticos de Enfermagem mapeados e contidos na classe “Funcao Urinaria” do dominio Eliminacao e Troca da taxonomia proposta pela NANDA- Internacional, em portadores de doenca de Parkinson em programa de reabilitacao. Metodos: Estudo descritivo de mapeamento cruzado cuja a fonte primaria de dados foram 67 prontuarios eletronicos com registro de cinco ou mais evolucoes de enfermagem. A coleta eletronica de dados foi realizada em tres etapas: levantamento dos termos, mapeamento e validacao. Resultados: Foi observada a abrangencia da taxonomia na identificacao das alteracoes urinarias. Foram mapeados sete diagnosticos de enfermagem. A “Eliminacao urinaria prejudicada” foi o mais frequente (60%) e, na maioria dos casos, esteve associada a outros diagnosticos especificos, como as incontinencias urinarias por urgencia (55%), reflexa (25%), por esforco (12%), por transbordamento (10%) e funcional (6%). Conclusao: A analise sobre os diagnosticos de enfermagem mapeados indicam a complexidade das alteracoes urinarias em pacientes com doenca de Parkinson.

Parkinson's disease: if you can’t change the outcome how can you qualify the journey?

“This is a personal story, sadly tragic and heart-breaking, but by sharing this information with you I know that you can help make a difference in the lives of others. (...) My hope is that it will help you understand your patients along with their spouses and caregivers a little more. And as for the research you do, perhaps this will add a few more faces behind the why you do what you do”, said Mrs. Susan Schneider Williams at the special editorial of the Neurology journal, in 2016.1 The manuscript written not by a neuroscientist, but by a wife, who was complicit in the suffering caused by a neurodegenerative disease, enables us to understand the urgent need for the adequacy of therapeutic care. Her husband, the actor Robin Williams, was diagnosed with Parkinson’s disease (PD), but three months after his death, the condition known as “Lewy Body Dementia” was confirmed by the results of necropsy, a condition included in the spectrum of parkinsonian diseases. This manuscript reveals the complexity of the facts experienced daily in clinics, doctors’ office and hospitals, where entire families are faced with the diagnosis of an incurable disease. In this year, in which the PD commemorates the 200 years since the publication of the monograph of James Parkinson,2 many observations can be made from the narrative not only of Mrs. Susan Williams but of all the family members who are fighting against the biological clock. The untiring search for cure and treatment of the symptoms of this disease can distract health professionals from the daily reality experienced by patients and their families.3 False hopes can be unconsciously instilled and these will consequently produce suffering and frustration for all involved. For this reason, the shift from the health care paradigm to those suffering from a chronic and progressive neurological condition is essential for the quality of care. This change requires a look beyond cure, a look at palliative care.

The Role of Nurses in Parkinson's Disease

Background: The complexity of motor and nonmotor symptoms in patients with Parkinsons disease (PD) requires multidisciplinary health actions. Objective: To describe the role of nurses as members of multidisciplinary teams tasked with treatment of motor and nonmotor symptoms and provide nursing protocols for the care of patients with Parkinsons disease. Methods: Analysis of the main diagnoses, outcomes, and ICNP® interventions identified by cross‐mapping empirical evidence described in 2123 nursing documents and data from medical records of patients with Parkinsons disease in the specialized rehabilita‐ tion program at the Sarah Network of Rehabilitation Hospitals in Brazil. The protocols were based on scientific evidence and international recommendations. Results: Clinical nursing protocols were developed based on a standardized nursing language of diagnoses, outcomes, and interventions focused on motor and nonmotor symptoms and principles of rehabilitation. Conclusion: These protocols are expected to guide the clinical reasoning of nurses for comprehensive care of patients with Parkinsons disease and their families.

Nursing diagnoses and interventions in patients with Parkinson’s Disease: cross mapping study

Aim: To build a validated affirmative databank incorporating the language used by the International Classification of Nursing Practice (ICNP®) with regard to nursing diagnoses and interventions for the rehabilitation of patients with Parkinson’s disease. Method: This is a cross mapping study that is descriptive and documental. The sample is composed of nursing procedures described in the medical records of 351 patients with Parkinson’s disease, who participated in a rehabilitation program from May 2009 to May 2014, in a rehabilitation center located in the city of Rio de Janeiro, Brazil. The validation of the affirmatives will occur as a result of the analysis of nurses who specialize in the area of rehabilitation. Expected Results: It is expected that the affirmatives of nursing diagnoses and interventions that are not standardized will be compared with the ICNP® language (version 4.0) within the context of the rehabilitation of patients with Parkinson’s disease.