The role of the community nurse in care provision for people with multiple sclerosis

Effects and influencing factors of Internet-based training on primary prevention of dementia among primary health care workers

BACKGROUND

Existing evidence-based guidelines and summaries on dementia prevention are not effectively disseminated and used by primary health care workers in developing countries. As such, the lack of knowledge and skills is a major obstacle to dementia prevention and has posed a need for relevant training.

OBJECTIVES

To evaluate the effects of an Internet-based dementia-related training program with the aim to improve the competence of primary health care workers to early detection of symptoms of memory disorder and dementia, and to provide effective guidance and consultation for residents.

DESIGN

A survey with 12 weeks follow-up.

SETTINGS

An Internet-based training program was conducted in four primary healthcare institutions in China between April and September 2020.

PARTICIPANTS

Primary health care workers, including doctors and nurses.

METHODS

A localized Internet-based training program on primary prevention of dementia for primary health care workers was built, based on existing guidelines. Self-made measures were used to evaluate the knowledge, self-efficacy, and behavioral intentions of primary health care workers. Data were collected before the training (T₀), after the training (T₁), and Week 12 after the training (T₂). Differences between the different time points were tested using a generalized estimation equation.

RESULTS

There were 268 study participants, 120 of whom completed the training and the questionnaire three times consecutively. At T₁ and T₂, the knowledge, self-efficacy, and behavioral intention scores were higher than those at T₀ (all B > 0, all p < 0.05. The knowledge scores were influenced by age, years of work, and occupation of participants. The self-efficacy and behavioral intention scores were influenced by age, dementia training history, and reception of complaints of memory loss. Eighty percent of the participants were satisfied with the training.

CONCLUSIONS

This study confirmed that Internet-based training on the primary prevention of dementia is highly accepted and improves the knowledge, self-efficacy, and behavioral intention of primary health care workers.

Palliative care needs of patients with multiple sclerosis in southeast Iran

BACKGROUND

Due to the chronic nature of multiple sclerosis, palliative care can play a significant role in improving the quality of life and well-being of the affected patients. An essential step for developing appropriate palliative care for these patients is to determine the types of palliative care necessary, from different points of view. Therefore, this study was conducted to compare the palliative care needs from the nurses' and patients' points of view in southeast Iran in 2017.

METHOD

This descriptive-analytical cross-sectional study was conducted on 154 nurses working in neurology wards of teaching hospitals associated with Kerman University of Medical Sciences and 132 patients with multiple sclerosis who were referred to these hospitals in southeast Iran. The data were collected using a questionnaire for assessing the palliative care needs of patients with multiple sclerosis. Pearson correlation coefficient, independent t-test, ANOVA, chi-square, and the Mann-Whitney and Kruskal-Wallis tests were used to examine the data.

RESULTS

Both nurses and patients mentioned the palliative needs of patients with multiple sclerosis in terms of physical, social, spiritual, psychological, and economic dimensions, respectively, but the results showed that there was a significant difference between the two groups in all dimensions of palliative needs (P < 0.0001).

CONCLUSION

Given the differences in how patients and nurses prioritize palliative care needs, it is essential to consider the different dimensions of palliative needs of patients with multiple sclerosis.

Validity and Reliability of the Turkish Version of the Monitoring My Multiple Sclerosis Scale

INTRODUCTION

This research was conducted to adapt the Monitoring My Multiple Sclerosis (MMMS) scale, which is a scale used for self-evaluation by multiple sclerosis (MS) patients of their own health and quality of life, to Turkish and to determine the psychometric properties of the scale.

METHODS

The methodological research was conducted in the outpatient MS clinic of a university hospital between January and September 2013. The sample in this study consisted of 140 patients aged above 18 who had a diagnosis of definite MS. Patients who experienced attacks in the previous month or had any serious medical problems other than MS were not included in the group. The linguistic validity of MMMS was tested by a backward-forward translation method and an expert panel. Reliability analysis was performed using test-retest correlations, item-total correlations, and internal consistency analysis. Confirmatory factor analysis and concurrent validity were used to determine the construct validity. The Multiple Sclerosis Quality of Life-54 instrument was used to determine concurrent validity and the Expanded Disability Status Scale, Hospital Anxiety and Depression Scale, and Mini Mental State Examination were used for further determination of the construct validity.

RESULTS

We determined that the scale consisted of four factors with loadings ranging from 0.49 to 0.79. The correlation coefficients of the scale were determined to be between 0.47 and 0.76 for item-total score and between 0.60 and 0.81 for items and subscale scores. Cronbach's alpha coefficient was determined to be 0.94 for the entire scale and between 0.64 and 0.89 for the subscales. Test-retest correlations were significant. Correlations between MMMS and other scales were also found to be significant.

CONCLUSION

The Turkish MMMS provides adequate validity and reliability for assessing the impact of MS on quality of life and health status in patients.