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Mühlbӓck A, van Walsem M, Nance M, Arnesen A, Page K, Fisher A, van Kampen M, Nuzzi A, Limpert R, Fossmo HL, Cruickshank T, Veenhuizen R. What we don't need to prove but need to do in multidisciplinary treatment and care in Huntington's disease: a position paper. Orphanet J Rare Dis 2023; 18:19. [PMID: 36717864 PMCID: PMC9887752 DOI: 10.1186/s13023-023-02622-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Accepted: 01/15/2023] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND Huntington's disease is a complex neurodegenerative hereditary disease with symptoms in all domains of a person's functioning. It begins after a healthy start in life and leads through the relentless progression over many years to complete care dependency and finally death. To date, the disease is incurable. The long progressive complex nature of the disease demands multiple disciplines for treatment and care of patient and family. These health care providers need inter- and multidisciplinary collaboration to persevere and be efficacious in this devastating disease trajectory. DISCUSSION The position paper outlines current knowledge and experience alongside the experience and consensus of a recognised group of HD multidisciplinary experts. Additionally the patient's voice is clear and calls for health care providers with a holistic view on patient and family. Building long-term trust is a cornerstone of the network around the patient. This paper describes a managed care network comprising all the needed professionals and services. In the health care system, the role of a central coordinator or case manager is of key importance but lacks an appropriate guideline. Other disciplines currently without guidelines are general practitioners, nurses, psychologists, and social workers. Guidelines for neurologists, psychiatrists, geneticists, occupational therapists, speech and language therapists, physiotherapists, dieticians, and dentists are being discussed. Apart from all these profession-specific guidelines, distinctive inter- and multidisciplinary collaboration requirements must be met. CONCLUSIONS AND RECOMMENDATIONS The complex nature of Huntington's disease demands multidisciplinary treatment and care endorsed by international regulations and the lay association. Available guidelines as reviewed in this paper should be used, made available by a central body, and updated every 3-5 years. Time needs to be invested in developing missing guidelines but the lack of this 'proof' should not prevent the 'doing' of good care.
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Affiliation(s)
- Alzbeta Mühlbӓck
- grid.6582.90000 0004 1936 9748Department of Neurology, University Ulm, Ulm, Germany ,Department of Neuropsychiatry, Huntington Center South, Kbo-Isar-Amper-Klinikum Taufkirchen, Taufkirchen, Germany ,grid.411798.20000 0000 9100 9940Department of Neurology and Center of Clinical Neuroscience, 1st Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
| | - Marleen van Walsem
- grid.55325.340000 0004 0389 8485Department of Neurorehabilitation, Oslo University Hospital, Oslo, Norway ,grid.5510.10000 0004 1936 8921Department of Neurology, Oslo University, Oslo, Norway
| | - Martha Nance
- Struthers Parkinson’s Center, Golden Valley, Minneapolis, MN USA ,grid.414021.20000 0000 9206 4546Hennepin County Medical Center, Minneapolis, MN USA
| | - Astri Arnesen
- European Huntington Association (EHA), Moerbeke Waas, Belgium
| | | | - Alexandra Fisher
- West Midlands Huntington’s Disease Team, Neuropsychiatry, The Barberry, Birmingham, UK
| | | | | | - Roy Limpert
- Department of Neuropsychiatry, Huntington Center South, Kbo-Isar-Amper-Klinikum Taufkirchen, Taufkirchen, Germany
| | - Hanne Ludt Fossmo
- grid.55325.340000 0004 0389 8485Unit for Congenital and Hereditary Neuromuscular Disorders (EMAN), Department of Neurology, Oslo University Hospital, Oslo, Norway ,Vikersund Rehabilitation Centre, Vikersund, Norway
| | - Travis Cruickshank
- grid.1038.a0000 0004 0389 4302Centre for Precision Health, Edith Cowan University, Perth, Australia
| | - Ruth Veenhuizen
- Huntington Expert Centre Atlant, Apeldoorn, The Netherlands. .,Department of Medicine for Older People, Amsterdam UMC, Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands. .,Amsterdam Public Health, Aging and Later Life, Amsterdam, The Netherlands.
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Wilson E, Aubeeluck A. Knowledge in practice: the specialist nurse role in Huntington's disease. ACTA ACUST UNITED AC 2016. [DOI: 10.12968/bjnn.2016.12.4.185] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Eleanor Wilson
- Senior Research Fellow, School of Health Sciences, University of Nottingham
| | - Aimee Aubeeluck
- Associate Professor, School of Health Sciences, University of Nottingham
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Baker M. Education requirements for nurses working with people with complex neurological conditions: nurses' perceptions. NURSE EDUCATION TODAY 2012; 32:71-77. [PMID: 21333416 DOI: 10.1016/j.nedt.2011.01.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/15/2010] [Revised: 01/12/2011] [Accepted: 01/19/2011] [Indexed: 05/30/2023]
Abstract
Following a service evaluation methodology, this paper reports on registered nurses' (RNs) and healthcare assistants' (HCAs) perceptions about education and training requirements in order to work with people with complex neurological disabilities. A service evaluation was undertaken to meet the study aim using a non-probability, convenience method of sampling 368 nurses (n=110 RNs, n=258 HCAs) employed between October and November 2008 at one specialist hospital in south-west London in the U.K. The main results show that respondents were clear about the need to develop an education and training programme for RNs and HCAs working in this speciality area (91% of RNs and 94% of HCAs). A variety of topics were identified to be included within a work-based education and training programme, such as positively managing challenging behaviour, moving and handling, working with families. Adults with complex neurological needs have diverse needs and thus nurses working with this patient group require diverse education and training in order to deliver quality patient-focused nursing care.
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Affiliation(s)
- Mark Baker
- Institute of Neuropalliative Rehabilitation, Royal Hospital for Neuro-disability, West Hill, London SW15 3SW, UK
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