Læknablaðið : fylgirit - 01.05.2002, Blaðsíða 48

POSTERS / 3 3RD SNC & 2ND SCNN
to evaluate the impact of various socio-demographic and medical
factor on QoL.
Methods: This study is part of the community-bascd Copenhagen
Stroke Study, and prospectively included 401 patients with acute
stroke. Assessment of QoL was done using the Frenchay Activity
Index (FAI). It was performed within the first week of admission,
and at the 6-month follow-up. The independent importance of
variables on QoL was evaluated in a multiple linear regression
model.
Results: The following factors were negatively related to QoL
before stroke: Male gender (p<0.01), nursing home recidence
(p=0.04), living single (p=0.02), diabetes (p=0.01), home help
(p<0.01), smoking (p<0.01), previous stroke (p<0.01), other
disabling disease (p=0.01), and increasing age (p<0.01). Working
prior to stroke was the only positive factor for QoL before stroke
(p=0.01). QoL after stroke was negatively related to increasing
neurological deficit on the Scandinavian Stroke Scale (p<0.01) and
disability in basic activities after stroke (Barthel Index, p=0.02),
male gender (p<0.01), nursing home recidence (p<0.01), diabetes
(p<0.01), home help (p<0.01), previous stroke (p<0.01), and age
(p<0.01), and positively related to QoL before stroke (p<0.01).
Conclusion: A good social network is important to life quality. Due
to differences in sex roles men performed poorer than women in
FAI score. QoL was significantly lower in patients with diabetes
both before and after stroke. Smoking was related to a poorer QoL
before stroke. Neurological deficit and functional disability after
stroke, nursing home recidence, previous stroke and diabetes were
the most important negative factors for QoL after stroke. A good
life quality before stroke was the most important factor for a good
QoL after stroke. Improvement in QoL after stroke should focus
on limiting the neurological deficits and basic functional disability
after stroke.
P34 - Documentation of tacit knowledge. Improving MS nursing
Jota PA, Haugstad R, Kornerud U, Wehus R, Klingsheim B, Nortvedt MW
Central Hospital in Hedemark HF, Elverum, Norway
Background/objective: After the introduction of the interferon-beta
therapy in multiple sclerosis (MS), nurses have been given new tasks
in the treatment of MS-patients. This includes the development and
organisation of information, training and follow-up of patients on
treatment. We wish to evaluate how the patients manage their new
treatment, and to find elements of our practice related to informa-
tion, training and follow-up that might be improved.
Method: All patients beginning with interferon treatment (Avonex,
Betaferon, Rebif) in four hospitals in Norway are consecutively
asked to participate in the study and will be followed-up with
individual consultations by MS nurses. The study will include 75
patients. The patients are given a questionnaire including a diary to
be filled out during a period ol' three months. In a follow-up after
one year the patients will be asked to fill out an equivalent
questionnaire. The questionnaire includes questions regarding how
the patient evaluates the information, training and the follow-up
given by the nurse. It also includes questions regarding side effects
and how these are managed. Additionally, a quality of life question-
naire (SF-36) is completed at baseline, month three and month 12.
Results: The collection of data started in October 2001 and 30
patients are included by the end of February 2002. All 75 patients
are expected to be included before the end of 2002. The project has
already had a positive effect on the member of the project group
during the planning process. We have become more aware of the
importance of documenting our clinical experience.
Conclusion: As nurses we ought to visualize the importance of what
we do. Our challenge is to document our experience and tacit
knowledge, and to show that appropriate nursing makes a positive
difference for the patients.
P35 - Evidence-based nursing to stroke patients. Application of
an evidence-based clinical guideline concerning the basic
need: Nutrition
Zielke S, Christensen D, Muus I
H:S Bispebjerg Hospital Copenhagen University Hospital Denmark
The aim of the project was to evidence-base nursing care of stroke
patients and to monitor the quality of nursing practice concerning
the basic needs: nutrition
Mcthods: A clinical guideline has been developed.
Recommendations for good clinical practice:
Identifying the risk patient:
Assessment according to screening tool
- Drinking test (B)
- Nutritional state (C)
Nutritional therapy for the risk patient:
- Calculating the patient\'s need for energy, protein and fluid (C)
Choosing diet:
- Adjusting food consistency in relation to dysphagia (C)
- nasogastric tube feeding within 72 hrs by transient dysphagia
- percutaneous endoscopic gastrostomy tube feeding within 2-4
weeks by expected Persistent dysphagia (B)
Evaluating the patient\'s need for specific training
Monitoring:
Quality indicators:
- Daily assessment of energy, protein and fluid
- Weekly assessment of body weight
- Eating ability according to Barthel Index or other validated
instrument
- Body Mass Index at admission, after 3 weeks, and at discharge
- Events of pneumonia treated with antibiotics during hospitalisation
Results/Conclusion: The clinical guideline has been implemented in
stroke units at Bispebjerg University Hospital, Árhus University
Hospital and Esbpnderup Hospital and results from the database
will be present at the congress.
P36 - Does rehabilitation improve quality of life in individuals
with Parkinson’s disease? Prospective pilot study
Gunnbjörnsdóttir H, Bjarnadóttir ÓH
Reykjalundur Rehabilitation Center, Mosfellsbær, Iceland
Objective: To determine if rehabilitation improves quality of life
and secondly, if quality of life measurements can be used for
locating hidden nursing problems.
Material and inethods: Thirty-five individuals with Parkinson's
disease received a five week inpatient group rehabilitation program
in small groups (4-6) from November 1999 - September 2001. Mean
age was 65 years (49-84). Individuals were selected according to
48 Læknabladið/Fylgirit 43 2002/88