BACKGROUND: Multiple sclerosis (MS) is associated with neurochemical alterations, cognitive impairment, and patient-reported symptoms that substantially affect quality of life. Although self-acupressure has shown promise for symptom management, its effects on neuropeptides and cognition remain unclear. This study aimed to evaluate the effects of self-acupressure on beta-endorphin, hypocretin, cognition, and patient-reported outcome measures in individuals with MS. METHODS: A single-center, randomized, single-blind controlled trial was conducted in Türkiye. Ninety-two participants with MS were randomly assigned to an intervention group receiving an 8-week self-acupressure program or a control group receiving standard care. Eighty-two participants completed the study. Primary outcomes were changes in serum beta-endorphin and hypocretin levels. Secondary outcomes included cognitive performance, pain, fatigue, depressive symptoms, and health-related quality of life. RESULTS: Compared with the control group, the intervention group demonstrated a significantly greater increase in beta-endorphin levels (mean change: 56.7 vs. 12.5; P <0.001), whereas no significant between-group difference was observed for hypocretin levels ( P =0.685). Cognitive performance did not differ significantly between groups. However, the intervention group showed significantly greater improvements in pain ( P <0.001), fatigue ( P <0.001), depressive symptoms ( P =0.002), and health-related quality of life ( P =0.016). CONCLUSION: Self-acupressure improved several patient-reported outcomes and increased beta-endorphin levels in people with MS but had no significant effect on hypocretin levels or cognitive performance. These findings support self-acupressure as a feasible complementary nursing intervention for symptom management in MS and suggest that beta-endorphin may represent a potential biological mechanism underlying its therapeutic effects.
BACKGROUND: The American Association of Neuroscience Nurses (AANN) has published Clinical Practice Guidelines (CPGs) and evidence-based clinical reviews to help guide nursing practice for more than 25 years. This is a summary of findings of the 2025 AANN aneurysmal subarachnoid hemorrhage (aSAH) CPG. METHODS: Population, intervention, comparison, outcome (PICO) questions were formulated based on membership feedback. Systematic literature searches were performed for each PICO question. Literature between January 1, 2013, and December 31, 2022, and seminal research were synthesized to inform practice recommendations. Critical evaluation of the evidence is detailed in the AANN CPG Methods paper. RESULTS: The literature search yielded 5217 publications; 190 were included after review and backward referencing. Quality evidence was low and scarce for 5 out of 9 PICO search topics. CONCLUSIONS: Despite significant morbidity, mortality, and incidence, there remain numerous research opportunities in aSAH nursing care. This paper provides summary recommendations for nursing care of the aSAH population. It also identifies gaps in the evidence as areas for future research.
BACKGROUND:Trimethobenzamide has been the antiemetic of choice in the United States for people with Parkinson disease initiating subcutaneous apomorphine injection (SC-APO) therapy to rapidly manage OFF episodes. Following a cessation of trimethobenzamide production in 2021, SC‑APO was increasingly initiated without antiemetic pretreatment. METHODS:Data from the SC-APO Clinical Nurse Navigator support program were analyzed for new patient starts between January 2019 and March 2024, spanning periods before and after trimethobenzamide absence and SC-APO labeling changes. SC-APO starting dose patterns and 90-day treatment continuation were compared between patients who started with and without antiemetic pretreatment. RESULTS:Among 2634 patients, SC-APO initiations without trimethobenzamide increased from 32.8% before cessation of production (2019-2020) to nearly 100% by the end of 2021. During 2021, most prescribers (56.7%) continued to use the 0.2 mL (2.0 mg) starting dose; following a 2022 labeling update, use of the 0.1 mL (1.0 mg) starting dose increased to 86% by early 2024. The 90-day SC-APO continuation rates increased from 75.4% when used with trimethobenzamide pretreatment to 83.1% without it. CONCLUSION:SC-APO is now routinely started without antiemetic pretreatment, with higher overall rates of early treatment continuation. Flexible starting doses and titration, together with nurse‑led patient education and support, may facilitate successful treatment initiation and continuation in contemporary clinical practice.
BACKGROUND:There has been an increase in the availability and use of artificial intelligence (AI) across many professional domains, and there are traces of AI in nearly every manuscript published using modern technology. It is becoming increasingly difficult for peer reviewers, editorial teams, and journal readers to identify the degree to which authors have used AI in the development of their manuscripts. METHODS:Our research group developed an AI scoring rubric to provide authors with an opportunity to self-disclose their use of AI. RESULTS:The Transparency and Reporting of Artificial Intelligence Contribution for Evaluating Submissions (TRACES) instrument provides a score from 0 to 40 across 3 domains: mechanics, writing, and illustrations. Higher scores indicate increased use of AI by the authors when writing or preparing a manuscript for submission. CONCLUSION:Authors in any field should self-report a TRACES score when submitting their manuscript. Journals may benefit from requiring authors to include a TRACES score when submitting a manuscript for peer review. While higher TRACES scores indicate greater use of AI, there is no specific cutoff provided to determine manuscript acceptance or rejection.
BACKGROUND:The Commit-to-Sit initiative, where the nurses will sit with patients during bedside shift report (BSR), has been proposed as a strategy to improve patient engagement, communication, and satisfaction. This quality improvement study evaluates the effectiveness of the Commit-to-Sit initiative in improving patient experience, as measured by Press Ganey Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores, on a neurological unit. METHODS:The initiative was implemented in our Neuroscience unit in May 2024, and HCAHPS scores were collected quarterly. RESULTS:Neuroscience unit demonstrated a notable increase in the "Rate the Hospital 0-10" score, rising from the 9 th percentile rank in Q1 2024 to the 77 th percentile rank in Q3 2025; "Communication with Nursing" also demonstrated notable increase from 58 th percentile rank in Q1 2024 to 99 th in Q3 2025. The percentile ranks for "Nurses listen carefully to you" and "Nurse treat with courtesy and respect" remained consistently above an 87 th percentile rank for over a 5-quarter timeframe. CONCLUSION:Integration of Commit-to-Sit during BSR and reinforcement through midday huddle report-outs and leadership rounds was associated with higher HCAHPS percentile rank scores. Patient feedback captured through Press Ganey and leadership rounds indicated that patients felt more engaged, heard, and involved in their care.
BACKGROUND:Postoperative delirium (POD) is a frequent complication following neurosurgery, yet research on its specific impact on multidimensional recovery in craniotomy patients is limited. This study aimed to determine the incidence of POD and investigate its impact on physical, psychological, and cognitive recovery at both hospital discharge and the first follow-up visit. METHODS:A prospective cohort study was conducted with 164 postcraniotomy patients at a tertiary hospital in Bangkok. POD was assessed 48 to 72 hours postoperatively using the Confusion Assessment Method for the ICU (CAM-ICU). Recovery was evaluated across 3 dimensions: physical (Sickness Impact Profile), psychological (State Anxiety Inventory), and cognitive (Montreal Cognitive Assessment). Multiple regression analysis was used to analyze the impact of CAM-ICU positive, adjusting for surgical duration, postoperative complications, and consciousness levels. RESULTS:The incidence of CAM-ICU positive was 18.29%. Patients who were CAM-ICU negative demonstrated significantly better physical and cognitive recovery and shorter lengths of stay, although they reported poorer psychological recovery. At the first follow-up, better physical and poorer psychological recovery persisted in the CAM-ICU-negative group, while cognitive recovery no longer differed between groups. After adjusting for confounding variables, CAM-ICU positive was a significant predictor of poorer physical (B=8.218, P=.01) and cognitive (B=-1.545, P<.001) recovery. CONCLUSIONS:POD significantly impairs physical and cognitive recovery in patients following craniotomy. Routine perioperative screening for delirium is essential for neuroscience nurses to identify at-risk patients early and implement interventions to promote recovery across all dimensions.
BACKGROUND:Stroke family caregivers have been found to neglect their own health as they provide much-needed care to their loved ones. They have been shown to experience significantly poorer health than non-caregiving populations. Studies addressing stroke family caregiver health tend to use a wide variety of instruments to measure this concept. The purpose of this review is to examine the psychometric instruments currently used in the stroke family caregiving literature to measure stroke caregivers' health. During this process, relevance will be assessed, key measurement gaps will be identified, and recommendations will be provided for future research and clinical practice. METHODS:Guided by PRISMA guidelines, a comprehensive search was conducted across multiple databases and included peer-reviewed studies published between January 2000 and October 2025. RESULTS:A total of 39 studies met the inclusion criteria. The most frequently used were the Medical Outcomes Short Form (SF-36), followed by the European Quality of Life Instrument (EuroQol), the Bakas Caregiving Outcomes Scale (BCOS), the Abbreviated World Health Organization Quality of Life Measure (WHOQoL-Bref), the Unhealthy Days Measure, and the Sickness Impact Profile (SIP). All were global measures, except for the BCOS, which was caregiver-specific. The BCOS did not measure healthy behaviors. CONCLUSIONS:Currently available instruments remain useful, but their selection and interpretation in stroke family caregiver populations require awareness of their strengths and limitations.
BACKGROUND:Ischemic stroke patients commonly experience sleep disturbances, fatigue, and bowel dysfunction, which negatively impact rehabilitation outcomes. Non-pharmacological interventions such as warm foot baths may offer supportive benefits. This study aimed to examine the effects of warm foot baths on sleep quality, fatigue, and constipation severity in patients with stroke. METHODS:A pretest-post-test control group design was used. The study was conducted between September 2024 and June 2025 with patients hospitalized for stroke at the neurology clinic of a training and research hospital in Eastern Turkey. The study population consisted of patients diagnosed with stroke who were followed up at the aforementioned unit during the study period. The 96 participants included 51 in the experimental and 45 in the control group; based on an effect size of 0.60, α=0.05, and power=0.95. Data were collected using the Personal Identification Form, Fatigue Severity Scale, Constipation Severity Scale, and Richards-Campbell Sleep Questionnaire. The experimental group received a 20-minute warm foot bath 30 minutes before bedtime for 1 week, whereas the control group received routine care only. RESULTS:Foot baths did not significantly reduce fatigue compared with the control group. However, significant improvements were observed in constipation severity and sleep quality in the experimental group ( P <0.001). CONCLUSION:Warm foot baths were effective in reducing constipation severity and improving sleep quality in patients with stroke. The results suggest that foot baths can be considered a supportive and feasible complementary care approach for managing symptoms in patients with stroke. These findings support the use of non-pharmacological interventions in stroke rehabilitation.
