Multiple Sclerosis Research Essay Paper
Multiple sclerosis is a serious diagnosis and it does have impact upon the lives of patients and their close people. The worst thing about it is that as soon as a patient is diagnosed with multiple sclerosis, his future is uncertain and unpredictable. Certainly the medical research about the disease and treatment methods continues to develop and the new achievements have their impact upon the ways how health care professionals work with such patients and their families. This explains the fact why nurses worldwide are to face a number of challenges, which are related to their MS patients in the rapidly changing field of multiple sclerosis.Multiple Sclerosis Research Essay Paper
Multiple sclerosis is a kind of state, when the insulating covers of nerve cells in the spinal cord and brain are damaged. “This damage disrupts the ability of parts of the nervous system to communicate, resulting in a range of signs and symptoms, including physical, mental, and sometimes psychiatric problems.” (Coles, 2008, p. 1503). MS is able to take different forms and then each isolated attack could be characterized by new symptoms. In addition the situation could be different for progressive forms. The fact is that symptoms might even absolutely disappear in the periods between attacks, this however should not be interpreted as the sign of the absence of permanent neurological problems. In order to understand the general scale of the problem, it is possible to trace the following statistics: “In 2015, about 2.3 million people were affected globally with rates varying widely in different regions and among different populations. That year about 18,900 people died from MS, up from 12,000 in 1990.” (Compston & Coles, 2002, p. 1222). The disease usually starts at the age between 20 and 50 and it could be more often diagnosed by women, in comparison to men. The name of the disease comes from the identification of the multiple scars (sclerae), which appear on the white matter of the brain and spinal cord. Discovery of this multiple sclerosis is associated with the names of Robert Carswell, a British professor of pathology and Jean Cruveilhier, a French professor of pathologic anatomy. They researched and described a lot of clinical details of the disease, but failed to compose the combination of these details into one separate disease. “Under the microscope,Multiple Sclerosis Research Essay Paper Swiss pathologist Georg Eduard Rindfleisch (1836–1908) noted in 1863 that the inflammation-associated lesions were distributed around blood vessels.” (Berer & Krishnamoorthy, 2014). Only in the year 1868 multiple sclerosis was recognized as a separate disease by the French neurologist Jean-Martin Charcot. He had collected the previous reports and had added his own observations and research data. He gave the name sclerose en plaques to the disease. After the disease was described by Charcot, there were several cases of this disease noted in historical accounts. For example there was information about a relatively young woman, she lived in Iceland. Suddenly she lost her ability to move and her vision. Several days passed and she managed to recover from these symptoms. “Saint Lidwina of Schiedam (1380–1433), a Dutch nun, may be one of the first clearly identifiable people with MS. From the age of 16 until her death at 53, she had intermittent pain, weakness of the legs, and vision loss—symptoms typical of MS.” (Medaer, 1979, p. 191).
A lot of researchers have contributed to development of the list of the signs and symptoms of multiple sclerosis. They came to conclude that an individual, suffering from MS, could have almost any neurological symptom. Most usually there are problems with motor, visual and sensory functions. The locations of the lesions in the nervous system influence the type of the symptoms. Patients might suffer from muscle weakness, blurred vision, problems with speaking or swallowing, they have poor coordination and balance, they experience muscle spasms or chronic and acute pain. In addition such emotional problems as depression or unstable moods are possible. “The main measure of disability and severity is the expanded disability status scale (EDSS), with other measures such as the multiple sclerosis functional composite being increasingly used in research.” (Compston & Coles, 2002, p. 1223).
There is little to no information about the concrete causes of MS. Researchers assume that this disease is the result of the combination of factors from genetic and environmental spheres. There are a lot of explanations, but none of them is really definitive with significant proofs. Thus there is a need to conduct further research to have clear vision about the real causes of MS.Multiple Sclerosis Research Essay Paper
The presenting signs and symptoms usually serve the basis for diagnosing of multiple sclerosis. As soon as these symptoms are found, a patient needs supporting medical imaging and corresponding laboratory testing. It is difficult to make conclusions immediately, as all these symptoms could be related to other medical problems. “The McDonald criteria, which focus on clinical, laboratory, and radiologic evidence of lesions at different times and in different areas, is the most commonly used method of diagnosis with the Schumacher and Poser criteria being of mostly historical significance.” (Compston & Coles, 2002, p. 1223). Unfortunately till the moment there is no one single test option, which would be used for providing a definite diagnosis of MS.
Making prognosis for multiple sclerosis patients is not an easy task. The expected development of the disease depends to a great extent upon the subtype of the disease, individual peculiarities of the patient, sex, age, initial symptoms and the current degree of disability. The life expectancy is usually defined as 30 years from the moment of the start of the disease, this figure is 5 to 10 years less in comparison to the unaffected individuals. Statistically up to 40% of individuals with MS can reach their seventies. Unfortunately this disease could be characterized by a great number of suicides, especially in those cases, when patients are more disabled.
MS is a rather challenging disease for all medical workers. MS nurse is expected to be a competent specialist, able to collaborate with individuals, affected by multiple sclerosis. The role of MS nurse continues to evolve along with obtaining more practical and theoretical knowledge about multiple sclerosis. At the moment the nursing practice should include special standards of providing the MS nursing case, including managing and impacting upon the illness of the patients via providing support in the form of disease- modifying treatments, facilitating symptoms management, strong promoting of safe functioning, helping to find the ways for wellness-oriented life quality. Multiple Sclerosis Research Essay Paper All the activities of a MS nurse in relation to patient care could be subdivided into three basic categories: establishing care, continuing care and sustaining care. By the second half of the 20th century the understanding of the multiple sclerosis and its treatment distanced from the previously developed hopeless prognosis, which were presented in 1948 by the National MS Society, which identified this disease as “crippler of young adults”( Colleen, 2014). MS started to be perceived rather as a treatable and more or less manageable condition of the patients. Such shifts in interpreting of the disease certainly led to transformation of the roles of medical care professionals. In the 1970s-1990s MS patients could expect to receive only “diagnose and adious” type of care and all the medical interventions were limited to offering temporary relief to the patients. Health care professionals were able to reduce symptoms and manage inflammation. There were not enough clinics, as well as medical personnel lacked for offering substantial help for the patients with MS. Advent of MRI technology did not change the situation significantly. In the 1990s the immunomodulatory agents were developed. They included interferon and glatiramer aceate. Development of these immunomodulatory agents had positive impact upon advances in diagnostic and monitoring procedures for the patients with MS. Such changes were meaningful not only for the patients and their families, they brought dramatic changes and expansion of the nurses’ roles in treating their patients with MS. “Treatment has shifted from a focus on crisis intervention and maintenance to a focus on prevention, symptom management, wellness, and empowerment. The nurse has emerged as a pivotal member of a multidisciplinar y team who provides education, skills development, and healthcare deliver y for patients with MS and their families.” (Colleen, 2014).
Plan of care
1. Planning
MR nurses are to take of the setting for treating of their patients, namely it should be acute, specialized and rehabilitative. The nurses are to perform the roles of both advocates and educators. Sometimes there is a need to work closely to the patients for better monitoring and assessment treatment results. If there is a chance, MS nurses should contribute to coordination and initiating of clinical research. Becoming an active participant of national or international organizations could be an advantage for a MS nurse. For example there is the International Organization of Multiple Sclerosis Nurses, which offers professional education options, networking, research and advocacy. Multiple Sclerosis Research Essay Paper
2. Intervention
A MS nurse should be able to collaborate with individuals, affected by multiple sclerosis and share the obtained knowledge, hope and strength for supporting the patients. The list of intervention practices could include:
- – managing the disease course via facilitating treatment, which could interrupt acute episodes and delays in progress of pathologies
- – promoting of safe and maximal functioning
- – supporting wellness-focused life quality
- – managing the symptoms and MS –related problems by the patients.
It was already mentioned that the course and outcomes of MS are difficult to predict. This is the reason, why MS nurses are to become responsive to changes of their patients’ physical and emotional status. Special attention in the intervention procedures should be paid to respect towards socioeconomic, cultural boundaries, along with provision of emphatic, comprehensive care.
Establishing of care is only the first step towards building relationship and encouraging positive and open communication with the patients. Determining of information needs, building trust and establishing of partnerships are also some integral parts of intervention measures. Multiple Sclerosis Research Essay Paper
3. Evaluation
Collection of data could be a part of the evaluation procedures for the MS nurses. First of all there is a need to collect demographic data, for example age, marital status, gender, living arrangements. Then medical data should be collected, including diagnosis, length of stay, discharge destination. One of the important outcomes of nursing care is considered to be functional health. This is the reason, why it is important to measure functionality, using the Extended Barthel Index as an instrument for rehabilitation settings. “Quality of life was measured using the German version of the WHOQoL-Bref. The instrument includes 26 items that are rated on a 5-point Likert scale (very poor to very good, very dissatisfied to very satisfied, not at all to an extreme amount, not at all to extremely, and never to always.” (Imhof, Lorenz & Suter-Riederer, 2015, p. 3).
Overall, multiple sclerosis is one of the sophisticated diseases, the causes and the treatment of which are still in the process of investigation and research. Rapid changes and introduction of innovative technologies into the sphere of medical care have their impacts upon the roles and the responsibilities of nurses, who take care of the patients with MS.Multiple Sclerosis Research Essay Paper