Background The chronic nature of multiple sclerosis (MS) affects patient’s activities of daily living (ADL) and quality of life (QOL). Nursing interventions based on patients’ active participation in goal-setting can be beneficial in improving ADL and QOL. Aims This study aimed to determine the effect of applying the nursing process based on King’s Theory of Goal Attainment (TGA) on ADL and QOL of persons with multiple sclerosis (PwMS) during the COVID-19 pandemic. Methods In this clinical trial, 70 patients referred to the MS Society of Hamadan, Iran, were recruited using the convenience sampling method and randomly assigned into 2 groups. A 4-stage TGA was developed and implemented for the intervention group for a month. Data were gathered by ADL, instrumental ADL (IADL), and QOL questionnaires, and Goal of Attainment Scale (GAS) before and 2 months after the intervention. Results Intervention group achieved a higher number of prioritized goals ( p < 0.001) and reported higher QOL ( P < 0.001) and instrumental ADL (IADL; P = 0.002) than the control group. Conclusions Given the results, TGA could effectively promote mutual goal attainment, QOL, and IADL for PwMS during the COVID-19 pandemic. Trial registration ClinicalTriasl.gov Identifier: IRCT20201210049668N1.
Background and purpose A prognostic score was developed to predict dependency and death after cerebral venous thrombosis (CVT) to identify patients for targeted therapy in future clinical trials. Methods Data from the International CVT Consortium were used. Patients with pre‐existent functional dependency were excluded. Logistic regression was used to predict poor outcome (modified Rankin Scale score 3–6) at 6 months and Cox regression to predict 30‐day and 1‐year all‐cause mortality. Potential predictors derived from previous studies were selected with backward stepwise selection. Coefficients were shrunk using ridge regression to adjust for optimism in internal validation. Results Of 1454 patients with CVT, the cumulative number of deaths was 44 (3%) and 70 (5%) for 30 days and 1 year, respectively. Of 1126 patients evaluated regarding functional outcome, 137 (12%) were dependent or dead at 6 months. From the retained predictors for both models, the SI2NCAL2C score was derived utilizing the following components: absence of female‐sex‐specific risk factor, intracerebral hemorrhage, infection of the central nervous system, neurological focal deficits, coma, age, lower level of hemoglobin (g/l), higher level of glucose (mmol/l) at admission, and cancer. C‐statistics were 0.80 (95% confidence interval [CI] 0.75–0.84), 0.84 (95% CI 0.80–0.88) and 0.84 (95% CI 0.80–0.88) for the poor outcome, 30‐day and 1‐year mortality model, respectively. Calibration plots indicated a good model fit between predicted and observed values. The SI2NCAL2C score calculator is freely available at http://www.cerebralvenousthrombosis.com. Conclusions The SI2NCAL2C score shows adequate performance for estimating individual risk of mortality and dependency after CVT but external validation of the score is warranted.
AimThis study aimed to explain the experiences of individuals with multiple sclerosis (MS) about the collaborative care programme.DesignThis qualitative study was conducted from July 2021 to March 2022.MethodsWe conducted this study with individuals with MS who participated in the collaborative care programme in Hamadan, Iran. A purposive sampling with maximum variety was applied to recruit patients until data saturation. Eventually, 18 patients consented and were interviewed using a semi‐structured interview guide. The transcriptions of audio‐checked interviews were analysed using a conventional content analysis approach of Graneheim and Lundman by MAXQDA 10, 2010 edition.ResultsThe study identified three main categories. that emerged from the participants' experiences of collaborative care: the ‘Beginning of Communication’, which included two subcategories, ‘Introduction and Acquaintance with Each Other’ and ‘Formation of Trust’; ‘Mutual Interaction’, which included three subcategories, ‘Dialogue’, ‘Mutual Goal Setting’ and ‘Mutual Agreement of Care Solutions’; and ‘Exchange of Targeted Behaviors’, which included six categories, Implementation of Strategies for ‘Nutritional Behaviors’, ‘Sleep and Rest’, ‘Constipation Relief’, ‘Promotion of Physical Activity and Exercise’, ‘Fatigue Reduction’ and ‘Stress Management’.ConclusionsThe findings highlight the statistically significant role of collaborative care in MS management. Utilizing these research findings can update the development of interventions based on collaborative care, which can provide appropriate support to individuals with MS.Patient or public contributionIndividuals with multiple sclerosis.
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