Effective Multiple Sclerosis Management Through Improved Patient Assessment

Amy Perrin Ross, MSN, MSCN, APRN, CNRN, Natalie Hackbarth MSCN, RN, Christine Rohl, MSN, CNS, CNRN, FNP, Kristi Whitmyre, BA

Disclosures

J Neurosci Nurs. 2008;40(3):150-157. 

In This Article

Questionnaire Benefits

In our experience, questionnaires provide numerous benefits. Nurses use them to flag issues that otherwise might not have been brought to their attention. Questionnaires also help nurses determine how well MS patients' symptoms are being managed. For example, one patient presented with an issue related to foot pain. Upon review of the questionnaire, the nurse noted this patient also indicated a bladder issue. The nurse was then able to address both the primary complaint and the potentially important issue of a bladder problem, which the patient had not intended to discuss.

Questionnaires also enable nurses to better recognize situations in which patients require referrals to other physicians, nurses, or social services. They place the focus of physician-patient consultations on medical issues because nurses can address nonmedical issues as they respond to questionnaire answers. Questionnaires also can help to differentiate MS diagnoses. A nurse who suspects a patient may have MS based upon his or her presenting symptoms can use the questionnaire to determine if he or she is experiencing specific MS symptoms. For patients already diagnosed with MS, the questionnaire allows nurses and physicians to better manage existing symptoms and identify new symptoms more efficiently (with assistance from caregivers who also track symptoms). Finally, the questionnaires provide patients with more comprehensive, "whole person" care, and have empowered them to take a more active role in their treatment. The questionnaire raises patients' awareness of their symptoms and allows them to track their treatment's progress. As a result, patients tend to interact with their caregivers more frequently, and they often request a questionnaire when they come into the office.

A series of educational programs based on issues identified in questionnaires has been established in the office of one of this article's authors. These programs focus on issues patients may not discuss with their physicians during standard office visits. The questionnaires identified a group of patients who curtailed their fluid intake, for example, because they had trouble locomoting to the toilet (potentially leading to dehydration). An educational session was established for these patients to lend emotional and psychological support and provide alternatives to limiting liquid consumption. Other customized group visits have also been organized around the themes of sexuality, workplace rights and disclosure, and mood issues.

The patient database that was established with questionnaire data also has been useful. The database tracks patient perceptions and progress and can be used to recruit patients for clinical trials and research studies. Further, data from existing questionnaires regularly are evaluated and used to generate new questionnaires that address patient quality-of-life issues in a more specific manner.

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