Multipl Sklerozlu Hastaların Tedavi Yönetimi ve Hemşirelik Yaklaşımları

Multipl skleroz (MS) hastalığı, çeşitli tedavi yaklaşımlarına (fizyoterapi, psikoterapi ve yönetim stratejileri) rağmen kesin tedavisi mümkün olmayan bir hastalıktır. Ancak hastalığın altında yatan patolojik bağışıklık tepkilerini değiştiren mevcut immünomodülatörler bu hastalığın gidişatını etkileyebilmektedir. Bu hastalık için kullanılan, hastalığı modifiye edici ilaçlar [disease modifying therapies (DMT)] akut nörolojik atakların oranını azaltmakta ve özürlülüğün ilerlemesini geciktirebilmektedir. Multipl sklerozlu hastaların tedavi rejimi ve hastalığa yönelik eğitim ve izlemde bu alanda çalışan hemşireler etkin ve aktif bir rol oynamaktadır. Hastalığın prognozunda değişikliklere yol açan hastalık modifiye edici tedavilerin etkilerini anlamak, hastalara birebir bakım veren hemşirelerin önemli sorumluluklarındandır. Multipl skleroza yönelik bu tedavilerinin yaşam boyunca sürebilmesi nedeniyle hekim ile birlikte hemşirenin de MS hastasıyla uyumlu çalışması önemlidir. Hastalığın tedavisinde uyum çok önemlidir ve tedaviye uyumu artırmak için hastanın tedaviden tam yarar görmesini sağlamak önemli bir hedeftir. Hasta eğitiminde hastanın durumu, uygulanması gereken tedavi ve tedavi yararlarının tartışılması bu hedefe ulaşılmasında büyük önem taşımaktadır. Hemşirelerin, MS hastalarının tedaviye uyumunu teşvik etmesi için DMT etki ve yan etkilerini bilmesi, MS hastasının gereksinimlerini anlaması önemlidir. Bu derlemede mevcut MS tedavi seçeneklerinin oluşturabileceği klinik etkiler, potansiyel yan etkiler, hasta izleme gereksinimleri ve hastaların bu etkileri anlamasına nasıl yardımcı olacakları konusunda hemşirelere rehberlik etmek ve MS tedavisine yönelik bilgi kazandırmak amaçlanmıştır.

Treatment Management of Patients with Multiple Sclerosis and Nursing Approaches

Multiple sclerosis (MS) is currently incurable, although a variety of treatment approaches are available, including physiotherapy, psychotherapy, and management strategies to mitigate the symptoms of MS. However, immunomodulatory agents are available that can modify the course of the disease by altering the pathological immune responses underlying MS. Treatment with these disease-modifying drugs (DMDs) aims to reduce the rate of acute neurological attacks, and can delay disability progression. Nurses play an effective and active role in patients with multiple sclerosis (MS) for the managing the treatment regimen, education and follow-up for the disease. Nurses who giving one-to-one care to patients, have important responsibilities to understand the effects of disease modifying therapies (DMT) therapies that lead to changes in the prognosis of MS. Because DMT treatments can last throughout life, doctor, nurse and MS patient should be compatible. Patient adherence is very important in the treatment of MS and it is an important goal to ensure that the patient is fully benefited from treatment to improve adherence. It is important for nurses to know the effects and side effects of DMT and to understand the needs of MS patients in order to encourage the adherence of treatment to MS patients.  In this review, it is aimed to guide the nurses about how they can help MS patients to understand the clinical effects, potential side effects, patient monitoring requirements of MS treatment options and to be able to understand these effects, and to gain knowledge about MS treatment.

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