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Behavioral aspects of nurse practitioners associated with optimal multiple sclerosis care in Spain

BACKGROUND: Nurse practitioners (NPs) play a critical role in the multidisciplinary management of patients with multiple sclerosis (MS). Neurologists´ behavioral characteristics have been associated with suboptimal clinical decisions. However, limited information is available on their impact among N...

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Autores principales: Saposnik, Gustavo, Del Río, Beatriz, Bueno-Gil, Guillermo, Sempere, Ángel P., Lendínez-Mesa, Alejandro, Rodríguez-Antigüedad, Alfredo, Terzaghi, María, Medrano, Nicolás, Maurino, Jorge
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8654214/
https://www.ncbi.nlm.nih.gov/pubmed/34879095
http://dx.doi.org/10.1371/journal.pone.0261050
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author Saposnik, Gustavo
Del Río, Beatriz
Bueno-Gil, Guillermo
Sempere, Ángel P.
Lendínez-Mesa, Alejandro
Rodríguez-Antigüedad, Alfredo
Terzaghi, María
Medrano, Nicolás
Maurino, Jorge
author_facet Saposnik, Gustavo
Del Río, Beatriz
Bueno-Gil, Guillermo
Sempere, Ángel P.
Lendínez-Mesa, Alejandro
Rodríguez-Antigüedad, Alfredo
Terzaghi, María
Medrano, Nicolás
Maurino, Jorge
author_sort Saposnik, Gustavo
collection PubMed
description BACKGROUND: Nurse practitioners (NPs) play a critical role in the multidisciplinary management of patients with multiple sclerosis (MS). Neurologists´ behavioral characteristics have been associated with suboptimal clinical decisions. However, limited information is available on their impact among NPs involved in MS care. The aim of this study was to assess nurses´ therapeutic choices to understand behavioral factors influencing their decision making process. METHODS: A non-interventional, cross-sectional, web-based study was conducted. NPs actively involved in the care of patients with MS were invited to participate in the study by the Spanish Society of Neurology Nursing. Participants answered questions regarding their standard practice and therapeutic management of seven simulated relapsing-remitting MS (RRMS) case scenarios. A behavioral battery was used to measure participants´ life satisfaction, mood, positive social behaviors, feeling of helpfulness, attitudes toward adoption of evidence-based innovations, occupational burnout, and healthcare-related regret. The outcome of interest was therapeutic inertia (TI), defined as the lack of treatment escalation when there is clinical and radiological evidence of disease activity. A score to quantify TI was created based on the number of simulated scenarios where treatment intensification was warranted. RESULTS: Overall, 331 NPs were invited to participate, 130 initiated the study, and 96 (29%) completed the study. The mean age (SD) was 44.6 (9.8) years and 91.7% were female. Seventy-three participants (76.0%) felt their opinions had a significant influence on neurologists´ therapeutic decisions. Sixteen NPs (16.5%) showed severe emotional exhaustion related to work and 13 (13.5%) had depressive symptoms. The mean (SD) TI score was 0.97 (1.1). Fifty-six of NPs showed TI in at least one case scenario. Higher years of nursing experience (p = 0.014), feeling of helpfulness (p = 0.014), positive attitudes toward innovations (p = 0.046), and a higher intensity of care-related regret (p = 0.021) were associated with a lower risk of TI (adjusted R(2) = 0.28). Burnout was associated with higher risk of TI (p = 0.001). CONCLUSIONS: Although NPs cannot prescribe MS treatments in Spain, their behavioral characteristics may influence the management of patients with RRMS. Continuing education and specific strategies for reducing occupational burnout may lead to better management skills and improve MS care.
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spelling pubmed-86542142021-12-09 Behavioral aspects of nurse practitioners associated with optimal multiple sclerosis care in Spain Saposnik, Gustavo Del Río, Beatriz Bueno-Gil, Guillermo Sempere, Ángel P. Lendínez-Mesa, Alejandro Rodríguez-Antigüedad, Alfredo Terzaghi, María Medrano, Nicolás Maurino, Jorge PLoS One Research Article BACKGROUND: Nurse practitioners (NPs) play a critical role in the multidisciplinary management of patients with multiple sclerosis (MS). Neurologists´ behavioral characteristics have been associated with suboptimal clinical decisions. However, limited information is available on their impact among NPs involved in MS care. The aim of this study was to assess nurses´ therapeutic choices to understand behavioral factors influencing their decision making process. METHODS: A non-interventional, cross-sectional, web-based study was conducted. NPs actively involved in the care of patients with MS were invited to participate in the study by the Spanish Society of Neurology Nursing. Participants answered questions regarding their standard practice and therapeutic management of seven simulated relapsing-remitting MS (RRMS) case scenarios. A behavioral battery was used to measure participants´ life satisfaction, mood, positive social behaviors, feeling of helpfulness, attitudes toward adoption of evidence-based innovations, occupational burnout, and healthcare-related regret. The outcome of interest was therapeutic inertia (TI), defined as the lack of treatment escalation when there is clinical and radiological evidence of disease activity. A score to quantify TI was created based on the number of simulated scenarios where treatment intensification was warranted. RESULTS: Overall, 331 NPs were invited to participate, 130 initiated the study, and 96 (29%) completed the study. The mean age (SD) was 44.6 (9.8) years and 91.7% were female. Seventy-three participants (76.0%) felt their opinions had a significant influence on neurologists´ therapeutic decisions. Sixteen NPs (16.5%) showed severe emotional exhaustion related to work and 13 (13.5%) had depressive symptoms. The mean (SD) TI score was 0.97 (1.1). Fifty-six of NPs showed TI in at least one case scenario. Higher years of nursing experience (p = 0.014), feeling of helpfulness (p = 0.014), positive attitudes toward innovations (p = 0.046), and a higher intensity of care-related regret (p = 0.021) were associated with a lower risk of TI (adjusted R(2) = 0.28). Burnout was associated with higher risk of TI (p = 0.001). CONCLUSIONS: Although NPs cannot prescribe MS treatments in Spain, their behavioral characteristics may influence the management of patients with RRMS. Continuing education and specific strategies for reducing occupational burnout may lead to better management skills and improve MS care. Public Library of Science 2021-12-08 /pmc/articles/PMC8654214/ /pubmed/34879095 http://dx.doi.org/10.1371/journal.pone.0261050 Text en © 2021 Saposnik et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Saposnik, Gustavo
Del Río, Beatriz
Bueno-Gil, Guillermo
Sempere, Ángel P.
Lendínez-Mesa, Alejandro
Rodríguez-Antigüedad, Alfredo
Terzaghi, María
Medrano, Nicolás
Maurino, Jorge
Behavioral aspects of nurse practitioners associated with optimal multiple sclerosis care in Spain
title Behavioral aspects of nurse practitioners associated with optimal multiple sclerosis care in Spain
title_full Behavioral aspects of nurse practitioners associated with optimal multiple sclerosis care in Spain
title_fullStr Behavioral aspects of nurse practitioners associated with optimal multiple sclerosis care in Spain
title_full_unstemmed Behavioral aspects of nurse practitioners associated with optimal multiple sclerosis care in Spain
title_short Behavioral aspects of nurse practitioners associated with optimal multiple sclerosis care in Spain
title_sort behavioral aspects of nurse practitioners associated with optimal multiple sclerosis care in spain
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8654214/
https://www.ncbi.nlm.nih.gov/pubmed/34879095
http://dx.doi.org/10.1371/journal.pone.0261050
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