Nasrin Esnaashari, DNP, FNP, CNS

Abstract:

Background. Neurological disorders, such as Parkinson’s disease (PD) and Essential Tremors (ET) are among the leading sources of disability. Several studies have demonstrated the efficacy of Deep Brain Stimulation (DBS) therapy for motor symptom control in a selected group of patients with PD or ET. However, patient education materials are not consistently available for DBS candidates or caregivers. The purpose of this quality improvement project was to examine the effects of an Advanced Practice Registered Nurse-led comprehensive DBS Education-Based Intervention program (DBS-EBI) on DBS knowledge and satisfaction in patients with PD or ET and their caregivers immediately after, and two weeks after DBS-EBI.

Methods. A single group design with three time-points was used to examine knowledge and satisfaction after DBS-EBI in patients with PD and/or ET and caregivers. Knowledge was measured using the Knowledge Evaluation Form before (T1), immediately after (T2), and two weeks after (T3) The Program Evaluation Form was used to measure satisfaction (T3).

Results. Patients (n=7 PD; 2 ET; 1 PD + ET, 58.8 ± 17.28 years) had a significant change in knowledge (χ2 df=2, 13.2, p = 0.001), with scores at T2 > T1 (p = 0.007) and T3 > T2 (p = .01).

Caregivers (n = 12; 58.0 ± 15.33 years) also had significant change over the three time-points (χ2 df=2, = 10.82, p = .004) with scores at T3 > T2 > T1 (p = 0.05). Patients found the DBS-EBI was helpful (33%), educational (33%), and had good information (33%). Caregivers thought that the most important information were related to before and after surgery (66.7%) and precautions to minimize risk for infection (50%). Both patient and caregivers (60%) had positive comments on the DBS-EBI PowerPoint presentation and the Pamphlet that was given for reference at home.

Conclusion. The DBS-EBI showed a significant increase in knowledge and the majority of participants were satisfied with the DBS-EBI. A nurse-lead DBS-EBI program can improve DBS knowledge, and may be a useful practice across many DBS centers, given that DBS knowledge is associated with improved health outcomes and quality of care for DBS patients and caregivers.

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