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      Comunicación terapéutica en la Esclerosis Lateral Amiotrófica: la enfermera gestora de casos al final de la vida Translated title: Therapeutic communication in Amyotrophic Lateral Sclerosis: case management at the end of life

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          Abstract

          Resumen La Esclerosis Lateral Amiotrófica (ELA) es una enfermedad neurodegenerativa caracterizada por una evolución rápida y mortal, produciendo un gran impacto emocional tanto en el paciente, como en su familia. El papel de la enfermera Gestora de Casos en el seguimiento, evaluación y control del paciente y su familia desde el diagnóstico de ELA, y como principal referente experta en cuidados, la posiciona como referente de nexo de unión del equipo multidisciplinar y la unidad familiar. Su papel dentro del equipo interdisciplinar ayuda a mejorar la asistencia que el cuidador familiar proporciona, evitando la sobrecarga del rol de cuidador, aumentando la seguridad del paciente, y por tanto la calidad de vida de ambos, mejorando así también la comunicación e información y la satisfacción familiar. En la práctica, resulta complicado mantener una continuidad de cuidados integrales a lo largo de todo el proceso de la enfermedad, desde el diagnóstico, hasta los últimos días.

          Translated abstract

          Abstract Amyotrophic Lateral Sclerosis (ALS) is a neurodegenerative disease characterized by rapid and fatal evolution, producing a great emotional impact on both the patient and their family. The role of the Nurse Case Manager in the monitoring, evaluation, and control of the patient and their family from the diagnosis of ALS, and as the main expert reference in care, positions her as a point of reference for the union of the multidisciplinary team and the family unit. Their role within the interdisciplinary team helps to improve the assistance that the informal caregiver provides, avoiding the overload of the caregiver role, increasing patient safety, and therefore the quality of life for both, thus also improving communication and information and family satisfaction. In practice, it is difficult to maintain a continuity of comprehensive care throughout the disease process, from diagnosis to the last days.

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          Most cited references15

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          Clinical care of patients with amyotrophic lateral sclerosis.

          Although amyotrophic lateral sclerosis and its variants are readily recognised by neurologists, about 10% of patients are misdiagnosed, and delays in diagnosis are common. Prompt diagnosis, sensitive communication of the diagnosis, the involvement of the patient and their family, and a positive care plan are prerequisites for good clinical management. A multidisciplinary, palliative approach can prolong survival and maintain quality of life. Treatment with riluzole improves survival but has a marginal effect on the rate of functional deterioration, whereas non-invasive ventilation prolongs survival and improves or maintains quality of life. In this Review, we discuss the diagnosis, management, and how to cope with impaired function and end of life on the basis of our experience, the opinions of experts, existing guidelines, and clinical trials. We highlight the need for research on the effectiveness of gastrostomy, access to non-invasive ventilation and palliative care, communication between the care team, the patient and his or her family, and recognition of the clinical and social effects of cognitive impairment. We recommend that the plethora of evidence-based guidelines should be compiled into an internationally agreed guideline of best practice.
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            The amyotrophic lateral sclerosis center: a model of multidisciplinary management.

            Amyotrophic lateral sclerosis (ALS) is a devastating, progressive motor neuron disorder that poses a myriad of clinical problems. Patients who have ALS are best cared for in a multidisciplinary fashion, with involvement of clinicians from various specialties, including neurology, physical medicine and rehabilitation, pulmonary medicine, clinical nurse specialists or nurse practitioners, physical and occupational therapists, speech language pathologists, dietitians, psychologists, social workers, and case managers. This article provides a summary of the current research into the rehabilitation of ALS, including the role of exercise, spasticity management, mood disorders, pain, and palliative care.
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              Ley 2/2010, de 8 de abril, de derechos y garantías de la dignidad de la persona en el proceso de la muerte

              (2010)
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                Author and article information

                Journal
                index
                Index de Enfermería
                Index Enferm
                Fundación Index (Granada, Granada, Spain )
                1132-1296
                1699-5988
                June 2021
                : 30
                : 1-2
                : 55-58
                Affiliations
                [1] Almería orgnameHospital de Poniente de Almería orgdiv1Servicio de Tocoginecología España
                [2] Almería Andalucía orgnameUniversidad de Almería Spain
                [3] Málaga orgnameHospital Universitario Regional de Málaga orgdiv1Servicio de Neurología España
                [4] Almería orgnameComplejo Hospitalario Torrecárdenas de Almería orgdiv1Servicio de Neurología España
                [5] orgnameComplejo Hospitalario Torrecárdenas de Almería orgdiv1Servicio de Medicina Interna
                [6] Almería orgnameDelegación Territorial de igualdad España
                Article
                S1132-12962021000100013 S1132-1296(21)03000100013
                6d0bd96e-5318-45e0-b79c-1a7f3cb2ab28

                This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

                History
                : 28 August 2020
                : 24 November 2020
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 16, Pages: 4
                Product

                SciELO Spain

                Categories
                Revisiones

                Comunicación,Nursing,Amyotrophic Lateral Sclerosis,Therapeutic Relationship,Palliative Care,Primary Care,Communication,Enfermería,Esclerosis Lateral Amiotrófica,Relación Terapéutica,Cuidados Paliativos,Atención Primaria

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