The role of the nurse in the care of a patient with multiple sclerosis

Multipla skleroza je autoimuna upalna kronična demijelinizacijska bolest središnjeg živčanog sustava. Bolest je relapsnog karaktera, a javlja se većinom kod mladih osoba te napreduje tijekom života s kasnijim stadijima karakteriziranim neurodegeneracijom i ireverzibilnim oštećenjima. Dijagnoza bolesti temelji se na prepoznavanju karakterističnih kliničkih simptoma, a potvrđuje se parakliničkim postupcima. Klinički simptomi započinju najčešće s kliničkim izoliranim sindromom, kombinacijom optičkog neuritisa, internuklearne oftalmoplegije i parcijalnog transverzalnog mijelitisa. Kasniji simptomi zahvaćaju gotovo svaki organski sustav s izrazitim oštećenjem vidnih, motoričkih i osjetnih funkcija te poremećajem koordinacije i ravnoteže i progresivnim kognitivnim propadanjem. Od parakliničkih postupaka koji se primjenjuju u dijagnostici multiple skleroze, najvažnija je magnetska rezonancija mozga i kralježničke moždine, a koriste se i analiza vidnih evociranih potencijala i analiza likvora. Zbog nemogućnosti liječenja uzroka bolesti, ciljevi liječenja su svladavanje akutnih napadaja i smanjenje vremena potrebnog za oporavak nakon napadaja, smanjenje broja napadaja i pokušaj usporavanja tijeka razvoja bolesti. U te svrhe primjenjuju se kortikosteroidi kod akutnih napadaja, razni lijekovi koji utječu na simptome bolesti te lijekovi koji mijenjaju tijek bolesti kao obećavajuća nova terapija koja djeluje na smanjenje broja i jačine relapsa. U ovom je radu istaknuta uloga medicinske sestre kao ključnog člana medicinskog tima koji skrbi za pacijenta oboljelog od multiple skleroze kao i važnost holističkog pristupa zbog same prirode bolesti koja osim što utječe na mnoge biološke funkcije bolesnika, donosi i mnoge psihološke probleme s kojima se susreću oboljeli jednako kao i njihovi bližnji. Analizirana je uloga medicinske sestre kroz sve faze bolesti, od sudjelovanja u postavljanju dijagnoze, liječenju i tretiranju simptoma multiple skleroze do edukacije bolesnika i njihove obitelji o samoj bolesti i pružanju podrške i savjeta kada je to potrebno.Multiple sclerosis is an autoimmune inflammatory chronic demyelinating disease of the central nervous system. The disease is relapsing in nature and occurs mostly in young individuals and progresses throughout life with later stages characterized with neurodegeneration and irreversible impairment. The diagnosis of the disease is based on the recognition of characteristic clinical symptoms and is confirmed by paraclinical procedures. Clinical symptoms most commonly begin with clinically isolated syndrome, a combination of optic neuritis, internuclear ophthalmoplegia, and partial transverse myelitis. Later symptoms affect almost every organ system with marked impairment of visual, motor and sensory functions, as well as impaired coordination and balance and progressive cognitive decline. Of the paraclinical procedures used in the diagnosis of multiple sclerosis, the most important is magnetic resonance imaging of the brain and spinal cord, analysis of visual evoked potentials and analysis of cerebrospinal fluid are also used. Due to the inability to treat the cause of the disease, the goals of treatment are to overcome acute seizures and reduce the time required to recover after an attack, reduce the number of seizures and try to slow down the course of disease development. For these purposes, corticosteroids are used in acute seizures, various drugs that affect the symptoms of the disease and drugs that change the course of the disease as a promising new therapy that reduces the number and severity of relapses. This paper highlights the role of the nurse as a key member of the medical team caring for a patient with multiple sclerosis as well as the importance of a holistic approach due to the nature of the disease which not only affects many biological functions but also brings many psychological problems that affect the patients as well as their loved ones. The role of the nurse was analyzed through all stages of the disease, from participation in diagnosing, treatment and treating the symptoms to educating patients and their families about the disease and providing advice and support when needed