Impact of clinical nurse specialists in multiple sclerosis – synthesis of the evidence

Authors

  • Angus Forbes BSc MSc RGN RHV DNCert CPT,

    1. Research Fellow, Primary and Intermediate Care Section, Florence Nightingale School of Nursing and Midwifery, King's College London, London, UK
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  • Alison While BSc MSc PhD RGN RHV,

    1. Professor of Community Nursing, Primary and Intermediate Care Section, Florence Nightingale School of Nursing and Midwifery, King's College London, London, UK
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  • Liz Dyson BSc MSc RGN RM,

    1. Research Assistant, Primary and Intermediate Care Section, Florence Nightingale School of Nursing and Midwifery, King's College London, London, UK
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  • Tricia Grocott BSc PhD RGN,

    1. Research Fellow, Primary and Intermediate Care Section, Florence Nightingale School of Nursing and Midwifery, King's College London, London, UK
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  • Peter Griffiths BSc PhD RGN

    1. Senior Lecturer, Primary and Intermediate Care Section, Florence Nightingale School of Nursing and Midwifery, King's College London, London, UK
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Angus Forbes,
Research in Primary and Intermediate Care  Section,
Florence Nightingale School of Nursing  and Midwifery,
King's College London,
James Clerk Maxwell Building,
Waterloo Road,
London SE1 8WA,
UK.
E-mail: angus.forbes@kcl.ac.uk

Abstract

Background. Multiple sclerosis is a chronic neurological condition demanding a broad range of interventions and support. Multiple sclerosis nurse specialists are emerging as a leading force in providing care to this group of patients.

Aim. This review aimed to identify and synthesize the evidence on the role of clinical nurse specialists in meeting the care needs of people with multiple sclerosis.

Methods. A systematic review of the literature addressing the role of the multiple sclerosis nurse specialist was undertaken. The review examined both the appropriateness and effectiveness of the multiple sclerosis nurse specialist role. The content of each item identified in the review was analysed, examining the structure, process and outcomes variables associated with the role. Materials containing an explicit methodology were critically appraised using established schedules and graded as strong, moderate or weak. The data were then synthesized in tables, thematically and using a quasi-judicial approach called the ‘System of Reasoning’.

Findings. Fifty-five items were examined and most (53%; n = 18) were descriptive in nature. There was insufficient evidence to demonstrate that the multiple sclerosis nurse role makes a difference to care. However, evidence was found to support current descriptions of the role – meaning? and there appeared to be a good fit between the role and the care needs of people with multiple sclerosis.

Conclusion. A systematic overview of the attributes of the multiple sclerosis nurse role is provided which should help service providers, nurses and other professionals consider how multiple sclerosis nurse specialists roles can contribute to the care of people with this condition. While there is little current evidence of effectiveness for the multiple sclerosis nurse specialist role, there is evidence for its appropriateness, although more rigorous primary research is required to test this.

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