Postgraduate Degree in Multiple Sclerosis Nursing

• To promote advanced training on MS and leadership, contributing to the sustainability and further development of clinical practices, patient advocacy, education and research.
• To develop nurses’ diagnostic, prescriptive and assessment skills to meet the specific needs of patients and families, contributing to a better adaptation in the psychological, social, family, professional, and financial domains, among others.
• To empower nurses to help MS patients and their families manage their therapeutic self-care.
• To contribute to produce evidence on MS best practices and their implementation on nursing clinical practice.
• To contribute to improve the quality of life of MS patients by promoting advocacy, knowledge acquisition, expertise and research.

PROGRAM PRESENTATION

1. CONCEPTS UNDERLYING CLINICAL PRACTICE
A. Fundamentals of Neurology
1. Neuroanatomy
2. Nerve conduction

B. Definition of Multiple Sclerosis
1. Disease course and Classifications
2. Epidemiology and Etiology
3. Natural history
C. Pathophysiology of Multiple Sclerosis
1. Disruption of Blood/Brain Barrier
2. Immune Dysfunction
3. Destruction of Myelin
4. Role of Oligodendrocytes
5. Axonal damage
6. Nerve conduction
7. Neuropathology
8. Neuroanatomy
D. Diagnosis of Multiple Sclerosis
1. Signs and Symptoms
2. Prognostic Indicators
3. Diagnostic Testing
a. Magnetic Resonance Imaging (MRI)
b. Evoked Potentials
c. Lumbar Puncture
d. Laboratory Tests
e. Other Tests
E. Diagnosis of Relapse
F. Clinically Isolated Syndrome (CIS)

2. THE TRANSITION PROCESS IN CHRONIC DISEASE AND SELF-CARE MANAGEMENT I
A. The experience of the health-illness transition
B. Properties of the transition
C. Facilitating and inhibiting conditions of the transition
D. Response patterns

3. ASSESSMENT AND INTERVENTION FOR CLINICAL PRACTICE I
A. Pharmacological Interventions
1. Relapse Management
a. Corticosteroids
b. Other
2. Disease-Modifying agents
a. Immunomodulating agents
3. Dosage
4. Side effects
5. Efficacy
a. Immunosuppressant Agents
b. Other

4. THE TRANSITION PROCESS IN CHRONIC DISEASE AND SELF-CARE MANAGEMENT II
A. Knowledge, emotions and adaptation
B. Self-care profiles
C. Nursing therapies in self-care management
1. Adaptive strategies
2. Assistive devices

5. ASSESSMENT AND INTERVENTION FOR CLINICAL PRACTICE I
B. Symptoms and symptom management
1. Fatigue
2. Pain
3. Spasticity
4. Tremor
5. Weakness
6. Altered Mobility and Balance Problems

6. LIVING WITH MULTIPLE SCLEROSIS: INDIVIDUAL RESPONSES TO THE DISEASE PROCESS I
A. Nursing focus areas - initial assessment
B. Nursing diagnoses
C. Nursing interventions
D. Nursing-sensitive outcomes

7. ASSESSMENT AND INTERVENTION FOR CLINICAL PRACTICE I
B. Symptoms and symptom management
7. Visual Impairment
8. Cognitive Impairment
9. Elimination Dysfunction
10. Altered Speech and Swallowing
11. Sexual Dysfunction
12. Altered Sensation
13. Other
C. Assessment Tools
D. Complementary Therapies
E. Pediatric Issues

8. LIVING WITH MULTIPLE SCLEROSIS: INDIVIDUAL RESPONSES TO THE DISEASE PROCESS II
A. Nursing focus areas - initial assessment
B. Nursing diagnoses
C. Nursing interventions
D. Nursing-sensitive outcomes

9. SOCIAL SUPPORT AND FAMILY
A. The Calgary Family Assessment Model
B. Nursing interventions toward the family
C. Role of the caregiver
D. Situational transition
E. Knowledge and skill acquisition
F. Support networks
G. Caregiver burden

10. MANAGEMENT OF THE THERAPEUTIC REGIMEN
A. Individual vulnerability and resilience
B. The Chronic Care Model
C. Styles and characteristics of therapeutic regimen management
1. Negligent management
2. Supervised management
3. Responsible management
D. Nursing interventions according to the styles of therapeutic regimen management
E. Case manager and his/her characteristics
F. Symptom management in nursing practice

11. REHABILITATION OF THE PERSON WITH MULTIPLE SCLEROSIS
A. Motor rehabilitation
B. Respiratory rehabilitation
C. Cognitive rehabilitation
D. Bladder rehabilitation

12. HEALTH EDUCATION
A. Patient education
1. Disease Specific
2. Principles of Teaching and Learning
3. Health Promotion and Change Theory
4. Special Populations
a. Developmental Issues
b. Comorbidities
c. Other
5. Cultural Sensitivity
6. Gender Differences
a. Pregnancy
b. Hormonal
7. Resources and Referrals
8. Adherence
B. Professional Development

13. ASSESSMENT AND INTERVENTION FOR CLINICAL PRACTICE II
C. Psychosocial Issues
1. Response to Chronic Illness
2. Emotional Status
3. Support Network
4. Cultural Issues
5. Family and Relationships
6. Vocational Issues
7. Financial Issues
8. Recreational Issues
9. Potential for Abuse and Neglect
10. Depression
11. End of life
12. Delivery of Bad News

14. ADVOCACY
A. Patient Rights
B. Ethical Practice
C. Negotiating the National Health Care System
D. Empowerment
E. Community Resources
F. Organizations
1. World Health Organization
2. National Multiple Sclerosis Society
3. International Organization of Multiple Sclerosis Nurses

15. RESEARCH
A. Research Terminology and Process
B. Protection of Human Subjects
C. Evidence-Based Practice

16. CARE QUALITY AND SAFETY

WORK PRESENTATIONS

OTHER ACTIVITIES
A. Meetings with multiple sclerosis patients and families
B. International symposium
C. Clinical internship
D. Elaboration of the Documentation Standard
E. Literature review focused on the practice
F. Presentation of the monograph elaborated by the students during the program.
G. Acquisition of skills specific to MS Nursing

METHODOLOGY
Based on a student-centered learning approach, the program will use methodologies that allow for the acquisition of skills in the management and provision of care to MS patients and their families. The program will have theoretical, theoretical-practical, practical and clinical components, in order to consolidate the knowledge and skills in this area.
The theoretical classes will be mainly explanatory using an overhead projector, board, laptop and multimedia projector, video, television, among other equipment. In the theoretical-practical and practical classes, we will use active strategies, such as discussion in small groups, simulation, among others.
The clinical component will consist of active strategies, such as the analysis and discussion of clinical studies in a clinical context of reference in this field (Neurology Unit of the Coimbra Hospital and University Center).
Students will be encouraged to conduct a literature search on the most recent evidence in the field of care provision to MS patients and families, complementing the contents presented in the classroom. Students will be assessed on their ability to perform a literature review.

ASSESSMENT AND CERTIFICATION
Students will be assessed through written exams, and the elaboration and presentation of a written literature review and a report on their clinical experience. Students who complete the program will be certified by the Nursing School of Coimbra. Students will be able to apply to international certification by the Multiple Sclerosis Nursing International Certification