Volume 24, Issue 6 (Feb - Mar 2021)                   2021, 24(6): 582-591 | Back to browse issues page

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Amini M, Zeighami R. Repeated Transcranial Magnetic Stimulation and Nursing Care: A Review. Journal of Inflammatory Diseases. 2021; 24 (6) :582-591
URL: http://journal.qums.ac.ir/article-1-3081-en.html
1- Department of Psychiatric Nursing, Faculty of Nursing and Midewifery, Qazvin University of Medical Sciences, Qazvin, Iran.
2- Department of Psychiatric Nursing, Faculty of Nursing and Midewifery, Qazvin University of Medical Sciences, Qazvin, Iran. , behsare@gmail.com
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1. Introduction
epeated Transcranial Magnetic Stimulation (rTMS) therapy is one of the novel treatment methods for various neurological and psychiatric diseases [1]. This method approved by the Food and Drug Administration (FDA) in October 2008, is important for the treatment of mood disorders and the establishment of mechanisms for clinical treatment. This treatment involves directly activating the brain with electricity, magnets, or implants to treat depression and other disorders, and works by targeting the brain areas involved in mood disorders [2]. Considering the importance of nursing care in the treatment of patients by rTMS, it seems necessary to identify the ways of communication between nurse and patient in this method. This study aims to review the mechanism of rTMS, psychiatric nursing records and the necessary details about setting up an rTMS clinical service, and the role of the psychiatric nurse in establishing rTMS clinical services and assisting patients undergoing rTMS.
2. Materials and Methods
This is a systematic review study. The search was conducted in IranMedex, PubMed, SID, Elsevier, Scholar Google, and Ovid databases using the keywords: Frequent transcranial magnetic stimulation, long-term potential, neuropsychological, and Psychiatric approach on related studies published from 2003 to 2020. Inclusion Criteria were being in English or Persian, and related to the purpose of our study, while exit criterion was the lack of access to full-texts. Based on these criteria, 24 eligible articles in the field of nursing care and rTMS were finally selected for the review. 
3. Results
The duration of rTMS depends on the treatment protocol; each rTMS session usually takes about 20 minutes. The number of sessions also varies according to the protocol; many studies used 10-15 sessions of 5 times per week [9]. The rTMS is non-invasive and can easily focus on a small area of the brain. It can cause changes in the selected areas of the cerebral cortex, and is a great technique to treat various brain disorders. In addition, rTMS minimizes the side effects. It is useful for a large number of psychiatric disorders that are resistant to drugs and other common therapies [3]. The most important known risk of TMS is the induction of unwanted seizures such that the use of high-dose rTMS in people without seizure can induce seizures [17].
4. Discussion
The purpose of this study was to gain knowledge of nursing care in rTMS. This review study showed that several factors such as first contact care, evaluation and orientation, treatment management, patient management and environment can be effective in treatment by rTMS. Since the first contact, it is very important for the nurse to assure the patient of this method and its aspects, understand the patient’s concerns, and address them as much as possible. The nurse-patient relationship includes teaching and supporting the patient which starts from the moment that the patient makes the first contact and receives the rTMS-related information [18]. Psychiatric nurses should be aware that patient assessment and awareness can be stressful for the patient. The patient should be given time to ask questions and his/her treatment concerns should be addressed. With the patient’s cooperation, the psychiatric nurse takes the necessary measures to give appropriate clinical information to the patient. The patient is encouraged to ask questions and share his/her concerns with the nurse. These steps enhance the care and helps the patient with his/her treatment during rTMS [19]. 
It can be concluded that the psychiatric nurses have an important role in rTMS care because they informs patients about rTMS, and teach them on the formation of realistic expectations and the establishment of systems that ensure the continuity of safety and care, and uses the nurse-patient relationship to support the patients and their family. The psychiatric nurse is also able to assess clinical problems, provide safety, and develop policies and organizational systems designed to support safe and patient-centered care. The psychiatric nurse has the ability to engage with the treatment problems of patients and their families and play an important role in this regard. The psychiatric nurse works with the patient to create a therapeutic environment that can lead to positive outcomes in the patient.

Ethical Considerations
Compliance with ethical guidelines

Ethical approval was not sought for the present study because this article does not contain any studies with human or animal subjects.

This research did not receive any grant from funding agencies in the public, commercial, or non-profit sectors.

Authors' contributions
Conceptualization: Reza Zeighami; investigation, editing & review, visualization, supervision, project management and funding acquisition: All Authors.

Conflict of interest
The authors declare no conflict of interest.

The authors would like to thank the officials and colleagues of the Information Technology Unit of Qazvin University of Medical Sciences and Health Services who helped in this study.

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Type of Study: Review article | Subject: Nursing & Midwifery

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