MICA · CARE LEARNING NOTES
Observe, keep care safe and communicate
In Sjögren disease, dryness can interfere with vision, eating, sleep and intimacy. Follow-up also considers fatigue, functional impact and new extraglandular features.
Understand the actual burden
Ask which situations are difficult: reading, screen use, dry meals, prolonged speech or night-time. Assess pain, fatigue and reduced activity without trivialising a sometimes invisible disease. Discuss intimate dryness sensitively and offer an appropriate referral. Record measures already used, their effectiveness and cost. Support should be feasible at home and reflect the person’s preferences.
[1][2]Protect surfaces and function
Support correct use of recommended or prescribed eye lubricants and mouth care. Check equipment hygiene and avoid contaminating eye-drop tips. Support dental and ophthalmic follow-up, oral hygiene and suitable food intake. Small sips may help if swallowing and fluid instructions allow. Eye pain, photophobia or reduced vision requires prompt assessment.
[1][2]Look for new findings
Report new or persistent salivary gland swelling, lymphadenopathy, night sweats or unexplained weight loss. These findings do not automatically indicate lymphoma but warrant early medical investigation. Also report purpura, weakness or sensory changes, persistent cough and breathlessness. Respiratory distress or an acute deficit requires emergency care. Compare with previous function rather than attributing everything to dryness.
[2][1]Eye and mouth dryness require regular care and dental prevention, not only occasional relief. Eye pain, photophobia or reduced vision requires prompt advice. Report persistent gland swelling or new systemic symptoms; do not regard these as a simple fluctuation in dryness.
- Check that prescribed care is feasible and dental follow-up arranged.
Review care with the team
List medications and non-prescription products; some worsen dryness. Request medical or pharmacist review without advising independent discontinuation. Check the monitoring plan when systemic treatment is used. Use teach-back to distinguish daily care from situations requiring contact. Document symptoms, intake, weight when monitored, new findings, response to comfort measures and the professional informed to support continuity.
[2][1]A learning situation
FICTIONAL SITUATION · REFLECTION WITHOUT A SCORE
Fictional situation: a patient with Sjögren disease has had newly swollen parotid tissue for several weeks. She assumes this is only part of her dry mouth.
Is increasing mouth care sufficient?
Read the reasoning
No. Describe duration, pain, progression and associated findings, then arrange early medical assessment. Infection, obstruction and other causes, including lymphoma, require medical consideration. Do not announce cancer or reassure without assessment. Continue suitable comfort care and document the appointment or handover obtained.
References and scope
- Sjögren’s Disease — fiche patient, mise à jour février 2025 ↗
- British Society for Rheumatology guideline on management of adult and juvenile onset Sjögren disease (2024 ; numéro 2025) ↗
Original documentary teaching summary for adult care. Procedures and medicines depend on professional competence, prescription and institutional procedures. International references do not establish an Algerian protocol. Independent human scientific review remains to be confirmed.