Rehabilitation Nursing最新文献

Purpose: The aim of this study was to develop a valid educational intervention to improve knowledge and confidence using communication strategies when interacting with a person with aphasia.

Design: A quantitative, nonrandomized pretest/posttest research study was performed.

Methods: Pre- and postcourse assessments were completed with learning participants. This educational intervention was developed using the underlying theoretical concepts of the integrated behavioral model.

Results: Forty-nine new employees from the nursing department participated in this study, with 61% reporting less than 1 year of experience. Pre- to posttraining assessments on the Test of Knowledge of Aphasia improved from 3.7 to 5.8 (p ≤ .0001) for direct knowledge, from 5.5 to 8.2 (p ≤ .0001) for confidence self-efficacy, and from 5.3 to 7.6 (p ≤ .0001) for knowledge self-efficacy.

Conclusion: Results indicated this theory-driven educational training was effective in training employees from the nursing department working in an inpatient rehabilitation environment.

Clinical relevancy: Improving communication effectiveness is critical for overall quality of care and patient safety.

Purpose: After transitioning from an intensive care unit (ICU), hospitalized older adults are inactive, which may affect discharge outcomes. We examined trends between post-ICU hourly activity counts and discharge disposition among hospitalized older ICU survivors.

Design: A prospective, exploratory research design was used in this study.

Methods: We enrolled older ICU survivors within 24-48 hours of ICU discharge. Actigraphy measured post-ICU hourly activity counts (0:00 a.m.-23:59 p.m.). Chart review provided discharge disposition. Analyses were conducted to illustrate trends between post-ICU hourly activity counts and discharge disposition.

Findings: Mean hourly activity was about 2,233 ± 569 counts/hour. Graphs revealed trends between hourly activity counts and discharge disposition. Participants with lower post-ICU activity counts, especially during daytime hours, tended to be discharged to a care facility.

Conclusions: Future nursing research should determine whether post-ICU inactivity during hospitalization is a modifiable risk factor for worse discharge outcomes.

Clinical relevance: Activity could be a prognostic indicator of discharge disposition for older ICU survivors.

Purpose: The aim of the study was to propose and test a quality of life model among Korean patients with amyotrophic lateral sclerosis (ALS) using structural equation modeling.

Design: A cross-sectional study was performed.

Methods: Data from 184 patients with ALS were collected from two university hospitals in Seoul and Busan, South Korea, between June and December 2018.

Findings: The modified model indices indicated adequate data fit. Quality of life predictors were social support, physical functional status, depression, and general health perception.

Conclusion: This study improved the understanding of quality of life for Korean patients with ALS, including complex direct and indirect relationships among quality of life factors.

Clinical relevance: Depression was identified as the most influential factor in this population; hence, early assessment and timely intervention for depression are essential for better quality of life in patients with ALS.

Purpose: This study examined whether a sleep enhancement protocol (SEP) could reduce nighttime room entries (NREs) for patients with orthopedic injury (OI) or acquired brain injury (ABI) in an inpatient rehabilitation facility.

Design: A two-wave prospective study assessing standard of care (SOC) versus SEP.

Methods: Sixty-five participants completed baseline and follow-up questionnaires and wore an actigraph for approximately 7 days. In the SEP, nighttime care was "bundled."

Findings: In SOC, NREs were associated with less efficient sleep and greater daytime fatigue. Nighttime room entries were approximately 50% lower in the SEP than SOC. Participants in the OI SOC had more room entries than any other group. There were no significant changes in room entries in the ABI SEP group.

Conclusions: There was a relationship between NREs and sleep. The SEP was effective at reducing NREs for patients with OI, but not ABI.

Clinical relevance: Sleep enhancement protocols in inpatient rehabilitation facilities may be effective at improving sleep. Future research may focus on developing individualized protocols to improve sleep across patients with a variety of presenting diagnoses.

Abstract: The SARS-CoV-2 coronavirus (COVID-19) pandemic is impacting post-acute inpatient rehabilitation nursing practice from preadmission assessment to inpatient care delivery and transition planning. Patients with disability following COVID-19 require interventions to address respiratory, cardiovascular, neurological, musculoskeletal, and psychosocial issues. The pandemic has resulted in changes to program structures and how inpatient rehabilitation facilities approach family caregiver engagement amidst visitation restrictions. Technology solutions can be utilized to reduce the patient and their family's feelings of isolation and support caregiver preparation for discharge. Nurse leaders are essential in supporting staff during this crisis through authentic presence and providing resources and training. Rehabilitation nurses are key in helping patients and families manage rehabilitation and the aftermath of COVID-19 to restore optimal functioning. In this clinical consultation, we synthesize insights learned from the COVID-19 responses at three inpatient rehabilitation facilities. We describe the impact of rehabilitation nursing interventions to improve outcomes for patients with COVID-19 and their caregivers.

Purpose: The aim of the study was to develop a comprehensive questionnaire for assessing resilience in patients with stroke during rehabilitation and examine the questionnaire's reliability and validity.

Design: A four-phased design was used to develop and validate the questionnaire.

Methods: The preliminary items of the Resilience Questionnaire for Stroke Rehabilitation (RQSR) were generated through a literature review and a qualitative study. Twenty experts were consulted for content validation and modification of the questionnaire. A pilot study was conducted with 55 patients with stroke. A total of 510 participants from seven rehabilitation centers or hospitals were subsequently recruited to examine the psychometric properties of the RQSR.

Results: The RQSR consists of 35 items within three dimensions. Dimensions include effective rehabilitation training, accessible support system, and appropriate self-regulation. The content validity index of the total questionnaire was .9335. Seven factors were derived through factor analysis, and cumulative contribution rate of variance was 65.455%. Cronbach's alpha of the total questionnaire was .957, with each dimension ranging from .731 to .918, demonstrating high levels of reliability.

Conclusion: The RQSR has sound reliability and validity and can be used as an appropriate tool for assessing resilience for patients with stroke during rehabilitation to facilitate effective interventions.