Rehabilitation Nursing最新文献

Purpose: The objective of the study was to explore the experiences of older adults with immobility posthospitalization.

Design: We conducted a focused ethnography qualitative study.

Methods: Data collection included in-depth interviews with 10 individuals ages 69-82 years who had been hospitalized for at least 1 week, field notes, and observations of mobility. An inductive approach was used to analyze the data.

Findings: Older adults believe mobility is a central element in their life. Hospitalizations lasting 1 week or longer often result in a loss of the older adult's ability to function as before, a pattern that we identified as The Crushing Assault: Consequences of Immobility. Rehabilitation involves a Rocky Road to Regaining Mobility that is challenging but possible.

Conclusions: Immobility after hospitalization has unexpected and profound consequences that are life-changing and distressing for older adults at home. Recovering function is prolonged and difficult. An individualized training program that includes flexibility and progressive resistance exercises is recommended over longer periods and with extended medical follow-up.

Clinical relevance: Lingering problems with immobility at home are frequently overlooked. Active programming promoting preservation of function and an optimistic attitude as well as focusing on milestones to reach are key to optimal function.

Purpose: The aim of this study was to explore the association between the presence and severity of anosognosia for hemiplegia (AHP) and falls in stroke survivors.

Design: A prospective, correlational research design was utilized.

Methods: Primary instrumentation included demographic information and the Visual-Analogue Test for Anosognosia for motor impairment (VATA-m). Correlational and regression analyses were performed between a priori variables.

Results: There was no statistically significant relationship found between AHP and falls. An incidental finding included that clinicians erroneously charted that their patients were aware of their physical limitations 100% of the time, which indicates that there is discord between clinicians and patients regarding physical limitations.

Conclusions: Though no statistically significant relationship was found between AHP and falls, the incidental finding of dissonance between the patient and the clinician has important clinical implications.

Relevance: The relationship between AHP and stroke rehabilitation outcomes is still not understood, and incorporating part of the VATA-m into patient assessment could improve clinician understanding of patient awareness.

Purpose: The aim of this study was to compare accidental dislodgement rates of nasal gastric tubes secured with standard methods or a nasal tube securement device in pediatric patients.

Design: A randomized controlled trial was conducted.

Methods: Participants ( n = 43) were randomized into standard securement or nasal tube securement device using block randomization to control for age and diagnosis. Surveys were collected from staff and caregivers on device ease of use and satisfaction.

Results: There were a similar number of tube dislodgements for patients in the nasal tube securement device group ( n = 6) and the standard practice group ( n = 7). The median hospital length of stay was higher for the standard practice group (13 days vs. 9 days).

Conclusion: Use of the nasal tube securement device did not significantly decrease the rate of tube dislodgements compared with standard practice.

Clinical relevance to rehabilitation nursing: The study provides information for pediatric rehabilitation nurses in choosing securement options for nasal gastric tubes.

Background: The original Association of Rehabilitation Nurses (ARN) Competency Model for Professional Rehabilitation Nursing published in 2016, and updated in 2020, provides a framework for rehabilitation nursing practice.

Aim: This companion, but stand-alone, article to a 2022 publication further explicates and informs the updated Competency Model from inside looking out toward an increasing application for evidence-based practice (EBP).

Approach: An eight-member 2020 ARN Task Force used an iterative process to review the original four domains and related competencies and came to consensus for the updated model.

Outcome: This model provides revised competency role descriptors or behaviors that guide nurses practicing at different proficiency levels in various settings.

Clinical relevance: The Competency Model for Professional Rehabilitation Nursing is a premier resource that can advance professional rehabilitation nursing and guide EBP, including evaluation, quality improvement, and research. The model describes the nurse's role on the intra/interprofessional team and fosters collaboration with other healthcare professionals to enhance the quality of life for those affected by disability and chronic illness.

Conclusion: The domains and associated competencies of this model clarify nursing roles at different proficiency levels, and role descriptors reflect current practice, supporting advancement of the specialty practice of rehabilitation nursing well into the 21st century.

Purpose: Many individuals with stroke require informal caregiver support. These caregivers are often unprepared and overwhelmed. This study assesses the feasibility and acceptability of GETCare, a remote Goal-based Education and skills Training program for Caregivers caring for an individual poststroke.

Design: Single-arm mixed-methods pilot trial was performed.

Methods: The GETCare program is a 5-week remote, individually administered program for informal stroke caregivers that includes education, skills training, guided goal setting, and resource recommendations. Quantitative data were analyzed using descriptive statistics and qualitative data via a deductive approach.

Results: Twenty-eight caregivers were recruited with 18 caregivers completing the program. These 18 caregivers reported high satisfaction, and over 75% reported program content was at least quite helpful. Caregivers suggested that the length of the program was appropriate, indicated that weekly check-ins were helpful, and supported this program for informal caregivers across the time trajectory poststroke. Eight of 10 caregivers who dropped out of the program were caring for someone 0-4 months poststroke.

Conclusions: Caregivers positively received the GETCare program, which was uniquely structured to provide resources and skills for this high-need population. This pilot study provides valuable insight for future remote interventions poststroke.

Clinical relevance to practice of nursing: Results provide foundational knowledge in how to better support caregivers through guided goal setting and individualized education.