Rehabilitation Nursing最新文献

Background: Approximately 795,000 Americans experience a new or recurrent stroke every year, and it remains one of the leading causes of disability worldwide. Patient engagement in rehabilitation and physical activity has been associated with improvements in functional outcomes during inpatient rehabilitation. There is limited knowledge of the barriers and facilitators to patients' engagement in stroke rehabilitation.

Methods: An integrative review with a systematic approach was conducted to explore the current available literature on barriers and facilitators to patient engagement in stroke inpatient rehabilitation.

Results: Twenty-five studies were included in the final review. Four major themes described the identified barriers and facilitators: (1) stroke impact, (2) self-efficacy, (3) therapeutic relationship, and (4) motivating factors. Individualized patient-centered goal setting was a commonly studied intervention found to successfully increase engagement.

Conclusion: Engagement in stroke rehabilitation is associated with improved patient outcomes. Using the identified themes from this review, nurses can develop focused interventions aimed at reducing barriers and increasing stroke patient engagement.

Purpose: The aim of this study was to examine current literature regarding effects of physical or cognitive training and simultaneous (dual-task) physical and cognitive training on cognition in adults surviving an intensive care unit (ICU) stay.

Design: Systematic mapping.

Methods: A literature search was conducted to examine effects of physical and/or cognitive training on cognitive processes.

Results: Few studies have targeted adults surviving ICU. Independently, physical and cognitive interventions improved cognition in healthy older adults with and without cognitive impairment. Simultaneous interventions may improve executive function. Small sample size and heterogeneity of interventions limited the ability to make inferences.

Conclusion: Literature supports positive effects of single- and dual-task training on recovering cognition in adults. This training could benefit ICU survivors who need to regain cognitive function and prevent future decline.

Relevance to practice: With the growing number of ICU survivors experiencing cognitive deficits, it is essential to develop and test interventions that restore cognitive function in this understudied population.

Abstract: The COVID-19 pandemic has caused a significant increase in stress for frontline healthcare workers, including rehabilitation workers. Contributing factors include disrupted workflows, heavier workloads, increased time restraints, and fear of contracting/passing the virus. Prolonged high stress levels can produce adverse health outcomes when unaddressed. Resilience can mitigate the negative effects of prolonged stress. Four healthcare workers relate their experiences from the frontlines of the pandemic, discussing their strategies to build resilience and maintain health. Highlighted strategies include mindfulness (the purposeful act of paying attention to the present moment without judgment), gratitude (the practice of being grateful for the positive things in life), self-care (the maintenance of a healthy lifestyle using physical, psychological, and emotional tools), and social support (the sense of belonging that comes from being cared for and valued). These strategies reduce negative outcomes produced by elevated stress levels and promote resilience in frontline healthcare workers.

Purpose: This study aimed to develop and validate the Stroke Symptom Cluster Scale for Korean Adults (SSCS-K) for stroke survivors.

Design: An exploratory sequential study with a mixed-methods design was performed.

Methods: In the development stage, a qualitative study with in-depth interviews was conducted with 27 stroke patients. The validation stage involved analyzing the psychometric properties from 288 stroke patients.

Findings: The SSCS-K comprising 65 items in six dimensions (mobility, cognition, sensory, mood, communication, and swallowing difficulty) demonstrated acceptable internal consistency (Cronbach's α = .92-.94). Confirmatory factor analyses with a six-factor solution showed that it explained 62% of the variance in stroke symptoms. The concurrent validity was confirmed with the Stroke-Specific Quality of Life Scale (r = .38-.83, p < .001).

Conclusion: The SSCS-K has strong psychometric properties as a measure to assess clustered symptoms in stroke survivors during their long-term rehabilitation.

Clinical relevance: Rehabilitation nurses may consider the SSCS-K as a useful tool for assessing symptoms of stroke survivors.

Purpose: The aim of this study was to describe and analyze dosing patterns for patients with ITB treatment over time and to identify possible subgroups demonstrating diversity in patterns.

Design: A retrospective design.

Methods: For 81 patients from six different hospitals, baclofen doses from the first 2 years of treatment were identified using medical records. Line graphs of each patient's doses were analyzed and grouped based on similarities in dosing pattern.

Findings: The analyses of the dosing patterns resulted in four different subgroups classified as stable, slow increase, rapid increase, and fluctuating.

Conclusion: The results highlight the clinical challenge of predicting dose development over time.

Clinical relevance to rehabilitation nursing: This study provides rehabilitation healthcare professionals with a better understanding of intrathecal baclofen dose development. Illustrations of the four subgroups can be used as an educational tool for patients, family, and caregivers.

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.