Rehabilitation Nursing最新文献

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Access, Utilization, and Implementation of Research Among Rehabilitation Nurses: A Qualitative Study 康复护理人员的获取、利用与实施研究:一项质性研究

IF 1.3 4区医学 Q2 Nursing

Rehabilitation Nursing

Pub Date : 2022-03-18 DOI: 10.1097/RNJ.0000000000000367

Jessica Pope Mitro, J. M. L. Pomeroy, S. Osman, Virina Matta, Cindy Cai, S. Garfinkel, A. Weinstein

Abstract Purpose This study aimed to understand rehabilitation nurses’ perceptions of research information, related barriers, and avenues for future research, specifically in those caring for individuals with burn injury, spinal cord injury, or traumatic brain injury. Design Qualitative semistructured interviews were conducted. Methods Eighteen interviews were conducted. A thematic network approach identified codes and developed basic, organizing, and global themes. Results Researchers identified factors that facilitated research uptake, determined organizational structures that support research culture, and described nurse engagement with literature. Conclusions Although participants desired to engage with the research literature, they identified barriers including time constraints, heavy workloads, and lack of access. To facilitate research uptake, research must be easily accessible, be easily digestible, and include clinical practice recommendations. Research must expand its scope to address issues relevant to the rehabilitation population. Clinical Relevance Our findings may be used to drive improvements in research competence, facilitate knowledge translation, and support evidence-based practice among rehabilitation nurses.

摘要目的本研究旨在了解康复护士对研究信息、相关障碍和未来研究途径的看法，特别是在护理烧伤、脊髓损伤或创伤性脑损伤患者时。设计进行定性半结构化访谈。方法对18例患者进行访谈。主题网络方法确定了代码，并制定了基本主题、组织主题和全球主题。研究人员确定了促进研究吸收的因素，确定了支持研究文化的组织结构，并通过文献描述了护士的参与。尽管参与者希望参与研究文献，但他们发现了包括时间限制、工作量大和缺乏访问在内的障碍。为了促进研究的吸收，研究必须易于获取，易于消化，并包括临床实践建议。研究必须扩大其范围，以解决与康复人口有关的问题。我们的研究结果可用于推动康复护士研究能力的提高，促进知识转化，并支持循证实践。

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引用次数: 2

Social Influences on Perceptions of Sense of Control and Attributed Dignity Among Older People Managing Multiple Chronic Conditions 管理多种慢性疾病的老年人控制感和归因尊严的社会影响

IF 1.3 4区医学 Q2 Nursing

Rehabilitation Nursing

Pub Date : 2022-03-10 DOI: 10.1097/RNJ.0000000000000369

R. LeBlanc, C. Jacelon

Abstract Purpose The aim of this study was to explore associations between social support, sense of control, and attributed dignity in persons aged 65 years and older who self-manage multiple chronic conditions while living in the community. Design A descriptive, nonexperimental, correlational design was used in this study. Methods Eighty-nine participants completed telephone surveys that measured social support, sense of control and attributed dignity. Regression analysis was used to identify associations. Results Participants were independent in seven of the eight instrumental activities of daily living, with participants having an average of 11 (±4) chronic conditions. Significant positive relationships between social support, perceived sense of control, and attributed dignity were identified. Conclusions Positive social support is strongly associated with perceived sense of control and attributed dignity. Clinical Relevance Healthcare professionals, especially rehabilitation nurses, can assess social support and offer ways to improve social support, thus enhancing sense of control and attributed dignity. These concepts enhance older individuals’ ability to manage multiple chronic conditions.

摘要目的本研究的目的是探讨65岁及以上在社区生活期间自我管理多种慢性疾病的人的社会支持、控制感和归因尊严之间的关系。设计本研究采用描述性、非实验性、相关性设计。方法89名参与者完成了电话调查，测量了社会支持、控制感和归属尊严。回归分析用于识别关联。结果参与者在日常生活的八项工具性活动中有七项是独立的，参与者平均有11（±4）种慢性病。社会支持、感知控制感和归因尊严之间存在显著的正相关关系。结论积极的社会支持与控制感和尊严感密切相关。临床相关性医疗保健专业人员，尤其是康复护士，可以评估社会支持，并提供改善社会支持的方法，从而增强控制感和归属感。这些概念增强了老年人管理多种慢性疾病的能力。

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引用次数: 1

COVID-19: The Effects on the Course, Outcomes, and Discharge Destination From Acute Rehabilitation COVID-19:对急性康复过程、结局和出院目的地的影响

IF 1.3 4区医学 Q2 Nursing

Rehabilitation Nursing

Pub Date : 2022-03-02 DOI: 10.1097/RNJ.0000000000000366

Shelly Amato-Curran, K. Green, Terrie Rader, Adrianne Shimek

Abstract This study aimed to (1) describe the rehabilitation hospital course after diagnosis with COVID-19 and the impact on functional outcomes and discharge destination and (2) compare outcomes for patients with and without COVID-19-related debility. Design A descriptive cohort study was performed. Methods Retrospective data were collected for 63 patients aged >18 years with COVID-19- or non-COVID19-related debility between January 2015 and September 2020. Results Patients admitted with COVID-19-related debility had a mean length of stay of 20.35 days. 15.4% were transferred back to acute service, 92.3% required respiratory interventions, and 88.5% were discharged to the same residence. Patients with COVID-19-related debility were significantly older, required more respiratory interventions, and had a longer length of stay than the non-COVID-19 group. No significant differences were found in functional outcomes. Conclusions Functional outcomes improved, allowing most patients to return to their same residence. Clinical Relevance Patients with COVID-19-related debility responded to rehabilitation as well as the non-COVID-19 group.

本研究旨在(1)描述COVID-19诊断后的康复住院过程及其对功能结局和出院目的地的影响;(2)比较有无COVID-19相关衰弱患者的结局。设计采用描述性队列研究。方法回顾性收集2015年1月至2020年9月期间63例年龄在0 ~ 18岁之间的COVID-19相关或非COVID-19相关衰弱患者的资料。结果新冠肺炎相关残疾患者平均住院时间为20.35天。15.4%转回急症室，92.3%需要呼吸干预，88.5%出院到同一住所。与非covid -19组相比，与covid -19相关的虚弱患者明显更老，需要更多的呼吸干预，住院时间更长。在功能结局方面没有发现显著差异。结论:功能预后得到改善，允许大多数患者返回原来的住所。与covid -19相关的虚弱患者对康复的反应与非covid -19组相同。

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引用次数: 1

Prominent Cognitive Impairment Sequelae in Adult Survivors of Acute Respiratory Distress Syndrome. 急性呼吸窘迫综合征成年幸存者显著的认知障碍后遗症。

IF 1.3 4区医学 Q2 Nursing

Rehabilitation Nursing

Pub Date : 2022-03-01 DOI: 10.1097/RNJ.0000000000000351

Brian C Peach, Samantha Cooney, Sadie Richards

Purpose: The primary objective of this scoping review was to identify prominent cognitive impairment sequelae in adult survivors of an intensive care unit admission for acute respiratory distress syndrome (ARDS).

Design: A scoping review was performed.

Methods: Search terms were entered into multiple EBSCOhost databases. Articles pertaining to pediatric survivors, not in English, lacking cognitive impairment sequelae, or focused on a single sequela were excluded; 12 articles remained.

Results: Cognitive impairment developed in 83.5% of patients with ARDS prior to discharge and persisted in 51.3% (n = 300/585) of survivors at the 1 year mark after discharge (range: 16.7%-100% across studies). Prominent sequelae included impairments in executive function, mental processing speed, immediate memory, and attention/concentration.

Conclusions: Survivors of an intensive care unit stay for ARDS often develop cognitive impairment persisting long after their admission. Clinicians in rehabilitation facilities should screen for these sequelae and connect survivors with treatment to improve cognitive outcomes.

Clinical relevance: Early recognition of prominent cognitive impairment sequelae by rehabilitation clinicians and referrals to neuropsychologists by providers are critical to limiting the severity of impairment.

目的:本综述的主要目的是确定急性呼吸窘迫综合征(ARDS)重症监护病房入院的成年幸存者中显著的认知障碍后遗症。设计:执行范围审查。方法:在多个EBSCOhost数据库中输入检索词。与儿童幸存者相关的非英文、缺乏认知障碍后遗症或仅关注单一后遗症的文章被排除;剩下12条。结果:83.5%的ARDS患者在出院前出现认知障碍，51.3% (n = 300/585)的患者在出院后1年仍存在认知障碍(研究范围:16.7%-100%)。突出的后遗症包括执行功能、心理处理速度、即时记忆和注意力/集中力的损害。结论:急性呼吸窘迫综合征重症监护病房的幸存者通常在入院后很长一段时间内仍会出现认知障碍。康复机构的临床医生应该筛查这些后遗症，并将幸存者与治疗联系起来，以改善认知结果。临床相关性:早期识别突出的认知障碍后遗症由康复临床医生和转介给神经心理学家的提供者是限制损伤的严重程度至关重要。

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引用次数: 0

Engaging Rehabilitation Technicians Through a Career Ladder During a Pandemic 在大流行期间通过职业阶梯吸引康复技术人员

IF 1.3 4区医学 Q2 Nursing

Rehabilitation Nursing

Pub Date : 2022-02-04 DOI: 10.1097/RNJ.0000000000000361

E. Squires, K. Shafer, Barbara Winters-Todd, B. Granger

Abstract Purpose Nursing assistant turnover is a growing healthcare concern that negatively impacts healthcare organization work environments and has significant financial implications. The purpose of this study was to implement a career ladder program for rehabilitation nursing technicians—nursing assistants who specialize in performing care duties aligned with therapeutic goals in inpatient rehabilitation. The study evaluated the effect on organizational quality metrics of employee engagement, job satisfaction, and annual turnover of rehabilitation nursing technicians. Design This pilot study was conducted using a quality improvement approach and a between-subjects pretest–posttest design. Methods A three-tier career ladder intervention for rehabilitation nursing technicians in a 76-bed inpatient rehabilitation facility was implemented. Employee engagement and job satisfaction were evaluated in all rehabilitation nursing technicians (n = 44), with a pre-implementation sample size of n = 23 and a post-implementation sample size of n = 21, from January 2020 through December 2020. Twelve rehabilitation nursing technicians participated in the intervention, which consisted of online learning modules, added job responsibilities, and continuing education and were included in the post-implementation sample size. Nondirectional statistical tests were performed with the level of significance set at .05 (two tailed). Findings A majority of the pre–post intervention sample (n = 44) were female (91%), African American (91%), and aged 30–59 years. Employee engagement increased from 78% favorable in 2019 to 86% favorable in 2020. Overall job satisfaction improved from 74% favorable in 2019 to 86% favorable in 2020. Annual turnover decreased from 35% in 2019 to 31% in 2020. Conclusion In this pilot study, a career ladder program for rehabilitation nursing technicians was effective in increasing and improving employee engagement and job satisfaction while reducing turnover. Clinical Relevance Rehabilitation nursing technicians are crucial members of the interdisciplinary rehabilitation team providing direct bedside care to optimize patient function. Rehabilitation nursing technician career ladders have the capacity to engage an often underrecognized employee population by creating a positive work environment that promotes job growth and retention in the rehabilitation setting.

摘要目的护理助理的离职是一个日益增长的医疗保健问题，对医疗保健组织的工作环境产生负面影响，并具有重大的财务影响。摘要本研究的目的是为康复护理技师(护理助理)制定职业阶梯计划，帮助他们在住院康复护理中履行与治疗目标相一致的护理职责。本研究评估了康复护理技术人员的员工敬业度、工作满意度和年流动率对组织质量指标的影响。设计本初步研究采用质量改进方法和受试者间前测后测设计。方法采用三级职业阶梯干预法对76个床位的住院康复机构康复护理技术人员进行干预。从2020年1月至2020年12月，对所有康复护理技术人员(n = 44)的员工敬业度和工作满意度进行了评估，实施前样本量为n = 23，实施后样本量为n = 21。12名康复护理技术人员参与了干预，包括在线学习模块，增加工作职责和继续教育，并纳入实施后样本量。进行非定向统计检验，显著性水平为0.05(双尾)。调查结果干预前后样本(n = 44)大多数为女性(91%)，非洲裔美国人(91%)，年龄在30-59岁之间。员工敬业度从2019年的78%上升到2020年的86%。总体工作满意度从2019年的74%上升到2020年的86%。年营业额从2019年的35%下降到2020年的31%。结论在本初步研究中，康复护理技术人员的职业阶梯计划能有效地增加和改善员工的敬业度和工作满意度，同时减少离职。临床相关性康复护理技术人员是跨学科康复团队的重要成员，提供直接的床边护理以优化患者的功能。康复护理技术人员的职业阶梯有能力通过创造积极的工作环境，促进康复环境中的就业增长和保留，吸引经常被低估的员工群体。

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引用次数: 0

Examining a Fatigue Management Model in Older Individuals 研究老年人的疲劳管理模型

IF 1.3 4区医学 Q2 Nursing

Rehabilitation Nursing

Pub Date : 2022-01-15 DOI: 10.1097/RNJ.0000000000000360

Maral R Torossian, Joohyun Chung, S. Mamo, C. Jacelon

Abstract Purpose The aim of this study was to examine a fatigue model for older individuals based on the theory of unpleasant symptoms. Research Design The research design used was a secondary data analysis of the “Patient-Reported Outcomes Measurement Information System Profiles–Health Utilities Index” data set. Methods Multiple regression analysis and path analyses were used to examine hypothesized model paths. Results A number of comorbidities, pain, sleep, depression, anxiety, education, and sensory impairment were significant predictors of fatigue. Higher fatigue scores predicted lower physical, social, and cognitive performances, as well as worse perceived health and quality of life (QOL). In addition, the identified fatigue outcomes mediated the relationship between fatigue and QOL. Conclusions Future research should be directed toward exploring other risk factors of fatigue and examining feedback loops depicted in the theory of unpleasant symptoms. Clinical Relevance to the Practice of Rehabilitation Nursing Rehabilitation nurses should closely monitor and manage the identified fatigue-influencing factors to improve older individuals’ performance, perceived health, and QOL.

摘要目的本研究的目的是检验一个基于不愉快症状理论的老年人疲劳模型。研究设计采用的研究设计是对“患者报告的结果测量信息系统概况-健康效用指数”数据集进行二次数据分析。方法采用多元回归分析和路径分析对假设的模型路径进行检验。结果许多合并症，疼痛、睡眠、抑郁、焦虑、教育和感觉障碍是疲劳的重要预测因素。较高的疲劳得分预示着较低的身体、社会和认知表现，以及较差的健康和生活质量(QOL)。此外，识别出的疲劳结果介导了疲劳与生活质量之间的关系。结论未来的研究应着眼于探索疲劳的其他危险因素，并检查不愉快症状理论中描述的反馈回路。康复护理实践的临床意义康复护士应密切监测和管理识别出的疲劳影响因素，以提高老年人的工作表现、感知健康和生活质量。

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引用次数: 0

Are Symptoms of Spasticity, Pain, and Fatigue Related in People With Stroke? 中风患者的痉挛、疼痛和疲劳症状是否相关?

IF 1.3 4区医学 Q2 Nursing

Rehabilitation Nursing

Pub Date : 2022-01-01 DOI: 10.1097/RNJ.0000000000000349

Rozina Bhimani, Charles Horowitz, Michelle A Mathiason, Lisa Carney Anderson

Purpose: The purpose of this study was to determine whether symptoms of spasticity, pain, and fatigue are correlated in people with stroke.

Design: A longitudinal-correlation, mixed-method design was used.

Methods: Spasticity, pain, and fatigue symptoms were explored in 22 patients with stroke admitted to three different rehabilitation units certified by the Commission on Accreditation of Rehabilitation Facilities. Data were obtained upon admission, postdischarge, and 1 month after discharge. Demographics, numeric ratings, and a semistructured interview were used to determine associations over time.

Results: Symptoms of spasticity, pain, and fatigue were quite variable. Fatigue was more likely to impair recovery. Spasticity appears to contain pain experiences. Pain does not appear to be a major factor over time.

Conclusions: In this sample of patients with stroke, symptoms of spasticity, pain, and fatigue were correlated.

Clinical relevance: In managing poststroke spasticity, pain, and fatigue, nurses should recognize that these symptoms are correlated.

目的:本研究的目的是确定中风患者的痉挛、疼痛和疲劳症状是否相关。设计:采用纵向相关、混合方法设计。方法:对22例卒中患者的痉挛、疼痛和疲劳症状进行分析，这些患者分别住在康复机构认证委员会认证的三个不同的康复单位。数据在入院时、出院后和出院后1个月获得。人口统计、数字评分和半结构化访谈被用来确定随时间推移的关联。结果:痉挛、疼痛和疲劳的症状变化很大。疲劳更有可能损害恢复。痉挛似乎包含了疼痛体验。随着时间的推移，疼痛似乎不是一个主要因素。结论:在这个中风患者样本中，痉挛、疼痛和疲劳的症状是相关的。临床相关性:在处理卒中后痉挛、疼痛和疲劳时，护士应该认识到这些症状是相关的。

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引用次数: 4

Human Trafficking in Rehabilitation: What Nurses Need to Know. 康复中的人口贩卖:护士需要知道什么。

IF 1.3 4区医学 Q2 Nursing

Rehabilitation Nursing

Pub Date : 2022-01-01 DOI: 10.1097/RNJ.0000000000000359

引用次数: 0

Updated Competency Model for Professional Rehabilitation Nursing: Practice Applications. 更新的职业康复护理胜任力模型:实践应用。

IF 1.3 4区医学 Q2 Nursing

Rehabilitation Nursing

Pub Date : 2022-01-01 DOI: 10.1097/RNJ.0000000000000350

Stephanie Vaughn, Jill Rye, Angela Allen, Amy Bok, Kris Mauk, Linda Park, Linda Pierce, Wendy Wintersgill Holler

Background: The Competency Model for Professional Rehabilitation Nursing is a lens through which nurses can view their practice; the four domains provide a template that guides that practice.

Purpose: The aim of this study was to describe a task force's review procedures and share the updated model.

Appraisal process: A rehabilitation nursing task force appraised the model over the course of 1 year.

Revision outcomes: The original four domains remain, with wording changes for content and clarity throughout. Notable changes include (1) new competency for Domain 1 that focuses on the understanding of the worldview of individuals who are culturally different and (2) case stories for each domain related to nurses' proficiency (beginner, intermediate, and expert).

Clinical relevance: This updated model can be used to explicate the rehabilitation nurses' role on intra/interprofessional teams, as well as provide a framework for education and staff orientation/performance evaluation.

Conclusion: This competency model reflects the current practice and advances of the specialty practice of rehabilitation nursing.

背景:专业康复护理胜任力模型是护士观察自身实践的一个视角;这四个领域提供了指导实践的模板。目的:本研究的目的是描述一个工作组的审查程序，并分享更新的模型。评估过程:康复护理工作组对该模型进行了为期一年的评估。修订结果:保留了原来的四个领域，在内容和清晰度方面进行了措辞更改。值得注意的变化包括:(1)领域1的新能力，侧重于理解不同文化个体的世界观;(2)与护士熟练程度(初级、中级和专家)相关的每个领域的案例故事。临床意义:此更新模型可用于阐明康复护士在专业内/跨专业团队中的角色，并为培训和员工入职/绩效评估提供框架。结论:该胜任力模型反映了康复护理专业实践的现状和进展。

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引用次数: 4

Updated Competency Model for Professional Rehabilitation Nursing: Practice Applications. 更新的职业康复护理胜任力模型:实践应用。

IF 1.3 4区医学 Q2 Nursing

Rehabilitation Nursing

Pub Date : 2022-01-01 DOI: 10.1097/RNJ.0000000000000358

引用次数: 0

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