Rehabilitation Nursing最新文献

Purpose: The objective of this study was to identify gaps in and to improve the falls prevention strategy (FPS) of an inpatient rehabilitation facility (IRF) in Toronto, Canada.

Design: A modified version of the Stanford Biodesign Methodology was used.

Methods: Chart reviews, a focus group (n = 8), and semistructured interviews (n = 8) were conducted to evaluate the FPS.

Findings: Admission Functional Independence Measure score, age, and gender significantly correlated with risk for a fall. The tool used at this IRF was not effectively capturing patients who were at high risk for falls. All healthcare providers interviewed were knowledgeable of fall risks; however, a patient's fall risk status was rarely discussed as a team.

Conclusions: The findings informed recommendations to improve the overall FPS at this IRF.

Clinical relevance: Staff may require more coaching for implementing preventative measures/ensuring accountability and evaluating whether current strategies work. These insights can guide improvement initiatives at similar facilities elsewhere.

Abstract: There are over 185,000 amputations annually in the United States, and most of these patients will receive a short inpatient rehabilitation hospital stay as part of their recovery. Complications in care after amputation can negatively impact rehabilitation and subsequent disposition and community reintegration after discharge. The purpose of this article is to discuss the literature, significance, and practice recommendations for three specific challenges-skin integrity, postamputation pain, and falls. The focus population is rehabilitation patients who have undergone nontraumatic, lower limb amputation. Information about the incidence and risks of these complications give nurses necessary knowledge to improve care delivery, reduce suffering, and improve patient safety for postamputation patients during inpatient rehabilitation.

Purpose: The purpose of this study was to describe the burden and educational needs of informal caregivers of care-dependent older adults with urinary incontinence (UI).

Design: A cross-sectional, descriptive survey of informal caregivers recruited through Google Ads was performed.

Methods: An online survey, including the Overactive Bladder-Family Impact Measure, was used to assess five areas of the experience of the informal caregiver that may be affected by caring for a person with UI and their educational needs.

Findings: Respondents (n = 77) reported a substantial impact of their care recipients' UI on their lives, with concern, travel, and social subscales most affected. However, 42% never sought treatment on behalf of their care recipient. Educational needs included UI treatment strategies and guidance to select appropriate supplies.

Conclusions: Caregivers underreported their care recipient's UI and need substantially more support from healthcare providers to manage the condition.

Clinical relevance: Nurses should assess for UI among care-dependent older adults and, if present, provide information and strategies to lessen the impact on caregiver lives.

Purpose: The purpose of this study was to test the reliability and validity of the Function-Focused Care Checklist for Caregivers using Rasch analysis.

Design: This was a descriptive study using data from the study "Testing the Dissemination and Implementation of Function-Focused Care for Assisted Living Using the Evidence Integration Triangle." The study was approved by a university institutional review board.

Methods: A Rasch analysis was completed, which included 691 staff-resident observations from 85 assisted living facilities.

Findings: There was evidence of internal consistency (alpha coefficient of .93), construct validity except for a high OUTFIT statistic for wheelchair mobility, and hypothesis testing based on an increase in performance of function-focused care by caregivers over 12 months.

Conclusions: The findings provided psychometric support for the measure and guidance for revisions.

Clinical relevance: This measure can be used clinically to teach caregivers to provide function-focused care to residents in assisted living.

Background: Fatigue is a symptom experienced by 40%-74% of older individuals in the United States. Despite its significance, clinicians face challenges helping individuals to manage or reduce fatigue levels. Some management issues are attributable to the ambiguity around the risk factors, consequences, and the effect of fatigue management strategies.

Methods: A literature review was conducted using four databases to identify themes in relation to risk factors, consequences, and management strategies from research studies about fatigue in older individuals with chronic diseases.

Results: Findings on fatigue risk factors, such as age, body mass index, and marital status, were contradictory. There was a positive association between fatigue and comorbidities, depression, and anxiety and a negative relationship between fatigue and physical activity, sleep, educational status, and socioeconomic status. Fatigue was perceived as a state of "feebleness" and negatively impacted individuals' quality of life. Consequences of fatigue included tiredness, sleepiness, depression, anxiety, worse sense of purpose in life, poor self-care, and an increased β-amyloid load. Predictors of worse fatigue consequences included functional health, symptom burden, subjective health, and self-acceptance. Fatigue management strategies included physical activity, rest, sleep, maintaining normal hemoglobin levels, and acetyl-l-carnitine supplementation.

Conclusion: This systematic review is of value to older individuals with chronic illnesses, researchers, and clinicians who strive to improve the quality of life of individuals experiencing fatigue. To prevent undesirable consequences of fatigue, older individuals should be screened for the discussed modifiable risk factors of fatigue. The inconsistencies in the studies reviewed can guide researchers to potential research areas that require further inquiry and exploration to ground future practice on best scientific evidence.