Rehabilitation nursing : the official journal of the Association of Rehabilitation Nurses最新文献

Background: This study explored patients' experience with a specialized rehabilitation course after aortic dissection surgery.

Method: A qualitative study was conducted using content analysis inspired by Graneheim and Lundman. Participants were recruited by a physiotherapist at the end of or shortly after the rehabilitation course at the hospital to partake in an interview. The interviews were held either over the phone or in a private room at the hospital.

Results: Through eight patient interviews (three women and five men aged 45-73 years), an overarching theme was identified: Finding peace in a new version of oneself , which deals with having to find oneself in a new role with a different body that must and can do less, at the same time with a feeling of gratitude for being alive. In addition, three subthemes arose from the time of operation and throughout the course of rehabilitation: (1) Having survived the operation-first the miracle! And what now ? (2) The rehabilitation course provides security and provides well-being. (3) Becoming a whole person again .

Conclusion: This study provides important insights of patients' perspectives of how structured cardiac rehabilitation after aortic dissection supports patients finding peace in a new version of themselves.

Purpose: The aim of the study was to develop a cognitive behavioral therapy (CBT)-grounded and tablet-based lifestyle modification intervention for Chinese older adults with osteoarthritis ("CBT-OA") and examine the CBT-OA's usability.

Design: A descriptive exploratory design was used in this study.

Methods: Using an iterative user-centered design approach, we developed the CBT-OA and evaluated its usability to identify any initial design issues (Phase 1) and if the CBT-OA was integrated into participants' daily living (Phase 2).

Results: In Phase 1 ( n  = 5), participants perceived the CBT-OA as easy to use and an excellent way to structure self-care. In Phase 2 ( n  = 15), the participants reported the CBT-OA as effective (completion rate = 85%-100%), efficient (0.01-0.29 task/second), and usable (mean System Usability Scale = 70.48, SD  = 9.94). They recognized two benefits as a motivator and improvement of self-management confidence and the SMART goal setting as the most preferred component. Suggestions for improvement include adding more videos to visually demonstrate steps of cooking healthy Chinese meals and having a forum to share ideas and experiences.

Clinical relevance and conclusion: Use of technology to improve chronic health outcomes and quality of life continues to grow. CBT-OA is one such application designed specifically for Chinese older adults with osteoarthritis. The findings indicate CBT-OA holds promise for improving arthritis outcomes.

Urinary tract infections (UTIs) are a frequent complication for persons with spinal cord injury (SCI) due to impaired bladder function and catheter use. This article presents a case study to illustrate current SCI UTI management strategies and describe how effective nursing care can impact patient outcomes. The method of bladder management affects UTI risk and bacterial resistance; clean intermittent catheterization lowers infection rates, while prolonged use of indwelling catheters increases multidrug-resistant infections. Antibiogram-guided therapy helps optimize antibiotic selection, improving treatment outcomes and reducing resistance. Nonpharmacological strategies, including proper hydration, hygiene, and bladder management techniques, also play a key role in prevention. Rehabilitation nurses can implement these strategies, promote antibiotic stewardship, and coordinate multidisciplinary care. By integrating microbial surveillance, early infection detection, and targeted interventions, nurses can help reduce UTIs and improve outcomes for patients with SCI.

Purpose: This observational study aimed to evaluate the use of a static air device (SAD) to prevent worsening pressure injuries (PIs) present on admission and the development of health care-acquired pressure injuries (HAPIs) of the foot, heel, or ankle (FHA) within the spinal cord injury population. The central hypothesis was that SADs would significantly reduce the incidence of HAPIs and prevent the worsening of existing PIs in the FHA, where "worsened" was defined as no reduction in wound size, deterioration in wound bed appearance, or increase in staging severity and promote improvement, defined as a decrease in wound size, improved granulation tissue, or complete epithelialization. The hypothesis further posited that SADs would outperform traditional offloading devices (e.g., foam boots, pillows) in reducing PI incidence and promoting healing due to their ergonomic design, temperature regulation, and patient comfort.

Design: Retrospective observational cohort study.

Methods: Data were reviewed for 12 months using our existing pressure relief protocol in our 179-bed inpatient rehabilitation hospital. These data included existing PIs and HAPIs of the FHA. Comparison data were reviewed retrospectively for a 6-month post-period, where SADs were added to the pressure relief protocol from a 24-bed unit. We used comparative analysis to calculate HAPI rates per patient day and the rate of the same or worsened PIs present on admission post-implementation of SAD.

Results: The data indicate an improvement in the rate of HAPIs per patient day and prevention of worsening of existing PIs. Implementing SADs significantly reduced the incidence of FHA pressure injuries.

Clinical relevance to the practice of rehabilitation nursing: This study compared the SAD device with alternatives previously used at our rehabilitation hospital. Pressure injuries cause pain, discomfort, longer hospital stays, and increased costs. Rehabilitation nurses should continue to explore new avenues for PI prevention.

Conclusions: The results indicate the benefit of using SADs for PI prevention and treatment of the FHA PIs.

Background: Toileting and ambulation have been identified as common activities associated with patient falls. Furthermore, miscommunication among health care teams was identified as a key contributing factor in falls resulting in injury.

Objective: To prevent falls through standardized interdisciplinary team communication related to supervision of patients' toileting in an inpatient rehabilitation hospital.

Methods: A fall safety initiative was implemented to display patient supervision needs during toileting. Using the colors of a stoplight as a form of communication, the colors were visible in patients' rooms and allowed for easily accessible interdisciplinary communication of the toileting needs of patients. Initial data demonstrated less than successful results, leading to a revised intervention. With the second intervention, development of a new careboard incorporating a stoplight form of communication, the project was successful.

Results: The use of clearly defined language and interdisciplinary collaboration successfully reduced toileting-related falls. The toileting-related fall rate decreased from 1.154 events/1,000 patient days to 0.720, resulting in a 38% reduction between fiscal year 2023-2024 postimplementation. The hospital's fall rate decreased from 3.143 events/1,000 patient days to 2.50.

Conclusions: Nurse leaders and interdisciplinary teams can reduce toileting-related falls and enhance the culture of safety by standardizing the communication of supervision needed while toileting. A careboard utilizing the colors similar to a stoplight as a form of communication can facilitate effective interdisciplinary communication regarding the supervision level required during toileting.

Purpose: This study aimed to assess the validity and reliability of the Turkish version of the Assessing Family Caregiver Communication in Chronic Illness (FCCT-CI) Scale.

Design: This study examined the psychometric properties of the FCCT-CI.

Methods: Data were collected between December 2023 and March 2024 from family caregivers of care recipients receiving home care services at a hospital in Central Anatolia, Türkiye. The study involved linguistic validation through translation and expert review. Construct validity was tested through confirmatory factor analysis, criterion validity through correlations with the Family APGAR, Bakas Caregiving Outcomes, and Family Climate Scales, and reliability through internal consistency.

Results: A total of 223 family caregivers were included in the study. The content validity index of the scale was 0.91. Confirmatory factor analysis supported a two-factor structure. Scale indicated acceptable convergent validity, whereas discriminant validity between the two subdimensions was not fully supported. Strong positive correlations were found between the FCCT-CI and both the Family APGAR Scale (conversation: r = 0.949; conformity: r = 0.824) and the Bakas Caregiving Outcomes Scale (conversation: r = 0.917; conformity: r = 0.786). For the Family Climate Scale, relationality showed strong positive correlations with conversation (r = 0.966) and conformity (r = 0.856), whereas intergenerational authority showed strong negative correlations with conversation (r = -0.862) and conformity (r = -0.754). Cognitive alignment also showed strong positive correlations with conversation (r = 0.930) and conformity (r = 0.838). The FCCT-CI demonstrated excellent internal consistency, with α = 0.992 for conversation and α = .804 for conformity.

Clinical relevance: The FCCT-CI scale, including its Turkish version, can help nurses identify and address family communication dynamics to improve chronic illness care.

Conclusions: The study provides initial evidence supporting the reliability and validity of the Turkish FCCT-CI for assessing FCCT-CI settings.

Purpose: Spinal cord injury is a significant cause of morbidity and mortality. This study aims to assess the caregiving competence and readiness of first-time caregivers for individuals with SCI.

Design: A cross-sectional and correlational study.

Methods: The study was conducted with 122 first-time caregivers of persons diagnosed with paraplegia or tetraplegia, hospitalized in a rehabilitation hospital in Ankara, Türkiye. Data were collected using the Descriptive Characteristics Form, the Caregiving Preparedness Scale, and the Caregiving Competence Scale. Analyses included descriptive statistics, correlation, and regression methods.

Results: Among the participants, 77% were female, and 41.8% had at least one chronic disease. Furthermore, 73.8% had received training from health care professionals on caregiving. The most challenging aspect of caregiving was transfers (45.1%). A strong positive correlation was found between caregiving competence and caregiving preparedness (r=.836, p<.001). Higher education and prior training were associated with greater competence and preparedness.

Clinical relevance to the practice of rehabilitation nursing: Findings underscore the importance of structured, individualized caregiver education. Rehabilitation nurses play a pivotal role in improving caregiver skills and reducing care burden.

Conclusions: Targeted training programs during inpatient rehabilitation can significantly enhance caregiver competence and readiness, contributing to better outcomes for both caregivers and individuals with SCI.

Problem: Orthostatic hypotension (OH) prevents many patients with stroke from fully engaging in rehabilitation therapy, slowing progress during a key stage of poststroke recovery.

Available knowledge: During inpatient rehabilitation, patients with ischemic stroke frequently experience OH, which can significantly limit participation in therapy. Conservative management of OH entails nonpharmacological measures like compression garments, physical countermeasures, and oral hydration.

Design: A multidisciplinary team (nursing, physicians, and therapists) developed a protocol for managing OH with nonpharmacological interventions based on a literature review. This protocol was specifically designed for patients recovering from ischemic stroke in an inpatient rehabilitation unit.

Strategy: The protocol included the application of compression stockings, abdominal binders, increased oral fluid intake (water), and physical exercises to manage symptomatic OH.

Results: Fifteen of 22 episodes of OH were successfully managed with nonpharmacological interventions, allowing patients to engage in therapy.

Interpretation: This quality improvement initiative created a standardized, effective protocol for managing OH in patients with ischemic stroke that all members of the team could enact without physician input, minimized missed therapy sessions, and improved participation in rehabilitation.

Purpose: Multiple sclerosis (MS) is a chronic neurological disorder with diverse symptoms impairing daily life and quality of life. Progressive muscle relaxation (PMR) is a nonpharmacological technique to reduce symptoms and enhance well-being. This study evaluated the effects of PMR on MS-related symptoms (fatigue, sleep, depression, stress, pain) and overall well-being (quality of life, daily activities, self-esteem, self-efficacy).

Design: The study was designed as a systematic review and meta-analysis.

Methods: Studies including adults (≥18 years) with MS who received PMR were reviewed (August 1, 2024-August 31, 2024). Literature searches were conducted in English and Turkish across EBSCO, PubMed, Web of Science, Embase, Scopus, Cochrane CENTRAL, TR Dizin, DergiPark, and YÖK Thesis. Data unsuitable for meta-analysis were narratively synthesized, standardized mean differences were calculated (P <.05), and the review was registered in PROSPERO (CRD42024597051).

Results: From 282 records, 10 studies with 671 participants were included. PMR showed consistent positive effects on symptoms and overall well-being in individuals with MS, with significant reductions in fatigue (P = .004) and pain (P < .0001). Some studies were not included in the meta-analysis due to methodological differences.

Clinical relevance to the practice of rehabilitation nursing: PMR can be effective in reducing fatigue and pain, and enhancing overall well-beingfor individuals with MS.

Conclusions: PMR appears effective in reducing fatigue and pain, enhancing overall well-being, and can be useful as complementary nursing care for individuals with MS.

Background: Swallowing dysfunction is a common consequence of neurological disorders such as stroke, and may lead to malnutrition, aspiration, and reduced quality of life. Nurses are key members of the interdisciplinary team involved in the early detection and management of these issues.

Purpose: This review explores the role of nurses in swallowing rehabilitation across the acute, recovery, and chronic phases, emphasizing interdisciplinary collaboration and the integration of emerging technologies.

Methods: A literature search was conducted using PubMed, focusing on studies involving swallowing rehabilitation in neurological patients, particularly those highlighting nursing interventions.

Results: In the acute phase, nurses perform bedside screening to identify dysphagia early and coordinate timely care with other team members. During recovery, they support swallowing exercises, monitor patient progress, and provide education to patients and caregivers. In the chronic phase, nurses oversee long-term care, support nutritional management, and train family members. Technologies such as virtual reality and artificial intelligence enhance individualized rehabilitation strategies.

Conclusions: Swallowing rehabilitation requires phase-specific nursing interventions and close interdisciplinary teamwork. Strengthening the role of nurses in assessment, implementation, and patient education contributes to better patient outcomes and ensures continuity of care throughout all recovery phases.