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

Background: Despite promising individual benefits, the combined efficacy of Baduanjin and Tri-Ball Breath training as a home-based pulmonary rehabilitation in Chronic Obstructive Pulmonary Disease (COPD) subjects remains unexplored.

Objective: The aim of the study was to evaluate the effect of combining Baduanjin (a traditional Chinese exercise) and Tri-Ball Breath training into a home-based pulmonary rehabilitation regimen for COPD patients.

Methods: A multicenter randomized controlled trial was conducted, enrolling 240 moderate COPD patients from 10 hospitals. Participants were randomly assigned to four groups: Baduanjin group, Tri-Ball Breath training group, Combination training group, and control group. The intervention lasted 12 weeks. Data were collected at baseline, 4 weeks, 8 weeks, 12 weeks, and 24 weeks post-intervention.

Results: After 12 weeks, the 6-Minute Walk Distance (6MWD) significantly improved in the Baduanjin group and the Tri-Ball Breath training group ( p <0 .05), with the most significant improvement observed in the Combination training group ( p <0 .01) compared to the control group. FEV1% increased in the Baduanjin group and the Tri-Ball Breath training group ( p <0 .05) and markedly improved in the Combination training group ( p <0 .01). No significant differences were observed in the COPD Assessment Test (CAT), the Modified British Medical Research Council Scale (mMRC), or the Traditional Chinese Medicine symptom scores at 4-week and 8-week. The mMRC scores improved significantly in the Baduanjin group and the Combination training group at 24-week ( p <0 .05). The vital signs of all participants were stable from the baseline, and no statistic difference was observed among the four groups at all visits.

Conclusion: Our findings underscore the significance of incorporating Baduanjin and respiratory muscle training into the long-term management of COPD patients. By fostering continuous improvements in pulmonary function (FEV1%) and exercise capacity (6MWD), these interventions may help to mitigate disease progression and enhance patients' quality of life.

Purpose: The purpose of this study is to assess the extent to which caregivers' perceived readiness for discharge improves after participating in a stroke inpatient rehabilitation program, as measured by their self-reported preparedness for transitioning patients to the community.

Design: This was a prospective study involving pre- and postsurveys of caregivers.

Methods: The Preparedness Assessment for the Transition Home After Stroke (PATH-s) survey instrument was administered to caregivers of patients following a stroke at admission and discharge from inpatient rehabilitation. The PATH-s final score is an average that ranges from 1 to 4. A higher average score indicates higher readiness for discharge.

Results: Twenty-five patient-caregiver dyads complete the study protocol representing a 42% survey response rate of consented participants for both the initial and discharge PATH-s surveys. The initial mean PATH-s was 2.86 ( SD = 0.434), and the discharge mean PATH-s was 3.25 ( SD = 0.436). The differences between these scores were significant ( Z = -4.280, p ≤ .0001), suggesting participation with inpatient rehabilitation following a stroke improved the caregivers' self-reported readiness for discharge.

Clinical relevance: It is important for rehabilitation nurses to be aware of the caregiver's self-reported readiness for discharge to address any issues identified to improve transition for discharge following a stroke.

Conclusion: Caregiver readiness for discharge is an important issue yet it may be an undervalued aspect of the care delivery system.

Purpose: The purpose of this project was to develop an educational program and competency tool for virtual care facilitation in the inpatient rehabilitation setting using the professional rehabilitation nursing updated competency model as a theoretical framework.

Methods: The setting for this pilot was a 123-bed subacute inpatient rehabilitation facility; nurses employed at the facility ( N = 61) were invited to participate in the project. Educational sessions were developed and delivered to introduce the Association of Rehabilitation Nurses Updated Competency Model, along with a competency tool and checklist. Measures included a presurvey with demographic data and the Riggs Personal Efficacy Beliefs subscale. The postsurvey was administered after 6 weeks of using the competency tool and checklist.

Results: The checklist was used in 17 out of the 33 total virtual visits. Pre and post self-efficacy scores were analyzed using the Mann-Whitney test to assess for differences in self-efficacy mean scores. The results of the Mann-Whitney test showed an increase of 7.50 points (or 24%) in the scores.

Clinical relevance: Nursing competencies for virtual visit facilitation in the inpatient rehabilitation setting are needed to optimize care. A consistent approach to high-quality virtual care has the potential to improve patient outcomes and positively impact nurse confidence and self-efficacy.

Purpose: Stroke is a growing health concern in the United States. Effective secondary prevention through antithrombotic pharmacological agents is crucial yet understanding and adherence to guidelines among nurses can be challenging, impacting patient care. This article aims to enhance nurses' understanding of antithrombotic therapy guidelines for secondary stroke prevention, as outlined in the 2021 American Heart Association (AHA)/American Stroke Association (ASA) guidelines.

Methods: Review of literature summarizes the updated 2021 AHA/ASA antithrombotic therapy guidelines for treatment and secondary prevention, using visual aids to illustrate antithrombotic therapy algorithms and pharmacological review.

Discussion: The evidence-based pharmacological review is expected to significantly enhance nurses' understanding of the 2021 AHA/ASA antithrombotic therapy guidelines for secondary stroke prevention and associated clinical drug trials. This comprehensive review aims to foster informed clinical decision-making and provider-patient education.

Conclusion: By summarizing complex pharmacological guidelines, this article aims to empower nurses with the knowledge and tools necessary for effective decision-making and patient education in poststroke antithrombotic treatment. Enhanced understanding and adherence to these guidelines can significantly impact patient outcomes, reducing stroke-related morbidity and mortality. This educational initiative underscores the critical role rehabilitation nurses have in optimizing secondary stroke prevention and improving overall patient care.

Purpose: Geriatric rehabilitation is intended for older adults with vulnerability, comorbidity, and acute functional impairments. To explore and evaluate referral criteria, this study followed hospital patients referred for rehabilitation in nursing homes.

Design: Exploratory, retrospective cohort study.

Methods: Participants were community living before acute hospitalization and referred for geriatric rehabilitation between January 15 and May 15, 2019. Data were collected at hospital admission, hospital discharge, and discharge from rehabilitation-oriented care. Outcome measure was the final discharge destination.

Results: Out of 87 hospital patients referred for rehabilitation (mean age = 76.3 years, SD = 10.7), 73 received rehabilitation-oriented post-acute care and 60 (82.2%) returned home after rehabilitation. Premorbid functional status was regained by 45 (61.6%) participants and mobility by 40 (54.8%). Independent baseline mobility, no complications during post-acute care, fewer cognitive symptoms, and multidomain vulnerability were associated with discharge destination after rehabilitation.

Clinical relevance to rehabilitation nursing: A multidomain assessment can make vulnerability applicable in referral decisions and induce tailored individual rehabilitation programs.

Conclusion: This study explored the case-mix characteristics of hospital patients following rehabilitation trajectories. No frailty measures were available; vulnerability was refined into physical, cognitive, and social components. Careful assessment of vulnerability can support personalized referral decision-making.

Purpose: The study purpose was to develop and assess a simulation for registered nurses to apply knowledge, skills, and attitudes in conducting a focused assessment in the clinic setting to prevent community-acquired pressure injuries (CAPrIs) in individuals living with spinal cord injury (SCI).

Methods: Development, psychometric assessment, and pilot of a simulation for a nurse-patient clinic appointment to prevent CAPrIs at home. Evaluations were conducted via focus group.

Results: The simulation required one round with five experts in preventing CAPrIs in SCI to reach 80% agreement. The simulation with a standardized patient and companion checklist was piloted with ( n = 4) post-baccalaureate registered nurse residents. Evaluation results indicated participants grew in knowledge, skills, and attitudes in conducting a focused assessment on prevention of CAPrIs.

Clinical relevance: Evidence-based nursing education is needed for CAPrI prevention for individuals living with SCI in the community setting. The simulation is replicable.

Conclusions: The online educational program, simulation, and checklist for nurses promoted knowledge, skills, and attitudes in assessment of CAPrI prevention.