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

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Weaving: a reflection of life. 编织:生活的反映。
Pub Date : 2001-09-10 DOI: 10.1002/J.2048-7940.2001.TB01945.X
V. Ho, B. Zimmerman
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引用次数: 0
Adherence to disease-modifying therapy in multiple sclerosis: Part II. 多发性硬化症对疾病改善治疗的坚持:第二部分。
Pub Date : 2001-09-10 DOI: 10.1002/J.2048-7940.2001.TB01959.X
N. Holland, P. Wiesel, P. Cavallo, C. Edwards, J. Halper, R. Kalb, L. Morgante, M. Namey, M. O’Leary, L. Smith-Williamson
Multiple sclerosis (MS) is a chronic, debilitating disease for which there is no cure; however, the recent introduction of injectable immunomodulating agents has reduced the rate of relapsing episodes and possibly slowed the progression of the disease. These disease-modifying agents are recommended by the National MS Society, but their true potential cannot be realized if patients do not accept them and healthcare professionals do not promote them. Since MS has an unpredictable course, and treatments can produce side effects, adherence to the recommended therapy is a complex and challenging issue. Improved understanding of the obstacles to adherence and the identification of possible solutions should be of value to nurses, who have numerous opportunities to encourage patients to initiate and continue therapy. Part I of this article, published in the September/October 2001 issue of Rehabilitation Nursing, described the particular problems of treatment adherence in MS. Part II proposes that the transtheoretical model of behavior change can be a useful tool in achieving both patient acceptance and treatment goals. This model is founded upon the concept that readiness for change is crucial, and that attempts at intervention should be sensitive to the patients' changing conditions and states of mind.
多发性硬化症(MS)是一种无法治愈的慢性衰弱性疾病;然而,最近引入的可注射免疫调节剂降低了复发的发生率,并可能减缓了疾病的进展。这些疾病调节剂是由国家多发性硬化症协会推荐的,但如果患者不接受它们,医疗保健专业人员不推广它们,它们的真正潜力就无法实现。由于多发性硬化症的病程不可预测,而且治疗可能产生副作用,因此坚持推荐的治疗是一个复杂而具有挑战性的问题。更好地了解坚持治疗的障碍和确定可能的解决方案对护士来说应该是有价值的,因为护士有很多机会鼓励患者开始并继续治疗。这篇文章的第一部分发表在2001年9月/ 10月的《康复护理》杂志上,描述了多发性硬化患者治疗依从性的特殊问题。第二部分提出,行为改变的跨理论模型可以成为实现患者接受和治疗目标的有用工具。这个模型是建立在这样一个概念之上的,即对变化的准备是至关重要的,干预的尝试应该对患者不断变化的条件和精神状态敏感。
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引用次数: 44
Rehabilitation nursing in Botswana. 博茨瓦纳的康复护理。
Pub Date : 2001-09-10 DOI: 10.1002/J.2048-7940.2001.TB01944.X
J. Popovich
As we bumped along the dry, sandy roadin our4x4,I learnedaboutthepatients we were about to visit that morning. Our group consisted of Johnson, a community-basedrehabilitation workeratMogoditshaneRehabilitation Centre; Toitoi, a graduate studentin nursingat the Universityof Botswana; and me. Our first home visit was to see a 4-year-old girl who had femoral tendon releases for contractures due to severe postmeningitis spasticity. Meningoccalmeningitis, an infectious diseaseaffecting childrenin Africaduringthe dry season, is a common cause of neurological disabilities, with an estimated 38,000 new cases reportedthis year alone (International Federation of Red Cross, 2001). When we arrived, all the family members gathered in the yard with the little girl in the center, lying on a blanket carefullyspreadoverthedirt.Her hair was freshly plaited and her skin had been scrubbed so that it sparkled.Her primary caregiver, the grandmother,stood nearby as we examined her incisions. Out of the comer of my eye, I could see a dead goat hanging by its feet from a tree. Toitoiand I discussedwoundhealing,confirmedthat the child was afebrileby feeling her skin, anddiscussedthe typeof range-of-motion exercises we would teach the family. We observed the family interacting with the child and noted she had a place of honor, as evidencedby her meticulousgrooming, nutrition, and care. As we were getting ready to leave, many villagers gathered around,out of curiosityand support,to observeour work.A familymember offered a gift of gratitude, a goat's leg that he placed in front of Johnson to inspect before wrappingit in newspaper. Weleftcarrying the meat as we climbed into our vehicle and drove off to see the next patient. This clinical experience was the first rehabilitation practicum organized for nursing students in the master's degree program at the University of Botswana (UB) in conjunction with the Mogoditshane Rehabilitation Centre (MRC) of the A sculpture in thecourtyard ofMogoditshaneRehabilitation Centre dramatizes thesignificance of mobility and independence for people with disabilities.
当我们开着四轮驱动汽车在干燥的沙质道路上颠簸时,我了解到我们那天早上要去看的病人。我们的小组由约翰逊组成,他是一名社区康复工作者,就职于goitshanrehabilitation Centre;博茨瓦纳大学护理专业的研究生Toitoi;和我。我们的第一次家访是看一个4岁的女孩,她因严重的脑膜炎后痉挛导致挛缩而进行股肌腱释放。脑膜炎是一种影响非洲旱季儿童的传染病,是造成神经系统残疾的常见原因,仅今年就报告了约38 000例新病例(红十字国际联合会,2001年)。当我们到达时,所有的家庭成员都聚集在院子里,小女孩站在中间,躺在一条毯子上,小心地铺在地上。她的头发刚编好,皮肤也擦得光彩照人。当我们检查她的切口时,她的主要照顾者,祖母站在旁边。我用余光看到一只死山羊倒挂在树上。我和totoand讨论了伤口的愈合,通过摸她的皮肤确认了孩子的发热,并讨论了我们将教给这个家庭的活动范围练习的类型。我们观察了这个家庭与孩子的互动,注意到她有一个值得尊敬的地方,从她精心的打扮、营养和照顾中可以看出。当我们准备离开时,许多村民出于好奇和支持,围过来观察我们的工作。一位家庭成员献上了一份表示感谢的礼物——一条羊腿,他把羊腿放在约翰逊面前,让他检查,然后用报纸包起来。我们端着肉爬上车去看下一个病人。这是博茨瓦纳大学(UB)与Mogoditshane康复中心(MRC)联合为护理专业硕士学位课程的学生组织的第一个康复实习,Mogoditshane康复中心庭院里的一座雕塑戏剧性地表达了残疾人行动能力和独立性的重要性。
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引用次数: 4
Rehabilitation nursing in home care. 居家康复护理。
Pub Date : 2001-09-10 DOI: 10.1002/J.2048-7940.2001.TB01947.X
B. Brillhart, L. Heard, B. Kruse
A randomized sample of 83 members of the Association of Rehabilitation Nurses' (ARN's) Home Health Special Interest Group (SIG) responded to a survey in 1998 and 1999 to determine the role intensity of rehabilitation nurses in home care. An instrument was developed that was based on role descriptions formulated by ARN. Significant differences in the roles were reported for caregiver, case manager, counselor, family-client educator, advocate, administrator, student/staff educator, and researcher. Rewards of home nursing included one-to-one interaction with clients, teaching opportunities, promotion of function, nurse autonomy, and seeing rehabilitation results. Difficulties included poor interdisciplinary coordination, budget restrictions, lack of understanding of rehabilitation nursing, and inadequate home aides. Differences between inpatient and home rehabilitation nursing included less equipment and resources and increased levels of responsibility in the home. Barriers for the transition to home rehabilitation nursing included interdisciplinary team communication, reimbursement standards and documentation, time management, autonomous nursing roles, and separation from help or emergency services.
在1998年和1999年进行的一项调查中,对康复护士协会(ARN)家庭健康特别兴趣小组(SIG)的83名成员进行随机抽样,以确定康复护士在家庭护理中的作用强度。根据ARN制定的角色描述,开发了一种工具。据报道,护理人员、病例管理员、咨询师、家庭客户教育者、倡导者、管理员、学生/教职员工教育者和研究员的角色存在显著差异。家庭护理的奖励包括与客户一对一的互动、教学机会、功能提升、护士自主权和看到康复效果。困难包括跨学科协调不力、预算限制、对康复护理缺乏了解以及家庭助理不足。住院和家庭康复护理之间的差异包括较少的设备和资源以及家庭责任水平的提高。过渡到家庭康复护理的障碍包括跨学科团队沟通、报销标准和文件、时间管理、自主护理角色以及与帮助或紧急服务的分离。
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引用次数: 4
Examining Peplau's pattern integrations in long-term care. 考察Peplau在长期护理中的模式整合。
Pub Date : 2001-09-10 DOI: 10.1002/J.2048-7940.2001.TB01951.X
P. J. Schaefer, J. Middleton
Contrary to the societal view that only the frail elderly reside in long-term care facilities, many young adults who require residential care to maintain optimal health, or who are in a rehabilitation program, also live in these facilities. The relationships between residents and caregivers in long-term care facilities may develop into relationships that are more typically familial than professional. With these emerging family-like relationships, the interpersonal pattern interactions may be healthy or unhealthy and may create opportunities for growth or pathology-producing patterns. This article illustrates how applying Peplau's concept of need-pattern integrations in the long-term care setting has the potential to enhance understanding, and subsequently guide interactions, between younger residents and caregivers. The potential is greatest when interactions are guided.
与只有体弱多病的老年人才住在长期护理机构的社会观点相反,许多需要住院护理以保持最佳健康状况或正在接受康复计划的年轻人也住在这些设施中。在长期护理机构中,住院医生和护理人员之间的关系可能会发展成更典型的家庭关系,而不是专业关系。随着这些家庭式关系的出现,人际互动模式可能是健康的,也可能是不健康的,并可能为成长或产生病理的模式创造机会。本文阐述了如何在长期护理环境中应用Peplau的需求模式整合概念,从而有可能增强年轻住院医生和护理人员之间的理解,并随后指导他们之间的互动。当相互作用受到引导时,潜力是最大的。
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引用次数: 3
An act of courage: women's decision-making processes regarding outpatient cardiac rehabilitation attendance. 勇气的行为:妇女关于门诊心脏康复出勤的决策过程。
Pub Date : 2001-07-08 DOI: 10.1002/J.2048-7940.2001.TB01935.X
J. McSweeney, P. Crane
The purpose of this qualitative study was to describe the factors that affect women's attendance and adherence to a cardiac rehabilitation (CR) program after a myocardial infarction (MI). We used in-depth interviews and a health survey form to collect data. The purposive sample consisted of 40 women who had experienced a first MI within the previous 6 weeks to 12 months. Of those 40, 18 women were not offered the program, 8 declined it, and 14 attended. Using content analysis and constant comparison, we identified three distinct phases: "initial decision," "CR attendance," and "reevaluation." Four data clusters positively influenced the continuation of CR attendance: "Psychological Appraisal," "Program Components," "Staff Behaviors," and "Outcomes." When women encountered a fifth cluster--"Barriers"--they entered the reevaluation phase. Results of this study support specific interventions for each phase.
本定性研究的目的是描述影响心肌梗死(MI)后妇女参加和坚持心脏康复(CR)计划的因素。我们使用深度访谈和健康调查表格来收集数据。目的样本包括40名在过去6周到12个月内经历过首次心肌梗死的妇女。在这40名女性中,有18名女性没有参加该项目,8名女性拒绝参加,14名女性参加了该项目。通过内容分析和持续比较,我们确定了三个不同的阶段:“初始决策”、“CR出席”和“重新评估”。“心理评估”、“计划组成部分”、“员工行为”和“结果”四个数据簇对企业社会责任出勤率的持续产生积极影响。当女性遇到第五组“障碍”时,她们进入了重新评估阶段。本研究的结果支持每个阶段的具体干预措施。
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引用次数: 44
Sexual problems before and after myocardial infarction: patients' needs for information. 心梗前后的性问题:患者对信息的需求。
Pub Date : 2001-07-08 DOI: 10.1002/J.2048-7940.2001.TB01939.X
Nevin Akdolun, Güisen Terakye
Changes occur in an individual's lifestyle after a myocardial infarction (MI), including his or her sexual activity. This study evaluated problems related to post-MI sexual functioning and the information needs of MI patients. The study included 110 MI patients who had home visits within 2-5 months after their discharge from the hospital. Data were gathered through a questionnaire that was completed through personal interviews. The study sample was predominantly male (95.5%). All patients were married, and 25% were between the ages of 24 and 40 years. We identified unnecessary limitations in sexual activities and mistakes in the reorganization of activities, such as resumption of sexual activity and frequency and positions of sexual intercourse. We found that all 110 patients had insufficient information about their future sexual functioning.
心肌梗死(MI)后个人生活方式的改变,包括他或她的性活动。本研究评估心肌梗死后性功能问题及心肌梗死患者的信息需求。该研究包括110例心肌梗死患者,他们在出院后2-5个月内进行了家访。数据是通过个人访谈完成的问卷收集的。研究样本以男性为主(95.5%)。所有患者均已婚,25%年龄在24 - 40岁之间。我们发现了性活动中不必要的限制和活动重组中的错误,比如恢复性活动和性交的频率和姿势。我们发现所有110名患者对他们未来的性功能都没有足够的了解。
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引用次数: 29
'E-health' and rehabilitation nursing. “电子保健”和康复护理。
Pub Date : 2001-07-08 DOI: 10.1002/J.2048-7940.2001.TB01933.X
R. Buhrer
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引用次数: 1
Women and cardiac rehabilitation: accessibility issues and policy recommendations. 妇女与心脏康复:无障碍问题和政策建议。
Pub Date : 2001-07-08 DOI: 10.1002/J.2048-7940.2001.TB01937.X
E. Missik
The purpose of this study was to identify whether certain factors related to accessibility can predict women's participation in cardiac rehabilitation (CR). This cross-sectional comparative study used a convenience sample of 370 women cardiac patients who were treated and discharged between April 1, 1995, and September 30, 1995. A self-report instrument and medical record reviews were used to collect data at five hospitals and four CR centers in three midsized cities in northeastern Ohio. Differences between participants and nonparticipants were examined on the groups of variables. Logistic regression showed women's participation in CR to be overwhelmingly determined by physician referral (odds ratio [OR] = 0.000), which was more likely to occur if the patient had CR insurance (OR = 0.73). The probability of compliance with a referral in women with CR insurance and no history of coronary heart disease (CHD) was .89; with no insurance and a history of CHD, the probability of participation was .37. Participation was associated with level of education, coronary artery bypass surgery, and available transportation. We recommend the promotion and encouragement of the use of Clinical Practice Guidelines by physicians, and lower cost and more accessible approaches to CR, such as contracting with managed care, home rehabilitation, and community-based programs.
本研究的目的是确定与可及性相关的某些因素是否可以预测女性参与心脏康复(CR)。这项横断面比较研究选取了1995年4月1日至1995年9月30日期间接受治疗和出院的370名女性心脏病患者作为样本。在俄亥俄州东北部三个中等城市的五家医院和四个CR中心,使用自我报告工具和医疗记录审查来收集数据。参与者和非参与者之间的差异在变量组上进行了检验。Logistic回归显示,女性参与CR的绝大多数是由医生转诊决定的(优势比[OR] = 0.000),如果患者有CR保险(OR = 0.73),这种情况更有可能发生。有CR保险且无冠心病史的妇女依从转诊的概率为0.89;无保险且有冠心病史者,参与的概率为0.37。参与程度与教育水平、冠状动脉搭桥手术和可用的交通工具有关。我们建议促进和鼓励医生使用临床实践指南,采用成本更低、更容易获得的CR方法,如承包管理式护理、家庭康复和社区项目。
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引用次数: 51
Rehabilitation options for patients with low vision. 低视力患者的康复选择。
Pub Date : 2001-07-08 DOI: 10.1002/J.2048-7940.2001.TB01938.X
L. C. Sperazza
Loss of vision has a profound effect on an individual's life. Reduced visual function, whether present at birth or appearing later in life, greatly affects one's perception of useful existence. When medical intervention can no longer restore or maintain a person's functional vision, rehabilitative measures are necessary to enable that person to adjust both physically and psychologically to his or her sensory loss. Rehabilitation for low vision offers visually impaired individuals a renewed independence and productivity that will enable them to rejoin society as active participants. Often patients and healthcare providers are unaware of the rehabilitation options that are available to them. Low-vision devices such as magnifiers and telescopes, as well as counseling and vocational training, are among the available options. Rehabilitation nurses are particularly qualified to identify patients with reduced functional ability and to recommend an appropriate visual assessment that can lead to maximized residual vision.
视力的丧失对一个人的生活有着深远的影响。无论是出生时出现还是以后出现的视觉功能减退,都会极大地影响一个人对有用存在的感知。当医疗干预不能再恢复或维持一个人的功能性视力时,就必须采取康复措施,使这个人能够在身体和心理上适应他或她的感官丧失。低视力康复为视障人士提供了新的独立性和生产力,使他们能够作为积极参与者重新加入社会。通常,患者和医疗保健提供者不知道他们可以选择的康复方案。诸如放大镜和望远镜之类的低视力设备,以及咨询和职业培训都是可用的选择。康复护士特别有资格识别功能下降的患者,并建议适当的视力评估,以最大限度地恢复剩余视力。
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引用次数: 4
期刊
Rehabilitation nursing : the official journal of the Association of Rehabilitation Nurses
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