Application Progress of the Case Teaching Method in Standardized Training for Rehabilitation Nurses.

Context: In China, the dearth of adept rehabilitation nurses has escalated into a pressing concern. Conventional nursing education has stymied nurses' autonomous scholarly pursuits. The case-teaching methodology can augment students' competencies and zeal, culminating in the enrichment of educational excellence. Objective: The study intended to elucidate the principles, taxonomy, and enactment of the case-teaching methodology and examine its salutary impacts on nursing practitioners and educators. Design: The research team performed a narrative review by searching BMJ Best Practice, OVID EBM, NGC et al databases. The search used the keywords 'Rehabilitation nursing', 'nursing', 'case teaching method'. Setting: The study took place at the Rehabilitation Medicine Center at West China Hospital of Sichuan University in Chengdu, China. Results: The current study scrutinizes the assimilation of the case-teaching methodology within the realm of nursing, dissects emerging paradigms in the standardized training of rehabilitation nursing staff, and furnishes precedents for the evolution of training frameworks in the field of rehabilitative care. Conclusions: The case-teaching methodology not only serves as an instructional tool but also embodies a fundamental transformation in the modernization of nursing education, embodying the aspiration for excellence, the desire for continuous improvement, and a dedication to the highest standards of patient care.

Rehabilitation nursing care in the acute phase of diseases with physical disabilities: A concept analysis study.

BACKGROUND: Despite the importance of rehabilitation nursing care in improving patient outcomes, the provision of this care in the early stages of diseases and injuries is limited. In this situation, analyzing the concept of rehabilitation nursing care can increase nurses' understanding of this concept and improve the provision of rehabilitation nursing care in the acute phase. This study aimed to analyze the concept of rehabilitation nursing care in acute phase of diseases with physical disability. METHOD: Walker and Avant's approach to concept analysis was performed in eight stages, including choosing a concept, determining the purpose of analysis, identifying all uses of the concept, defining attributes, identifying a model case, identifying borderline and contrary cases, identifying antecedents and consequences, and defining empirical referents. RESULTS: The important characteristics of rehabilitation nursing are comprehensive, education-based, specialized, client and family centered, interprofessional, and need-based. The antecedents of rehabilitation nursing care are related to nurses, the care settings and the nursing profession. The most important consequence of rehabilitation nursing care is improving the quality of life of patients. Rehabilitation nursing care also has positive outcomes for nurses and the healthcare systems. CONCLUSION: The findings indicate that rehabilitation nursing care has several attributes that require antecedents such as knowledge and specialized skills such as teamwork skills, effective communication skills, cultural sensitivity, holistic perspective, intuitive thinking, and reasoning. The most important consequence of rehabilitation nursing care is improving the quality of life of patients.

Enhancing Gastrointestinal Function Recovery in Post-Intestinal Surgery Patients Through Rapid Rehabilitation Nursing Therapy.

Objective: This study aimed to investigate the efficacy of rapid recovery nursing therapy in enhancing digestive tract function recovery following intestinal surgery. Methods: This study included 100 post-intestinal surgery patients between March 2020 and March 2022. A random table method was used, and patients were assigned to either a control group receiving standard nursing care or an experimental group receiving rapid rehabilitation therapy. A thorough assessment compared different outcomes such as gastrointestinal function recovery, physical recuperation, stress levels, postoperative adverse events, nutritional status, nursing efficacy, and patient satisfaction between the two groups. Results: Compared to the control group, the experimental group exhibited significant improvements in gastrointestinal function and physiological parameters (P < .05). Additionally, the experimental group experienced fewer adverse effects, improved nursing outcomes, and higher patient satisfaction post-treatment (P < .05). Conclusions: Rapid rehabilitation nursing therapy in patients undergoing intestinal surgery substantially enhances digestive tract function and overall patient well-being. It effectively reduces the incidence of postoperative complications, accelerates the patient's recovery process, and improves their quality of life. Patient satisfaction with postoperative fast recovery care was notably high. This rehabilitation approach holds significant promise for patients undergoing intestinal surgery and merits wider adoption.

Ganhos em saúde com a implementação de programas de reabilitação respiratória nos utentes com DPOC: uma scoping review / Health gains with the implementation of respiratory rehabilitation programs in patients with COPD: a scoping review

A tendência global da saúde e o envelhecimento demandam uma expansão significativa dos serviços de reabilitação. A Enfermagem de Reabilitação é portadora de um corpo de conhecimentos e procedimentos específicos que permitem atuar e ajudar as pessoas portadoras de patologias agudas, crónicas ou que apresentem sequelas, a maximizar o seu potencial funcional e a sua independência. Assim, foi realizado um Estágio de Natureza Profissional com o objetivo de desenvolver competências no âmbito da Enfermagem de Reabilitação em contexto comunitário. Este apresenta uma análise crítica fundamentada sobre as competências profissionais desenvolvidas, enquanto Enfermeiro Especialista e Enfermeiro Especialista em Enfermagem de Reabilitação. Para orientar este percurso foi tido em conta o modelo teórico de Afaf Meleis com a sua Teoria das Transições. Relativo à prática de investigação trata-se de um estudo de revisão, uma scoping review, que tem como objetivo: Mapear a evidência científica disponível para identificar quais os ganhos em saúde obtidos através da implementação de um Programa de Reabilitação Respiratória pelo Enfermeiro Especialista em Enfermagem de Reabilitação aos portadores de Doença Pulmonar Obstrutiva Crónica. Sustentado na metodologia de Joanna Briggs Institute e que obedece aos critérios de inclusão segundo a estratégia Participantes, Conceito e Contexto. Elaborada a frase boolenana e realizada pesquisa nas seguintes bases de dados: CINAHL complete (via EBSCO), COCHRANE Databases of Sistematic Reviews, MEDLINE (Via PUBMED), OPENGREY, MEDLATINA e SCIELO. Foram incluídos sete artigos, sendo três estudos randomizados controlados, um estudo randomizado não controlado, uma meta-análise, um estudo retrospetivo-correlacional de natureza quantitativa e um estudo quase experimental. Os resultados apontam para os ganhos na capacidade respiratória, na capacidade motora, na saúde mental e na qualidade de vida. Este estágio permitiu, enquanto mestranda, o desenvolvimento de conhecimentos e competências variadas. Para a unidade onde decorreu teve um impacto positivo através da sensibilização para uma referenciação mais precoce para o Enfermeiro Especialista em Enfermagem de Reabilitação e para os utentes a possibilidade de uma prestação de cuidados cada vez mais diferenciada, célere e adequada as suas reais necessidades

The global health trend and aging demand a significant expansion of rehabilitation services. Rehabilitation Nursing is the bearer of a body of knowledge and specific procedures that allow acting and helping people with acute, chronic pathologies or those with sequelae, to maximize their functional potential and independence. Thus, a Professional Internship was carried out with the aim of developing skills in the field of Rehabilitation Nursing in a community context. This presents a grounded critical analysis of the professional skills developed as a Specialist Nurse and Specialist Nurse in Rehabilitation Nursing. Toguide this path, the theoretical model of Afaf Meleis was taken into account with his Theory of Transitions. Regarding research practice, this is a review study, a scoping review, which aims to: Map the scientific evidence available to identify the health gains obtained through the implementation of a Respiratory Rehabilitation Program by the Nurse Specialist in Nursing of Rehabilitation for patients with Chronic Obstructive Pulmonary Disease. Supported by the methodology of the Joanna Briggs Institute and which complies with the inclusion criteria according to the Participants, Concept and Context strategy. The Boolean phrase was elaborated and a search was carried out in the following databases: CINAHL complete (via EBSCO), COCHRANE Databases of Systematic Reviews, MEDLINE (via PUBMED), OPENGREY, MEDLATINA and SCIELO. Seven articles were included, three randomized controlled studies, one randomized uncontrolled study, one meta-analysis, one retrospective correlational quantitative study and one quasi-experimental study. The results point to gains in respiratory capacity, motor capacity, mental health and quality of life. This internship allowed, as a Master's student, the development of varied knowledge and skills. For the unit where it took place it had a positive impact through raising awareness of an earlier referral for the Specialist Nurse in Rehabilitation Nursing and for users the possibility of providing increasingly differentiated care, faster and adequate to their real needs.

Promoção do conforto na pessoa em processo cirúrgico: intervenção do enfermeiro de reabilitação / Promoting comfort in people undergoing surgery: rehabilitation nurse intervention

Perante o aumento exponencial de cirurgias realizadas, surge a necessidade de criar conhecimento e evidência científica sobre a intervenção especializada junto desta população específica. As complicações pós-operatórias são a maior causa de morbilidade, mortalidade e institucionalização prolongada com aumentos inerentes de custos económicos. Estas complicações podem ser de diversas etiologias e estar dependentes de diversos fatores de risco associados. As intervenções do enfermeiro especialista em enfermagem de reabilitação à pessoa em processo cirúrgico promovem diagnósticos precoces e ações preventivas, assegurando a manutenção da funcionalidade e a prevenção de complicações. Esta atuação especializada possibilita manter ou recuperar independência, controlando e minimizando efeitos das complicações associadas. O conforto é a condição experimentada pelas pessoas que recebem as medidas de conforto, é a experiência imediata e holística de ser fortalecido através da satisfação das necessidades dos três tipos de conforto ­ alívio, tranquilidade e transcendência, nas dimensões física, psico-espiritual, social e ambiental. Para o âmbito do presente relatório, foi realizada uma revisão narrativa da literatura, recorrendo ao método PI(C)O partindo da seguinte questão: "Quais as intervenções de enfermagem de reabilitação (Intervention), na promoção do conforto (Outcomes), na pessoa em processo cirúrgico (Population)?" O presente relatório permitiu desenvolver conhecimento e competências aos níveis do processo cirúrgico, complicações pós-operatórias e respetiva intervenção do enfermeiro especialista em enfermagem de reabilitação. No decorrer do processo de aquisição das competências comuns e específicas do enfermeiro especialista, foi fundamentada a intervenção especializada como promotora de conforto apoiada na Teoria do Conforto de Kolcaba. O enfermeiro especialista em enfermagem de reabilitação ao abordar o conforto na sua intervenção, deve esperar resultados realistas assentes nessas dimensões, obtendo os respetivos níveis de conforto. O conforto e as suas necessidades são mutáveis e consideram-se interdependentes dos programas de enfermagem de reabilitação e vice-versa.

Given the exponential increase in the number of surgeries performed, there is a need to create knowledge and scientific evidence on the specialised intervention for this specific population. Postoperative complications are a major cause of morbidity, mortality, and prolonged institutionalisation with inherent increases in economic costs. These complications may have different etiologies and be dependent on several associated risk factors. The interventions of the nurse specialist in rehabilitation to patients undergoing surgery promote early diagnosis and preventive actions, ensuring the maintenance of functionality and the prevention of complications. This specialised action allows maintaining or regaining independence, controlling and minimising the effects of the associated complications. Comfort is the condition experienced by people who receive comfort measures, it is the immediate and holistic experience of being strengthened through the satisfaction of the needs of the three types of comfort - relief, tranquillity and transcendence, in the physical, psycho-spiritual, social and environmental dimensions. To address this topic, a narrative literature review was conducted using the PI(C)O method based on the following question: "What are the interventions of rehabilitation nursing (Intervention), in the promotion of comfort (Outcomes), in people undergoing surgery (Population)?" During the process of acquisition of common and specific competencies of the specialist nurse, the specialised intervention was based on Kolcaba's Comfort Theory as a promoter of comfort. The specialist nurse in rehabilitation, when addressing comfort in his intervention, should expect realistic results based on these dimensions, obtaining the respective levels of comfort. Comfort and its needs are changeable and are considered interdependent on rehabilitation nursing programs, and vice-versa.

Effect of traditional Chinese medicine-based rehabilitation nursing combined with scalp acupuncture on negative emotions and quality of life of patients with stroke: A randomized controlled trial.

BACKGROUND: This study aimed to analyze the effect of traditional Chinese medicine-based rehabilitation nursing combined with scalp acupuncture (TCMRN + SA) on negative emotions and the quality of life of patients with stroke. METHODS: 102 patients with stroke admitted to The First People's Hospital of Huzhou from September 2019 to December 2020 were included in this study using the convenience sampling method and split into an observation group and a control group at random (n = 51 in each group). Individuals in the control group received TCMRN, whereas patients in the observation group received TCMRN + SA. Furthermore, the negative emotions and quality of life of the individuals in both groups were evaluated before and after the intervention using the Pittsburgh sleep quality index scale, Self-Rating Depression Scale (SDS), Self-Rating Anxiety Scale (SAS), as well as Activity of Daily Living Scale. Furthermore, the efficiency of the sleep-quality intervention between the 2 groups was compared. RESULTS: After the intervention, the Pittsburgh sleep quality index scale, SDS, as well as self-rating anxiety scale scores of individuals in the observation group were considerably lower in comparison to the individuals in the control group (P < .01). Activity of daily living scale scores in the observation group also differed considerably from those in the control group (P < .01). Moreover, the sleep quality efficiency rate in the observation group (90.19% [46/51]) was substantially higher than that in the control group (70.59% [36/51]) (P < .05). CONCLUSION: TCMRN + SA can effectively improve patients' negative emotions and quality of life and is worthy of clinical promotion and application.

Effects of All-Inclusive and Hierarchical Rehabilitation Nursing Model Combined with Acupuncture on Limb Function and Quality of Life in Elderly Patients with Cerebral Infarction during Convalescence.

Objective: To investigate effects of all-inclusive and hierarchical rehabilitation nursing model combined with acupuncture on limb function and quality of life in elderly patients with cerebral infarction during convalescence. Methods: Eighty elderly patients with cerebral infarction who were treated in our hospital (February 2018-February 2020) and met the inclusion and exclusion criteria were chosen as the research objects, and their materials were analyzed in the way of retrospective study. They were equably randomized into observation group and reference group. Based on the acupuncture treatment, the patients in the observation group and the reference group were given routine rehabilitation nursing and all-inclusive and hierarchical rehabilitation nursing respectively for three months. The simplified Fugl-Meyer Assessment (FMA) scores, Modified Edinburgh-Scandinavian Stroke Scale (MESSS) scores, Activities of Daily Living Scale (ADL) scores, and Stroke-Specific Quality of Life Scale (SS-QOL) scores in the two groups before and after intervention were recorded, and the changes of limb function, neurological function, and living quality of the patients in the two groups were analyzed. Results: Compared with the reference group, the observation group after intervention achieved prominently higher FMA score (P < 0.001), markedly lower MESSS score (P < 0.001), and signally higher SS-QOL scores (P < 0.05). After intervention, the observation group achieved obviously higher ADL score than the reference group (68.88 ± 8.91 vs 59.00 ± 8.38, P < 0.001). Conclusion: The all-inclusive and hierarchical rehabilitation nursing model combined with acupuncture can accelerate the recovery of neurological function of the elderly patients with cerebral infarction, enhance the rehabilitation of their limb function, and markedly improve their quality of life. Therefore, this model has referential significance in clinic.

A Enfermagem de Reabilitação e o planeamento da alta hospitalar / Rehabilitation nursing and hospital discharge planning

O internamento hospitalar interfere na forma como a pessoa desempenha as suas atividades de vida diária (AVD), sendo frequentemente associado a alterações da funcionalidade, qualidade de vida, interação familiar, aumento da prevalência de complicações, além do impacto económico no Serviço Nacional de Saúde (SNS). A alta precipitada está associada a transtornos graves na dinâmica familiar e qualidade de vida do doente, pelo que é imprescindível o início precoce do planeamento de alta. O enfermeiro de reabilitação dirige os seus cuidados à pessoa com necessidades especiais, nomeadamente na preparação do regresso a casa, na continuidade de cuidados e na reintegração na comunidade, promovendo a mobilidade, a acessibilidade e a participação social. As intervenções dirigidas ao planeamento da alta, nem sempre estão bem aferidas entre os enfermeiros de cuidados gerais e os enfermeiros de reabilitação, sendo notória a falta de coordenação das equipas. Com base nestes pressupostos, desenvolvemos um estudo qualitativo, constituindo-se uma amostra intencional de enfermeiros, com o critério de inclusão de exercer funções em serviços de internamento de um hospital central do norte do país, tendo como objetivos compreender o processo de planeamento de alta na perspetiva dos enfermeiros e, analisar as diferenças de planeamento de cuidados, de acordo com a formação académica e especialidade. Foi utilizado um instrumento de recolha de dados, com recurso a uma entrevista semi-estruturada, tendo sido elaborado um guião, suportado pelo modelo teórico de enfermagem de Nancy Roper, Winifred Logan e Alison Tierney. Após a recolha de dados, foi aplicado o método de análise de conteúdos com a sustentação teórica de Bardin, através do recurso ao software Atlas.ti para o tratamento de dados. Da análise emergiram as seguintes áreas temáticas: o processo de planeamento de alta, a continuidade de cuidados, os instrumentos de apoio ao planeamento de alta, as boas práticas e o modelo em uso. Face aos resultados obtidos, concluímos que os enfermeiros desenvolvem o planeamento de alta de forma pouco organizada e sistematizada, desprovida de instrumentos de medição, e sem fundamentação teórica na sua tomada de decisão. Não há uma articulação sustentada ao longo do processo de planeamento de alta, entre o momento em que é iniciado e a alta efetiva do doente. Os enfermeiros que manifestaram maior envolvimento no processo e utilização de recursos, como os instrumentos de medida, embora restritos ao seu âmbito profissional, foram os enfermeiros especialistas de reabilitação.

Hospitalization interferes with the way a person performs daily living activities, being frequently associated to functionality changes, decrease of quality of life, family interaction dysfunction, increased prevalence of complications, in addition to the economic impact on the National Health Service. The unbalanced discharge can cause severe disorders in the patient's family dynamics and quality of life, which is why an early start of discharge planning is urgent. The rehabilitation nurse promotes healthcare to a person with special needs, including the preparation of the home return, the continuity of care and the community reintegration, encouraging mobility, accessibility and social participation. The discharge planning interventions aren't always well measured between general nurses and rehabilitation nurses, showing a gap in team coordination. Based on these facts, we developed a qualitative study, under an intentional sample of nurses, who had to work in services of a central hospital of the north in the country, aiming to understand the process of discharge planning from the perspective of nurses and, analyze the differences in care planning, according to academic training and specialty. Our instrument used was a half-structured interview, and a script was developed, supported by the theoretical nursing model of Nancy Roper, Winifred Logan and Alison Tierney. After data collection, the content analysis method was applied with the theoretical support of Bardin, using the Atlas.ti software for data processing. The following thematic areas emerged from the analysis: the discharge planning process, continuity of care, support instruments for discharge planning, good practices and the model in use. The results highlight that nurses develop discharge planning in an unorganized and systematic way, without using instruments of measure, and without theoretical basis in their decision making. There is no sustained articulation throughout the discharge planning process, between the moment it is initiated and the patient's actual discharge. The nurses who showed greater involvement in the pro

Effect of comprehensive rehabilitation nursing intervention on hemiplegia patients in sequela stage of stroke.

OBJECTIVE: To explore the clinical effect of comprehensive rehabilitation nursing intervention on hemiplegia patients in the sequela stage of stroke. METHODS: Patients with knee reflex after stroke were divided into the treatment group and the control group. Patients in the control group received Activities of Daily Living (ADL) training. Patients in the treatment group received comprehensive rehabilitation training in addition to the ADL training of the control group, including joint flexion and extension training, active resistance training, low-frequency electrotherapy, and standing training. The knee reflex angle and ankle dorsiflexion angle of patients in both groups were measured before and after 4 weeks of treatment. Also, the Manual Muscle Testing (MMT) scale, the modified Ashworth scale, the Fugl-Meyer assessment (FMA), and Barthel index (lower limb) rating scale of patients in both groups were compared. RESULTS: It was found that there was significant difference between the two groups in the changes of knee and ankle joint angles after treatment (P < 0.05). In the Ashworth and MMT (Manual Muscle Testing) grading analysis of patients, it was found that the Ashworth grading of quadriceps femoris and triceps leg improved significantly before and after treatment (P < 0.01). There was significant difference in MMT grade between the two groups after treatment of quadriceps and hamstring muscles (P < 0.05). There was significant difference in satisfaction degree of pain control or relief methods (P < 0.05). In the analysis of Fugl-Meyer and Barthel integral effects of lower limbs for the patients with knee reflex before and after treatment, a significant difference (P < 0.05) was found in the Fugl-Meyer motor function and Barthel index scores of the two groups. CONCLUSIONS: Therefore, the results suggested that comprehensive rehabilitation nursing could promote the treatment of sequelae of hemiplegia. Although there were some shortcomings in the experimental process, it still provided a reliable basis for the clinical treatment of sequelae of stroke.

Capacitar a pessoa com défice respiratório em contexto comunitário / Empowering the person with respiratory deficit in community settings

O envelhecimento da população e o aumento de hábitos de vida prejudiciais à saúde, levou ao aumento das doenças de evolução prolongada, como as doenças respiratórias, criando dependência na pessoa. A elaboração deste relatório pretende dar conta do desenvolvimento de competências de mestre e de especialista em reabilitação durante o curso, com particular relevo para o Estágio final. Pretende também descrever os resultados do programa de intervenção de como capacitar a pessoa com défice respiratório no contexto comunitário, aplicado numa Unidade de Cuidados na Comunidade (UCC). Foram 6 os participantes que cumpriram os critérios de inclusão. Após a implementação do programa, observamos e registamos melhorias na dispneia, funcionalidade e realização das técnicas respiratórias. Podemos concluir que teve um impacto positivo na realização das atividades de vida diárias (AVD's) de forma independente. O desenvolvimento das competências foi analisado à luz das gerais, especificas e de mestre, ilustrando-se com experiências de aprendizagem concretas esse processo. Concluímos que não é um processo acabado no términus do curso, em que teve origem. O agir profissional permitirá continuar na senda da excelência do cuidar em enfermagem de Reabilitação, na preocupação com a saúde dos cidadãos, mas com apoio na investigação alimentando a prática baseada na evidência.

The ageing population and the increase or harmful health life habits, led to a growth in long-term diseases, such as respiratory diseases, creating dependency on the person. This report elaboration intends to account for the development of competences of master and specialist competences in rehabilitation during the course, with particular emphasis on the final internship. It also intends to describe the results of the intervention programme on how to empower the person with respiratory deficit in the community contexto, applied in a Care Unit in the Community (UCC). There were 6 participants who fulfilled the inclusion criteria. After the programme implementation, we observed and recorded improvements in dyspnea, functionality and respiratory techniques performance. We can conclude that it had a positive impact in carrying out daily life activities (ADLs) autonomously. The competences development was analyzed in general light, specific and master, illustrating this process with particular learning experiences. We conclude that is not a finished process at the end of the course, from which it was originated. Professional action will allow us to continue on the path of excellence in rehabilitation nursing care, concerning for citizens, but with backup powered by evidence-based practice.

Synergy Between Licensed Rehabilitation Professionals and Clinical Exercise Physiologists: Optimizing Patient Care for Cancer Rehabilitation.

OBJECTIVES: To differentiate between rehabilitation and exercise training and propose how rehabilitation professionals and exercise physiologists can collaborate to optimize cancer survivor care. DATA SOURCE: Professional organizations and peer-reviewed manuscripts. CONCLUSION: Both professions offer complementary skillsets that, when integrated, optimize the ability of the cancer care team to implement more effective survivorship care plans. Future models of care must incorporate efficient communications between the cancer rehabilitation program and oncology team, include various reimbursement/payment/funding options, and continuously assess program efficacy. IMPLICATIONS FOR NURSING PRACTICE: Nurses must be cognizant of physical needs (ie, functional and conditioning status) and cancer-related comorbidities when referring cancer survivors for exercise reconditioning.

Validação de um protocolo de auriculoterapia com laser para dor crônica na coluna vertebral / Validación de un protocolo de auriculoterapia láser para el dolor crónico en la columna vertebral / Validation of a laser auriculotherapy protocol for chronic spinal pain

RESUMO Objetivo: validar um protocolo de auriculoterapia com laser para dor crônica na coluna vertebral. Método: estudo metodológico realizado a partir de uma revisão sistemática, baseada no PRISMA Statement; validação de conteúdo por 21 experts e validação clínica do protocolo desenvolvido em pessoas com dor. Resultados: a partir da análise de 13 artigos foi observado o efeito positivo da acupuntura no alívio da dor e foi possível construir o seguinte protocolo: auriculoterapia com laser, em cinco sessões, com a proporção de uma sessão por semana, aplicação bilateral com alternância do pavilhão auricular nos pontos Shenmen, rim, simpático, bexiga, fígado, subcórtex e vértebras cervical, torácica e/ ou lombar, dependendo do local da dor. A avaliação desse conteúdo assumindo nível de concordância de 80% interavaliadores resultou em aprovação de todos os itens do protocolo. Na avaliação clínica, ao ser administrado em pessoas com dor na coluna vertebral, o protocolo desenvolvido demonstrou reduzir a média de dor, aumentar o limiar de tolerância e diminuir o impacto da dor nas atividades de vida diária. Conclusão: a acupuntura auricular, realizada com laser de baixa potência infravermelho no protocolo estudado, provou ser capaz de tratar com efetividade a dor crônica na coluna vertebral.

RESUMEN Objetivo: validar un protocolo de auriculoterapia láser para el dolor crónico en la columna vertebral. Método: estudio metodológico realizado a partir de una revisión sistemática, en base a la declaración PRISMA; validación de contenido por 21 expertos y validación clínica del protocolo de tratamiento en personas con dolor. Resultados: del análisis de 13 artículos se observó el efecto positivo de la acupuntura en el alivio del dolor y se pudo construir el siguiente protocolo: auriculoterapia láser, en cinco sesiones, con una sesión por semana, aplicación bilateral con alternancia de pabellón auricular en los puntos Shen Men, Riñón, Nervio simpático, Vejiga, Hígado, Subcórtex y vértebras cervicales, torácicas y / o lumbares, dependiendo de la localización del dolor. La evaluación de este contenido, asumiendo un nivel de acuerdo del 80% entre evaluadores, resultó en la aprobación de todos los ítems del protocolo. En la evaluación clínica, cuando se administró a personas con dolor en la columna, el protocolo de tratamiento demostró reducir el promedio de dolor, aumentar el umbral de tolerancia y disminuir el impacto del dolor en las actividades de la vida diaria. Conclusión: la acupuntura auricular, realizada con láser infrarrojo de baja potencia en el protocolo estudiado, demostró ser capaz de tratar eficazmente el dolor crónico de columna vertebral.

ABSTRACT Objective: to validate a laser auriculotherapy protocol for chronic spinal pain. Method: methodological study carried from a systematic review based on the PRISMA Statement; content validation carried out by 21 specialists and pilot test with clinical validation of the protocol developed in people with pain. Results: from the analysis of 13 articles, a positive effect of acupuncture on pain relief was noted and it was possible to develop the following protocol: laser auriculotherapy, in 5 sessions, with the proportion of one session a week, bilateral application with alternation of the auricular pavilion at Shenmen points, Kidney, Sympathetic Nervous System, Urinary Bladder, Liver, Subcortex and Cervical, Thoracic and/or Lumbar Vertebrae, depending on the location of the pain. The evaluation of this content, assuming a level of agreement of 80% interobserver, resulted in the approval of all items in the protocol. In the clinical evaluation, when it was administered in people with spinal pain, the protocol developed showed a reduction in the pain average, an improvement in the tolerance threshold and a reduction in the pain impact on daily activities. Conclusion: the auricular acupuncture, carried out using an infrared low-level laser, in the studied protocol, proved to be capable of effectively treating chronic spinal pain.

A práxis da enfermagem de reabilitação e os contributos da osteopatia / Rehabilitation nursing practice and the contribution of osteopathy / La práctica de la enfermería de rehabilitación y las contribuciones de la osteopatía

Enquadramento: A reabilitação, enquanto especialidade de enfermagem, abrange conhecimentos e procedimentos específicos que permitem auxiliar as pessoas a maximizar o seu potencial funcional e independência. O enfermeiro especialista em enfermagem de reabilitação (EEER) tem a possibilidade de utilizar técnicas e tecnologias que não as comummente utilizadas no seu desempenho profissional, nomeadamente as da osteopatia, de modo a potenciar a efetividade dos cuidados. Objetivo: Conhecer as vivências dos enfermeiros especialistas em enfermagem de reabilitação que utilizam técnicas osteopáticas na sua prática profissional. Metodologia: Estudo exploratório descritivo, com recurso à entrevista semiestruturada a 8 enfermeiros, especialistas em enfermagem de reabilitação com formação e prática em osteopatia, recrutados através do método de amostra bola de neve. A técnica de tratamento de dados escolhida foi a análise de conteúdo. Resultados: Os participantes consideram que superam os cuidados que prestam, aquando da utilização de técnicas ostopáticas. Conclusão: Considera-se que o recurso a técnicas osteopáticas, pode constituir um novo paradigma na práxis da enfermagem de reabilitação.

Background: Rehabilitation nursing is a nursing specialty that comprises specific specific knowledge and procedures to help individuals maximize their functional potential and independence. The rehabilitation nurse is able to use techniques and technologies other than those that are commonly used in their professional practice, namely osteopathic techniques, in order to enhance the effectiveness of care. Objective: To explore the experiences of rehabilitation nurses who use osteopathic techniques in their professional practice. Methodology: Descriptive exploratory study using semi-structured interviews with 8 rehabilitation nurses with training and practice in osteopathy. They were recruited through the snowball sampling method. Data were processed using the content analysis technique. Results: Participants believe that they provide more differentiated care when using osteopathic techniques. Conclusion: The use of osteopathic techniques may constitute a new paradigm in rehabilitation nursing practice.

Marco contextual: La rehabilitación, como especialidad de enfermería, abarca conocimientos y procedimientos específicos que permiten ayudar a las personas a maximizar su potencial funcional y su independencia. El enfermero especialista en enfermería de rehabilitación (EEER) tiene la posibilidad de utilizar técnicas y tecnologías distintas de las utilizadas habitualmente en su desempeño profesional, en particular las de la osteopatía, a fin de aumentar la eficacia de la atención. Objetivo: Conocer las experiencias de los enfermeros especialistas en enfermería de rehabilitación que utilizan técnicas osteopáticas en su práctica profesional. Metodología: Estudio exploratorio descriptivo, en el que se recurrió a la entrevista semiestructurada a 8 enfermeros especialistas en enfermería de rehabilitación con formación y práctica en osteopatía, reclutados mediante el método de muestreo de bola de nieve. La técnica de tratamiento de datos elegida fue el análisis de contenido. Resultados: Los participantes consideran que superan los cuidados que proporcionan cuando utilizan técnicas osteopáticas. Conclusión: Se considera que el uso de técnicas osteopáticas puede constituir un nuevo paradigma en la práctica de la enfermería de rehabilitación.

Capacitação para o autocuidado da pessoa idosa na RNCCI: contributos dos cuidados de enfermagem de reabilitação / Training for the self-care of the elderly in the RNCCI: contributions of rehabilitation nursing care

Enquadramento: A dependência para o autocuidado, comumente relacionado com patologias crónicas e com o envelhecimento, são causas de dificuldades para utentes e família, particularmente no domicílio. Os cuidados continuados no âmbito da saúde integram um dos desafios presentes nas sociedades contemporâneas. A qualidade dos cuidados prestados concentra-se numa das preocupações que, além da eficácia a nível clínico e da segurança do utente, conduz a que este seja considerado um cuidado central. A RNCCI assume-se como um novo padrão organizacional que, perante este, resulta numa resposta integrada da saúde assumindo a reabilitação, readaptação e reintegração como objetivos de intervenção. Objetivo: Apresentar o processo subjacente à aquisição e desenvolvimento de competências de Enfermagem de Reabilitação e de Mestre. Metodologia: Implementou-se uma estratégia de intervenção profissional, com base na metodologia de estudo de caso (Yin, 2003) e na teoria de médio alcance de Lopes (2006) com vista à avaliação dos ganhos sensíveis aos cuidados de Enfermagem de Reabilitação, na capacitação para o autocuidado da pessoa idosa na RNCCI. Resultados: Certifica-se que através dos dado recolhidos as intervenções do enfermeiro de reabilitação cooperaram para uma melhoria da funcionalidade da pessoa, reduzindo a dependência no autocuidado, proporcionando ganhos em saúde. Conclusão: Observou-se que as competências de Enfermagem de Reabilitação e de Mestre, propostas inicialmente foram inteiramente adquiridas, contribuindo para uma melhoria funcional das pessoas incluídas na estratégia de intervenção profissional.

Background: Dependence on self-care commonly related to chronic conditions and aging, are causes of difficulties for users and families, particularly at home. Continuing care in health is one of the challenges present in contemporary societies. The quality of care is focused on one of the concerns that, in addition to clinical efficacy and patient safety, leads to a central care. The RNCCI is a new organizational standard that results in an integrated health response, assuming rehabilitation, rehabilitation and reintegration as intervention objectives. Objective: To present the process underlying the acquisition and development of Rehabilitation and Master's Nursing competences. Methodology: A professional intervention strategy was implemented in order to evaluate the gains gained in the care of Rehabilitation Nursing, in the training for the self-care of the elderly in the RNCCI. Results: It is certified that through the collected data the interventions of the rehabilitation nurse cooperated to improve the person's functionality, reducing dependence on self-care, providing health gains. Conclusion: It was observed that the competences of Rehabilitation Nursing and Master, initially proposed were fully acquired, contributing to a functional improvement of the people included in the professional intervention strategy.

Home-based inspiratory muscle training for management of older patients with heart failure with preserved ejection fraction: does baseline inspiratory muscle pressure matter?

BACKGROUND: Heart failure with preserved ejection fraction is a clinical syndrome characterised by reduced exercise capacity. Some evidence has shown that a simple and home-based programme of inspiratory muscle training offers promising results in terms of aerobic capacity improvement in patients with heart failure with preserved ejection fraction. This study aimed to investigate whether the baseline inspiratory muscle function predicts the changes in aerobic capacity (measured as peak oxygen uptake; peak VO2) after a 12-week home-based programme of inspiratory muscle training in patients with heart failure with preserved ejection fraction. METHODS: A total of 45 stable symptomatic patients with heart failure with preserved ejection fraction and New York Heart Association II-III received a 12-week home-based programme of inspiratory muscle training between June 2015 and December 2016. They underwent cardiopulmonary exercise testing and measurements of maximum inspiratory pressure pre and post-inspiratory muscle training. Maximum inspiratory pressure and peak VO2 were registered in both visits. Multivariate linear regression analysis was used to assess the association between changes in peak VO2 (Δ-peakVO2) and baseline predicted maximum inspiratory pressure (pp-MIP). RESULTS: The median (interquartile range) age was 73 (68-77) years, 47% were women and 35.6% displayed New York Heart Association III. The mean peak VO2 at baseline and Δ-peakVO2 post-training were 10.4±2.8 ml/min/kg and +2.2±1.3 ml/min/kg (+21.3%), respectively. The median (interquartile range) of pp-MIP and Δ-MIP were 71% (64-92) and 39.2 (26.7-80.4) cmH2O, respectively. After a multivariate analysis, baseline pp-MIP was not associated with Δ-peakVO2 (ß coefficient 0.005, 95% confidence interval -0.009-0.019, P=0.452). CONCLUSIONS: In symptomatic and deconditioned older patients with heart failure with preserved ejection fraction, a home-based inspiratory muscle training programme improves aerobic capacity regardless of the baseline maximum inspiratory pressure.

Prática e efetividade da enfermagem de reabilitação: contributos da osteopatia / Practice and effectiveness of rehabilitation nursing: contributions of osteopathy

Uma sociedade cada vez mais competitiva exige que os enfermeiros especialistas em enfermagem de reabilitação, aprofundem a sua área de competência com recurso a técnicas e tecnologias que as não comummente utilizadas na enfermagem, através de uma formação contínua e de qualidade onde o recurso a técnicas utilizadas na osteopatia, poderão ser uma mais valia. O enfermeiro especialista em enfermagem de reabilitação tem competências que lhe permite intervir precocemente, em todas as fases da vida da pessoa, planeando e adaptando as suas intervenções de modo a maximizar potencialidades e prevenir possíveis complicações. Neste sentido, surge este estudo que visa compreender como é que os cuidados de enfermagem de reabilitação podem ser mais efetivos com o recurso a técnicas de osteopatia. Este estudo assenta numa abordagem qualitativa, com caráter exploratório-descritivo, em que a estratégia de recolha de dados recaiu na entrevista semiestruturada dirigida a oito enfermeiros especialistas em enfermagem de reabilitação e com formação em osteopatia igual ou superior a 2000h, recrutados através do método de amostra "bola de neve". Os dados obtidos foram tratados através do método de análise de conteúdo com apoio do software NVivo® 11 Plus, dos quais ressaltam a experiência vivenciada pelos enfermeiros especialistas em enfermagem de reabilitação relativa à motivação para a utilização de técnicas osteopáticas; o tipo de situações clínicas em que são utilizadas; o tipo de técnicas utilizadas; os princípios subjacentes à sua utilização e o local e frequência da sua utilização, assim como as vantagens e os constrangimentos decorrentes da utilização de técnicas osteopáticas no seu desempenho profissional enquanto especialistas em reabilitação. Foi visível que o recurso a técnicas osteopáticas tornam mais efetivos os cuidados de enfermagem de reabilitação, trazendo vantagens a vários níveis destacando-se a complementaridade da osteopatia face à enfermagem de reabilitação; o encurtamento do tempo de recuperação decorrente do uso de técnicas osteopáticas; os resultados observados nos utentes; os ganhos económicos gerados; a nova filosofia de cuidar que favorece a osteopatia à enfermagem de reabilitação, a satisfação do utente e a rentabilização de recursos. Estes resultados sugerem que é importante implementar estratégias favorecedoras de uma formação contínua que proporcione uma intervenção ainda mais efetiva por parte dos enfermeiros especialistas em enfermagem de reabilitação com recurso a novas técnicas e tecnologias.

An increasingly competitive society, the rehabilitation nurse, have deepen their area of competence using techniques and technologies that are not commonly used in nursing, through continuous and quality training where the resource the techniques used in osteopathy, may be an asset. The rehabilitation nurse has skills that allow her to intervene early in all phases of the person's life, planning and adapting their interventions in order to maximize potentialities and prevent possible complications. In this sense, this study aims to understand how nursing care rehabilitation can be more effective with the use of osteopathy techniques. This study is based on a qualitative, exploratory-descriptive approach, in which the data collection strategy fell into the semi-structured interview directed to eight rehabilitation nurse and with training in osteopathy superior to 2000h, recruited through the sample snowball method. The data obtained were treated through the content analysis method with the support of NVivo® 11 Plus software, which highlight the experience experienced by rehabilitation Nurse, related to motivation for the use of osteopathic techniques; the type of clinical situations in which they are used; the type of techniques used; the principles underlying their use and the location and frequency of their use, as well as the advantages and constraints arising from the use of osteopathic techniques in their performance professionals as rehabilitation nurse. It was apparent that resources to osteopathic techniques make rehabilitation nursing care more effective, bringing advantages at several levels emphasizing the complementarity of osteopathy in the face of rehabilitation nursing; the shortening of recovery time due to the use of osteopathic techniques; the results observed in the users, the economic gains generated, the new philosophy of care that favors osteopathy to the rehabilitation nursing, the satisfaction of the user and the profitability of resources. These results suggest that it is important to implement strategies conducive to continuous training that provide an even more effective intervention on the part of nurses who are rehabilitation nurse using new techniques and technologies.

Understanding Symptoms of Muscle Tightness, Weakness, and Rigidity From a Nursing Perspective.

PURPOSE: This study examined the nature of muscle tightness from nurses' perspectives and explored how the symptoms of muscle tightness are communicated, managed, and differentiated from other conditions, such as muscle rigidity and muscle weakness. DESIGN: An exploratory, descriptive qualitative design was used. METHODS: Eight rehabilitation nurses described lexicons, care strategies, and communication for muscle tightness, weakness, and rigidity. FINDINGS: Nurses used conflicting terms to describe muscle tightness, weakness, and rigidity. They identified medications and range of motion as the best strategies to manage muscle conditions. Nurses approach care holistically and do not differentiate care strategies that are based only on a symptoms lens. CONCLUSIONS: Nurses were unable to clearly differentiate between muscle tightness and rigidity. CLINICAL RELEVANCE: Nurses influence patients' choice of vocabulary; therefore, they must use simple but precise terminologies to educate their patients. Miscommunication between nurses and patients can lead to errors, which can have negative consequences.

Aquatic Exercise Program for Individuals With Osteoarthritis: Pain, Stiffness, Physical Function, Self-Efficacy.

PURPOSE: This research was conducted to determine the effects of an aquatic exercise program on pain, stiffness, physical function, and self-efficacy in individuals with osteoarthritis. DESIGN: A randomized controlled trial. METHODS: Participants in the experimental group participated in the aquatic exercise program three times a week for 8 weeks; participants in the control group did not. FINDINGS: The mean scores of the experimental group on the pain, stiffness, and difficulty in carrying out physical functions subscales of the Western Ontario and McMaster Universities Osteoarthritis Index decreased significantly, whereas those of the control group decreased very little. The mean scores of the experimental group on the Arthritis Self-Efficacy Scale and the isokinetic muscle strength measurements increased, but those of the control group did not change in the final measurements. The difference between the groups was statistically significant. CONCLUSIONS: Through the study, it was determined that the aquatic exercise program decreased pain, stiffness, and difficulty in carrying out physical functions and increased self-efficacy and muscle strength of individuals with osteoarthritis. CLINICAL RELEVANCE: The aquatic exercise program can be used by nurses as a reference in the management of osteoarthritic patients' health status.

Atuação do enfermeiro na reabilitação do paciente oncológico: revisão integrativa / The nurse's performance in the rehabilitation of the cancer patient: integrative review

Objetivo: avaliar as evidências disponíveis na literatura sobre a atuação do enfermeiro na reabilitação do paciente oncológico. Método: trata-se de uma revisão integrativa seguindo as seguintes etapas: identificação do problema, busca na literatura, extração de dados dos estudos primários, avaliação dos estudos primários e apresentação da revisão integrativa. A busca dos estudos primários foi realizada nas bases de dados CINAHL, LILACS e PubMed publicados no período de 30 de junho de 2008 a 30 de junho de 2018. Resultados: a amostra foi composta de 32 estudos primários, agrupados em três categorias: (1) ações interacionais (n=8); (2) ações educacionais (n=10); e (3) ações assistenciais (n=14) do enfermeiro na reabilitação oncológica. Na categoria 1, os principais temas investigados foram comunicação, apoio espiritual e psicológico. Na categoria 2, apurou-se orientações prestadas ao paciente e elaboração de estratégias de ensino. Já na categoria 3, atenção domiciliar, processo de enfermagem, procedimentos técnicos e práticas alternativas foram os principais temas abordados. Constatouse que o enfermeiro inserido na reabilitação oncológica deve utilizar do diálogo e da escuta como recursos para atingir suas ações interacionais, e que suas habilidades permitem um relacionamento paciente-enfermeiro eficaz e terapêutico, resultando em uma melhor assistência biopsicossocial e espiritual. Além disso, suas ações educacionais mostraram-se importantes ao paciente no sentido de motivá-lo a ser responsável por seu cuidado, o que o auxiliará no enfrentamento de problemas e no alcance de sua autonomia. Já suas ações assistenciais se voltaram à promoção da saúde em todos os aspectos e pautaram-se na sistematização da assistência, que lhe proporciona recursos científicos e humanos; demonstraram, ainda, a importância da inserção das práticas alternativas no cuidado do paciente oncológico. Conclusão: todas as evidências forneceram subsídios para que o enfermeiro pudesse compreender sua atuação na reabilitação oncológica. A diversidade e complexidade do seu papel neste cenário demonstra claramente que suas ações são fundamentais, pois abordam todos os comprometimentos biopsicossociais impostos ao cliente pela doença, promovendo uma assistência de enfermagem individualizada, humanizada e holística

Objective: to evaluate the available evidences in the literature about the nurse's performance in the rehabilitation of the cancer patient. Method: it is an integrative review following the following steps: identification of the problem, research in the literature, extraction of data from the primary studies, evaluation of the primary studies and presentation of the integrative review. The search of the primary studies was performed in the databases CINAHL, LILACS and PubMed published in the period from June 30, 2008 to June 30, 2018. Results: the sample consisted of 32 primary studies, grouped into three categories: (1) interactional actions (n = 8); (2) educational actions (n = 10); and (3) care actions (n = 14) of the nurse in cancer rehabilitation. In category 1, the main subjects investigated were communication, spiritual and psychological support. In category 2, guidelines were found and given to the patient and elaboration of teaching strategies. In category 3, home care, nursing process, technical procedures and alternative practices were the main topics addressed. It was verified that the nurse involved in cancer rehabilitation should use dialogue and listening as resources to achieve his interactional actions, and that his skills allow an effective and therapeutic patient-nurse relationship, resulting in a better biopsychosocial and spiritual care. In addition, his educational actions have been proved important to the patient in order to motivate him to be responsible for his own care, which will help him in facing problems and reaching his autonomy. His care actions turned to health promotion in all aspects and were based on the systematization of care, which provides him scientific and human resources; they also demonstrated the importance of the insertion of alternative practices in the care of the cancer patient. Conclusion: all the evidences provided support to the nurse to understand his performance in cancer rehabilitation. The diversity and complexity of his role in this context clearly demonstrates that his actions are fundamental, as they address all the biopsychosocial commitments imposed on the client by the disease, promoting an individualized, humanized and holistic nursing care