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1.
Comput Math Methods Med ; 2022: 1247002, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35465014

RESUMEN

Objective: To explore the influence of rehabilitation nursing under the guidance of Health Action Process Approach (HAPA) model on the perioperative nursing effect of artificial hip replacement and to analyze the effect of this nursing model on the quality of life and postoperative rehabilitation of patients undergoing artificial hip replacement. Methods: A total of 200 patients with hip arthroplasty treated in our hospital from January 2019 to July 2021 were enrolled. The patients were randomly assigned into the control group and study group. The former received routine nursing, and the latter received rehabilitation nursing under the guidance of the HAPA model. Nursing satisfaction, pain score, Harris hip function score, timed stand-up-walk test, MBI score, and quality of life score were compared. Results: First of all, we compared the nursing satisfaction. In the study group, 86 cases were very satisfied, 8 cases were satisfied, and 6 cases were general; the satisfaction rate was 100%. In the control group, 48 cases were very satisfied, 22 cases were satisfied, 12 cases were general, and 18 cases were dissatisfied; the satisfaction rate was 82.0%. The nursing satisfaction in the study group was higher compared to that in the control group (P < 0.05). Secondly, we compared the pain scores. Before nursing, there exhibited no significant difference (P > 0.05). After nursing, the pain score of the two groups increased. Moreover, the pain score of the study group at discharge and 1 month, 3 months, and 6 months after operation was lower compared to that of the control group (P < 0.05). Before nursing, there exhibited no significant difference in the Harris hip joint function score (P > 0.05). After nursing, the Harris hip function score increased. Furthermore, the Harris hip function score of the study group at discharge and 1 month, 3 months, and 6 months after operation was higher compared to that of the control group (P < 0.05). In terms of the timed stand-up-walking test, there exhibited no significant difference before nursing (P > 0.05). After nursing, the time of the timed stand-up-walk test in both groups decreased. And the timed stand-up-walk test at discharge and 1 month, 3 months, and 6 months after operation in the study group was lower compared to that in the control group (P < 0.05). Compared with the MBI scores, there exhibited no significant difference before nursing (P > 0.05). After nursing, the MBI scores increased. Of note, the MBI scores of the study group at discharge and 1 month, 3 months, and 6 months after operation were higher compared to those of the control group (P < 0.05). Finally, we compared the scores of life quality. Before nursing, there exhibited no significant difference (P > 0.05). After nursing, the scores of life quality decreased. The scores of physiological function, psychological function, social function, and health self-cognition in the study group were lower compared to those in the control group (P < 0.05). Conclusion: The perioperative rehabilitation nursing program of artificial hip replacement for the elderly based on the HAPA model is feasible, which can effectively enhance the functional recovery of hip joint, promote the ability of self-care of daily life, relieve pain and anxiety, and help to achieve dynamic balance and gait stability in the early stage. The rehabilitation program is better than routine nursing. As a new social cognitive model, the HAPA model is applied to the rehabilitation nursing environment of hip replacement from the aspect of social cognitive behavior, which can help to enhance the rehabilitation behavior of elderly patients, playing an important role in the rehabilitation effect of perioperative nursing.


Asunto(s)
Artroplastia de Reemplazo de Cadera , Enfermería en Rehabilitación , Anciano , Artroplastia de Reemplazo de Cadera/efectos adversos , Artroplastia de Reemplazo de Cadera/métodos , Artroplastia de Reemplazo de Cadera/psicología , Humanos , Dolor/etiología , Enfermería Perioperatoria , Calidad de Vida , Enfermería en Rehabilitación/métodos , Resultado del Tratamiento
2.
Comput Math Methods Med ; 2022: 4646454, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35126624

RESUMEN

This research was aimed at exploring the application value of a mobile medical management system based on Internet of Things technology and medical data collection in stroke disease prevention and rehabilitation nursing. In this study, on the basis of radio frequency identification (RFID) technology, the signals collected by the sensor were filtered by the optimized median filtering algorithm, and a rehabilitation nursing evaluation model was established based on the backpropagation (BP) neural network. The performance of the medical management system was verified in 32 rehabilitation patients with hemiplegia after stroke and 6 healthy medical staff in the rehabilitation medical center of the hospital. The results showed that the mean square error (MSE) and peak signal-to-noise ratio (PSNR) of the median filtering algorithm after optimization were significantly higher than those before optimization (P < 0.05). When the number of neurons was 23, the prediction accuracy of the test set reached a maximum of 89.83%. Using traingda as the training function, the model had the lowest training time and root mean squared error (RMSE) value of 2.5 s and 0.29, respectively, which were significantly lower than the traingd and traingdm functions (P < 0.01). The error percentage and RMSE of the model reached a minimum of 7.56% and 0.25, respectively, when the transfer functions of both the hidden and input layers were tansig. The prediction accuracy in stages III~VI was 90.63%. It indicated that the mobile medical management system established based on Internet of Things technology and medical data collection has certain application value for the prevention and rehabilitation nursing of stroke patients, which provides a new idea for the diagnosis, treatment, and rehabilitation of stroke patients.


Asunto(s)
Internet de las Cosas , Enfermería en Rehabilitación/métodos , Rehabilitación de Accidente Cerebrovascular/enfermería , Accidente Cerebrovascular/prevención & control , Algoritmos , Biología Computacional , Hemiplejía/etiología , Hemiplejía/enfermería , Hemiplejía/rehabilitación , Humanos , Redes Neurales de la Computación , Dispositivo de Identificación por Radiofrecuencia , Enfermería en Rehabilitación/estadística & datos numéricos , Tecnología de Sensores Remotos , Relación Señal-Ruido , Rehabilitación de Accidente Cerebrovascular/estadística & datos numéricos
3.
J Healthc Eng ; 2022: 7087844, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35126942

RESUMEN

At present, the most commonly used surgical treatment for fractures caused by external force injury is clinical, and unsupervised data mining is more advantageous in the face of the unknown format of perioperative network data. Therefore, this research aims to explore the application effect of unsupervised data mining in the concept of rapid rehabilitation nursing intervention after fracture surgery. 80 patients who underwent fracture surgery in the Department of Orthopedics of XXX Hospital were determined as the subjects, who were rolled into a research group (group R, 40 cases) and a control group (group C, 40 cases) by drawing lots. An unsupervised data mining algorithm based on unsupervised data mining for support vector machines (VDMSVMs) was proposed and applied to two groups of patients undergoing perioperative fracture surgery with the rapid rehabilitation nursing intervention and basic routine nursing. The results showed that the number of important features selected by the VDMSVM algorithm (5) was obviously more than that of the compressed edge fragment sampling (CEFS) algorithm (1) and the multicorrelation forward searching (MCFS) algorithm (2) (P < 0.05). The number of noise features screened by the VDMSVM algorithm (3) was much less in contrast to that of the CEFS algorithm and the MCFS algorithm, which was 8 and 10, respectively (P < 0.05). The Visual Analogue Scale (VAS) scores of the fracture site at the 4th, 8th, 12th, and 16th hour after surgery in group R were all lower than the scores in group C (P < 0.05). The length of hospital stay (LoHS) in group R was greatly shorter than that in group C (P < 0.05). After different nursing methods, the World Health Organization Quality of Life (WHOQOL-BREF) score of patients in group R (89.64 points) was greatly higher than the score in group C (61.45 points) (P < 0.05). The nursing satisfaction score of group R was 92.35 ± 3.65 points, and that in group C was 2.14 ± 1.25 points, respectively (P < 0.05). The test results verified the effectiveness of the feature selection of the VDMSVM algorithm. The rapid rehabilitation nursing intervention was conductive to reducing the postoperative pain of fracture patients, shortening the LoHS of patients, improving the quality of life (QOL) of fracture surgery patients, and increasing the patient's satisfaction with nursing.


Asunto(s)
Fracturas Óseas , Enfermería en Rehabilitación , Minería de Datos , Humanos , Tiempo de Internación , Calidad de Vida , Enfermería en Rehabilitación/métodos
5.
Contrast Media Mol Imaging ; 2021: 1197728, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34602911

RESUMEN

This study was to explore the effects of imaging characteristics of magnetic resonance angiography (MRA) based on deep learning on the comprehensive rehabilitation nursing on the neurological recovery of patients with acute stroke. In this study, 84 patients with acute stroke who were treated in hospital were selected as the research objects, and they were rolled into a control group (routine care) and an experimental group (comprehensive rehabilitation care). The dense dilated block-convolution neural network (DD-CNN) algorithm under deep learning for cerebrovascular was adopted to assess the effect of comprehensive rehabilitation care on the neurological recovery of patients with acute stroke. The results showed that the Berg scale scores, Fugl-Meyer scores, and Functional Independence Measure (FIM) scores of the experimental group of patients after 6 weeks and 12 weeks of comprehensive rehabilitation nursing were greatly different from those before treatment, showing statistical differences (P < 0.05). Compared with conventional magnetic resonance imaging (MRI) images, MRA images based on CNN algorithm, Dense Net algorithm, and DD-CNN algorithm can more clearly show the patient's cerebral artery occlusion. The average dice similarity coefficient (DSC) values of CNN algorithm, Dense Net algorithm, and DD-CNN algorithm were determined to be 84.3%, 95.7%, and 97.8%, respectively; the average sensitivity (Sen) values of the three algorithms were 76.1%, 95.4%, and 96.8%, respectively; and the average accuracy (Acc) values were 87.9%, 96.3%, and 97.9%, respectively. Thus, there were statistically obvious differences among the three algorithms in terms of average values of DSC, Sen, and Acc (P < 0.05). The MRA images processed by the DD-CNN algorithm showed that the degree of neurological recovery of the experimental group was observably greater than that of the control group, and the difference was statistically obvious (P < 0.05). In short, the image features of MRA based on the deep learning DD-CNN algorithm showed good application value in studying the effect of comprehensive rehabilitation nursing on the neurological recovery of patients with acute stroke, and it was worthy of promotion.


Asunto(s)
Aprendizaje Profundo , Recuperación de la Función/fisiología , Rehabilitación de Accidente Cerebrovascular/métodos , Accidente Cerebrovascular/diagnóstico , Anciano , Algoritmos , Femenino , Humanos , Angiografía por Resonancia Magnética/métodos , Imagen por Resonancia Magnética/métodos , Masculino , Persona de Mediana Edad , Redes Neurales de la Computación , Enfermería en Rehabilitación/métodos , Accidente Cerebrovascular/diagnóstico por imagen , Accidente Cerebrovascular/patología , Accidente Cerebrovascular/terapia , Tomografía Computarizada por Rayos X/métodos
6.
Medicine (Baltimore) ; 100(32): e26869, 2021 Aug 13.
Artículo en Inglés | MEDLINE | ID: mdl-34397901

RESUMEN

ABSTRACT: Studies have shown that rapid rehabilitation surgery has a positive effect on recovery after major orthopedic surgery. However, very few studies have examined the impact of fast track surgery on physical and psychological rehabilitation in patients who have undergone total hip replacement.This study aimed to investigate the value of the rapid rehabilitation surgical model for patients undergoing total hip arthroplasty during the perioperative period.We conducted a prospective cohort study that included patients who underwent total hip arthroplasty at our hospital from January 2015 to December 2018. We divided the patients into 2 groups - the rapid rehabilitation group and the conventional rehabilitation group - and compared their length of hospital stay, time to off-bed activity, pain score, Self-Rating Anxiety Scale scores, Self-Rating Depression Scale scores, complication rate, and rate of satisfaction during hospitalization.A total of 348 patients were included in the study. Of these, 180 received rapid rehabilitation nursing and 168 patients received conventional nursing. Compared with the patients in the conventional rehabilitation group, those in the rapid rehabilitation group had shorter hospital stays (11.5 ±â€Š1.2 day vs 15.5 ±â€Š2.3 day, P = .021), resumed off-bed activities sooner (20.5 ±â€Š3.4 hours vs 61.8 ±â€Š4.7 hours, P = .001, had less postoperative pain (4.0 ±â€Š1.2 vs 6.5 ±â€Š1.1, P < .001), and lower anxiety and depression scores (anxiety score: 24.4 ±â€Š2.1 vs 47.9 ±â€Š2.9; depression score: 25.8 ±â€Š1.8 vs 43.7 ±â€Š1.7, P < .001).The application of rapid rehabilitation surgery in total hip arthroplasty can accelerate patients' postoperative recovery, relieve anxiety and depression, and increase the patient's satisfaction with the treatment.


Asunto(s)
Ansiedad , Artroplastia de Reemplazo de Cadera , Depresión , Recuperación Mejorada Después de la Cirugía , Complicaciones Posoperatorias/prevención & control , Enfermería en Rehabilitación/métodos , Anciano , Ansiedad/etiología , Ansiedad/prevención & control , Artroplastia de Reemplazo de Cadera/efectos adversos , Artroplastia de Reemplazo de Cadera/métodos , Artroplastia de Reemplazo de Cadera/rehabilitación , China/epidemiología , Depresión/etiología , Depresión/prevención & control , Femenino , Fracturas del Cuello Femoral/epidemiología , Fracturas del Cuello Femoral/cirugía , Necrosis de la Cabeza Femoral/epidemiología , Necrosis de la Cabeza Femoral/cirugía , Humanos , Tiempo de Internación , Masculino , Ejercicio Preoperatorio/fisiología , Ejercicio Preoperatorio/psicología , Estudios Prospectivos , Resultado del Tratamiento
8.
Clin Interv Aging ; 16: 1173-1184, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34188460

RESUMEN

PURPOSE: To determine the effectiveness of rehabilitation nursing program interventions in patients with acute ischemic stroke. PATIENTS AND METHODS: An assessment-blinded randomized controlled trial was conducted at a tertiary referral hospital in China. Eligible patients were stratified according to their weighted corticospinal tract lesion load and then randomly assigned to an experimental group (n = 121) or a control group (n = 103). The experimental group received rehabilitation nursing from well-trained, qualified nurses (30 minutes per session, two sessions per day for seven consecutive days). The control group received therapist-led rehabilitation with the same timing and frequency. Comparative analysis of the primary outcomes was performed to determine non-inferiority with a predetermined non-inferiority margin. The primary outcomes were the Motor Assessment Scale, Fugl-Meyer Assessment, and the Action Research Arm Test assessed at baseline and after seven days of treatment. The secondary outcomes were the modified Barthel Index, the National Institutes of Health Stroke Scale, and the modified Rankin Scale, evaluated before and after the intervention and at 4 and 12 weeks of follow-up. RESULTS: Two hundred participants completed the trial. In both groups, all outcomes improved significantly after seven days and at follow-ups. The rehabilitation nursing program was non-inferior to therapist-led treatment with lower 95% confidence limits beyond the margins for primary outcomes (P < 0.001). CONCLUSION: Both treatments had comparable effects; however, no definite conclusion could be drawn. Adequately powered studies are required.


Asunto(s)
Isquemia Encefálica/enfermería , Accidente Cerebrovascular Isquémico/enfermería , Enfermería en Rehabilitación/métodos , Rehabilitación de Accidente Cerebrovascular/métodos , Anciano , China , Terapia por Ejercicio/enfermería , Humanos , Masculino , Persona de Mediana Edad , Relaciones Profesional-Paciente , Accidente Cerebrovascular/terapia , Resultado del Tratamiento
9.
World Neurosurg ; 149: 470-480, 2021 05.
Artículo en Inglés | MEDLINE | ID: mdl-33940698

RESUMEN

OBJECTIVE: To analyze neurological function recovery and the impact of rehabilitation nursing in patients with cerebral stroke after treatment to aid clinical diagnosis and treatment of cerebral stroke. METHODS: The study comprised 140 patients who were hospitalized in the neurology department for magnetic resonance angiography examination. Patients were divided into a treatment group (70 patients) and a control group (70 patients) based on treatment plan. Digital subtraction angiography was regarded as the gold standard diagnostic examination. In patients in both groups, magnetic resonance angiography features of the M1 segment of the middle cerebral artery and diagnostic specificity and sensitivity were recorded. An activities of daily living score was used to assess neurological function of patients before and after rehabilitation. RESULTS: The activities of daily living scores of patients in both groups increased significantly after treatment (P < 0.05); the scores of patients in the treatment group increased more significantly (P < 0.05). The total effective rate was 89% in the treatment group and 60% in the control group. The difference between the 2 groups was statistically significant (P < 0.05). After treatment, the degree of M1 segment stenosis in both groups was better than before treatment, and the number of collateral circulation branches was increased; the improvements in the treatment group were more significant (P < 0.05). CONCLUSIONS: Rehabilitation nursing could greatly improve the stenosis of blood vessels in patients with acute cerebral stroke and promote the establishment of collateral circulation, thereby effectively enhancing the recovery of neurological function and strengthening the ability of patients to perform activities of daily living.


Asunto(s)
Angiografía de Substracción Digital/métodos , Angiografía por Resonancia Magnética/métodos , Recuperación de la Función/fisiología , Enfermería en Rehabilitación/métodos , Rehabilitación de Accidente Cerebrovascular/métodos , Accidente Cerebrovascular/diagnóstico por imagen , Actividades Cotidianas , Adulto , Anciano , Angiografía de Substracción Digital/tendencias , Isquemia Encefálica/diagnóstico por imagen , Isquemia Encefálica/rehabilitación , Femenino , Cabeza/diagnóstico por imagen , Humanos , Angiografía por Resonancia Magnética/tendencias , Masculino , Persona de Mediana Edad , Cuello/diagnóstico por imagen , Enfermería en Rehabilitación/tendencias , Rehabilitación de Accidente Cerebrovascular/tendencias
10.
Rehabil Nurs ; 46(4): 187-196, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34009902

RESUMEN

ABSTRACT: The SARS-CoV-2 coronavirus (COVID-19) pandemic is impacting post-acute inpatient rehabilitation nursing practice from preadmission assessment to inpatient care delivery and transition planning. Patients with disability following COVID-19 require interventions to address respiratory, cardiovascular, neurological, musculoskeletal, and psychosocial issues. The pandemic has resulted in changes to program structures and how inpatient rehabilitation facilities approach family caregiver engagement amidst visitation restrictions. Technology solutions can be utilized to reduce the patient and their family's feelings of isolation and support caregiver preparation for discharge. Nurse leaders are essential in supporting staff during this crisis through authentic presence and providing resources and training. Rehabilitation nurses are key in helping patients and families manage rehabilitation and the aftermath of COVID-19 to restore optimal functioning. In this clinical consultation, we synthesize insights learned from the COVID-19 responses at three inpatient rehabilitation facilities. We describe the impact of rehabilitation nursing interventions to improve outcomes for patients with COVID-19 and their caregivers.


Asunto(s)
COVID-19/rehabilitación , Continuidad de la Atención al Paciente , Personas con Discapacidad/rehabilitación , Pacientes Internos , Enfermería en Rehabilitación/métodos , SARS-CoV-2 , Cuidadores , Humanos
11.
Medicine (Baltimore) ; 100(1): e23879, 2021 Jan 08.
Artículo en Inglés | MEDLINE | ID: mdl-33429749

RESUMEN

BACKGROUND: Despite the availability of pharmacological intervention, patients with burn injuries experience pain during the treatment of wounds. Supplementary rehabilitation nursing intervention are required to enhance the wellbeing of patients sustaining injuries from burns. The present study aims to conduct a systematic exploration of the impact of rehabilitation nursing intervention on the wellbeing in patients sustaining burn injuries. METHODS: The electronic databases listed below will be searched systematically: PubMed, EMBASE, CINAHL, Cochrane Library, Web of Science, Scopus, China National Knowledge Infrastructure, and WanFang database. All the databases will be searched from their inauguration to November 2020. There will be no language constraints. Independent undertaking by 2 authors will select studies, extract data from selected studies, and assess the quality of the included studies. All disagreements will be resolved through discussion, or by consulting a third independent author. This study will make use of RevMan 5.3 software to perform statistical analysis. RESULTS: The present protocol summarizes high-quality evidence to assess the impact of rehabilitation nursing intervention on the wellbeing of patients sustaining burn injuries. CONCLUSION: The results of the present protocol has the potential to present evidence to assess whether rehabilitation nursing intervention can enhance the wellbeing of patients sustaining burn injuries. REGISTRATION NUMBER: November 17, 2020.osf.io/t6b8c/. (https://osf.io/t6b8c/).


Asunto(s)
Quemaduras/enfermería , Protocolos Clínicos , Calidad de Vida/psicología , Enfermería en Rehabilitación/normas , Quemaduras/psicología , Humanos , Metaanálisis como Asunto , Enfermería en Rehabilitación/métodos , Revisiones Sistemáticas como Asunto
12.
World Neurosurg ; 149: 397-405, 2021 05.
Artículo en Inglés | MEDLINE | ID: mdl-33276176

RESUMEN

OBJECTIVE: The study aimed to provide a guideline for continuous rehabilitation nursing for patients with severe finger replantation, and establish a satellite contact point for patients with severe finger replantation after discharge, so as to ensure scientific and effective rehabilitation training after discharge and explore the role of continuous rehabilitation nursing measurement in severe finger rehabilitation and neurovascular preservation. METHODS: A total of 380 patients accepting neurovascular preservation finger replantation in the hand surgery department were divided into an observation group and a control group according to the number of hospitalizations. All patients underwent reconstructive surgery of severed finger. X-ray filming was used to monitor the postoperative nursing effect of neurovascular preservation of severed finger. The discharged patient information questionnaire was filled 3 days before the discharge. Then, a patient information database was established, and rehabilitation training was performed. Finally, sexual rehabilitation nursing follow-up intervention, telephone follow-up, and cross-referring intervention were carried out. Postoperative x-ray images were taken regularly to observe the recovery of reconstructed finger. RESULTS: There was no difference in daily life ability scores and hand function scores between the 2 groups at discharge (P > 0.05). The daily life ability scores and hand function scores of the observation group were better than those of the control group at 1 and 6 months after discharge (P < 0.05), the difference is statistically significant. As the discharge time prolonged, the daily life ability score and hand function score of the 2 groups of patients gradually increased. X-ray images showed that the replanted finger body was well developed, phalanx was in good antithesis, and there was no epiphysis. CONCLUSIONS: Continuous rehabilitation nursing measures should be taken after the replantation of the severed finger after neurovascular preservation, which provides standardized rehabilitation training standards for patients with replantation of severed finger after discharge, improves patient training compliance, promotes hand function recovery as soon as possible, and enables patients to return to society as soon as possible, which is worthy of clinical promotion and application.


Asunto(s)
Amputación Traumática/cirugía , Traumatismos de los Dedos/cirugía , Enfermería en Rehabilitación/métodos , Reimplantación/enfermería , Actividades Cotidianas , Adolescente , Adulto , Amputación Traumática/diagnóstico por imagen , Amputación Traumática/enfermería , Amputación Traumática/fisiopatología , Femenino , Traumatismos de los Dedos/diagnóstico por imagen , Traumatismos de los Dedos/enfermería , Traumatismos de los Dedos/fisiopatología , Humanos , Masculino , Radiografía , Enfermería en Rehabilitación/organización & administración , Reimplantación/rehabilitación , Adulto Joven
13.
Rehabil Nurs ; 46(3): 137-145, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-32195764

RESUMEN

PURPOSE: The objective of this study was to identify gaps in and to improve the falls prevention strategy (FPS) of an inpatient rehabilitation facility (IRF) in Toronto, Canada. DESIGN: A modified version of the Stanford Biodesign Methodology was used. METHODS: Chart reviews, a focus group (n = 8), and semistructured interviews (n = 8) were conducted to evaluate the FPS. FINDINGS: Admission Functional Independence Measure score, age, and gender significantly correlated with risk for a fall. The tool used at this IRF was not effectively capturing patients who were at high risk for falls. All healthcare providers interviewed were knowledgeable of fall risks; however, a patient's fall risk status was rarely discussed as a team. CONCLUSIONS: The findings informed recommendations to improve the overall FPS at this IRF. CLINICAL RELEVANCE: Staff may require more coaching for implementing preventative measures/ensuring accountability and evaluating whether current strategies work. These insights can guide improvement initiatives at similar facilities elsewhere.


Asunto(s)
Accidentes por Caídas/prevención & control , Medición de Riesgo/métodos , Anciano , Anciano de 80 o más Años , Femenino , Grupos Focales/métodos , Humanos , Masculino , Investigación Cualitativa , Enfermería en Rehabilitación/métodos , Enfermería en Rehabilitación/tendencias , Investigación Biomédica Traslacional
14.
J Nurs Res ; 28(5): e113, 2020 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-32568954

RESUMEN

BACKGROUND: Stroke in a family affects both patients and their spousal caregivers. Despite advances in the medical management of stroke, less is known about the social and cultural factors that impact couples regarding stroke recovery. PURPOSE: The purpose of this study was to explore the experiences of stroke from the perspectives of couples affected by stroke and the nurses managing patient rehabilitation. METHODS: An interpretive descriptive study was conducted. Purposive sampling was used to enroll 17 participants, comprising eight nurses, five spousal caregivers, and four stroke survivors. Individual, in-depth interviews were performed at a rehabilitation hospital in Singapore in June 2018. RESULTS: The primary theme was the diverse meanings of stroke recovery attributed to limited conversations about the care decisions made by couples and rehabilitation nurses. The second theme was the challenges in nursing responsibilities that hindered the recovery of patients with stroke. CONCLUSIONS/IMPLICATIONS FOR PRACTICE: The meaning of recovery differs between patients and their informal and formal care providers. This issue should be explored in patient-provider conversations, as these conversations highlight the values and preferences that affect the stroke recovery trajectory. Enhancing shared decision making by patients, spousal caregivers, and healthcare providers during the stroke trajectory may promote the alignment of values that are critical to the stroke recovery experience. Further research into whether and how to incorporate shared decision making in rehabilitation hospital settings as an interventional component is warranted to better support stroke survivors before discharge.


Asunto(s)
Enfermeras y Enfermeros/psicología , Rehabilitación/normas , Parejas Sexuales/psicología , Accidente Cerebrovascular/enfermería , Accidente Cerebrovascular/psicología , Anciano , Cuidadores/psicología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Rehabilitación/métodos , Rehabilitación/psicología , Enfermería en Rehabilitación/métodos , Enfermería en Rehabilitación/normas , Singapur , Accidente Cerebrovascular/complicaciones , Sobrevivientes/psicología
16.
J Clin Nurs ; 29(13-14): 2260-2274, 2020 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-32145040

RESUMEN

AIMS AND OBJECTIVES: To explore and describe nurses' role in the rehabilitation and care of patients in one subacute care facility in Melbourne, Australia. BACKGROUND: The role of nurses in subacute care and within the rehabilitation team is evolving and remains unclear. DESIGN: Mixed methods. METHODS: Fourteen nurses from seven rehabilitation and geriatric evaluation and management wards in one subacute facility in Melbourne, Australia, were observed in practice for two hours and then interviewed. Activities were recorded electronically. Interviews were audio-recorded and transcribed. Data were analysed using content analysis. The study complied with the Consolidated Criteria for Reporting Qualitative Research (COREQ). RESULTS: Three main themes are as follows: (a) Nurses as rehabilitators; (b) Teamwork in rehabilitation; and (c) The changing context of subacute care. Nurses prioritised patient personal and clinical care above other responsibilities. They were largely excluded from team decision-making because clinical responsibilities precluded them from attending team meetings. Unsuitable buildings, increased patient acuity and time constraints were further challenges. CONCLUSIONS: Nurses have a multifaceted role in patient rehabilitation that is poorly understood. An evaluation of the nursing role within the interdisciplinary team, skills and processes of care may increase understanding, and improve communication and relationships between disciplines potentially benefiting patients. Role clarity and differentiation in nursing skills are required within the nursing workforce. RELEVANCE TO CLINICAL PRACTICE: Nurses have a unique role in both clinical care and rehabilitation of patients, and as part of the interdisciplinary team. Respectful professional relationships need fostering within the interdisciplinary team to achieve optimal patient outcomes. The way that team meetings and decision-making occur in the subacute wards requires adjustment to ensure that the valuable contribution of nurses, both to the interdisciplinary team and to the rehabilitation of patients, is used and acknowledged to improve patient care.


Asunto(s)
Rol de la Enfermera , Grupo de Atención al Paciente , Adulto , Anciano , Australia , Femenino , Humanos , Masculino , Investigación Cualitativa , Enfermería en Rehabilitación/métodos
17.
Nurs Health Sci ; 22(3): 521-528, 2020 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-32017365

RESUMEN

Because of the crisis in the health sector with few employment opportunities, many Spanish nurses are looking for professional development abroad. No studies have mapped nursing practices across Europe. The aim of this research was to provide a comprehensive approach to understand nursing practices and features of the context in Spain and the United Kingdom within the rehabilitation unit and to discuss those practices from a patient safety point of view. Multiple case study design with thematic analysis was applied in this study. The methods for data collection were in-depth interviews, nonparticipant observations, and document analysis. Results were classified into six categories: resources, techniques and nursing procedures, patients' personal care, health education, documentation task, and attitudes and communication skills. This study concludes that differences exist between nursing practices despite both countries having similar nursing competences. In addition, the UK unit has a positive safety culture, recognizes that mistakes happen, and applies more barriers to avoid them. The study provides valuable information to help the decision-making process for Spanish nurses considering working in the UK.


Asunto(s)
Proceso de Enfermería/clasificación , Habitaciones de Pacientes/tendencias , Enfermería en Rehabilitación/métodos , Actitud del Personal de Salud , Humanos , Proceso de Enfermería/normas , Proceso de Enfermería/tendencias , Habitaciones de Pacientes/organización & administración , Profesionalismo , Enfermería en Rehabilitación/clasificación , España , Reino Unido
18.
Rehabil Nurs ; 45(3): 147-157, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-29985871

RESUMEN

PURPOSE: The aim of the study was to determine the cognitive impairment level influence in descriptive characteristics, comorbidities, complications, and pharmacological features of older adults with hip fracture. DESIGN: Cross-sectional study. METHOD: Five hundred fifty-seven older adults with hip fracture were recruited and divided into cognitive impairment levels (severe/moderate, mild, no impairment). Descriptive characteristics, comorbidities, complications, and pharmacological data were collected. FINDINGS: Significant differences (p < .05, R = .012-.475) between cognitive impairment levels were shown. Shorter presurgery hospital length of stay and lower depression and Parkinson comorbidities; delirium complication; and antidepressants, antiparkinsonians, and neuroleptics use were shown for the no-impairment group. With regard to the cognitive impairment groups, lower presence of cardiopathy and hypertension; higher presence of dementia; antihypertensives, antiplatelets, and antidementia medication; infection/respiratory insufficiency complications; and lower constipation complications were shown. CONCLUSION: Cognitive impairment levels may determine the characteristics, comorbidities, pharmacology, and complications of older adults with hip fracture. CLINICAL RELEVANCE: Cognitive impairment level may impact rehabilitation nursing practice, education, and care coordination.


Asunto(s)
Disfunción Cognitiva/clasificación , Disfunción Cognitiva/etiología , Fracturas de Cadera/complicaciones , Anciano , Anciano de 80 o más Años , Estudios Transversales , Femenino , Fracturas de Cadera/clasificación , Fracturas de Cadera/psicología , Humanos , Masculino , Enfermería en Rehabilitación/métodos , España
19.
J Orthop Surg Res ; 14(1): 417, 2019 Dec 09.
Artículo en Inglés | MEDLINE | ID: mdl-31818330

RESUMEN

BACKGROUND: Nursing intervention following discharge is a long-term rehabilitation process that is essential for improving hip joint function and quality of life in affected patients. This study aimed to assess the effect of nursing intervention via WeChat on the rehabilitation of patients after total hip arthroplasty (THA). METHODS: We conducted a retrospective analysis of 232 patients who underwent THA at our hospital from January 2013 to October 2015. Of the 232 patients, 114 received nursing intervention via telephone (Group A), and 118 received nursing intervention via WeChat (Group B). Furthermore, the Harris hip score and Short-Form 36 (SF-36) health survey score were used to evaluate hip joint function and quality of life in patients in the two groups at discharge and 1, 3 and 6 months following discharge. Moreover, the functional independence measure was applied to assess the recovery of joint function in the patients. RESULTS: No significant difference was observed in the Harris hip score and the SF-36 health survey score between the two groups at discharge and 1 month following discharge (p > 0.05). However, the Harris hip score and SF-36 health survey score were lower in group A than in group B at 3 and 6 months following discharge (p < 0.05). Furthermore, no obvious difference was observed in terms of functional independence between the two groups at discharge (p > 0.05). However, more individuals were completely independent in group B than in group A at 1, 3 and 6 months following discharge (p < 0.05). CONCLUSIONS: Nursing intervention via WeChat can improve the effect of rehabilitation after THA and promote the recovery of joint function in patients.


Asunto(s)
Artroplastia de Reemplazo de Cadera/psicología , Rol de la Enfermera/psicología , Calidad de Vida/psicología , Recuperación de la Función/fisiología , Enfermería en Rehabilitación/métodos , Anciano , Anciano de 80 o más Años , Artroplastia de Reemplazo de Cadera/métodos , Femenino , Encuestas Epidemiológicas/métodos , Humanos , Masculino , Persona de Mediana Edad , Educación del Paciente como Asunto/métodos , Estudios Retrospectivos , Envío de Mensajes de Texto , Resultado del Tratamiento
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