Effect evaluation of competency-based education (CBE) combined with multi-disciplinary team (MDT) teaching mode in respiratory rehabilitation nursing teaching：A randomized controlled trial.

AIM: To explore the application effect of competency-based education (CBE) combined with multi-disciplinary team (MDT) teaching mode in respiratory rehabilitation nursing teaching. BACKGROUND: Respiratory rehabilitation, as an important non drug treatment for chronic respiratory disease, started late in China, with low implementation rate in hospitals and insufficient knowledge of nursing staff. Therefore, it is urgent to cultivate high professional level nurses with strong professional ability. DESIGN: A randomized controlled trial. METHODS: We selected nurses from the respiratory and critical care department at a Grade III, Level A hospital in Beijing, who participated in the respiratory rehabilitation training program between March 2020 and August 2022, as our study participants. Participants were grouped using a random number method. Nurses who participated in the study from March 2020 to May 2021 were set as the control group, and the nurses who participated in the study from June 2021 to August 2022 were set as the test group. The control group used traditional teaching methods, and the test group used the CBE combined MDT teaching model. At the end of the test, the theory, operating skills, satisfaction and core competence were assessed. RESULTS: After training, the theoretical examination score of the test group (93.71 ± 1.94) was higher than that of the control group (92.37 ± 1.92), the operational examination score of the test group (93.11 ± 2.12) was higher than that of the control group (91.61 ± 1.93), the overall teaching satisfaction of the test group (4.45 ± 0.50) was higher than that of the control group (4.13 ± 0.57), and the total score of the core competence of the test group (148.73 ± 7.08) was higher than that of the control group (141.02 ± 6.41). The difference between the two groups was statistically significant (P<0.05). CONCLUSION: CBE combined with MDT teaching mode has a good effect in Pulmonary and Critical Care Medicine (PCCM) respiratory rehabilitation nursing teaching.

Effect of accelerated rehabilitation nursing programmes on surgical site wound infection in patients undergoing laparoscopic cholecystectomy: A meta-analysis.

This study aims to evaluate the effect of an accelerated rehabilitation nursing programme on the incidence of surgical site wound infections in patients undergoing laparoscopic cholecystectomy. Relevant studies regarding the use of an accelerated rehabilitation nursing programme in laparoscopic cholecystectomy were retrieved from databases, including PubMed, Web of Science, the Cochrane Library, EMBASE, CNKI and Wanfang Database. The search was conducted from the inception of each database until June 2023. Two independent researchers performed the literature screening, data collection and quality assessment of the included studies. Odds ratio (OR) and 95% confidence interval (CI) were used as the measures of effect. Statistical analysis was conducted using Stata 17.0, and a sensitivity analysis and publication bias evaluation were performed. A total of 21 studies involving 2480 patients (1179 in the intervention group and 1301 in the control group) were included. The meta-analysis revealed that the incidence of surgical site wound infections in the intervention group was significantly lower than in the control group (1.18% vs. 5.99%, OR: 0.322, 95% CI: 0.168-0.556, p < 0.001). Current evidence suggests that implementing accelerated rehabilitation nursing programmes for patients undergoing laparoscopic cholecystectomy has a clinically significant effect, leading to a substantial reduction in the incidence of surgical site wound infections. However, owing to the low quality of some of the included studies, further high-quality, multicentre, large-sample randomised controlled trials are required to validate the conclusions of this study.

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.

Intervenção dos enfermeiros especialistas em enfermagem de reabilitação na promoção da autonomia dos idosos de um ACES / Intervention by nurses specialising in rehabilitation nursing in promoting the autonomy of the elderly in an ACES

INTRODUÇÃO: O conceito de autonomia é multidimensional, sendo a sua promoção/manutenção um direito fundamental da pessoa e um dever dos profissionais de saúde, nomeadamente dos enfermeiros. Acredita-se que o esclarecimento e a reflexão em torno deste conceito melhorariam a qualidade dos cuidados de enfermagem, tendo o Enfermeiro Especialista em Enfermagem de Reabilitação, um papel primordial na manutenção/promoção da autonomia, sendo o idoso a faixa etária com maior vulnerabilidade e fragilidade. OBJETIVO: Identificar a perceção dos Enfermeiros Especialistas em Enfermagem de Reabilitação, de um Agrupamento de Centros de Saúde de Portugal, quanto à implementação das intervenções promotoras da autonomia nos cuidados que prestam aos idosos. METODOLOGIA: Trata-se de um estudo de natureza quantitativa, descritivo-correlacional. A amostra é não probabilística por conveniência e participaram no estudo 18 Enfermeiros Especialistas em Enfermagem de Reabilitação que trabalham nas Equipas de Cuidados Continuados Integrados de um Agrupamento de Centros de Saúde de Portugal. A recolha de dados foi realizada com o preenchimento de um questionário online, onde foi aplicada a Escala de Autoavaliação da Promoção da Autonomia dos Idosos. RESULTADOS: As dimensões que a amostra perceciona investir mais são o "Desenvolvimento de intervenções avaliativas na área do autocuidado" (M= 3.69, DP= 0.69), a "Capacitação do Cuidador" (M= 3.50, DP= 0.66), o "Desenvolvimento de intervenções emocionais, sociais e de autocuidado" (M= 3.34, DP= 0.634) e o "Desenvolvimento de intervenções físicas e cognitivas" (M= 3.25, DP= 0.79). As dimensões que a amostra perceciona investir menos são o "Desenvolvimento de intervenções de atividades instrumentais de vida diária" (M=2.12, DP= 0,67) e o "Desenvolvimento de intervenções avaliativas nas áreas emocionais, cognitivas e sociais" (M= 2.74, DP= 1.06). Observou-se também uma correlação negativa moderada e estatisticamente significativa (r= -0.554, p<0.05) entre a dimensão "Desenvolvimento de intervenções de atividades instrumentais de vida diária" e o Tempo total de experiência profissional como Enfermeiro, pelo que, estes resultados sugerem que os enfermeiros com mais anos de experiência profissional promovem menos este item. CONCLUSÃO: Os Enfermeiros Especialistas em Enfermagem de Reabilitação parecem dar mais importância às intervenções avaliativas do autocuidado e da capacitação dos cuidadores, e menos importância às intervenções de atividades instrumentais de vida diária e às intervenções avaliativas nas áreas emocionais, cognitivas e sociais. Todavia, desenvolvem intervenções para a promoção da autonomia em todas as suas dimensões.

INTRODUTION: The concept of autonomy is multidimensional, being its promotion/maintenance a fundamental right and a duty of health professionals, namely nurses. It is believed that clarifying and reflecting on this concept would improve the quality of nursing care, with the Specialist Nurse in Rehabilitation Nursing playing a key role in maintaining/promoting autonomy, being the elderly the most vulnerable age group. OBJECTIVE: To identify the perception of Specialist Nurses in Rehabilitation Nursing, from a Group of Health Centers in Portugal, regarding the implementation of autonomy-promoting interventions in the care they provide to the elderly. METHODOLOGY: This is a quantitative, descriptive-correlational study. The sample is non-probabilistic by convenience and participated 18 Specialist Nurses in Rehabilitation Nursing working in Integrated Continuous Care Teams from a Group of Health Centers in Portugal. Data collection was done by filling out an online questionnaire, where the Self-Assessment Scale of Elderly Autonomy was applied. RESULTS: The dimensions that the sample perceives to invest the most are "Development of evaluative interventions in self-care" (M= 3.69, DP= 0.69), "Caregiver Empowerment" (M= 3.50, DP= 0.66), "Development of emotional, social, and self-care interventions" (M= 3.34, DP= 0.634), and "Development of physical and cognitive interventions" (M= 3.25, DP= 0.79). The dimensions that the sample perceives to invest the least are "Development of interventions for instrumental activities of daily living" (M=2.12, DP= 0,67) and "Development of evaluative interventions in emotional, cognitive, and social areas" (M= 2.74, DP= 1.06). A moderate, statistically significant negative correlation (r= -0.554, p<0.05) was also observed between the dimension "Development of interventions for instrumental activities of daily living" and the Total Time of Professional Experience as a Nurse, therefor, these results suggest that nurses with more years of professional experience promote this item less. CONCLUSION: Specialist Nurses in Rehabilitation Nursing seem to attach more importance to evaluative interventions in self-care and caregiver empowerment, and less importance to interventions in instrumental activities of daily living and evaluative interventions in emotional, cognitive, and social areas. However, they develop interventions to promote autonomy in all its dimensions.

Lesões musculoesqueléticas relacionadas com o trabalho nos enfermeiros: explorando a dor oculta: um olhar mais atento sobre lesões musculoesqueléticas entre os enfermeiros / Work-related musculoskeletal injuries among nurses: exploring hidden pain: a closer look at musculoskeletal injuries among nurses

Introdução: As lesões musculoesqueléticas relacionadas com o trabalho são atualmente um problema de saúde de elevada prevalência na classe de enfermagem, de origem multifatorial e sensível à atuação do Enfermeiro Especialista em Enfermagem de Reabilitação. A prevenção destas patologias deve ser prioritária e visa, por um lado, a promoção da qualidade de vida da pessoa com risco elevado para as mesmas e, por outro, a redução do gasto económico relacionado com o seu tratamento. Finalidade e objetivos: Este estudo visou caraterizar os enfermeiros, quanto à sintomatologia musculoesquelética relacionada com o trabalho. O objetivo geral do estudo foi descrever a prevalência das lesões musculoesqueléticas relacionadas com o trabalho nos enfermeiros do serviço de especialidades cirúrgicas de um hospital do Norte do país e explorar a sua associação com fatores sociodemográficos e contexto laboral. Metodologia: Trata-se de um estudo quantitativo, descritivo e correlacional. A amostra foi obtida por conveniência, não probabilística. As variáveis de investigação são a prevalência das lesões musculoesqueléticas relacionadas com o trabalho e a caraterização sociodemográfica e laboral. Foi aplicado um questionário com duas partes: a parte um corresponde à caraterização sociodemográfica e laboral e a parte dois corresponde ao Questionário Nórdico Musculoesquelético. Os dados foram tratados em formato de base de dados e apresentados em tabelas, com auxílio do software IBM SPSS® Statistics, versão 29.0 para Windows, de acordo com os procedimentos de estatística descritiva e inferencial. Resultados: Os resultados indicam que a prevalência das lesões musculoesqueléticas relacionadas com o trabalho é alta, com 92,3% dos participantes a relatar um problema musculoesquelético nos últimos 12 meses. As regiões mais afetadas são o pescoço (53,8%), os ombros (61,5%) e a região lombar (69,2%). Foram encontradas relações entre idade e as áreas afetadas, assim como foram observadas associações entre ocorrência de lesões musculoesqueléticas e anos de experiência profissional, tal como ocorrência de dor e caraterísticas laborais, como horas de trabalho semanal e tipo de horário. Conclusões: Este estudo identificou uma alta prevalência de lesões musculoesqueléticas relacionadas com o trabalho. O estudo ressalva a importância de abordagens multifatoriais e sistémicas na prevenção destas lesões. Ficou evidente que é necessário procurar melhorias nas condições de trabalho dos enfermeiros, como fator preventivo de desenvolvimento de lesões musculoesqueléticas relacionadas com o trabalho.

Introduction: Work-related musculoskeletal injuries are currently a highly prevalence health problem among nurses, of multifactorial origin and sensitive to the Rehabilitation Nursing specialist nurse. The prevention of this pathologies should be a priority and aims to promote the quality of life of high-risk people and, on the other hand, to reduce the economic cost related to their treatment. Purpose: This study aimed to characterize the nurses, regarding work-related musculoskeletal symptoms. The main objective was to describe the prevalence of these health problems in nurses and working in the surgical specialties ward of a hospital in the north of Portugal and to explore their association with sociodemographic factors and work context. Methods: This was a quantitative, descriptive, correlational study. The sample was obtained by convenience, not probabilistic. The variables are the prevalence of work-related musculoskeletal disorders and sociodemographic and work characteristics. A two-part questionnaire was applied: part one stands for the sociodemographic and work characterization and part two corresponds to the Nordic Musculoskeletal Questionnaire. Data was processed in a database format and presented with graphics and charts, with the assistance of IBM SPSS® Statistics, version 29.0 for Windows software, in accordance with descriptive and inferential statistic procedures. Results: The results indicate that the prevalence of musculoskeletal injuries is high, with 92,3% of participants reporting a musculoskeletal problem in the last 12 months. The most affected regions are the neck (53.8%), shoulders (61.5%) and lumbar region (69.2%). Relations were found between age and the affected areas, as well as associations between the occurrence of musculoskeletal injuries and years of professional experience, such as the occurrence of pain and work characteristics, such as hours of work per week and type of schedule. Conclusions: This study identified a high prevalence of musculoskeletal injuries. The study highlights the importance of multifactorial and systemic approaches in preventing these injuries. It became evident that it is necessary to seek improvements in the working conditions of nurses, as a preventive factor in the development of musculoskeletal injuries.

Clientes submetidos a Artroplastia total da Anca: As intervenções do Enfermeiro Especialista de Reabilitação / Clients undergoing total hip arthroplasty: The interventions of the Rehabilitation Nurse Specialist

Introdução: A osteoartrose afeta 10% da população acima dos 60 anos e é a doença articular com maior prevalência no mundo afetando as pessoas na realização dos autocuidados. Os referenciais teóricos sustentam a prática de enfermagem, a Teoria do autocuidado de Orem fornece bases conceptuais na prestação de cuidados, no sentido da (in)dependência nos autocuidados. A Enfermagem de Reabilitação constitui-se como uma área de intervenção reconhecida, capaz de dar resposta às necessidades efetivas da população, bem como às exigências nos cuidados, traduzindo-se esse aporte na procura de ganhos em saúde dos clientes nos diversos contextos da sua prática. Objetivos: Descrever as atividades clínicas para o desenvolvimento de competências na área de enfermagem de Reabilitação e apresentar um estudo de investigação com o tema: Clientes submetidos a Artroplastia total da Anca: As intervenções do Enfermeiro Especialista em Enfermagem de Reabilitação. Metodologia: Para a concretização do estudo foi realizada uma Scoping Review com base nas recomendações do Joanna Briggs Institute. Os artigos, selecionados através de uma lista de verificação PRISMA-ScR, incluem os com data de publicação igual e superior ao ano de 2018, nos idiomas português, inglês e espanhol. Resultados: De 420 artigos, 10 foram incluídos nesta Scoping Review. Todos os resultados valorizaram as intervenções do Enfermeiro Especialista de Reabilitação, com contributos relevantes para o cuidado dos doentes submetidos a ATA. Ficou evidenciado que todos os programas de enfermagem de reabilitação devem ser centrados e personalizados para a pessoa que necessita de ajuda do EEER na reconstrução da sua autonomia, durante as diferentes fases do processo de cuidados. Conclusões: Os artigos selecionados e considerados válidos indicam claramente a importância do Enfermeiro de Reabilitação, enquanto contributo direto para o sucesso de um processo de transição saudável e na capacitação do cliente e família/cuidador durante o processo de cuidados. A sua intervenção favorece os ganhos globais na saúde e na reconstrução da autonomia de cliente submetidos a ATA. O desenvolvimento de estudos que analisem as intervenções do Enfermeiro Especialista em Enfermagem de Reabilitação é indispensável para apurar os contributos destes profissionais nesta área.

Rehabilitation nursing after lower limb fracture: Preventing deep vein thrombosis and enhancing quality of life.

This study aimed to assess the preventive role of rehabilitation nursing in the formation of deep vein thrombosis (DVT) in the lower limbs after fracture and its effect on the patient's quality of life. Ninety patients with lower limb fractures were randomly divided into a study group (n = 45) and a control group (n = 45). Patients in the control group received routine care postoperatively, whereas patients in the study group received rehabilitation nursing intervention on the same postoperative day. A follow-up examination was conducted after 3 months. The occurrence rate of lower limb DVT (LDVT) complications, hemorheology, quality of life (SF-36) scores, coagulation profile, and nursing satisfaction were compared between the groups. After the intervention, the study group presented with lower extremity DVT and higher hemorheology indices than those of the control group (P < .05). The SF-36 scores of both groups increased, but the increase in SF-36 scores in the study group was more significant (P < .001). The satisfaction level of the patients in the study group with nursing services was higher than that of the control group (P = .004). Coagulation indicators can be effectively adjusted and the occurrence of postoperative complications can be reduced in patients undergoing spine fracture surgery such as DVT via standardized rehabilitation care, thereby improving patients' quality of life and nursing conditions.

Resultados de um plano de reabilitação num doente hospitalizado em cuidados paliativos: um estudo de caso / Results of a rehabilitation plan for a hospitalised palliative care patient: a case study

A Enfermagem de Reabilitação e os Cuidados Paliativos são conceitos que se interligam, pois possuem objetivos em comum e uma intencionalidade em reabilitar a pessoa ainda que a possibilidade de cura não esteja presente. Objetivo: Implementar um plano de intervenção na área da enfermagem de reabilitação a um doente internado na unidade de cuidados paliativos e avaliar os resultados. Métodos: Trata-se de um estudo de caso, onde será implementado um plano de intervenção na área da Reabilitação, a um doente internado na unidade de cuidados paliativos, 3 dias por semana ao longo de 4 semanas. Serão aplicadas escalas de avaliação em 3 momentos distintos (no 1 contacto, na 2 semana da aplicação do plano de intervenção e no final da intervenção). Para o tratamento de dados recorreu-se ao Microsoft Office- Excel. Resultados: Entre a primeira e a segunda avaliação verificaram-se melhorias traduzidas num aumento da capacidade da pessoa para a realização dos exercícios, com aumento da tolerância à actividade, embora não mensurável a nível da aplicação das escalas, traduzindo só num aumento da Palliative Performance Scale (PPS). Na terceira avaliação houve um declínio a todos os níveis devido ao agravamento da doença. Conclusão: De acordo com os resultados obtidos, considera-se que a intervenção do enfermeiro especialista em reabilitação, fez a diferença em alguns aspetos da vida e funcionalidade do doente em causa. O enfermeiro especialista em enfermagem de reabilitação deve ser um elemento integrante da equipa de cuidados paliativos.

Rehabilitation Nursing and Palliative Care are interconnected concepts, as they share common goals and an intention to rehabilitate individuals even in the absence of a possibility for cure. Aim: Implement an intervention plan in the area of reahabilitation nursing for a patient admitted to the palliative care unit and evaluate the outcomes. Methods: This is a case study where an intervention plan will be implemented in the area of Rehabilitation for a patient admitted to the Palliative Care Unit, three days a week over a period of four weeks. Evaluation scales will be applied at three different time points (at the initial contact, in the second week of intervention plan`s implementation, and at the end of the intervention). Microsoft Office-Excel was used for data processing. Results: Between the first and second assessment, improvements were observed, reflected in an increase in the person's ability to perform exercises and an increase in activity tolerance, although not measurable in terms of scale application, only resulting in an increase in Palliative Performance Scale (PPS). In the third assessment, there was a decline at all levels due to disease progression. Conclusion: According to the results obtained, it is considered that the intervention of the specialist rehabilitation nurse made a difference in certain aspects of the life and functionality of the patient in question. The specialist rehabilitation nurse should be an integral part of the Palliative Care team.

Impacto de um programa de reabilitação num doente internado na unidade de cuidados paliativos / Impact of a rehabilitation programme on a patient in the palliative care unit

A Enfermagem de Reabilitação e os Cuidados Paliativos são conceitos que se entrelaçam, uma vez que partilham objetivos comuns e uma profunda intencionalidade na recuperação da pessoa, mesmo quando a cura não é uma possibilidade. A Reabilitação deve ser orientada por quatro princípios: educação, independência, desenvolvimento de competências e qualidade de vida, que estão expressamente ou implicitamente incluídos na legislação que rege os Cuidados Paliativos em Portugal. Objetivo: Implementar um programa de reabilitação a um doente internado numa Unidade de Cuidados Paliativos e identificar os seus ganhos. Métodos: A investigação a ser realizada enquadra-se no estudo descritivo do tipo estudo de caso. Este estudo inicia-se com uma avaliação inicial abrangente da funcionalidade da pessoa, seguida da identificação e definição de objetivos, organização e implementação de um plano de intervenção e, por fim, avaliação dos resultados obtidos num doente em situação paliativa, internado na Unidade de Cuidados Paliativos. Resultados: O programa de reabilitação implementado revelou um impacto positivo no doente internado na Unidade de Cuidados Paliativos, traduzindo-se numa melhoria da sintomatologia, da funcionalidade; otimização de terapêutica, prevenção e controlo de situações de agudização e de complicações, traduzindo-se numa melhoria da qualidade de vida. Conclusão: Foi justificado que existem evidências claras da importância da intervenção do Enfermeiro Especialista em Enfermagem de Reabilitação no doente paliativo. Os benefícios decorrem da atuação na promoção do conforto em todas as suas vertentes, na maximização da funcionalidade, autonomia e independência no autocuidado, na minimização do impacto das incapacidades já instaladas e na capacitação para a gestão da terapia e dos processos de doença. Isso contribui para a redução da ocorrência de agravamentos, da necessidade de hospitalização e para a melhoria da qualidade de vida da pessoa em situação paliativa.

Rehabilitation Nursing and Palliative Care are intertwined concepts, as they share common objectives and a profound intention to restore the individual, even when a cure is not a possibility. Rehabilitation should be guided by four principles: education, independence, skill development, and quality of life, which are explicitly or implicitly included in the legislation governing Palliative Care in Portugal. Aim: Implementing a rehabilitation program for a patient admitted to a Palliative Care Unit and identifying their gains. Methods: The research to be conducted falls under the descriptive study type of a case study. This study begins with a comprehensive initial assessment of the individual's functionality, followed by the identification and definition of goals, organization and implementation of an intervention plan, and finally, evaluation of the outcomes obtained in a patient in a palliative care situation, admitted to the Palliative Care Unit. Results: The implemented rehabilitation program showed a positive impact on the patient admitted to the Palliative Care Unit, resulting in an improvement in symptoms, functionality, optimization of therapy, prevention and management of exacerbations and complications, leading to an improvement in quality of life. Conclusion: It was justified that there are clear pieces of evidence regarding the importance of the intervention of the Specialist Nurse in Rehabilitation Nursing for the palliative patient. The benefits stem from their actions in promoting comfort in all its aspects, maximizing functionality, autonomy, and self-care independence, minimizing the impact of pre-existing disabilities, and empowering patients to manage therapy and disease processes. This contributes to reducing the occurrence of exacerbations, the need for hospitalization, and the improvement of the quality of life of the palliative patient.

Percursos de cuidados para a autonomia da pessoa portadora de lesão medular no autocuidado andar ­ vivências da fase aguda / Care pathways for the autonomy of people with spinal cord injuries in self-care for walking - experiences of the acute phase

A lesão medular na fase aguda exige cuidados imediatos especializados em unidades hospitalares, conduzindo a uma interrupção dos projetos de vida pessoais. Este contexto poderá agravar-se com a perda de mobilidade da pessoa e afetar a sua autonomia e independência no autocuidado andar. Objetivo: Compreender como percecionam as pessoas com LM na fase aguda a situação de dependência adquirida no autocuidado andar e o processo assistencial que suporta a sua independência e autonomia. Métodos: Estudo qualitativo de abordagem fenomenológica, com recurso a entrevistas semiestruturadas a dezasseis pessoas com LM internadas num serviço de neurocirurgia, com uma amostra do tipo intencional. As categorias criadas têm como referência o modelo conceptual de enfermagem de Dorothea Orem. A análise de conteúdo foi realizada pela metodologia de Bardin e com auxílio da ferramenta AtlasTi. Resultados: Os dezasseis participantes relataram vivências sobre o autocuidado andar, revelando a importância deste autocuidado durante internamento. Identificaram-se vinte categorias que se agruparam em: Requisitos Universais de Autocuidado, Fatores Condicionantes Básicos de Autocuidado, Requisitos de Autocuidado no Desvio de Saúde, Intervenções de Enfermagem e Sistemas de Enfermagem. A participação nas recomendações de reabilitação e a ativação dos três sistemas de enfermagem, com destaque para o apoio-educativo, são assumidos como elementares para a recuperação. É encontrada motivação na esperança sempre presente de recuperar. O recurso a auxiliares de marcha contribuiu para aumentar a autonomia com manifesta satisfação. Conclusão: Na fase aguda da LM, as pessoas identificam necessidades específicas de cuidados para dar resposta à dependência adquirida no autocuidado andar, o que leva à procura de cuidados de saúde diferenciados. As intervenções de enfermagem de reabilitação são reconhecidas como fundamentais e dão resposta às questões funcionais, proporcionando apoio em ambientes favorecedores do desenvolvimento pessoal.

Spinal cord injury acute phase requires immediate specialized care in hospital units, leading to an interruption of personal life projects. This context may worsen with the person's loss of mobility and affect their autonomy and independence in walking self-care. Objective: To understand how people with SCI in the acute phase perceive the situation of dependence acquired in self-care walking and the healthcare process that supports their independence and autonomy. Methods: Qualitative study with a phenomenological approach, using semi-structured interviews with sixteen people with SCI admitted to a neurosurgery ward, with an intentional sample. The categories created are based on Dorothea Orem's conceptual nursing model. Content analysis was performed using Bardin's methodology and the AtlasTi tool. Results: The sixteen participants reported walking self-care experiences, revealing the importance of this self-care during hospitalization. Twenty categories were identified and grouped into Universal Self-Care Requisites, Basic Conditioning Factors, Health- Deviation Self-Care Requisites, Nursing Interventions and Nursing Systems. Participation in rehabilitation recommendations and activation of the three nursing systems, emphasizing educational support, are assumed to be essential for recovery. Motivation is found in the ever-present hope of recovery. The use of walking aids contributed to increase autonomy with manifest satisfaction. Conclusion: In the acute phase of SCI, people identify specific care needs to respond to the dependency acquired in walking self-care, which leads to the search for differentiated health care. Rehabilitation nursing interventions are recognized as fundamental and respond to functional issues, providing support and environments that favour personal development.

O enfermeiro de reabilitação e a educação para a saúde à pessoa com insuficiência cardíaca / Rehabilitation nurses and health education for people with heart failure

impacto na sociedade, apresentando uma prevalência de 1 a 3% da população adulta nos países industrializados. A reabilitação cardíaca (RC) é uma importante estratégia de prevenção secundária nas doenças cardiovasculares, sendo ainda subutilizada em território nacional, com apenas 20% dos programas de RC necessários. A educação da pessoa com IC, é de uma importância vital para que esta perceba os benefícios e adira ao programa de gestão da sua condição, contribuindo para uma melhoria da qualidade de vida, diminuição do número de readmissões e da taxa de mortalidade. Finalidade e objetivo: Pretende-se que este estudo contribua para demonstrar a importância do enfermeiro de reabilitação na recuperação da pessoa com IC. É objetivo geral deste projeto: demonstrar os ganhos obtidos com um programa de educação para a saúde à pessoa com insuficiência cardíaca. Metodologia: Estudo quantitativo, correlacional, quase experimental, longitudinal. Foi constituída uma amostra de 15 pessoas (n=15) encaminhadas para a consulta de insuficiência cardíaca avançada, com idades entre os 36 e os 81 anos, maioritariamente do sexo masculino e com idades iguais ou superiores a 60 anos. Foi implementado um programa de educação para a saúde à pessoa com IC, elaborado após revisão de literatura e validado com recurso à técnica de Delphi. Os resultados foram avaliados pela aplicação do questionário do Conhecimento da Insuficiência Cardíaca Crónica e a Escala Europeia de Autocuidado na Insuficiência Cardíaca. O questionário do Conhecimento da Insuficiência cardíaca foi aplicado no final da sessão de educação para a saúde ou na data de alta e novamente duas semanas após. A Escala Europeia de Autocuidado na Insuficiência Cardíaca foi aplicada uma semana e duas semanas depois da sessão de educação para a saúde ou da alta hospitalar. Resultados: Como resultado da intervenção, foi obtido um score médio final de 9,8 para o conhecimento sobre a IC e de 15,13 para a adesão ao regime terapêutico. Não se pôde comprovar estatisticamente uma melhoria do conhecimento sobre a IC ao longo da intervenção (Z= -1,115; p-value= 0,144). Houve uma melhoria na adesão ao regime terapêutico ao longo da intervenção, ainda que sem significância estatística (Z= -0,357; pvalue= 0,377). Não se conseguiu provar estatisticamente que o conhecimento sobre a IC influencia a adesão ao regime terapêutico (rs= 0,135 e 0,009 e p-value= 0,631 e 0,973). Foi constatada uma associação positiva, estatisticamente significativa, entre o nível de escolaridade e o conhecimento sobre a IC (rs=de 0,715; p-value= 0,003). Conclusões: O estudo permitiu evidenciar os resultados obtidos com o programa de educação para a saúde à pessoa com IC, no que respeita ao conhecimento sobre a IC e à adesão ao regime terapêutico. Foi também possível estabelecer a existência de uma relação positiva entre a escolaridade e o conhecimento sobre a IC. Ainda assim, não foi possível confirmar a existência de uma relação entre o conhecimento sobre a IC e adesão ao regime terapêutico, nem a evolução positiva destas duas variáveis desde o início até ao final da intervenção do estudo. Torna-se evidente a necessidade de um maior investimento na investigação nesta área do conhecimento para consolidar a evidência existente, perceber melhor as necessidades e fenómenos em seu redor e reforçar a importância da enfermagem de reabilitação.

Introduction: Heart failure (HF) is a complex clinical syndrome that has considerable impact in society, with prevalence of 1 to 3% in the adult population of industrialised countries. Cardiac rehabilitation (CR) is an important strategy in the secondary prevention of cardiovascular diseases, still underused in national territory, with only 20% of needed CR programs. Educating the person with HF is of fundamental importance so they can understand the benefits and adhere to the management program for their condition, contributing to an improved quality of life, a lower number of hospital admissions as well as a lower mortality rate. Goal and aim: The goal of this study is to contribute to demonstrate the importance of the rehabilitation nurse in the recovery of the person with HF. It is a general aim for this project: demonstrate the gains obtained with a health education program for the person with heart failure. Methodology: Quantitative, correlational, quasi experimental, longitudinal study. A sample of 15 people referred to the advanced heart failure clinic (n=15) was obtained, with ages between 36 and 81 years old, mostly male and with ages from 60 years old. A health education program for people with heart failure was implemented, which was created as result of the literature review and validated via the Delphi methodology. The results were evaluated by the application of the Knowledge of Chronic Heart Failure questionnaire and the European Heart Failure Self-care Behaviour Scale. The Knowledge of Chronic Heart Failure questionnaire was applied at the end of the health education session or at the discharge date and again two weeks after. The European Heart Failure Self-care Behaviour Scale was applied one week and two weeks after the health education session or hospital discharge. Results: As result of the intervention, final mean scores of 9,8 for the knowledge about heart failure and 15,13 for the adherence to the therapeutic regimen were obtained. It wasn't possible to statistically prove an improvement in the knowledge about heart failure throughout the intervention (Z= -1,115; p-value= 0,144). There was an improvement in the adherence to the therapeutic regimen throughout the intervention, though without statistical significance (Z= -0,357; p-value= 0,377). It wasn't possible to statistically prove that the knowledge about heart failure influences the adherence to the therapeutic regimen (rs= 0,135 and 0,009; p-value= 0,631 and 0,973). A positive, statistically significant, association between the participants' scholarship and knowledge about heart failure was found (rs=de 0,715; p-value= 0,003). Conclusions: The study allowed to evidence the results obtained with the health education program for the person with heart failure, in the dimensions of knowledge about heart failure and adherence to the therapeutic regimen. It was also possible to establish the existence of a positive relation between scholarship and knowledge about heart failure. Despite these results, it wasn't possible to confirm a relation between the knowledge about heart failure and adherence to the therapeutic regimen, neither a positive evolution of those two variables from the beginning until the end of the study's intervention. The need for a stronger investment in research within this area of knowledge becomes evident, to strengthen the existing evidence, understand better the necessities and phenomena surrounding it and reinforce the importance of rehabilitation nursing.

O Enfermeiro especialista em enfermagem de reabilitação na gestão da ansiedade / The rehabilitation nurse specialising in anxiety management

Introdução e Enquadramento: O presente relatório reporta-se ao Estágio de Natureza Profissional realizado em contexto comunitário, cujo objetivo principal foi desenvolver competências comuns e específicas na prática de Enfermagem de Reabilitação, envolvendo também a componente de investigação. A ansiedade constitui um dos sintomas negativos relatados pelos trabalhadores face às exigências do ambiente laboral e a ginástica laboral constituiu-se como uma das estratégias apontadas para os distúrbios físicos e emocionais na saúde dos trabalhadores, nomeadamente na ansiedade. O objetivo geral do estudo foi avaliar o contributo de um programa de exercício realizado pelo Enfermeiro Especialista em Enfermagem de Reabilitação (EEER) na diminuição da ansiedade nos profissionais. Como objetivos específicos foram traçados: avaliar o estado de ansiedade dos profissionais antes e após a realização do programa de exercício, identificar a importância atribuída pelos profissionais à prática de exercício em contexto laboral e avaliar a relação entre a realização de um programa de exercício e a ansiedade nos profissionais. Metodologia: Trata-se de um estudo quantitativo, quasi-experimental e longitudinal, com aplicação de um programa de ginástica laboral. Definimos como questão de investigação: Qual o contributo de um programa de exercício realizado pelo EEER na diminuição da ansiedade nos profissionais? A amostra foi composta por dezoito profissionais de um ACES da zona Norte. Definimos como hipótese de investigação: Espera-se que a realização de um programa de exercício interfira nos níveis de ansiedade dos profissionais. Para a recolha de dados utilizamos um questionário sociodemográfico com o Inventário de Estado-Traço de Ansiedade (STAI) Forma Y-1, de preenchimento online. Resultados: Após a aplicação das sessões de ginástica laboral verificou-se uma diminuição nos valores médios de ansiedade, no entanto não se obteve evidência estatística para afirmar que a realização de um programa de exercício interfira nos níveis de ansiedade dos profissionais Conclusão: As sessões de exercício físico diminuem, em termos médios, os níveis de ansiedade, mas são necessários mais estudos para reforçar esta constatação.

Introduction and Framework: This report refers to the Internship of a Professional Nature carried out in a community context, whose main objective was to develop common and specific skills in the practice of Rehabilitation Nursing, also involving the research component. Anxiety is one of the negative symptoms reported by workers in view of the demands of the work environment and workplace gymnastics was one of the strategies pointed out for physical and emotional disorders in workers´ health, namely anxiety. The general objective of the study was to evaluate the contribution of an exercise program carried out by the Specialist Nurse in Rehabilitation Nursing in the reducing anxiety in professionals. The specific objectives were: to evaluate the state of anxiety of the professionals before and after carrying out the exercise program, to identify the importance attributed by the professionals to the practice of exercise in the work context and to evaluate the relationship between the performance of an exercise program and the anxiety in professionals. Methodology: This is a quantitative, quasi-experimental and longitudinal study, with the application of a labor gymnastics program. We defined as a research question: What is the contribution of an exercise program carried out by the Specialist Nurse in Rehabilitation Nursing in reducing anxiety in professionals? The sample consisted of eighteen professionals from an ACES in the North region. We defined as research hypothesis: It is expected that the performance of an exercise program interferes in the professionals´ anxiety levels. For data collection, we used a sociodemographic questionnaire with the State-Trait Anxiety Inventory (STAI) Form Y-1, to be completed online. Results: After the application of the labor gymnastics sessions, there was a decrease in the average values of anxiety, however, no statistical evidence was obtained to affirm that the performance of an exercise program interferes in the professionals´ anxiety levels. Conclusion: Physical exercise sessions decrease, on average, anxiety levels, but more studies are needed to reinforce this finding.

Effect of early rehabilitation nursing on neurological function and quality of life of patients with hemiplegia after stroke: A meta-analysis.

BACKGROUND: Meta-analysis was used to systematically evaluate the effects of early rehabilitation nursing on neurological function and quality of life of patients with hemiplegia after stroke. METHODS: Literature was searched from PubMed, Web of Science, cochrane library, China National Knowledge Infrastructure, and Wanfang Database. Relevant literature up to 2022 was screened, followed by data extraction and quality evaluation. Next, Stata17.0 was employed for meta-analysis. RESULTS: A total of 18 articles, including 1631 subjects, were enrolled in this study. The control group subjects (n = 825) received routine nursing, and the observation group subjects (n = 806) underwent early rehabilitation nursing. The results of meta-analysis showed that early rehabilitation nursing could significantly improve neurological function the National Institute of Health Stroke Scale [standardized mean difference (SMD) = -1.623, 95% confidence interval (CI) (-2.280, -0.967), P < .001], Fugl-Meyer assessment [SMD = 2.688, 95% CI (1.767, 3.608), P < .001], cure rate [relative risk = 1.333, 95% CI (1.138, 1.562), P < .001], quality of life activity of daily living [SMD = 1.784, 95% CI (0.791, 2.777), P < .001], Barthel index [SMD = 1.617, 95% CI (1.138, 2.096), P < .001] and nursing satisfaction [relative risk = 1.191, 95% CI (1.091, 1.300), P < .001] in patients with hemiplegia after stroke. There was no obvious publication bias for the included articles in this research. CONCLUSION: Compared with the controls, early rehabilitation nursing can effectively improve neurological function and quality of life of patients with hemiplegia after stroke. This study provides a theoretical basis for the clinical application of early rehabilitation nursing in patients with hemiplegia after stroke.

Efficacy of Rapid Rehabilitation Nursing in Postoperative Care in China: A Meta-Analysis.

BACKGROUND: Rapid rehabilitation nursing (RRN) has been increasingly adopted in China to improve patient outcomes following surgery. This systematic review and meta-analysis aimed to assess the impact of RRN on hospital stays, postoperative complications, postoperative pain, patients' quality of life (QOL), and patient satisfaction with nursing care compared to traditional nursing care. METHODS: A systematic search of relevant databases, including PubMed, EMBASE, and Cochrane Library, was conducted to identify eligible studies. The standardized mean difference and 95% confidence intervals were calculated for continuous outcomes (hospital stays, postoperative pain, and QOL). Risk ratios (RRs) and 95% confidence intervals were used for dichotomous outcomes (postoperative complications, patient satisfaction with nursing care). Heterogeneity was assessed using the I2 statistic. Fixed-effects and random-effects models were calculated for each outcome measure. RESULTS: A total of 10 studies including 1,565 patients were included in the meta-analysis. Rapid rehabilitation nursing significantly reduced hospital stays and postoperative complications compared to traditional nursing care. Patients receiving RRN experienced lower postoperative pain scores and improved QOL, although the latter result was not statistically significant. Patient satisfaction with nursing care was significantly higher in the RRN group compared to traditional nursing care. CONCLUSIONS: Rapid rehabilitation nursing appears to be an effective approach for shortening hospital stays, reducing postoperative complications and postoperative pain, and increasing patient satisfaction with nursing care compared to traditional nursing care. The findings support the integration of RRN into clinical practice to enhance patient outcomes and patients' satisfaction with nursing care. Future research should focus on further investigating the impact of RRN on patients' QOL using larger, well-designed studies.

The Role of Nursing Staff Regarding Goal Setting and Achieving in Geriatric Rehabilitation: A Focus Group Study.

PURPOSE: The aim of this study was to explore and clarify the role of nursing staff in geriatric rehabilitation on supporting patients in goal setting and achieving, through reflecting on rehabilitation interventions. DESIGN: A descriptive qualitative study was conducted. METHODS: We conducted four online focus group interviews with 23 members of the nursing staff working in geriatric rehabilitation. They reflected on six interventions, preclassified into three types: setting goals in the admission phase, increasing patient participation in order to personalize the rehabilitation trajectory, and supporting patients in working on short-term goals. Data were analyzed using thematic content analysis. RESULTS: Setting goals in the admission phase is primarily the task of the multidisciplinary team rather than the nursing staff. Interventions to increase patient participation align with the coordinating role of nursing staff in the rehabilitation team. Working on short-term goals is of great value to patients. CLINICAL RELEVANCE TO THE PRACTICE OF REHABILITATION NURSING: The connection between the patient's personal goals and professional treatment aimed at functional recovery can be enhanced by strengthening the position of nursing staff working in geriatric rehabilitation. CONCLUSION: Members of nursing staff in geriatric rehabilitation see themselves playing a coordinating role in the multidisciplinary team, supporting the patient in goal work. Interventions aimed at advancing patient participation and providing support for short-term goals reinforce this role.

Development and evaluation of an early rehabilitation nursing program for patients with pulmonary tuberculosis.

To develop and evaluate an early rehabilitation nursing program for patients with pulmonary tuberculosis to improve their exercise endurance, pulmonary function, and self-care ability, promote their rehabilitation, improve their quality of life, and explore the construction and application of early rehabilitation nursing program. From March 2021 to August 2022, 104 patients with pulmonary tuberculosis in the improvement stage were recruited and randomly assigned to an intervention group (n = 52) and a control group (n = 52). Exercise endurance was assessed before and 12 weeks after the nursing program, and the groups were compared. Changes in pulmonary function were also analyzed. The exercise of self-care agency scale, self-rating depression scale, self-rating anxiety scale, and generic quality of life inventory-74 were used to assess differences in patients' quality of life. Patients in the intervention group performed significantly better than those in the control group in the 6-minute walking test, and had significantly higher arterial blood oxygen partial pressure and significantly lower arterial partial pressure of carbon dioxide after the intervention (P < .001). After the intervention, the forced vital capacity and forced expiratory volume in 1 second in the intervention group were significantly higher than those in the control group (P < .001). After the intervention, the scores for health knowledge (P < .001), self-care skills (P = .001), self-concept (P < .001) and self-care responsibility (P = .002) of patients in the intervention group were significantly higher, and the self-rating depression scale, self-rating anxiety scale, and generic quality of life inventory-7 scores were significantly lower in the intervention group than in the control group (P < .001). This study demonstrates the clinical value of early rehabilitation nursing during the improvement period in patients with pulmonary tuberculosis.

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.