Rehabilitation, chronic illness and disability: the missing elements in nurse education

Chronic illnesses represent one of the most significant health challenges in all developed countries and currently there is considerable debate about how to meet the rehabilitative needs of chronically ill and disabled people. The literature suggests that nursing has a potentially significant, but largely unrealized, role to play in addressing areas of current deficit. However, to fulfil this potential it is vital that the educational preparation of nurses at both qualifying and post-qualifying levels equips them with the necessary knowledge and skills. This paper describes a study which analysed curriculum documents from an extensive range of courses in the United Kingdom (UK) in order to determine the emphasis placed on rehabilitation, chronic illness and disability. The results reveal the overall lack of attention given to these important areas and the superficial manner in which key concepts are addressed. The need to identify more clearly the nursing contribution to rehabilitation is highlighted and indicative areas of knowledge and skill required to develop an expanded role are presented.     

上海市部分医院骨科护士康复护理行为现状及其影响因素

目的了解上海市部分医院骨科护士康复护理行为的现状及其影响因素，为提高骨科护士的康复护理水平提供依据。方法采用自行设计的骨科护士康复护理行为问卷，内容包括骨科护士一般资料及康复护理行为，对上海市15所医院的282名骨科护士进行调查，调查数据用SPSS11．0软件进行统计分析。结果在康复护理行为的6项内容中，只有健康教育得分较高，其他项目如康复护理评估、指导患者功能锻炼、日常生活活动能力训练、心理护理和出院指导及随访得分都较低。不同学历、职称的护士康复护理行为得分无显著性差异；不同工作年限的护士康复护理行为得分有显著性差异（P〈0．05）。结论亟须通过规范化继续教育提高骨科护士的康复护理水平，加强对低年资护士的培训，同时充分发挥高年资护士的业务专长。     

程序康复对急性心肌梗死患者生活质量的影响

目的 :观察 2周程序康复能否改善急性心梗 (AMI)患者的生活质量 (QOL)。方法 :通过多种QOL问卷(QOLQ)对顺利完成早期康复计划的 2 1例AMI患者进行QOL评估。结果 :对完成程序康复的AMI患者 (平均住院时间为 15 .4 1± 3 .76天 )通过WHOQOL等量表进行QOLQ的测试 ,主观感受积分较对照组高 (P <0 .0 0 1) ,在生理、心理及环境领域的得分亦高于对照组 (P <0 .0 0 0 1)。结论 :AMI患者早期程序康复可改善患者的生活质量     

基于脑-机接口的康复辅助机械手控制

目的：研究一种基于脑-机接口技术的康复辅助机械手运动的控制方法，并论证其可行性。方法：构建基于脑-机接口的控制系统机架。通过基于稳态视觉诱发电位构造的脑-机接口获取控制指令，通过可编程逻辑控制器(PLC)控制机械手完成规划的动作。结果：实现了利用稳态诱发脑电控制多自由度机械手完成倒水动作的过程。结论：通过脑-机接口技术控制康复辅助机械手进行复杂运动是一种可行的方法，这种新的控制方法可以应用于残疾人对假肢的控制。     

Post‐Traumatic Heterotopic Ossification: An Old Problem in Need of New Solutions

Heterotopic ossification (HO) is the formation of pathological bone in ectopic sites and it can have serious consequences for functional outcomes. For many years, its main clinical relevance was as a rare complication of elective joint arthroplasty or CNS injury and a number of prophylaxes were developed to mitigate against it in these settings. As a consequence of changes in patterns of wounding and survival in conflicts since the turn of the century, post‐traumatic HO has become much more common and case severity has increased. It represents one of the main barriers to rehabilitation in a large cohort of combat‐injured patients. However, extant prophylaxes have not been shown to be effective or appropriate in this patient cohort. In addition, the lack of reliable early detection or means of predicting which patients will develop HO is another barrier to effective prevention. This review examines the current state of understanding of post‐traumatic HO including the historical context, epidemiology, pathophysiology, clinical issues, currently prophylaxis and detection, management, and potential future approaches. Our aims are to highlight the current lack of effective means of early detection and prevention of HO after major trauma and to stimulate research into novel solutions to this challenging problem. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 36:1061–1068, 2018.     

The context, measures and outcomes of psychosocial care interventions in long-term health care for older people

This paper examines the psychosocial dimensions of long-term care with reference to the new International Classification of Functioning, Disability and Handicap (ICIDH 2) and to research conducted in Hong Kong. It also draws on selected international literature about older people. It discusses the different ways in which information can be gained about the personal, social and emotional processes of rehabilitation that influence outcomes and raises methodological questions about the study of interventions. Outcomes that are sensitive to psychosocial interventions and that take account of the elderly person's own perspective are identified as important challenges for nurses and other professionals in the multidisciplinary team, in order to respond to an individualized approach to long-term care. It is concluded that gaining a better understanding of the psychosocial dimensions of long-term care will enhance professional practice and benefit older people and their carers.     

Who Goes to Inpatient Rehabilitation or Skilled Nursing Facilities Unexpectedly Following Total Knee Arthroplasty?

Background

Inpatient rehabilitation facilities (IRFs) and skilled nursing facilities (SNFs) represent a significant portion of post-operative expenses of bundled payments for total knee arthroplasty (TKA). Although many surgeons no longer routinely send patients to IRFs or SNFs, some patients are unable to be discharged directly home. This study identified patient factors for discharge to post-acute care facilities with an institutional protocol of discharging TKA patients home.

精神卫生全程服务对社区精神分裂症患者的康复作用

目的探讨精神卫生全程服务对社区精神分裂症患者的康复作用。方法将 90名社区精神分裂症患者随机分为干预组和对照组 ,每组各 45例。在抗精神病药物治疗的同时 ,对于干预组施以精神卫生全程服务 ,约 2 4个月。采用简明精神病评定量表 (BPRS)、社会功能缺陷筛选量表 (SDSS)评定康复效果。结果干预前与干预后评分差值的比较 ,干预组的BPRS总分、反应缺乏因子分、思维障碍因子分、偏执因子分、SDSS评分 ,均明显优于对照组 (P <0 .0 5— 0 .0 1)。结论精神卫生全程服务对控制社区精神分裂症患者的病情、提高其社会功能具有积极作用。     

发育性髋关节脱位Steell三联截骨手术后的综合康复

研究大龄发育性髋关节脱位(DDH)的儿童,行Steell三联截骨手术后,髋关节功能的恢复与综合康复的方法和疗效。方法:5例平均年龄为7.4±1.5岁的DDH的患儿,行Steell三联截骨手术治疗,术后不同时期进行相应的康复训练,如助力训练、CPM训练及物理治疗等。分别在治疗前后测定患侧髋关节各个方向活动的最大角度。结果康复治疗前平均髋关节功能受损为55.2%,治疗后为10%。结论:Steell三联截骨术是治疗大龄DDH的一种有效的手术方法,术后早期、合理的综和康复训练是保证手术效果、恢复髋关节功能最有效的方法,但不同的患儿应根据临床体征等条件合理制定康复计划,防止髋关节再脱位和股骨头缺血性坏死的发生。     

老年康复期病人两种护理模式的比较研究

目的：探索不同的护理模式对老年康复期病人身心健康的影响。方法：将意识清醒，有一定的躯体功能缺损的老年康复期病人102例，随机分成两组，每组51例，对照组在争取客观支持的基础上加强生活护理，实验组强化主观支持与利用度的基础上强化功能锻炼。应用SSRS、SDS、LSR、ADL量表在护理干预前后进行测试、分析。结果：实验组明显优于对照组，在社会支持增加、抑郁状态减轻、日常生活能力及生活满意度提高方面更为显著，差异有统计学意义。结论：老年康复期病人应重视主观支持与社会利用度的提高及功能锻炼，以增进病人身心健康，提高生活质量，同时减少亲友等的照顾压力。