School of Nursing, University of Navarre, Spain.
Int J Nurs Stud. 2009 Feb;46(2):204-19. doi: 10.1016/j.ijnurstu.2008.09.012. Epub 2008 Dec 6.
Very few neurological rehabilitation programmes have successfully dealt with patients' and relatives' social needs. Furthermore, the nurses' contribution in those programmes is poor or unclear.
To determine the rationale, effectiveness and adequacy of a nurse-led social rehabilitation programme implemented with neurological patients and their carers.
In this action research study Hart and Bond's experimental and professionalizing typologies were applied through Lewinian cycles. A social rehabilitation programme was planned, based on the results of an in-depth baseline assessment of the context and individual needs. The programme focused on increasing the level of acceptance/adaptation of the disease through verbal and written education, easing the discharge planning, and offering social choices based on the social assessment of individual needs and possibilities at home.
Two neurological wards of a hospital in Spain.
The programme evaluation included 27 nurses, and two groups of patients and relatives (control group=18 patients and 19 relatives, intervention group=17 patients and 16 relatives).
The two groups of patients and relatives were compared before and after discharge to determine the effectiveness of the programme. Socio-demographic forms, semi-structured interviews, participant observations, and validated scales to measure activities of daily living and social life were used, and data were analysed using content (QSR Nudist Vivo, v.2.0) and statistical (SPSS v. 13.0) analyses.
The new programme resulted in social care being integrated in daily practice and developed knowledge about social rehabilitation. This had a positive impact on nurses' attitudes. Patients and relatives had more realistic expectations and positive attitudes towards social life, and developed a wider variety of choices for social changes. Better adaptation, and more coping skills and satisfaction were achieved.
This rehabilitation programme was feasible and effective. Patients and relatives benefited from better understanding of the socialisation process, as a result of advancing nurses' knowledge, experience and role in psychosocial care.
很少有神经康复计划成功地满足了患者及其家属的社会需求。此外，护士在这些计划中的作用也很差或不明确。
确定由护士主导的社会康复计划对神经科患者及其照顾者的合理性、有效性和充分性。
在这项行动研究中，通过Lewinian 周期应用了 Hart 和 Bond 的实验和专业化类型学。根据对背景和个人需求的深入基线评估结果，计划了一个社会康复计划。该计划侧重于通过口头和书面教育提高疾病的接受/适应程度，简化出院计划，并根据个人需求的社会评估和家庭中的可能性提供社会选择。
西班牙一家医院的两个神经科病房。
该计划评估包括 27 名护士，以及两组患者和家属（对照组=18 名患者和 19 名家属，干预组=17 名患者和 16 名家属）。
在出院前后比较两组患者和家属，以确定该计划的有效性。使用了社会人口学表格、半结构化访谈、参与者观察以及评估日常生活活动和社会生活的验证量表，并使用内容分析（QSR Nudist Vivo，v.2.0）和统计分析（SPSS v.13.0）对数据进行了分析。
新计划导致社会护理融入日常实践，并发展了社会康复方面的知识。这对护士的态度产生了积极影响。患者和家属对社会生活有了更现实的期望和更积极的态度，并为社会变化发展了更多的选择。更好的适应、更多的应对技巧和更高的满意度得到了实现。
该康复计划是可行且有效的。患者及其家属通过提高护士在心理社会护理方面的知识、经验和角色，更好地理解了社会化过程，从中受益。
