McKillop Ann, Parsons John, Slark Julia, Duncan Lindsay, Miskelly Philippa, Parsons Matthew
School of Nursing, The University of Auckland and the Institute of Healthy Ageing, Waikato District Health Board , Auckland , New Zealand .
Disabil Rehabil. 2015;37(11):963-70. doi: 10.3109/09638288.2014.948968. Epub 2014 Aug 12.
Nurses' contribution during inpatient rehabilitation is well documented. However, despite being the largest professional group in this setting, the specialty of rehabilitation nursing is poorly recognised. This article reports on the first of a four-phase study that aimed to clarify and develop the nursing contribution to inpatient rehabilitation for older persons. The aim of this study was to identify activity patterns and time use during daytime and evenings of older adult patients undergoing inpatient rehabilitation.
Direct observation using behavioural modelling was undertaken of a convenience sample of 37 older people undergoing inpatient rehabilitation in a specialist unit of a large tertiary hospital in New Zealand. The primary outcome was the observation of meaningful activity. Binomial logistic regression was used to study the association between relevant variables.
Meaningful activity was most likely to involve walking without assistance and to occur 08:00 to 14:00 h and 16:00 to 21:00 h during weekdays. Patients were more likely to receive treatment during the weekend. Irrespective of time, registered nurses were the health professionals most often present with patients.
There is likely to be unrealised opportunities for registered nurses to support improved rehabilitation outcomes. Registered nurses' involvement in rehabilitation needs to be actively optimised.
Nurses' engagement with older adults in rehabilitation settings is likely to be substantial, placing them as key members of the rehabilitation team. Nurses make a pivotal contribution to inpatient rehabilitation based on specialised knowledge and skills but this contribution is not well understood. Opportunities are likely, at times when allied health professionals are less often present, e.g. evenings and weekends, for registered nurses to more intentionally overlap rehabilitation activities with other care requirements.
护士在住院康复期间的贡献已有充分记录。然而，尽管护士是该环境中最大的专业群体，但康复护理专业却未得到充分认可。本文报告了一项分四个阶段进行的研究中的首个阶段，该研究旨在阐明并发展护理工作对老年人住院康复的贡献。本研究的目的是确定接受住院康复的老年患者在白天和晚上的活动模式及时间利用情况。
采用行为建模的直接观察法，对新西兰一家大型三级医院专科病房中37名接受住院康复的老年人进行了便利抽样。主要观察指标是有意义活动的观察情况。使用二项逻辑回归研究相关变量之间的关联。
有意义的活动最有可能是在无辅助情况下行走，且在工作日的08:00至14:00以及16:00至21:00发生。患者在周末接受治疗的可能性更大。无论时间如何，注册护士都是最常陪伴患者的医护人员。
注册护士在支持改善康复效果方面可能存在未被充分利用的机会。需要积极优化注册护士参与康复工作的情况。
护士在康复环境中与老年人的接触可能非常多，这使他们成为康复团队的关键成员。护士基于专业知识和技能对住院康复做出了关键贡献，但这一贡献并未得到充分理解。在诸如晚上和周末等其他健康专业人员在场较少的时段，注册护士有可能更有意地使康复活动与其他护理需求重叠。
