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Rehabilitation Wards (rehabilitation + ward)
Selected AbstractsMini Nutritional Assessment in geriatric rehabilitation: Inter-rater reliability and relationship to body composition and nutritional biochemistryNUTRITION & DIETETICS, Issue 3 2007Sonja A. NEUMANN Abstract Aim:, To determine the inter-rater reliability of the Mini Nutritional Assessment (MNA) and relationship with body composition and nutritional biochemistry among older Australians undergoing rehabilitation. Methods:, Thirty-eight adults aged ,65 years were prospectively and consecutively recruited from an Australian rehabilitation ward. Two dietitians independently administered the 18-item MNA to determine inter-rater reliability. MNA classifications (well nourished, at risk of malnutrition, malnourished) were compared with body composition (using dual-energy X-ray absorptiometry) and serum albumin. These analyses were also performed for the short-form version of the MNA (six items). Results:, In this cross-sectional study, inter-rater reliability of the 18-item MNA score, estimated by the intraclass correlation coefficient, was 0.833, while inter-rater reliability estimated by the weighted kappa index was 0.53. The two raters reached agreement on MNA classification for 26 of 38 cases (68%). Women classified as malnourished/at risk of malnutrition using the 18-item MNA had lower total body fat (11 kg vs 29 kg, P < 0.01) and per cent body fat (25% vs 40%, P < 0.01), compared with women classified as well nourished. Similar findings were not apparent for men, although men classified as malnourished/at risk of malnutrition had lower serum albumin (32 g/L vs 36 g/L, P = 0.04) compared with men classified as well nourished. Similar findings were evident for the short-form version of the MNA. Conclusion:, The MNA was found to be useful for identifying older women with lower body fat in the Australian rehabilitation setting. The 18-item MNA score has substantial inter-rater reliability, and fair inter-rater reliability when used according to the classifications. Inclusion of subjective and self-reported items in surveys can be problematic for optimal reliability as can the use of such items in a subject population that is experiencing rapid progress in recovery. [source] An exploration of mental health nursing students' experiences and attitudes towards using cigarettes to change client's behaviourJOURNAL OF PSYCHIATRIC & MENTAL HEALTH NURSING, Issue 8 2010M. J. NASH msc pclt bsc (hons) rnt rmn fhea Accessible summary ,,This study explores the experiences of mental health nursing students in using cigarettes as a means of token economy. ,,The majority of the sample experienced the use of this particular intervention in various settings but also reported that other items apart from cigarettes were also used as part of a reward system. ,,Respondents generally did not like this practice, feeling that it did not work well, led to client staff conflict, was implemented in an ad hoc way and rarely recorded in a care plan. ,,An open debate on tobacco control and the use of cigarettes in behavioural change programmes is urgently required. Abstract Using cigarettes to change client behaviour is a common, yet little studied, practice in mental health care. A questionnaire survey was used to explore mental health nursing student's experiences and attitudes to this practice. The sample was four cohorts of mental health nursing students (n= 151). Of them, 84% had experienced the practice of using cigarettes to change client behaviour in acute wards (73%), rehabilitation wards (28%) and elderly care (14%). Cigarettes were used to change client behaviour in areas such as attending to personal hygiene (57%) or engaging in the ward routine (39%). However, items such as leave (60%) or drinks (tea and coffee) (38%) were also reportedly used. Of the respondents, 54% inferred that the practice did not work well with 46% stating it was not written up in care plans; 52% felt it was an ad hoc practice, 60% inferred that at times it was used as a punishment while 55% intimated that they felt bad withholding cigarettes. There are ethical and moral dilemmas around using lifestyle risk factors as rewards or using client's nicotine addiction as a means of controlling behaviour. The question of whether this intervention should ever be used, given its associated health risk, requires more critical debate in clinical practice. [source] Prospective study of fall risk assessment among institutionalized elderly in JapanNURSING & HEALTH SCIENCES, Issue 4 2002Kiyoko Izumi RN Abstract The purpose of the present study was to identify risk factors for falls among institutionalized elderly, using the standardized risk assessment tool developed by Izumi. We examined 746 patients from three types of facilities: rehabilitation wards in four general hospitals, three long-term care facilities, and three nursing homes, for up to three months. The incidence of falls within all facilities was 12.5%. Patterns of relative risks of falling differed among types of facilities. The highest relative risk of fall in long-term care facilities and nursing homes was nurses' prediction, followed by history of fall and altered mentation. In contrast, that in general hospitals was mobility. In long-term care facilities, history of falls (odds 3.68, 95CI: 1.47,9.23) and interaction (history of falls and assistance with toileting) (odds 3.13, 95CI: 1.48,6.64) showed significance on adjusted-odds ratios for fall. History of falls, altered mentation, and assistance with toileting may be used to screen patients at a high risk for fall at admission. [source] Mobility on discharge from an aged care unitPHYSIOTHERAPY RESEARCH INTERNATIONAL, Issue 2 2007Edward Gorgon Abstract Background and Purpose.,Independent mobility is a crucial element of independent living and quality of life. However, little is known about the mobility of older people around the time of discharge from inpatient rehabilitation. The present study aimed to describe mobility on discharge from an aged care rehabilitation unit. Method.,The study utilized a descriptive, cross-sectional design. Ninety-five patients (mean age 81 (±8) years; 60% female) with diverse chronic conditions (median 5) who were able to walk at least 10,m without weight-bearing restrictions were recruited from the aged care rehabilitation wards. Scores on the Barthel Index were obtained on admission and discharge to provide information about their overall level of function. Within the last week of rehabilitation stay, scores on the mobility and locomotion subsections of the Functional Independence Measure, gait velocity, and time and distance parameters of gait were obtained. Gait variables were measured by use of the GAITRiteTM, an instrumented walkway. Medians and interquartile ranges (IQR) were reported for mobility variables. Results.,Following inpatient rehabilitation, many patients achieved independence in bed or chair transfers (83%), toilet transfers (81%), shower transfers (60%) and level-surface walking (74%). Only 31% achieved independence in stair climbing. Patients walked slowly at a median (IQR) gait velocity of 45.96 (31.51) cm/s and with markedly diminished cadence and step length. Subjects with a low number of chronic conditions generally performed better on mobility measures than those with a high number of chronic conditions. Conclusions.,Although many older people are able to transfer and walk independently around the time of discharge from inpatient rehabilitation their mobility is still often impaired. For example, only 9.5% achieved a walking velocity considered to be adequate for street crossing and few demonstrated the ability to negotiate stairs. This highlights the need for ongoing rehabilitation for many of these older people. The possible cumulative effects of chronic conditions on mobility require further investigation. Copyright © 2006 John Wiley & Sons, Ltd. [source] | ||||||||||