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Ekolojik, Ekonomik ve Sosyal Sürdürülebilirlik İçin
Department of Nursing (ENG)
Name of Course: REHABILITATION NURSING
Name of Lecturer: Assist. Prof. Dr. Hasan Büyükdoğan
e-mail: buyukdogan@gelisim.edu.tr
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3 Credit/ 6 ECTS
https://gbs.gelisim.edu.tr/ders-detay-5-160-11147-1
Ders Günü veSaati
Course credit
GBS Linki
Course Information
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Week Week 2
What will we learn in this week?
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qWhat is the Rehabilitation?qWhat are the Concepts of Rehabilitation?
The Definition and Concepts of Rehabilitation
*Rehabilitation is an essential component of universal health along with promotion, prevention, treatment and palliation.
* Health Care Services Types???
* Please remember?
* Health Care Services Types* 1- PROTECTIVE HEALTH SERVICES* 2- TREATMENT HEALTH SERVICES* 3- REHABILITATIVE HEALTH SERVICES
Rehabilitative Health Services (Tertiary Care)
These services are organized in 2 types;1- Medical rehabilitation2- Social rehabilitation
* Medical Rehabilitation: It deals with the rehabilitation of physical injuries.
* Social rehabilitation: a set of activities aimed at rehabilitation and improving the functional capability of people and their inclusion in the society.
* to give the individual a new job and profession
* Do you thinkJ what is rehabilitation???
*Rehabilitation is a set of interventions needed when a person is experiencing limitations in everyday functioning due to ageing or a health condition, including chronic diseases or disorders, injuries or traumas.
*Examples of limitations in functioning are difficulties in thinking, seeing, hearing, communicating, moving around, having relationships or keeping a job etc.
*Rehabilitation enables individuals of all ages to maintain or return to their daily life activities, fulfil meaningful life roles and maximize their well-being.
Rehabilitation
“A set of measures that assist individuals who experience, or are likely to experience, disability to achieve and maintain optimal functioning in interaction with their environment”(WHO)
REHABILITATION
Rehabilitation is the process of helping a person to reach thefullest physical, psychological,
social, vocational, andeducational potential consistent
with his or her physiologic oranatomical impairment,
environmental limitations, anddesires and life plans.
*There is an increasing need for rehabilitation worldwide associated with changing health and demographic trends of increasing prevalence of noncommunicable diseases and population ageing.
*The proportion of individuals aged over 60 is predicted to double by 2050 and there has been an 18% increase in the prevalence of noncommunicable diseases in the last 10 years.
*15% of all years lived with disability are caused by health conditions associated with severe levels of disability. *Rehabilitation is a fundamental health
intervention for people living with these conditions.
REHABILITATION
*Diagnosis is not mandatory*Concerned with functional
problems
* Exercises to regain the ability to swallow or upper-limb retraining to regain coordination, skill and movement of an affected limb following a stroke.
Some examples of rehabilitation include:
* Interventions that improve safety and independence at home and reduce the risk of falls for an older person, such as balance training or modifying their home environment.
Some examples of rehabilitation include:
* Early interventions to address developmental outcomes of a child with cerebral palsy, such as fitting an orthosis, or providing training in sensory integration and self-care, which in turn can improve participation in education, play, and family and community activities.
Some examples of rehabilitation include:
*Interventions that optimize surgical outcomes after a hip fracture, including exercise prescription, provision of a walking aid and education about hip movements to avoid during the recovery process.
Some examples of rehabilitation include:
*Cognitive behavioural therapy and interventions aiming to increase exercise for an individual with depression.
Some examples of rehabilitation include:
* Interventions that support daily activities and community access for individuals with vision loss, such as providing strategies to complete personal care tasks and training in the use of a white cane.
Some examples of rehabilitation include:
COMMON GOALS OF REHABILITATION
Principles of rehabilitation:
* 1. The prevention, diagnosis and treatment of concomitant medical problems (co-morbid illnesses, complications)
* 2. Training for maximum functional independence, * 3. To support psychosocial coping and assist in the adaptation
of patients and families,* 4. To support the return to community life * 5. To improve the quality of life of patient and family members
who provide care
1. Rehabilitation can reduce the impact of a broad range of health conditions, including diseases (acute or chronic), disorders, injuries or trauma.
For example, rehabilitation can help to prevent complications associated with many health conditions, such as spinal cord injury, stroke, or a fracture.
The benefits of rehabilitation
2. Rehabilitation can also help to minimize or slow down the disabling effects of chronic health conditions, such as cardiovascular disease, cancer and diabetes by equipping people with self-management strategies and the assistive products they require, or by addressing pain or other complications.
3. Rehabilitation is an investment, with cost benefits for both the individuals and society. It can help to avoid costly hospitalization, reduce hospital length of stay, and prevent re-admissions.
4. Rehabilitation also enables individuals to participate in education and gainful employment, remain independent at home, and minimize the need for financial or caregiver support.
5. Rehabilitation programs are carried out with services such as education, counseling, care and treatment applications.
6. Rehabilitation enables the individual to reintegrate into his / her family and society and maintain his / her functions at an optimal level
*Rehabilitation is a process of adaptation or recoverythrough which an individual suffering from a disablingor functionally limiting condition, whether temporaryor reversible, participates to regain maximal function, independence, and restoration.
Rehabilitation is a process!!!
*The rehabilitation process can be short-term or lifelong time.
Rehabilitation involves identification of a person’s problems and needs, relating the problems to relevant factors of the person and the environment, defining rehabilitation goals, planning and implementing the measures, and assessing the effects
Rehabilitation• Problem solving process
Assessment
Identify needs/modifiable factors
Goal setting
Measurement, planning & implementation of interventions
Evaluation of change & effectiveness
* Educating people with disabilities is essential for developing knowledge and skills for self-help, care, management and decision-making.
* People with disabilities and their families experience better health and functioning when they are partners in rehabilitation.
*In rehabilitation, each individual is viewedas a unique, comprehensible, holistic being.
* The philosopy of Rehabilitation is distinctly differentfrom acute care.
WHYYYY????
*In acute care thepatient’s survival is a primary focus.* Nurses provide
care provisionthat involvesperformingactivities of Daily living for persons.
* Rehabilitation focuses on educatingpersons to be able toperform activities of dailiy living forthemselves.
* Promoting self care is key to rehabilitation.
*The first applications about rehabilitation started with Hippocrates.*Hippocrates treated atrophies due to non-
use of organs, identified implant devices.
History of Rehabilitation
* to treat shoulder dislocation with a device by Hippocrates
*Several nurses also played an important role in increasing the value of rehabilitation
*Florence Nigtingale was able to drastically reduce mortality by using rehabilitation principles during the Crimean war..
*The idea of rehabilitation was developed in a dormitory opened by Vincent de Pauld. After World War II, the need for rehabilitation became widespread due to the rapid increase of wounded and disabled soldiers.
Nightingale «Saved more lives in the entire British medical department by applying the hygiene and rehabilitation principles of the ancient
Romans in the Crimean War».Christine Mumma
*After World War I, the patient had a life expectancy of less than one year with spinal cord injury.
*In such cases, mortality was high and rehabilitation was generally reduced.
*After World War II, the need for rehabilitation became widespread due to the rapid increase of wounded and disabled soldiers.
* HOWARD RUSK, is generally recognized as the “father of comprehensive rehabilitation.
* In comprehensive rehabilitation, those suffering disabilities that result from illness, injury, or congenital defect are given therapy and training designed to help them to live and work in the community to the best of their abilities.
* Rusk initially developed this field as a contribution to military medicine during World War II and later broadened it in application to the civilian population.
* Howard Rusk, a pioneer in rehabilitation medicine, emphasized that the care of those with spinal cord injury was poor.
* The first rehabilitation center in the United States was founded by Dr. Rusk.
* Rusk focused more on physical medical rehabilitation
* Rusk was a great supporter of the disabled and argued passionately for the rights of the disabled to contribute to society.
* He campaigned for medical rehabilitation as a public health issue and argued that the control of many infectious diseases, the consequent lengthening of the lifespan, the aging of the population, and the shift in emphasis from infectious to chronic diseases meant that chronic physical and mental disabilities would continue to increase.
* He believed that rehabilitation for all those with disabilities was essential to the health and happiness of the population.
* Rusk’s ideas and new ways of thinking transformed the response to disability in the fields of public health and made it possible to rehabilitate millions of people with disabilities and help them to achieve healthier lives.
*Consepts provide a way of categorizing orconsidering some major factors that mayinfluence rehabilitation.
CONCEPTS AND PRINCIPLES
* «I think nurses should encourage all clients and patients to practice self-care. Orem’s Self-Care Deficit Nursing Theory is an excellent theoretical model for rehabilitation nurses. As one progresses from a state of dependence to independence, self-care bocomes a major attribute of independence»
(Paul Nathenson, ARN Leader)
PROMOTE ADAPTATION, NOT JUST RECOVERY* Adaptation is important in the rehabilitation process.* The physical and emotional challenges that come with a disabling
condition make a patient’s experience intensely personal. * The process of rehabilitation helps individuals adjust or adapt to life-
altering situations without giving false hope of total recovery.
CONCEPTS AND PRINCIPLES
* Many persons living with functional deficits do not consider thethemselves disabled.
* There are things they can not do, but other things they can do.* Rehabilitation assists these persons in making the most abilites and
strengths that remain and working with what they have.
* The process of adaptation and recovery engage in by those with physicallimitation must be optimistic in nature and center on developing andmaximizing the functions that remain.
* EMPHASIZE ABILITIES* People who have experienced a major health crisis have reason enough
to think negatively. * If rehabilitation focused on what patients had lost, then there would be
cause for despair.
* For example, an amputated limb may not be restored, but an artifical onecan return the function of ambulation.
* A hemiplegic arm may no longer be able to write, but it can help providebalance and stability.
* A traumatic brain injury may have hold a person of speech, but withspeech therapy, effective communication may be restored.
* Realistic and achievable goals ensure that individuals participate in the rehabilitation process both in the short term and in the long term.
* Clients feels a sense of accomplishment when they overcome obstaclesto meet their objectives.
* For some patients, being able to walk or talk again is a major step towardregaining independence.
CARE AND TREATMENT WITH HOLISTIC APPROACH
* Every person is a unique individiual, worthy of same respect andconsideration as any other, regardless of age, race, gender, creed, orfunctional capacity.
* When a life-changing event occurs, it is essential for healthcareprofessionals to remember that the person being treated brings withthem all past experiences, problems, values and beliefs.
* A disability affects not only the individual’s health, but everything abouthis/her body, relationships, environment and community.
* Therefore, a patient’s preferences, culture, religious beliefs, values, developmental stage, social support, cognitive and physical abilities andstress and coping patterns are all assessed by the interdisciplinary teamwhen formulating a plan of care.
* DISABILITY AFFECTS THE ENTIRE FAMILY
* Grieving is a normal part of the rehabilitation process for those who havesuffered loss. This includes both the patient and those close to him orher.
* Coping with a chronic health problem requires many changes to thepatient’s entire support system.
* Thus, a long-term ilness or disability affects the entire familiy.
* The interdisiplinary team assists the patient and familiy to attain a qualityof life that is acceptable to them.
* The grieving process may take time and continue long after the patienthas been discharged.
* Follow-up programs can also have a positive impact on long-term copingskills.
* REHABILITATION BEGINS «FIRST DAY» WITH TO PREVENT COMPLICATIONS
* Today’s healthcare Professionals are more aware of the need forpreventive care.
VERY IMPORTANT
* For example; for example in the knee amputation, if rehabilitation does not start after the acute period, contracture can be development.
* In acute care, the nurse may interfere with the development of contracture by training the patient, placing a pillow under the knee joint and performing ROM exercises, and then the patient can walk more comfortably.
* Another example; The preservation of the skin integrity of a person with paraplegia with complete spinal cord injury is very important in terms of the occurrence of complications.
* What should the nurse do?* Why is important?????
If a sacral pressure ulcer forms, that client would be unable to developneeded wheelchair skills and perhaps be confined to a prone position untilthe wound heals.
* If proper range of motion (ROM) exercises don't be given in stroke patients who have been in acute care even one week or less, patient may permanently have a contracted hemiplegic arm and hand.
* All this conditions are likely preventable when thehealthcare professional applies the concepts andprinciples of rehabilitation.
qWhat is the Rehabilitation?qWhat are the goals of rehabilitation?qWhat are the principles of rehabilitation?qWhat are the benefits of rehabilitation?qWho are the important persons in the history of rehabilitation?qWhat is rehabilitation process?qWhat are the Concepts of Rehabilitation?qWhat is the difference between acute care and chronic care?
Next LessonI will ask!!!!
Ekolojik, Ekonomik ve Sosyal Sürdürülebilirlik İçin
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