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Atuação do enfermeiro na reabilitação do paciente oncológico: revisão integrativa / The nurse\'s performance in the rehabilitation of the cancer patient: integrative reviewTeles, Priscila Alvarenga 22 March 2019 (has links)
Objetivo: avaliar as evidências disponíveis na literatura sobre a atuação do enfermeiro na reabilitação do paciente oncológico. Método: trata-se de uma revisão integrativa seguindo as seguintes etapas: identificação do problema, busca na literatura, extração de dados dos estudos primários, avaliação dos estudos primários e apresentação da revisão integrativa. A busca dos estudos primários foi realizada nas bases de dados CINAHL, LILACS e PubMed publicados no período de 30 de junho de 2008 a 30 de junho de 2018. Resultados: a amostra foi composta de 32 estudos primários, agrupados em três categorias: (1) ações interacionais (n=8); (2) ações educacionais (n=10); e (3) ações assistenciais (n=14) do enfermeiro na reabilitação oncológica. Na categoria 1, os principais temas investigados foram comunicação, apoio espiritual e psicológico. Na categoria 2, apurou-se orientações prestadas ao paciente e elaboração de estratégias de ensino. Já na categoria 3, atenção domiciliar, processo de enfermagem, procedimentos técnicos e práticas alternativas foram os principais temas abordados. Constatouse que o enfermeiro inserido na reabilitação oncológica deve utilizar do diálogo e da escuta como recursos para atingir suas ações interacionais, e que suas habilidades permitem um relacionamento paciente-enfermeiro eficaz e terapêutico, resultando em uma melhor assistência biopsicossocial e espiritual. Além disso, suas ações educacionais mostraram-se importantes ao paciente no sentido de motivá-lo a ser responsável por seu cuidado, o que o auxiliará no enfrentamento de problemas e no alcance de sua autonomia. Já suas ações assistenciais se voltaram à promoção da saúde em todos os aspectos e pautaram-se na sistematização da assistência, que lhe proporciona recursos científicos e humanos; demonstraram, ainda, a importância da inserção das práticas alternativas no cuidado do paciente oncológico. Conclusão: todas as evidências forneceram subsídios para que o enfermeiro pudesse compreender sua atuação na reabilitação oncológica. A diversidade e complexidade do seu papel neste cenário demonstra claramente que suas ações são fundamentais, pois abordam todos os comprometimentos biopsicossociais impostos ao cliente pela doença, promovendo uma assistência de enfermagem individualizada, humanizada e holística / Objective: to evaluate the available evidences in the literature about the nurse\'s performance in the rehabilitation of the cancer patient. Method: it is an integrative review following the following steps: identification of the problem, research in the literature, extraction of data from the primary studies, evaluation of the primary studies and presentation of the integrative review. The search of the primary studies was performed in the databases CINAHL, LILACS and PubMed published in the period from June 30, 2008 to June 30, 2018. Results: the sample consisted of 32 primary studies, grouped into three categories: (1) interactional actions (n = 8); (2) educational actions (n = 10); and (3) care actions (n = 14) of the nurse in cancer rehabilitation. In category 1, the main subjects investigated were communication, spiritual and psychological support. In category 2, guidelines were found and given to the patient and elaboration of teaching strategies. In category 3, home care, nursing process, technical procedures and alternative practices were the main topics addressed. It was verified that the nurse involved in cancer rehabilitation should use dialogue and listening as resources to achieve his interactional actions, and that his skills allow an effective and therapeutic patient-nurse relationship, resulting in a better biopsychosocial and spiritual care. In addition, his educational actions have been proved important to the patient in order to motivate him to be responsible for his own care, which will help him in facing problems and reaching his autonomy. His care actions turned to health promotion in all aspects and were based on the systematization of care, which provides him scientific and human resources; they also demonstrated the importance of the insertion of alternative practices in the care of the cancer patient. Conclusion: all the evidences provided support to the nurse to understand his performance in cancer rehabilitation. The diversity and complexity of his role in this context clearly demonstrates that his actions are fundamental, as they address all the biopsychosocial commitments imposed on the client by the disease, promoting an individualized, humanized and holistic nursing care
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Mobile music touch: using haptic stimulation for passive rehabilitation and learningMarkow, Tanya Thais 30 March 2012 (has links)
Hand rehabilitation after injury or illness may allow a patient to regain full or at least partial use of a limb. However, rehabilitation often requires the patient to perform multiple repetitions of motions. While absolutely essential to regaining usage, such exercises are not always mentally engaging or enjoyable for the patient. The loss or degradation of the use of the hands can cause considerable loss of independence.
In this dissertation, we present Mobile Music Touch (MMT), a wireless glove paired with a computing device, such as a laptop, smart phone, or MP3 player. The MMT system plays a song, while also "tapping" the fingers using vibration motors
to indicate the correct finger to use to play the song on a piano keyboard. Learning a new skill or activity without active focus, an idea called Passive Haptic Learning(PHL) may allow an individual to learn one skill through their sense of touch while performing another, unrelated activity. Most rehabilitation activities are active in nature, requiring the focused participation of the injured person. Passive rehabilitation is the idea that some technologies and activities may bring about beneficial changes without the active engagement of the injured person. In order to study the concepts of PHL and PHR, we propose the Mobile Music Touch (MMT) system. We show that using passive rehabilitation in conjunction with the active rehabilitation
of piano playing will bring about a greater degree of improvement in the hands than that achieved using only active rehabilitation. This dissertation research makes three unique contributions. First, we demonstrate that Passive Haptic Learning (PHL) using just the sense of touch is feasible and provides a form of learning and reinforcement of learned skills and tasks. Second, we identify the attributes and design features of a glove suited for long term wear
by persons who use a manual wheelchair for mobility. Third, we show that Passive Haptic Rehabilitation (PHR) is possible using vibrotactile stimulation of the hands in persons classified as tetraplegic due to incomplete spinal cord injury.
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The effect of a behavioral medicine intervention on coronary risk factors in patients following a coronary artery bypass graft procedureVenter, Albertus Johannes Etienne 11 February 2014 (has links)
D.Litt. et Phil. (Psychology) / It is an accepted fact that the incidence of coronary heart disease has reached endemic proportions in South Africa. One of the fastest growing clinical populations in this domain is that of the coronary artery bypass patient. As a result the facilities catering to the biomedical needs of this population are amongst the most sophisticated in the world. However, facilities for the effective psychosocial rehabilitation of these patients are relatively scarce. When they are addressed they tend to focus essentially on secondary emotional factors impeding reintegration back into society. A sadly neglected psychosocial factor and independent risk factor is that of the Type A behaviour pattern. Extensive research in this area has not only found this behaviour pattern to be detrimental to effective rehabilitation but has also found it to be instrumental in the reocclusion of grafted blood vessels resulting in an elevated re-operation rate as well as putting these patients at risk for a potentially fatal coronary event. In an attempt to address this problem a rehabilitation group intervention program adapted for South African conditions was launched. This program was based on the Recurrent Coronary Prone Prevention Project intended for the treatment of post-myocardial infarct patients in San Francisco. Essentially the aim of the project was to ascertain whether this intervention could be applied effectively to the coronary artery bypass population and whether its duration could significantly shortened so as to be more economically viable given the limited economic resources characteristic of the health care services in this country. The modified programme was administered to a group of 13 post-coronary artery bypass graft patients at two local cardiac rehabilitation centres. A second group of 10 patients at these same centres served as a no-treatment waiting list control group, while simultaneously undergoing an aerobic exercise and cardiovascular counselling programme. Results of the study indicate the modified programme to be highly successful in modifying Type A behaviour and its components within the South African context in the post coronary artery bypass patient samples exposed to it. Comparisons of the experimental and control groups after the intervention showed statistically significant differences on the majority of measures. Thus it was- concluded that the modified programme has the potential to be an invaluable aid in the treatment of .this population in South Africa. Presently, however, this sample is being monitored longitudinally in order to ensure that the treatment benefits remain.
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Patient's perceptions of inpatient group psychotherapyStandish, Kevin Francis 17 February 2014 (has links)
M.A. (Clinical Psychology) / The context of psychotherapy groups determine which factors are experienced as therapeutic. The nature of inpatient setting, the brief duration of the groups. and the concurrent nature of therapy were hypothesised as having a possible effect on which factors are perceived as therapeutic. For this particular study the added effect of substance dependency was taken into account. Each of these factors were discussed in a detailed review of the literature. The model of research used in the study was the attitudinal survey with the means of a questionnaire. The patients rank-ordered the relative importance of the various treatment experiences offered by Phoenix House. The primary research data was obtained by means of Yalom's (1985) therapeutic statement questionnaire. well validated in terms of reliability and validity. The statements have previously been used in a forced Q-sort method. In this study it was decided to leave it open as more factors may be rated as therapeutic than those achieved in a Q-sort. Time and expediency were also factors taken into account in using the questionnaire rating in an unforced manner. Open ended questions were used to obtain descriptive data regarding the helpfulness of group psychotherapy and their perceptions of concurrent therapy. A nonprobability sampling procedure was used. The present study addressed the following questions: 1. How do inpatients dependent upon substances perceive. in relation to other treatment methods, their group psychotherapy experiences? 2. Which aspects of the inpatient group psychotherapy experiences. as reflected in the therapeutic factors. seemto be perceived as most and least useful to people dependent upon substances? 3. How do the inpatients perceive their concurrent individual and group psychotherapy? 4. Do high and low valuers of inpatient group psychotherapy value different therapeutic factors?
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Terapeutiese sisteme binne 'n dwelmkonteksCoetzee, Beatrix Jacqueline 27 March 2014 (has links)
M.A. (Psychology) / It is generally accepted that the management and treatment of individuals addicted to chemical substances or drugs entail challenges for the professions involved in drug contexts. In this dissertation a number of therapeutic systems in drug contexts are explored in aim of the treatment of people with drug addiction. In the literature survey it is indicated that the manner in which therapeutic intervensions are operationalized in drug treatment practices, are influenced by the organization's theoretical-philosophical orientation with regard to therapeutic treatment modes. This aspect is examined in the study on the basis of a critical discussion of the perspectives of the medical model and an alternative model, namely the adaptive model, concerning the therapeutic management of people addicted to drugs. It is further established from the literature that people with drug addiction problems are often treated within the boundaries of a therapeutic community and that various therapeutic interventions, namely individual psychotherapy, family therapy and group therapy, are also implemented in this therapeutic context. The present study specifically concentrates on an alternative approach concerning the therapeutic modes of treatment for individuals with drug addiction. One such an approach, as discussed in this study, entails that therapeutic approaches regarding people addicted to drugs, progress from a causal-theoretical manner of defining these people (for instance the view that individuals addicted to drugs have a progressive disease and that they are unable to take responsibility for their behaviour) to an approach based on the principles of interactional therapy and motivational milieu therapy {for instance the idea that such individuals have the ability to conduct their interpersonal relationships
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The effect of a coronary-prone lifestyle change programme on cardiac risk factors in post-myocardial infarction patientsViljoen, Hendre 11 February 2014 (has links)
D.Litt. et Phil. (Psychology) / It has long been known that South Africans are a high risk population for the development of coronary heart disease. Cardiovascular diseases accounted for 8,7% of all deaths in this country in 1988. Despite this distressing situation, rehabilitation facilities for people who have suffered a myocardial infarction or heart attack are relatively scarce. The facilities that exist tend to focus on the biomedical aspects of cardiac rehabilitation such as exercise and diet, and tend to neglect the psychosocial factors. A review of the literature shows, however, that psychosocial factors, and in particular the Type A coronary-prone behaviour pattern are significantly related not only to the development of coronary heart disease, but also to the probability of sUffering and surviving a heart attack. In addition, Type A.behaviour has been shown to be predictive of the risk of a second infarction after an initial attack. For this reason, the proven technology of a treatment programme developed under the auspices of the Recurrent Coronary Prevention Project (Powell & Thoresen, 1986) was applied in an attempt to adapt the programme for the" South African context. The study was aimed at establishing whether the RCPP programme could successfully be employed in this country, and whether the duration could be shortened so as to be more economically viable given the limited economic resources that characterise health care in South Africa. The modified programme was administered to a group of 13 post-myocardial patients at a local cardiac rehabilitation centre. A second group of 11 patients at the same centre served as a no-treatment waiting list control group, but simultaneously underwent an aerobic exercise and cardiovascular counselling programme. Results of the study indicate that 'the modified programme is highly successful in modifying Type A behaviour and its components in South African sUbjects. Comparisons of the experimental and control groups after the intervention showed statistically significant differences on the majority of measures. It was therefore concluded that the modified programme can be used fruitfully in the local context, but it was cautioned that the present sample needs to be followed up over time to ensure that the treatment gains are maintained.
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Successful outcomes of adult ex-offenders: "Catalyst to Change"Crowley-Ames, Coleen, McNeal, Phyllis Paulette 01 January 2003 (has links)
This descriptive, statistical survey research design sought to identify factors that motivate individuals to stay crime free after serving time in prison. The purpose of this research study was to examine the factors that played a significant role in recidivism.
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Cognitive Rehab Solutions: A computer-assisted cognitive training programPatel, Avani Rajnikant 01 January 2002 (has links)
The purpose of this project is to offer a functionally comprehensive application, Cognitive Rehab Solutions (CRS), that is designed for neuropsychologists to deliver restorative cognitive training in areas of attention and memory of persons with brain impairment.
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Therapeutic-yoga after stroke : effect on walking recoveryMiller, Kristine Kay 16 December 2013 (has links)
Indiana University-Purdue University Indianapolis (IUPUI) / Stroke is a sudden and devastating medical condition. People who experience a stroke tend to have long-term physical limitations including impaired walking as part of the ongoing consequences of stroke. While a variety of rehabilitation interventions have demonstrated efficacy for improving walking after stroke, none of the interventions have emerged as superior, and prior to this study, therapeutic-yoga had not been tested as an intervention to improve walking recovery after stroke. METHODS: This study was a secondary data analysis of group therapeutic-yoga on walking recovery measures including walking speed, walking distance, and spatiotemporal step parameter symmetry. The walking recovery measures were collected as secondary outcomes in a sub-sample (n=12) in a pilot randomized controlled study (n=47) designed to test the efficacy of 8-weeks of group therapeutic-yoga on balance and fear of falling. Participants in the current study completed 12-weeks of group therapeutic yoga with outcome assessments at baseline, 8-weeks, and 12-weeks. The main analysis was repeated measures ANOVA to assess the main effect of time with additional analyses including effect sizes, percent of participants achieving change greater than or equal to minimal detectable change (MDC), and mean change score comparisons between baseline and 8-weeks, 8-weeks and 12-weeks, and baseline and 12-weeks. RESULTS: Twelve people with chronic stroke enrolled in the study with 9 completing the intervention and all 3 assessments. No significant main effect of time was found on any of the variables of interest. Walking distance demonstrated a trend toward significant change (p=0.064) and step length symmetry demonstrated significant change (p=0.05) between baseline and 12-weeks. Several spatiotemporal step parameter symmetry ratios demonstrated small to medium effect sizes with the majority (91%) being a negative effect. CONCLUSION: Twelve weeks of group therapeutic-yoga appears to be feasible in a population of people with chronic stroke. Walking distance and step parameter symmetry should be tested in a larger sample. An improved understanding of the impact, progression, and remediation of walking asymmetry is needed.
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Expanding the role of functional mri in rehabilitation researchGlielmi, Christopher B. 06 April 2009 (has links)
Functional magnetic resonance imaging (fMRI) based on blood oxygenation level dependent (BOLD) contrast has become a universal methodology in functional neuroimaging. However, the BOLD signal consists of a mix of physiological parameters and has relatively poor reproducibility. As fMRI becomes a prominent research tool for rehabilitation studies involving repeated measures of the human brain, more quantitative and stable fMRI contrasts are needed. This dissertation enhances quantitative measures to complement BOLD fMRI. These additional markers, cerebral blood flow (CBF) and cerebral blood volume (CBV) (and hence cerebral metabolic rate of oxygen (CMRO₂) modeling) are more specific imaging markers of neuronal activity than BOLD. The first aim of this dissertation assesses feasibility of complementing BOLD with quantitative fMRI measures in subjects with central visual impairment. Second, image acquisition and analysis are developed to enhance quantitative fMRI by quantifying CBV while simultaneously acquiring CBF and BOLD images. This aim seeks to relax assumptions related to existing methods that are not suitable for patient populations. Finally, CBF acquisition using a low-cost local labeling coil, which improves image quality, is combined with simultaneous acquisition of two types of traditional BOLD contrast. The demonstrated enhancement of CBF, CBV and CMRO₂measures can lead to better characterization of pathophysiology and treatment effects.
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