Stroke survivor behaviors that caregivers identify as bothersome can lead to family caregiver stress, which can result in premature institutionalization of the survivor. The purpose of this study was to explore demographic and theory-based factors associated with survivor bothersome behaviors as identified by family caregivers.

A secondary analysis of a combined sample of 96 family caregivers of stroke survivors was conducted using baseline data from two existing studies. Bothersome behaviors were measured using the Revised Memory and Behavior Problems Checklist (RMBPC). Theory-based factors were measured using well-validated scales.

Male stroke survivors exhibited more bothersome behaviors (t = 3.53, p < .01). After controlling for survivor gender, 35% of the variance in bothersome behaviors was explained by caregiver depressive symptoms, task difficulty, life changes, and threat appraisal (F[5, 88] = 10.82, p < .001).

These results identify potential areas for nursing interventions designed to reduce bothersome behaviors as identified by family caregivers.

The purposes of this descriptive study were (a) to identify the relative frequencies of a priori categories of phantom limb pain (PLP) quality descriptors reported by Mid-Southerners with limb loss, (b) to analyze their descriptions for emerging categories of PLP, and (c) to identify the relative frequencies of the emerging categories.

This cross-sectional descriptive verbal survey assessed PLP descriptors. A content analyses determined relative frequencies of a priori PLP descriptors as well as emerging categories that were identified.

The most common a priori PLP quality descriptors reported by 52 amputees with PLP were intermittent, tingling/needles/numb, sharp, cramping, burning, and stabbing. The most common emerging categories reported were pain compared to illness/injury, electrical cyclical, and manipulated/positional.

The detailed descriptions of PLP provide insight into the vivid experiences of PLP.

Rehabilitation nurses can use this information with PLP assessment, patient teaching, and counseling.

The development and implementation of interprofessional (IP) clinical learning units as a method to enhance IP clinical education and improve patient care in a rehabilitation setting are described.

Using a community-based participatory research approach, academia and healthcare delivery agencies formed a partnership to create an IP clinical learning unit in a rehabilitation setting. Preimplementation data from surveys and focus group data identified areas for improvement to enhance IP understanding and collaboration. A working group developed and implemented initiatives to enhance IP practice.

Preimplementation, eight themes emerged from which the working group identified goals and implemented strategies to strengthen IP learning. Goals included Creation of an IP Learning Environment, Increased Awareness of IP Practice, Role Clarification, Enhanced IP Communication, and Reflection and Evaluation. Postimplementation data revealed six themes: Communication, Informal IP Learning, Role Awareness, Positive Learning Environment, Logistics, and Challenges.

The development of the IP clinical learning unit was successful and rewarding, but not without its challenges. Formal IP education was necessary to enhance collaborative practice, even in a multidisciplinary environment. Commitment and support from all participants, particularly managers and administrators from the healthcare agency, were critical to success.

The focus of this unit was on a stroke rehabilitation unit; however, the development and implementation principles identified may be applicable to any team-based clinical setting.

To identify the incidence of adverse events (AE) that occurred in stroke survivors during the first year following discharge from inpatient rehabilitation and to determine the type and patterns of AE.

Data were collected for 12 months on events resulting in admissions to the emergency department, hospital, long-term care facility, or death. Descriptive statistics were used to depict the patterns of AE and univariate comparisons were made of the differences between survivors who did or did not experience one or more AE.

Of the 159 participants, 50% reported a total of 163 AE. Most AE (82.2%) were unexpected and the majority occurred during the first 6 months; 12 recurrent strokes and 6 transient ischemic attacks occcurred.

Education on prevention and treatment of common AE is important prior to discharge. Anticipatory guidance may help survivors and caregivers modify their lifestyle and prevent common AE.

This theoretical article outlines the deliberate process of applying a qualitative data analysis method rooted in Friedemann's Framework of Systemic Organization through the study of a web-based education and support intervention for stroke caregiving families.

Directed by Friedemann's framework, the analytic method involved developing, refining, and using a coding rubric to explore interactive patterns between caregivers and care recipients from this 3-month feasibility study using this education and support intervention. Specifically, data were gathered from the intervention's web-based discussion component between caregivers and the nurse specialist, as well as from telephone caregiver interviews.

A theoretical framework guided the process of developing and refining this coding rubric for the purpose of organizing data; but, more importantly, guided the investigators' thought processes, allowing them to extract rich information from the data set, as well as synthesize this information to generate a broad understanding of the caring situation.

To examine accreditation from nursing homes accredited by the Commission on Accreditation of Rehabilitation Facilities (CARF) and whether this is associated with improved rehabilitation care.

Cross-sectional association of CARF accreditation and quality.

Comparison of the short-stay quality measures (influenza and pneumococcal vaccination; pain; delirium; pressures sores; five-star quality and health inspection scores) between the sample of 246 CARF-accredited homes compared with the 15,393 nursing homes in the 2010 On-Line Survey Certification of Automated Records (OSCAR).

CARF-accredited nursing homes demonstrate better quality with regard to the short-stay quality measures.

Approaches beyond traditional regulation and governmental inspections are necessary to improve the quality of care in nursing homes.

During a patient's rehabilitation stay, minimizing iatrogenic complications is paramount. Given the findings of this study, it is unfortunate that very few nursing homes are CARF accredited.

A phenomenological method was used to investigate the experience of FI. Eleven men participated in unstructured interviews. Van Manen's approach was used for data analysis.

The findings display men's experiences of living with FI through space, relationships, time and body. The essential theme generated from the analysis was “secret resignation.” Resignation of having FI was the main coping strategy of the men in this study and was reflected in the limited approaches they used to manage their symptoms. The common reason of the resignation was considering FI normal for them and a consequence of aging.

The findings provide guidance to rehabilitation nurses to first inquire about the presence of FI, education men about its etiologies, and develop plans of care that address men's main concerns.

Retrospective analysis of falls occurring during 6-month period in 2009. Age and diagnosis were used to create comparison groups between patients who fell and those who did not. T-tests were used to determine differences between the two groups in FIM scores and Morse fall scores.

Patients who had stroke as a primary diagnosis were more likely to fall than other patients. Length of stay was greater for patients who fell (p = .008). The positive predictive value of the Morse fall scale for patients who fell was 57%, suggesting that it is not a sensitive predictor of falls in rehabilitation patients. Patients who fell had significantly lower FIM expression scores (p = .02).

Following the establishment of a nationwide therapeutic riding program for America's wounded service veterans in 2007, a Certified Rehabilitation Registered Nurse from the Michael E. DeBakey Veteran Affairs Medical Center worked with an incomplete spinal cord injured veteran who participated in the Horses for Heroes program.

This program resulted in many benefits for the veteran, including an increase in balance, muscle strength, and self-esteem.

A physical, psychological, and psychosocial benefit of therapeutic horseback riding is shown to have positive results for the spinal cord injured. Therapeutic riding is an emerging field where the horse is used as a tool for physical therapy, emotional growth, and learning.

Veterans returning from the Iraq/Afghanistan war with traumatic brain injuries, blast injuries, depression, traumatic amputations, and spinal cord injuries may benefit from this nurse-assisted therapy involving the horse.

Social care providers can reduce the risk for dysfunction in low-income families of preschoolers and increase resilience by responding to needs identified by the families themselves. Quality instruments developed to identify family needs within this population are scarce. To measure the needs of families with disabled children effectively, valid and reliable instruments that are sensitive to parents’ expectations and to the constructs of nursing must be used.

Nine factors were detected in the results, Cronbach's α reliability coefficient was .95 and item–total point correlations were between .32–.81. In addition, it was found that the test–retest correlation value was .91, which was found to be statistically significant (p < .001).

This scale can be used in nursing research projects to evaluate family needs regarding the care of children with a disability.

Sarcopenia and vitamin D deficiency increase risk of disability outcomes associated with a million hip and knee replacements annually. The purpose of the present study was to identify protein and vitamin D inadequacy in arthroplasty patients, and observe the effect of supplementation on metabolic markers on protein and vitamin D status.

One hundred and eighty obese arthroplasty patients admitted for inpatient rehabilitation, positive for protein and vitamin D insufficiency, received supplemental protein and vitamin D.

Following supplementation, normalization of protein and vitamin D status was achieved. Nutrient supplementation during physical rehabilitation provided an efficient and effective means to reverse nutrient deficiency in an obese, orthopedic population.

Inpatient physical rehabilitation is an opportune environment for nurses to provide education and intervention of nutrient supplementation, which may lessen consequences of sarcopenic obesity and related frailty disorders.

The study determined the feasibility of implementing a brief, preference-based non-medication insomnia treatment for Iraq/Afghanistan war Veterans who experienced blast and/or other injuries resulting in an altered level of consciousness.

The study used a one-group pre-post design with a 3-month follow-up assessment. Forty-one veterans (two females, mean age 30.32 ± 7.73 years) with a mean insomnia duration of 3.90 years (±2.03) received treatment that included one in-person and three telephone sessions of behavioral intervention and incorporated electronic delivery components. Feasibility indicators and preliminary treatment effectiveness were assessed.

Results indicate the preference-based treatment was acceptable to veterans and feasible to implement. Treatment components delivered in-person were used more than electronic methods. Insomnia decreased from moderate severity to the sub-threshold range. Pre- to post-treatment effect sizes were large for most sleep outcomes. Sleep improvement maintained at the 3-month follow-up assessment.

Further testing of a brief insomnia treatment model is needed.

Successful insomnia treatment has the potential to maximize rehabilitation outcomes in Operations Enduring Freedom and Iraqi Freedom veterans and may provide a non-stigmatizing entry to mental health services.

To investigate the occurrence and severity of agitation in patients after severe traumatic brain injury (TBI), to identify predictors of agitation and to study interrater reliability for a translated version of the Agitated Behavior Scale (ABS).

Prospective observational study. From November 1, 2006, through October 2007, 46 consecutive patients with TBI were included in the early rehabilitation phase following neurosurgical intervention. Agitated behavior was assessed by the ABS, which was implemented in clinical practice. Logistic regression analysis identified predictors of agitated behavior and Intra Class Correlation was used to analyze reliability.

Agitated behavior occurred in 41% of patients, of whom one third exhibited severely agitated behavior. The interrater reliability between three nurses was good to excellent.

Using ABS as a tool in care of patients with agitated behavior may be effective through working as a common language.

We recommend the use of ABS as a routine assessment in early rehabilitation of patients with TBI.

In Italy, nurses can use pelvic floor muscle exercises (PFMEs) and extracorporeal magnetic innervation (ExMI) to treat urinary incontinence after radical retropubic prostatectomy (RRP). The efficacy of these treatments remains unclear.

Purpose: To compare PFMEs, ExMI, in the management of post-RRP urinary incontinence.

Methodology: This study compared PFMEs versus no treatment in reducing bladder continence difficulties, and PFMEs versus ExMI in reducing urine leakage. A total of 87 patients were treated with PFMEs, 23 with ExMI; 22 refused rehabilitation (control group).

Three months after RRP, both interventions reduced the International Prostate Symptom Score, when compared to control group. After 6 months, no significant differences between the treatments were found (p = .8346). After a complete ExMI treatment (6 weeks), 63.88% lost less than 10 grams of urine per day (32.73% in the PFMEs group, p < .0001).

PFMEs are useful up to the 3rd month after surgery; ExMI reduces leakages faster than PFMEs.