Studying the Quality of Life and Life Satisfaction among Persons with Spinal Cord Injury Undergoing Urinary Management

The purpose of this survey was to investigate quality of life and life satisfaction among persons with spinal cord injury (SCI) who require various types of urinary management. A sample of 230 persons with SCI completed the Quality of Life Index (QLI), the Satisfaction With Life Scale (SWLS), and a demographic data form. Findings of this study indicated that there was no significant difference in QLI and SWLS with regard to the type of urinary management used (reflex voiding, indwelling catheter, suprapubic catheter, intermittent catheterization, external catheter or a combination of intermittent catheterization and external catheter). There also was no significant difference in QLI and SWLS with regard to the level of SCI or the incidence of hospitalizations for urinary infections. There were significantly higher QLI and SWLS scores for those with greater abilities to work, attend school, and participate in activities. There also was a significantly higher QLI for those without skin problems associated with urinary dysfunction.

Internet education for spinal cord injury patients: focus on urinary management

The goal of this project was to develop a Web site with articles that focus on urinary self-care management for those with spinal cord injuries. The investigator wrote 18 articles on topics that were selected by two review panels--one whose members have long-term spinal cord injuries and another consisting of rehabilitation nurses. The panel members critically reviewed the articles for content and topic. After revisions, nine of the 18 articles were translated from English into Spanish and then translated back into English to ensure accuracy. Consumers were asked to rate their satisfaction with the articles on a scale of 1-10, with 10 being the highest. There were a total of 1,162 hits on the Web site during a period of 13 months; 811 were for the Spanish articles, and 351 were for the English articles. The mean rating score for the articles was 8.02, with a standard deviation of 1.38. These findings are consistent with reports that the Internet can provide both user-friendly education for those living with disabilities and culturally sensitive health information for those who have limited access to other sources of information.

Research insights. Part III

This section of Research Insights focused on the Methods section of quasiexperimental or experimental studies. This section described the design, subjects, setting, instruments, procedures, and statistical analysis of the data. The researcher considers this section of the study carefully to ensure the internal integrity of the study, thus permitting generalization of study results for professional nursing practice.

Research insights

In any research study, the literature review and the theoretical or conceptual framework guide the development of the subsequent research questions and hypotheses. Both professional nurses and researchers evaluate the research article and its applicability to practice. This article presented the purpose of the theoretical framework or conceptual framework in a study, plus the purpose for the review of the literature.

Pressure Sore and Skin Tear Prevention and Treatment During a 10-Month Program

This article reports the results of a 10-month skin care program for 30 clients on a residential Alzheimer's disease unit. The majority (n = 26) of the clients were free of pressure sores and skin tears through preventive care during this study. Four clients with Stage I pressure sores and/or skin tears were successfully identified by consistent assessment and healed quickly due to rapidly initiated treatments. This skin care program's success was attributed to consistent education, preventive care, assessment, documentation, and treatment executed by the entire care team under the leadership of nurse practitioners, one of whom was certified as a rehabilitation nurse.

A Study of Spirituality and Life Satisfaction Among Persons with Spinal Cord Injury

The purpose of this study was to investigate the relationship of spirituality and life satisfaction among persons with spinal cord injury. A nationwide sample of 230 persons with long-term spinal cord injury completed the Satisfaction With Life Scale (SWLS), the Quality of Life Index (QLI), and a demographic data form. Data analysis also indicated that there was a significant positive correlation between life satisfaction and psychological/spiritual factors of the QLI instrument. Nurses are mandated by the International Council of Nurses, the Joint Commission on Accreditation of Healthcare Organizations, and the Patient's Bill of Rights (Maddox, 2001) to provide spiritual care for clients. Rehabilitation nurses have the opportunity to support spirituality and life satisfaction as we assist our clients with disabilities to redefine their lives and explore new life opportunities.

Safety concerns for rehabilitation nurses in home care

As the number of acute inpatient days decreases, more nurses are entering the home healthcare field, including those in the rehabilitation field. A major concern shared by many nurses is personal safety as they conduct home visits. A survey of 83 nurses in the home health field found that these individuals had community-safety concerns, such as poor communication systems, and safety concerns in clients' homes, such as lack of sanitation and uncontrolled pets, and lifestyles that included violence and substance abuse. Many participants said being the only healthcare provider in an isolated situation was a safety concern. Guidelines to help these workers ensure their own safety in home healthcare situations were developed to address the concerns expressed in the survey.

Rehabilitation nursing in home care

A randomized sample of 83 members of the Association of Rehabilitation Nurses' (ARN's) Home Health Special Interest Group (SIG) responded to a survey in 1998 and 1999 to determine the role intensity of rehabilitation nurses in home care. An instrument was developed that was based on role descriptions formulated by ARN. Significant differences in the roles were reported for caregiver, case manager, counselor, family-client educator, advocate, administrator, student/staff educator, and researcher. Rewards of home nursing included one-to-one interaction with clients, teaching opportunities, promotion of function, nurse autonomy, and seeing rehabilitation results. Difficulties included poor interdisciplinary coordination, budget restrictions, lack of understanding of rehabilitation nursing, and inadequate home aides. Differences between inpatient and home rehabilitation nursing included less equipment and resources and increased levels of responsibility in the home. Barriers for the transition to home rehabilitation nursing included interdisciplinary team communication, reimbursement standards and documentation, time management, autonomous nursing roles, and separation from help or emergency services.

Motivation and the coping process of adults with disabilities: a qualitative study

Adults with disabilities who have completed rehabilitation programs and have returned to active lifestyles are experts on the importance of motivation after an injury or an illness. This qualitative descriptive study was conducted with 9 men and 3 women who had completed a spinal cord injury rehabilitation program at a rehabilitation hospital. The subjects were asked two questions: What helped motivate you during rehabilitation to return to an active, productive life? and How did rehabilitation nurses and staff assist you with that process? An analysis of the interviews revealed five motivational categories--independence, education, socialization, self-esteem, and realization--within the specific themes of nursing and healthcare interventions. Gaining insight into the motivation of adults who have coped with disabilities effectively can help rehabilitation nurses determine how they can promote the motivation that clients need to achieve a quality lifestyle.

Body image in preoperative and postoperative lumbar laminectomy patients

Many patients each year undergo a lumbar laminectomy for removal of a herniated disc. This study was conducted to determine if the patient had a change in body image from the preoperative to postoperative period. Body image was measured using the Body-Cathexis Scale. Twenty-four (24) patients were included in the study. Results indicated that there was a significantly higher difference in the total Body-Cathexis score postoperatively as compared to preoperatively. In addition, there was a significantly higher difference in the patients' ratings of back, knee, posture, energy level and sexual activity in the postoperative period. Further research is needed with a larger sample and over time to see whether these effects hold true.

Analysis of the roles and responsibilities of rehabilitation nursing staff

This article describes a study whose purpose was to identify the roles and the responsibilities of rehabilitation nursing staff members, specifically the registered nurses and the nurse extenders, or rehabilitation technicians. The members of the nursing staff kept work diaries, listing each work activity and the time spent on that activity. Results of the study indicated that the majority of the registered nurses' time was focused on either direct or indirect patient care. The majority of the rehabilitation technicians' time was focused on direct patient care; however, rehabilitation technicians on the evening shifts spent significantly more time in indirect patient care and unit maintenance than did their day-shift counterparts. Data analysis indicated that 33% of evening-shift rehabilitation technicians' time and 36% of day-shift rehabilitation technicians' time was unaccounted for in the work diaries. As a result of this study, the authors recommend a review of the job description for rehabilitation technicians. Furthermore, the results identify a need for staff development education for rehabilitation technicians so that they can expand their roles and responsibilities.

Rural Nurses as Self-Directed Learners: Overcoming Obstacles to Continuing Education

Evaluation of a fieldtest of a self-directed learning (SDL) program included assessing rural nurses' self-perceived competencies in this method and loci of control for motivation. A significant negative relationship occurred between high scores for learner skills and internal motivation ratings. Sixty-two percent rated themselves above the mean as self-directed learners regardless of perceived loci of control in the stressful rural practice environment. SDL can offer an alternative way to meet continuing education needs of rural nurses in their efforts to overcome the many obstacles to professional growth in rural practice.

Education as the key to rehabilitation

Rehabilitation education is the key for successful transference to the home setting for the client and family. Can you picture a family at the rehabilitation facility on the day of discharge taking home a 19-year-old son with a severe head injury or a high spinal cord injury without this preparation? The client and family must be evaluated by the rehabilitation team to plan the individualized educational program. Education must start at admission and involve every member of the rehabilitation team in order to offer a complete educational program. The criteria for discharge of the client are based on an educational program successfully addressing self-care, self-direction, and self-responsibility.

Factors determining length of hospitalization for patients having laminectomy surgery

The purpose of this study was to determine factors associated with length of stay for patients undergoing lumbar laminectomy. Significant differences were identified related to method of payment for hospitalization, number of doses of analgesic medications, and presence of muscle spasms. Other factors studied were sex, pre- or postoperative administration of steroids, presence of complications, age, length of surgical procedure and types of antispasmodic medications administered. The study was conducted in an urban north Texas hospital, using a retrospective review of 30 charts selected randomly. Further study of factors related to length of hospitalization is necessary in this, as well as other patient populations, especially since the advent of prospective payment.