دانلود رایگان مقاله انگلیسی سهم دانشجویان پرستاری در زمینه توانبخشی بیماران خانگی - الزویر 2018

Abstract

Home-dwelling rehabilitation has expanded in the last years in Norway. The goal is to strengthen self-care for those who have suffered acute impairment or has due to chronic diseases. The purpose of this study was to explore whether nursing students in home-based nursing care (HBNC) can contribute to patients’ rehabilitation and mastery work during clinical placement. The study considered 121 undergraduate nursing students’ HBNC clinical placements where they, in collaboration with patients, have designed and applied a rehabilitation plan. The duration of the clinical placements were 8 weeks and took place in the municipality of Oslo. Prior to the clinic placement, the students have followed an introductory course rehabilitation plan development. During the initial phase of the placement, the students an eight-step model for mapping the patient`s values: 1) home, 2) close relatives, 3) physical activities, 4) friends, 5) job, 6) leisure activities, 7) body and appearance, and 8) spiritual and philosophical values. The students scaled the intensity of each value on a scale from 1 to 10. Through their clinical training a teacher and clinical supervisors have coached the students. The clinical placements have been followed by a written exam. Based on patients’ values and resources, the students coached patients in selfcare activities that brought the patients closer to their targets, whether it was on an activation or a participation level. The principal finding of this study was that the students in HBNC were adequately prepared to plan and carry out rehabilitation activities with patients.

Conclusion

The study has shown that the introduction class and supervisions in clinical placement had prepared the students in making rehabilitation plans and activities with home-dwelling patients. The students were well-suited to work with patients and multidisciplinary staff to identify activities that would bring patients closer to their targets independently, whether it was on an activation or participation level. The results point out that spending time in establishing a good trusting, cooperative relationship where the patient's values, problems and resources are investigated is a good and efficient strategy in the long run. The results support previous research by stressing that rehabilitation activities should be based on the patients’ values and resources.

The study also revealed that rehabilitation activities are difficult to implement in daily practice in homecare when new public management inspires the organisation model. The results point to the need for flexible organizational models tailored to give patients the most intensive services in the beginning of a rehabilitation process and more flexible and limited services when the patients are doing better on their own.