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- is the continuous process of learning to live withchronic and disabling conditions, often those resulting from trauma.
- THe goal is to return patient to the best possible physical, mental, social, vaocational, and reconomic capacity.
Definition of Impairment
any loss or deviation of physiological, neurological or anatomical structure of function of an organ or body part (organ and body dimension), a physiological disorder or injury.
Definition of Disability
A disability reflects any limitation or lack of ability what a person experiences in pefroming an activity in the manner or within the range considered normal for a person, in other words, a limitation in learnig, speaking, walking or some other activity (individual dimension)
Definition of Handicap
loss or limitation of opportunities to take part in the life of the community on an equal level with others; encounter a personwith disability and socail, physical environemnt. In an inability to accomplish something ne might want to do. THe term emphasize the focus on shortcomings in the environment and in many tasks and activities, ex. in education, occupation, information or communicatino (social demension)
PHYSICAL ASSESSMENT RELATED TO REHAB
- The focuse of the assesment related to rehab and chronic disease is on the functional abilities of the patient.
- assess systamatically:(current status and evalutation or risk)
- low cardiac output may casue activity intolarance.
- Sign and symptoms - chest pain, farigue, fear( hindrance to rehab, afraide or recurrence of heart attack or death)
- ask about shortness of breath during or after activity.
- Determine the level of activity that can be accomplished without experiencing shortness of breath.
- Activity tolerance
- Fear of inability to breathe
GI system and Nutrition
- Monitor Oral intake, eating pattern, anorexai, nause, vomiting and dysphagia that may interfear with oral intake.
- Lab data
- Weight loss or gain
- Bowel elimination pattern or habits
- hange in stool
- Ability to get to toilet
- Urinary pattern
- Fluid intake
- Urinary incontinence or retention
- Urinary culture or urinalysis
Neurologic system assessment
- Motor funciton
- Cognitive abilities
- functional abilities
- range of motion
- muscle strength
- risk of skin breakdown
- presence of skin lesions
- the ability to perform ADLs such as bathing, dressing, feeding, and anbulating.
- Independent living skills: using telephone, shopping, rpeparing food, and housekeeping.
- Categories for assessment: self-care, sphincter control, mobility and locomotion, communication, and cognition.
- Theories of body image and self-esteem are important to assess the patients pshychosocial needs adequately. These cocepts serve as a basis for understanding phychological responses to chronic illness and the resutling disability.
- How pt maintaines stress
- Support system
to assist patients in maximizing functional status, allow them to resume many usual activities. Vocational conselors can hlp patient to find meaningful trainig, education, or empoymen tater discharege.
Retional for teaching patients and their families
- Because patients participate in their own healthcare dicisions. So they need info so that they make informed decisions.
- Hospital stays are brief: pt are sent home still needing meds, dressing chante, skiled procedures.
- Healthcare is expensive so education can help to dicrease the overall cost.
- Promote wellness, prevent or limit illness, restore health, adapt to change in body function and facilitate coping with stress, illness, and loss.
- an interactive process that involves planning and implementing instructional activities to meet intended learner outcomes or providing acticities that allow the learner to learn.
- 1. adequately convey info
- 2. assess verbal and nonverbal feedback
- 3. accommodate various learning styles
is a change in behavior, knowledge, skills or attitudes. Conscious, goal-oriented learning is intended and deliberate. It involves motivation to learn.
People learn in 3 ways, or domains
- Use all three when writting teaching stretegies.
- Cognitive: Thinking. Move from knowldege to evaluation
- Psychomotor: Skills. Move from guided action to adapting and originating new actions
- Affective: Feelings. Move through receiving, respoding, valuing, organizing, internalizing.
- storing and recallininfo in the brain.
- From simple to complex processes, 6 levels of behaviors: memorization, recall, comprehension, and ability to analyze, sinthesize, apply, and evaluate idea.
- Learning a skill that required both mental andphysical activity. It requires the learned to accept and values the skill as well as know about the skill.
- Do demonstration, simulation models, audiovisual materials, journaling and self-reflection and printed.
- it involves changes in feelings, beliefs, attitudes and values.
- Includes receiving and responding to new ideas, demonstrating commitment to or preference for new ideas, and integrating ndew ides into a value system.
- ex. role modeling, group work, panel discusion, role playing, mentoring, one-to-one counseling and discussion.
- it is a more outcomes-based approach
Factors affecting learning process
- ● Motivation is desire from within that is linked to behavior. Motivation may be based on physical needs, emotion, social needs, the need for task mastery, and health beliefs. The greatest when clients recognized the need for learning, believe it is possible ti improve their health and are interesred in info they are being given.
- ● Readiness is the demonstration of behaviors that indicate that the learner is motivated and able to learn at a specific time and conducive situation or environment.
- ● Physical condition includes pain, strength, coordination, energy, senses, mobility; it is one aspect of readiness.
- ● Emotions are feelings, such as anxiety, stress, emotional pain, or happiness. Emotions are another aspect of readiness.
- ● Timing means either the time at which the material is presented in relation to the client’s readiness or how soon the person has an opportunity to use the information after it is presented.
- ● Active involvement refers to how actively engaged the learner is in the goal planning and acquiring new knowledge, skill, or attitudes, as opposed to just listening passively. Active learning involves participation in the learning process.
- ● Feedback is evaluative information to the learner about the learner’s performance.
- ● Repetition means to go over the information more than once. It includes practice.
- ● Environment includes both the setting in which the teaching takes place and the relationship among the learner(s), the conditions, and the instructors’ or mentors’ teaching strategies.
- ● Scheduling the session involves planning undistracted time to allow for adequate assessment and understanding of the client.
- ● Amount and complexity of content implies that the more complex or detailed the content, the more difficult it is to learn and retain. However, when a learner is highly motivated or the material is perceived as relevant, learning information is easier.
- ● Communication is the giving and receiving of information. It is central to the teaching–learning process. Teachers and learners communicate information, perceptions, and feelings to each other. It can be verbal or nonverbal.
- ● Special population refers to clients with conditions that might interfere with learning (e.g., those with learning disabilities, attention-deficit disorder, mental illness, communication disorders, or brain injury).
- ● Developmental stage refers to the cognitive and psychosocial abilities of the person, which develop throughout the life span and differ at various stages. An understanding of intellectual development helps the teacher to customize teaching strategies and content to the level and learning style of the learner.
- ● Cultural factors involve norms, values, communication, social structure, time orientation, language spoken, and cultural identification. All are important in planning.
- ● Health literacy is the ability to understand basic health information and services needed to make appropriate healthcare decisions
How to motivate a client
- Motivation may be based on physical needs, social needs, the need for task mastery, and health beliefs. Students may include the following or other “factors that affect learning” (see the preceding question):
- Conveying interest in and respect for the learner and the learning process helps to motivate the learner.
- Creating an open, friendly environment where learners are interactive can increase the learner’s desire to learn. A healthy learning environment is one where students are encouraged to be responsive in the classroom (whether physical or virtual) and do not fear criticism. Interactive teaching/learning style can stimulate participants to engage in the educational experience.
- You can sometimes motivate clients by helping them identify a physical need that is relevant to the teaching point. For example, Heather (“Meet Your Client,” in Volume 1) may not be aware that her child is at risk for accidents and injury from home hazards. Helping her to understand the normal behavior of a 4-year-old preschooler may help her to see the need for childproofing her home.
- As people have a basic need to achieve and succeed in various ways, learning can be gratifying and raise self-esteem. When a person masters a goal or competently handles a situation or performs a task, he often is motivated to continue learning. Therefore, setting up the learning experience in a way so that learners will achieve the goal can motivate learning. Rewards and incentives can also provide this type of motivation.
- The client will be motivated to learn only if she believes the information taught is important. In the example from the book, Heather may understand that a 4-year-old preschooler likes to explore and may recognize that there are safety hazards in the home, but she will not be motivated to learn safety measures if her attitude is that “it is no big deal.”
Barriers to learning
personal stress, illness, physical condition, anxiety, low literacy, lack of time tolearn, lack of willingness, teaching not adapted to learner's teaching style, lack of support and ongoing positive reinforcement.
- are statements of understading between teacher and learner about how to achieve mutually ste goals.
- It describes the responsibilities of both teacher and learner, time frame for the teaching, contentto be included, and expectations of all participatns.
- It increases comitment and usually informal.
- are broad in scope and set down what is expected as thefianl outcome of the teaching and learning process.
- Should adress all three domains of learning.
- single , specific, one-dimensional behaviors that must be completed to accomplish the goal.
- Short term and ideally are accomplished in one or two sessions.
- Similar to patient outcomes in the nursing process, learning objectives goals should include: an action verb, an activity that can be measured or observed, the circumstances of the learner's performance, and how learning will be measured.
How to write learning outcomes
- The outcomes you choose depend on whether you have used Deficient Knowledge in the problem clause or the etiology clause of the nursing diagnosis.
- Ex. if nursing diagnosis for mother were Deficient Knowledge (Preschooler Nutrition) r/t lack of experience and family support; then one outcome might be, "mother will plan nutritious meals for her child, based upon the MyParamid."
- If diagnosis for the child were Risk for Impaired Nutrition: Less Than Body Requirements related to the mother's Deficient Knowledge about nutrition, then one outcome might be, "preschooler will gain weight so that she is in at least the 10th percentile for weight by Septeber of this year."
Creating teaching plan
- Asses to determine the rigt setting for the teaching, the necessary content to cover, learning goals, and teahing strategies.
- Asses the following: learning needs, client's knowledge level, health beliefs and practices, physical readiness, emotional readiness, ability to learn, literacy level, neurosensory factors, learning styles.
- Learning objectives(outcomes)
- Interventions: teaching strategies. When planning teaching, you will plan content, sequencing, and thetypes of instructional materials to be used.
- Evaluation of learning: outcome that is achieved or not. When evaluating the teahing, consider the type of strategy you used, the timing of the teaching, the content, the amout of information and the taching materials. Client is the best source of feedback.
- Test and written exercises
- Oral question/interviews/questinnaires/checklists
- Direct observations of licen tperformance
- Reports and client records.
Creating teaching plan cont.
- Teaching strategies: it is method used to to present concent.
- The content: of your teahing includes the information your learner must understand to reach the desired goal. It can include facts, skills, or emotions.
- Scheduling and sequencing: refer to how you organize the info, that is, in what order to present the topics. Present simple before complex topics and nonthreatening topics before more controversial ones.
- Schedule in advance, when estensive content is involved.
- Instructional material: are tools that are used tin introduce info and reinforce learning.
Teaching strategies pg. 566 in wilk (1)
Lecture, group discussion, demnstration and return demonstration, one to one istruction and mentoring, printed materials, audiovisual materials, simulation, role-plyaing, role modeling, self-instruction, distance learning, online sources of information, computer-assistied instructin and online coursework, gaming, concept mapping
- is the process of planning for selfcare and contiuity of care after the patient leaves a healthcare setting.
- Begin at assessment. Assess for cognition, vision, hearing, functional abilities, social support, and psychological well being msut be a part of the initial assessment so that you can identify needed servixes at discharege.
- is done to evaluate the patient's health status on leaving the institution, to prepare the patient for self-care, to prepare family members for caregiving, and to coordinate services that will be needed after the patient leaves the hospital or other healthcare agency.
Different settings of community based care
Community based care refers to acute care of rehabilitative services performed in clinics, offices, mobile care unites and other facilities in the community - rather than acute care settings, such as hospitals.
- Promote health and prevent disease.
- Educating susceptible individuals with no known disease process is an example of a routine, primary intervention.
- The least invasive and least expensive of the three levels of interventions.
aim to reduce the impact of the disease process by early detection and treatment.
to halt (ostanovit') disease progression and /or restore client functioning to pre-disease state. The disease process is clinically apparent and client debilitation, including death, is likely without intervention.