Impairment-Driven Cancer Rehabilitation: An Essential Component of Quality Care and Survivorship.
Impairment-driven cancer rehabilitation: An essential component of quality care and survivorship.
CA Cancer J Clin. 2013 May 17;
Silver JK, Baima J, Mayer RS
Answer questions and earn CME/CNE Adult cancer survivors suffer an extremely diverse and complex set of impairments, affecting virtually every organ system. Both physical and psychological impairments may contribute to a decreased health-related quality of life and should be identified throughout the care continuum. Recent evidence suggests that more cancer survivors have a reduced health-related quality of life as a result of physical impairments than due to psychological ones. Research has also demonstrated that the majority of cancer survivors will have significant impairments and that these often go undetected and/or untreated, and consequently may result in disability. Furthermore, physical disability is a leading cause of distress in this population. The scientific literature has shown that rehabilitation improves pain, function, and quality of life in cancer survivors. In fact, rehabilitation efforts can ameliorate physical (including cognitive) impairments at every stage along the course of treatment. This includes prehabilitation before cancer treatment commences and multimodal interdisciplinary rehabilitation during and after acute cancer treatment. Rehabilitation appears to be cost-effective and may reduce both direct and indirect health care costs, thereby reducing the enormous financial burden of cancer. Therefore, it is critical that survivors are screened for both psychological and physical impairments and then referred appropriately to trained rehabilitation health care professionals. This review suggests an impairment-driven cancer rehabilitation model that includes screening and treating impairments all along the care continuum in order to minimize disability and maximize quality of life. CA Cancer J Clin 2013. © 2013 American Cancer Society. HubMed – rehab
Impact of Voluntary Accreditation on Short-Stay Rehabilitative Measures in U.S. Nursing Homes.
Rehabil Nurs. 2013 May 17;
Wagner LM, McDonald SM, Castle NG
PURPOSE: 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. DESIGN: Cross-sectional association of CARF accreditation and quality. METHODS: 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). FINDINGS: CARF-accredited nursing homes demonstrate better quality with regard to the short-stay quality measures. CONCLUSIONS: Approaches beyond traditional regulation and governmental inspections are necessary to improve the quality of care in nursing homes. CLINICAL RELEVANCE: 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. HubMed – rehab
Serious Adverse Events Experienced by Survivors of Stroke in the First Year Following Discharge from Inpatient Rehabilitation.
Rehabil Nurs. 2013 May 17;
Ostwald SK, Godwin KM, Ye F, Cron SG
PURPOSE: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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. HubMed – rehab