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Advances in the application of rehabilitation nursing in chronic diseases in the community

source:Zhejiang Banger Medical Investment Management Co., Ltd.     Date of publication:2019-06-12     Browsing volume:1193

Guide reading:

With the rapid development of economy and science and technology and the aging of the population, the incidence, incidence and disability of chronic non-communicable diseases have increased year by year. This has led to an increasing demand for rehabilitation of a large number of chronic patient groups, and at the same time, the contradiction between supply and demand of rehabilitation services has become increasingly prominent.

Community rehabilitation care is an integral part of the community health service organization function. Community health service agencies carry out community rehabilitation is a new policy determined by the Chinese government. Community rehabilitation care has become an important task of community health services, and rehabilitation care for elderly patients with chronic diseases in the community is a key point. This paper reviews the application examples and effects of rehabilitation nursing in community chronic diseases in recent years, and proposes development strategies, in order to achieve better development of community rehabilitation care in China.

With the development of medicine and the improvement of people's living standards, lifestyle changes, disease spectrum and death spectrum have changed, chronic diseases have gradually replaced acute infectious diseases and become the main health problems of Chinese community residents, such as cardiovascular disease, diabetes, Malignant tumors, etc. [1]. The occurrence and development of chronic diseases are closely related to human behaviors and lifestyles [2]. With the aging of the population and the increase in the intensity and frequency of unhealthy lifestyles in the population, especially the contradiction between the prevention of health care measures due to changes in diet structure The absolute and relative number of NCD prevalence rates have increased significantly and become a major health problem in most areas of China [3-5].

In recent years, with the popularization and promotion of rehabilitation nursing knowledge to clinical specialties, rehabilitation nursing has expanded from hospitalized and outpatients who only serve in hospital rehabilitation medicine to patients in hospital-related clinical departments or communities, and emphasized rehabilitation care. Early intervention and full involvement. In the work of community hospitals, rehabilitation nursing for elderly patients with chronic diseases in the community is a key point. The application of rehabilitation nursing in chronic diseases in the community is introduced as follows.

"The concept of community rehabilitation care

Rehabilitation nursing (RN) is a specialized nursing knowledge generated by the combination of nursing and rehabilitation medicine. During the implementation of the rehabilitation plan, the nurses cooperate with rehabilitation professionals such as rehabilitation doctors and therapists to provide basic care for the rehabilitation subjects. And implement various rehabilitation nursing techniques to prevent secondary disability, reduce the impact of disability, and achieve maximum functional improvement and reintegration [6]. Its rehabilitation characteristics are as long as it is to prevent secondary dysfunction, assist in the implementation of related rehabilitation treatment, give psychological support and emphasize active care [7].

Community refers to the human life group and its activity area with a certain interaction and common cultural strength. It is the basic place of human life and the combination of social space and geographical space.

Community rehabilitation care refers to the rehabilitation of the rehabilitation object and its family members in the community by utilizing and relying on the human resources of the community and according to the rehabilitation needs of the rehabilitation objects in the community. The target of community rehabilitation is all the sick, injured, disabled, elderly and sub-health groups living in the community. Community rehabilitation takes the community as the region, and provides rehabilitation services for community rehabilitation subjects according to the economic development of the community and the rehabilitation resources that can be utilized. [6,8]

"Requirement status of rehabilitation nursing in chronic diseases in the community

Rehabilitation is a major feature of the development of modern medicine. It conducts research on the rehabilitation knowledge and health education needs of patients with chronic diseases, and carries out relevant knowledge health education in a targeted manner. It plays a very important role in the prevention of second and third grades of chronic diseases and case management. Important role [8].

In order to understand the needs of rehabilitation health education for patients with chronic diseases in the community, the nursing staff is instructed to conduct health education in a targeted manner. 11% of the 20 patients were aware of rehabilitation-related knowledge, 43% were partially aware, and 46% were not aware; all patients had different levels and different types of needs for rehabilitation health education, and the total demand rate for each educational content was More than 90%; the top 3 demand for disease prevention, four seasons health, diet knowledge needs; one-on-one education of medical staff is the most popular form of health education; 75% of patients want to educate their families at the same time.

It shows that patients with chronic diseases have a greater need for rehabilitation-related knowledge; the awareness and ability of self-care, rehabilitation and prevention of chronic diseases need to be improved. Patients with chronic diseases have insufficient knowledge of rehabilitation related knowledge and have a large demand. The countermeasures and suggestions for rehabilitation health education should be promoted, the community should be promoted to promote the culture of rehabilitation, and the habits of rehabilitation and rehabilitation should be promoted. Increase the emphasis on community medical points and increase the scope of radiation.

In order to reflect the connotation of the overall care at a deeper level. To meet the needs of the majority of patients and their families for disease care knowledge, so that patients and their families actively participate in health decision-making and promote self-care. According to the pathophysiology and psychological characteristics of elderly chronic patients, Zhihengxiang [12] adopts oral explanation, graphic propaganda, audio-visual materials, demonstration training, etc. to integrate health education such as psychology, diet, work and rest, exercise, medication and behavior guidance. The whole process of rehabilitation nursing has improved the patient's quality of life and self-care ability, and laid a good foundation for patients to return to their families and return to society.

"Application status of rehabilitation nursing in chronic diseases in the community

1 application examples of rehabilitation nursing in chronic diseases in the community

The elderly are very susceptible to chronic diseases. Chronic diseases will not only have a serious impact on the physical and mental health of the elderly, but also greatly reduce the quality of life of the elderly, and the chronic diseases of the elderly have hidden diseases and slow development of the disease, complicated conditions and long course of disease. And the characteristics of slow recovery [13-15], therefore, we must do a good job in the rehabilitation of the elderly patients with chronic diseases in the community.

Some scholars have studied [16] that the current nursing status of elderly patients with chronic diseases in the community mainly includes three modes, namely, community care mode, community home care mode and Chinese medicine care mode. Community health care workers and family members are important bearers in the prevention and management of elderly patients with chronic diseases. Community chronic diseases patients with the help of community health care workers, through their own and family supervision and management, are conducive to improving the care effect of elderly patients with chronic diseases, so that The health level and quality of life of elderly patients with chronic diseases in the community have been improved.

In order to better carry out rehabilitation care for patients with chronic diseases in the community, improve the quality of life of chronic patient groups in the community, change bad habits, and reduce the incidence of various diseases. Gu Limin [17] selected 40 patients with chronic diseases, including 18 patients with diabetes, 12 patients with hypertension, and 10 patients with coronary heart disease, with targeted psychological, exercise, diet, medication and complications.

The results show that 90% of patients with chronic diseases can gradually improve their self-care ability and constantly correct bad habits in daily life. This shows that community rehabilitation care can effectively ensure the health of the elderly, help them establish self-care awareness, greatly improve the quality of life, reduce the mortality rate of chronic diseases, and it is worth promoting and applying in the community. Wu Enmei [13] found that rehabilitation nursing for psychological care, diet care, sports care, disease care and complications care for elderly patients with chronic diseases in the community has the effect of improving their quality of life, reducing the incidence of various diseases and major societies. Meaning, worth promoting.

Yan Meiying [18] and other people's research confirmed that psychological care for elderly patients with chronic diseases in the community, such as: communicating with elderly patients with chronic diseases in the community in daily life, timely understanding of their physical health and family situation, and establishing equal rights with patients, Good relationships with each other can create a sense of trust for community care workers, proactively cooperate with community care workers for rehabilitation, and their psychological state will also change positively.

2 application of rehabilitation nursing in chronic diseases in the community

Community intervention

Community rehabilitation mainly provides rehabilitation counseling and psychological support, implementation of rehabilitation therapy, assisting referral services with higher-level hospitals, and providing independent living guidance for chronic diseases. It can be seen that its application methods are diverse, and it is common to provide community care interventions. the way.

To explore the application effect of community nursing intervention methods in the care of elderly patients with chronic diseases in the community. Rehabilitation exercise and rehabilitation guidance for patients with cerebral vascular sequelae and postoperative activities; psychological nursing, health education, etc., and the effect of nursing intervention before and after the elderly patients' self-care ability questionnaire were compared.

After the intervention, the knowledge of disease-related knowledge of elderly patients with chronic diseases in the community was significantly improved, blood pressure and blood sugar were effectively controlled, and the quality of life score was significantly improved. It is also pointed out that community nursing staff should base themselves on the community, evaluate the chronic diseases of the elderly in the community through preliminary research, master the detailed information, and then set up a community medical service team to implement nursing interventions including basic nursing, rehabilitation nursing and psychological nursing. It can effectively improve the health knowledge level and self-care ability of the people in the community.

Community nursing intervention has a significant effect on the care of elderly patients with chronic diseases. Through psychological intervention, health education, diet nursing, rehabilitation nursing and other comprehensive interventions, it can improve the self-care ability and quality of life of elderly patients with chronic diseases in the community, and can be promoted in the community.

Community health and rehabilitation guidance

Community health and rehabilitation guidance refers to health care measures and rehabilitation guidance in the community [21-22]. To analyze the effect of nursing intervention on chronic diseases, explore the most reasonable community health and rehabilitation guidance strategies.

After the community health and rehabilitation guidance, the condition of patients with chronic diseases remained stable, and most of the patients were better than before the treatment.

Conclusion Strengthening the health and rehabilitation guidance of patients with chronic diseases in the community and increasing the proportion of community nursing in nursing interventions is of great significance for the control of chronic diseases, which not only enables patients to obtain better quality of life, but also makes patients psychologically relieved. Anxiety, reduce the onset of chronic diseases, and control the progress of chronic diseases. Practice has proved that the nursing measures are feasible, the rehabilitation guidance measures are effective, the anxiety of the patients is alleviated, and the medication compliance is improved.

After entering the 21st century, the aging of human beings has made the comprehensive management of chronic diseases a major problem in community pension and community chronic disease management. Community care services have become the focus of the community industry as the focus of community aging, chronic disease management, and chronic disease rehabilitation. One of the contents of the reform [24-25].

"Countermeasures for the development of community rehabilitation nursing

One of the most critical issues facing the development of community rehabilitation is the lack of professional and technical personnel. The few health care providers and rehabilitation therapists in community health service organizations are unable to meet the rehabilitation needs of many patients with disabilities and dysfunctional chronic patients. . In the “six-in-one” work of community health services, community rehabilitation is the weakest link. The lag of community rehabilitation is the result of incomplete management of chronic diseases in the community and the impact of small systems. Therefore, we will actively establish a community rehabilitation nursing team, cultivate community rehabilitation nursing talents, and combine rehabilitation with community health care, health education, and chronic disease management, and combine disease prevention and health care. Carrying out community rehabilitation care is undoubtedly an effective way to alleviate the problem of lack of rehabilitation talents.

At the same time, improve community rehabilitation equipment, make full use of community and family resources; establish a quality management and effect evaluation system suitable for rehabilitation needs, based on functional evaluation, and design a special rehabilitation nursing record form. Psychological rehabilitation care is widely carried out because rehabilitation care is related to social and psychological factors and has a positive impact on the overall improvement of community health services.


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