Cardiac and Oncology Rehabilitation Quiz

Istanbul Gelisim University

• Istanbul Gelisim University was established in 2008
• The university has a Faculty of Health Sciences
• Contact number is +90 212 422 70 00
• Website Address: https://www.gelisim.edu.tr

Nursing Course Information

• Course Code: HEY413E REHABILITATION NURSING
• Course Week: 14
• Course Day and Time: Tuesday (12:00 to 13:50)
• Course Credits: 2
• Examination Type: MCQs
• Instructor: Dr. Hina Zahoor
• Instructor's Email: [email protected]
• Instructor's Room: 305
• Office Hours: 9.00 to 5.00
• GBS Link: https://gbs.gelisim.edu.tr/ders-detay-5-160-6267-1
• ALMS Link: https://lms.gelisim.edu.tr/almsp/u/Home/Index
• A-VESIS Link: https://persis.gelisim.edu.tr/Default.aspx

Weekly Learning Outcomes

• Understanding the importance of oncology rehabilitation in the cancer care continuum
• Identifying the different settings where oncology rehabilitation occurs
• Recognizing the key phases of the rehabilitation process for cancer patients
• Understanding the roles of various cancer rehabilitation professionals involved in the rehabilitation process
• Gaining knowledge of how oncology rehabilitation contributes to improving the quality of life for cancer survivors

Important Notes

• Attendance is mandatory for all scheduled lectures.
• Be responsible and come to class on time.
• Avoid talking to friends in class.
• Mobiles are not allowed in class

About the Last Lesson

• Principles of Neurological Rehabilitation
• Cognitive Rehabilitation Strategies: Nurturing Brain Function
• Targeted Exercise Programs for Neurological Recovery
• Assistive Technologies in Neurorehabilitation: Enhancing Independence
• Conditions That Can Be Treated With Neuro Rehab
• Case study

About the Today's Lesson

• Oncological Rehabilitation Nursing 1&2

Daily Flow

• 12.00-12.50 / 1st Hour: Indication Phases
• 13.00-13.50/ 2nd Hour: Settings For Oncology Rehabilitation, Rehabilitation process, Types Of Cancer Rehabilitation Professionals

Oncology Rehabilitation Nursing 1&2

• Oncology rehabilitation is an area that has the potential to reduce cancer-related morbidity and healthcare costs.
• Often used interchangeably with cancer rehabilitation, oncology rehabilitation focuses on managing and improving the impairments and functional limitations experienced by individuals with cancer due to the disease itself or the side effects of the treatment they receive.
• The Rehabilitation 2030 call to action, launched by the World Health Organization in 2017, aimed to advance global access to rehabilitation for non-communicable diseases.

Indications

• Pain
• Fatigue
• Chemotherapy-Induced Peripheral Neuropathy (CIPN)
• Spasticity
• Cognitive deficits
• Psychosocial problems
• Sexual dysfunction
• Urinary dysfunction
• Speech impairment
• Swallowing impairment
• Chemotherapy Side Effects and Syndromes
• Symptoms of Lymphoedema
• Radiation Side Effects and Syndromes
• Paraneoplastic Syndrome
• Cardiovascular Disease
• Amputations
• Functional Limitations

Four Phases of Oncology Rehabilitation

• Preventative rehabilitation phase / prehabilitation
• Restorative rehabilitation
• Supportive rehabilitation
• Palliative phase

Settings For Oncology Rehabilitation

• Post-acute care: Inpatient rehabilitation facilities, skilled nursing facilities, home health care agencies, and long-term care hospitals.
• Outpatient therapy: Involves patient visits at a therapy center for focused rehabilitation intervention.

Advantages Of Cancer Rehabilitation

• Improved Physical Function
• Pain Management
• Enhanced Quality of Life
• Boosted Energy and Endurance
• Emotional and Mental Support
• Improved Body Image and Self-confidence
• Enhanced Survivorship
• Nurturing Community

How Do You Rehabilitate Cancer Patients?

• Assessment
• Development of a rehabilitation plan:
• Implementation of the rehabilitation plan:
• Monitoring and adjustment of the rehabilitation plan:
• Discharge planning and follow-up care:

Assessment Tools

• Health-related quality of life and/or quality of life: The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire, the 36-Item Short Form Survey, and the Functional Assessment of Cancer Therapy.
• Activities of daily living and instrumental activities of daily living
• Fatigue
• Functional mobility
• Exercise behavior
• Cognition function
• Communication
• Sexual function
• Return to work

Types Of Cancer Rehabilitation Professionals

• Physicians
• Physical Therapists
• Occupational Therapists
• Speech Therapists
• Psychologists
• Social Workers
• Nurse

Cardiac Rehabilitation Nursing

• Cardiac rehabilitation is a complex intervention offered to patients diagnosed with heart disease, which includes components of health education, advice on cardiovascular risk reduction, physical activity and stress management
• Cardiac rehab has three equally important parts: Exercise counseling and training; Education for heart-healthy living; Counseling to reduce stress

Components and organization of cardiac rehabilitation

• Patient assessment
• Exercise training
• Physical activity counseling
• Tobacco cessation
• Nutritional counseling
• Weight management
• Aggressive coronary risk-factor management
• Psychosocial counseling

Cardiac Rehabilitation Programs

• Usually span three months, with sessions two or three times a week (usually 36 sessions over a 12-week time-period)

Dietary Recommendations for Cardiac Patients

• Reduced intake of saturated fats (<7% of total calories) and cholesterol (<200 mg/d)
• Increased intake of polyunsaturated (about 10% of total calories) and monounsaturated fats (20% of total calories)
• Adequate repartition of calorie sources (about 50-60% of total calories for carbohydrates, 15% for protein and 25-35% for fat)
• Increased fiber intake (about 20-30 g/d)

Weight Management

• Waist circumference > 88 cm in women and >102 cm in men indicates central obesity
• Risk is accepted as > 80 cm for women and >94 cm for men.
• BMI >25 kg/m2, individualized targets are determined.

Diabetes Management

• About 26% of patients referred to cardiac rehabilitation have diabetes.
• Most patients (93%) have another associated risk factor (smoking, hypertension, hypercholesterolemia, overweight, obesity)
• Therapeutic education, improves diabetes control.
• Glycemic control is important.
• Goal of diabetes management is to maintain glycosylated hemoglobin (HbA1c) concentration of <7%.

Management of Psychosocial and professional issues

• Patients with heart disease often confront psychological and social problems that can affect morbidity and mortality.
• Depression, anxiety, and denial occur in up to 20% of patients following myocardial infarction.
• Patients undergo a routine screening to identify anxiety, depression, substance abuse, and familial or other social problems.

Pulmonary Rehabilitation Nursing

• Pulmonary rehabilitation is a multidisciplinary approach designed to improve the physical and emotional well-being of patients with chronic respiratory diseases.
• It involves supervised exercise, education, support, and behavioral intervention.

Indications for Pulmonary Rehabilitation

• Chronic Obstructive Pulmonary Disease (COPD)
• Interstitial Lung Disease (ILD)
• Cystic Fibrosis
• Pulmonary Hypertension
• Severe Asthma
• Post-lung transplant
• Post-surgical recovery (e.g., pneumonectomy)
• Pulmonary Fibrosis

Benefits of pulmonary rehabilitation

• Improved exercise capacity
• Reduced breathlessness
• Improved survival
• Reduced hospitalizations
• Reduced anxiety and depression
• Improved health-related quality of life
• Improved psychological well-being

Goals of Pulmonary Rehabilitation

• Improve exercise capacity
• Enhance quality of life
• Decrease symptoms (e.g., dyspnea)
• Prevent hospital readmissions
• Enhance emotional well-being and self-management

Components of Pulmonary Rehabilitation

• Exercise training
• Inspiratory muscle training
• Psychosocial counseling
• Nutritional evaluation and counseling
• Education, including on proper use of prescribed drugs

Role of Nursing in Pulmonary Rehabilitation

• Nursing Assessment
• Thorough health history and clinical assessment
• Monitoring vital signs: Oxygen saturation, heart rate, and blood pressure
• Assessment of physical function: Mobility, muscle strength, and endurance
• Psychological assessment: Anxiety, depression, and coping strategies

Key Nursing Interventions in Pulmonary Rehabilitation

• Breathing techniques (diaphragmatic breathing, pursed-lip breathing)
• Exercise programs (low-impact aerobic exercises)
• Patient education
• Psychosocial support
• Nutritional support

Barriers to Pulmonary Rehabilitation

• Physical limitations
• Psychological factors
• Socioeconomic factors
• Cultural factors

Pulmonary Rehabilitation in Special Populations

• Older adults (COPD, ILD, Pulmonary Fibrosis)
• Patients with Obesity Hypoventilation Syndrome.

Programmed Design

• Six-Week Structure/National guidelines/Sessions per week/Exercise and education/Home training/Health topics/Individualized plans

Goal-Oriented Therapy

• Personalized goals
• Patient defines specific goals (e.g., reducing breathlessness, understanding their disease, or increasing mobility)
• Six-week program structured around these goals.
• Encouraging Self-Responsibility:
• Dependence/Interdependence/Independence
• Empoering patients

Pulmonary Rehabilitation Programs

• Relaxation
• Disease education
• Dietary advice
• Benefits advice
• Energy conservation
• Medication advice
• Chest clearance
• Breathing control techniques

Advance Care Planning in Pulmonary Rehabilitation (PR)

• Key Components of ACP in PR:
• Burden of Treatment: Physical, emotional, and psychological impact of ongoing treatments.
• Therapies: Ventilation and quality of life implications.
• Preferred Place of Death: Patient's wishes.
• Nurse’s Contributions to ACP:
• Provide compassionate guidance.
• Facilitate the creation of a care pathway.
• Ensures dignity, autonomy, and a patient-centered approach.
• Reduces uncertainty and emotional distress.

Neurological Rehabilitation Nursing-1

• Neurological rehabilitation refers to the process of engaging in therapy to improve function and well-being.
• Neurological rehabilitation program helps patients with neurological conditions recover or increase functionality within their environment.
• Goal of every neurorehabilitation program is to improve health, independence, and functionality using the best rehabilitation strategies.

Phases of Neurological Rehabilitation

• Long-Term Acute Care Hospital (LTACH)
• Acute Rehab
• Subacute Rehabilitation in Skilled Nursing Facilities
• Long-Term Care Facility or Nursing Home
• Home with services

Conditions That Can Benefit From Neurological Rehabilitation

• Traumatic brain injuries
• Spinal cord injuries
• Hemorrhagic strokes, ischemic strokes, subdural hematoma, and transient ischemic attacks (TIAs)
• Structural or neuromuscular disorders
• Functional disorders
• Brain Infections
• Neurodegenerative diseases

Aims of Neurological Rehabilitation

• Prevent complications (neurological conditions, deterioration of conditions, secondary complications)
• Teach adaptive strategies
• Facilitate function in a normal environment

Approaches to Neurological Rehabilitation

• Bobath approach - neuro-developmental treatment (NDT)
• Carr and Shepherd approach- functional movements
• Gait re-education
• Transfer rehabilitation
• Mobility rehabilitation
• Contracture management
• Equipment and adaptations assessment

Neurological Rehabilitation Nursing-2

• Targeted Exercise Programs for Neurological Recovery: Functional Movement Training / Tailored Workouts / Adaptive Equipment Integration
• Assistive Technologies in Neurorehabilitation:
• Augmented Reality Tools
• Smart Wearables
• Robot-assisted Therapy

Conditions That Can Benefit From Neuro Rehab

• Traumatic Brain Injuries
• Spinal Cord Problems
• Parkinson's Disease
• Other neurological issues (Alzheimer's, Epilepsy, Huntington's Disease)

References

• Various articles and reports from World Health Organization (WHO)
• Other research articles, specifically focusing on rehabilitation nursing in cancer, physical medicine, and rehabilitation.

Take-Home Topics for Review

• Indication
• Phases for Oncology Rehabilitation
• Settings for Oncology Rehabilitation
• Rehabilitation process
• Types of Cancer Rehabilitation Professionals

Questions and Suggestions

• General questions and suggestions are welcome

Recommended Daily Studies

• McPherson, K, Gibson, BE & Leplege, A 2015, Rethinking Rehabilitation: Theory and Practice, CRC Press, NW, Florida.
• Hoeman, SP 2008, Rehabilitation Nursing: Prevention, Intervention and Outcomes, 4th edn, Mosby, St Louis, United States

About the Next Week

• Final Exam

Test your knowledge on key aspects of cardiac and oncology rehabilitation, including BMI thresholds, diabetes management, and the roles of professionals in cancer rehabilitation. This quiz covers important strategies and goals for improving patient outcomes in these fields.