Cardiac Rehabilitation and Diabetes Management

Course Information

• Course Code and Name: HEY413E REHABILITATION NURSING
• Course Week: 14
• Course Day and Time: Tuesday (12:00 to 13:50)
• Course Credit/ACTS: 2
• Examination Type: Mcqs
• Instructor's Name & Surname: Dr. Hina Zahoor
• E-mail & Phone: [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
• AVESIS Link: https://persis.gelisim.edu.tr/Default.aspx

Weekly Learning Outcomes

• Understand the importance of oncology rehabilitation in the cancer care continuum.
• Identify the different settings where oncology rehabilitation occurs.
• Recognize the key phases of the rehabilitation process for cancer patients.
• Understand the roles of various cancer rehabilitation professionals involved in the rehabilitation process.
• Gain knowledge of how oncology rehabilitation contributes to improving the quality of life for cancer survivors.

Attendance and Conduct

• Attendance is mandatory for all scheduled lectures.
• Be responsible: Come to class on time.
• Be disciplined: Avoid talking to friends in the class.
• Mobiles are not allowed in the 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 Lesson

• Oncological Rehabilitation Nursing 1&2

Daily Flow

• 12:00-12:50: Indication/Phases (1st Hour)
• 13:00-13:50: Settings For Oncology Rehabilitation/Rehabilitation process/Types Of Cancer Rehabilitation Professionals (2nd Hour)

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: encompasses the time between the onset of cancer diagnosis and the beginning of oncological treatment.
• Restorative rehabilitation: focuses on restoring the cured or controlled patients with residual impairments that cause disability to their previous level of function.
• Supportive rehabilitation: provides care to maximize functionality as individuals experience declines due to progressive or stable cancer.
• Palliative phase: emphasises the care aiming at comfort and function in the terminal stage of cancer.

Settings For Oncology Rehabilitation

• Post-acute care: Includes 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, Increased Energy and Stamina
• Emotional and Psychological Support
• Improved Body Image and Self-esteem
• Enhanced Survivorship, Supportive Community
• Boosted Energy and Endurance
• Emotional and Mental Support
• Improved Body Image and Self-confidence, Enhanced Survivorship and Nurturing Community

How Do You Rehabilitate Cancer Patients?

• Assessment: The rehabilitation team will conduct a comprehensive evaluation of the patient's physical, functional, and emotional status.
• Development of a rehabilitation plan: Based on the assessment results, the rehabilitation team develops a tailored plan.
• Implementation of the rehabilitation plan: The team works with the patient to implement the plan.
• Monitoring and adjustment of the rehabilitation plan: The team will closely monitor and make adjustments.
• Discharge planning and follow-up care: The team develops a discharge plan and provides follow-up care to the patient.

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: Neuropsychological tests, patient-reported outcome measures.
• Communication
• Sexual function
• Return to work

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.
• Core components in cardiac rehabilitation include patient assessment, exercise training, physical activity counseling, tobacco cessation, nutritional counseling, weight management and aggressive coronary risk-factor management and psychosocial counseling.
• Cardiac rehabilitation programs generally span three months, with sessions two or three times a week (usually 36 sessions over a 12-week period).
• Dieticians organize workshops to teach patients healthy eating habits, label reading and cooking demonstrations. General dietary recommendations for cardiac patients include a reduced intake of saturated fats and cholesterol, increased intake of polyunsaturated and monounsaturated fats and increased fiber intake. Recommendations emphasize moderation and plant-based food.
• Weight management considerations address central obesity according to waist circumference.
• Blood pressure management, important to learn importance of control, medications and therapeutic life changes during cardiac rehabilitation sessions.
• Management of diabetes is a priority in cardiac care and includes education and support to achieve better glycemic control. The goal is maintaining glycosylated hemoglobin (HbA1c) concentration of <7%.

Pulmonary Rehabilitation Nursing

• Pulmonary rehabilitation is a multidisciplinary approach to improve physical and emotional well-being of patients with chronic respiratory diseases.
• Pulmonary rehabilitation includes supervised exercise, education, support, and behavioral intervention to improve daily function and quality of life.
• Indications for pulmonary rehabilitation include COPD, Interstitial Lung Disease, Cystic Fibrosis, Pulmonary Hypertension, Severe Asthma, Post-lung transplant, Post-surgical recovery, Pulmonary Fibrosis.
• Benefits of pulmonary rehabilitation include improved exercise capacity, reduced breathlessness, improved survival, reduced hospitalizations, reduced anxiety and depression and improved psychological well-being.

Neurological Rehabilitation Nursing-1, Neurological Rehabilitation Nursing-2

• Neurological rehabilitation is a program designed to improve function and well-being of patients with neurological conditions.
• The goal of neurorehabilitation is to restore health, independence, and functionality, using best rehabilitation strategies to prevent complications
• Phases of neurorehabilitation include Long-term acute care hospital, Acute rehab, Subacute rehabilitation in skilled nursing facilities, Long-term care facility or nursing home, home with services.
• Assessment Tools include the Barthel Index.
• Approaches to neurological rehabilitation include Bobath, Carr and Shepherd approachs, gait re-education transfer rehabilitation and mobility rehabilitation, contracture management, and equipment and adaptations assessment.

Take-Home Topics for Review

• Indication
• Phases
• Settings For Oncology Rehabilitation
• Rehabilitation process
• Types Of Cancer Rehabilitation Professionals

Questions and Suggestions

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

References

• (List of references)

About the Next Week

• Final Exam

Disclaimer

• Using the texts and images in the presentation on social media or else without permission is against the regulations Law no. 6698.

Test your knowledge on the intersection of cardiac rehabilitation and diabetes management. Explore questions about cardiovascular risks, goals of rehabilitation, and the impact of high blood pressure on treatment outcomes. This quiz will challenge your understanding of key concepts in managing patients with diabetes in cardiac and oncology rehabilitation settings.