This Web-based intervention helped new carers make informed decisions about healthcare needs of stroke survivors, thus reducing service use.

Background: The Competency Model for Professional Rehabilitation Nursing is a lens through which nurses can view their practice; the four domains provide a template that guides that practice. Purpose: The aim of this study was to describe a task force's review procedures and share the updated model. Appraisal Process: A rehabilitation nursing task force appraised the model over the course of 1 year. Revision Outcomes: The original four domains remain, with wording changes for content and clarity throughout. Notable changes include (1) new competency for Domain 1 that focuses on the understanding of the worldview of individuals who are culturally different and (2) case stories for each domain related to nurses' proficiency (beginner, intermediate, and expert).Clinical Relevance: This updated model can be used to explicate the rehabilitation nurses' role on intra/interprofessional teams, as well as provide a framework for education and staff orientation/performance evaluation. Conclusion: This competency model reflects the current practice and advances of the specialty practice of rehabilitation nursing.

The purpose of this pilot study was to test the feasibility of providing Internet-based education and support intervention to caregivers living in rural settings, including caregivers' satisfaction with the intervention. A secondary aim was to explore their experience of caring. Nine adult caregivers of persons with stroke were enrolled in this descriptive study from rehabilitation centers in northwestern Ohio and southeastern Michigan. They were given access to the intervention, Caring-Web, for three months. Data were collected from participants' bimonthly interviews, as well as e-mail communications. Procedures were tested and found valid, and caregivers were willing and able to use Caring-Web. Using Friedemann's framework of systemic organization, a coding system was developed for analyzing the qualitative data on the experience of caring. Five main themes emerged from these data. These findings help expand knowledge about caregivers dealing with stroke.

These findings provided an in-depth, theorybased description of the experience of being a new caregiver and can help explain how caring can be a difficult yet rewarding experience. Knowledge of the changes over time allows health care professionals to tailor their interventions, understanding, and support.

Seventy-three caregivers of persons with stroke who were new to that role participated in an interview every two weeks for a year as part of a NIH project. Of these caregivers, 36 participants were randomly assigned and had access to a web-based intervention and its email discussion. In this secondary data analysis guided by Friedemann’s framework, 2148 email discussion messages plus 2455 narrative interview entries were used to examine dimensions of caregivers’ emotional strain in caring for persons with stroke. Rigorous content analysis was applied to these data. Three themes emerged: 1) being worried, 2) running on empty, and 3) losing self. Caregivers worried about themselves and their care recipient, sharing feelings of being just “plain tired.” They felt that their lives were lost to giving care. This study informs nurses about caregivers’ emotional strain, or incongruence in Friedemann’s terms, from their viewpoint and provides direction for supportive education interactions.