Barriers and facilitators of rehabilitation nursing care for patients with disability in the rehabilitation hospital: A qualitative study

Abstract

Nurses play a key role in providing rehabilitation care. In this regard, identifying the factors that affect their practice can be useful in planning to improve the quality of rehabilitation nursing care. This study aims to explore the experience of nurses and members of the rehabilitation team about barriers and facilitators of rehabilitation nursing care of patients with disability in the rehabilitation hospital. This qualitative study was conducted in the main public rehabilitation hospital in Tehran, Iran. Eighteen persons including 12 nurses in clinical and managerial positions, an occupational therapist, a physical medicine specialist, a patient, and an informal caregiver participated in this study. Participants were selected based on purposeful sampling. Data were collected through 18 in-depth semi-structured interviews and analyzed based on qualitative content analysis principles. Three themes were derived from the data analysis, which represented Barriers and facilitators related to nurses (specialized knowledge and skills, psychological status, mentoring, professional communication), barriers and facilitators related to the work environment (nurses' performance evaluation, nursing workforce, comprehensive care facilities, workplace design, specialized unit), barriers and facilitators related to patients and caregivers (patient's participation in nursing care, patient adaptation, efficiency of formal caregivers). The experiences of the rehabilitation team shows that not only nurses, but also the environment, patients, and caregivers can affect the provision of care and change the quality of care. Identifying these factors can help managers, researchers, and clinical nurses to facilitate and improve rehabilitation nursing care by modifying the influencing factors.

Rehabilitation nursing care in the acute phase of diseases with physical disabilities: A concept analysis study

“…Rehabilitation nursing care providers are nurses, so a part of the antecedents of this concept is related to them. The most important prerequisites for providing rehabilitation nursing care are having specialized knowledge and skills (Clarke, 2014;Gutenbrunner et al, 2021;Havrilla, 2017;Hoeman, 2008;Miller et al, 2010;O'Connor, 2000;Portillo & Cowley, 2011;Pryor et al, 2005;Shirozhan et al, 2022aShirozhan et al, , 2022bSuter-Riederer et al, 2018;Thomas & Flannery, 1990;Thorn, 2000;Vaughn et al, 2016). Adequate work experience in different wards from intensive care units to public wards and outpatient centers is another antecedent for rehabilitation nursing care (Portillo & Cowley, 2011;Thomas & Flannery, 1990).…”

“…This concept also has other antecedents that are related to the setting in which the rehabilitation nursing care is provided. Interprofessional communication and collaboration between nurses, patients, their families and caregivers, and other members of the rehabilitation team are the important antecedents of this concept (Aadal et al, 2018;Havrilla, 2017;Hoeman, 2008;Kosevich et al, 2014;Meng et al, 2020;Shirozhan et al, 2022aShirozhan et al, , 2022bZhang et al, 2021;Zhu & Zhan, 2021).…”

“…Along with professional collaboration, familiarity with rehabilitation skills and services provided by other rehabilitation team members is an antecedent for rehabilitation nursing care (Dreyer et al, 2016;Miller et al, 2010;Shirozhan et al, 2022aShirozhan et al, , 2022b. Providing rehabilitation care also requires adequate time, facilities, suitable environment and adequate nursing staff, supportive policies, and clarity in scope of rehabilitation nursing practice (Barreca & Wilkins, 2008;Clarke, 2014;Hoeman, 2008;Meng et al, 2020;O'Connor, 2000;Pryor et al, 2005;Shirozhan et al, 2022aShirozhan et al, , 2022b.…”

“…There are other antecedents of this concept that are related to the nursing profession. The existence of specialized theories and models in the field of rehabilitation nursing and ethical codes are prerequisites for providing rehabilitation nursing care (Hoeman, 2008;Shirozhan et al, 2022aShirozhan et al, , 2022b. The development of rehabilitation education for nursing students in universities and specialized training courses for graduate nurses in various settings are also important antecedents of rehabilitation nursing care in the acute phase of diseases (Clarke, 2014;Hoeman, 2008;Shirozhan et al, 2022aShirozhan et al, , 2022bThorn, 2000;Vaughn et al, 2016).…”

“…Studies that can guide the practice of rehabilitation nurses are still limited. Moreover, some main concepts in this field have not yet been well clarified, and rehabilitation nursing care in different stages of diseases has not been empirically defined (Association of Rehabilitation Nurses, 2018;Clarke, 2014;Dreyer et al, 2016;O'Connor, 2000;Shirozhan et al, 2022aShirozhan et al, , 2022bSt-Germain et al, 2011;Vähäkangas et al, 2006;Vaughn et al, 2022).…”