Page 158 - HA Convention 2015

Masterclasses

MC9.5 Nursing – Rehabilitation and Patient Empowerment 13:15 Theatre 1

Patient and Carer Empowerment in Rehabilitation: Challenges and Success Factors
Li KY, Tang IFK, Kwong MWY, Chan RWH, Ko CSH, Wong YN
Department of Rehabilitation and Extended Care, Tung Wah Group of Hospitals Wong Tai Sin Hospital, Hong Kong

Tuesday, 19 May Introduction

Living with chronic illness or diseases will greatly affect patient’s quality of life. However, rehabilitation is the strategy
to soften this sorrow. Patient/carer empowerment is the key to improve quality of life through strengthening domains of
knowledge, skills and affection, especially for geriatric patients and their carers. Patients can be discharged home and their
family attachment will not be affected. Therefore, great challenges include cognitive readiness, physical capability and the
attributed values of the patient and carer need to be addressed, especially for those geriatric patient, older carer or domestic
helper. To overcome the hurdles in rehabilitation, nurse adopts special approach in following areas, such as providing
specialised cognitive and repeated psychomotor training to older patient; encouraging early engagement of carer to reinforce
their positive sense of control; and delivering early discharge plan to build successful empowerment.

Objectives

(1) To increase health literacy of patient and carer; (2) to improve patient’s physical mobility and psychomotor skills; (3) to
assist patients with disability and chronic illness to attain maximised function; (4) to increase awareness of their personal
strength; and (5) to relieve carer stress by increasing their sense of control.

Methodology

840 patients were recruited in rehabilitation programmes (including pulmonary, neurological, muscular skeletal and
geriatric rehabilitation programme) in 2013/14. Rehabilitation nurse provided individual/group health education with big
font size materials repeatedly, delivered psychomotor skills sessions with louder speak tone and paraphrasing technique
etc. Reminiscence sessions were provided weekly. Immediate skill technique correction was provided in each episode
of demonstration. Besides, prompt communication on discharge plan was started and carer training was invited during
admission. Follow-up and monitoring for target patient group were also included. Related outcome parameters were
measured.

Results

In 2013/14, the overall score of Mini-mental State Examination; Predicting Pressure Ulcer Risk, Braden scale; Elderly Mobility
Scale, Modified Functional Ambulation Category, Modified Barthel Index and Modified Rivermead Mobility Index were
increased and the overall pain score was decreased when patient was discharged to community. Besides in general, more
than five times of psychomotor skills training were provided to each patient’s carer during patient hospitalisation. 65% of
patients were discharged home with active carer training provided.

Conclusion

Rehabilitation nurse plays an important role in patient/carer empowerment for improving patient longevity and quality of life.
Rehabilitation nurse adopts specific approach to arouse older people/carer attention in turning challenges into success.
Eventually, clients live easier with chronic illness with empowered knowledge, skills and affection, also with better carer
support.

HOSPITAL AUTHORITY CONVENTION 2015

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