Patients as peer preceptors for orthopaedic oncology rehabilitation patients

Patients as peer preceptors for orthopaedic oncology rehabilitation patients Smith C, Haynes K, Rebeek S, Murdoek B, King N, Kleinbeck S, Werkowitch M, Rosenthal H This article describes a training programme that was implemented to assist orthopaedic oncology patients during their rehabilitation period following limb preservation surgery. The programme provides for patients who have completed their treatment and rehabilitation and aims to complement the professional counselling and support that trained staff offer. A detailed literature review evaluates the advantages and disadvantages of similar programmes in related fields and explores possible ways in which a programme could be implemented. The authors then go on to explain the training strategies used, how the progress of potential preceptors can be assessed and how they themselves are supported. Eight trained preceptors have been observed by trained staff and monitored using the Attendance Behaviour Scale (which rates listening skills) and the Empathy Scale. These scales showed that after training the preceptors showed improved communication skills in terms of empathy, listening and voice expression. The cost of implementing the programme, continued training and support for preceptors is adequately recognized in the study. Follow-up survey reports from patients and preceptors were positive. Patients found that they could talk to their preceptors about concerns they would not raise with medical staff and preceptors were able to prepare a patient for what was to happen along each step of the way. This is an interesting concept, which nurses working in clinical areas in contact with orthopaedic oncology patients would benefit from utilizing. It may be that they do not feel it realistic to implement a full preceptor programme, but there may be aspects of it that they would like to further consider.

Rehabilitation Nursing 1998; 23 (2):78-83.

Mentally restorative experiences supporting rehabilitation of high functioning elders recovering from hip surgery Travis S, MeAuley W This relatively small, prospective descriptive study was undertaken to discover more about the opportunities for, locations, and actions taken by elderly people that produced agreeable or pleasurable states of mind and perceived improvement in their ability to pay attention. The literature review was comprehensive but perhaps a little weak on the evidence to support the main precept of the research, that is, the benefits of mentally restorative experiences to patient outcomes. Simple interventions such as providing views of nature

" Orthopaedic Nursing ([ 998) 2, 121 9 1998 Harcourt Brace & Co. Led

from windows were discussed and exemplified as having a powerful effect on the individual's well-being. The study design used well-known functional assessment strategies to easily and quickly score the participants. Apart from this the research was very subjective and retied on 'generating an ongoing set of hunches'. The researchers clearly identified the limitations of the study due to the small number of participants (n -- 8) and that they all came from one subacute care facility. This would make generalization of the findings very unwise. Future studies would need to greatly increase the type of patient groups and overall number of participants to generate sufficient weight of evidence on which to base action. This study identifies an important and worthwhile area for future research. Its relevance to orthopaedic nursing is immediately apparent and is probably an aspect of nursing care that has been forgotten and rediscovered rather than discovered anew.

Journal of Advanced Nursing 1998; 27: 977-985.

Orthopaedic nursing research priorities: a replication and extension Sedlak C, Ross D, Arslanian C, Taggart H This study continued the work of the National Association of Orthopaedic Nurses published in 1994. As in 1994 it identified current orthopaedic nursing research priorities that should be investigated. Research methods were descriptive and used to identify research priorities. A Delphi survey technique was used with a total of 113 orthopaedic nurses stratified by academic degrees held. Nine high priority research questions were identified. These were grouped into patient acuity, care delivery models, staffing issues, patient complications, pain management (in the elderly and those with altered mental status) and patient mobility. The authors emphasized the need for more research on pain and patient complications, such as deep vein thrombosis. The questions should be used by orthopaedic nurses to develop nursing research proposals as well as collaborative research endeavours. The study shows a distinct and dramatic change in priorities since the early 1990s, which reflects the rapid pace of fundamental changes in orthopaedic care and treatment. This work should prove extremely useful to all orthopaedic nurses although it applies more specifically to North American nurses. It would be interesting to follow it up with a study to determine the research carried out in the next few years as a result of taking action on its findings.

Orthopaedic Nursing 1998; 17 (2): 51-58.

Summaries by PeterDavis, Editor-in-Chief,Journalof OrthopaedicNursingand JudyScotter,CommitteeMember,

Journal of OrthopaedicNursing