Basic Care and Comfort / 03

Make sure to:

  • Assess communication with speech, vision, and hearing problems.
  • Learn the management of assistive devices.
  • Identify care interventions to assist the patients/clients.

According to the World Health Organization (2023a), rehabilitation is defined as “a set of interventions designed to optimize functioning and reduce disability in individuals with health conditions in interaction with their environment”. Some examples of rehabilitation include:

  • Psychological therapies.
  • Social skills training for individuals with schizophrenia, autism spectrum disorders, or intellectual disabilities.
  • Physical exercises for enhancing mobility and physical condition.
  • Respiratory exercises for improving oxygenation.
  • Positioning and splinting techniques to promote skin integrity.
  • Medications to enhance comfort.
  • Assisting clients in the use of prostheses.
  • Training individuals with speech, vision, or hearing impairments.

In this learning experience, the last two forms of rehabilitation will be addressed, aimed at managing human responses to clients’ needs related to speech, vision, hearing impairments or the use of prostheses. Forms of communication and functioning are essential factors in integrating individuals into society. The ability to function effectively in a group, share ideas and thoughts, underpins the coexistence of all human beings. Unfortunately, some individuals encounter speech, vision or hearing challenges, as well as overall functioning issues.

Speech problems can lead to anxiety and social phobia. Visual impairment can result in difficulties perceiving the environment and challenges with reading and writing. Poor hearing can lead to speaking and reading problems or delays. In older adults, hearing loss is associated with dementia, and treating the problem can reduce the risk of it. All these medical conditions can cause low self-esteem, learning or social difficulties, depression, disruptions in family functionality, loneliness, and more. Helping patients and families to detect and treat these conditions is essential. Nurses should guide the client and their families to achieve the best outcomes in prevention, correction, or adaptation. Most importantly, early detection can provide more intervention opportunities.

3.1 Assessment of Speech, Vision or Hearing Impairments

Numerous sociocultural, genetic, biological, and pathological factors have a direct or indirect impact on sensory disabilities. The initial step to provide the proper care is to define the clinical state of the patient. Subsequently, the attention process must continue with the cycle of documenting the patients’ signs, running any assessment/screening necessary, as well as drawing a course of treatment.

The following tables provide an overview of some condition-specific factors for each condition.

Table 1

Stages for evaluating sensory alterations

Adapted from Khan, I., & Khan., M. A. (2023). Sensory and Perceptual Alterations. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK563136/

Table 2

Signs, Assessment and Screening, and Treatments for Speech Impairments

Adapted from Kaplan Nursing. (2023). Sensory and Perceptual Alterations. NCLEX-RN Content Review Guide: Preparation for the NCLEX-RN Examination; Silvestri et al. (2021). Eye and Ear Problems. Saunders Comprehensive Review for the NCLEX-PN Examination; World Health Organization. (2023a). Rehabilitation. https://www.who.int/news-room/fact-sheets/detail/rehabilitation; World Health Organization. (2023b). Hearing Loss in Adults: When to Suspect and What to Do. https://cdn.who.int/media/docs/default-source/ncds/sdr/deafness-and-hearing-loss/0123-hearing-loss-adults-flyer.pdf?sfvrsn=83fb5bb9_19&download=true; World Health Organization. (2023c). Package of Interventions for Rehabilitation. https://iris.who.int/bitstream/handle/10665/370399/9789240071247-eng.pdf?sequence=1

Table 3

Signs, Assessment and Screening, and Treatments for Vision Impairments

Adapted from Kaplan Nursing. (2023). Sensory and Perceptual Alterations. NCLEX-RN Content Review Guide: Preparation for the NCLEX-RN Examination; Silvestri et al. (2021). Eye and Ear Problems. Saunders Comprehensive Review for the NCLEX-PN Examination; World Health Organization. (2023a). Rehabilitation. https://www.who.int/news-room/fact-sheets/detail/rehabilitation; World Health Organization. (2023b). Hearing Loss in Adults: When to Suspect and What to Do. https://cdn.who.int/media/docs/default-source/ncds/sdr/deafness-and-hearing-loss/0123-hearing-loss-adults-flyer.pdf?sfvrsn=83fb5bb9_19&download=true; World Health Organization. (2023c). Package of Interventions for Rehabilitation. https://iris.who.int/bitstream/handle/10665/370399/9789240071247-eng.pdf?sequence=1

Table 4

Signs, Assessment and Screening, and Treatments for Hearing Impairments

Adapted from Kaplan Nursing. (2023). Sensory and Perceptual Alterations. NCLEX-RN Content Review Guide: Preparation for the NCLEX-RN Examination; Silvestri et al. (2021). Eye and Ear Problems. Saunders Comprehensive Review for the NCLEX-PN Examination; World Health Organization. (2023a). Rehabilitation. https://www.who.int/news-room/fact-sheets/detail/rehabilitation; World Health Organization. (2023b). Hearing Loss in Adults: When to Suspect and What to Do. https://cdn.who.int/media/docs/default-source/ncds/sdr/deafness-and-hearing-loss/0123-hearing-loss-adults-flyer.pdf?sfvrsn=83fb5bb9_19&download=true; World Health Organization. (2023c). Package of Interventions for Rehabilitation. https://iris.who.int/bitstream/handle/10665/370399/9789240071247-eng.pdf?sequence=1

3.2 Assessment of the Client’s Use of Assistive Devices

When clients begin using a medical device, it is essential to provide them with gradual and safe instructions for adapting to their new lifestyle. This should involve incorporating family and social resources to facilitate the transition. The intervention program prioritizes daily activities and the home environment, expanding to include the community, workplace, and recreation areas.

The fundamental assessments aim to observe the client’s engagement in daily activities to identify the need for instructions and assistive interventions. It's important to note that the nurse's role is to assist the client in areas where they require support, with the ultimate objective being the achievement of autonomy.

The nursing diagnoses include:

  • Risk of injury
  • Disturbed sensory perception
  • Compensatory visual behavior
  • Impaired verbal communication
  • Communication enhancement
  • Environmental enhancement

3.3 Interventions for Caring and Managing Clients Utilizing Assistive Devices or Prostheses

People with disabilities may require assistive medical devices to compensate for weakened or absent functions. In some cases, a prosthesis may be necessary, which is a manufactured component that replaces a part of the body. In the following lines, there will be information about primary interventions for assisting and managing clients with assistive devices or prostheses.

The primary interventions for assisting and managing clients with assistive devices or prostheses are outlined in the following table.

Table 5

Interventions to Assisting and Managing Clients Using Assistive Devices or Prostheses

Adapted from Kaplan Nursing. (2023). Sensory and Perceptual Alterations. NCLEX-RN Content Review Guide: Preparation for the NCLEX-RN Examination; Silvestri et al. (2021). Eye and Ear Problems. Saunders Comprehensive Review for the NCLEX-PN Examination; World Health Organization. (2023a). Rehabilitation. https://www.who.int/news-room/fact-sheets/detail/rehabilitation; World Health Organization. (2023b). Hearing Loss in Adults: When to Suspect and What to Do. https://cdn.who.int/media/docs/default-source/ncds/sdr/deafness-and-hearing-loss/0123-hearing-loss-adults-flyer.pdf?sfvrsn=83fb5bb9_19&download=true; World Health Organization. (2023c). Package of Interventions for Rehabilitation. https://iris.who.int/bitstream/handle/10665/370399/9789240071247-eng.pdf?sequence=1

3.4 Care Interventions for Assisting and Managing Clients with Physical or Sensory Impairments

Some of the important aspects to consider when assisting and managing a patient or client with a physical or sensory impairment include:  

  • Encourage regular check-ups.
  • Involve all family members in the treatment process.
  • Facilitate the participation of individuals with impairments in social activities.
  • Connect individuals with impairments to assistance and support groups.
  • Provide assistance in accessing healthcare services and organizations for treatments and medical devices.
  • Minimize background noise whenever possible.
  • Encourage one-at-a-time speaking to avoid simultaneous conversations.

The primary interventions for assisting and managing a client with a physical or sensory impairment are provided in the following table:

Table 6

General Interventions for Individuals with Speech, Vision or Hearing Impairments

Adapted from Kaplan Nursing. (2023). Sensory and Perceptual Alterations. NCLEX-RN Content Review Guide: Preparation for the NCLEX-RN Examination; Silvestri et al. (2021). Eye and Ear Problems. Saunders Comprehensive Review for the NCLEX-PN Examination; World Health Organization. (2023a). Rehabilitation. https://www.who.int/news-room/fact-sheets/detail/rehabilitation; World Health Organization. (2023b). Hearing Loss in Adults: When to Suspect and What to Do. https://cdn.who.int/media/docs/default-source/ncds/sdr/deafness-and-hearing-loss/0123-hearing-loss-adults-flyer.pdf?sfvrsn=83fb5bb9_19&download=true; World Health Organization. (2023c). Package of Interventions for Rehabilitation. https://iris.who.int/bitstream/handle/10665/370399/9789240071247-eng.pdf?sequence=1

Disability can have its origins in both external and internal factors. In addition to preventive measures, such as the intake of folic acid and prenatal monitoring during pregnancy, as well as accident prevention, early detection is crucial. Generally, one should be vigilant for congenital malformations in newborns and maintain regular health check-up appointments to identify disability-related issues promptly, thus increasing the likelihood of successful interventions.

Treatment for a disability not only affects the disability itself but also influences an individual's social interactions, self-esteem, mood, as well as their performance in education and at work.

Now that you understand the significance of clients being able to express themselves, see, or hear, remember not to overlook any intervention for early detection, prevention, correction, or rehabilitation. Even a small change can make a profound difference in people's lives.   

  • Kaplan Nursing. (2023). Sensory and Perceptual Alterations. NCLEX-RN Content Review Guide. Preparation for the NCLEX-RN Examination (9th ed.). Elsevier. 163–182.
  • Khan, I., & Khan, M. A. (2020). Sensory and Perceptual Alterations. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK563136/
  • Silvestri, L. A., Silvestri, A. E., Grewal, A., & Gray, E. H. (2021). Eye and Ear Problems. Saunders Comprehensive Review for the NCLEX-PN Examination (9th ed.). Elsevier. 821-841.
  • World Health Organization. (2023a, January 30). Rehabilitation. https://www.who.int/news-room/fact-sheets/detail/rehabilitation
  • World Health Organization. (2023b). Hearing Loss in Adults: When to Suspect and What to Do. https://cdn.who.int/media/docs/default-source/ncds/sdr/deafness-and-hearing-loss/0123-hearing-loss-adults-flyer.pdf?sfvrsn=83fb5bb9_19&download=true
  • World Health Organization. (2023c). Package of Interventions for Rehabilitation. Module 6: Sensory Conditions. https://iris.who.int/bitstream/handle/10665/370399/9789240071247-eng.pdf?sequence=1

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