Abstract
Fifty cases of limb disorders combined with visual disorders were diagnosed and treated in 155 patients with rheumatoid arthritis at the Department of Rehabilitation Medicine, Showa University, from July 1994 through July 1996. The role of team-based nursing in the treatment of these 50 patients was evaluated by examining the patients' daily and social environment. Results show that many cases of cataracts, Sjögrens syndrome, and keratoconjunctivitis were diagnosed in patients with visual disorders and rheumatoid arthritis and that the combined disorders limited patients' daily and social activities. Functional disorders differ between limb disorders and visual disorders but severe disorders are the same in both limb disorders and visual disorders. Functional disorders larely affect the sensitivity of the distal upper limb and the mobility of the lower limb. Limb disorders lead to sensory disorders of the hand and finger and mobility disorders of the lower limb.
Activities of daily living can be accomplished even if the above functional disorders are combined with visual disorders, but activities parallel to daily living tend to be limited even if prosthese and self-help devices are used. The degree of disability in daily and social activities varies with weather conditions if visual and limb disorders are both present.
The degree of disability becomes more prominent in public facilities, since they are designed for patients who have only one of the two disorders. It is imperative in dyscrasic nursing care to respect patients control of their own lives by considering how patients independence and dependence vary with the degree of disability. Today's nursing staff play an important role solving problems of medical care which patients face by recognizing policies of medical care, welfare, and education implemented by national governments.
