脑外伤监护室患者家属心理调查

对108名脑外伤监护室患者家属进行问卷调查,结果显示脑外伤监护室患者家属的心理需求依次为:对亲人所患疾病知识了解,很想与医生护士沟通患者病情,渴望医生护士很有责任心、态度好,调查结果还显示患者家属中85%出现焦虑,对医院环境感到恐惧不适,对亲人健康及预后担心.提示:监护室护士必须正确认识患者家属的心理需求,帮助患者家属应付焦虑恐惧心理,使患者家庭获得更多社会支持.     

人性化护理在血透患者中的应用

人性化护理就是以人为本,以关注人的情感和需要为特征,在满足人、理解人,尊重人的基础上,发挥人的积极性、主动性来提高医院的护理水平.近几年来我们科从心理关爱、自主权力、社会支持、医患交流、尊严保护、健康教育、优化环境、便捷流程等方面实施人性化服务树立以人为本的护理理念,加强医患方面的沟通,营造优美舒适的环境,创建方便温馨的工作流程,完善护理服务内容,及时解决社会问题,得到了血透患者的满意评价,增强了他们的治疗信心,提高了护理工作自身价值.现将其体会总结如下.     

对住院患者健康教育需求调查研究

目的:探讨住院患者的健康教育需求.方法:采用自行设计问卷调查表对300例住院患者进行问卷调查,以了解其健康教育需求.结果:患者对康复计划的健康教育需求率最高(97.0%);其次是病情咨询(96.2%),药物作用、不良反应及使用方法(96.2%),饮食指导(91.8%),住院制度(91.4%)等;对心理及社会问题的健康教育需求率最低(66.5%).结论:对住院患者进行健康教育是必要的,其内容要根据患者的需要而制定,不能忽视对患者的心理护理和建立社会支持.     

脑外伤监护室患者家属心理调查

对108名脑外伤监护室患者家属进行问卷调查，结果显示脑外伤监护室患者家属的心理需求依次为：对亲人所患疾病知识了解，很想与医生护士沟通患者病情，渴望医生护士很有责任心、态度好，调查结果还显示患者家属中85％出现焦虑，对医院环境感到恐惧不适，对亲人健康及预后担心。提示：监护室护士必须正确认识患者家属的心理需求，帮助患者家属应付焦虑恐惧心理，使患者家庭获得更多社会支持。     

重度颅脑外伤患者家属的心理需求调查分析

目的了解重度颅脑外伤患者家属的心理需求,以期为制定相应的心理护理对策提供依据。方法便利抽样法抽取2012年12月至2013年6月在上海某四所医院神经外科重症监护病房(neurosurgical intensive care unit,NICU)治疗的住院患者的家属391名为研究对象,采用危重患者家属需求量表(critical care family needs inventory,CCFNI)对其进行问卷调查。结果患者家属需求5项因子中按得分高低排序依次为病情保证因子、获取信息因子、被接纳因子、支持因子、自身舒适因子,平均评分分别为(3.51±0.48)、(3.36±0.46)、(3.29±0.50)、(2.80±0.52)、(2.70±0.63)分。女性患者家属的需求高于男性患者家属,差异有统计学意义(P0.05);不同学历患者家属的需求差异有统计学意义(P0.05);中青年患者家属的需求高于老年患者家属,差异有统计学意义(P0.05)。结论医护人员应了解并重视重度颅脑外伤患者家属的心理需求,及时满足患者家属的合理需求,营造和谐的医患关系。     

应用Delphi法构建终末期肾病患者延续护理需求评估体系

目的构建适合我国国情的终末期肾病患者延续护理需求评估体系。方法在文献分析和半结构访谈患者与家属的基础上,以奥马哈系统为理论框架,课题小组对评估指标进行删除、合并和补充。应用Delphi法向全国15位专家发送两轮函询问卷,并分析专家意见和建议。结果两轮函询专家积极系数分别为88.2%和100%,专家权威系数(Cr)为0.83,专家意见的总体协调系数(W)分别为0.20和0.53,P值均小于0.01,评估体系由ABC3部分组成。A部分为患者基本资料,B部分为护理问题评估表,包括生理、认知、心理社会和健康相关行为4项一级指标和30项二级指标,C部分为延续护理需求服务项目表,包括护理需求等级和干预项目2项指标。结论 Delphi法评价的终未期肾病患者延续护理需求评估体系,具有可靠性和权威性,能较全面反映终未期肾病患者延续护理需求特点,能用于同行的延续护理实践与研究。     

机械通气患者的需求分析

目的掌握患者在机械通气时的生理与心理需求,主动提供更适合患者需要的人性化护理服务,促进疾病恢复。方法采用自行设计的调查表,对56例呼吸机辅助呼吸患者在拔管后进行回顾性调查。结果在15项需求内容中,有8项需求率达50%以上,属于机械通气患者的主要需求。不同文化程度的机械通气患者在对病情的了解、担心住院费用等需求内容上的差异有统计学意义(P<0.05)。结论对机械通气患者应掌握多种交流技巧,深入了解患者的生理与心理需求,满足不同文化程度患者的需求,有助于护理工作中因人而异地实施护理,充分体现以人为本的护理服务。     

急诊外伤患者家属心理状态和心理需求调查分析

目的:探讨急诊外伤患者家属的心理状态和心理需求,以寻求对患者恢复的有效护理支持.方法:采用问卷调查法对66名急诊外伤患者家属的心理状态和心理需求进行调查分析.结果:患者家属出现不同程度的恐惧心理(100%)、烦闷心理(78.79%)、抑郁心理(74.24%)、无助心理(54.55%)、依赖心理(46.97%).心理需求主要表现在:了解患者的治疗方案(95.46%);了解患者的病情(93.94%);了解患者的预后(93.94%);希望得到最好的医生治疗(93.94%);了解患者治疗的危险性(90.91%);了解患者的治疗费用(89.39%);了解住院医疗环境(81.82%);了解患者疾病的相关知识(69.70%).结论:通过对急诊外伤患者家属的心理状态和心理需求进行调查分析,有利于减轻其不良心理,对患者提供有效的护理支持,在外伤急诊护理实践中有重要意义.     

高血压脑出血56例术后并发症原因分析及护理

目的探讨急诊外伤患者家属的心理状态和心理需求,以寻求对患者恢复的有效护理支持.方法采用问卷调查法对66名急诊外伤患者家属的心理状态和心理需求进行调查分析.结果患者家属出现不同程度的恐惧心理(100%)、烦闷心理(78.79%)、抑郁心理(74.24%)、无助心理(54.55%)、依赖心理(46.97%).心理需求主要表现在了解患者的治疗方案(95.46%);了解患者的病情(93.94%);了解患者的预后(93.94%);希望得到最好的医生治疗(93.94%);了解患者治疗的危险性(90.91%);了解患者的治疗费用(89.39%);了解住院医疗环境(81.82%);了解患者疾病的相关知识(69.70%).结论通过对急诊外伤患者家属的心理状态和心理需求进行调查分析,有利于减轻其不良心理,对患者提供有效的护理支持,在外伤急诊护理实践中有重要意义.     

综合性医院儿科住院患儿家属对医院需求的调查分析

目的调查综合性医院儿科住院患儿家属对医院的需求，寻求更人性化服务的方式。方法对255例住院患儿家长进行问卷调查。结果对医院设施和管理、对疾病相关内容的了解、对医生护士的要求、对健康教育进行了排序。结论根据排序的结果，寻求最需解决的问题来提高儿科住院患儿家长的满意度。     

关于精神病人及其家属对住院精神卫生服务满意度的调查

[目的 ]探讨在住院精神卫生服务中影响住院精神病人及其家属满意度的相关因素。[方法 ]应用世界卫生组织提供的住院精神卫生服务满意程度量表 (病人版本和家属版本 ) ,采用自评和了解病情相结合的方法 ,对 3 12例住院病人、2 49例病人家属进行调查。 [结果 ]病人最满意的是入院当时与医生的面谈时间以及对该医院病人信息的保密措施 ,最不满意的是住院期间与医生、护士的面谈频率 ;家属最满意的是入院当时医务人员对家属的倾听方式 ,不满意的是医务人员让其参与治疗护理过程的程度以及到达医院的方便程度 ;诊断、年龄、文化程度对病人满意度有影响。 [结论 ]病人和其家属的满意度表现有所不同 ,改善病人满意度的主要措施是医务人员应增加与住院精神病人的沟通 ,及时让病人了解有关治疗护理的信息并提供其所需的心理卫生服务 ;重视家属要求参与治疗护理的愿望 ,定期与病人家属联系 ,探讨治疗方案 ,并提供有效的健康教育服务等     

Patients’ Perceptions of What Makes a Good Doctor and Nurse in an Israeli Mental Health Hospital

The aim of this study was to identify inpatients’ expectations of their doctors and nurses in a mental health hospital setting. Individual interviews were conducted with 72 inpatients of a large mental health hospital in northern Israel. Our study produced three major results. First, most patients, whatever their emotional status, share similar expectations of staff, of which the most conspicuous is that they be respected as whole persons and that staff not treat them merely as cases of illness. Second, they expect to be involved in making decisions about their treatment, including being informed of reports and records referring to them. Third, patients expect all hospital staff, particularly nurses, to provide them with emotional support. The findings of this study can be used to facilitate improved care of mental health inpatients by both doctors and nurses. Structured and methodical examinations of inpatients’ expectations at the time they are hospitalized can help adjust not only the professional aspect of health care but also the therapeutic communication approach to patients’ individual needs.     

Who cares for older people with mental illness? A survey of residential aged care facilities in the Australian Capital Territory: Implications for mental health nursing

Residential aged care facilities are increasingly becoming locations wherein the most frail and older people with mental illness live out the remainder of their lives, yet it has become apparent in recent years that these institutions are fraught with a variety of social and clinical problems. One issue of concern has been the exodus of registered nurses (both general and psychiatric), who have been increasingly replaced by carers with little or no expertise in psychiatric illness or disorders of cognitive decline. This 'de-professionalizing' of aged care has important implications for the well-being of clients, particularity those with complex mental health problems. In this survey we sought to discover demographic information concerning those who provide front-line care to this population of aged Australians, and we sought also to ascertain how much education in caring for residents who suffer specifically from neurodegenerative disorders (the dementias) and mental illness was provided by the facilities to those who care for such older people. The lack of training in the areas of mental health and cognitive impairment raises a variety of issues that mental health nurses need to address. These issues cover clinical, professional, and social justice dimensions. We believe that mental health nurses are strategically and professionally placed to take a leadership role in raising the profile of aged care in this country and they need to act proactively to secure the well-being of this particularly vulnerable client group.     

Prevalence of mental illness within families in a regional child‐focussed mental health service

Nearly 50% of all mental illnesses begin in childhood before the age of 14 years, and over 20% of parents have a mental illness. Few studies have examined the co‐occurrence of mental illnesses in parents and children. In the present study, we examined the extent of mental illness within families of 152 clients attending an Australian regional child and adolescent mental health service (CAMHS). A cross‐sectional study design was employed involving a case record review and clinician‐completed questionnaire of the children and youth attending a CAMHS. It was found that 79% of these children were living with a parent with mental illness. The predominant diagnosis of both child and parent was an anxiety or mood disorder, and many families had co‐occurring risk factors of domestic violence and limited social supports. The findings in this Australian cohort are similar to those of other international research. While novel in nature, the present study has highlighted the extent of both mental illness and scarce supports for both children and parents in the same family. The findings indicate the need for a coordinated multiservice delivery of appropriate and consistent family‐focussed interventions, responding to both mental illness and social supports for children and parents. Further research should examine specific components of family need and support, as seen through the eyes of the child and their parent.     

Psychiatric rehabilitation: a framework for psychiatric home care

Psychiatric home care offers excellent opportunities to help the psychiatric patient achieve positive outcomes. Home care agencies need to develop a treatment model that supports the type of care provided to the psychiatric patient, such as psychiatric rehabilitation. This model purports that mental illness is a biologic illness affected by stress and inadequate problem-solving and coping skills. These patients have inadequate social skills, but they can improve. This article describes interactive tools and methods that the home care staff can use with such patients and their families.     

2型糖尿病病人心理健康水平及其相关因素的研究

[目的 ]研究 2型糖尿病病人心理健康水平以及相关因素。 [方法 ]采用综合性医院焦虑抑郁量表 (HAD )和基本资料问卷 ,对 198例门诊病人作一般资料、疾病资料、焦虑抑郁水平的调查。 [结果 ] 198例 2型糖尿病病人中抑郁症患病率 2 5 .8% ,焦虑症患病率 14 .1% ,同时患有焦虑抑郁症者8.1% ;2型糖尿病病人的心理健康问题与病程长短、家庭支持度、接受健康教育情况、经济状况等因素有关。 [结论 ] 2型糖尿病病人存在心理健康问题 ,并受诸多因素的影响 ,在给予病人药物治疗的同时 ,要重视和加强心理护理。     

The attitudes of mental health professionals towards patients with mental illness in an inpatient setting in Palestine

Culture plays a vital role in shaping public and professional attitudes towards mental illness. In Arab cultures negative attitudes toward patients experiencing mental illnesses are common. There is a lack of studies that investigate the attitudes of professionals towards patients in inpatient mental health settings. This study aimed to assess the attitudes of professionals towards patients with mental illnesses in the only psychiatric hospital in Palestine. A survey was undertaken using the Attitudes Toward Acute Mental Health Scale (ATAMHS 33). The scale was distributed to a variety of professionals at the only psychiatric hospital in Bethlehem. Data was managed and analysed by using SPSS 15 (a statistical package for social sciences). The participants (mostly nurses) expressed both negative and positive attitudes toward patients, however, results revealed more negative than positive attitudes, particularly in relation to alcohol misuse, medication, patients' ability to control their emotions, and genetic predisposition to mental illness. This paper provides baseline data about the attitude of mental health professionals towards patients experiencing mental illnesses. Education and direct contact with patients with mental illness may not be enough to foster positive attitudes towards them. This may indicate the need to revise educational curriculum at the Palestinian universities and offer more training for mental health professionals in order to change their attitudes.     

The role of psychiatric diagnosis in satisfaction with primary care: data from the department of veterans affairs

BACKGROUND: Although patient satisfaction is widely used as a quality indicator, most such measures do not account for patient subgroups such as those with psychiatric illness. There is also very little data on satisfaction of psychiatric patients with their medical care. OBJECTIVE: The objective of this study was to assess the role of psychiatric illness in satisfaction with outpatient primary care services in the Department of Veterans Affairs (VA). METHOD: Data from the VA Customer Feedback Survey (n = 50,532) were merged with administrative data to determine diagnoses and other characteristics. Satisfaction ratings were compared across psychiatric diagnoses and across various aspects of satisfaction with care. RESULTS: After controlling for patient characteristics (eg, gender, age, disability, acute vs. routine visit) and subjective health, patients with schizophrenia, posttraumatic stress disorder, drug abuse, depression, and other psychiatric disorders reported significantly lower satisfaction with their outpatient primary care. Dissatisfaction was particularly reported for access to care and overall coordination of care. CONCLUSIONS: Despite VA characteristics that might be thought to improve satisfaction (eg, easier access to specialty mental health services as a result of the integrated VA system), patients with psychiatric disorders are significantly less satisfied than patients without such disorders. Possible explanations include both lower technical quality of care and poorer interpersonal communication between providers and patients with mental illness, including the negative effects of stigma. These findings highlight the need for satisfaction ratings to be case-mix-adjusted, including the incorporation of health and mental health diagnoses, and the need for further research that elucidates the reasons behind lower satisfaction ratings.     

Risk factors associated with 30-day unplanned hospital readmission for patients with mental illness

Unplanned hospital readmission rate is up to 43% in mental health settings, which is higher than in general health settings. Unplanned readmissions delay the recovery of patients with mental illness and add financial burden on families and healthcare services. There have been efforts to reduce readmissions with a particular interest in identifying patients at higher readmission risk after index admission; however, the results have been inconsistent. This systematic review synthesized risk factors associated with 30-day unplanned hospital readmissions for patients with mental illness. Eleven electronic databases were searched from 2010 to 30 September 2021 using key terms of 'mental illness', 'readmission' and 'risk factors'. Sixteen studies met the selection criteria for this review. Data were synthesized using content analysis and presented in narrative and tabular form because the extracted risk factors could not be pooled statistically due to methodological heterogeneity of the included studies. Consistently cited readmission predictors were patients with lower educational background, unemployment, previous mental illness hospital admission and more than 7 days of the index hospitalization. Results revealed the complexity of identifying unplanned hospital readmission predictors for people with mental illness. Policymakers need to specify the expected standards that written discharge summary must reach general practitioners concurrently at discharge. Hospital clinicians should ensure that discharge summary summaries are distributed to general practitioners for effective ongoing patient care and management. Having an advanced mental health nurse for patients during their transition period needs to be explored to understand how this role could ensure referrals to the general practitioner are eventuated.