老年病院患者心理特点及心理护理体会

目的：分析老年人群在老年病院的情绪变化及心理特点,找到有效心理护理方法.方法：通过对我院110例老年患者在常规护理措施基础上采用一系列心理护理措施.结果：经过本次心理护理后,老年人情绪得到了较好的控制.结论：老年人群在退休后,无论是身体、心理还是情绪都会有很多改变,加之年龄大小、健康水平、医学知识等方面的影响,从而导致了诸多老年患者存在着不同的心理问题.重视老年人群入院后心理护理工作对临床工作是具有重要意义的.     

呼吸科老年患者的心理护理体会

心理护理已成为新的医学模式的重要组成部分,它是从患者在护理中出现的心理问题出发,通过医患、护患的行为或人际关系的影响,来改善患者的心理状态和行为,也是维护人们身心健康,唤起患者战胜疾病的乐观情绪和信心,保证患者处于接受诊治的最优生理和心理状态.患呼吸系统疾患的老年患者在人群中占有相当大的比重,医务人员应该重视这类老年患者,了解老年患者的心理特点,关心、尊重、照顾老年患者,提供良好的医疗服务,使他们真正体会到生存的价值,增加战胜疾病的自信心.经多年的临床观察与实践,笔者认为对患呼吸系统疾病的老年患者,其护理尤其是加强对老年患者的心理护理是至关重要的.下面根据老年患者的心理持点谈谈心理护理的体会.     

老年住院患者的心理护理体会

随着社会的进步，人们生活水平和医疗水平的不断提高，人类的寿命逐渐延长，老年人也逐渐增多，相应的老年人住院治疗逐步增多，老年医疗保健和心理社会问题日益突出。人是一个有机的整体，身体的健康包括躯体的健康和心理的健康，二者相辅相成，老年患者不但具有一般患者的心理特点，而且还有其他特殊表现。因此，应掌握其心理特点，有针对性的制定护理措施，以高质量的护理，帮助他们减少疾病带来的痛苦，保持身心健康，以求达到药物所起不到的作用。因此做好老年住院患者的心理护理，了解患者的内心世界，掌握他们的心愿，实施有效护理，是护理工作的一项重要内容，现就根据老年患者的心理特点及多年的护理经验，浅述老年住院患者的心理护理体会。     

社区老年患者心理护理

目的探讨如何加强老年患者的心理护理,消除患者的心理障碍。方法对2011年1～12月住院患者中65岁以上老人323例的心理特点及护理进行了详细的分析。结果通过护理人员热情,耐心,细致的护理,体贴和周到的服务,老年患者的自卑,焦虑情绪等得到了有效的改善。结论加强老年患者的心理护理后明显提高了老年患者的生存质量。     

关于老年患者心理护理的方法及措施

<正>随着我国医疗水平的提高及老年人口增加,护士应该按照社会的需要来调整自己的职能,使自己适应社会的需要,做好老年人的心理护理盒临床护理。老年人体弱多病,心理和生理机能退化,容易产生孤独寂寞、怕残废、怕死、急躁易怒等情绪。笔者根据住院老年病人存在的心理问题,采取同情、尊重老人,与病人进行言语沟通,了解病人的心理需求,积极开展健康教育,为患者提供健康心理等护理,取得满意的效果。1老年病人心理特点及常见的心理问题1.1自尊心理老年人因资历老,对社会及家庭贡献大,经验丰富,特别喜     

老年骨折患者的护理体会

目的：探讨老年骨折患者的护理特点及护理干预.方法：选择我院2009年1月至2010年12月老年骨折住院患者56例,其中男16例,女40例,年龄60-104 岁,平均73.6岁.分析本组病例入院时合并症、入院后心理特点及住院期间出现的并发症,根据其特点采取相应的护理措施. 结果：老年骨折患者并发症多,病情复杂,且多有心理障碍和精神改变.结论：应严密观察老年骨折患者病情变化,加强基础护理和心理护理,可减少术后并发症,提高治愈率,降低死亡率.     

老年糖尿病患者应用胰岛素的心理应激及护理对策

目的对老年糖尿病知识型患者应用胰岛素不良反应进行调查分析,提出防治对策.方法216例患者中发生不良反应(心理)者168例,根据护理问题实施了个体化健康教育,突出了人性化心理护理内容,重点做好出院的自我健康指导和胰岛素应用培训.结果168例患者临床治疗效果得到显著提高.结论根据老年糖尿病知识型患者应用胰岛素时的不同心理问题积极防治,采取相应护理措施、是提高临床治疗效果的重要途径.     

心电监护及护理干预在老年患者拔牙围手术期中的应用

目的：探讨心电监护在老年患者拔牙围手术期中的应用及其护理干预,以提高手术成功率。方法：根据心电监护老年患者的生理心理特点,提供相应手术全过程的心电监护、心理干预及手术护理。结果：通过心电监护及护理心理干预,使老年拔牙患者手术顺利。结论：专业医护团队与手术医生默契配合,实施完善的管理制度与适时的心理干预相结合的方法,对于确保心电监护拔牙成功具有重要意义。     

浅谈老年患者的心理变化及心理护理应对措施

随着社会和经济的发展,人口老龄化,老年患者所独有的生理及心理特点,老年患者的心理护理问题非常严重。护理人员除了必须具备良好的心理素质和精湛的护理技术外,还要正确地评估和诊断老年患者的身心特征,加强与老年患者沟通交流,针对其心理特点进行心理护理,消除不良心理反应,保持积极向上的心理状态,积极配合治疗,树立生活的信心。     

老年患者的心理特点及护理体会

人口老龄化问题是世界性的问题,老年患者的逐渐增多,给社会和家庭带来了很大的压力和负担。老年患者由于各种生理功能的衰退,器官结构的变化,使他们体弱多病,常因慢性疾病的折磨而情绪低落,性情偏执,怕孤独、寂寞,这就给医疗护理工作提出了新的课题。多年来,我们针对不同病人的心理特点进行心理护理,收到了良好效果,现总结如下：     

机构养老的老年人医养结合服务需求分析--基于日常生活能力评估

目的:了解河南省不同失能等级老年人的医养需求特点,为未来机构养老的发展提出合理化建议。方法:采用多阶段整群抽样方法,在河南省抽取57家养老机构,对入住老年人进行面对面问卷调查。结果:医疗服务方面,老年人相对更需要医疗巡诊、临床治疗、医学护理服务;健康管理方面,更需要建立健康档案、健康体检;生活服务方面,更需要助浴、助厕等必需的日常服务。结论:机构养老老年人的生活能力受损率较高,建议为不同失能等级的老年人提供有针对性的养老服务,合理分配卫生资源,切实满足老年人对医养服务的需求。此外,应注重老年人的精神服务需求。     

Were less disabled patients the most affected by 2003 heat wave in nursing homes in Paris, France?

OBJECTIVE: To analyse the change of mortality rates (MRs) and their contributing medical factors among nursing home patients during the 2003 heat wave in France. METHODS: A retrospective observational study was conduced in all nursing homes of the Assistance-Publique-H?pitaux de Paris (AP-HP), the French largest public hospital group. All AP-HP nursing home patients (4,403) who were institutionalized in May, 2003, were concerned. The MRs of patients between three periods (before, during and after the August 2003 heat wave period) were compared according to their demographic characteristics, level of dependence and medical condition. RESULTS: The MR increased from 2.2 per cent persons month (ppm) (1.9-2.4) before heat wave up to 9.2 ppm (8.0-10.4) during heat wave and back to 2.4 ppm (2.2-2.7) after heat wave. MRs before heat wave were higher among highly dependent patients compared to those less dependent [mortality rate ratio (MRR) = 2.66 (1.69-4.21)]. This difference disappeared during the heat wave [MRR = 1.28 (0.91-1.81)] and appeared again after heat wave [MRR = 2.21 (1.52-3.23)]. The same pattern was observed for several medical conditions, such as severe malnutrition or swallowing disorders. CONCLUSION: These results suggest that medical care during heat wave has been directed towards more fragile patients, helping to limit deaths in this group. Less frail patients made the largest contribution to excess mortality during the heat wave. During extreme weather conditions, specific attention should be paid not only to frail persons, but to all the elderly community.     

北京市老年人卫生服务需求研究

目的　了解北京地区老年人的健康现状及卫生服务需求 ,为政府及相关部门制定老年人保健政策和有针对性地开展老年人卫生服务提供依据。方法　抽样调查北京不同地区 (城区、城乡结合部、郊区农村 ) 6 0岁及以上老年人群 2 4 87人。调查内容涉及老年人的健康状况 ,医疗、护理、康复及保健需求 ,以及社区卫生服务。分析不同地区及人群的老年人健康现状与卫生服务需求的差异。结果　慢性病是老年人的主要卫生问题 ,罹患的前 4种慢性病是高血压、冠心病、骨关节病、脑血管病 ,糖尿病患病率增加较快。约 10 %的老人躯体功能有障碍 ,日常生活能力下降 ,生活需要他人帮助。老年人增多对医疗及护理照料服务的需求量增大。社区卫生服务的优势日益显出 ,得到老年人的认可。经济困难是影响老年人就医行为的主要原因。结论　老年人群是健康的弱势群体 ,随着人口老龄化 ,老年人卫生服务的需求增加。健康是影响老年人生活质量的重要因素 ,大力加强慢性病的防治应列为老年保健的中心任务 ,也是提高老年人生活质量的关键。     

健康中国下的医养结合服务模式研究

本研究以文献回顾分析和问卷调查方式对我国医养结合服务机构性质、服务模式、基本配置、服务内容和医疗质控等内容进行系统研究,结果显示我国医养结合机构目前存在专业人才缺乏、机构开展诊疗项目不能满足老人就医需求、医疗保险和新型合作医疗保险受限、部分老人存在着养老思想落后固化等问题。未来应该适度放宽医保政策,将医养结合服务项目就诊费用纳入医保报销范围,加强医养结合机构医护人员的培训,增加对老年服务机构的资金投入。     

2型糖尿病患者健康教育方式需求和知识掌握情况

目的了解2型糖尿病患者对不同健康教育方式的需求状况及其对糖尿病知识掌握程度，为进一步有效开展糖尿病教育提供依据。方法采用横断面研究，以方便抽样法抽取广州市5家医院就诊的349例2型糖尿病患者，以问卷的方式调查其糖尿病知识来源、对来源的信任度、知识需求内容、教育途径的选择意愿和知识知晓程度。结果患者对糖尿病知识需求愿望强烈（95．1％），其中71．6％的人希望了解治疗方面信息；最希望选择的受教育途径以医务人员讲座（49．9％）、个别教育（31．5％）占主导；患者知识来源为多向性，大众媒体信息受质疑；近10％患者对医务人员信任不足；患者技能训练不足。结论提倡以医务人员直接教育为主导的综合性教育；加强健康信息来源和医疗行业管理；重视社会、家庭支持作用。     

政策文献计量视角下江苏省养老服务特征及优化策略

目的:分析政策文本结构及外部属性,厘清江苏省养老服务的主要特征及关注重点,为各省市完善政策体系提供参考。方法:采用政策文献计量法分析23项养老服务政策的出台频率、颁布机构及政策主题,并借助ROST CM工具提取主题词,利用Ucinet软件绘制图谱、计算中心度指标。结果:江苏省老龄化进程逐步放缓,养老政策出台频率与老年人口占比增长幅度趋同。养老资源及信息集中在以省民政厅为主的9所机构中,其余职能部门参与度较弱。现阶段政府关注老年群体的基本生活及医疗需求,工作重心在于养老模式的完善优化,高龄、失能等弱势老年群体的养老问题尚未成为热点。结论:各省市需及时掌握当地老年群体特征,在满足基本需求的基础上保障不同时期、不同群体的多层次养老需求。应鼓励各机构整合优势资源,补充完善体育健身、"互联网+养老"等多领域政策。同时营造积极养老氛围,鼓励老年人通过志愿服务、再就业等方式实现社会价值,在中度老龄化社会进一步释放老年人口红利。     

Health Care and Personal Care Needs Among Residents in Nursing Homes,Group Homes,and Congregate Housing in Japan: Why Does Transition Occur,and Where Can the Frail Elderly Establish a Permanent Residence?

ObjectivesJapan has had high rates of transition to nursing homes from other long term care facilities. It has been hypothesized that care transitions occur because a resident's condition deteriorates. The aim of the present study was to compare the health care and personal care needs of residents in nursing homes, group homes, and congregate housing in Japan.DesignThe present study was conducted using a cross-sectional study design.Setting/SubjectsThe present study included 70,519 elderly individuals from 5 types of residential facilities: care medical facilities (heavy medical care; n = 17,358), geriatric intermediate care facilities (rehabilitation aimed toward a discharge to home; n = 26,136), special nursing homes (permanent residence; n = 20,564), group homes (group living, n = 1454), and fee-based homes for the elderly (congregate housing; n = 5007).MeasurementsThe managing director at each facility provided information on the residents' health care and personal care needs, including activities of daily living (ADLs), level of required care, level of cognitive impairment, current disease treatment, and medical procedures.ResultsA multinomial logistic regression analysis demonstrated a significantly lower rate of medical procedures among the residents in special nursing homes compared with those in care medical facilities, geriatric intermediate care facilities, group homes, and fee-based homes for the elderly. The residents of special nursing homes also indicated a significantly lower level of required care than those in care medical facilities.ConclusionThe results of our study suggest that care transitions occur because of unavailable permanent residence option for people who suffer with medical deterioration. The national government should modify residential facilities by reorganizing several types of residential facilities into nursing homes that provide a place of permanent residence.     

Community-oriented medical education in Glasgow: developing a community diagnosis exercise

OBJECTIVES: Recent NHS changes have included an increasing emphasis on primary care settings, and hence community needs assessment. This has led to suggestions that medical education should become more community-oriented if today's medical students are to become effective medical practitioners. Recent curriculum reforms in a number of medical schools frequently involve a more student-centred approach, which encourages students to learn by intellectual discovery and critical thinking. We describe one such exercise in community diagnosis that has been developed in Glasgow's new undergraduate medical curriculum. DESIGN: The exercise has been developed as three teaching sessions, each with specific learning objectives. The first session explores the strengths and weaknesses of routine statistics, and reveals the lack of information regarding individual's and community's health and health care needs. The second session is a community-based rapid participatory appraisal arranged by general practitioners. Students interview patients, carers, and local key informants and health care professionals about their perceptions of health and health needs. In the final campus-based session, students combine and present their findings. Development included two pilot exercises involving detailed evaluation. SETTING: University of Glasgow. SUBJECTS: Medical students. RESULTS: Students valued the contrasting perspectives and information provided by different sources. After completing the three sessions, most students and tutors considered it an interesting, enjoyable and educational experience. CONCLUSIONS: This innovative community-oriented teaching programme gave students some insight into how health, morbidity and mortality are measured, why these might vary between different communities, and how different community members' perspectives might differ regarding perceived health and social needs.     

ADL评估量表在老年病房实施基础护理中的应用

目的：探讨ADL评估量表在老年病房实施基础护理中的应用效果。方法：按入院时间先后顺序,将2013年9月~11月入住老年病房的80例患者设为对照组,2013年12月~2014年2月入科的86例患者设为观察组。对照组入院时按常规护理评估,根据医嘱实施分级基础护理和生活护理;观察组在常规护理的基础上加上ADL评估,按照ADL评估结果实施分级护理。结果：观察组的基础护理合格率及患者满意度显著高于对照组,差异均有统计学意义（P<0.05）。结论：在老年病房中应用ADL评估量表实施基础护理,可提高护理服务质量和护理满意度,ADL评估量表可以作为患者对基础护理需求的依据。     

Rhetoric and reality in stroke patient care

The aim of this study was to identify aspects of the process of care that might help explain the improved outcomes associated with stroke units. Three different care settings for stroke patients, an elderly care unit and general medical ward in an inner-city teaching hospital and a stroke unit in another teaching hospital in the same city, were compared using non-participant observational methods. Nurses on the stroke unit and general medical ward usually engaged in standardised and functional interaction with patients, while nurses on the elderly care unit were observed to adopt a more personal and attentive approach with patients. Rehabilitation nursing was rarely observed on the stroke unit, never on the general medical ward but always on the elderly care unit. There was evidence of effective communication between nurses and therapists on the elderly care unit but this was not observed on the stroke unit. On the elderly care unit the team appeared divided, with therapists and nurses on one side and medicine on the other, while on the stroke unit the divide was between doctors and therapists on one hand and nurses the other. On the general medical ward there was no team working. The observed lack of rehabilitation nursing, nurses' disengagement from the team and nurses' observed lack of warmth towards patients on the stroke unit were all surprising findings. Further research needs to examine whether such findings would be reproduced in stroke units elsewhere. If so, it might be that the better outcomes achieved on stroke units are despite rather than because of the nursing they receive there.