The relationship between maternal needs and priorities in a neonatal intensive care environment

AIM: The aim of this study was to investigate the nature and organization of maternal needs and priorities in a neonatal unit. BACKGROUND: The relationship between maternal needs and priorities appears to be an under studied area in neonatal nursing. METHODS: A quantitative survey was carried out based on 209 mothers with premature infants. Two self-assessment schedules were used: critical care maternal needs inventory (J. Leske, Heart and Lung 15, 27-42) and a ranking scale. The data were analysed with multivariate analysis. FINDINGS: Data analysis revealed clear priorities in maternal needs. In particular the need for accurate infant related information was a priority for 93% of the mothers. Good communication practices with professionals were also valued. The mothers displayed altruistic behaviour, and self-related needs took second place. It is proposed that maternal needs demonstrate a hierarchical organization. CONCLUSION: It is important for nurses to consider the individual needs of the mothers, simply because the satisfaction of these needs is essential for maternal well-being.     

Mortality Rates and Predictors of Mortality Among Late-Middle-Aged and Older Substance Abuse Patients

This study describes mortality rates and predictors of mortality among late-middle-aged and older (55+) substance abuse inpatients ( n = 21, 139) in Department of Veterans Affairs (VA) Medical Centers in the 4 years after an index episode of care. A total of 24% of the patients died; this mortality rate was 2.64 times higher than expected. Predictors of earlier mortality included older age and nonmarried status, alcohol psychosis and organic brain disorder diagnoses, and several medical diagnoses, including neoplasms, liver cirrhosis, respiratory, endocrine and metabolic, and blood system disorders. Three proxy indicators of illness severity also predicted mortality: more prior inpatient and outpatient medical care and an index episode in an extended care unit. In contrast, more prior outpatient mental health care and remitted status predicted lower mortality. These diagnostic and treatment indicators can be used to identify patients at heightened risk for premature mortality. Moreover, they show that intensive mental health aftercare and remission of substance abuse may delay mortality, even among older patients who have longstanding substance abuse problems.     

大学生的元担忧、情感表达与友善的关系研究

目的：探讨元担忧、情感表达与友善之间的关系。方法：采用元担忧量表、情感表达量表和友善量表对170名工科大学生进行了问卷调查。结果：①性别对外向思维、友善易接近性和有益性有显著的影响；年级对友善的易接近性有显著影响；在情感描述不能和自我概念上存在性别与年级的交互作用。②元担忧对友善存在直接负向预测作用，对情感表达有直接正向预测作用，情感表达对友善存在直接负向预测作用。结论：打破元担忧恶性循环．增加情感表达，能够有效增强大学生对他人的友善表现。     

上海城市社区老年人生殖保健需求分析

目的:了解上海城市社区老年人生殖保健需求的特点。方法:对20个居民区35例老年人、20例服务人员进行访谈;对116例老年人进行结构式问卷调查。结果:31.9％的老年人自诉患有生殖系统疾病,23.3％担心患有生殖系统疾病,53.4％对性生活无兴趣,46.6％没有性生活,48.4％性生活中遇到困难。83.2％的老年人在遇到生殖系统问题时首选到医院就诊。表示会参加专门为老年人提供的生殖系统健康检查、有兴趣与异性老人结伴活动,以及希望社区提供有关老年人生殖保健方面的宣传、咨询服务的老年男性比例明显高于女性,分别为68.2％:32％、40.9％:24％、48.5％:38％。结论;老年人当中存在着大量潜在的生殖保健需求,而目前的老年生殖保健需求层次还较低,重点仍是生殖系统疾病的治疗;老年男性希望获得生殖保健服务的愿望比老年女性更为强烈。     

妇癌患者的社会心理因素调查

本文以自编病前负性情绪调查表、ＬＳＥ─Ｒ及ＥＰＱ对５６例妇癌住院病人进行了调查，并以５６例内科病住院病人作对照。结果显示，６９．６％的妇癌病人在病前有负性情绪，而内科病病人只有１６．１％；８５．７％的妇癌病人病前经历了负性生活事件，而内科病组则为５８．９％；ＥＰＱ评定结果神经质分亦为前者高于后者，均提示社会心理因素与妇癌的发生密切相关。     

The influence of clinical problems, age and social support on outcomes for elderly persons referred to regional aged care assessment teams

Abstract Background: Aged Care Assessment Teams (ACATs) have been established throughout Australia during the past seven years. Early studies of their effect have concentrated on their impact on the rate of institutionalisation of disabled elderly, the clinical characteristics of referred cases and the relationship between disability and recommended care plan. Aims: The aim of this study was to explore the relationship between age, clinical features and social characteristics of AC AT subjects with outcomes at 12 months after assessment. Methods: The examination of an arbitrary sample of persons referred to ACATs over a year by one generalist geriatrician with follow-up of all cases by the three ACATs associated with the study was carried out. All analyses were performed on raw data presented as categorical variables in the form of contingency tables. Results: The sample included 324 subjects who suffered from 2030 clinical problems with a mean of 6.5 per person aged 75 or over and 5.5 for those under 75. Cardiovascular and neurological disease were the commonest source of problems. Study of accommodation outcome at 12 months, for those subjects who survived this period revealed that, in the older group, over 60% of subjects with neurological disease were resident in nursing homes while the majority of all other groups remained in the community, as did two-thirds of those aged under 75. Admission to a nursing home was independent of social support for older subjects with neurological disease, but it played a significant role in those with cardiopulmonary or musculoskeletal disease. Conclusions: The study demonstrates that for one-year survivors there is an increased likelihood of admission to a nursing home of people aged 75 or over with neurological disease, while those under 75 were more likely to remain at home. The association was independent of whether spouse, family or friends were living with the subject. (Aust NZ J Med 1994; 24: 378–385.)     

城市社区医疗预防保健人员知识与技能的需求调查

通过对405名城市基层医疗预防保健人员的知识和技能的需求调查看出,面对医学模式的转变,社区居民医疗预防保健需求的不断增长,他们现有的知识和技能已极不适应。2/3以上的人员认为以往所学的知识不够用,较普遍地要求增加预防医学、临床医学等课程的学习,提高疾病诊断、群众工作、组织交往、科研的能力。调查为基层在职医学教育提供了参考依据。     

The Fetal Patient: Coordinated Care for Families

Complete and accurate knowledge is critical to parent decision making for families with complex and/or life-threatening fetal conditions. Comprehensive fetal centers are available to provide multidisciplinary specialized assessment, evaluation, diagnosis, and nondirectional counseling. Interventional option may include fetoscopic procedures, open fetal surgery, and ex utero intrapartum treatment. The nurse coordinator serves as the family and health care provider liaison for arrangement of services and communication of the plan of care.     

Collaboration--a new IT-service in the next generation of regional health care networks

During the past 10–15 years, Regional Health Care Networks (RHCN) have been established in many regions throughout the world. RHCN build on well-known techniques, methodologies and appropriate standards. Most of the European Countries today have set up IT strategic plans that focus on the establishment of RHCN. The benefits of having access to all relevant information are tremendous and contribute to cost-effective and coherent health services. By the rapid spread and use of Internet, technology has made it possible to interconnect all kinds of applications. In 2000, the most experienced regions in Europe joined PICNIC, a European project to develop the Next Generation Regional Health Care Networks and to support their new ways of providing health and social care. The previous generation of Regional Health Care Networks supported the interconnection of applications by transfer of messages. Messaging is an effective means of integration for isolated high-specialised systems that only need to exchange data. This service will continue to be one of the most important services in the future health care networks. However, tighter coupling may be desirable in some instances to avoid replicating the same functionality in several applications. In other words, certain services can be common and used by a number of applications instead of building that service inside each application. These common services are called middleware services. In PICNIC (http://www.medcom.dk/picnic), a new middleware Collaboration IT service has been identified and developed. This service allows the end users to perform real-time clinical collaboration, with exchange of text, structured data, voice and images across the limits of a single region. A clinical collaboration is associated with the shared clinical context to provide a record of relevant clinical information and facilitates synchronous as well as asynchronous collaboration. This new IT service builds on the increasing popularity of instance messaging and presence systems that facilitate smooth transition between synchronous and asynchronous interaction. The new Collaboration IT service is expected to have a strong impact on the practice of health care in the next generation of Regional Health Care Networks.