加强临终关怀护理

阐明了临终关怀的理念及服务重点，指出疼痛控制和死后家属的情绪支持是目前临终关怀的重点内容。建议根据中国国情，实施临终关怀护理。首先，要建立临终关怀机构；其次，加强对病人、家属以及医护人员自身的死亡教育；第三，对护士进行抚慰知识和技能的培训；第四，培养护士的高尚道德情操，加强临床技能训练，开展心理学教育、掌握心理学的护理技能，做好临终关怀工作。     

老年护理医院病人长期护理服务模式的研究

我国老年护理实践起步晚,患者在老年护理医院需要接受何种护理服务,并没有明确的标准。本文分析了我国老年护理医院长期护理服务模式的发展现状和存在不足,提出老年护理医院应建立针对老年、慢性病、临终关怀患者的长期医疗护理服务模式,从转变传统护理服务观念,探索助理护士管理模式,合理配置护理人力资源,建立老年护理质量评价体系等方面着手,构建适合国情的老年护理医院长期护理服务模式的建议,对提高老年护理病人生活质量和促进护理事业发展具有现实意义。     

上海市老年护理医院基本状况的分析与建议

目的 对上海市老年护理医院的基本状况、卫生人力资源配置进行调查和分析，旨在为政府和行政管理部门决策本市老年人群医疗卫生服务提供参考。方法 制定“上海市老年护理医院卫生服务调查表”，由被调查的医院负责按要求全面填写调查内容，如期寄回市卫生工作者协会汇总。结果 本次调查显示，至2002年6月经上海市卫生行政部门审批注册的各类建制的老年护理医院67所，总核定床位5480张，实际开放床位7724张(其中市区开放床位占33．20％)，医院的基础设施和卫生人力资源有较大的改观。结论 随着上海市人口老龄化的加剧，社会对适合老年患者医疗护理、生活照料的需求将进一步增大，卫生行政部门应未雨绸缪，合理调整区域内医疗卫生机构的布局和功能定位，设置一定数量的老年护理、临终关怀医院，以满足老年人医疗保健服务的需求。     

本专科护生临终关怀认知程度及态度现况调查

目的:通过对在校护生临终关怀认知程度及态度的调查,分析护生临终关怀的认知度及态度现状及相关性。方法:抽取延吉市某综合大学护理学院本专科大一至大三240名护生作为调查对象进行研究,运用临终关怀认知度和态度调查问卷收集资料。结果:通过调查结果显示,目前护生对于临终关怀了解不够,不同性别、专业和年级的护生临终关怀认知度差异存在统计学意义(P0.05),不同年级护生临终关怀态度差异存在统计学意义(P0.05)。护生临终关怀认知度与态度之间存在显著正相关,相关系数=0.241,P0.05。结论:目前在校护生对临终关怀相关知识不够了解,临终关怀态度也没有建立起来,因此有必要对在校护生普及临终关怀教育及死亡教育,以认识临终关怀护理的必要性。     

军队医院护理人员灾害救护技能调查及启示

目的：了解西部军队医院不同类别护理人员（军人、文职和招聘）灾害救护技能掌握现状,分析原因,提出对策。方法采用自制问卷调查表对3所西部军队医院945名不同类别护理人员灾害救护技能掌握情况进行调查。结果护理人员类别不同,掌握灾害护理的技能有所不同,显著差别,有统计学意义（P＜0．01）。结论不同类别护理人员具备的灾害护理技能和能力不同,与现阶段军队承担平战时应对各种灾害事故救护技能的需求有一定差距。军队医院在职培训上应增加相关灾害护理的系列知识与技能的内容,提高军队医院护理人员整体灾害应对能力,以适应军队发展和卫勤保障需求。     

老年晚期癌症患者的临终护理

老年晚期癌症患者的临终护理中国人民解放军第１０５医院刘克玲近年来，临终关怀护理逐渐受到我国护理界的重视。自１９９２年以来，我科对收治的老年晚期癌症患者实施了临终关怀护理，本文报道１０例提出安乐死要求的老年晚期癌症患者的监终护理体会。１监床资料１０例患...     

城市老年护理医院安宁护理探索

人口老龄化是世界人口发展的必然趋势。上海是最早进人人口老龄化，老龄化程度最高发展速度最快的一个大城市。城市红十字老年护理医院是伴随人口老龄化而兴起的全新事业，它的建立提高了老年人生命质量，适应了社会发展和人民群众的需求，进一步开展城市老年护理医院在临终关怀中安宁护理作用实践研究，对提高老年人生命质量，完善老年护理医院的功能和发展有着重要的意义，在我国发展前途是广阔的。我院自1993年开设老年病区，设床位120张，至1996年底已收治935例老年疾病患者以及374例需临终关怀的老年病人，平均床位使用率高达110％。现…     

家庭病床老年病人临终阶段调查

为了解社区家庭病床临终关怀现状，为开展社区卫生服务的老年保健临终关怀提供科学依据，我们对上海市闸北区临汾社区家庭病床84例老年疖人临终阶段的情况进行了调查。现报告如下：     

临终关怀护理中护士心理状态调查

临终关怀护理是为现代医学治愈无望的病人缓解极端痛苦、维护至死尊严、帮助其安宁地走完生命的最后历程和对临终患者家属提供生理和心理关怀的主体化社会卫生服务[1]。为了加强对临终患者的护理,作者对永州市一县城内两所医院的护士对临终关怀护理的心理状况进行了调查,现报告     

江苏省“优质护理服务示范工程”实施现状调研

【摘要】目的 通过调查江苏省内医院“优质护理服务工程”的实施现状，了解住院患者对当前优质护理服务现状的意见和建议，分析住院患者对“优质护理服务”的满意度和接受度，从而促进优质护理服务的有效落实。 方法 自制调查问卷，随机抽取江苏省内21家综合医院的387名住院患者进行调查，使用SPSS软件进行录入与统计分析。 结果 住院患者对优质护理服务的总体得分为67.63±8.47分，68.7%的住院患者认为目前医院的服务情况与他们的要求没有差距，29.5%的患者认为有一定差距，1.8%的患者认为有很大差距。 结论 “优质护理服务工程”总体实施情况良好，但仍需进一步完善和提高。     

Medical implications of organization of the home help service.

The organizational structure and of the role of home help service is described. Doctors working in both geriatric medicine and the community are aware of the home help service through shared contact mainly with frail elderly patients. They are usually well informed about the practical value of the home help service to the patients but seem to lack knowledge about the internal structure of the home help service and its value as an important source of information about the mental and physical ability of the elderly in the community. In our experience direct contact with the home help service is more effective than indirect contact--through the hospital Social Worker. Home care organizers should be part of the multi-disciplinary team when discussing the possible discharge of a frail elderly patient. All medical staff caring for the elderly, whether community or hospital based, should be aware of the administration structure of the home help service to facilitate the interchange of information.     

病人对责任护士满意情况调查分析

为了全面了解责任护士工作中存在的问题,有利于采取改进措施,提高责任护士的整体素质,采用从服务态度、技术水平、专业知识水平、健康教育水平和协调能力5个方面自行设计调查表,对2000年3－4月在该院5个整体护理病房住院的150位病人进行问卷调查。其结果：病人对责任护士的服务态度满意度灰96.94%,技术水平的满意度为95.96%,专业知识水平86.11%,健康教育能力71.81%,协调能力86.11%;而且护士专业知识水平、健康教育水平和协调能力是影响整体护理深入发展的主要原因,应引起管理者的重视。     

新入职护士对精神科护理知识认知情况调查

目的了解精神病医院新入职护士对精神病护理知识的认知状况,为精神科临床新入职护士的带教提供理论依据,进一步提高精神病医院的护理质量。方法自行设计问卷,对惠州地区三所精神病医院2013年新入职的71名护理人员进行调查。结果新入职护士对精神病护理知识认知存在偏差,其中,如何与精神病人接触与交谈及对精神病人意外事件的处理项目认知度较低。学历、社会环境因素与影响精神科护理识知的认知相关(p<0.01)。教学经历、实践经历是影响新入职护士对精神科护理知识认知的主要因素。结论学校有必要对护理专业学生加强对精神科知识的理论教学与实践培训;临床对新入职护士的带教中,应制订比较系统的专科培训计划,以全面提高精神病医院的临床护理质量。     

Outcomes of preventive case management among high-risk elderly in three medical groups: a randomized clinical trial

Preventive case management was implemented by Sharp Healthcare of San Diego with the intention of complementing primary care for geriatric patients enrolled in PacifiCare's Secure Horizons Medicare plan. This article presents patient outcomes after 12 months of participation. The program featured an annual screening questionnaire, appointment monitoring, disease education, and self-management support. It used a prospective design, tracking randomly assigned treatment (n= 1,537) and control patient samples (n = 1,542) for 12 months. Outcomes included physical and mental health status; hospital, ER, and nursing home use; hospital days and expenditures among persons having an inpatient stay; and primary care physician visits. Utilization data were obtained from Sharp Healthcare systems and from screening questionnaires. No statistically significant main effects were found, but persons with three or more independent activity of daily living limitations were about half as likely to have a nursing home admission if they were in case management rather than in the control group.     

An evaluation of provider educational needs in geriatric care

Providers of geriatric care in Arkansas were surveyed to determine the desire for more information on their specialty as well as opportunities for further training. Those in the nursing profession were most interested in further training, and the major area of interest for all providers was in cognitive decline and mental health information. Specifically, information was sought in the areas of dementia, depression, and memory loss. It is recommended that improvement in geriatric care in the future should focus on nursing education and on raising the level of knowledge and academic prestige in the treatment of elderly patients, especially in the mental health areas.     

医疗队海上训练的组织与实施

根据海上局部战争伤病员救治需要及我悔军卫生船舶现状,强调选派的海上医疗队人员必须具有较好的政治、军事、心理、专业素质和能吃苦耐劳的精神。在海上训练期间,医疗装备是否携带上船取决于船舶条件和船上医疗设备的原有配备情况。并从勤务、技术和舰船特点出发论述了组织海上训练的实施方法和内容：首先要学习必要的海军军事常识、海洋知识、海上遇险时的求生知识及有关的国际法规,以便在海上遇到各种意外情况时能作出相应的处置;其次要掌握必需的海军卫生勤务知识,以训练医疗队员的工作协调性。     

上海市老年护理院现状调查

目的了解上海老年护理需求及老年护理院现状。方法收集2000～2006年本市老年人口结构资料,并采用问卷方式对本市53所老年护理医院进行现况调查。结果上海的人口老龄化问题日趋严重,现有老年护理院数量不足;老年护理工作需求多样化,老年护理人员缺乏相关专业知识。结论应加强对老年护理院的建设,培养老年护理的专业人才,以满足不断增加的老年护理的需求。     

Being altruistically egoistic—Nursing aides’ experiences of caring for older persons with mental disorders

Older persons with mental disorders, excluding dementia disorders, constitute a vulnerable group of people. With the future international increase in the older population, mental disorders will increase as well, thus entailing new challenges for their caregivers. These older persons often remain in their own homes, and in Sweden they are cared for by nursing aides. With little previous research, an increased workload and facing new strenuous situations, it is important to make use of the knowledge the nursing aides possess and to deepen the understanding of their experiences. The study aimed at illuminating the meaning of caring for older persons with mental disorders as experienced by nursing aides in the municipal home help service. Interviews with nine female nursing aides were performed and analysed with a phenomenological hermeneutical research method inspired by the philosophy of Paul Ricoeur. Being altruistically egoistic emerged as a main theme in the nursing aides’ narratives. The nursing aides’ experiences could be interpreted as a movement between being altruistic and egoistic. The findings revealed a continuous distancing by the nursing aides and their struggle to redress the balance between their altruistic and egoistic actions. Caring for these older persons constitutes a complex situation where distancing functions as a recourse to prioritize oneself and to diminish the value of caring. The study suggests that an increased knowledge base on older persons with mental disorders, followed by continuous supervision, is necessary for the nursing aides to improve the quality of the care given.