以家庭为中心的护理及延续性护理在非重症哮喘患儿中的应用

[目的]观察以家庭为中心的护理及延续性护理在非重症哮喘患儿中的应用效果。[方法]将110例非重症哮喘患儿分为对照组和观察组各55例,对照组采用儿科常规护理,观察组采用“以家庭为中心”的护理及延续性护理照护,比较两组哮喘患儿住院时间、住院费用、治疗效果、家长焦虑自评、生命质量等。[结果]两组患儿在住院时间、住院费用、家长焦虑自评、生命质量方面比较,差异有统计学意义（P〈0.05）。[结论]实施“以家庭为中心”的护理及延续性护理,可以缩短住院时间、减少住院费用、缓解家长焦虑心理、提高患儿生命质量。     

Finding a balance point: A process central to understanding family caregiving in Taiwanese families

The grounded theory method was used to explore the psychosocial process of family caregiving to frail elders in Taiwan. Interview and observation data from 15 family caregivers were analyzed using constant comparative analysis. Caregivers used the process of finding a balance point to achieve or preserve equilibrium between and within caregiving and family life. Caregivers who did better in finding a balance point provided better quality care to frail elders. Caregivers who were good at finding a balance point anticipated competing needs, conceptualized multiple strategies to meet the needs, and predicted accurately the consequences of the strategies. They described a wide variety of balancing strategies. © 1998 John Wiley & Sons, Inc. Res Nurs Health 21:261–270, 1998     

Use of Care by Home-dwelling Stroke Patients during Three Years following Hospital Discharge

Of 82 stroke survivors who had been discharged from hospital, 49 were still living at home after a three-year period. Thirty-three of these patients formed the population of the present study of the use of care at home. Sixty-one percent had received professional care and 88% had received family care. Although their overall functional status indicated only mild handicaps, after three years patients still reported a large number of disabilities and problems. The average weekly amount of family care was 37 h, and many family carers experienced a high burden of care and had emotional problems coping with the patients' disabilities. Concerning factors related to the use of care, in spite of the relatively small number of study patients, some interesting hypotheses can be advanced.     

亲情护理在择期手术病人围术期中的应用效果

[目的]研究亲情护理在择期手术病人围术期中的应用效果。[方法]采用随机数表法将120例择期手术病人分为观察组与对照组各60例,对照组采取常规护理,观察组在常规护理的基础上给予亲情护理,对两组病人在术前1d以及麻醉前的心率、血压进行记录,并于术后对护理质量相关指标及病人护理满意度进行对比分析。[结果]观察组在手术麻醉前的血压与心率水平均低于对照组、护理质量相关指标评分均高于对照组、护理满意度明显高于对照组,经比较差异均有统计学意义(P0.05)。[结论]围术期开展亲情护理可消除或降低手术病人的生理应激,增强其对手术的耐受力,提高护理质量及病人的满意度。     

Family members' experiences of the quality of geriatric care

The quality of institutional geriatric care is a topical issue in Finland. The study to be described here is part of a Finnish project on the quality assessment and development of long-term geriatric care provided by the City of Helsinki. The health care division of the City of Helsinki authorized an outside survey of long-term geriatric care in the hospitals providing such care in 1998. Based on the results, recommendations concerning the development of geriatric care were issued. In the years 1999-2000, a further education programme was arranged for ward nurses, chief nurses and heads of profit centres concerning leadership in long-term geriatric nursing. A re-survey was conducted in 2001, using the same criteria of quality assessment. The purpose of this paper is to report on the quality of institutional geriatric nursing as evaluated by family members in 2001 and to compare the responses to those obtained in 1998. The results are presented as frequency and percentage distributions, means and medians and cross-tabulations. The responding family members were generally content with the care of their elderly relatives: 92% said they were very satisfied or satisfied with the care, and the average of the marks given for geriatric care was 8.3 (range 4-10). Family members were more content now than in 1998, when the corresponding figures were 86% and 7.3 (range 4-10). Nevertheless, the results still highlight certain aspects that should be improved and developed.     

照顾病人家属的时机和方法探讨

[目的]减轻病人家属的焦虑、抑郁心理，与家属建立良好关系。[方法]按护理组别将312名病人家属分为实验组与对照组，实验组病人家属在不同的时机给予人文关怀，在入院后1d及出院前采用SAS和SDS进行心理测评，对结果进行统计分析。[结果]在不同时间对病人家属进行人文关怀后焦虑和抑郁状况都比对照组降低。[结论]提供人文关怀能明显减轻家属的心理压力，从而减轻焦虑、抑郁心理，为病人提供有力的社会支持。     

照顾病人家属的时机和方法探讨

[目的]减轻病人家属的焦虑、抑郁心理,与家属建立良好关系.[方法]按护理组别将312名病人家属分为实验组与对照组,实验组病人家属在不同的时机给予人文关怀,在入院后1 d及出院前采用SAS和SDS进行心理测评,对结果进行统计分析.[结果]在不同时间对病人家属进行人文关怀后焦虑和抑郁状况都比对照组降低.[结论]提供人文关怀能明显减轻家属的心理压力,从而减轻焦虑、抑郁心理,为病人提供有力的社会支持.     

社区家庭康复护理对脑卒中后患者的作用 张凤① 赵忆文② 赵纯红① 赵力群② （上海市浦东新区沪东社区卫生服务中心①，上海 200129 上海市浦东新区公利医院②，上海 200135）

【摘要】目的 探讨社区家庭康复护理对脑卒中后患者的日常生活能力及抑郁状态的作用。方法 选取2011年10月-2012年09月沪东社区卫生服务中心的脑卒中后患者80例,采用随机分组,分为康复组和对照组,对照组给予常规治疗和护理,使用活血化瘀药物及积极治疗并发症等,康复组除在常规治疗基础上,通过心理支持疗法、家庭康复护理和放松疗法等护理服务干预12个月,采用日常生活能力量表（ADL）（采用改良Barthel指数评分量表）和汉密顿抑郁评定量表（HAMD）进行比较。结果 通过12月实施社区家庭康复护理后,康复组Barthel指数评分和HAMD评分均优于对照组,P＜0.05有统计学意义。结论 社区家庭康复护理服务干预可以缓解脑卒中后患者负面心理,提高患者的战胜疾病信心,减轻抑郁状态,提高患者日常生活能力,提高患者生命质量,可在社区护理工作中广泛推广。     

Creating avenues for relative empowerment (CARE): a pilot test of an intervention to improve outcomes of hospitalized elders and family caregivers

The purpose of this pilot study was to evaluate the effectiveness of a family caregiver-focused intervention program (CARE) on the outcomes of hospitalized elders and their family caregivers. A randomized clinical trial was conducted with 49 family caregivers of hospitalized elders in a university medical center in upstate New York. Driven by self-regulation and role theories, the two-phase CARE program consisted of: (a). a mutual agreement consisting of family caregiving activities during hospitalization; and (b). audiotaped information regarding emotional responses and possible complications associated with an elderly patient's hospitalization as well as instructions for effectively participating in the elder's hospital care. The comparison program consisted of information about hospital services and policies. CARE elders had fewer incidents of acute confusion reported by family caregivers during hospitalization and fewer depressive symptoms at 2 weeks and 2 months posthospitalization than did the comparison group. CARE family caregivers participated more in the care of their hospitalized elders and had higher scores on role rewards prior to hospital discharge. Findings from this study support the need for further testing of the CARE intervention with family caregivers to determine its effectiveness on outcomes of hospitalized elders and their family caregivers.     

Person-centred medicine in the context of primary care: a view from the World Organization of Family Doctors (Wonca)

Rationale, aims and objectives Most professional medical care is provided in the community, and this determines the importance of primary care for the health care system. As family doctors are involved in the care of different health problems over time to the same individual, the personal dimension is strong. This paper analyses the importance of person‐centred medicine from the perspective of primary care and family medicine. Methods The views and opinions of the leadership of the World Organization of Family Doctors, Wonca, provided the background material. Wonca brings together national colleges and academies of family medicine around the world. Results The community, with its social, cultural and economic characteristics, is an important determinant of illness, health and disease. This shapes the personal relation between patient and family physician, with its basis of trust, and determines the effectiveness with which primary care functions. Continuity and integration of care are important person‐centred ‘techniques’. Conclusions As the effectiveness of primary care is a major factor for overall effective health care, it is important to come to a better understanding of how to address the personal context of care and the mechanisms through which this determines outcome of care.     

A comparative study of nursing staff, care recipients' and their relatives' perceptions of quality of older people care

hasson h. & arnetz j.e. (2009)   A comparative study of nursing staff, care recipients' and their relatives' perceptions of quality of older people care. International Journal of Older People Nursing   5 , 5–15
doi: 10.1111/j.1748-3743.2009.00186.x
Background.  Comparisons of different stakeholders' ratings of the quality of older people care can help to drive quality improvement.
Aim.  The aim was to compare staff, older care recipients' and their relatives' quality of care ratings.
Design.  Cross-sectional questionnaire surveys in 2003 and 2004, using a repeated measures design on an organizational level.
Methods.  Nursing staff, care recipients and relatives in two older people care organizations were included. The ratings of an overall quality grade, information, activities, general care and staff skills were compared between the respondent groups.
Results.  Care recipients in both organizations rated the overall quality grade significantly higher than nursing staff and relatives. Staff ratings of the information given to care recipients were significantly more positive than care recipients' and relatives' ratings. All three groups gave lowest ratings to the quality of activities offered to care recipients, with lowest ratings from nursing staff.
Conclusions.  Concurrent measurements of staff, care recipients and relatives' care quality perceptions can provide a broad evaluation of an organization's strength and limitations.
Relevance to clinical practice.  Staff, care recipients' and relatives' perceptions can be useful for older people care organizations and decision makers in developing care processes and outcomes of care.     

Evaluation of Care in Psychogeriatric Units: Family Support in Quality of Care

ABSTRACT As institutionalised psychogeriatric patients are very vulnerable, a pilot project was undertaken to develop an instrument to evaluate the quality of their care. The proposed instrument is based on qualitative findings from observations, interviews, records and literature review. It focuses on individual patients, groups of patients, families and the unit, and includes nine items which are measured in terms of administrative, affective and instrumental aspects of care. This paper only describes the data gathered on one of these foci—the involvement of families as both providers of care and as clients requiring support. From the data it appears that the family role as a provider of care is enhanced by support received from the staff and, therefore, family support was selected as an item by which to evaluate quality of care. Material from the data was used as examples for assigning quantitative values to aspects of family involvement.     

Nurses' experience of loss on the death of older persons in long-term residential care: findings from an interpretative phenomenological study

Background. Little is known of the experience of loss among nurses working with older persons in long-stay settings. Objectives. The aim of this study was to explore and describe the experience of loss among nurses working in a long-term residential care setting. Design. Interpretative Phenomenological Analysis (IPA) was the method adopted. Data was collected by semi-structured interviews undertaken with seven nurses. Results. The findings revealed three main themes: 'life's final journey', 'family' and 'professional carer'. Conclusions. The experience of loss on the death of an older person is described by nurses in the context of the care they give at end of life, and the relationships nurses developed with the older person's family. Where the older person has no contact with family, nurses become the 'family' and this contributed to the feeling of loss experienced. Finally, the loss experienced by nurses when an older person dies suddenly can often be emotive. Relevance to clinical practice. Supporting nurses in their provision of end-of-life care to older persons is essential. Nurses' attempts to keep memories of deceased residents alive by remembrance, helps place loss in the context of acknowledgment of the person's life.