BEREAVEMENT PRACTICES AMONG CALIFORNIA HOSPICES: RESULTS OF A STATEWIDE SURVEY

During 1999–2000, the California Hospice and Palliative Care Association (CHAPCA) surveyed its 160 member hospices regarding bereavement support services. Over 80% of hospices participated, providing information about program content, staff training, and costs incurred by participants. Results revealed that a greater percentage of larger hospices and non-profit hospices offer support groups and workshops than do smaller hospices and for-profit hospices. Volunteers account for almost one quarter of bereavement staff. The professional background of paid staff is varied, with social workers and clergy being most common overall but nurses more common in small hospices. Almost 90% of hospices provide all bereavement support at no charge to the bereaved. Services most likely to be associated with a fee include special support groups, children's programs, and professional counseling to individuals and families.     

HOMICIDE BEREAVEMENT COUNSELING: A SURVEY OF PROVIDERS

The opinions of 116 homicide bereavement caregivers of interventions recommended for survivors were solicited. Presenting problems, optimum treatment framework, and reasons for treatment failure were also surveyed. Respondents preferred methods associated with crisis intervention and grief counseling. Other clinical techniques were rated as moderately helpful, except family therapy, which was highly rated. Suppression of trauma imagery was deemed harmful to survivors, though diversion was recommended often in cases of complicated grief. Caregivers who are themselves survivors appeared more sensitive to some of the emotional aspects of homicide bereavement, such as the potential for retraumatization in therapy.     

A SURVEY OF CONCURRENT DRUG THERAPY AMONG DAY UNIT PATIENTS

SUMMARY In order to assess the reliability of drug information supplied by day-stay cases, 85 consecutive patients were interviewed. A comparison of the interview answers with the details previously volunteered during the admission procedure showed an increase of 80% in the information given by the patient. While the detailed interviewing technique is time-consuming and may not be infallible, this substantial increase in information highlights problems in the current routine.     

殡仪职工手卫生措施的效果调查

目的了解殡仪职工手部细菌污染状况及非干预情况下洗手效果,为规范殡仪职工手的清洁消毒方法提供依据。方法采用现场采样和细菌检测方法,对北京等8省市区38个殡仪馆的231名殡仪职工进行了洗手前后细菌污染检测。结果殡仪职工洗手前手上污染细菌总数≥15 cfu/cm2者占28.14%,洗手后手上细菌总数≥15cfu/cm2者为34.20%。结论殡仪职工洗手后手上细菌总数显著高于洗手前,常规洗手方法不能有效清除手上的细菌;应当规范殡仪职工方法和采取必要的手消毒措施。     

老年患者医院感染调查结果

目的了解医院老年病科老年患者医院感染发病情况及其危险因素,探讨如何有效预防和控制老年患者医院感染。方法采用回顾性调查方法,对某医院老年病科1826例年龄>60岁的老年患者医院感染病例资料进行统计分析。结果老年病科60岁以上的老年患者医院感染发病率为14.46%。在270例次医院感染患者中有224例次为呼吸道感染,占82.96%;泌尿系感染27例次,占10.00%。住院时间由10d以内增加到30d,医院感染发生率由1.89%增加到14.39%;住院时间>60d者,医院感染发生率占46.21%。医院感染患者送检的微生物标本中检出阳性率41.24%,其中真菌占22.5%,肺炎克雷伯菌占17.5%。结论老年患者医院感染发生率比较高,感染部位呼吸道感染为主,感染病原菌以真菌为主;患者年龄越大,住院时间越长,医院感染发生率越高。     

THE SEXUAL ABUSE OF ADULTS WITH LEARNING DISABILITES: RESULTS OF A TWO YEAR INCIDENCE SURVEY

This paper reports the results of the largest survey to date of the sexual abuse of adults with learning disabilities. Existing knowledge is reviewed in the light of complex methodological and definition issues that exist and limit any work undertaken. The few existing studies of sexual abuse of adults with learning disabilities are described. Details of the current survey of sexual abuse carried out by the University of Kent and funded by the Rowntree Foundation are then provided. Detailed results of the survey are presented followed by a discussion of their implications and comparability with previous research.     

某三甲医院住院患者鼻前庭带菌情况调查

目的了解医院住院患者鼻前庭定植细菌的种类及其耐药情况。方法采用棉拭涂抹采样和细菌检测分离鉴定方法,对某三甲医院住院患者的鼻前庭定植菌进行了检测。结果在2010年5月的某日共采集433例住院患者鼻前庭标本,检出阳性标本385份,总带菌率为88.9%。共分离出456株菌,其中革兰阳性球菌412株,革兰阴性杆菌39株,真菌5株。主要致病菌种类有凝固酶阴性葡萄球菌369株,耐甲氧西林的金黄色葡萄球菌16株;肠杆菌科细菌22株,铜绿单胞杆菌10株,鲍曼不动杆菌7株,白色念珠菌5株。结论该医院住院患者鼻前庭细菌携带率较高,以革兰阳性球菌为主,凝固酶阴性葡萄球菌所占比重最高。     

住院患者医院感染现患率调查

目的了解住院患者医院感染现状,以便完善医院感染监控措施。方法采用横断面调查方法,分别在2009年9月2日和2010年10月19日对青州市人民医院住院患者进行了医院感染现患率调查。结果该医院2009年调查当日应调查住院患者494例,实查率98.99%,医院感染现患率为1.43%。2010年调查当日应调查住院患者514例,实查率99.81%,医院感染现患率为1.95%。2009与2010年度医院感染部位均以呼吸道感染占首位,分别为57.14%和70.00%;当日抗菌药物使用率分别为64.62%和59.65%;标本送检率分别为3.85%和15.08%。结论该医院2次调查的医院感染现患率和抗菌药物使用率均无明显差别,2010年细菌标本送检率明显提高。     

某三甲医院医务人员疼痛诊疗现状及疼痛相关知识的调查

目的:调查重庆市某三甲医院医务人员疼痛诊疗现状及疼痛相关知识的掌握程度,以期提高医务人员疼痛诊疗水平,提高患者满意度。方法:于2013年7月23日~7月25日对该院医务人员进行问卷调查。结果:有53.1%的手术科室医生经常接诊疼痛患者,非手术科室医生为41.6%。镇痛效果不佳时,向疼痛专业医师进行咨询的医疗人员较护理人员、医技人员多。97.5%的医务人员知晓用口服药物进行镇痛,放疗镇痛的知晓率为27.8%;医务人员评价疼痛的方法中以病人主诉和视觉模拟评分知晓率较高,痛阈测定法知晓率较低。结论:疼痛是患者前来就诊的主要原因之一。该院医务人员疼痛相关的基础知识普及较高,但疼痛相关的专业知识普及较低。护理人员和医技人员对疼痛诊疗相关认知相对较差,尚需加强。     

老年患者下呼吸道医院感染调查

目的了解老年患者下呼吸道医院感染情况,探讨预防与控制有效措施。方法采用资料调查方法 ,对老年患者下呼吸道感染现状及危险因素进行了调查。结果该医院3 350例年龄在65以上岁老年患者中,发生医院感染238例,医院感染发病率为7.10%;其中下呼吸道感染135例,占56.72%。发生下呼吸道感染的老年患者均患有各种慢性基础疾病,痰培养病原菌以革兰阴性杆菌为主,占57.89%。结论老年病人下呼吸道医院感染发病率比较高,年老体弱和慢性基础病是医院感染高发的主要因素。     

临床护理人员消毒灭菌知识状况调查

目的了解临床护理人员在护理操作中消毒灭菌知识掌握情况,以促进医院消毒管理水平。方法采用问卷调查方式,对全院临床一线护理人员进行了调查。结果近一半护理人员没有熟练掌握消毒与灭菌基本知识。护理人员答题正确率最高的项目为消毒作用水平的应用,正确率为46.11%。中高级技术职称的护理人员对消毒与灭菌知识的知晓率明显高于初级技术职务的人员。医院医护人员获取消毒知识主要靠自学或部分在职培训。结论医院护理人员消毒与灭菌知识欠缺,不能熟练掌握基本消毒知识和技能,需要加强在职培训。     

口腔门诊患者感染认知现状调查

目的了解口腔门诊患者对感染的认知现状,以便加强感染防护知识宣传教育。方法采用问卷调查方式,对台州市10所口腔医疗机构的门诊患者进行了调查。结果口腔门诊患者对自己就诊过程可能受到医院感染的知识严重缺乏,平均得分都在4分左右。有88%的口腔门诊患者都有学习了解医院感染知识的教育需求,另有约25%的患者自认为曾经接受过相关知识宣传和教育。结论口腔门诊患者群体缺乏必要的感染防护知识,不了解自身所接受的操作是否符合防护要求,需要加强感染防护知识的宣传教育。     

THE USE OF RESEARCH FINDINGS IN BEREAVEMENT PROGRAMS: A CASE STUDY

Violent death is a major public health problem in the United States, yet there is no consensus among bereavement researchers and clinicians regarding a "gold standard" of bereavement services to be offered to family survivors. This article has three purposes: (a) to describe the planning, implementation, and results of a theory-based intervention study involving parents bereaved by the violent deaths of their children; (b) to suggest programmatic elements of bereavement services based on some findings from both the bereavement program and the follow-up data obtained from parents up to 5 years postdeath; and (c) to identify future research and theory development needs. The results of the intervention study involving 261 bereaved parents provide helpful insights regarding parent bereavement program preferences as well as changes in parent outcomes. Some of the most relevant findings pertain to variability in distress levels, gender, and causes of deceased children's deaths. Findings suggest that many different types of services are needed to meet parents' needs. The follow-up data collected from the parents 1, 2, and 5 years postdeath demonstrate that loss accommodation following violent death bereavement is both lengthy and difficult. Recommendations follow for both bereavement services and research studies.     

RECOVERY FOLLOWING BEREAVEMENT: AN EXAMINATION OF THE CONCEPT

Abstract

The idea of “self-mourning” can be extended to shed light on the existential challenge of coping with life in the shadow of death. Coming to terms with personal finiteness and mortality can be understood as a grieving process. Just as grieving the death of another is an extremely complex and multifaceted experience with emotional, physical, spiritual, intellectual, and social impacts challenging the very integrity of the grieving person, so confrontation with and coming to terms with one's own finiteness (self-mourning in the extended sense proposed) has a similar range of impacts and poses a comparable challenge to personal integrity. Just as grieving persons coping with the death of another must work through the tasks of grieving, so persons coping with their own mortality must work through similar tasks. The extended concept of self-mourning illuminates the potentially lifelong struggle to cope with the finiteness, impermanence, uncertainty, and vulnerability that mortality entails. In conclusion, implications of these findings for death education are sketched.     

内蒙古自治区住院癌痛患者疼痛状况的调查

目的:调查内蒙古自治区肿瘤科住院的癌痛患者的疼痛状况,为本地区癌痛管理的实施提供依据。方法:通过对内蒙古自治区参加"春分行动调查"的5家三级甲等综合医院肿瘤科及1家肿瘤专科医院的患者进行问卷调查,并对53例存在癌痛的患者进行了疼痛情况以及镇痛情况的调查分析。调查内容包括:患者一般情况、疼痛部位性质、治疗前后疼痛评分变化、治疗方案、不良反应、患者满意度及治疗不满意患者和医护方面原因等。结果:本组癌痛患者入院时NRS(数字等级评分Numerical rating scale)评分为(6.15±2.37)分,轻度疼痛者9例(16.98%),中度疼痛者20例(22.64%),重度疼痛者24例(45.28%)。有49例(92.45%)患者应用止痛药治疗癌痛,其中46例(93.88%)应用口服止痛药,12例(9.48%)患者应用止痛药后疼痛完全缓解,疼痛控制理想42例(79.2%)。结论:内蒙古自治区住院癌症患者癌痛控制效果较满意,但在止痛药规范用药方面有待进一步加强。