老年空巢综合征的社区护理

老年空巢综合征是中老年人常见的一种心理危机，在精神疾病分类中属于“适应障碍”的一种，多发生于子女成年离开家庭之后独自生活的老人，这类老人常被称为“空巢老人”，目前在中国至少达2360多万。“空巢老人”既要经历个人生命周期的转型（从中年期到老年期），还要经历家庭周期的转型（从核心或主干家庭到空巢家庭），     

我国社区空巢老人护理需求及护理对策的研究进展

随着我国老龄化社会的到来,空巢老人人数呈明显增多趋势。本文主要以空巢老人的护理需求以及护理对策为主线,对近几年相关研究文献进行回顾,为提高空巢老人护理质量、推进老年护理以及构建适合我国国情的社区老年护理模式提供依据。     

浅谈社区空巢老人的心理护理

联合国社会发展委员会在1997年召开的第35届会议上，提醒各会员国要“铭记21世纪老龄化是人类前所未有的，对任何社会都是一项重大挑战”。当21世纪钟声敲响的时候，中国已经进入世界人口老年型国家的行列，2000年，60岁以上老年人口将达1．3亿，占总人口10％以上；2025年达到2．8亿，占总人口18．4％左右；2050年达到4亿左右，占总人口的四分之一以上。由于随着年龄的增长，老年人身体每况越下，目前我国老年人家庭空巢化趋势非常明显，上海空巢家庭大约占到老年人家庭数的三分之一，并预测到2020年上海老年人空巢家庭将占到整个老年人家庭数的80％。空巢家庭老年人普遍存在孤独感焦虑情绪。     

社区空巢老人心理健康状况调查及对策

目的调查杭州市北山社区空巢老人心理健康状况,并提出对策。方法采取随机抽样的方法抽取北山社区60岁以上的空巢老人121人和非空巢老人160人,采用一般情况调查表和心理健康自评问卷、社区老年人抑郁筛查量表、简易应对方式问卷、总体幸福感量表进行调查,并对结果进行分析。结果空巢老人与非空巢老人年龄、性别、受教育程度、婚姻状况以及经济状况比较差异无统计学意义(P0.05)。空巢老人心理健康自评问卷、抑郁情绪总平均分较非空巢老人高,差异有统计学意义(P0.05);应对方式中积极应对维度平均分较非空巢老人低,消极应对维度平均分较非空巢老人高,差异有统计学意义(P0.01);总体幸福感平均得分较非空巢老人低,差异有统计学意义(P0.01)。结论社区空巢老人心理健康水平偏低,社区卫生服务中心在积极关注空巢老人身体健康的同时,应做好心理健康促进工作。     

我国农村空巢老人心理问题及社区护理对策

综述我国农村空巢老人主要的心理问题及相关因素,提出相应的社区护理对策,强调建立全方位、多层次的社区服务网络,深入开展社区护理工作,对改善农村空巢老人心理状况、提高其生活质量意义重大。     

高校社区空巢老人的负性心理及护理对策

高校社区空巢老人的主观意识强,精神需求迫切,空巢综合征、孤独、抑郁和焦虑是他们存在的主要负性心理.应用体现自我价值、建立良好人际关系、倡导体育生活方式、健康教育、心理疏导等社区护理措施进行有效干预,对维护、提高和促进空巢老人心理健康十分必要.     

北京市某社区空巢老人接受社区照顾现状及其与抑郁发生关系的研究

目的：了解北京市某社区空巢老人接受社区照顾现状及其与空巢老人抑郁发生的关系。方法 ：采用自行设计的问卷,调查100例空巢老人接受社区照顾的情况和心理抑郁症状。结果 ：空巢老人抑郁平均分为（10.74±6.89）分,发生率为49%;有配偶、与子女亲友联系密切、接受社区照顾的空巢老人抑郁发生率低（P〈0.05）。社区生活照顾、社区医疗服务、社区娱乐活动、社区心理支持均可降低空巢老人抑郁的发生风险。结论 ：社区照顾可以降低空巢老人的抑郁发生率,应制定相应措施,加强对空巢老人的社区照顾。     

我国城市空巢老人心理健康状况及社区护理现状

空巢老人是指身边无子女共同生活的老年人,其中既包括无子女的老人,也包括与子女分开居住的老人[1].由于社会、经济、文化、观念等多种因素的共同作用,家庭结构的核心化和空巢化转向是一种必然趋势,空巢家庭将会成为未来老年家庭最重要的类型[2].用护理手段或措施解决老年人的健康问题,满足空巢老人的社区护理需求,提高他们的生活质量,开展全方位的社区护理服务,实现健康老龄化的战略目标,已成为护理领域关注的重要课题和研究方向[3].     

银川市776名空巢老人健康状况及社区护理需求分析

[目的]调查银川市空巢老人的健康状况及社区护理需求.[方法]采用问卷对4个社区内共776名空巢老人进行调查,内容包括一般资料、健康状况及社区护理需求.[结果]银川市空巢老人慢性病的患病率为68.6%,在调查的10种慢性病中,患病居前5位的慢性病依次是高血压、冠心病、关节炎、糖尿病和脑血管疾病.在社区护理需求方面,空巢老人需求比较高的主要是老年慢性病预防宣教与护理(63.9%)、生病时护士上门护理(60.4%)和传染病预防知识宣教(58.1%)等.[结论]空巢老人的慢性病发病率较高.在针对空巢老人开展社区护理工作时,应以老年慢性病的预防宣教与护理、生病时护士上门护理和传染病预防知识宣教等为重点.     

我国空巢老人健康状况及社区护理需求情况的研究进展

阐述空巢老人存在生理、心理问题,综述我国空巢老人健康状况及社区护理需求,提出相应的对策,强调完善社区卫生服务网络的建设是当前解决空巢老人健康问题最重要、最有效的措施。     

Responses to medical students' frequently asked questions about family medicine

This article provides answers to many questions medical students ask about the specialty of family medicine. It was developed through the collaborative efforts of several family medicine organizations, including the American Academy of Family Physicians, the Society of Teachers of Family Medicine, the Association of Family Medicine Residency Directors, and the Association of Departments of Family Medicine. The article discusses the benefits of primary care and family medicine, the education and training of family physicians, the scope of medical practice in the specialty, and issues related to lifestyle and medical student debt.     

Managing cancer pain: frequently asked questions

For a variety of reasons, cancer pain is often undertreated, adversely affecting the quality of life for patients and caregivers. To manage cancer pain effectively, physicians need to understand its pathogenesis, how to assess it, how to treat it, and, in particular, how to optimize opioid treatment. We discuss common questions faced by physicians in everyday practice.     

Answers to frequently asked questions about migraine

Migraine is a common primary headache disorder associated with pronounced disability and hence marked economic and public health Implications. Appropriate treatment is warranted to limit the associated disability migraineurs experience. Because of the heterogeneity of migraine, treatment plans must be individualized. The purpose of this article is to provide answers to frequently asked questions regarding the management of migraine.     

The five most frequently asked questions about private duty home care

Where are the growth opportunities in home care? How can I reduce my dependency on Medicare? What can I do to improve the bottom line? These are some of the questions being asked by successful home care leaders as they work to recover from the effects of the Balanced Budget Act and the Interim Payment System and prepare for the Prospective Payment System.     

Silent myocardial ischemia. Answers to frequently asked questions

Patients with coronary artery disease and silent myocardial ischemia have a prognosis similar to that of symptomatic patients. Screening of totally asymptomatic patients is not likely to identify many with silent ischemia. However, certain cohorts of patients--middle-aged men with two or more risk factors for coronary arteriosclerosis--are at risk of presenting initially with myocardial infarction or sudden death, and the screening of such persons is advised. Use of radionuclear imaging techniques during exercise stress testing appears to be helpful in identifying patients at high risk, who should then be offered coronary arteriography. An ideal treatment has not been established, but a treatment strategy based on symptom relief alone is suboptimal. Measures used for symptomatic ischemia are just as effective with silent ischemia. Treatment must be individualized, and ambulatory electrocardiographic monitoring appears useful in adjusting antiischemic therapy for a given patient.     

Approach to the new oral anticoagulants in family practice: Part 2: addressing frequently asked questions

Objective

To address common “what if” questions that arise relating to the long-term clinical follow-up and management of patients receiving the new oral anticoagulants (NOACs).

Sources of information

For this narrative review, we searched the PubMed database for recent (January 2008 to week 32 of 2013) clinical studies relating to NOAC use for stroke prevention in atrial fibrillation and for the treatment of acute venous thromboembolism. We used this evidence base to address prespecified questions relating to NOAC use in primary care settings.

Main message

Dabigatran and rivaroxaban should be taken with meals to decrease dyspepsia and increase absorption, respectively. There are no dietary restrictions with any of the NOACs, beyond moderating alcohol intake, and rivaroxaban and apixaban can be crushed if required. The use of acid suppressive therapies does not appear to affect the efficacy of the NOACs. As with warfarin, patients taking NOACs should avoid long-term use of nonsteroidal anti-inflammatory and antiplatelet drugs. For patients requiring surgery, generally NOACs should be stopped 2 to 5 days before the procedure, depending on bleeding risk, and the NOAC should usually be resumed at least 24 hours after surgery. Preoperative coagulation testing is generally unnecessary. In patients who develop bleeding, minor bleeding typically does not require laboratory testing or discontinuation of NOACs; with major bleeding, the focus should be on local measures to control the bleeding and supportive care, and coagulation testing should be performed. There are currently no antidotes to reverse NOACs. The NOACs should not be used in patients with valvular heart disease, prosthetic heart valves, cancer-associated deep vein thrombosis, or superficial thrombophlebitis.

Conclusion

Management of “what if” scenarios for patients taking NOACs have been proposed, but additional study is needed to address these issues, especially periprocedural management and bleeding.