206例老年患者的综合评估结果分析

目的 探讨老年综合评估对山西省某三甲医院老年科患者初步实施效果分析.方法 采用老年综合评估量表对老年患者进行评估.结果 接受评估的206例患者,年龄平均为(79.165±9.298)岁.经CGA发现,跌倒率为42.23%(87/206),小便失禁率为21.29%(43/202),大便失禁率为3.96%(8/202),疼痛发生率为49.03%(101/206),听力异常发生率为67.96%(140/206),视力异常发生率为79.13%(163/206),睡眠异常发生率为49.51%(102/206),日常生活能力有缺陷率为60%(114/190),抑郁发生率为31.96%(62/194),焦虑发生率为25.81%(48/186),营养状况不正常的比例为48.91%(90/184),认知功能障碍的比例为29.22%(45/154),前列腺增生率为100%(44/44).结论 老年患者老年综合征发生率高,通过老年综合评估能够尽早发现老年综合征并且给予有效的干预措施,能够有效地延缓衰老,改善老年人的生活质量,使他们安享晚年.     

The Hartford Geriatric Nursing Initiative experience in geriatric nursing education: looking back, looking forward

This article traces the impact of the John A. Hartford Foundation’s (JAHF) Hartford Geriatric Nursing Initiative (HGNI) on the geriatric preparation of nursing students. With over 2.6 million practitioners, nurses play a critical role in assuring the health care of older adults. Older adults make up the majority of patient days in hospitals, home care, and nursing homes. Yet, when the JAHF began its investment in geriatric nursing, specific content on care of older adults was woefully absent in academic programs preparing entry- and graduate-level nurses. Clearly, the JAHF HGNI investment in nursing education has paid huge dividends. Baccalaureate nursing students are now likely to graduate with competencies in care of older adults. In the next 5 years, ongoing JAHF HGNI initiatives should yield similar outcomes in associate degree-prepared graduates and in advanced practice registered nurse graduates. This article traces the impact of the JAHF HGNI on nursing education.     

Rehabilitation in geriatric orthopaedics

The paper reviews the advantages to be gained from a joint approach to fractured neck of femur by departments of orthopaedic surgery and geriatric medicine.     

Emergency Nurses’ Perception of Geriatric Readiness in the ED Setting: A Mixed-Methods Study

IntroductionThe Centers for Disease Control and Prevention (CDC) reports 136.9 million ED visits in 2015, of which 21.4 million (15.6%) were by patients who were 65 or older. This US population demographic is expected to grow by 112% over the next 40 years, becoming just below 25% of the total US population. Emergency nurses will play an increasingly important part in the development of nursing care for geriatric patients. The purpose of this study was to explore emergency nurses’ perception of their ability to care for geriatric patients in the emergency setting.MethodsThis was a mixed-methods sequential design using quantitative survey data and qualitative focus group data, which were analyzed separately and then given equal priority during the data-interpretation phase.ResultsLess than 50% of survey respondents (N = 1,610) reported geriatric-specific screenings, accommodations, and communication with outside agencies as “always available” in their care settings. Qualitative analysis (N = 23) yielded the categories of Triage/Assessment, Care in the Emergency Environment, Discharge Planning, and Facilitators and Barriers, which generally reflected the trajectory of care for the older patient. The overarching concern was keeping patients safe in both the community and in the emergency department.DiscussionEmergency departments should develop integrated systems to facilitate appropriate care of older patients. Identified barriers to improved care include a lack of integration between emergency care and community care, deficits in geriatric-specific education, inconsistent use of early screening for frailty, and lack of resources in the emergency care environment to intervene appropriately.     

Co-morbidity and functional deficits independently contribute to quality of life before chemotherapy in elderly cancer patients

Goal of the work The quality of life (QoL) of patients with cancer is a major area of concern for both patients and their physicians. The independent contribution of functional impairment and co-morbidity to QoL is unclear. Materials and methods We investigated initial global QoL in 477 patients: 195 cancer patients aged 60 years or older (group A), 152 cancer patients below the age of 60 years (group B), admitted as inpatients for chemotherapy initiation and 130 patients aged 60 years or older admitted for non-cancer-related disorders (group C). Global QoL was assessed by the EORTC-QLQ-C30 subscale, functional status by the Karnofsky Performance Scale (KPS) and the Instrumental Activities of Daily Living (IADL) scale, and co-morbidity by the Cumulative Illness Rating Scale (CIRS). Results In multivariate analyses, global QoL is significantly associated with KPS, IADL and co-morbidity in group A (r ² = 0.27), with KPS and IADL in group B (r ² = 0.23), and with age, KPS and IADL in group C (r ² = 0.38). Conclusions IADL contributes to global QoL in addition to the known effect of KPS. In addition, co-morbidity independently influences global QoL in elderly cancer patients.     

老年护理学网络教学平台的建立与应用

网络教学平台是基于现代计算机网络的全新学习环境,通过建立老年护理学网络教学平台及网络互动教学终端,将老年护理学教育资源进行整合,为学习者提供老年护理自主学习、教师引导的网络一体化无缝学习环境,满足学生课后复习老年护理学的需求,提高教学效果.     

日本老年护理制度介绍

随着老龄化社会的加剧,老有所养、老有所依的问题被提上议程。传统的家庭养老模式已不再适应当代社会发展的需求,而社会养老日益进入人们的视线,成为应对老龄化照护需求的一个流行趋势。由于我国经济水平的限制,     

高职老年护理学课程教学的改革

以"融传授知识、培养能力和提高素质为一体,贯穿教学始终"为指导思想,对高职学生的老年护理学课程从教学目标、内容、方法、考核方式等方面进行教学改革,取得了良好的教学效果。     

A 2-item screen for depression in rehabilitation inpatients

OBJECTIVE: To generate a brief screening measure to assist frontline rehabilitation health care workers to rapidly and validly screen patients for depressive symptoms. DESIGN: Case series. SETTING: Inpatient rehabilitation unit. PARTICIPANTS: Five hundred patients (age, >/=60y) cognitively able to complete the outcome measure. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURE: The Geriatric Depression Scale (GDS). RESULTS: Based on the strength of the correlation with the GDS total score, 5 items were selected for model development. A 2-item screen, consisting of items "downhearted and blue" and "worthless," correctly classified 78.4% of patients, with only 3.6% of patients having false-negative classifications. The 2-item screen did not differ significantly in its accuracy or predictive utility from the more inclusive models. CONCLUSIONS: The identified 2-item screening instrument may be an effective tool for health care staffs to use in their efforts to identify symptoms of depression in older adults on a rehabilitation unit.     

Ultrasonography of the thyroid gland in hospitalized,chronically III geriatric patients: Thyroid volume,its relationship to age and disease,and the prevalence of diffuse and nodular goiter

Ultrasonography of the thyroid gland was performed in a screening study of 177 chronically ill, hospitalized geriatric patients older than 60 years of age, from an area with only moderate iodine deficiency. The normal reference ranges of thyroid volume for males (1.7 mL to 22.2 mL) and for females 2.4 mL to 20.9 mL) were similar. The thyroid volume decreased with age in the euthyroid group and was also smaller in euthyroid females in bad health. The prevalence of goiter and thyroid nodules were 7.9% and 11.3%, respectively. Thus, the decrease of the thyroid volume in this geriatric population is probably related to both old age and diseases of the aged. © 1994 John Wiley & Sons, Inc.     

老年人易患疾病的临床表现和护理

老年病人由于机体的老化,可能导致疾病的临床表现与年轻人大不相同。以下针对老年人易患的几种常见疾病,包括感染、消化系统疾病、心血管系统疾病、内分泌系统疾病和抑郁症,分别介绍其临床表现以及相应的护理对策。     

Does additional weekend and holiday physiotherapy benefit geriatric patients with hip fracture? — A case-historical control study

Objective:To evaluate the new service model of additional weekend and holiday physiotherapy (PT) by comparing functional outcomes and hospital length of stay between a group of geriatric patients with hip fracture receiving daily PT training and a group of geriatric patients with hip fracture receiving weekdays PT training.Methods:A retrospective case-historical control chart review was conducted and a total of 355 patients were identified. Between-group comparisons were done on functional outcomes including Modified Functional Ambulation Classification (MFAC), Elderly Mobility Scale (EMS), Modified Barthel Index (MBI) and process outcome in terms of length of stay (LOS) in hospitals.Results:With similar characteristics, patients who received weekend and holiday PT training had a significant higher percentage of MFAC Category III and a significant lower percentage of MFAC Category II (p=0.015) and significant higher MBI scores (mean±standard deviation, median; Study group: 47.4±19.6 points, 51 points; Control group: 43.0±20.0 points, 43 points; p=0.042) upon admission to rehabilitation hospital. A similar trend in EMS scores (Study group: 8.2±5.5 points, 7 points; Control group: 8.4±6.1 points, 6 points; p=0.998) and MBI scores (Study group: 63.0±23.4 points, 68 points; Control group: 61.2±26.1 points, 64 points; p=0.743) were observed upon discharge from the rehabilitation hospital. The average LOS in acute hospitals remained static (Study group: 7.7±3.9 days, 7 days; Control group: 7.4±5.0 days, 6 days; p=0.192). The average LOS in rehabilitation hospital (Study group: 20.0±5.5 days, 20 days; Control group: 24.3±9.9 days, 23 days; p<0.001) and total in-patient LOS (Study group: 26.7±6.4 days, 26 days; Control group: 30.7±11.2 days, 28 days; p<0.001) were significantly reduced. A higher percentage of days having PT training during hospitalization in rehabilitation hospital was shown with the implementation of new service (Study group: 89.1%; Control group: 65.9%, p<0.001).Conclusion:Additional weekend and holiday PT training in post-operative acute and rehabilitation hospitalization benefits geriatric patients with hip fracture in terms of improved training efficiency, where hospital LOS was shortened with more PT sessions, without any significant impacts on functional outcome.     

家庭护理评估量表的汉化和信效度检验

目的 翻译国际居民评估工具家庭护理评估量表（International Resident Assessment Instrument Home Care,InterRAI Home Care）,简称InterRAI家庭护理评估量表,并对中文版InterRAI家庭护理评估量表的信效度进行检验。方法 采用Beaton简洁六步法对InterRAI家庭护理评估量表进行翻译和跨文化调试,形成中文版InterRAI家庭护理评估量表。采用便利取样法,选取在北京市东城区6所社区卫生服务中心门诊就诊、符合纳入标准的老年患者215例,使用中文版InterRAI家庭护理评估量表和改良巴氏指数量表、改良工具性日常生活能力量表、简易精神状态检查量表对社区居家老年人进行评估。 结果 中文版InterRAI家庭护理评估量表总的Cronbach’s α系数为0.871,量表平均内容效度为1.00,评定者间信度为0.916~0.942。中文版InterRAI家庭护理评估量表的ADL维度与改良巴氏指数量表每个条目的Pearson相关系数为 -0.999~-0.810;工具性日常生活能力维度与改良工具性日常生活能力量表的每个条目的Pearson相关系数为-0.996~-0.962;触发认知能力问题与MMSE量表评分判断认知障碍的一致性系数为100%;使用中文版InterRAI家庭护理评估系统所触发的问题与医生诊断间的一致性是100%。结论 中文版InterRAI家庭护理评估量表在社区居家老年人群体中具有良好的信效度,量表的稳定性好、可靠性高,可以在我国社区居家老年人群体中使用。     

PET-CT和CT对老年人胃肠道肿瘤及术后复发转移诊断比较

目的分析正电子发射断层显像/X线计算机体层成像（Positron Emission computed Tomography,PET-CT）和电子计算机X射线断层扫描技术（computer tomography,CT）对老年人胃肠道原发肿瘤和术后复发转移的诊断价值。方法回顾分析同时予PET-CT和CT检查的23例原发胃肠道恶性肿瘤及55例胃肠道肿瘤术后老年患者,肿瘤原发灶及复发转移病灶均经病理证实,对比PET-CT及CT对老年胃肠道肿瘤患者原发灶、术后复发转移的诊断结果。结果 PET-CT对老年人胃肠道肿瘤原发灶诊断准确率为95.7%,CT为77.5%。PET-CT对老年人胃肠道原发肿瘤分期的诊断灵敏度、特异度、阳性预测值、阴性预测值分别为86.7%,90.0%,91.7%,81.8%,而CT为58.3%,72.7%,70.0%,61.5%。PET-CT对老年胃肠道肿瘤术后患者肿瘤复发转移病灶的诊断灵敏度、特异度、阳性预测值、阴性预测值分别为94.6%,83.3%,92.1%,88.2%,CT为43.2%,61.1%,69.6%,34.4%。结论 PET-CT对老年人胃肠道原发肿瘤诊断及术后肿瘤复发转移诊断价值高于CT,为老年胃肠道肿瘤患者临床治疗方案选择提供更有效的检查手段。