我国老年人失能失智及长期照护的现状

目的依照老年人的躯体功能和认知能力评定我国老年人的失能失智状况,了解其长期照护服务现状,旨在为我国建立长期照护保障制度提供依据。方法采用中国老人健康长寿影响因素研究2011年跟踪调查数据,根据KATZ量表和MMSE量表对老年人失能失智现状进行评估,利用SPSS 19.0对相关数据进行描述性分析,同时分析失能失智老人长期照护现状。结果 65~79岁、80~89岁、90~99岁和百岁以上老年人的失能率分别是5.5%、15.6%、34.1%和51.7%;失智率分别是4.8%、17.1%、36.3%、56.6%。结合2010年中国人口普查数据进行加权处理,我国城市地区男性老人失能率为10.5%,女性为11.2%;镇区男性老人失能率为7.5%,女性为8.1%;农村地区男性老人失能率为5.2%,女性为8.0%。城市地区男性老人失智率为7.4%,女性老人失智率7.1%;镇区男性老人失智率4.2%,女性为7.9%;农村地区男性老人失智率6.1%,女性为10.8%。随着老人失能或失智程度的加重,部分老人表示家庭成员提供的照护无法完全满足其需求,对于社会服务有需要,但是老年人作为低收入群体,支付能力有限,无力负担高昂的照护费用。结论老年人中存在不同程度的失能或失智状况,在高龄老人中尤为多见。随着家庭照护能力的不断弱化,国家和政府层面构建更为完善的社会长期照护服务体系是非常有必要的。     

医疗保健服务检验公寓的成熟度

按图索引,很快我就来到太阳宫老年公寓。 北京市朝阳区太阳宫老年公离是北京市第一家为失能、失智老人提供专业化服务的敬养型养老机构,是隶属朝阳区民政局的一所中高档老年公寓,主要收住人群为不同程度失能老人和失智老人。     

上海失能失智老人健康服务保障体系研究

目的:从建立健全上海失能失智老人健康服务保障体系的视角,通过政策分析、实证研究和归纳梳理,对老年群体,尤其是高龄、失能失智老人的实际需求开展调研,发现不同生物学特性的老年群体在"医养结合"上门服务项目的选择偏好上存在差异。方法:选取共建合作关系的老龄服务行业主管部门或机构的服务对象共401人开展调研,进行统计学分析。结果:针对筛选出的6类23个服务项目:(1)失能失智老人(80.7%)比健康高龄老人(62.5%)、健康低龄老人(51.0%)对上门照护服务的需求更强烈(P=0.000);(2)失能失智老人(32.6%)比健康高龄老人(25.0%)、健康低龄老人(11.0%)享受长期护理保险的比例更高(P=0.000);(3)在医疗类、家政类、清洁类、生活类、移动类、看护类服务项目方面,健康低龄老人、健康高龄老人的需求相较于失能失智老人更高(P值均小于0.05)。结论:提升失能失智老年人的生存质量,实现老年群体"未病先防,既病防变,愈后防复"的目标,公立医院、康复中心、社区卫生服务中心、社区是在医养结合的服务主体,需要有效配合、有序衔接、有机整合。建立健全与上海国际大都市生活品质相适应的失能失智老人健康服务保障体系,以家庭医生签约制为基础,做好健康守门人;以互联网医疗为驱动引擎,做强线上联络人;以长期护理保险制度为依托,做好专业吹哨人;以专业化职业化为发展方向,做实行业局内人,为老年人提供从专业医疗康复护理到生活照护等全方位、全流程的医养服务。     

基于失能程度差异的老年长期照护服务需求分析

基于2019年老年长期照护调查数据,实证分析了老年人基于失能程度差异的长期照护服务需求以及实际利用情况.调查结果显示,不同失能状况老年人的长期照护服务需求内容不同,社区轻度失能老年人对医疗相关服务、精神慰藉服务、康复指导类和低照护性服务项目需求较大.中度、重度和极重度失能老年人对社会服务类中的事务代办、就医或购物陪同,...     

北京市失能老年人失能等级对非正式照护成本的影响研究

目的：以北京市失能老年人为研究对象,分析失能老年人失能等级对非正式照护成本的影响。方法：使用中国老年健康影响因素跟踪调查（Chinese Longitudinal Healthy Longevity Survey,CLHLS） 2005年、2008年、2011年、2014年、2018年5期调查数据,探究失能老年人失能等级对非正式照护的支出和时间的影响。结果：失能等级对非正式照护成本具有显著影响,老年人失能等级越高,其接受的非正式照护的支出和时间越多;子女和其他亲属与失能老年人的配偶在非正式照护时间的提供上具有一定的替代性;相较于与家人居住的老年人,独居老年人接受的非正式照护的时间明显降低。结论：建议加强对子女等非正式照护者的照护技能培训,提升非正式照护质量,同时积极探索多种形式的照护方式,例如推进正式照护以满足不同失能老年人的照护需求。     

老年失能预防核心信息

<正>失能是老年人体力与脑力的下降和外在环境综合作用的结果。引起老年人失能的危险因素包括衰弱、肌少症、营养不良、视力下降、听力下降、失智等老年综合征和急慢性疾病。不适合老年人的环境和照护等也会引起和加重老年人失能。积极预防失能,对提升老年人的生活质量,     

北京市基层医务人员新发传染病知信行现况调查

目的 了解北京市基层医务人员对于几种常见(艾滋病、SARS、人禽流感等)和不常见(莱姆病、埃博拉出血热、军团病等)新发传染病的知信行情况。 方法 采用整群随机抽样的方法,2020年8—9月选取北京市的四个社区卫生服务中心中医务人员为调查对象,参考国内外相关文献自行设计调查问卷,调查基层医务人员的基本情况及对新发传染病的知信行情况。采用SPSS 18.0统计软件分析基层医务人员新发传染病的知信行情况。结果 北京市基层医务人员对新发传染病知信行平均得分为(18.24±3.25)分,其中对新发传染病知识掌握程度平均得分为(9.86±2.71)分,态度平均得分为(4.17±0.86)分,行为平均得分为(4.21±1.04)分,且年龄越大、学历越高、职称越高的医务人员掌握新发传染病知识得分越高。结论 北京市基层医务人员对于新发传染病相关知识的掌握程度较低,应加强基层医务人员的相关医学培训力度,提高基层医务人员对新发传染病的认识能力。     

老年失能预防核心信息

<正>失能是老年人体力与脑力的下降和外在环境综合作用的结果。引起老年人失能的危险因素包括衰弱、肌少症、营养不良、视力下降、听力下降、失智等老年综合征和急慢性疾病。不适合老年人的环境和照护等也会引起和加重老年人失能。积极预防失能,对提升老年人的生活质量,     

发达国家及地区老年失智全程服务的经验及启示

通过综述经验,发现发达国家及地区在诊断前明确政府责任、制定失智服务计划,诊断早期发挥基层作用、加强失智早期筛查,诊断中期注重服务整合、社区服务、喘息服务等,诊断晚期为患者提供持续照护、安宁疗护.建议出台针对失智的照护计划,提供连续、整体、整合型的服务,关注社区服务和管理支持,为照护者提供支持与经济激励.     

宁波市长期照护服务现状及挑战*

随着人口老龄化的不断加快,养老问题变得尤为突出。家庭或一般养老机构难以解决老年人的医疗照护问题。长期照护服务体系是未来应对失能、失智老年人照护危机的根本出路。随着我国家庭结构和社会结构的不断转型,对老年人口的照护服务逐渐成为整个社会的责任。总结归纳国内外照护体系的模式,结合宁波市人口老龄化的趋势和中国特有的人口政策,提出问题和挑战,旨在为构建适合宁波市整合型长期照护服务体系的建设提供参考与借鉴。     

Education and staffing levels in the intensive care unit.

The Joint Board of Clinical Nursing Studies (JBCNS), established in 1972, sought to standardize the type of clinical experience and theoretical input required for postregistration nurses in specialist areas. The English National Board (ENB) superseded the JBCNS as a result of the Nurses, Health Visitors and Midwives Act of 1979. Colleges of nursing will become the providers of specialist intensive care education and the clinical areas or individual nurses will become the purchasers. The implementation of Project 2000 may alter the educational needs of nurses wishing to specialize in intensive care. The introduction of the Credit Accumulation Transfer System will lead to diploma or degree level modules being developed in intensive care. Increasing clinical expertise will be engendered through the ENB Higher Award. More flexible use of the workforce is envisaged, promoting the use of part-time and episodic employment, to meet the demands of the NHS as a contract-based organization.     

基质金属蛋白酶9及其组织抑制因子1在社区获得性 肺炎和肺结核鉴别诊断中的价值*

摘 要：保持孕妇体内微生态系统的动态平衡对保护母婴健康至关重要。胎盘是胎儿与母体之间进行物质交换的重要器 官，长期以来均被认为是无菌的。然而，最新的多重组织学和高通量测序研究结果显示，即使在没有感染的情况下，胎盘和 胎膜可能也不是无菌的，相反胎盘有着不同于其他器官系统的、丰富的微生物群。据有关报道显示，胎盘上的微生物会直接 影响胎儿的健康, 可能会导致胎儿早产甚至流产。世界卫生组织估计，每年约有1 500万名婴儿早产，早产是导致婴幼儿患病 和死亡的主要原因，严重威胁孕妇和胎儿健康。文章就胎盘微生态与早产的研究进展进行综述，旨在为临床早期胎盘微生态 的监测和早产的预防提供参考依据。     

新疆牧业地区失能老年人居家照护时间影响因素分析

目的 探讨新疆牧业地区失能老年人居家照护时间及影响因素。方法 对335例新疆牧业地区哈萨克族失能老年人居家照护时间影响因素进行分析。结果 居家照护总时间为（5.72±2.108） h/d,其中以日常家务活动照护时间（IADLT）最高,为（4.19±0.857） h/d。多重线性回归分析显示:老年人失能程度、居家照护者性别、年龄、照护能力、照护者健康状况、照护者的子女是否需要照护、社会支持以及照护负担会影响照护时间。结论 居家照护时间的影响因素涉及失能老年人、居家照护者及家庭内外部相关因素,应优先针对不同影响因素导致居家照护时间较长的照护者进行相应的照护费用补偿及政策支持。     

Redefinition of School Nursing Practice: Integrating the Developmentally Disabled

Results of three needs assessment studies which had the purpose of providing direction for school nursing practices which would address some of the unmet health needs of today's children and adolescents are reported. Results provide specific examples of how school nurses have not been meeting school health needs through an analysis of one specific need -- integrating the developmentally disabled into the regular school setting. Data were collected from parents, teachers and other supportive personnel in schools by interview and survey methods. Environmental assessments were conducted and the policies and procedures governing health-related activities required by special need students were reviewed. The data indicated that for developmentally disabled students, nurses were not performing the commonly accepted functions of nursing and were not transposing their knowledge of the components of health care ordinarily provided in health care settings to care provided in nontraditional health care settings. Examples of nursing functions and the activities needed to fulfill those functions are provided.     

我国老年长期护理服务质量及其影响因素分析——基于上海市的实证研究

利用上海市调研数据,以60岁及以上老人为研究对象,基于SERVQUAL模型和有序多分类逻辑回归方法分析我国老年长期护理服务质量及其影响因素。研究发现:老人对长期护理服务质量评价不高,且常用临床护理服务质量略低于基本生活照料服务质量。供给方因素中护理机构基础设施、管理水平、护理人员专业水平对长期护理服务质量的提升具有正向激励作用。需求方因素中老人养老金水平对长期护理服务质量的提高具有显著正向激励,而老人的失能程度对服务质量具有显著负向影响,且与男性老人相比,女性老人对长期护理服务质量评价显著更高。研究结果为精确地评估我国老年长期护理服务质量提供了科学依据,对提升失能老人的生活质量,促进我国长期护理服务产业的发展具有重要的政策启示。     

失能老人生活照料需求未满足状况及其影响因素:基于2005—2018年CLHLS数据的分析*

目的：研究失能老人生活照料需求未满足状况及其影响因素,为我国建立健全长期护理保障制度提供科学依据。方法：以拓展的安德森健康行为模型作为理论框架,利用2005—2018年中国老年健康影响因素跟踪调查(CLHLS)数据构建Logit模型。结果：失能老人生活照料需求未满足率呈缓慢下降趋势,但仍有一半以上的失能老人生活照料需求未得到满足。家庭相对经济资源越不足、老人身体状况越差、失能程度越高,非子女和配偶照料、照料者不情愿时,失能老人生活照料需求越难得到满足。结论：建议加强对农村、低龄、低收入和重度失能老人生活照料的关注,强化家庭成员照料,并为家庭成员照料创造有利条件。     

Where are the missing elders? The decline in nursing home use, 1985 and 1995.

Findings from the 1995 National Nursing Home Survey suggest that elderly Americans are reducing their use of nursing home care. The numbers reflect a change in the role of the nursing home, as defined in this survey. By 1995 nursing facilities were increasingly focusing on patients with greater disability and postacute care needs. Preferred alternatives, most notably home-delivered care and assisted living, were likely filling the gap left by declining nursing home use. Better population-based studies are needed to track emerging trends and ascertain whether elders with disabilities are receiving the care they need. Such data could inform development of better public and private financing strategies for long-term care.     

失能老人代际照顾需求未满足状况及影响因素分析

目的 了解我国65岁以上失能老人的代际照顾现状及其需求未满足的影响因素,为提高失能老人代际照顾能力提供参考依据。方法 本研究基于2018年中国老年健康影响因素跟踪调查（CLHLS）数据,分析1 908名失能老人代际照顾需求满足状况,再通过多元logistic回归探讨代际照顾需求未满足的影响因素。结果 49.6%的失能老人的代际照顾需求未完全满足。多元logistic回归分析显示,失能老人的年龄、居住地、失能程度、居住方式、子女个数、生活来源是否够用、代际经济支持、照顾者类别、照顾时间、照顾表现是影响失能老人代际照顾需求满足的主要因素（P＜0.05）。结论 失能老人长期照顾问题亟需受到关注,应根据失能老人及其照顾者特点给予针对性的干预措施,提高失能老人的代际照顾水平,满足代际照顾需求。     

THE STATUS OF RURAL NURSING IN AUSTRALIA: A REVIEW

ABSTRACT: While much has been written about the practice roles of remote area nurses in Australia, less is known about the role and function of the rural nurse. The majority of rural nurses practise in rural hospitals, community health settings and nursing homes. In contrast, the remote area nurses work setting is generally involved with Aboriginal and Torres Strait Islander primary health care services. Rural nurses' practice setting is usually located in a larger organisation than that of the remote area nurse. There is usually at least one medical practitioner in the town or on-call close by. Nurses who are employed in the smaller rural hospitals have what has been described as a 'specialist generalist' role. This means that they are required to be multi-skilled and competent in a wide range of nursing and non-nursing practice. In contrast, nurses who work in base/provincial hospitals, may have either a generalist or specialist role. This paper provides a summary of the literature on Australian rural nurses and develops some of the themes contained therein.     

Assessment of Knowledge and Attitude towards Palliative Care and Associated Factors among Nurses Working in North Wollo Hospitals

BackgroundPalliative care improves the quality of life of patients facing a life-threatening illness. Nurses should improve their caregiving capacity. In Ethiopia, palliative care is underestimated. The availability of data regarding the knowledge and attitude of nurses towards palliative care is critically important. Thus, this study aimed to assess the level of knowledge and attitude of nurses towards palliative care.MethodsInstitution-based, cross-sectional study was conducted in North Wollo hospitals. A simple random sampling technique was used. The data was collected using structured self-administered questionnaires from February to March 2019. The analysis was done using a binary logistic regression model. P-value < 0.05 was considered as statistically significant.ResultsThe result revealed that 59.7% of the respondents had good knowledge and 44.2% had a favorable attitude towards palliative care. Level of education, experience in caring for chronically ill patients, and experience in caring for dying family members within the last 6 months had a significant association with the knowledge of nurses. Monthly income, experience in caring for chronically ill patients, formal palliative care education, and knowledge were found statistically significant with the attitude of nurses towards palliative care.ConclusionMore than half of the nurses had good knowledge, but less than half of the respondents had a favorable attitude towards palliative care. Attention should be given towards palliative care by the health policy and needs to be incorporated into the national curriculum of nursing education.