老年脑卒中后遗症患者的综合康复护理

2000年6月-2002年12月本院康复科收治老年脑卒 中后遗症患者380例,男244例,女130例;平均年龄78岁, 其中>70岁140例;病程3个月;均伴有偏瘫。护理方法:① 入院后进行ADL和行动能力评定,站立平衡达3级,而步态 不稳的患者专人陪护,并给扶拐器扶助步行;卧床时给予护 栏保护,上下床时协助,病区配备辅助步行器械及助力自行 车,供下肢肌力>4级患者使用或训练,并定期检查器械质 量。②根据患者体质、ADL评定、偏瘫等级等制定具体的康 复计划,并按计划给予一对一手法、运动及作业治疗等[1],运 动量以患者轻微出汗和呼吸增快,运动后次日晨起感觉…     

老年脑卒中患者吞咽障碍康复护理研究现状

检索脑卒中后吞咽功能康复护理相关文献,对老年脑卒中患者吞咽障碍的评估和康复护理方法,包括基础训练、摄食训练、代偿性训练、冰刺激、神经肌肉电刺激、针灸疗法、强化认知训练等进行综述,以期为康复护理措施的选择及研究提供参考。     

老年脑卒中60例康复护理

2006年12月-2007年6月，我们共收治60例老年脑卒中患者，对其实施康复指导与功能锻炼，经临床观察，取得满意效果。现报告如下。     

老年脑卒中吞咽障碍112例早期康复护理

近年来，我们对112例老年脑卒中吞咽障碍患者进行早期康复护理，取得满意效果。现报告如下。     

老年脑卒中吞咽障碍112例早期康复护理

2006年6月～2007年3月,我们应用医院焦虑及抑郁情绪自评量表(HAD)测评586例孕妇的情绪变化,并以艾迪产后抑郁量表(EPDS)跟踪调查其产后抑郁症发生率,分析孕期情绪对产后抑郁症发生率的影响,并制定护理措施.现报告如下.     

康复护理对老年脑卒中病人运动功能恢复的效果分析

将91例老年脑卒中偏瘫患者随机分为观察组45例和对照组46例,对照组患者行常规基础护理。观察组在常规护理的基础上给予康复护理干预。结果治疗后观察组患者Fugl-Meyer运动功能评分及Barthel Index量表评分显著高于对照组,P0.05。康复护理能够促进患者运动功能的恢复,提高患者的生活自理能力,降低致残率,提高患者的生活质量。     

老年脑卒中康复疗效及影响因素分析

目的 评价康复治疗对老年脑卒中患的临床疗效,探讨影响康复的原因。方法 ２０９例不同时期脑卒中患,分为两组。对照组在学历、对康复要求及康复时间与康复组不同。采用ＰＵＬＥＳＥ评分标准评定ＡＤＬ。结果 康复组治疗前后ＰＵＬＥＳＥ评分差异显（Ｐ〈０．０１）。与对照组比也有显差异。结论 康复治疗可有效恢复老年脑卒中患肢体运动功能,提高ＡＤＬ能力,同时多种因素影响临床康复疗效。     

老年脑卒中患者家庭康复护理

<正>脑卒中患者大多仅经过1月住院抢救治疗后病情稳定、好转,回家休养,回家后难以得到系统和正规的康复治疗,从而错过最佳康复期,留下失语、偏瘫、自理缺陷等后遗症,给患者造成痛苦,给家庭造成负担,尤其是老年脑卒中患者由于年龄大、功能恢复差,更易造成残疾,因而对脑卒中患者进行家庭康复护理对促进康复、减轻家庭负担具有长远意义。自2001年2月～2005年6月我们对16例脑卒中患者进行了家庭康复护理,收到满意效果。现报告如下:     

老年综合评估在老年康复中的应用①

老年综合评估是全面关注和处理与老年患者健康和功能状态相关问题的重要研究方法.它不仅包括一般的医学评估(诊断),而且还包括对老年人躯体功能、精神心理、社会经济、生活环境和生存质量等方面的评估.本文介绍老年综合评估的概念、目标人群、评估内容和实施方法,以及老年综合评估在老年康复中的应用.     

上海市社区康复资源分析

目的 调查上海市社区卫生服务中心康复资源现状。方法 2018年12月,调查上海全市16个区所有社区卫生服务中心,共计247家。发放《医疗机构调查表》,内容包括康复人员数(康复医师数、康复治疗师数)、康复床位数等资源情况。结果 截至2017年底,上海市社区共有康复医师152人,康复治疗师597人。每千户籍人口康复医师、康复治疗师分别为0.01人、0.04人,每千户籍老年人口康复医师、康复治疗师分别为0.03人、0.12人。社区共有床位17 484张,其中康复床位1425张(8.15%)。上海市每千户籍人口、户籍老年人口的康复床位数分别为0.10张和0.30张。结论 上海社区康复发展不充分,资源较为缺乏,服务供给规模相对较小,供需不匹配。建议加强对社区康复工作的支持、增加社区康复资源供给。     

上海市康复人力资源发展现状

目的 调研上海市康复人力资源现状。方法 基于世界卫生组织《健康服务体系中的康复：行动指南》“康复现状系统评估配套工具 康复信息收集模板”,按照上海市康复治疗质量控制中心要求,上海市康复医学会实施上海市康复相关从业人员数量及其知识结构调查。结果 调研医疗机构311家,开设康复医学科254家(82.47%);康复从业医师1414名,注册康复医师528名(37.34%),其中高级、中级、初级职称分别为142名(26.89%)、262名(49.62%)、124名(23.48%);具有康复资质治疗师共2668名,其中高级、中级、初级职称分别为11名(0.41%)、461名(17.28%)、2196名(82.31%);康复护师共1614名,其中高级、中级、初级职称分别为13名(0.81%)、476名(29.49%)、1125名(69.70%)。每10万人口中康复医师、康复治疗师、康复护师分别为2.17人、11.11人、6.65人,仅为国际平均水平的1/5;无康复执业医师机构121家,多点康复执业机构40家。结论上海市的康复医师、治疗师和护师存在较大缺口。基于当前物理治疗师、作业治疗师、言语治疗师等专业的职业系列和资质认证尚未完善的现状,建议多渠道、多形式进行针对性岗位培训,尤其须加强康复从业人员规范化岗位培训和康复转型培训;推进康复住院医师和专科医师规范化培养,快出人才,出好人才,以满足临床康复工作需求。     

Geriatric Assessment,Falls and Rehabilitation in Patients Starting or Established on Peritoneal Dialysis

Individuals aged over 70 years at the time of starting dialysis have a varied and often challenging existence on dialysis. Canadian data suggest those starting dialysis between the ages of 75 and 79 years will have an average life expectancy of 3.2 years, while based on US data, patients can expect an average life expectancy of 25 months. A substantial proportion of these patients will, however, experience transient or permanent loss of personal independence within the first few months to years on dialysis. Preliminary data from patients recently started on peritoneal dialysis (PD) suggest patients and families adapt, but that the adaptation often involves limiting activities and altering the social role the patient has within the family. As data emerge, it will be possible to hypothesize whether this adaptation is beneficial in the long term, or whether these adaptations are permissive, allowing the patient to play a sick role leading to an accelerated transition to frailty and possibly death. Future research will hopefully inform us whether the functional dependency can be identified early and whether it is preventable. In the interim, repair rather than prevention is possible through rehabilitation. We therefore advocate that programs providing PD care consider the integration of protocols whereby patients may undergo formal evaluation to identify those who would benefit from walking or personal care aids, rehabilitation interventions, and, when needed, personal support.     

武汉市武钢社区脑卒中患者康复需求调查分析

目的调查武钢社区脑卒中患者的现状和康复需求,为制定有效的社区康复干预措施提供依据。方法采用自行设计问卷对武钢社区127例脑卒中患者进行问卷调查。结果收回有效问卷127份。康复需求主要集中于康复基础知识宣教、肢体功能训练和心理问题的康复。结论掌握了社区脑卒中患者的基本状况和需求情况。     

Motivation in Geriatric Rehabilitation

In this study, critical ethnography was used to explore the factors that help motivate people in a geriatric rehabilitation unit and factors that decreased motivation. Five key informants were chosen using purposeful selection. The participants were white women with an average age of 87. The women were interviewed within the first week of admission and follow up interviews were done at 3- to 5-day intervals. Each informant was interviewed at least three times and one informant was interviewed eight times. Additionally, participants were observed in therapy and on the nursing unit. The following themes emerged regarding factors that improved motivation — goals, humor, caring, beliefs, encouragement, a motive disposition, and "power with" relationships. Several factors decreased motivation including feelings of domination and negative beliefs. The study helped identify ways in which clinicians can motivate older adults in a geriatric rehabilitation program.     

脑卒中患者在康复过程中的心理健康状况

目的了解患者在脑卒中康复过程中的心理卫生状况。方法采用心理卫生症状自评量表(SCL-90)对脑卒中2 周后的患者进行心理检测,并对出血性脑卒中和缺血性脑卒中以及脑卒中的肢体瘫痪不同程度进行比较。结果脑卒中患者患病后2 周普遍存在不同类型和不同程度的心理问题(100%)。出血性脑卒中与缺血性脑卒中患者发生的心理问题类型和程度均无显著性差异(P>0.05)。肢体瘫痪严重者,抑郁、焦虑、恐怖得分明显高于较轻者(P<0.01),强迫和人际敏感次之(P<0.05)。结论脑卒中后心理问题发生率极高,肢体瘫痪越严重,心理问题越重。     

脑卒中失能老人康复治疗中家庭关怀度与自我感受负担的调查

目的调查脑卒中失能老人康复治疗中家庭关怀度与自我感受负担,以期为实施优质护理提供现实依据。方法2014年12月至2015年12月,便利抽样法选取在第二军医大学长征医院治疗的225例脑卒中失能老人为研究对象,采用家庭关怀度问卷和自我感受负担量表对其进行调查。结果 225例患者中,有88.00%的患者存在自我感受负担;自我感受负担总分为(32.33±1.46)分;家庭关怀度总分为(7.23±1.37)分。结论脑卒中失能老人康复治疗期间自我感受负担发生率较高,家庭关怀度普遍较低相关部门应制定相关措施提高患者的家庭关怀度,降低患者的自我感受负担。     

Nursing Interventions in Stroke Rehabilitation: A Study of Nurses' Views of Their Pattern of Care in Stroke Units

The care given to stroke patients in acute care general wards has been described as of a poor standard, with resultant poor outcomes. Systematic reviews have established the benefits of stroke units on patient, outcomes such as functional ability and mortality. The trials have also hypothesized on the reasons for such improvements. One explanation is that the establishment of an interested, enthusiastic, and specialized nursing workforce within a stroke unit improves levels of care and hence, outcomes. However, there has been no research to identify the nature of the nursing care that is provided. To identify the nursing interventions of such a work force, we asked 90 nurses in 21 stroke units about the care that they provide for stroke patients and their caregivers. Our study suggests that nursing interventions in stroke care can be discussed within the criteria and concepts of six themes—focus of care, outcomes of care, direct care, continuity of care, mode of care, and context of care. These themes are dependent on one another for the successful delivery of the care that the nurses expect to deliver. The implications of these findings for the delivery and organization of rehabilitative nursing care are discussed.