Sexuality and the satisfaction of sexual needs. A study on the attitudes of aged home-nursing clients

This article discusses conceptions of sexuality and the satisfaction of sexual needs in a sample of aged home nursing patients (N = 50) in a small rural town in Finland. The purpose of the study, which was carried out as part of a nursing development project in the form of action research, was to gain a deeper understanding of the satisfaction of basic human needs and problems of need-satisfaction in aged people, particularly in the domain of sexual needs. The data were collected using a semi-structured questionnaire, which was designed primarily on the basis of the need theories of Yura & Walsh and Orem. Negative attitudes towards sexual needs were found in more than half of the aged respondents; they did not consider it proper for aged people to have an active sex life. One-quarter felt that sexual needs and desires were shameful and sinful. Only less than one-quarter had positive attitudes towards sex. The majority of the respondents felt that they could freely and confidently talk about sex with the nursing staff, but only less than one-quarter were willing to do so. Almost all had some need to show affection to another person. The majority accepted their own self-image, but half were not satisfied with their physical appearance.     

Identifying the health needs of elderly people using the Omaha Classification Scheme

An examination of what constitutes assessment would help to clarify those aspects which are essential for establishing a suitable nursing plan for clients. There is no consensus on one assessment tool in nursing, and many methods are used. The important areas in a comprehensive assessment (physiological, mental, social and environmental factors) which need to be addressed are covered by the Omaha Classification Scheme (OCS). This paper discusses the application of a research tool (OCS) for assessing the health needs of a given population. The primary focus of this paper is upon the methodology used in the study. A random sample of 500 elderly people was drawn from all elderly people aged 65 years and over, who lived in the rural areas of Isfahan province, Iran. Data were collected to identify the health needs of the population under study using the OCS. The reliability of this research tool was tested for quantitative scores using Cronbach's alpha test. The results showed an acceptable score for reliability ( r =0.78).     

The use of touch to enhance nursing care of older person in long-term mental health care facilities

The self-care deficits experienced by older clients in long-term mental health settings, because of cognitive impairment, are likely to impact upon the clients' higher-order needs. The practice of nursing the elderly involves a lot of personal contact, during the delivery of fundamental physical care. While physiological and safety needs are crucial to clients in long-term settings, higher-order needs need also to be addressed. From the clients' perspective nurse's use of touch provides comfort, warmth and security, although there is a dearth of empirical evidence of these benefits. This paper explores the nurse's use of touch, the impact of touch and the experiences of touch on the older person in long-term settings. Because of the dearth of research in the use of touch with elderly clients in long-term care mental health facilities, a review of the literature was performed on the topic. This revealed that touch by nurses is frequently associated with routine tasks within nursing, and is less likely to be a caring touch intervention. Recommendations include further research on the topic and caution with widespread adoption of caring touch as an intervention.     

Promise and problems in reminiscence research

Nurses use reminiscence as an intervention with elderly clients to meet a wide variety of needs. Research on reminiscence has provided some support for benefits of reminiscence in maintaining or improving mood, cognitive functioning, life satisfaction, and self-esteem in the elderly. Weaknesses in reminiscence research have been presented along with suggestions for developing a body of knowledge for nursing regarding reminiscence.     

社区老年人护理需求及生活质量的相关性研究

目的 了解社区老年人对社区护理服务的需求情况及对生活质量的影响因素,提出改进社区护理的对策,以提高老年人生活质量.方法 选择深圳市2个社区的388名老人作为研究对象,用自制的社区护理需求调查问卷及生活质量综合评定表(GQOLI-74),对其生活质量状况、社区护理需求情况及影响因素进行调查.结果 老年人生活质量得分为61.71±9.85;对社区护理需求得分为2.52±1.03,对健康促进需求最高(2.88±1.09)分.影响社区护理需求的主要因素是对社区护理的认识、患病数目、年龄等;影响老人生活质量的主要因素是患病情况、经济状况、文化程度、职业、婚姻状况、年龄等.老年人对社区护理各领域需求与生活质量的躯体功能、心理功能呈负相关关系(P＜0.05,P＜0.01);对疾病护理方面和护理需求总分与社会功能呈负相关关系(P＜0.05,P＜0.01).结论 社区老年人生活质量偏低,对社区护理需求较高,其生活质量和社区护理需求呈负相关关系,需针对老年人需求特点开展社区护理工作,提高其生活质量.     

Developing trusting, caring relationships: home care nurses and elderly clients

Trusting as an area of research has not been critically examined in nursing research literature In this study, nurses working in home care and elderly clients were interviewed to ascertain the process of developing a trusting relationship Data were obtained from seven home care nurses and six elderly clients who were interviewed from one to three times The data were analysed using grounded theory methodology and sorted using Microsoft Word software on a Macintosh computer The core category which was identified in the data was labelled 'trusting, caring relationships' This core category encompassed trusting which is developed and the caring which the nurses provide Home care nurses and elderly clients moved through four phases initial trusting, connecting, negotiating, and helping The findings have implications for novice nurses working with elderly people, as well as for programme development and education More research needs to be done on trust in different contexts to assist all nurses in establishing nurse–client relationships     

A Delphi study of district nursing research priorities in Australia.

This study, using a Delphi approach, sought the opinion of a self-selected panel of 320 district nurses regarding research priorities for district nursing in Australia. Over three rounds of questionnaires, the 419 research clinical problem areas requiring research as suggested by the panel were each rated in importance by the panel and then ranked through analysis from high to low average rating scores, thereby, whittling down the list to the top 15% (68) research questions and to a final list of the top 10 research priorities overall. Research questions focusing on discharge planning are dominant in these top 10 priorities, with documentation issues the second most common focus. Other foci in the top 10 priorities are staffing, aged care, palliative care, and assessment. The organization-specific top 10 research priorities focus on wound care, funding, education, and communication issues. Additionally, the top 68 priorities, which are either finitely practice-based or contextual-issues research questions, were categorized into 20 themes. The results will hopefully lead to scarce human and financial resources being directed to practice-relevant research programs that will facilitate improved health for district nursing (primarily home-nursing) clients in Australia and elsewhere.     

Measuring the Need for Nursing Care in Older Adults Living at Home

Abstract The Community Health Intensity Rating Scale (CHIRS) has been found to significantly explain variation in resources consumed by both home health care clients and high-risk public health nurse clients. Secondary analysis of CHIRS scores from two earlier retrospective studies provided insights into basic similarities and differences between older adults served by a home care program ( n = 208) and those served by a public health nursing program for frail elderly ( n = 47). CHIRS scores for both client groups demonstrated a substantial need for care, with a greater range of CHIRS global scores for home health care clients but significantly higher CHIRS total scores for the public health nurse clients ( t = -5.24, p < .001). These findings suggest that the public health nurse clients experienced needs across multiple areas whereas the home health care clients' needs were more narrowly focused and episodic. Representation of needs by an intensity rating such as CHIRS can foster more focused visit planning and more specific outcome assessment, assist in planning staffing and in-service education, and focus nursing education regarding care of older adults.     

Toward conceptualizations in nursing: harbingers from the sciences and humanities.

Conceptualizations of care and caring generated from ethnographic study of Tohono O'odham children, Norwegian-Americans, elderly clients in nursing clinics, preschoolers, children with cancer, and gender differences is outlined. Where research questions came from during life experiences of the author, a journey of nursing scholarship viewed from concepts of context development, transformation and care, and "Where do we go from here?" serve as the outline for a discussion of the generation of conceptualizations. A question for nursing research is proposed: What characteristics of care promote human responses for quality human experience? Suggestions for nursing research in the future emphasize the potential of human responses, variations in conceptualizations of care during the life cycles of human beings living in diverse cultural contexts, and changes in conceptualizations of care over time.     

与老人生活的经历对护生老年护理意愿及对老人态度影响的调查分析

目的 了解护生与老人生活经历对其从事老年护理工作意愿的影响,为老年护理人才培养提供参考.方法 随机抽取231名护理专科生进行问卷调查,内容包括一般资料、与老人生活经历、从事老年护理工作意愿、对老人态度及老化知识水平.并对调查结果进行分析.结果 45.9％的护生愿意从事老年护理,是否与老人生活过、与老人关系如何影响护生的老年护理意愿,护生对老人态度偏负向,且老化知识缺乏.结论 多创造机会让护生与老年人接触,可以帮助护生建立对老人的肯定印象,从而激发护生选择老年护理工作的意愿.     

杭州市社区老年护理院建设与发展的研究

目的了解杭州市社区老年护理现状,探索社区老年护理院建设和发展模式,为政府决策部门提供参考依据。方法以走访、信函调查、问卷调查相结合的方式,调查社区卫生服务中心及患者、社区护士、临床护士。结果社区护士数量少、学历低、职称低,在社区为老服务工作中没有发挥较好作用;家庭护理没有很好开展;社区卫生服务中心有一定住院床位,其功能已类似于老年护理院的功能。结论应以社区卫生服务中心为依托,开展社区老年护理院硬件建设,同时建立老年护理评估体系、加强老年护理人才培养,积极稳妥推进老年护理院的发展,以应对老年人快速增长的护理需求。     

The transition to nursing home life: a comparison of planned and unplanned admissions

The percentage of elderly people in nursing homes increases with age from 7% for adults aged 75–84 years to 20% for those over 85 years old. Limited research has been done with elderly people whose admission to a nursing home was planned or unplanned. This study addressed: what are the initial experiences of elderly people in making the transition to nursing home life when the admission was planned or unplanned? A grounded theory approach using constant comparative methods was used to discover the process and patterns of transition to nursing home life. Data were collected 24 hours after admission and every other day for 2 weeks, and 1 month post-admission using in-depth semistructured interviews and field notes. Data analysis demonstrated that the transition to nursing home life occurred in three phases: overwhelmed, adjustment and initial acceptance phase. The phases of adjustment are discussed along with interventions to assist older adults in making this transition.     

The impact of client selection on clinical teaching

Inclusion of gerontological nursing in curricula is emerging as an issue of concern to faculty of schools of nursing. Using research findings which view the setting and client selection as major determinants of learning outcomes, faculty are experimenting with teaching strategies which support a positive more realistic view of the elderly and their inherent potential and motivation for health. This paper examines the learning outcomes about ageing of a senior clinical experience at the baccalaureate level directed toward learning to nurse the elderly in a responsive and health promoting manner. Students were provided with an opportunity to become comfortable working with the elderly and their families in order to: 1 increase their level of knowledge about the process of ageing; and 2 incorporate this knowledge within a nursing framework by identifying critical aspects of development used in the health assessment of the elderly. The method of study was primarily experiential in nature with each student making a series of home visits over a 3-month period to one selected client family. Two groups of clients participated in the programme: clients in group A were maintaining themselves in their own homes, were not anticipating institutionalization and were in good health; clients in group B were in hospital for treatment of a major health problem but would be recuperating in their own homes. By using Palmore's Facts on Ageing Quiz, it was determined that client selection did in fact make a difference vis-à-vis learning outcomes about ageing and the aged.     

A study of functional status among elders at two academic nursing centers

Using the Older Americans Resources and Services (OARS) tool, this study examined quality of life related to functional status in 68 elderly clients at two community-based nurse-managed centers (NMCs) in California. Undergraduate and graduate nursing students administered the OARS to three cohort groups. Data from the tool were used to assess functional independence among these clients and organize and evaluate the quality of nursing care delivered at the centers. The study provides the basis for evidence-based nursing care that integrates research strategies and the nursing process.     

Teaching family nursing: strategies and experiences

The traditional hospital-based approach to Australian nurse education curricula was primarily based on the medical model and directed towards the preparation of nurses who were able to give care to individual clients The major focus was on the needs of the individual A notable absence in curricula was any consideration of the role or importance of families to individual and family health This was despite the continuing involvement that nurses have in their practice with the families of their clients This paper describes the experiences of introducing a family nursing subject in an undergraduate, preregistration nursing programme which focuses on the family as a unit of care Educational strategies, clinical experiences, and evaluation of the unit of study are discussed     

Nurses' knowledge of pain in the elderly

The purpose of this study was to investigate nurses' knowledge of pain and pain management with respect to elderly persons. Registered nurses at several general hospitals and nursing homes were surveyed by questionnaire concerning their knowledge of pain management in the elderly. The findings indicated a significant knowledge deficit in this area. There were also significant differences in knowledge levels between general hospital nurses and those working in nursing homes. We conclude that more education about pain management in elderly patients is needed for nurses. This deficit needs to be addressed in both undergraduate nursing programs and hospital in-service courses. Presently, the majority of patients entering hospitals are aged 65 years and over. Hence, nurses in all areas of care, not just specifically those working in aged care facilities, need a sound knowledge of pain management of the elderly to facilitate compassionate and effective nursing care.     

Necessities and needs of intervention for workplace health promotion in residential elderly care?

The current demographic change coincides with an increasing demand for elderly care nursing services as well as a decrease of available nursing personnel. Against this background, efforts should be made to sustain the health and work motivation of the current workforce. In order to adequately design interventions, one needs an appropriate overview of subjective stress and health-related experiences of target groups as well as insight into influencing factors and organisational conditions. The study at hand analyses corresponding relations on the basis of a scientific survey conducted in six residential nursing homes and one institution for assisted accommodation. Survey results show that burnout is the most meaningful health indicator, while the strongest predictor for burnout turned out to be a conflicting relation between work and private life. There were significant differences between groups of staff concerning subjective perceptions of health. Based on these results, the authors argue for an organisational concept of health promotion.     

农村中老年人慢性病认知现状及健康需求的调查与分析

目的了解农村中老年人慢性病健康知识掌握情况和健康服务需求现状,以期为政府和医疗保健机构制定农村地区改善和提高中老年人健康状况的政策和措施提供依据。方法自行设计问卷,便利抽样法选择上虞市百官镇街道三个村共402名中老年人进行问卷调查。内容包括中老年人的社会人口学特征、生活行为方式、慢性病患病情况、慢性病认知及健康服务需求等,并对中老年人慢性病认知情况和相关因素进行统计分析。结果该地区农村中老年人对慢性病相关知识认知普遍较低,其影响因素主要有性别、年龄、经济收入、文化程度、是否患有慢性病等。结论农村中老年人对慢性病防范意识需要加强,人们的文化生活要寓教于乐,具体、生动、形象地增加中老年人对慢性病相关知识的认知,达到提高健康意识和健康水平的目的。     

Geriatric rehabilitation nursing

This article is derived from a statement initially developed by the author for the Gerontology Special Interest Group of the Association of Rehabilitation Nurses. It draws on the standards and scope of practice of rehabilitation nursing as established by the American Nurses Association and the Association of Rehabilitation Nurses. The article provides insight into the needs of the elderly individual in the healthcare system; ultimately, its focus is on the necessity of providing responsible rehabilitation nursing care for clients with varied gerontological problems by evaluating and promoting restorative function. Rehabilitation nursing joins with gerontology to assist elderly clients in meeting individual goals.