护理院慢性病患者焦虑抑郁影响因素的调查研究

目的研究长期入住护理院的慢性病患者焦虑抑郁发生情况及其影响因素。方法选取187例长期入住护理院的慢性病患者为研究对象,使用综合医院抑郁/焦虑量表(HADS)为工具,应用Logistic多元回归分析HASD的主要影响因素。结果入住护理院的慢性病患者焦虑/抑郁的发生率较高(58.29%),其主要影响因素是性别和家庭关怀度。结论护理院工作人员应提高对慢性病患者焦虑和抑郁的识别,特别要注意对高危患者进行心理护理干预,以减少焦虑和抑郁的发生,提高患者的生活质量。     

无缝隙护理院后服务对糖尿病患者糖化血红蛋白的影响

目的 探讨无缝隙护理院后服务对精尿病患者糖化血红蛋白的影响.方法 将80例2型糖尿病患者随机分为干预组和对照组各40例.干预组除药物治疗外采用无缝隙护理院后服务干预,对照组采用常规出院指导.2组均随访1年.比较出院后第3,6,9,12个月2组患者空腹血糖(FPG),餐后2 h血糖(2 hPG),糖化血红蛋白(HbAlc)的变化情况,对数据进行t检验.结果 干预组糖化血红蛋白控制程度显著优于对照组,各项指标都显著改善.结论 无缝隙护理院后服务能维持糖尿病患者良好的糖化血红蛋白水平,减少并发症的发生,提高患者生活质量,值得推广.     

北京市护理院住院费用影响因素及付费方式探索性研究

目的:分析护理院患者住院费用的影响因素,探索适用于北京市护理院的付费方式.方法:对北京市护理院试点机构收治的96例住院患者进行问卷调查.结果:患者的认知功能状况、ADL分级和鼻饲情况是护理院住院费用的影响因素;以这3个因素为基础,采用决策树模型分析,将患者分为4个不同的资源利用分组,预测费用与实际费用的相对比为92.0%-97.5%.结论:根据资源利用程度,认知功能状况、ADL分级和鼻饲情况3个变量可将护理院住院费用有效分为4组.资源利用分组的付费方式适用于北京市护理院,便于更合理地利用和配置卫生资源.     

无缝隙护理院后服务对糖尿病患者糖化血红蛋白的影响

目的 探讨无缝隙护理院后服务对精尿病患者糖化血红蛋白的影响.方法 将80例2型糖尿病患者随机分为干预组和对照组各40例.干预组除药物治疗外采用无缝隙护理院后服务干预,对照组采用常规出院指导.2组均随访1年.比较出院后第3,6,9,12个月2组患者空腹血糖(FPG),餐后2 h血糖(2 hPG),糖化血红蛋白(HbAlc)的变化情况,对数据进行t检验.结果 干预组糖化血红蛋白控制程度显著优于对照组,各项指标都显著改善.结论 无缝隙护理院后服务能维持糖尿病患者良好的糖化血红蛋白水平,减少并发症的发生,提高患者生活质量,值得推广.     

无缝隙护理院后服务对糖尿病患者糖化血红蛋白的影响

目的探讨无缝隙护理院后服务对糖尿病患者糖化血红蛋白的影响。方法将80例2型糖尿病患者随机分为干预组和对照组各40例。干预组除药物治疗外采用无缝隙护理院后服务干预,对照组采用常规出院指导。2组均随访1年。比较出院后第3,6,9,12个月2组患者空腹血糖（FPG）,餐后2h血糖（2hPG）,糖化血红蛋白（HbAlc）的变化情况,对数据进行t检验。结果干预组糖化血红蛋白控制程度显著优于对照组,各项指标都显著改善。结论无缝隙护理院后服务能维持糖尿病患者良好的糖化血红蛋白水平,减少并发症的发生,提高患者生活质量,值得推广。     

英国老年护理院管理对发展我国老年护理院的启示

2011年6月18日第六次全国爱心护理工程工作会议暨老年基金会工作座谈会重点申明,十二五期间,全国将实现拥有600家爱心护理院的目标,为生活不能自理的老人提供更专业、更周到、更加人性化的养老服务.目前,我国老年福利事业发展的状况和保有量,与老龄化社会带来的巨大养老服务需求不相匹配,养老机构服务对象对服务满意度与养老机构管理质量的矛盾十分突出.因此,在政府大力鼓励养老护理院建立的同时,健全护理院的管理凸显其重要性.英国从20世纪30年代初出现老龄化问题,较早开始探寻应对老龄化问题合理的养老体系,并且已形成了较为完善的养老管理制度及监管体制.     

结合资源利用分组的护理院护理服务内容研究

目的:依据我国卫生部颁布的《护理院基本标准(2011版)》中护理院的服务定位,结合国内外护理院的服务发展现状,基于美国长期护理机构资源利用分组(RUG)的理念,探讨适合我国实际需要的护理院护理服务内容框架。方法:采用德尔菲(Delphi)法,选取临床护理管理、卫生行政管理和护理教育领域的28名专家,对形成护理院护理服务内容框架问卷进行两轮咨询。结果:两轮咨询问卷的有效回收率分别为96.43%和88.89%,专家权威系数为0.86,专家意见协调性有统计学意义(P<0.05);形成的护理院护理服务内容框架包括3个一级条目,即日常生活护理、一般专业性护理和特殊专业性护理;22个二级条目和87个三级条目。结论:护理院护理服务内容框架的确立,有助于护理院规范其服务内容,为进一步探索护理院的运行和管理模式奠定基础。     

老年护理院护士职业吸引力影响因素的质性研究

目的：探讨影响老年护理院护士职业吸引力的因素。方法：采用半结构质性访谈的方法对苏州市3家老年护理院的16名护士进行访谈。结果：通过Colaizzi分析法提炼出3个主题。主题1,护士选择老年护理院工作的因素是亲戚或同学介绍、老年护理院就业门槛低;主题2,影响老年护理院护士职业吸引力的积极因素是认识和接受老年护理、工作相对大医院轻松、快速自我成长;主题3,影响老年护理院护士职业吸引力的消极因素是护士职业认可度低、生活婚恋压力大、外出培训机会少。结论：苏州市老年护理院护士职业吸引力低,建议政府相关部门通过开展护理专业学生的老年护理教育、提高老年护理人员薪酬待遇、提升老年护理人员职业发展空间等策略来提高老年护理院护士的职业吸引力。     

北京康复医院脑卒中患者预期居家康复需求调查及影响因素

摘要目的：调查脑卒中患者出院前预期居家康复需求,并分析其影响因素,以期为患者制定最优化出院后居家康复方案。方法：采用横断面研究,自行设计问卷对2022年6—11月于神经康复中心住院的145例2周内计划出院的脑卒中患者进行问卷调查。结果：共发放问卷145份,回收有效问卷138份,问卷回收率95.2%。研究结果显示,脑卒中患者生活自理能力是影响其居家康复需求得分的主要因素（P=0.000）,且相关性分析结果显示,脑卒中患者居家康复需求与生活自理能力呈负相关（r=﹣0.4222,P<0.0001）。居家康复技术需求状况分析发现：康复训练计划、定期评估和随访、中医推拿和针灸、药物治疗和残余肢体功能训练为居家康复技术需求前5位。结论：不同生活自理能力的脑卒中患者出院后均有居家康复需求,但需求程度不一致。生活自理能力越差的脑卒中患者,居家康复意愿较高、需求较大,医疗单位应该重点关注并加强其出院前居家康复指导。     

护理院老年人身体约束的护理研究进展

介绍身体约束的定义,综述国内外护理院身体约束使用现状,对老年人、家属和护理人员的影响及减少身体约束使用的策略,为实现身体约束最小化及提高护理院服务质量提供参考依据。     

Cost analyses of home care and nursing home services in the southern Taiwan area

This study compares the cost of long-term care provided at patient homes with that of long-term care provided in nursing homes in southern Taiwan. Caring for a patient with a high degree of dependence at home is more expensive than caring for a patient in a nursing home facility when family costs and provider costs are considered together. This phenomenon is not demonstrated for patients with medium degrees of dependence. To be cost-effective, home care services should target patients with medium physical disability, and nursing home care should focus on patients with high levels of dependence.     

我国家庭护理的现状

对家庭护理的概念、需求、管理等内容进行了综述,分析了我国家庭护理的现状,提出家庭护理有广阔的发展前景。     

Comparisons of the cost-effectiveness among hospital chronic care, nursing home placement, home nursing care and family care for severe stroke patients

AIM: This study compared the cost and effectiveness of long-term institutional care and home care for stroke patients with severe physical disabilities. BACKGROUND: Whether home care is more economical or effective than institutional care for patients with chronic illnesses remains controversial when the cost of family labour is considered. Thus, decisions concerning the appropriate type of care setting for patients with severe chronic illness remain difficult. METHODS: From November 1995 to March 1996, 313 hospitalized stroke patients with severe physical disabilities treated at one of five hospitals in the Taipei metropolitan area were followed from the day of hospital discharge until the third month after discharge. These 313 patients were divided into four groups as follows: (1) 106 who were admitted to a chronic care unit in a hospital, (2) 60 who were admitted to nursing homes, (3) 60 who received professional home nursing care and (4) 87 who returned home without receiving professional care. The change of physical functional status in the patient was examined as the difference between activities of daily living (ADL) scores measured at discharge and at the end of the third month after discharge. RESULTS: Information on family costs for caregiving, including pay for long-term services utilized, labour costs for caregiving and out-of-pocket expenditures for miscellaneous materials was obtained during a weekly telephone interview. The results indicated that caring for patients in their own homes was not only more expensive but was also less effective in improving ADL scores than caring for patients in nursing homes and in chronic care units of hospitals. CONCLUSIONS: The results suggest that caring for patients with severe physical disabilities in institutions is more appropriate than caring of them at home.     

临终病人家属需求分析及护理对策

[目的]探讨临终病人家属的需求及其护理对策.[方法] 对我科2005年2月-2008年2月32例临终病人家属的需求进行分析,并给予相应的护理对策.[结果] 32例病人中30例病人家属的需求得到满足,有效率93.75%,无效率6.25%.[结论]根据临终病人家属的需求给予相应的护理对策是临终护理十分重要的部分,能使家属得到最大的慰藉,同时可减少医患纠纷.     

健康体检人群护理需求状况调查分析

目的了解健康体检人群的护理需求,为体检者提供满意的护理服务。方法采用问卷调查的方法对496名健康体检者从体检流程、健康宣教、不同护理服务需求度以及选择体检医院的原因等方面进行调查。结果496名体检者中有55.85%认为在体检流程方面以体检秩序好、等候时间短为第一需求,38.91%认为导医人员的及时导诊为第二需求;不同文化层次的体检者对于营养指导和生活方式指导以及发放健康资料方面的需求存在差别(P<0.05)。结论提高护理人员素质是提高体检质量的关键,改善服务质量是体检的生存之本,缩短候诊时间、维持候诊秩序是做好体检的基本条件,开展健康指导、提出预防措施、保持体检者健康是健康体检的目的。     

Cost comparisons between family-based care and nursing home care for dementia

A prospective study was carried out in Taiwan to measure the family cost of caregiving at home for 289 patients newly diagnosed with dementia (106 with senile-type dementia, 171 with vascular-type dementia). Their families were first interviewed in the outpatient department and then followed for 1 month after the dementia diagnosis was made. Simultaneously, the costs for providing nursing home care to patients with dementia were calculated using accounting data reported from six nursing homes. Comparisons were made between the amount and type of cost encountered by families and by nursing homes to determine whether family-based care was cheaper and more appropriate than nursing home care for dementia patients with different functional levels. The results showed that higher costs were encountered for caregiving at home when the patients had severe dependence. This tendency was more evident for patients with senile dementia than for patients with vascular-type dementia. The cost of labour was an important expense for families caring for patients at home (at least 85% of family costs). Our findings suggest that, when family labour cost is considered, nursing home care is less expensive than family-based care for long-term care, especially for dementia patients with severe or moderate dependence. Nursing home care is also a better choice when patients have great need for multiple health services.     

健康促进型疗养院护理管理实践

目的：探析健康促进型疗养院护理管理实践及效果。方法：尝试实施护理组织支持管理策略、护理部垂直管理策略、多元化培养管理策略。结果：疗养服务对象对疗养护理服务综合评价、护理健康促进内涵评价、护理健康促进技术能力评价提高,差异有统计学意义（P〈0.001）;护理人员工作满意度提升,护理管理策略实施前后差异有统计学意义（P〈0.001）。结论：实施护理人力资源的组织支持管理、垂直管理、多元化培养以及项目带动内涵建设管理策略,有利于健康促进疗养模式下的疗养护理服务质量提升,护理人员职业价值认同提高,稳定护理队伍建设。     

Quality of nursing home care assessed by competent nursing home patients

Interviews were conducted with 60 chronically ill but cognitively competent nursing home patients with a mean age of 80 years, living in 13 nursing homes in the county of Stockholm, Sweden. Quality of nursing home care was assessed through discrepancy between individual priorities (i.e. degree of perceived personal autonomy) and institutional possibility. The results show that there was a high degree of satisfaction with quality of care with regard to meal and shower routines, as well as with the possibilities to watch television, listen to the radio and feel secure. Social relations, on the other hand, was a subject which exposed large discrepancies. Most respondents believed in the importance of social relations whereas results point to a lack of intimacy in the daily living.