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。     

Studying side effects of dental amalgam

Risk factors for permanent admission to a nursing home were studied in a prospective study of persons 70 years and over who received home nursing. Demographic data and use of psychotropic drugs were registered, and mental capacity, behaviour, and performance of activities of daily living (ADL-function) estimated. 214 patients received home nursing. 166 patients were available for the follow-up study after 16 months, of whom 31 had been admitted to a nursing home. Senile dementia and stroke were the most frequent diagnoses of admitted patients. Mental impairment, age, and amount of home nursing were associated with permanent admission to a nursing home. The odds for being admitted were 10.2 (C. I. 2.3–44.4) times higher in moderately and severely mentally impaired persons than in not mentally unpaired persons. The odds for admittance for those 85 years and over, compared with those younger than 80, were 5.0 higher (C. I. 1.6–15.6); and those receiving home nursing three times weekly or more had 3.8 (C. I. 1.4–9.8) times higher odds than those with less help.     

天津市南开区民营养老院养老护理现状与对策

目的:了解天津市南开区民营养老院养老护理现状,为养老护理教育及研究提供参考,为政府部门提供建议,促进养老护理工作与养老机构的和谐发展。方法:对南开区民营养老院进行单纯随机抽样,抽取8家养老院进行实地考察,并对其中的养老护理员及意识清晰的老年人进行问卷调查。结果:南开区民营养老院养老护理员年龄偏大,学历偏低,职业待遇偏低,养老护理工作的全面化不足,心理护理不到位,养老护理模式存在缺陷。结论:目前养老护理工作需要政府支持,养老护理员整体素质亟待提高,养老护理模式有待改善。     

我院开设老人护理院做法与体会

目的:探讨基层医院开设老人护理院的可行性。方法:选择一个环境优静,相对独立的科室,按养老院和医院的功能设施进行相应配置,对营养师、护工、护理人员进行专业培训。结果:老人及家属满意,护患关系和谐,社会效益良好。结论:基层医院开设老人护理院可盘活相对闲置的医疗资源,达到既养老又治病的双重效果。     

福建省养老机构对老年护理专业人才的素质要求及校企合作意愿调查

目的：探讨养老机构对老年护理专业人才素质要求及校企合作意愿,以利于制定老年护理专业的培养目标。方法：采用自制调查问卷,由福建卫生职业技术学院30名教师至福建省9个设区市共74所公办养老机构进行调查。结果：75.7%的养老机构认为护理人才需要进行老年护理专业学习;对于老年护理专业毕业生就业问题,67.6%的机构表示非常希望他们能到养老机构就业;在校企合作意愿方面,55.4%的机构愿意与学校合作,而各级养老机构在合作意愿上无统计学差异（P〉0.05）。结论：应加大校企合作力度,建立养老机构等级评价标准,合理设置人文及专业课程,培育老年专业护理人才,应对人口老龄化。     

Ⅰ-Ⅱ期硅沉着病患者“回归家庭”照护模式的研究

目的探讨适合硅沉着病患者疗养的有效运行模式,为今后这一职业病的社区康复提供理论依据和指导。方法选择符合标准的150例住院患者采取自身对照的方法,于回家前和回家后1年进行费用、上呼吸道感染发生率、生存质量的调查对比。结果患者在＂回归家庭＂照护期间发生的费用、上呼吸道感染发生率较住院期间降低,生理、心理、精神、主观生存质量得分明显高于住院期间,有显著性差异（P〈0.05）。结论 ＂回归家庭＂照护模式有利于提高Ⅰ-Ⅱ期硅沉着病患者的生存质量,是一种很好的疗养模式,值得提倡。     

精神疾病家庭护理的现状与思考

当今的医疗卫生服务已经从单纯治病向预防、治疗、康复、保健一体化转变。随着疾病谱的明显变化,精神、心理疾患已成为影响健康的重要因素,这对护理工作提出了新的目标和任务[1]。精神疾病是严重危害人们健康,影响生存质量的一种慢性、易反复发作的疾病,其治疗过程漫长。因此,开展精神疾病家庭护理具有重要的社会意义和经济学意义。1精神疾病家庭护理的现状1.1家庭护理的内涵家庭护理是社区护理工作的一个重要方面。家庭护理是指护理人员为基本治愈或无法治愈而出院的病人在家中提供治疗、护理服务。其内容主要有:一是提供康复护理和健康指…     

39例家庭腹膜透析的护理体会

终末期肾功能衰竭的有效治疗措施之一为腹膜透析,虽然可有效缓解终末期肾衰患者的症状,延长患者的生命,但不能使肾脏病逆转,因而决定了腹膜透析只能是一种长期维持性治疗。目前由于经济方面的原因,许多患者缺乏足够的资金支持,因而绝大部分采用家庭腹膜透析。我科自2000年开展腹膜透析以来,其中98%以上的患者采用家庭腹膜透析并取得较好的治疗效果,现将护理体会报告如下。1临床资料本组39例中,男性14例,女性25例。年龄31～72岁,平均51.5±20.5岁,持续腹膜透析近3年的有28例,发生腹膜炎的有7例,占总数的17.95%;1例反复发生腹膜炎造成腹膜硬化…     

居家腹膜透析患者对家访的需求及护理

目的了解居家腹膜透析患者对家访的需求。方法随机选择60例即将出院需要居家腹膜透析患者,采用自行设计的问卷进行调查。结果患者对上门护理时间的需求:出院后1周、1个月、3个月、6个月。对护理内容的需求:帮助布置腹透间环境、指导腹透操作、腹透疑难问题解答、评估居家腹透质量、腹透患者复诊。根据患者对家访的需求,家访护士对居家腹膜透析患者全程跟踪指导,科学地安排上门服务时间,居家透析知识指导,给予心理支持,积极争取家庭社会支持,提供信息、资料。结论通过因需施护,保证患者坚持长期有效透析,减少透析并发症,提高透析质量。     

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.     

Moving from a culture of blame to a culture of safety in the nursing home setting

TOPIC: A culture of safety. PURPOSE: To explore the current culture of blame and what organizational elements must be impacted to move toward a culture of safety in the nursing home setting. METHODS: A mixed-method approach incorporating a case study and staff member survey results were used to explicate the organizational elements impacting the current nursing home culture. CONCLUSION: Nurse leaders can create an environment in which every member of the team feels a responsibility and an ability to insure that residents are safe by improving communication and participation in decision making.     

北京市9所城区养老服务机构304位老年人生活质量影响因素调查分析

目的:探讨影响养老服务机构老年人生活质量的因素。方法:采用了健康调查问卷sf-36对调查对象进行现场问卷调查。结果:经过单因素分析,影响养老服务机构老人生活质量的主要因素:性别、年龄、职业、文化程度、婚姻、自理能力(ADL)、家庭经济状况、是否患慢性疾病。结论:通过调查,了解了养老服务机构老年人生活质量影响因素,可为行业管理部门制定养老服务的相关政策提供依据,从而达到全面提高老年人生活质量的目的。     

Sexual behaviour of nursing home residents: staff perceptions and responses

AIMS: This paper presents the results of a study that investigated nursing home staff perceptions of affectionate and sexual behaviour of residents. BACKGROUND: Despite growing recognition of the importance of sexual expression among residents and a increasing willingness to discuss the topic, sexual activity for nursing home residents remains an ignored component of life satisfaction. Even when 'sexuality' has been included as part of a resident's plan of care, this may not mean that attention has been paid to maintaining that aspect of their life. Thus, nursing homes can mark the end of many types of freedom for older people. Given that intimate basic care is performed by others and often by members of the opposite sex, loss of sexual freedom may also occur. METHOD: A grounded theory approach was used to study staff working in nursing homes in Australia and Sweden. Data were generated through interviews and nominal groups with nursing home staff. Thirty women volunteered to be interviewed, and 18 others were involved in the three nominal group discussions; a further five participants were involved as key informants. FINDINGS: Staff perceptions and responses to residents' sexual behaviour were found to be influenced by their own level of comfort related to sexuality issues, and the ethos within the organization where they worked. The conceptual paradigm was termed 'Guarding Discomfort' and specified the ways in which staff guard against sexuality discomfort as well as the ways their behaviour fits within different types of organizations. CONCLUSION: Both staff and nursing home managers need to work toward developing a home environment that is supportive of residents' sexuality rights, that permits sexuality expression and promotes a culture where all people concerned are comfortable with sexuality issues.     

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。     

智能居家护理教学在社区护理学课程中的应用价值

结合我国健康老年化的需求和社区护理课程自身特点,从智能医疗在社区护理学课程教育中的发展现状及学习意义等方面进行论述,探讨教师与学生们掌握智能医疗相关知识与技术的可行性、必要性及有效方法,从而促进社区护理智能医疗领域的发展。     

我国老年居家护理的研究进展

居家护理服务是配合我国医疗改革实施的一项重要工作,但目前我国居家护理正处于起步阶段,通过对居家护理研究现状的介绍,发现我国居家护理现存的问题,并提出相应的改进措施,为我国居家护理服务对象提供更完善、更优质的居家护理服务,同时为居家护理质量评价体系和评估的完善提供进一步的参考。