对社区康复中老年康复的思考

人口老龄化作为全球性问题之一受到世界各国政府的高度重视和社会各界的广泛关注。经过多年发展 ,发达国家已形成了一整套完备的制度体系和规范的运作程序 ,确保解决人口老龄化所带来的各种社会问题。而我国因受多方面因素影响 ,对人口老龄化所带来的社会问题认识不足 ,解决方法基本还停留在政府对“三无”、“五保”户施行单纯救济的层面 ,虽然城镇职工有退休金、享受公费医疗 ,但广大农村老人则完全由子女赡养。改革开放 ,不仅给中国社会注入了前所未有的活力 ,而且也使中国社会变化的速度大大加快。特别是进入 2 0世纪 90年代后 ,这场深…     

社区康复干预对精神分裂症患者康复的影响

目的探讨社区康复干预对精神分裂症患者康复效果的影响。方法对社区109例精神分裂症患者在药物治疗的基础上进行系统的社区康复干预,观察1a。于干预前后采用社会支持评定量表、简明精神病量表、社会功能缺陷筛选量表、阴性症状量表评定临床疗效。结果人组患者中87．16％存在不同程度的精神残疾,轻度精神残疾患者社会支持评定量表总分、客观支持、主观支持和对支持利用度因子分均显著高于中度以上精神残疾患者（P〈0．05或0．01）。康复干预1a后,简明精神病量表、社会功能缺陷筛选量表、阴性症状量表评分均显著低于干预前（P〈0．01）。结论社区精神分裂症患者中大多数存在不同程度的精神残疾,系统化的社区康复干预和家庭干预,能显著提高患者的社会支持度,改善社会功能,有利于患者的全面康复。     

Psychosocial rehabilitation

One example of a psychosocial rehabilitation model uses an intensive case management approach. This approach offers an interdisciplinary model that integrates pharmacotherapy, social skills training, and family involvement. This evidence-based plan of care is cost-effective and offers psychiatric nurses opportunities to facilitate symptom management, facilitate self-efficacy, and improve communication and social skills. Ultimately, nursing interventions promote a higher level of functioning and quality of life. Nurses in diverse practice settings must be willing to plan and implement innovative treatment models that provide seamless mental health care across the treatment continuum.     

Paediatric rehabilitation

More and more researchers are questioning the theoretical and scientific foundations as well as the efficacy and effects of many physiotherapy interventions. The same applies for many of the neurophysiological based interventions that are being used in paediatric rehabilitation. Opinions and views regarding the development of motor behaviour of infants and children are significantly changing. Paediatric interventionists should consider bringing their interventions and focus of treatment into agreement with changed scientific knowledge. Moreover, for almost all other medical problems in childhood, paediatric rehabilitation has little to offer but mostly miniaturized forms of adult treatment. It not only means that we have to make a paradigm shift, but also are in the need of a broader view on paediatric rehabilitation as a specialized professional activity.     

Geriatric rehabilitation

Elderly people experience motor, sensory and cognitive losses that affect their mobility and their ability to perform activities of daily living. There is often gradual loss of function, which requires recognition and correction. Sudden events, such as stroke, amputation or trauma, may occur in an environment of diminished function and reserve. Rehabilitation measures must be directed toward prevention of dysmobility, correction of functional losses and provision for continuing aftercare.     

Paediatric rehabilitation

More and more researchers are questioning the theoretical and scientific foundations as well as the efficacy and effects of many physiotherapy interventions. The same applies for many of the neurophysiological based interventions that are being used in paediatric rehabilitation. Opinions and views regarding the development of motor behaviour of infants and children are significantly changing. Paediatric interventionists should consider bringing their interventions and focus of treatment into agreement with changed scientific knowledge. Moreover, for almost all other medical problems in childhood, paediatric rehabilitation has little to offer but mostly miniaturized forms of adult treatment. It not only means that we have to make a paradigm shift, but also are in the need of a broader view on paediatric rehabilitation as a specialized professional activity.     

Neurological rehabilitation

Summary

A new system of urine collection to be used with indwelling catheters or condom drainage was developed and evaluated in the laboratory, and clinically. The aims included prevention of twisting of the tubes, nonleakage, comfortable body bags and ease of use of drainage taps. The new system was highly acceptable to patient and attendant alike.

Résumé

Un nouveau système pour le recueil d'urine, utilisé conjointement avec les cathéters internes ou le système de drainage par condom, a été mis au point et évalué en laboratoire et mědicalement. Son but est d'éviter la torsion des tubes et les fuites, de fournir des poches de corps confortables et de faciliter l'utilisation des robinets de drainage. Le nouveau système a donné entière satisfaction, autant au patient qu'à l'aide soignante.

Zusammenfassung

Ein neues System Harn zu sammeln, unter Verwendung von Dauerkathetern und Kondomdrainage wurde im Labor und klinisch entwickelt und bewertet. Es wird darauf gezielt zu verhindern, dass sich die Kanülen verdrehen, dass Flüssigkeit austritt, dass die Harnreservoire hinderlich sind, und die Abflusshähne müssen leicht zu handhaben sein. Das neue System wurde von dem Patienten und dem Pflegepersonal als äusserst akzeptable gepriesen.     

Residential rehabilitation

In recent years new avenues of medical rehabilitation have been made possible in order to allow a more flexible and better care for patients. This includes day care and outpatient treatment additional to inpatient services. A further new development are centers which provide "residential rehabilitation". It allows a continuous cooperation with physicians and therapists who send patients or take care of them after discharge. Cooperation with acute care hospitals is easier. Inpatient care, day care and outpatient care can be better integrated. The social network of the patient can easier be taken into account in treatment planning. Patients can be supported when going back to work. Contact with self-help groups can be arranged while the patient is still in treatment.