Access to mental health care among older adults

Many older adults experience common mental health problems that can have a negative impact on physiological health, functional status, and quality of life. Lack of access to mental health care for community-dwelling older adults is a significant problem. Busy primary care practices, few mental health professionals, inadequate problem recognition, and flaws in the health care system all contribute to restricted access to mental health care. As the population of adults 65 and older continues to grow, the need for mental health care for this group will increase. Strategies to improve access to mental health care must be targeted at the individual level, the provider level, and the system level.     

Relocating care: negotiating nursing skillmix in a mental health unit for older adults

Mental health care in Australia in the last 20 years has moved from stand-alone psychiatric hospitals to general hospitals and the community. This paper reports an action research project exploring the experiences of nurses on an acute mental health unit for older adults staffed with a skillmix of mental health and general nurses, which recently transitioned from a psychiatric to a general hospital. The new service provides comprehensive health care, including the management of physical co-morbidity and a recovery orientation. Recovery acknowledges the role and rights of consumers and carers in planning and management of care, choice and individual strengths (Shepherd). The new ward received additional resources to establish the model of care, including a broader skillmix. The paper explores the dynamics of development of a new model of care and of bringing together staff with different professional orientations, cultures and priorities. Focus groups and interviews were conducted with 18 staff. Analysis resulted in three themes relating to the impact of competing goals and foci of care upon professional boundaries; competing organisational cultures and the impact of service change upon work practices. The findings are explored in relation to ideas about health care delivery associated with neoliberalism.     

Mental health and functional mental disorder in older adults

The available literature on mental health and older people tends to focus on dementia rather than functional illness, despite the greater prevalence of the latter. This review analyses articles published on mental health in nursing journals and considers their content. The author suggests that those working with older adults need to hear more about the experiences of those who suffer with mental health problems.     

The Betty Neuman Systems Model applied to practice: a client with multiple sclerosis

The importance of nursing theories and models for the growth and development of the profession of nursing is widely acknowledged. The variety of nursing phenomena and situations demands some flexibility in the choice of specific conceptualizations to be used. This paper demonstrates the goodness of fit of the Betty Neuman Systems Model to the care of clients with multiple sclerosis. An adapted assessment tool, based on Neuman's tool, but more useful in the acute care medical setting, is used to gather data related to a woman with recently diagnosed multiple sclerosis. A nursing care plan illustrating the use of Neuman's model is generated, implemented and evaluated. The Neuman Model is demonstrated to be useful and effective in the implementation of the nursing process in this case.     

应用Neuman保健系统模式对非精神科住院患者心理压力状况的调查

目的了解住院患者所承受的压力源以及突出的心理压力问题。方法采用非精神科住院患者心理压力评估量表对150例非精神科住院患者进行调查,分析住院患者承受的压力源和突出的心理压力问题。结果住院患者存在一定程度的心理压力,其中盼望早日康复是平均得分最高的压力源（7．21±3．17）分;而担心患病后自己在家中的地位降低的得分最低（2．56±2．15）分。患者的心理压力状况与年龄、性别、文化程度、家庭收入、婚姻状况等呈现显著相关性。结论住院患者存在一定心理压力,不同心理压力源的心理压力反应不同,应针对不同类别的压力源开展有针对性的心理护理,提高住院患者的生活质量和护理质量。     

应用Neuman保健系统模式对非精神科住院患者心理压力状况的调查

目的 了解住院患者所承受的压力源以及突出的心理压力问题.方法 采用非精神科住院患者心理压力评估量表对150例非精神科住院患者进行调查,分析住院患者承受的压力源和突出的心理压力问题.结果 住院患者存在一定程度的心理压力,其中盼望早日康复是平均得分最高的压力源(7.21±3.17)分;而担心患病后自己在家中的地位降低的得分最低(2.56±2.15)分.患者的心理压力状况与年龄、性别、文化程度、家庭收入、婚姻状况等呈现显著相关性.结论 住院患者存在一定心理压力,不同心理压力源的心理压力反应不同,应针对不同类别的压力源开展有针对性的心理护理,提高住院患者的生活质量和护理质量.     

The Neuman Systems Model in nursing education: course development and implementation

Nursing education programmes increasingly are integrating nursing models into their curriculum. The model chosen can provide a guide for curriculum content as well as strategies for learning content. In the clinical setting a model can facilitate the student's nursing practice by assisting in the organization of observations and interpretation of data. This paper describes the introduction of the Betty Neuman Systems Model to fourth year baccalaureate students at the University of Ottawa School of Nursing, Canada. The selection of this model for a senior nursing course reflects its congruency with the school's philosophy of learning and nursing and the purpose of the course. Course development and implementation, teaching strategies and outcomes are discussed and reflect an attempt at incorporating a nursing model into course design.     

老年综合征评估在老年患者临床护理中的应用

目的 探讨老年综合征评估在老年患者临床护理中的作用.方法 采用SPICES评估表对308例老年患者进行评估并开展有针对性的护理干预.结果 由于在护理工作中采取了主动的护理干预,避免了医源性损伤的出现,提高了护理质量.结论 老年综合征评估在老年患者护理中具有实用性,值得在临床护理工作中推广应用.     

Surveying nursing practice on wards for older people with mental health needs

This article discusses a survey of the nursing care of older people with mental health problems in inpatient units. The survey considered assessment and care planning, record keeping, the environment, staff, user and carer feedback, staffing systems, compliments, complaints, incidents, dementia care mapping, and a clinical supervision and training needs audit. Practice development work, undertaken to ensure that the project's recommendations were implemented, is also described.     

The use of Tai Chi to improve health in older adults

Tai Chi is a slow and gentle exercise that is suitable for older adults with chronic illness. This exercise offers the benefits of flexibility, muscle strengthening, and endurance training. Tai Chi has the capability of improving the health of elders without exacerbating existing impairments. Therefore, older adults may be more inclined to participate in and maintain an exercise program. The purpose of this article is to (1) compare Tai Chi to muscle-strengthening and aerobic exercise, (2) describe possible mechanisms for the effects of Tai Chi on factors that contribute to disability, and (3) identify nursing interventions to promote the use of Tai Chi.     

The Betty Neuman Systems Model in nursing practice: a case study approach

The value of models of nursing to provide direction for nursing practice, education and research is becoming increasingly evident in the literature. Nursing is developing a heightened awareness of the importance of models as vehicles to professional accountability. By delineating the boundaries of nursing, they serve as a framework for the development of nursing knowledge. This paper describes the use of the Betty Neuman Systems Model in practice using a case study approach. The selection of the model for practice reflects the congruency between the practitioner's personal values and assumptions and those of the model, the major elements of which are highlighted in the first section of the paper. The second section explores the model in practice via a nursing situation in which the client is recovering at home following hospitalization and treatment for a myocardial infarction.