老年人入住养老机构体验及影响因素调查

目的了解老年人养老机构入住体验现状及其影响因素,为养老机构照护服务改进以提升照护质量和老年人生活质量提供依据。方法采用横断面调查方法,方便抽取5家医养结合型养老机构的老年人202人,采用自行设计的老年人养老机构入住体验问卷进行调查。结果医养结合型养老机构老年人入住体验总得分为73～150(123. 82±17. 39)分,各维度得分由高到低依次为可靠性、有形性、保证性、关怀性、连续性。年龄、月收入、亲人支持程度、子女个数对老年人入住体验有显著影响(P 0. 05,P 0. 01)。结论老年人对养老机构入住体验评价较好,但在人文关怀性和医疗连续性上有待加强。亲人支持程度能在很大程度上提升老年人的入住体验,养老机构需提供条件促进子女与老年人的联系,以提升老年人的生活质量。     

社会养老机构老年人主观幸福感及相关因素研究

目的 探讨社会养老机构老年人主观幸福感(SWB)及其相关影响因素.方法 采用自制问卷、纽芬兰大学幸福度量表(MUNSH)对西安市城区20所社会化养老机构的462名老年人的SWB进行调查,并分析人口社会因素、负性生活事件等对老年人SWB的影响.结果 社会养老机构老年人的MUNSH总分32.93±12.23,高SWB水平者246名(53.25%),低SWB水平者47名(10.17%),不同性别、年龄、婚姻状况老年人的SWB比较,差异无显著性意义(均P＞0.05).多元逐步回归分析结果表明,养老机构老年人SWB的主要影响因素排序依次为:个性、经济状况自评、在社会家庭中地位、健康恶化、对养老公寓满意度、子女就业困难、体育锻炼.结论 社会养老机构老年人SWB不容乐观,应采取针对性措施提高其SWB水平.     

四川城区老年人养老方式选择及其影响因素调查

目的了解四川城区老年人养老方式选择及其影响因素。方法在四川省6个地区,采用自行设计问卷方便抽样640名城区老年人进行调查,分析老年人养老方式选择及相关影响因素。结果 640名老年人中,8.1%选择社区居家养老,10.3%选择机构养老,81.6%选择家庭养老。单因素分析中,性别、文化程度、个人月收入、与子女关系满意度、子女个数、养老费用来源个数对老年人养老方式选择有影响;多因素Logistic回归分析中,文化程度越高、与子女关系越不满意的老年人越愿意接受机构养老和社区居家养老;养老费用来源个数越多的老年人更愿意接受社区居家养老。结论家庭养老仍然是城区老年人养老方式的主要选择,合适的养老方式对满足老年人需求、合理利用养老资源,实现"健康四川2030"健康老龄化有积极作用。     

养老机构老年人保健品知信行现况及影响因素分析

目的调查太原市养老机构老年人保健品知信行现况,为养老机构及社区管理者开展健康教育提供参考。方法采用保健品知信行问卷对5所养老机构的287名老年人进行调查。结果老年人保健品知识得分19.44±3.28、态度得分51.65±3.53、行为得分20.66±3.07;不同文化程度、慢性疾病、职业、收入、知识途径、服用保健品种数的老年人保健品知识、态度、行为得分差异有统计学意义(P0.05,P0.01)。结论养老机构老年人对服用保健品态度较积极,但知识与行为状况不佳。养老机构管理者应针对服用保健品的老年人开展健康教育讲座,纠正其对使用保健品的错误认知,从而纠正不合理行为。     

护理本科生老人观及服务老年人态度的调查

目的 了解护理本科生老人观现状及服务老年人的态度.方法 采用老人观量表及服务老年人态度量表对天津市某高校在校护理本科生进行调查.结果 护理本科生老人观中的老年人印象总得分为55.52±8.94,老年人家庭作用总得分为51.32±21.54;服务老年人态度得分为53.51±9.84.不同来源地及是否为独生子女的护理本科生老人观水平存在差异(P＜0.05,P＜0.01);不同来源地、志愿者与否、年级、专业的护理本科生服务老年人态度评分比较,差异有统计学意义(均P＜0.01);护理本科生服务老年人态度与其老人观、外在特征、内在特征、人格特征、老年人印象呈正相关(均P＜0.05).结论 护理本科生老人观、服务老年人态度均有待提高;护理教育工作不仅要加强护理本科生职业教育,还应多举办与老年人相处的活动,培养护理本科生对老年人的责任心和爱心,提高其服务老年人的意愿.     

实习护生死亡态度调查

目的 了解实习护生对死亡的态度,为开展死亡教育提供资料.方法 以60名实习护生为对象,采用自制的死亡态度问卷进行问卷调查.结果 实习护生对个人死亡及濒死的态度认识不足,得分为(2.92±0.18)分;接触过濒死(或死亡)患者的实习护生对死亡态度的认识优于未接触者(P＜0.05);对"生命永存观念"持否定态度者占71.67%.结论 应对护生加强死亡教育,使其树立科学的死亡观,用科学的态度对待死亡,更好地为人类健康服务.     

养老机构老年人社会参与现状及影响因素

目的 了解养老机构老年人社会参与现状,分析其影响因素.方法 采用方便抽样法,选取重庆市243名养老机构老年人,采用一般资料调查表、Barthel指数评定表、中文版自主参与测评问卷、社会支持评定量表、老化态度问卷进行横断面调查.结果 养老机构老年人社会参与得分为(31.70±15.52)分;多元线性回归显示,自理能力、老...     

辽宁省养老机构老年人长期照护需求及影响因素调查

目的了解辽宁省养老机构老年人长期照护需求现状及其影响因素,为有效开展养老机构老人长期照护服务提供参考。方法于2017年5～9月选择辽宁省内提供长期照护服务的8家养老机构,运用日常生活活动能力(ADL)量表、焦虑自评量表、老年抑郁量表和长期照护需求调研问卷对518名老年人进行横断面调查。结果老年人生活需求维度(2. 16±1. 12)分、健康需求(3. 04±1. 09)分、知识需求(3. 44±1. 14)分、依存需求(3. 50±0. 80)分。ADL能力、焦虑、抑郁是照护需求的影响因素(均P 0. 01)。结论辽宁省养老机构老年人对照护需求中依存方面的需求最迫切,自理能力低下、焦虑、抑郁的老年人应成为关注的重点。     

代际支持及人口学特征对社区老年人老化态度的影响

目的探究代际支持和人口学特征对社区老年人老化态度的影响。方法采用老化态度量表、代际支持量表对西安市810名社区老年人进行调查。结果社区老年人老化态度的心理社会丧失、应对身体变化、心理获得3个维度得分依次为21.39±5.55、26.07±5.04、28.32±4.46;不同婚姻状况、健康自评和生活自理能力者老化态度3个维度得分差异有统计学意义(均P0.01)。多元线性回归分析显示,年龄、户籍所在地、受教育程度、生活自理能力、患慢性病和给予子代生活照料是心理社会丧失的影响因素(P0.05,P0.01);婚姻、子女健康状况、健康自评、患慢性病、情感支持、给予孙代生活照料以及接受子代生活照料是心理获得感的影响因素(P0.05,P0.01)。年龄、婚姻状况、健康自评、患慢性病、情感支持、给予子代和孙代生活照料是应对身体变化的影响因素(P0.05,P0.01)。结论社区老年人老化态度较积极;代际支持和人口学特征对社区老年人老化态度影响侧重点各有不同,应通过构建和谐健康的代际关系和加强个体特征导向的心理辅导,促进老年人老化态度进一步向积极方向发展。     

养老机构老年人衰弱现状及影响因素分析

目的了解养老机构老年人衰弱现状,分析其影响因素,为制订养老机构老年人衰弱干预计划提供参考。方法选取武汉市养老机构老年人245人为调查对象,采用自行设计的一般情况调查表、老年人衰弱评估量表修订版、中文版健康促进生活方式量表、生活质量量表简版(SF-12)进行面对面调查。结果衰弱140人(57.14%),衰弱总评分为(8.16±3.72)分,生理衰弱维度最为严重。多元线性回归分析显示,性别、年龄、文化程度、慢性病、入住时长、睡眠质量、健康促进生活方式是养老机构老年人衰弱的影响因素(均P0.01)。不同衰弱程度老年人生活质量得分比较,差异有统计学意义(P0.01)。结论养老机构老年人衰弱现象普遍,且受多种因素影响,需采取针对性干预措施,改善老年人衰弱现状,延缓衰弱进程。     

Brain death

Summary Following the research of Giessen Neurosurgery on primary and secondary lesions of the hypothalamo-pituitary system and the brainstem over a period of more than 30 years, cerebral failure and death does not represent a uniform syndrome but consists of several, well characterized syndromes of irreversible hypothalamo-pituitary, mesencephalic and bulbar failure. The specific syndromes are described in detail. The diagnosis is based on establishing complete irreversible damage of specific vital basal functions such as hypothalamo-pituitary transmission, water-and electrolyte metabolism, temperature regulation, circulation and respiration. The common feature of all types is the irreversible break-down of the complex central neurogenous and/or neurohumoral regulatory system. The permanent and irreversible loss of central regulation and modulation means at the same time the complete cessation of the specific human cortical function, the death of the whole brain. Only in bulbar failure with primary irreversible cessation of respiration artificial respiration can maintain the autonomous functions of the heart for a limited time. It is indicated when organ explantation is to be considered. Complete and irreversible isolated loss of cortical function abolishes the normal human life, but does not mean death of the remaining vegetating human being.Presented at the meeting of the Working Group of the Pontificia Academia Scientiarum on The artificial prolongation of life and the exact determination of the moment of death, Vatican City, October 19–21, 1985.Dedicated to Prof. Dr. Jean Brihaye at the occasion of his 65th anniversary.     

新入职护士死亡教育需求状况及影响因素分析

目的 了解新入职护士死亡教育需求状况并分析其影响因素,为医院管理者对新入职护士开展死亡教育培训提供参考.方法 以便利抽样法于2021年7～8月选取河北省11所医院的387名新入职护士,采用一般资料调查表、死亡教育需求量表、死亡态度描绘量表及死亡焦虑量表进行调查.结果 新入职护士死亡教育需求总分为171.76±40.83...     

Permanent brain arrest as the sole criterion of death in systemic circulatory arrest

Historically, there has been a tendency to think that there are two types of death: circulatory and neurological. Holding onto this tendency is making it harder to navigate emerging resuscitative technologies, such as extracorporeal membrane oxygenation and the recent well-publicised experiment that demonstrated the possibility of restoring cellular function to some brain neurons 4 h after normothermic circulatory arrest (decapitation) in pigs. Attempts have been made to respond to these difficulties by proposing a unified brain-based criterion for human death, which we call ‘permanent brain arrest’. The clinical characteristics of permanent brain arrest are the permanent loss of capacity for consciousness and permanent loss of all brainstem functions, including the capacity to breathe. These losses could arise from a primary brain injury or as a result of systemic circulatory arrest. We argue that permanent brain arrest is the true and sole criterion for the death of human beings and show that this is already implicit in the circulatory-respiratory criterion itself. We argue that accepting the concept of permanent cessation of brain function in patients with systemic permanent circulatory arrest will help us better navigate the medical advances and new technologies of the future whilst continuing to provide sound medical criteria for the determination of death.     

Brain stem death

The concept of brain and brain stem death developed from the observation of apnoeic comatose patients. In the UK, the diagnosis of brain stem death is made by clinically testing brain stem function once specific preconditions have been met. The exact definition of brain death and some details regarding the tests required to make this diagnosis vary across the globe. However, the majority of tests carried out are similar to those in the UK. In this review we define brain stem death and the clinical tests used to confirm it. The use of ancillary testing can have a role in patients where clinical tests are not possible and this is also discussed.     

Brain stem death

The concept of brain and brain stem death developed from the observation of apnoeic comatose patients. In the UK, the diagnosis of brain stem death is made by clinically testing brain stem function once specific pre-conditions have been met. The exact definition of brain death and some details regarding the tests required to make this diagnosis vary across the globe. However, the majority of tests carried out are similar to those in the UK. In this review we define brain stem death and the clinical tests used to confirm it. The use of ancillary testing can have a role in patients where clinical tests are not possible and this is also discussed.     

Traumatic death in urban children

Trauma has remained one of the leading causes of death in children in spite of improved medical care. A review of 911 pediatric trauma deaths which occurred over a 5 yr period in an urban setting revealed that almost 50% of these children died before receiving medical care. A significant improvement of the trauma mortality can thus only be accomplished by reducing the number of “DOAs”. We therefore analyzed the cause and type of injury and its relationship to age, sex, race, seasonal occurrence, and sociological circumstances. The following four categories are merely part of the overall material developed in this review. Even with improved medical care of trauma patients the overall pediatric trauma mortality cannot be significantly reduced unless the number of DOAs is decreased through prevention. Educational and family assistance programs can be designed for specific problem areas to reach identified susceptible groups through existing channels such as day care centers, schools, or welfare agencies. Statistical data, such as presented here (but not previously available) are essential to analyze the particular problems of specific geographic and sociologic areas. Since the vast majority of pediatric trauma deaths fall within the interest sphere of the pediatric surgeon, our active participation in accident prevention is essential to achieve a significant reduction of pediatric trauma mortalities.     

肾移植受者移植肾带功能死亡与失功能死亡原因比较

目的 分析肾移植受者移植肾带功能死亡与失功能死亡原因.方法 回顾分析我院2001年至2010年期间死亡的207例肾移植受者资料.将其分为移植肾带功能死亡组(102例)和失功能死亡组(105例),对两组死亡原因进行比较分析.结果 所有受者的死亡原因依次为感染(31.9％)、心血管疾病(21.3％)、肝功能衰竭(15.9％...     

The use of cerebral computed tomographic angiography as an ancillary investigation to support a clinical diagnosis of death using neurological criteria: a consensus guideline

This multidisciplinary consensus statement was produced following a recommendation by the Faculty of Intensive Care Medicine to develop a UK guideline for ancillary investigation, when one is required, to support the diagnosis of death using neurological criteria. A multidisciplinary panel reviewed the literature and UK practice in the diagnosis of death using neurological criteria and recommended cerebral CT angiography as the ancillary investigation of choice when death cannot be confirmed by clinical criteria alone. Cerebral CT angiography has been shown to have 100% specificity in supporting a diagnosis of death using neurological criteria and is an investigation available in all acute hospitals in the UK. A standardised technique for performing the investigation is described alongside a reporting template. The panel were unable to make recommendations for ancillary testing in children or patients receiving extracorporeal membrane oxygenation.