Promoting autonomy and independence for older people within nursing practice: a literature review

The principles of promoting autonomy and independence underpin many approaches to improving the quality of nursing care for older people in whatever setting, and are in line with wider developments in health care such as the Patient's Charter. However, these concepts require careful definition if nursing practices which might promote autonomy and independence are to be identified. Although the generalizability of the research-based literature in this field is limited by a focus upon older people in continuing-care settings, a review of the literature found a number of indicators associated with attempts to promote patient autonomy and independence. These were grouped into the following categories: systems of care delivery which promote comprehensive individualized assessment and multidisciplinary care planning; attempts to encourage patients/clients to participate in decisions about their care; patterns of communication which avoid exerting power and control over patients/clients and attempts to modify the environment to promote independence and minimize risk. It is suggested that the review identifies a number of principles for nursing practice which can be applied in a range of care settings in order to promote the autonomy and independence of older people.     

青年人大肠癌误诊原因探讨

目的 探讨青年人大肠癌的误诊原因，以便早期诊断治疗。方法 回顾性分析62例青年人大肠癌的诊断及其治疗效果。结果 本组直肠癌36例中被误诊为结肠炎7例，痔疮并出血5例，痢疾3例，肛周脓肿并肛瘘2例；结肠癌26例中被误诊为阑尾周围脓肿3例，结肠炎2例，缺铁性贫血1例。误诊率37．1％。结论 青年人大肠癌早期临床症状不明显，恶性程度高，预后差,其治疗水平有赖于对这些特征的认识，力争早期诊断及治疗。     

'Not everything that can be counted counts and not everything that counts can be counted'– towards a critical exploration of modes of satisfaction measurement in sheltered housing

This paper reflects on a research project funded by a consortium of leading sheltered housing (SH) providers and their regulatory body, the Housing Corporation. The project aimed to ascertain which aspects of SH older people perceived to be central to their satisfaction and the methods they judged most appropriate to measuring this. We outline key policy developments of importance to SH (specifically the development of performance measurement regimes), and changes in the nature of SH, which are driving providers to re‐evaluate how they measure user satisfaction. We discuss the aims of the project, our methodology and findings, and conclude by raising critical questions about the process of measuring satisfaction within an increasingly managerialised housing system. We argue that this favours standardised methods of information gathering (such as questionnaires) rather than engage with clients in order to develop methods and systems capable of eliciting qualitative issues of concern to them. Our conclusions are, we believe, applicable to health and social care provision, where similar tensions exist around performance measurement and user satisfaction.     

商州市劳教人员艾滋病认知健康教育效果分析

目的　了解收容劳教人员对艾滋病认知情况和相关态度 ,提高他们对艾滋病的认知。方法　教育前后采取相同问卷 ,以不记名自填式答卷方式对教育前后艾滋病认知状况进行调查。结果　健康教育后 ,收容劳教人员对艾滋病的认知显著提高 (P <0 0 5 )。对婚前、婚外性行为持正确态度的比例有所增加 ,但无显著性差异。选择部分安全行为的趋向显著提高。结论　在收容劳教人员中开展艾滋病健康教育是可行的 ,但扭转有关不正确态度需要长期的过程     

温州市农村贫困人群卫生服务需求和利用分析

通过对近2000份调查表的分析,评价温州市农村贫困人群在就诊过程中对医疗机构的选择、未就诊原因方面的特点,提出提高卫生服务利用的方法。     

Mortality and suicide rates of involuntarily committed patients

The mortality and suicide rates for involuntarily committed patients in Denmark are presented. Two cohorts of psychiatric patients committed to a mental hospital from January 1, 1971 to December 31, 1975 (8322 people) and January 1, 1981 to December 31, 1985 (5253 people) have been followed. The standard mortality rate (SMR) in relation to the total Danish population were 4.9 (4.5–5.4) and 5.2 (4.7–5.8), respectively, for the two cohorts, during the first year after involuntarily commitment to a mental hospital. During the same period, the SMR for suicide among the committed patients were 44.9 (37.1–53.9) and 30.9 (24.2–38.9), respectively. The crude suicide rates among the committed patients during the first year after the commitment were 14.3 and 14.0, respectively, per 1000 years, unchanged between the cohorts. Short length of stay in hospital (< 14 days), a nonpsychotic main diagnosis, male sex, and age 35 years or more were equally related to high risk of suicide in the 1971 cohort as evaluated to proportional hazard methods (Cox regression), and short length of stay and commitment on the danger indication provided the most information in relation to high suicidal risk in the 1981 cohort. Methodological problems and the reasons for the results are discussed.     

老年人健康行为与心理健康关系的调查

目的探讨老年人的健康行为与心理健康之间的关系。方法采用候玉波等编制的健康行为量表和症状自评量表（SCL-90）对300名老年人进行测试,并进行相关分析。结果不同年龄和文化程度老年人在健康行为与心理健康方面有显著性差异（P〈0.05）;参与活动与心理健康水平呈显著正相关（P〈0.05）;心理应激、不良生活习惯与心理健康呈显著负相关（P〈0.05）。结论积极参与各项活动、减少各种心理应激和建立良好的生活习惯有利于提高老年人的心理健康水平。     

The social sciences and successful aging: Issues for Asia–Oceania

Aim:   This paper presents social science understandings of successful aging for a broad audience in multidisciplinary gerontology in Asia–Oceania.
Methods:   The international literature on social science aspects of successful aging is reviewed with a focus on Asia and social improvement.
Results:   New positive approaches to aging research are identifying opportunities for maintaining capacities and well-being over the life course. Successful aging, productive aging, and active aging are key concepts. Increasing life expectancy and fertility control are major social achievements that underpin population aging as the mainstream social transformation facing the world. Asia will be at the forefront of this change and the consequences will vary greatly between cultures, nations, and subgroups within them. Older people generally maintain good quality of life and the capacity to 'age well' is influenced by life-long maturation and emotional, social, and economic resources. Good health can be enhanced through positive actions such as physical activity, good nutrition, and not smoking. Mental capacities can also be improved and maintained throughout old age. In advanced old age, the 'fourth age', the focus turns to ameliorating the effects of loss and to maintaining dignity.
Conclusions:   The social sciences contribute knowledge useful for improving life experiences for older people and aging societies. Population aging is central to national economic development. Public policy and individual action concerning aging can benefit all age groups. To better inform these developments it is important to address the serious shortfall of social science research on aging in the Asia–Oceania region.     

老年股骨颈骨折围手术期的治疗分析

目的探讨老年人股骨颈骨折的治疗及围手术期的处理。方法回顾性分析2003年1月～2006年12月手术治疗的201例老年股骨颈骨折患者资料，其中男51例，女150例，年龄60～98岁，平均78．2岁。按Garden分型，Ⅱ型20例，Ⅲ型86例，Ⅳ型95例。采用多枚中空螺钉固定、Morre型人工股骨头置换术或双极人工股骨头置换手术进行治疗。结果本组患者平均住院10～14d，5～7d即能早期下床活动，住院期间及术后1年内无一例死亡。85％患者获得8个月～4年（平均2年）的随访，功能恢复按Harris评分，优良率为85％。结论老年人各脏器机能衰退，多同时合并各种内科疾病，手术治疗存在风险，但老年人股骨颈骨折的手术治疗仍能取得满意疗效。