The influence of clinical problems, age and social support on outcomes for elderly persons referred to regional aged care assessment teams

Abstract Background: Aged Care Assessment Teams (ACATs) have been established throughout Australia during the past seven years. Early studies of their effect have concentrated on their impact on the rate of institutionalisation of disabled elderly, the clinical characteristics of referred cases and the relationship between disability and recommended care plan. Aims: The aim of this study was to explore the relationship between age, clinical features and social characteristics of AC AT subjects with outcomes at 12 months after assessment. Methods: The examination of an arbitrary sample of persons referred to ACATs over a year by one generalist geriatrician with follow-up of all cases by the three ACATs associated with the study was carried out. All analyses were performed on raw data presented as categorical variables in the form of contingency tables. Results: The sample included 324 subjects who suffered from 2030 clinical problems with a mean of 6.5 per person aged 75 or over and 5.5 for those under 75. Cardiovascular and neurological disease were the commonest source of problems. Study of accommodation outcome at 12 months, for those subjects who survived this period revealed that, in the older group, over 60% of subjects with neurological disease were resident in nursing homes while the majority of all other groups remained in the community, as did two-thirds of those aged under 75. Admission to a nursing home was independent of social support for older subjects with neurological disease, but it played a significant role in those with cardiopulmonary or musculoskeletal disease. Conclusions: The study demonstrates that for one-year survivors there is an increased likelihood of admission to a nursing home of people aged 75 or over with neurological disease, while those under 75 were more likely to remain at home. The association was independent of whether spouse, family or friends were living with the subject. (Aust NZ J Med 1994; 24: 378–385.)     

孕产妇生殖器尖锐湿疣的30例护理

目的:探讨妊娠合并尖锐湿疣的护理.方法:选择1999年1月～2001年3月30例孕产妇生殖器感染尖锐湿疣进行分析.结果:产妇均痊愈出院,新生儿无1例发生咽部乳头瘤.结论:孕产妇尖锐湿疣对孕妇及新生儿均有重大影响,医护人员应注意消毒隔离,以剖宫产终止妊娠,使新生儿患病率明显下降.     

自发性食管破裂的护理

目的 总结自发性食管破裂患者的护理措施，提高护理水平。方法 在保守及手术治疗的同时，严密观察病情变化，做好心理护理，加强呼吸道、消化道及各种管道的护理。结果 7例患者治愈出院。结论 精心的专业化护理在治疗自发性食管破裂中起重要作用。     

Identifying the special needs of children with Type 1 diabetes in the school setting. An overview of parents' perceptions.

AIMS: The aims of this observational study were to identify the special needs of children with Type 1 diabetes in schools from the parents' point of view and the difficulties experienced with full integration, and to define a series of interventions which may improve the situation. METHODS: Parents of children aged 3-18 years with Type 1 diabetes were eligible. Those who agreed to participate completed a self-reporting questionnaire which determined the effects of the disease on children, parents and school personnel, and addressed aspects including children's integration, glycaemic control, insulin administration, meals, sports, trips and attitudes of teachers and school colleagues to their disease. RESULTS: A total of 499 questionnaires were completed and validated. Median age of children was 11.5 years (95% CI 7.8-15.2). Only 34% of parents believed that teachers could recognize the symptoms of a mild hypoglycaemic episode. Seventeen per cent of parents experienced problems at their schools when they informed staff about their children's disease, 5% were finally not accepted and 8% were forced to change school. In some cases, they had to modify glucose monitoring (9%) and treatment administration (16%) because of a lack of cooperation from the school. CONCLUSIONS: Training sessions on Type 1 diabetes, an increase in the number of nurses, better availability of resources from diabetic associations to schools and improved communication between school personnel and parents were identified as key factors that may improve the full integration of the diabetic child in this setting.     

全程责任制助产的临床意义

目的:了解为产妇提供产时"全程责任制助产"的个性化服务,对产妇妊娠结局的影响,以及对提高产科护理质量的意义.方法:将114例住院分娩的初产妇随机分为"全程组"与常规待产组(对照组),"全程组"是指在导乐的基础上实行一名助产士专门为一名产妇提供全过程(宫口开大2cm至产后2h)的服务和指导.结果:"全程组"与对照组的产程时间、分娩方式、产后出血率,均有显著性差异(P＜0.05).结论:"全程"责任制助产有利于提高产科质量,护理满意度调查平均达98%,值得推广应用.     

影响下尿路尿动力学检查准确性的因素及护理措施

笔者通过对270例患者进行尿动力学检查,认为环境、病人的配合程度、检查体位、导管的型号、膀胱灌注情况及护士操作技术、服务态度对尿动力学检查有一定的影响。针对影响因素采取护理措施:积极创造良好的检查环境,加强对患者的宣教与沟通,正确放置体位和选择导管、冲洗液的速度,操作护士熟练的技术和人性化服务,是获得准确检查结果的关键。     

腰大池持续外引流的临床观察与护理

笔者报道72例腰大池持续外引流病人的观察与护理。认为对于腰穿持续外引流的病人，观察脑脊液的性质、量，严密观察病情变化，加强引流管的护理及基础护理，增强营养，是提高治愈率，减少并发症的重要措施。     

The role of the nurse in health promotion

This paper describes and discusses issues concerned with therole of the nurse in health promotion work. It represents thefirst phase of a research project designed to explore this role,and presents the evolving philosophical framework for the study.The study is taking place currently in the United Kingdom andhas been made possible by the (first) award of a Post DoctoralNursing Research Fellowship to the project director. Against the backdrop of the World Health Organization's ‘Healthfor All by the year 2000’ (WHO HFA 2000) movement therehave been repeated calls for nurses to be the leaders in healthpromotion. Policy makers and educators have responded to thesecalls by claiming a central role for nursing and putting healthpromotion high on policy and training agendas. Very little attention,however, has been devoted to exploring the legitimacy and developmentof this role in nursing. Generally, nurses seem enthusiasticabout health promotion, and sure that they have a role to play.What is less certain is what this role is. The study seeks toclarify this by exploring policy, behaviour, and attitudes.Policy provides the framework for practice, and operates ata number of levels. In this early paper we review the literatureto explore policy and practice from international to grassrootslevels. We also make some initial observation derived from ourpilot work.     

走出低谷──再谈渐进式责任制护理

渐进式责任制护理是据国情产生的一个新生事物。其特征是全员参与，在完成功能制工作之后，每位护士负责一位重危病人的护理。其护理内容完全按照责任制护理进行。其不足之处是人员素质的差异，使责任制护理质量有别。不过，可随着条件的成熟，不断得到改进。