关于慢性老年病人的社区护理

随着我国人口的老龄化,慢性病人的发病率不断增加.由于受到经济条件及其他原因的限制,使许多病人不能延续更好的治疗和护理.社区护理的设置,不仅减轻了病人的经济负担也节省了病人家属的时间,从而满足了不同层次家庭卫生服务的需要.

慢性老年病人的社区护理分析

目的:通过对老年病人的社区护理进行探讨,阐明社区护理对提高老年慢性病病人生活质量的有效性。方法:2010年1月～2011年8月随机抽取482例慢性老年病人的临床资料进行回顾性分析,并将其随机分为两组,对照组(n=241)实施常规护理,观察组(n=241)实施优质护理、健康教育等内容的社区护理服务。通过家庭随访对护理效果以及病人对社区护理的满意度进行观察。并采用焦虑自评量表(SAS)及抑郁自评量表(SDS)对两组病人的心理状况进行对比;对两组病人健康知识知晓度、自我保健意识以及健康习惯的养成等方面进行对比分析。结果:观察组SAS与SDS得分均比对照组低,且存在统计学意义(P<0.05);在健康知识知晓度、自我保健意识以及健康习惯的养成等方面,对照组所占的比例均低于观察组,且存在显著的统计学意义(P<0.01)。结论:对慢性老年病人进行社区护理,能改善病人的不良心理状态,还能提高病人健康知识的知晓率与自我保健意识。

在慢性老年病患者护理中应用心理护理的效果

文章通过比较基础的常规护理、常规基础上强化心理护理两种护理措施应用后对患者情绪、依从性及生活质量的影响,来探讨心理护理在慢性老年病患者中的实际应用效果。 方法:70 例样本均选自2020 年 9 月以来本院收录的慢性疾病老年患者,随机性的将这 70 例样本划分为两个组别,并给予不同临床护理措施,分组情况如下:将 35 例应用常规护理的患者设置为常规组;将 35 例采用强化心理护理的患者设置为心理组。 比较两组应用效果。 结果:护理前组间情绪状态无显著差异,护理后两组均有好转,组内相较 P<0.05,且心理组指标更优,组间相较 P<0.05。 心理组患者的各项生活习惯评分更优,组间相较 P<0.05。 治疗前组间生活质量相较 P>0.05;治疗后两组各项评分均有提升,且心理组更高,组间相较 P<0.05。 结论:心理护理在慢性老年病患者中的应用效果显著。

慢性老年病病人的心理护理

随着社会的进步，物质财富的丰富，现代医学的迅速发展，人类的寿命正在不断的延长，老年人口比例逐渐增加，老年人的健康也引起人们的关注和全社会的重视，老年人由于器官、组织、细胞的生理性自然衰老，生理和心理功能都逐渐减退，躯体适应能力逐渐下降，慢性病发病率高，并发症多，恢复缓慢，病痛和衰老的心理压力，干扰着他们的工作和生活。

基于叙事医学护理对慢性老年病患者负性情绪、护理满意度的影响

评析基于叙事医学护理对慢性老年病患者的影响。方法:慢性老年病患者120例(2020.01-2020.12),按照掷硬币分组法,分成A组(常规护理)、B组(基于叙事医学护理),各60例,对比、分析两组护理效果。结果:B组负面情绪改善效果和护理满意度明显优于A组(P<0.05)。结论:基于叙事医学护理可改善慢性老年病患者负性情绪,具有临床推广价值。

浅谈老年人的心理护理

老年人随着年龄的增长,各系统衰老退化,各种生理机能减退,常患有多种慢性老年病并伴有心理方面的一系列变化及障碍。医护人员应掌握老年患者的心理特点,根据不同的老年患者的病症、职业、资历及职务和心理需要等,有的放矢地开展心理护理,能起到药物所起不到的治疗作用,我们的护理体会如下。

出院患者确定延续性护理时间需求研究进展

延续性护理作为新兴事物在我国尚处于起步阶段。目前,大多医院对出院患者采用电话随访、家庭随访、护士门诊、延续性护理中心、网络信息平台、患者联谊会与发放健康教育资料等进行延续性护理,除网络信息平台及发放健康资料的服务时间不需要要求过高外,电话随访、家庭随访、护士门诊及延续性护理中心这些方式对患者和护理人员在时间上的要求较高,常会出现患者拒访或者失访等现象,使出院患者的客观护理需求不能得到满足,这就要求医院需要根据患者的个人及延续性护理人员特性制定个性化的延续性护理方案，如何确定患者出院后延续性护理服务时间是其中重要的环节。

健康教育初浅体会

随着我国人口的老龄化和人民生活水平的提高，带来了疾病谱的变化，高血压、心脑血管疾病、糖尿病等慢性老年病越来越多。怎样告诫人们摒弃不良习惯，建立健康的生活行为与生活方式，以减少和预防疾病，已成为社会特别是干部保健工作者的重要责任。

免疫学检验

9700621 自动免疫检测的血清 SyttatinC:一种更为敏感的 GFR 变化的指标/Ne Wman D J//Kibney Int.-1995,47(1)一3 xZ^318冀医图9了00622慢性老年病住院病人的甲状腺自身抗体:非甲状腺的临床状态与甲状腺功能不同年龄流行病的不同效果/S:abol-es IZJAm

Factors associated with balance function in patients with knee osteoarthritis:An integrative review

This integrative review is to identify the factors associated with balance function in patients with knee osteoarthritis and explore the relationship between these factors and balance function.Osteoarthritis commonly occurs in elderly people.Patients with knee osteoarthritis have balance impairment,and maintaining knee stability is important for such patients to prevent accidental injuries caused by falling.Therefore,it is important to clarify the factors related to balance function in patients with knee osteo-arthritis.The PubMed,Science Direct,CINAHL,Ovid,ProQuest,CNKI,WanFang databases were searched,and relevant articles published up to December 2015 were included.Twenty articles were included in the analysis.Age,gender,dominant limb,foot length,knee alignment,diurnal variation,and meniscus tears were the non-modifiable factors,whereas body mass index,knee pain,muscle strength,joint range of motion,severity,and cognitive loading were the modifiable factors.Knee sleeve and custom-molded insoles showed protective effects against knee osteoarthritis.

Determination of glycated hemoglobin in patients with advanced liver disease

AIM:To evaluate the glycated hemoglobin(HbA_(1c)) determination methods and to determine fructosamine in patients with chronic hepatitis,compensated cirrhosis and in patients with chronic hepatitis treated with ribavirin. METHODS:HbA_(1c) values were determined in 15 patients with compensated liver cirrhosis and in 20 patients with chronic hepatitis using the ion-exchange high performance liquid chromatography and the immunoassay methods. Fructosamine was determined using nitroblue tetrazolium. RESULTS:Forty percent of patients with liver cirrhosis had HbA_(1c) results below the non-diabetic reference range by at least one HbA_(1c)method,while fructosamine results were either within the reference range or elevated.Twenty percent of patients with chronic hepatitis(hepatic fibrosis) had HbA_(1c)results below the non-diabetic reference range by at least one HbA_(1c)method.In patients with chronic hepatitis treated with ribavirin,50% of HbA_(1c)results were below the non-diabetic reference using at least one of the HbA_(1c)methods. CONCLUSION:Only evaluated in context with all liver function parameters as well as a red blood count including reticulocytes,HbA_(1c)results should be used in patients with advanced liver disease.HbA_(1c)and fructosamine measurements should be used with caution when evaluating long-term glucose control in patients with hepatic cirrhosis or in patients with chronic hepatitis and dbavidn treatment.

Effectiveness of fire needle combining with moist healing dressing to promote the growth of granulation tissue in chronic wounds:A case report

In this case study,we analyzed the wound-healing process of a patient with a chronic wound who underwent fire needle treatment,and we tracked the coverage of granulation tissue and decrease of slough and exudate.An 85-year-old man had repeated right shoulder and back pain,itching,and skin festering for more than 1.5 years.A fire needle was administered combined with moist dressing once every 5 days to promote wound healing.After six rounds of fire needle treatment,granulation tissue formed over the surface of the wound base,the depth of the wound had become shallow,and the wound area was reduced.No complications occurred during the intervention.Fire needle therapy combined with a moist wound-healing dressing can be an effective alternative approach in managing chronic wounds.

Establishing a predictive model for aspirin resistance in elderly Chinese patients with chronic cardiovascular disease

Background Resistance to anti-platelet therapy is detrimental to patients. Our aim was to establish a predictive model for aspirin resistance to identify high-risk patients and to propose appropriate intervention. Methods Elderly patients （n = 1130） with stable chronic coronary heart disease who were taking aspirin （75 mg） for 〉 2 months were included. Details of their basic characteristics, laboratory test results, and medications were collected. Logistic regression analysis was performed to establish a predictive model for aspirin resistance. Risk score was finally established according to coefficient B and type of variables in logistic regression. The Hosmer-Lemeshow （HL） test and receiver operating characteristic curves were performed to respectively test the calibration and discrimination of the model. Results Seven risk factors were included in our risk score. They were serum creatinine （〉 110 μmol/L, score of 1）; fasting blood glucose （〉 7.0 mmol/L, score of 1）; hyperlipidemia （score of 1）; number of coronary arteries （2 branches, score of 2; 〉 3 branches, score of 4）; body mass index （20-25 kg/m2, score of 2; 〉 25 kg/m2, score of 4）; percutaneous coronary intervention （score of 2）; and smoking （score of 3）. The HL test showed P ≥ 0.05 and area under the receiver operating characteristic curve ≥ 0.70. Conclusions We explored and quantified the risk factors for aspirin resistance. Our predictive model showed good calibration and discriminative power and therefore a good foundation for the further study of patients undergoing anti-platelet therapy.

A family nurse-led intervention for reducing health services’utilization in individuals with chronic diseases:The ADVICE pilot study

Objectives:Intensive health services'utilization is common in older individuals affected by chronic diseases.This study assessed whether a structured family nurse-led educational intervention would be effective in reducing health services'use(readmissions and/or emergency service access)among older people affected by chronic conditions.Methods:This is a non-randomized before-after pilot study.A sample of 78 patients was recruited from two general practices in Italy and 70 among them were followed for 8 months.Standard home care was provided during the first four months'period(months 1-4),followed by the educational intervention until the end of the study(months 5-8).The intervention,based on the teach-back method,consisted of by-weekly 60-min home sessions targeting aspects of the disease and its treatment,potential complications,medication adherence,and health behaviours.Rates of health services'use were collected immediately before(T0),and after the interventions(T1).Differences in utilization rates were examined by the McNemar's test.Potential factors associated with the risk of health services'use were explored with a Cox proportional hazard regression model.Results:The sample(n=78)was predominantly female(n=50,64.1%),and had a mean age of 76.2(SD=4.8)years.Diabetes mellitus was the most frequent disease(n=27,34.6%).McNemar's test indicated a significant reduction in health services'use at T1(McNemar χ^(2)==28.03,P<0.001).Cox regressions indicated that time and patient education,as well as their interaction,were the only variables positively associated with the probability of health services'use.Conclusion:A teach-back intervention led by a family nurse practitioner has the potential to reduce health services'use in older patients with chronic diseases.

Implementation and evaluation of the peer-training program for village health volunteers to improve chronic disease management among older adults in rural Thailand

Objectives This study aimed to investigate the effect of a peer-training program for village health volunteers(VHVs)to improve chronic disease management among older adults in rural Thailand.Methods The study was guided by community-based participatory research(CBPR).The peer-training program was developed by engaging diverse stakeholders,including community organizations,healthcare services,VHVs,older adults with chronic illnesses,and folk scholars in remote communities with high healthcare needs.The peer-training program comprised a three-day training workshop that convened once a week for three weeks with the following six sessions:knowledge sharing,peer support and empowerment,health literacy and health behavior,the general caring procedure for older adults with chronic illnesses,information sharing and communication,and home visit.From January to April 2021,a total of 28 VHVs completed the peer training program in a rural area in Chiang Rai province,Thailand.The Health Literacy and Health Behavior-3E2S(HLHB-3E2S),the Management of Non-Communicable Diseases Questionnaire(MNCDQ),and a self-confidence questionnaire were used to survey pre(week 1)and post-intervention(week 12),respectively.Then VHVs were interviewed to collect attitudes,and opinions about the intervention.Results After the intervention,the HLHB-3E2S scores(49.39±5.54 vs.52.35±4.26,P=0.001),the MNCDQ scores(44.10±6.27 vs.50.60±4.84,P<0.001),and the self-confidence questionnaire scores(22.28±2.46 vs.23.21±1.81,P=0.01)of VHVs significantly increased.VHVS also reported that the peer-training program enhanced their healthcare services,including health education,chronic disease management,leadership skills,and improving their relationship with healthcare providers.Conclusion Peer training programs are a practical strategy to improve VHVs’capacities.Healthcare professionals should provide a continuous training program for VHVs with their peers to increase capacities,confidence,and satisfaction in caring for the older adults with chronic diseases in the community.

Influence of age on prevalence rates of chronic complications of hospitalized aged patients with hypertension -- analysis of 17,682 cases

Objective To understand the relationship between age and chronic complications in hospitalized aged patients with hypertension, to provide evidence for hypertension prevention and control. Methods To retrospectively analyze the clinical and laboratory data on 17,682 patients with essential hypertension during Jan 1 s,, 1993-Dec 12th, 2008 in PLA general hospital. Results 1） Among all of the inrolled cases, those aged 60-64 account for 27.87%, 65-69 years group account for 26.55%, 70-74 years group accounted for 23.96%, 75-79 years group accounted for 14.14%, 80-84 years group accounted for 5.26%, 85-89 years group accounted for 1.69%, 〉 90 years accounted for 0.41%. 2） The prevalence rate of chronic complications in 60-69 years group were 31.3-31.2% for diabetes and,22.6-27.0% for cerebrovascular disease, 9.5-11.1% for myocardial infarction, 6.7-9.1% for heart failure, 5.8-6.0% for renal dysfanction 4.9-6.8% for atrial fibrillation, 0.1-0.3% for multiple organ dysfunction syndrome （MODS） in the elderly（P 〈0.05 ）. 3） The first four complications of hypertension were diabetes（33.5%）, cerebrovascular disease （31.9%）, myocardial infarction（13.2%） and heart failure（12.3%） in 70-74 years group （P〈0.05）, cerebrovascular disease （42.8%）, diabetes （32.8%）, heart failure （16.5%） and myocardial infarction（15.9%） in 75-79 years group （P〈0.05）, cerebrovascular disease （45.4%）, diabetes （35.0%）, heart failure （21.1%） and myocardial infarction（l 5.9%） in 80-84 years group （P〈0.05）, cerebrovascular disease（42.5%）, diabetes （35.8%）, heart failure （23.1%） and renal dysfanction （17.7%） in 85-89 years group（P〈0.05 ）,and cerebrovascular disease （45. 2%）, heart failure（31.5%） , diabetes （26.0%） and renal dysfanction （20.5%） in patients more than 90 years group （P〈0.05）. Conclusions The prevalence rate and kinds of chronic complications in hospitalized aged patients with hypertension were changed with the increasing age, and the first kind of complication is cerebrovascular disease. It is of more importance to prevent the occurrence of renal dysfanction and heart failure in those hypertension patients who were more than 80 years old.

Chronic kidney disease as a predictor of clinical risk in the elderly

Facing the needs of an increasingly ageing population is rapidly becoming a major public health issue in western countries, Chronic kidney disease （CKD）, whose current prevalence is estimated around 10%-15% in the general population, with considerably higher figures in at-risk groups, is widely known to increase with age. In the elderly, renal impairment is often concomitant or secondary to several other systemic disorders such as hypertension, atherosclerosis,

老人夏季莫忘补钾

夏季天气炎热，老人耐受力差，易出汗。同时，炎热环境中，人体新陈代谢加快，血浆中钾离子随之转入细胞内。另一方面，老人胃肠功能下降，小肠黏膜萎缩，有效吸收面积减少；又因夏天炎热胃口差，进食减少，摄入钾离子往往不足。还有一些老人患有慢性老年病，长期用药。其中有的药(如抗高血压药双氢克尿塞)具有利尿作用，同时加速排钾。这些因素都可导致老人身体血浆钾离子浓度下降，

Effect of warming needle moxibustion on pulmonary function of elderly patients with stable chronic obstructive pulmonary disease

Objective To observe the therapeutic effects of warming needle moxibustion on pulmonary function of elderly patients with stable chronic obstructive pulmonary disease. Method Eighty elderly patients with stable chronic obstructive pulmonary disease were divided randomly into an acupuncture group and a drug group, with forty cases in each group. The patients in the acupuncture group were treated with warming needle moxibustion on specific acupoints. Main acupoints include Zusanli （足三里 ST 36）, Feishu （肺俞 BL 13） and Dingchuan （定喘 EX-B 1）. Matching acupoints include Gaohuang （膏肓 BL 43）, Xinshu （心俞 BL 15）, Dazhui （大椎 GV 14） and Fangmen （风门 BE 12）. The acupoints were punctured with even reinforcing and reducing method. Meanwhile, two moxa stick of warming needle moxibustion were applied separately at the acupoints at back and ST 36. The needles were retained for approximately 0.5 h each time. The treatment was given every other day, 3 times a week and the course of treatment was 8 weeks. Patients in the drug group were treated by seretide inhalation （50 μg salmeterol and 250 μg fluticasone propionate）, twice a day for 8 weeks. The improvement in pulmonary function and the symptom of chills and fever were compared between the two groups. Results After treatment, pulmonary function indices [forced expiratory volume in one second （FEV1）, forced expiratory volume in one second to forced vital capacity （FEVl/FVC）, forced expiratory volume in one second to predicted value ratio （FEV1%） and peak expiratory flow （PEF）] of the patients in both groups were improved significantly compared with that before treatment （P〈0.05）. There was no statistically significant difference between the two groups （all P〉0.05）. Improvement in comprehensive scores of the symptom of chill and fever in the acupuncture group was significantly superior to that in the drug group after 4 and 8 weeks of the treatment, respectively （P〈0.05）. Conclusion Warming needle moxibustion was obviously effective on the improvement in pulmonary function of elderly patients with stable chronic obstructive pulmonary disease.

Exploration of collaborative drug therapy management mode for elderly patients with chronic diseases

As China is accelerating into an aging society,the coexistence of multiple diseases,multiple drugs,and the decline of body function are serious problems faced by elderly patients.Therefore,it is imperative to carry out the comprehensive prevention and control of chronic diseases,strengthen the health guidance and comprehensive intervention of common and chronic diseases of the elderly,and strengthen the health management of elderly patients.Collaborative drug therapy management(CDTM)is a drug treatment management mode that emerged in pharmaceutical services under the situation of new medical reform,aiming to expand the role of pharmacists in the medical team and improve the quality of hospital medical service.Although CDTM has shown some favorable effects in managing chronic diseases in the elderly population,the popularization of CDTM in China is limited by the differences in supporting facilities,management mode,and pharmacist’s abilities in hospitals.By exploring the CDTM mode for elderly patients with chronic diseases,we provided a reference for further promoting the CDTM services and laid a good foundation for displaying pharmacist value and the realization of real pharmaceutical care.