访视护理——卫生护理事业中的一支新军

访视护理作为卫生事业发展中一个新生事物,具有服务场所的家庭化、服务关系的稳定性、服务内容的广泛性等特点,在疾病预防和康复指导中发挥着重要作用,大力发展访视护理具有极大的现实意义.访视护理的发展有其历史文化背景,应从观念、人才培养和规范管理等方面加强和发展访视护理.     

手术室护士术前访视存在的问题及对策

通过对手术患者实施术前访视工作中存在的问题进行分析,主要问题有:护理人员对访视重要性认识不足、缺乏知识、缺乏沟通技巧、人力资源不足及患者自身问题等.认为制定相关措施、贯彻落实术前访视制度、提高护士的业务水平、增进护患交流可提高术前访视质量,使患者以最佳状态接受手术.     

宗教改革前基督教与护理发展的关系探讨

护理作为一门古老的艺术,在发展过程中与基督教有着密切的联系。特别是宗教改革前,基督教对看护者工作纪律和职责的规定、护理活动服务对象的改变、看护者服务范围的扩大和军事护理团体的创立等方面都产生了重要的影响。通过对以上问题进行初步探讨,希望能够对现代护理学的发展提供历史借鉴。     

宗教改革前基督教与护理发展的关系探讨

护理作为一门古老的艺术,在发展过程中与基督教有着密切的联系.特别是宗教改革前,基督教对看护者工作纪律和职责的规定、护理活动服务对象的改变、看护者服务范围的扩大和军事护理团体的创立等方面都产生了重要的影响.通过对以上问题进行初步探讨,希望能够对现代护理学的发展提供历史借鉴.     

ACTION和Sweet-Home模式对我国智慧居家养老的启示

面对全球老龄化的趋势,国外一些国家在智慧居家养老服务理论与实践方面进行了有益探索,我国发展智慧居家养老服务也具有客观必然性。国外开展的ACTION模式为老年人及其家庭护理者提供可靠、信任的服务,一直被认为是欧洲信息通信技术在养老服务中应用的最好示范;由法国国家支持的以音频技术为基础设计的新的智能居家系统SweetHome也取得了很好的效果。阐述了ACTION模式和Sweet-Home模式的提出背景、体系构成、实施效果,借鉴其经验,对我国在模式设计、服务项目、参与主体和人才培养等方面发展智慧居家养老服务具有一定的启示。     

从住院患者的主观感受谈人性化护理服务需求

通过半结构式访谈,从住院患者的主观感受分析其对人性化护理服务的需求.住院患者对医院提供的人性化护理服务满意度较高,在简化医院流程、得到理解和尊重、保护隐私、提供健康知识、提高人性化护理服务素质等方面表现出较大的需求.本文根据患者的需求结合临床实际提出了针对性的意见和建议.     

老年人护理需求调查研究

随着我国老龄化程度的逐步加深,高龄老年人所占比例也逐渐增高,疾病与健康困扰导致高龄老年人的护理需求迅速上升。为了解老年人的护理需求,分析老年人生活质量的影响因素,采用整群抽样法对山东省17个地级市的1429名老年人进行问卷调查。结果显示,75.9%的老年人患有高血压、骨质疏松等严重影响老年人生活质量的疾病;55.9%的老年人需要多样化的护理服务;75.4%的老年人喜欢居家养老。由此可见,老年人普遍具有多种健康问题和生活困扰,应针对老年人的身心健康状况及护理需求提供相应的护理服务,以提高老年人的生活质量。     

老年人长期护理保险的研究

老年人长期护理保险是一项应对人口老龄化的重要措施,它可以通过提供针对性的护理服务及经济补偿缓解老年护理的经济负担。国外的长期护理保险模式主要有四种:全民保险模式、社会保险模式、商业保险模式和储蓄保险模式。我国尚处于长期护理保险的起步阶段,目前正以青岛市、长春市等为试点城市,探索符合我国国情的保障制度。现阶段的试点工作暴露出该制度在国内发展面临的一些问题。建议应从筹资模式、给付方式、养老体系与医疗体系的融合、护理人力资源及宣传等方面着手改善,以推动该制度的进一步完善。     

层次化护理团队在优质护理服务中的应用探讨

将所研究的临床科室的护理人员按照职称进行分层并组成护理团队.1年后比较实施前后护理质量和护理服务质量的相关指标.实施后,护理质量和护理服务质量均有显著提高(P＜0.01).临床科室组建层次化优质护理团队,能为患者提供更为安全、满意的护理服务,推动优质护理服务的开展.     

基于消费水平升级的医护养老发展研究

结合消费升级理论及居民消费升级的现实,分析医护养老需求与消费的相关性,探讨医护养老供给的现状及存在的问题,指出医护养老的发展模式和保障措施。老年人消费能力的提升导致医疗、健康服务消费支出在其总支出中的比重不断增加,医护型养老服务迎来政策和市场机遇。相关制度缺位、养老服务人才缺口大、社会资本投资动力不足、支付能力低等,导致包括机构养老、医疗护理、临终关怀等医护养老服务供给不足。应发展"医"、"养"一体式、对接式的医护养老模式,并从立法、财政政策、人才培养机制等方面提供保障。     

Voices from the Dark

While visiting the severely ill in the West Vir inia mountains, the author came to know two people, Dennis Hal f and Elizabeth Wright. Dennis has battled multiple sclerosis for a third of his life and is now living his last days in a nursing home. Elizabeth, despite the amyotropic lateral sclerosis that had deteriorated her muscles and eventually caused her death, discovered a richness in her suffering. In their struggles against suffering and dying, these people reveal something about that which endures.     

临床共情与护理技术结合：人性化的护理

临床共情是一种能体验患者内心世界的能力,通过患者的言语和非言语表达,觉察和认识患者情感和情绪需求,并对其做出恰当的回应.临床共情具有科学的理论和实践基础,具有缓解患者心理上的痛苦,改善护患关系,促进患者康复等作用.在当今复杂的医疗环境下,务必要重视共情培养,适时运用临床共情.然而,我们强调临床共情的重要作用,并不能忽视护理技术的根本作用,根除躯体上的病变仍有赖于护理技术的有效性.在临床护理实践中,坚持共情与护理技术的有机结合,推进人性化的护理构建.     

Observing home-visit quality with the home visit rating scales: Introduction to the special section

Evidence-based home-visiting programs aim to address one of the most important challenges facing our species—setting the next generation on a healthy path of development that prepares them for a future that is simultaneously uncertain and promising. Diverse research literatures have pointed to practices to effectively meet this challenge and better achieve the unfulfilled promise of home visiting by more effectively engaging parents in supporting their children's early development and well-being. Measures of home-visit quality practices drawn from social work, pediatric nursing, early childhood, and early intervention research literatures have identified building relationships with families and focusing on their strengths as effective, practices that are particularly important for vulnerable families. The articles in this special section used the Home Visit Rating Scales to examine stability in home-visit quality over time, study specific home-visiting processes linked with quality, validate a supervisor checklist of home-visiting implementation, and consider the home visit in relation to an array of indicators reflecting overall home-visiting program strength and stability. These articles exemplify progress in home-visiting research over recent decades, including advances in direct observational methods and measurement as well as examinations of home visiting as an observable process across various home-visiting program models and populations.     

Pilot test of a measure to assess clients’ perceptions of their home visitors

Home visiting services for caregivers of infants and young children have been found to be an effective method for promoting child development. Unfortunately, such services suffer from high rates of attrition, suggesting the need to identify factors related to client retention in services. Research has indicated that the client-provider relationship is an important predictor of client retention in home visiting services; however, measures to assess this relationship are limited. This study reports on a pilot test of the Client Perceptions of Home Visitors Questionnaire, developed to assess home visiting clients’ perceptions of their relationship with their home visitor. The measure was completed by 39 diverse home visiting clients during pregnancy in a midwestern town in the United States. The scale was found to have good internal consistency. Validity analyses found that the scale was positively associated with client satisfaction with services and perceived provider cultural sensitivity. The scale was also positively associated with retention in services at an 8-month follow-up. Additional research should examine the measure's psychometrics with larger samples.     

Introduction to the special section: The development of infant mental health home visiting in Michigan state government

This issue of the Infant Mental Health Journal presents the first papers from a tripartite evaluation study of state-sponsored infant mental health home visiting program in Michigan, United States. This series of studies has been led by Kate Rosenblum PhD and Maria Muzik MD, Department of Psychiatry, the University of Michigan and faculty from the Michigan Collaborative for Infant Mental Health Research for the State of Michigan, Department of Health and Human Services, Mental Health Services for Children, to fulfill the requirements of state legislation (State of Michigan Act No. 291, Public Acts of 2013) that required that all home visiting programs meet certain requirements to be established as an evidence-based practice. In this introduction, we provide a historical context for the delivery of infant mental health home visiting through the community mental health system in the state of Michigan.     

预防患者术中知哓的早期心理干预——颅内动脉瘤介入栓塞术患者中的研究

探讨早期心理干预在预防颅内动脉瘤栓塞术患者术中知晓的效果。将100例患者按入院先后顺序随机分为观察组和对照组,各50例,均实行整体护理,对照组给予常规的术前、术后护理,观察组在常规护理的基础上给予一系列针对术中知晓的心理护理干预措施。观察组干预前后焦虑程度明显减轻（P〈0．01）,对护理质量满意度均优于对照组（P〈0．05）,差异有统计学意义。针对不同患者心理状态进行系统的早期心理干预可减轻脑血管介入患者术前焦虑情绪,从而积极有效地预防颅内动脉瘤栓塞术患者术中知晓的发生,提高护理质量满意度。     

广州市14种常见疾病门诊就诊时间定量分析

为了确定常见疾病的合理就诊时间,本文对广州市区县级医院和社区机构的门诊就诊时间进行了调查,结果分别是9.46分钟和5.92分钟,并进一步分析发现门诊就诊时间的长短与机构级别和病种有关,且前者的影响显著高于后者。医院管理者应科学合理地确定门诊就诊时间。     

护理实践中的辩证思维

用辩证思维方法分析护理实践中存在的问题,从事物的异同性、矛盾的对立统一性、护理工作的两重性、主从性等方面探讨辩证思维在护理实践中的运用,有利于培养护士的人文素养和哲学思维能力,能在工作中缕出头绪、抓住问题的根本,提高护理工作效率和质量,收到事半功倍的效果。