浅谈老年患者择期手术麻醉问题

随着社会老龄化,老年患者占手术麻醉比例逐年增加。对手术和麻醉危险因素、各重要器官的储备功能和应激能力的评估,以及了解老年人随年龄变化而产生的药效学和药代学改变,给予老年择期手术患者个体化麻醉是极其重要的。     

Perception and Help-Seeking Intention of Intimate Partner Violence in Later Life: An International Perspective

This study examines whether elderly Koreans recognize a scenario of intimate partner violence as such and whether they would seek help in the given situation of elder mistreatment (EM). Two cohorts of Korean elders (one immigrant and one Korea-based), each numbering 124 participants, were recruited using a quota sampling strategy. The study used a mixed method approach, employing a hypothetical scenario, and patriarchy theory informed the study. Findings revealed low perception of the vignette as EM and low help-seeking intention in both cohorts. Among the immigrant cohort, intention to seek help was greater among respondents who were female, demonstrated lower adherence to traditional values, and perceived the vignette as EM. Among the Korea-based cohort, the only significant factor was recognition of the scenario as EM. Development of culturally competent and geographically specific practice and intervention is urgently needed, particularly among elders who have greater adherence to traditional cultural values.     

“Granny dumping”: Acceptability of sacrificing the elderly in a simulated moral dilemma

In a simulated moral dilemma, most people would be willing to endorse killing a single individual to save five others, but do people show the same degree of resistance to sacrificing people of different ages? In the present study, participants were asked to choose how acceptable it was to sacrifice one individual from a number of different age groups in order to save five others in a trolley problem. The sacrificial targets were a 70‐year‐old male stranger, a 20‐year‐old male stranger, a 5‐year‐old male stranger, or a 20‐year‐old male disabled stranger. Our results indicated that more participants accepted sacrificing the elderly stranger than the other three targets; sacrificing the child was the least accepted option. These results indicate that the decision‐making process in a moral dilemma involves weighing others' lives according to their age and implicitly predicting their life span.     

Spiritual Need Four: Opportunities to Be Served and to Share with Others

SUMMARY

Older adults have unique opportunities to be served and to share with others through groups and individual relationships and programs in religious congregations. Where programs and senior centers with public funding can provide only for physical, emotional, and social needs, religious congregations can be more wholistic and provide for the spiritual needs as well. This chapter offers further discussion of planning that will facilitate program development for the whole person.     

Application of the Theory of Signal Detectability to Kinesthetic Discrimination Tasks

The psychophysical methods of the theory of signal detectability were applied to the measurement of kinesthetic recognition sensitivity. Subjects (n = 12) were tested on a kinesthetic discrimination apparatus, and were randomly assigned to one of four treatment conditions. Each subject operated under five response criteria which were imposed through a priori probabilities of high and low kinesthetic stimuli. The fundamental assumptions of the theory of signal detectability were tested and the basic premises of normality and equality of variance observed in most cases. A subproblem investigated the relationship between kinesthetic recognition sensitivity and the two independent variables of direction and extent of forearm movement, but no relationship was observed. This study was conducted at Kansas State University under the direction of Richard H. Cox with technical assistance from Harold L. Hawkins. The study was funded by a Faculty Research Grant awarded by Kansas State University.     

家属参与授权教育对老年原发性高血压伴同型半胱氨酸血症患者管理中的应用

探讨家属参与授权教育对老年原发性高血压伴同型半胱氨酸血症患者的干预效果.选取120名老年原发性高血压伴同型半胱氨酸血症患者,随机分成试验组和对照组,每组60名,两组均采取相同的药物治疗,给予常规的授权教育模式.试验组在此基础上给予家属参与授权教育模式,为期6个月.试验组与对照组比较,总胆固醇（TC）、甘油三脂（TG）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）、同型半胱氨酸（Hcy）及血压值低于对照组,差异有统计学意义（P＜0.05）;试验组的生存质量及满意度评分均高于对照组,两组差异有统计学意义（P＜0.05）.经过为期6个月的健康教育干预,这一模式取得了较好的效果.     

社区老年人的生活质量与心理健康:SEM研究

在Lawton理论框架以及先前研究基础上,进一步对上海社区老年人生活质量与心理健康进行研究。采用结构方程建模的方法对老年人健康生活质量(QHL)、客观生活环境质量(QOE)与心理健康(PWB)的理论构念及其相互关系的理论模型予以实证研究。结果表明,该模型与社区老人测评数据(N=262)的拟合度良好,证明QHL对PWB具有显著正面影响,QOE与QHL显著相关且直接或间接地正面影响PWB。研究表明良好身体健康状况、行为调适能力以及家庭一社区养老环境对促进老人心理健康具有重要意义。     

代际支持对中国农村老年人认知功能的影响研究

基于西安交通大学人口研究所2001年在安徽省巢湖市进行的“安徽省老年人生活福利状况”的抽样调查,采用多元线性回归,结合农村实际状况,详细分析经济支持、生活照料和情感支持的代际问双向交流对中国农村老年人认知功能的影响。结果显示,经济支持和情感支持的双向交流对老年人的认知功能有积极影响;老年人生活照料的获得对其认知功能也积极的影响;老年人对子女的生活照料的提供对其认知功能无显著影响。     

AN ANALYSIS OF SOCIAL SKILLS GENERALIZATION IN TWO NATURAL SETTINGS

The interactional behavior of two groups of elderly mentally retarded residents of a community facility was measured in two generalization situations before, during, and after one group received social skills training. The training group received social skills training within a game format, whereas the contrast group simply played a game with no emphasis on interactional behavior. Results suggested that generalization to natural interactional situations may be delayed following training and that it is more likely in some situations (i.e., with trained peers) than others (i.e., in the presence of untrained peers).     

老年人的消极交往与心理健康

积极交往和消极交往分别会对老年人的心理健康产生有利和不利影响, 然而, 探讨消极交往的负面作用及其机制的研究相对较少。目前研究主要涉及消极交往的类型(社会隔离、丧偶或离婚)、来源(配偶、子女或朋友)及强度, 并探讨感知评估、自尊的中介作用及性别、婚姻、受教育水平等变量的调节作用。社会情感选择理论、优劣势整合理论、社会交换理论及镜中我理论在一定范围内对消极交往的负面作用做出了合理解释。采取“原谅”或“认知疏远”的应对策略能有效缓解消极交往的负面影响。未来研究应进一步考察不同文化背景及社会网络背景下消极交往对老年人心理健康的影响, 同时加强对消极交往的理论研究和线上研究, 并关注相关的干预研究。