整体护理与新医学模式

整体护理作为当代护理的基本工作模式和护理学发展的基本趋势,是与生物心理社会医学模式的确立直接相联系的。在临床护理中,落实新医学模式,是推行整体护理所必需的。在整体护理中落实新医学模式应从转变护理人员观念、整体护理规范化、改变护理队伍的知识和技能结构、提供护士职业道德水平等方面做起。     

The Michigan infant mental health home visiting model

Selma Fraiberg's pioneering work with infants, toddlers, and families over 40 years ago led to the development of a field in which professionals from multiple disciplines learned to work with or on behalf of infants, very young children, their parents, and the relationships that bind them together. The intent was to promote social and emotional health through enhancing the security of early developing parent–child relationships in the first years of life (Fraiberg, 2018). Called infant mental health (IMH), practitioners from fields of health, education, social work, psychology, human development, nursing, pediatrics, and psychiatry specialize in supporting the optimal development of infants and the developing relationship between infants and their caregivers. When a baby is born into optimal circumstances, to parents free of undue economic and psychological stressors and who are emotionally ready to provide care and nurturing for an infant's needs, an IMH approach may be offered as promotion or prevention, with the goal of supporting new parent(s) in developing confidence in their capacity to understand and meet the needs of the tiny human they are coming to know and care for. However, when parental history is fraught with abandonment, loss, abuse or neglect, or the current environment is replete with economic insecurity, threats to survival due to interpersonal or community violence, social isolation, mental illness, or substance abuse, the work of the IMH therapist may require intervention or intensive treatment and becomes more psychotherapeutic in nature. The underlying therapeutic goal is to create a context in which the baby develops within the environment of a parent's nurturing care without the psychological impingement that parental history of trauma or loss or current stressors such as isolation, poverty, or the birth of a child with special needs, can incur.     

Taking Access to the Community: An Ecological Systems Framework for In‐Home Counseling With Older Adults

Bronfenbrenner's (1977) ecological systems theory is a holistic framework placing an individual in a system's context to address their concerns. This article offers a case study demonstrating use of the theory with older adults and the in‐home setting. Implications for the counseling field and future research needs are discussed.     

Transgender and gender non-conforming adult preparedness for aging: Concerns for aging,and familiarity with and engagement in planning behaviors

Abstract

Background: Research on transgender and gender-nonconforming (TGNC) aging is limited. To date, most of the literature about TGNC aging has focused on discrimination (particularly in healthcare), violence and abuse, caregiving and family relations, and religiosity.

Aims: The purposes of this study were to: (a) document concerns about aging among TGNC adults, including concerns that are identity-specific; (b) examine preparation for aging and end of life (i.e., familiarity and planning) among TGNC adults; and (c) examine potential differences in familiarity and planning based on gender identity.

Methods: One hundred fifty-four individuals who currently or have ever identified as TGNC completed a national online survey assessing these constructs.

Results: TGNC individuals reported many concerns about aging, both gender identity-specific and not. The most common aging concern was losing the ability to care for themselves followed by having to go into a nursing home or assisted living facility. The age preparatory behaviors individuals were most commonly aware of included: life insurance, wills, organ donation, regular medical checkups, living wills, durable power of attorney for healthcare, and trusts. Gender-nonconforming individuals had significantly more familiarity with age preparatory behaviors than trans feminine individuals, but had lower levels of planning to engage in age preparatory behaviors than both trans masculine and trans feminine individuals.

Conclusion: The current findings highlight the need for providers to address age preparatory behaviors with TGNC individuals or provide referrals to support individuals in this planning.     

养老院老人社会支持网络和生活满意度研究

本研究所用问卷的编制参照了《中国心理卫生评定量表手册》中的PASS、GWB和社会支持评定等量表。以企了解上海市区养老院老人的社会支持网络状况及其与生活满意度之间的关系。研究表明：(1)养老院老人的社会支持与其生活满意度之间存在极其显著的相关;(2)经回归分析,影响养老院老人生活满意度的最主要因素是养老院的软硬件设施条件与院中老人之间的相互支持;但在生病等特殊状况下,子女仍是最主要的支持来源;(3)对养老院中的老人来说,精神支持的需求比物质支持和认知支持更重要。     

护理学专业学位硕士研究生临床实践体验研究

采用质性研究中的现象学研究方法,对来自全国各地10所院校的12名护理学专业学位研究生进行半结构式深度访谈。通过对录音访谈内容进行三级编码,逐步归纳提炼出三个主题,每个主题下涵盖不同的副主题：（1）临床实践获益感方面：提升核心能力、体现自身价值;（2）心理体验：归属感、失落感;（3）影响临床实践效果的瓶颈因素：缺乏明确的临床能力考评标准、临床带教师资队伍薄弱。因此,教育者和管理者应重视专业学位硕士研究生,晦床核心能力培养,构建一个充满人文关怀的临床实习环境,消除瓶颈因素,以提高其临床实践效果。     

本科实习护生人文关怀能力及影响因素的质性研究

采用质性研究的方法,分析实习期拳科护生对人文关怀的理解、将其运用到临床实践的能力及影响关怀能力的因素。结果显示,本科护生对护理人文关怀的作用有比较明确的认知,但人文关怀能力不足,护理人文关怀行为主要来自模仿带教老师,其关怀能力主要受到自身素质、带教老师、科室管理、人文氛围等因素的影响。因此,医院应注意加强医护人员人文关怀教育,提高带教老师人文素养,树立角色榜样,改善临床人文环境,促进护生提升人文关怀能力,真正将人文关怀运用到临床护理实践中。     

Reporting spiritual needs of older adults living in Bavarian residential and nursing homes

We intended to study unaddressed psychosocial and spiritual needs among older people (of at least 65 years of age) living in nine residential/nursing homes in Bavaria in Southern Germany. We conducted an anonymous cross-sectional study with standardised questionnaires (i.e., Spiritual Needs Questionnaire, Brief Multidimensional Life Satisfaction Scale, Schedule for Meaning in Life Evaluation, etc.). Religious needs were predicted best by residents’ religious trust. Existential needs and inner peace needs correlated moderately with grief, and were predicted best by family/social support needs. All members of an interdisciplinary team should be trained in the specific competence of recognising older people's unmet spiritual needs. When these needs are recognised, caregivers and relatives have the chance to react.     

Nursing students’ reflections on an interprofessional placement in ambulatory care

Reflection has been identified as key to interprofessional education as it facilitates a focus on interprofessional communication, collaborative practice and professional roles, while contributing to debunking ingrained understandings of roles and behaviours. The aim of this study is to explore the written reflections of nursing students following an interprofessional placement in ambulatory care. A deductive analysis of nursing student reflective journal entries mapped against the university interprofessional framework was conducted. A purposeful sample of 19 graduate entry Master of Nursing Science students participating in a two-week interprofessional educational placement completed a reflective journal relating to an interprofessional placement in ambulatory care. The analysis of the journals found that all students were able to reflect on their interprofessional clinical experience, but the ability to reflect varied between students. Despite the challenges that some nursing students experienced in achieving deep levels of reflection, the study demonstrated the usefulness of incorporating reflective journals into nursing curriculums and as part of interprofessional practicums.