mind
Nursing problems faced by empty nesters and their countermeasures
He aijun
Xu yujing
200040
Authors: Huadong Hospital affiliated to Fudan University.
Keywords nursing problems of empty nesters and nursing countermeasures
An empty-nest family refers to a family where there are no children or their children leave the family one after another, resulting in the elderly living alone [1]. It is estimated that the empty nest rate of urban elderly families will reach 80% in 20 10 [2], and the proportion of empty nest elderly families will reach 90% in 2030, when the elderly families in China will be empty nests [3]. The "empty nesters" have to go through not only the transition of personal life cycle (from middle age to old age), but also the transition of family cycle (from nuclear or backbone families to empty nesters), and will face the problem of socialization during the transition period. If we can't adapt well, it will easily cause various physical and mental problems, which will not only affect the quality of life of the elderly, but also bring various difficulties to the family and society. The health problems and countermeasures of empty nesters are summarized as follows.
Dance, play ball, etc. Old people should actively participate in social activities, make friends, talk to friends about their inner boredom, or go to universities for the elderly to enrich themselves. Secondly, skilled old people should repay the society, exert their residual heat and make a difference in their later years. Re-establishing life goals is the best way to overcome empty nest psychology.
2.2 According to the characteristics of the nursing needs of the elderly in the community, strengthen health education research.
Investigation [6] shows that the primary needs of the elderly for community nursing are related to health promotion and health knowledge education. Studies at home and abroad [7] also show that health education and health promotion are a health care strategy with low input, high output and high benefit. Carrying out community health education, improving the health awareness and self-care ability of the elderly in the community and advocating a civilized lifestyle are effective measures to prevent and control diseases closely related to lifestyle, such as hypertension and diabetes. However, hypertension and cardiovascular diseases are still the main diseases of the elderly found in this survey, so health education is a nursing measure.
1. Problems faced by empty nesters 1. 1 mental health
Children's lack of affection and spiritual comfort is the cause of empty nest.
The main causes of mental health problems of the elderly. "Go out with a lock and enter with a light" is a true portrayal of the life of empty nesters. After their children leave home, many retired empty nesters live in seclusion, rarely contact the society, and stay at home all day doing nothing, which will naturally lead to loneliness. In the long run, it is easy to produce pessimism and depression, and even lead to mental disorders and Alzheimer's disease. Tian et al [4] used qualitative research methods to conduct in-depth interviews with 2 1 empty nesters in urban communities. As a result, some elderly people show negative emotions such as being forgotten, lost, bored, lonely, helpless, hopeless, depressed and procrastinating.
2.3 Strengthen the dynamic supervision of family medication for empty nesters and provide safe medication.
Medical service guarantee is based on
Empty nesters lack care and supervision for their children.
They are more likely to encounter difficulties than ordinary old people, and lack the corresponding knowledge and ability in disease control and self-care. Therefore, nursing services must be extended to communities and families, and social support for empty nesters should be strengthened. Community health service centers set up family medication files for empty-nest families. Although the drugs used are separated from hospitals, they are not separated from doctors and nurses [8]. Community nurses regularly come to the door for guidance or call back, and timely understand the situation and give corresponding guidance; Leave a ward contact number for the discharged empty nesters, so that patients can contact medical staff at any time when needed; Establish medication health records for empty nesters with chronic diseases, and follow them up regularly.
1.2 Life Care Problems Empty nesters depend entirely on themselves for food and shelter.
Reason. Some elderly people have poor self-care ability, and even the problem of eating and dressing is difficult to solve. Even those elderly people with strong self-care ability are helpless when faced with trivial matters such as broken appliances, blocked pipes and leaking toilets, and have to turn to neighbors or community service departments for help.
2.4 Carry out free physical examination and on-site service, and pay attention to low-income people and self-funded medical care.
The survey results show that empty nesters know about drug management.
Health service demand of patients
Regular physical examination is helpful for early detection and diagnosis of diseases.
It is one of the important ways of self-care to stop early and treat early and have a comprehensive health examination regularly. Empty nesters seldom go to the hospital for physical examination due to economic, physical inconvenience, unaccompanied children and other reasons, and there is a high demand for free physical examination and on-site service. Community health service departments should pay attention to the health service needs of low-income empty-nest elderly and self-funded medical empty-nest elderly, provide them with some necessary health services, such as free blood pressure measurement and free physical examination, and visit elderly people with mobility difficulties and chronic diseases.
Incidence of family fractures and burns in empty nesters.
Services, such as re-examination of diseases and intravenous infusion. Transportation fees and corresponding service fees can be charged for home visits as appropriate.
1.3 drug safety issues
Low level of knowledge and poor management of self-provided drugs can easily lead to accidental taking or taking expired or deteriorated drugs. Gu et al. [5] have found that there are
13.49% empty nesters took the wrong medicine or took it by mistake. 73.02% of the survey is correct.
Don't know the first aid method when taking medicine by mistake or by mistake. Once the drug is taken by mistake, the empty nesters will be at a loss, unable to save themselves in time and effectively, and delay the rescue opportunity.
1.4 personal safety issues
Very high. Some elderly people are inconvenient to move, unable to take care of themselves at all, and often accidentally fall or burn. In recent years, crimes such as theft, robbery and rape have also occurred from time to time in the families of empty nesters. The incident that the old man died alone at home is also frequently seen in newspapers. There are always hidden dangers in the life of empty nesters, which need vigilance and attention from all walks of life.
2.5 improve the social pension mechanism, and gradually increase the nuclear family, family
The function of providing for the aged is weakening day by day, and it is an inevitable trend for social pension to replace family pension. At present, there are nearly 40,000 public institutions for the aged in China, providing 165438+ 10,000 beds, which is less than1%of the elderly population [9]. This is obviously difficult to meet the needs of empty nesters in China. Therefore, government departments should vigorously set up nursing homes, sanatoriums, apartments for the elderly and nursing homes.
Step 2: Countermeasures
2. 1 Empty nesters should change their ideas and overcome their empty nest mentality.
First of all, empty nesters
People should cultivate a wide range of hobbies, such as planting flowers and birds, playing cards and chess, calligraphy and painting,
Nursing homes and other pension institutions should also encourage the establishment of private pension institutions to supplement the shortcomings of state-owned pension institutions and improve the monopoly of state-owned pension institutions.
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mind
China Journal of Geriatric Health Care Medicine, Vol.7, No.5, 2009
Nursing care of patients with spinal tuberculosis treated by bone grafting and internal fixation
A country in the Zhou dynasty
sun
Liu Yulan
Spinal surgery
Authors: People's Hospital Affiliated to Yunyang Medical College, Hubei Province 442000.
Tuberculosis; Spinal tuberculosis
99% of the lesions of spinal tuberculosis occur in vertebral bodies, which can be seen at any age, especially in lumbar vertebrae, followed by thoracic vertebrae. Pathological changes will lead to the loss of spinal stability. Pathological products such as cold abscess and dead bone can compress the spinal cord and cause spinal cord dysfunction, which can cause paraplegia in severe cases [1]. Surgery is an important means to treat this disease. Lesion clearance is often used in general surgery, which can accelerate the cure of tuberculosis, but destroy the stability of the spine. From 2006 to 2008, 6 patients with spinal tuberculosis/kloc-0 were treated in our department. The focus was cleared and bone graft was used for internal fixation. Nursing experience is summarized as follows.
3. 1. 1 Routine Nursing Patients routinely bathe, change clothes and have blood tests after admission.
Blood type, coagulation time, liver and kidney function, erythrocyte sedimentation rate, etc. To evaluate the general situation of patients and actively correct anemia, hypoproteinemia and liver and kidney dysfunction; Smokers quit smoking for 2 weeks before operation; Pay attention to cold and warmth to avoid catching a cold; Preoperative 1.2 h fasting, 8h water deprivation; Cross-match blood before operation and make good preparations before operation.
3. 1.2 posture nursing patients with spinal tuberculosis and vertebral body destruction and spinal instability,
You must definitely lie on the hard bed to rest, which can reduce the pressure on the spine, relieve the pain and prevent the aggravation of spinal deformation and nerve damage. After admission, patients should be informed of the importance and necessity of absolute bed rest, improve their understanding, make them actively cooperate and avoid medical disputes. Encourage patients to take deep breaths and cough after bed rest to prevent lung infection; Urge patients to do physical exercise to prevent muscle atrophy; Teach patients to do axial rotation, and keep the head, neck and trunk on the same axis when rotating to prevent spinal torsion from aggravating nerve injury; Because of the change of posture and habits, some patients are not suitable for bed defecation. It is necessary for nurses to explain the necessity of bed defecation to patients and teach them the correct methods to meet the needs of bed rest after operation and avoid urinary retention or constipation after operation.
1. Clinical data
There are 65438 06 patients in this group, including 65438 02 males and 4 females. Age (22 ~ 42 years old); 12 cases had a history of pulmonary tuberculosis, accounting for 75% of all cases; Thoracic tuberculosis in 5 cases, accounting for.
3 1.25%, lumbar tuberculosis 1 1 case, accounting for 67.75%. All patients were examined by X-ray, CT and MRI.
The results showed that the vertebral body was destroyed, the intervertebral space narrowed or disappeared, accompanied by kyphosis in different degrees, dead bone formation and paravertebral cold abscess. Esr (60 ~120) mm/1sth, average.
83mm/ 1 sth； According to Frankel's classification, neurological function was classified as B 1 case, C-3 cases, D-3 cases and E-9 cases.
2. Treatment process and results
All cases were treated with debridement, bone grafting and internal fixation. 16 patients were successfully treated, the incision healed in one stage, and no complications such as infection, cerebrospinal fluid leakage and sinus formation occurred. The symptoms of pulmonary tuberculosis poisoning were relieved, and the erythrocyte sedimentation rate began to decrease 1 week after operation, and gradually returned to normal in about 2 ~ 4 weeks after operation. He recovered and was discharged in (14 ~ 29) days after operation. The follow-up time was (3 ~ 265438 0) months, with an average of 65438 02 months. The neurological function of 7 patients with preoperative neurological deficit was improved or completely recovered. During the follow-up period, there was no recurrence of tuberculosis, good bone graft fusion and no loosening, displacement and fracture of internal fixation.
3. 1.3 diet care pulmonary tuberculosis is a chronic wasting disease, especially in terms of complications.
After abscess, the consumption increases, so we should give a digestible diet with high calorie, high protein and vitamins, such as moderate meat, fresh vegetables and fruits, bean products, fresh milk and eggs. At the same time, we should introduce the importance of diet therapy to patients, and tell them that if they can't get enough protein and vitamins in time, it will affect the treatment and postoperative recovery of the disease, so as to gain patients' understanding and cooperation.
3. 1.4 Psychological nursing Because of the complicated condition and long treatment period of spinal tuberculosis,
3. Nursing experience 3. 1 Preoperative nursing
A little. There are many private pension institutions, which will inevitably lead to competition. As a result of competition, all old-age care institutions will reduce fees and improve service quality. The ultimate benefit will be the empty nesters.
In addition, the patient's lack of knowledge of the disease leads to fear and pessimism in the early stage, and anxiety and depression may occur in the later stage because of the cost of treatment.
Journal of Science, 2003,23 (7): 405-407.
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Tian, Liu Junen, et al. Discussion on the inner feelings of empty nesters in urban communities [J]. chinese nursing management, 2009,9 (1): 31.
Gu, Sun Qingling. Investigation, analysis and countermeasures of family drug management for empty nesters [J]. Nursing Research, 2008,22 (9): 2476-2477.
Jay Song, Liu Jinfeng, Cui Ning. Analysis on the demand of empty nesters for home-based care and its influencing factors [J]. Journal of Nursing Science, 2008,23 (21):17.
3. Summary
Today, with the aging of our country becoming more and more serious, it is of great significance to do a good job in community nursing for empty nesters and improve their mental and physical conditions, so as to improve the quality of life, maintain social stability and realize the construction of a harmonious society.
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Date of receipt: September 2009-14
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