Risk Factors and Intervention Programs for Depression in Nursing Home Residents: Nursing Home Staff Interview Findings

The in-depth qualitative interviews with 25 nursing home staff members were done to examine (a) their perceptions and experiences of risk factors for residents' depression, (b) current depression intervention programs, and (c) specific needs for staff training. The interviewees identified the residents' sense of loss and grief and feelings of isolation and loneliness as the causes of their depression and in-house activities and contract mental health services as current services aimed at reducing depression. They also pointed out the following barriers to providing effective depression interventions: too much dependence on antidepressant medication, low Medicaid reimbursement rate, staff shortage, residents' attitudes, and nursing home culture. The types of training that the staff members desired were: skills to monitor nonverbal signs and changes and to systematically screen different types of depression; education about antidepressants and their effects, side effects, and interaction effects with other medication; and systematic training in different types of psychosocial and behavioral interventions for late-life depression in residents with various levels of physical disabilities and cognitive impairments.     

Foster Family Care for Frail Elderly

For the last 10 years, the development of cost-effective, community alternatives for chronically ill has been a serious concern of many service providers and policy-makers. The expanding of the elderly population has been well documented. In this state, projections show a need for an additional 1602 long-term care beds by the year 2000, almost double the current capacity. The state Medicaid Program is searching for ways to reduce the 50 million spent in 1982 for institutional long-term care. Already experiencing the shortage of long-term beds, hospitals have a chronic loss of revenue potential through the holding of non-acute patients in the hospital while waiting for a nursing home bed vacancy. At the 500 bed acute care hospital, 25-30 beds daily are occupied by nursing home wait-listed clients. The average wait-listed days per patient is 20.4. In September 1979, the hospital's department of social work began foster family care for elderly persons eligible for nursing home care. Foster families are extensively screened and trained for the severely dependent clients. The social worker and registered nurse team are closely involved in placements, developing and implementing an individualized written treatment plan to assure the clients quality of care. Data collected over the past three years clearly indicates that this setting provides cost-effective, quality care. Overall scoring on bathing, dressing, toileting, transfer, and continence, utilizing the KATZ Activity of Daily Living, shows that 71% of the clients improve after 3 months on placement. Although 45% of the clients are incontinent of bowel or urine at the time of placement, 33% make significant improvement to only occasional accidents. With 41% of the clients at placement requiring adaptive device and assistance for walking, 48% of the clients show functional improvements in walking. Most significant for continued survival of this type of care, the total program cost is half the cost of institutional care for these elderly clients. The paper will examine the multiple needs served through the program: the ill elderly person's need of a therapistic, caring environment; the hospital's need to curb loss of potential revenue; and the need of the Medicaid Program to contain costs. The paper also reviews client characteristics, foster family characteristics, quality assurance, and overall cost-effectiveness of the foster family model.     

云南少数民族护理实习生心理健康状况及影响因素分析

胃的探讨云南少数民族护理实习生心理健康状况,分析其主要的影响因素。方法采用一般情况量表、症状自评量表（SCL-90）,对云南省昆明医科大学某附属医院243名少数民族护理实习生进行无记名自评问卷调查。结果被调查学生中SCL-90得分除恐怖因子分低于中国青年组常模（P=0．00〈0．05）;敌对因子分与常模组无显著性差异（P=0．806〉0．05）外;其他七项因子分均显著高于常模组（P〈0．05）;其中以强迫因子分得分最高,其次是人际敏感、抑郁、偏执。结论少数民族护理实习生存在一定的心理健康问题,学习压力大、文化程度低、对专业满意度低是影响心理健康的主要因素。     

Nurses: Training for new job demands

Abstract

This paper argues that both the present and future job demands faced by nurses are likely to exceed the resources of the training which is currently provided for them. This argument will be supported by reference to the authors' studies of stress in nursing, as well as a variety of other sources. The common themes underlying reactions to both present and future demands include first, awareness of high stress levels to be found amongst nurses, and second, an emphasis on communication as both the problem and as the proposed solution. Common responses to these two themes are outlined, including training in stress management, and communication training. Some of the problems and unexamined assumptions (for example that hospital management actually wants to lower stress levels and improve communication in nursing) are examined. Some suggestions are made for developing training in health care contexts, to deal more adequately with likely future demands.     

Midwifery students’ conceptions of worst imaginable pain

BackgroundThe Visual Analogue Scale (VAS) is one of the most widely used pain assessment scales in clinical practice and research. However, the VAS is used less frequently in midwifery than in other clinical contexts. The issue of how people interpret the meaning of the VAS endpoints (i.e. no pain and worst imaginable pain) has been discussed. The aim of this study was to explore midwifery students’ conceptions of ‘worst imaginable pain’.MethodsA sample of 230 midwifery students at seven universities in Sweden responded to an open-ended question: ‘What is the worst imaginable pain for you?’ This open-ended question is a part of a larger study. Their responses underwent manifest content analysis.ResultsAnalysis of the midwifery students’ responses to the open-ended question revealed five categories with 24 sub-categories. The categories were Overwhelming pain, Condition-related pain, Accidents, Inflicted pain and Psychological suffering.ConclusionsThe midwifery students’ conceptions of ‘worst imaginable pain’ are complex, elusive and diverse.     

某校护理专业大一女生人格特征的调查研究

为了调查山西省某医学院护理专业女大学生的人格特征,探讨医学专业护理专业学生良好人格培养的方法。本研究发放共计734份问卷进行调查,随后采用16PF法进行相关指标测试,进行统计分析。结果显示本批学生中60%以上学生在怀疑性、幻想性这两项得分大于7分;60%以上学生在世故性这一项得分小于4分;本科层次的学生较专科学生喜欢冒险,遇事不畏缩,有敢做敢为的精神;城镇学生较农村学生轻松、心情愉快,社会联系广泛,在集体中较引人注目。因此应加强学生的合作、交往能力,加强爱心、感恩及责任感教育,培养学生做情绪的主人,尤其注意培养专科学生的自信心。     

情景教学法在《护理心理学》教学中的应用探究

《护理心理学》是高校护理本科专业学生的必修课,对于培养高素质的现代护理工作者起着重要的作用。《护理心理学》课程的教学起步较晚,存在＂教学研究薄弱、教学方法单一＂等问题。通过情景教学法在《护理心理学》课程教学的优势分析和不足反思,从五个方面加强《护理心理学》的课程建设,实现＂教学做＂合一,提高课程教学效果。     

Centralized nurse scheduling to simultaneously improve schedule cost and nurse satisfaction

Nursing managers are faced with rising turnover and shortages of qualified nursing staff. At the same time they are under increased pressure to simultaneously increase patient care and satisfaction while reducing costs. In this study, we examine the impact of centralizing scheduling decisions across departments in a hospital. By pooling nurses from multiple units and scheduling them in one model, improved costs and reduced overtime result. Reduced overtime improves schedules for nurses. Improved satisfaction levels can positively impact turnover rates among nurses. Our results show that by using a centralized model, nursing managers in hospitals can improve the desirability of nurse schedules by approximately 34% and reduce overtime by approximately 80% while simultaneously reducing costs by just under 11%.     

The Presence of Memory-Enriched Environments for Cognitively Impaired Nursing Home Residents

Abstract

Enriched living environments that contain a wide array of personal memorabilia and memory-stimulating cues have the potential to support cognitive functioning. The purpose of this ethnographic research was to describe the care environments of older adults with cognitive impairment living in nursing homes (n?=?42), to evaluate the degree to which these environments contained memory-stimulating cues, and to understand the extent to which these environments were cognitively stimulating for older adults with dementia. Results indicated varying levels of enrichment both within and between homes, with nearly a quarter of the residents living in environments that contained no memory-enhancing stimuli.