The Art of Pacifying an Aggressive Client: ‘Feminine’ Skills and Preventing Violence in Caring Work

This article explores the complex interconnection between gender and emotion in the context of client‐perpetrated violence at work, focusing on interviews with and writings by Finnish nurses and social workers to discuss the ‘feminine’ emotional skills that are supposed to prevent violence. The social formation of these skills is analysed with the concept ‘emotional habitus’: emotional skills derive from the socially acquired disposition to manage emotions according to the gendered values of caring work. Emotional habitus, based on the internalized, second‐nature sense of emotional management, is shown to both persuade and enable employees to use emotional skills as assets for negotiating violence. This article discusses the potentiality for active agency enabled by skilful emotional management in violence prevention, bearing in mind the gender inequalities and internal contradictions connected to the social formation and practice of those skills.     

Medicare and Medicaid Reimbursement Rates for Nursing Homes Motivate Select Culture Change Practices But Not Comprehensive Culture Change

Components of nursing home (NH) culture change include resident-centeredness, empowerment, and home likeness, but practices reflective of these components may be found in both traditional and “culture change” NHs. We use mixed methods to examine the presence of culture change practices in the context of an NH’s payer sources. Qualitative data show how higher pay from Medicare versus Medicaid influences implementation of select culture change practices, and quantitative data show NHs with higher proportions of Medicare residents have significantly higher (measured) environmental culture change implementation. Findings indicate that heightened coordination of Medicare and Medicaid could influence NH implementation of reform practices.     

Does Nursing Home Ownership Change Affect Family Ratings on Experience with Care?

Person-centeredness may suffer in nursing homes (NHs) with recent ownership changes. This study identifies associations between ownership change and reported care experiences, important measures of person-centered care for long-term residents in Maryland NHs. Care experience measures and ownership change data were collected from Maryland Health Care Commission reports, which reported data on 220 Maryland NHs from 2011 and 2012. Facility and market covariates were obtained from 2011 NH Compare and Area Health Resource Files. Linear regression was used to examine whether ownership change in 2011 was associated with lower care experience ratings reported during April to June 2012. Dependent variables were overall care rating (scale 1–10), percentage of respondents answering that they would recommend the NH, and assessments of five care and resident life domains (scale 1–4). Care experiences reported in 2012 were high; however, after controlling for covariates, ownership change was associated with significant decreases in 6 out of 7 measures, including a 0.39-point decrease in overall care rating (p = .001). NH managers and policy makers should consider strategies to improve patient-centeredness after ownership change.     

鼻内窥镜下等离子低温射频治疗老年人鼻出血的护理

目的总结等离子低温射频治疗老年人鼻出血的护理要点。方法总结80例用等离子低温射频治疗仪治疗老年人鼻出血病例资料,总结护理体会。结果配合整体护理,明显提高了治疗疗效,减轻了患者痛苦。结论等离子低温射频治疗老年人鼻出血疗效显著,患者痛苦小。整体护理是治疗成功的的重要环节。     

宁养服务与医学伦理

宁养服务和医学伦理的关系 ,主要表现在以下几个方面 :宁养服务与治疗伦理 ,宁养服务与用药伦理 ,宁养服务与护理伦理 ,宁养服务与心理疏导。宁养服务的目的是提高患者的生命质量 ,保证其生命的尊严 ,同时 ,也要求医护人员加强自身的修养和业务水平 ,成为一名称职的宁养服务工作者     

现代科学教育中护理教师的能力要求

随着医学模式的转变和整体护理的开展,以及教育、科学、社会三大因素的发展,促进了传统的学科教育向现代科学教育的转变。现代科学教育以培养受教育者综合素质、培养科技专业人才为中心。作为护理教学的直接实施和参与者,护理教师在现代科学教育中,应加强备课能力、授课能力、动手能力和评价能力的提高,才能培养与现代医学需求相适应的高素质的护理人员,才能成为一个合格护理教师。     

术后胃瘫患者早期肠内营养支持治疗的护理方法及效果

目的：探讨肠内营养支持治疗腹部术后胃瘫的护理方法及效果。方法经确诊的11例腹部手术后胃瘫患者均放置鼻胃肠营养管,行肠内营养（ EN）治疗,观察患者的适应情况、肛门排气;前白蛋白及淋巴细胞计数等营养状况的变化,做好肠内营养的护理。结果本组病例淋巴细胞计数和前白蛋白术后较术前有显著改变,显示术后早期EN可提高营养状况和机体免疫功能;所有患者胃肠功能均恢复,无再次手术,无相关并发症。结论腹部术后胃瘫患者应用肠内营养可以缩短胃瘫的病程,采用鼻胃肠营养管泵入肠内营养的方法符合生理,且经济、安全、方便,又能减少并发症的发生。     

Therapeutic Effects of an Outdoor Activity Program on Nursing Home Residents with Dementia

Abstract

Objective: The purpose of this one-year pilot study was to obtain preliminary information on the effects of an outdoor activity program, in comparison to an indoor activity program, on sleep and behavior in nursing home residents with dementia. Structured activity programs have been shown to improve dementia-related behavior problems, and there are some indications that improved behavior is associated with improved sleep. Previous research has shown that sleep disturbance is common in nursing home residents, and that limited exposure to light bright enough to entrain circadian rhythms contributes to their sleep problems. Thus, we expected to see improvements in behavior in both the outdoor and indoor activity groups, but improvements in sleep in the outdoor activity group only.

Methodology: A two-group (outdoor program, indoor program) two phase (baseline, intervention) design was used. Subjects were randomized to the outdoor or indoor program groups. Sleep and behavior disturbance were assessed over a 10-day period at baseline (usual activity conditions, which were expected to include little or no time spent outdoors) and at intervention (daily structured activity program offered outdoors or indoors). Sleep was assessed with wrist actigraphs with photocells, which also allowed for monitoring of light exposure. Behavior disturbance was assessed with the Cohen-Mansfield Agitation Inventory. Both activity programs were offered Monday-Friday over a 2 week period, included similar content and were offered by research project staff. The analytical approach emphasized primary changes between baseline and intervention measures of sleep and behavioral symptoms in the two activity groups. Because this was a pilot study, the significance level was set a priori at p< 0.10.

Findings: The outdoor activity group experienced significant improvements in maximum sleep duration. Both groups showed significant improvements in total sleep minutes. There also was a significant improvement in verbal agitation in the outdoor activity group.     

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