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随着人口老龄化进程的加快
老年人群的健康状况越来越受到重视
各种生理功能的衰退以及健康问题的增加
让人们意识到寿命长不等于健康
年龄老化不仅伴随着慢性病增多 共存
还伴有多种老年综合征
比如营养不良 认知能力下降
焦虑 抑郁 谵妄 睡眠障碍等
这些健康问题是除典型老年慢性病
比如糖尿病 高血压以外
另一种严重影响老年人功能
以及健康状态的重要因素
然而这些问题在传统医疗模式中常被忽略
以致不能及时发现并治疗 护理干预
相对于专注疾病评估
以及各种慢病管理的传统医疗评估模式
囊括了身体健康 心理健康
和社会健康管理的
老年综合健康评估模式更具有优势
老年人综合健康评估的概念
最早是由英国的Marjory Warren博士提出
20世纪40年代
她因为工作从英国的米德尔塞克斯医院
调动到一家护理院
开始给那里的虚弱老人进行详细评估
再给予适当治疗
使多数老人摆脱了卧床不起的状态
约三分之一的老人康复出院回家
基于这样的结果
Warren博士提出
老年人在入住护理院前
应进行全面评估及康复治疗
此后
老年综合健康评估逐渐被临床所接受
现在的老年人综合健康评估
则是指从老年人的整体出发
综合躯体健康 精神健康 功能状态
社会适应能力 环境状况等方面
多维度 全面科学地
对老年人实施健康状况评估
这种评估模式
也不是单一的评估
而是包含健康监测
健康评估 健康干预三部曲
监测 评估的内容有
疾病 认知 体能 心理 社会 经济等
涉及到具体残存或共患的疾病健康问题有
谵妄 痴呆 失语的认知和言语评估
焦虑抑郁等的心理状态评估
视觉 听力 吞咽 进食
营养状态评估
不同层次的功能状态评估
跌倒压疮的风险评估
家庭环境社会支持的社会环境评估
以及照顾者压力评估等
评估小组根据评估结果制定一个
总体的康复治疗计划和长期的照护随访计划
然后按计划实施健康干预
最终以保护老年人健康和功能状态为目的
最大限度地提高老年人的生活质量
在我国
老年医学专科医师教育委员会
已确定老年综合健康评估
为老年科医师应该掌握的5项技能之一
用于老年综合健康评估的经典量表有
1975年美国杜克大学
老龄化研究中心研制的服务与资源评估量表
1977年编制的综合评价量表
还有1982年研制的
费城老年中心多水平评价量表等
以上量表均包括身体健康 心理健康
日常活动能力 经济
以及社会资源状况等方面的评估内容
老年人综合健康评估模式可以较为客观
全面地反映老年人的健康状况
从而为制定相关医疗卫生政策
提高老年人健康功能
推进健康老龄化提供科学依据
护理人员应根据老年人的健康特点
选择合宜的评估工具
通过耐心细致的观察 询问以及体格检查等方式
判断老年人的健康水平与功能状态
-1.1 Human Life Expectancy and Age Classification of the Elderly
--Human Life Expectancy and Age Classification of the Elderly
--【Vedio Recommendation】 How do we measure life expectancy ?
-1.2 Population Aging
--【Literature Recommendation】World Report on Ageing and Health: 2015
-1.3 Influence and Countermeasures of Population Aging
--Influence and Countermeasures of Population Aging
--【Literature Recommendation】World Population Ageing Highlights:2019
-1.4 Goals and Principles of Elderly Care
--Goals and Principles of Elderly Care
--【Book Recommendation】Evidence-Based Geriatric Nursing Protocols for Best Practice
-1.5 Theories Related to Elderly Care
--1.5.1 Personality Development Theory and Life Review
--1.5.2 Disengagement Theory and Activity Theory
--1.5.3 Self-efficacy and Chronic Disease Management
--【Vedio Recommendation】8 Stages of Development by Erik Erikson
--【Literature Recommendation】Activity Theory, Disengagement Theory, and Successful Aging
--【Book Recommendation】Self-Efficacy in Changing Societies
-1.6 Elderly Support and Elderly Care
--1.6.1 Concepts of Elderly Healthcare, Elderly Support and Elderly Care
--1.6.2 Home-based Elderly Care Model
--1.6.3 Institutional Elderly Care Model
--1.6.4 Integrated Medical and Nursing Care Model
--【Vedio Recommendation】Day in the Life of Home Care
--【Website Recommendation】Official Website of the National Institutes of Health
-Concept Map
--【Concept Map】General Introduction to Geronological Nursing
-【Test】CHAPTER 1
-2.1 Aging Changes in the Elderly
--2.1.1 Aging of the Respiratory System
--2.1.2 Aging of the Cardiovascular System
--2.1.3 Aging of the Digestive System
--2.1.4 Aging of the Urinary System
--2.1.5 Aging of the Endocrine System
--2.1.6 Aging of the Motor System
--2.1.7 Aging of the Nervous System
--2.1.8 Aging of the Sensory System
--【Literature Recommendation】Exercise Attenuates the Major Hallmarks of Aging
--【Book Recommendation】Hazzard's Geriatric Medicine and Gerontology
-2.2 Comprehensive Health Assessment of the Elderly
--Comprehensive Health Assessment of the Elderly
--【Literature Recommendation】Instruments to evaluate mental well-being in old age: a systematic review
-2.3 Principles of Elderly Health Assessment
--Principles of Elderly Health Assessment
-2.4 Assessment of the Functional Status of the Elderly
--Assessment of the Functional Status of the Elderly
--【Literature Recommendation】The Lawton Instrumental Activities of Daily Living (IADL) Scale
-2.5 Assessment of Cognitive Function in the Elderly
--Assessment of Cognitive Function in the Elderly
-2.6 Assessment and Adjustment of the Living Environment for the Elderly
--Assessment and Adjustment of the Living Environment for the Elderly
-Concept Map
--【Concept Map】Elderly Health Assessment(1)
--【Concept Map】Elderly Health Assessment(2)
-【Test】CHAPTER 2
-3.1 Overview of the Psychological Characteristics of the Elderly
--Overview of the Psychological Characteristics of the Elderly
-3.2 Influencing Factors of Psychological Changes in the Elderly
--Influencing Factors of Psychological Changes in the Elderly
-3.3 Common Psychological Issues and Their Management in the Elderly
--3.3.1 Common Psychological Issues and Their Management in the Elderly (1)
--3.3.2 Common Psychological Issues and Their Management in the Elderly (2)
--【Book Recommendation】Development Through the Lifespan
-3.4 Depression in the Elderly
--3.4.1 Overview of Depression in the Elderly
--3.4.2 Clinical Symptoms of Depression in the Elderly
--3.4.3 Caring for Elderly Patients with Depression
--【Documentary Recommendation】Depression:Out of the Shadows
-3.5 Elderly Patients with Dementia
--3.5.1 Identification of Dementia Symptoms in the Elderly
--3.5.2 Intelligence Rehabilitation of Elderly Patients with Dementia
--3.5.3 Safety Care of Elderly Patients with Dementia
--【Website Recommendation】The Global Voice on Demaentia
-Concept Map
--【Concept Map】Elderly Mental Health and Mental Health Care
-【Test】CHAPTER 3
-4.1 Precautions for Daily Care of the Elderly
--Precautions for Daily Care of the Elderly
-4.2 General Care of Elderly Skin
--4.2.1 Characteristics and General Care of Elderly Skin
--4.2.2 Skin Itching and Its Management in the Elderly
--【Website Recommendation】American Academy of Dermatology
-4.3 Clothing Hygiene for the Elderly
--Clothing Hygiene for the Elderly
--【Literature Recommendation】The Design Methods of Functional Clothing for the Elderly
-4.4 Dietary Care for the Elderly
--4.4.1 Nutritional Needs of the Elderly and Influencing Factors of these Needs
--4.4.2 Dietary Care for the Elderly
--【Book Recommendation】Nutrition Care of the Older Adult: a Handbook for Dietetics
--【Website Recommendation】Nutrition for older persons
-4.5 Sleep Guidance for the Elderly
--4.5.1 Sleep Characteristics of the Elderly
--4.5.2 Sleep Guidance for the Elderly
--【Book Recommendation】An Occupational Therapist's Guide to Sleep and Sleep Problems
--【Website Recommendation】American Academy of Sleep Medicine
-4.6 Exercises Guidance for the Elderly
--4.6.1 Evaluation of Exercise Intensity in the Elderly
--4.6.2 Precautions Elderly Undertaking Exercises
--【Website Recommendation】American College of Sport Medicine
--【Book Recommendation】Handbook of Activities for the Elderly
-Concept Map
--【Concept Map】Elderly Daily Care
-【Test】CHAPTER 4
-5.1 Characteristics of Drug Metabolism and Pharmacodynamics in the Elderly
--Characteristics of Drug Metabolism and Pharmacodynamics in the Elderly
--【Website Recommendation】How Drugs Work In the Elderly
-5.2 Common Adverse Drug Reactions and Their Causes in the Elderly
--Common Adverse Drug Reactions and Their Causes in the Elderly
-5.3 The Principles of the Use of Medications in the Elderly
--The Principles of the Use of Medications in the Elderly
-5.4 Prevention of Adverse Drug Reactions in the Elderly
--Prevention of Adverse Drug Reactions in the Elderly
-5.5 Medication Compliance in the Elderly
--Medication Compliance in the Elderly
-Concept Map
--【Concept Map】Medication Safety and Care for the Elderly
-【Test】CHAPTER 5
-6.1 Falls in the Elderly
--6.1.1 Epidemiological Characteristics of Elderly Falls
--6.1.2 Risk Factors for Falls in the Elderly
--6.1.3 Prevention of Falls in the Elderly
--【Website Recommendation】CDC STEADI(Stopping Elderly Accidents, Deaths & Injuries Tool Kit)
-6.2 Dysphagia in the Elderly
-6.3 Urinary Incontinence in the Elderly
--Urinary Incontinence in the Elderly
-6.4 Constipation in the Elderly
-6.5 Dry Mouth in the Elderly
--【Website Recommendation】Academy of Nutrition and Dietetics
-6.6 Elderly Nutritional Deficiencies
--Elderly Nutritional Deficiencies - emaciation
-6.7 Visual Impairment in the Elderly
--Visual Impairment in the Elderly
--【Website Recommendation】Senior Eye Exams
-6.8 Senile Deafness
-6.9 Elderly Delirium
-6.10 Elderly Frailty
--【Literature Recommendation】Frailty in elderly people/Frailty in older people
-6.11 Pneumonia in the Elderly
-6.12 Hypertension in the Elderly
--【Literature Recommendation】2018 Chinese Guidelines for Prevention and Treatment of Hypertension
-6.13 Stroke in the Elderly
-6.14 Stable Angina in the Elderly
--Stable Angina in the Elderly
-Concept Map
--【Concept Map】Nursing Care for the Elderly with Common Health Problems and Diseases
-【Test】CHAPTER 6
-7.1 Concept of Hospice Care
--【Website Recommendation】 Definition of Palliative Care,WHO
-7.2 Death Education
--【Book Recommendation】The Meaning of Death by Herman Feife
-7.3 Nursing for Pain in the Dying Elderly
--Nursing for Pain in the Dying Elderly
-7.4 Nursing for Major Bleeding in the Dying Elderly
--Nursing for Major Bleeding in the Dying Elderly
-7.5 Nursing for Delirium in the Dying Elderly
--Nursing for Delirium in the Dying Elderly
-7.6 Nursing for Dyspnea in the Dying Elderly
--Nursing for Dyspnea in the Dying Elderly
--【Website Recommendation】The Hospice and Palliative Nurses Association,HPNA
-7.7 Psychological Problems and Nursing in the Dying Elderly
--Psychological Problems and Nursing in the Dying Elderly
--【Book Recommendation】On Death and Dying ,by Elisabeth Kübler-Ross
-7.8 Grief Counseling for the Widowed Elderly
--Grief Counseling for the Widowed Elderly
--【Book Recommendation】I Wasn't Ready to Say Goodbye,by Noel·Brook,Blair·Pamela
-Concept Map
--【Concept Map】Hospice Care for the Elderly
-【Test】CHAPTER 7