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1.5.1 Personality Development Theory and Life Review课程教案、知识点、字幕

同学们好

今天我们要学习的内容是

《人格发展理论与人生回顾》

首先请大家看一下这张图

大家认识图片中的这个人物吗

图片中的这个人物是末代皇帝

爱新觉罗 溥仪

为什么我会在这里提到溥仪

因为溥仪的人生轨迹

可以说是我们今天要学习的

人格发展理论的典型案例

带着这个悬念

让我们一起走进今天的课堂

要掌握人格发展理论

我们首先要弄明白什么是人格

人格是指人与人之间

在心理与行为上的差异

那发展理论又是什么

弗洛伊德于19世纪末20世纪初

创立了科学心理学史上的

第一个人格心理学体系

又称发展理论

弗洛伊德认为

婴幼儿期是人格发展的最重要阶段

一个人出生之后长到6岁时

其人格的基本模式就大致形成了

弗洛伊德主张

人格发展经历5个阶段

即口唇期 肛门期 性蕾期

潜伏期和生殖期

这一理论至今

在老年护理实践中仍有应用

比如用回归口唇期来解释

老年痴呆患者的异食癖行为问题

虽然弗洛伊德的理论

对护理实践有指导意义

但他的理论忽略了人格发展的终身性

20世纪30年代

埃里克森强调

社会文化因素对人格形成发展的作用

他提出了以自我为核心的

人格发展的心理社会理论

目前为止

这个理论在老化的研究和实践中

应用最为普遍

埃里克森认为人格是终身发展的

他将人格发展从出生到死亡

分为8个主要阶段

婴儿期 幼儿期 学龄前期

学龄期 少年期 青年期

成年期和晚年期

表明了一个完整的过程

埃里克森认为

每个阶段都有对应的危机

如果危机没有很好地被解决

就会产生一些不良的影响

埃里克森认为

老年期的任务是发展自我整合

否则就会出现绝望

他认为个体在老年期

会自发回顾自己过去的经历

寻找生命价值

以便接受逐渐进入死亡的事实

自我整合是接纳生命的意义

这是前7个阶段的成熟期

包含完整的意思

表示能以成熟的心灵和威严

不畏惧死亡的心态来接纳自己

作自我肯定

也意味着对过去所发生的事件

不心存懊悔

且对未来生活充满乐观和进取的心态

学会面对死亡

绝望是指个体在老年时期

觉得自己一生不如意但时间又太仓促

没有机会重新选择可以接纳的生活

以后也不会有什么值得追求的

从而充满失望和无力感

以刚才提到的溥仪为例

溥仪的晚年岁月

是在北京植物园度过的

这是他人生中最为自由最为安心的时光

在植物园

他学会了浇水 插枝 移栽 嫁接等工作

还负责售卖门票

这种养花种草 简单劳动的日子

给了历尽磨难的溥仪一定的治愈作用

过往在皇宫中他是最耀眼的

而那这段时间他则重新认识了自己

接受了自己

离开植物园以后

溥仪一直在全国政协任职

在文史资料研究委员会任职

此时他已经接受了自我 承认现实

有一种超脱的智慧之感

著书《我的前半生》

从家世 出身到他三岁登基

一直写到1957年 坦然面对过往

溥仪的晚年是一个在老年时期

成功完成自我整合的案例

但是

并不是所有的老年人

都可以顺利地完成自我整合

学者指出

老年人的发展危机

常常也是其个人所经历的

许多心理社会危机的顶峰

有没有什么办法

可以促进老年人进行自我整合呢

1963年

Butler根据埃里克森的心理社会发展理论

提出了怀旧治疗的设想

怀旧治疗又称回忆疗法

reminiscence therapy

是指运用对过去事件 感受

和想法的回忆

以促进人们改善情绪 提高生活质量

或适应当前环境

怀旧治疗可分为基本层次

和深入层次的怀旧治疗

前者主要侧重于

鼓励老年人重温过去的事件和经验

重新感受该事件带给他们的喜怒哀乐

以及鼓励老人与他人分享这些经验

以增进彼此了解 强化相互关系

深入层次的怀旧即人生回顾

life review

主要通过帮助

老年人回忆 评价 整合一生的经历

协助他们接纳自己的过去

确认自己一生的价值

从而能坦然面对将来的死亡

怀旧治疗是如何实施的呢

老年人的怀旧疗法形式包括个体和团体

其中团体怀旧疗法更常见

通常包括6-12单元

通过引导老年人回忆

以往的工作经历 家庭生活 娱乐活动

所处年代国家或社会大事

并使用一些如老照片 老歌 老电影等引导物

给予老年人充分的机会

去重新体会过去的荣耀与愉快

重新找回自尊与快乐感

请看这张表

这是我国学者

冯文来的研究

他将怀旧治疗分为八周开展

每周选择一个特定的主题

引导老年人进行往事的回忆

以提高老年人的主观幸福感

那老年人的人生回顾又是如何实施呢

我们可以参考Barbara Haight

著作的人生回顾指南

这是这个指南推荐的六单元人生回顾方案

每个单元都有特定的主题

每个主题有相应的引导性问题

例如第一单元童年时期

这一时期主要围绕家人 关爱

玩伴 食物 困境等主题进行

由于这一时期与老年人仍处于建立关系阶段

因此

可以使用一般性问题

在您的生命中您所能想起来的最遥远的记忆是什么

来帮助回顾者打开记忆的闸门

然后逐步通过提纲上的引导性问题如

可以说说您的家人么

小时候家里是否有充足的食物

等问题对其进行引导回顾。

这是我们团队关于人生回顾的一项系统评价

研究结果显示

人生回顾可以减少老年人的抑郁和无望

提高老年人的生活质量和幸福感

因此 目前

回忆疗法或人生回顾

已作为一种有效的护理干预措施

被美国护理措施分类系统收录

成为老年护理专科领域的核心措施之一

对怀旧疗法有兴趣的同学

可以阅读Butler的相关文献

以及Barbara 书籍

《The Handbook of structured life review》

今天我们的课就讲到这里

谢谢

Gerontological Nursing课程列表:

CHAPTER 1: General Introduction to Geronological Nursing

-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

--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

--【Literature Recommendation】Obstacles and Policies of the Social Capital Participates in the Combination of Medical Care and Pension: A Literature Review

-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

-【Case Discussion】CHAPTER 1

CHAPTER 2: Elderly Health Assessment

-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

--【Literature Recommendation】Age-friendliness of living environments from the older person’s viewpoint: development of the Age-friendly Environment Assessment Tool

-Concept Map

--【Concept Map】Elderly Health Assessment(1)

--【Concept Map】Elderly Health Assessment(2)

-【Test】CHAPTER 2

-【Case Discussion】CHAPTER 2

CHAPTER3: Elderly Mental Health and Mental Health care

-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

--【Website Recommendation】

--【Documentary Recommendation】Depression:Out of the Shadows

--【Literature Recommendation】Management of depression in older adults:A review depression in older people

-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

-【Case Discussion】CHAPTER 3

CHAPTER4: Elderly Daily Care

-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

-【Case Discussion】CHAPTER 4

CHAPTER5:Medication Safety and Care for the Elderly

-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

--【Literature Recommendation】The American Geriatrics Society 2015 Updated Beers Criteria for Potentially Inappropriate Medication Use in Older Adults

-5.4 Prevention of Adverse Drug Reactions in the Elderly

--Prevention of Adverse Drug Reactions in the Elderly

--【Literature Recommendation】Drug-related falls in older patients: implicated drugs, consequences, and possible prevention strategies

-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

-【Case Discussion】CHAPTER 5

CHAPTER6:Nursing Care for the Elderly with Common Health Problems and Diseases

-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

--Dysphagia in the Elderly

-6.3 Urinary Incontinence in the Elderly

--Urinary Incontinence in the Elderly

-6.4 Constipation in the Elderly

--Constipation in the Elderly

--【Literature Recommendation】Chronic Constipation in the Elderly Patient: Updates in Evaluation and Management

-6.5 Dry Mouth in the Elderly

--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

--Senile Deafness

-6.9 Elderly Delirium

--Elderly Delirium

-6.10 Elderly Frailty

--Elderly Frailty

--【Literature Recommendation】Frailty in elderly people/Frailty in older people

-6.11 Pneumonia in the Elderly

--Pneumonia in the Elderly

-6.12 Hypertension in the Elderly

--Hypertension in the Elderly

--【Literature Recommendation】2018 Chinese Guidelines for Prevention and Treatment of Hypertension

-6.13 Stroke in the Elderly

--Stroke in the Elderly

-6.14 Stable Angina in the Elderly

--Stable Angina in the Elderly

--【Literature Recommendation】2019 ESC Guidelines for the diagnosis and management of chronic coronary syndromes

-Concept Map

--【Concept Map】Nursing Care for the Elderly with Common Health Problems and Diseases

-【Test】CHAPTER 6

-【Case Discussion】CHAPTER 6

CHAPTER7 Hospice Care for the Elderly

-7.1 Concept of Hospice Care

--Concept of Hospice Care

--【Website Recommendation】 Definition of Palliative Care,WHO

-7.2 Death Education

--7.2.1 Death Education (1)

--7.2.2 Death Education (2)

--【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

--【Journal Recommendation】

-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

-【Case Discussion】CHAPTER 7

FINAL EXAM

-Final Exam

1.5.1 Personality Development Theory and Life Review笔记与讨论

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