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3.3.1 Common Psychological Issues and Their Management in the Elderly (1)课程教案、知识点、字幕

大家好

古人云

体壮曰健 心贻曰康

老年人的心理健康是

健康老龄化的重要组成部分

由于老年人多伴有各种慢性病

使得老年人自理能力受限

重者卧床不起

大小便失禁

这些情况均严重威胁着老年人的身心健康

使老年人出现焦虑 抑郁

孤僻 情绪不稳定等多种心理不健康表现

心理问题严重者出现自杀

世界卫生组织

《2016中国老龄化与健康国家评估报告》

指出

自杀率随着年龄的增长不断增加

70岁以上男性自杀率高于女性

最高年龄组80岁以上的

自杀死亡风险最高

而且农村地区老人的自杀率比城市要高得多

焦虑 抑郁 孤独 自卑

以及离退休综合征

空巢综合征等

是老年人常见的心理问题

例如

焦虑是一种很普遍的现象

几乎人人都有过焦虑的体验

适度的焦虑有益于个体更好地适应变化

有利于个体通过自我调节保持身心平衡等

但持久过度的焦虑

则会严重影响个体的身心健康

究其原因

造成老年人焦虑的可能原因有

体弱多病 行动不便 力不从心

疑病性神经症

以及各种应激事件

如离退休 丧偶 丧子 经济窘迫

家庭关系不和

搬迁 社会治安以及

日常生活常规的打乱等

还有某些疾病如抑郁症

甲状腺机能亢进 低血糖

体位性低血压等

以及某些药物副作用

如抗胆碱能药物 咖啡因

皮质类固醇 麻黄素等

均可引起焦虑反应

焦虑包括指向

未来的害怕不安和痛苦的内心体验

精神运动性不安

以及伴有自主神经功能失调表现三方面症状

持久过度的焦虑

可严重损害老年人的身心健康

加速衰老 增加失控感

损害自信心

并可诱发高血压 冠心病

急性焦虑发作可导致脑卒中 心肌梗死

青光眼高压性头痛失明

以及跌倒等意外发生

因此

必须积极的防治护理老年人的过度焦虑

例如

首先应该进行评估焦虑程度

可用汉密顿焦虑量表

和焦虑状态特质问卷

对老人的焦虑程度进行评定

其次

需要针对原因进行处理

指导和帮助老年人

及其家属认识分析焦虑的原因和表现

正确对待离退休问题

想法子解决家庭经济困难

积极治疗原发疾病

尽量避免使用

或慎用可引起焦虑症状的药物

再者

可以指导老年人保持良好心态

学会自我疏导和自我放松

建立规律的活动与睡眠习惯

子女的理解尊重也很重要

帮助老人的子女学会谦让和尊重老人

理解老人的焦虑心理

鼓励和倾听老人的内心宣泄

真正从心理精神上去关心体贴老人

对于重度焦虑

应该要遵医嘱应用抗焦虑药物进行治疗

孤独和自卑也是老年人常见的心理问题

孤独是一种被疏远

被抛弃和不被他人接纳的情绪体验

而自卑即自我评价偏低

就是自己瞧不起自己

它是一种消极的情感体验

当人的自尊需要得不到满足

又不能恰如其分

实事求是地分析自己时

就容易产生自卑心理

某国外研究机构在历时4年的研究中

研究人员对823名

80岁以上的老人进行跟踪问卷调查

评估老人的孤独感受等级

在调查开始时

所有接受调查者都没有老年痴呆症

在调查过程中

76名老人确诊患上了脑萎缩

老年痴呆症

出现了丧失记忆和糊涂的症状

研究人员参照所有受调查者提供的数据发现

最初孤独感等级每提高一级

患老年痴呆的风险就增加51%

因此

解除老年人孤独感和自卑感

是不容忽视的社会问题

造成老年人孤独和自卑的可能原因有

离退休后远离社会生活

或角色转换障碍

没有子女或因子女独立成家后

成为了空巢家庭

体弱多病 行动不便

降低了与亲朋来往的频率

性格孤僻

丧偶

家庭矛盾等

孤独寂寞

社会活动减少会使老年人产生伤感

抑郁情绪

精神萎靡不振

常偷偷哭泣

顾影自怜

如果加上体弱多病 行动不便时候

上述这些消极感就会明显加重

久而久之

机体免疫功能的降低

容易导致躯体疾病

孤独也会使老年人选择更多的不良生活方式

如吸烟 酗酒 不爱活动等

不良的生活方式与心脑血管疾病

糖尿病等慢性疾病的发生

和发展密切相关

有的老年人会因孤独而转化为抑郁症

有自杀倾向

一个人形成自卑心理之后

往往从怀疑自己的能力

到不能够表现自己的能力

从而怯于与人交往到孤独地自我封闭

本来经过努力可以达到的目标

也会认为 我不行

而放弃追求

他们看不到人生的光华和希望

领略不到生活的乐趣

也不敢去憧憬那美好的明天

因此

社会应予以关注和支持老年人

子女必须从内心深处诚恳地关心父母

尽量常回家看望老人

老年人也可以参与社会

做到老有所为

对生活完全不能自理的老人

应注意保护

在不影响健康的前提下

尊重他们原来的生活习惯

使老年人尊重的需要得到满足

关爱老年人的心理健康

需要全社会的共同努力

谢谢大家

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

3.3.1 Common Psychological Issues and Their Management in the Elderly (1)笔记与讨论

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