当前课程知识点:老年护理学(Gerontological Nursing) > CHAPTER3: Elderly Mental Health and Mental Health care > 3.3 Common Psychological Issues and Their Management in the Elderly > 3.3.1 Common Psychological Issues and Their Management in the Elderly (1)
返回《老年护理学(Gerontological Nursing)》慕课在线视频课程列表
返回《老年护理学(Gerontological Nursing)》慕课在线视频列表
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
-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