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大家好

在中国老龄化趋势下

老年人已经成为每个家庭中不可缺少的一部分

他们的健康越来越受到社会的关注

除了身体上的变化

老年人的心理健康是我们容易忽视的问题

2019年2月22日

我国第一部心理健康蓝皮书

《中国国民心理健康发展报告(2017-2018)》

正式出炉

该报告聚焦心理健康

从学术视角

研究和分析2017-2018年

我国国民及各个群体的心理健康状况

报告指出

对老年人使用心理卫生自评量表

SCL-90的调查结果显示

心理健康正常者占11.9%

临界组即低分者占79.6%

患有心理疾病组即高分者占8.5%

由于进入老年期

各种生理功能逐渐衰退

并常常面临社会角色的改变

疾病 丧偶等生活事件

老年人必须努力面对和适应这些事件

如果适应不良

常可导致一些心理问题

损害老年人的健康

降低生命质量

其实很多老年人也会发现

自己的性格 脾气变化了

因此

老年人想要安享晚年

也要注意自己的心理健康

大量研究表明

老年人的心理

伴随生理功能的减退而出现老化

使某些心理功能或心理功能的某些方面

出现下降 衰退

我们应当首先认识到

老年人的心理变化具有哪些特点

老年人的心理变化

是指心理能力和心理特征的改变

包括感知觉 智力和人格特征等

也就是心理现象

为了让大家更好地理解老年人的心理变化

我们在这里一起简要地回顾心理现象及其结构

如同高山流水 四季变化等

是大自然的运作规律形成的自然现象一样

心理现象是心理活动的表现形式

包括心理过程和人格两个方面

其中心理过程是指心理活动

发生和发展的过程

包括了认知过程 情绪情感过程

和意志过程

也就是我们常说的知 情 意

认知过程则包含了感知觉 记忆 思维等要素

人格是指一个人整个的精神面貌

即具有一定倾向性的心理特征的总和

例如我们所熟知的需要 兴趣 气质 性格等

老年人心理变化就是其知 情 意

和人格方面发生的变化

会呈现什么样的特点呢

这是老年人心理变化的主要特点

包括了感知觉的衰退

记忆力的下降 智力的变化

思维的变化 情感与意志的变化

和人格的改变

感知觉的变化

随着老化

老年人的感觉器官逐渐衰退

出现老花眼 听力下降

味觉减退等

这些都会给老年人的生活和社交活动

带来诸多不便

例如由于听力下降

容易误听 误解他人的意思

出现敏感猜疑

知觉一般尚能保持

只是易发生定向力障碍

影响老年人对时间 地点 人物的辨别

记忆能力

神经递质乙酰胆碱影响着人的学习记忆

老年人可能是由于

中枢胆碱能递质系统的功能减退

导致记忆能力减退

老年人记忆变化特点

主要是有意记忆为主

无意记忆为辅

近事记忆容易遗忘

而远事记忆尚好

机械记忆不如年轻人

在规定时间内速度记忆衰退

但是其理解性

逻辑性记忆常不逊色

记忆与人的生理因素 精神健康状况

记忆的训练 社会环境等相关

智力的改变

智力可以分为流体智力和晶体智力两大类

流体智力是指获得新观念

洞察复杂关系的能力

例如机械记忆 识别图形关系等

主要与人的神经系统的生理结构和功能有关

晶体智力指对词汇 常识等的理解能力

与后天的知识 文化和经验的积累有关

随着年龄的增长

老年人的流体智力呈逐渐下降的趋势

高龄后下降明显

而晶体智力则保持相对的稳定

随着后天的学习和经验积累

有的甚至还有所提高

到高龄后才缓慢下降

大量研究证实

智力与年龄 受教育程度 自理能力等

有密切关系

思维是人类认知过程的最高形式

是更为复杂的心理过程

但由于老年人记忆力的减退

无论在概念形成

还是在解决问题的思维过程方面

以及创造性的思维和逻辑推理方面

都会受到影响

而且个体差异较大

老年人的情感和意志因为其

社会地位 生活环境

文化素质的不同而存在较大差异

在老化过程中情感活动是相对稳定的

即便有变化也是生活条件

社会地位变化所造成的

并非年龄本身所决定

到了老年期

人格也逐渐发生相应改变

例如由于记忆减退

有的老年人说话会重复唠叨

再三叮嘱

总怕别人和自己一样忘事

学习新事物的能力降低 机会减少

很多时候会根据老经验办事

保守 固执 刻板

因为把握不住现状而易产生怀旧和发牢骚等

对健康和经济的过分关注和担心

也容易让老年人产生不安和焦虑

虽然老年人有某些心理功能

或心理功能某些方面的下降和衰退

但另一些心理功能

或心理功能的某些方面仍可能趋于稳定

甚至可以产生新的适应代偿功能

从而使老年人在整体上能够适应良好

因此

心理学家把老年人的人格类型主要分为4种

整合良好型 防御型

被动依赖型和整合不良型

有高度的生活满意度 成熟

能正视新的生活

属于整合良好型

防御型则是指刻意追求目标

对衰老完全否认

有些老年人

尤其是患有慢性疾病的老年人

会强烈依赖他人

和盼望他人对自己的帮助和体恤

或者是对周围一切似乎都毫无兴趣

则属于被动依赖型

若有明显的心理障碍

需要在家庭照料和组织帮助下

才能生活的则是属于整合不良型

因而

心理健康不仅意味着没有心理疾病

还意味着个人的良好适应和充分发展

综合国内外心理学专家对

老年人心理健康标准的研究

结合我国老年人的实际情况

老年人心理健康的标准

可从以下六个方面进行界定

其中

认知正常是心理健康的首要标准

愉快而稳定的情绪是情绪健康的重要标志

还应该有融洽和谐的人际关系

能够与外界环境保持接触

行为符合自己的年龄特征

人格健全等等

心理健康是老年人健康不可或缺的

重要组成部分

认识老年人的心理特点

和正确理解老年人心理健康的标准

才能更好地为老年人提供心理关爱

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

Overview of the Psychological Characteristics of the Elderly笔记与讨论

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