Holistic care

整体护理
  • 文章类型: Journal Article
    本文旨在考虑“生活方式医学”的护理方法,重点关注那些可以从生活方式护理方法中受益的患者,支持和授权人们改变生活方式,这将有利于他们的健康。护理中的生活方式医学在美国正获得动力,并可能成为英国护理领导的机会。本文探讨了生活方式方法对医疗保健的重要性,以及为什么护士在运动中起关键作用。
    This article aims to consider the \'lifestyle medicine\' approach to nursing, which focuses on patients with conditions that would benefit from a lifestyle nursing approach, supporting and empowering people to make lifestyle changes that would benefit their health. Lifestyle medicine in nursing is gaining momentum in the USA and could be a nursing leadership opportunity in the UK. This article explores the importance of lifestyle approaches to health care and why nurses have a pivotal role in the movement.
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  • 文章类型: Journal Article
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  • 文章类型: Journal Article
    背景:患者安全是影响全球患者的全球性健康问题。在重症监护病房(ICU)提供安全护理是护士最重要的任务之一。许多因素会影响护士在ICU内提供安全护理的能力。因此,本研究的目的是确定ICU中安全护理的组成部分.
    方法:当前研究构成了2022年1月至2022年6月进行的定性常规内容分析研究。研究参与者包括护士,密集主义者,负责患者安全的护士,护理人员,病人,和病人的家庭成员,共有21个人通过目的抽样选出。数据收集涉及个人,深入,半结构化面试。随后,利用Graneheim和Lundman概述的方法进行数据分析(NurseEducToday24(2):105-12,2004),导致确定参与者的观点。
    结果:三个主题被确定为ICU安全护理的组成部分。这些主题包括专业行为(包括类别:政策的执行,组织沟通,职业道德),整体护理(含类别:系统护理,全面照顾所有系统),和以安全为导向的组织(类别:人力资源管理和安全环境)。
    结论:这项研究的结果强调了通过强调专业行为在ICU中倡导安全护理实践的重要性,整体护理,和以安全为中心的组织结构。这些结果与现有研究一致,建议通过引入由这些要素提供信息的量身定制的干预措施和策略,可以为ICU患者建立更安全的护理环境。
    BACKGROUND: Patient safety is a global health issue that affects patients worldwide. Providing safe care in the intensive care units (ICUs) is one of the most crucial tasks for nurses. Numerous factors can impact the capacity of nurses to deliver safe care within ICUs. Consequently, this study was undertaken with the aim of identifying the components of safe nursing care in ICUs.
    METHODS: The current research constitutes a qualitative conventional content analysis study conducted from January 2022 to June 2022. The study participants comprised nurses, intensivists, nurse responsible for patient safety, paramedic, patients, and patients\' family member, totaling 21 individuals selected through purposive sampling. Data collection involved individual, in-depth, and semi-structured interviews. Subsequently, data analysis was performed utilizing the approach outlined by Graneheim and Lundman (Nurse Educ Today 24(2):105-12, 2004), leading to the identification of participants\' perspectives.
    RESULTS: Three themes were identified as components of safe nursing care in ICUs. These themes include professional behavior (with categories: Implementation of policies, organizing communication, professional ethics), holistic care (with categories: systematic care, comprehensive care of all systems), and safety-oriented organization (with categories: human resource management and safe environment).
    CONCLUSIONS: The findings of this study underscore the significance of advocating for safe nursing practices in ICUs by emphasizing professional conduct, holistic care, and safety-focused organizational structures. These results align with existing research, suggesting that by introducing tailored interventions and tactics informed by these elements, a safer environment for nursing care can be established for ICUs patients.
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  • 文章类型: Journal Article
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  • 文章类型: Journal Article
    在不断发展的老年人护理环境中,探索整体方法的必要性仍然存在,特别是在围绕非正式护理的社会规范不同的地区。根深蒂固的家庭护理传统,通常由女性家庭成员领导,历史上已经弥补了医疗保健系统在集成度较低的系统中的差距。因此,社会期望可能会影响注册护士的经验,并影响老年人的护理质量。这项研究旨在描述在希腊护理环境中照顾老年人的含义。对老年人护理机构中的注册护士进行了十次深入访谈,进行了定性主题分析。分析中出现了四个主题:(i)与老年人生活和联系,作为照顾的基础,(二)把关怀作为一种双面履行,(三)关怀关系中的不充分感,和(Iv)生存问题的遭遇造成孤独。这项研究提供了对照顾老年人的意义的见解,强调老年人最亲密的专业护理人员的经验。对文化规范纠缠的具体捕捉,社会期望,以及它们对专业护理人员经验的影响可能有助于在植根于家庭护理传统的系统中提供高质量的护理。
    In the evolving landscape of older person care, the imperative to explore holistic approaches persists, especially in regions with distinct societal norms around informal caregiving. The deeply ingrained tradition of familial caregiving, often led by female family members, has historically compensated for healthcare system gaps in less integrated systems. Hence, societal expectations may affect registered nurses\' experiences and impact the quality of care for older persons. This study aims to describe the meaning of caring for older persons in care settings in Greece. Ten in-depth interviews with registered nurses in older person care settings underwent qualitative thematic analysis. Four themes emerged from the analysis: (i) Living and bonding with older people as a basis for caring, (ii) Caring as a double-faced fulfillment, (iii) A sense of insufficiency in the caring relationship, and (iv) The encounter of existential issues creating loneliness. This research provides insights into the meaning of caring for older persons, highlighting the experiences of the closest professional caregivers of older individuals. A specific capture of the entanglement of cultural norms, societal expectations, and their impact on professional caregivers\' experiences may contribute to quality care provision in systems rooted in familial caregiving traditions.
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  • 文章类型: Journal Article
    目的:护士有资格提供综合补充治疗干预措施,一个整体的方法来帮助经历焦虑和压力的人。自我调节,据报道,控制呼吸练习(临床方法)可以减少焦虑并增加压力耐受性。这项系统评价的目的是评估呼吸运动干预对成年人焦虑和压力的心理和生理结果的有效性,并评估COVID-19后人群的科学状况。方法:系统评价,搜索了四个科学数据库:PubMed,CINAHL,EMBASE,和WebofScience。纳入标准包括:(1)同行评审研究,(2)18岁以上的成年人,(3)呼吸运动干预,和(4)焦虑或压力作为结果。结果:在确定的309项研究中,包括19个。12人报告了焦虑的显着改善,9人报告了不同呼吸运动干预后的压力显着改善(p<0.05)。未报告不良事件。结论:呼吸练习被发现可以有效地减少成人的焦虑和压力,然而,包括大型随机对照试验在内的证据仍然有限.呼吸练习是一种整体护理方法,可以由护士安全地实施,以减少成年人的症状,包括后COVID人群。
    Aim: Nurses are well-qualified to deliver integrative complementary therapy interventions, a holistic approach to assist individuals experiencing anxiety and stress. Self-regulated, controlled breathing exercises (a clinical approach) are reported to decrease anxiety and increase stress tolerance. The aim of this systematic review was to evaluate the effectiveness of breathing exercise interventions on the psychological and physiologic outcomes of anxiety and stress among adults and assess the state of the science in the post-COVID-19 population. Methods: A systematic review was conducted, and four scientific databases were searched: PubMed, CINAHL, EMBASE, and Web of Science. Inclusion criteria included: (1) peer-reviewed studies, (2) adults over 18, (3) breathing exercise interventions, and (4) anxiety or stress as outcomes. Results: Out of 309 studies identified, 19 were included. Twelve reported significant improvements in anxiety and nine reported significant improvements in stress following varying breathing exercise interventions (p < .05). No adverse events were reported. Conclusions: Breathing exercises were found to be effective in reducing anxiety and stress in adults, however, there continues to be limited evidence that includes large randomized controlled trials. Breathing exercises are a holistic care approach that can be safely implemented by nurses to decrease symptomatology among adults, including the post-COVID population.
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  • 文章类型: Journal Article
    营养是护理的一个基本方面,然而,老年人在医院照顾,在养老院或在自己的家中,他们的营养需求并不总是得到足够的支持,这可能会使他们面临营养不良的风险。使用整体,支持包括营养不良筛查在内的全面营养评估的生物心理社会框架可以支持护士确定老年人的营养状况和营养需求。进行此程序的护士必须确保他们具有这样做的知识和技能,并在其能力范围内工作。•老年人营养不良会导致功能能力下降,肌肉力量降低,疲劳,免疫力受损,伤口愈合欠佳,感染风险增加和跌倒风险增加。•筛查,并评估风险,营养不良是任何医疗保健环境中护理评估的重要组成部分。•全面的营养评估应纳入生理,心理,情感,精神,社会和文化因素。反思活动:“如何\”文章可以帮助更新您的实践,并确保它仍然是基于证据。将本文应用于您的实践。反思并撰写简短的说明:•当与老年人进行全面的营养评估时,本文如何改善您的实践。•您如何使用这些信息来教育护理学生或您的同事,了解与老年人进行全面营养评估的适当技术和证据基础。
    UNASSIGNED: Nutrition is a fundamental aspect of nursing care, however older people cared for in hospital, in a care home or in their own home do not always receive adequate support with their nutritional needs, which can leave them at risk of malnutrition. Using a holistic, biopsychosocial framework to support a comprehensive nutritional assessment that includes malnutrition screening can support the nurse to identify the older person\'s nutritional status and nutrition needs. Nurses undertaking this procedure must ensure they have the knowledge and skills to do so and work within the limits of their competence. • Malnutrition in older people can lead to a decline in functional ability, reduced muscle strength, fatigue, impaired immunity, suboptimal wound healing, increased risk of infection and increased risk of falls. • Screening for, and assessing the risk of, malnutrition is an important part of nursing assessments in any healthcare setting. • A holistic nutritional assessment should incorporate physiological, psychological, emotional, spiritual, social and cultural elements. REFLECTIVE ACTIVITY: \' How to\' articles can help to update your practice and ensure it remains evidence based. Apply this article to your practice. Reflect on and write a short account of: • How this article might improve your practice when undertaking a holistic nutritional assessment with an older person. • How you could use this information to educate nursing students or your colleagues on the appropriate techniques and evidence base for undertaking a holistic nutritional assessment with an older person.
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  • 文章类型: Journal Article
    了解患有精神疾病的地区人群的观点对于适应服务至关重要,改善整体护理和满足个人需求。这项研究探索了患有精神疾病的人对身体健康的看法,心理健康和幸福。进行了以赋权理论为基础的描述性定性研究设计。定性数据是通过半结构化访谈口头收集的,在采访结束时口头提供了人口统计细节。利用专题分析来确定主题。COREQ核对表用于报告。采访了14位年龄在25至84岁之间的地区精神卫生住院患者。参与者认为他们的整体健康良好,尽管他们感到身体健康或心理健康欠佳,这表明他们的幸福感受到身体和心理健康之外的因素的影响。大多数参与者报告说照顾他们的身体健康,心理健康和福祉,并确定了他们发现有帮助的各种行为生活方式策略。专题分析确定了三个主题:运作良好、感觉在控制和满足基本需求。心理健康服务和临床医生在增强精神疾病患者改善身体健康方面发挥着重要作用,住院期间的心理健康和福祉;然而,这是公认的资源可以是有限的。精神卫生服务可以考虑将患有精神疾病的人转介给社会处方计划,以满足他们出院时的个性化需求。
    Understanding the perspectives of regional people living with mental illness is crucial to adapting services, improving holistic care and meeting individual needs. This study explored people living with mental illness perceptions of physical health, mental health and well-being. A descriptive qualitative study design underpinned by empowerment theory was conducted. Qualitative data were collected verbally via semi-structured interviews, with demographic details provided verbally at the end of the interview. Thematic analysis was utilised to identify themes. The COREQ checklist was used for reporting. Fourteen participants admitted to regional mental health inpatient units aged between 25 and 84 years old were interviewed. Participants felt their overall well-being was good despite feeling their physical health or mental health was suboptimal, suggesting that their perceived well-being is influenced by factors beyond their physical and mental health. Most participants reported looking after their physical health, mental health and well-being and identified various behavioural lifestyle strategies they found helpful. Thematic analysis identified three themes: functioning well, feeling in control and meeting basic needs. Mental health services and clinicians play an important role in empowering people with mental illness to improve their physical health, mental health and well-being while admitted to inpatient services; however, it is acknowledged resources can be limited. Mental health services may consider referring people with mental illness to social prescribing programmes to meet their individualised needs on discharge.
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  • 文章类型: Journal Article
    直到最近,糖尿病护理的重点还是管理血糖-一种以葡萄糖为中心的观点。这正在向更全面的预防模式转变,通过生活方式干预和药物治疗和管理。据估计,英国有500万人患有糖尿病,大多数患有与肥胖有关的2型糖尿病。2型糖尿病是可以预防的,用饮食和减肥治疗,或者用药物管理。糖尿病患者的数量已达到流行病的比例。为了更好地管理糖尿病,减少糖尿病管理不善的并发症,这种疾病的管理不再局限于内分泌学家和糖尿病专科护士。本文提供了胰高血糖素样肽-1受体激动剂如何用于2型糖尿病治疗的指导。
    Until recently the focus in diabetes care was on managing blood glucose - a glucocentric view. This is changing to a more holistic model aimed at prevention, treatment and management through lifestyle interventions as well as medication. An estimated 5 million people in the UK are living with diabetes, most have type 2 diabetes which is associated with obesity. Type 2 diabetes can be prevented, treated with diet and weight loss, or managed with medication. The number of people with diabetes has reached epidemic proportions. To manage diabetes well and reduce complications of poorly managed diabetes, management of the condition can no longer be restricted to endocrinologists and diabetes specialist nurses. This article provides guidance on how glucagon-like peptide-1 receptor agonists can be used in the management of type 2 diabetes.
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  • 文章类型: Letter
    化脓性汗腺炎(HS)是一种复杂的慢性复发性炎症性疾病,锚定在毛囊中,其中疼痛的脓肿,结节,在皮肤下形成隧道,有可能出现间歇性脓液引流和组织疤痕。目前估计全球发病率为1-4%,该疾病在女性中的发病率是女性的三倍,在黑人人群中的发病率更高。HS患者也更容易患抑郁症,焦虑,和孤独感强调了对疾病意识和干预措施采取谨慎策略的必要性。正式诊断的延迟,平均估计为7-10年,妨碍及时提供最佳护理。尽管有最好的意图,当患者出现在医生的办公室,患者经历的负面相互作用会加剧与身体外观有关的柱头。除了漫长的等待时间和缺乏可用的HS专家皮肤病学专业人员,患者认为医师对HS耀斑危险因素中的两个因素(吸烟和体重指数[BMI])的高度关注会对他们的护理产生负面影响.鉴于持续的需要,个人,和敏感的病人支持,在此,我们主张重新审查护理方法和利用高度个性化的数字支持解决方案。可以直接或间接控制疾病要素及其合并症的新药物也正在进入市场。总的来说,我们认为这些新的发展为HS患者提供了整体治疗的机会,导致长期参与和改善结果。
    Hidradenitis suppurativa (HS) is a complex chronic relapsing inflammatory condition anchored in the hair follicle wherein painful abscesses, nodules, and tunnels form under the skin with the potential for intermittent pus drainage and tissue scarring. Current estimates of incidence are 1-4% globally with the disease three times more prevalent in women and higher rates among Black populations. Patients with HS are also more likely to suffer from depression, anxiety, and loneliness underscoring the need for carefully approached strategies on disease awareness and interventions. Delays in formal diagnosis, which have been estimated at 7-10 years on average, impede timely provision of optimal care. Despite best intent, when patients present at a physician\'s office, stigmas relating to physical appearance can be exacerbated by negative interactions experienced by patients. In addition to long wait times and the dearth of available HS expert dermatology professionals, patients perceive heightened physician focus on two of the HS flare risk factors (smoking and body mass index [BMI]) as negatively impacting their care. Given the need for continual, personal, and sensitive patient support, herein we advocate for re-examination of approach to care and the leveraging of highly personalized digital support solutions. New medications which can directly or indirectly control elements of the disease and its comorbidities are also entering the marketplace. Collectively, we posit that these new developments provide opportunity for a holistic approach for patients with HS, leading to long-term engagement and improved outcomes.
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