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Practice and Evaluation of Perioperative Care of Elderly People with Dementia by the Cooperation between Nurses and Families

护患家属合作对痴呆老人围术期护理的实践与评价

基本信息

批准号：
21592925
负责人：
ITO Mayumi
金额：
$ 2.16万
依托单位：
Gunma Paz University
依托单位国家：
日本
项目类别：
Grant-in-Aid for Scientific Research (C)
财政年份：
2009
资助国家：
日本
起止时间：
2009 至 2012
项目状态：
已结题

项目摘要

In acute care hospital surgical wards, we examined the following points: i) the sharing of the information of the dementia patients from the admission between the nurses and the families, and the adjustment of the medical treatment environment utilizing the information; ii) taking advantage of the family function during the hospitalization; iii) the effect of staying at home overnight for the arrangement of sleep environment at the time of the onset of delirium. As a result, the delirium symptoms of the "stay at home" group disappeared in about half of the number of days of stay compared with the "hospitalization" group. It was suggested that staying at home overnight is effective for improving the postoperative delirium of elderly people with dementia. Furthermore, by sharing the patients' information between the nurses and the families while practicing and evaluating the perioperative care of the elderly people with dementia based on the cooperation of nurses and the families of the … More hospitalized patients, active intervention to the patients and anxiety reduction of the families were begun.Next, we analyzed and evaluated the results of the care plan that was in practice. Then, for the purpose of standardization, we conducted interviews with mid-level or upper-level nurses and ward administrators working in the surgical/cardiovascular wards of the threehospitals where many elderly people with dementia were hospitalized for operative and surgical treatment. The interviews were conducted in both focused groups and with individuals. As a result, as the perioperative care of the elderly people with dementia who were undergoing surgeries, we created a standardized plan of perioperative care for them based on the following three points:(1)Preoperative care, including how to respond effectively and understanding of behavioral and psychological symptoms of dementia derived from life information so far;(2)Creating an environment in which the patients are familiar with and post-operative care for protecting the comfort and safety of the patients by personal care provided by their families;(3)Nursing intervention which brings the interaction of comfort of the patients and their families. In the future, it is necessary to practice the perioperative care for the elderly people with dementia by taking advantage of this plan. Furthermore, it is also necessary to evaluate and modify the plan. Less

在急诊科医院外科病房中，我们探讨以下几点：一）护士与家属分享痴呆病人入院时的资讯，并利用这些资讯调整医疗环境;二）在住院期间发挥家属的功能;（iii）在家中过夜对谵妄发作时睡眠环境安排的影响。结果，与“住院治疗”组相比，“居家治疗”组的谵妄症状在约一半的住院天数内消失。提示居家过夜可有效改善老年痴呆患者术后谵妄。此外，通过护士与家属在实施和评价老年痴呆患者围手术期护理时共享患者信息， ...更多信息对住院患者进行护理干预，积极干预患者家属，减轻家属焦虑情绪，并对护理计划实施效果进行分析评价。然后，为了标准化的目的，我们进行了采访的中层或高层护士和病房管理人员在外科/心血管病房的三家医院，许多老年痴呆症患者住院手术和手术治疗。访谈是在重点群体和个人中进行的。因此，对于接受手术的老年痴呆症患者的围手术期护理，我们基于以下三点制定了一个标准化的围手术期护理计划：（1）术前护理，包括如何有效应对和了解迄今为止生活信息中的痴呆症行为和心理症状;（2）创造一个患者熟悉和了解的环境，（3）护理干预，使患者与家属在舒适感上产生互动。未来应利用此计画，针对失智症老人施行围手术期照护。此外，还需要对计划进行评估和修改。少