The first part of the opening report of nursing thesis
Hypertension, clinical nursing, psychological nursing, nursing countermeasures Hypertension is a common and frequently-occurring disease in middle-aged and elderly people. According to the report of the World Health Organization, the prevalence rate of hypertension in the elderly over 60 years old in China is as high as 39. 7%, if not treated in time, will often lead to stroke, coronary heart disease, myocardial infarction and heart failure, and can be complicated and promote the damage of target organs such as brain and kidney, and even disability or sudden death. With the continuous development of society, people put forward higher requirements for the rehabilitation, diagnosis and nursing of hypertension in the elderly with high incidence. The author analyzes the reasonable nursing methods of clinical nursing for elderly patients with hypertension, and now reports as follows.
1, psychological care, establish good medical ethics.
Create a good environment, strengthen patients' love for life and belief in fighting against diseases, so that patients can recover as soon as possible. Pathogenic factors: overeating, constipation, mental stress, emotional excitement, great joy and great sorrow, anxiety, depression, paranoia, loneliness, depression, etc. , will increase the release of catecholamine in the body, make blood pressure rise, heart rate accelerate, thus aggravating the condition. Patients should maintain emotional balance, give psychological counseling to patients' various ideological concerns, establish a good nurse-patient relationship, enhance trust, and eliminate their worries and paranoia, which will play a positive role in the treatment of hypertension and the occurrence and progress of complications. Explain the relationship between mental factors and disease formation to patients and their families, teach patients to master certain psychological emergency methods, learn self-psychological consultation and adjustment, improve their psychological endurance and maintain a good psychological state. If blood pressure control is not ideal, even complications or other diseases occur, patients often feel pessimistic, disappointed and afraid. Nurses should be honest with each other, have patience and in-depth understanding of patients' inner world, understand patients' pain, give them emotional help such as care and encouragement, so as to eliminate their fragile emotional state, keep their healthy, peaceful and optimistic psychology, eliminate their self-confidence, enable them to actively cooperate with treatment, improve their self-control ability and help them finally overcome the disease.
2. Health knowledge guidance
Strengthen health education, including the risk factors of hypertension, the treatment of complications, medication precautions and adverse reactions. Personalized health knowledge education, demonstration and guidance should be given to patients' families, and the basic knowledge of hypertension prevention and treatment should be introduced to them according to their cultural background, customs and habits, so as to help them establish a knowledge system related to hypertension, so that patients and their families can fully realize the harm of bad living habits and actively establish scientific living habits. Encourage and guide patients and their families to actively participate in learning, master the skills of self-care, self-care and self-management, achieve self-control of blood pressure, and regularly check the functions of heart, brain, kidney and other organs and fundus conditions. Adhere to long-term rational drug use according to the condition, so as to reduce and delay the occurrence and development of complications, improve patients' ability to maintain their own health and promote the improvement of their quality of life.
3, a reasonable diet, keep the stool unobstructed, prevent constipation.
Reasonable diet is the basis of hypertension treatment, which is of great significance to control the disease and prevent the occurrence and development of its complications. In principle, the diet is light, easy to digest, low in calories, fat and cholesterol, and it is advisable to eat less and eat more meals, mainly with high vitamins. Foods should be diversified, mainly cereals, and coarse grains, freshwater fish, bean products, poultry, lean meat and low-fat milk, such as celery, Chinese cabbage, tomatoes, black fungus, mushrooms, celery, hawthorn, apples, rice and other fresh vegetables and fruits with health care functions, and seafood and foods with high calcium content should be appropriately increased. Avoid overeating, drink plenty of water, quit smoking and limit alcohol, and keep your stool unobstructed.
4. Exercise and rest care
Actively and appropriately participate in aerobic exercise, combine the changes of blood pressure and consciousness symptoms, choose the appropriate exercise mode and intensity, and do what you can. Walking, jogging, playing Tai Ji Chuan, relaxation therapy and other exercise methods can promote blood circulation and enhance the body's disease resistance. According to the patient's own situation and feelings during and after exercise, exercise moderately. For example, obese people can appropriately increase the intensity of exercise. Avoid the abnormal excitement of sympathetic nerve after strenuous exercise, which will lead to a sharp increase in blood pressure and cause cardiovascular and cerebrovascular accidents. In the process of exercise, in addition to strengthening safety awareness, we should also keep company with people to prevent accidents such as bumping and falling. Sympathetic nerve is excited in the morning, and blood pressure fluctuates easily. Therefore, patients should wake up slowly, wake up for a while, and then get up gradually to prevent the sudden drop of blood supply to the brain from causing fainting and falling. First of all, patients can be allowed to do moderate housework and encouraged to participate in social activities, such as cultivating personal hobbies according to their own interests, such as calligraphy, planting flowers and raising birds. And guide them to make a personalized schedule, get enough sleep and keep the balance between exercise and rest.
5, drug care
The principle of medication is: control the dose, slowly lower the blood pressure, and insist on long-term medication, that is, start with a small dose and gradually increase. Because the elderly often suffer from arteriosclerosis of heart, brain, kidney and other organs, the overall circulation regulation function of the body is poor, the overall fluid volume of the body is reduced, and excessive hypotension is prone to occur during treatment, so it is necessary to balance the internal environment of the machine. Therefore, for the elderly patients with hypertension, the drug dosage should start from 1/3 ~ 1/2 of the young and middle-aged patients, and gradually increase the dosage by observing its response, and satisfactory results can be obtained after 2 ~ 3 months. According to the dynamic changes of blood pressure in elderly patients with hypertension, the medication time was 6: 00, 14: 00 and 22: 00, and the mechanism of different antihypertensive drugs was considered. In addition, patients and their families should be informed of the precautions and adverse reactions of drugs taken so as to take corresponding preventive measures. In addition, encouraging patients to develop their potential can alleviate physical pain and psychological pressure to a certain extent and promote physical and mental health. Even if the blood pressure drops to the normal range, you can't stop taking drugs without authorization. You should get in touch with the doctor in time and ask him to adjust the medication and dosage to prevent the sudden increase of blood pressure after stopping the drug, which will lead to repeated illness. If the blood pressure suddenly changes greatly, it will easily lead to the damage of target organs such as heart, brain and kidney. Patients should be instructed to take medicine according to the doctor's advice.
Step 6 discuss
Hypertension is divided into primary and secondary. WTO standard of hypertension in the elderly: systolic blood pressure at rest in people over 60 years old&; Ge, 140mmHg( 1mmHg equals 0. 133kPa) and/or diastolic pressure &; Germanium, 90 mm Hg. Elderly hypertensive patients are important risk factors for common metabolic disorder atherosclerotic cardiovascular and cerebrovascular diseases, and active prevention and treatment of hypertension is an important link in the prevention and treatment of cardiovascular and cerebrovascular diseases. Effective nursing guidance should be given to patients, and the inducing factors of hypertension should be avoided as much as possible, so as to better cooperate with clinical treatment to stabilize blood pressure, prevent the disease from getting worse, and finally achieve the purpose of health care.
Hypertension is a global chronic disease, and rehabilitation nursing of elderly patients with hypertension is a long-term work. It requires nurses not only to have relevant theoretical knowledge and corresponding clinical experience, but also to play the role of educators, strengthen nurse-patient communication, carry out health education, and promote the early recovery of elderly patients with hypertension. In addition, while taking medicine reasonably, we should also actively treat the primary disease, pay attention to genetic tendency and guide patients to do daily health care in order to achieve good curative effect. The development of medicine has proved that hypertension is closely related to psychosocial factors besides biological genetic factors. With the improvement of people's living standards, the incidence of hypertension in the elderly is increasing day by day, and China will enter an aging society. Therefore, we should organize nursing work from patients' physiological, social and psychological aspects, improve patients' self-care awareness, advocate scientific and healthy lifestyle and eating habits, improve diet structure, prevent obesity, advocate abstinence from drinking and smoking, and prevent hypertension from childhood. To control hypertension, we should renew our ideas, change our strategies, establish the concept of putting prevention first and strengthening mental health care, shift the focus of our work from medical care to preventive health care and strengthening mental health care, and generally improve the quality of the population.
The second part of the opening report of nursing thesis
Research purposes: 1. To understand the needs of the elderly in social pension institutions.
2. Analyze the related factors that affect the needs of the elderly in social pension institutions.
3. Understand the basic situation of supply and demand of nursing homes with good hardware facilities in Chengdu.
Research significance:
1, which provides a basis for the government to further standardize and improve the services of social pension institutions.
1928 The Vienna International Plan of Action on Ageing (1982), which was adopted by the United Nations and implemented all over the world, pointed out: to provide medical care for the elderly, and on this basis, to seek an appropriate balance between social institutions and families for the elderly, the state and society should provide more reasonable and effective ways and conditions for the elderly, and provide favorable guarantees in policies and systems to make up for 2 1. In terms of medical care for the elderly, the leading role of China government is not obvious, which is mainly manifested in the promotion of social awareness of providing for the elderly [3]. Therefore, through the investigation and study on the needs of the elderly in nursing homes, it can provide the corresponding basis for the government to guide the policies, laws and directions of the developers of apartments for the elderly and make corresponding regulations and supervision on the service quality of apartments for the elderly. At the same time, it can also promote the government to strengthen the promotion and publicity of social pension, so that family pension and social pension can develop steadily.
2. To provide a basis for social pension institutions to improve and improve service quality and meet the needs of the elderly.
The development of social pension institutions in China is relatively late, and the requirements for employees lack industry standards. Generally, some temporary workers with low cultural quality or some laid-off women workers are employed. These service personnel have not received professional training, but have only completed life services such as feeding and delivering water, and cannot consider and meet the psychological and social needs of the elderly. In order to further improve the service quality of nursing homes and promote the development of old-age care, it is necessary to conduct this study to provide a basis for the old-age care institutions to improve and improve the service quality.
3. To provide basis and guidance for improving the service quality of college students' social practice and voluntary service in nursing homes.
Nowadays, there are more and more college students' social practice, which has developed from the previous practice around campus to various welfare units, especially volunteering in nursing homes. Even so, in recent years, the effect of college students' voluntary activities in nursing homes is not ideal, and some needs of the old people have not been well met. The reason for this phenomenon is that they don't know the specific needs of the old people, and practical activities have become their own wishful thinking. To this end, we hope that through the development of this project, we can provide some directional guidance for college students and provide quality services for nursing homes.
4. It is beneficial to expand the theory of aged care.
The research progress of geriatric nursing in China is relatively slow. The articles with the theme of geriatric nursing are mostly geriatric nursing experience and psychological nursing experience. Facing the actual needs of the elderly, it is the future development direction and trend to carry out elderly nursing. Facing the development direction and trend of gerontology in the future, gerontology should have a sense of being ahead of the times, strengthen the summary of relevant research and clinical practice experience, make nursing work adapt to the changes in the new period, meet the needs of gerontology nursing work and meet the needs of people's health.
Research status and development trend at home and abroad
1, related research status abroad
With regard to the satisfaction of the needs of the elderly abroad, some people have made an investigation using the Z ~ R demand framework model, and found that people generally put economic needs first, followed by physical health needs, living environment needs, activity needs, mental health needs and self-development needs. Barbara and others used the Quality of Life Scale (SF ~ 36) to investigate the social service needs of elderly outpatients in Massachusetts. The results show that 49.48% people need physiological function, 54.50% people need emotional role, 54.46% people need pain relief, 65.74% people need mental health, 63.6% people need social function, 52.50% people need general health and 46.50% people need vitality.
2. Research status of China.
With regard to the needs of the elderly in the old-age care institutions in China, some scholars in Taiwan Province Province have studied the unmet nursing needs of the disabled elderly living in the old-age care institutions. The results show that about 4.8% of the demand has not been met. These needs mainly include all-round joint activities, beauty, nutrition education, transportation and information. The main factors affecting these unmet needs are the age of the elderly, education level and knowledge level of health care providers. 199 1 year, China research center on aging organized the "survey on the support system for the elderly in China". 1994 ~ 1996, East China Normal University and other organizations conducted surveys and studies on social services for the elderly in Beijing, Shanghai, Guangzhou, Wuhan, Hong Kong and other cities, but most of these surveys and studies focused on them.
3. Development trend
As a populous city, Chengdu's pension problem is more prominent. According to the fifth national census, the standard time is June 2000 1 65438+1October1hour. The object of census registration is people with China nationality and permanent residence in China. In 2000, the registered population of the whole city was 165438+65438+ 10: 00, which was1244272 (including migrants, excluding migrants). There are 894,820 elderly people over 65 years old, accounting for 7.96% of the registered population. [7] It can be seen that the absolute number of elderly people in Chengdu is very large, and many elderly people have to face the problem of providing for the elderly. As of June 65438+ 10/5, according to the information provided by the Civil Affairs Bureau, there are only 13 nursing homes in seven districts of Chengdu. These beds are far from meeting the needs of the elderly. Most of these nursing homes provide services such as food, clothing, shelter and washing. Through understanding, the Civil Affairs Bureau lacks relatively uniform and specific service standards for nursing homes.
Therefore, it is necessary to understand the needs of the elderly in nursing homes in Chengdu and the situation of nursing homes in Chengdu, so as to provide the corresponding basis for the government and pension institutions to improve the service of nursing homes and meet the needs of the elderly in nursing homes in Chengdu to a limited extent.
The third part of the opening report of nursing thesis
(1) Instrumentation refers to a person's appearance, which is the external expression of a person's mental outlook. A person's hygiene habits and clothes are closely related to the formation and maintenance of a dignified and generous appearance.
1. Hygiene: Cleanliness is the key to beautiful appearance and the basic requirement of etiquette. No matter how beautiful clothes and luxurious clothes are, if the whole body is covered with dirt and smell, it will inevitably destroy a person's aesthetic feeling. Therefore, everyone should develop good hygiene habits, wash their faces and feet after going to bed and getting up, brush their teeth in the morning and evening and after meals, wash their hair and bathe frequently, pay attention to neatness and change clothes frequently. Don't "clean personal hygiene" in front of people. For example, picking teeth, picking nostrils, digging ear wax, manicure, rubbing dirt and so on. These behaviors should be avoided by others, otherwise, it is not only unsightly, but also disrespectful to others. When talking with people, keep a certain distance, don't speak too loudly, and don't splash on the population.
2. Clothing: Clothing reflects a person's cultural quality and aesthetic taste. Specifically, it is necessary to be natural, decent, harmonious and generous, and to abide by some established norms or principles. Clothing should not only adapt to its own specific conditions, but also always pay attention to the dress requirements of objective environment and occasions, that is, dress should give priority to time, place and purpose, and strive to keep in harmony with time, place and purpose in all aspects of dress.
(2) Speech
As an art, speech is also an important part of personal etiquette.
1, courtesy: be sincere and kind; The sound size should be appropriate, and the tone should be peaceful and calm; Respect others.
2. Terminology: honorifics, words expressing respect and courtesy. Such as "please", "thank you", "sorry" and "you" in the second person. The first meeting was "I've heard a lot about you"; I haven't seen you for a long time. Please criticize it as "teaching"