Iglesias G H
Undergraduate Department, Seton Hall University, USA.
Clin Nurse Spec. 1998 Jan;12(1):38-44. doi: 10.1097/00002800-199801000-00013.
With the aging of our population and shortened periods of hospitalization, increasing numbers of people are attempting to manage complex health recovery protocols at home. Not only are these adults at greater risk for health complications, but many have lost significant social supports and have diminished coping abilities. Few home healthcare agencies, however, provide mental health services. The investigator reviewed 150 charts and clinical nurse specialist (CNS) consultation request forms at a large home healthcare agency to analyze the practice of the mental health CNS. First, a comparison between assessment concerns of the home care nurse and the CNS revealed a variance in focus and offers support for Benner's (1984) model of differentiation of practice. Second, the psychosocial assessments by the CNS do not reflect as great a level of severity of illness as the home care nurse-identified behaviors. Finally, the nursing implications for in-service and family education include seminars on adjusting to change, the grieving process, medication education, the importance of opportunities for ventilation and social support, and developing collaborative nurse-patient relationships.
随着我国人口老龄化以及住院时间的缩短，越来越多的人试图在家中执行复杂的健康康复方案。这些成年人不仅面临更高的健康并发症风险，而且许多人失去了重要的社会支持，应对能力也有所下降。然而，很少有家庭医疗保健机构提供心理健康服务。研究者查阅了一家大型家庭医疗保健机构的150份病历和临床护士专家（CNS）会诊申请表，以分析心理健康CNS的实践情况。首先，家庭护理护士与CNS的评估关注点比较显示出重点的差异，并为本纳（1984年）的实践分化模型提供了支持。其次，CNS进行的社会心理评估没有反映出与家庭护理护士所识别行为一样严重的疾病程度。最后，在职培训和家庭教育的护理意义包括关于适应变化、悲伤过程、药物教育、通气和社会支持机会的重要性以及建立协作性护患关系的研讨会。
