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The context of healthcare 医疗保健的背景
Pub Date : 2020-11-01 DOI: 10.1093/med/9780198831822.003.0001
This chapter begins by covering the UK health profile, then defines the key concepts in primary care and public health, and outlines the generic long-term conditions model. It provides a brief overview of the National Health Service, including differences in England, Northern Ireland, Scotland, and Wales. It covers current NHS entitlements for people from overseas, commissioning of services, and public health in a broader context. It also describes health needs assessment, and provides an overview of the services in primary care, the role of general practice, and other primary healthcare services. Further services, including those to prevent unplanned hospital admission, aid hospital discharge, those that support children and families, housing, social support, and care homes are all covered.
本章首先介绍了联合王国的卫生概况,然后界定了初级保健和公共卫生方面的关键概念,并概述了一般的长期条件模型。它提供了国家卫生服务的简要概述,包括英格兰、北爱尔兰、苏格兰和威尔士的差异。它涵盖了海外人员目前享有的国民保健制度权利、服务委托以及更广泛背景下的公共卫生。它还描述了卫生需求评估,并概述了初级保健服务、全科医生的作用和其他初级保健服务。进一步的服务,包括防止意外住院、帮助出院、支持儿童和家庭、住房、社会支持和护理院的服务都包括在内。
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引用次数: 0
Adult care provision 成人护理服务
Pub Date : 2020-11-01 DOI: 10.1093/med/9780198831822.003.0010
This chapter covers the provision of primary care to adults. This includes urinary incontinence, catheter care, constipation and incontinence, stoma care, spinal cord injury, the prevention of pressure ulcers, wound infection and debridement, malignant fungating wounds, wound dressings, leg ulcers and their dressing, compression therapy for venous ulcers, and lymphoedema. It also covers palliative care, including services for the dying patient, pain assessment and management, nausea, breathlessness, fatigue, depression, and spiritual care, and caring for patients in the dying phase. Emergencies, assisted dying, legal issues around the end of life, and bereavement are all covered. Common technical procedures including the care of central venous catheters, injections, venepuncture, recording a 12 lead electrocardiogram, tracheostomy care, and ear irrigation are also described.
本章涉及向成年人提供初级保健。这包括尿失禁、导管护理、便秘和失禁、造口护理、脊髓损伤、预防压疮、伤口感染和清创、恶性真菌性伤口、伤口敷料、腿部溃疡及其敷料、静脉溃疡的压迫治疗和淋巴水肿。它还涵盖姑息治疗,包括为临终病人提供服务、疼痛评估和管理、恶心、呼吸困难、疲劳、抑郁和精神护理,以及对临终病人的护理。紧急情况、协助死亡、生命终结的法律问题和丧亲之痛都包括在内。常见的技术程序包括中心静脉导管的护理,注射,静脉穿刺,记录12导联心电图,气管切开术护理和耳部冲洗也被描述。
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引用次数: 0
Child health promotion 促进儿童健康
Pub Date : 2020-11-01 DOI: 10.1093/med/9780198831822.003.0006
L. Whiting, S. Roberts
The Children Act (2004) places a responsibility on health practitioners to work together to help a child be healthy, stay safe, enjoy and achieve, make a positive contribution, and achieve economic well-being. This chapter covers the assessment of children, screening tests for vision and hearing, the immunization schedule, and accident prevention. It includes information for working with parents, providing support to new parents, and new birth visits. It then covers pre-term infants, new babies (including twins and multiple births), breast and bottle feeding, and weaning. Growth and development milestones are explained for different age ranges. The promotion of development, toilet training, good food habits, speech and language acquisition, and communication are all covered. The chapter also covers puberty and adolescence, health promotion in schools, sex and relationship education, and child and adolescent mental health. Separately, the care of children with complex health needs, disabilities, and special educational needs is described. Safeguarding children, identifying at-risk individuals, child protection processes, and the care of looked-after children are all included.
《儿童法》(2004年)规定保健从业人员有责任共同努力,帮助儿童保持健康、保持安全、享受和取得成就、作出积极贡献并实现经济福利。本章涵盖儿童的评估,视力和听力的筛选测试,免疫计划和事故预防。它包括与父母一起工作的信息,为新父母提供支持,以及新生儿访问。然后涵盖早产儿、新生儿(包括双胞胎和多胞胎)、母乳喂养和奶瓶喂养以及断奶。成长和发展的里程碑被解释为不同的年龄范围。促进发展,如厕训练,良好的饮食习惯,说话和语言习得,以及沟通都包括在内。本章还涉及青春期、学校健康促进、性和关系教育以及儿童和青少年心理健康。另外,还叙述了对有复杂健康需要、残疾和特殊教育需要的儿童的照顾。保护儿童、识别有风险的个人、儿童保护程序以及照顾被照顾的儿童都包括在内。
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引用次数: 2
First aid and emergencies 急救和紧急情况
Pub Date : 2020-11-01 DOI: 10.1093/med/9780198831822.003.0013
D. Gibbs
This chapter covers first aid, including adult basic life support, automated external defibrillation, the recovery position for babies, children, and adults, adult choking, child basic life support, and the management of the choking child. How to manage emergencies such as anaphylaxis, external bleeding, burns and scalds, eye trauma, hypothermia, poisoning and overdoses, sprains, strains and fractures in the context of primary and community care are all included. Sepsis in infants, children, young people and adults, pregnancy, and postpartum women is also discussed. Finally, the identification and management of stroke is explained.
本章涵盖了急救,包括成人基本生命支持、自动体外除颤、婴儿、儿童和成人的恢复体位、成人窒息、儿童基本生命支持和窒息儿童的处理。在初级保健和社区保健的背景下,如何处理诸如过敏反应、外部出血、烧伤和烫伤、眼外伤、体温过低、中毒和过量用药、扭伤、拉伤和骨折等紧急情况都包括在内。脓毒症在婴儿,儿童,青少年和成人,怀孕和产后妇女也进行了讨论。最后,对脑卒中的识别和处理进行了说明。
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引用次数: 2
Service users with extra needs 服务有额外需求的用户
Pub Date : 2020-11-01 DOI: 10.1093/med/9780198831822.003.0009
This chapter covers populations who have special circumstances that increase their needs when accessing healthcare. This includes asylum seekers and refugees, homeless people, gypsies and other travellers, those affected by domestic violence, adults at risk from harm and abuse, victims of crime, and young people transitioning to adult services. It also covers adults with learning disabilities, carers, people living with HIV, people with eating disorders, those who abuse substances, people with bipolar disorder, psychosis, and post-traumatic stress disorder, patients with dementia, and armed forces veterans. The chapter also covers female genital mutilation (FGM), and identifying women and girls who have been subject to FGM.
本章涵盖了在获得医疗保健服务时需要增加其特殊情况的人群。这包括寻求庇护者和难民、无家可归者、吉普赛人和其他游民、受家庭暴力影响的人、面临伤害和虐待风险的成年人、犯罪受害者以及向成人服务过渡的年轻人。它还涵盖有学习障碍的成年人、护理人员、艾滋病毒感染者、饮食失调患者、滥用药物者、双相情感障碍患者、精神病患者和创伤后应激障碍患者、痴呆症患者和武装部队退伍军人。本章还涉及女性生殖器切割(FGM),以及识别遭受女性生殖器切割的妇女和女孩。
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引用次数: 0
Adult health problems 成人健康问题
Pub Date : 2020-11-01 DOI: 10.1093/med/9780198831822.003.0012
This chapter covers primary care and nursing of various conditions that adults may present with including frailty, skin infections (bacterial, fungal, and viral), skin cancer, eczema, psoriasis, pigmentation and hair problems, and allergies. It also covers deafness, mouth and throat problems, adrenal disorders, anal conditions, gastro-oesophageal reflux and disorders of the bowels, viral infection, and food-borne disease. It also covers bowel disease, coeliac disease, appendicitis, hernias, intestinal obstructions, problems of the liver, gallbladder, and pancreas, as well as common musculoskeletal problems, and bone and connective tissue disorders. Sexual health problems are extensively described, including how to conduct a consultation, sexually transmitted infections, sexual problems, and sexual health in the context of adults with learning difficulties. Breast and gynaecological cancers are covered, alongside problems with menstruation, the ovaries, uterus, and vagina. The final section covers issues relating to termination of pregnancy.
本章涵盖了成人可能出现的各种疾病的初级保健和护理,包括虚弱、皮肤感染(细菌、真菌和病毒)、皮肤癌、湿疹、牛皮癣、色素沉着和头发问题以及过敏。它还包括耳聋、口腔和喉咙问题、肾上腺疾病、肛门疾病、胃食管反流和肠道疾病、病毒感染和食源性疾病。它还包括肠道疾病、乳糜泻、阑尾炎、疝气、肠梗阻、肝脏、胆囊和胰腺问题,以及常见的肌肉骨骼问题、骨骼和结缔组织疾病。广泛地描述了性健康问题,包括如何进行咨询、性传播感染、性问题以及有学习困难的成年人的性健康。包括乳腺癌和妇科癌症,以及月经、卵巢、子宫和阴道问题。最后一节涉及有关终止妊娠的问题。
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引用次数: 0
Useful information 有用的信息
Pub Date : 2020-11-01 DOI: 10.1016/b978-0-12-811309-7.00050-3
Maria Cristina
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引用次数: 0
Care of adults with long-term conditions 照顾有长期疾病的成年人
Pub Date : 2020-11-01 DOI: 10.1093/med/9780198831822.003.0011
Multiple comorbidities necessitate care from a number of healthcare providers. Continuity of care is important for both patient satisfaction and quality of life. This chapter outlines primary care for adults with a variety of conditions, including osteoarthritis, rheumatoid arthritis, lower back pain, asthma and acute asthma, and stable and chronic obstructive pulmonary disease. It covers drugs commonly used in the treatment of respiratory conditions, including long-term oxygen and nebulizers. It then goes on to cover coronary heart disease, angina, hypertension, cardiac rehabilitation, heart failure, abnormal cardiac rhythms and atrial fibrillation, patients on anticoagulant therapies, and drugs used in cardiovascular diseases. The chapter also includes information on anaemia, varicose veins, diabetes, multiple sclerosis, motor neurone disease, and Parkinson’s disease.
多种合并症需要许多医疗保健提供者的护理。护理的连续性对患者满意度和生活质量都很重要。本章概述了患有各种疾病的成人的初级保健,包括骨关节炎、类风湿性关节炎、腰痛、哮喘和急性哮喘,以及稳定和慢性阻塞性肺病。它涵盖了通常用于治疗呼吸系统疾病的药物,包括长期氧气和雾化器。接着介绍冠心病、心绞痛、高血压、心脏康复、心力衰竭、心律失常和心房颤动、接受抗凝治疗的患者以及用于心血管疾病的药物。本章还包括贫血,静脉曲张,糖尿病,多发性硬化症,运动神经元疾病和帕金森病的信息。
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引用次数: 0
Adult health promotion 促进成人健康
Pub Date : 2014-02-01 DOI: 10.1093/med/9780199653720.003.0008
V. Drennan, C. Goodman
Health promotion aims to enable people to increase control over their health as well as cause an overall improvement. It includes individual, social, and environmental interventions. This chapter covers group health promotion, community approaches to health, and the role of the expert patient. It then covers areas in which health promotion can be highlighted in adults, including principles of good nutrition, obesity, malnutrition, home food safety, exercise, smoking cessation, managing stress, and alcohol advice. It outlines UK screening programmes, the menopause, healthy ageing, ways of preventing cancers (skin, bowel, breast, cervical, and testicular), travel health promotion (including vaccinations and a topic on malaria), different types of contraception, and pregnancy from preconception, antenatal care, maternity rights, common problems in pregnancy, birth options, and postnatal care.
健康促进的目的是使人们能够加强对自己健康的控制,并使其得到全面改善。它包括个人、社会和环境干预。这一章涵盖了群体健康促进、社区健康方法和专家病人的作用。然后,它涵盖了可以在成年人中突出促进健康的领域,包括良好营养、肥胖、营养不良、家庭食品安全、运动、戒烟、管理压力和酒精咨询等原则。它概述了联合王国的筛查方案、更年期、健康老龄化、预防癌症(皮肤癌、肠癌、乳腺癌、宫颈癌和睾丸癌)的方法、促进旅行健康(包括接种疫苗和关于疟疾的专题)、不同类型的避孕、孕前怀孕、产前护理、产妇权利、怀孕中的常见问题、生育选择和产后护理。
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引用次数: 0
Approaches to individual health needs assessment 个人健康需求评估方法
Pub Date : 2014-02-01 DOI: 10.1093/med/9780199653720.003.0004
V. Drennan, C. Goodman
The purpose of assessment at an individual level is to establish a baseline of the health and well-being of the person and create a mutually agree plan of care. This chapter explains an integrated assessment for adults, the core components of a case management programme, and consultation models and frameworks, alongside standardized assessment tools. The principles of good communication in patient assessment are outlined, as well as more detailed instructions for situations where the patient has additional needs (for example, deafness, where English is a second language, non-fluent English speakers, or those with learning difficulties). Assessment by remote consultation is covered, as well as motivational interviewing.
在个人层面进行评估的目的是建立个人健康和福祉的基线,并制定双方同意的护理计划。本章解释了成人综合评估、病例管理规划的核心组成部分、咨询模式和框架以及标准化评估工具。本文概述了在评估患者时良好沟通的原则,以及针对患者有额外需求的情况(例如,耳聋、英语为第二语言、英语不流利或有学习困难的患者)的更详细说明。包括远程咨询评估,以及动机性访谈。
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引用次数: 0
期刊
Oxford Handbook of Primary Care and Community Nursing
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