针对晚年焦虑的简短行为干预的可行性和影响:全科护士的看法。

Contemporary nurse Pub Date : 2024-08-01 Epub Date: 2024-02-01 DOI:10.1080/10376178.2024.2310254
Julie Reis, Sharon Hills, Tracy Robinson, Danny Hills
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引用次数: 0

摘要

背景:焦虑症在老年人中普遍存在,并与不良的健康后果相关。早期发现和干预是当务之急,但临床上对老年人焦虑症的诊断往往不足。一旦确诊,药物治疗通常是最初的治疗方法,但由于耻辱感、对多种药物的担忧以及副作用等原因,老年人普遍对药物治疗产生抵触情绪。非药物干预,如深呼吸和渐进式肌肉放松,可能会为控制焦虑症提供更容易接受且更具成本效益的选择。虽然初级保健是解决老年人焦虑问题的理想选择,但评估全科护士主导的干预措施的可行性和可接受性也很重要:目的:探讨在澳大利亚大都市和地区环境中,全科护士(GPNs)对有焦虑症状的老年人实施指导性放松干预的可行性和可接受性的看法:方法:对 GPN 进行培训,然后在三个大都市综合诊所和一个包括四个地点的大型乡村诊所对老年人实施有指导的放松干预。随后,五名全科护士参加了半结构化访谈,探讨实施干预的可接受性和可行性。对访谈进行了记录和转录,并将结果映射到四个主要关注领域:"结果:总的来说,普通PN 报告说,干预措施易于实施,深受欢迎,有助于建立关系,并促成了有关心理健康和幸福的对话。他们还指出,所学到的知识和技能可以更广泛地应用于其他客户:结论:该干预措施有望促进和支持初级保健中的医疗保健能力。全科医生是检测老年人焦虑临床症状和提供简短幸福感倡议的理想人选。然而,要维持和扩大福利干预措施的规模,就需要进行结构性技能开发、全科医生的承诺以及政策转变,例如政府为全科医生提供回扣。
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The feasibility and impact of a brief behavioural intervention for anxiety in later life: perceptions of general practice nurses.

Background: Anxiety is prevalent in older people and is associated with adverse health outcomes. Early detection and intervention are imperative, yet clinically significant anxiety in older people is often under-diagnosed. When diagnosed, pharmacotherapy is often the initial treatment, but resistance due to stigma, polypharmacy concerns, and side effects are common among the elderly. Non-pharmacological interventions such as deep breathing and progressive muscle relaxation may offer more acceptable and cost-effective options to managing anxiety. While primary care is ideal for addressing anxiety in older adults, it is important to assess the feasibility and acceptability of nurse-led interventions in general practice.

Objective: To explore the perspectives of General Practice Nurses (GPNs) on the feasibility and acceptability of implementing a guided relaxation intervention for older people living with symptoms of anxiety, in Australian metropolitan and regional settings.

Methods: GPNs were trained and then administered a guided relaxation intervention to older people at three metropolitan general practices and one large rural practice encompassing four sites. Subsequently, five GPNs participated in semi-structured interviews exploring the acceptability and feasibility of implementing the intervention. Interviews were recorded, transcribed and findings were mapped to four key domains of interest: "Screening", "Training and Delivery", "Perceived impact of the Intervention" and "Barriers to the intervention".

Results: Overall, GPNs reported that the intervention was easy to implement, was well received, helped build relationships and enabled conversations about mental health and well-being. They noted broader applicability of acquired knowledge and skills with other clients.

Conclusion: The intervention shows promise in promoting and supporting healthcare capabilities in primary care. GPNs are ideally placed to detect clinical symptoms of anxiety among older people and deliver brief well-being initiatives. However, to sustain and scale well-being interventions structured skill development, commitment from general practices, and policy shifts such as government rebates for GPNs are required.

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