Mode 1: "Reflections on the Mental Health of Retired Old People" With the continuous advancement of aging, the proportion of the elderly population in China is rising. Paying attention to the health of the elderly population is not only a family problem, but also a problem that society and the country need to face [1-3]. Happiness is the expectation of the whole society for the life of the elderly, but due to physical and psychological problems, the quality of life of the elderly is seriously affected. Providing effective support for the elderly can improve their quality of life and satisfaction, and increase their happiness in their later years. Under the background of social population mobility, more and more young people leave home to work in different places, resulting in a large number of empty nesters. The phenomenon of empty nesters reduces the social support level of the elderly to a certain extent, and the reduction of social support level affects the mental health level of the elderly to a certain extent. How to care for the elderly and improve their mental health level has become a subject we have to face. A lot of research in China also shows the fragility of their mental health level. Social support includes emotional support of children, spouses, relatives and friends to the elderly, as well as economic support such as income status. Some studies believe that social support and low psychological resilience are the key influencing factors of mental health problems of the elderly [5-6]. The relationship between husband and wife and children are two important pillars of China family. As a link of social support, a good relationship between children can give the elderly a good spiritual sustenance, communicate with their children regularly and relieve their inner loneliness [7]. Major adverse life events refer to major events that affect the mental health of the elderly and even cause symptoms such as depression of the elderly. Based on social support, this study analyzes the correlation between different social support and mental health status of the elderly.
1 objects and methods
1. 1 object
A total of 205 elderly people were selected from April, 20 13 to June, 20 14, including 38 males (67.32%) and 67 females (32.68%). The average age was 60-82 years (7 1.42? 12.05). Inclusion criteria: ① age? 60 years old; (2) Clear thinking, certain expression and reading and writing skills, and being able to cooperate with investigators to complete the questionnaire; (3) retirees such as enterprises and institutions; ④ No mental illness or malignant disease in the body; ⑤ Informed consent, willing to participate in this survey.
1.2 method
1.2. 1
Survey tools In this study, general situation questionnaire, symptom checklist 90 (SCL-90) and social support rating scale [8] were used, in which the general situation questionnaire mainly collected basic information such as patients' gender, age, education level and marital status, and the symptom checklist 90 * * had 90 items to detect somatization, obsessive-compulsive symptoms, interpersonal sensitivity, depression, anxiety, hostility, terror, paranoia and psychosis respectively. Each item was given (1 ~ 5) 5 points, namely: 1. None (aware of problems/symptoms), 2. Very light (aware of the problem, but not frequent and serious), 3. Moderate (aware of symptoms, with mild to moderate severity), and 4. The social support rating scale has 10 items, including objective support (3 items), subjective support (4 items) and social support utilization (3 items).
1.2.2 quality control
This questionnaire was completed by the nursing evaluation team. The nursing evaluation team * * * has five nurses with bachelor degree, all of whom have received training before the questionnaire survey, and the training evaluation results are excellent. After the questionnaire was collected, 5% was selected for re-examination to verify the information and ensure the accuracy of information collection and scale evaluation.
1.3 statistical processing
In this study, SPSS 18.0 statistical software was used for data analysis, and the quantitative data were analyzed by (x? S) means that the correlation analysis method is used for two groups of related data, and the linear regression method is used to analyze and predict the relationship between two groups of quantitative data, P
Two results
2. 1 Scores of mental health and social support of the elderly in different dimensions
It is found that different ages, marital status, living status, self-rated health status and child relationship have significant effects on the mental health of the elderly; Different age, education level, marital status, self-rated health status and child relationship have significant effects on the social support score of the elderly, as shown in table 1.
2.2 Correlation between social support and mental health score
It is found that the total score of social support of retired elderly people is negatively correlated with compulsion, depression, anxiety and hostility in SCL-90. Specifically, in the three dimensions, objective support and subjective support are only negatively correlated with anxiety, and the utilization of support is negatively correlated with compulsion, depression, anxiety and hostility, as shown in Table 2.
3 discussion
With the research on the mental health of the elderly in different fields in China, it is found that social support has different degrees of influence on the mental health of the elderly [9- 1 1]. This study takes psychological symptoms as an evaluation index to analyze psychological symptoms under different social support. Social support includes subjective support and objective support, as well as the use of support by the elderly, which determines the effect of social support and therefore attracts the attention of many experts.
3. 1 Factors affecting mental health and social support of the elderly
In this study, the influence of age on psychological symptoms and social support of the elderly is more obvious when they are over 70 years old. This may be because the elderly over 70 years old have reduced their ability to communicate with others and their use of subjectivity and objectivity due to their aging bodies. At the same time, the difficulty of communication and their physical health also affect the psychological ups and downs, which can also be confirmed by the analysis of self-evaluation of health. People with poor self-health have lower social support scores and higher symptom scores.
3.2 Relationship between subjective support and mental health status of the elderly
Subjective support refers to the support that individuals experience or feel emotionally, and refers to the emotional experience and satisfaction that individuals are respected, supported and understood in society, which is closely related to their subjective feelings. If a major adverse event occurs in the family, such as widowhood, it will have a great impact on the mental health of the elderly, and their mental health status is poor and their social support scores are poor. According to related research, there is also a significant correlation between subjective support and anxiety of the elderly. At the same time, subjective support can also be analyzed from the relationship between children and living conditions. Social support such as poor relationship between children, living alone and empty nesters is relatively poor, and their psychological symptoms are more obvious. This study is also certified by Wu Junfu and other studies [12- 14].
3.3 Relationship between objective support and mental health status of the elderly
Objective support is visible or practical, including direct material help, the existence and participation of group relations, etc. Compared with other rural areas and elderly people without social retirement security [15], retired elderly people have retirement pension insurance for their lives, which can alleviate their worries about material life and pension problems to some extent. Therefore, in univariate analysis, the objective support of income status has no obvious influence on the total score of psychological symptoms of the elderly, but this cannot deny the relationship between objective support and psychological symptoms. This study also shows that there is a significant correlation between objective support and anxiety.
3.4 Relationship between support utilization and mental health status of the elderly
Support utilization is the most effective index to evaluate the support that the elderly can get. This study also shows that the utilization of support has the highest correlation with the psychological symptom score of the elderly. Because the old people of different ages are affected by their health, the degree of support and utilization is different. Although the same support is provided, the results are quite different. Therefore, in the future research, we should pay attention to the research on the use of support and explore how to improve the use of support through the intervention of the use of support for the elderly to achieve the goal of improving the mental health of the elderly. In a word, the quality of life and happiness of the elderly can be improved by reasonably evaluating their health status and actively exploring effective pension models.
As a relatively weak and rapidly expanding group, the elderly have become an important factor affecting the harmonious and healthy development of our society, and their mental health has attracted more and more attention. On the basis of modern nursing care for the elderly, this paper puts forward how to carry out active and effective psychological care according to the mental health standards, factors affecting mental health and psychological characteristics of the elderly.
Keywords the elderly; Mental health; Psychological nursing
With the social progress and economic development, the average life expectancy is gradually extended, and the degree of population aging is increasing. The mental health problems of the elderly are also paid more and more attention by medical workers. How to improve the mental health level of the elderly, solve and do effective psychological care, and make the elderly spend their old age in a state of physical and mental pleasure has become an important content of psychological care for the elderly and an important part of nursing psychology.
1 Current situation of aging society in China
Since 1990, the elderly population in China has increased by 3.32% annually. In 2000, the population over 60 in China reached1300,000, accounting for10.09% of the total population in China [1], and the whole country began to enter an aging society. It is predicted that it will exceed 200 million in 20 15 years, accounting for 14% of the total population, and will reach 400 million in the middle of 2 1 century, accounting for14 [2]. China's aging population has the characteristics of advanced age, high speed and a large number [3], which puts forward severe psychological care for the elderly.
Challenge.
2 mental health standards for the elderly
Based on the research of psychologists at home and abroad on the mental health standards of the elderly, combined with the actual situation of the elderly in China, we believe that the mental health standards of the elderly have five aspects.
2. 1 Good mental state, optimistic mood, cheerful spirit, loving life and family, humorous, open-minded, helpful, curious, knowing how to cherish one's health, and having a sense of security and happiness in his later years.
2.2 Normal intelligence judges that things are basically accurate; When recalling the past, remember clearly; Be clear when analyzing problems; Be able to answer questions freely; In normal life, I have rich imagination and am good at designing a happy life goal for myself with imagination.
2.3 sound personality, emotional stability, strong will, able to correctly evaluate themselves and others and external things, able to control their own behavior, able to withstand the strong stimulation of external things, able to calmly find ways to overcome difficulties, rather than complaining blindly.
2.4 Have good interpersonal relationships, be ready to help others, and be willing to accept others' help. At home, you can maintain emotional harmony with your wife and younger generation and get heartfelt understanding and respect from your family; Outside, I can keep good relations with my past friends and my present friends, and have a sense of collective honor and social responsibility.
2.5 They can maintain normal behavior and correctly play their age-appropriate identities and roles on various occasions. Their views on society and their understanding of morality and ethics are basically consistent with the attitudes of most people in society, that is, they live in harmony with society.
3 The influencing factors and characteristics of mental health of the elderly
The mental health of the elderly in the modern sense [4], also known as mental health, refers to the development of personal emotions to the best within the scope of physical, intellectual and emotional adaptation to the mental health of others.
3. 1 Main factors affecting mental health of the elderly
3. 1. 1 Physiological factors After people enter old age, the ability, speed and quality of accepting new things are obviously reduced due to the degradation of physiological functions [5]. The decline of organ function caused by aging in the elderly is the basis of multiple organ failure [6]. Most elderly people have poor memory, narrow language activities and thinking range, and it is difficult to express their thoughts, which leads to obstacles in auditory understanding and judgment. It mainly includes: age, gender, increased diseases, decreased self-care ability, audio-visual dysfunction, Cognitive aging, lifestyle, etc. These are the normal physiological changes of the elderly. With the change of health status and social environment, the psychology of the elderly will change more or less, resulting in some mental health problems.
3. 1.2 Psychological factors mainly include: life events, economic income and cultural education, marriage and family, physical quality and cultural and sports activities. A person with high cultural literacy will have a correct attitude towards life, be able to correctly handle all setbacks and misfortunes encountered on the road of life, and will not cause psychological obstacles because of unexpected situations.
3. 1.3 Social factors mainly include: social support, individual participation in social leisure activities and community health services for the elderly [7]. People's mental health is directly related to the environment. Psychological research shows that moderate anxiety can maintain psychological balance through self-regulation, which is conducive to better adapting to changes in the body and environment [8]. Mental health is positively correlated with interpersonal satisfaction, family relationship satisfaction, life satisfaction, physical condition satisfaction, sleep satisfaction, cultural and sports activities satisfaction, economic income satisfaction and housing satisfaction [9].
3.2 Characteristics that affect the mental health of the elderly
3.2. 1 The brain and other organs in the body of lonely old people tend to decline, their functions decline, and they feel weak everywhere, especially psychologically they feel old, useless and lonely [10]. In addition, the elderly are widowed, live alone, retire, have little interpersonal communication, have changed their social and family status, have increased living space or are inconvenient to communicate physically and psychologically, so the elderly feel empty and lonely, often feel isolated or lonely psychologically, and then feel bored.
3.2.2 Anxiety and depression Psychological anxiety is the fear and depression that a person feels threatened. Depression is a gloomy and depressed negative psychology. It is reported that the incidence of depression in normal people is 10% ~ 23%, while the incidence of depression in elderly patients due to irreversible illness is significantly higher than that in normal people, which has a negative impact on the treatment of diseases. Most elderly people have negative emotions, especially those with disharmonious families [1 1]. Paying attention to the mental health of the elderly is an issue that cannot be ignored in comprehensively improving the quality of life of the elderly [12]. Depression is a persistent state of depression, often accompanied by anxiety and physical discomfort. Usually it has a strong concealment, and its manifestations vary from mild sadness to severe pain [13]. Due to the change of social role, the elderly will feel lost psychologically, thus showing two emotions: some are silent, indifferent and depressed, and indifferent to everything; Some people are grumpy, easy to lose their temper, don't like things around them, and lose their temper for a little thing.
3.2.3 Sensitive and suspicious elderly patients are often sensitive and suspicious, guessing that their illness is serious, and suspecting that doctors, nurses and even family members are deliberately hiding their illness from him. A small gesture and an unintentional word around him may arouse his suspicion and increase his psychological burden. When patients may have symptoms similar to those of incurable diseases and have doubts, they often show depression, sadness and reticence, and often lose their temper for no reason.
3.2.4 Fear Fear This is the initial reaction of the elderly when they enter the role of patients. I am afraid of the unfamiliar environment in the hospital, I am too worried about my illness, I am afraid of bringing trouble to my family, I am afraid of being annoyed by others, I am afraid of the bad attitude of medical staff, and I am afraid of accidents. , resulting in fear.
3.2.5 Suspicious old people think that they are old, have no future after illness, are on the verge of death, are disheartened, wait passively, and even do not receive treatment. Most of them are depressed, depressed, helpless, often crying secretly, unwilling to communicate or talk with others, indifferent to treatment and prognosis of diseases, unwilling to receive treatment and care, and passively waiting? Final destination? .
4 psychological care of the elderly
In view of the unique physiological and psychological characteristics of the elderly, according to individual differences and different psychology at different stages of the disease, nurses should not only have good psychological quality and exquisite nursing skills, but also use psychological nursing procedures for psychological evaluation and diagnosis, implement nursing and evaluation, and serve to restore and improve patients' health through the interaction between psychology and physiology and the dynamic role of psychology in the disease.
4. 1 psychological evaluation: carefully observe and understand the patient's personality, hobbies, illness changes and family environment, collect the patient's psychological information, and master their psychological activities, so as to carry out targeted personalized psychological care. The methods of collecting data are as follows: 1. Talk to patients directly; Second, talk to relatives of patients; And collect their psychological change information through psychological questionnaire.
4.2 Psychological diagnosis analyzes patients' psychology and puts forward psychological nursing diagnosis. For the elderly, psychological diagnosis is not completed at one time, and it should be constantly improved.
4.3 Implement measures to propose solutions to the psychological problems of elderly patients, and psychological counseling and counseling can be adopted. Specific measures are as follows.
4.3. 1 Good nurse-patient communication is the premise of psychological nursing. A good word warms three winters, but a bad word hurts June? Good language can make the elderly in the best psychological and physiological state needed for treatment and nursing. ① To communicate with the elderly patients, we should first adopt an inclusive attitude, be good at using the artistry and skills of language, take the initiative to talk with the elderly, understand the outstanding problems in their hearts, and patiently answer them, so as to achieve better cooperation. ② Respect the patient's personality, properly address the elderly patients, obtain their consent when nursing, and kindly avoid things that hurt the patient's self-esteem. (3) Win the trust of elderly patients with superb technology, eliminate their psychological barriers and actively cooperate with treatment. ④ Nurses should understand patients' emotional needs, take the initiative to contact patients more, give patients great care, take care of patients' daily life and meet the needs of medical care. Pay attention to civilized medical practice, be polite to others [14], and always use friendly language and considerate care to solve their maladjustment to the new environment after admission. Let them treat them as relatives and be willing to talk to us about their inner pain [15].
4.3.2 Respecting, understanding and caring for elderly patients is the key to psychological care. Old people, from warm families to strange hospitals, are not adapted to all the surrounding environment. Coupled with the torture of the disease and their ignorance of the disease, they have anxiety and fear. As a nurse who is in close contact with patients, we should first respect, care and cherish patients. We need to give them spiritual support and meticulous care for their lives, speak politely and kindly, listen to them patiently, forgive the forgetfulness and wordiness of the elderly and try our best to meet their demands. Never laugh at or dig at elderly patients and hurt their self-esteem.
4.3.3 Try to eliminate the influence of loneliness on elderly patients. Due to the strong dependence of the elderly, it is easy to feel lonely. Children are busy with work on weekdays and only use their spare time to accompany them, especially widowed elderly people. Emotional hunger? Phenomenon, especially need the care of nurses. So nurses should be patient, talk to them as much as possible, and listen to them patiently? Heart? Don't interrupt at will, don't make promises to them at will, and let them be satisfied mentally and psychologically, which is conducive to mental health and longevity. At the same time, we should strengthen social ties, encourage our relatives and friends, old colleagues and employees to visit, and arrange conversation activities for the elderly [16]. Encourage them to chat with patients around them, watch TV, listen to the radio and read various newspapers. Cultivate a variety of interests and enrich the content of life, so as to distract attention, adjust tension, eliminate loneliness and maintain a happy and good psychological state.
4.3.4 Actively maintaining the best psychological state of elderly patients is a necessary condition for obtaining good psychological treatment. Because the physiological function and personality of the elderly have changed obviously, we always give understanding, respect, sympathy and consideration to everything, and give a realistic answer with a scientific attitude to keep the elderly in the best psychological state.
4.4 Effect evaluation: Observation and investigation can be used to evaluate the effect of psychological care individually or comprehensively. Through the investigation of higher authorities, anonymous questionnaire survey and listening to the opinions of family members, we can collect more feedback information from patients on nursing work, find out the shortcomings in nursing work and the requirements of the elderly for nursing staff, so as to improve the nursing plan and improve the nursing work. Through psychological care for the elderly, adjust the role of patients in time, stabilize their emotions, help them enhance their adaptability, and actively cooperate with the treatment and nursing of medical staff to promote the body's disease resistance and accelerate the recovery of physical and mental health.
5 abstract
To sum up, psychological care of the elderly is an important part of psychological care research at present. Psychological nursing is different from psychological consultation and treatment, and it is a routine behavior. In view of the mental health problems of the elderly, humanistic care runs through, meeting the needs of patients to the greatest extent, improving the quality of nurses, making nurses change the old nursing concept and establish the concept of humanistic care. In the process of nursing, as long as the trust and harmonious relationship between doctors and patients, nurses and patients, family and society are established, and the necessary patience and skills are added, good results will be achieved.
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