| Objectives:1.Understand the status quo of the adaptability of the elderly persons in nursing homes and relevant influencing factors.2.Explore the effect of narrative nursing on the mental adaptation of the elderly persons in nursing homes through a randomized controlled study,so as to provide reference for the intervention on the mental adaptation of the elderly persons in nursing homes in the future.Methods:1.Cross-sectional survey: Based to the inclusion and exclusion criteria,216 elderly persons in 9 nursing homes in 6 cities and counties in Fuzhou were screened with the convenience sampling method,and their basic information,Social-Adaptive Functioning Evaluation(SAFE)and other data were collected and used to analyze the factors influencing the adaptability of the elderly persons in nursing homes.2.Randomized controlled trial: 102 elderly persons with SAFE≤16 points in 5nursing homes in downtown Fuzhou and Minhou County were included in the study from January to December 2020.Among others,95 elderly persons completed the study.There were 48 subjects in the Control Group and 47 subjects in the Intervention Group.The Control Group was given routine care,while the Intervention Group was given both routine care and narrative nursing intervention,one time per week,30-60 minutes each time,for 12 weeks.Forms and scales such as SAFE,GDS-15,SAS and LSIA were used before and at the 12 th week of the intervention to evaluate the intervention effect.Results:1.Cross-sectional survey: The average SAFE score of the elderly persons in nursing homes was(12.04 ± 11.93),and 65.2% of these elderly persons had poor or very poor adaptability(including 42.1% with poor adaptability and 23.1% with very poor adaptability).Occupation before retirement,the length of stay in nursing homes,physical handicap,communication with other elderly persons in nursing homes,and participation in activities organized in nursing homes are important factors affecting the adaptability of the elderly persons in nursing homes.The elderly who were in charge of organizations and units before retirement had the highest SAFE score(20.70±9.24),followed by military personnel(20.57±9.07),and other practitioners with inconvenience classification scored the lowest(0.83±12.72).The elderly who stayed in less than 1 year scored the lowest(7.62±12.22).The score(6.15±12.78)of the elderly with physical impairment is lower than that of the elderly without physical impairment(15.64±9.80).The elderly who often communicate with other elderly people scored the highest(16.56±9.46).Those who frequently participate in activities scored the highest(17.74±9.62).2.Randomized controlled trial:(1)Comparison of balance: The basic data,the basic situation of living in nursing homes,the scores of each scale,and the level of adaptability of two groups were comparable.(2)Adaptability:(1)SAFE scores: After the intervention,the SAFE scores 12.00(6.00～18.00)of the Intervention Group were higher than those scores 8.00(0.00～14.00)before intervention(z=-5.962,p=0.000)and those scores 10.00(2.00～14.00)of the Control Group(z=-2.382,p=0.017).Before and after the intervention,there was a significant difference(z=-3.143,p=0.002)in the SAFE scores of the Control Group.(2)Level of Adaptability: Both the Control Group and the Intervention Group had significant differences(p=0.003,p=0.000)in the level of adaptability within the group.What’s more,the level of adaptability of the Intervention Group was significantly higher than that of the Control Group(z=-2.343,p=0.019).(3)Depression symptoms: After the intervention,the GDS-15 scores(4.81±2.53)of the Intervention Group were lower than those scores(7.68±3.31)before intervention(t=13.832,p=0.000)and those scores(7.13±3.72)of the Control Group(t=3.538,p=0.001).Before and after the intervention,there was no significant difference(t=1.430,p=0.159)in the GDS-15 scores of the Control Group.(4)Anxiety symptoms: After the intervention,the SAS scores(42.98±8.06)of the Intervention Group were lower than those scores(49.18±8.97)before intervention(t=13.179,p=0.000)and those scores(47.97±9.03)of the Control Group(t=2.840,p=0.006).Before and after the intervention,there was a significant difference(t=2.104,p=0.041)in the SAS scores of the Control Group.(5)Life satisfaction: After the intervention,the LSIA scores(12.26±3.85)of the Intervention Group were higher than those scores(8.60±4.26)before intervention(t=-21.515,p=0.000)and those scores(10.13±3.34)of the Control Group(t=-2.883,p=0.005).Before and after the intervention,there was no significant difference(t=-1.860,p=0.069)in the LSIA scores of the Control Group.Conclusion:1.Cross-sectional survey: The elderly persons in nursing homes generally has poor adaptability.Occupation before retirement,the length of stay in nursing homes,physical handicaps,communication with other elderly persons in nursing homes,and participation in the activities organized in nursing homes are the important factors affecting the adaptability of the elderly persons in nursing homes.Caregivers should pay special attention to the adjustment of the newly admitted elderly.At the time of admission,caregivers should comprehensively evaluate the elderly,so as to carry out personalized care services for different groups,and provide medical services,rehabilitation training guidance and nursing care for the elderly with physical disabilities.The staff can organize various activities on a regular basis to help the elderly establish new social support system and interpersonal communication system,so as to help them better adapt to the life of nursing homes.2.Cross-sectional survey: For the elderly persons in nursing homes,narrative nursing can improve their adaptability,reduce their depression,reduce their anxiety,raise their life satisfaction.It provides a new way of thinking for nursing homes to carry out mental health guidance and organize activities for the elderly with adaptive problems. |
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