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ChronicAnnaMarieAgustin, Acuteillnessisalimitedeventwithonset,treatment,andrecuperationphases,andsreturntotheirusuallifestyles,ifchangesrequired.急性疾病是一個(gè)有限的發(fā)作,治療和休養(yǎng)的,患者通?？梢曰謴?fù)平常Inacuteconditionsymptomsappearandchangeorworsenrapidly.急 Achronicconditiondevelopsandworsensoveranextendedperiodoftime.慢 Thereisnocompleterecuperationphase,andlifestylechangesareinevitableasthediseaseprogresses.隨著疾病的發(fā)展，慢 sexperienceachronicillness, nsofcaremustshiftfromafocusoncuretoafocusondisease/symptomscontrolandlifestylechanges.當(dāng)WhatischronicAdiseasethatpersistsforalongtime.長時(shí)間持續(xù)的AccordingtotheUSNationalCenterforHealthStatistic,achronicdiseaseisonelastingfor3monthsormore.根據(jù) Chronicdiseasesgenerallycannotbepreventedbyvaccinesorcuredbyanymedication.慢性疾病通常不能通過預(yù)防，也無法通過藥物治愈。Whydopeoplesufferfromchronicdisease?Healthdamagingbehaviorsparticularly–cigarettesmoking,lackofphysicalactivity,andpooreatinghabitsaremajorcontributorstotheleadingchronicdiseases.損害健康的行Exposuretorisk Obesityepidemic.Chronicdiseasestendtoemorecommonwithage.慢性疾病會(huì)隨著 municableDiseaseTheFiveLeadingCauseofDeath Thefiveleadingcauseofdeathfromchronic,municablediseasein個(gè)導(dǎo) 的因CardiovascularsuchashypertensionandChronicrespiratorysuchasCancersuchasbreastcolon 和腸RiskNon-ModifiableRiskFamily RaceModifiableRiskSmokingAlcoholDietandeatinghabitsSedentarylifestyleSocialandEnvironmentalfactorssuchasavailabilityofhealthyfoodoptions,andairpollution社會(huì)和環(huán)境的因素，例如：健康食Whatpeopleshouldknowaboutchronicdisease?Chronicdiseasesarefor7of10deathseachyear.每年10 Chronic,disablingconditionscausemajorlimitationsinactivityinevery1of10people.10人中就有1人因慢Chronicdiseasesaccountfor84%ofthenation’shealthcarecost.慢性疾病占國家健康 Chronic,municablediseasesaccountforanestimated80%oftotaldeathsand70%ofdisability-adjustedlifeyears(DALY).慢性非傳染性疾病占總?cè)藬?shù)的80%以及70%傷殘調(diào)整年Morethan300millionmensmokes大于3億的Morethan160millionarehypertensive–mostofwhomarenotbeingtreated.大于1.6億的人口患有高血壓——大多數(shù)沒有參與ycst–men%fne7o7ngsewtr.肥胖癥流行迫在眉睫——肥胖。Itissaidthatabout25%of deathsglobally–netEarth–areof sin .據(jù)統(tǒng) Theageingofthepopulationwillincreasetheincidenceofchronicdiseases.人 Manychronicconditionscanbepreventedbynotsmoking,beingphysicallyactive,andeatingnutritiousfoods.ManagementofHealthcanhelpreducetheprevalence,healtheffects,andcostsofchronicillnesses.Promotinghealthandwellnessprogramsatschools,worksites,healthcareandcommunity-basedsettings–lectures,seminars,posters,etc.加強(qiáng)健康 EnactingpoliciesthatsupporthealthychoicesandhealthyCreateawarenessandeducatethepublicabouttheirhealthandpreventionofchronicdisease–printandmediaadvertisements, Breastcancerawareness DiabetespreventionEnvironmentalhealthNutritionReproductivehealthInadditiontobeingthemostprevalentandcostlyhealthconditions,chronicdiseasesarealsoamongthemostpreventableofallhealthproblems.除了最普Physical$5.6billioninheartdiseasecostscouldsavedif10percentofadultsbeganaregularwalkingprogram.如果10%的成人開始步行計(jì)劃活 Physicalinactivitycontributestodiseaseanddisability,accountingfor22percentofcoloncancer,18percentofosteoporoticfractures,and12percentofdiabetesandhypertension.缺乏活 HealthOfthe50millionUSadultswithhighbloodpressure,70percentdonothavetheirbloodpressureundercontrol.5000萬的患有高血壓的美 ,morethan160millionarehypertensive–mostofwhomarenotbeingtreated. HealthAmammogramevery1-2yearsforwomenintheir40sand50sreducestheriskofdeathfrombreastcancerbyabout15percent.每1~2年進(jìn)行 Colorectalcancerscreeningcanreducethenumberofcoloncancerdeathsbyatleast30percent.直腸癌檢查可以降低30%的腸癌 Regularmedicalcheck-Regulareyetreatmentcouldpreventupto90percentofdiabetes-relatedblindness.常規(guī)的眼科檢查/及Regularfootexaminationandpatienteducationcouldpreventupto85percentofdiabetesrelatedamputations.防85%的HealthyCigarettesmokingisthesinglemostpreventablecauseofdeath.吸煙是最可預(yù)ImprovednutritionRegularexerciseRelaxationtechniquestohelpreducestress.運(yùn)用放松技巧幫CurativeThechallengeforhealthpractitionersischoosinganappropriatetherapeuticmanagementtoaddressthepatient’shealthcondition.Thisisusuallyachievedthroughtheapplicationofacombinationoftherapeuticandnon-therapeuticinterventionsthatisworkedonbythehealthcareteamandthepatient.醫(yī)療工作者的就是選擇合理的治療方案來幫助的健康狀況。這個(gè)通常需要醫(yī)療團(tuán)隊(duì)以及一起結(jié)合運(yùn)用治療性干預(yù)和非治療性Useoflifestylechanges(lifestylemodification)WeightmanagementprogramHealthydietReducedintakeofsaturatedfats減少飽和脂ReducedsodiumPatientswithchronicdiseasemaybeprescribedwithseveralmedicationstobetakenatthesametime&/orthroughouttheday.慢ProperuseofMedicationcompliance藥RehabilitativeWhensomeoneundergoestreatment(orsurgery)forchronicdiseasemanagementitcantaketimeforthemtoregaintheirabilitytogetaroundontheirownandmanagetheirdailyactivitiesonceagain.經(jīng)歷了慢性疾病治療（或手術(shù)）的人需要時(shí)間Nursesneedtoprovidesupportivecarethathelppatientsrestorehealthandindependenceandgetbacktolivingtheirlives.護(hù)PhysicalSpeech

RespiratoryPalliativePalliativecareisaspecialtypeofmedicalcarethatfocusesontreatmentofsymptomspeoplemayhavewhentheyarelivingwithachronic(longstanding)illness,suchascancerorheartfailure.Itisoftencomparedtothehospicecarethatisofferedtoterminallyillpeople. PalliativeTheWorldHealthdefinespalliativecareasaninterventionthatimprovesthequalityoflifeofpatientsandtheirfamiliesexperiencingintermittentillness,withtheultimategoalofbeingtoofferpainandsymptomrelief,aswellaspsychosocialandspiritualsupport.世界衛(wèi)生組織定義 GoalofPalliativeInpalliativecare,thegoalistoprovidethebestqualityoflifepossible–evenifsomeoneisnotterminallyill.HowisthisTreatmentofproblemssuchaspain,lossofappetite,nausea,depression,fatigue,etc.inpalliativetherapyallsymptomsareaddressedincludingphysical,emotional,psychological,andspiritualproblems.問

Relievecaregiverburden–chronicillnessputsspecialstressonfamilies,andhavingsupportcanbeveryhelpful.Anotherkeyfeatureofpalliativecareisit’sfocusonthepatient’sfamily,aswell.Talkingaboutand forthefuturecanhelpprepareaandthe ’sfamilytomakethebestchoicesforeveryoneinvolved.減輕患者負(fù) FocusofNursingHealthPatientContinuityofFollow-upChecksHealthUnderstandingthediseaseandthediseaseprocessThesadtruthisthatchronicdiseasesprogressesslowlyandmaypersistfortheremainderofa ’slife可Somepeoplearenotevenawaretheyhavethedisease.Othersareawareoftheirillnessesbuttheyknownothingonthemanagementoftheirillnesses.有些人沒有 Thekeypointisforthatnursesneedtohelpthepatientsinunderstandingthediseaseprocessandprovidecareandcomforttothe goingthroughthatprocess.Becausewithproperhealthteaching,patientswithchronicillnessescanstillenjoyahealthylifestyleandthereforehaveabetterlife.護(hù)士最關(guān)鍵的ManagementofHealtheducationactivitiesareconductedbyhealthcareprofessionalstohelppatientswithchronicdiseasesandhealthconditionsandlearntounderstandabouttheirconditionandlivesuccessfullyThetermisequivalenttodiseasemanagement(health)forchronicconditions.Theworkinvolvesmotivatingpatientstopersistinnecessarytherapiesandinterventionsandhel themachieveanongoing,reasonablequalityoflife.這個(gè)詞相當(dāng)于慢 TherapeuticChroniccaremanagementhelpspatientsystematicallymonitortheirprogressandcoordinatewithexpertstoidentifyandsolveanyproblemstheyencounterintheirtreatment.長期的護(hù)理管理可以幫 Patientswithchronicconditionshaveanimportantroleinthemanagementoftheirconditions,astheyareoftentheonesadministeringthetreatmentsineverydaylife.Theyalso yanimportantroleinmonitoringtheirhealthandchangesintheirhealthbymeansofObservationsofDailyLiving(OOLs).慢 Certainproblemsrelatedtochronicillnessesarenotspecificallymedical,butinvolvepatient’s ctionswithfamiliesand Interventionsoftenrequirepatientsandfamiliestomakedifficultlifestylechanges.一些慢性疾病的有關(guān) Patientsneedtobeeducatedonthebenefitsoftreatmentsandrisksofnotproperlyfollowingtheirtreatmentregimen. Theyneedtobemotivatedtocomplybecausetreatmentusuallyproducedanimprovedstate,ratherthantheresultthatmostpatientsdesire–a Therapeuticisaprocessinwhichanurseconsciouslyinfluencesa helpsthe toabetterunderstandingthroughverbalornon-verbalcommunicationincludingtherapeutictouchandactivelistening.這是一個(gè)護(hù)士不斷 Itinvolvestheuseofstrategiesthatencouragethepatienttoexpressfeelingsandideasthatconveyacceptanceandrespect.他涉及到策Whyistherapeuticcommunicationimportant?Anattempttointroducechangeinanunpreparedsituationwouldfailunlessguidanceandassistanceareoffered.在沒有TherapeuticCommunicationAllowingthepatientandtheirfamilytimetoadjusttothenewsetting.使 Provideandrespect alspacenomatterhowlimited無論Expectgrievingbehaviorsrelatedtolossoflifestyle,healthchangesandfamilychanges.預(yù)期到由生活方式的減少，健康狀ProvidethepatientandfamilymembersopportunitiestotalkaboutorexpresstheirfeelingsinprivateifatallpossibleIncludethepatientandfamilyin nningroutinesandactivitieswheneverpossible.提供患者和家屬在私密空間討論以及表達(dá)的機(jī)Ifnewcareroutinesmustbeestablished,worktogethertoestablishroutinesthatwillbecarriedoverintothehomeroutinesasmuchaspossible若要建立新的常規(guī)護(hù)理，盡可能共建立并列Letthepatientknowwhothecaregiverswillbeandhowtoinformthemifneedsarise.讓患者知道誰是看護(hù)著以及有需要將如何告知。Supportgroups&/orservicesavailablee.g.diabetessociety,nationalchronicpainassociation,etc.組織 等Culturalpracticesthatneedtobeincorporatedinthepatient’scare.MedicalID FoodPatientplianceisamajorobstacleinthedeliveryofhealthcare. Inmedicine,compliancedescribesthedegreetowhichapatientcorrectlyfollowsamedicaladvice.Mostcommonlyitreferstomedicationordrugcompliance,butitcanalsoapplytoothersituationssuchasuseofmedicaldevise,self-care,exercises,ortherapysessions. Thehealthcareproviderandthepatientmustmakedecisiontogetheraboutthetreatmentthereforeagoodrelationshipisthemostimportantfactorinimprovingcompliance.Top3ReasonsforKnowledgedeficitAdverseeffectsofmedication(sCostofmedication(sandtherapy藥物和治Inhealthcarepracticeoutsideofthehospital,about80%ofthediseasestreatedarechronic.Althoughmuchofthetreatmentisremarkablyefficient,itsqualityisoftenfarfromsatisfactory.Mostpatientsdonotcomplywithinstructions.Fewerthan50%followtheirtreatmentcorrectly.大部分的 Ithasbeenobservedthatpatientsareinadequa yinformedabouttheirconditionandthatfewhave nhelpe manageortakeresponsibilityfortheir Thoughmosthealthcareprovidersarehighlycompetentinthediagnosisandtreatmenttoofeweducatetheirpatientstomanagetheircondition.Theremaybeseveralreasonsforfailingtoeducatepatients,suchastoolittletimeorlackofawarenessoftheneedtodoso盡管大AdverseeffectsofPatientscansufferfromavarietyofadverseeffectsfromtheirmedication(s).Thisaffectthequalityof life.Otherthanthat,thebeneficialeffectforsomemedicationscannotbeexperiencedimmedia y.Somepatientswillevensaythattheyfeltbetterbeforetakingtheirmedications.Thiscanleadtodiscontinuanceoftheirmedication(s). Irregularintake&/ordiscontinuanceofmedicationcanworsenorprogressthedisease.Costofmedications&/ortherapy藥物和治療成本Therisingcostofmedicinesisanotherfactor.Mostpatientswhofeltbetterdiscontinuetheirmedicationanddonotcomplywiththeirmedicalcheck-ups醫(yī)療成本的上升也是另一個(gè)主ContinuityofTheimportanceofseeingthesamedoctorateachappointmenthelpbuilduptrustandconfidenceinthedoctorandthatpatientsaremorelikelytobeprovidedwithamoreconsistentadvice.Importanceoffollow-upcarePatientswithachronicillnessmayneedregularcheckstomonitortheirhealthandwell-being.慢病患者需要 Thismayinvolvecertaintestssuchasbloodtest