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The Impact of the Physical Home Environment for Family Carers of People with Dementia: A Qualitative Study 家庭物理环境对痴呆症患者家庭照顾者的影响:一项质性研究
Pub Date : 2017-10-02 DOI: 10.1080/02763893.2017.1335666
Dia Soilemezi, Phevos Kallitsis, A. Drahota, J. Crossland, R. Stores, A. Costall
Abstract Background: The majority of people with dementia are cared for by their families at home. This study aimed to elicit family carers' perceptions on home environmental aspects and strategies with the view to identify barriers and facilitators when caring for a person with dementia at home. Design and methods: Thirteen co-resident family carers were engaged in semi-structured in-depth walking interviews. Interviews were recorded, transcribed and analysed using thematic analysis. Results: Home environments can pose a number of challenges and opportunities. Aspects of the architectural and interior environment (e.g. size, condition, layout and accessibility, familiarity) are perceived as important (Theme 1) as well as a plethora of environmental strategies that encourage independence and comfort at home (Theme 2). Carers' scepticism, timing, costs, property characteristics and mistrust to services are some barriers to implementing environmental strategies (Theme 3). Conclusions: Carers improvised solutions via trial and error and need further education on strategies to create an enabling and comfortable home environment.
摘要背景:大多数痴呆症患者由家人在家照顾。本研究旨在了解家庭护理人员对家庭环境方面和策略的看法,以确定在家护理痴呆症患者时的障碍和促进因素。设计和方法:13名共同居住的家庭护理人员参与了半结构化的深入步行访谈。访谈采用专题分析法进行记录、转录和分析。结果:家庭环境可能带来许多挑战和机遇。建筑和室内环境的各个方面(例如大小、条件、布局和可达性、熟悉度)被认为是重要的(主题1),以及鼓励在家独立和舒适的大量环境策略(主题2)。护理人员的怀疑、时间、成本、财产特征和对服务的不信任是实施环境战略的一些障碍(主题3)。结论:护理人员通过试错即兴制定了解决方案,需要进一步学习创造有利和舒适的家庭环境的策略。
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引用次数: 9
Housing in Old Age: Dynamical Interactions Between Neighborhood Attachment, Neighbor Annoyance, and Residential Satisfaction 老年居住:邻里依恋、邻居烦恼与居住满意度的动态交互作用
Pub Date : 2017-08-31 DOI: 10.1080/02763893.2017.1335671
A. Beyer, Stefan T. Kamin, F. Lang
ABSTRACT Objective: Residential satisfaction and neighborhood quality play major roles in aging well. However, longitudinal research about the interplay between such factors is still sparse. Our 1-year study examined whether change in residential satisfaction was associated with change in two indicators of neighborhood quality: neighborhood attachment and neighbor annoyance. Methods: Findings come from a longitudinal study with 85 community-dwelling German older adults (age range: 60 to 92 years). Participants filled out questionnaires at two measurements that were 1 year apart. The interplay between residential satisfaction and neighborhood was explored using a cross-path model. Results: Higher levels of residential satisfaction predicted enhanced attachment and reduced annoyance over time. Moreover, attachment predicted positive change in residential satisfaction over the course of 1 year. Conclusion: Results suggest that older adults may apply adaptive behaviors and strategies to optimize their neighborly experiences. Such findings have implications for improving residential satisfaction in community-dwelling older adults.
【摘要】目的:居住满意度和邻里环境质量对老年人生活质量的影响。然而,关于这些因素之间相互作用的纵向研究仍然很少。我们为期一年的研究考察了居住满意度的变化是否与社区质量的两个指标的变化有关:社区依恋和邻居烦恼。方法:研究结果来自一项对85名居住在德国社区的老年人(年龄范围:60至92岁)的纵向研究。参与者在两次测量中填写问卷,间隔一年。使用交叉路径模型探讨了居住满意度与邻里关系之间的相互作用。结果:随着时间的推移,较高的居住满意度水平预示着依恋的增强和烦恼的减少。此外,在1年的过程中,依恋预测了居住满意度的积极变化。结论:老年人可以运用适应性行为和策略来优化邻里体验。这些发现对提高社区居住老年人的居住满意度具有启示意义。
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引用次数: 9
Formal Volunteering among Vulnerable Older Adults from an Environmental Perspective: Does Senior Housing Matter? 从环境角度看弱势老年人的正式志愿服务:老年住房重要吗?
Pub Date : 2017-07-28 DOI: 10.1080/02763893.2017.1335668
Sojung Park, BoRin Kim, Joonyoung Cho
ABSTRACT Based on the premise that environmental support is an important facilitator for engagement in formal volunteering among vulnerable subgroups of older adults, we focus on older low-income individuals who live alone. Drawing on the environmental docility hypothesis, we examine the role living in senior housing has on the likelihood of volunteering. Data came from the 2012 wave of the Health Retirement Study (N = 1415). Kernel weights derived from propensity scores were used to account for observed sociodemographic and health characteristics associated with both senior housing living and the outcome. Logistic regression models showed that living in senior housing positively affected engagement in formal volunteering after adjusting for personal and environmental factors. As a modifiable target of intervention for successful and healthy aging, our findings provide important background knowledge for the development and implementation of housing-specific volunteer programs for vulnerable elders.
摘要基于环境支持是老年人弱势群体参与正式志愿服务的重要促进因素这一前提,我们将重点关注独居的低收入老年人。根据环境顺从性假设,我们研究了居住在养老院对志愿服务可能性的影响。数据来自2012年的健康退休研究浪潮(N=1415)。从倾向得分得出的核心权重用于解释观察到的与老年住房生活和结果相关的社会人口统计学和健康特征。Logistic回归模型显示,在调整了个人和环境因素后,居住在养老院对正式志愿服务的参与产生了积极影响。作为成功健康老龄化干预的可修改目标,我们的研究结果为弱势老年人住房专项志愿者计划的制定和实施提供了重要的背景知识。
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引用次数: 4
Effects of Impact-Absorbing Flooring in Residential Care from the Perspectives of Enrolled Nurses 从注册护士的角度看冲击吸收地板在寄宿护理中的作用
Pub Date : 2017-07-28 DOI: 10.1080/02763893.2017.1335670
J. Gustavsson, Gullbritt Rahm, Carolina Jernbro, F. Nilson
ABSTRACT Falls are a daily occurrence in nursing homes and few interventions for reducing fall-related injuries have proven to be effective. Impact absorbing flooring (IAF) in residential care has shown promising results in reducing fall-injuries and in the process of developing and implementing IAF all aspects are valuable to explore. Therefore, the aim of this qualitative study is to describe the enrolled nurses (ENs) experiences of IAF. We carried out focus group interviews with ENs and used content analysis to process the data. The ENs experienced both negative and positive aspects with the IAF. Importantly, the ENs perceived the IAF as effective in preventing fall-injuries. They also appreciated the improvements in acoustics. Negative aspects were that the flooring initially was challenging to walk on and that it made it harder to maneuver heavy equipment. A significant and transferable finding in this study was the importance of the ENs' perceived difficulty in preventing fall-injuries amongst elderly people living in nursing homes. This seemed to be a driving force to accept the intervention. Although IAF affects the working conditions in a nursing home, ENs are willing to accept these issues given the perceived effectiveness of the intervention.
摘要跌倒在养老院每天都会发生,很少有干预措施能有效减少与跌倒有关的伤害。住宅护理中的冲击吸收地板(IAF)在减少跌倒伤害方面显示出了良好的效果,在开发和实施IAF的过程中,所有方面都值得探索。因此,本定性研究的目的是描述注册护士在IAF中的经历。我们对ENs进行了焦点小组访谈,并使用内容分析来处理数据。ENs在IAF中经历了消极和积极的一面。重要的是,ENs认为IAF在预防跌倒伤害方面是有效的。他们也对声学方面的改进表示赞赏。不利的方面是,地板最初很难行走,而且它使重型设备更难操作。这项研究中的一个重要且可转移的发现是,在养老院的老年人中,ENs在预防跌倒伤害方面的困难是重要的。这似乎是接受干预的动力。尽管IAF会影响养老院的工作条件,但考虑到干预的有效性,ENs愿意接受这些问题。
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引用次数: 10
Medicaid Beneficiaries' Access to Residential Care Settings 医疗补助受益人获得住院护理的机会
Pub Date : 2017-07-28 DOI: 10.1080/02763893.2017.1335669
M. Lepore, M. Knowles, Kristie A Porter, J. O'keeffe, J. Wiener
ABSTRACT Residential care settings (RCSs) are community-based housing and supportive services providers. Medicaid beneficiaries' access to RCSs is of concern to policymakers and other stakeholders because most people prefer community-based to institutional services and RCSs are generally less expensive than nursing homes. To better understand Medicaid beneficiaries' access to state-licensed RCSs, we examined Medicaid policies in 50 states and the District of Columbia, interviewed seven subject-matter experts, and conducted four state case studies informed by reviews of state policies and interviews with 27 stakeholders. Factors identified as influencing Medicaid beneficiaries' access to RCSs include Medicaid reimbursement rates for RCS services, the supply of Medicaid-certified RCSs and RCS beds, and policies that affect RCS room and board costs for Medicaid beneficiaries. Shifting Medicaid spending toward community-based instead of institutional care may require attention to these interrelated issues of RCS payment, supply, and room and board costs.
摘要养老机构是以社区为基础的住房和支持性服务提供者。医疗补助受益人获得RCS是政策制定者和其他利益相关者关注的问题,因为大多数人更喜欢社区服务而不是机构服务,而且RCS通常比疗养院便宜。为了更好地了解医疗补助受益人获得州许可的RCS,我们研究了50个州和哥伦比亚特区的医疗补助政策,采访了7位主题专家,并根据对州政策的审查和对27位利益相关者的采访,进行了4个州的案例研究。被确定为影响医疗补助受益人获得RCS的因素包括RCS服务的医疗补助报销率、医疗补助认证的RCS和RCS床位的供应,以及影响医疗援受益人RCS食宿费用的政策。将医疗补助支出转向社区而非机构护理可能需要关注RCS支付、供应以及食宿费用等相互关联的问题。
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引用次数: 8
Factors Influencing Family-Member Perception of “Homelikeness” in Long-Term Care Homes 影响长期护理院家庭成员“相似性”认知的因素
Pub Date : 2017-07-28 DOI: 10.1080/02763893.2017.1335672
Stephanie A. Chamberlain, L. Weeks, J. Keefe
ABSTRACT Background: A number of long-term care homes in Nova Scotia, Canada, have been built or redesigned with new models of care with expanded care aide scope of practice and neighborhood-style layouts. Our objective was to examine what physical characteristics (bed size, owner-operator), model of care, and relational (family–staff relationship, perceived staff–resident relationship) factors were associated with increased family-member perception of homelikeness in long-term care homes. Methods: We analyzed surveys collected from 273 family members from 23 long-term care homes in Nova Scotia, Canada. We conducted a multivariate linear regression to assess variables associated with increased family-member perception of homelikeness. Results: We found that relationships between family and staff, perceived resident-to-resident relationships, and family involvement in decision making were positively associated with increased family perception of homelikeness. We found no significant associations between model of care or physical characteristics and increased family perception of homelikeness. Conclusion: Relationships among family members, residents, and staff are integral to family members feeling at home in their loved one's long-term care home. Feeling at home in long-term care is largely related to family-member perception of meaningful social interactions between family and staff, and between residents.
背景:加拿大新斯科舍省的一些长期护理院已经建成或重新设计了新的护理模式,扩大了护理助手的实践范围和社区风格的布局。我们的目的是研究在长期护理院中,哪些物理特征(床位大小、业主-经营者)、护理模式和关系(家庭-员工关系、感知到的员工-住院关系)因素与家庭成员对家的感觉增加有关。方法:我们分析了来自加拿大新斯科舍省23家长期护理院的273名家庭成员的调查。我们进行了多元线性回归,以评估与增加家庭成员的相似性感知相关的变量。结果:我们发现家庭与工作人员之间的关系,感知到的住院医师与住院医师之间的关系,以及家庭参与决策与家庭对家的感知增加正相关。我们发现护理模式或身体特征与家庭对家庭相像感的增加之间没有显著的关联。结论:家庭成员、住院医师和工作人员之间的关系对于家庭成员在他们所爱的长期护理之家有家的感觉是不可或缺的。在长期照护中,家的感觉主要与家庭成员对家庭与工作人员之间,以及居民之间有意义的社会互动的感知有关。
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引用次数: 0
Environmental and Behavioral Circumstances and Consequences of Falls in a Senior Living Development 老年人生活发展中跌倒的环境和行为环境及后果
Pub Date : 2017-07-03 DOI: 10.1080/02763893.2017.1335667
Daejin Kim, S. Ahrentzen
ABSTRACT This article investigated the role of environmental and behavioral factors surrounding fall incidents in a senior living community. Using a mixed-methods approach, this research included both a retrospective analysis of fall reports and resident interviews. The quantitative analysis showed falls in the bedroom and bathroom were more likely to happen between 12 am and 8 am. Falls in the bathroom were more likely to result in severe injuries compared to falls in other rooms. The qualitative analysis identified three types of fall-related activity (transfer, ambulation, standing) and five behavioral factors surrounding fall incidents (transferring, slipping, misjudged behavior, tripping, health issue).
摘要:本文研究了环境和行为因素在老年生活社区中跌倒事件中的作用。本研究采用混合方法,包括对秋季报告和住院医师访谈的回顾性分析。定量分析显示,早上12点到8点之间,在卧室和浴室摔倒的可能性更大。与在其他房间摔倒相比,在浴室摔倒更容易导致严重伤害。定性分析确定了三种与跌倒相关的活动(转移、走动、站立)和与跌倒事件相关的五种行为因素(转移、滑倒、误判行为、绊倒、健康问题)。
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引用次数: 6
Housing Governance and Senses of Home in Older Age: The Provider Scale 住房治理与老年人的家园感:提供者规模
Pub Date : 2017-07-03 DOI: 10.1080/02763893.2016.1268561
Emma R. Power
ABSTRACT Extensive research examines senses of home in aging, focusing on built and care environments. In parallel, a body of work examines housing governance, reviewing degrees of resident satisfaction. However, there is little crossover between this work, with governance research only rarely considering senses of home. This article argues for attention to the interconnections between provider-scale housing governance and senses of home in older age, arguing that governance mechanisms structure the housing context and provide the framework through which home is experienced and lived. Through a case study of a small, affordable housing community in Sydney, Australia, it shows that housing governance can profoundly shape senses of home in aging, both contributing to and diminishing senses of home. Further, it points to a connection between housing governance and housing design with different housing typologies associated with different aging bodies and forms of management practice, with profound implications for residents' senses of home.
摘要广泛的研究考察了老年人对家的感觉,重点关注建筑和护理环境。与此同时,一系列工作审查了住房管理,审查了居民的满意度。然而,这项工作之间几乎没有交叉,治理研究很少考虑家的感觉。本文主张关注提供者规模的住房治理与老年人的家园感之间的相互联系,认为治理机制构建了住房环境,并提供了体验和生活家园的框架。通过对澳大利亚悉尼一个小型经济适用房社区的案例研究,它表明,住房治理可以深刻塑造老龄化中的家园感,既有助于增强家园感,也有助于削弱家园感。此外,它指出了住房治理和住房设计之间的联系,不同的住房类型与不同的老龄化身体和管理实践形式有关,对居民的家园感有着深远的影响。
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引用次数: 6
Defining the Goals of Age-Friendly Interventions 确定老年友好干预的目标
Pub Date : 2017-04-03 DOI: 10.1080/02763893.2017.1309925
A. Glicksman, L. Ring
Abstract While the term “age-friendly” has become ubiquitous in the field of social gerontology, a clear definition of the term remains elusive. In an effort to clarify the role of age-friendly initiatives, Menec and colleagues presented a framework focused on social connectivity within an ecological model. The articles in this special issue address issues raised by this approach and its implications for policy, programs and scientific research.
虽然“老年友好”一词在社会老年学领域已经变得无处不在,但该术语的明确定义仍然难以捉摸。为了阐明老年友好倡议的作用,Menec和他的同事提出了一个框架,重点关注生态模型中的社会联系。本期特刊的文章讨论了这种方法提出的问题及其对政策、项目和科学研究的影响。
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引用次数: 9
The Future of Age-Friendly: Building a More Inclusive Model Using Principles of Ecology and Social Capital 老年友好的未来:利用生态和社会资本原理构建更具包容性的模式
Pub Date : 2017-04-03 DOI: 10.1080/02763893.2017.1309930
L. Ring, A. Glicksman, M. Kleban, J. Norstrand
ABSTRACT Menec's (2011) framework for understanding age-friendly efforts rests on two ideas: first, that we need to take an ecological approach to develop these programs; second, that social connectedness forms the core of what makes a program age-friendly. Building on previous research in which we demonstrated the association between social connectedness and the health outcomes that are often the goals of age-friendly efforts, we added an environmental measure in order to determine if using an ecological approach improves our understanding of the relation of social connectedness to health outcomes. We discovered that the added measure does strengthen our model.
Menec(2011)关于理解老年友好努力的框架基于两个想法:首先,我们需要采取生态方法来制定这些计划;其次,这种社会联系构成了一个项目对年龄友好的核心。在之前的研究中,我们证明了社会联系与健康结果之间的联系,而健康结果往往是老年人友好努力的目标,在此基础上,我们增加了一项环境措施,以确定使用生态方法是否能提高我们对社会联系与健康结果关系的理解。我们发现,增加的措施确实加强了我们的模型。
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引用次数: 4
期刊
Journal of Housing for the Elderly
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