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Loneliness and social isolation of ethnic minority/immigrant older adults: a scoping review 少数民族/移民老年人的孤独感和社会隔离:范围界定审查
IF 2.5 3区 社会学 Q2 GERONTOLOGY Pub Date : 2024-06-04 DOI: 10.1017/s0144686x24000205
Mengxing Joshi, Nissa Finney, Jo Mhairi Hale

Loneliness and social isolation among older adults are emerging public health concerns. Older adults from ethnic minority communities or with immigration backgrounds may be particularly vulnerable when encountering loneliness and social isolation due to the double jeopardy of their old age and minority status. The goal of this study is to conduct a scoping review of published journal articles on ethnic minority/immigrant older adults' loneliness and social isolation experiences to show the extent, range and nature of empirical studies in this area across several high-income countries (i.e. European countries, United States of America (USA), Canada, Australia and New Zealand). This review uses Arksey and O'Malley's five-state framework, a well-established scoping review method. We identify and analyse 76 articles published between 1983 and 2021. This evidence base is largely US-focused (54%) with the vast majority (76%) having a quantitative design. We summarise and map factors of loneliness and social isolation into a multi-dimensional socio-ecological model. By doing so, we show how ethnicity/immigration-specific factors and general factors intersect in multiple dimensions across places and time, shaping ethnic minority/immigrant older adults' heterogeneous experiences of loneliness and social isolation. Several critical gaps that should be at the forefront of future research are highlighted and discussed.

老年人的孤独和社会隔离是新出现的公共健康问题。来自少数族裔社区或有移民背景的老年人由于年老和少数族裔身份的双重危险,在遭遇孤独和社会隔离时可能特别脆弱。本研究的目的是对期刊上发表的有关少数族裔/移民老年人孤独和社会隔离经历的文章进行一次范围性综述,以显示几个高收入国家(即欧洲国家、美利坚合众国(美国)、加拿大、澳大利亚和新西兰)在这一领域的实证研究的程度、范围和性质。本综述采用了 Arksey 和 O'Malley 的五状态框架,这是一种行之有效的范围界定综述方法。我们确定并分析了 1983 年至 2021 年间发表的 76 篇文章。这些证据主要集中在美国(54%),其中绝大多数(76%)采用了定量设计。我们总结了孤独和社会隔离的因素,并将其绘制成一个多维社会生态模型。通过这种方法,我们展示了种族/移民特定因素和一般因素如何在不同地点和时间的多个维度上相互交织,从而形成了少数民族/移民老年人孤独和社会隔离的不同经历。本文强调并讨论了未来研究应关注的几个关键缺口。
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引用次数: 0
Labour market exit routes in high- and low-educated older workers before and after social insurance and retirement policy reforms in Sweden 瑞典社会保险和退休政策改革前后高学历和低学历老年劳动者退出劳动力市场的途径
IF 2.5 3区 社会学 Q2 GERONTOLOGY Pub Date : 2024-05-31 DOI: 10.1017/s0144686x24000047
Melody Almroth, Daniel Falkstedt, Tomas Hemmingsson, Maria Albin, Kathryn Badarin, Jenny Selander, Per Gustavsson, Theo Bodin, Emelie Thern, Kuan-Yu Pan, Katarina Kjellberg

Few previous studies have investigated how socioeconomic differences in labour market exit have changed after restrictions in social insurance policies. The aim of this register-based study is to investigate how early labour market exit pathways among older men and women with different levels of education changed after major restrictive social insurance and retirement policy reforms in Sweden. Cohort 1 (pre-reform) consisted of individuals who were 60 or 61 years old in 2005 (N = 186,145) and Cohort 2 (post-reform) consisted of individuals who were 60 or 61 years old in 2012 (N = 176,216). Educational differences in four labour market exit pathways were investigated using Cox proportional hazards regression; the exit pathways were disability pension, early old-age pension with and without income respectively, and no income for two consecutive years. As expected, exits through disability pension were rarer in Cohort 2. Lower education was also more strongly associated with disability pension in Cohort 2. Parallel to this, lower education showed a stronger association with both early old-age pension types in Cohort 2. Additionally, a tendency towards a relatively higher likelihood of earning no income was seen among the less educated. Increases in inequalities tended to be greater for women. Our results indicate that educational inequalities in labour market exit have grown significantly after restrictions in social insurance and changes in retirement policies, which can have negative financial repercussions for those already in a vulnerable position. These results indicate that careful analyses of effects on disparities are needed before making major changes in welfare systems.

以往很少有研究调查在社会保险政策限制之后,劳动力市场退出的社会经济差异是如何变化的。这项基于登记册的研究旨在调查在瑞典进行重大限制性社会保险和退休政策改革后,不同教育水平的老年男性和女性早期退出劳动力市场的途径发生了怎样的变化。组群 1(改革前)包括 2005 年年满 60 或 61 岁的人(样本数 = 186,145 人),组群 2(改革后)包括 2012 年年满 60 或 61 岁的人(样本数 = 176,216 人)。利用考克斯比例危险回归法调查了四种劳动力市场退出途径的教育差异;退出途径分别是残疾抚恤金、有收入和无收入的早期养老金以及连续两年无收入。不出所料,在第二组群中,通过残疾抚恤金退出的情况较少。在第 2 组中,教育程度较低与残疾抚恤金的关系也更为密切。与此同时,在第 2 组群中,较低的教育程度与两种早期养老金类型都有更强的关联。此外,在受教育程度较低的人群中,没有收入的可能性相对较高。女性的不平等程度往往更高。我们的研究结果表明,在限制社会保险和改变退休政策之后,劳动力市场退出方面的教育不平等现象显著增加,这可能会对那些已经处于弱势地位的人造成负面的经济影响。这些结果表明,在对福利制度进行重大改革之前,需要仔细分析对差距的影响。
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引用次数: 0
Social engagement and wellbeing in late life: a systematic review 晚年的社会参与和福祉:系统性综述
IF 2.5 3区 社会学 Q2 GERONTOLOGY Pub Date : 2024-05-08 DOI: 10.1017/s0144686x24000011
Joana Miguelote Monteiro, Raquel Gonçalves, Alice Bastos, Maria Raquel Barbosa

Social engagement is considered a relevant modifiable factor for older adults' wellbeing. Theory and policies highlight its importance for ageing well. Empirical evidence shows that social activities are associated with positive psychological outcomes and might buffer wellbeing declines in late life. Despite growing research, social engagement lacks conceptual clarity, it is difficult to adopt standardised measures and findings are sometimes inconsistent. Previous systematic reviews either take a different approach to this topic or were published over a decade ago. Therefore, the present study aimed to review the literature systematically regarding the relationship between social engagement and wellbeing in community-dwelling older adults. Papers published from 2000 to 2021 were searched in five databases using a combination of terms. The reviewers screened the records according to predefined inclusion and exclusion criteria. After identifying eligible articles, the authors extracted data and produced a narrative synthesis covering conceptualisation, measurement and main findings. The review includes 42 papers. Despite great conceptual and methodological diversity, research supports that older adults with higher participation in social activities have improved wellbeing. Findings also suggest that these associations are stronger for individuals with disadvantages and have a cumulative nature whereby the greater the social engagement, the higher the wellbeing. Conversely, for more demanding activities, there might be optimal participation levels. Regardless of accumulating knowledge, social engagement remains diffuse and difficult to measure. This paper summarises the current state of research on this topic, showing encouraging evidence of social engagement benefits, but also questions that deserve further inquiry. Future studies should be anchored in a clear conceptual framework, use robust measures, and explore hedonic and eudaimonic wellbeing. Social engagement can be an important developmental resource for social interventions and policies aimed at improving people's lives.

社会参与被认为是老年人福祉的一个相关可调节因素。理论和政策都强调了社会参与对安享晚年的重要性。经验证据表明,社交活动与积极的心理结果有关,并可缓冲晚年幸福感的下降。尽管研究越来越多,但社会参与的概念并不清晰,很难采用标准化的测量方法,研究结果有时也不一致。以往的系统性综述要么对这一主题采取了不同的方法,要么是在十多年前发表的。因此,本研究旨在系统回顾有关社区老年人社会参与与幸福感之间关系的文献。研究人员使用多种术语在五个数据库中检索了 2000 年至 2021 年间发表的文献。审稿人根据预先确定的纳入和排除标准对记录进行筛选。在确定了符合条件的文章后,作者提取了数据,并撰写了涵盖概念、测量和主要发现的叙述性综述。综述包括 42 篇论文。尽管在概念和方法上存在很大差异,但研究支持参与社会活动较多的老年人的幸福感有所提高。研究结果还表明,对于处境不利的人来说,这些关联性更强,而且具有累积性,即社会参与度越高,幸福感越强。相反,对于要求较高的活动,可能会有最佳的参与水平。尽管知识在不断积累,但社会参与度仍然很分散,难以衡量。本文总结了这一主题的研究现状,显示了社会参与益处的令人鼓舞的证据,但也提出了值得进一步探究的问题。未来的研究应立足于一个清晰的概念框架,使用可靠的测量方法,并探讨享乐型和幸福型福利。社会参与可以成为旨在改善人们生活的社会干预措施和政策的重要发展资源。
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引用次数: 0
Understanding older adults' travel behaviour and mobility needs during the COVID-19 pandemic through the lens of the hierarchy of travel needs: a systematic review 从旅行需求层次的角度了解 COVID-19 大流行期间老年人的旅行行为和移动需求:系统性综述
IF 2.5 3区 社会学 Q2 GERONTOLOGY Pub Date : 2024-05-02 DOI: 10.1017/s0144686x24000102
Melisa Yazdanpanahi, Evangelia Pantelaki, Carol Holland, Rose Gilroy, Ben Spencer, Richard Weston, Allyson Rogers

The aim of this article is to critically review the scientific literature about the changes in travel behaviour and mobility amongst older adults caused by the COVID-19 pandemic across various countries, identify unmet travel needs and highlight patterns of inequalities in older adults' mobility. We have collected articles from four academic databases: PubMed, Scopus, Transportation Research International Documentation (TRID) and Web of Science. Papers were considered for inclusion if they were published online in 2020 or later, written in English, and referred to urban or rural changes in travel behaviour and mobility of older adults over 50 years old. We examined the pre-existing models developed before the outbreak and classified the articles based on Musselwhite and Haddad's hierarchy of older adults' travel needs. The synthesis of the selected 25 articles shows a general decline in literal mobility amongst older adults, an increased share of virtual travel and their decreased capacity to fulfil different levels of travel needs. Findings also indicate an increased gap in older adults' mobility across geographical regions with various levels of transport infrastructure and digital capital. We conclude the paper with the lessons learned, the opportunities ahead, and the challenges that must be overcome to achieve sustainable development and the United Nations Decades of Healthy Ageing goals in the post-pandemic world.

本文旨在批判性地回顾有关各国 COVID-19 大流行对老年人旅行行为和流动性造成的变化的科学文献,确定未得到满足的旅行需求,并强调老年人流动性不平等的模式。我们从四个学术数据库中收集了相关文章:PubMed、Scopus、国际交通研究文献(TRID)和科学网。只要是 2020 年或之后在线发表的、用英语撰写的、涉及城市或农村地区 50 岁以上老年人出行行为和流动性变化的文章,都会被纳入考虑范围。我们研究了疫情爆发前已存在的模型,并根据 Musselwhite 和 Haddad 的老年人出行需求层次对文章进行了分类。对所选 25 篇文章的综合分析表明,老年人的实际流动性普遍下降,虚拟旅行的比例增加,满足不同层次旅行需求的能力下降。研究结果还表明,在交通基础设施和数字资本水平不同的地理区域,老年人的流动性差距也在加大。最后,我们总结了在流行病后世界实现可持续发展和联合国健康老龄化十年目标所必须吸取的经验教训、面临的机遇和必须克服的挑战。
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引用次数: 0
Tragedy and value of life of older persons in long-term care homes during COVID-19: a critical discourse analysis COVID-19 期间长期护理院老年人的悲剧和生命价值:批判性话语分析
IF 2.5 3区 社会学 Q2 GERONTOLOGY Pub Date : 2024-04-26 DOI: 10.1017/s0144686x24000217
Sabrina Lessard, Oluwagbemiga Oyinlola, Tamara Sussman

During the COVID-19 pandemic, the media provided daily coverage of this unprecedented crisis in the history of the 21st century. Some topics, such as how the virus affected older adults, were widely covered. The way in which COVID-19 was documented evoked a ‘tragedy’ narrative through consistent reporting about the suffering it was causing and the deleterious consequences it had on specific populations, including residents of long-term care homes (LTC). This article explores how reports on COVID-19 in LTC homes in a national newspaper (The Globe and Mail) fuelled a tragedy discourse that modulated the value of life of older adults living in those environments. We used critical discourse analysis and analysed 74 articles focusing on older persons residing in LTC homes in two Canadian provinces (Quebec and Ontario) during COVID-19. This article offers a brief overview of the notion of tragedy and how the discourse of tragedy is intertwined with humanitarian crises, life and death, and the value of life. Our findings revealed the construction of three types of tragedies that shape our societal values around life and death in LTC: the tragedy of the threat to life, the tragedy of the unfortunate (old, vulnerable and lacking in agency) and, finally, the tragedy of historical neglect and abandonment. Our findings suggest that the nature of reporting on life and death in LTC homes during the COVID-19 pandemic provoked a sense of fear and pity for a passive other. Re-thinking what gets reported in the media, including whose voice is represented/missing and how tragedy narratives are balanced with contesting stories, could elicit more sentiments of solidarity and action rather than reinforce pity, distancing and immobilisation.

在 COVID-19 大流行期间,媒体每天都在报道这场 21 世纪史无前例的危机。一些话题,如病毒如何影响老年人,被广泛报道。通过持续报道 COVID-19 带来的痛苦及其对特定人群(包括长期护理院(LTC)的居民)造成的有害后果,COVID-19 的报道方式唤起了一种 "悲剧 "叙事。本文探讨了一家全国性报纸(《环球邮报》)对长期护理院中 COVID-19 的报道如何助长了悲剧论调,从而改变了生活在这些环境中的老年人的生命价值。我们采用批判性话语分析方法,分析了 74 篇文章,这些文章关注的是在 COVID-19 期间居住在加拿大两个省份(魁北克省和安大略省)的长者护理院中的老年人。本文简要概述了悲剧的概念,以及悲剧话语如何与人道主义危机、生死和生命价值交织在一起。我们的研究结果表明,有三种类型的悲剧塑造了我们对长期治疗中生与死的社会价值观:生命受到威胁的悲剧、不幸者(年老、易受伤害和缺乏行为能力)的悲剧以及历史忽视和遗弃的悲剧。我们的研究结果表明,在 COVID-19 大流行期间,有关长者照护中心的生死报道的性质激起了人们对被动他者的恐惧和怜悯。重新思考媒体报道的内容,包括谁的声音被代表/缺失,以及悲剧叙事如何与有争议的故事保持平衡,可以激发更多的团结和行动情绪,而不是强化怜悯、疏远和无动于衷。
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引用次数: 0
Ageing with spinal cord injury: a longitudinal study 脊髓损伤患者的老龄化:纵向研究
IF 2.5 3区 社会学 Q2 GERONTOLOGY Pub Date : 2024-04-08 DOI: 10.1017/s0144686x24000084
Haoai Zhao, Shu Cole, Karo Omodior, Dubravka Svetina Valdivia

Limited studies have evaluated the impact of recreation on successful ageing (SA) for individuals with spinal cord injury (SCI) in a longitudinal manner. Most existing SA models emphasise biomedical-based dimensions of physical functioning, which has been criticised as unrealistic and limited, especially for people with disabilities. Various researchers and organisations have proposed that SA needs to be reassessed using more self-perceived, self-reported measurements. Understanding long-term life satisfaction predictors for individuals ageing with SCI is still limited, particularly when including longitudinal recreation participation data. This study, based on Rowe and Kahn's SA model and utilising self-reported measurements, observes the long-term changes in self-reported health status, recreation participation time and social integration levels, and evaluates the long-term impacts of these predictors on life satisfaction among individuals with SCI. The sample comprises individuals with SCI (N = 11,450) who are at least 45 years old at the time of injury or have lived with their injury for over 15 years. Results indicate that when ageing with SCI, life satisfaction increases over time, but their recreation time, social interactions and self-perceived health status decline. Moreover, regular participation in recreational activities, engagement in and maintenance of certain levels of social relationships, and high self-evaluation of health can positively impact life satisfaction during ageing. The study explores the feasibility of using self-perceived measurements to replace biomedical-based variables in Rowe and Kahn's SA model and examines their impacts on life satisfaction among people ageing with disabilities. In the future development of SA models, researchers can incorporate more self-reported, self-evaluated assessment variables to better capture the ageing experience, especially for people with disabilities.

对娱乐对脊髓损伤(SCI)患者成功老龄化(SA)的影响进行纵向评估的研究十分有限。大多数现有的成功老龄化模型都强调以生物医学为基础的身体机能维度,这被批评为不切实际且具有局限性,尤其是对残疾人而言。不同的研究人员和组织已经提出,需要使用更多的自我感知、自我报告的测量方法来重新评估自理能力。对老年 SCI 患者长期生活满意度预测的了解仍然有限,尤其是在包括纵向娱乐参与数据的情况下。本研究以 Rowe 和 Kahn 的生活满意度模型为基础,利用自我报告的测量方法,观察自我报告的健康状况、娱乐参与时间和社会融入水平的长期变化,并评估这些预测因素对 SCI 患者生活满意度的长期影响。样本包括受伤时年龄至少为 45 岁或带伤生活超过 15 年的 SCI 患者(人数 = 11,450 人)。结果表明,随着时间的推移,患有 SCI 的老年人的生活满意度会提高,但他们的娱乐时间、社会交往和自我感觉健康状况会下降。此外,定期参加娱乐活动、参与并保持一定程度的社会关系以及对健康的高度自我评价会对老年期的生活满意度产生积极影响。本研究探讨了在罗恩和卡恩的 SA 模型中使用自我感知测量来替代生物医学变量的可行性,并研究了它们对残疾老年人生活满意度的影响。在 SA 模型的未来发展中,研究人员可以纳入更多自我报告、自我评价的评估变量,以更好地捕捉老龄化体验,尤其是残疾人的老龄化体验。
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引用次数: 0
Ageing of the Australian LGBQ population: estimates and projections to mid-century 澳大利亚男女同性恋、双性恋和变性者人口的老龄化:到本世纪中叶的估计和预测
IF 2.5 3区 社会学 Q2 GERONTOLOGY Pub Date : 2024-04-08 DOI: 10.1017/s0144686x23000971
Jeromey Temple, Tom Wilson

Although evidence on aspects of individual ageing of LGBTQI (lesbian, gay, bisexual, transgender, queer and/or intersex) people is mounting, there is a poor understanding of the macro aspects of population ageing within the LGBTQI population itself. This paper seeks to address this lacuna through an examination of structural and numerical ageing of the Australian LGBQ population. Drawing upon new data sources, alongside recent advances in demographic modelling, we utilised a modified multi-state cohort-component projection model to produce estimates and projections of the ageing of the Australian LGBQ population from 2016 to 2041. Our results indicate that the LGBQ population is significantly younger than the heterosexual population and is ageing structurally (in relative terms) at a slower rate. However, the LGBQ population is ageing considerably faster numerically (in absolute percentage growth terms) relative to the heterosexual population. We show the LGBQ population aged 65+ is projected to grow between 150 and 170 per cent between 2016 and 2041, under relatively conservative assumptions. This strong numerical ageing counters traditional assumptions about ageing of the LGBQ population and provides data to improve visibility of this population and to ameliorate future planning for health, care and social service provision that is appropriate and well-funded. The methods and materials we develop in this paper provide new opportunities for other countries to improve planning for LGBQ populations similarly.

尽管有关 LGBTQI(女同性恋、男同性恋、双性恋、变性人、同性恋和/或双性人)个体老龄化的证据越来越多,但人们对 LGBTQI 群体本身人口老龄化的宏观方面了解甚少。本文试图通过对澳大利亚 LGBTQ 人口结构性和数量性老龄化的研究来弥补这一空白。利用新的数据来源以及人口建模方面的最新进展,我们采用了经过修改的多州队列-成分预测模型,对 2016 年至 2041 年澳大利亚 LGBTQ 人口的老龄化情况进行了估计和预测。我们的研究结果表明,男女同性恋、双性恋和变性者人口明显比异性恋人口年轻,而且结构性老龄化(相对而言)速度较慢。然而,与异性恋人口相比,LGBQ 人口在数量上(按绝对增长百分比计算)的老龄化速度要快得多。我们显示,根据相对保守的假设,65 岁以上的 LGBQ 人口预计将在 2016 年至 2041 年间增长 150% 至 170%。这种强劲的数字老龄化反驳了有关 LGBQ 人口老龄化的传统假设,并提供了数据来提高这一人群的能见度,改善未来的健康、护理和社会服务规划,使其更加合适且资金充足。我们在本文中开发的方法和材料为其他国家提供了新的机会,使其也能改善对 LGBQ 人口的规划。
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引用次数: 0
How do research participants with age-related vision loss talk about their experiences? A secondary discourse analysis of published qualitative extracts 患有老年性视力丧失的研究参与者是如何谈论他们的经历的?对已发表的定性摘录进行二次话语分析
IF 2.5 3区 社会学 Q2 GERONTOLOGY Pub Date : 2024-04-02 DOI: 10.1017/s0144686x24000138
Jamie Enoch, Ahalya Subramanian, Carla Willig

Age-related macular degeneration (AMD) is a chronic, progressive eye condition that can affect individuals in later life and lead to loss of central visual function. In this analysis, we aimed to explore the discursive landscape of talk about AMD, drawing on extracts published in peer-reviewed qualitative studies on AMD. Drawing on procedures of qualitative meta-synthesis, we compiled a corpus of raw data extracts from 25 qualitative studies on AMD published in English, largely carried out in high-income countries. Extracts were analysed to identify dominant discourses and key interpretative repertoires (such as recurring metaphors, tropes and figures of speech). We adopted a Foucauldian discourse analytic approach, to consider the implications of dominant discourses, and their associated subject positions, for the subjective experience of living with AMD. Our analysis identified five distinct ways in which AMD was constructed in research participants' talk about experiences of AMD. They included: AMD as a mysterious affliction, linked to biological ageing; AMD as a total loss of independence; AMD as grievous loss; AMD as a condition to be stoically accepted; and – to a more limited extent – AMD as an opportunity for discovery. Drawing on theory from critical disability studies and gerontology, we suggest that the constructions identified are underpinned by broader societal discourses which construct ageing and disability in largely negative, medicalised and individualistic terms. Taking up subject positions within such discourses may compound feelings of isolation, hopelessness and powerlessness. We suggest there may be value in exploring talk about experiences of living with AMD within a broader range of everyday social, relational and environmental contexts.

老年性黄斑变性(AMD)是一种慢性、进展性眼病,可影响晚年人,导致中枢视觉功能丧失。在本次分析中,我们以同行评议的有关老年黄斑变性的定性研究中发表的摘录为基础,旨在探索有关老年黄斑变性的话语景观。借鉴定性元综合的程序,我们从 25 项用英语发表的有关老年性痴呆症的定性研究中摘录了原始数据,汇编成一个语料库,这些研究主要在高收入国家进行。我们对摘录内容进行了分析,以确定主导性话语和关键的解释性语汇(如反复出现的隐喻、套语和语词)。我们采用福柯的话语分析方法,考虑主流话语及其相关的主体地位对老年痴呆症患者主观生活体验的影响。我们的分析确定了研究参与者在谈论 AMD 的经历时构建 AMD 的五种不同方式。它们包括AMD是一种神秘的疾病,与生理衰老有关;AMD是完全丧失独立能力;AMD是令人痛心的损失;AMD是一种需要委曲求全的病症;以及--在较有限的程度上--AMD是一个发现的机会。借鉴批判性残疾研究和老年学的理论,我们认为,所确定的建构是以更广泛的社会话语为基础的,这些社会话语在很大程度上以消极、医疗化和个人主义的方式建构老龄化和残疾。在这些论述中占据主体地位可能会加重孤独感、绝望感和无力感。我们认为,在更广泛的日常社会、关系和环境背景下探讨老年痴呆症患者的生活体验可能会有价值。
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引用次数: 0
‘Only my family can help’: the lived experience and care aesthetics of being resident on an NHS psychiatric/mental health inpatient dementia assessment ward – a single case study 只有我的家人能帮忙":入住英国国家医疗服务系统精神科/心理健康科痴呆症评估住院病房的生活体验和护理美学--单个案例研究
IF 2.5 3区 社会学 Q2 GERONTOLOGY Pub Date : 2024-03-27 DOI: 10.1017/s0144686x24000096
Lesley Jones, Nicky Cullum, Ruth Watson, James Thompson, John Keady

In the United Kingdom, people living with dementia admitted to National Health Service (NHS) psychiatric/mental health inpatient dementia assessment wards (dementia assessment wards) are nearly always compulsorily detained under a section of the Mental Health Act 1983 owing to the risk and complexity of the presenting condition. As such, dementia assessment wards admit some of the most vulnerable patients in society, yet these environments of care are under-researched and under-reported in the literature. Using care aesthetics as an overarching explanatory lens, this article focuses on the care of one patient (Charlotte – not her real name) resident on a dementia assessment ward and uses a range of qualitative methods to illuminate that experience, including ethnographic observations and a care record review. To further develop the reach of the case study, interviews were also conducted with Charlotte's husband as her main family carer and key ward staff involved in Charlotte's care. Data were analysed using a sensory and narrative-based method to provide a sequential, embodied, individually positioned and storied account of Charlotte's care and interpreted experience on the ward. The analysis revealed that Charlotte's presentation of dementia was complex insofar as she resisted any attempt by the ward staff to offer her food or drink or to help with washing and dressing. Charlotte also swore frequently and loudly and spent time actively ‘watching’ and ‘looking’ at people and the environment in which she was now living. The findings contribute to the fields of critical dementia studies, dementia education, health-care practice and policy making, and may be used to highlight the value of sensory and embodied approaches to capturing a caring dynamic.

在英国,国民医疗服务系统(NHS)的精神科/心理健康科痴呆症评估住院病房(痴呆症评估病房)收治的痴呆症患者几乎都是根据《1983 年精神健康法案》(Mental Health Act 1983)的某一条款强制收治的,因为他们的病情具有风险性和复杂性。因此,痴呆症评估病房收治的都是社会上最脆弱的病人,但文献中对这些护理环境的研究和报道却很少。本文以护理美学为总体解释视角,重点关注一位居住在痴呆症评估病房的患者(夏洛特--非真名)的护理情况,并采用一系列定性方法(包括人种学观察和护理记录回顾)来阐明其护理体验。为了进一步扩大案例研究的范围,还对夏洛特的丈夫(她的主要家庭照顾者)和参与夏洛特护理工作的主要病房工作人员进行了访谈。数据分析采用了基于感官和叙事的方法,对夏洛特在病房的护理和解释经历进行了有序的、体现性的、个人定位的和故事性的描述。分析结果显示,夏洛特的痴呆症表现非常复杂,她拒绝病房工作人员为她提供食物或饮料,也不愿意帮助她洗漱和穿衣。夏洛特还经常大声咒骂,并花时间主动 "观察 "和 "注视 "周围的人和她现在生活的环境。研究结果有助于痴呆症批判性研究、痴呆症教育、医疗保健实践和政策制定等领域,并可用于强调感官和体现方法在捕捉关爱动态方面的价值。
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引用次数: 0
Gendered repartnering in later life: structural and processual dimensions of the transition into new relationships 晚年的性别再婚:向新关系过渡的结构和过程问题
IF 2.5 3区 社会学 Q2 GERONTOLOGY Pub Date : 2024-03-25 DOI: 10.1017/s0144686x24000072
Luisa Bischoff

Against the backdrop of demographic change and the pluralisation of living arrangements, the article focuses on repartnering after widowhood, divorce and separation in older age in Germany. While theoretically framing repartnering as a lifecourse transition, the question arises of how later-life relationships form in relation to gender- and ageing-specific as well as structural and processual dimensions. Since previous research indicates that there are gender-specific patterns when repartnering in older age which differ from repartnering in middle age, the article explicitly accounts for gendered ageing and attitudes towards ageing. Using data from the German Ageing Survey (1996–2017), longitudinal hybrid panel regressions are modelled for 3,653 respondents, 11,628 observations and 179 new relationships. I propose to understand within-effects as processual and between-effects as structural dimensions of repartnering. The results for the structural dimensions show that the likelihood of repartnering is higher for men and for individuals with more negative attitudes towards ageing. The results for the processual dimensions show how repartnering becomes less likely the older one gets and the more positive one's attitudes towards ageing become. The interaction term for gender and ageing shows that ageing has a stronger influence on the likelihood to repartner for women than for men. Additionally, the findings reveal a difference between forms of singlehood: in the short term, repartnering is less likely for divorced or separated individuals than for widowed individuals, whereas the opposite effect shows in the long term. In sensitising the lifecourse perspective with gender- and ageing-specific concepts and analytically separating processual and structural dimensions, this article demonstrates the importance of gendered ageing and of the linkage between relationship transitions. Applying hybrid panel models to lifecourse transitions in older age reveals the processual dynamic and structural embeddedness of repartnering in older age.

在人口结构变化和生活安排多元化的背景下,文章重点关注德国老年丧偶、离婚和分居后的重新伴侣关系。虽然从理论上讲,重新结为伴侣是一种生命历程的过渡,但同时也提出了一个问题,即晚年关系是如何形成的,这与性别、年龄、结构和过程等方面都有关系。以往的研究表明,老年再婚与中年再婚有不同的性别模式,因此本文明确阐述了性别老龄化和对老龄化的态度。利用德国老龄化调查(1996-2017 年)的数据,对 3653 名受访者、11628 个观测值和 179 个新关系建立了纵向混合面板回归模型。我建议将内部效应理解为再婚的过程性因素,将之间效应理解为再婚的结构性因素。结构维度的结果显示,男性和对老龄化持消极态度的人重新结为伴侣的可能性更高。过程维度的结果表明,年龄越大,对老龄化的态度越积极,再婚的可能性就越小。性别与老龄化的交互项表明,老龄化对女性重新缔结伴侣的可能性的影响要大于男性。此外,研究结果还揭示了不同单身形式之间的差异:从短期来看,离婚或分居者重新结为伴侣的可能性要低于丧偶者,而从长期来看,则出现了相反的效果。这篇文章用性别和老龄化的特定概念对生命历程视角进行了宣传,并在分析中将过程和结构维度分开,从而证明了性别老龄化和关系转变之间联系的重要性。将混合面板模型应用于老年期的生命历程转换,揭示了老年期再婚的过程动态性和结构嵌入性。
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引用次数: 0
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Ageing & Society
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