Journal of long-term care最新文献

英文中文

Organizational Culture and High Medicaid Nursing Homes Financial Performance 组织文化与高医疗补助养老院财务绩效

Q2 Health Professions

Journal of long-term care

Pub Date : 2022-06-09 DOI: 10.31389/jltc.115

A. Ghiasi, J. Lord, J. Banaszak-Holl, Ganisher K. Davlyatov, L. Hearld, R. Weech-Maldonado

Organizational Culture and High Medicaid Nursing Homes Financial Performance

组织文化与高医疗补助疗养院财务绩效

引用次数: 2

Whose Outcome is it Anyway? Outcome and Brain Injury Case Management 这到底是谁的结局?结果和脑损伤病例管理

Q2 Health Professions

Journal of long-term care

Pub Date : 2022-04-29 DOI: 10.31389/jltc.107

J. Lowry, Thomas C. Wakeham, A. Norman, J. Dean, M. Holloway, Ben Needham-Holmes, V. Clark-Wilson, Philippa Feltham-White

Context: The acquired brain injury (ABI) literature highlights various factors that can prevent successful community rehabilitation and hinder good long-term outcomes. Brain injury case management is a service model with the potential to overcome these barriers within rehabilitation and longer-term care and support, but there is minimal research surrounding the effectiveness of case management in ABI. Objectives: This study aims to gain a better understanding of outcomes in brain injury case management and what facilitates good outcomes when working with clients from the perspective of brain injury case managers. Methods: A mixed qualitative study using both conventional content analysis and thematic analysis. Twenty-eight brain injury case managers completed an online questionnaire about what constitutes a good outcome in brain injury case management. Of these, five took part in a follow-up interview. Findings: The analysis identified four themes related to brain injury case management outcomes;1) A client-centred approach to outcome, 2) the role of the brain injury case manager, 3) monitoring outcome in case management, and 4) issues of funding. Limitations: Participation in the survey and interviews was somewhat low, largely due to conducting the study during the COVID-19 pandemic. The study only included brain injury case mangers and future studies should examine clients’ and family members’ perspectives. Implications: This study identified that brain injury case management is a holistic approach to rehabilitation and case coordination that requires further attention to develop evidence-informed practice. Appropriate holistic measures of quality of life and outcome need to be developed to support the evidence base for case management. © 2022 The Author(s).

背景：获得性脑损伤（ABI）文献强调了各种因素，这些因素可能会阻碍成功的社区康复并阻碍良好的长期结果。脑损伤病例管理是一种有潜力在康复和长期护理和支持中克服这些障碍的服务模式，但围绕ABI病例管理的有效性的研究很少。目的：本研究旨在从脑损伤病例管理者的角度更好地了解脑损伤病例处理的结果，以及在与客户合作时，是什么促进了良好的结果。方法：采用传统内容分析和主题分析相结合的定性研究。28名脑损伤病例管理人员完成了一份在线问卷，内容是什么构成了脑损伤病例处理的良好结果。其中5人参加了后续采访。研究结果：分析确定了与脑损伤病例管理结果相关的四个主题；1）以客户为中心的结果方法，2）脑损伤病例经理的作用，3）监测病例管理中的结果，以及4）资金问题。局限性：参与调查和访谈的人数略低，主要是由于在新冠肺炎大流行期间进行了这项研究。这项研究只包括脑损伤病例管理人员，未来的研究应该考察客户和家庭成员的观点。启示：这项研究表明，脑损伤病例管理是一种全面的康复和病例协调方法，需要进一步关注以证据为基础的实践。需要制定适当的生活质量和结果的整体衡量标准，以支持案件管理的证据基础。©2022作者。

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引用次数: 2

Facilitators and Barriers to Research Participation in Care Homes: Thematic Analysis of Interviews with Researchers, Staff, Residents and Residents’ Families 养老院参与研究的推动者和障碍：对研究人员、工作人员、居民和居民家庭的访谈主题分析

Q2 Health Professions

Journal of long-term care

Pub Date : 2022-02-23 DOI: 10.31389/jltc.87

Emma Law, R. Ashworth

Following the global health pandemic of COVID-19, a spotlight has been placed on care homes in the UK and the disproportionate impact the virus has had, and continues to have (Hanratty et al., 2020). There is an urgent need to widen our knowledge base about care homes and the inclusion of people living and working in care homes in research studies. This paper presents qualitative findings from a study exploring the facilitators and barriers to research participation in care homes. Semi-structured interviews were conducted with residents (n = 12), staff (n = 15), relatives (n = 6) and researchers (n = 8) across three care homes in Scotland between 2014 and 2015. The findings suggest that the key barriers and facilitators to research participation are best captured by three themes: relationships, knowledge about research, and structural challenges. The way these themes are navigated within the care home is expected to shape the willingness and ability of care homes to engage in research. Positive relationships, accessible information about research, and adequate time and space are all likely to increase research presence within care homes. Conversely, poor relationships, alienating research communication, and limited time and space are all likely to result in care homes being unable or unwilling to participate. Overall, this paper demonstrates that care homes face several barriers to research participation, and efforts to improve relationships, raise awareness of the research process and provide flexible solutions for structural challenges are needed. Future research needs to be mindful of these challenges in order to facilitate research relating to COVID-19 and more generally in gerontology and dementia.

在新冠肺炎全球卫生大流行之后，英国的养老院以及该病毒已经并将继续产生的不成比例的影响成为人们关注的焦点（Hanratty et al.，2020）。迫切需要扩大我们对养老院的知识基础，并将在养老院生活和工作的人纳入研究。本文介绍了一项研究的定性结果，该研究探讨了养老院参与研究的推动者和障碍。2014年至2015年间，对苏格兰三家养老院的居民（n=12）、工作人员（n=15）、亲属（n=6）和研究人员（n=8）进行了半结构化访谈。研究结果表明，参与研究的主要障碍和推动者最好通过三个主题来捕捉：关系、研究知识和结构性挑战。在养老院内处理这些主题的方式有望塑造养老院参与研究的意愿和能力。积极的关系、可获取的研究信息以及充足的时间和空间都可能增加研究在养老院的存在。相反，糟糕的关系、疏远的研究交流以及有限的时间和空间都可能导致养老院无法或不愿参与。总的来说，本文表明，养老院在参与研究方面面临着一些障碍，需要努力改善关系，提高对研究过程的认识，并为结构性挑战提供灵活的解决方案。未来的研究需要注意这些挑战，以促进与新冠肺炎有关的研究，更广泛地说，是老年病学和痴呆症的研究。

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引用次数: 7

The Influence of Chronic Pain on Social Care Service Use in the UK 慢性疼痛对英国社会护理服务使用的影响

Q2 Health Professions

Journal of long-term care

Pub Date : 2022-02-16 DOI: 10.31389/jltc.89

J. Humphreys, L. Cook, P. Clarkson, W. Dixon

引用次数: 0

Risk Recognition Policies for the Long-Term Care Workforce during the First Year of the COVID-19 Pandemic: A Multi-Country Study 新冠肺炎大流行第一年长期护理劳动力的风险识别政策：多国研究

Q2 Health Professions

Journal of long-term care

Pub Date : 2022-02-02 DOI: 10.31389/jltc.110

A. Reed, Maya Murmann, Amy Hsu, Agnes Turnpenny, C. Van Houtven, M. Laberge, L. Low, S. Hussein, S. Allin

Context: The precarious work arrangements experienced by many long-term care workers have led to the creation of a “shared” workforce across residential, home, and community aging care sectors. This shared workforce was identified as a contributor to the spread of COVID-19 early in the pandemic. Objective: This analysis sought to review policy measures targeting the long-term care workforce across seven high income jurisdictions during the first year of the COVID-19 pandemic. The focus was on financial supports introduced to recognize long-term care workers for the increased risks they faced, including both (1) health risks posed by direct care provision during the pandemic and (2) economic risks associated with restrictions to multi-site work. Method: Environmental scan of publicly available policy documents and government news releases published between March 1, 2020 and March 31, 2021, across seven high income jurisdictions. Findings: While there was limited use of financial measures in the United States to compensate long-term care workers for the increased health risks they faced, these measures were widely used across Canada, as well as in Wales, Scotland, and Australia. Moreover, there was a corresponding use of financial measures to protect workers from income loss in parts of Canada, Australia and the UK. Limitations: Our analysis did not include additional policy measures such as sick pay or recruitment incentives. We also relied primarily on publicly available policy documentation. In some cases, documents had been archived or revised, making it difficult to ascertain and clarify original information and amendments. Implications: While these financial measures are temporary, they brought to light long-standing issues related to the supply of and support for workers providing care to older adults in long-term care homes. © 2022 The Author(s).

背景：许多长期护理人员所经历的不稳定的工作安排导致了住宅、家庭和社区老龄护理部门的“共享”劳动力的形成。在大流行早期，这种共享劳动力被确定为新冠肺炎传播的贡献者。目的：本分析旨在审查新冠肺炎大流行第一年期间七个高收入司法管辖区针对长期护理劳动力的政策措施。重点是财政支持，以表彰长期护理人员面临的风险增加，包括（1）疫情期间直接护理带来的健康风险和（2）与限制多点工作相关的经济风险。方法：对2020年3月1日至2021年3月31日期间公布的七个高收入司法管辖区的公开政策文件和政府新闻稿进行环境扫描。调查结果：虽然美国有限地使用财政措施来补偿长期护理人员面临的健康风险增加，但这些措施在加拿大以及威尔士、苏格兰和澳大利亚得到了广泛应用。此外，在加拿大、澳大利亚和英国的部分地区，也相应地使用了财政措施来保护工人免受收入损失。限制：我们的分析没有包括额外的政策措施，如病假工资或招聘激励。我们还主要依靠公开的政策文件。在某些情况下，文件已经存档或修订，因此很难确定和澄清原始信息和修订。影响：虽然这些财政措施是暂时的，但它们揭示了与长期护理院为老年人提供护理的工作人员的供应和支持有关的长期问题。©2022作者。

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引用次数: 3

Waiving Medicaid Regulations During a Public Health Crisis: Identifying Heterogeneous Effects of Suspending Pre-Admission Screening Requirements on COVID-19 Deaths 公共卫生危机期间放弃医疗补助条例：确定暂停入院前筛查要求对新冠肺炎死亡的异质性影响

Q2 Health Professions

Journal of long-term care

Pub Date : 2022-01-24 DOI: 10.31389/jltc.90

J. Semprini, B. Kaskie

Background: During the COVID-19 Public Health Emergency, states were authorized to waive Pre-Admission Screening Resident Review (PASRR), a federal regulation requiring all individuals be evaluated before admission into a federally qualified nursing facility. We suspect states waived PASRR to reallocate resources from admission towards infection control and outbreak mitigation. However, by waiving PASRR and fast-tracking admissions, vulnerable elders may have been exposed to COVID-19 and unexpectedly placed at substantial risk for increased morbidity. Methodology: We reviewed all COVID-19 Medicaid emergency waiver requests to identify states waiving PASRR. We then analyzed daily, state-level COVID-19 deaths with a panel regression model, controlling for state and time fixed effects, and daily case rates. Finally, we expanded the model to identify heterogeneous effects shaped by market and administrative oversight factors. Results: Suspending PASRR led to significant declines in state COVID-19 deaths (–2.3 deaths per 100,000 population, p < 0.001). However, the effect waiving PASRR varied by excess nursing bed capacity (7.3 deaths per 100,000 population, p = 0.024) and historical PASRR deficiencies (0.9 deaths per 100,000, p = 0.009). Implications: Within the first month of the COVID-19 emergency invocation, nearly all states suspended PASRR, which our estimates suggest averted 7,600 deaths nationwide. However, we found that greater pre-emergency bed availability and less administrative oversight may have reduced the effectiveness of a PASRR waiver. While future research should aim to understand the mechanisms for such heterogeneity, immediate concerns relate to the variation, both between and within states, for adhering to a critical regulation protecting older adults. © 2022 The Author(s).

背景:在COVID-19突发公共卫生事件期间，各州被授权放弃入院前筛查居民审查(PASRR)，这是一项联邦法规，要求在进入联邦合格的护理机构之前对所有个人进行评估。我们怀疑各州放弃PASRR是为了将资源从入院重新分配到感染控制和疫情缓解上。然而，通过放弃PASRR和快速准入，脆弱的老年人可能已经接触到COVID-19，并意外地面临发病率增加的巨大风险。方法:我们审查了所有COVID-19医疗补助紧急豁免请求，以确定放弃PASRR的州。然后，我们使用面板回归模型分析了每日州一级的COVID-19死亡人数，控制了州和时间固定效应以及每日病例率。最后，我们扩展了模型，以识别市场和行政监管因素形成的异质性效应。结果:暂停PASRR导致州COVID-19死亡人数显著下降(每10万人中有2.3人死亡，p < 0.001)。然而，免除PASRR的效果因护理床位过剩(每10万人中有7.3人死亡，p = 0.024)和历史PASRR不足(每10万人中有0.9人死亡，p = 0.009)而异。影响:在COVID-19紧急启动的第一个月内，几乎所有州都暂停了PASRR，我们的估计表明，这在全国范围内避免了7600人死亡。然而，我们发现更多的急诊前床位可用性和更少的行政监督可能降低了PASRR豁免的有效性。虽然未来的研究应旨在了解这种异质性的机制，但迫切需要关注的是各州之间和各州内部的差异，以遵守保护老年人的关键法规。©2022作者。

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引用次数: 0

The Impact of Pandemic Management Strategies on Staff Mental Health, Work Behaviours, and Resident Care in One Long-Term Care Facility in British Columbia: A Mixed Method Study 大流行管理策略对不列颠哥伦比亚省一家长期护理机构工作人员心理健康、工作行为和住院护理的影响:一项混合方法研究

Q2 Health Professions

Journal of long-term care

Pub Date : 2022-01-01 DOI: 10.31389/jltc.100

Farinaz Havaei, Ibrahim Abughori, Yue-Li Mao, Sabina Staempfli, Andy Ma, M. MacPhee, A. Phinney, David Keselman, Loren Tisdelle, Dan Galazka, V. Anderson

Context: To slow the spread of COVID-19 within the Canadian long-term residential care (LTRC) sector, a series of pandemic management strategies were introduced, including restricted visitation and single site employment. These strategies were enacted to prevent and control infection, resulting in unknown impact on direct care staff and staff capacity to deliver quality care or service. Objective: To explore staff reports of outcomes associated with LTRC pandemic management strategies, particularly their impact on LTRC staff mental health, work behaviours and quality of care or service provision. Method: This was a case study using mixed methods including a longitudinal survey and interviews with staff from one LTRC site in British Columbia. Survey data from 68 staff who participated in both survey times were analyzed using regressions with relative weight analysis. Semi-structured interviews were conducted with 26 LTRC staff and analyzed using content analysis. Findings: Survey data demonstrated that staff perceived the sick time policy and staffing levels as the most inadequate pandemic management strategies. Survey data also showed the visitation policy, the sick time policy and the single site employment policy were most significantly associated with negative outcomes to staff mental health, work behaviours and quality of care or service delivery. Qualitative data suggested connections between these policies and inadequate staffing levels and heavy workloads. Limitations: The study design along with the low response rate and the small sample size limits the generalizability of the findings to other settings. Implications: The development and implementation of pandemic management strategies must be informed by and give consideration to working conditions of LTRC staff including long standing systemic issues such as staffing shortages and heavy workloads. © 2022 The Author(s).

背景:为了减缓COVID-19在加拿大长期住宿护理(LTRC)部门的传播，引入了一系列大流行管理策略，包括限制访问和单一地点就业。制定这些战略是为了预防和控制感染，这对直接护理人员和工作人员提供高质量护理或服务的能力造成了未知的影响。目的:探讨工作人员报告的与ltc大流行管理战略相关的结果，特别是这些战略对ltc工作人员心理健康、工作行为和护理或服务提供质量的影响。方法:这是一个混合方法的案例研究，包括纵向调查和对不列颠哥伦比亚省一个LTRC站点的工作人员的访谈。对参加两次调查的68名员工的调查数据进行了回归分析和相对权重分析。对26名LTRC员工进行半结构化访谈，并采用内容分析法进行分析。调查结果:调查数据表明，工作人员认为病假政策和人员配备水平是最不充分的大流行病管理战略。调查数据还显示，探视政策、病假政策和单一地点就业政策与工作人员心理健康、工作行为和护理或服务质量的负面影响最显著相关。定性数据表明，这些政策与工作人员不足和工作量大之间存在联系。局限性:研究设计以及低回复率和小样本量限制了研究结果的推广到其他情况。影响:大流行病管理战略的制定和实施必须了解并考虑到ltc工作人员的工作条件，包括人员短缺和工作量繁重等长期存在的系统性问题。©2022作者。

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引用次数: 5

Who Works Less When a Parent Needs Long-Term Care? Gender Disparities in Labor Market Effects in Mexico. 当父母需要长期照顾时，谁工作更少?性别差异对墨西哥劳动力市场的影响。

Q2 Health Professions

Journal of long-term care

Pub Date : 2022-01-01 DOI: 10.31389/jltc.116

Marco Stampini, María Laura Oliveri, Pablo Ibarrarán, Carlos Flores

We use longitudinal data from the Mexican Health and Aging Study to analyze the effect of having a parent in need of long-term care on labor supply of men and women aged 50-64 in Mexico. After accounting for both individual and time fixed effects, we find that parents' need of long-term care is associated with both a significant drop in the likelihood of working (by 2.42 percentage points), and a reduction in the number of hours worked (by 7.3%) among women who remain employed. In contrast, we find no effect on the labor supply of men. In a context of rapid population aging, the increase in the need of long-term care risks to hinder the efforts to reduce gender imbalances in the labor market.

我们使用墨西哥健康与老龄化研究的纵向数据来分析父母一方需要长期护理对墨西哥50-64岁男性和女性劳动力供应的影响。在考虑了个人和固定时间的影响后，我们发现，在仍有工作的女性中，父母对长期护理的需求与工作可能性的显著下降(下降2.42个百分点)和工作时间的减少(下降7.3%)有关。相比之下，我们没有发现对男性劳动力供给的影响。在人口迅速老龄化的背景下，长期护理需求的增加可能会阻碍减少劳动力市场性别不平衡的努力。

引用次数: 2

Austria’s Long-Term Care System: Challenges and Policy Responses 奥地利的长期护理系统:挑战和政策应对

Q2 Health Professions

Journal of long-term care

Pub Date : 2022-01-01 DOI: 10.31389/jltc.112

B. Trukeschitz, A. Österle, Ulrike Schneider

引用次数: 4

Spirituality and the Quality of Life of Individuals with Intellectual Disability 智障人士的灵性与生活品质

Q2 Health Professions

Journal of long-term care

Pub Date : 2022-01-01 DOI: 10.31389/jltc.139

P. Sango, R. Forrester-Jones

引用次数: 1

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