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A Pilot Study of the Acceptability of a Dance Café for People with Severe Dementia 重度痴呆症患者舞蹈咖啡馆可接受性的试点研究
Q2 Health Professions Pub Date : 2021-07-05 DOI: 10.31389/JLTC.67
Clara Ajoke Awoyomi, D. Oliver, R. Forrester-Jones
Context: Dance has been suggested as a way of helping people with advanced dementia, providing meaningful involvement and activity. Objectives: To investigate if individuals with advanced dementia would be able to take part in dancing in a Dance Cafe within a residential home setting and undertake the assessment of nutrition, quality of life, balance and mobility. Methods: A wait-list intervention approach was used, with residents allocated randomly to the intervention or a control group, who received the dance intervention later. A Dance Cafe was held weekly for 8 weeks, and assessments were made of weight, nutrition, balance, mobility and quality of life. Focus groups were held with staff and family members after the intervention period to assess their opinions. Findings: The regular assessments of nutrition, balance and quality of life were obtained for the residents with dementia, and they were able to join in the Dance Cafe. No conclusions could be made from the limited quantitative results; in the qualitative assessment, however, the staff and families all felt the participants had benefitted from the Dance Cafe in terms of improved mobility and positive psychosocial effects. Limitations: The small size of the intervention group prevented any statistical analysis of the quantitative assessments. Implications: It is possible to undertake a Dance Cafe with people with severe dementia, and assessments of nutrition and mobility can be undertaken. Further research with a larger group would be needed to investigate its effectiveness.
背景:舞蹈被认为是帮助晚期痴呆症患者的一种方式,提供有意义的参与和活动。目的:调查晚期痴呆症患者是否能够在住宅环境中的Dance Cafe参加舞蹈,并对营养、生活质量、平衡和行动能力进行评估。方法:采用等待名单干预方法,将居民随机分配到干预组或对照组,随后接受舞蹈干预。每周举办一次舞蹈咖啡馆,为期8周,对体重、营养、平衡、行动能力和生活质量进行评估。干预期结束后,与工作人员和家庭成员举行了焦点小组,以评估他们的意见。研究结果:对痴呆症患者的营养、平衡和生活质量进行了定期评估,他们能够加入舞蹈咖啡馆。有限的定量结果无法得出任何结论;然而,在定性评估中,工作人员和家属都认为参与者从舞蹈咖啡馆中受益,改善了活动能力和积极的心理社会影响。局限性:干预组规模较小,无法对定量评估进行任何统计分析。影响:可以为患有严重痴呆症的人开设一个舞蹈咖啡馆,并可以对营养和行动能力进行评估。需要与更大的小组进行进一步研究,以调查其有效性。
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引用次数: 2
How to Position, Attract and Retain Registered Nurses in Nursing Homes: A Qualitative, Explorative Study 养老院如何定位、吸引和留住注册护士:一项定性的探索性研究
Q2 Health Professions Pub Date : 2021-06-29 DOI: 10.31389/jltc.80
Ramona Backhaus, Inge Jochem, Helga Reijnders-Paffen, J. Meijers
Context: In most countries, registered nurse retention and role development in nursing homes is a challenge. Objective: To obtain insight into factors contributing to successful retention of registered nurses in nursing homes and into how to differentiate the role of vocationally trained registered nurses and baccalaureate-educated registered nurses. Method: A qualitative, descriptive, explorative study. In June 2019, World Cafe was held, a method for hosting group dialogs, in which direct care professionals, managers, human resources employees, and teachers participated. A theme-based content analysis was used to analyze data. Findings: Identified factors expected to contribute to retention were role clarity, role content, role model availability, room for professional development, learning on the job, a match between education and actual work, management and board-level support, adequate salaries, and a positive image of working in nursing homes. Vocationally trained registered nurses were considered to perform a key role resident care by serving as case managers. Baccalaureate-educated registered nurses were considered to focus on indirect care (e.g., coaching staff, stimulating evidence-based practices, implementing innovations). Limitations: Due to the limited sample size and the qualitative, explorative nature of the study, findings can only be generalized with caution. Implications: To refine registered nurse roles in nursing homes, it seems crucial to rethink the current roles and hierarchies. Even though management and human resources departments are considered responsible for contributing to role clarity and the creation of supportive practice environments, the registered nurses themselves are also expected to come up with their role.
背景:在大多数国家,养老院的注册护士保留和角色发展是一个挑战。目的:了解养老院成功留住注册护士的因素,以及如何区分职业培训注册护士和本科教育注册护士的作用。方法:定性、描述性、探索性研究。2019年6月,举办了“世界咖啡馆”,这是一种举办小组对话的方式,直接护理专业人员、管理人员、人力资源员工和教师参加了对话。采用基于主题的内容分析方法对数据进行分析。研究结果:确定了有助于保留的因素是角色清晰度,角色内容,角色榜样的可用性,专业发展空间,在工作中学习,教育与实际工作之间的匹配,管理和董事会层面的支持,足够的薪水,以及在养老院工作的积极形象。经过职业培训的注册护士被认为是住院护理的关键角色,担任病例管理人员。受过学士学位教育的注册护士被认为专注于间接护理(例如,指导人员,鼓励循证实践,实施创新)。局限性:由于样本量有限,研究的定性和探索性,研究结果只能谨慎概括。启示:要完善养老院的注册护士角色,重新思考当前的角色和等级制度似乎至关重要。尽管管理和人力资源部门被认为有责任为角色明确和创造支持性的实践环境做出贡献,但注册护士本身也被期望发挥自己的作用。
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引用次数: 3
Making My Day. Volunteering or Working at a Day Centre for Older People: Findings of Exploratory Research in English Day Centres 创造我的一天。在老年人日间中心做志愿者或工作:英语日间中心探索性研究的结果
Q2 Health Professions Pub Date : 2021-06-09 DOI: 10.31389/JLTC.58
Katharine Orellana, J. Manthorpe, A. Tinker
Context: Day centres have long traditions in social care in the United Kingdom and internationally. In England, they are provided by a mix of organisations, they are not regulated, and there is no national representative body. Research mainly focuses on centre attenders and carers. Frontline staff and volunteer perspectives are rarely reported. Objective: To highlight the role of day centre work and volunteering for individuals and inform recruitment and workforce development. Methods: Qualitative interview data gathered from seven volunteers and ten staff at four English day centres for older people were thematically analysed. Data are drawn from three-year case study research investigating the role, outcomes, and commissioning of day centres. Findings: Paid or volunteer work in day centres has the potential to make unique contributions to people’s lives. Older volunteers and staff particularly value centres’ group environment and the continuity involved which contribute to person-centred relationships and role satisfaction. These experiences and satisfaction help explain why day centre staff retention is above average in social care. Limitations: Although in diverse settings, this research was small-scale. Only high-quality centres may have participated. Methods may have unintentionally excluded volunteers with learning disabilities. Implications: Within a context of problematic recruitment and retention and policy aspirations for community engagement and building on local assets, findings are relevant to workforce development and local recruitment strategies. Further research might explore what creates the working and volunteering culture within a centre and links between culture and outcomes, with a view to developing a model of day centre culture.
背景:日间中心在英国和国际社会护理方面有着悠久的传统。在英国,它们是由多种组织提供的,不受监管,也没有全国性的代表机构。研究主要集中在中心护理人员和护理人员。前线员工和志愿者的观点很少被报道。目的:突出日间中心工作和个人志愿服务的作用,并为招聘和劳动力发展提供信息。方法:从4个英语老年人日间中心的7名志愿者和10名工作人员收集的定性访谈数据进行主题分析。数据来自为期三年的案例研究,调查了日托中心的作用、结果和委托。研究发现:日托中心的有偿或志愿工作有可能对人们的生活做出独特的贡献。年长的志愿者和工作人员特别重视中心的团体环境和连续性,这有助于建立以人为本的关系和角色满意度。这些经历和满意度有助于解释为什么日托中心的员工保留率高于社会护理的平均水平。局限性:虽然在不同的环境中,这项研究是小规模的。只有高质量的中心才能参加。方法可能无意中排除了有学习障碍的志愿者。启示:在招聘和保留问题以及社区参与和建立当地资产的政策愿望的背景下,研究结果与劳动力发展和当地招聘战略相关。进一步的研究可能会探索是什么创造了中心内的工作和志愿文化,以及文化与成果之间的联系,以期开发一种日间中心文化模式。
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引用次数: 1
COVID, Communication and Care Homes: A Staffs’ Perspective of Supporting the Emotional Needs of Families COVID,沟通与养老院:员工支持家庭情感需求的视角
Q2 Health Professions Pub Date : 2021-06-01 DOI: 10.31389/JLTC.74
J. Hockley, Trish Hafford-Letchfield, Sarah Noone, B. Mason, L. Jamieson, Rikke Iversholt, K. Musselbrook, George Palattiyil, Dina Sidhva, N. Quinn, Sumeet Jain, L. McKie, D. Tolson
An important part of care home life is the support given to older residents by their families/friends through regular visiting. Social visits to residents by their families ceased in response to the COVID-19 pandemic and residents were confined to their rooms. This paper reports on how care home staff improvised to address this situation during the first wave of the pandemic. It focuses on steps taken to maintain communication between residents and families to support emotional well-being. We undertook in-depth cafe-style interviews with twenty-one staff to explore creative practices that they introduced. It was part of a wider Scottish study examining the effect of lockdown on families whose relative was living/dying in a care home (May–October, 2020). Findings reveal the enormous effort by care staff to maintain family connections and the rapid acclimatisation involved working with a number of different on-line platforms, the pulling together of staff from across the care home, and, the attention to emotional well-being of residents living and dying in the care home. Findings highlight the professionalism and commitment of the leadership and staff involved. Whilst some of the staff accounts need no further comment, we draw on some themes from the care home research literature to make sense of the findings in terms of what we might learn going forward. This in-depth qualitative study emphasises the importance of recognising, fostering and nurturing relational compassionate care within long-term care. There is however little evidence whether health and social care policies recognise the importance of this on-going relationship.
安老院生活的一个重要部分,是家人/朋友定期到访,给予长者支持。由于新冠肺炎大流行,家庭成员停止了对居民的社会访问,居民被限制在自己的房间里。本文报道了在大流行的第一波期间,养老院工作人员如何临时应对这种情况。它的重点是采取措施保持居民和家庭之间的沟通,以支持情感健康。我们对21位员工进行了深入的咖啡馆式采访,以探索他们介绍的创意实践。这是苏格兰一项更广泛的研究的一部分,该研究调查了封锁对亲属在养老院生活/死亡的家庭的影响(2020年5月至10月)。调查结果显示,护理人员在维持家庭联系方面付出了巨大的努力,并迅速适应了许多不同的在线平台,将整个护理院的工作人员聚集在一起,并关注在护理院生活和死亡的居民的情感健康。调查结果突出了领导和有关工作人员的专业精神和承诺。虽然有些工作人员的叙述不需要进一步的评论,但我们从养老院研究文献中借鉴了一些主题,以便根据我们可能学到的东西来理解这些发现。这项深入的定性研究强调了在长期护理中认识、培养和培养关系关怀的重要性。然而,几乎没有证据表明卫生和社会保健政策认识到这种持续关系的重要性。
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引用次数: 5
Profile of Residents with Mental Disorders in Canadian Long-Term Care Facilities: A Cross-Sectional Study 加拿大长期护理机构中精神障碍患者概况:一项横断面研究
Q2 Health Professions Pub Date : 2021-06-01 DOI: 10.31389/JLTC.47
Vahe Kehyayan, Jonathan Chen, J. Hirdes
Brief Summary: Residents in long-term care facilities in Canada with mental and cognitive disorders have complex care needs. To meet these needs an integrated model of care is recommended. Context: The high prevalence of mental disorders in residents of long-term care (LTC) facilities raises serious concerns for facility operators and staff. These residents have multiple vulnerabilities that facility staff should have the necessary knowledge and skills to properly meet their needs. Objectives: To describe the profile of residents with mental disorders (MD) and Alzheimer’s Disease and Related Dementias (ADRD) in Canadian long-term care (LTC) facilities. Findings: Seventy-six percent of residents had MD (40%) and ADRD (36%). These residents compared to those without such disorders were more likely to be cognitively impaired, manifest aggressive behavior, receive psychotropic drugs, and physically restrained, and less likely to be socially engaged. Strengths and Limitations: The large representative sample was a key strength. The findings add to the knowledge about the profile of LTC residents. The cross-sectional design of the study limits the findings to the population studied. Implications: Residents with MD and ADRD compared to those without such disorders are highly vulnerable because of their double burden of mental and physical comorbidities. Their profile may be of interest to LTC facility operators, clinicians, and policy makers about their complex care needs. Our findings raise awareness of the need for trained LTC facility staff for knowledge and skills in psychogeriatric conditions to assess, plan, and implement appropriate interventions for these residents. Coordinated and integrated models of care with access to psychogeriatric specialists such as psychiatrists or advanced practice nurses will also be of benefit to them.
摘要:加拿大长期护理机构中患有精神和认知障碍的居民有复杂的护理需求。为了满足这些需求,建议采用综合护理模式。背景:长期护理(LTC)设施居民中精神障碍的高患病率引起了设施经营者和工作人员的严重关注。这些居民有多重弱点,设施工作人员应该具备必要的知识和技能,以适当满足他们的需求。目的:描述加拿大长期护理(LTC)设施中患有精神障碍(MD)和阿尔茨海默病及相关痴呆(ADRD)的居民的概况。结果:76%的居民患有MD(40%)和ADRD(36%)。与没有这些障碍的人相比,这些居民更容易出现认知障碍,表现出攻击行为,接受精神药物治疗,身体受到限制,并且不太可能参与社会活动。优势和局限性:大的代表性样本是一个关键优势。这些发现增加了对LTC居民概况的了解。该研究的横断面设计将研究结果限制在所研究的人群中。意义:与没有这些疾病的居民相比,患有MD和ADRD的居民由于精神和身体合并症的双重负担而非常脆弱。LTC设施运营商、临床医生和政策制定者可能会对他们复杂的护理需求感兴趣。我们的研究结果提高了对训练有素的LTC设施工作人员在老年精神疾病方面的知识和技能的认识,以评估、计划和实施适当的干预措施。协调和综合的护理模式,以及获得精神科医生或高级执业护士等老年心理专家的机会,也将对他们有益。
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引用次数: 1
The Impacts of COVID-19 on Unpaid Carers of Adults with Long-Term Care Needs and Measures to Address these Impacts: A Rapid Review of Evidence up to November 2020 2019冠状病毒病对有长期护理需求的成人无薪照护者的影响及应对这些影响的措施:截至2020年11月的证据快速审查
Q2 Health Professions Pub Date : 2021-05-14 DOI: 10.31389/JLTC.76
K. Lorenz-Dant, A. Comas-Herrera
Context: Unpaid carers are the backbone of long-term care (LTC) systems around the world. The COVID-19 pandemic has further increased the pressure many unpaid carers experience; however, their experience has been largely absent from public reporting. Objective: We aim to map the available evidence of the impacts of COVID-19 on unpaid carers of adults (>18 years) with LTC needs as well as of measures implemented to mitigate these effects and how well they have worked. Method: We conducted a rapid review of the academic and grey literature on unpaid carers of adults with LTC needs during the COVID-19 pandemic, covering the period until November 2020. Findings: We identified six key themes that highlight the impacts of COVID-19 on unpaid carers of people living in the community. These are: care commitment, concerns related to COVID-19, availability of formal and informal support, financial implications, carer health and well-being, and carers’ adaptability. In addition, we captured aspects identified by unpaid carers supporting people in residential care settings under the theme ‘carers of people in residential settings’. Finally, we reported evidence of measures implemented to mitigate the impacts on carers. This included the use of technology and the receipt of financial assistance and support for working carers. Limitations: The evidence reported in this review is based largely on cross-sectional data and some of the data reported relies on convenience samples. Implications: We highlight the financial and health impacts that many unpaid carers experience. Given the vital support carers provide to adults with LTC needs, policy makers should consider supporting unpaid carers to mitigate the negative impacts on their lives.
背景:无薪护理人员是世界各地长期护理系统的支柱。2019冠状病毒病大流行进一步增加了许多无薪照护者面临的压力;然而,他们的经历在很大程度上没有出现在公开报道中。目标:我们的目标是绘制COVID-19对有长期护理需求的成人(0 - 18岁)无薪照护者影响的现有证据,以及为减轻这些影响而采取的措施及其效果。方法:我们对截至2020年11月的2019冠状病毒病大流行期间有LTC需求的成人无薪照护者的学术文献和灰色文献进行了快速回顾。研究结果:我们确定了六个关键主题,突出了2019冠状病毒病对社区中无薪照护者的影响。这些因素包括:护理承诺、与COVID-19有关的关切、正式和非正式支持的可得性、财务影响、护理人员健康和福祉以及护理人员的适应能力。此外,我们还以“住宿护理机构的护理人员”为主题,收集了支持住宿护理机构中人员的无薪护理人员所确定的方面。最后,我们报告了减轻对护理人员影响的措施的证据。这包括对技术的使用和对在职护理人员的财政援助和支持。局限性:本综述中报道的证据主要基于横断面数据,部分报道的数据依赖于方便样本。启示:我们强调了许多无薪照顾者所经历的经济和健康影响。鉴于护理人员为有长期服务需求的成年人提供的重要支持,政策制定者应考虑支持无薪护理人员,以减轻对他们生活的负面影响。
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引用次数: 27
Delivering Personalised Home Care for People with Dementia: An Investigation of Care Providers’ Roles and Responsibilities 为痴呆症患者提供个性化的家庭护理:护理提供者角色和责任的调查
Q2 Health Professions Pub Date : 2021-02-15 DOI: 10.31389/JLTC.35
C. Sutcliffe, K. Davies, Saima Ahmed, J. Hughes, D. Challis
Context: Home care agencies are a critical part of the social care system in England, however little is known of how they perceive their role in delivering personalised care or their approach to supporting people with dementia. Objectives: To investigate the perception of home care managers of their capacity and capability to provide care for people living with dementia with a focus on specialist care, and the challenges of delivering personalised support. Methods: A qualitative study employing semi-structured interviews (May-October 2018) of ten independent home care managers in England. Findings: Three themes were identified. First, managers aimed to provide responsive care, assessing individual needs and family circumstances including addressing social and emotional needs in keeping with a model of personalised care. Second, in responding to commissioning processes, managers found prescriptive specifications constrained delivery of responsive home care. Sharing assessment and care planning with commissioning teams helped managers personalise client care but created tensions. Third, workforce preparedness was a priority, with life skills and experience valued above qualifications. Agencies used different service models, with only a few referring to specialist dementia roles or services. However, all were aiming to increase understanding of dementia across their teams as part of their approach to personalisation. Limitations: It was not possible to interview home care workers who may have given alternative viewpoints.
背景:家庭护理机构是英国社会护理系统的重要组成部分,然而,人们对他们如何看待自己在提供个性化护理方面的作用或他们支持痴呆症患者的方法知之甚少。目的:调查家庭护理管理者对他们为痴呆症患者提供以专科护理为重点的护理的能力和能力的看法,以及提供个性化支持的挑战。方法:采用半结构化访谈(2018年5月- 10月)对英国10名独立家庭护理经理进行定性研究。研究结果:确定了三个主题。首先,管理者的目标是提供响应式护理,评估个人需求和家庭情况,包括解决社会和情感需求,以保持个性化护理模式。其次,在对委托流程的回应中,管理人员发现规范性规范限制了响应式家庭护理的提供。与委托团队共享评估和护理计划有助于管理人员个性化客户护理,但也造成了紧张关系。第三,为劳动力做好准备是一个优先事项,生活技能和经验比资格更重要。各机构使用了不同的服务模式,只有少数机构提到了痴呆症专家的角色或服务。然而,所有人的目标都是在他们的团队中增加对痴呆症的理解,作为他们个性化方法的一部分。局限性:不可能采访可能提供不同观点的家庭护理人员。
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引用次数: 2
Understanding Resource Allocation Processes in Social Care for Frail Older People: Lessons from a National Survey 了解弱龄老人社会照护的资源分配过程:来自全国调查的经验教训
Q2 Health Professions Pub Date : 2021-02-08 DOI: 10.31389/JLTC.21
K. Stewart, J. Hughes, D. Challis, A. Worden, S. Davies, Chengqiu Xie, S. Asthana, Alex Gibson
Context: Traditionally local authorities in England allocated resources in social care following a professional assessment of need and a costed care plan. With the introduction of personal budgets, resource allocation tools have been used to provide service users with an initial indicative budget for their care. This is promoted as being more transparent, equitable and giving people greater control over decisions about their care. Objective: This study examined the different approaches to resource allocation and the content of resource allocation tools used for social care in England. Methods: Information was obtained from local authorities about their resource allocation systems. An analytic framework was developed and applied to the tools to explore: who identified needs; whether informal and formal support were recorded; and whether 17 need indicators covering functional status, mental health, and health and wellbeing were present and in what detail. Findings: Ninety-one per cent of 152 authorities responded and 61 per cent of authorities’ tools were analysed. Three approaches were identified: points-based self-assessment tools; standardised assessment data (FACE); and non-points-based/ready reckoner tools. Most authorities used a points-based self-assessment tool. All tools included the service user’s views and a high proportion included a professional’s view, while fewer covered the carer’s view on need. Coverage and presence of detail for the 17 need indicators showed high variation and was least on points-based self-assessment tools. Limitations: The study is the first to examine a large sample of resource allocation tools and provides a valuable baseline for future work. However, non-points-based/ready reckoner tools were under-represented in the sample. Implications: Further research could build upon this study to examine key properties of the tools used such as reliability, validity, sensitivity and specificity; and explore their impact upon service users and staff in terms of time use, cost, utility and equity.
背景:传统上,英格兰地方当局根据专业的需求评估和成本计算的护理计划来分配社会护理资源。随着个人预算的引入,资源分配工具已被用于向服务使用者提供其护理的初步指示性预算。这被宣传为更加透明、公平,并使人们对自己的护理决定有更大的控制权。目的:本研究考察了英国社会护理中资源分配的不同方法和资源分配工具的内容。方法:从当地有关部门获取资源分配制度信息。开发了一个分析框架,并将其应用于探索的工具:谁确定了需求;是否记录了非正式和正式的支持;是否有17项需要指标涵盖功能状态、心理健康、健康和福祉,以及具体细节。调查结果:152家机构中有91%做出了回应,61%的机构工具得到了分析。确定了三种方法:基于点数的自我评估工具;标准化评估数据(FACE);和非基于点/现成的计算工具。大多数权威机构使用基于分数的自我评估工具。所有工具都包括服务用户的观点,而且有很大比例的工具包括专业人员的观点,而较少的工具包括护理人员对需求的看法。17个需求指标的覆盖范围和细节显示出很大的差异,而基于点的自我评估工具的差异最小。局限性:该研究首次检查了大量的资源分配工具样本,并为未来的工作提供了有价值的基线。然而,非基于点/现成的计算工具在样本中代表性不足。启示:进一步的研究可以建立在本研究的基础上,以检查所使用的工具的关键属性,如可靠性,有效性,敏感性和特异性;并探讨它们在时间使用、成本、效用和公平性方面对服务使用者和员工的影响。
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引用次数: 0
Fractures in the Austrian Model of Long-Term Care: What are the Lessons from the First Wave of the COVID-19 Pandemic? 奥地利长期护理模式的断裂:从第一波COVID-19大流行中吸取了什么教训?
Q2 Health Professions Pub Date : 2021-02-02 DOI: 10.31389/JLTC.54
K. Leichsenring, A. Schmidt, Heidemarie Staflinger
Context: The COVID-19 pandemic highlights limitations of long-term care (LTC) systems in Europe, which continue to be divided between health and social care, and between formal and informal care. Objective: This article focuses on Austria’s LTC sector and its critical features that became visible during the outbreak of the COVID-19 pandemic. Method: The analysis was carried out via desk-research, which covered literature, on-going qualitative analysis of media coverage, and statements and reports by interest organisations and governmental agencies between March and August 2020. Where necessary, useful and feasible, update information on ensuing developments until the end of 2020 was added during a final revision. Findings: In Austria, the number of cases as well as the number and share of deaths in care homes were lower than in other countries until August 2020. Yet, the crisis brought several idiosyncrasies to the fore, most prominently a lack of support for informal caregivers and lack of acknowledgements of the rights of live-in personal (migrant) carers. We find that the COVID-19 crisis has shed light on the fact that existing inequalities are being aggravated by gender and migration issues. Implications: (i) The crisis highlights the need for better communication, integrated care and health information flows between health and social care; (ii) Clear guidelines are required to balance older people’s right to self-determination versus (public) health concerns; (iii) Increasing reliance on migrant carers from Eastern Europe has led to a dualisation of the LTC labour market in the past decades, which needs to be countered by increased quality standards and endeavours to fundamentally change the employment situation of live-in carers; (iv) Informal carers are vulnerable groups that deserve special attention and call for expansion of community services in long-term care.
背景:2019冠状病毒病大流行凸显了欧洲长期照护系统的局限性,这些系统继续分为卫生和社会照护以及正规和非正规照护。目的:本文重点介绍奥地利的LTC部门及其在COVID-19大流行爆发期间显现出来的关键特征。方法:在2020年3月至8月期间,通过桌面研究进行分析,包括文献,持续的媒体报道定性分析以及利益组织和政府机构的声明和报告。在必要、有用和可行的情况下,在最终修订期间添加了有关后续发展的最新信息,直至2020年底。调查结果:在奥地利,直到2020年8月,养老院的病例数以及死亡人数和比例都低于其他国家。然而,危机带来了几个特质,最突出的是缺乏对非正式照顾者的支持,以及缺乏对住家个人(移民)照顾者权利的承认。我们发现,2019冠状病毒病危机揭示了一个事实,即性别和移民问题正在加剧现有的不平等现象。影响:(i)危机突出表明需要在保健和社会保健之间加强沟通、综合护理和保健信息流动;㈡需要制定明确的准则,以平衡老年人的自决权与(公共)健康关切;(iii)在过去几十年里,越来越依赖来自东欧的移徙照顾者,导致长期照顾者劳动力市场出现了两极化现象,需要通过提高质量标准和努力从根本上改变住家照顾者的就业情况来加以应对;非正式照顾者是值得特别注意的脆弱群体,需要扩大长期照顾方面的社区服务。
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引用次数: 4
Electronic Information Sharing Between Nursing and Adult Social Care Practitioners in Separate Locations: A Mixed-Methods Case Study 在不同地点的护理和成人社会护理从业人员之间的电子信息共享:一个混合方法的案例研究
Q2 Health Professions Pub Date : 2021-01-12 DOI: 10.31389/JLTC.16
Helen Chester, J. Hughes, I. Bowns, M. Abendstern, S. Davies, D. Challis
Context: A longstanding concern, both in the UK and internationally, is that multiple health and social care professionals undertake assessments of adults and older people with complex needs, but that information is not shared. Electronic information sharing within assessment and support planning has been identified as a means of promoting integrated care for adults with complex health and social care needs. Objective: To evaluate the implementation of a shared electronic record between nursing and adult social care practitioners in separate agencies and locations to inform the assessment of need for adults and older people with complex needs. Methods: The design of the study reflected the incremental implementation of the shared electronic record between 2010 and 2012 in one geographical area within England. It was a mixed-methods case study employing data from three sources: audit of patient case files; survey of nurse practitioners’ time use, well-being and job satisfaction; and manager interviews post-implementation providing further insights into the implementation process. Findings: Electronic information sharing facilitated greater involvement of adult social care practitioners in the continuing healthcare assessment process and contributed to a more streamlined service. No adverse effects of the intervention on the well-being and job satisfaction of nursing practitioners’ were reported. Limitations: This research was undertaken in a single setting. Implications: Continuing healthcare services are a universal service that uses a standardised assessment process, offering the potential for this to be replicated elsewhere. Thus, findings are of value to policy makers and practitioners and offer the potential to inform wider roll-out.
背景:在英国和国际上,一个长期存在的问题是,多个健康和社会护理专业人员对有复杂需求的成年人和老年人进行评估,但这些信息没有共享。评估和支助规划中的电子信息共享已被确定为促进对具有复杂健康和社会护理需求的成年人的综合护理的一种手段。目的:评估在不同机构和地点的护理和成人社会护理从业人员之间共享电子记录的实施情况,为有复杂需求的成人和老年人的需求评估提供信息。方法:本研究的设计反映了2010年至2012年在英格兰一个地理区域逐步实施共享电子记录的情况。这是一个混合方法的案例研究,使用的数据来自三个来源:审计患者病例档案;执业护士时间利用、幸福感与工作满意度调查实施后的经理访谈提供了对实施过程的进一步了解。结果:电子信息共享促进成人社会护理从业人员更多地参与持续的医疗保健评估过程,并有助于提供更精简的服务。干预对护理从业人员的幸福感和工作满意度无不良影响。局限性:本研究在单一环境下进行。含义:持续医疗保健服务是一种使用标准化评估过程的普遍服务,提供了在其他地方复制的潜力。因此,研究结果对政策制定者和从业者具有价值,并有可能为更广泛的推广提供信息。
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引用次数: 1
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Journal of long-term care
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