Dissertationen zum Thema „Residential care centre“

This study explores the experiences of young orphans who transition into extended families in Zimbabwe, focusing on the five- to ten-year-old age group. The study embraced a qualitative approach which is situated within the interpretivist paradigm. The choice of the qualitative mode of inquiry was to ensure that the researcher interacted with participants who were remarkably close to young orphans and, henceforth, gather as much reliable and pertinent data as possible. A multiple case study design was employed to investigate five extended family members and their five to ten-year-old young orphans, one social worker and two residential care centre administrators. All five extended families with young orphans lived in the Mutoko, Murewa, Mudzi and Uzumba Maramba Pfungwe (UMP) districts. Data were gathered through interviews, drawings, narratives, and observations. The preference for the research methods were to necessitate a high level of trustworthiness and comprehensive data. The study established that although the government is mandated to provide services in the transitioning of young orphans into extended families in Zimbabwe, lack of resources inhibit efforts to support these children. Due to lack of funds social workers seldom follow up on young orphans. Although Zimbabwe has well stipulated national, regional and international agreements in its archives on transition, this research study had established that the strained Zimbabwean economy had a negative effect on children who transitioned into extended families. The situation is exacerbated by the fact that extended family members are inadequately prepared and trained to handle young orphans who transition into their families. Furthermore, extended families also face challenges on the scarcity of resources to support young orphans. Young orphans were further challenged by the fact that people stereotyped them because they came from residential care centres. These young orphans also faced several psychological challenges. The study concluded that both young orphans and extended families are victims of a system that does not have the resources, nor the political and social will to support the transition process. Based on these findings, the recommendations were made for the attention of the government of Zimbabwe, as well as the Department of Social Welfare, who act as executive body in implementing Government’s directives. The study therefore, upholds that extended family members should have relevant skills to enable them to appropriately deal with young orphans. The study further recommends the implementation of policies to take cognisance of the needs of young orphans who transition to extended families are taken on board, as they access appropriate services and resources to mitigate their impediments.
Thesis (PhD)--University of Pretoria, 2020.
pt2021
Early Childhood Education
PhD
Unrestricted

Magister Artium (Child and Family Studies) - MA(CFS)
Child and Youth Care Workers employed in residential Child and Youth Care Centres are often challenged by the behaviour of children in their care. The goal of the study was therefore to explore and describe the challenges faced by Child and Youth Care Workers with regard to the discipline of children with challenging behaviour in Child and Youth Care Centres. A qualitative research approach employing explorative, descriptive and contextual designs were followed. Participants were selected by means of purposive sampling from four Child and Youth Care Centres from four different metropoles in the Cape Peninsula. Data was collected by means of focus groups with the aid of an interview schedule. The interviews were be recorded and transcribed verbatim. Data was analysed according to Tesch (in Creswell, 2003) eight steps of data analysis. Ethical considerations such as informed consent, confidentiality and debriefing were adhered to. The findings of the study pointed inter alia to the fact that CYCWs are the first line disciplinarians that they need more support with regards to the discipline of children from colleagues, management and social workers. Multi-disciplinary in CYCCs teams tend to be ineffective and they experience disempowerment from the management and social workers. In addition, they are challenged by the behaviour of children in their care, such as truancy, stealing, absconding, aggressiveness, inappropriate sexual behaviour, development problems. Recommendations for all the stakeholders in the field of CYC were made to improve service delivery.

Includes bibliographical references (leaves 153-175).
The oblective of this mixed-method approach study was to explore and describe key protective factors that contribute to resilience among adolescents in long-term residential care in Namibia. The sample consisted of three caregivers and 61 male and female adolescents between the ages of 11-19 years (mean age=14.45, SD=2.26.) Data was collected by means of in-depth interviews and two self-report questionnaires including the Child and Youth Resilience Measure (CYRM) and the Strengths and Difficulties Quetionnaire (SDG).

The overall aim of the study was to explore factors that could be associated with criminal behaviour of youth offenders diverted in the life skills residential diversion programmes at Walter Sisulu Child and Youth Care Centre, so as to contribute towards a better understanding of their profile. Therefore the study explored the participants' family backgrounds, the circumstances surrounding the committal of their offences and their responses to the offences they were diverted for in the life skills diversion programmes. An exploratory-descriptive type of a qualitative design was adopted in this study. A semistructured interview schedule was used as the research instrument for conducting in-depth face-to-face interviews with the participants. The study had one set of target population; who were 18 youth offenders (both male and female) between the ages 14-17 attending life skills residential diversion programmes at Walter Sisulu Child and Youth Care Centre. The profile of the participants seem to indicate that most of them had absent fathers and therefore lacked male figures who could act as role models. The study found that biological fathers of most participants were either deceased, whereabouts unknown, not involved in their financial maintenance or those who had stepfathers, had a bad relationship with them. The findings indicated that the participants' mothers were unavailable and therefore most participants were taken care of by their grandmothers. However, it seems most grandmothers often failed to supervise their grandchildren properly and as such it created an opportunity for the participants to be mischievous with no consequences for their behaviour. It was also found that violence in the family also contributed significantly to the aggressive criminal offences of some of the participants. Lastly, the study showed that the influence of drugs and negative peer pressure also played a significant role in the participants' involvement in criminal behaviour.

Purpose: The movement away from task-oriented care toward the consistent provision of person-centred care (i.e., care based on residents??? needs and preferences) is widely recognized as the goal of the residential care culture change movement. The purpose of this study was to explore why the attainment of this goal has remained elusive for many residential care facilities (RCFs), despite significant effort to alter practice. Methods: I conducted an institutional ethnography to explore the textually mediated work processes that influence the day-to-day work practices of front-line care staff in RCFs. The social organization of RCFs was explored through the observation of resident care attendants??? (RCAs') practices and the interaction of those practices with institutional texts. The data were derived from three RCFs and included 104 hours of naturalistic observation, 76 in-depth interviews, and document analysis. Results: Practical access to institutional texts containing care-related information was dependent on job classification. Regulated healthcare professionals (e.g., RNs) frequently accessed these texts to exchange information. Although RCAs provided 80% of the care to residents, in all sites studied, they lacked practical access to the institutional texts that contained important information relevant to the residents??? individualized care needs and preferences (e.g., assessments, care plans, social histories). The RCAs primarily received and shared information orally; however, the organizational systems in the facilities studied mandated the written exchange of information and did not formally support an oral exchange. Consequently, the oral exchange of care information was largely dependent upon the quality of the RCAs' working relationships with one another and especially with management. Implications: Access to detailed knowledge of residents??? needs and preferences is fundamental to the provision of person-centred care. The transfer of this knowledge to and between front-line care staff is dependent upon the quality of the relationships managers develop with and among RCAs. Initiatives aimed at building supportive and collaborative work teams are essential to the inclusion of RCAs in the care planning process and to the attainment of the goal of person-centred care.

Children have been shown to respond differently to the hurt that they suffer at the hands of others. Some of these responses involve internalised behaviours (i.e., repression of feelings, bodily symptoms, etc.); whilst others hurt manifest as externalised behaviours, such as physical attacks on others. These may include sexualised behaviours. The latter is particularly common amongst (but not restricted to) children who have been sexually abused (The American Psychological Association, 2001). For the purposes of this study a distinction is made between developmentally appropriate sexual behaviour and non normative sexualised behaviour which evoke complaints from and discomfort in those involved in the behaviour. The manifestation of these sexualised behaviours is especially pronounced amongst children in institutional care; and hence, it calls for constructive and effective management by the child care workers who are primarily responsible for their safe care and behaviour modification whilst in the institution. This qualitative study – with an exploratory, descriptive and contextual research design – served to explore how the child care workers’ effective management of such behaviours could be enhanced, so that the emotional wellbeing of both the “offender” and the “perpetrator” of this behaviour can be promoted. A non-probability purposive sampling technique was employed to recruit research participants from three different child and youth care centres in Port Elizabeth. A total number of 10 research participants were involved and data was collected up to the point of data saturation. Thematic content analysis was utilised for the analysis of the data and the necessary strategies were employed to enhance the trustworthiness of the data and to meet all the ethical requirements of the study. The main findings alert to the key requirements of Child and Youth Care Workers; it confirms the occurrence of sexualised behaviours; the urgent need for a consistent approach to the management of such behaviours; and for enhanced team work between the helping professionals in the team. The value of the study is embedded in the contributions it can make to practical interventions for children in institutional care, and to the sparse body of knowledge in this area.

This study compared the ratings of self-efficacy and burnout by traditionally-trained direct care staff in a residential treatment center with ratings by a group of direct care staff that were trained to implement Positive Behavioral Interventions and Supports (PBIS) with adults who have intellectual or developmental disabilities. Staff responses on measures of self-efficacy, using the Teacher’s Sense of Efficacy Scale (TSES) and burnout, using the Maslach Burnout Inventory (MBI) were compared across the two groups: One group of staff was not exposed to PBIS training (traditional training only), whereas the other group was trained to implement PBIS. A total of 70 direct care staff members from a Residential Treatment Center (RTC) participated in this study. The mean differences of total scores on each measure were compared using t-tests to determine if there were significant between-group differences. In addition, as the measure of self-efficacy was originally designed for use with teachers and was slightly modified here for use with direct care staff, an exploratory factor analysis was conducted to examine the factor structure of the measure when administered to staff in an RTC.

The results indicate that the modified TSES has one factor, which differs from the three factors found when the TSES was administered to teachers who were implementing PBIS in schools. Additionally, significant differences were found in staff members’ sense of self-efficacy between the control and PBIS groups. However, staff members’ degree of burnout were not significantly different. The results must be interpreted with caution because of the study’s small sample size. However, there are several implications for future research that are discussed to further examine the impact of implementing PBIS on direct care staff members in residential treatment settings.

Aquesta Tesis pretén aprofundir en conèixer els factors que determinen l’experiència escolar dels infants en acolliment residencial i analitzar de quina manera els programes de mentoria poden contribuir a millorar-la, a través de tres estudis realitzats en el context d’un projecte pilot europeu de mentoria social. Els resultats van mostrar que la satisfacció escolar és un component rellevant pel benestar subjectiu dels/les joves en acolliment residencial i que les relacions socials són el factor predictiu més potent d’una alta satisfacció amb l’escola. D’altra banda, proveint al/la jove d’una relació de suport i cura, estable i basada en la confiança, els programes de mentoria podien crear una oportunitat per a la promoció del benestar, resiliència i el capital social. A més, els mentors/es jugaven un rol complementari i compensatori dins la xarxa de relacions dels i les joves en acolliment residencial amb adults significatius que donen suport a la seva educació.
This Thesis seeks to better understand the factors that shape the school experience of children in residential care and analyse how mentoring programmes can help enhance it. A series of three studies were designed in the context of a European social mentoring pilot project targeted at children in residential care and focused on their education improvement. Results showed that school satisfaction was an important component of the subjective well-being of children in residential care, and satisfactory relationships were highlighted as the strongest predictor of higher school satisfaction levels among these children. On the other hand, the findings indicated that by providing supportive, caring, trusting and steady relationships, mentoring programmes may create an opportunity for promoting the well-being and resilience of children in care as well as their social capital. Mentors also played a specific, unique and supplementary role within the existing network of supportive adults in residential care contexts.

El trabajo de investigación presenta la explicación de un taller realizado en un Centro de Atención Residencial cuyo objetivo era definir lo que es una familia dentro de un CAR, para poder hacer la convivencia más dinámica. La población con la cual se trabajó fueron niños cuyas edades oscilaban entre los 9 y los 12 años. Como instrumento se utilizó el taller y una ficha de observación que se creó antes de llevar a cabo el taller. Dentro de los resultados obtenidos se tuvo una mejora en el comportamiento de los menores respecto al modo en el que se jugaba. Otro resultado significativo fue con respecto a los alumnos que iban a la escuela, ya que ahora contaban como les había ido en su día y no como se habían portado. Finalmente, con la realización del taller se llegó a la conclusión de la importancia de realizar más estudios de este tipo, ya que permiten conocer de cerca como es la dinámica de estos niños institucionalizados.
The research work presents the explanation of a workshop held in a Residential Care Center whose objective was to define what a family is within a CAR, in order to make living more dynamic. The population with which they worked were children whose ages ranged from 9 to 12 years. The workshop was used as an instrument and an observation sheet that was created inside before carrying out the workshop. Among the results obtained, there was an improvement in the behavior of minors with respect to the way in which it was played. Another significant result was with respect to the students who went to school, since they now told how they had done in their day and not how they had behaved. Finally, with the completion of the workshop, it was concluded that it is important to carry out more studies of this type, since they allow us to learn about the dynamics of these institutionalized children.
Trabajo de investigación

Bakgrund: Människor blir idag allt äldre och demenssjukdomar förväntas bli ett växande problem. Inget bot finns men symtom kan hämmas genom farmakologiska behandlingar, dock ofta med flera biverkningar. Personer med demenssjukdom utvecklar ofta beteendeförändringar som kan vara svåra att bemöta för vårdgivare. I och med sjukdomens karaktär och olika förekommande symtom är en god och personcentrerad vård att föredra för att främja vårdtagarens delaktighet och integritet. Syfte: Att sammanställa och beskriva aktuell forskning om vilka effekter musik har som omvårdnadsåtgärd inom demensvård. Metod: Studien är en litteraturöversikt baserad på (n=18) artiklar från tio länder. Databaserna CINAHL, Pubmed och Web of Science användes och de artiklar som inkluderats är av kvantitativ ansats (n=12), kvalitativ ansats (n=5) samt Mixed method (n=1). Efter analys har skillnader och likheter i artiklarnas resultat skapat teman och subteman. Resultat: Musikinterventioner hade positiva effekter, bland annat gällande BPSD, kognitiva funktioner och psykofarmakologisk behandling. Musik kunde även bidra till en ökad samhörighet mellan vårdgivare och personer med demenssjukdom. Anhörigas och vårdgivares uppfattningar om musikens effekter var blandade, åsikterna var dock samstämmiga om att musik bör användas som omvårdnadsåtgärd. Slutsats: Musik har en positiv påverkan på personer med demenssjukdom och BPSD genom att fungera som en personcentrerad åtgärd inom omvårdnaden och bör implementeras mer.
Background: People are growing older and dementia is expected to become an increasing problem. There is no available cure, but symptoms can be inhibited by pharmacological treatments, often with side effects. People with dementia often develop behavioral changes that are difficult to respond to for caregivers. With the nature of the disease and the different symptoms occuring, a person-centered care is preferable to promote participation and integrity. Aim: To conclude current research on the effects of music in the nursing care of people with dementia. Method: A literature review based on (n=18) articles from ten countries. Quantitative (n=12), qualitative (n=5) and mixed method (n=1) articles were used from CINAHL, Pubmed and Web of Science. After the analysis, differences and similarities in the articles created themes and subthemes. Results: Music interventions proved to have positive effects, regarding BPSD, cognitive functions and psychopharmacological treatment. Music could contribute to increased association between caregivers and people with dementia. The caregivers and family members' perceptions of the effects of music were mixed, however, the views were consistent that music should be used as a nursing measure. Conclusion: Music has a positive impact on people with dementia and BPSD by acting as a person-centered nursing measure and should be implemented more.

Bakgrund: Andelen äldre i befolkningen ökar nationellt och internationellt, och med ökande ålder ökar både fysisk och psykisk ohälsa. Äldre personer med ohälsa i form av kognitiv svikt (oftast demenssjukdom) kan bli beroende av vård och omsorg i särskilda boenden för äldre för att kunna känna trygghet och välbefinnande samt ha ett gott liv, i gemenskap med andra. Dock visar utvärderingar av särskilda boenden för äldre att vården ofta kan vara uppgiftscentrerad och inte motsvara de äldres individuella behov och önskemål. Personcentrerad vård är en vårdmodell som beskrivs kunna tillgodose äldre personers multidimensionella behov och önskemål, genom att personens livshistoria, personlighet, kapacitet och perspektiv uppmärksammas, respekteras och inkluderas i vården. Den vetenskapliga litteraturen inom området visar dock att det finns begränsad kunskap om förekomsten av personcentrerad vård i särskilda boenden för äldre i Sverige och internationellt, liksom om vilka faktorer som är mest betydelsefulla för att särskilda boenden för äldre ska bedriva en personcentrerad vård. Syfte: Syftet med denna avhandling var att beskriva faktorer som samvarierar med förekomst av personcentrerad vård i särskilda boenden för äldre i Sverige. Metod: Samtliga delstudier var tvärsnittstudier och data samlades in genom enkäter till äldre med kognitiv svikt och personal i särskilda boenden för äldre i Sverige. I studie I bestod insamlad data av skattningar av personcentrerad vård från vårdpersonal (n=1465) i 182 särskilda boendeenheter. I studie II insamlades data i form av vårdpersonalens (n=1169) skattningar av personcentrerad vård och proxyskattningar av de äldres (n=1261) livskvalitet, ADL-förmågor, smärta, depressiva symtom och agitation i 151 särskilda boendeenheter. Delstudie III baserades på data i form av personalskattningar (n=1169) av personcentrerad vård, tillfredställelse med arbete och vård, samvetsstress, arbetsbelastning och psykosocialt klimat i samma 151 särskilda boendeenheter. Även delstudie IV baserades på data från de 151 särskilda boendeenheterna och inkluderade skattningar av de äldre och vårdpersonal, men också skattningar av organisation och miljö vid dessa enheter (n=151). Samtliga studiernas data analyserades med hjälp av statistiska analyser, beskrivande, bivariata och multivariata analysmetoder. Resultat: Studie I visade att enkätinstrumentet The Person-Centred Care Assessment Tool (P-CAT) har tillfredställande psykometriska egenskaper för intern konsistens och test-retest-reliabilitet. Instrumentet består av två subskalor: Individualisering av vården och Stöd från organisation och miljö. Delstudie II visade att de boendes ADL-förmågor och livskvalitet skattades bättre vid enheter som kan beskrivas som mer personcentrerade. Delstudie III visade att en mer personcentrerad vård har samband med att personalen upplever ett positivt psykosocialt klimat, mindre samvetsstress, lägre arbetsbelastning samt högre tillfredställelse med vård och arbete. Studien visade också att personcentrerad vård var positivt relaterat till i vilken omfattning vårdarna hade vidareutbildning i demensvård. Delstudie IV visade att vårdmiljön var mest betydelsefull för förekomsten av personcentrerad vård vid boendeenheterna och att en gynnsam vårdmiljö innebar att personal upplevde att det var ett positivt psykosocialt klimat på enheten, att de hade tid att prata med eller bara vara med de boende samt att de upplevde sig ha en gemensam värdegrund, låg arbetsbelastning och en fysisk miljö som var anpassad till de boendes behov. Slutsatser: Resultaten i avhandlingen visar att den svenska versionen av P-CAT kan användas för valida och reliabla utvärderingar av personcentrerad vård samt att den kan rekommenderas för fortsatt forskning och vårdutveckling inom särskilda boenden för äldre. Resultatet visar också att den vård- och arbetsmiljö som omger de äldre och vårdpersonal i särskilda boenden för äldre är betydelsefull för förekomsten av personcentrerad vård. Dessa aspekter behöver fokuseras ytterligare för att kunna erbjuda en personcentrerad vård. Vidare är det psykosociala klimatet och förekomsten av en upplevd gemensam värdegrund viktig att förstå och prioritera om vården ska utvecklas mot en ökad personcentrering. Fortsatt forskning och kliniskt utvecklingsarbete behövs för att operationalisera och implementera de komponenter som bidrar till ett positivt psykosocialt klimat och en personcentrerad värdegrund på särskilda boenden för äldre. Dessutom behövs en ökad förståelse för hur en sådan värdegrund kan omsättas i personcentrerade interaktioner, handlingar, aktiviteter och prioriteringar. Det vore alltså önskvärt att äldrevården utvecklades mot ett mer personcentrat förhållningssätt, eftersom avhandlingens resultat visar att högre grad av personcentrerad vård i särskilda boenden för äldre var positivt relaterat till välbefinnande och tillfredställelse för såväl de äldre som för vårdpersonal.
Introduction: The proportion of older people in the population increases nationally and internationally, with a declining physical and mental health often accompanying older age. Older people with health issues such as cognitive impairment or dementia often become dependent upon residential aged care to feel safe, experience well being and a good life with others. However, it has been shown that residential aged care can largely be taskoriented and not tailored to residents' needs and wishes. Person-centred care is a contemporary best practice model of care that can meet the multidimensional needs and preferences of older people dependent on care, by acknowledging, respecting and including each person’s life story, personality, capacities, and perspective in care. Nevertheless, the research literature indicates a limited knowledge on the extent to which residential aged care units are person-centred in Sweden and internationally, as well as a limited knowledge into factors of importance for person-centred care in residential aged care units. Aim: The overall aim of this thesis was to describe factors that associate with person-centred care in Swedish residential aged care units. Methods: The thesis consists of four studies with cross-sectional designs, and data was collected through resident and staff surveys in Swedish residential aged care units. Study I collected data consisting of ratings of person-centred care from staff (n=1465) in 182 residential aged care units. Study II collected data consisting of staff (n=1169) ratings of person-centred care and proxy ratings of resident (n=1261) quality of life, ADL-capacity, pain, depressive symptoms and agitated behaviours, in 151 residential aged care units. Study III was based on staff (n=1169) ratings of person-centred care, satisfaction with care and work, job strain, stress of conscience, and perceived psychosocial climate in the same 151 residential aged care units as in study II. Study IV was also based on data from the 151 residential aged care units as described in study II and III, and included ratings of resident and staff variables, as well as variables related to the organization and environment at the units. Data was analyzed using statistical analyses such as descriptive, bivariate, and multivariate methods. Results: Study I showed that the Person-Centred Care Assessment Tool (PCAT) has satisfactory psychometric properties relating to internal consistency and test-retest reliability. The tool consists of two subscales: Extent of personalizing care and Amount of organizational and environmental support. Study II showed that residents were rated as having higher quality of life and better ability to perform activities of daily living in units described as being more person-centred. Study III highlighted that person-centred care was associated with higher staff satisfaction, less job strain, less stress of conscience, and a positive psychosocial unit climate. Person-centredness of care was also positively associated with the extent to which staff had continuing education in dementia care. Study IV showed that the environment is the most influential factor for person-centred care, and that an environment facilitating person-centred care consists of a positive psychosocial unit climate, where staff perceives having time to spend being with residents, where staff perceives a shared philosophy of care, a low job strain, and a physical environment adapted to residents’ needs. Conclusions: The results of the thesis show that the Swedish version of the P-CAT can be used for valid and reliable assessment of unit personcentredness, and that it can be recommended for further research and practice development in residential aged care. The results of the thesis also show that the environment of care and work that encapsulates residents and staff in residential care units is important for person-centred care. These aspects need further focus to enable person-centred care in residential aged care units. Furthermore, the psychosocial climate and the presence and content of a shared philosophy of care are important to understand and prioritize if care is to move towards increased person-centredness. Further research and practice development work is needed to operationalize and implement the components that contribute to a positive psychosocial climate and a person-centred philosophy in residential aged care units, as well as to increase the knowledge of how such a philosophy of care can be translated into person-centred actions, interactions, activities and priorities. strive towards developing person-centredness further within aged care is desirable, as the results in this thesis indicate that residential aged care units

Bakgrund: Måltider utgör en social och kulturell grund där människor kan mötas i ett välbefinnande och samtidigt tillgodose sig näring. Ökad malnutrition med stigande ålder är ett globalt problem som omfattar både kognitivt medvetna och kognitivt nedsatta.Syfte: Syftet med litteraturstudien var att identifiera faktorer som vid måltider är av betydelse för välbefinnande och nutritionsstatus hos äldre människor boendes i särskilda boenden.Metod: En litteraturstudie med globalt perspektiv där vetenskapliga artiklar från Canada, Amerika, Storbritannien, Sverige, Danmark, Nya Zeeland och Australien var underlaget till resultatet. Inklusionskriterier var äldre över 65 år, kognitivt medvetna och kognitivt nedsatta vilka levde i särskilda boenden samt vårdgivare som arbetade i sådana.Resultat: Måltiden ger ett socialt och kulturellt sammanhang som stärker både boenden och vårdgivares relationer. Utformning av en terapeutisk fysisk miljö visade sig vara till fördel både för de äldre och vårdgivare. Möjlighet att utöva personcentrerad vård skulle kunna förbättras enligt den här litteraturstudien. Litteraturstudien visar på att social samvaro under måltider är en stund för gemenskap och ett välkommet avbrott under dagen.Slutsats: Måltidssituationen är en komplex situation där många faktorer är inbegripna för välbefinnande och nutritionsstatus. Tre huvudteman identifierades nämligen fysisk måltidsmiljö, personcentrerad vård och social samvaro.
Meals form a social and cultural basis where people can meet in a state of well-being while at the same time consuming enough food to meet thier nutritional needs. Regardless of age, social relationships and the need for food have been linked to enhance the quality of life. Older adult´s poor nutritional status is a global problem that include risks for both cognitive conscious and cognitive impairment.Aim: The purpose of the study was to identify and describe the aspects that are of nutritional beneficial importance and the well-being of the elderly in residential homes.Method: A litterature study with a global perspective whereby scientific articles from Canada, America, Britain, Sweden, Denmark, New Zealand and Australia laid forth foundation of the key findings. Inclusion criterias were elderly over 65 years, cognitive consciousness and cognitive impairment, whom resided in residential homes with round the clock caregivers.Results: The meal provides a social and cultural ambience that strengthens relationships for both the reisdents and caregivers.Three themes emerged and these affected well-being and nutritional status. The possibility of applying person-centered care could be augmented according to the literature study. The literature study shows that social interactions during meals are intervalls for gathering as well as they are welcome intermisssions during the day.Conclusion: The mealtime situation is a complex situation where multiple aspects involved in the well-being and nutrition status of the elderly. Three main themes where identified, physical mealtime environment, person centered care and social interactions.

Relatório de Estágio do Mestrado em Ciências da Educação apresentado à Faculdade de Psicologia e de Ciências da Educação
O Acolhimento Residencial surge como uma resposta necessária e importante para as crianças que se encontram expostas a situações de risco e/ ou perigo. Esta é uma realidade em muitas familias portuguesas, o que tem conduzido a diversos estudos, mudanças legislativas e institucionais e intervenções de diferentes tipos.O presente relatório intitulado “Crianças que sentem, crianças felizes”: Um projeto de intervenção socioeducativa em Educação Emocional em contexto de Casa de Acolhimento Temporário” pretende fundamentar, dar a conhecer e refletir sobre todo o trabalho desenvolvido durante o período do estágio curricular do Mestrado em Ciências da Educação, da Faculdade de Psicologia e Ciências da Educação da Universidade de Coimbra, realizado no Ninho dos Pequenitos, no ano letivo de 2019/2020. Esta casa pertence à Associação SORRISO- Associação dos Amigos do Ninho dos Pequenitos e acolhe e encaminha crianças dos 0 aos 6 anos que se encontrem numa situação de perigo, pondo em causa o seu bem-estar e desenvolvimento integral. O projeto realizado, que se intitula de “ Crianças que sentem, crianças felizes” é a atividade a que se dá mais destaque neste relatório, uma vez que o seu principal objetivo foi contribuir para o desenvolvimento das competências emocionais das crianças em situação de acolhimento. O relatório que se apresenta encontra-se organizado em quatro capítulos. O Capítulo 1 incluí o Enquadramento Institucional, onde foi efectuada uma caracterização da Associação SORRISO bem como da Casa de Acolhimento, Ninho dos Pequenitos onde efetivamente se realizou o estágio curricular. O capitulo 2 diz respeito ao Enquadramento Conceptual onde se aborda um pouco como evoluiu o reconhecimento dos direitos das crianças, sendo referida também alguma da lei bem como o sistema que promove e protege as crianças e jovens em risco/ perigo. Em seguida, aborda-se o Acolhimento Residencial como sendo uma alternativa a estas crianças, nas situações em que as famílias se revelam incapacitadas para cuidar delas, colocando em causa o seu superior interesse e por fim, para que possamos compreender um pouco melhor como decorre o processo de acolhimento de Crianças e Jovens em Portugal iremos analisar alguns indicadores importantes do Relatório CASA 2017, um relatório que retrata a Caracterização Anual da Situação de Acolhimento de Crianças e Jovens.Em seguida, no capítulo 3 é apresentada a intervenção realizada através do projeto de estágio, descrevendo as suas diferentes fases: diagnóstico, planificação, aplicação-execução, avaliação e por fim, uma reflexão final acerca do mesmo. No capítulo 4 fazemos referência às restantes atividades nas quais podemos colaborar durante todo o estágio curricular. Terminamos o nosso relatório com a apresentação das considerações finais, onde realizamos uma reflexão do todo este percurso, fazendo uma análise das aprendizagens adquiridas, bem como dos ganhos aprendidos ao nível dos conhecimento e das competências desenvolvidas. Por fim, terminamos com uma reflexão sobre o contributo das Ciências da Educação num contexto de Casa de Acolhimento Temporário.
The Residential Reception is a necessary and important answer for children who are exposed to situations of risk and / or danger. This is a reality in many Portuguese families, which has led to various studies, legislative and institucional changes and interventions of different types. This report entitled "Children who feel happy children: A socio-educational intervention projet in Emotional Education in the context of a residential care center”intends to inform and reflet on all the work developed during our internship of the Master’s degree in Educational Sciences, of the Faculty of Psychology and Educational Sciences of the University of Coimbra, held in Ninho dos Pequenitos, in the academic year 2019/2020. This residential care centre belongs to the Association SORRISO - Association of Friends of Ninho dos Pequenitos for children from 0 to 6 years who are in a situation of danger, jeopardizing their well-being and integral development.The project, entitled "Children who feel happy children", is the activity that is most highlighted in this report, since its main goal was to contribute to the development of the emotional competences of children.The report is organized in four chapters. Chapter 1 included the Institutional Framework, where a characterization of the SORRISO Association was conditioned, as well as the Home of the Reception, Nest of the Little Ones, where a curricular internship was held.Chapter 2 deals with the Conceptual Framework, which proposes to be a little more widespread for the dissemination of children's rights, and is one of the laws that most promote children and young people at risk / danger. Then approach the subject as the children, the situations in which they reveal themselves, the ones in consideration of their superior interest, in their superior interest and finally, so that they conform a little better how to decorate The process of childcare and young people in Portugal will present some important data from the CASA 2017 Report, a report that portrays a Characterization of the Situation of Reception of Children and Young People.Then, in Chapter 3 is presented through the stage design, describing its phases: diagnosis, planning, implementation application, evaluation and evaluation, final reflection on it.In chapter 4, you should be part of the activities in which the possibility is to collaborate throughout the curricular stage.We conclude our report with the publication of the final conclusions, making a reflection on the course, analyzing the acquired learning, as well as making progress in terms of knowledge and skills. Finally, we end with a reflection on the contribution of education sciences in a context of the Temporary Home.

The purpose of this study was to examine Residential Care Aides’ (RCAs) experiences of good quality dementia care provision. Informed by a political economy perspective, I sought to understand how RCAs conceptualize quality dementia care, whether such conceptualizations are reflected in their daily care practice and how the organizational care context impedes or facilitates such care provision. Drawing on a focused ethnographic approach, I utilized in-depth interviews, participant observation and the review of selected documents to contextualize RCAs’ experiences within the organizational care environment. Over a 12-month period, in-depth interviews with 29 staff (21 RCAs, 3 LPNs and 5 managers) and 239 hours of participant observation were conducted in four small-scale dementia units in two nursing homes in British Columbia, Canada. In-depth interviews yielded information-rich data about RCAs’ care experiences and their relationships with residents, while participant observation afforded the opportunity to strategically link RCAs’ actions and interactions with what was said, a feature missing from much of the previous research examining staff perceptions of quality dementia care. A select review of facility documents and provincial licensing regulations provided additional insight regarding the relevance of the larger structural context for RCAs’ care experiences. In general, RCAs conceptualized, and exhibited in their daily physical care provision, quality dementia care as that which focused on tangible care outcomes (i.e., keeping residents clean, comfortable, calm and happy), on their care approach (i.e., delivering care in a compassionate, patient and affectionate manner) and was guided by family ideology (i.e., invoking of family metaphors). Inherent in their care provision was a sense of role tension, as they sought to incorporate social interaction with task completion and their co-workers’ conflicting expectations. Study findings also illustrated how, in the face of continued disempowerment and organizational constraints, RCAs sought to provide quality dementia care by negotiating their peer and supervisory relationships and selectively breaking formal and informal policies/procedures. Salient to RCAs’ experiences of personhood was the limited recognition and appreciation they received from management and the manner in which work-life balance, staffing coverage, human resource management practices and limited information sharing further devalued them and their work. Study findings draw attention to the importance of: acknowledging the role of structural constraints in the pervasiveness of a task-oriented work culture; attending to (and facilitating) staff personhood; facilitating supportive peer and supervisory relationships and; fostering effective management practices as a means of potentially improving care quality. As such, the study sheds important light on what RCAs require within their work environments to help facilitate resident well-being, reinforcing the assertion that residents’ care conditions are inextricably linked to RCAs’ care work conditions.
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0351

Este estudo teve como objetivo realizar um estudo preliminar do desenvolvimento de instrumentos de avaliação da dimensão educativa e escolar em casas de acolhimento, que permitam detetar pontos de convergência e divergência entre os diferentes intervenientes, detetar fatores críticos de promoção do envolvimento e do sucesso escolar e, ainda, detetar áreas de melhoria que possam ser usadas como pistas para a intervenção. O estudo enquadra-se numa metodologia mista, ou seja, de natureza qualitativa e quantitativa, e assume uma perspetiva ecológica. Para o desenvolvimento da investigação participaram no estudo 36 intervenientes de duas casas de acolhimento situadas no norte de Portugal, dos quais 29 crianças e jovens, 5 cuidadores e 2 diretoras técnicas. Foi construído um guião de entrevista para os diretores técnicos, uma checklist para as crianças e jovens e uma checklist para os respetivos cuidadores. Os dados qualitativos foram alvo de análise de conteúdo com recurso ao NVivo e os dados quantitativos foram analisados com recurso ao SPSS. Os dados permitiram identificar pontos de convergência e divergência relevantes no discurso dos participantes, permitiram identificar fragilidades que condicionam a promoção do envolvimento e do sucesso escolar nas casas de acolhimento e possibilitaram identificar áreas de melhoria. Assim, consideramos que os instrumentos desenvolvidos se revelaram adequados para os objetivos preconizados
This study’s main goal was to test a pilot to assess the educational dimension in residential care centres, in order to detect convergence and divergence points between different players, as well as understand the critical factors linked to dedication and success in school and, lastly, to determine possible improvement aspects, strengths and weaknesses, which can be used in the intervention process. The study is framed in a mixed methodology, both qualitative and quantitative, while assuming an ecological standpoint. To develop the investigation, 36 participants were involved, from two different residential care centres in the north of Portugal. Of the 36 participants, 29 were children, 5 were caretakers and 2 were technical directors. An interview guide was developed for the technical directors and a checklist for children and young people, and a checklist for their caregivers. Qualitative data were analyzed using NVivo and quantitative data were analyzed using SPSS. The data allowed us to identify relevant points of convergence and divergence in the discourse of the participants, allowed us to identify weaknesses that condition the promotion of school involvement and success in the host families and made it possible to identify areas for improvement. Thus we consider that the instruments developed proved adequate for the objectives.

The aging Canadian population is becoming increasingly ethno-culturally diverse primarily due to immigration. This, together with research indicating increased likelihood of long-term residential care (LTRC) use at older ages and challenges in providing these services, prompt important questions about whether LTRC services are prepared to provide culturally responsive and competent care to immigrant and ethno-cultural minority older adults (EMOA). This ethnographic study, informed by a critical theoretical perspective, explored these questions from the perspectives of South Asian older adults (SAOAs) and their family caregivers (FCGs). In-depth interviews with 18 SAOAs in LTRC, assisted living and those at home, their FCGs, and seven key informants from LTRC and the South Asian (SA) community (n=43) were undertaken. These interviews, in addition to 220 hours of participant observation in two LTRC facilities, provided information regarding the needs, preferences, experiences and situation of SAOAs in LTRC as well as how SA families make decisions regarding the use of such services. A select review of provincial policy, residential care regulation, health authority and facility documents, exposed taken-for-granted assumptions in how care and services are provided and the sociopolitical context of LTRC provision. Study findings suggest that LTRC services are challenged to meet the needs of immigrant and EMOA and reflect unequal and inequitable care, illuminated by the differential impact of macro-policies and resource-constrained LTRC environments on SAOAs and their families and on the ability of existing LTRC services to provide person-centred care. This inequity in service provision has implications for immigrant and EMOA and their family members in light of findings that the decision to move to LTRC is essentially a (non) decision influenced by a range of social structural factors that interact to necessitate the move to LTRC. Study findings revealed the salience of socio-economic status and economic resources in particular, in the (non) decision for LTRC placement. The findings from this study along with demographic shifts in the aging Canadian population call for LTRC service providers and policy makers to actively prepare for increasing ethno-culturally diverse resident populations and point to the need for equity informed approaches to the care of older adults.
Graduate
2022-03-31

The aim of this thesis is to identify and to describe barriers to the implementation of person-centered care in specific residential care facility for the elderly. For this purpose, the author firstly conceptualizes the concept of person-centered care. Consequently, she develops the Framework for conducting research. The theoretical portion consists of five chapters. The first chapter focuses on the person- centered care concept introduction, then it describes the relationship between concepts 'individualization of care' and 'person-centered care'. In the conclusion of the first chapter, the Schema of the concept is introduced. The Schema visualizes the structure for chapters two to five. In those chapters, a description of the systems defined in the Schema is provided. Those are: Care Recipients, Direct Care Actors, and Service Providers. The end of the first part brings the topic of a suitable organizational culture. The empirical portion firstly offers the summary of the theoretical background - so follows the Framework for the consequent analysis and data interpretation - then introduces relevant aspects within researched organization, particularly within organization currently implemented a psychobiographical model of care that is the approach to person-centered care. The empirical portion...

Background: Substance abuse is usually associated with young people, but occurs also among elderly for whom the abuse of alcohol and other substances poses an increased risk of a whole range of health and social harms. The current system of addictological care in the Czech Republic is not systematically focused on the target group of elderly and this target group is rather at the edge of attention. Nevertheless, in the Czech Republic there are social services, residential social care centres with special regime for elderly people with a dependency problem. These programs are similar to the nursing homes for aging drug users known from abroad. Aims: The aim of this work is to describe the characteristics of residential social care centres with special regime for substance abusers and persons at risk of substance use in the Czech Republic in the areas of clients of the facilities, methods of work with the target group, personnel and funding of the facilities. Methods: An on-line cross-sectional questionnaire study and descriptive data analysis were conducted. According to the Registry of Social Service Providers in the Czech Republic there is 16 residential social care centres with special regime for substance abusers and persons at risk of substance use, all of them were chosen for the study....

A exclusão social, enquanto processo de acumulação gradual, concentra-se de forma mais expressiva na população idosa. A literatura, especializada na temática, alerta para maior risco relativo de exclusão social para os idosos residentes fora das áreas urbanas. Esta investigação inclui dois estudos, realizados através de uma abordagem exploratória, focada na experiência de idosos residentes fora dos centros urbanos, com o intuito de contribuir para a compreensão da multidimensionalidade da exclusão social na população idosa, explorando o papel específico do contexto. Inicialmente realizou-se uma descrição da população idosa portuguesa, no âmbito da exclusão social, através de uma base de dados secundária ("European Social Survey"), identificando aspetos diferenciadores entre centros urbanos e fora dos mesmos. No segundo estudo, exploraram-se essas diferenças qualitativamente, com entrevistas a idosos da vila de Arraiolos, recolhendo perceções acerca dos dois contextos e das instituições e serviços de apoio aos idosos, pelo seu papel central na prevenção da exclusão social. Os resultados mostram que os idosos residentes fora dos centros urbanos, sentem-se mais vulneráveis à exclusão social no acesso a cuidados de saúde e menos participativos em atividades sociais, porém percecionam um maior apoio social por parte de amigos e familiares. Relativamente às instituições e serviços de apoio à população idosa, observa-se uma opinião positiva face ao seu trabalho no âmbito da prevenção da exclusão social, devido ao convívio e acesso a cuidados de saúde, facilitados pelas instituições.
Social exclusion, as a gradual accumulation process became more frequent among the aged population. The specialized literature on the subject, alerts about the higher relative risk of social exclusion for older adults living outside urban areas. This research includes two studies, conducted through an exploratory approach and focused on the experience of older adults living outside urban areas, in order to contribute to the understanding of social exclusion multidimensionality among the elderly population, accounting for the role of the context. Firstly, a description of the Portuguese elderly population, in the context of social exclusion, was carried out through a secondary data base (European Social Survey), identifying distinctive experiences in urban centres and outside them. In the second study, those differences were studied under a qualitative approach, through interviews with older adults from Arraiolos, collecting perceptions about both contexts and about institutions and services direct to aged population, by their central role in social exclusion prevention. Results show that older adults living outside urban centres, feel more vulnerable to social exclusion in health care access and less participative in social activities, but perceive more social support from friends and family. Regarding the institutions and services direct to the aged population, there is a positive opinion about their work in social exclusion prevention, due to social contact and access to health care, made easier in institutions.

As a social worker practising in long-term residential care for people living with dementia, I am alarmed by discourses in the media and health policy that construct persons living with dementia and their health care needs as a threatening “rising tide” or crisis. I am particularly concerned about the material effects such dominant discourses, and the values they uphold, might have on the collective provision of care and support for our elderly citizens in the present neoliberal economic and political context of health care. To better understand how dominant discourses about dementia work at this time when Canada’s population is aging and the number of persons living with dementia is anticipated to increase, I have rooted my thesis in poststructural methodology. My research method is a discourse analysis, which draws on Foucault’s archaeological and genealogical concepts, to examine two contemporary health policy documents related to dementia care – one national and one provincial. I also incorporate some poetic representation – or found poetry – to write up my findings. While deconstructing and disrupting taken for granted dominant crisis discourses on dementia in health policy, my research also makes space for alternative constructions to support discursive and health policy possibilities in solidarity with persons living with dementia so that they may thrive.
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0452
0680
0351
macsuz@shaw.ca