Dissertations / Theses on the topic 'Institutional care'
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1
Habjanic, A. (Ana). "Quality of institutional elderly care in Slovenia." Doctoral thesis, University of Oulu, 2009. http://urn.fi/urn:isbn:9789514291869.
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Abstract
Elderly people, because of the frail health condition and consequent problems, have in most cases substantial difficulties living at home. Despite the need for widened nursing home custody, the field of quality institutional elderly care in Slovenia in the past did not undergo comprehensive research.
The purpose of this two-part study was to investigate the quality of institutional elderly care and elderly care offered in Slovenian nursing homes. Additional purpose was to evaluate nursing staff members about their willingness, knowledge, skills and importance to meet residents’ physical and psychosocial nursing care needs. Also, a part of this research was bound for recognition of maltreatment and nursing staff members’ well-being.
The qualitative and quantitative research methods were used. The quality of institutional elderly care and elderly care offered were researched by interviewing the parties involved in elderly care, residents, relatives and nursing staff members (N=48). The data for quantitative research was collected by surveying nursing staff by using a structured questionnaire (N=148). All data have been collected in three public and one private nursing home located in two major cities of Ljubljana and Maribor. Collected data was examined by content analysis method and statistical analysis, to corroborate findings across data sets, reducing the impact of potential biases that can exist in a single study. Triangulation was used to approach to data analysis to synthesize data from multiple sources.
Main categories of quality institutional elderly were formulated as attentive care, optimal custody and holistic approach. The most important issue of quality institutional elderly care was formulated as meeting needs on time. Nursing staff members were found to be better skilled in meeting physical than psychosocial needs of residents. Maltreatment was recognised as neglect of care due to postponed duties or hastiness in nursing interventions resulting in discomfort of residents. Factors in connection to quality of institutional elderly care were expressed as quality of nursing care, friendly relationship, meaningful activities, pleasant dwelling environment and versatile assistance.
The obtained findings were presented in form of proposals to improve quality of institutional elderly care in Slovenian nursing homes, and could be used to develop institutional elderly care and improve dwelling. In addition many specific terms have been extracted during the analysis process that may contribute to development of gerontological nursing care rationale in Slovenia.
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Darton, Robin. "The changing landscape of residential care : care homes and alternative forms of housing with care." Thesis, University of Kent, 2014. https://kar.kent.ac.uk/48026/.
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This thesis draws together a series of publications that were based on research studies conducted between 1981 and 2011, covering care homes and alternative forms of housing with care. The majority of the studies were funded by the Department of Health or its predecessors, and were aimed at responding to policy issues, particularly for local authority grant funding. However, the funding provided the opportunity to collect information for broader purposes, and a central feature linking the studies was the collection, as far as possible, of consistent information about the characteristics of residents over time. The thesis includes 12 pieces of work, based on information collected in ten studies, and illustrates the changes in care home provision from 1981 onwards, and the potential role of alternative forms of housing with care. The aim of the thesis is to explore the following themes: the changing role of care homes and the development of the independent sector, particularly the private sector; factors associated with care home costs; changes in the relative role of residential and nursing homes, including changes in the characteristics of residents over time; changes in the quality of provision; the impact of care home closures; provision for self-funders and the expectations of residents; and the development of alternative forms of housing with care, and the degree to which specialised housing can provide an alternative to residential care. Care homes in the UK provide around 470,000 places and account for over half the expenditure on social care for older people in England. However, information about care facilities and residents is very limited. The papers presented here aimed to fill some of the gaps in understanding residential care and possible alternatives by making use of data collected in a unique series of related research studies conducted over a period of 30 years.
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Sandman, Per-Olof. "Aspects of institutional care of patients with dementia." Doctoral thesis, Umeå universitet, Institutionen för omvårdnad, 1986. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-100563.
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The aim of the present study was to investigate all long-term institutions in the county of Västerbotten, Northern Sweden, to give a detailed description of the institutionalized population with respect to motor functions, vision, hearing, speech, ADL-functions, prevalence of psychiatric symptoms and behavioral disturbances, staff work load, use of psychoactive drugs and prevalence of dementia. Another aim was to select some specific 'problem areas' in the nursing care of demented patients for further descriptive and interventional studies. For this reason, morning care procedure (hygiene, dressing), meal behavior (eating, communication), nutrition, constipation and relocation between institutions were selected. The results of the study have been reported in six papers summarized below: I.The study has shown that the proportion of demented patients is increasing in longterm institutions in Sweden. Furthermore, demented patients were shown to be more impaired in all rated functioning abilities and exhibited more psychiatric symptoms and behavioral symptoms. A high proportion of the demented probands were also prescribed psychoactive drugs, i.e. neuroleptics. II. Five patients with Alzheimer-type dementia were monitored during morning care. A 12-step classification system was developed to be used as a guide to understand and determine abilities essential for performance of morning care for demented patients. The quantitative assessment showed that none of the patients were able to manage morning care independently, but there was a wide variation in their highest level of performance. III. Five patients with Alzheimer-type dementia were observed (video taped) during their meals in a changed meal milieu and with new meal routines. When the patients ate without staff participation, the two least demented patients became 'caregivers'. When two mental nurses joined the group, first in civil clothes and then in white uniforms, the patients dropped their roles as helpers. The patients were able to compose complete meals in 0-79 per cent of the meals. The conversation during the meals could be characterized as incomplete, with short sentences and a lot of breaks. Sixty-three per cent of all utterances were about food and eating and almost all conversation concerned the present time. IV. Thirty-three psychogeriatric patients, with severe constipation were given a high- bran bread instead of their accustomed laxatives. During the high-bran treatment period, the number of bowel evacuations and the volume of faeces increased. The total laxative consumption decreased by 93 per cent. V. Nutritional status and dietary intake were studied in a sample of severely demented, institutionalized patients. Energy and /or protein malnutrition was found in 50 per cent of the patients. The mean energy intake was 2059 kcal. Malnourished patients had had four times as many infectious periods during their hospital stay as patients without malnutrition. Thirty-nine of 44 patients lost weight during their hospital stay. VI. Thirty-three psychogeriatric patients were followed for 36 weeks after relocation from a mental hospital to two newly built nursing homes. An intensive pre-relocation program was performed. No negative effects of the relocation were found. On the contrary, the relocated group improved their ADL-functions after the transfer. Based upon the above cited studies, a model for nursing care of demented patients is presented.S. 1-45: sammanfattning, s. 46-192: 6 uppsatser
digitalisering@umu
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ABREU, PAULA PETRELLI DE. "TEENAGERS IN INSTITUTIONAL CARE: THE PROCESS OF EXIT." PONTIFÍCIA UNIVERSIDADE CATÓLICA DO RIO DE JANEIRO, 2016. http://www.maxwell.vrac.puc-rio.br/Busca_etds.php?strSecao=resultado&nrSeq=28107@1.
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PONTIFÍCIA UNIVERSIDADE CATÓLICA DO RIO DE JANEIROCOORDENAÇÃO DE APERFEIÇOAMENTO DO PESSOAL DE ENSINO SUPERIOR
PROGRAMA DE SUPORTE À PÓS-GRADUAÇÃO DE INSTS. DE ENSINO
Partindo do referencial teórico da psicanálise, o presente estudo busca identificar as principais questões mobilizadas no processo de desligamento de adolescentes acolhidos institucionalmente que estão prestes a atingir a maioridade legal. Através de pesquisa bibliográfica, procurou-se compreender quais as principais angústias e inseguranças mobilizadas neste período. Realizou-se breve revisão da construção histórica e social do acolhimento institucional no Brasil e uma análise das políticas atuais e do contexto familiar e socioeconômico da criança e do adolescente encaminhados para os serviços. Foram discutidas as possibilidades de subjetivação e de construção do sentimento de pertencimento dentro da instituição, assim como a formação do vínculo existente entre o adolescente e esse espaço. A adolescência foi abordada através da perspectiva winnicottiana, considerando-se o momento de transição e de transformação que ela representa e a condição de vulnerabilidade social presente no grupo estudado. Compreendendo como fundamental a realização de um trabalho de luto diante de mais um rompimento de vínculos, repetindo suas histórias anteriores, foram levantadas propostas de intervenção que auxiliem o adolescente a realizar um atravessamento desse processo. Verificou-se que, para além da profissionalização e da promoção de moradia, a oportunidade de criação de espaços onde os adolescentes possam narrar suas próprias histórias se apresenta como recurso necessário para que venham a se apropriar delas. Com isso, pretende-se que tenham a oportunidade de construir outros caminhos e não permaneçam presos apenas à repetição da história pessoal e familiar anterior.
From the psychoanalytical theoretical framework, this study seeks to identify the main issues mobilized in teenagers in process of institutionally exit who are about to reach the age of majority. Through literature, we tried to understand what are the main anxieties and insecurities mobilized during this period. It was held brief review of the historical and social construction of institutional care in Brazil and an analysis of current policies and teenager s family and socioeconomic context. It was discussed the possibilities of subjectivity and construction of the sense of belonging within the institution, as well as the formation of the bond between the teenager and this space. Teenage was study by Winnicott s perspective, considering the time of transition and transformation that it represents and the condition of social vulnerability present in the studied group. Understanding the importance of the realization of a work of mourning before another break ties, repeating their earlier stories, intervention proposals were raised to assist the teenage to carry out a through this process. It was found that, in addition to professional training and housing promotion, the space creating opportunity where teens can tell their own stories is presented as necessary resource to come to appropriate them. Thus, it is intended to have the opportunity to build other roads and do not remain stuck only to repeat previous personal history and family.
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Esendemir, Serif. "Determinants of the Applications to the Institutional Care in Turkey: Darulaceze Example." Thesis, University of North Texas, 2013. https://digital.library.unt.edu/ark:/67531/metadc271811/.
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Although institutional care has started to be outmoded in the developed countries with development of different models of care, it still has a considerable place in the developing countries such as Turkey. This is because, changes in the demographic structure, extended family, and urban development of Turkey has brought about several aging problems leading older adults to end up in institutions. Loneliness was one of the significant reasons given in the Social Inquiry Survey of Applicants of Darulaceze Old-Age Institution and the basis for a micro level analysis in this study. Therefore, the main objective of the study was to determine the predictors of loneliness, including age, the state of living alone, functional independence, education, and gender. Analysis of the results indicated that these predictors have significant effects on the loneliness predominantly defined by social factors rather than medical factors. In addition, the meso and macro level analyses were employed to control the micro level analysis and see a general picture of institutional care. Thus, an academic example of diagnosing the main reasons behind the institutional care was presented to understand the context of aging in Turkey.
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Andersson, Kjerstin. "Talking Violence, Constructing Identity : Young Men in Institutional Care." Doctoral thesis, Linköpings universitet, Tema Barn, 2008. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-12581.
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The aim of the study is to investigate how young men constructing identities in talk about their own use of violence. The study is based on a fieldwork at a youth detention home in Sweden. The data consists of individual interviews and video recordings of the treatment programme Aggression Replacement Training (ART). Detailed analyses have been made of conversations between the young men, between the young men and the trainers, and of the narratives generated in the individual interviews. The study has a social constructionist approach to identity, which is seen as constructed in a joint achievement in social interaction. An important analytical perspective in the study is how social categories and subcategories are constructed. The study has a particular focus on gender, primarily masculinity, but age and ethnicity are also being emphasised. The analysis draws on four empirical studies. It is shown how the young men construct a preferred self-presentation when talking about violent events. The narratives on violence are either based on experiences or talked about as a hypothetical use of violence. Violence based on personal experience is problematized and legitimized in terms of self-defence, defending friends, restraint and justified violence. Narratives of violence are shown to be interactional resources available to the young men. When talking about violence, the young men can be seen to regulate social relations, and to position themselves in relation to particular discourses of masculinity. The specific understanding of what it entails to be a man enables the use of violence with respect to social categorizations such as age, ethnicity or criminal identity. It is also argued that the treatment programme ART may, at times, facilitate maintaining a criminal identity.Avhandlingens övergripande syfte är att undersöka hur unga män konstruerar identiteter kring berättelser om eget våldsutövande. Den bygger på en studie gjord vid ett särskilt ungdomshem i Sverige. Såväl enskilda intervjuer som videoinspelningar av behandlingsprogrammet Aggression Replacement Training (ART) har utgjort analysmaterialet. Ingående analyser har gjorts av samtalen mellan de unga männen, mellan de unga männen och behandlingspersonalen, och berättelserna i de enskilda intervjuerna. Avhandlingen bygger på en socialkonstruktionistisk ansats där identitet analyseras i social interaktion med andra. Ett viktigt analytiskt perspektiv i studien är hur sociala kategorier och underkategorier skapas. Ett särskilt fokus ligger på genus och då främst maskulinitet, men även ålder och etnicitet lyfts fram som viktiga perspektiv. Avhandlingen omfattar fyra delstudier. Studien visar hur de unga männen konstruerar en positiv självpresentation när de talar om våldshändelser. Våldsberättelserna är antingen erfarenhetsbaserade eller utgår ifrån tal om hypotetiskt våld. Det erfarenhetsbaserade våldet problematiseras och legitimeras genom att talas om som självförsvar, försvar av kompisar, återhållsamt eller rättmätigt. Studien visar att våldsberättelser är interaktionella resurser för de unga männen. Genom att tala om våld reglerar de sociala relationer och positionerar sig i relation till vissa maskulinitetsdiskurser. Den specifika förståelsen av vad det innebär att vara en man, möjliggör användandet av våld avhängigt andra sociala kategorier, så som ålder, etnicitet och kriminell identitet. Studien indikerar också att behandlingsprogrammet ART ger möjlighet att underlätta upprätthållandet av en kriminell identitet.
Due to copyright matters, have the articles, published in chapter 4, 5, 6 and 7, been removed.
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Andersson, Kjerstin. "Talking violence, constructing identities : young men in institutional care." Doctoral thesis, Department of Child Studies, The Tema Institute, Linköping University, Linköping, Sweden; Faculty of Arts and Sciences, Linköping University, Linköping, Sweden, 2008. http://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-38584.
Full textAbstract:
The aim of the study is to investigate how young men constructing identities in talk about their own use of violence. The study is based on a fieldwork at a youth detention home in Sweden. The data consists of individual interviews and video recordings of the treatment programme Aggression Replacement Training (ART). Detailed analyses have been made of conversations between the young men, between the young men and the trainers, and of the narratives generated in the individual interviews. The study has a social constructionist approach to identity, which is seen as constructed in a joint achievement in social interaction. An important analytical perspective in the study is how social categories and subcategories are constructed. The study has a particular focus on gender, primarily masculinity, but age and ethnicity are also being emphasised. The analysis draws on four empirical studies. It is shown how the young men construct a preferred self-presentation when talking about violent events. The narratives on violence are either based on experiences or talked about as a hypothetical use of violence. Violence based on personal experience is problematized and legitimized in terms of self-defence, defending friends, restraint and justified violence. Narratives of violence are shown to be interactional resources available to the young men. When talking about violence, the young men can be seen to regulate social relations, and to position themselves in relation to particular discourses of masculinity. The specific understanding of what it entails to be a man enables the use of violence with respect to social categorizations such as age, ethnicity or criminal identity. It is also argued that the treatment programme ART may, at times, facilitate maintaining a criminal identity.Avhandlingens övergripande syfte är att undersöka hur unga män konstruerar identiteter kring berättelser om eget våldsutövande. Den bygger på en studie gjord vid ett särskilt ungdomshem i Sverige. Såväl enskilda intervjuer som videoinspelningar av behandlingsprogrammet Aggression Replacement Training (ART) har utgjort analysmaterialet. Ingående analyser har gjorts av samtalen mellan de unga männen, mellan de unga männen och behandlingspersonalen, och berättelserna i de enskilda intervjuerna. Avhandlingen bygger på en socialkonstruktionistisk ansats där identitet analyseras i social interaktion med andra. Ett viktigt analytiskt perspektiv i studien är hur sociala kategorier och underkategorier skapas. Ett särskilt fokus ligger på genus och då främst maskulinitet, men även ålder och etnicitet lyfts fram som viktiga perspektiv. Avhandlingen omfattar fyra delstudier. Studien visar hur de unga männen konstruerar en positiv självpresentation när de talar om våldshändelser. Våldsberättelserna är antingen erfarenhetsbaserade eller utgår ifrån tal om hypotetiskt våld. Det erfarenhetsbaserade våldet problematiseras och legitimeras genom att talas om som självförsvar, försvar av kompisar, återhållsamt eller rättmätigt. Studien visar att våldsberättelser är interaktionella resurser för de unga männen. Genom att tala om våld reglerar de sociala relationer och positionerar sig i relation till vissa maskulinitetsdiskurser. Den specifika förståelsen av vad det innebär att vara en man, möjliggör användandet av våld avhängigt andra sociala kategorier, så som ålder, etnicitet och kriminell identitet. Studien indikerar också att behandlingsprogrammet ART ger möjlighet att underlätta upprätthållandet av en kriminell identitet.
Due to copyright matters, have the articles, published in chapter 4, 5, 6 and 7, been removed.
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Hodges, Jill. "Adolescent development following institutional care in the early years." Thesis, University College London (University of London), 1991. http://discovery.ucl.ac.uk/10018510/.
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This thesis reports the development in mid-adolescence of a group of children raised in institutions until at least 2 years of age, then adopted or restored to a biological parent. These children were previously followed up at four and a half and at eight years of age. They were compared with a group of individually matched adolescents who had never been in institutional care. IQ depended largely on the type of family placement, and did not appear to be adversely affected by institutionalisation, at least so long as this did not extend beyond age four and a half. The experience of multiple changing caregivers during the period of institutionalisation did not necessarily prevent the children from forming strong and lasting attachment relationships to parents once placed in families, but this too depended on family environment, being much more common in adoptive families. However, some long-term effects of early institutionalisation were apparent. Ex-institutional adolescents showed more behaviour and emotional difficulties than matched comparisons, according to teacher questionnaires and interviews with the adolescents and their parents. They also showed greater orientation towards adult attention, and had more difficulties with peers and fewer close or confiding peer relationships than comparison adolescents, again indicating some long term effects of early institutional experience.
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Chan, Kam Tong, and 陳錦棠. "The provision of residential child-care service under six: a policy analysis." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 1987. http://hub.hku.hk/bib/B42128286.
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Lin, Che-Ying. "The development of quality indicators for Taiwanese institutional dementia care." Thesis, University of Stirling, 2010. http://hdl.handle.net/1893/2542.
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This study is a mixed-method study that seeks to develop a set of institutional dementia care indicators to evaluate quality of care and inform the improvement of quality of life (QOL) for Taiwanese people with dementia living in care homes. It also uses comparative analysis to compare the different features of policy and its delivery in dementia care between Scotland and Taiwan, a comparison designed to aid the development of dementia care policy, and the establishment of quality indicators for institutional dementia care, in Taiwan. This study employed the person-centred care approach at the micro perspective, and the total quality management (TQM) approach at the macro perspective, in order to inform a seamless care model for people with dementia living in care homes. Data were collected in two stages: comments from experts in dementia care were recorded in an exercise using “Delphi” methodology; subsequently the opinions of service receivers were recorded in a fieldwork exercise. The Delphi exercise (stage one) acted as the pre-test, involving 24 experts in dementia care in Scotland and Taiwan in evaluating the usefulness and applicability of proposed quality indicators for institutional dementia care. Quantitative and qualitative data from the Delphi panel were analyzed. The fieldwork (stage two) collected 237 questionnaires (from 122 residents with dementia and 115 family members) in 14 Taiwanese care homes for people with dementia (including special care units within care homes). The field test data were analyzed using reliability and item analysis, confirmatory factor analysis (CFA), and descriptive and inferential statistics. Initially, 43 proposed quality indicators for institutional dementia care were identified through literature review. However, after two Delphi rounds, only six key dimensions (41 quality indicators) were identified by consensus as the important items for use in measurement of quality of care for people with dementia living in Taiwanese care homes. Through reliability and item analysis, and CFA, this research developed a model which is a three-factor structure (social care, health and personal care, and environment) with 18 quality indicators. The 18 quality indicators have high reliability, validity, and credibility and load onto a second order factor which represents quality of care for people with dementia living in care homes. Further analysis was then conducted to explore how relative ratings on these three factors differed according to measured characteristics of the residents and their family members. In general, only a few strong patterns of difference emerged and multiple linear regression analysis suggested that differences in ratings could not be attributed to influences of socio-economic and socio-demographic differences between respondents. The study concludes that the Delphi method could be used as a methodology for health services research to integrate the opinions of multidisciplinary dementia experts and that CFA is an effective technique to study the empirical factor structure. The findings suggest that the 18 quality indicators could be suitable criteria for people with dementia and their family members to evaluate care quality and select an appropriate care home. The indicators also have important policy implications for the Taiwanese Government and regulations intended to ensure that care homes meet the requirements of service receivers.
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Steven, John Mowat. "Problems/needs inventory of seniors with arthritis : implications for training of care-facility staff." Thesis, University of British Columbia, 1987. http://hdl.handle.net/2429/26127.
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A problems/needs inventory enquired into special social-psychological-emotional problems experienced by seniors in care facilities, due to arthritis. The inventory was based on three questions: are there any such problems? If so, what are they? And, what could be done by facility staff to help relieve such problems? This was the first stage in a proposed larger project: to develop a Social Work component dealing with such special problems, in order to augment an existing staff training program, and to test, evaluate, revise and implement the complete program package.
A community-based approach was used. The Department of Social Work Services at the Arthritis Society produced a listing of key areas of concern at a brainstorming session; health-care and social-service professionals were surveyed by interview or by the Delphi Technique; a seniors' arthritis support group participated in a Nominal Group Technique session; care-facility staff met to discuss relevant issues; and, data was gleaned from current literature by a content analysis method.
There was general agreement that seniors in care with arthritis do have special social-psychological-emotional problems because of the disease, and also there was consistency regarding the nature of these problems.
Analysis of the data led to findings that included the following propositions: A sense of self-reliance and of social integration are essential to well-being. Limitations on movement, and the effects of chronic pain and of pain medication are associated with significant social-psychological emotional problems among seniors in care with arthritis. Two principles of care were identified: 1) support and encourage independence; and, 2) support and encourage social integration.
The propositions will be applied to the development of the content of the Social Work component of the training program. Also, many respondents made important recommendations regarding methods and format for the training program. These are included in this paper.Arts, Faculty of
Social Work, School of
Graduate
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Enell, Sofia. "Transit i samhällsvården : När unga utreds på särskilda ungdomshem." Doctoral thesis, Linnéuniversitetet, Institutionen för socialt arbete (SA), 2015. http://urn.kb.se/resolve?urn=urn:nbn:se:lnu:diva-47346.
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This thesis is about assessments of young people in secure accommodations. Institutional assessments relate to the paradox in child welfare of combining control and care. The procedure raises questions about their implications for young people, their caseworkers and evolving care trajectories. Although institutional assessments of young people have a historical heritage, research about their implications is lacking. The aim of the thesis is to explore young people’s and their caseworkers’ experiences of assessments in secure accommodations and their implications for young people’s care trajectories. Methods used are primarily repeated interviews with 16 young people during a period of two years and one interview with their caseworkers. Surveys about 85 youths, participatory observations and written assessments are also included. This thesis takes an interactionist approach and the material has been analysed with the main concept of care trajectory along with the concepts of self-presentation, total institution, institutional identity and texts as coordinators. The results are presented in four papers. The concluding analysis shows that assessments in secure accommodations can be divided into three elements: the practice, the text and the placement. These three elements have different implications for the young people and the caseworkers. For the young people the practice and the placement converge into an assessment universe that, with the text, intensifies their shaping of self-identity. The young people’s experiences are characterised by lack of control over their self-presentations, the present and the future. For the caseworkers, the practice has implications for their understanding of the young people’s individual troubles, the text for negotiating with other actors and the placement in their efforts to achieve change in the young people’s troublesome situations. The assessments’ implications for stability and foreseeability in the young people’s further care trajectories are limited. Moreover, the procedure of assessing young people in itself contains instability through involving several professionals in different parts of the assessment and decision-making process. Despite lack of stability, the thesis reveals that some young people experience the assessment as a place for self-development and where the course of the care trajectory changes to the better.
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Boychuk, Orysia. "A community-based program from the perception of youth : a case study /." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1997. http://www.collectionscanada.ca/obj/s4/f2/dsk2/ftp04/mq21155.pdf.
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Green, F. T. "The costs of community and institutional care of the dependent elderly." Thesis, University of Canterbury. Economics, 1987. http://hdl.handle.net/10092/4799.
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Estimates have been obtained of the cost of care of the
dependent elderly in private and public hospital and in the
community, based upon information collected on samples of
elderly in Christchurch, New Zealand. In order to properly
compare the costs between modes of care, the estimates
obtained were variable costs, related to patient dependency,
and represented the cost of all resources provided, including
informal care.
Using weighted least squares estimation, models were
developed relating the consumption of direct nursing care in
hospital to patient disabilities. These models explained a
substantial proportion of the variability of the consumption
of this resource.
Nursing care was identified as the major determinant of
the variation between patients in the cost of hospital care.
Estimates of cost for individual patients in public and
private hospital were obtained as functions of the direct
nursing car~ consumed, and were found to vary substantially
between patients in each type of hospital.
The costs of public and private hospital care were
compared, using the nursing care models to correct for the
lower average dependency of the private hospital patients.
The result was that private hospital care was cheaper
although private hospital patients received more direct
nursing care than did public hospital patients of the same
level of dependency.
The cost of community care varied between individual
elderly and was related to the level of dependency. Informal
care was the largest single component of this cost. Models
relating informal and formal care to patient disabilities
showed that informal care responded more strongly to
dependency than did formal care.
Community care was found to be cheaper than hospital
care for all patients sampled, the greatest cost difference
being for the very dependent elderly.
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These results emphasize the importance of including
informal care when estimating the cost of community care and
show the need for variable (disability-reI ) costs,
rather than average costs, when planning
dependent elderly.
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Ng, Yim-wah, and 吳艷華. "Social skill training for children in institutional care: an exploratory study." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 1991. http://hub.hku.hk/bib/B31249012.
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Xie, Haifeng. "Modelling issues in institutional long-term care : placement, survival and costs." Thesis, University of Westminster, 2004. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.434382.
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Ng, Yim-wah. "Social skill training for children in institutional care : an exploratory study /." [Hong Kong : University of Hong Kong], 1991. http://sunzi.lib.hku.hk/hkuto/record.jsp?B13117051.
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Tresidder, Anna Foucek. "The Institutional Context that Supports Team-Based Care for Older Adults." PDXScholar, 2013. https://pdxscholar.library.pdx.edu/open_access_etds/1517.
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The aging population in the U.S. is dramatically increasing; it is predicted that not only will individuals live longer but also that they will live with multiple chronic diseases that could require high levels of medical and social resources. While the aging population increases, the number of health care providers choosing to specialize in caring for the elderly is decreasing just as dramatically. Teams are believed to be a possible response to more efficiently use the providers available, take advantage of alternative provider types, and integrate a range of health and social services to meet patient needs more effectively. Interdisciplinary teams are the best practice in the care of older adults, who require both medical and social services. However, maintaining functional collaborative teams has been an ever-present challenge to health and social care organizations. Research has found that institutional support is critical for teams to benefit patients and organizations alike.
This study examined the role of institutional context in supporting interdisciplinary teams (IDT) in the care of older adults through interviews of the management and staff of the Program for All-Inclusive Care of the Elderly (PACE) in six states. PACE organizations must commit to an interdisciplinary model of care consisting of 11 different disciplines from across the professional spectrum. The research question posed for this study was: What elements of institutional context support the use of interdisciplinary teams in the care of older adults? Due to the standardized team structure used, PACE was selected as the model to see how institutions at macro and micro levels support the work done by PACE teams and possibly highlight where support is still lacking. A case study approach drawing upon qualitative methods was used to examine policy-regulative, cultural-cognitive, normative, relational, and procedural elements of institutional context and the extent to which they support collaborative teamwork. Thirty-two interviews were conducted with administrators and team members from seven PACE programs across the country. For these PACE programs, five elements and 14 categories of support were identified by the interviewees. Policy and regulatory elements constrain and systematize behavior. PACE IDT experience these constraints and systems through regulatory body practices, resource allocation, and quality measurement. Cultural-cognitive elements mediate between an IDT's external environmrder to make sense of what is happening. PACE IDTs create meaning through their interactions with their external environments through interdependence, demographic characteristics, and organizational structure. Normative findings constrain behavior and confer the rights and duties of IDT members, which arise from organizational mission and values, leadership, and professient and the response of the IDT in oonal boundaries. Relational elements emphasize relationships among IDT members and team interaction with the organization's environment. Social constructs within the team affect role definition and communication, which support IDT practice. Procedural support standardizes practices to maintain highly functional teams. In order to support IDT practice, PACE organizations highlighted recruitment and retention, time and space, and training and education as the primary ways to support IDTs. These categories illustrate the complexity of supporting teams and actualizing teamwork in practice. These findings suggest that PACE is succeeding in supporting the IDT model and provides lessons for other organizations that wish to do the same.
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Lau, Wai-kwan Dianna. "The utilisation of home care and residential care services by seniors in Canada: critical appraisal." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2011. http://hub.hku.hk/bib/B4693862X.
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Wong, Oi-ling. "Supervision and teamwork in halfway houses for the ex-mentally ill : from institutional care to community care /." Hong Kong : University of Hong Kong, 1995. http://sunzi.lib.hku.hk/hkuto/record.jsp?B19470319.
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Forbat, Liz. "Exploring accounts of care : two sides to the story." n.p, 2001. http://library7.open.ac.uk/abstracts/page.php?thesisid=84.
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O'Reilly, Daria J. "The annual institutional long-term care needs in the St. John's region." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1997. http://www.collectionscanada.ca/obj/s4/f2/dsk3/ftp05/mq25872.pdf.
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Chen, Zhiyu. "Knowledge and Perceptions: Chinese Older Adults' Willingness to Use Institutional Elder Care." Digital Archive @ GSU, 2011. http://digitalarchive.gsu.edu/gerontology_theses/22.
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This study explores explanations for Chinese elders’ willingness or lack of willingness to use institutional care. The data is drawn from a survey over intergenerational relationships and age models conducted in Zhenjiang, China, in 2007. Only the responses of interviewees aged 55 and above (310 males and 318 females) were used in this study. Using zero-order correlation and multi-nominal regression analyses, this study examined the factors associated with Chinese elders’ willingness to use institutional care. Study results reveal that Chinese elders’ confidence in availability of familial care was negatively related to their willingness to use institutional care; elders’ knowledge about and impression on elder care homes were positively associated with their willingness. Male interviewees expressed lower levels of willingness compared to female respondents. This study shows that increased knowledge about elder care institution may increase Chinese elders’ willingness to accept institutional elder care.
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Kwok, Am-ping Louisa, and 郭鶯萍. "An exploratory study of the adjustment problems of children entering institutional care." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 1985. http://hub.hku.hk/bib/B31247507.
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Miller, Leanne R. "Understanding Attachment and Perceptions of Orphan Caregivers in Institutional Care in Kenya." Thesis, The Chicago School of Professional Psychology, 2015. http://pqdtopen.proquest.com/#viewpdf?dispub=3720289.
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This concurrent nested mixed methods study assessed institutional caregivers’ perception on their role as caregivers and caregivers’ attachment orientation in Kenya. Additionally, the study looked for a connection between attachment and perception. Participants were 15 female caregivers, 8 from a government institution and 7 from a nongovernment institution. Data from a semi-structured interview indicated that caregivers, regardless of attachment, were emotionally invested in the children’s wellbeing, felt a sense of duty, and stated their job was challenging but rewarding. ECR-R assessed attachment and found that attachment varied slightly between institutions. The most significant difference was between institutions with 4 secure caregivers in the nongovernment institution and only 1 secure caregiver in the government institution. A slight relationship between attachment and perception was found as all secure caregivers indicated they believed both physical and emotional needs of children were essential. Results indicate additional cultural studies on attachment and perception are warranted.
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Gibson, Oliver. "Health, environment and the institutional care of children in late Victorian London." Thesis, Queen Mary, University of London, 2017. http://qmro.qmul.ac.uk/xmlui/handle/123456789/25821.
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Using the example of the London-based children's organisation Barnardo's, this thesis examines the influence of contemporary ideas regarding the relationship between environment, health and disease on the organisation and everyday institutional practices of the charity. While autobiographical accounts and historical investigations have written on the 'man himself' as well as the discursive and representational strategies used by Barnardo's to justify child removal, the importance of environmental discourses to the institution remain underexplored. The thesis addresses this lacuna through a detailed analysis of archival materials relating to Barnardo's (committee minutes, pamphlets, reports, Dr Barnardo's personal notebooks) as well as through a textual analysis of Night & Day, the main outlet for publicising the work of the charity and stimulating support for it. The thesis covers the period from 1866, when Barnardo's was founded, to the death of Dr Barnardo in 1905. This is a period when the environmental idea was arguably at its strongest, with a host of social ills (from criminality and prostitution, to human health and vitality and later in the period racial degeneration) linked to the influence of the environment. Like many other social reformers and philanthropists, Dr Barnardo was a firm believer in environmental explanations for such social ills, as well as a committed evangelical Christian, and promoted the rapid removal of young people (not all were orphaned but the vast majority were destitute) from urban and familial environments believed to do harm to their physical, moral and spiritual health. Where the first part of the thesis covers the importance of environment to the Barnardo's justification for his child removal practices, the remainder of it considers the response of the institution to environmental ideas. In addition to examining the influence of environment on institutional design and on the everyday practices of the 'inmates', for example the promotion of light and air in the girl's home at Barkingside, emphasis is also placed on ideas of mobility and movement. Here the thesis explores the paradoxical relationship between the organisation's 'anti-institutional' projection and the institutional realities of constructing and policing 'out of home' care practices (trips to the country- and seaside, boarding-out, emigration). This thesis contributes to extant accounts of Dr Barnardo's; however, its primary contribution lies in its nuanced examination of the role of environmental ideas on shaping institutional design and on its influence on the everyday practices of Barnardo's young inmates.
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Humphreys, Clare Joanne. "'Undying spirits' : religion, medicine and institutional care of the dying 1878-1938." Thesis, University of Sheffield, 2000. http://etheses.whiterose.ac.uk/15046/.
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This thesis focuses upon the emergence of a new phenomenon in the late nineteenth century: institutional provision for the 'respectable poor' medically certified as 'dying'. For the first time this group was identified as having special medical, nursing and spiritual needs which could only be provided by trained staff through an institutional medium. Through a comparative study of three institutions founded in London - St Joseph's Hospice, the Hostel of God and St Luke's House - this study aims firstly, to understand why homes for the dying were set up during this period; secondly, to explore their foundation and development up to 1938; and thirdly, to situate them within the broader context of late nineteenth and early twentieth-century Britain. It argues that the homes were essentially a response to three perceived deficiencies in care for the dying 'respectable' poor which became apparent to certain groups and individuals at this time: a paucity of medical provision, inadequacies in domiciliary care and a lack of spiritual ministration. As religious and philanthropic institutions, the homes were very much influenced by wider developments in these areas, particularly moral attitudes towards the poor and the Churches' concern to counter what were seen as widespread working class religious indifference. The different denominational basis of each home (Catholic, Anglo-Catholic and Methodist) was important in determining perceptions of death and dying and how patients' deathbed experiences were portrayed, while their varying management structures had profound implications for subsequent development. In particular the homes provide an insight into the tensions that can arise when modernising influences encounter strong prevailing traditions. An increasingly modernising and secularising medical and social climate posed considerable challenge to institutions set up with the primary objective of caring for patients' souls and the homes responded to it in different ways.
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Highland, Samuel Vladimir. "Adoptive Identity: Emerging Adult International Adoptees’ Narrative Coherence Following Early Institutional Care." Antioch University / OhioLINK, 2021. http://rave.ohiolink.edu/etdc/view?acc_num=antioch1607043824349026.
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Kwok, Am-ping Louisa. "An exploratory study of the adjustment problems of children entering institutional care /." [Hong Kong : University of Hong Kong], 1985. http://sunzi.lib.hku.hk/hkuto/record.jsp?B12322404.
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Allen, Natalie Ruth. "The transition to institutional living : the experience of elderly people." Thesis, University of British Columbia, 1985. http://hdl.handle.net/2429/24410.
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The purpose of this study is to identify how elderly subjects perceive their transition from home to institutional living.
The study was conducted with a convenience sample of five subjects, 6-13 months following their admission to a unit which provides care for dependent elderly clients. The methodology introduced by Glaser and Strauss (1967), for the discovery of grounded theory, was used.
A conceptualization of the transition to institutional living as five sequential and inter-related phases is introduced. These phases are: anticipation, reaction, interpretation, negotiation and integration. In the first two phases subjects' responses to challenges to development, introduced by the transition, tend to predominate. The third and fourth phases are characterized by subjects' working through these challenges to achieve mastery within the new situation. The final phase is manifest in each individual's attributing personal meaning to the transition within the context of his or her total life.
Mastery within the new situation is achieved through problem solving approaches to increasing dependency, acceptance of personal responsibility for adjustment, and the perception of
institutionalization as but one incident in each individual's life history.
This transition was found to differ from those described amongst younger populations. It is proposed that this difference occurs as a function of developmental stage, frailty, and the environmental situation.
The findings of this study a) emphasize the holistic nature and complexity of nursing practice with frail elderly clients, b) support the use of concepts from developmental theory as a basis for nursing practice with elderly clients, and c) suggest ways in which nursing education and research may contribute to the development of nursing care for elderly clients.Applied Science, Faculty of
Nursing, School of
Graduate
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Mallett, Jane. "Nurse-patient haemodialysis sessions : orchestrated institutional communication and mundane conversations." Thesis, Open University, 1997. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.364120.
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Chan, Ho-yung Dennis, and 陳可勇. "The Institutional control and care of young people in colonial Hong Kong 1932-1997: a social history." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2003. http://hub.hku.hk/bib/B31244002.
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Bergqvist, Caroline, and Sofia Tingberg. "En fråga med dolda svar : en registerstudie." Thesis, Högskolan Väst, Avdelningen för omvårdnad - avancerad nivå, 2016. http://urn.kb.se/resolve?urn=urn:nbn:se:hv:diva-9411.
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Background: Since 2008 there is a law stating that patients who do not require institutional forensic psychiatric care may be moved to non-institutional forensic care, with special conditions. RättspsyK is a national quality register where all of the 25 forensic care units in Sweden collect information about their patients and their care. Previous analysis showed that a considerable amount of patients continue to receive institutional forensic psychiatric care despite they are assessed and found ready to move onto non-institutional forensic care. Aim: The objective of this study was to identify factors affecting why patients were still in institutional forensic care despite assessed to be ready for non-institutional forensic care.Method: First, yearly assessment of each patient between 2009 and 2014 was drawn from the RättspsyK register. Answers to the specific question, Question 10, were analyzed with descriptive statistics and were planned to be used in regression analyses as dependent variable. Result: 1900 patients were included. During analyses the fact that answers to this question were not trustable was found, therefore no exact prevalence of inpatients kept in institutional forensic care despite assessed ready for non-institutional care could be determined. Other information revealed that lack of housing and lack of collaboration were the most frequent reasons for this phenomenon. Conclusion: The present study could not give answer to the original question, but pointed out avalidity problem in the Swedish Forensic Psychiatry Register. The result calls for caution and for the need of validation of RättspsyK register.
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Dale, Pamela Louise. "The Mental Deficiency Acts 1913-48 : medical care, control and eugenics." Thesis, University of Exeter, 2001. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.482827.
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Martin, Christine. "The lived experience of the aged care nurse." Thesis, Edith Cowan University, Research Online, Perth, Western Australia, 1996. https://ro.ecu.edu.au/theses/959.
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The purpose of this phenomenological study was to describe and interpret the common, shared meanings of the experience of aged care nursing from the perspective of the registered nurse working in a nursing home. There are insufficient registered nurses being attracted into aged care, with resulting difficulties in maintaining regular staffing levels in nursing homes. Previous studies conducted in Australia have predominantly used quantitative research methods to investigate various influences QD the recruitment and retention of aged care nurses. These studies do not take into account the practitioners' perceptions of their experience of aged care nursing. A purposive sample of 15 registered nurses was interviewed and the resulting data were analysed using phenomenology to identify thematic structures of the experience of aged care nursing. The NUD.IST qualitative data analysis software package was used as an analysis tool. Significant statements were coded, patterns and relations between categories were identified and the categories were clustered into conceptual, hierarchical themes. Four major themes emerged as being central to the experience of aged care nursing-Gratification, Rapport, Non-productivity and Conflict. While constraints and obstacles to productivity and personal and political conflict may be seen as the negative aspects of aged care, these experiences were relieved by uplifting events described within the framework of resident care and rapport, and collegial support. The nature of aged care nursing is both complex and ambiguous but nurses have readily identified the interwoven threads of the experience. Findings from this study will increase the depth of understanding of aged care nursing and hence contribute to the development of a nursing home environment which enriches the experience of both nurse and resident.
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Summerton, Rebecca, and Paulina Grönevik. "Preventive Work Among Youth at Risk in Tegucigalpa - Subjective Experiences of Institutional Care." Thesis, Linnéuniversitetet, Institutionen för pedagogik, psykologi och idrottsvetenskap, PPI, 2011. http://urn.kb.se/resolve?urn=urn:nbn:se:lnu:diva-11492.
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This study aims to explore how secondary prevention carried out at a Honduran institution for youth at risk is experienced by its professional workers and former residents. This qualitative research is based on ethnographic approaches conducted at Hogar de Niños Renacer, Tegucigalpa, which is a facility for institutional care of youth at risk. Renacer applies a holistic, multidimensional approach to preventive work by covering various dimensions of youth development such as needs for emotional care, education, and spiritual growth. All research participants claim that positive aspects of Renacer include the provision of such possibilities. The project is constantly developing and accommodates various areas in need of improvement such as acquiring sufficient, competent staff. The majority of individuals who have participated in Renacer‟s project are proven to establish a functioning adult life after leaving the institution.
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Stuckless, Susan N. "Inter-regional comparisons in the pattern of use and needs for institutional care." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 2001. http://www.collectionscanada.ca/obj/s4/f2/dsk1/tape4/PQDD_0032/MQ62431.pdf.
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Wilding, Karl Damian. "A geography of institutional health care in late-nineteenth century England and Wales." Thesis, University of Leeds, 2000. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.427172.
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Mitchell, Margaret J. "Establishing a grief care ministry at the Olivet Institutional Baptist Church, Cleveland, Ohio." Theological Research Exchange Network (TREN), 1994. http://www.tren.com.
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McCormack, Cynthia Ann. "LONELINESS IN THE INSTITUTIONALIZED AGED." Thesis, The University of Arizona, 1985. http://hdl.handle.net/10150/275240.
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Cook, Ailsa. "Understanding the communication of older people with dementia living in residential care." Thesis, University of Stirling, 2003. http://hdl.handle.net/1893/3301.
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This thesis explores the communication of a group of older people with dementia living in a residential care home and specifically, seeks to understand how living with dementia in a care home influences communication. The study draws broadly on a symbolic interactionist perspective and uses an ethnographic, inclusive, video methodology. In so doing, the study grounds the research in the experiences of the older residents with dementia and explores communication as it is interwoven with social life. The empirical data, on which this thesis is based, were gathered over the course of six months in one residential care home in Central Scotland. Analysis of these data, in conjunction with the theoretical literature informing the study, led to the development of a framework and a set of concepts to understand the communication of the older people with dementia living in residential care. This framework was used to examine the ways in which the older residents' experiences of institutionalisation, ageing, and dementia, generally, and of life in the care setting, specifically, influenced their communication. The findings revealed that the older residents made diverse meanings of their experiences in the home, and mat many of the meanings that they made were threatening to their self-identity, self-determinacy and social relationships. The residents engaged in a range of strategies to respond to the impact of these meanings and to negotiate their life in the care home. The research presented in this thesis has many implications for understanding the experiences of older people with dementia in residential care. In particular, the research highlights the need for a new social understanding of dementia, that examines the experience of dementia in relation to broad structural and cultural processes and that seeks to promote the social inclusion and citizenship of older people with dementia.
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Reid, Lorna Margaret. "The social organisation of exclusion, 'abandonment' and compulsory advance care planning conversations : how ruling concepts and practices about death, dying and the 'do not attempt' cardiopulmonary resuscitation form entered, organised and ruled the working practices of senior social care workers in a residential care home in Scotland : an institutional ethnography." Thesis, Edinburgh Napier University, 2017. http://researchrepository.napier.ac.uk/Output/979680.
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Institutional Ethnography (IE) is a method of inquiry into the social organisation of knowledge. It begins with a disjuncture/troubling experience impacting a specific group of workers and adopts their standpoint/subject positon to look out into the wider institution and trace the work and textual practices that organised (and produced) the disjuncture under investigation. The study took the standpoint of Senior Social Care Workers (SSCWs) from one RCH in Scotland to uncover the complex social organisation of “abandonment” SSCWs described when there was insufficient support from NHS services to care appropriately for sick and dying residents. The focal point of inquiry was on SSCWs descriptions of being “pushed” into “difficult” decision-making conversions with family members about “serious illness” andthe Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) – without the support of doctors (or nurses).To inquire into how SSCWs work had become tied into the medical, legal and bureaucratic practices that rule death, dying and Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) decision making in Scotland's RCHs the study drew on ten open-ended interviews (SSCWs, n= 4 and others whose work influenced SSCWs working practices, n= 6). Interview transcripts were examined to uncover SSCWs accounts of their knowledgeable work related to managing illness, death and dying - along with the characteristic tensions,frustrations and contradictions embedded in those accounts. The study traced how doctors and nurses were routinely, and systematically, absent from RCHs - leaving residents systematically excluded from the level of care that they needed. It also traced how SSCWs work with “serious illness” and “difficult” conversations was co-ordinated in disquieting ways in an apparent commitment to high quality “palliative care”.What was discussed between SSCWs and family members during conversations about “serious illness” and the DNACPR form was out of step with the DNACPR policy, the rhetoric of palliative care, and the actual needs of SSCWS, family members, and residents for medical support. However, the study shows that what happened in the RCH was not simply an error of practice. This is becauseit was textually planned, organised, and co-ordinated across healthcare institutions, professional groups, the regulatory body acting on behalf of the Scottish Government and the management and care staff of the RCH itself. SSCWs - and others – were organised to take up the powerful ruling discourse of palliative care in ways which treated residents and family members withincreasing objectivity, where institutional needs to reduce NHS spending and to protect the income generating potential of the care home as a business ruled over individual needs. In taking up and enacting the powerful ruling discourse of palliative care, SSCWs – and others- (intentionally but unknowingly) took up the very tools of oppression that dominated and overpowered their own and others lives. The knowledge generated by this research can be used to show SSCWs and others how they unknowingly participate in taking up actions that are not in their own or others interests. This is the basis of changing the conditions of SSCWs and others lives thereby advancing anti-oppressive work.
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Yu, Mei-yuk Doris. "The perceptions of home help services recipients towards institutional services." Hong Kong : University of Hong Kong, 1997. http://sunzi.lib.hku.hk/hkuto/record.jsp?B19470289.
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Reaume, Geoffrey. "999 Queen Street West, patient life at the Toronto Hospital for the Insane, 1870-1940." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1997. http://www.collectionscanada.ca/obj/s4/f2/dsk2/ftp02/NQ41572.pdf.
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Kim, Kyung Ho. "Equity in the provision and use of institutional care for older people in Korea." Thesis, Online version, 2002. http://ethos.bl.uk/OrderDetails.do?did=1&uin=uk.bl.ethos.251875.
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Elyas, Nada Abdullah. "Care of elderly women in Saudi Arabia : a comparison of institutional and family settings." Thesis, University of Hull, 2011. http://hydra.hull.ac.uk/resources/hull:13574.
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In recent decades, the structure of social and economic life in Saudi Arabia has undergone enormous change, and among those most affected are the elderly. While Islam enjoins respect for and care of the elderly, economic and social factors are changing the traditional system of family-based care. This thesis investigates care of elderly women in institutional and family settings in Medina. It examines the experience of old age and the discourse surrounding it, focusing on the factors influencing care arrangements, elderly women’s perceptions of their role in the family and society, the practical, economic, social and psychological implications of care for the elderly women and their relatives, the profile of carers, the dynamics of the care relationship, problems faced and support received. Data for 20 elderly women in a care home were collected through participant observation during a three-month placement, together with semi-structured interviews with 5 residents and 31 members of staff. Data for seven elderly women in family settings were collected through semi-structured interviews with the women, their main carer(s) and domestic staff. It was found that care decisions were influenced mainly by economic status and family structure. Women in family settings underwent a gradual transition, continuing to a great extent to enact former roles, while care home residents suffered an abrupt change and reconstruction of identity as “patients” and “victims”. While both groups had subsistence and medical needs met, social and psychological needs were poorly met in the care home. Findings for both groups shed light on the roles of female carers, including a heavy reliance on migrant employees, whose motivations, working conditions and relationships with employers are explored. Implications from the findings are drawn for both ageing and migration theory, and for the support needed by elderly women and their carers in both family and care home settings.
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Hsieh, Yu-Chung, and 謝宇忠. "The care need of institutional long-term care residents." Thesis, 2010. http://ndltd.ncl.edu.tw/handle/05617246428417995930.
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碩士嘉南藥理科技大學
醫療資訊管理研究所
98
This study was designed by cross-sectional method for exploring the characteristics of institutional long-term care residents. Our data was collected by the residents’ report of long term care institution. The research samples were selected from nursing homes and long-term care facilities at the Northern and Southern Taiwan. We used the statistic software of SPSS 12.0 version for the analysis of data describetion and analyze the difference with chi-square test. We went to understand the residents’ functional limitation of mental and physical, the status of residents receive professional care and their living assistance, and to compare the care need of residents among different facility that stay in Southern and Northern Taiwan. The results showed that there were 82.8% and 66.8% of residents with cognitive impairment in nursing homes and long-term care facilities, and nursing home residents with severe cognitive impairment were higher than the long-term care facilities. There were 28.0% residents need “non-professional nursing care” in nursing home that was less then the long-term care facilities(67.3%). In addition, the residents’ care need types were disparity between nursing home and the long-term care facilities, but the local difference was not significant. This study can provide the managers of institutions as a reference to set manpower and served the holistic care in facilities. This study were recommend that the main services of long-term care institution should be focus on the cognitive impairment and physical care needs. Furthermore, we were suggest to establish a long-term care information system for facilities management to avoid the early institutionalization.
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Dale, Craig M. "Locating Critical Care Nurses in Mouth Care: An Institutional Ethnography." Thesis, 2013. http://hdl.handle.net/1807/43531.
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Intubated and mechanically ventilated patients are vulnerable to respiratory tract infections. In response, the Ontario government has recently mandated surveillance and reporting of ventilator-associated pneumonia (VAP). Serious respiratory infections, and the related costs of additional care can be reduced in part, through oral hygiene. However, the literature asserts that oral care is neglected in busy, high-tech settings. Despite these concerns, little research has examined how mouth care happens in the critical care unit. The purpose of this institutional ethnography (IE) was to explore the social organization of mouth care in one critical care unit in Ontario, Canada. As a reflexive and critical method of inquiry, IE focuses on features of everyday life that often go unnoticed. In paying special attention to texts, the ethnographer traces how institutional forces that arrive from outside the practice setting coordinate experiences and activities. Inquiry began in the field with day/night participant observation to better understand the particularities of nursing care for orally intubated patients. Other data sources included reflexive fieldnotes, stakeholder interviews, and transcripts as well as work documents and artifacts. Over time, the analysis shifted from the critical care unit to the larger social context of Ontario’s Critical Care Transformation Strategy. Analysis traced the discursive and translocal social relations that permeate nursing work. Findings revealed a disjuncture between the ideals of VAP prevention and the actualities of mouth care. Tensions and contradictions emerged as nurses described their location within an expansive accountability network: nursing duties now extend beyond oral care to a controversial project of epidemiological surveillance. Patient comfort and safety now rest upon a hidden nursing agenda to overcome limited time, training and tools in oral care. Nurses worried that the effectiveness of preventative oral care was inhibited by technical problems of application that remain uninvestigated and unresolved. As a counterpoint to assertions that oral care is neglected, this study demonstrates how nursing knowledge and agency is obscured. Because international infection-prevention guidelines increasingly endorse oral care, novel research investigating the practice problems nurses encounter is warranted.
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Liu, Ming Wei, and 劉銘維. "A Study on RFID for Institutional Care." Thesis, 2009. http://ndltd.ncl.edu.tw/handle/11014934425951825913.
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碩士國立中央大學
環境工程研究所碩士在職專班
97
With the rise of population aging and high prevalence of elderly chronic diseases, institutional care has become a major choice of care for the elderly population, though the service quality of care institutions is the prime concern of citizens. Apart from enhancing the quality and safety of care from care institutions, the automatic position monitoring system provides families with information concerning the daily life of patients in care institutions and the efforts and determination to improve care quality and the environment of care institutions in order to relieve the care quality uncertainty of family. This study developed a system for detecting the location and location staying time of patients with the RFID identification and 2-way radio positioning technologies and delivering real-time monitoring and afterward enquiry functions with data transferred to the rear-end server. In addition to locating the patient, the system provides alert functions for care safety to reduce accidents in care institutions. A number of tests were conducted to verify the feasibility of applying the system to institutional care, including 100% positioning accuracy in the stability and care service simulation test and 100% success in care safety maintenance tests (emergency call and alert for extended toilet occupancy). Additionally, this study solved the communication interference problem from short positioning distance in care institutions with care route planning and body coverage characteristics. Testing results show that the successful positioning rate is 97%, indicating that the solution can successfully overcome the communication interference problem. The test of onsite dynamic route shows 97% success, indicating that both the positioning accuracy and care safety maintenance function of the system have met the practical demand, and validating the feasibility of the automatic position monitoring system in practice.
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Chang, Chia-Lun, and 張嘉倫. "A Study of demands in Long-Term Care Insurance and Institutional Care." Thesis, 2014. http://ndltd.ncl.edu.tw/handle/76846820222481009301.
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碩士銘傳大學
風險管理與保險學系碩士班
102
Due to the growth of aging population and lack of family-care function, there are increasing demands of long-term care and Institutional care. It''s urgent to promote Long -term care system. In 2009, “Long Term Care Insurance Planning” referenced the Long term care system for other countries, in order to promote Long-Term Care Insurance. Our experiment based on Anderson behavioral model of health care utilization for analyzing the demands in Long-Term Care Insurance and Institutional Care. Subjects consisted of 500 persons and recovered 426 questionnaires. The main findings of this study are as follows: (1) gender, age, occupations, marriage, Long-Term Care insurence plan , health status , health examination, are the main factors that influence the demand in Institutional Care. (2) There is a significant correlation between the recognition and demand of long-term care Insurance. (3) In short, there are around 62 % of the respondents showing their demands for the long-term care insurance, 68.5% of the respondents prefer Institutional care when their farmily have long-term care demands. The study has suggestions for the government: In order to satisfy the demands of long-term care for our people, the authorities should speed up the planning of long-term care insurance.