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Tomasi, Rodolfo, Giovanni de Girolamo, Giovanni Santone, Angelo Picardi, Rocco Micciolo, Domenico Semisa, Silva Fava et Gruppo Progres. « Drug prescription in Italian Residential Facilities ». Epidemiologia e Psichiatria Sociale 14, no 2 (juin 2005) : 77–90. http://dx.doi.org/10.1017/s1121189x0000628x.
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SUMMARYAims — To investigate in a representative national sample (N=2,962) of patients living in Residential Facilities (RFs) patterns of polypharmacy as well as related variables, association between diagnoses and therapeutic patterns, and the rate of adverse events. Methods — Structured interviews focusing on each patient were conducted by trained research assistants with the manager and staff of each RF. Patients were rated with the HoNOS and the SOFAS, and comprehensive information about their sociodemographic and clinical status, and their pharmacological regimes were collected. Results — Conventional antipsychotics and second-generation antipsychotics were prescribed to 65% and 43% of the sample, respectively. Benzodiazepines were prescribed to two-thirds of the sample, while antidepressants were the least-used class of psychotropics. Polypharmacy was common: on average, each treated patient was taking 2.7 drugs (±1.1); antipsychotic polypharmacy was also common. Many prescriptions were loosely related to specific diagnoses. Antiparkinsonianian drugs were prescribed to approximately 1/4 of the sample. Mild or severe adverse events in the previous month were reported for 9.9% and 1.4% of the sample, respectively. About 15% of patients suffered from tardive dyskinesia. Conclusions — Psychotropic drug prescription patterns for severe patients living in RFs are only sometimes satisfactory and offer the opportunity of improvement. Specific actions are required to improve prescription patterns for severe patients in RFs.Declaration of Interest: in the past two years GdG has received two speaker fees from Janssen-Cilag and from Eli Lilly; GS has received one speaker fee from Solvay. RM, AP, SF and RT have received no fees or other financial support from pharmaceutical companies.
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de GIROLAMO, GIOVANNI, ANGELO PICARDI, GIOVANNI SANTONE, IAN FALLOON, PIERLUIGI MOROSINI, ANGELO FIORITTI et ROCCO MICCIOLO. « The severely mentally ill in residential facilities : a national survey in Italy ». Psychological Medicine 35, no 3 (5 octobre 2004) : 421–31. http://dx.doi.org/10.1017/s0033291704003502.
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Objective. In Italy, Residential Facilities (RFs) have completely replaced Mental Hospitals (MHs) for the residential care of mentally ill patients. We studied all patients resident in 265 randomly sampled Italian RFs (20% of the total).Method. Structured interviews focusing on each patient were conducted by trained research assistants with the manager and staff of each RF. Patients were rated with the HoNOS and the GAF, and comprehensive information about their sociodemographic and clinical status and care history were gathered.Results. Of the 2962 patients living in the sampled facilities, most were males (63·2%) who had never married, more than 70% were over 40 years; 85% on a pension, most commonly because of psychiatric disability. A substantial proportion (39·8%) had never worked and very few were currently employed (2·5%); 45% of the sample was totally inactive, not even assisting with domestic activities in the facility. Two-thirds had a diagnosis of schizophrenia; co-morbid or primary substance abuse were uncommon. Twenty-one per cent had a history of severe interpersonal violence, but violent episodes in the RFs were infrequent. The managers judged almost three-quarters appropriately placed in their facilities and considered that very few had short-term prospects of discharge.Conclusions. Italian RFs cater for a large patient population of severely mentally ill requiring residential care. Discharge to independent accommodation is uncommon. Future studies should attempt to clarify how to match residential programmes with patients' disabilities.
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Grigoletti, Laura, Francesco Amaddeo, Giovanni de Girolamo et Angelo Picardi. « Costs of psychiatric residential care in Italy ». Epidemiology and Psychiatric Sciences 13, no 4 (décembre 2004) : 262–69. http://dx.doi.org/10.1017/s1121189x00001780.
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SummaryObjective – The aims of this study are: (1) to estimate patients' costs in Italian non hospital Residential Facilities (RF); (2) to analyse the relationship between the costs of care received by residents and patients' or facilities characteristics. Method – The PROGRES study included all Italian private and public RF (1370) with more than 4 beds. Of those, 265 were selected through stratified random sampling to be included in phase 2. Data were obtained through a schedule filled in by the facility manager. Additional information about costs related to the use of Community Psychiatric Service (CPS) by residents has also been collected. The cost components of residential accommodation include the costs of the RF, of the CPS, of general medical care, of the informal assistance provided by family or friends, and other non-medical costs. Results – The mean annual cost of stay in RFs was approximately 34,000 Euro, and it was related to the RF size and to staffing levels. Both RF and CPS are more expensive in the north of Italy, as compared to the center and the south. Costs were lower for older patients. CPS costs are lower when RF staffing levels are higher. Conclusions – In general, patients in RFs cost between 20,000 and 40,000 Euro per year; to this sum, additional 2,000-6,000 Euros per year should be added to include the costs of care provided outside the facility. Both RFs and CPS have different costs depending on the geographical area where the facilities are located, and staffing levels. Changes in CPS costs seem to be related to patients' characteristics.Declaration of Interest: none
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Cravello, Luca, Katie Palmer, Giovanni de Girolamo, Carlo Caltagirone et Gianfranco Spalletta. « Neuropsychiatric symptoms and syndromes in institutionalized elderly people without dementia ». International Psychogeriatrics 23, no 3 (3 août 2010) : 425–34. http://dx.doi.org/10.1017/s1041610210001304.
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ABSTRACTBackground: Neuropsychiatric disorders are mainly studied in people with dementia but estimates are still not available for institutionalized elderly people without dementia. The aim of this work was to investigate neuropsychiatric syndromes in non-demented elderly people living in residential facilities (RFs).Methods: Data from the PROGRES-Older people project, including 95 RFs in Italy, were analyzed. From a total of 1215 people, 252 without dementia were recruited. Behavioral syndromes were identified using both factor and cluster analysis of results from the 12-item Neuropsychiatric Inventory. Logistic regression was used to assess factors associated with behavioral syndromes. Global cognitive functioning was assessed with the Mini-mental State Examination (MMSE). Current pharmacological treatments were taken from the residents’ records.Results: Five neuropsychiatric syndromes were identified: (1) Affective (depression, anxiety, night-time behaviors); (2) Hyperactive (agitation, irritability, appetite abnormalities); (3) Psychotic (delusions and hallucinations); (4) Manic (euphoria and disinhibition); (5) Apathetic (apathy and aberrant motor behavior). The risk of having a neuropsychiatric syndrome was higher in people with younger age (OR: 5.1, 1.3–20.0), higher education (OR: 7.3, 2.4–22.1), and low MMSE score (OR: 6.5, 1.9–22.2). Almost half of people with behavioral syndromes were not undergoing psychotropic treatment. Hypnotic and anxiolytic agents were the most frequently used drugs for most of the syndromes.Conclusions: Older people without dementia living in RFs exhibit a syndrome pattern of neuropsychiatric behaviors different from those observed in patients with dementia, which are associated with cognitive and sociodemographic characteristics. A large proportion of non-demented older people with neuropsychiatric syndromes are not having adequate treatment for their psychiatric disturbances.
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Nonnis, Marcello, Alessandro Lorenzo Mura, Fabrizio Scrima, Stefania Cuccu et Ferdinando Fornara. « The Moderation of Perceived Comfort and Relations with Patients in the Relationship between Secure Workplace Attachment and Organizational Citizenship Behaviors in Elderly Facilities Staff ». International Journal of Environmental Research and Public Health 19, no 2 (15 janvier 2022) : 963. http://dx.doi.org/10.3390/ijerph19020963.
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This study focuses on caregivers who work in residential facilities (RFs) for the elderly, and specifically on their organizational citizenship behaviors (OCBs) in relation to their interaction respectively with the overall context (workplace attachment dimension), the spatial-physical environment (perceived environmental comfort), and the social environment (relationship with patients). A sample of health care workers (medical or health care specialists, nurses, and office employees, n = 129) compiled a self-report paper-pencil questionnaire, which included scales measuring the study variables. The research hypotheses included secure workplace attachment style as independent variable, OCBs as the dependent variable, and perceived comfort and relations with patients as moderators. Results showed that both secure workplace attachment and perceived comfort promote OCBs, but the latter counts especially as a compensation of an insecure workplace attachment. As expected, difficult relationships with patients hinder the relationship between secure workplace attachment style and OCBs. In sum, our study highlights the importance of the joint consideration of the psychological, social, and environmental dimensions for fostering positive behaviors in caregivers employed in elderly care settings.
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Nordin, Susanna, Kevin McKee, Helle Wijk et Marie Elf. « Exploring Environmental Variation in Residential Care Facilities for Older People ». HERD : Health Environments Research & ; Design Journal 10, no 2 (22 juin 2016) : 49–65. http://dx.doi.org/10.1177/1937586716648703.
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Objective: The aim of this study was to explore variation in environmental quality in Swedish residential care facilities (RCFs) using the Swedish version of the Sheffield Care Environment Assessment Matrix (S-SCEAM). Background: Well-designed physical environments can positively impact on health and well-being among older persons with frail health living in RCFs and are essential for supporting person-centered care. However, the evidence base for informing the design of RCFs is weak, partly due to a lack of valid and reliable instruments that could provide important information on the environmental quality. Methods: Twenty RCFs were purposively sampled from several regions, varying in their building design, year of construction, size, and geographic location. The RCFs were assessed using S-SCEAM and the data were analyzed to examine variation in environmental quality between and within facilities. Results: There was substantial variation in the quality of the physical environment between and within RCFs, reflected in S-SCEAM scores related to specific facility locations and with regard to domains reflecting residents’ needs. In general, private apartments and dining areas had high S-SCEAM scores, while gardens had lower scores. Scores on the safety domain were high in the majority of RCFs, whereas scores for cognitive support and privacy were relatively low. Conclusions: Despite high building standard requirements, the substantial variations regarding environmental quality between and within RCFs indicate the potential for improvements to support the needs of older persons. We conclude that S-SCEAM is a sensitive and unique instrument representing a valuable contribution to evidence-based design that can support person-centered care.
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Towne, Samuel D., Jinmyoung Cho, Matthew Lee Smith et Marcia G. Ory. « Factors Associated With Injurious Falls in Residential Care Facilities ». Journal of Aging and Health 29, no 4 (22 avril 2016) : 669–87. http://dx.doi.org/10.1177/0898264316641083.
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Objective: Despite a growing literature on the epidemiology of falls, little is known about injurious falls in residential care facilities (RCFs). Addressing this gap, this study examined demographic, interpersonal, institutional, and community factors associated with injurious falls in RCFs. Method: We conducted analyses using a nationally representative sample ( n = 733,309) of RCF residents (2010) examining whether or not a resident experienced a fall that resulted in any injury (past year). Results: Overall, 15% of RCF residents experienced an injurious fall. Residents needing assistance with activities of daily living were more likely to experience injurious falls (adjusted-OR = 1.85), whereas males (adjusted-OR = 0.74) and those residing in smaller facilities (adjusted-OR = 0.68) were less likely. Other resident sociodemographic characteristics, payment status, social connectedness, and rurality were not significant independent predictors. Discussion: Research further exploring multifactorial fall prevention screening and treatment programs in RCFs is recommended for reducing injurious falls in this understudied setting.
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Berish, Diane E., Robert Applebaum et Jane K. Straker. « The Residential Long-Term Care Role in Health Care Transitions ». Journal of Applied Gerontology 37, no 12 (11 novembre 2016) : 1472–89. http://dx.doi.org/10.1177/0733464816677188.
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The objective of the current study is to describe the activities long-term care facilities are undertaking to reduce hospital admissions and readmissions by working to improve health care transitions. The data were collected via an online survey from 888 nursing facilities (NFs) and 527 residential care facilities (RCFs) that completed the care integration module of the Ohio Biennial Survey of Long-Term Care. Questions focused on partnerships, current work, type of care model, and perceived barriers to reducing hospital readmissions. More than nine in 10 (93.1%) of NFs and 63.6% of RCFs reported being engaged in a program to reduce hospital admissions/readmissions. Evidence-based care models were utilized by two thirds of NFs and one third of RCFs. Financial barriers were the most frequently cited challenges faced by facilities. Long-term care settings are increasingly becoming transitional care stops for short-term stay residents. Ensuring that facilities are well versed in current transition research and practice is critical to improve system outcomes.
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Nakane, Naruhisa, et Ichiro Wada. « Estimating the Social Costs of Child Abuse in Residential Care for Children with Disabilities Using the Japanese Survey on the Interactions of Adverse and Positive Childhood Experiences toward Adulthood ». International Journal of Environmental Research and Public Health 19, no 24 (8 décembre 2022) : 16476. http://dx.doi.org/10.3390/ijerph192416476.
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We sought to calculate the extra social costs resulting from child abuse in residential care facilities (RCFs) for children with disabilities (CWD) in Japan. We distributed a survey to 260 residential facilities for CWD in 2020 and obtained responses from 91 facilities. Among the children placed in these facilities, our estimates by four different criteria determined that 23–67% were affected by child abuse. We also estimated extra costs for each of the four criteria, which we estimated to average USD 647.7 million. This study is meaningful in that there are no existing official statistics or research findings on the extra costs of residential care due to child abuse in Japan.
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Wang, Danni, Changjian Qiao, Sijie Liu, Chongyang Wang, Ji Yang, Yong Li et Peng Huang. « Assessment of Spatial Accessibility to Residential Care Facilities in 2020 in Guangzhou by Small-Scale Residential Community Data ». Sustainability 12, no 8 (15 avril 2020) : 3169. http://dx.doi.org/10.3390/su12083169.
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Population aging has increasingly challenged socio-economic development worldwide, highlighting the significance of relevant research such as accessibility to residential care facilities (RCFs). However, a number of previous studies are carried out only on street (town)-to-district scales, which could cause errors of the accessibility to RCFs for a family. In order to improve the resolution to individual families, we measure and compare the accessibilities to RCFs based on 3494 residential communities and 169 streets of Guangzhou in 2020 through the two-step floating catchment area (2SFCA) method. It was found that the distributions of the elderly and the service-dense blobs of the RCFs show patterns of a three-level spatial distribution, with a characteristic clustering at the center with peripheral dispersion. The resultant accessibility to RCFs in Guangzhou, ranging from 2.5 to 3.45, is generally consistent with the studies focusing on street scales. However, the maximum difference in the accessibility of two residential communities on the same street ranges from less than 0.02 to 0.94 in Guangzhou, indicating large variations. Although the relative errors of the accessibility results based on bi-scale data are relatively low, the cumulative errors can be high, e.g., over 25% in many streets of large cities. Consequently, hundreds of elderly persons per street can be adversely affected by those errors, with six streets over 1000. Therefore, this study focusing on the smaller-scale residential community data may provide more accurate reference to individual households. For the spatial allocation and optimal layout of Guangzhou and similar cities with population aging, we suggest maximizing RCFs in metropolises by taking full advantage of existing residential care facilities with necessary restructuring, improvements, and expansions on service capability. While for less connected cities, we encourage building new RCFs in situ.
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Jia, Min, et Timothy Heath. « China’s diversifying demand for housing for the elderly ». International Journal of Housing Markets and Analysis 9, no 2 (6 juin 2016) : 256–71. http://dx.doi.org/10.1108/ijhma-04-2015-0018.
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Purpose This paper aims to examine the trends among the elderly population in China about residential preferences and policy applications, as the elderly is a rapidly expanding demographic group that has increasing and diversifying inclinations for demanding the residential facilities for the elderly (RFEs) now and in the foreseeable future. Design/methodology/approach Based on a review of the existing literature and policies, a model is conceptualised for understanding the demands of the elderly. Their needs for functional supportiveness and richness of residential resources in RFEs are then categorised into focal groups. Findings The Chinese elderly’s demand for specialised residential facilities is under a shift from seeking deficit relief to pursuing personal choices. It is suggested that there will be a continuing demand for affordable RFEs from a number of key focal groups, including: the functionally impaired; marginally housed; socially isolated; and the elderly requiring social relief. In addition, retirement housing in China is likely to be more affordable for the next elderly generation. However, the immature social welfare system and low average income level of the current elderly generation means that the Chinese Government has tough decisions to make about service priorities. Practical implications Policy and investment priorities may have to be inclusive of those who demand social relief (free-of-charge) and affordable professional long-term care in RFEs, whereas the rest of the demand could be released by growth in the development of community- and home-based service systems. Originality/value This study is one of the first to identify the diversifying demands of age-exclusive living facilities for the elderly that deserve priorities in China. The results can inform and guide future policy and project investment in China.
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Kennedy, Katherine, Robert Applebaum et Kathryn Brod. « The Financial and Operational Effects of COVID-19 on Ohio’s Long-Term Care Residential Settings ». Innovation in Aging 5, Supplement_1 (1 décembre 2021) : 954–55. http://dx.doi.org/10.1093/geroni/igab046.3445.
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Abstract The COVID-19 pandemic has had a drastic impact on Ohio’s long-term care facilities. Yet, months into the crisis, the financial ramifications and workforce shortage were unknown. In partnership with the Scripps Gerontology Center at Miami University, LeadingAge Ohio and the Ohio Health Care Association developed an online survey that was launched in July 2021. Response rates were 46.4% for skilled nursing facilities (SNFs; N=446) and 35.8% for residential care facilities (RCFs; N=287). Core questions compared the first quarters of 2020 and 2021. Declines in operating revenues (-11.7% SNFs; -10% RCFs) and rising labor costs per patient day (17.9% SNFs; 16.1% RCFs) contributed to most providers experiencing a financial loss in the most recent month (78% SNFs; 66% RCFs). The increased documented use of agency staff is an important finding of this work; 62% of SNFs and 34% of RCFs spent money on agency staff. Despite increases in starting wages, the labor crisis remains severe. As of July 2021, SNFs had an average of 19.51 open positions, of which 9.82 were for state-tested nurse aides and 5.65 were for nurses. RCFs had an average of 8.83 open positions, of which 4.24 were for resident care assistants and 1.89 were for nurses. The challenges faced by the long-term care industry have rightly focused on the deleterious impacts of COVID on residents and staff. But these data also suggest that the financial impacts on the industry are serious and will likely shape access and provision of care in the future.
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Roos, Charlotte, Moudud Alam, Anna Swall, Anne-Marie Boström et Lena Hammar. « Factors Associated with Older Peoples′ Perceptions of Dignity and Well-being at Residential Care Facilities. » Innovation in Aging 5, Supplement_1 (1 décembre 2021) : 968. http://dx.doi.org/10.1093/geroni/igab046.3488.
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Abstract Dignity and well-being should be promoted in care of older people living at residential care facilities (RCFs). In addition, care should be person-centred. Dignity and well-being can be interpreted as person-centred outcomes. Older people living at RCFs experience a lack of dignity and well-being. To promote this, it is important to understand the associated factors to target. The aim of this study was to examine the associations between perceived dignity and well-being and factors related to attitudes of staff, the care environment and individual issues (age, gender, self-rated health and dementia) among older people living at RCFs. A national cross-sectional study was conducted retrospectively. All older people 65 years and older (n=71,696) living at RCFs in 2018 were invited to respond to the survey. The survey included the areas: self-rated health, indoor-outdoor-mealtime environment, performance of care, treatment from staff, safety, social activities, availability of staff and care in its entirety. Age, gender and diagnosed dementia were collected from two national databases. Data was analysed using ordinal logistic regression models. The result indicated that respondents who had experienced disrespectful treatment, who did not thrive in the indoor-outdoor-mealtime environment, who rated their health as poor and respondents with dementia had higher odds of being dissatisfied with dignity and well-being. There is a need to improve the prerequisites of staff regarding respectful attitudes and to improve the care environment. The Person-centred Practice framework, targeting the prerequisites of staff and the care environment, can be used as a theoretical framework for designing future improvements.
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Cheng, Min, et Xiao Cui. « Spatial Optimization of Residential Care Facility Configuration Based on the Integration of Modified Immune Algorithm and GIS : A Case Study of Jing’an District in Shanghai, China ». International Journal of Environmental Research and Public Health 17, no 21 (3 novembre 2020) : 8090. http://dx.doi.org/10.3390/ijerph17218090.
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As the population is aging rapidly, the irrationality of residential care facility (RCF) configuration has impacted the efficiency and quality of the aged care services so significantly that the optimization of RCF configuration is urgently required. A multi-objective spatial optimization model for the RCF configuration is developed by considering the demands of three stakeholders, including the government, the elderly, and the investor. A modified immune algorithm (MIA) is implemented to find the optimal solutions, and the geographic information system (GIS) is used to extract information on spatial relationships and visually display optimization results. Jing’an District, part of Shanghai, China, is analyzed as a case study to demonstrate the advantages of this integrated approach. The configuration rationality of existing residential care facilities (RCFs) is analyzed, and a detailed recommendation for optimization is proposed. The results indicate that the number of existing RCFs is deficient; the locations of some RCFs are unreasonable, and there is a large gap between the service supply of existing RCFs and the demands of the elderly. To fully meet the care demands of the elderly, 6 new facilities containing 1193 beds are needed to be added. In comparison with the optimization results of other algorithms, MIA is superior in terms of the calculation accuracy and convergence rate. Based on the integration of MIA and GIS, the quantity, locations, and scale of RCFs can be optimized simultaneously, effectively, and comprehensively. The optimization scheme has improved the equity and efficiency of RCF configuration, increased the profits of investors, and reduced the travel costs of the elderly. The proposed method and optimization results have reference value for policy-making and planning of RCFs as well as other public service facilities.
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Berta, Whitney, Audrey Laporte et Vivian Valdmanis. « Observations on Institutional Long-Term Care in Ontario : 1996–2002 ». Canadian Journal on Aging / La Revue canadienne du vieillissement 24, no 1 (2005) : 71–84. http://dx.doi.org/10.1353/cja.2005.0002.
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ABSTRACTWe provide descriptive statistics for data collected via the Residential Care Facilities Survey (RCFS), from long-term care (LTC) facilities operating in Ontario between 1996 and 2002. The LTC sector in Ontario is dominated by large, proprietary for-profit facilities. The proportion of residents receiving extended care has increased from 53 per cent in 1996 to over 61 per cent in 2002. Government-owned facilities are significantly larger than both for-profit proprietary facilities and lay non-profit facilities. Religious and lay non-profit facilities provide care to more residents 85 years of age and older than do for-profit and government-owned facilities, while government-owned facilities provide care to a greater proportion of higher needs residents. Government-owned facilities have higher nursing intensity levels and higher direct care staffing levels than other ownership types, while for-profit facilities have significantly lower levels than other facility types. Non-profit operators have higher ratios of administrative to care staff than proprietary and government-owned facilities.
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Lestage, Catherine, Nicole Dubuc et Gina Bravo. « Développement et validation d’une classification québécoise des résidences privées avec services accueillant des personnes âgées ». Canadian Journal on Aging / La Revue canadienne du vieillissement 33, no 1 (20 janvier 2014) : 72–83. http://dx.doi.org/10.1017/s0714980813000627.
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ABSTRACTPrivate Residential Care Facilities (RCFs) fill the gap between independent community living and institutional settings for seniors. There are marked differences between RCFs which make them difficult to compare. To address this issue, the objective of this study was to develop and validate a classification of RCFs based on their physical and organizational environments. RCF owners across Quebec were invited to complete a questionnaire that described the setting’s physical and organizational environment. Different combinations of cluster analysis methods and statistical parameters were used to identify plausible classifications. The final choice was made by an expert committee. Overall, 552 owners returned the questionnaire. Three plausible classifications were submitted to the committee. The selected classification included five clusters that differed with regard to admission criteria, services offered and recreational activities. This classification could help health professionals select the RCF that best responds to older adults’ needs.
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Loi, Samantha M., Alice Bennett, Marta Pearce, Khanh Nguyen, Nicola T. Lautenschlager, Rajiv Khosla et Dennis Velakoulis. « A pilot study exploring staff acceptability of a socially assistive robot in a residential care facility that accommodates people under 65 years old ». International Psychogeriatrics 30, no 7 (4 décembre 2017) : 1075–80. http://dx.doi.org/10.1017/s1041610217002617.
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ABSTRACTSocially assistive robots have successfully been trialed in residential care facilities (RCFs) for older adults. These robots may have potential for younger adults (i.e. under 65 years old) who also live in RCFs. However, it is important to investigate staff acceptability and ease-of-use of these robots. This pilot study used the Technology Acceptance Model to investigate how staff working in a specialized RCF for younger adults accept Betty, a socially assistive robot who was introduced in the facility for 12 weeks. Twenty-four staff completed pre-questionnaires, reporting that they thought Betty would have the ability to engage and entertain the residents they cared for. While there were only eight staff who completed the post-questionnaires, there were significant improvements compared to the pre-questionnaire results in areas such as residents enjoying the contact and activities. Impacting on ease-of use were technical difficulties. Although this study had limitations and could be improved by a better response rate and investigating the residents’ acceptability of Betty, this study is one of the first to report that this novel technology may have much potential for engaging adults in RCFs.
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Houben, Famke, Mitch van Hensbergen, Casper D. J. Den Heijer, Nicole H. T. M. Dukers-Muijrers et Christian J. P. A. Hoebe. « Barriers and facilitators to infection prevention and control in Dutch residential care facilities for people with intellectual and developmental disabilities : A theory-informed qualitative study ». PLOS ONE 16, no 10 (29 octobre 2021) : e0258701. http://dx.doi.org/10.1371/journal.pone.0258701.
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Background Care institutions are recognised to be a high-risk setting for the emergence and spread of infections and antimicrobial-resistant organisms, which stresses the importance of infection prevention and control (IPC). Accurate implementation is crucial for optimal IPC practice. Despite the wide promotion of IPC and research thereof in the hospital and nursing home setting, similar efforts are lacking in disability care settings. Therefore, this study aimed to assess perceived barriers and facilitators to IPC among professionals working at residential care facilities (RCFs) for people with intellectual and developmental disabilities (IDD), as well as to identify professional-reported recommendations to improve IPC. Methods This qualitative study involved semi-structured interviews (before COVID-19) with twelve professionals from five Dutch RCFs for people with IDD. An integrated theoretical approach was used to inform data collection and analysis. Thematic analysis using inductive and deductive approaches was conducted. This study followed the COnsolidated criteria for REporting Qualitative research (COREQ) guidelines. Results Our findings revealed barriers and facilitators at the guideline, client, professional, professional interaction, professional client interaction, client interaction, organisational, community, and societal level. Six main themes covering multiple barriers and facilitators were identified: (1) guidelines’ applicability to (work)setting; (2) professionals’ cognitions and attitude towards IPC (related to educational background); (3) organisational support and priority; (4) educational system; (5) time availability and staff capacity; and (6) task division and change coaches. The main professional-reported recommendations were the introduction of tailored and practical IPC guidelines, structural IPC education and training among all professionals, and client participation. Conclusions To promote IPC, multifaceted and multilevel strategies should be implemented, with a preliminary need for improvements on the guideline, professional, and organisational level. Given the heterogeneous character, i.e., different professionals, clients and care needs, there is a need for a tailored approach to implement IPC and sustain it successfully in disability care. Our findings can inform future IPC practice improvements.
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Ogras, Selman, et Fevzi Onen. « Flood Analysis with HEC-RAS : A Case Study of Tigris River ». Advances in Civil Engineering 2020 (24 février 2020) : 1–13. http://dx.doi.org/10.1155/2020/6131982.
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Floods are seen in countries in tropical climatic zones, both in terms of quantity and harm. The non-tropical climate countries such as Turkey are also affected by the floods. The geographical structure of Turkey is extremely complex and varies even at short distance. Therefore, the shape and effects of the floods vary from region to region. Considering the peculiar state of nature, floods, which are the greatest disasters after the earthquake, are unlikely to occur. But floods are becoming more risky for human beings day by day because of the population growth, need of water and settlements, wrong zoning plan, and unplanned engineering practices. Regulation comes at the beginning of measures to be taken to minimize the damages that occur from the floods. To do these studies, it must be specified the changes which bridges on the rivers and hydraulics structures like regulator cause in cross sections and the effects of the changes to water surface profile due to the natural state of the land. In order to determine water surface profiles, many software packages have been developed for facilitating the analysis and calculation. HEC-RAS is one of them. In this study, the floodplain analysis was handled between Diyarbakır-Silvan Highway and historical Ten-Eyed Bridge. There are three bridges, and one of which are historical bridges, as well as fertile agricultural lands, facilities, and hospitals in the Dicle University campus, the Hevsel Gardens on the UNESCO World Cultural Heritage List, and some residential areas on the route under study. The aim of the study we have done in this much important route is to evaluate the flood areas and create a flood hazard map which can predict risky areas. And also contributing to the Tigris River Rehabilitation Project is one of the aims. About methodology, the 1/1000 maps of the study area were digitized using the AutoCAD Civil 3D program and cross sections were made by obtaining the digital elevation models of the region. The obtained cross sections were defined in the HEC-RAS software, and the hydraulic characteristics of the flood bed and the water surface profiles of the Q25, Q50, Q100, and Q500 flood recurring and one-dimensional floodplain analysis of the Tigris River were determined.
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Fehling, Patrick, et Theo Dassen. « Prevalence of mobility disabilities in nursing home residents and the association with age, BMI, fall risk and social participation ». Journal of Nursing Education and Practice 7, no 12 (14 août 2017) : 105. http://dx.doi.org/10.5430/jnep.v7n12p105.
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Background and aim: Physical mobility is often described as a basic prerequisite for independence, self-determination, and social participation. Older people, particularly those in long-term care facilities, are more often affected by the loss of their mobility. However, the prevalence of the mobility disabilities of nursing home residents and their association with demographic and care-specific/medical factors have so far been studied less. This prevalence study should investigate a possible association of mobility disability with age, BMI, multimorbidity, fall risk, and social participation.Methods: The prevalence study covered the data of residents in 30 German residential care facilities (RCFs). Trained staff nurses used a standardised instrument to collect data about the age, obesity, medical diagnoses, the fall risk, the level of mobility disability, and the need for supporting the social participation of the residents.Results: The representative sample included 2,066 nursing home residents, of whom 81.5% required support in their mobility. The level of a mobility disability or the need for a support in matters of mobility by others was not associated either with age, with the BMI, or with the fall risk of the participants. The groups with higher mobility disability included the more multimorbid participants with more difficult medical diagnoses, and these had a higher need for support in their social participation.Conclusions: It may be that professional care must reflect the premature link between older and obese patients with mobility disability. In addition to nursing diagnoses, medical diagnoses should necessarily be integrated into the nursing assessment. The association between the level of mobility disability and the fall risk, which is often mentioned in the literature, should be critically reflected. Nursing home residents should be informed that there is a possible association between their mobility disability and their social participation.
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Qachchachi, Nabil, Hassane Mahmoudi et Abdennebi El Hassnaoui. « Control Strategy of Hybrid AC/DC Microgrid in Standalone Mode ». International Journal of Renewable Energy Development 9, no 2 (30 avril 2020) : 295–301. http://dx.doi.org/10.14710/ijred.9.2.295-301.
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The fluctuation of production of renewable energy resources (RESs) is a big problem for its installation and integration in isolated residential buildings. A hybrid AC/DC microgrid facilitates the good operation of RESs with a storage system in standalone mode and the possibilities of smart energy management. In this paper optimization research of the hybrid ac/dc microgrid in isolated mode of operation is presented. The power system is supplied by various Renewable Energy Resources (RESs), Photovoltaic arrays (PVA), a Wind Turbine Generator (WTG), Diesel Generator (DG) and supported by Batteries Storage System (BSS) for short term storage. The main objective of this study is to optimize power flow within a hybrid ac/dc microgrid with regards to reliability in islanded mode. First a mathematical model optimized by mixed integer linear programming and solved by CPLEX solver with JAVA language is developed for an islanded RES system and then, based on the developed model, the power system control is simulated for different cases of off-grid mode. Simulation results have shown that the management strategy can maintain power balancing while performing optimized control and give a controllable loads and batteries charging/discharging powers, even with unpredictability of RESs powers outputs and arbitrary energy tariffs. Finally, the proposed algorithm respects the optimization in real-time operation under various constraints.%.©2020. CBIORE-IJRED. All rights reserved
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Gaba, Anu, Li Cao, Rebecca Renfrew, Janet Wernisch, Abe Sahmoun, Sanjay Goel et Ross Crosby. « Abstract P1-06-03 : Differences in Breast Cancers among American-Indians and Whites in the United States ». Cancer Research 83, no 5_Supplement (1 mars 2023) : P1–06–03—P1–06–03. http://dx.doi.org/10.1158/1538-7445.sabcs22-p1-06-03.
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Abstract Differences in Breast Cancers among American-Indians and Whites in the United States Background - The United States has made substantial progress in improving breast cancer (BC) outcomes over the years, but unfortunately, this improvement has not impacted all races equally. BC death rates have not improved significantly for American Indian (AI) women, whereas, it significantly decreased for White women. In addition, AI women were more likely to be diagnosed at a younger age with a late-stage disease. We sought to determine the reasons for these disparities. Methods - This is a retrospective cohort study using a hospital registry database (the National Cancer Data Base) (NCDB). We identified female AIs and non-Hispanic Whites in the US diagnosed with BC between the years 2004 and 2016. We compared patient and tumor characteristics between the 2 groups and its effect on age and stage at diagnosis. We also determined hazard ratios (HRs) for overall survival using Cox regression models, both before and after adjustment for covariates. Results – Data on 6,866 AIs and 1,987,324 White women diagnosed with BC were analyzed. The mean (SD) age at diagnosis was significantly younger for AI than for White women (57.72 ± 12.23 vs. 61.87 ± 13.21). AI women traveled double the distance to their treatment facilities, lived in lower median income zip codes, reported a higher percentage of no insurance, and higher comorbidities than Whites. Furthermore, AIs were less likely to be diagnosed with Stage 0 and I BCs, had a larger tumor size, greater number of positive lymph nodes at diagnosis, and higher proportion of triple negative and HER2-positive BCs than Whites. Whites were more likely to have other cancers diagnosed prior to or after their BC diagnosis. All the above tests for comparisons were significant (p-value < 0.001). Correlation between patient/tumor characteristics with age and stage at diagnosis was not significantly different between AIs and Whites. Unadjusted overall survival (OS) was significantly worse for AIs as compared to Whites (HR=1.07; 95% CI: 1.01-1.14, p-value = 0.025). After adjustment of all covariates including age, travel distance, median income of residential zip code, insurance status, cancer sequence, comorbidities, stage, tumor size, number of positive lymph nodes, grade, histology, and hormonal/HER2 status, OS was not significantly different between AIs and Whites (HR=1.04; 95% CI: 0.90-1.20, p-value = 0.601). Conclusion - Our study showed significant differences in patient and tumor characteristics among AI and White BC patients which adversely impacted BC outcomes in AIs. Survival was lower in AIs, but when adjusted for various covariates, the survival difference disappeared. Improvement in BC outcomes in AIs will involve not only improved and early access to screening to identify patients at younger ages and earlier stages at diagnosis, but also long term plans to provide affordable and the full spectrum of cancer care closer to home. Citation Format: Anu Gaba, Li Cao, Rebecca Renfrew, Janet Wernisch, Abe Sahmoun, Sanjay Goel, Ross Crosby. Differences in Breast Cancers among American-Indians and Whites in the United States [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P1-06-03.
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Martinelli, Alessandra, Helen Killaspy, Cristina Zarbo, Sara Agosta, Letizia Casiraghi, Manuel Zamparini, Fabrizio Starace et al. « Quality of residential facilities in Italy : satisfaction and quality of life of residents with schizophrenia spectrum disorders ». BMC Psychiatry 22, no 1 (18 novembre 2022). http://dx.doi.org/10.1186/s12888-022-04344-w.
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Abstract Background Recovery and human rights promotion for people with Schizophrenia Spectrum Disorders (SSDs) is fundamental to provide good care in Residential Facilities (RFs). However, there is a concern about rehabilitation ethos in RFs. This study aimed to investigate the care quality of Italian RFs, the quality of life (QoL) and care experience of residents with SSD. Methods Fourty-eight RFs were assessed using a quality assessment tool (QuIRC-SA) and 161 residents with SSD were enrolled. Seventeen RFs provided high intensity rehabilitation (SRP1), 15 medium intensity (SRP2), and 16 medium-low level support (SRP3). Staff-rated tools measured psychiatric symptoms and psychosocial functioning; user-rated tools assessed QoL and satisfaction with services. RFs comparisons were made using ANOVA and Chi-squared. Results Over two-thirds patients (41.5 y.o., SD 9.7) were male. Seventy-six were recruited from SRP1 services, 48 from SRP2, and 27 from SRP3. The lowest QuIRC-SA scoring was Recovery Based Practice (45.8%), and the highest was promotion of Human Rights (58.4%). SRP2 had the lowest QuIRC-SA ratings and SRP3 the highest. Residents had similar psychopathology (p = 0.140) and functioning (p = 0.537). SRP3 residents were more employed (18.9%) than SRP1 (7.9%) or SRP2 (2.2%) ones, and had less severe negative symptoms (p = 0.016) and better QoL (p = 0.020) than SRP2 residents. There were no differences in the RF therapeutic milieu and their satisfaction with care. Conclusions Residents of the lowest supported RFs in Italy had less severe negative symptoms, better QoL and more employment than others. The lowest ratings for Recovery Based Practice across all RFs suggest more work is needed to improve recovery.
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Shah, M., A. Clancy, M. Regan, A. M. Maher, S. Armitage, C. Ryan, C. Mannion et al. « O02 Improving antimicrobial use in HSE older persons residential care facilities ». JAC-Antimicrobial Resistance 5, Supplement_1 (19 janvier 2023). http://dx.doi.org/10.1093/jacamr/dlac133.002.
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Abstract Background Antimicrobial use in Irish older persons residential care facilities (OP RCFs) is higher than in other European countries. In 2020/21, for the first time, an antimicrobial pharmacist (AMP) was appointed to each community healthcare organization (CHO) to monitor, develop and promote antimicrobial stewardship in community settings. Objectives To establish baseline antibiotic use, develop antimicrobial stewardship tools for OP RCFs, promote best practice in relation to antimicrobial stewardship (AMS) and monitor trends in antimicrobial use in HSE (state-run) OP RCFs. Methods A baseline point prevalence survey (PPS) of antimicrobial use was conducted across all HSE OP RCFs between October 2020 and August 2021. Following the survey, key national recommendations and AMS resources were developed in collaboration with the national Antimicrobial Resistance and Infection Control Programme. Feedback was provided to participating facilities by CHO AMPs with antimicrobial stewardship support and education for nursing and medical staff. In September 2021, monthly monitoring of antibiotic use was established in HSE OP RCFs in collaboration with local managers, to capture the proportion of antibiotics used for prophylaxis or treatment each month. Results A baseline PPS of antimicrobial use in 2020/21 showed that 11.9% (528/4446) of residents were on a systemic antibiotic, with 6.3% on antibiotic prophylaxis. Urinary tract infection accounted for 51% of antibiotic prescriptions. Following the baseline PPS, CHO AMPs developed an AMS toolkit for OP RCFs, engaged with nursing and medical staff to communicate PPS results, AMS resources and support implementation of AMS recommendations. Subsequently, monthly self-reporting of antimicrobial use in HSE OP RCFs was commenced in September 2021 and showed a sustained decrease in antimicrobial use with 7.9% residents on an antibiotic in Quarter 2 2022, with 2.7% on antibiotic prophylaxis. Conclusions Newly appointed CHO AMPs have successfully promoted AMS across HSE OP RCFs. Following audit, feedback, education, development and promotion of antimicrobial stewardship resources, there was a sustained decrease in the proportion of residents on antibiotics used for treatment and prophylaxis of infection.
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Mu, Jingyi, Jian Kang et Sui Zheng. « Evaluating the objective and subjective physical environments of residential care facilities ». Indoor and Built Environment, 17 janvier 2023, 1420326X2311525. http://dx.doi.org/10.1177/1420326x231152561.
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The aim of this research was to explore the objective and subjective physical environments of residential care facilities (RCFs) by studying 34 facilities in Harbin, Changchun, Shenyang and Dalian. A study that combines questionnaires and instrumental testing. Pearson’s correlation and regression analysis were used to analyse the correlation between the measured value and the evaluation result and the impact on the results of the participants’ personal background evaluations. The results showed that the brightness intensity ranged from 100 to 450 cd/m2, illuminance 200–550 lx and sound pressure level (SPL) 40–58 dBA. In reconstructed RCFs (RCFs converted from other buildings), the odour and other factors were significantly positively correlated with the satisfaction of participants. Seasonal changes had a significant impact on the level of different physical environments, particularly in the assessment of the thermal environment. Temperatures were highest in bedrooms, reaching 27°C. The correlation between the measured value and the evaluated satisfaction was high. The education level of participants was related to their satisfaction with the overall Indoor environmental quality (IEQ). Participants in the study were satisfied with the overall IEQ of the RCFs. These results can provide data-based support and act as a reference for IEQ research on RCFs.
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McGrane, N., P. Dunbar, M. Dunnion et L. O'Connor. « Practice surrounding adverse events in residential care facilities in Ireland ». European Journal of Public Health 31, Supplement_3 (1 octobre 2021). http://dx.doi.org/10.1093/eurpub/ckab165.338.
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Abstract Background Part of regulation of residential care facilities (RCFs) is the statutory responsibility of RCFs to notify the regulator about adverse events (AEs). Notifications typically include a description of practice in the aftermath of AEs and are an information source that can inform quality and safety improvements. The herein aim therefore was to analyse narratives in notifications received by the Health Information and Quality Authority (HIQA) in Ireland, to identify practice surrounding AE management and reporting. Methods A sample (n = 447) of notifications received by HIQA in 2018 was drawn from the Database of Statutory Notifications from Social Care in Ireland, 2013-2019. Inductive thematic analysis was conducted. Analysis was structured using the a priori agreed themes of: practice in the aftermath of an AE, system vulnerabilities and reporting practices. Results Two overarching themes were identified. The first, a chronological theme contained three sub-themes: pre event, including existing measures and situations, response to the event and continued response. Measures that are resident focused and follow policies and protocols in RCFs to prevent or mitigate the seriousness of AEs, were evident in the response and continued response. From this chronological order emerged the cyclical theory where short and longer term actions become part of the pre-event of future similar or repeated AEs. The second overarching theme, regulatory input, encapsulated procedural notes, requests for further information and notes on repetitive patterns. Conclusions RCFs respond to AEs with short and longer term actions with resident health and wellbeing as the focus. These actions in turn become part of the pre-event of future AEs. This cycle can be leveraged for quality improvement initiatives. Input from inspectors was positive and constructive but highlighted some regulatory burden. Dissemination of these results as good practice guides may improve management and reporting of AEs. Key messages Residential care facilities respond to adverse events with short and long term measures which feed into the management of future AEs. This cycle can be leveraged for quality improvement initiatives. Improvement opportunities in reporting practices were found. The development of good practice guides for residential care facilities and inspectors could reduce regulatory burden.
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Wood, Katherine, Nader Mehri, Nytasia Hicks et Jonathon M. Vivoda. « Family Satisfaction : Differences Between Nursing Homes and Residential Care Facilities ». Journal of Applied Gerontology, 22 novembre 2020, 073346482097152. http://dx.doi.org/10.1177/0733464820971520.
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This study compared differences in overall family satisfaction, specific satisfaction domains, and correlates of satisfaction between nursing homes (NHs) and residential care facilities (RCFs), using data from the 2016 Ohio Long-Term Care Family Satisfaction Survey. Satisfaction was higher for RCFs overall and within nearly every domain, with the largest difference observed in the environment domain. In both facility types, higher satisfaction was associated with male respondents, older respondent age, White race, less-frequent visitation, longer anticipated length of stay, less help provided during visits, smaller facilities, lower Medicaid-reliant resident percentage, and nonprofit status. Resident age, visitation frequency, perceived assistance required, and kinship tie were differentially related to satisfaction between facility types. NH administrators should focus on the environment and the moving in process. All administrators should address how residents spend time and should be aware that residents’ and their family members’ characteristics may affect satisfaction levels.
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Clancy, A., M. Regan, S. Armitage, M. Shah, C. Mannion, O. Gallagher, R. Foran, S. Fagan, M. Donnelly et B. Love. « 88 NATIONAL ANTIMICROBIAL POINT PREVALENCE SURVEY IN HSE OLDER PERSONS RESIDENTIAL CARE FACILITIES (OPS-RCFS) ». Age and Ageing 51, Supplement_3 (25 octobre 2022). http://dx.doi.org/10.1093/ageing/afac218.072.
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Abstract Background The HALT study in 2016 found that residents in Irish OPS RCFs were twice as likely to be on systemic antimicrobial compared with European average (10% v 5%). National antibiotic prescribing guidelines are available at www.antibioticprescribing.ie and prescribers are encouraged to choose ‘green’ (preferred) over ‘red’ (reserved) agents. HSE Community Antimicrobial Pharmacists (AMPs) have been employed since 2020. We aimed to establish the quality and quantity of antimicrobial prescribing in OPS-RCFs to inform antimicrobial stewardship activities. Methods All residents in HSE OPS-RCFs were surveyed between October 2020 and August 2021. AMPs reviewed all medication charts for systemic antimicrobials prescribed within previous 30 days. Medical notes +/- laboratory results were reviewed for persons on antimicrobials. Adherence to guidelines was assessed and information obtained on practices related to antimicrobial use. Results The survey included 4,448 individuals in 121 OPS RCFs. 12% were on systemic antimicrobial at time of survey. 27% received an antimicrobial in the previous 30 days. 50% of antibiotic use on survey day was for prophylaxis (6.3% of all residents). Prophylaxis exceeded 6 months in 66% persons, and 12 months in 57%. There was high usage of green versus red agents (65% vs 30%). Co-amoxiclav (red) was most commonly prescribed antimicrobial to treat infection (19%). 42% of sites reported routine use of dipstick urinalysis to support diagnosis of UTI in asymptomatic residents. 36% of sites did not have onsite electronic laboratory access. 61% of facilities did not record residents’ pneumococcal vaccination status. Conclusion Key national recommendations: Review all UTI prophylaxis within 6 months of initiation with view to de-prescribing.Cease routine use of dipstick urinalysis to support diagnosis of UTI for asymptomatic persons.Electronic access to laboratory results on-site required to support timely decision-making.All staff should be aware of the national antimicrobial guidelines.Pneumococcal vaccine status should be determined, and provided as necessary.
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Jingyi, Mu, Zhang Shanshan et Yue Wu. « The Influence of Physical Environmental Factors on Older Adults in Residential Care Facilities in Northeast China ». HERD : Health Environments Research & ; Design Journal, 3 septembre 2021, 193758672110367. http://dx.doi.org/10.1177/19375867211036705.
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Objectives: To evaluate the aspects of the objective physical environments of five residential care facilities (RCFs) for older adults and the residents’ subjective perceptions of these aspects. Background: The physical environment in RCFs impacts the health and comfort of the residents. However, the design standards for RCFs lack details which can result in insufficient living conditions. Methods: Through questionnaire surveys, older adults’ satisfaction on the degree of the light, acoustic, and thermal environment in the facilities was obtained. Indoor lighting condition was measured by an illuminance meter in lux, sound pressure level (SPL) with sound level meters in dBA, and temperature in °C with a temperature data logger, and an audiometer was used to test the hearing of the older adults. Results: A total of 480 questionnaires were obtained. Results show that (a) older adults need an appropriate light environment to avoid the negative impact of limited light, (b) poor acoustic environment could affect their mood and health, and (c) when the room temperature is within the range of 20–26 °C (68–78.8 °F), they feel most comfortable. When the appropriate temperature and humidity, balanced illumination, and SPL meet the needs of older adults, it can provide a more comfortable physical environment for them. Conclusion: Examining the interaction between the physical environmental factors that affect older adults in RCFs is important for the design of residential housing and provides more theoretical support for research on the influence of the physical environment on the quality of life of older adults.
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Boumans, Jogé, Leonieke C. van Boekel, Marjolein EA Verbiest, Caroline A. Baan et Katrien G. Luijkx. « Exploring how residential care facilities can enhance the autonomy of people with dementia and improve informal care ». Dementia, 2 juillet 2021, 147130122110305. http://dx.doi.org/10.1177/14713012211030501.
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Background and objectives Residential care facilities (RCFs) strive to enhance autonomy for people with dementia and to enhance informal care provision, although this is difficult. This study explored how RCF staff can enhance autonomy and improve informal care by looking at the influence of interactions (contact and approachability between residents, staff members and informal caregivers) and the physical environment, including the use of technologies. Research design and methods A realist evaluation multiple-case study was conducted using document analyses, eight semi-structured interviews with staff members and relatives and 56 hours of observations of residents across two RCFs aiming to provide person-centred care. Realist logic of analysis was performed, involving Context-Mechanism-Outcome configurations. Findings The behaviour, attitudes and interactions of staff members with residents and informal caregivers appeared to contribute to the autonomy of people with dementia and enhance informal care provision. The physical environment of the RCFs and the use of technologies were less relevant to enhancing autonomy and informal care provision, although they can support staff members in providing person-centred care in daily practice. Discussion and implications The findings add to those of other studies regarding the importance of interaction between residents, staff members and informal caregivers. The findings provide insight for other RCFs on how successfully to enhance autonomy for their residents and to improve informal care provision, as well as, more broadly, how to implement person-centred care.
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Roos, Charlotte, Anna Swall, Lena Marmstål Hammar, Anne-Marie Boström et Bernice Skytt. « Promoting the person-centred aspects of dignity and well-being : learning from older persons’ experiences of living in residential care facilities ». Working with Older People, 13 septembre 2022. http://dx.doi.org/10.1108/wwop-08-2022-0034.
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Purpose Dignity and well-being are key aspects of the legislation and policies that regulate care of older persons worldwide. In addition, care of older persons should be person-centred. Dignity and well-being are described as results of person-centred care (PCC). The purpose of this study was to gain an understanding of important aspects for older persons to experience dignity and well-being in residential care facilities (RCFs). Design/methodology/approach This study had a qualitative approach, and individual semi-structured interviews were conducted with 20 older persons living in RCFs. Data were analysed using inductive content analysis. Findings To experience dignity and well-being older persons emphasized the importance of preserving their identity. To do this, it was important to be able to manage daily life, to gain support and influence and to belong to a social context. However, the findings indicate a need for improvements. Practical implications Insights into older persons’ experiences of important aspects for experiencing dignity and well-being in RCFs can be used by first-line managers and registered nurses when designing improvement strategies to promote PCC. Originality/value Dignity and well-being are described as results of PCC. The findings provide an understanding of what older persons perceive as important for experiencing dignity and well-being in RCFs. The findings are useful when designing improvement strategies to promote PCC.
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van Loon, Jolande, Katrien Luijkx, Meriam Janssen, Ietje de Rooij et Bienke Janssen. « Facilitators and barriers to autonomy : a systematic literature review for older adults with physical impairments, living in residential care facilities ». Ageing and Society, 30 octobre 2019, 1–30. http://dx.doi.org/10.1017/s0144686x19001557.
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Abstract Autonomy is important in every stage of life. However, little is known about how autonomy is enhanced for older adults living in residential care facilities (RCFs). This leads to the research question: which facilitators and barriers to autonomy of older adults with physical impairments due to ageing and chronic health conditions living in RCFs are known? The results will be organised according to the framework of person-centred practice, because this is related to autonomy enhancement. To answer the research question, a systematic literature search and review was performed in the electronic databases CINAHL, PsycINFO, PubMed, Social Services Abstracts and Sociological Abstracts. Inclusion and exclusion criteria were derived from the research question. Selected articles were analysed and assessed on quality using the Mixed Methods Appraisal Tool. Facilitators and barriers for autonomy were found and arranged in four themes: characteristics of residents, prerequisites of professional care-givers, care processes between resident and care-giver, and environment of care. The established facilitators and barriers are relational and dynamic. For a better understanding of the facilitators and barriers to autonomy for older adults with physical impairments living in RCFs, a description is based on the 35 included articles. Autonomy is a capacity to influence the environment and make decisions irrespective of having executional autonomy, to live the kind of life someone desires to live in the face of diminishing social, physical and/or cognitive resources and dependency, and it develops in relationships. The results provide an actual overview and lead to a better understanding of barriers and facilitators for the autonomy of older adults with physical impairments in RCFs. For both residents and care-givers, results offer possibilities to sustain and reinforce autonomy. Scientifically, the study creates new knowledge on factors that influence autonomy, which can be used to enhance autonomy.
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Adamus, Christine, Jovin Alpiger, Matthias Jäger, Dirk Richter et Sonja Mötteli. « Independent Supported Housing Versus Institutionalised Residential Rehabilitation for Individuals with Severe Mental Illness : A Survey of Attitudes and Working Conditions Among Mental Healthcare Professionals ». Community Mental Health Journal, 13 octobre 2022. http://dx.doi.org/10.1007/s10597-022-01037-2.
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AbstractDespite widespread support for Independent Supported Housing (ISH) interventions, psychiatric housing rehabilitation still commonly takes place in residential care facilities (RCFs). This study compares preferences, attitudes and working conditions of mental healthcare professionals (MHCPs) in ISH and RCFs using an online survey. The survey included setting preferences, stress and strain at work, recovery attitudes, stigmatisation, and factors experienced as particularly important or obstructive in housing rehabilitation. Data were analysed using quantitative and qualitative approaches. Of the 112 participating MHCPs, 37% worked in ISH and 63% in RCFs. Professionals’ education, work-related demands and influence at work were higher in ISH, stigmatising attitudes were higher in RCFs. MHCPs in both settings endorsed ISH. The support process was seen as particularly important whereas stigmatisation, regulatory and political requirements were seen as obstructive for successful housing rehabilitation. Results indicate that social inclusion of individuals with severe mental illness is seldom feasible without professional support.
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de Graaf, Lisette, Meriam Janssen, Tineke Roelofs et Katrien Luijkx. « Substance use and misuse of older adults living in residential care facilities : a scoping review from a person-centred care approach ». Ageing and Society, 20 août 2021, 1–27. http://dx.doi.org/10.1017/s0144686x21001215.
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Abstract Person-centred care (PCC) in residential care facilities (RCFs) is valuable but creates challenges for care professionals balancing involvement and a partnership approach for residents while considering the health and safety outcomes of all residents. This review evaluates what is known about the substance use and misuse of residents living in RCFs and what is important to study in future research to enhance PCC, especially in cases in which residents wish to choose unhealthy behaviours. A scoping review was conducted and exclusion criteria were set. The included papers were assessed on methodological quality using the Mixed Methods Appraisal Tool and the results were qualitatively analysed. The included papers consisted of studies regarding alcohol, tobacco and illicit drugs. The results showed that care professionals are involved in facilitating and regulating alcohol and tobacco. The focus of the included papers is on alcohol and tobacco. Five of the 16 papers assessed the residents’ perspective. This review highlights the importance of incorporating the perspectives of residents, care professionals and the organisation to enhance PCC and enable residents to make shared and well-informed decisions in dialogue with care professionals. Future research should also assess the distinction between substance use and misuse, and how this affects implementing PCC in RCFs.
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Walakira, Eddy J., Aloysious Nnyombi, James T. Ssenfuuma, Agnes Kyamulabi, Francis Kato, Helen PM Natukunda, Lyndsey Lange et Daniel Oliver. « A qualitative insight into children’s and care-givers’ experience following re-integration from Uganda’s residential care facilities into family-based care ». Global Studies of Childhood, 2 mai 2022, 204361062210872. http://dx.doi.org/10.1177/20436106221087297.
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This article aims to elevate children’s and caretakers’ voices in shaping reunification and reintegration planning and implementation. It takes into consideration, the priority for children to experience fulfilling and happy childhoods following reunification from residential care facilities (RCFs) to homebased care (HBC). The article is based on 23 children who were followed up, 12 months post reunification from RCFs into HBC in six districts within central Uganda, a region with the highest concentration of RCFs. We conducted 11 in-depth interviews with older children aged 8–13 years and 23 in-depth interviews from the caregivers, who also provided information on 12 children who on account of age (less than 8 years) could not be interviewed. The qualitative study was nested under a longitudinal study (Randomised Controlled Trial NCT03498469). This study has revealed positive experiences following re-unification of children with homebased caregivers such as; continuous and positive child-caregiver interactions which translated into trusting and loving relationships and bonding between children and caregivers; improved parenting practices characterised by warmth and responsiveness to children’s physical, emotional and material needs and less reliance on harsh disciplinary practices; and social reintegration exemplified by children forging positive relationships with family and community members and their active participation in ongoing social activities. Yet the voices that perceived reunification negatively point to the overarching need to prioritise household welfare through economic strengthening efforts and other forms of provisioning and more crucially, ensuring children’s continued access to quality education as key ingredients in planning and implementing successful child reintegration efforts, including assuring children of happy and fulfilling childhoods.
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Woo, Nam-Sub, Young-Ju Kim, Young-Do Jo et In-Ju Hwang. « Performance Investigation of the Hybrid-Renewable Energy System With Geothermal and Solar Heat Sources for a Residential Building in South Korea ». Journal of Solar Energy Engineering 135, no 2 (28 novembre 2012). http://dx.doi.org/10.1115/1.4007844.
Texte intégralRésumé :
This study investigates annual performance of the hybrid energy system with geothermal and solar heat sources for hot water, heating and cooling of a residential house in South Korea. A small-scale hybrid-renewable energy system (H-RES) consists of a geothermal heat pump for heating and cooling, solar collectors for hot water, a gas fired backup boiler, and incidental facilities. All pipelines are designed for heat flow between the modules such as storage tank, heat production units, and radiators. Also, all systems automatically operated by the integrated sensing and control system. The average coefficient of performance of geothermal module during cooling and heating seasons is evaluated as about 4.1 and 3.5, respectively. Solar fraction for hot water is calculated as over 54%. And annual energy consumption of the H-RES is estimated as much as about 40% of conventional energy systems.
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September, Jason, Leon Geffen, Kathryn Manning, Preneshni Naicker, Cheryl Faro, Marc Mendelson et Sean Wasserman. « Colonisation with pathogenic drug-resistant bacteria and Clostridioides difficile among residents of residential care facilities in Cape Town, South Africa : a cross-sectional prevalence study ». Antimicrobial Resistance & ; Infection Control 8, no 1 (19 novembre 2019). http://dx.doi.org/10.1186/s13756-019-0643-y.
Texte intégralRésumé :
Abstract Background Residential care facilities (RCFs) act as reservoirs for multidrug-resistant organisms (MDRO). There are scarce data on colonisation with MDROs in Africa. We aimed to determine the prevalence of MDROs and C. difficile and risk factors for carriage amongst residents of RCFs in Cape Town, South Africa. Methods We performed a cross-sectional surveillance study at three RCFs. Chromogenic agar was used to screen skin swabs for methicillin-resistant S. aureus (MRSA) and stool samples for extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL-E). Antigen testing and PCR was used to detect Clostridiodes difficile. Risk factors for colonisation were determined with logistic regression. Results One hundred fifty-four residents were enrolled, providing 119 stool samples and 152 sets of skin swabs. Twenty-seven (22.7%) stool samples were positive for ESBL-E, and 13 (8.6%) residents had at least one skin swab positive for MRSA. Two (1.6%) stool samples tested positive for C. difficile. Poor functional status (OR 1.3 (95% CI, 1.0–1.6)) and incontinence (OR 2.9 (95% CI, 1.2–6.9)) were significant predictors for ESBL-E colonisation. MRSA colonization appeared higher in frail care areas (8/58 v 5/94, p = 0.07). Conclusions There was a relatively high prevalence of colonisation with MDROs, particularly ESBL-E, but low C. difficile carriage, with implications for antibiotic prescribing and infection control practice.
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Koh, Rui Ting Grace, Abirami Thirumanickam et Stacie Attrill. « How are the mealtime experiences of people in residential aged care facilities informed by policy and best practice guidelines ? A scoping review ». BMC Geriatrics 22, no 1 (9 septembre 2022). http://dx.doi.org/10.1186/s12877-022-03340-9.
Texte intégralRésumé :
Abstract Background Mealtimes are embedded routines of residents living in residential aged care facilities (RACFs) that directly impact their health and quality of life. Little is known about how mealtime experiences are informed and affected by structures such as government and organisational policies and processes. This scoping review used Giddens’ (The constitution of society: outline of the theory of structuration, 1984) Structuration Theory to investigate how governance structures related to mealtime practices inform residents’ mealtime experiences. Methods Using Arksey and O’Malley’s (Int J Soc Res Methodol 8:19–32, 2005) scoping review framework, a systematic database, grey literature and policy search was completed in May 2020 and updated in July 2021. From 2725 identified articles, 137 articles were included in data charting and deductive analysis, and 76 additional Australian government policy papers were used interpretatively. Results Data charting identified that the included studies were prominently situated in Western countries, with a progressive increase in publication rate over the past two decades. Qualitative findings captured structures that guide RACF mealtimes, how these relate to person-centred mealtime practices, and how these facilitate residents to enact choice and control. Conclusions Current policies lack specificity to inform the specific structures and practices of RACF mealtimes. Staff, residents, organisational and governance representatives possess different signification, legitimation and domination structures, and lack a shared understanding of policy, and how this influences processes and practices that comprise mealtimes.
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Sommerfeld, David H., Amy M. Brunner, Danielle Glorioso, Ellen E. Lee, Cynthia Ibarra, Elizabeth Zunshine, Rebecca E. Daly, Christine Zoumas et Dilip V. Jeste. « Improving Healthy Living in Residential Care Facilities : Feasibility, Acceptability, and Appropriateness of Implementing a Multicomponent Intervention for Diabetes Risk Reduction in Adults with Serious Mental Illnesses ». Administration and Policy in Mental Health and Mental Health Services Research, 3 février 2022. http://dx.doi.org/10.1007/s10488-022-01189-z.
Texte intégralRésumé :
AbstractPersons with serious mental illnesses experience high rates of medical comorbidity, especially diabetes. This study examined initial implementation feasibility, acceptability, and appropriateness of a new 6-month Multicomponent Intervention for Diabetes risk reduction in Adults with Serious mental illnesses (MIDAS) among persons in residential care facilities (RCFs). We conducted a mixed-methods study using four types of quantitative and qualitative data sources (administrative data; structured facility-level observations; resident assessments including blood-based biomarkers, 24-h dietary recalls, and self-report physical activity; and focus groups/interviews with staff and participants), to assess evidence of and factors affecting intervention feasibility, acceptability, and appropriateness. It was feasible to provide a high percentage of MIDAS class sessions (mean 50 of 52 intended sessions delivered) and make nutrition-related RCF changes (substitutions for healthier food items and reduced portion sizes). Class attendance rates and positive feedback from residents and staff provided evidence of MIDAS acceptability and appropriateness for addressing identified health needs. The residents who attended ≥ 85% of the sessions had greater improvement in several desired outcomes compared to others. Implementing a fully integrated MIDAS model with more extensive changes to facilities and more fundamental health changes among residents was more challenging. While the study found evidence to support feasibility, acceptability, and appropriateness of individual MIDAS components, some challenges for full implementation and success in obtaining immediate health benefits were also apparent. The study results highlight the need for improving health among RCF populations and will inform MIDAS adaptations designed to improve intervention fit and effectiveness outcomes.