中国实行长期护理保险的意义

通过阐述保险、医疗保险及长期护理保险的概念,分析中国人口学特征和现阶段中国家庭结构的改变以及医疗费用的不断上升。指出中国已进入老龄化社会,老年人生活照料需求和丧失日常生活能力之后的护理需求,也在同步迅速增长。同时家庭结构的改变又无法很好地满足老年人护理服务的需求。因此,为了确保需要长期护理的人员得到及时、有效、专业的护理,减轻家庭的负担和有效利用医疗护理资源,中国应尽快发展长期护理保险。     

中国实行长期护理保险的意义

通过阐述保险、医疗保险及长期护理保险的概念,分析中国人口学特征和现阶段中国家庭结构的改变以及医疗费用的不断上升.指出中国已进入老龄化社会,老年人生活照料需求和丧失日常生活能力之后的护理需求,也在同步迅速增长.同时家庭结构的改变又无法很好地满足老年人护理服务的需求.因此,为了确保需要长期护理的人员得到及时、有效、专业的护理,减轻家庭的负担和有效利用医疗护理资源,中国应尽快发展长期护理保险.     

日本介护保险对上海长期护理保险的借鉴

笔者通过赴日本旭川莊学习,详细了解了日本的老年介护,与上海长期护理保险比较,提出对我国老年人长期护理保险的意见和建议。     

福建省6家长期护理保险护理机构失能老年人服务供需匹配现状调查

目的 ：调查福建省长期护理保险（以下简称长护险）制度下失能老年人服务供需现状,为缩小长护险服务供需匹配差距提供参考依据。方法 ：2021年5月—7月,采用便利抽样法,使用自设问卷调查福建省6家长护险护理机构390名失能老年人服务供需情况。结果 ：390名失能老年人的服务需求总分为（57.82±3.47)分,失能老年人服务供给总分为（52.94±8.41)分。长护险护理机构为失能老年人提供的护理服务与失能老年人护理服务需求差距较大（P<0.001）。结论 ：福建省长护险制度下失能老年人护理服务供需匹配情况不容乐观,长护险护理机构应以失能老年人需求为重点,精准对接其多样化、多层次的健康需求,以缩小供需匹配差距。     

长期护理保险护理服务项目的分析与建议

运用比较分析的方法对我国和日本相关地区长期护理保险(长护险)的护理服务项目进行梳理和比较,重点探讨了长护险护理服务项目存在的问题.借鉴我国台湾和日本相关地区长护险服务项目内容,对我国长护险的构建和完善提出如下建议:照护服务项目应个性化、多元化,划分照护服务项目风险等级,保障服务项目获得者与提供者的安全,为满足长护险获益者照护需求提供参考依据.     

长期护理保险管理体系构建进展

对长期护理保险相关概念、长期护理保险的顶层设计、长期护理保险模式、长期护理保险的评估体系及长期护理保险的护理级别5个方面进行综述,为探索我国长期护理保险管理体系构建、政府决策及相关制度的制定提供参考。     

长期护理保险照护服务等级评定现状

综述国内外长期护理保险服务等级认定标准、评估工具和分级方法,以期为进一步发展和完善我国长期护理保险服务等级评定体系提供科学依据。     

医保窗口护理服务质量调查与对策

为提高医保窗口服务质量，切实作好医保窗口护理工作，应分析医保患的心理特点，找出影响医保门诊护理服务满意度的可能原因，采取相应改进措施，为患提供优质高效的护理服务，成为医保门诊护理工作的主要内容。     

长期护理保险在养老机构护理服务中的实施效果观察

目的:探讨长期护理保险(简称长护险)在养老机构护理服务中的实施效果,旨在提高养老机构护理服务质量,让养老机构中的老年人享受到优质的护理服务。方法:选取上海市金山区社会福利院在职护理员为研究对象,根据长护险试点实施的时间前后分为两组,回顾性选取2016年7月—2016年12月接受《社会福利机构护理对象分级与分级护理规范》提供护理服务的43名护理员作为对照组,2018年7月—2018年12月接受《长期护理保险试点办法》提供护理服务的43名护理员作为观察组。比较长护险实施前后护理服务质量及护理员的照护能力。结果:长护险实施后观察组的护理质量得分明显高于对照组(P<0.05),观察组护理员的照护能力得分明显高于对照组(P<0.05)。结论:长护险的实施可促进养老机构护理质量的提升,并对护理员照护能力的提高有积极作用。     

护患协同提高护理服务质量

有效的护患合作对护理质量的提高有着一定的促进作用。患者作为医院的主要服务对象,参与对护理服务的评价,为护理服务提出意见和建议,有利于医院改进护理服务措施、提高护理服务水平。患者参与对护理工作的评价,虽然会带有主观想法,但基本上能够保证客观公平地给予评价,有利于护理部全面考核护理人员、制定激励政策、调动护理人员的工作积极性。在传统的服从型护患关系中,护士与患者交流较少,不听取患者意见,让患者绝对服从医护人员,伴随着医学模式的转变,护理工作者的服务观念也随之转变。     

某试点地区长期照护保险保障对象服务项目选择的现况研究

目的:调查某试点地区长期照护保险保障对象对服务项目的选择现状,分析不同照护模式和日常生活能力状况下项目选择的差异,为长期照护保险相关政策的制定与完善提供参考.方法:于2019年6—7月采用自设问卷对该地区长期照护保险的81位长期照护保险保障对象进行服务项目选择现状的追踪调查.结果:该地长期照护保险保障对象选择服务项目为...     

Consistency of quality assessments in long-term care by the clients, family members and named nurses

Combining assessments by the clients, their family members and named nurses of the quality of long-term care leads to a more comprehensive picture of the quality of the service. Clients should be the primary source of information, but particularly when they are not able to express their opinion, other sources of assessment are needed. This study describes and compares the consistency of quality assessments of long-term institutional care for the elderly made by the client (n = 312), his/her family member (n = 312) and the named nurse (n = 312). Data were gathered in 2002 from service houses, nursing homes and health centres. The consistency of the assessments made by the different groups of respondents was measured by frequency distributions, the weighted kappa coefficient and exact agreement. Frequency distributions differed significantly between the respondent groups in almost every item. Family members were more critical in their assessments than the other two groups. The consistency of assessments was highest with regard to the items 'contact with significant others' and 'medication'. In general the consistency of assessments, measured by weighted kappa, was rather low, but it was fair for 'clothing' (clients/family members) and 'privacy' (clients/named nurses and family members/named nurses). The occurrence of the option 'not applicable' to certain items was quite high, but varied somewhat between the three respondent groups. The results of this study support the viewpoint that comprehensive information gathering from family members and named nurses is useful, but they should not replace clients' assessments.     

关于构建我国长期护理保险制度的思考

目的探讨建立我国老年长期护理保险制度,以此应对人口老龄化的快速发展。方法采用对比分析的方法,将德国、日本和美国的长期护理保险制度进行简要介绍与对比,分析了可供我国参考借鉴之处。结果我国的长期护理保险制度既不能完全照搬德国、日本的强制型长期护理社会保险,也不能简单复制美国的商业型长期护理保险。结论我国的长期护理保险制度应立足基本国情,借鉴发达国家经验,从建立政策法规、加强人才培养、完善市场规范等各方面做好相关工作。     

Documentation practices of nurses in long-term care

Documentation of nursing care is an important source of reference and communication between nurses and other health care providers. This article describes a study of the documentation practices of nurses in a long-term care institution. Results revealed a number of positive aspects of nurses' documentation practices and areas requiring modification or change which could be facilitated through redesigning the documentation system. Implications for professional practice are discussed, which include the need for a concise, non-duplicating system of documentation, and the importance of nursing documentation in support of evidence-based practice.     

长期照护保险制度视域下成都市失智老人社会支持类居家上门照护服务标准构建

目的 构建长期照护保险制度视域下成都市失智老人社会支持类居家上门照护服务标准,旨在规范上门服务人员的工作,从而提高其照护质量,为更好的满足失智老人居家照护需求提供参考。方法 在采用文献研究、混合研究的基础上,根据全人理论,使用德尔菲法对成都市20名专家进行3轮函询,确定失智老人社会支持类居家上门照护服务标准指标。应用SPSS26.0计算专家积极系数、权威系数与和谐系数,运用Yaahp12.7确定各级指标的权重。结果 3轮专家函询的有效回收率分别为100%、100%和90%,专家权威系数均为0.912,Kendall's W系数分别为0.231、0.226和0.187（均P<0.05）。最终失智老人社会支持居家上门照护服务标准包括2项一级指标、9项二级指标和62项三级指标。结论 本研究构建的社会支持类居家上门照护服务标准的研究方法科学,且内容具有针对性,可为今后提升失智老人居家照护服务品质,保障失智老人照护权益提供参考。     

在开展优质护理服务中对护士自身满意度调查分析

目的 了解在开展优质护理服务中护理人员的自身满意度.方法 采用自行设计的满意度调查表对235名临床科室护理人员进行满意度调查.结果 235名护理人员满意度依次为:排班模式(71.49％),管理者的关爱(70.64％),人际关系(67.66％),职业安全(31.91％),工作认可度(26.81％),劳动价值(11.91％...     

Dimensions of quality in long-term care facilities in Taiwan

AIM: This article presents the results of a qualitative study designed to explore the perceptions of Taiwanese elders about the quality of their care while in residence at a long-term care facility. BACKGROUND: As the population of elders in Taiwan is increasing rapidly, quality long-term care has become both a necessity and social responsibility. Research related to quality of care has focused on structure, process and outcomes as well as perceptions of quality of care and life satisfaction. Few authors have considered residents' perspectives within a cultural context. METHOD: A convenience sample of 22 residents, aged between 61 and 86 years and living in four Taiwanese care facilities, participated in semi-structured interviews. The data were generated during 2001/2002 and were analysed using content analysis. RESULTS: Six key dimensions of quality care were elicited. The dimensions were: a caring attitude, respect for individual differences, emotional support, social interaction, a supportive environment, and accessible care. These dimensions are discussed within a cultural context supportive of family connectedness and filial piety, values underpinning care expectations of elders. CONCLUSIONS: The findings provide a foundation for increased understanding of the perceived gaps between residents' aspirations about quality care and priorities identified in other studies. Additional studies based on these data are planned in order to generate a culturally relevant, psychometrically sound resident assessment tool to evaluate the quality of care from a resident perspective in long-term care facilities in Taiwan.     

养老机构管理者对质量管理体会的质性研究

目的探索养老机构管理者对于质量管理的感受及需求。方法采用质性研究方法,深入访谈北京市10名养老机构管理者,并运用Colaizzi的7步分析法分析资料。结果养老机构管理者的体验提炼为3大主题：面临的难题、支持与使命感、挑战与机遇。在质量管理中他们面临管理标准及评价体系缺失、理念模糊等难题,但国家的政策支持及做好养老服务的使命感促使其应对压力,并在此过程中感受到挑战,主动寻找发展机遇。结论应尽快完善养老机构服务质量管理标准与质量评价体系,为质量管理与评价提供理论支持。     

How nurses manage time and work in long-term care

AIMS OF THE STUDY: The aim of this study was to better understand the ways in which conditions of work, including staffing, affect how nurses in long-term care (LTC) facilities do their jobs and the quality of care they provide. BACKGROUND: The research reported here was performed in the context of public policy debates about the relationship between staffing levels and quality in LTC. METHODS: In 1995 and 1996, interviews and participant observation were used to examine how 18 licensed nurses employed in two LTC facilities in the midwestern United States experience their day-to-day work. RESULTS: Time was an extremely salient work condition for the nurses interviewed. Under conditions of too little time and many interruptions, nurses compensated by developing strategies to keep up or catch up. These strategies included minimizing the time spent doing required tasks, creating new time and redefining work responsibilities. Although these strategies allowed nurses to complete the tasks for which they were accountable, there were adverse consequences for nurses and residents. Nurses realized that time demands often made it impossible to provide care of high quality. They expressed their ideas about quality care as the notion of 'should do' work. In effect, time pressures forced them to forego the 'should do' work to complete the 'must do' work. CONCLUSION: Increased staffing could improve the quality of care in LTC facilities.