宝安区西乡街道桃源居社区居家老人护理需求研究

目的调查分析桃源居社区居家老人对社区护理服务需求的现状,为开展居家护理服务和制定内容规划提供依据。方法编制居家老人护理需求评估表,通过专业人员对240名老年人的健康功能状况和居家护理服务需求进行入户评估。结果67.08%的居家老人有居家护理服务,年龄、文化程度、自理能力是影响老年人护理需求的影响因素。结论开展居家护理能够有效提高老年人的自我保健意识和能力,对保障老年人的健康生活具有重要意义。     

Long-term care elderly residents in general hospitals

Long-term care facilities for the elderly have regularly to work together with general hospitals to provide care to acutely ill residents or when they require all together more complex diagnostic procedures and multi-specialty care. The decision to hospitalize a nursing home elderly resident is multifactorial and it is based on factors such as illness severity and care facility infrastructure. Hospitalizations have benefits and risks such developing iatrogenic diseases, delirium, and functional decline, which may deteriorate patients' general condition and their quality of life during and/or after hospitalization. This study aimed at addressing specific aspects of assessment, treatment and management of nursing home elderly who require to be hospitalized, especially focusing on their effective care. Common conditions such delirium, iatrogenic diseases, poor nutrition, functional decline, hospice care and special characteristics of nursing home elderly during their admission to general hospitals are discussed.     

Creating a health-promoting group for elderly couples on a home health care program

The hospital home care social worker has a unique opportunity to develop a home-keeping, health-promoting group for frail elderly couples within his or her caseload. Through home visits, working as a filial professional, the worker enters, then strengthens the couples' pre-illness formal and informal support networks, and then goes on to create an additional informal peer support group, that meets in each other's homes. The group is capable of decreasing the chance of nursing home placement for all its members. It is proposed that home health care agencies within hospitals incorporate such groups into their regular programs.     

Being a nursing teacher, woman and mother: showing the experience in the light of social phenomenology

The trajectory of this study was focused on understanding the experience of being a nursing teacher, woman and mother and reconciling work, motherhood and other daily activities. Participants were 11 women, mothers, teachers at higher education Institutions. Social Phenomenology was adopted for the analysis. The context of meanings was evidenced by categories: Difficulty in performing multiple activities; care of oneself and conciliation of social roles. Women give priority to being a mother, so that they have less time to take care of themselves. In spite of desiring to invest in teaching, they expect to have more time available to be in touch with their children and partner. This study showed that the professional and personal worlds need an interface, which allows for co-existence between the different roles women play in society.     

老年人长期照护需求影响因素研究

目的 探析我国老年人长期照护需求及其影响因素。方法 选取CHARLS 2018年数据中60岁及以上老年人样本7 365例,基于Andersen模型构建框架,采用无序多分类logistic回归模型进行分析。结果 98.32%老年人选择家庭长期照护,0.38%选择养老院长期照护,1.24%选择其他照护方式。其中,在倾向特征层次上,离异(OR=10.95; 95%CI:0.272～0.971)和分居(OR=10.29; 95%CI:1.114～4.396)的老年人更愿意选择养老院和其他长期照护方式; 80岁及以上(OR=0.18; 95%CI:0.038～0.851)、女性(OR=0.35; 95%CI:0.161～0.778)、居住地为城乡结合部(OR=0.13; 95%CI:2.014～4.262)和农村(OR=0.15; 95%CI: 0.072～0.332)的老年人更倾向于选择家庭长期照护方式。使能资源层次上,有退休工资的老年人更愿意选择养老院(OR=8.57; 95%CI:1.722～2.751)和其他(OR=4.13; 95%CI:2.047～3.519)长期照护方式; 有2个子女(OR=0.89; 95%CI:2.314～3.613)和与子女每周联系一次以上(OR=0.10; 95%CI:0.156～0.679)的老年人更愿意选择家庭长期照护方式。需求层次上,日常生活活动参与3项以上(OR=18.38; 95%CI:1.217～2.775)、有慢性病(OR=4.69; 95%CI:1.753～4.291)的老年人更愿意选择养老院和医院长期照护方式。结论 我国老年人长期照护需求以家庭照护为主,养老院和医院照护为辅,老年人自主选择上存在很大局限性,老年人的非家庭照护还有很大发展空间。     

Filial obligations to elderly parents: a duty to care?

A continuing need for care for elderly, combined with looser family structures prompt the question what filial obligations are. Do adult children of elderly have a duty to care? Several theories of filial obligation are reviewed. The reciprocity argument is not sensitive to the parent–child relationship after childhood. A theory of friendship does not offer a correct parallel for the relationship between adult child and elderly parent. Arguments based on need or vulnerability run the risk of being unjust to those on whom a needs-based claim is laid. To compare filial obligations with promises makes too much of parents’ expectations, however reasonable they may be. The good of being in an unchosen relationship seems the best basis for filial obligations, with an according duty to maintain the relationship when possible. We suggest this relationship should be maintained even if one of the parties is no longer capable of consciously contributing to it. We argue that this entails a duty to care about one’s parents, not for one’s parents. This implies that care for the elderly is not in the first place a task for adult children.     

Defining roles, relationships, boundaries and participation between elderly people and nurses within the home: an ethnographic study

Recently there has been a marked shift in the location of nursing care in the UK from the hospital setting to the community and more particularly the home, with elderly people identified as key recipients of care in this setting. A number of commentators have highlighted the particular situation of elderly people with regard to care provision, illuminating the often disempowering nature of care interactions between nurses and elderly people. However, although there is clear evidence from a number of settings that care for elderly people has been less than optimal, to date there is little comparable evidence available regarding elderly people's experiences of nursing care within the home environment. Utilising an ethnographic approach, incorporating participant observation and semistructured interviews with nurses and elderly people (aged 65 years and over), the aim of this study was to explore the nature of the care relationship within the home setting. Thirteen elderly people who were receiving nursing care within the home and 16 community nurses within one Primary Care Trust in the UK took part in the study and data were collected over a period of 1 year. Three themes emerged from the data: the location of care; the nature of nurse–patient relationships; and the meaning of health and illness. These offer an account of the ways in which roles and relationships are constructed, negotiated and experienced by nurses and elderly people in the home, illuminating the centrality of relationships between nurses and elderly people in defining the experiences and perceptions of both groups of the quality of care overall. As the location of care continues to move closer to home, it is crucial that the implicit qualities that are valued within nurse–patient relationships in this context are recognised and made more explicit at both the organisational and policy level.     

Telenursing for the elderly. The case for care via video-telephony.

As most elderly people prefer home care to residential care, the nursing profession must change its current practice. New models of care are necessary. Information and communications technologies, such as video-telephony (i.e. any form of face-to-face video-communication), allow elderly people to maintain their autonomy by strengthening their emotional, relational and social abilities. Experiments in a variety of settings have tested a range of interventions based on video-telephony, from the simple giving of information to the provision of therapeutic procedures. The elderly have appreciated the opportunity to use video-telephony to communicate with a nurse about their needs, expectations and feelings. After some initial scepticism, nurses have concluded that telenursing complements traditional nursing practice. Although technology is no panacea for the problems of ageing, when applied judiciously it can bolster the position of vulnerable ageing citizens.     

Nursing home and nursing home physician: the Dutch experience

Dutch nursing home care today includes a broad range of institutional and outreaching care functions. Medical care is an essential part of this care. Nursing home medicine in The Netherlands has developed as an officially acknowledged medical specialty. This is unique because The Netherlands is the only country in which nursing home medicine is a specific medical discipline. Because of this, a continuum in the medical care for the elderly has been developed: the family physician for medical care in the community, the nursing home physician for the institutionalized elderly, and the clinical geriatrician plus other medical specialists for elderly who require hospital care. This article describes the characteristics of Dutch nursing home care and nursing home medicine and the advantages of this system. The article also shows that the combination of the medical knowledge of family physician and nursing home physician can be expected to increase the quality of medical care for the disabled elderly in institutions and in the community.     

Where are the missing elders? The decline in nursing home use, 1985 and 1995.

Findings from the 1995 National Nursing Home Survey suggest that elderly Americans are reducing their use of nursing home care. The numbers reflect a change in the role of the nursing home, as defined in this survey. By 1995 nursing facilities were increasingly focusing on patients with greater disability and postacute care needs. Preferred alternatives, most notably home-delivered care and assisted living, were likely filling the gap left by declining nursing home use. Better population-based studies are needed to track emerging trends and ascertain whether elders with disabilities are receiving the care they need. Such data could inform development of better public and private financing strategies for long-term care.     

Adult Daughters and Parent Care

This paper compares the effects of parent-care associated with three living arrangements of elderly widowed mothers who were being helped by married daughters: elderly mother living separately; two-generation households (mothers, daughters, sons-in-law); and three-generation households (grandchildren present). Daughters whose mothers lived separately fared the best; their mothers were the most cognitively and functionally capable and the daughters reported the fewest negative effects of caregiving. Daughters in two-generation households provided the most care; their mothers were the oldest and most impaired. Since daughters in three-generation households reported more negative mental and emotional effects of care, the unique problems of caregiving in such households are discussed.     

Adult daughters and parent care: a comparison of one-, two- and three-generation households.

This paper compares the effects of parent-care associated with three living arrangements of elderly widowed mothers who were being helped by married daughters: elderly mother living separately; two-generation households (mothers, daughters, sons-in-law); and three-generation households (grandchildren present). Daughters whose mothers lived separately fared the best; their mothers were the most cognitively and functionally capable and the daughters reported the fewest negative effects of caregiving. Daughters in two-generation households provided the most care; their mothers were the oldest and most impaired. Since daughters in three-generation households reported more negative mental and emotional effects of care, the unique problems of caregiving in such households are discussed.     

Personal care expectations: Photovoices of Chinese ageing adults in Hong Kong

The increasing ageing population contributes to growing demands for personal care that fulfils ageing adults’ preferences and expectations. This study explored Chinese ageing adults’ expected forms and sources of future personal care and the factors influencing care expectations. A qualitative photovoice research method – which integrated photography, interviews and group discussions – was used for data collection between January and April 2016. Through purposive sampling, 36 community‐residing participants aged 51–80 years took photographs that captured personal care preferences or expectations within individual, familial and societal contexts. Participants described feelings of worry, uncertainty and unpreparedness for future care needs and arrangements. They preferred practicing self‐care for as long as possible and remaining in their homes and communities (“ageing in place”) through support from assistive technologies, family members or home‐based and community services. Institutional care was regarded as the last resort. The findings reflected discrepancies between ageing adults’ care preferences and realities and their ambivalent attitudes towards filial care when switching between roles. Confronted with the increasingly unreliable family care, financial resources and insufficient community services, participants anticipated receiving institutional care that would be less satisfying or that they would dislike. As caregivers, ageing adults displayed strong commitment to filial obligations, whereas when perceiving themselves as care receivers they felt that they could not expect care from their children because of practical considerations. By understanding preferred care forms and sources, actors can devote resources, policies and interventions to support self‐care through proactive planning and technological advancement, foster “ageing in place” through family and community care, and improve institutional care to enable ageing with dignity.     

Adolescent mother experiencing child care: a theoretic model

The study aimed to comprehend the meaning for the adolescent mother of experiencing care with her child and the construction of a theoretic model that is representative of this experience. The strategies employed were participant observations and a semi-structured interview. Eight adolescent mothers who had become mothers between 15 and 19 years old took part in the study. The Symbolic Interactionism was adopted as a theoretic referential and the Grounded [corrected] Theory as a methodological reference. The comparative analysis of data revealed that for the adolescent mother the experience of taking care of her child is driven by experiencing positive feelings, which provide the development of action and interaction strategies, in the sense of searching for resources to take care of her child the best way as possible.     

Attitudes toward the elderly among students of health care related studies at the University of Salamanca, Spain

INTRODUCTION: This study uses a cross-sectional approach in terms of evaluating attitudes toward the elderly among health sciences students. The aim of this study was to measure attitudes among final year pregraduate students of seven health care careers. METHOD: A cross-sectional study was conducted with final year students of medicine (M), occupational therapy (OT), physiotherapy (P), nursing (N), psychology (Ps), social work (Sw), and dentistry (D). The data was collected using the validated Spanish version of the questionnaire that uses the Aged Semantic Differential (ASD), a scale developed by Rosencrantz and colleagues. Additional information about sociodemographic characteristics of students was collected. RESULTS: A total of 472 valid questionnaires were collected; 54% of the students showed positive attitudes toward the elderly. Female students had more positive attitudes than male ones. The Ps and P students showed a high interest in choosing geriatrics as their speciality (36%), while only 16% of the medical students considered it among their career options. DISCUSSION: Pregraduate health care students' attitudes tend to be less positive concerning older people's capacity for self-determination. Therefore, it would be advisable to enhance continuous interaction among healthy aged people and students of the named specialities during their specific training. The fact that the N students had less positive attitudes toward the elderly, while they were also more likely to take action, and the fact that the Ps and Sw students had more positive attitudes might suggest a need to enhance and combine the approach to the care of the older people in nursing with the psychological and life course approaches.     

Smoking Cessation during Pregnancy and Relapse after Childbirth: The Impact of the Grandmother’s Smoking Status

Objectives Smoking during pregnancy can result in negative effects in exposed children. It is well established that the smoking status of husbands is a major predictor of smoking among pregnant women. It was investigated whether the smoking status of the women's parents and parents-in-law has an impact on smoking cessation during pregnancy and relapse after birth above the smoking status of the husband. Method An initial sample of 458 women and their husbands was assessed prospectively during a 17-month period after birth regarding smoking habits. Five months after birth the women and their husbands reported the smoking status of their own parents. Results Smoking during pregnancy was related to the smoking status of the women's husband and mother. Women with a husband and mother who smoke were more likely to continue smoking. Relapse after smoking cessation during pregnancy was related to the smoking status of the husband and the mother-in-law. The smoking status of the women's father and father-in-law was not related to smoking cessation or relapse. Conclusion The smoking status of the pregnant women's mothers and mothers-in-law is related to fetal and newborn's nicotine exposure. The findings suggest benefits of taking the smoking status of pregnant women's mothers and mothers-in-law into account in smoking prevention programs for pregnant women and mothers with infants.     

Qualitative assessment of home environment across the different educational status of parents

This study examined the home environment of preschool children among 6 villages in Ludhiana district in Punjab state, India. The sample included 120 children aged 3-5 years. Eight composite scales were used to measure the home environment: learning stimulation, language stimulation, physical environment, warmth and affection, academic stimulation, role modeling, variety of experience, and acceptance. The sample reflected four educational groups for the father (illiterate, primary, matric, and graduate) and three educational groups for the mother (illiterate, primary, and matric). Findings clearly indicate that graduate level parents provided a more enriched home environment than less educated and illiterate parents. Education was unrelated to warmth and affection or acceptance between parents and children. Educated mothers showed slightly more warmth and affection. The stimulation in the growth of language and learning stimulation was significantly greater among graduate parents. Mothers encouraged their children to speak correctly, whereas illiterate mothers did not realize the importance. The lesser physical environment among lower educated parents supports findings of R.K. Srivastava (1974) on the association between lower scholastic achievement and overcrowding in the home. The study included homes where parents had sufficient financial resources to provide a safe and adequate physical environment but did not do so.     

Hospitalized child: care sharing between mother and nursing

This research aimed to verify at what moment, in what kinds of care and in what way mothers are included in care to the hospitalized child and to verify how care is negotiated between nursing team and mothers. The field research was carried out through participant observation of everyday care at a pediatric hospital unit, as well as interviews with mothers and the nursing team. The inclusion of the mother in care has taken place in a subtle way. The mother has taken on procedures that had been part of nursing competence before, concentrating information on the therapeutic process. The lack of a collective therapeutic project from the perspective of family-centered care is one of the obstacles to the involvement of mothers in care. Results demonstrate that the relation between mothers and the nursing team reveal to be complex and influenced by the exercise of power, which results in the need to construct shared care.     

Factors influencing single mother's employment status

Changes in the welfare system limit the length of time a person can receive welfare benefits, thus mandating employment for many current welfare recipients. Single mothers with young children who do not become employed will lose financial support for housing, food, clothing, and health care and place their own and their children's health and safety at risk. The purpose of this qualitative study was to explore women's experiences of being unemployed and to examine the barriers to employment perceived by single mothers who expressed a desire to be employed. Nine mothers were recruited from a larger sample of single mothers who had participated in a quantitative study about employment conducted 1 to 2 years earlier. Using focus group interviews, mothers were asked what it was like to be a single mother, and then what barriers to their employment they perceived. Two dimensions were identified from the mothers' statements. The first, a sense of obligation, included themes of "being there" for their own and their child's benefit and doing what it takes to optimize the child's growth and development. The second, negotiating the obstacles, referred to problems regarding child care, lack of involvement of the child's father and lack of support from relatives and friends for the mother's efforts toward securing employment. These findings have important implications for welfare reform, namely, that efforts aimed at moving nonemployed single mothers into the workforce will fail if these factors are not considered.