Tesi: "Home in a nursing home"

1

Allocca, Hernandez Giacomo Antonio. "Nursing Home". Thesis, Virginia Tech, 2016. http://hdl.handle.net/10919/73662.

Abstract (sommario):

Getting old involves a lot of changes in life. Family and social relations change and mobility can decrease. These variations require new settings, and of course special care. A nursing home is a place dedicated to help with this situation. Sometimes nursing homes can be perceived as mere institutions by society, and even by future residents. Inside, senior citizens are suppose to spend the rest of their lives doing the same activities day after day. How can we improve these days? Architecture can help. This project deals with architectural design of a nursing home located in an open green area in Blacksburg, Virginia. The project's focus is in creating a home that is related to its surroundings and the proximity to nature. Also deals with all the complexity of this kind of program, but tries to create a homely feeling, and an architectural environment that can adapt to the resident's physical and mental condition over time.
Master of Architecture

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2

Burd, David. "A nursing home community". PDF viewer required Home page for entire collection, 2008. http://archives.udmercy.edu:8080/dspace/handle/10429/9.

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3

Nelson, Ian M. "Predictors of Nursing Home Placement for Home Care Consumers". Miami University / OhioLINK, 2004. http://rave.ohiolink.edu/etdc/view?acc_num=miami1073924945.

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4

Bonifas, Robin P. "Multi-level factors related to deficiencies in psychological care in Washington State skilled nursing facilities /". Thesis, Connect to this title online; UW restricted, 2007. http://hdl.handle.net/1773/8139.

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5

Peltz, Claudia. "Facility design & planning to improve nurses' effectiveness in administering care to fulltime residents of nursing homes". Muncie, Ind. : Ball State University, 2009. http://cardinalscholar.bsu.edu/436.

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6

Sheehy, Christine M. "Differences in Nursing Home Utilization and Clinical Outcome in Veterans Administration Nursing Home Patients". VCU Scholars Compass, 1987. https://scholarscompass.vcu.edu/etd/5520.

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Abstract (sommario):

Because of increasing costs and demand for nursing home care, studies are needed that can better describe the population of users and improve prediction of clinical outcomes and program requirements. The major purpose of this study was to explore the incremental and seven month outcomes of nursing home patients using the Andersen model. The design was longitudinal. Patients from one Veterans Administration (VA) hospital-based nursing home and six freestanding. VA contract community nursing homes were studied. Functional and cognitive ability were analyzed along with socioeconomic and demographic data. and utilization patterns. A second purpose was to assess associations among variables and their interaction effects in predicting outcome. A third purpose was to assess the contribution of such independent variables as case-mix and rehospitalization rates to possible cost differences evidenced by the two nursing home types. The results of this study suggest avenues for planning and allocation of resources in the two program alternatives. The Barthel Index (BI) (Mahoney & Barthel. 1965) was used to measure functional status and the Short Portable Mental Status Questionnaire (SPMSQ) (Pfeiffer. 1975) for cognitive ability. In addition to standardized measures. sociodemographic and utilization data. perceptions of health and outcomes of care were collected on all subjects. Analytical techniques included descriptive and inferential statistics. The major hypothesis was that veterans in the hospital-based versus contract statistically signiﬁcant differences in characteristics and on measures of service use and clinical outcome. Findings were evaluated for policy adequacy. adherence to program intent. federal and state cost complement and other qualitative implications. Statistically signiﬁcant differences were found between patients in the two settings on predisposing, enabling and need characteristics. The hospital-based NHCU patients were more likely to be married and living with someone. They also had higher incomes, more Medicare A coverage, a greater percentage of service-connected veterans and demonstrated greater limitation in functional ability than did those in contract. The predominant outcome for both groups was continued nursing home care. Statistically signiﬁcant differences were also found for outcome measures. Higher income and being 76 years or older were predictive of continued nursing home residence. The type of nursing home was not signiﬁcant in explaining continued care. The total number of diagnoses. age group and type of nursing home were predictive of death as an outcome. There were signiﬁcantly more deaths among those 75 years or younger. among those with lower incomes and among NHCU patients. Health service utilization did not differ signiﬁcantly by nursing home type. Neither group of nursing home patients demonstrated any signiﬁcant improvement in functional or mental status and self-perceived health. The only differences of note were among those 75 years or less who did improve in functional ability from the third to the sixth month. The ﬁndings suggest that the two nursing home types do have different patient population proﬁles. However. the continued use of nursing home care by both groups indicates some lack of ﬁt between legislative intent and actual clinical utilization.

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7

Cohn, Arthur M. "Effectiveness of nursing home administrators /". The Ohio State University, 1988. http://rave.ohiolink.edu/etdc/view?acc_num=osu1487596307358779.

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8

Bercovitz, Anita Roth. "Mortality of nursing home residents". Available to US Hopkins community, 2003. http://wwwlib.umi.com/dissertations/dlnow/3080625.

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9

Lansmon-Winter, Erin Cready Cynthia M. "Family perception of quality in nursing home care impact of gender, level of involvement, and utilization of empowered CNA teams /". [Denton, Tex.] : University of North Texas, 2008. http://digital.library.unt.edu/permalink/meta-dc-9069.

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10

Bostick, Jane E. "The relationship of nursing personnel and nursing home care quality". MU has:, 2002. http://wwwlib.umi.com/cr/mo/fullcit?3052150.

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11

Shin, Juh Hyun. "Relationship between nurse staffing and quality of life in Iowa nursing homes". Diss., University of Iowa, 2008. http://ir.uiowa.edu/etd/18.

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12

Saxer, Susanne. "Urinary incontinence in nursing home care". [Maastricht] : Maastricht : [Maastricht University] ; University Library, Universiteit Maastricht [host], 2008. http://arno.unimaas.nl/show.cgi?fid=13767.

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13

Davidson, Carrie Jane. "Profit Status and the Relationship between Medicaid Reimbursement and Nursing Home Quality in Ohio Nursing Homes". Connect to text online, 2006. http://rave.ohiolink.edu/etdc/view?acc%5Fnum=case1138477611.

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Abstract (sommario):

Thesis (Ph. D.)--Case Western Reserve University, 2006.
[School of Medicine] Department of Epidemiology and Biostatistics. Includes bibliographical references. Available online via OhioLINK's ETD Center.

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14

Yoggerst, Lauren M. "Predictors of depression in nursing home residents /". View online, 2010. http://repository.eiu.edu/theses/docs/32211131576037.pdf.

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15

Rolls, Elsie E. C. "Night time sleeping in a nursing home". Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1998. http://www.collectionscanada.ca/obj/s4/f2/dsk2/tape17/PQDD_0022/MQ36372.pdf.

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16

Neyens, Jacques Christiaan Luc. "Fall prevention in psychogeriatric nursing home residents". [Kerkrade] : Maastricht : D&L Graphics ; University Library, Universiteit Maastricht [host], 2007. http://arno.unimaas.nl/show.cgi?fid=8716.

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17

Zurakowski, Tamara Lee. "Interpersonal factors and nursing home resident health". Case Western Reserve University School of Graduate Studies / OhioLINK, 1990. http://rave.ohiolink.edu/etdc/view?acc_num=case1054909283.

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18

Clarke, John William. "The home help service". Thesis, University of Sheffield, 1989. http://etheses.whiterose.ac.uk/14832/.

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Abstract (sommario):

This thesis is a study of the role of the domiciliary home help and community auxiliary nursing services in England and Wales. The origins of the two services, interwoven as they are with political, social and demographic changes, are traced. Factors in the development of the services such as the effects of war, infant mortality, the professionalisation of nursing and medicine, the low status of domestic service, the role of voluntary organisations and the policies of successive governments in particular since 1948, are discussed. The parallel development of both services since 1948 is analysed. The increase in the numbers employed in the auxiliary nursing field, since the separation of nursing and the home help service in 1972, and its effect upon the role of the home help is examined. The concern at the possible duplication and overlapping of a role, because of the independent development of the two services since 1972, is also discussed. In an attempt to identify the actual tasks carried out by both groups of workers, I carried out a large study of the role of each group. A postal questionnaire, listing 110 tasks was completed by 1037 home helps in 20 Local Authorities and 1368 nursing auxiliaries in 81 District Health Authorities. The completed questionnaires were analysed under the headings of: Professional Nursing; Basic Nursing; Administrative; Domestic; Personal; Advisory; Escorting and Miscellaneous Tasks. The data collected on the role of the home help and auxiliary nurse is examined and areas of potential overlap discussed, along with an analysis of the perception that each group has of their role. The variation in practice in differing authorities is also discussed. The thesis is concluded by a summary and conclusions. In the appendices each group of tasks is analysed, in tables, by frequency, perception of role, age, sex, time in post, marital status, qualifications, political affiliation of each authority and type cf authority. A comparison of the number of tasks and the percentage of staff carrying them out in each authority is also included.

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19

Boyce, Bridget Marne. "Oral health care practices and perceptions among nursing home residents a case study /". Morgantown, W. Va. : [West Virginia University Libraries], 2004. https://etd.wvu.edu/etd/controller.jsp?moduleName=documentdata&jsp%5FetdId=63.

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Abstract (sommario):

Thesis (M.S.)--West Virginia University, 2004.
Title from document title page. Document formatted into pages; contains viii, 92 p. : ill. (some col.). Vita. Includes abstract. Includes bibliographical references (p. 71-76).

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20

Chang, Hui-Chen. "Evidence-based practice in nursing homes a study of Taiwanese nurses' and nursing managers' perceptions /". Connect to full text, 2008. http://hdl.handle.net/2123/3572.

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Abstract (sommario):

Thesis (Ph. D.)--University of Sydney, 2008.
Title from title screen (viewed 11 February 2009). Includes tables and questionnaires. Submitted in fulfilment of the requirements for the degree of Doctor of Philosophy to the School of Behavioural and Community Health Sciences, Faculty of Health Sciences. Includes bibliographical references. Also available in print form.

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21

Harker, Jeanne M. "Planning for the future in home care nursing". Thesis, National Library of Canada = Bibliothèque nationale du Canada, 2001. http://www.collectionscanada.ca/obj/s4/f2/dsk3/ftp04/MQ59501.pdf.

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22

Kerrison, Susan Helen. "Images of the protected in nursing home regulation". Thesis, London School of Economics and Political Science (University of London), 2007. http://etheses.lse.ac.uk/2037/.

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Abstract (sommario):

In a simple model of regulation, three different types of actor, "the regulator", "the regulated" and "the protected" are positioned in relationship to each other by a legal framework. Academic scholarship has mainly focused on the first two types of actor, with little attention paid to "the protected". Yet "the protected" are the raison d'etre of nursing home regulation and "the resident" is at the centre of many key rules. Without an image of "the resident", such rules are without meaning. The central question for this thesis, then, is how are nursing home residents represented in the regulatory system which aims to protect them. Within this regulatory regime a number of social networks in which the category of "the resident" has meaning were identified. These included elements of the system that are key to the interpretation of regulatory rules - specifically, the practices of nursing home inspectors and the appeal system for nursing home owners - as well as the discourses of nursing and health policy. The practices of nursing home inspectors were observed, the decisions of the Registered Homes Tribunal analysed, and the construction of "the resident" in the discourses of nursing and health policy was explored. Taken together, these methods provided a broad multiperspectival understanding of influences and constraints on the construction of the term "resident". As a group, the residents of nursing homes are elderly people in poor health and at the end of their lives. This thesis concludes that there are great difficulties in understanding extreme old age either as a lived experience or a sociological construct. In nursing home regulation, these difficulties are compounded by a framework of normative and fiscal policies where the state ensures that the term "resident" remains unstable or ill-defined. Against this background, the articulation of any clear moral purpose for nursing home regulation becomes extremely vexed.

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23

Yates-Bolton, N. J. "Meaning and purpose in care home (nursing) life". Thesis, University of Salford, 2017. http://usir.salford.ac.uk/42545/.

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Abstract (sommario):

Meaning and purpose in life are important aspects of the life experience of individuals. These aspects of life have often been studied using psychological and quantitative approaches addressing meaning and purpose across the life span. However, there is a dearth of studies of meaning and purpose in care home (nursing) life. This care sector has an important contribution to make nationally and internationally to the lives of older people who require long-term care. This study addresses the gap in the body of knowledge by exploring how to enhance meaning and purpose in the lives of care home (nursing) residents. This study of meaning and purpose in the lives of care home (nursing) residents was undertaken using an appreciative inquiry methodology. Two U.K. care homes (nursing) were the settings for the study; 20 residents and 25 members of staff were included in the sample of the study. The residents who participated in the study had moved into the care homes because of their physical disabilities. None of the residents who participated in the study had appreciable cognitive incapacity. Data were collected using life story interviews, structured interviews and focus groups. Data were constructed during the four stages of appreciative inquiry: Discovery, Dream, Design and Destiny. The data were analysed using the Framework Analysis approach. The findings of the study provide clear definitions of meaning and purpose in care home (nursing) life. The knowledge generated addresses the required focus on the creation of opportunities for residents to flourish and optimise their potential in order to enhance meaning and purpose in their lives. The ways in which care home staff can support residents enhance meaning and purpose in their care home experience through the physical setting, valuing of residents’ identities, the dynamics of relationships, the focus of activities and the component of care are articulated. This study presents the benefits of appreciative inquiry dialogue as a way of enhancing meaning and purpose in the lives of care home residents.

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24

Lee, Hyang Yuol. "Quality of care: Impact of nursing home characteristics". Diss., Search in ProQuest Dissertations & Theses. UC Only, 2009. http://gateway.proquest.com/openurl?url_ver=Z39.88-2004&rft_val_fmt=info:ofi/fmt:kev:mtx:dissertation&res_dat=xri:pqdiss&rft_dat=xri:pqdiss:3352465.

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Abstract (sommario):

Thesis (Ph.D.)--University of California, San Francisco, 2009.
Source: Dissertation Abstracts International, Volume: 70-04, Section: B, page: 2206. Advisers: Mary A. Blegen; Charlene A. Harrington. Includes supplementary digital materials.

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25

Dahlbäck, Anna. "Talkin' bout our generations : Preschool and nursing home". Thesis, Umeå universitet, Arkitekthögskolan vid Umeå universitet, 2019. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-160121.

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26

Saint-Clarke, Gwendolyn E. "Chemotherapy Side Effects at Home: A Nursing Impact". NSUWorks, 2017. https://nsuworks.nova.edu/hpd_con_stuetd/49.

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Background: Approximately 32% of all lymphoma patients experience immunocompromised severe avoidable side effects of nadir at home after discharge postchemotherapy. The certified oncology nurses employed at a large metropolitan hospital in Atlanta, Georgia, lack standardized discharge guidelines that include regulatory organizations’ recommendations to assist patients/families with at-home self-management of the avoidable side effects. Purpose: The purpose of this quality improvement project was to utilize the institution’s existing postchemotherapy discharge protocol to assess certified oncology nurses’ knowledge of severe avoidable side effects of nadir; modify the existing healthcare institution’s postchemotherapy discharge protocol to reflect standardized practice for promoting clinical practice continuity by leading organizations; conduct multifaceted training seminars to disseminate the modified postchemotherapy discharge guideline; evaluate the oncology nurses’ knowledge of severe avoidable side effects of nadir postchemotherapy after modified guideline implementation; and collaborate with the intraprofessional team to determine if the modified postchemotherapy discharge guideline was feasible and acceptable for system wide hospital implementation. Theoretical Framework: The theoretical framework used was Benner’s model of nurse proficiency: expert nurses develop skills and understanding of patient care through a sound educational base and a multitude of experiences. Methods: The existing postchemotherapy discharge protocol was used to develop a developed standardized guideline incorporating regulatory organizations’ recommendations for severe avoidable side effects of nadir postchemotherapy for nursing discharge information and patients’ at-home management. Ten oncology registered nurses on a 16-bed oncology unit participated in two 10-question Likert scale questionnaires based on the existing guideline (pretest) and the modified guideline (posttest) before and after an educational intervention. A quantitative nonparametric descriptive design was used. The questionnaires were analyzed with a two-tailed paired t test, p = 0.05, CI = 95, SD = 12. Results: Nurses significantly improved from pretest to posttest—63% before receiving modified guideline education and 83% after receiving education (p < 0.005). Conclusion: A standardized guideline that included regulatory organizations’ recommendations for at-home management of severe avoidable side effects of nadir showed significant nurses’ improvement in knowledge and competency. The effectiveness of nurses disseminating discharge information was paramount when knowledge awareness and appropriate patient/family assessment were incorporated in the discharge instructions.

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27

Venskus, Diana Gilroy. "Nursing Home Staffing Adequacy, Rehabilitation Orientation and Quality". VCU Scholars Compass, 2003. https://scholarscompass.vcu.edu/etd/5959.

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Abstract (sommario):

Objective: The primary objective of this research is to examine how changing levels of nursing home stafﬁng adequacy and variations in rehabilitation orientation have affected facility deﬁciencies and the quality of patient care as facilities responded to the Balanced Budget Act of 1997.Data Sources: Analyses were performed using data from the On-Line Survey Certiﬁcation and Reporting System (OSCAR) data from years 1997, 1998, 1999, 2000 and 2001 and were merged with Area Resource File (ARF) data released in February 2001.Study Design: Contingency strategic adaptation provides the theoretical framework for developing the effects of environmental characteristics, organizational characteristics and strategic change on nursing facilities’ performance. The study employed a non-experimental, longitudinal panel design focusing on the individual nursing home as the unit of analysis. Measurement models were proposed and validated for each of the research constructs. Structural equation modeling was used to specify the relationships between stafﬁng adequacy, rehabilitation orientation and nursing home quality.Principal Findings: Decreases in stafﬁng adequacy and rehabilitation orientation, and also in nursing home quality occurred during the period of 1997 to 2001. Environmental and organizational characteristics have various direct effects on stafﬁng, rehabilitation orientation and nursing facility performance. Stafﬁng directly affects rehabilitation orientation; rehabilitation orientation directly affects quality. The variances accounted for in the ﬁnal structural model are small.Conclusion: Stafﬁng and rehabilitation orientation are, respectively, structures and processes of care subject to strategic change within organizations in response to changing environmental conditions. Changes in stafﬁng and rehabilitation that occurred during the period of implementation of the BBA of 1997 reduced nursing facility performance. The relatively small contribution of each to the measurement of nursing facility performance suggests that other structures and processes should be identiﬁed, and their impact on the quality of care evaluated.Keywords: Staffing, rehabilitation, nursing home deficiencies, strategic adaptation, Balanced Budget Act of 1997.

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28

Just, Mary Margaret. "Factors that affect the quantity and quality of interactive social support for nursing home residents /". Digital version accessible at:, 1998. http://wwwlib.umi.com/cr/utexas/main.

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29

Damberg, Jonas. "Availability of primary care physicians in nursing homes and home care nursing services and associations with emergency care consumption". Thesis, Örebro universitet, Institutionen för medicinska vetenskaper, 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-61585.

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30

Quail, J. Charles. "Developing a manual of worship for nursing home services". Theological Research Exchange Network (TREN), 1990. http://www.tren.com.

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31

Baker, Kay Stouffer. "Home care clients' perceptions of nursing invasiveness, territorial control, and satisfaction with nursing care". Thesis, The University of Arizona, 1987. http://hdl.handle.net/10150/276586.

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Abstract (sommario):

This descriptive correlational study describes the relationships among 30 home care clients' perceptions of nursing invasiveness, territorial control, and satisfaction with nursing care. The self-report data were collected using a Nursing Invasiveness Scale (NIS), Index of Patient Territorial Control Perceptions (IPTCP), and Patient Satisfaction Instrument (PSI). The subjects were males and females, aged 23 to 93 years, who were receiving home care nursing. Analysis of the data suggests that the subjects perceived a low level of invasiveness by home care nurses, "much control" within their homes (their primary territories), and were highly satisfied with their nursing care. There was a significant negative correlation (r = -0.79) between perceptions of nursing invasiveness and satisfaction with nursing care. The relationships between perceptions of nursing invasiveness and territorial control (r = -0.02) and between perceived territorial control and satisfaction with nursing care (r = 0.14) were not significant.

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32

Lindabury, Jennifer Kate. "Nursing Home Use Expectations: The Influence of Family Structure". Oxford, Ohio : Miami University, 2010. http://rave.ohiolink.edu/etdc/view?acc%5Fnum=miami1272642887.

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33

Nakrem, Sigrid. "Measuring quality of care in nursing home - what matters?" Doctoral thesis, Norges teknisk-naturvitenskapelige universitet, Institutt for samfunnsmedisin, 2011. http://urn.kb.se/resolve?urn=urn:nbn:no:ntnu:diva-14729.

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Abstract (sommario):

Residential care in nursing homes continues to be necessary for those individuals who are no longer able to live safely and comfortably at home. The demographic change with increasing number of persons over 65 years in the next 20 years also means that the percentage of those who will require care in a nursing home some time before the end of their lives will increase. Therefore, anticipating this pressure to expand nursing home availability, it is critical that these services are developed from a profound understanding of what creates the best value. Nursing homes in developed countries have evolved over the past half-century from being places of mainly custodial care to facilities responsible for the management of an ever increasing range of complex nursing and medical conditions. Nursing home residents are frail older adults with complex needs, dependent on advanced nursing care. Determining what aspect of nursing homes should and can be measured is the current work of many national health care systems. However, uncovering what the nursing home residents perceive as the most important aspects of quality and how they experience living in a nursing home is necessary to develop effective person-centred care. The overall aim of the present thesis was to contribute to a deeper understanding of quality of care in nursing homes, integrating the professionals’, residents’ and family’s perspectives. The research design is a qualitative approach to explore the concept quality of care and its domains. The thesis comprises a review of internationally used nursing sensitive quality indicators for nursing homes. The indicators are evaluated for their validity as described in the literature. The thesis further describes the residents’ experiences with the interpersonal factors of nursing care quality, as well as the residents’ experiences of living in a nursing home. The thesis also explores the understanding and belief about nursing home quality held by family members of residents. The thesis is based on in-depth interviews of residents in four different nursing homes, and focus group interviews of family members of residents in two different nursing homes. The findings are that quality of care in long-term care in nursing homes encompasses at least four domains: quality of the living conditions, quality of the nursing staff, quality of direct nursing care, and quality of the social environment. Moreover, care quality is influenced by a range of external factors such as the national policy, laws and regulations, management of the organization and the physical building. The local community provides a context in which the nursing home is more or less integrated into. The review of internationally used quality indicators indicate that some factors of care processes and health outcomes for nursing home residents could be measured and give valid and reliable evaluation of the nursing home care quality. In the explorative qualitative study, residents and family placed more emphasis on physical and psychological well-being, interpersonal relationships and the social environment if quality of care is to result. Objective indicators of essential areas of resident-experienced quality need to be developed. This should be done in collaboration with the residents and their next-of-kin, in addition to professional expertise. Methodological and practical implications of the results are discussed.
Sykehjem er en helsetjeneste som vil være nødvendig for eldre som ikke føler seg trygge eller kan få tilstrekkelig behandling, pleie og omsorg i eget hjem. Antall eldre over 65 år er økende i Norge, noe som innebærer et økt press på sykehjem i framtiden. Det er derfor av stor betydning at sykehjemstjenesten utvikles med tanke på å skape best mulig nytteverdi ut fra behov. Sykehjemmene har utviklet seg de siste 50 årene fra hovedsakelig et botilbud til helseinstitusjoner som gir avansert helsehjelp. Sykehjemsbeboere er skrøpelige eldre med komplekse problemstillinger, avhengig av avansert sykepleie. Kvalitetsindikatorer er kvantitative mål som reflekterer en profesjonell standard for pleie og omsorg, og slike mål benyttes i økende grad for å vurdere kvalitet i sykehjem. Imidlertid er det nødvendig å inkludere det som har størst betydning for sykehjemsbeboere i slike mål for å kunne gi god pasientsentrert sykepleie. Hovedmålsettingen med studien var å bidra til en dypere forståelse av sykehjemskvalitet, ut fra helsepersonellets, beboernes og pårørendes ståsted. Avhandlingen omfatter en oversikt over kvalitetsindikatorer som er i bruk internasjonalt. Videre beskriver avhandlingen beboernes erfaringer med mellommenneskelige faktorer ved sykehjemskvalitet, samt hvordan de erfarer å bo i et sykehjem og opplever kvaliteten på “hjemmet” sitt. I avhandlingen blir også pårørendes forståelse av og meninger om sykehjemskvalitet utforsket. Avhandlingen er basert på dybdeintervju av beboere ved fire ulike sykehjem, og fokusgruppeintervjuer med pårørende ved to av sykehjemmene. Funnene viser at kvalitet på pleie og omsorg i sykehjem omfatter minst fire hovedområder: Bokvalitet, personellkvalitet, helsetjenestekvalitet og sosial kvalitet. Videre er pleie- og omsorgskvaliteten påvirket av en rekke eksterne faktorer som nasjonale føringer, lovverk, ledelsesstruktur, bygningskonstruksjon og lokale forhold. Den internasjonale oversikten over kvalitetsindikatorer gir indikasjoner på at noen av dem kan brukes som pålitelige og gyldige evalueringer av kvaliteten på pleie og omsorg, samt helserelaterte resultater for beboerne. I den kvalitative intervjuundersøkelsen med beboere og pårørende, ble fysisk og psykisk velvære, mellommenneskelige forhold og det sosiale miljøet tillagt større betydning for kvaliteten. Objektive indikatorer for disse beboererfarte områdene for kvalitet må utvikles. For å sikre at disse er pasientsentrerte, bør utviklingen av kvalitetsindikatorer gjøres i tett samarbeid med sykehjemsbeboerne og pårørende, i tillegg til helsepersonell.

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34

Chien, Hui-Wen. "Understanding the Nursing Home Care Processor: An Ethnographic Study". University of Sydney, 2009. http://hdl.handle.net/2123/6389.

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Abstract (sommario):

Doctor of Philosophy
Aim and significance: The aim of this research was to explore the phenomenon of Australian nursing home care from the perspective of those who provide and receive it. Its focus is on the processes of ‘quality care’ provision and the meanings and evaluations that care providers attach to their work. In other words, its purpose was to shed light on the practices based on a conceptualisation of care that is entwined with the mechanisms of ‘care’ production and identity creation, or what actually happens in the daily life of the complex social phenomenon that is a nursing home. A related aim was to add to understandings of clinical nursing competence and develop tools that will assist nurses to conceptualise and implement positive change in this setting. Background: The provision of care to our elderly has become a major concern with the ageing of the world population. This is occurring in the context of decline in the capacity of families to take on the responsibility of elder care, and of increasing commercialisation of medical care. Governments have responded by shifting their responsibilities from direct care provision to become auditors of the business of care provision that is supported by public funding. However poor care delivery has largely been hidden from the public gaze. Governments present themselves as having systems in place, creating the illusion of rational control; in reality, like the market economy, there is a ‘black box’ of unknown factors driven by human impulse. The aim of this study was to open up the black box of ‘quality care’ to direct observation, drawing insights from the literature on organisational culture and with a focus on the frontline worker and the construct of quality assurance. Specific research objectives were to: • Document the beliefs and attitudes of care providers towards elderly people in general and the needs of nursing home residents in particular • Elicit the range of meanings and evaluations that care providers attach to their work • Describe their constructions of ‘care’ and ‘quality of care’ and the organisational factors they believe to impact (positively and negatively) on their ability to provide it. • Through in-depth understanding of a particular setting, generate grounded theoretical insights into the phenomenon of quality of residential care that are more widely applicable Method: The study adopted a paradigmatic bricoleur approach, seeking to develop connections between a diverse range of methodologies. These included combinative ethnography, phenomenology, hermeneutics and traditional grounded theory. Conceptual insights were drawn from organisational studies, psychosocial nursing and coping theory. The research site was an Australian for-profit suburban nursing home. The student investigator conducted more than 500 hours of participant observation, recording extensive field notes which were analysed through the perspective of a hermeneutic middle way horizon that directed an augmented constant comparison traditional grounded theory approach. Additional data were collected through formal indepth interviews with six key stakeholders. Interviews were tape recorded, transcribed in full and analysed to reveal themes that were brought within a hermeneutic circle that spiralled recursively from the whole to the part and back to the whole. Findings: Eight key interrelated factors in the production of care within the nursing home were identified: internal and external accountability (the accreditation system); economic considerations; management and training; advocacy; characteristic of residents; care providers’ working conditions and environmental stressors; organisational culture; and the work/care styles of individual care providers. I have categorised the latter into two main types: ‘tortoises’ and ‘hares’. This typology is then used to generate a process-driven schematic diagram that tracks a hypothetical novice care provider through the process of learning how to produce ‘care’. Specifically, I found that nursing home ‘care’ is the outcome of a complex social process involving the interplay between resident, relative, care provider, proprietor, quality assessors and government within the phenomenon of the nursing home. Such care, indeed the phenomenon of the nursing home itself, is not a stable, controllable entity but is in a constant state of flux – what I refer to as a moral ecology. In their everyday practice, care providers devise a construction of ‘quality care’ that is more clearly grounded in their own worldviews and the development of the own identity than in the formal quality assurance system of standards, guidelines and evaluations. Conclusion: Understanding the ‘black box’ of processes that produce care is the key to identifying courses of action that will improve care outcomes. The study findings also question the validity, assumptions and significance of the accreditation system, which only identifies some of the component variables, disregarding both the complexity within the ‘black box’ and failing to acknowledge that the quality of care outcomes is overwhelmingly dependent on individual care providers.

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Huizing, Anna Rensche. "Towards restraint-free care for psychogeriatric nursing home residents". Maastricht : Maastricht : [Maastricht University] ; University Library, Universiteit Maastricht [host], 2008. http://arno.unimaas.nl/show.cgi?fid=10682.

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36

Almendarez, Bertha Longoria. "Mexican American elders and nursing home transition : a dissertation /". San Antonio : UTHSC, 2007. http://proquest.umi.com/pqdweb?did=1390289481&sid=1&Fmt=2&clientId=70986&RQT=309&VName=PQD.

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37

Davies, Susan M. "Relatives' experiences of nursing home entry : a constructivist inquiry". Thesis, University of Sheffield, 2001. http://etheses.whiterose.ac.uk/4222/.

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Abstract (sommario):

The study reported within this thesis sought to better understand nursing home placement from multiple perspectives. Using a two stage approach, data were collected from semi-structured interviews with 37 people who had assisted a close relative to move into a nursing home, together with case studies in three nursing homes which explored how relatives are supported in maintaining their caring role in this new context. Data analysis revealed three phases to the transition: 'making the best of it'; 'making the move' and 'making it better', with relatives' experiences across these phases being understood in terms of five continua, reflecting the extent to which they felt they were: operating 'under pressure' or not; 'in the know' or 'working in the dark; 'working together' or 'working alone'; 'in control of events' or not, and 'supported' or 'unsupported' both practically and emotionally. Data from the case studies demonstrated the utility of these factors in understanding the experiences of relatives, residents and staff working in the care homes. In particular, the extent to which carers were able to meet their ultimate goal, that of ensuring 'best care' for their relative was influenced by these factors and the type of 'community' operating in the home. Analysis identified three types of community within the care homes studied: the controlled community; the cosmetic community; and the complete community. Findings suggest that the 'complete community' is consistent with the most positive experiences for older people, for family caregivers and for staff, and therefore promotes 'best care'. The ways in which staff, carers and older people can help to forge a complete community are considered.

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Kennedy, Katherine A. "Is Nurse Aide Retention Associated with Nursing Home Quality?" Miami University / OhioLINK, 2021. http://rave.ohiolink.edu/etdc/view?acc_num=miami1618591173416498.

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39

Reece, Heather Rae. "NURSING HOME QUALITY AND THE EFFECTS OF STRUCTURAL VARIABLES". Miami University / OhioLINK, 2009. http://rave.ohiolink.edu/etdc/view?acc_num=miami1240854315.

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40

Herk, Rhodee van. "A closer look at pain in nursing home residents". [S.l.] : Rotterdam : [The Author] ; Erasmus University [Host], 2008. http://hdl.handle.net/1765/13962.

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41

Hudson, Kathleen Marie. "The meaning of quality nursing care in the nursing home /". 1991. http://wwwlib.umi.com/dissertations/fullcit/9218754.

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42

ling, huang hsiu, e 黃秀玲. "Evaluation of Nursing Home Care Quality of A Vet’s Hospital Nursing Homex". Thesis, 2007. http://ndltd.ncl.edu.tw/handle/95516907841836502991.

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Abstract (sommario):

碩士
亞洲大學
長期照護研究所
95
The purpose of this study was to explore service quality and users’ satisfaction of the veterans living in nursing home. Purposive sampling was used to recruit 123 elders who met the sampling criteria from a nursing home under a veteran hospital in Taiwan. The measurement tools included demographic data sheets, living unit data sheets, a Chinese version of 「The Observable Indicators of Nursing Home Care Quality Instrument 」 (OINHCQI) by Ku, Sheau-Ming (2001). The collected data were analysis by the twelfth version of the Statistical Package for the Social Science. Data analysis included frequency distribution, arithmetic mean, t-test, one-way ANOVA, Pearson correlations & multiple Regression. Results showed that service quality and users’ satisfaction differences in the different dimensions under 0.1 probability. The dimensions of 「communication」&「home/family involvement」that users’ satisfaction is higher than service quality； but dimensions of 「environment」、「care」、「staff」 that users’ satisfaction is lower than service quality. Moreover, in the demographic data demobilized grade differences in the different satisfaction gaps of 「home/family involvement」(p＜0.05)； present ADL differences in the different satisfaction gaps of 「communication」(p＜0.05)； living of nursing home station difference in the different satisfaction gaps of 「home/family involvement」(p＜0.01)「staff」(p ＜0.05)；beds in rooms difference in the different satisfaction gaps of 「home/family involvement」(p＜0.05). In the station characteristic, the「occupancy rate 」was negatively correlated with satisfaction gaps of 「staff」(p＜0.05)；the 「NA hours per patient day」was negatively correlated with satisfaction gaps of 「home/family involvement」(p＜0.05). The results of Multiple Regression showed that demographic data and station characteristic difference in the（1）different service quality of 「home/family involvement」 & 「care」(p＜0.05) ;（2）but no different in any dimensions of users’ satisfaction (p＞0.05)；（3）different satisfaction gap of「home/family involvement」(p＜0.05). The result of this study could provides to understand the relationship between service quality and users’ satisfaction of the veterans who livie in nursing home. The findings can not only provide the information of improvement veterans’ nursing home service quality, a basis of their management for the government, but also serve as references for research. In this way, the residents will receive appropriate care and meet the demands of the aged.

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Ai-Cheng, Li, e 李愛誠. "Quality of Care in Home Care and Nursing Home". Thesis, 2011. http://ndltd.ncl.edu.tw/handle/12111248590566418717.

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Abstract (sommario):

碩士
亞洲大學
健康產業管理學系長期照護組
99
Objective: The problem of long-term healthcare for a disabled and aging population has gradually become a point of concern in many countries. Improvement of the quality of long-term healthcare is a topic that requires urgent focus. Thus, this study used the National Health Insurance (NHI) Claim Database to investigate differences in quality of care with regard to home care and nursing home services. Methods: This study obtained data on 2006 inpatient and outpatient medical claims from the data of one million people in 2005 Health Insurance Database. A sample of 1,564 users of home care and nursing home services was taken. This study then investigated the difference in quality indicators of healthcare, drug use, and healthcare utilization among these users within a two-year period. Results: Observation of users of home care services showed the following statistics: 4.5 % sought medical care due to depressive illnesses in the first year; 49.8 % sought medical care due to urinary tract infection (UTI) in the second year; 4.6 types of drugs were issued on average at each outpatient visit, and the average number of outpatient visits per year was 34.Observation of users of nursing home services showed the following statistics: 9.6 % sought medical care due to depressive illnesses in the first year; 62.1 % sought medical care due to urinary tract infection (UTI) in the second year; 4.2 types of drugs were issued on average at each outpatient visit, and the average number of outpatient visits per year was 49. The differences among users of home care services and users of nursing home services reached statistical significance. After other variables had been controlled, logistic regression analysis showed that the probability of depression (first year) and UTI (second year) among users of nursing home services was 2.62 and 1.54 times that of users of home care services, respectively. Conclusion: Although NHI in Taiwan affords a similar degree of disability benefits to users of home care services and nursing home services, the quality of the two service models differs. Related medical referral units and service providers should plan health education and guidance, and improve index management and care processes as soon as possible, to enhance the quality of healthcare services.

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Zhang, Angela Rong Yang. "At home in a nursing home: on movement and care". Thesis, 2020. http://hdl.handle.net/2440/129650.

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Abstract (sommario):

This thesis follows the everyday movements of a group of elderly Australians, to critically examine how they came to experience a sense of home while living with bodily and cognitive impairments in a nursing home. In tracing their steps and the minutiae of their day-to-day activities, this research illustrates how nursing home residents experience ‘home’ as a sense of ‘rightness’ of being through doing the most mundane activities of walking, transferring position and eating. Examining care through the lens of home, I analyse how home, bodies and movement are reconfigured through multiple contexts of care. I argue that it is only in constellations of care that produce movements that residents attempt to make, but are unable to make on their own, that the potential to become at home is made possible. Based on 12 months of fieldwork in two nursing homes in metropolitan Adelaide, South Australia, this research attends closely to the sensory extensions (Dennis 2007) and restrictions of residents’ bodies vis-à-vis their engagements with other people and things. From the taste of a home cooked meal, to the touch of staff and family members, medications, handrails, carpeted floors and walking aids, residents’ ageing and declining bodies respond to, and may resist, assistance to walk, stand or eat. Care plans, staff and equipment, as this thesis will show, can also restrain residents’ bodies, inhibiting their movements and their becoming at home. This thesis draws on Deleuze and Guattari’s (1977, 1988) theories of becoming and desiring production to expand Jackson’s notion of home (1995, 2002) and ‘existential imperative’ (2002, p. 14) to propose that home is a matter of becoming-at-home-in-the-world. Key to my argument is how residents experience an innermost drive to move, and in examining how their urge to move is responded to, I demonstrate the multiple and at times contested forces that can propel residents to sit, to stand, or to put one foot ahead of the other. It is through this Deleuzian approach that I detail the multiple persons and things that enact and produce assemblages (Deleuze & Guattari 1988) of care. In so doing, I demonstrate that an ethically responsive care, or the care that was communicated and experienced as ‘right’ by residents, requires tinkering (Mol, Moser & Pols 2010) to achieve a balance between inclusion and autonomy (Rapport 2018). From moment to moment, and day-to-day, as bodies age, decline and eventually die, each resident requires different assemblages of care to move and to become at home. Examining the varieties of experience for nursing home residents through the theoretical lens of becoming at-home-in-the-world, this thesis provides new knowledge about the interrelations between movement and care, and the generative and productive affects of walking, standing and eating in residents’ lives. I argue that this ethnographically informed understanding of the sensibilities and potentialities of movement presents a challenge to clinical constructions of bodily and cognitive impairment and is at odds with aged care discourses and practices that may render the lives of nursing home residents inactive or meaningless and thus further constrain their existential and bodily potentials.
Thesis (Ph.D.) -- University of Adelaide, School of Social Sciences, 2020

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YANG, TSAI-JU, e 楊采汝. "Unexpected hospitalization of residents in nursing home: A study of nursing home in Nautou". Thesis, 2016. http://ndltd.ncl.edu.tw/handle/767s4n.

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Abstract (sommario):

碩士
弘光科技大學
健康事業管理研究所
104
Abstract Unexpected hospitalization of the residents in long-term care institutes will make many troubles for residents and nursing person. At the same time, it is also relevant to the quality of nursing. Therefore, the aim of this research was to analysis the incidence rate and related factors of unexpected hospitalization of residents. This study was prospective study. The 152 participants of the study were the residents who lived in the nursing home in Nantou Country from January 2104 to December 2014. This study applied Andersen’s Behavioral Model to explore the related factors of unexpected hospitalization utilization; there were three factors in the framework: predisposing, enabling, and needs factors. Data was collected from the medical records of nursing home, the summary of the resident’ hospital discharge records, etc. Descriptive statistics were used to analyze the characteristic of nursing home residents and the unexpected utilization of hospitalization. Logistic regression models were used to identify the predictors of unexpected hospitalization. A paired t- test was used to compare changes in health status. The data was analyzed by SPSS 20.0 Software. The results indicated that 27.0% of 152 residents suffered from unexpected hospitalization. The incident rate of male was higher than that of female. Infection was the main reason for unexpected hospitalization, especially who with URI or UTI. Most of notable factors that related unexpected hospitalization are need factors, such as placement without tubes (t=-2.046, p< .046), the number of tubes (F=5.652, p< .001). Residents with high blood pressure, dementia and heart disease also revealed a significant effect on the rate unexpected hospitalization. Logistic regression showed that, after controlling for other variables, the more the tubes (OR=0.152, p< .027), the number of diseases in the past (OR=3.810, p< .001) had significant effects on using unexpected hospitalization. The results of this research were beneficial to offer practical management to nursing home and the related institutional care. Residents of the nursing home had the traits of unexpected hospitalization; we should take more attention to prevent unexpected hospitalization happen, and care plan should be improved the rate of hospitalization. Keywords: nursing home, residents, unexpected hospitalization

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46

Kao, Hsin-yi, e 高心儀. "Nursing home service quality－Subsidiary of a teaching hospital in Taichung Nursing Home Case". Thesis, 2011. http://ndltd.ncl.edu.tw/handle/40870222448876684275.

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47

WU, WEN-LING, e 吳紋翎. "Service Quality of Nursing Homes for the Aged– Tainan Philanthropy Home". Thesis, 2018. http://ndltd.ncl.edu.tw/handle/9pnxw9.

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Abstract (sommario):

碩士
康寧大學
企業管理研究所
106
In a highly competitive environment, providing high quality service to customers is becoming increasingly important for the business in the service industry. In order to sustain competitive advantage, companies will keep providing their customers superior services by all means, regardless its cost. In doing that, companies not only obtain their reputation, but also gain loyalty from outside customers who received superior service from satisfied workers inside the companies. This study explores the influence of service, quality of the long-term care institution on employees’ perceived value. This research used a questionnaire to survey employees in the Tainan who are staffed in the long-term care institution. The survey data were used SPSS 23.0 statistical software and analyzed Statistical.

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48

Cheng-DaJiang e 江承達. "SCREEN -Nursing Home Cinemetrics Transcript". Thesis, 2018. http://ndltd.ncl.edu.tw/handle/4ajer5.

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Abstract (sommario):

碩士
國立成功大學
建築學系
106
This study attempts to involve Cinemetrics tools in the nursing home design attentive to intangible aspects, such as feeling and belonging, which can’t be measured by conventionalevaluation tools. By filming the living environment and the elder's daily routine in a nursing home, detailed perceptions and relationships can be captured. This practice also includes letting the elders filming by themselves to acquire the subjective sight of the elders and create better interactions. After filming, Cinemetrics exercises begin with editing, transcript developing, drawing and design to create a new methodology for better evaluating and designing the nursing home.

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Ke, Shu-Jing, e 柯淑菁. "Investigations of Effects of Painting Activities in Nursing Home Residents— A Single Nursing Home Study". Thesis, 2014. http://ndltd.ncl.edu.tw/handle/28611937051003407131.

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Abstract (sommario):

碩士
靜宜大學
社會工作與兒童少年福利學系
102
Art therapy activities have been used in various fields, but few researches have been conducted to explore the benefits of art therapy activities for nursing home residents. The main purposes of this study are to investigate the benefits of the “digital painting activities” for nursing home residents, and to explore the experiences of the participants involved in the painting activities. The “one-shot case study” in “pre-experimental design” was used in this study, combined with the methods of the quantitative and qualitative data analysis. The standard assessment instruments including the Chu’s hand dexterity test, the Geriatric Depression Scale-short form and the WHOQOL-BREF (Taiwanese version) were used in this study. The semi-structured interview questionnaire was used in qualitative interview and theme analysis was used in qualitative analysis. A total of 18 residents from a nursing home participated in this study at first, but only 16 residents of these participants’ individual attendance rates were over 60%, and then for further statistical analysis. The differences of functional performance (including hand function, depressive status and quality of life status) of the participants between pre- and post interventions were significant statistically. The “effect size” of the differences between pre- and post intervention except hand function (0.4) reached “moderate effect” to “high effect”. The results of “standardized response mean” showed all the differences between pre- and post interventions reached “moderate effect” to “high effect”. The thematic analysis method was employed for qualitative analysis and six themes were summarized to explore. The results of qualitative analysis and quantitative analysis were mutual supported. The lack of a control group study design, the small sample size and the participants from single nursing home would threaten the generalization of our results, although the combination of the qualitative and quantitative analysis was used to compromise these shortcomings. When referring to the results of our study, the limitation should be considered. The results of our study are suitable to be a reference for the practitioners and researchers in the related fields of elderly care.

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Toles, Mark Pettiss. "Transitional Care in a Nursing Home". Diss., 2011. http://hdl.handle.net/10161/3827.

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Abstract (sommario):

Background: Each year, 2 million older Americans complete three to four week courses of post-acute care in nursing homes and return home; however, scant research describes services to protect older adults during their transitions from nursing homes to home. In hospital-based studies, transitional care interventions were associated with improved health outcomes for older adults, but these interventions added new staff positions, which are likely cost-prohibitive in nursing homes. Further, no prior study explored transitional care provided for vulnerable, post-acute care patients in nursing homes. Thus, this dissertation was designed to develop new understandings about transitional care provided by existing staff members in nursing homes. The study has two specific aims: (a) describe transitional care and outcomes for older adults who obtain post-acute care in nursing homes from the day of admission through discharge; (b) explore the influence of interactions, among selected older adult patients and their group of nursing home caregivers, on their ability to accomplish transitional care processes.

Method: Using data from a literature review and theoretical models, including Donabedian's Model of Healthcare Quality and Anderson's Local Interaction Model, a conceptual model of transitional care for post-acute care patients in nursing homes was constructed. The conceptual model was then used to guide exploration of the research aims with a longitudinal, multiple case study of transitional care in a nursing home. The unit of analysis was the patient care-team, defined as individual post-acute care patients, family caregivers, and 6 to 8 professional staff in each team (e.g., rehabilitation therapists, physicians, nurses and social workers). Three patient care-team members were purposively sampled for study. Moreover, longitudinal data were collected using repeated interviews and observations with patients, family caregivers, and staff; document and daily chart reviews; and surveys of patient preparedness for discharge. Manifest content analysis and thematic analysis (qualitative methods) were used to conduct within- and across-case analyses of trajectories of transitional care and to identify strengths, gaps and inconsistencies in care.

Results: Findings related to the first research aim include a description of transitional care in the study nursing home. Serious gaps and inconsistencies in transitional care exposed older, post-acute care patients to risks for complications in their transitions from the study nursing home to home: (a) systemic supports were not available to support nursing home staff who provided transitional care; further, nursing home staff and leadership were unaware that they provided transitional care; (b) care processes were not in place to prepare older adults and their caregivers to continue care at home; (c) care-team interactions often excluded family members; and (d) post-acute care patients left the nursing home without resources needed to support safe transitions in care, including transitional care plans, education to appropriately respond to acute changes in health, written materials to guide care at home, referrals for medical follow-up after discharge, and transfers of clinical information to primary care physicians.

Findings related to the second research aim include a description of local interaction strategies and the effectiveness of transitional care processes. When professional staff more consistently used local interaction strategies, specified in the model, care-team members exhibited greater capacity for connections, information exchange, and cognitive diversity. Further, when care-team interactions were of high quality and sufficient frequency, there were multiple indications of more effective transitional care, such as patient engagement in care, inclusion of patient priorities in care plans, and problem solving which included family members and diverse members of the patient care-team. Thus, local interaction strategies were essential staff behaviors needed to adapt care processes to the specific transitional care needs of individual patients.

Because transitional care is a grossly under-developed care process in nursing homes, these findings will likely have immediate implications for practice and research. Findings will provide nursing home administrators and staff with resources to develop and evaluate care in nursing homes; further, the findings will help to create targets for protocol and care process development to strengthen existing practice and address deficiencies. Findings will provide researchers with resources for studying transitional care in diverse samples of nursing homes, which should facilitate development of testable hypotheses for needed intervention studies. In addition, the local interaction strategies findings in the study may generalize to other settings of care, where interdependent staff work is required to establish connections, information networks, and to coordinate care among multiple staff members.

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Tesi sul tema "Home in a nursing home"

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