Research Centre for Clinical and Community Practice Innovation, Griffith University, Meadowbrook, 4131, Australia.
Disabil Rehabil. 2011;33(13-14):1190-202. doi: 10.3109/09638288.2010.524275. Epub 2010 Oct 22.
There is ongoing public and private concern regarding the appropriateness of young people with complex health needs residing in nursing homes and the search for alternative living environments. Despite the demand for change, there is only tacit understanding of the key motivations behind this call for change and even less in the way of coherent arguments underlying the need for alternative solutions. The study aimed to explore the assumed truths that have formed around this topic in recent years and to reposition ambitious but ambiguous arguments regarding the need to relocate younger people from aged care facilities.
By applying the method of systematic metaphor analysis, the authors conducted a review of social discourse (i.e. media corpus of 904 published articles dated 2001-2009).
A conceptual media map was developed to document the process of social change around this topic. Additionally, the narrative described five metaphors that outlined the experience of aged care residential homes for young people with complex health conditions, namely 'captivity', 'commodity', 'battlelines', 'fragmentation' and 'a contemporary life'. These metaphors reflected the fears and hopes held by young people and their families.
Results indicate that young people at risk of nursing home placement are confronted with a range of distinct and complex personal dilemmas which ought to be resolved through initiatives purported to offer 'more appropriate' residential options. We conclude that principles of good quality care are in danger of becoming misplaced within over-simplified interpretations of the needs of young people with complex conditions. Alignment of disability and rehabilitation policy with residential care practice will allow for more informed decisions about long-term care needs of young people, leading to quality outcomes.
公众和私人对居住在养老院的有复杂健康需求的年轻人的适当性以及寻找替代生活环境的问题持续表示关注。尽管人们要求改变，但对于这种变革需求背后的关键动机只有心照不宣的理解，对于替代解决方案所需的基础的一致性论点甚至更少。本研究旨在探讨近年来围绕这一主题形成的假设真理，并重新定位关于需要将年轻人从养老院转移的雄心勃勃但模糊的论点。
通过应用系统隐喻分析方法，作者对社会话语（即 2001-2009 年 904 篇已发表文章的媒体语料库）进行了审查。
制定了一个概念性媒体地图来记录该主题的社会变革过程。此外，该叙述描述了五个隐喻，概述了有复杂健康状况的年轻人居住在养老院的体验，即“囚禁”、“商品”、“战线”、“碎片化”和“当代生活”。这些隐喻反映了年轻人及其家人的恐惧和希望。
结果表明，有被安置在养老院风险的年轻人面临着一系列不同且复杂的个人困境，这些困境应该通过旨在提供“更合适”的居住选择的举措来解决。我们得出结论，优质护理的原则有在对复杂状况的年轻人的需求的过于简单的解释中错位的危险。残疾和康复政策与居住护理实践的一致将使年轻人的长期护理需求能够做出更明智的决策，从而带来更好的结果。
