Fischer Thomas, Worch Andreas, Nordheim Johanna, Wulff Ines Martin, Gräske Johannes, Meye Sandra, Wolf-Ostermann Karin
Charité - Universitätsmedizin Berlin, Institut für Medizinische Soziologie.
Pflege. 2011 Apr;24(2):97-109. doi: 10.1024/1012-5302/a000105.
Shared-Housing Arrangements (SHA) for care-dependent older persons gain increasing importance as a setting for nursing care in Germany, both in terms of numbers and user preference. This article aims to answer the questions in which phases SHA have developed over time, what the initiator's objectives are, and what factors contributed to SHA proliferation. A systematic review of the literature was conducted that finally included 73 articles. As a result it can be demonstrated that SHA started from "individual user initiatives", became "developing novel services" and finally established themselves as "regular services" in the nursing setting. A typology of different models of SHA can be organised along two dimensions: Firstly the temporal dimension of care organisation and secondly the way care services are purchased. Objectives formulated by the initiators of SHA are: Establishment of a family - like environment, inclusion of relatives, community orientation, security of care provision and maintenance of self-determination. Tailor-made financial and legal regulations supported the spread of SHAs. In reflection of the available literature it becomes evident that no satisfactory consensus on those elements exist that are constitutive for SHAs. Furthermore, there is a dearth of research on whether postulated objectives and other health related goals are actually being met in SHAs. Open questions pertain also the level of self-determination achieved in practice and other outcomes attained.
对于需要护理的老年人来说,共享住房安排(SHA)在德国作为一种护理模式,无论是在数量上还是在用户偏好方面,其重要性都日益增加。本文旨在回答以下问题:SHA随着时间的推移经历了哪些发展阶段,发起者的目标是什么,以及哪些因素促成了SHA的普及。我们对文献进行了系统综述,最终纳入了73篇文章。结果表明,SHA始于“个人用户倡议”,发展为“开发新型服务”,最终在护理领域确立为“常规服务”。SHA的不同模式类型可以从两个维度进行组织:一是护理组织的时间维度,二是护理服务的购买方式。SHA发起者制定的目标包括:营造家庭般的环境、让亲属参与、以社区为导向、保障护理服务以及维护自主决定权。量身定制的财务和法律法规推动了SHA的推广。从现有文献来看,很明显,对于构成SHA的那些要素,尚未达成令人满意的共识。此外,关于SHA是否实际实现了假定目标和其他与健康相关的目标,缺乏相关研究。悬而未决的问题还涉及在实践中实现的自主决定权水平以及取得的其他成果。