“我接受（工作人员的帮助）；别无选择”：一项关于居民对养老院内部流动性态度的民族志研究。
'I accept it [staff assistance]; no choice': an ethnographic study of residents' attitudes towards mobility within nursing homes.
机构信息
Faculty of Medicine, Nursing and Health Sciences, Monash University, Notting Hill, Vic., Australia.
出版信息
Int J Older People Nurs. 2014 Dec;9(4):258-68. doi: 10.1111/opn.12029. Epub 2013 Apr 26.
BACKGROUND
Mobility contributes to the quality of life and independence of residents in nursing homes. To perform resident-centred mobility care, staff need to understand residents' physical capacity and perspectives of care.
AIMS AND OBJECTIVES
The aim of the study was to explore residents' perspectives of intrinsic factors influencing their mobility and associations between these factors with a view to informing resident mobility care practice improvements.
DESIGN
The study was part of a larger ethnographic project exploring safe resident mobility care in nursing homes.
METHODS
Semi-structured interviews with nursing home residents supplemented by non-participant observations were conducted over a 20-month period from July 2010. Fifteen residents consented to be interviewed in three nursing homes in Melbourne, Australia. Unobtrusive observations of 46 mobility events took place in three nursing homes over 5 months from September, 2011.
RESULTS
Participants identified intrinsic factors that influence their mobility including mobility capacity, strategies to cope with mobility loss, motivation and efforts to remain mobile. Three themes related to resident attitudes and responses to mobility loss emerged: acceptance of mobility loss and staff assistance; motivation to remain mobile; and acquiescence and loss of control during mobility events. A conceptual model developed from the study outlined associations between resident attitudes and mobility and quality of life outcomes. Discussion was framed by theories of ageing and adaptation: selection, optimisation and compensation; learned dependency; and learned helplessness.
CONCLUSION
Resident acceptance of mobility loss, and required staff assistance and realistic determination to remain mobile contribute to residents' quality of life. Mobility care based on considerations of resident choice, autonomy and the value of mobility is important.
背景
行动能力有助于养老院居民的生活质量和独立性。为了进行以居民为中心的移动护理，工作人员需要了解居民的身体能力和护理观点。
目的和目标
本研究旨在探讨影响居民移动性的内在因素，并探讨这些因素与居民移动性护理实践改进之间的关联。
设计
该研究是一项更大的人种学项目的一部分，该项目探讨了养老院中安全居民移动性护理。
方法
在 2010 年 7 月至 2011 年 9 月的 20 个月期间，对澳大利亚墨尔本的 3 家养老院的居民进行了半结构式访谈，并辅以非参与式观察。有 15 名居民同意在这 3 家养老院接受采访。在 5 个月的时间里，对这 3 家养老院的 46 次移动事件进行了不显眼的观察。
结果
参与者确定了影响其移动性的内在因素，包括移动能力、应对移动性丧失的策略、动机和努力保持移动性。与居民对移动性丧失的态度和反应有关的三个主题出现：接受移动性丧失和接受工作人员的帮助；保持移动性的动机；在移动事件中默许和失去控制。从研究中得出的概念模型概述了居民态度与移动性和生活质量结果之间的关联。讨论框架是老龄化和适应理论：选择、优化和补偿；习得依赖；以及习得性无助。
结论
居民对移动性丧失的接受程度，以及对所需的工作人员的帮助和保持移动性的现实决心，有助于提高居民的生活质量。基于考虑居民的选择、自主性和移动性的价值的移动护理是很重要的。
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