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“这很重要,但是……”:养老院居民社会接触偏好的感知障碍和情境依赖性。

"It's important, but…": Perceived Barriers and Situational Dependencies to Social Contact Preferences of Nursing Home Residents.

机构信息

The Department of Sociology and Gerontology, Miami University, Oxford, Ohio.

Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Rochester, Minnesota.

出版信息

Gerontologist. 2018 Nov 3;58(6):1126-1135. doi: 10.1093/geront/gnx109.

Abstract

BACKGROUND AND OBJECTIVES

U.S. Nursing homes (NH) are shifting toward a person-centered philosophy of care, where staff understand each residents preferences, goals and values, and seek to honor them throughout the care delivery process. Social interactions are a major component of life and while low rates of social interactions are typically found among NH residents, little research has examined resident preferences for specific types of social interactions. The purpose of this study is to explore, from the perspective of the NH resident, barriers to social contact preferences and situations when social preferences change.

RESEARCH DESIGN AND METHODS

Two interviews were conducted with 255 NH residents 3 months apart, recruited from 32 NHs using 13 social-contact items from the Preferences for Everyday Living Inventory-NH.

RESULTS

Content analysis of 1,461 spontaneous comments identified perceived barriers to preference fulfillment along with reasons why residents would change their mind about the importance of a preference (situational dependencies). Nearly 50% of social preferences for choosing a roommate, having regular contact with friends, giving gifts, and volunteering were associated with barriers. Social preferences were likely to change based upon the quality of the social interaction and the resident's level of interest.

DISCUSSION AND IMPLICATIONS

Knowledge of barriers regarding social preferences can inform care efforts vital to advancing the delivery of person-centered care. In addition, understanding the reasons why NH resident preferences change based upon context can help providers with staff training leading to individualized care and develop meaningful social programs that are in line with resident preferences.

摘要

背景与目的

美国养老院(NH)正在转向以患者为中心的护理理念,在这种理念中,工作人员了解每位患者的偏好、目标和价值观,并在整个护理过程中努力尊重这些偏好。社交互动是生活的重要组成部分,尽管 NH 患者的社交互动率通常较低,但很少有研究探讨患者对特定类型社交互动的偏好。本研究旨在从 NH 患者的角度探讨社交接触偏好的障碍以及偏好发生变化的情况。

研究设计与方法

使用日常生活偏好量表-NH 中的 13 项社交接触项目,从 32 家 NH 中招募了 255 名 NH 居民,在 3 个月的时间内进行了两次访谈。

结果

对 1461 条自发评论的内容分析确定了偏好实现的感知障碍,以及居民改变对偏好重要性的想法的原因(情境依赖性)。选择室友、与朋友保持定期联系、赠送礼物和志愿服务等社交偏好近 50%与障碍有关。社交偏好可能会根据社交互动的质量和居民的兴趣程度而改变。

讨论与意义

了解社交偏好障碍的相关知识,可以为推进以人为本的护理服务提供重要的护理工作。此外,了解 NH 居民偏好基于情境变化的原因,可以帮助护理人员进行个性化培训,制定符合居民偏好的有意义的社交计划。

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