居民选择：养老院工作人员对紧张关系及解决方案的看法
Resident Choice: A Nursing Home Staff Perspective on Tensions and Resolutions.
作者信息
Palmer Jennifer A, Parker Victoria A, Berlowitz Dan, Snow A Lynn, Hartmann Christine W
机构信息
Center for Healthcare Organization and Implementation Research, Edith Nourse Rogers Memorial VA Hospital, 200 Springs Road, Bedford, MA 01730, USA; Department of Health Law, Policy, and Management, Boston University School of Public Health, Talbot Building, 715 Albany Street, Boston, MA 02118, USA.
Department of Health Law, Policy, and Management, Boston University School of Public Health, Talbot Building, 715 Albany Street, Boston, MA 02118, USA.
出版信息
Geriatr Nurs. 2018 May-Jun;39(3):271-278. doi: 10.1016/j.gerinurse.2017.10.001. Epub 2017 Nov 10.
UNLABELLED
A central component of person-centered care, resident choice in daily life, has received little research attention in the U.S.
CONTEXT
This study investigated nursing home staff experiences in realizing resident choice. Twenty-six qualitative staff interviews were conducted in an opportunistic sample from two Veterans Health Administration (VHA) Community Living Centers (CLCs, i.e., nursing homes) implementing the Green House Model. Thematic content analysis surfaced several key tensions at the intra-personal, inter-personal, and organizational levels. Most salient were staff mental models within the intra-personal level. Staff conveyed a lack of clarity on how to realize resident choice when faced with varying tensions, especially the competing goal of resident medical and safety needs. Staff-employed resolutions to resident choice-related tensions also emerged (e.g., preventive practices, staff reinforcement, and staff deliberation). This study offers specific and concrete insights on how resident choice in daily life, and thus resident quality of life, can be advanced.
未标注
以患者为中心的护理的一个核心组成部分，即居民在日常生活中的选择权，在美国很少受到研究关注。
背景
本研究调查了养老院工作人员在实现居民选择权方面的经历。从两个实施绿屋模式的退伍军人健康管理局（VHA）社区生活中心（CLC，即养老院）中进行了机会抽样，对26名工作人员进行了定性访谈。主题内容分析揭示了在个人、人际和组织层面的几个关键矛盾。最突出的是个人层面的工作人员思维模式。工作人员表示，在面对各种矛盾时，尤其是居民医疗和安全需求这一相互竞争的目标时，对于如何实现居民选择权缺乏清晰认识。还出现了工作人员针对与居民选择权相关矛盾所采用的解决办法（例如预防措施、工作人员强化和工作人员商议）。本研究就如何推进居民在日常生活中的选择权，进而提高居民生活质量提供了具体而明确的见解。
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