养老院中的文化变革：养老院资源的作用是什么？
Culture Change in Nursing Homes: What Is the Role of Nursing Home Resources?
作者信息
Chisholm Latarsha, Zhang Ning J, Hyer Kathryn, Pradhan Rohit, Unruh Lynn, Lin Feng-Chang
机构信息
1 University of Central Florida, Orlando, USA.
2 Seton Hall University, South Orange, NJ, USA.
出版信息
Inquiry. 2018 Jan-Dec;55:46958018787043. doi: 10.1177/0046958018787043.
Quality of care has been a long-standing issue in US nursing homes. The culture change movement attempts to transition nursing homes from health care institutions to person-centered homes. While the adoption of culture change has been spreading across nursing homes, barriers to adoption persist. Nursing homes that disproportionately serve minority residents may have additional challenges implementing culture change compared with other facilities due to limited financial and staffing resources. The objective of this study was to examine how nursing home characteristics are associated with culture change adoption in Central Florida nursing homes. This cross-sectional study included 81 directors of nursing (DONs) who completed the Artifacts of Culture Change survey. In addition, nursing home organizational data were obtained from the Certification and Survey Provider Enhanced Reports (CASPER). A logistic regression was conducted to examine the relationship between high culture change adoption and nursing home characteristics. The overall adoption of culture change scores in Central Florida nursing homes was low. Nevertheless, there was variability across nursing homes in the adoption of culture change. High culture change adoption was associated with nursing homes having lower proportions of Medicaid residents.
护理质量一直是美国养老院长期存在的问题。文化变革运动试图将养老院从医疗机构转变为以居民为中心的家园。虽然文化变革的采用已在养老院中广泛传播，但采用过程中仍存在障碍。与其他机构相比，为少数族裔居民提供服务比例过高的养老院在实施文化变革时可能会面临更多挑战，因为其财政和人员资源有限。本研究的目的是探讨佛罗里达州中部养老院的特征与文化变革采用情况之间的关联。这项横断面研究纳入了81名完成文化变革人工制品调查的护理主任（DONs）。此外，养老院组织数据来自认证和调查提供者增强报告（CASPER）。进行了逻辑回归分析，以检验高文化变革采用率与养老院特征之间的关系。佛罗里达州中部养老院文化变革得分的总体采用率较低。然而，各养老院在文化变革采用方面存在差异。高文化变革采用率与医疗补助居民比例较低的养老院相关。
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