Department of Community Health Nursing, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan.
School of Nursing, Midwifery & Social Work, The University of Queensland, At Lucia, QLD 4072, Australia.
Int J Environ Res Public Health. 2020 Mar 20;17(6):2061. doi: 10.3390/ijerph17062061.
Adult day care (ADC) provides various services for meeting clients' needs. Based on the mini-Delphi method with 46 ADC staff and the discussions with eight ADC administrators, this study developed and finalized a comprehensive logic model to represent the elements of ADC. For the three basic structures of a logic model-inputs/activities, outputs, and outcomes-the model contained seven core categories and 23 sub-categories. The ADC inputs/activities consisted of two core categories: "Place to stay" and "Intervention from staff". These inputs/activities caused two kinds of outputs: "Clients' experiences" and "Families' experiences". "Accumulating experiences" with repeated ADC visits was established as the link between the ADC outputs and outcomes, which were "Clients' change" and "Families' change". ADC centers provide various experiences for their clients and their caregivers, ranging from the fulfillment of needs for fundamental care to psychiatric care and self-actualization. Improving various model-related inputs/interventions can produce better experiences and outcomes. The model can guide ADC administrators, policymakers, and researchers in the evaluation of a heterogeneous ADC service program that is community-based, thereby ensuring optimal care for clients with an efficient use of resources.
成人日托（ADC）提供各种服务以满足客户的需求。本研究采用迷你德尔菲法，对 46 名 ADC 工作人员进行调查，并与 8 名 ADC 管理人员进行讨论，制定并最终确定了一个综合逻辑模型，以代表 ADC 的各个要素。对于逻辑模型的三个基本结构——投入/活动、产出和结果——该模型包含了七个核心类别和 23 个子类别。ADC 的投入/活动包括两个核心类别：“停留场所”和“员工干预”。这些投入/活动导致了两种产出：“客户体验”和“家庭体验”。通过重复 ADC 访问积累的“体验”被确立为 ADC 产出和结果之间的联系，即“客户的变化”和“家庭的变化”。ADC 中心为其客户及其护理人员提供各种体验，从满足基本护理需求到精神科护理和自我实现。改善各种与模型相关的投入/干预措施可以产生更好的体验和结果。该模型可以指导 ADC 管理人员、政策制定者和研究人员评估以社区为基础的异质 ADC 服务项目，从而确保为客户提供最佳护理，并有效地利用资源。
