Jones B, Nackerud L, Boyle D
School of Social Work, University of Georgia, Athens 30602-7012, USA.
Hosp J. 1997;12(3):41-57. doi: 10.1080/0742-969x.1997.11882868.
During the completion of an interpretive evaluation project, differences in rates of dying patients using hospice services between nursing homes were examined. Rates were found to vary from 2% to 39% in 23 nursing homes owned by one company. Twenty of the 23 administrators responded to a survey regarding attitudes toward hospice care in the nursing home. Nursing homes with administrators most sympathetic to hospice care had rates three times higher than nursing homes with administrators least sympathetic. Specific concerns were discussed in interviews with four of the least sympathetic administrators. The findings are congruent with program implementation theory which describes the discretionary power of local administrators to limit access to new programs that they find problematic.
在完成一项解释性评估项目期间，对各养老院中使用临终关怀服务的临终患者比例差异进行了调查。在一家公司旗下的23家养老院中，这一比例从2%到39%不等。23位管理人员中有20位回复了一项关于养老院对临终关怀态度的调查。对临终关怀最同情的管理人员所在的养老院，其临终患者比例是最不同情的管理人员所在养老院的三倍。与四位最不同情的管理人员进行访谈时讨论了具体问题。这些发现与项目实施理论一致，该理论描述了地方管理人员有权自行决定限制他们认为有问题的新项目的使用。
