Institutional care

机构护理
  • 文章类型: Journal Article
    背景:一些国家人口的快速老龄化导致了越来越多的失能老人,创造了对长期护理(LTC)的巨大需求并满足其成本,这对残疾人家庭和政府来说是沉重的经济负担。因此,长期照护(LTC)成本的测算已成为政府制定长期照护(LTC)政策的重要依据,而学术界对长期照护(LTC)成本的研究也在不断发展和深化的过程中。
    方法:这是一项系统评价,旨在研究过去十年(2010-2019年)中关于中国和其他国家长期护理(LTC)成本测量比较的证据。
    结果:这篇综述包括18项中国研究和17个其他国家的研究。大多数中国学者根据残疾老人的残疾程度来估计长期护理费用。然而,欧美国家的研究越来越深入和全面,更详细的关于特定疾病的护理后费用,如帕金森病,老年痴呆症,和癫痫。
    结论:在未来的学术研究中,我们应充分考虑长期护理提供者的人文价值,并进一步研究不同慢性病的长期护理成本差异。在中国未来的政策制定中,根据德国的经验,瑞典,和其他国家,这可能是发展私人长期护理保险,实现私人长期护理保险与公共长期护理保险(LTCI)之间有效互补的有效途径。
    BACKGROUND: The rapid aging of populations in some countries has led to a growing number of the disabled elderly, creating a huge need for Long-Term Care (LTC) and meeting its costs, which is a heavy economic burden on the families of the disabled elderly and governments. Therefore, the measurement of Long-Term Care (LTC) costs has become an important basis for the government to formulate Long-Term Care (LTC) policies, and academic research on Long-Term Care (LTC) costs is also in the process of continuous development and deepening.
    METHODS: This is a systematic review that aims to examine the evidence published in the last decade (2010-2019) regarding the comparison of the measurement of Long-Term Care (LTC) costs between China and other countries.
    RESULTS: Eighteen Chinese studies and 17 other countries\' studies were included in this review. Most Chinese scholars estimated long-term care costs based on the degree of disability among the disabled elderly. However, the studies of European and American countries are more and more in-depth and comprehensive, and more detailed regarding the post-care cost of specific diseases, such as Parkinson\'s disease, Alzheimer\'s disease, and epilepsy.
    CONCLUSIONS: In future academic research, we should fully consider the human value of long-term care providers and further study the differences in the long-term care costs of different chronic diseases. In China\'s future policymaking, according to the experience of Germany, Sweden, and other countries, it may be an effective way to develop private long-term care insurance and realize the effective complementarity between private long-term care insurance and public long-term care insurance (LTCI).
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  • 文章类型: Journal Article
    Although literature describing and evaluating training programmes in hospital settings increased in recent years, there are no reviews that summarise these programmes. This review sought to address this, by collecting the current evidence on dementia training programmes directed to staff working in general hospitals.
    Literature from five databases were searched, based on a number of inclusion criteria. The selected studies were summarised and data was extracted and compared using narrative synthesis based on a set of pre-defined categories. Methodological quality was assessed.
    Fourteen peer-reviewed studies were identified with the majority being pre-test post-test investigations. No randomised controlled trials were found. Methodological quality was variable with selection bias being the major limitation. There was a great variability in the development and mode of delivery although, interdisciplinary ward based, tailor-made, short sessions using experiential and active learning were the most utilised. The majority of the studies mainly evaluated learning, with few studies evaluating changes in staff behaviour/practices and patients\' outcomes.
    This review indicates that high quality studies are needed that especially evaluate staff behaviours and patient outcomes and their sustainability over time. It also highlights measures that could be used to develop and deliver training programmes in hospital settings.
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  • 文章类型: Journal Article
    托儿质量对儿童的发展和心理调整有着至关重要的影响,特别是对于有虐待和创伤史的孤儿。然而,对孤儿的充分照顾往往受到不利的照顾者-儿童比例和训练不足的影响,人员负担过重,特别是在资源有限和大量孤儿的国家的机构护理中。本系统综述调查了机构环境中结构性干预和护理人员培训对儿童发育的影响。本系统综述中包含的24项干预研究报告了对儿童情绪的有益影响,社会,和认知发展。然而,很少有研究关注干预措施对儿童-照顾者关系或一般机构环境的影响。此外,我们的审查显示,旨在改善机构护理环境的干预措施在很大程度上忽视了暴力和虐待预防.不幸的是,我们的研究结果部分受到研究设计和方法的限制.总之,本系统综述阐明了改善机构护理的障碍和可能性。必须作出更大的努力防止暴力,滥用,忽视住在机构照料中的儿童。因此,我们主张将基于依恋理论的模型与虐待预防方法相结合,然后使用严格的科学标准进行测试。通过使用基于证据的方法,有可能使更多的孩子在支持性和非暴力的环境中成长。
    Quality of child care has been shown to have a crucial impact on children\'s development and psychological adjustment, particularly for orphans with a history of maltreatment and trauma. However, adequate care for orphans is often impacted by unfavorable caregiver-child ratios and poorly trained, overburdened personnel, especially in institutional care in countries with limited resources and large numbers of orphans. This systematic review investigated the effects of structural interventions and caregiver trainings on child development in institutional environments. The 24 intervention studies included in this systematic review reported beneficial effects on the children\'s emotional, social, and cognitive development. Yet, few studies focused on effects of interventions on the child-caregiver relationship or the general institutional environment. Moreover, our review revealed that interventions aimed at improving institutional care settings have largely neglected violence and abuse prevention. Unfortunately, our findings are partially limited by constraints of study design and methodology. In sum, this systematic review sheds light on obstacles and possibilities for the improvement in institutional care. There must be greater efforts at preventing violence, abuse, and neglect of children living in institutional care. Therefore, we advocate for combining attachment theory-based models with maltreatment prevention approaches and then testing them using rigorous scientific standards. By using approaches grounded in the evidence, it could be possible to enable more children to grow up in supportive and nonviolent environments.
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