Residential care facility

住宅护理设施
  • 文章类型: Published Erratum
    [这更正了文章DOI:10.3389/fpsyt.2015.00173。].
    [This corrects the article DOI: 10.3389/fpsyt.2015.00173.].
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  • 文章类型: Journal Article
    这项研究旨在描述日本家庭中sc疮及其暴发的流行病学特征,住宅护理设施(RCF),和使用索赔数据的医院。
    这项描述性流行病学研究是使用来自日本八个城市的索赔数据进行的。使用记录的诊断和施用的药物的组合来识别the疮病例。研究期为2015年4月至2019年3月。疫情定义为一个家庭在一个日历月内发生≥2例sc疮,RCF,或医院。
    我们确定了857例sc疮病例进行分析。sc疮的年患病率为每100,000个受益人40至67个。在RCF中,sc疮的年发作率最高(每1000RCF中有21例),其次是医院(每1000家医院11家)和家庭(每1000家家庭0.25家)。RCF的年度爆发攻击率也最高(每1000RCF4.0),其次是医院(每1000家医院1.6家)和家庭(每户0.027家)。RCF之间的爆发模式差异很大。
    该研究展示了索赔数据在检测传染病暴发方面的潜力,这可以为未来的管理和预防of疮提供有价值的见解。RCF中sc疮的感染控制在老龄化社会中至关重要。
    UNASSIGNED: This study aimed to characterize the epidemiology of scabies and its outbreaks in Japanese households, residential care facilities (RCFs), and hospitals using claims data.
    UNASSIGNED: This descriptive epidemiological study was conducted using claims data from eight municipalities in Japan. Scabies cases were identified using a combination of recorded diagnoses and administered medications. The study period was from April 2015 to March 2019. Outbreaks were defined as ≥2 cases of scabies occurring within a calendar month at a single household, RCF, or hospital.
    UNASSIGNED: We identified 857 scabies cases for analysis. The annual prevalence of scabies ranged from 40 to 67 per 100,000 beneficiaries. The annual attack rate of scabies was found to be highest in RCFs (21 per 1000 RCFs), followed by hospitals (11 per 1000 hospitals) and households (0.25 per 1000 households). The annual outbreak attack rate was also highest in RCFs (4.0 per 1000 RCFs), followed by hospitals (1.6 per 1000 hospitals) and household (0.027 per household). The patterns of outbreaks varied widely among the RCFs.
    UNASSIGNED: The study showcases the potential of claims data for detecting infectious disease outbreaks, which could provide valuable insight for the future management and prevention of scabies. Infection control of scabies in RCFs is crucial in aging societies.
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  • 文章类型: Journal Article
    来自住宅护理机构的老年人的SARS-CoV-2感染率和相关死亡率很高。这项研究的目的是探讨65岁及以上人群接种COVID-19疫苗后的免疫状态。
    这项研究涉及居住在住宅护理设施中的志愿者参与者。在完全接种疫苗后2-12周测量抗Spike/RBD抗体的水平,使用化学发光微粒免疫测定法(SARS-CoV-2IgGIIQuantAbbott)。
    我们分析了居住在21个住宅护理机构中的志愿者的635份血清样本。除了一个例外,用Moderna疫苗进行疫苗接种,所有志愿者都接受了辉瑞-Comirnaty疫苗.参加该研究的个体的年龄在65-110岁之间(中位数为79岁)。在接受测试的人中,54.8%报告至少有一种合并症,59.2%报告在接种前患有COVID-19。在98.7%的受测者(n=627人)中检测到保护性水平的抗S/RBD抗体的存在,抗体水平差异很大,从7.1到5,680BAU/ml(中位数1287BAU/ml)。抗体水平似乎与先前的感染显着相关(r=0.302,p=0.000)。
    该研究揭示了抗SARSCoV-2抗体在测试者中的显著百分比(98.7%)的存在。其中,超过一半的人有高抗体水平。接种前COVID-19是唯一发现与较高的抗S/RBD水平相关的因素。老年人的重大反应,即使是那些有合并症的人,支持此类别的疫苗接种措施,无论相关的残疾或以前的感染。
    UNASSIGNED: SARS-CoV-2 infection rates and related mortality in elderly from residential care facilities are high. The aim of this study was to explore the immune status after COVID-19 vaccination in people 65 years and older.
    UNASSIGNED: The study involved volunteer participants living in residential care facilities. The level of anti-Spike/RBD antibodies was measured at 2-12 weeks after complete vaccination, using chemiluminescent microparticle immunoassay (SARS-CoV-2 IgG II Quant Abbott).
    UNASSIGNED: We have analyzed 635 serum samples collected from volunteers living in 21 Residential Care Facilities. With one exception, in which the vaccination was done with the Moderna vaccine, all volunteers received the Pfizer-Comirnaty vaccine. Individuals enrolled in the study had ages between 65-110 years (median 79 years). Of the people tested, 54.8% reported at least one comorbidity and 59.2% reported having had COVID-19 before vaccination. The presence of anti-S/RBD antibodies at a protective level was detected in 98.7% of those tested (n = 627 persons) with a wide variation of antibody levels, from 7.1 to 5,680 BAU/ml (median 1287 BAU/ml). Antibody levels appeared to be significantly correlated to previous infection (r = 0.302, p = 0.000).
    UNASSIGNED: The study revealed the presence of anti-SARS CoV-2 antibodies in a significant percentage of those tested (98.7%). Of these, more than half had high antibody levels. Pre-vaccination COVID-19 was the only factor found to be associated with higher anti-S/RBD levels. The significant response in elderly people, even in those with comorbidities, supports the vaccination measure for this category, irrespective of associated disabilities or previous infection.
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  • 文章类型: Journal Article
    背景:尽管需要将来自各种环境的老年人纳入基于正念的实证研究,老年人虚弱和不合规的问题仍然存在。这项研究旨在评估基于正念的老年人护理(MBEC)计划对长期护理住宿环境中残疾老年人的心理健康和精神福祉的影响。
    方法:这种单盲,随机对照试验(RCT)将77名参与者随机分为MBEC组或对照组,接受为期8周的MBEC项目.参与者在基线(T0)每四周进行一次评估,中期干预(T1),使用老年抑郁量表简表(GDS-SF)进行干预(T2)和随访(T3),状态特质焦虑量表(STAI)和精神幸福感量表(SWBS),分别。
    结果:线性混合模型(LMM)表明,MBEC参与者完成干预后,心理健康显着改善;与对照组相比,MBEC组的焦虑(T2时的状态焦虑;T2和T3时的特质焦虑)和抑郁症状较少.与对照组相比,精神幸福感也显着增强。
    结论:MBEC对残疾老年人的心理健康和精神幸福感都有积极影响。在长期护理机构中,有能力的老年人有可能坚持并参与基于正念的干预活动。这种低风险,容易接近,建议将有效的8周计划纳入定期的长期护理机构程序。
    背景:本研究已在临床试验注册中心(ClinicalTrials.gov-U.S.NationalLibraryofMedicine#NCT05123261)注册。2021年4月7日回顾性注册。).本研究使用CONSORT2010指南,以正确报告如何进行随机试验。
    Despite the need to incorporate seniors from various settings into mindfulness-based empirical research, issues of geriatric frailties and non-compliance remain. This study aimed to evaluate the effects of a mindfulness-based elder care (MBEC) program on mental health and spiritual well-being among seniors with disabilities in long-term care residential settings.
    This single-blind, randomized controlled trial (RCT) randomly assigned seventy-seven participants into an MBEC group or control group of an eight-week MBEC program. Participants were assessed every four weeks at baseline (T0), mid-intervention (T1), post-intervention (T2) and follow-up (T3) using the Geriatric Depression Scale Short Form (GDS-SF), the State-Trait Anxiety Inventory (STAI) and the Spiritual Well-Being Scale (SWBS), respectively.
    Linear mixed model (LMM) showed that MBEC participants\' mental health improved significantly after completing the intervention; compared with controls, the MBEC group exhibited significantly lower anxiety (state-anxiety at T2; trait-anxiety at T2 and T3) and fewer depressive symptoms. Spiritual well-being was also significantly enhanced compared to that in the control group.
    MBEC has positive effects on both mental health and spiritual well-being outcomes among seniors with disabilities. In long-term care facilities, seniors with abilities have the potential to adhere to and engage in activities of a mindfulness-based intervention. This low risk, easily accessible, and effective 8-week program is recommended to be integrated into regular long-term care institutional routines.
    This study was registered with Clinical Trial Registry (ClinicalTrials.gov - U.S. National Library of Medicine #NCT05123261. Retrospectively registered on 07/04/2021.). The CONSORT 2010 guidelines were used in this study for properly reporting how the randomized trial was conducted.
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  • 文章类型: Journal Article
    限制性做法(RP)是卫生和社会护理服务中的一个有争议的问题。虽然在某些情况下可能需要使用,围绕侵犯人权存在风险和担忧。国际上关于卫生和社会护理服务中使用的RP的类型和发生率的数据有限。这项研究的目的是描述爱尔兰残疾寄宿护理设施(RCF)的RP类型和使用发生率。从2019年11月至2020年10月报告的残疾RCF的RP通知是从爱尔兰社会护理法定通知数据库中提取的。计算了RPs类别和类型的国家使用频率和发生率。报告使用RP的残疾RCF的数量和百分比,连同年平均使用率,也计算了。在12个月期间,从1387个残疾RCFs(9487张病床)中通知了总共48,877次使用RPs。全国每1000张床使用RP的发生率如下:所有类别:5152.0,环境:2988.2,物理:1403.0,其他:527.0和化学:233.8。每个类别最常用的RP如下:环境:门锁,物理:其他物理,其他:自由和自主和化学:抗焦虑药。大多数RCF(81.7%)报告至少使用过一次RP。这些RCFs中每1000个床的任何RPs的中位发生率为4.75(IQR:2.00至51.66)。RP的使用率普遍较低,尽管一些RCF报告的使用率相对较高。在全国范围内,平均而言,每个居民在12个月内应用了5个RP;环境贡献超过一半。这些发现可以用来为政策提供信息,衡量减少RP使用和跨辖区比较的进展。
    Restrictive practices (RPs) are a contentious issue in health and social care services. While use may be warranted in some instances, there are risks and concerns around human rights infringements. There are limited data available on the types and incidences of RPs used in health and social care services internationally. The objective of this study is to describe the type of RPs and incidence of use in disability residential care facilities (RCFs) in Ireland. RP notifications from disability RCFs reported from November 2019 to October 2020 were extracted from the Database of Statutory Notifications from Social Care in Ireland. National frequency and incidence of use of categories and type of RPs were calculated. The number and percentage of disability RCFs reporting RP use, along with the mean annual incidence of use, were also calculated. A total of 48,877 uses of RPs were notified from 1387 disability RCFs (9487 beds) during the 12-month period. The national incidence of RPs use per 1000 beds was as follows: all categories: 5152.0, environmental: 2988.2, physical: 1403.0, other: 527.0 and chemical: 233.8. The most frequently used RPs for each category was as follows: environmental: door locks, physical: other physical, other: liberty and autonomy and chemical: anxiolytics. Most RCFs (81.7%) reported at least one RPs use. The median incidence of any RPs per 1000 beds in these RCFs was 4.75 (IQR: 2.00 to 51.66). Usage of RPs was generally low, although some RCFs reported relatively high usage. Nationally, on average, five RPs were applied per resident over 12 months; environmental contributing to more than half. These findings can be used to inform policy, measure progress in reducing RPs use and for cross-jurisdiction comparisons.
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  • 文章类型: Journal Article
    对居住在住宅护理设施(RCF)中的老年人的护理应促进尊严和福祉,但是研究表明,这些设施缺乏这些方面。促进尊严和福祉,重要的是要了解要针对哪些相关因素。这项研究的目的是研究感知的尊严和福祉之间的关联以及与员工态度有关的因素,居住在RCF中的老年人的护理环境和个人问题。在瑞典290个城市的所有RCF中对老年人进行了国家回顾性横断面研究。2018年居住在RCF的所有65岁及以上的老年人(n=71,696)都应邀参加了调查。反应率为49%。调查包括以下领域:自评健康、室内-室外-用餐时间环境,护理表现,员工的态度,安全,社会活动,工作人员和护理的可用性。数据得到了来自两个国家数据库的关于年龄的补充数据,性和诊断痴呆症。描述性统计和序数逻辑回归模型用于分析数据。经历过不尊重待遇的受访者,那些没有在室内外用餐环境中茁壮成长的人,那些认为自己的健康状况较差的人和痴呆症患者对尊严和幸福不满意的可能性更高。促进尊严和福祉,有必要改善工作人员尊重态度的先决条件,并改善护理环境。以人为本的实践框架可以作为改进的理论框架,因为它针对员工的先决条件和护理环境。由于尊严和福祉是全世界老年人护理的核心价值,这项研究的结果可以推广到瑞典以外国家的其他老年人护理机构。
    The care of older people living in residential care facilities (RCFs) should promote dignity and well-being, but research shows that these aspects are lacking in such facilities. To promote dignity and well-being, it is important to understand which associated factors to target. The aim of this study was to examine the associations between perceived dignity and well-being and factors related to the attitudes of staff, the care environment and individual issues among older people living in RCFs. A national retrospective cross-sectional study was conducted in all RCFs for older people within 290 municipalities in Sweden. All older people 65 years and older (n = 71,696) living in RCFs in 2018 were invited to respond to the survey. The response rate was 49%. The survey included the following areas: self-rated health, indoor-outdoor-mealtime environment, performance of care, attitudes of staff, safety, social activities, availability of staff and care in its entirety. Data were supplemented with additional data from two national databases regarding age, sex and diagnosed dementia. Descriptive statistics and ordinal logistic regression models were used to analyse the data. Respondents who had experienced disrespectful treatment, those who did not thrive in the indoor-outdoor-mealtime environment, those who rated their health as poor and those with dementia had higher odds of being dissatisfied with dignity and well-being. To promote dignity and well-being, there is a need to improve the prerequisites of staff regarding respectful attitudes and to improve the care environment. The person-centred practice framework can be used as a theoretical framework for improvements, as it targets the prerequisites of staff and the care environment. As dignity and well-being are central values in the care of older people worldwide, the results of this study can be generalised to other care settings for older people in countries outside of Sweden.
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  • 文章类型: Journal Article
    目标:为增加老年住宅护理机构居民(ORCFR)体力活动的策略提供信息,这项研究探索了自我认同的动机,参与体育活动的好处和障碍。
    方法:这项研究是在一个生色健康模型中进行的,将健康视为一个人的健康资源和生活压力源形成的连续体。这项探索性的定性研究检查了布里斯班七个ORCFR的体育锻炼经历,澳大利亚。开放式问题的半结构化访谈评估了基本的人口统计学,体力活动(PA)水平,PA的感知益处和障碍。所得数据经过专题分析。
    结果:经过七次访谈,数据达到饱和,揭示了三个主要主题和七个子主题。这些是积极的社会化(包容),具有享受社交联系和避免“僵尸”(孤独)的子主题。消极的社会化(孤立),其主题是避免冲突和感到尴尬。保持独立是好处,围绕社交的子主题,日常生活和保持健康的社交活动。
    结论:强调医疗和临床益处的常规体力活动计划与ORCFR动机脱节,因为居民认为流动性和社会化方面的好处。这种脱节部分解释了过去25年中ORCFR身体活动干预措施的可接受性和吸收不良。
    OBJECTIVE: To inform strategies to increase physical activity amongst Older Residential Care Facility Residents (ORCFR), this research explored self-identified motivators for, benefits of and barriers to physical activity engagement.
    METHODS: The research was framed within a salutogenic model of health, viewing health as a continuum shaped by one\'s health resources and life stressors. This exploratory qualitative research examined the physical activity experiences of seven ORCFR in Brisbane, Australia. Semi-structured interviews with open-ended questions assessed basic demographics, Physical Activity (PA) levels, perceived benefits of and barriers to PA. The resulting data underwent thematic analysis.
    RESULTS: After seven interviews, data saturation was reached, revealing three major themes and seven subthemes. These were positive socialisation (inclusion) with subthemes of enjoying social contact and avoiding \"zombieland\" (loneliness). Negative socialisation (isolation) with subthemes of avoiding conflict and feeling awkward. Maintaining independence was the benefit, with subthemes of getting around to socialise, activities of daily living and preserving health to socialise.
    CONCLUSIONS: Conventional physical activity programs emphasising medical and clinical benefits are disconnected from ORCFR motivators, as residents perceive benefits in terms of mobility and socialisation. This disconnect partially explains poor acceptability and uptake of ORCFR physical activity interventions over the last 25 years.
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  • 文章类型: Journal Article
    世界各地都发生了对精神病患者的强迫约束和监禁,包括印度尼西亚。自2010年以来,当GerakanBebasPasung(GBP)或印度尼西亚摆脱精神病患者的强迫限制(Pasung)运动启动时,已经发布了国家政策,通过改善精神保健系统来根除印度尼西亚的Pasung。本文分析了这一政策,特别是《国家精神卫生立法》(2014年)和《卫生部应对精神疾病患者强制限制条例》(2017年),并通过本地评估其当前实施状态,深入的案例研究。使用精神卫生机构地图,两组对政府官员和医护人员的半结构化定性访谈,在练习Pasung的设施中进行参与者观察,我们确定了2017年法规在Winong村实施的程度,并讨论了消除Pasung的当前努力和持续障碍。我们建议,尽管在我们的案例研究中进行了改革和新的治疗设施,继续使用Pasung是由于获得护理问题和广泛持有的精神疾病解释模型的组合,其特征是强烈的治疗信念,失望的时候,导致威胁感和绝望感。
    Forcible restraint and confinement of persons suffering from mental illness occurs throughout the world, including in Indonesia. Since 2010, when Gerakan Bebas Pasung (GBP) or the Indonesian Freedom from Forcible Restraint (Pasung) of Mentally Ill Persons movement was launched, national policy has been published to eradicate Pasung in Indonesia by improving the mental healthcare system. This article analyses this policy, specifically the National Mental Health Legislation (2014) and the Ministry of Health Regulation Tackling Forcible Restraint of People with Mental Illness (2017), and evaluates their current state of implementation through a local, in-depth case study. Using mental health institution mapping, two sets of semi-structured qualitative interviews with government officials and healthcare workers, and participant observation in a facility practicing Pasung, we identify the extent to which the 2017 regulation has been implemented in Winong village and discuss current efforts and persistent obstacles to eradicating Pasung. We suggest that despite reforms and the new treatment facility in our case study, the continuing use of Pasung is due to a combination of access to care issues and a widely held explanatory model of mental illness characterized by strong curative beliefs that, when disappointed, lead to a sense of threat and hopelessness.
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  • 文章类型: Journal Article
    (1)目的:在现代社会,使用智能设备的基于增强现实(AR)的训练已经成为解决训练问题的一种手段。因此,这项可行性研究旨在确定刷牙训练的效果,基于AR使用智能牙刷,关于韩国智障人士的口腔卫生护理。(2)方法:30名智力残疾的人,住在一个住宅护理机构,被选中。基于AR的刷牙训练,使用智能牙刷,应用于实验组(n=15),对照组(n=15)采用视觉材料进行训练。作为口腔卫生护理的评估,测量了刷牙性能和口腔卫生的变化。(3)结果:两组训练后的所有结果均存在显着差异。(4)结论:在本可行性研究的受试者中,使用智能牙刷基于AR的刷牙训练比使用视觉材料进行口腔卫生护理的训练更有效。因此,使用智能牙刷的基于AR的培训可以应用于居住在住宅护理设施中的智障人士,作为刷牙培训的个人工具。
    (1) Purpose: In modern society, augmented reality (AR)-based training using a smart device has emerged as a means of resolving problems with training. Thus, this feasibility study aimed to identify the effects of tooth-brushing training, based on AR using a smart toothbrush, on oral hygiene care among people with an intellectual disability in Korea. (2) Methods: Thirty people with an intellectual disability, residing in a residential care facility, were selected. Tooth-brushing training based on AR, using a smart toothbrush, was applied in the experimental group (n = 15), and training using visual material was applied in the control group (n = 15). As an assessment of oral hygiene care, the changes in tooth-brushing performance and oral hygiene were measured. (3) Results: There were significant differences in all results after training between the two groups. (4) Conclusions: Tooth-brushing training based on AR using a smart toothbrush is more effective than training using visual material on oral hygiene care among the subjects of this feasibility study. Thus, training based on AR using a smart toothbrush could be applied to people with intellectual disabilities residing in residential care facilities as an individual tool for tooth-brushing training.
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  • 文章类型: Journal Article
    本文阐述了与养老院居民感染检测和管理相关的关键挑战,然后探索南非的情况,并使用决策支持工具作为改进这一实践领域的机制。根据全球趋势,人们对南非迅速老龄化的人口以及当前医疗保健系统跟上患者需求的能力提出了担忧,尤其是养老院的居民。疗养院居民,经常表现出非典型的体征和症状,感染和计划外入院的风险增加,占所有卧床天数的65%,每年给美国医疗保健经济带来超过一万亿美元的损失。有证据表明,南非目前的劳动力在这一领域接受的培训有限,并且在很大程度上没有准备好满足人口老龄化的需求。建设南非劳动力的能力和技能是一种方法,可以帮助改善感染的早期发现,并协助疗养院劳动力提供更有效和及时的护理,特别是在当前的COVID-19大流行期间。决策支持工具,如早期检测感染量表,可以帮助确保一致性并确保更及时的治疗,最大限度地减少计划外招生和医疗支出。然而,潜在的好处,或者实际上如何容易地将其整合到南非的疗养院中,目前尚不清楚。重要的第一步,就像在世界其他地方一样,因此,探索护士在实践中如何检测和管理感染的观点和意见,养老院的护理人员和管理人员。
    This paper sets out key challenges related to detection and management of infection in nursing home residents, and then explores the situation in South Africa, and use of decision support tools as a mechanism to improve this area of practice. In line with global trends, concerns have been raised about the rapidly increasing aging population in South Africa and the ability of the current healthcare system to keep pace with patient demand, particularly nursing home residents. Nursing home residents, who often exhibit atypical signs and symptoms, are at increased risk of infection and unplanned admissions, which account for 65% of all bed days, and cost the US healthcare economy more than a trillion dollars a year. Evidence suggests that the current workforce in South Africa receive limited training in this area and are largely unprepared to meet the demands of the aging population. Building the capacity and skills of the workforce in South Africa is one approach that could help to improve the early detection of infection and assist the nursing home workforce to provide more effective and timely care, particularly during the current COVID-19 pandemic. Decision support tools, such as the Early Detection of Infection Scale, can help ensure consistency and ensure more timely treatment, minimising unplanned admissions and healthcare expenditure. However, the potential benefits or indeed how easily this could be integrated in to nursing homes in South Africa is unknown. An important first step, as in other parts of the world, is therefore to explore views and opinions of how infections are detected and managed in practice by nurses, care workers and managers in nursing homes.
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