This study explores explanations for Chinese elders’ willingness or lack of willingness to use institutional care. The data is drawn from a survey over intergenerational relationships and age models conducted in Zhenjiang, China, in 2007. Only the responses of interviewees aged 55 and above (310 males and 318 females) were used in this study. Using zero-order correlation and multi-nominal regression analyses, this study examined the factors associated with Chinese elders’ willingness to use institutional care. Study results reveal that Chinese elders’ confidence in availability of familial care was negatively related to their willingness to use institutional care; elders’ knowledge about and impression on elder care homes were positively associated with their willingness. Male interviewees expressed lower levels of willingness compared to female respondents. This study shows that increased knowledge about elder care institution may increase Chinese elders’ willingness to accept institutional elder care.

Thesis advisor: Jacqueline V. Lerner / The current study examines the development of social skills in delinquent adolescents in the context of the care they receive in a residential treatment facility (RTF). Reviews of prevention and intervention programs for delinquency have provided support for parent training and child social skills training as the most promising approaches to treatment. However, for adolescents in an RTF, their primary parental figures have become the care workers with whom they are placed. Based on their caregiving behaviors, these workers could provide an environment that counteracts or exacerbates the effects of the residents' prior experiences. Therefore, three major factors that may influence the social skills outcomes of adjudicated youth will be examined: (1) the prior effect of family life, (2) the current effect of youth workers, and (3) the possible interaction between (1) and (2). Using a sample of 82 delinquent adolescents (aged 13-18 years old at entry) and 41 of their caregivers from a RTF, OLS regression models indicate that several factors at the individual level and in the treatment milieu are important to consider when addressing social skills development for delinquent youth. At the individual level, adolescents identified as early-onset delinquents entered treatment with lower social skills, but also experienced the greatest improvement in these skills while in treatment. In addition, older youth and youth from larger households entered treatment with higher levels of initial social skills on average. When considering the behaviors of care workers, two caregiving measures were surprisingly associated with positive social skills growth - caregiver psychological control and attributions of internality and controllability. The unexpected relationships between caregiving and positive development are discussed with an emphasis on the unique characteristics and context of the present sample. / Thesis (PhD) — Boston College, 2009. / Submitted to: Boston College. Lynch School of Education. / Discipline: Counseling, Developmental, and Educational Psychology.

Este estudo organiza-se como pesquisa bibliográfica no campo da literatura psicanalítica, vetorizada pela experiência clínico-institucional da autora e pela pergunta formulada: o que se pode pensar, a partir da psicanálise, sobre as condições de constituição e preservação do espaço onírico comum e compartilhado da equipe em instituições de cuidado? Parte da hipótese de que a equipe tem entre suas funções a de metabolizar a experiência de seu espaço intersubjetivo para restaurar a capacidade de sonhar daqueles que a compõem e daqueles a quem se endereça sua tarefa, e assim os tratar. Objetiva assim contribuir para identificar e discutir operadores clínico-teóricos da psicanálise pertinentes ao cuidado e trabalho das equipes dessas instituições. Para tanto, passando pela discussão sobre a intersubjetividade na psicanálise e o papel do outro nos processos de constituição do psiquismo e de subjetivação, recorre a conceitos da metapsicologia dos conjuntos intersubjetivos, de René Kaës, a compreensões do sonhar apoiadas nas teorias de Bion e Winnicott e ao pensamento contemporâneo sobre clínica psicanalítica de grupos e instituições (desenvolvido por autores ligados à Université Lyon-2, como Gaillard, Pinel, Vidal). Sugere que as condições para que a equipe opere como um aparelho de sonhar a clínica institucional relacionam-se àquelas que possibilitam a experiência e o espaço transicional (Winnicott) / This study is organized as a bibliographic research of psychoanalytical literature which dialogues with the authors clinical experience on institutions and with the question: based on psychoanalysis, what can be thought about the constitution and preservation of the shared onyric space of professional teams in care institutions? It assumes that, among its functions, the professional team has to metabolize its intersubjective space experience, in order to restore the dreaming capacity of those who compose it and of those to whom its task is addressed and, finally, treat them. It aims to contribute to identify and discuss some psychoanalytic clinical-theoretical operators which are adequate for the care and the work of professional teams in socio-assistance and care institutions. Thus, through some discussion of the intersubjectivity in Psychoanalysis and of the role of the other in the processes of the constitution of the psychic and subjectivation, it uses concepts from the metapsychology of shared psychic spaces (Kaës), from Bions and Winnicotts comprehension of the dream, and from contemporary production about the psychoanalytic clinic of groups and institutions (developed mainly by authors related to Université Lyon- 2, as Gaillard, Pinel and Vidal). It suggests that the conditions for the group to operate as an apparatus for dreaming the institutional clinic relate to those that enable transicional experience and space (Winnicott)

Este trabalho teve por objetivo investigar e discutir as imagens sociais atribuídas às instituições de acolhimento e aos jovens institucionalizados, a partir de dois estudos empíricos exploratórios. O estudo I investigou as imagens sociais atribuídas às instituições de acolhimento. Participaram da pesquisa 202 adultos selecionados por conveniência, com idades entre 16 e 69 anos (M=32,76, DP=11,67), sendo a maioria do sexo feminino (79,2%), solteiro (51%), com ensino médio (48%) ou curso superior (37,6%). Os participantes responderam a um questionário aberto utilizando até cinco palavras para descrever uma instituição de acolhimento. O estudo II investigou as imagens sociais atribuídas aos jovens em acolhimento institucional. Participaram 224 adultos selecionados por conveniência, com idades entre 18 e 71 anos (M=33,97, DP=11,42), sendo que 68,4% já tiveram contato com adolescentes em situação de vulnerabilidade e risco. Foi utilizado um questionário fechado, com 37 palavras para descrever os jovens típicos e em acolhimento, com itens em escala Likert. Os resultados do primeiro estudo indicam que as imagens sociais sobre as instituições de acolhimento, em geral, são positivas e que predominam as percepções relacionadas ao acolhimento/proteção e à organização. Os resultados do segundo estudo apontam que as palavras consideradas negativas foram significativamente mais associadas aos jovens em acolhimento institucional, indicando haver uma imagem social negativa desta população. Embora as mudanças legais e políticas referentes à proteção infantojuvenil venham contribuindo para a qualificação dos serviços de acolhimento, permanecem os estigmas que classificam os jovens inseridos nesse contexto. É importante que se faça uma reflexão social coletiva sobre essa realidade a fim de que se encontrem estratégias de modificação do imaginário social que ainda rotula e discrimina essa população. / This study aimed to investigate and discuss the social images associated to the residential care institutions and the young people in care through two exploratory empirical studies. The first study investigated the social images assigned to the residential care institutions. The participants were 202 adults selected by convenience, aged 16 to 69 years old (M=32.76, SD=11.67), mostly female (79.2%), single (51%), with high school (48%) or higher education (37.6%). The participants answered an open questionnaire using up to five words to describe a residential care institution. The second study investigated the social images assigned to young people in care. The participants were 224 adults selected by convenience, aged 18 to 71 years old (M=33.97, SD=11.42), 68.4% of them have already had contact with teenagers in vulnerability and risk situations. The instrument was a Likert scale questionnaire with 37 words used to describe young people in general and in care. The results of the first study indicated that social images are generally positive, prevailing perceptions related to care/protection and organization. The results of the second study indicated that the negative words were significantly more associated with young people in care, indicating that there is a negative social image related to this population. Although legal and political changes concerning children and youth protection have been contributing to the qualification of residential care institutions, the stigmas that classify young people inserted in this context remain. It is important to make a collective social reflection about this reality in order to find strategies to modify the social imaginary that still labels and discriminates this population.

The diploma thesis is focused on the legal hospital health care regulation in the Czech Republic. The main efford is to provide a sufficient review of the up-to-date situation in this field. It examines hospitals by a theoretical standpoint and also its key problems concerning actual situation of the czech health care and lack of finance as the main significance. The top part of thesis focuses on actual legal hospital health care regulation and proposes ways of improvement. Following part assesses proposals of improvement of the hospital care quality. Final chapter presents possible ways of optimal solutions of hospital care as well as health care at all.

The aim of this study was to investigate fall risk and predisposing factors for fall among the residents in long-term care institutions. Methods. Elderly care homes residents 48 men (mean ± SD, 78,6±7,0) and 101 women (mean ± SD, 81,6±6,4), all 149 residents, participated in the study. For investigation a questionnaire was used, which was made according literature and including following instruments: Environmental Falls Audit Tool – Individual, Falls Risk Assessment Tool and Risk Factor Checklist, Mini Mental State Examination. Results. The most frequently diseases among men and women were heart and vascular (89,6 % and 92,1 %) and eyes diseases (70,8 % and 75,2 %). Ambulatory aid was needed for a half of all residents (54,4 %); ambulatory aid, which respondents didn’t want to used were three times common for women than men (p=0,007). Most residents had low fall risk (72,5 %), but high fall risk was more common in women (14,9 %) than men group (4,2 %); there were no significant difference between groups. High fall risk significantly dominated among the residents older than 85 year in comparison with 65-74 and 75-84 year age groups. Residents who had lower education (p<0,001), were older (p=0,005) and took more medications (p=0,002) had higher fall risk scores evaluated by Fall Risk Assessment Tool. Residents who had such risk factors as unsafe mobility, over-reaches transfer, forgot gait aids, observed behavioural agitation, disorientation had more medium-high fall risk... [to full text]

Este trabalho teve por objetivo investigar e discutir as imagens sociais atribuídas às instituições de acolhimento e aos jovens institucionalizados, a partir de dois estudos empíricos exploratórios. O estudo I investigou as imagens sociais atribuídas às instituições de acolhimento. Participaram da pesquisa 202 adultos selecionados por conveniência, com idades entre 16 e 69 anos (M=32,76, DP=11,67), sendo a maioria do sexo feminino (79,2%), solteiro (51%), com ensino médio (48%) ou curso superior (37,6%). Os participantes responderam a um questionário aberto utilizando até cinco palavras para descrever uma instituição de acolhimento. O estudo II investigou as imagens sociais atribuídas aos jovens em acolhimento institucional. Participaram 224 adultos selecionados por conveniência, com idades entre 18 e 71 anos (M=33,97, DP=11,42), sendo que 68,4% já tiveram contato com adolescentes em situação de vulnerabilidade e risco. Foi utilizado um questionário fechado, com 37 palavras para descrever os jovens típicos e em acolhimento, com itens em escala Likert. Os resultados do primeiro estudo indicam que as imagens sociais sobre as instituições de acolhimento, em geral, são positivas e que predominam as percepções relacionadas ao acolhimento/proteção e à organização. Os resultados do segundo estudo apontam que as palavras consideradas negativas foram significativamente mais associadas aos jovens em acolhimento institucional, indicando haver uma imagem social negativa desta população. Embora as mudanças legais e políticas referentes à proteção infantojuvenil venham contribuindo para a qualificação dos serviços de acolhimento, permanecem os estigmas que classificam os jovens inseridos nesse contexto. É importante que se faça uma reflexão social coletiva sobre essa realidade a fim de que se encontrem estratégias de modificação do imaginário social que ainda rotula e discrimina essa população. / This study aimed to investigate and discuss the social images associated to the residential care institutions and the young people in care through two exploratory empirical studies. The first study investigated the social images assigned to the residential care institutions. The participants were 202 adults selected by convenience, aged 16 to 69 years old (M=32.76, SD=11.67), mostly female (79.2%), single (51%), with high school (48%) or higher education (37.6%). The participants answered an open questionnaire using up to five words to describe a residential care institution. The second study investigated the social images assigned to young people in care. The participants were 224 adults selected by convenience, aged 18 to 71 years old (M=33.97, SD=11.42), 68.4% of them have already had contact with teenagers in vulnerability and risk situations. The instrument was a Likert scale questionnaire with 37 words used to describe young people in general and in care. The results of the first study indicated that social images are generally positive, prevailing perceptions related to care/protection and organization. The results of the second study indicated that the negative words were significantly more associated with young people in care, indicating that there is a negative social image related to this population. Although legal and political changes concerning children and youth protection have been contributing to the qualification of residential care institutions, the stigmas that classify young people inserted in this context remain. It is important to make a collective social reflection about this reality in order to find strategies to modify the social imaginary that still labels and discriminates this population.

Este trabalho teve por objetivo investigar e discutir as imagens sociais atribuídas às instituições de acolhimento e aos jovens institucionalizados, a partir de dois estudos empíricos exploratórios. O estudo I investigou as imagens sociais atribuídas às instituições de acolhimento. Participaram da pesquisa 202 adultos selecionados por conveniência, com idades entre 16 e 69 anos (M=32,76, DP=11,67), sendo a maioria do sexo feminino (79,2%), solteiro (51%), com ensino médio (48%) ou curso superior (37,6%). Os participantes responderam a um questionário aberto utilizando até cinco palavras para descrever uma instituição de acolhimento. O estudo II investigou as imagens sociais atribuídas aos jovens em acolhimento institucional. Participaram 224 adultos selecionados por conveniência, com idades entre 18 e 71 anos (M=33,97, DP=11,42), sendo que 68,4% já tiveram contato com adolescentes em situação de vulnerabilidade e risco. Foi utilizado um questionário fechado, com 37 palavras para descrever os jovens típicos e em acolhimento, com itens em escala Likert. Os resultados do primeiro estudo indicam que as imagens sociais sobre as instituições de acolhimento, em geral, são positivas e que predominam as percepções relacionadas ao acolhimento/proteção e à organização. Os resultados do segundo estudo apontam que as palavras consideradas negativas foram significativamente mais associadas aos jovens em acolhimento institucional, indicando haver uma imagem social negativa desta população. Embora as mudanças legais e políticas referentes à proteção infantojuvenil venham contribuindo para a qualificação dos serviços de acolhimento, permanecem os estigmas que classificam os jovens inseridos nesse contexto. É importante que se faça uma reflexão social coletiva sobre essa realidade a fim de que se encontrem estratégias de modificação do imaginário social que ainda rotula e discrimina essa população. / This study aimed to investigate and discuss the social images associated to the residential care institutions and the young people in care through two exploratory empirical studies. The first study investigated the social images assigned to the residential care institutions. The participants were 202 adults selected by convenience, aged 16 to 69 years old (M=32.76, SD=11.67), mostly female (79.2%), single (51%), with high school (48%) or higher education (37.6%). The participants answered an open questionnaire using up to five words to describe a residential care institution. The second study investigated the social images assigned to young people in care. The participants were 224 adults selected by convenience, aged 18 to 71 years old (M=33.97, SD=11.42), 68.4% of them have already had contact with teenagers in vulnerability and risk situations. The instrument was a Likert scale questionnaire with 37 words used to describe young people in general and in care. The results of the first study indicated that social images are generally positive, prevailing perceptions related to care/protection and organization. The results of the second study indicated that the negative words were significantly more associated with young people in care, indicating that there is a negative social image related to this population. Although legal and political changes concerning children and youth protection have been contributing to the qualification of residential care institutions, the stigmas that classify young people inserted in this context remain. It is important to make a collective social reflection about this reality in order to find strategies to modify the social imaginary that still labels and discriminates this population.

No description available.

Magistro baigiamajame darbe išanalizuoti LR egzistuojančių viešų ir privačių sveikatos priežiūros įstaigų veiklos skirtumai bei jų sąveiką. Ištirti tokie viešųjų ir privačių sveikatos priežiūros sektorių aspektai: sveikatos priežiūros sektoriai patys savaime, šių įstaigų institucinis išsidėstymas, teisinis reglamentavimas, finansavimas, konkurencingumas, prieinamumas pacientui. Pirmojoje darbo dalyje yra aptarta Lietuvos nacionalinės sveikatos sistema, kaip turinti vienyti viešąsias ir privačiąsias sveikatos priežiūros įstaigas, aptarta jos bendroji charakteristika. Antrojoje dalyje išsamiai išnagrinėtos, suklasifikuotos sveikatos priežiūros įstaigos, aptarta jų priklausomybė viena nuo kitos. Trečiojoje darbo dalyje kaip atskiros grupės išskirtos privačios ir viešosios sveikatos priežiūros: aptarta jų sąveika, pagrindiniai skirtumai, pamatiniai teisinio reglamentavimo ypatumai. Paskutinė ketvirta lyginamoji darbo dalis leido surasti tuos taškus, per kuriuos viešasis sveikatos priežiūros sektorius galėtų bendradarbiauti su privačiu. Palyginta šių sektorių finansavimo bazė, surasta papildoma alternatyva papildomojo sveikatos draudimo pavidalu. Kadangi sveiktos priežiūros sektoriuje centrinė figūra vis tik turi būti pacientas, pateiktas ir jo požiūris į privatų ir viešąjį sveikatos priežiūros sektorius, šių sektorių vertinimas. / The distinction and interface of health care institutions of Lithuania Republic are analyzed in this final master’s work Such public ant private health care institutions aspects are analyzed: health care institutions by themselves, deployment of these institutions, their legal regulation, sponsorship, competitive ability, accessibility for the patients. The first part of the work is concerned about national health care system of Lithuania, which must unify public and private health care institutions. The common characteristics of this system are discussed. The second part thoroughly reveals and classifies health care institutions; knock about their dependence on each other. In the third part as separate groups are divided private and public health care institutions: their interaction, main differences and basic legal regulation principles are discussed. The last fourth comparative part enabled to find those points, which could help for private health care sector to collaborate with public one. The comparison of financial basis of those sectors, allowed to found an additional assurance alternative. Since the patient is the central figure in a health care sector, his attitude towards the private and public health care institutions, and those sectors valuation is represented.