According to the statistics from Department of Health, Executive Yuan, in 2007,brain attack has been listed as the third of the top ten reasons for death. In Taiwan, the occurrence rate of brain attack on population above 35-year-old is 3/1000. And the total amount of population above 35-year-old is nearly 10,000,000. Then the latest number of occurrence of brain attack is approximately 30,000¡COnce the stroke happens, under such a circumstance, not only the expense of acute care increases but also the long-term medical care expense, the family and social cost will become larger. In view of that, the long-term care plan for stroke patient has been in urgent need. This research, ¡¨Long-distance Community Health Care Nursing Service for Stroke Patients¡¨, which is originated from a plan conducted by a medical center in Southern Taiwan. Based on Andersen¡¦s¡]1968¡^health behavior model as the theoretical structure¡Awe studied 102 patients who had a stroke (including high stroke risk patients)within one year in Kaohsiung. In this study, we applied JMP V6.0¡]SAS Institute, Cary, NC, USA¡^to analyzing case characters¡Aconducting univariate analysis by £q2 analysis and ANOVA. Then we applied multivariate logistic regression analyses to significant variables. We hope to find out the predisposition, enabling factors and need factor from those important predictor variables in ¡§Long-distance Community Health Care and Nursing Service¡¨. We research the differences of stroke patients¡¦ behaviors, providing those research results as the reference materials for related business promotional strategy in future, hoping to advance the quality of long-term care and nursing for stroke patients. In this study, total 102 copies of the questionnaire were sent out and returned, with a return rate of 100%, and 100 copies of questionnaire were effective. The research results show that: 1. Predisposition¡GThere are significant differences on these items--¡§Number of Children¡¨(Demography), ¡§Buddhist¡¨(Religion) and ¡§Those who have a health check within nearly one year¡¨(Health Concept). 2.Enabling factors¡GThere are significant differences on these items--¡¨Monthly Family Income¡¨(Economical factor),¡¨Monthly Balance of Payment¡¨(Economical factor) and ¡§Commercial Insurance¡¨(Insurance resource). 3.Need factors¡GPeople (those who think their health state stay at the average level), Health State (¡§High Blood Pressure and Heart Attack¡¨,¡¨Eye Diseases¡¨, ¡¨Cancer¡¨,¡¨Bone and Muscle¡¨,¡¨Asthma¡¨,¡¨Ears Disease¡¨and ¡¨Neural Diseases¡¨are involved. The behavior research includes ¡§Number of Accepting Medical Treatment per month¡¨(1 to 2 times), ¡§Activity in Daily Life ¡¨¡]ADL¡BIADL-Shopping Ability¡^and ¡§Functional Behaviors¡¨. 4. To sum up, the predisposition, enabling and need factors in this research could partially influence using behaviors¡Ain accordance with Andersen¡¦s inference in health behavior model. In conclusion¡G1.¡¨Long-term Community Health Care and Nursing¡¨ can be applied to stroke patients, which can help patients to build up effective self-management and advance life quality; 2. This service combines Medical Service Chain established by Information-Telegraphic Technology. Currently, blood pressure checking and telephone consultation are most popular service among interviewees, and other kinds of service are under development; 3. Stroke patients with different demographical characters show a great difference on using behaviors; 4. To speak briefly, this service can meet the ideal long-term care and nursing standard for local aging population.

This two-part study evaluates a government sponsored Long Term Care Aide/ESL Program taken by a group of immigrant women. The purpose of the first part of the study was to assess how effective a B.C. government sponsored Long Term Care Aide/ESL program was in preparing a group of immigrant women for the workplace. A questionnaire was used to determine demographics and employment status. Also, it obtained perceptions on the strengths and weaknesses of the program. The purpose of the second part of this study was to hear the women's personal insights and voices about their experiences while taking the program and after the program. Semi-structured interviews were used to obtain these stories. Results from the quantitative questionnaire indicated that 94% of the immigrant women who had taken this course were employed as care aides. Three years after the completion this program, the women felt that the course had provided them with both a vocational skill and more English language skills. Results from the qualitative portion of this paper focused on how the women felt about their experiences in this Long Term Care Aide/ESL program in their own words. The data were analyzed and put into themes. Theme 1 was "The pain of renewal". It presented their collective stories of being an immigrant and struggling to begin again. Theme 2 was "The costs and the benefits". This theme presented the women's insights on working as care aides. Most of the women liked their jobs but found trying to secure a full time job difficult. Theme 3 was "The need to learn the language of care". All the women interviewed wanted to have more "caring" language, the "everyday" language to relate to their clients. Theme 4 was "Advice to other immigrant women". This theme revealed how some women felt about the work they did. The last theme, Theme 5, was "Hopes and dreams". Half of the women interviewed had aspirations to continue their education and these women were already enrolled in other health care courses. The results of the study are discussed and implications are drawn for research and pedagogy.

Darbo tikslas - įvertinti Kauno Raudonojo Kryžiaus slaugos ir palaikomojo gydymo ligoninės darbo organizavimo ypatumus ir jo gerinimo galimybes. Tyrimo metodika. Kauno Raudonojo Kryžiaus slaugos ir palaikomojo gydymo ligoninės 2005-2007 metų veiklos statistinių rodiklių analizė, anketinė pacientų (n = 102) ir personalo (n = 82) apklausa, bei jų vertinimų palyginimas. Duomenų analizė atlikta naudojant statistinę programą SPSS for Windows 12,0. Rezultatai. Palaikomojo gydymo ir slaugos ligoninių poreikis auga: 2007 metais Raudonojo Kryžiaus slaugos ir palaikomojo gydymo ligoninėje gydyta 18 proc. pacientų daugiau nei 2005 metais. Ligoninėje slaugomų ligonių daugumą sudaro asmenys sergantys širdies ir smegenų kraujotakos sutrikimais (70 proc.), po traumų (11 proc.) ir sergantys onkologiniais susirgimais (8 proc.). Lovos funkcionavimo rodiklis ir vidutinė ligonio gulėjimo ligoninėje trukmė aukšti (364,9 ir 74,9 dienos), lyginant su kitomis Lietuvos slaugos ligoninėmis (atitinkamai 345,2 ir 51,7), galimai dėl nemažo skaičiaus savivaldybės finansuojamų ligonių, laukiančių eilėje į globos įstaigas (2007 m. 1,2 proc. gydytų ligonių pateko į globos namus, 2008 m.sausio 1 d. - 34 laukiantys eilėje). Patekti į ligoninę galima greitai – 70 proc. pacientų pateko iš karto arba laukė eilėje iki 7 d. Didelė problema ligoninėje yra slaugos personalo kaita: per tris metus įsidarbino 82, o atleista 57 slaugytojų padėjėjos, priimta 11 ir atleista 8 bendrosios praktikos slaugytojos. Tiriant... [toliau žr. visą tekstą] / Aim of the study – to evaluate the management and potential for improvement at Kaunas Red Cross long-term care hospital. Material and methods. The study included analysis of statistical performance indicators at hospital setting during 2005–2007, the questionnaires for patients (n = 102) and staff (n = 82). Data analysis was conducted using statistical package „SPSS for Windows 12.0“. Results. The demand of long-term care institutions is increasing: in 2007 the number of patients was increased by more then 18% compare to 2005. The majority of patients had cardiovascular disorders (70%), post-traumatic conditions (11%), or cancer (8%). The bed occupancy and average length of stay were relatively high (364.9 and 74.9 days, respectively), compared to other hospital care settings in Lithuania (345.2 and 51.7, respectively), probably due to high number of patients waiting for municipality-financed nursing homes (in 2007 only 1.2% of patients got to nursing home, while on 1st January 2008 the waiting list contained 34 persons). On the other hand, the acceptance to long-term care is quite fast – 70% of patients were hospitalized immediately or were on the waiting list up to 7 days. However, a significant issue is the changing of staff: during 3 years, 82 nurse assistants were employed and 57 dismissed, while general practice nurses 11 and 8, respectively. Analysis of quality of care revealed, that lowest scores were for hospital signalization system (average scores 3.0 by staff and... [to full text]

The purpose of this study was to explore the effect an intervention, based on responses from a Life Strengths Interview questionnaire (LSI), has on the quality of life of elderly persons receiving private pay home care. A total of 12 subjects for this study were recruited from Cardinal Health Systems (CHS) Home Care service. This research employed a basic pretest posttest quasiexperimental design, with one experimental group and one control group. Subject selection was not randomized; however, subjects were randomly assigned to either the experimental or control group. Subjects in the experimental group completed the LSI pre-test and subjects in both groups completed the Quality of Life Index (QLI) pre-test and post-test, as well as a posttest care questionnaire. Data from eight subjects were coded and entered into a database; however, due to the small sample size, statistical analysis of responses from the QLI could not be performed. The primary thematic issues identified through qualitative data analysis indicate that home health aide services positively contribute to client quality of life, and that private-pay clients of CHS Homecare are currently satisfied with their quality of care. Qualitative results gathered by this study support future research efforts to explore the relationship between home care services and client quality of life. More specifically, this study can serve as a pilot for researchers interested in exploring the effects of a LSI intervention on clients receiving home care. / Fisher Institute for Wellness and Gerontology

Objective: determine whether accreditation through Accreditation Canada is associated with more favorable resident safety in Ontario LTC homes and which facility characteristics are predictive of accreditation. Methods: logistic regression was used to determine predictors of accreditation. To examine the association between accreditation and safety, safety was operationalized as five MDS-RAI quality indicators: prevalence of falls, restraints, catheters, pressure ulcers, and infections. Separate multivariable models were developed for each indicator. Results: the odds of accreditation were approximately six times smaller for municipal (p < 0.001) and non-profit facilities (p < 0.001) relative to for-profits; three times greater for chains relative to non-chains (p < 0.001); and twice as large for urban relative to rural facilities (p = 0.04). Of the five quality indicators examined, only one (falls) was associated with accreditation. After adjusting for confounders, accredited homes were estimated to have 8% lower fall rates than non-accredited homes (p = 0.01).

With the aging of our population and the higher risk of chronic illness and disability with age, more and more family members may be faced with the experience of having a relative transition into a long-term care (LTC) home. This reality necessitates greater understanding of family care partner needs to ensure wellness throughout their caring career. Using participatory action research, notions of wellness were explored for family partners in care with relatives residing in LTC homes. Using two LTC homes from a privately owned company called Specialty Care, ten family members were interviewed, followed by one focus group at each of the two LTC homes. Three major themes were revealed, each with several sub themes: (1) understanding wellness amidst challenges to keep a sense of wellness in life; (2) self-appraisal: becoming aware of personal beliefs and perceptions that influence wellness; and (3) assessing LTC homes and their influence on the experience of wellness. We not only revealed more about wellness and how it is experienced in the caring context, we also discovered leisure’s role in maintaining wellness and how embedded leisure’s influence is on the various aspects of wellness that family partners in care experience. Relationship-centred care is a framework we used to guide this study. It highlights the importance of family member needs, along with the needs of the residents and staff. With our enhanced understanding of family care partner needs, recommendations were made to the Specialty Care communities so they can work together to ensure optimal wellness is maintained for all parties, including family partners in care.

There is some evidence about the efficacy of preferred music on agitation in elders with dementia; however, little is known about its effectiveness on agitation when implemented by nursing staff in long-term care facilities. Even less is known about use of preferred music for managing anxiety in those with dementia. This quasi-experimental study aimed to evaluate the implementation of a preferred music intervention delivered by nursing staff on agitation and anxiety of institutionalised elders with dementia. The sample comprised of 57 elders with dementia residing in two building complexes which provided similar care routines and staffing in a large Taiwanese residential care facility. These two building complexes were randomly assigned as the experimental and control group. Nursing staff in the experimental group received a facilitation program to prepare them for implementing the preferred music intervention; whereas nursing staff in the control group received no facilitation program. The music intervention based on each resident's music preferences was then provided by the trained nursing staff for 32 experimental residents twice a week for six weeks. Meanwhile, 25 residents in the control group only received the usual standard care without music. All residents were assessed by Cohen-Mansfield Agitation Inventory (CMAI) for overall and three subtypes of agitated behaviours and by Rating of Anxiety in Dementia for anxiety at baseline and week 6. Additionally, the modified CMAI measured the 30-minute occurrence of agitation at baseline, session 4, and session 12. The results indicate that institutionalised elders with dementia who received six weeks of preferred music intervention implemented by trained nursing staff had significant reductions on overall, three subtypes of agitated behaviours, anxiety, and 30-minute occurrence of agitation over time compared to those who received the usual standard care without music. Preferred music shows promise as a strategy for reducing agitation and anxiety in those with dementia when implemented by trained nursing staff. Such intervention can be incorporated into routine activities to improve the quality of care provided by nursing staff and the quality of life of those with dementia in long-term care settings. Our study results provide clinically relevant evidence which contribute to closing the gap between research and practice.

Thesis (M.A.)--Carleton University, 2008. / Includes bibliographical references (p. 118-130). Also available in electronic format on the Internet.

Thesis (M.G.S.)--Miami University, Dept. of Sociology and Gerontology, 2008. / Title from first page of PDF document. Includes bibliographical references (p.66-68).

Thesis (M.S.)--University of Michigan, 1996.