Resident-centered care has been the standard philosophy in accredited personal care homes (PCHs) across Canada since 1990. Health care aides (HCAs) are the primary health care providers in PCHs and key to residents' quality of care and quality of life. However, studies have not examined HCA work satisfaction in relation to the four elements of resident-centered care: providing flexible scheduling, following residents' preferences, promoting a home-like environment and offering permanent assignment to promote consistency of care. This cross-sectional, ethnographic study was conducted using face-to-face interviews with nine HCAs working in four PCHs in Winnipeg, Manitoba, Canada. The results indicate that HCAs' work satisfaction was highly related to their caring relationships with residents and their working relationships with other HCAs and staff. The implementation of resident-centered care depended on institutional and managerial support. Lack of this support created stressful situations for HCAs and caused them concern about the quality of care and quality of life of residents. / May 2009

Antalet äldre blir idag allt fler och behovet av vård flyttas upp i åldrarna. Det kräver att insatser inom äldrevård och omsorg håller hög kvalité och placerar människan i centrum för att skapa förutsättningar för äldre att leva ett värdigt, meningsfullt liv och känna välbefinnande. Frågan om mat, trygghet, identitet, social interaktion, anpassning och KASAM är faktorer som påverkar äldres tillvaro på äldreboende. Syftet med studien var att få djupare kunskap och förståelse i äldres livsvärld på äldreboende, hur man som boende upplever sin vardag och vilken betydelse äldreboendet som institution har för deras hälsa. Två livsberättelseintervjuer genomfördes under en timme var med två äldre, en man och en kvinna boende på ett äldreboende i Mellansverige. Resultatet tolkades och analyserades utifrån tidigare forskning, salutogent och patogent perspektiv på hälsa och teorier som KASAM, Maslows behovstrappa och immanent pedagogik. Resultatet visade att deltagarna är väldigt nöjda med sin vistelse på äldreboendet och hänvisar till aspekter som uppskattning av hjälp med mat, trygghet och tillit. Tidigare livserfarenheter och livsförhållanden lyfts fram i samband med uppskattningens betydelse. Dock framgår det även att tillvaron består av begränsningar som gör att personernas viktiga, betydelsefulla områden i livet inte fullt tillgodoses, vilket påverkar de äldres möjlighet att uppleva meningsfullhet i tillvaron. De äldres hälsotillstånd, tidsaspekt gällande personalens möjlighet att tillgodose behov, en fråga om mindre spontanitet och de äldres uppfattningar att inte kunna fodra hur mycket hjälp som helst är påverkande faktorer.

The aim of this thesis was to explore the key care factors that influence the educational achievement of children looked after at home and away from home in Scotland. Traditionally there has been less research conducted in Scotland than in the rest of the United Kingdom. The research analysed a large new sample - one fifth of the care leaving population in Scotland - and spans a five year period. The thesis makes an original research contribution. A unique features of the research is that it investigates the experiences of children looked after at home, alongside those looked after away from home. In addition, the research involved two large local authority areas in Scotland that had not previously participated in such research on looked after children. What emerged from the research was that the Corporate Parent (local authorities and partner agencies) had not yet successfully prioritised the educational achievement of looked after children in policy and practice, despite education being identified by the government as a mechanism for combating social exclusion. The key findings of the research demonstrated that looked after children perform less well academically than the general school population. In particular, placement type, the reason for becoming looked after and the age on becoming looked after were significant factors in determining educational achievement. Other factors such as gender and number of placements were also found to be associated with educational achievement. Empirical results further indicated that looked after children suffered from discrimination and social exclusion in all aspects of their lives, including school and where they lived. This was a significant finding as the disadvantage experienced by many looked after children continues to impact on their lives into adulthood, making them some of the most socially excluded adults in Scotland and the United Kingdom today.

Resident-centered care has been the standard philosophy in accredited personal care homes (PCHs) across Canada since 1990. Health care aides (HCAs) are the primary health care providers in PCHs and key to residents' quality of care and quality of life. However, studies have not examined HCA work satisfaction in relation to the four elements of resident-centered care: providing flexible scheduling, following residents' preferences, promoting a home-like environment and offering permanent assignment to promote consistency of care. This cross-sectional, ethnographic study was conducted using face-to-face interviews with nine HCAs working in four PCHs in Winnipeg, Manitoba, Canada. The results indicate that HCAs' work satisfaction was highly related to their caring relationships with residents and their working relationships with other HCAs and staff. The implementation of resident-centered care depended on institutional and managerial support. Lack of this support created stressful situations for HCAs and caused them concern about the quality of care and quality of life of residents.

Resident-centered care has been the standard philosophy in accredited personal care homes (PCHs) across Canada since 1990. Health care aides (HCAs) are the primary health care providers in PCHs and key to residents' quality of care and quality of life. However, studies have not examined HCA work satisfaction in relation to the four elements of resident-centered care: providing flexible scheduling, following residents' preferences, promoting a home-like environment and offering permanent assignment to promote consistency of care. This cross-sectional, ethnographic study was conducted using face-to-face interviews with nine HCAs working in four PCHs in Winnipeg, Manitoba, Canada. The results indicate that HCAs' work satisfaction was highly related to their caring relationships with residents and their working relationships with other HCAs and staff. The implementation of resident-centered care depended on institutional and managerial support. Lack of this support created stressful situations for HCAs and caused them concern about the quality of care and quality of life of residents.

This dissertation focuses on the long term (2006 - 2015) unsolved problems with the critical nature of healthcare payments in residential social services (PZSS) in the Czech Republic. The aim is a critical reflection of the legitimacy and the causes of this condition, including past efforts to identify and solutions. The used research methods are institutional analysis in combination with critical discourse analysis. The work is conceived as a critically-oriented research on social and health policies in the field of health care financing in PZSS in the period 1998 - 2015. Main findings of the cause of this problem are the failure to use the tool health- insurance plans and their unjustifiable replacement tool called. Reimbursement regulations, the use of which in combination with by power unilateral approach in the contractual relationship between health insurance and PZSS not only leads to problems, but especially to the general alienation public health insurance from the objectives and functions of the health system itself, which provides in this case health care in PZSS.

Cette thèse porte sur la fonction de direction d’une maison d’enfants à caractère social (MECS). Le travail réalisé s’inscrit dans une approche clinique d’orientation psychanalytique. À partir de quatre entretiens cliniques de recherche auprès de deux directrices et deux directeurs de MECS, la chercheuse, occupant elle-même des fonctions de direction de MECS, propose de poser un regard clinique sur les différentes postures sous-jacentes à l’exercice de cette fonction. La thèse est organisée en trois parties : la première partie analyse l’itinéraire professionnel de la chercheuse et témoigne de l’évolution de son positionnement dans une démarche clinique d’abord en tant que professionnelle puis en tant que chercheuse. La deuxième partie présente le champ de la Protection de l’Enfance, la spécificité des MECS comme institutions de la mésinscription et des adolescents qui y sont accueillis, la fonction de direction à travers plusieurs ouvrages consacrés à cette question mis en écho avec l’expérience de fonction de direction occupée par la chercheuse. Un dernier chapitre propose quelques éclairages théoriques à propos de la pulsion et la pulsion de mort. La troisième et dernière partie est dédiée à l’analyse des entretiens et à la mise en perspective de ces analyses dans laquelle sont avancées des hypothèses de compréhension des enjeux conscients et inconscients dans l’exercice de la fonction de direction de MECS. / This thesis focusses on the role of leadership in Children’s Social Care Homes (MECS) and on the analysis of the psychological sources which underlie this role. The work is done as part of a clinical approach from a psychoanalytical position. Based on clinical interviews conducted with directors of MECS, the researcher proposes to take a clinical look at the different aspects of this function. The thesis is organised in three parts : the first part traces the professional journey of the researcher and shows the evolution of her position in a clinical approach to psychoanalytical orientation, first as a professional and then as a researcher. The second part presents an overview of child protection as well as the specificities of the “MECS” as institutions of care (mesinscription) linked to the characteristics of the adolescents they welcome. Based on the reading of several works on the function of leadership in this type of institutions and using her own experience as a director of a MECS countertransferentially, the researcher analyses the outlines of the definition of this function. The third and final part is dedicated to the analysis of the interviews and putting into the perspective of these analyses in which are advanced hypotheses for understanding of the conscious and unconscious stakes process of “déliaison” in such an institution and to the dualism of the impulse to life/impulse to death.

Pain is the most prevalent medical problem that elderly persons experience in a long-term care home. Nurses play an essential role in managing their pain. The purpose of this study was to explore nurses’ pain management practices in Ontario long-term care homes facilities. The ultimate aim was to recommend measures for effective pain management in aged people. The setting for this study was a selected long-term care home in Ontario, Canada, a 160-bed nursing home for aged people offering various medical care services. Semi-structured focus group interviews, averaging approximately one hour, were conducted. The population of this study was 45 nurses. The researcher used a purposive sampling method to select a sample of 25 nurses. Open-ended questions were used to explore pain management practices and to find barriers to effective pain management. Qualitative data analysis was used to review the data to identify common issues that recurred, and they were summarised in a narrative form. This study demonstrated the importance of recognising and overcoming barriers to the effective management of pain and reinforcing good practices in long-term care homes. Therefore, improved pain management practices are required to manage pain in a long-term care home effectively. / Health Studies / M.A. (Nursing Sciences)

The aim of the master´s thesis is to design a Residential care home as smart building. It is situated in the centre of Křenovice near Brno. The master´s thesis is divided into three parts, first part presents design documentation, second part is focused on building services and the final part presents noise control in building. Residential care house is designed as two-storey building without basement with flat roof. On the first floor there is utility area for senior house and healthcare facility and on the second floor there are flats for seniors. Residential care house is built on footing. Load-bearing and non-load-bearing walls are designed from hollow bricks type THERM. External walls are insulated with mineral wool. The roofing of residential care house is made up of extensive green roof. The building services of the building includes two ground-water heat pumps with boreholes for heating and cooling, photovoltaic panels, HVAC, hot water cylinder and rainwater storage tank. The final part is focused on noise control in building. It is about acoustic in construction. Noise study is also included.

No description available.