The primary focus of this organizational study of thirty two homes for the aged was to explore the degree of difference between administrator (expert) and resident (consumer) judgments of the psycho-social environment of their homes and to detect organizational variables which might account for these differences. It was hypothesized that adequate communication linkages to the homes would be negatively correlated with resident-administrator differences in viewpoints of the psychosocial environment. Adequate communication linkages were defined as those which approximated a model of linkage adequacy derived from the ''balance theory of coordination" postulated by Eugene Litwak. Based on a multimodel theory of organizational structure it calls for mechanisms of coordination between antithetical organizational substructures to insure sufficient closeness for communication but sufficient distance to prevent conflict. A secondary focus of this study was the substantive findings regarding resident viewpoints of the psychosocial environment irrespective of their differences from administrators. The concept of "psychosocial environment" was defined and operationalized by Allen Pincus who developed an instrument (HDQ) for measuring the degree of privacy, freedom, social resources, and integration into the larger community provided by the psychosocial environment of homes for the aged. The study hypothesis was not supported by correlational findings; however, linkage adequacy ratings did account for seven percent of the variation in administrator-resident differences when entered into a regression analysis with variables measuring contacts between administrator and residents and residential participation in group activities. Of significance at the .05 level was the age of the administrators with the younger ones tending to have fewer differences from the residents; administrators' ranking of professional staff meetings and communications with the housekeeping staff as useful sources of information about their residents; and higher mean resident HDQ Dimension II (freedom) scores. A multiple regression analysis of these variables plus the mean home ratings of resident friendliness to staff accounted for 55% of the variation in resident-administrator differences. These findings support the balance theory of coordination in that they reflect both distancing mechanisms (indirect linkages; i.e., administrator-staff contacts) and conditions which promote closeness (resident friendliness to staff). The age of the administrator, positively correlated with resident-administrator differences, reflected greater reliance by the younger administrators on their staffs and less control by their boards. Neither resident age, health, size of home, socio-cultural similarity between resident and administrator, nor the degree of informal administrator contact with residents were associated with resident-administrator differences. Resident scores on the HDQ suggest the psychosocial environments of the homes providing a great deal more privacy than a lack of privacy, more integration into the larger community than isolation, slightly more social resources rather than a lack of social resources, and as much freedom as structure. Those variables negatively associated with the dimension scores on a home by home basis included poorer ratings on resident mental health, mobility, and physical isolation. Homes with a greater degree of board control less participating activities and where residents tended to take their complaints to the administrator tended to have less freedom. Homes located in the country, with a resident council and social worker and with frequent administrator-resident contacts tended to score higher on the resource dimension. Implications for social planning include greater confidence in the older consumer as a source of informational feedback and increased scrutiny of administrator viewpoints especially as they relate to utilization of staff. The study suggests that planning must be geared to providing for the needs for the immobile, mentally impaired, isolated resident as well as stimulating administrative and structural changes which allow for a greater degree of freedom and social resources.

研究背景: 居住於安老院舍的長者通常患有多種不可逆轉的慢性疾病或未期病症。相對其他組群，他們將更快面對臨終與死亡的問題。因此，了解他們對「臨終問題」的態度、臨終地方的選擇意向及其預測因素是非常重要的。研究所得資將有助提供優質的“善終“服務予這群弱勢的長者。 / 研究目的: 本研究旨在探討有關居於香港安老院舍的長者對「臨終問題」的態度、臨終地方的選擇意向、是否視安老院舍如同自己的家及其預測因素。 / 研究方法: 本研究採用橫斷面量性研究的方法，以便利抽樣方式在香港不同地區的安老院舍進行研究。研究對象為年齡65歲或以上，及簡短智能測試達6分或以上，並能以廣東話溝通的安老院舍長者。研究採用結構性問卷以面對面訪談形式進行，作者把「對臨終問題的態度調查問卷」翻譯成中文版本用作調查長者對臨終問題的態度。並採用EQ-5D和Barthel Index (20) 以評估長者的自我健康評估及日常生活自我照顧能的狀況。調查問卷亦包括探討長者對安老院視為自己的家的看法和死亡地點的選擇。收集之數據採用了二分類邏輯回歸進行各因素與結果變量之間的單因關聯分析，那些p值<0.25的因素被選定為候選自變量，然後利用逐步多因素邏輯回歸分析來劃定結果變量的獨立相關因素。 / 研究結果: 合共317名來自20間安老院舍的長者參與了此項研究，包括248名女性(78.2%)和69名男性(21.8%)，年齡介乎65至99歲，平均年齡為84歲(標準差6.6)。多因素分析顯示多種預測因素與「臨終問題」的態度有著相關性；對於有家庭財政支持的長者來說，他們較傾向不同意由醫生作出所有有關照顧上的決定；有接受教育和患有較多慢性病的長者較傾向同意訂立預前指示；那些在安老院舍居住時間較長的長者較傾向不同意使用藥物讓他們可以隨時選擇結束生命；但患有糖尿病者較傾向同意安樂死；有宗教信仰者較傾向同意靈性或宗教的支持對他們是重要的。此外，310名安老院舍長者(97.8%)認為安老院舍如同自己的家。有261名長者 (68.1%) 表示希望在目前的安老院去世。那些認為安老院舍如同自己的家、有獨立經濟支持、及同意安樂死的院舍長者，較傾向希望在目前的安老院去世。 / 研究結論: 本研究譂述了居於香港安老院舍的長者對「臨終問題」的態度及其相關因素的實證結果。研究發現幾乎所有安老院舍的長者視安老院舍如同自己的家，明顯地相當多的長者表示如果條件允許下，希望在目前的安老院舍去世。這種強烈的聲音指出我們需要發展院舍的臨終照顧以滿足院舍長者的需要及期望。而從獲悉長者對「臨終問題」的態度及臨終地方的選擇意向，可讓醫護專業人員在安老院舍裡更有效地規劃臨終照顧服務，並能讓長者善終與好死。 / Background: Older people living in residential care homes for the elderly (RCHEs) have high incidences of irreversible chronic illnesses and terminal diseases. They are the most significant group facing impending death and dying. It is vital to understand their attitudes toward end of life (EOL) issues and their preference for EOL care in order to promote their quality of life. / Objective: This study aims to examine the attitudes toward EOL issues, the preference for place of death, the perception of RCHE as a resident’s own home and their predictors amongst older RCHE residents in Hong Kong. / Method: A cross-sectional quantitative study with convenience sampling was conducted in RCHE in different regions of Hong Kong. RCHE residents aged ≥65 achieving abbreviated mental test score ≥6 and who were able to communicate in Cantonese were recruited. Face-to-face interviews were conducted with the aid of a structured questionnaire. Demographic and clinical characteristics were collected. Health and functional status were measured by Euroqol-5D and Barthel Index (20). The “Attitudes of older people to end of life issues questionnaire“ was translated from the English version into a Chinese version and employed to examine the attitudes toward EOL issues. The perception of RCHE as own home and the preference for place of death were examined. Univariate analysis on the association between the outcome variables was performed. Factors with a p value <0.25 in univariate analyses were selected for multivariable logistic regression to delineate factors independently associated with the outcome. / Results: A total of 317 participants including 248 (78.2%) women and 69 (21.8%) men from 20 RCHE participated in the study. Their mean age was 84 ± 6.6 (mean ± SD). As showed in multivariate analysis, respondents financially supported by their family were less likely to allow doctors to make all the decisions about their care. Those respondents with higher number of morbidities and had higher education were more likely to agree with making a living will. Those who lived longer in RCHE were less likely to agree to having a drug at their disposal to end their life. Respondents with diabetic mellitus were more likely to agree with euthanasia. Respondents who followed a religion were more likely to agree on the importance of spiritual or religious support. Furthermore, 310 (97.8%) respondents perceived RCHE as their own home. Two hundred and sixteen (68.1%) residents wished to die in their present RCHE. Residents with the means to support themselves financially, agreed with euthanasia and who perceived RCHE as their own home were more likely to wish to die in RCHEs. / Conclusion: Nearly all residents perceived RCHEs as their own home and a significant proportion wished to die there if conditions allowed. This asserts that EOL care in RCHE should be developed to meet the wishes of the older residents. This study delineated significant factors associated with the attitudes of older people toward EOL issues. Knowing those factors allows health care professionals to plan for quality EOL care services in RCHEs more effectively and foster good death for this vulnerable population. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Law, Po Ka. / Thesis (D.Nurs.)--Chinese University of Hong Kong, 2013. / Includes bibliographical references (leaves 160-173). / Abstracts also in Chinese; appendixes includes Chinese. / Chapter 1. --- CHAPTER ONE: INTRODUCTION AND BACKGROUND / Chapter 1.1 --- Introduction --- p.1 / Chapter 1.2 --- Epidemiology data of ageing in Hong Kong --- p.3 / Chapter 1.3 --- Impact of ageing population --- p.4 / Chapter 1.4 --- Residential care services in Hong Kong --- p.5 / Chapter 1.5 --- Quality of residential care homes for the elderly (RCHEs) in Hong Kong --- p.7 / Chapter 1.6 --- Definition of end of life care, palliative care and hospice care --- p.9 / Chapter 1.7 --- End of life care in residential care homes in Hong Kong --- p.11 / Chapter 1.8 --- Dying in place --- p.14 / Chapter 1.9 --- Perception of RCHEs as own home --- p.15 / Chapter 1.10 --- Factors influencing attitudes to end of life issues --- p.15 / Chapter 1.11 --- The proposed framework --- p.18 / Chapter 1.12 --- Aim of the study --- p.20 / Chapter 1.13 --- Operational definitions of key terms --- p.20 / Chapter 1.14 --- Significance of the study and its impact on the society and future service development --- p.22 / Chapter 1.15 --- Overview of each chapter of the thesis --- p.24 / Chapter 2. --- CHAPTER TWO: LITERATURE REVIEW / Chapter 2.1 --- Introduction --- p.25 / Chapter 2.2 --- Literature search --- p.26 / Chapter 2.3 --- Search results --- p.27 / Chapter 2.4 --- Unmet need for end of life care in RCHEs in Hong Kong --- p.28 / Chapter 2.5 --- EOL care in RCHEs of other Western and Asian countries --- p.33 / Chapter 2.6 --- Preference for place of death --- p.34 / Chapter 2.7 --- Attitudes toward end of life issues --- p.38 / Chapter 2.8 --- Factors affecting older residents when choosing to die in RCHEs --- p.41 / Chapter 2.9 --- Barriers to EOL care in RCHEs --- p.43 / Chapter 2.10 --- Conclusion --- p.45 / Chapter 3. --- CHAPTER THREE: RESEARCH DESIGN AND METHOD / Chapter 3.1 --- Introduction --- p.47 / Chapter 3.2 --- Aim of the study --- p.47 / Chapter 3.3 --- Objectives of the study --- p.47 / Chapter 3.4 --- Research questions --- p.48 / Chapter 3.5 --- Research design --- p.50 / Chapter 3.6 --- Sample size --- p.51 / Chapter 3.7 --- Study setting --- p.52 / Chapter 3.8 --- Sampling method --- p.52 / Chapter 3.9 --- Data collection --- p.54 / Chapter 3.10 --- Study instruments --- p.55 / Chapter 3.11 --- Translation process for the AEOLI questionnaire --- p.60 / Chapter 3.11.1 --- Establishing the semantic equivalence --- p.64 / Chapter 3.11.2 --- Establishing the content and face validity --- p.66 / Chapter 3.12 --- Pilot study --- p.67 / Chapter 3.12.1 --- Testing the feasibility --- p.67 / Chapter 3.12.2 --- Test-retest --- p.68 / Chapter 3.13 --- Data cleaning --- p.70 / Chapter 3.14 --- Data analysis --- p.70 / Chapter 3.15 --- issues and consent Ethical --- p.72 / Chapter 4. --- CHPATER FOUR: RESULTS / Chapter 4.1 --- Introduction --- p.74 / Chapter 4.2 --- Recruitment of participants --- p.74 / Chapter 4.3 --- Characteristics of the study sample / Chapter 4.3.1 --- Socio-demographic characteristics --- p.76 / Chapter 4.3.2 --- Clinical characteristics --- p.79 / Chapter 4.3.3 --- Functional and health status --- p.81 / Chapter 4.4 --- Descriptive statistics of AEOLI-C, preference for place of death and perception of RCHEs as residents’ own home / Chapter 4.4.1 --- Descriptive statistics of AEOLI-C --- p.83 / Chapter 4.4.1.1 --- Decision making (Attitude 1) --- p.83 / Chapter 4.4.1.2 --- Pain (Attitude 5, 9, 20) --- p.83 / Chapter 4.4.1.3 --- Care environment (Attitude 3, 6, 10, 15, 27) --- p.84 / Chapter 4.4.1.4 --- Living wills (Attitude 8, 14, 19, 24) --- p.84 / Chapter 4.4.1.5 --- Euthanasia / Physician assisted suicide (Attitude 4, 17, 18, 26) --- p.85 / Chapter 4.4.1.6 --- Ageism (Attitude 13, 16, 23) --- p.85 / Chapter 4.4.1.7 --- Psychological needs including religious/spiritual (Attitude 11, 25) --- p.85 / Chapter 4.4.1.8 --- Quality versus quantity of life (Attitude 2, 7, 21, 22) --- p.85 / Chapter 4.4.1.9 --- Societal awareness (Attitude 12) --- p.86 / Chapter 4.4.2 --- Descriptive statistics of the perception of RCHEs as residents’ own home --- p.86 / Chapter 4.4.3 --- Descriptive statistics of the preference for place of death --- p.86 / Chapter 4.5 --- Correlational and logistic regression results / Chapter 4.5.1 --- Correlational and regression results of the predictive factors associated with AEOLI-C --- p.89 / Chapter 4.5.1.1 --- Decision making (Attitude 1) --- p.89 / Chapter 4.5.1.2 --- Pain (Attitude 5, 9, 20) --- p.90 / Chapter 4.5.1.3 --- Care environment (Attitude 3, 6, 10, 15, 27) --- p.91 / Chapter 4.5.1.4 --- Living wills (Attitude 8, 14, 19, 24) --- p.93 / Chapter 4.5.1.5 --- Euthanasia / Physician assisted suicide (Attitude 4, 17, 18, 26) --- p.95 / Chapter 4.5.1.6 --- Ageism (Attitude 13, 16, 23) --- p.97 / Chapter 4.5.1.7 --- Psychological needs including religious/spiritual (Attitude 11, 25) --- p.99 / Chapter 4.5.1.8 --- Quality versus quantity of life (Attitude 2, 7, 21, 22) --- p.100 / Chapter 4.5.1.9 --- Societal awareness (Attitude 12) --- p.101 / Chapter 4.5.2 --- Correlational and regression results of the predictive factors associated with the perception of RCHEs as residents’ own home --- p.104 / Chapter 4.5.2.1 --- Relationship with socio-demographic characteristics, clinical characteristics, health and functional status --- p.104 / Chapter 4.5.2.2 --- Relationship with AEOLI-C --- p.108 / Chapter 4.5.3 --- Correlational and regression results of the predictive factors associated with preference for place of death --- p.110 / Chapter 4.5.3.1 --- Relationship with socio-demographic characteristics, clinical characteristics, functional and health status --- p.110 / Chapter 4.5.3.2 --- Relationship with AEOLI-C --- p.114 / Chapter 4.6. --- Summary of the results --- p.116 / Chapter 5. --- CHAPTER FIVE: DISCUSSION / Chapter 5.1 --- Introduction --- p.117 / Chapter 5.2 --- Characteristic of the participants --- p.118 / Chapter 5.3 --- The attitudes toward end of life issues --- p.120 / Chapter 5.3.1 --- Decision making (Attitude 1) --- p.121 / Chapter 5.3.2 --- Pain (Attitude 5, 9, 20) --- p.123 / Chapter 5.3.3 --- Care environment (Attitude 3, 6, 10, 15, 27) --- p.125 / Chapter 5.3.4 --- Living wills (Attitude 8, 14, 19, 24) --- p.128 / Chapter 5.3.5 --- Euthanasia / Physician assisted suicide (Attitude 4, 17, 18, 26) --- p.131 / Chapter 5.3.6 --- Ageism (Attitude 13, 16, 23) --- p.133 / Chapter 5.3.7 --- Psychological needs including religious/spiritual (Attitude 11, 25) --- p.135 / Chapter 5.3.8 --- Quality versus quantity of life (Attitude 2, 7, 21, 22) --- p.136 / Chapter 5.3.9 --- Societal awareness (Attitude 12) --- p.137 / Chapter 5.4 --- The perception of RCHEs as residents’ own home --- p.138 / Chapter 5.5 --- The preference for place of death --- p.140 / Chapter 5.6 --- Summary --- p.143 / Chapter 6. --- CHAPTER SIX: CONCLUSION / Chapter 6.1. --- Introduction --- p.145 / Chapter 6.2 --- Limitations of the study --- p.145 / Chapter 6.2.1 --- Generalization of the results --- p.145 / Chapter 6.2.2 --- Lack of theoretical construct of the translated questionnaire --- p.147 / Chapter 6.2.3 --- Limitations of quantitative study and cross-sectional design --- p.149 / Chapter 6.3 --- Contributions of the study --- p.150 / Chapter 6.4 --- Recommendations and implications to nursing practice --- p.152 / Chapter 6.5 --- Implications to the EOL Care Practice in Residential Care Setting --- p.154 / Chapter 6.6 --- Implications to residential care policy --- p.155 / Chapter 6.7 --- Recommendations for further studies --- p.156 / Chapter 6.8 --- Conclusion --- p.158 / Chapter 7. --- REFERENCES --- p.160 / Chapter 8. --- APPENDICES --- p.174

No description available.

One concern of this study is sexuality among the aged, since every person, regardless of age, is a sexual being. Society, however, has been slow to recognize this fact and has not accepted sexual activity among the aged. Along with the lack of social sanctioning, elderly persons are very susceptible to the myriad of myths, half-truths, misinformation, and incomplete data which affect their attitudes toward sexuality. Furthermore, older persons are susceptible to negative stereotypes of themselves as sexual beings. However, the effect of actual sexual activity upon overall life satisfaction among the aged has yet to be determined. Because there has been no empirical evidence concerning this, the degree of relationship between sexual activity and life satisfaction remains unknown. Since human beings remain sexual throughout life, and a large proportion of the elderly are institutionalized, this study will focus attention on the relationship between life satisfaction and sexuality among the institutionalized aged. It is important for social workers to explore these concepts, as empirically validated knowledge can be used as guidelines for professional values and practice.

Abstract not available

<p>The aim of this study was to increase our knowledge about how the “Conversational-contact with the social services” is experienced by the parents who attend it. The research was based on a qualitative method consisting of four individual interviews.</p><p>Main issues of the study:</p><p>• The parents experience of the content of the meetings with the social workers</p><p>• Do the parents experience that the conversational-contact has contributed to some changes in their lives?</p><p>Results indicated that all parents were positiv to the conversational-contact. Afterwards they felt more secure and stable both as persons and in their role as parents. The parents experienced a change in both thoughts and how to handle troublesome situations in life. The social workers knowledge about family relations and their promotive professional approach towards the parents, was recognized as contributing to these changes. In general results agree with earlier research, except from one distinction which indicates that the social workers knowledge about the family dynamics is just as important as their approach. The interviews and the interpretation of the interviews were framed by a cognitive- and conversational perspective.</p>

<p>In this study have I examined how treatment of girls with neuropsychological impairments is functioning? I have looked at the theories and methods of treatment on the base of the care program and how it is put into practice. In addition I have interviewed four girls who have undergone the treatment program.</p><p>To gain perspective on institutional care as a social phenomenon, I have tried to give a brief historical retrospect in which particular care for women are described. I am also affecting certain gender aspects of institutional care. I have also tried to make a brief account of current research on the treatment.</p><p>The study is a qualitative study in which I am apart from literature studies used participant observation in depth interviews as a method.</p><p>My results indicate that a well structured treatment with CBT approach can work well to achieve lasting behavioural changes in students.</p>

The aim of this study was to increase our knowledge about how the “Conversational-contact with the social services” is experienced by the parents who attend it. The research was based on a qualitative method consisting of four individual interviews. Main issues of the study: • The parents experience of the content of the meetings with the social workers • Do the parents experience that the conversational-contact has contributed to some changes in their lives? Results indicated that all parents were positiv to the conversational-contact. Afterwards they felt more secure and stable both as persons and in their role as parents. The parents experienced a change in both thoughts and how to handle troublesome situations in life. The social workers knowledge about family relations and their promotive professional approach towards the parents, was recognized as contributing to these changes. In general results agree with earlier research, except from one distinction which indicates that the social workers knowledge about the family dynamics is just as important as their approach. The interviews and the interpretation of the interviews were framed by a cognitive- and conversational perspective.

In this study have I examined how treatment of girls with neuropsychological impairments is functioning? I have looked at the theories and methods of treatment on the base of the care program and how it is put into practice. In addition I have interviewed four girls who have undergone the treatment program. To gain perspective on institutional care as a social phenomenon, I have tried to give a brief historical retrospect in which particular care for women are described. I am also affecting certain gender aspects of institutional care. I have also tried to make a brief account of current research on the treatment. The study is a qualitative study in which I am apart from literature studies used participant observation in depth interviews as a method. My results indicate that a well structured treatment with CBT approach can work well to achieve lasting behavioural changes in students.

The aim of the study was to develop an understanding of how adolescent South African girls in institutional care perceive their female gender role, in the past, the present and future. The research question was: How do adolescent girls living in institutional care in South Africa perceive their female gender role in the past, the present and future? A mixed design, a combination of qualitative and quantitative methods, was used in order to answer the research question. The quantitative part of the study consisted of a questionnaire, and the qualitative part of the study contained seven interviews. To interpret the analyzed data a theoretical framework was used, consisting of the theory of social constructionism and gender theory. The final result of the quantitative and the quantitative parts of the study showed that the perception of the female gender role among the respondents is more stereotyped/ traditional when it comes to the area of relationships and sexuality, but more equal in the field of future occupation and the professional role. The result shows that a majority of the respondents have one view of gender roles in general, a more traditional picture of how things are supposed to be, and another, less conservative when they express their own desires of how they want their future life and household.