An ethnographic study of stigma and ageism in residential care or assisted living
An ethnographic study of stigma and ageism in residential care or assisted living
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DOI：
10.1093/geront/48.4.517
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发表时间：
2008-08-01
期刊：
影响因子：
5.7
通讯作者：
Zimmerman, Sheryl
中科院分区：
文献类型：
--
作者：
Dobbs, Debra;Eckert, J. Kevin;Zimmerman, Sheryl
目的.本研究探讨了居住在寄宿护理或辅助生活（RC-AL）社区的老年人的污名化方面，以及这些环境为解决污名化所做的工作。设计和方法：我们使用民族志和其他定性数据收集和分析技术，收集数据，从309名参与者（居民，家庭和工作人员）从六个RC-AL设置在马里兰州。我们将转录数据输入到Atlas.ti 5.0中。我们使用扎根理论技术的新兴主题的数据进行分析。结果如下：出现了四个与RC-AL中的污名化有关的主题：（a）长期护理中的老龄歧视;（B）与疾病有关的污名化;（c）污名化的社会文化方面;（d）RC-AL作为一种污名化环境。RC-AL环境中使用的一些策略，以打击污名化包括家庭成员代表被污名化的居民，主张居民的自主权，和管理员意识到潜在的污名化。含义：研究结果表明，可以改变的结构，以及提供护理的过程中，以尽量减少发生的RC-AL设置的耻辱。结构性变化包括审查如何最好地考虑到居民病例组合，以适应痴呆症患者的护理（例如，单独的单位或综合护理）;护理过程包括工作人员承认居民的偏好和优势，而不是他们的局限性。
Purpose. This study explored aspects of stigmatization for older adults who live in residential care or assisted living (RC-AL) communities and what these settings have done to address stigma. Design and Methods: We used ethnography and other qualitative data-gathering and analytic techniques to gather data from 309 participants (residents, family and staff) from six RC-AL settings in Maryland. We entered the transcript data into Atlas.ti 5.0. We analyzed the data by using grounded theory techniques for emergent themes. Results: Four themes emerged that relate to stigma in RC-AL: (a) ageism in long-term care; (b) stigma as related to disease and illness; (c) sociocultural aspects of stigma; and (d) RC-AL as a stigmatizing setting. Some strategies used in RC-AL settings to combat stigma include family member advocacy on behalf of stigmatized residents, assertion of resident autonomy, and administrator awareness of potential stigmatization. Implications: Findings suggest that changes could be made to the structure as well as the process of care delivery to minimize the occurrence of stigma in RC-AL settings. Structural changes include an examination of how best, given the resident case mix, to accommodate care for persons with dementia (e.g., separate units or integrated care); processes of care include staff recognition of resident preferences and strengths, rather than their limitations.