An Unintended Consequence of Culture Change in VA Community Living Centers.
An Unintended Consequence of Culture Change in VA Community Living Centers.
复制标题
退伍军人事务部社区生活中心文化变革的意外后果。
DOI：
10.1016/j.jamda.2016.10.006
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发表时间：
2017
影响因子：
7.6
通讯作者：
Allen,SusanM
中科院分区：
文献类型：
--
作者：
Harrison,Jill;Tyler,DeniseA;Shield,RenéeR;Mills,WhitneyL;Morgan,KristenE;Cutty,MaxwellE;Coté,DanielleL;Allen,SusanM
尽管越来越多的证据表明，文化变化及其必然结果，以人为本的护理改善了养老院环境中的居民结果，对于急症后患者在回家前接受相对较短时间的熟练护理和康复服务的文化变化的影响，人们知之甚少。这项研究的设计数据是作为一个更大的项目的一部分收集的，该项目旨在了解退伍军人健康管理局(VHA)政策的影响，该政策将VHA社区生活中心(CLCs)的使命从长期监护转变为短期熟练护理和康复护理。结果尽管在对八个地理位置不同的CLC进行实地访问期间收集的定性数据表明，退伍军人的生活质量和护理有所提高，但访谈数据也表明了一个意想不到的后果。具体地说，工作人员描述了家庭式环境、基于关系的护理提供以及对退伍军人偏好的关注这些方面是如何体现文化变化的，这些方面可以延长退伍军人在治疗完成后的停留时间。除了提供熟练的护理和康复，VHA CLC还具有潜在的功能，为退伍军人提供舒适的家和同龄人社区，让他们相互联系和社交。具有退伍军人共同象征性地位的人的聚集生活环境是VHA CLC所独有的。同龄人和员工之间的牢固纽带以及员工对退伍军人服务国家的尊重可能会增加他们让退伍军人在预期退伍日期后继续服役的责任感。结论我们的研究结果表明，短期护理环境中文化变化和以退伍军人为中心的护理的复杂性可能被低估。我们讨论了研究结果如何也适用于非VHA部门。
ObjectiveAlthough a growing body of evidence suggests that culture change and its corollary, person-centered care improves resident outcomes in the nursing home setting, little is known about the effect of culture change in a postacute setting in which patients receive skilled nursing and rehabilitation services for a relatively short period of time before returning home.DesignData for this study were collected as part of a larger project to understand the impact of Veterans Health Administration (VHA) policies to shift the mission of VHA Community Living Centers (CLCs) from long-stay custodial care to short-stay skilled nursing and rehabilitative care.ResultsAlthough qualitative data collected during interviews from site visits to eight geographically diverse CLCs suggest an increase in the quality of life and care for veterans, interview data also indicate an unintended consequence. Specifically, staff described how aspects of the homelike environment, relationship-based care delivery, and attention to veterans' preferences that characterize culture change can prolong a veteran's length of stay beyond treatment completion. In addition to providing skilled nursing and rehabilitation, VHA CLCs also serve a latent function of providing a comfortable home and a peer community for veterans to connect and socialize with one another. A congregate living environment for persons with the shared symbolic status of being a veteran is unique to VHA CLCs. Strong bonding among peers and staff as well as staff respect for veterans' service to the country may increase their sense of obligation to keep veterans past their expected discharge date.ConclusionOur findings suggest that the complexities of culture change and veteran- centered care in a short-term care setting may be underrecognized. We discuss how findings may also be relevant for the non-VHA sector.
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DOI：
--
发表时间：
1987
期刊：
影响因子：
--
作者：
H. Shore;D. Zimmerman
通讯作者：
D. Zimmerman
监管美国疗养院：我们正在吸取经验吗？
影响因子：
9.7
作者：
Kieran Walshe
通讯作者：
Kieran Walshe
长期护理中“人文”文化变迁的历史语境
DOI：
10.1300/j181v02n01_04
发表时间：
2003
期刊：
Journal of Social Work in Long-Term Care
影响因子：
--
作者：
S. Tobin
通讯作者：
S. Tobin
优先考虑疗养院的文化变革：居民、工作人员和家庭成员的观点
影响因子：
6.3
作者：
H. White;K. Corazzini;J. Twersky;G. Buhr;E. McConnell;M. Weiner;C. Colón
通讯作者：
C. Colón
影响因子：
2.7
作者：
Johnson, Barbara S.;Boudiab, Lina D.;Carter, Jemica
通讯作者：
Carter, Jemica