Maneuvering Together, Apart, and at Odds: Residents' Care Convoys in Assisted Living
Maneuvering Together, Apart, and at Odds: Residents' Care Convoys in Assisted Living
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DOI：
10.1093/geronb/gbx184
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发表时间：
2018-05-01
影响因子：
6.2
通讯作者：
Perkins, Molly M.
中科院分区：
文献类型：
--
作者：
Kemp, Candace L.;Ball, Mary M.;Perkins, Molly M.
目标：脆弱和残疾的个人，如辅助生活的居民被嵌入在“护理车队”组成的有偿和无偿的照顾者。我们试图了解如何护理车队的配置和功能，在辅助生活，并了解他们如何以及为什么不同，什么居民和照顾outcome.Method：我们分析了数据从一个定性研究，涉及正式的深入访谈，参与者观察和非正式的采访，并记录审查。我们前瞻性地研究了28名居民和114名护理车队成员来自四个不同的辅助生活communities over 2 years.Results：护理车队涉及家庭和朋友谁单独或共同负责，辅助生活的工作人员，和多个外部护理人员。居民和车队成员在日常和健康危机期间谈判护理景观时，参与了“一起机动、分开机动和不一致”的过程。共识水平的基础上，和协作和沟通的质量，我们确定了三个主要的车队类型：凝聚力，分散，和discordant.Discussion：护理车队明确塑造护理经验和成果。确定战略，建立有效的沟通和协作的做法，促进车队成员的共识，特别是随着时间的推移，是至关重要的成功和支持性的护理伙伴关系的创建和维护。
Objectives: Frail and disabled individuals such as assisted living residents are embedded in "care convoys" comprised of paid and unpaid caregivers. We sought to learn how care convoys are configured and function in assisted living and understand how and why they vary and with what resident and caregiver outcomes.Method: We analyzed data from a qualitative study involving formal in-depth interviews, participant observation and informal interviewing, and record review. We prospectively studied 28 residents and 114 care convoy members drawn from four diverse assisted living communities over 2 years.Results: Care convoys involved family and friends who operated individually or shared responsibility, assisted living staff, and multiple external care workers. Residents and convoy members engaged in processes of "maneuvering together, apart, and at odds" as they negotiated the care landscape routinely and during health crises. Based on consensus levels, and the quality of collaboration and communication, we identified three main convoy types: cohesive, fragmented, and discordant.Discussion: Care convoys clearly shape care experiences and outcomes. Identifying strategies for establishing effective communication and collaboration practices and promoting convoy member consensus, particularly over time, is essential to the creation and maintenance of successful and supportive care partnerships.