ELDERLY OUTPATIENT CARE AND INFORMAL SOCIAL SUPPORTS

这项研究的目的是探索两者之间的联系 非正式支持网络和正式的社会支持系统 在提供门诊服务方面趋同。现建议在 在某些情况下，医疗保健系统可以作为社会福利的来源 支持那些社会和经济资源有限的人。检视 这一命题，研究计划集中在那些最年长的 由于其有限的社会和经济资源而易受伤害 将全面的社会服务整合到 提供门诊护理。 我们的具体目标有四个。1)研究将评估契合度 患者的需求和他们的社会资源之间的关系，并将识别 未得到满足的需求造成的痛苦程度。2)我们将审查 他们的非正式支持与他们对 卫生和社会服务。3)研究将确定两者之间的联系 在非正式和正式网络之间建立这些情况 正式制度与非正式制度相辅相成 它替代或补偿其不足之处。4)研究将 也使用人种学方法来探索主观成本和回报 在社会支持过程中获得的支持。在这一定性部分中， 研究，目标是确定这些支持性维度 可以转移到次要关系的主要关系 在正式的支持系统中。 为了实现这些目标，对65岁以上的门诊患者进行了抽样调查 将从已经进行试点研究的两家门诊诊所中挑选出来 已经进行过了。在这些诊所接受服务的老年人人数很多。 有资格获得医疗补助和S.I.的比例许多人还缩写了 社交网络和高水平的功能障碍。两家诊所 已将全面的社会服务纳入卫生保健服务 关心。该项目将采用多种方法相结合的方式：医疗审查 记录，重点访谈，标准的老年评估工具， 以及诊所里的自然主义观察。

The purpose of this research is to explore associations between the informal support network and the formal social support system as they converge in the delivery of outpatient services. It is proposed that in some cases the health care system may function as a source of social support to those with limited social and economic resources. To examine this proposition, the research plan focuses on those elderly who are most vulnerable because of their limited social and economic resources and those settings which have integrated comprehensive social services in the delivery of outpatient care. Our specific objectives are fourfold. 1) The research will assess the fit between the patients' needs and their social resources and will indentify the level of distress created with unmet needs. 2) We will examine associations between their informal supports and their utilization of health and social services. 3) The research will identify linkages between between the informal and formal network to establish those situations in which the formal system complements the informal system and those in which it substitutes or compensates for its deficiencies. 4) The research will also use ethnographic methods to explore the subjective costs and rewards obtained in the social support process. In this qualitative portion of the research, the objective is to identify those supportive dimensions of primary relationships which can be transferable to secondary relationships in the formal support system. To accomplish these objectives, a sample of outpatients, 65 years and older will be drawn from two outpatient clinics where pilot research has already been conducted. The population of elderly served in these clinics has high proportions who qualify for Medicaid and S.S.I. Many also have abbreviated social networks and high levels of functional impairment. Both clinics have integrated comprehensive social services into the delivery of health care. The project will use a combination of methods: review of medical records, focussed interviews, standard geriatric assessment instruments, and naturalistic observations in the clinics.