지원사업
학술연구/단체지원/교육 등 연구자 활동을 지속하도록 DBpia가 지원하고 있어요.
커뮤니티
연구자들이 자신의 연구와 전문성을 널리 알리고, 새로운 협력의 기회를 만들 수 있는 네트워킹 공간이에요.
논문 기본 정보
- 자료유형
- 학술저널
- 저자정보
- 발행연도
- 2016.2
- 수록면
- 5 - 17 (13page)
- DOI
- 10.15187/adr.2016.02.29.1.5
이용수
초록· 키워드
오류제보하기
Background : Nursing homes are a prevalent component of the United States health care system. New models for providing skilled care services are being developed to respond to the increasing demand for better housing and service options for frail elderly persons. These new models are being referred to as “households” (HH) and the philosophy of the practices revolves around a selfdirected model called “person-centered care” (PCC). This research paper presents a case study of a HH model for nursing home design that incorporated PCC practices. An articulation of four highly regulated routines common to all nursing home services will demonstrate where congruence and incongruence exist between the organizational and environmental design strategies as well as with the existing regulatory framework.
Methods : A case study methodology was applied for this inquiry. A qualitative research design using a mixed-methods strategy was employed that included (1) ethnographic tactics of participant observation and open-ended staff interviews; (2) structured interviews with administrative personnel; (3) archival search and schematic articulation of the setting; and (4) photodocumentation of the composition of the HH features, spaces, and equipment that were integral in four routines. Using a mixed method approach allowed for triangulation of the analysis of the collected data.
Result : It was observed that care staff must participate in multiple roles within the HH in order to achieve the goal of PCC. It was also observed that staff assigned to the HH as well as staff outside the HH were integral in many of the routines that support the residents’ daily need. The evidence also revealed that there were multiple examples of both congruence and incongruence between the organizational and environmental design. Some routines were modified to meet existing regulatory requirements due to a lack of “fit” between the environmental features of the HH and the operational rules. The overall environmental design of the HH did, however, create a new expectation for the work, and a difference in meaning of place was reported.
Conclusions : This case study reinforces the importance of recognizing the role the environment plays in supporting the work of care staff and the organization’s goals for PCC. This study also provide evidence that it is no longer acceptable to make assumptions about practices that may not be practical in HHs without the proper environmental and organizational supports. The routines of care settings may have the same purpose, but the nature of work in HHs changes, and therefore, assumptions about this work as well as the environment must also change.
Methods : A case study methodology was applied for this inquiry. A qualitative research design using a mixed-methods strategy was employed that included (1) ethnographic tactics of participant observation and open-ended staff interviews; (2) structured interviews with administrative personnel; (3) archival search and schematic articulation of the setting; and (4) photodocumentation of the composition of the HH features, spaces, and equipment that were integral in four routines. Using a mixed method approach allowed for triangulation of the analysis of the collected data.
Result : It was observed that care staff must participate in multiple roles within the HH in order to achieve the goal of PCC. It was also observed that staff assigned to the HH as well as staff outside the HH were integral in many of the routines that support the residents’ daily need. The evidence also revealed that there were multiple examples of both congruence and incongruence between the organizational and environmental design. Some routines were modified to meet existing regulatory requirements due to a lack of “fit” between the environmental features of the HH and the operational rules. The overall environmental design of the HH did, however, create a new expectation for the work, and a difference in meaning of place was reported.
Conclusions : This case study reinforces the importance of recognizing the role the environment plays in supporting the work of care staff and the organization’s goals for PCC. This study also provide evidence that it is no longer acceptable to make assumptions about practices that may not be practical in HHs without the proper environmental and organizational supports. The routines of care settings may have the same purpose, but the nature of work in HHs changes, and therefore, assumptions about this work as well as the environment must also change.
목차
Abstract
1. Introduction
2. Conceptual Framework
3. Method
4. Results
5. Conclusion
References
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UCI(KEPA) : I410-ECN-0101-2016-658-002393407