Love and space in the nursing home

Nursing homes and other institutionsdesigned for persons with impairments are not,in fact, designed for persons with impairments.They are typically designed for theimpairments, not the persons, and therebybecome a part of the problem by reinforcingphysical and cultural manifestations of theimpairments. In the essay that follows, Idescribe an architectural design project inwhich students were asked to make changes to anexisting nursing home for the persons who livedthere. This requires not only becoming familiarwith the spaces, but with the personsthemselves and designing space to helparticulate their voices and being. This revised version was published online in June 2006 with corrections to the Cover Date.     

A Social Version of Gerotranscendence: Case Study

This article reexamines the concept of gerotranscendence in the light of anthropological findings. Particular social patterns in a nursing home reveal a unique reality communal to its tenants. The author assumes that the tenants' spontaneous patterns of social gathering construct a collective death consciousness which is spiritual in its nature. Tornstam's term another paradigm seems suitable not only for a developmental shift in old age but also for the situational shift in the daily life of the subjects. Anthropological concepts, as well as contextual and inter-subjective parameters, join to indicate that some gerotranscendence dimensions are experienced in what the author terms as sitting and giving episodes.     

Improving staff nutritional practices in community-based group homes: evaluation, training, and management.

We evaluated the effectiveness of a staff training and management package on nutritional practices in two community-based group homes serving adults with developmental disabilities. Food storage, menu development, and meal preparation were trained in a multiple baseline format, followed by supervisor feedback. All staff behaviors increased after training and were maintained for up to 1 year. Biological indices reflected collateral improvements in the health of consumers, and surveys of staff and parents established social validity.     

临床共情与护理技术结合：人性化的护理

临床共情是一种能体验患者内心世界的能力,通过患者的言语和非言语表达,觉察和认识患者情感和情绪需求,并对其做出恰当的回应.临床共情具有科学的理论和实践基础,具有缓解患者心理上的痛苦,改善护患关系,促进患者康复等作用.在当今复杂的医疗环境下,务必要重视共情培养,适时运用临床共情.然而,我们强调临床共情的重要作用,并不能忽视护理技术的根本作用,根除躯体上的病变仍有赖于护理技术的有效性.在临床护理实践中,坚持共情与护理技术的有机结合,推进人性化的护理构建.     

People with severe and profound intellectual disability: Nurse carer experiences in a South African setting

We explored nurse carer experiences with people with severe and profound intellectual disability in a care and rehabilitation centre in South Africa. Informants were a convenience sample of 10 nurses (females = 7; males = 3; mean years of service = 7.8, SD = 4.8 years). They completed an unstructured interview on their care provision experiences. The data were thematically analysed using Tesch’s method of open coding. Findings resulted in the following three themes to characterise the nurse carer experiences: compassion, person-centred care, and importance of parent involvement. Compassionate and person-centred care is fundamental to the establishment of a therapeutic relationship between nurse carers and people with severe and profound intellectual disability.     

Spirituality and spiritual care – missing concepts from core undergraduate children’s nursing textbooks

Background: Spiritual care is espoused to be fundamental in children’s nursing; however, the extent to which current fundamental children’s nursing textbooks support and advocate spiritual care delivery by children’s nurses and nursing students is unknown. Aim and objectives: To examine whether or not fundamental undergraduate children’s nursing textbooks include spiritual care content. Methods: Five hundred and nineteen books were sampled from the Nursing and Midwifery Core Collection list (UK) using a survey, the Spirituality Textbook Analysis Tool (STAT) to collect data. Analysis and Results: 519 books were included in the study using the STAT and 13 books included content on children’s spirituality. There were a variety of textbooks in the audit of those that made reference to the search terms in the STAT, it was found that content mainly addressed only two areas; religious faiths and the dying child. Recommendations: Children’s nurses require education about children’s spiritual developmental stage and age appropriate spiritual assessment. A lack of detailed information in core children’s nursing textbooks means that this area of nursing practice may be taught as an adjunct to care and not as an element of holistic care which is the gold standard that children’s nurses should strive for.     

Chapter 7. Workfare

SUMMARY

In this chapter, I present the participants' experiences in the work setting from their own perspective.     

Occupational stress of professional nurses in South Africa

The objective of this study was to identify occupational stressors for professional nurses in South Africa. A cross-sectional survey design was used. A stratified random sample of professional nurses (n=818; females?=?97%) in hospitals in South Africa was used. The Nursing Stress Indicator (NSI) was administrated together with a biographical questionnaire. Three internally consistent stress factors, namely lack of organisational support, job demands and nursing-specific demands, were extracted. The most severe stressors for professional nurses included staff shortages, inadequate salaries and excessive administrative duties. Work overload, fellow workers not doing their job, health risks posed by contact with patients and demands of patients were also identified as stressors. Stress was associated with specific factors, including age, position (rank), care unit, and work experience.     

Mental Health Services in Kentucky Nursing Homes: A Survey of Administrators

National surveys have shown that mental health problems are prevalent in long-term care and suggest that these settings are largely underserved by mental health services. Nursing home administrators are gatekeepers for mental health services in nursing homes. Administrators of Kentucky nursing homes were surveyed regarding their perceptions of mental health problems, current and future services use, satisfaction with services, and need for consultation. The response rate was 24%. Administrators appeared to underestimate mental health problems among residents. Most facilities were using at least one type of mental health service, but fewer residents received services than would be expected given the problem prevalence. Psychological services were underused, in spite of the fact that behavior management stood out as a major need. Psychiatry was more frequently used, but with less satisfaction. Results indicate significant financial and logistical barriers to mental health services. Future work is needed on developing, assessing, and disseminating models of effective service provision to long-term care.     

Factors Influencing Level of Stress During the Nursing Home Decision Process

This investigation examined whether characteristics of elders and their caregivers and facets of the nursing home decision-making context were associated with recalled levels of stress during nursing home decision-making. Employing a conceptual framework based upon the literature on caregiver stress and nursing home decision-making, we considered a number of factors that might influence sponsors' stress as decisions were being made about nursing home placements. We examined data from telephone interviews with a sample of 142 sponsors (responsible parties) of first-time, recently admitted nursing home residents. Higher levels of reported stress were directly associated with more factors triggering the decision to admit, higher levels of competing demands, and limited time. Employment was indirectly related to higher stress through its impact on demands. Hospitalization and being the spouse or an adult child of the resident were indirectly related to stress because they were associated with limited available time. The results offer some insights into the types of individuals who may be vulnerable to higher levels of stress and the kinds of interventions that might avert high stress in the nursing home decision process.