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首页> 外文学位 >Evaluating person-environment fit in skilled nursing facilities: Factors affecting physical and chemical restraint use.
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Evaluating person-environment fit in skilled nursing facilities: Factors affecting physical and chemical restraint use.

机译：评估熟练护理设施中的人与环境适应性：影响物理和化学约束使用的因素。

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摘要

Although nursing home use of physical and chemical restraints is associated with adverse resident outcomes and was extensively addressed by the Omnibus Budget and Reconciliation Act of 1987 (OBRA87), preliminary evidence suggests that many nursing homes are continuing their use. While the use of physical and chemical restraints adversely affect all residents, residents with dementia are at a higher risk of being restrained.;Although administrators traditionally have been reluctant to admit individuals with dementia due to behavioral problems, some nursing homes are now actively marketing services to the demented population. Some nursing homes have established a special care unit for residents with dementia which provides--or claims to provide--a care environment designed specifically to address their needs. Reduction in the use of chemical and physical restraints is a stated primary objective of many special care units. However, some researchers report that the phrase "special care unit" is primarily a marketing tool and specialized services are not provided.;The goal of this study is to identify the care environment characteristics associated with reduced restraint use, determine if special care units are associated with reduced restraint use, and provide information to policymakers engaged in setting reimbursement and regulation policies.;Using the data from the Alzheimer's Special Care Units: Longitudinal Outcome Study, this study examined differences in restraint condition as a function of resident capabilities and competence, unit physical design characteristics, and organizational and management characteristics.;The primary finding from the study is that special care units are associated with a decreased likelihood of a resident being physically restrained, but are associated with an increase in the likelihood of chemical restraint. Additionally, a higher percentage of MediCal reimbursement is associated with an increased likelihood of chemical restraint, while the presence of an exit monitor is associated with a decreased likelihood of physical restraint.;This findings have important implications for nursing home policy initiatives regarding special care units and Medicaid reimbursement rates, regulation, and the implementation of OBRA87. Additional research in special care units regarding different physical design features, regulatory effects, cost of care, and international comparisons is still needed.
机译：尽管疗养院使用物理和化学约束物会给居民带来不良后果，并且在1987年《综合预算与和解法案》（OBRA87）中得到了广泛解决，但初步证据表明，许多疗养院正在继续使用它们。尽管使用物理和化学约束对全体居民产生不利影响，但痴呆症患者受到约束的风险更高。；尽管传统上管理员由于行为问题不愿接纳患有痴呆症的人，但一些疗养院现在正在积极推销服务对痴呆的人群。一些疗养院已为痴呆症居民建立了一个特别护理单位，该单位提供或声称提供-专为满足其需求而设计的护理环境。减少化学和物理约束的使用是许多特殊护理部门的既定主要目标。但是，一些研究人员报告说，“特殊护理病房”一词主要是一种营销工具，并且不提供专门服务。与减少约束的使用相关，并为从事制定报销和监管政策的决策者提供信息。使用来自阿尔茨海默病特殊护理部门的数据：纵向结果研究，该研究考察了约束条件随居民能力和能力的差异，该研究的主要发现是，特殊护理单位与居民身体受到束缚的可能性降低有关，但与化学物质束缚的可能性增加有关。此外，较高的MediCal报销比例与化学束缚的可能性增加有关，而退出监控器的存在与物理束缚的可能性减少有关;该发现对养老院有关特殊护理部门的政策措施具有重要意义。以及医疗补助报销率，法规和OBRA87的实施。仍需要在特殊护理部门中就不同的物理设计特征，监管效果，护理成本以及国际比较进行其他研究。

著录项

  • 作者

    Fogarty, Toni Elizabeth.;

  • 作者单位

    University of California, Berkeley.;

  • 授予单位 University of California, Berkeley.;
  • 学科 Health care management.;Nursing.;Public health.
  • 学位 Ph.D.
  • 年度 1995
  • 页码 123 p.
  • 总页数 123
  • 原文格式 PDF
  • 正文语种 eng
  • 中图分类
  • 关键词

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