Care management journals : Journal of case management ; The journal of long term home health care最新文献

{"title":"Expressions of Identity and Self in Daily Life at a Group Home for Older Persons With Dementia in Japan.","authors":"Els-Marie Anbäcken,&nbsp;Kayoko Minemoto,&nbsp;Miwa Fujii","doi":"10.1891/1521-0987.16.2.64","DOIUrl":"https://doi.org/10.1891/1521-0987.16.2.64","url":null,"abstract":"<p><p>This study focuses on expressions of identity and self among residents at a group home for older persons with dementia in Japan--a study, which started as an explorative study on spirituality--and how residents make meaning of life. Although aware of stages of dementia illness and briefly commenting on these, the analysis does not make any specific point of it. This article views dementia from a sociocultural perspective and is based on participant observations at a group home with 19 residents, combined with interviews with 6 of them. Two central concepts for the study are discussed and drawn on in the analysis: ie, meaning home and family, and dementia and boke, senility. The study examines how the group home is ie and concludes that it is \"home enough\" in the sense that one's identity and self are honored here. The old word boke represents a state in which one has \"given up\" any attempts to keep one's mental health. This concept was used by some residents to mark the line between those who were \"helpless\" with boke and those who could manage by themselves without boke. Identities are analyzed in different terms: as profession, as feeling secure, as being physically close, in social interactions, and as being cared for properly also after death. The analysis of self and identity showed that contentment in life was expressed in various ways, as a whole or as a patchwork with light and dark colors, and that it is still in process. Here, the supportive but discreet scaffolding of staff seems to matter. Life is lived until death, and the farewell ceremonies are analyzed as existential closures for many--and for life finalized here at Ie, the group home.</p>","PeriodicalId":80262,"journal":{"name":"Care management journals : Journal of case management ; The journal of long term home health care","volume":"16 2","pages":"64-78"},"PeriodicalIF":0.0,"publicationDate":"2015-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1891/1521-0987.16.2.64","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34283029","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Approaches to Information Sharing and Assessment: Evidence From a Demonstration Program.","authors":"Helen Chester,&nbsp;Jane Hughes,&nbsp;Paul Clarkson,&nbsp;Sue Davies,&nbsp;David Challis","doi":"10.1891/1521-0987.16.3.150","DOIUrl":"https://doi.org/10.1891/1521-0987.16.3.150","url":null,"abstract":"<p><p>This article categorizes and delineates approaches to information sharing and assessment in a demonstration program established by central government in England. Its purpose was to develop and test a set of principles relating to a general assessment framework for adults in demonstrator sites, maximizing the use of information technology where feasible. The method employed comprised the systematic analysis of documents associated with the funding application and a telephone interview with personnel in each site. Data were collected from 17 initiatives, 13 of which provided detailed information on information sharing within the assessment process. A taxonomy of approaches was produced and information sharing in the assessment process reported in terms of setting and personnel; approaches to data collection, storage, and transfer; and changes to the process. A classification of the initiatives within a demonstration program was a useful means of describing them. Measures of intermediate outcomes captured changes in information sharing between agencies. Local initiatives were successful in promoting electronic information sharing between health and social care agencies.</p>","PeriodicalId":80262,"journal":{"name":"Care management journals : Journal of case management ; The journal of long term home health care","volume":"16 3","pages":"150-8"},"PeriodicalIF":0.0,"publicationDate":"2015-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1891/1521-0987.16.3.150","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34167388","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Frankly, None of Us Know What Dementia Is: Dementia Caregiving Among Iranian Immigrants Living in Sweden.","authors":"Eleonor Antelius,&nbsp;Mahin Kiwi","doi":"10.1891/1521-0987.16.2.79","DOIUrl":"https://doi.org/10.1891/1521-0987.16.2.79","url":null,"abstract":"<p><p>In quite a short amount of time, Sweden has gone from being a relatively homogeneous society to a multicultural one, with a rapid expansion of immigrants having culturally and linguistically diverse (CALD) backgrounds growing old in Sweden. This is particularly interesting in relation to studying age-related dementia diseases. Research shows that not only do CALD persons with dementia diseases tend to mix languages, have difficulties with separation of languages, or revert to speaking only their native tongue as the disease progresses, but they also show tendencies to experience that they live in the cultural environment in which they were brought up, rather than in the current Swedish one. In this article, we explore findings in relation to one such CALD group in Sweden, Iranians. The article is empirically driven and based on data gathered in 2 separate settings with specific ethnocultural profiles, offering dementia care with Middle Eastern, Arab, and/or Persian profile. Observations were carried out in combination with semistructured in-depth interviews (n = 66). By using a combination of content and ethnographic analysis, 4 main findings related to ethnocultural dementia care were elucidated. These include (a) a wider recognition of people from different CALD backgrounds possibly having different perceptions of what dementia is, (b) a possibility that such ascribed meaning of dementia has a bearing on health maintenance and health-seeking behavior as well as the inclination to use formal services or not, (c) choosing to use formal service in the forms of ethnoculturally profiled dementia care facility seems to relate to being able to \"live up to ideals of Iranian culture,\" and (d) \"culture,\" however ambiguous and hotly debated a concept it is, appears to be a relevant aspect of people's lives, an aspect that is both acquired as well as ascribed to oneself and to others. As such, we argue that culture needs to be further addressed in relation to dementia care in multicultural societies because ascribing culture boxes people in as well as out. In addition, ethnocultural contextualization of dementia care needs to be understood in relation to this because it affects the care provided.</p>","PeriodicalId":80262,"journal":{"name":"Care management journals : Journal of case management ; The journal of long term home health care","volume":"16 2","pages":"79-94"},"PeriodicalIF":0.0,"publicationDate":"2015-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1891/1521-0987.16.2.79","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34283030","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identifying pious and heretical citizens in a permanent supported housing community.","authors":"Anthony Wright","doi":"10.1891/1521-0987.16.1.30","DOIUrl":"https://doi.org/10.1891/1521-0987.16.1.30","url":null,"abstract":"<p><p>This article offers an analysis of the impact of recovery-oriented treatment discourses and practices on tenant-staff relationships in the context of the Pinewood Apartments, a Texas-based permanent supported housing community. Drawing on 6 months of ethnographic research and personal experience of working as a caregiver at Pinewood, I demonstrate how tenant-staff relationships were compromised by service providers' negative evaluations of certain tenants in the context of emotionally charged service interactions. These negative evaluations, I argue, stem from deeply held ideas about valuable citizenship that are embedded in the philosophy and practices of recovery, which emphasizes client choice, self-sufficiency, and autonomy. It should be noted, though, that negative evaluations were not necessarily definitive; both tenants and service providers at times exhibited sympathy and forgiveness for each other.</p>","PeriodicalId":80262,"journal":{"name":"Care management journals : Journal of case management ; The journal of long term home health care","volume":"16 1","pages":"30-40"},"PeriodicalIF":0.0,"publicationDate":"2015-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1891/1521-0987.16.1.30","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33256845","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Introduction to the Special Issue.","authors":"J Neil Henderson","doi":"10.1891/1521-0987.15.4.158","DOIUrl":"https://doi.org/10.1891/1521-0987.15.4.158","url":null,"abstract":"","PeriodicalId":80262,"journal":{"name":"Care management journals : Journal of case management ; The journal of long term home health care","volume":"15 4","pages":"158-159"},"PeriodicalIF":0.0,"publicationDate":"2014-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1891/1521-0987.15.4.158","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34109633","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Survey of Self-Management and Intrusiveness of Illness in Native Americans with Diabetes Mellitus.","authors":"Ann F Chou,&nbsp;Evaren E Page,&nbsp;Ann I Norris,&nbsp;Sue E Kim,&nbsp;David M Thompson,&nbsp;Robert H Roswell","doi":"10.1891/1521-0987.15.4.170","DOIUrl":"https://doi.org/10.1891/1521-0987.15.4.170","url":null,"abstract":"<p><p>Diabetes mellitus (DM) has emerged as an important focus of national public health efforts because of the rapid increase in the burden of this disease. In particular, DM disproportionately affects Native Americans. Adequate management of DM requires that patients participate as active partners in their own care and much of patient activation and empowerment can be attributed to their experience with DM and self-care. That is, the degree to which the patient feels the disease intrudes on his or her daily life would impact the motivation for self-care. We conducted a study in collaboration with 2 tribal nations in Oklahoma, collecting data on survey questions regarding intrusiveness of illness and self-management behaviors from a sample of 159 members of the Chickasaw and Choctaw Nations. Previously validated variables measuring intrusiveness of illness and self-care were included in the survey. Descriptive statistics and bivariate analyses illustrated the distribution of these variables and identified possible tribal and gender differences. Our findings showed that our sample adjusted well to DM and in general exhibited high compliance to self-care. However, our findings also revealed striking gender differences where female respondents were better adjusted to their disease, whereas male respondents reported higher adherence to self-management. Findings from our study, particularly those that describe tribal differences and gender disparities, can inform strategies for case management and patient interactions with providers and the health care system.</p>","PeriodicalId":80262,"journal":{"name":"Care management journals : Journal of case management ; The journal of long term home health care","volume":"15 4","pages":"170-183"},"PeriodicalIF":0.0,"publicationDate":"2014-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1891/1521-0987.15.4.170","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34109636","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"American Indian Diabetes Prevention Center: Challenges of a Health Equity Quest.","authors":"J Neil Henderson, L D Carson","doi":"10.1891/1521-0987.15.4.196","DOIUrl":"10.1891/1521-0987.15.4.196","url":null,"abstract":"<p><p>American Indians are classified by the federal government as a \"health disparities population\" with significant excess morbidity and mortality caused by diabetes and its many complications. The National Institute on Minority Health and Health Disparities of the National Institutes of Health has created a national program titled \"Centers of Excellence\" whose primary goal is the elimination of health disparities. This article describes the American Indian Diabetes Prevention Center at the University of Oklahoma Health Sciences Center, College of Public Health, in terms of its intellectual foundations rooted in a biocultural analytic model and operationalized by an interdisciplinary functioning staff. Challenges are described in terms of the monumental task of impacting health disparity conditions and in the exigencies of research collaborations with American Indian Nations located in rural areas remote to the University's health sciences urban-based hub.</p>","PeriodicalId":80262,"journal":{"name":"Care management journals : Journal of case management ; The journal of long term home health care","volume":"15 4","pages":"196-204"},"PeriodicalIF":0.0,"publicationDate":"2014-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4540070/pdf/nihms695814.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34109637","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perceptions and Concerns Regarding Diabetes Mellitus During Pregnancy Among American Indian Women.","authors":"L D Carson,&nbsp;J Neil Henderson,&nbsp;Kama King,&nbsp;Keith Kleszynski,&nbsp;David M Thompson,&nbsp;Patricia Mayer","doi":"10.1891/1521-0987.15.4.160","DOIUrl":"https://doi.org/10.1891/1521-0987.15.4.160","url":null,"abstract":"<p><p>Diabetes among American Indian (AI) people is a. condition that creates excessive morbidity and mortality and is a significant health disparity. This research delineated culturally constructed models of diabetes mellitus (DM) among 97 pregnant women in 2 large AI Nations to Oklahoma. Analysis of data revealed intense anxiety, fear, and dread related to DM during pregnancy. The sample was stratified by DM status: (a) absence of DM (<i>n</i> = 66), (b) DM prior to pregnancy (<i>n</i> = 4), and (c) gestational (<i>n</i> = 27). Structured and semistructured interviews elicited patient culturally based explanatory models (EMs) of etiology, course, and treatment. The research incorporated an integrated phenomenologic and ethnographic approach and yielded both quantitative and qualitative data. General findings comprised the following main categories of patients' concerns regarding DM as an illness: (a) care-seeking behaviors, (b) medical management, (c) adherence and self-management, (d) complications, and (e) the conceptual sense of DM as a \"severe\" and feared condition. Many findings varied according to acculturation status, but all included significant fear and anxiety surrounding (a) the health and well-being of the unborn child, (b) the use of insulin injections, (c) blindness, (d) amputation, and (e) death, but with (f) a paradoxically lowered anxiety level about diabetes severity <i>overall,</i> while at the same time expressing extreme dread of specific outcomes. The latter finding is considered consistent with the presence of chronic conditions that can usually be managed, yet still having risk if severe.</p>","PeriodicalId":80262,"journal":{"name":"Care management journals : Journal of case management ; The journal of long term home health care","volume":"15 4","pages":"160-169"},"PeriodicalIF":0.0,"publicationDate":"2014-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1891/1521-0987.15.4.160","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34109634","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Weight-Bearing Exercise and Foot Health in Native Americans.","authors":"Elena Cuaderes,&nbsp;Lise DeShea,&nbsp;W Lyndon Lamb","doi":"10.1891/1521-0987.15.4.184","DOIUrl":"https://doi.org/10.1891/1521-0987.15.4.184","url":null,"abstract":"<p><p>Diabetes contributes to sensory peripheral neuropathy, which has been linked to lower limb abnormalities that raise the risk for foot ulcers and amputations. Because amputations are a reason for pain and hospitalization in those with diabetes, it is of critical importance to gain insight about prevention of ulcer development in this population. Although the American Diabetes Association (ADA) now recommends that individuals with neuropathy can engage in moderate-intensity weight-bearing activity (WBA), they must wear appropriate footwear and inspect their feet daily. The physical forces and inflammatory processes from WBA may contribute to plantar characteristics that lead to ulcers. The purpose of this study was to compare neuropathic status and foot characteristics in Native Americans according to WBA classification. The <i>t</i> tests for unequal sample sizes found that exercisers had more difficulty sensing baseline temperature than nonexercisers, except at the right foot (all <i>p</i> values < .05). By dividing groups into no/low risk and high risk for ulcer, a majority showed no/low risk according to touch and vibration sense. Exercisers demonstrated higher surface skin temperature gradients at the first metatarsal head, a plantar site where wounds tend to form. The more consistently exercisers performed, the higher the plan-tar pressures were at the right second (<i>r</i> = .24, <i>p</i> = .02) and third metatarsal heads (<i>r</i> = .26, <i>p</i> = .01). Findings from this investigation do not refute current ADA recommendations and further intervention studies are needed that are longitudinal and measures WBA more accurately.</p>","PeriodicalId":80262,"journal":{"name":"Care management journals : Journal of case management ; The journal of long term home health care","volume":"15 4","pages":"184-195"},"PeriodicalIF":0.0,"publicationDate":"2014-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1891/1521-0987.15.4.184","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34109638","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Second Life and Access for the Disabled and Homebound","authors":"J. Traphagan, Katherine Sanchez","doi":"10.1891/1521-0987.15.3.147","DOIUrl":"https://doi.org/10.1891/1521-0987.15.3.147","url":null,"abstract":"","PeriodicalId":80262,"journal":{"name":"Care management journals : Journal of case management ; The journal of long term home health care","volume":"283 1","pages":"147 - 151"},"PeriodicalIF":0.0,"publicationDate":"2014-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73180571","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}