Institutional Ethnography and Experience as Data

Experience, as concept, is contested among feminists as to its epistemological status, thus its usefulness in knowledge claims. Institutional ethnography (Smith 1987) is a feminist methodology that nonetheless relies fundamentally on people's experience. Not as Truth, nor the object of inquiry, but as thepoint d'appui for sociological inquiry. This article offers a demonstration of institutional enthnography using observational and interview data that show experience as methodologically central to a trustworthy analysis. A moment in the work lives of nursing assistants in a long-term care setting is captured by a participant observer. The analysis produces two lines of argument. One is methodological; it is argued that nursing assistants' experiences are an entry into the social relations of the setting that, when mapped and disclosed, make those experiences understandable in terms of the ruling arrangements permeating both the organization and their own experiences. The other argument is substantive; the inquiry uncovers how a quality improvement' strategy in a long term care hospital in Canada is reorganizing caregivers' values and practices toward a market orientation in which care appears to be compromised. Use of experience as data in this approach holds the analysis accountable to everyday/everynight actualities in a lived world.     

Staff Perceptions of Same-Gender Sexual Contacts in Long-Term Care Facilities

An ongoing fear in the gay and lesbian community is that long-term care (LTC) facilities may not be sensitive to their needs. In the present study, 218 LTC staff members responded to one of three vignettes in which resident sexual contact was observed, with only the gender of the characters changing, to create different gender pairings. Results suggested that staff rated male-male and female-female pairings more negatively than heterosexual intimacy. Knowledge about older adult sexuality made little difference in staff ratings. However, staff attitudes were directly related to ratings of negative reaction and level of acceptability of same-gender sexuality.     

Improving medicolegal death investigative gaps of fatal elder abuse

The purpose of this brief is to present several case vignettes that illustrate omissions in the investigation of elder deaths. These vignettes demonstrate the need for a standardized approach in the conduct of medicolegal investigations of fatal elder abuse. For each of the described oversights, a recommendation is offered to address the gap in investigation processes, which in turn could improve the determination of cause and manner of elder death. Inherent limitations of resources and practical realities of death investigation are discussed and recommendations are made for future research. Viewed broadly, deficiencies in elder death investigations can lead to the underreporting of elder abuse and the reduction of legal options for victims, which may reflect a systemic pattern of social injustice.     

人口老龄化背景下机构养老国内外研究比较

当前学界对机构养老的讨论日趋热烈，但遍观国内现有文献，对国外机构养老研究进展普遍关注不足。本研究通过从机构养老的概念界定、养老机构、入住老年人群、机构养老服务质量这四个维度对国内外机构养老研究成果进行归类梳理，发现国内机构养老研究在功能界定、管理与运营、服务质量监管等方面差距较大，而对于入住老年人群的需求和入住意愿分析方面则与西方差距较小。同时，我国机构养老的理论对于实践的指导作用并不显著，我国理论界相对于养老实践有滞后之虞。基于以上分析，本文提出以下建议：探索机构养老发展的新模式，完善养老机构管理与运营结构以及发展第三方服务监管体系。     

2000—2010年广东省老年人口空间分布演变研究

根据2000年第五次人口普查数据、2010年第六次人口普查数据和相关社会经济统计数据,利用地理信息系统技术对广东省老年人口空间分布变化和特征进行分析,阐明导致该空间格局演变的主要原因,并据此提出完善养老服务的建议,主要包括：全面提高全省医疗卫生服务水平;经济落后的、老人比例较高的地区应完善公办老年公寓、托老所、老人活动中心等相关养老福利的落实;经济发达的、老人比例较低的地区除提供基本养老福利以外,还可以尝试新型老人居住模式,如旧社区适老性改造、商住—养老复合社区等。     

Children's nurses' experiences of child protection: what helps?

This paper reports on one area of findings of a study undertaken in the spring of 2008 at a district general hospital in the south of England. Individual semi‐structured interviews using an interpretive phenomenological approach were undertaken with 15 nurses and midwives working in paediatrics who had been involved in child protection cases. The aim was to explore their views and feelings of the experience. Very little research was found to inform this subject and none specifically with nurses working with sick children. Interviews were taped, transcribed and analysed thematically. It was discovered that involvement in child protection has a lasting impact on individuals; nurses need procedural information from a knowledgeable supporter during a case; and they need support from the right person in the right place at the right time for them. The Named Nurse was identified as being crucial in giving effective support to individuals during child protection cases and trusted advice and support helps staff follow through on niggling concerns, potentially preventing abuse. Copyright © 2009 John Wiley & Sons, Ltd.     

Assessing social work and nursing students’ intentions to work with dying patients

This study assessed social work and nursing students’ intentions to provide end-of-life care, based on the Theory of Planned Behavior. A total of 181 social work and nursing students completed a questionnaire examining intentions to provide end-of-life care, attitudes, subjective norms, perceived control, death anxiety, subjective knowledge, and sociodemographic characteristics. Students manifested a moderate level of intentions to provide end-of-life care, with nursing students indicating higher levels of intentions than social work students. Multiple regression analyses revealed that attitudes, subjective norms, and previous experience were the main predictors of intentions to provide end-of-life care. Recommendations for academic programs are discussed.     

The “Our Homes,Not Nursing Homes” Project

ABSTRACT

The voices of non-elderly adults with disabilities who currently-or used to-reside in nursing homes are rarely heard. A grassroots disability advocacy organization conducts participatory action research in the form of a writing workshop in collaboration with a local community-college. Participants with disabilities describe their lives and their experiences in nursing homes with the help of volunteer scribes. The information provided in their accounts will help strengthen community-organizing efforts of the disability advocacy organization. And participants have been empowered by the realization that their life stories are helping others to leave nursing homes and join community settings.     

The Family Group Within the Nursing Home:

An ongoing monthly family group was implemented in an intermediate care facility in hopes of improving communication between staff and families of long term care residents. Other objectives of the group were to provide families with information about policies and procedures, education about the aging process, and to facilitate an informal support group network where families could share problems and concerns. The feedback and evaluation process indicated that sharing feelings of anger, quiet, frustration and other emotions helped the families deal with the responsibilities of institutionalizing a relative and helped to facilitate better communication between staff and family members.