Key Determinants to using Telehealth Technology to Serve Medically Ill and Depressed Homebound Older Adults

Despite the increasing evidence for the effectiveness of telehealth technology in screening and treating chronic diseases, and comorbid depression among older adults, they have been slowly adopted by home health care (HHC) agencies. Therefore, this study aimed to identify factors that determine telehealth technology adoption. Twenty directors from the National Association for Homecare & Hospice member agencies completed a 45-min telephone interview. Questions were asked regarding their perceptions of telehealth, the key determinants of telehealth adoption and use, and recommendations they would give on telehealth adoption. The majority of the participants perceived telehealth as effective for managing symptoms and reducing cost. Meanwhile, some participants had a mixed feeling toward telehealth for depression care as they did not recognize their agency as equipped with the necessary resources and trained staff. Moreover, significant determinants of telehealth adoption included the agency-related characteristics, the patient-home environment, reimbursement and cost-related factors, and staff telehealth perception. Findings imply that there is a need for financial support both at the state and the federal levels to encourage telehealth adoption among HHC agencies. Future studies should consider exploring strategies used by successful programs to overcome barriers.     

孤残儿童的机构照顾与社会融合

机构照顾是我国目前孤残儿童福利服务的主要模式,对孤残儿童的衣、食、住、行、医有了较全面的保障,并为这些特殊儿童提供了安全、健康的集体环境。但随着我国改革开放的不断深入,儿童福利照顾的理念和照顾模式也在发生新的变革,跟很多发达国家的发展经历相似,在照顾模式中,改革、变化的趋势是:从大机构到小机构的转变,从机构照顾到家庭寄养和家庭收养模式的转变。本文重点探讨国外孤残儿童机构照顾的实践及其反思,以及我国孤残儿童机构照顾模式存在的问题,特别在社会融合方面存在的缺陷。试图分析孤残儿童走向社会融合的可能途径,并以上海市儿童福利院为例,从现实操作层面来看这些途径的有效性。     

福建省养老服务问题及对策初探

在分析福建省养老服务事业发展所面临的问题基础上,对发展福建省养老服务事业提出对策和建议,指出要以科学发展观为指导,发展养老服务理念;加快政府职能转变,推进养老服务体系建设;建立社会多元筹资模式,鼓励社会力量投入养老产业;提升社区服务水平,优化社区养老服务体系运行机制;建立专业化养老工作者队伍,充分发挥志愿者作用,力图为发展养老服务需求提供政策理论依据,积极有效地应对福建省人口老龄化以及社会变迁。     

Differences and similarities in monetary benefits for informal care in old and new EU member states

This article presents an overview of the monetary benefits available in the context of long‐term care provided by family or other informal carers in 11 old and 10 new EU member states. All but one country in our sample offer at least some monetary benefits that can be used to help finance informal care. Old EU member states tend to direct benefits to individuals in need of care, whereas new EU member states place more emphasis on benefits for carers. Among new EU member states, monetary benefits are less often means‐tested and tend to be lower compared with benefits in old EU member states. Because social policies in many countries increasingly rely on monetary benefits rather than on benefits in kind and because the share of informal care in the overall provision of elderly care will scarcely decline, monetary benefit incentives for labour market participation need to be carefully monitored.     

Placement characteristics and stability: a longitudinal analysis of Norwegian children in foster homes

This paper investigates how enhanced support for foster parents, such as covering fees and providing consultants and relief, may reduce the number of replacements experienced by children in foster care. It also investigates the extent to which replacements are associated with family (kin) vs. non‐family foster parents, or with legal characteristics of the placement (i.e. forced administrative decisions vs. relief measures agreed upon by the parents). Statistical analyses of administrative data from Norway investigated the longitudinal relationships between these characteristics and the number of replacements at two levels – children (N = 16 109) and municipalities (N = 418) – over 5 years (2007–2011). The results reveal modest associations between enhanced support and fewer replacements; for example, replacement rates are lower for children placed in homes of kin than in non‐family homes. Replacements also tend to be fewer when the placement is forced rather than consensual.     

临终关怀制度构建:挑战与线路图

临终关怀对于减轻身心痛苦和死亡恐惧的显著作用已经得到国内外数十年研究成果的充分证明。据世界卫生组织及国内外专业期刊统计数据,中国临终关怀现状堪忧,中国社会老龄化及城市化加速发展使临终关怀事业遭遇日益严峻的挑战,体现于医疗资源分配不平等、法律法规缺位、职业培训不足和程序化措施不力。研究基于国内过去30年来临终护理经验教训的现实,以充分数据资料分析中国临终关怀体系建构在观念层面、财政保险资金层面、法律法规层面、教育培训层面和医护制度层面所面临的挑战,指出问题的核心是医护观念陈旧和政府投入严重不足,解决问题的关键在于临终关怀法律法规体系的构建,具体为临终关怀法规与医保管理的制度性优化、拓宽慈善资源和培育临终医护资源。     

建立中国特色的社区综合养老社会服务体系

支持老人就地养老是当前老年社会服务的一个核心实践。它不仅能够让老人在熟悉的社区环境里度过晚年,维系对身心健康具有重要意义的社会网络和社会支持,而且与机构照顾相比,能够显著降低社会成本。分析我国当前社区养老服务的有利条件和不利因素,总结梳理国际上的养老服务经验,提出在我国城市和农村建立社区综合养老社会服务体系的框架。这一框架试图将当前参与养老社会服务的多元主体纳入其中,包括社区养老服务、机构养老服务、居家养老服务、家庭(类似家庭或模拟家庭)养老、结伴(老年公寓)养老等方面。最后就政府的宏观战略规划、完善社会服务支持体系和构建良好的养老环境提出了政策建议,以期对社区综合养老服务体系的建立和完善提供必要支持。     

家庭状况对残疾人服务模式选择的影响

利用2009年北京市残疾人服务需求状况调查数据,以1 198名残疾人为研究对象,采用Logistic Regression模型进行逐步回归,研究了残疾人的家庭状况对其服务模式选择的影响。研究发现,家庭特征、照料资源、家庭及社区环境等因素对残疾人的服务模式选择有重要影响:残疾人多乐于选择居家服务;由子女/孙子女和配偶照料的残疾人选择机构托养服务的较少;社区服务设施状况越好,残疾人越乐于利用社区服务。     

试论康有为的终极关怀

康有为以大同理想作为终极目标,从道德和宗教两个层面同时建构其终极关怀体系,不仅实现了"仁"的本体境界的深化与突破,而且使传统儒学的核心接受了西方现代文明的洗礼,首开近代终极关怀思想之先河,深刻影响了现代新儒家"内圣开出新外王"的终极关怀之路.从这个意义上说,把康有为列为新儒家的先驱或启蒙,似不为过.     

农民工公共服务歧视性供给现象探究——基于公共服务均等化的视角

城市农民工在公共服务方面存在多方面的歧视和不公平对待,其主要根源是二元经济结构和户籍制度的限制。以“基本公共服务均等化”为普遍标准解决农民工问题,就需要推动二元经济结构和户籍制度的改革,转变政府治理理念：而“公共服务均等化”意味着政府将致力于逐步缩小城乡之间、不同区域之间、不同群体的基本公共服务差距．推动社会管理向实现基本公共服务均等化、城乡居民权利平等的社会治理转变,以促进社会公平和正义,共同享受改革开放的成果。