Adult Day Services(adult day care): Cultural Contexts and Programming Effects

成人日间服务（成人日托）：文化背景和规划效果

• 批准号: 9065473
• 负责人: Robert L. Rubinstein
• 金额: $ 34.82万
• 依托单位: UNIVERSITY OF MARYLAND BALTIMORE COUNTY
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-06-15 至 2018-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9065473
• 关键词: Adult; Affect; Atlases; Attitude; Behavior; Belief; Caregivers; Caring; Case Study; Client; Complex; Data; Data Analyses; Day Care; Development; Elderly; Ethnography; Family; Family Caregiver; Family member; Foundations; Goals; Health; Home environment; Individual; Institutes; Interview; Life; Life Experience; Literature; Location; Maryland; Medical; Nature; Nursing Homes; Participant; Pattern; Personal Satisfaction; Policies; Problem behavior; Public Health; Qualitative Methods; Qualitative Research; Research; Research Methodology; Services; Site; Social Interaction; Structure; Text; Time; base; caregiving; community based care; innovation; operation; programs; social

DESCRIPTION (provided by applicant): Adult day services (ADS) have emerged as a significant non-institutional form of care for impaired older persons. There are about 4,601 ADS programs nationally serving about 260,000 clients. ADS centers offer daily programming (medical care, social activities and meals) for impaired elders at a central location and, at the same time, offer daily respite for family caregivers who receive time away at home from their often-onerous caregiving duties. There has been little or no study of the sociocultural backdrop or context to ADS. We are proposing a 48-month sequential study of 6 ADS centers (6 months each) in Maryland, conducting ethnographic research. The general goal of this proposed research is to examine the cultures, contexts, programming and activity content and client life within these centers. Through this research, we hope to better understand how ADS cultures (including values, meanings, taken- for-granted assumptions, patterns of attendance, problematic behaviors, staff relationships, client social interactions, activities and programming, and ideas on retention versus transfer) differentially affect the lives of clients, the key family members of the clients, and the ADS staff. This proposed research has 4 specific aims: 1. To examine the cultural and contextual beliefs, structures, similarities and differences among 6 diverse ADS centers; 2. To examine the differential understanding among staff, family and clients of the lived experiences of clients, including perceived benefits and difficulties of each ADS center; 3. To understand and describe the operation and meaning of both individually- and group-oriented programming and activities in each of the 6 ADS; 4. To better understand, through case studies and other qualitative research methods, the following: a) local ADS policies on and attitudes to daily attendance; b) social relations of ADS clients; c) problem behaviors; d) retention versus transfer strategies; e) types of programming used; f) introduction of new forms of programming; g) "individual" versus "lowest-common-denominator" approaches to programming; and h) program goals and local meanings (definitions of what each ADS is trying to accomplish). This proposed research is highly innovative and would be, to our knowledge, one of the first ethnographic studies of ADS. Life and the first study to compare in detail multiple sites. Research would utilize participant observation (PO), ethnographic interviewing (EI), and case studies to better understand the culture and daily life of the 6 ADS centers. Standard methods of qualitative data analysis, including the development of a text base in Atlas.ti, would be utilized to manage and interpret the data we gather.

描述（由申请人提供）：成人日服务（AD）已成为对老年人受损的重要非机构护理形式。全国大约有4,601个广告计划为大约260,000个客户提供服务。广告中心为中心地点的长者提供日常编程（医疗保健，社交活动和餐点），同时为家庭护理人员提供每日喘息的机会，这些家庭护理人员会在家里远离经常忙碌的护理职责。几乎没有研究社会文化背景或广告背景的研究。我们提出了一个48个月的顺序研究，对马里兰州的6个ADS中心（每个6个月）进行了人种志研究。这项拟议的研究的一般目标是检查这些中心内的文化，环境，节目和活动内容以及客户生活。通过这项研究，我们希望更好地了解广告文化如何（包括价值，含义，有善利的假设，出勤模式，有问​​题的行为，员工关系，客户社交互动，活动和编程， 关于保留与转移的想法）差异地影响了客户的生活，客户的关键家庭成员和广告员工的生活。这项拟议的研究具有4个具体目标：1。检查6种不同广告中心之间的文化和背景信念，结构，相似性和差异； 2。检查员工，家庭和客户对客户的生活经历的不同理解，包括每个广告中心的福利和困难； 3。了解和描述6个广告中的每个广告中的单独和团体编程和活动的操作和含义； 4。通过案例研究和其他定性研究方法更好地理解：a）本地广告政策和对日常出勤的态度； b）广告客户的社会关系； c）问题行为； d）保留与转移策略； e）使用的编程类型； f）引入新形式的编程； g）编程的“个人”与“最低命令”的方法； h）计划目标和本地含义（每个广告都试图完成的定义）。这项拟议的研究具有很高的创新性，据我们所知，这是广告的首批人种学研究之一。生命和第一个详细比较多个站点的研究。研究将利用参与者观察（PO），人种学访谈（EI）和案例研究来更好地了解6个广告中心的文化和日常生活。定性数据分析的标准方法，包括在Atlas.ti中开发文本基础的方法，用于管理和解释我们收集的数据。