scholarly journals ‘Keeping up appearances’ – negotiating identities of being fit in older age: a multi-site ethnographic study of daily life in contemporary day centres

2021 ◽  
pp. 1-18
Author(s):  
Christine Øye ◽  
Reidun Norvoll ◽  
Mia Vabø
Keyword(s):  
Participant Observation ◽  
Functional Decline ◽  
Ethnographic Study ◽  
Care Staff ◽  
Cognitive Capacity ◽  
Active Ageing ◽  
Brain Training ◽  
Staff Members ◽  
Care Services ◽  
Social Events

Abstract As governments adapt to ‘active ageing’ policies, care services are increasingly oriented towards helping older adults to stay active in order to maintain their physiological and cognitive capacity. Day centres for the frail old adults are adding more planned activities to their conventional social programmes. Although evidence indicates that they may benefit from physical fitness sessions and brain training, little is known about the way in which the activation agenda influences social interaction among participants. The article aims to fill this knowledge gap by exploring how staff and participants manoeuvre between the new activation agenda and processes of coming to terms with the functional decline of ageing bodies. We draw on ethnographic data, collected in four day centres in Denmark and Norway, constituting participant observation of 18 days, 19 interviews with older participants and 18 interviews with staff members. With reference to the dramaturgical approach of Erving Goffman, we demonstrate how different fitness identities are negotiated on different social stages. Firstly, we identify a social stage at a crossroad between staff acting as motivators in training sessions and older participants as active contributors. We demonstrate how day-care staff assist participants in keeping up appearances as fit for one's age by recognising their performance and concealing flawed performances. Secondly, we identify a social stage where participants socialise with co-participants around the lunch table and other social events. Here the act of ‘keeping up appearances’ turns into a complex art whereby people strive to retain their fitness identity by comparing themselves with peers. Finally, based on observation ‘backstage’, we reveal how participants distance themselves from the functional decline of old age by claiming that they are fit enough. We conclude that day centres are contested sites for active-ageing policies.

scholarly journals Mealtime Care for People With Dementia: What Do Nursing Home Staff Think?

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 182-183
Author(s):  
James Faraday ◽  
Clare Abley ◽  
Catherine Exley ◽  
Joanne Patterson
Keyword(s):  
Nursing Homes ◽  
Ethnographic Study ◽  
Direct Care ◽  
Care Staff ◽  
Direct Care Staff ◽  
Structured Interviews ◽  
Staff Members ◽  
People With Dementia ◽  
Comparison Approach ◽  
The Right

Abstract More and more people with dementia are living in nursing homes (NH). Often, they depend on NH staff for help with eating and drinking. It is important that staff have the skills and support they need to provide good care at mealtimes. This qualitative study explores mealtime care for people with dementia, from the perspective of NH staff. Semi-structured interviews with NH staff (n=16) were carried out in two nursing homes. The homes were chosen to have diverse characteristics: one home had a large number of beds and was part of a small local organization; the other had a small number of beds and was part of a large national organization. Various staff members were interviewed, including direct care staff, senior carers, nurses, managers, and kitchen staff. Interviews were audio-recorded and transcribed verbatim. A constant comparison approach was taken, so that data from early interviews were explored in more depth subsequently. From the analysis, five themes emerged as important in mealtime care for people with dementia living in nursing homes: Setting the right tone; Working well as a team; Knowing the residents; Promoting autonomy and independence; Gently persevering. This work forms part of a larger ethnographic study on the topic, which includes data from residents with dementia, and family carers. Results will inform the development of a staff training intervention to optimize mealtime care for this population.

The Snog and Grog Club

2012 ◽  
Vol 23 (2) ◽  
pp. 147-155 ◽  
Author(s):  
Allison Kabel
Keyword(s):  
Palliative Care ◽  
Health Professionals ◽  
Day Care ◽  
The United States ◽  
Care Staff ◽  
Staff Members ◽  
Care Services ◽  
Life Threatening Illness ◽  
Palliative Care Services ◽  
End Stage

The popularity of British hospice day care signals the expanding boundaries of palliative care beyond end-stage illness. In this article, I examine the ways hospice philosophy was interpreted and implemented in an outpatient day therapy setting run by a multidisciplinary team of health professionals. Findings suggest that hospice day care staff members used several strategies to help patients cope and retain a sense of personhood while facing numerous emotional and physical challenges associated with life-threatening illness. Health professionals in the United States will need to prepare for patients accessing hospice and palliative care services earlier in the illness trajectory to take advantage of these opportunities for patient support and advocacy.

scholarly journals Understanding client satisfaction in elderly care: new insights from social resource theory

2020 ◽  
Author(s):  
Ali Kazemi ◽  
Petri J. Kajonius
Keyword(s):  
Client Satisfaction ◽  
Participant Observation ◽  
Elderly Care ◽  
Principal Component ◽  
Self Report ◽  
Care Staff ◽  
Resource Theory ◽  
Satisfaction With Care ◽  
Social Resource ◽  
Care Services

AbstractSocial resource theory suggests that social interaction can be conceived as resource transaction or exchange with behaviours falling within six fundamental resource categories (i.e. love, status, information, money, goods, and services) organised along two underlying dimensions: particularism–universalism and concreteness–abstractness. With the purpose of extending knowledge about quality of care, this study adopts a novel approach in that it describes and categorises care behaviours using social resource theory instead of using single instances of care behaviour. The categorisation is further used to predict client satisfaction in care services targeting older people. Daily interactions between care staff and older persons were observed in two different residential care facilities using a structured non-participant observation design. The data were analysed using principal component analysis, correlation, and regression analysis. The results confirmed the hypothesis that satisfaction with care services is predicted by resource transactions that are high on the underlying dimensions of particularism and abstractness. Thus, the resource categories of love and status (resource categories high on particularism and abstractness) were shown to be strong predictors of client satisfaction. The use of social resource theory is a novel and appropriate approach to examine person-centred care and satisfaction with care. Also, in addition to addressing potential problems in previous self-report studies on care staff behaviour, the observational technique was highly practical to this service area where dealing with clients not always able to provide feedback directly.

Impact of the organisational culture on primary care staff members’ intention to engage in research and development

2015 ◽  
Vol 29 (2) ◽  
pp. 234-251 ◽  
Author(s):  
Helena Morténius ◽  
Amir Baigi ◽  
Lars Palm ◽  
Bengt Fridlund ◽  
Cecilia Björkelund ◽  
...  
Keyword(s):  
Primary Care ◽  
Research And Development ◽  
Organisational Culture ◽  
Ethnographic Study ◽  
Care Staff ◽  
Content Type ◽  
Staff Members ◽  
Norms And Values ◽  
Primary Care Staff ◽  
The Invisible

Purpose – The purpose of this paper is to understand how organisational culture influences the intentions of primary care staff members (PCSM) to engage in research and development (R&D). Design/methodology/approach – The participants (n=30) were PCSM employed in a care centre in south-western Sweden. The study had an observational design with an ethnographic approach. The data were collected by means of observations, interviews and analysis of documents. Findings – The results revealed the perceptions of PCSM in two domains, research and clinical practice, both of which existed at three different cultural levels: visible (structures and policy), semi-visible (norms and values) and invisible (taken-for-granted attitudes). Research limitations/implications – It is difficult to conduct a purely objective ethnographic study because the investigation is controlled by its context. However, it is necessary to highlight and discuss the invisible level to improve understanding of negative attitudes and preconceptions related to the implementation of R&D in the clinical setting. Practical implications – By highlighting the invisible level of culture, the management of an organisation has the opportunity to initiate discussion of issues related to concealed norms and values as well as attitudes towards new thinking and change in the primary health context. Originality/value – This paper is one of the very few studies to investigate the influence of organisational culture on the intentions of PCSM to engage in R&D.

scholarly journals Understanding hard-to-reach communities: local perspectives and experiences of trachoma control among the pastoralist Maasai in northern Tanzania

2020 ◽  
pp. 1-20
Author(s):  
Tara B. Mtuy ◽  
Kevin Bardosh ◽  
Jeremiah Ngondi ◽  
Upendo Mwingira ◽  
Janet Seeley ◽  
...  
Keyword(s):  
Health Care Services ◽  
Participant Observation ◽  
Post Partum ◽  
Human Movement ◽  
Ethnographic Study ◽  
Livestock Grazing ◽  
Seasonal Migration ◽  
Care Services ◽  
Lack Of Information ◽  
Effective Delivery

Abstract As progress to eliminate trachoma is made, addressing hard-to-reach communities becomes of greater significance. Areas in Tanzania, inhabited by the Maasai, remain endemic for trachoma. This study assessed the effectiveness of Mass Drug Administration (MDA) through an ethnographic study of trachoma amongst a Maasai community. The MDA experience in the context of the livelihoods of the Maasai in a changing political economy was explored using participant observation and household interviews. Factors influencing MDA effectiveness within five domains were analysed. 1) Terrain of intervention: Human movement hindered MDA, including seasonal migration, domestic chores, grazing and school. Encounters with wildlife were significant. 2) Socio-cultural factors and community agency: Norms around pregnancy led women to accept the drug but hide refusal to swallow the drug. Timing of Community Drug Distributor (CDD) visits conflicted with livestock grazing. Refusals occurred among the ilmurrani age group and older women. Mistrust significantly hindered uptake of drugs. 3) Strategies and motivation of drug distributors: Maa-speaking CDDs were critical to effective drug delivery. Maasai CDDs, whilst motivated, faced challenges of distances, encounters with wildlife and compensation. 4) Socio-materiality of technology: Decreases in side-effects over years have improved trust in the drug. Restrictions to swallowing drugs and/or water were relevant to post-partum women and the ilmurrani. 5) History and health governance: Whilst perceptions of the programme were positive, communities questioned government priorities for resources for hospitals, medicines, clean water and roads. They complained of a lack of information and involvement of community members in health care services. With elimination in sight, hard-to-reach communities are paramount as these are probably the last foci of infection. Effective delivery of MDA programmes in such communities requires a critical understanding of community experiences and responses that can inform tailored approaches to trachoma control. Application of a critical social science perspective should be embedded in planning and evaluation of all NTD programmes.

scholarly journals Encouraging Student Access to and Use of Pastoral Care Services in Schools

2012 ◽  
Vol 22 (2) ◽  
pp. 227-248 ◽  
Author(s):  
Patricia Cardoso ◽  
Laura Thomas ◽  
Robyn Johnston ◽  
Donna Cross
Keyword(s):  
Drug Use ◽  
Pastoral Care ◽  
School Health ◽  
Care Staff ◽  
Staff Members ◽  
Health And Wellbeing ◽  
Care Services ◽  
School Based ◽  
School Counsellors ◽  
Health Teachers

School-based health services (SBHS) including pastoral care can play a pivotal role in addressing adolescent health and wellbeing; including their tobacco and other drug use. To maximise the benefits of these services, they need to be accessible, useful for, and acceptable to students. This formative, qualitative study involved 12 focus groups within nine lower socio-economic Western Australian Government secondary schools. The purpose was to identify student (n = 59) perceptions of the availability and usefulness of SBHS (and other identified caring staff) to reduce students’ harm associated with tobacco and other drug use. The findings suggest students were aware of the SBHS available to them, but considered them less useful if staff were regularly unavailable; presented a ‘don't care’ attitude; held solely disciplinary roles; and were based in an area of the school unfamiliar to the student. Services were considered useful when staff members built rapport with students; took time to listen; followed-up with students and displayed a general concern for the student's wellbeing. Interestingly, students acknowledged trusting health teachers more than SBHS staff for tobacco information and support. These findings have important implications for school counsellors and other school health/pastoral care staff who want to increase the likelihood of students approaching and using school support services to reduce harm associated with tobacco and other harmful drug (OHD) use.

‘Women are just more active’ – gender as a determining factor in involvement in senior centres

2013 ◽  
Vol 34 (9) ◽  
pp. 1482-1504 ◽  
Author(s):  
JAROSLAVA HASMANOVÁ MARHÁNKOVÁ
Keyword(s):  
Social Services ◽  
Leisure Time ◽  
Participant Observation ◽  
Ethnographic Study ◽  
Active Ageing ◽  
The Czech Republic ◽  
Male Clients ◽  
Gender Patterns ◽  
Depth Interviews ◽  
The Way

ABSTRACTCentres for seniors offering leisure-time activities currently represent significant actors that translate the idea of active ageing into a particular approach to seniors. Despite the fact that active ageing is now represented by the state and providers of social services as the universally desirable way of ageing, the significantly smaller numbers of male clients was identified as a marked feature of such organisations. A three-year ethnographic study was conducted at two centres in the Czech Republic which offer seniors-only leisure-time activities strongly grounded in the idea of active ageing. The method of participant observation was used, and 47 in-depth interviews were conducted with the centres' clients and employees. The higher participation by women in the centres and the role they attribute to such organisations in their lives is analysed in the context of their previous gendered biographies. Gender patterns embedded in the way daily activities at the senior centres are organised, as well as in the idea of active ageing itself, are highlighted. Despite the seeming invisibility of gender as a principle that structures the way these centres are run, they are in fact gendered organisations, where gender emerges as a basic principle affecting the chances of participating in active ageing as presented by the centres.

scholarly journals Coaxing as a Strategy to Deal with Ethical Issues in Community Home Care: An Ethnographic Study

2020 ◽  
Author(s):  
Dara Rasoal
Keyword(s):  
Health Care ◽  
Home Care ◽  
Health Care Professionals ◽  
Ethical Issues ◽  
Participant Observation ◽  
Home Care Services ◽  
Ethnographic Study ◽  
Western Society ◽  
Care Services ◽  
Difficult Situations

Introduction: The provision of home health care services increases as a desirable option in western society. Previous studies indicate that health care professionals encounter ethically difficult situations when providing home care services. There is a lack of studies describing ethically difficult situations through observation. This study aimed to explore ethical issues experienced by healthcare staff when providing community home care services.  Methods: Qualitative design, using the ethnographical approach. Data gathered as fieldwork in terms of memos, non-participant observation and informal interview with registered nurses (n=8), and nurse-assistants (n=4) during three weeks (in total 148 hours, 7am -5pm) . Results: The result generated two main categories: 1) To balance stakeholders’ requirements, and, 2) Strategy to deal with ethical issues. Coxing was used as a strategy to deal with ethically difficult situations in patient care. The results showed that the complexity of the ethical issues is often related to personal values and organisational impact. The staff experienced need for a structured approach to assist them in identifying, analysing, and resolving ethical issues that arise in clinical practice. Health care organisations, personnel and patients are disagreed about values and choices that could lead to the best course of actions. Conclusion: This study reveals that the ethically difficult situations in the context of community home care services are complex and are influencing the provision of care. The personnel enforced to find a balance between different expectations and from different stakeholders. To deal with these situations coaxing was used as a strategy for managing ethical issues.

Communication Disordered: Program Implementation in Long-Term Care

2016 ◽  
Vol 1 (15) ◽  
pp. 64-67
Author(s):  
George Barnes ◽  
Joseph Salemi
Keyword(s):  
Program Implementation ◽  
Long Term Care ◽  
Family Satisfaction ◽  
Regulatory Compliance ◽  
Care Staff ◽  
Term Care ◽  
Staff Members ◽  
Change Policy

The organizational structure of long-term care (LTC) facilities often removes the rehab department from the interdisciplinary work culture, inhibiting the speech-language pathologist's (SLP's) communication with the facility administration and limiting the SLP's influence when implementing clinical programs. The SLP then is unable to change policy or monitor the actions of the care staff. When the SLP asks staff members to follow protocols not yet accepted by facility policy, staff may be unable to respond due to confusing or conflicting protocol. The SLP needs to involve members of the facility administration in the policy-making process in order to create successful clinical programs. The SLP must overcome communication barriers by understanding the needs of the administration to explain how staff compliance with clinical goals improves quality of care, regulatory compliance, and patient-family satisfaction, and has the potential to enhance revenue for the facility. By taking this approach, the SLP has a greater opportunity to increase safety, independence, and quality of life for patients who otherwise may not receive access to the appropriate services.

Urban Diabetic Women’s Perception of Healthy Eating Lifestyles from West Java

1970 ◽  
Vol 2 (2) ◽  
Author(s):  
Mayumi Mizutani ◽  
Junko Tashiro ◽  
Nia Damiati ◽  
Uswatun Khasanah
Keyword(s):  
Type 2 Diabetes ◽  
Health Promotion ◽  
Healthy Eating ◽  
Health Care Services ◽  
Interpersonal Relations ◽  
Social Situation ◽  
West Java ◽  
Care Services ◽  
Social Events

This study aimed to explore perceptions about a healthy-eating lifestyle and reasons to practice a healthy-eating lifestyle of women with type 2 diabetes in a city of West Java by using a case study design. Six female patients, with type 2 diabetes, ages 47–63 from a hospital were interviewed guided by the health promotion model. Their healthy-eating lifestyle included currently practicing or not practicing a healthy-eating lifestyle. Reasons to practice were: beliefs for health and for physical energy to work for family, definition of multidimensional health and self-efficacy increased by: support from God, support from family, support from health professionals and improved or deteriorated health status by prior experience. Reasons not to practice were: difficulty in arranging diet, rejecting eating, controlling appetite, and accessing health care services. Related difficulties were interpersonal relations with family and social situation such as social events, expensive medical fee, and distance to the hospital. These findings suggest that women with type 2 diabetes in Indonesia need to be supported with the reasons to practice a healthy-eating lifestyle.Key words:Diet, health promotion, Indonesia, type 2 diabetes, women AbstrakTujuan dari penelitian ini adalah untuk mengeksplorasi persepsi tentang gaya hidup mengonsumsi makanan sehat dan alasan untuk mempraktikkan gaya hidup memakan makanan sehat pada wanita penderita diabetes tipe 2 di satu kota di Jawa Barat dengan menggunakan desain penelitian studi kasus. Enam pasien wanita penderita diabetes tipe 2 berumur antara 47–63 tahun. Penelitian ini dilakukan di sebuah rumah sakit. Pasien diwawancara secara terbimbing menggunakan model promosi kesehatan. Gaya hidup partisipan dalam mengonsumsi makanan sehat dinilai dalam penelitian ini, termasuk yang sedang dipraktikkan atau tidak sedang dipraktikkan. Hasil penelitian menunjukkan alasan partisipan untuk mengonsumsi makanan sehat adalah: keyakinan untuk sehat dan kekuatan fisik untuk bekerja bagi keluarga, definisi kesehatan multidimensi dan efikasi diri meningkat oleh dukungan Tuhan, dukungan dari keluarga, dukungan dari petugas kesehatan, dan meningkatnya atau menurunnya status kesehatan oleh pengalaman sebelumnya. Alasan untuk tidak mengonsumsi makanan sehat adalah kesulitan dalam: mengatur diet, menolak makan, mengontrol nafsu makan, dan kesulitan mengakses pelayanan kesehatan. Kesulitan-kesulitan yang terkait dengan masalah ini adalah hubungan interpersonal dengan keluarga dan situasi sosial seperti acara-acara sosial, biaya medis yang mahal, dan jarak ke rumah sakit. Penelitian ini menyarankan peningkatan dukungan bagi wanita penderita diabetes tipe 2 di Indonesia agar mempraktikkan gaya hidup memakan makanan yang sehat.Kata kunci:Diabetes tipe 2, Indonesia, makanan, promosi kesehatan, wanita

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