一项针对等待安置进入养老院的老人和已居住在养老院的老人的职能水平和护理工作量对比研究【外文翻译】.doc

1、本科毕业设计（论文）外文翻译原文FUNCTIONALLEVELSANDNURSEWORKLOADOFELDERLYAWAITINGNURSINGHOMEPLACEMENTANDNURSINGHOMERESIDENTSACOMPARATIVESTUDYTHEAIMOFTHISSTUDYWASTWOFOLDTOCOMPARETHEFUNCTIONALLEVELSOFELDERLYAWAITINGNURSINGHOMEPLACEMENTANDNURSINGHOMERESIDENTS,ANDTOCOMPARETHEIRNURSESPHYSICALANDPSYCHOLOGICALWORKLOADSINN

2、ORWAY,THEDEMANDFORNURSINGHOMEPLACEMENTHASINCREASEDGREATLYELDERLYAWAITINGPLACEMENTCANRECEIVECAREFROMHOMEHEALTHCARESERVICESAND/ORFROMTHEIRFAMILIESDOCUMENTINGELDERLYSFUNCTIONALLEVELSMAYILLUMINATETHEEXTENTOFTHECARERSWORKLOADSANDTHENEEDFORSUPPORTDURINGTHEWAITINGPERIODTHESTUDYWASCONDUCTEDIN2005ONTWOGROUPS

3、INNORTHERNNORWAYUSINGTHEMULTIDIMENSIONALDEMENTIAASSESSMENTSCALETOASSESSFUNCTIONALLEVELS,ONEGROUPOFNURSESASSESSEDELDERLYAWAITINGNURSINGHOMEPLACEMENTANDANOTHERGROUPOFNURSESASSESSEDNURSINGHOMERESIDENTSTHENURSESALSOREPORTEDPHYSICALANDPSYCHOLOGICALWORKLOADSINCARINGFORTHESEELDERLYACOMPARISONOFTHEFUNCTIONA

4、LLEVELSBETWEENELDERLYAWAITINGNURSINGHOMEPLACEMENTANDNURSINGHOMERESIDENTSSHOWEDFEWSTATISTICALLYSIGNIFICANTDIFFERENCESNURSINGHOMERESIDENTSHADTWOLOWERMOTORFUNCTIONS,NEEDEDMOREASSISTANCEWITHACTIVITIESOFDAILYLIVING,MOREREGULARADMINISTRATIONOFENEMAS,WEREMOREOFTENUNABLETOSPEAK,ANDSHOWEDLOWERORIENTATIONLEVE

5、LSCLINICALLYSIGNIFICANTSIMILARITIESWEREFOUNDINFIVEMOTORFUNCTIONS,INCLUDINGRISINGFROMLYINGTOSITTING,RISINGOUTOFBEDANDWALKING,ANDINBEHAVIORALANDPSYCHIATRICSYMPTOMSBOTHGROUPSOFELDERLYHADAHIGHPREVALENCEOFSADNESSANDFEARFULNESSTHERESULTSOFTHISSTUDYINDICATETHATELDERLYAWAITINGNURSINGHOMEPLACEMENTCANBEASFRAI

6、LASNURSINGHOMERESIDENTSTHESERESULTSHIGHLIGHTTHEELDERLYSNEEDFORASSISTANCEANDREVEALTHENEEDFORMORE1NURSINGHOMEBEDSNURSESINHOMEHEALTHCAREANDNURSINGHOMESRATEDPHYSICALANDPSYCHOLOGICALWORKLOADSSIMILARLYASMANYCARERSPROVIDECARE24HOURSADAY,THESERESULTSALSOILLUMINATETHENEEDTOSUPPORTCARERSDURINGTHEWAITINGPERIOD

7、WHENELDERLYBECOMETOOFRAILTOMANAGEATHOME,ORWHENTHEIRCARERSCANNOTTAKECAREOFTHEMANYLONGER,THEYORTHEIRCARERSCANREQUESTNHPLACEMENTAPHYSICIANANDTHENURSELEADEROFHOMEHEALTHSERVICESTHENCONDUCTATHOROUGHASSESSMENTOFTHEIRNEEDSDISCUSSIONSIMILARITIESOURASSESSMENTINCLUDEDALLRESIDENTSINTHENH,INCLUDINGELDERLYRECENTL

8、YADMITTEDTOTHENHASWELLASTHOSEATTHEENDOFLIFETHUS,WEHADEXPECTEDTOFINDGREATERDIFFERENCESBETWEENTHETWOGROUPSOUREXPECTATIONSWERETHATTHEFUNCTIONALLEVELSOFELDERLYAWAITINGNHPLACEMENTWOULDBECLOSETOTHEFUNCTIONALLEVELSOFELDERLYRECENTLYADMITTEDTONHWEDISCUSSVARIABLESTHATSHOWEDNOSTATISTICALLYSIGNIFICANTDIFFERENCE

9、SASSIMILARITIESFORTHESEVARIABLES,WECONSIDERELDERLYAWAITINGNHPLACEMENTASFRAILASNHRESIDENTSYET,FORMANYOFTHESEVARIABLES,INCLUDINGFIVEMOTORFUNCTIONS,THEREWERECLEARLYTENDENCIESTHATELDERLYAWAITINGNHPLACEMENTHADHIGHERFUNCTIONALLEVELSTHANNHRESIDENTSHOWEVER,THESIMILARITIESBETWEENTHEGROUPSARECLINICALLYSIGNIFI

10、CANTANDILLUMINATETHEFRAILTYOFELDERLYAWAITINGNHPLACEMENTSTILL,WEBELIEVETHATMOSTTENDENCIESWOULDBECOMESTATISTICALLYSIGNIFICANTWITHALARGERSAMPLEINADDITION,RELOCATIONTOANHIMPLIEDADJUSTMENTTONEWENVIRONMENTS,WHICHCOULDHAVEPOSITIVELYORNEGATIVELYAFFECTEDNHRESIDENTSFUNCTIONALLEVELSACCORDINGTOTHEAMERICANPSYCHO

11、LOGISTLAWTON,ENVIRONMENTSAFFECTHUMANBEINGSBEHAVIORALCOMPETENCE,HEALTH,COGNITION,ANDSOCIALBEHAVIOR,ASWELLASTHEIRPSYCHOLOGICALWELLBEINGANDQUALITYOFLIFEMOTORFUNCTIONSRESULTSOFTHETWOGROUPSSHOWEDSIMILARITIESINMOTORFUNCTIONSABILITYTORISEFROMLYINGTOSITTING,RISINGOUTOFBED,WALKINGWITHOUTASSISTANCE,ANDWALKING

12、WITHINSTRUMENTALHELPTHISINDICATESTHATELDERLYAWAITINGNHPLACEMENTNEEDEDALMOSTASMUCHASSISTANCEASNHRESIDENTSINTRANSFERRINGFROM2BEDTOCHAIRANDWALKINGDURINGTHEDAYONEIMPORTANTDIFFERENCETOCONSIDERISTHATWHENNHRESIDENTSNEEDEDASSISTANCE,THEPHYSICALCONDITIONSWEREADJUSTEDTOTHEIRPERFORMANCEWITHDEVICESSUCHASMECHANI

13、CALLIFTSINADDITION,TWOATTENDANTSWEREOFTENAVAILABLEINTHENHTOASSISTWITHMOBILITYELDERLYAWAITINGNHPLACEMENTRECEIVEDALMOSTTHESAMEAMOUNTOFASSISTANCEINTHEIRHOMES,WHEREQUARTERSCOULDBECLOSEASSISTANCEINTHEHOMEWASPROVIDEDBYCARERSORCOMMUNITYNURSES,WHOOFTENCAMEINTHEMORNINGANDASSISTEDTHEELDERLYINGETTINGOUTOFBEDDU

14、RINGTHEDAY,CARERSHADTOASSISTELDERLYWHENCOMMUNITYNURSESWEREUNAVAILABLEASSISTINGELDERLYWITHRISINGFROMLYINGTOSITTING,RISINGOUTOFBED,ANDWALKINGCANBEPHYSICALLYDEMANDING,ASADEQUATEDEVICES,SUCHASMECHANICALLIFTS,SEEMEDSCARCECOMMODITIESINTHEHOMES,WHICHEXPLAINSTHEOCCURRENCEOFSOMECARERSBACKACHESBEHAVIORALSYMPT

15、OMSFORMOSTVARIABLES,ELDERLYAWAITINGNHPLACEMENTANDNHRESIDENTSHADTHESAMEPREVALENCEOFBEHAVIORALSYMPTOMSTHESEBEHAVIORALSYMPTOMSTYPICALLYOCCURREDWITHCOGNITIVEIMPAIRMENT,WHICHWASASTRONGPREDICTOROFNHPLACEMENTTHREEOUTOFFOURELDERLYAWAITINGNHPLACEMENTALSOHADMEMORYDISTURBANCESMANYNHRESIDENTSCONTINUALLYSOUGHTAT

16、TENTIONOFTHESTAFF,WHICHWASCOMMONLYREPORTEDINANORWEGIANNHWHERERESIDENTSRARELYCOMMUNICATEDWITHEACHOTHERANDCOMMUNICATEDWITHSTAFFMAINLYDURINGCAREANDMEALTIMESTHERESTOFTHETIME,MANYNHRESIDENTSTRIEDTOSEEKSTAFFSATTENTIONLIMITEDCOMMUNICATIONBETWEENNHRESIDENTSANDSTAFFCANBEBECAUSEOFLOWSTAFFINGLEVELS,ANDHENCE,LA

17、CKOFTIMEFORSATISFACTORYCONVERSATIONSINTHECURRENTSTUDY,THEPREVALENCEOFVERBALTHREATSANDPHYSICALHITTINGWASHIGH,ESPECIALLYAMONGNHRESIDENTSWEDIDNOTEXPLORETHEAMOUNTOFCOMMUNICATIONBETWEENNHRESIDENTSANDSTAFF,BUTANUNSATISFACTORYINTERACTIONCANINCREASETHEPREVALENCEOFTHREATSANDHITTINGANDRESULTINWORKSTRESSFORNUR

18、SESINASWEDISHNH,684OFTHECAREGIVERSREPORTEDTHEYHADBEENEXPOSEDTOVIOLENCEDURINGTHEPREVIOUSYEARSOMEAUSTRALIANNURSESEXPERIENCEDHIGHLEVELSOFSTRESSWORKINGWITHCOGNITIVELYIMPAIREDRESIDENTS,ESPECIALLYIFTHEIRBEHAVIORWASPERCEIVEDASTHREATENINGPSYCHIATRICSYMPTOMSMANYSIMILARITIESWEREFOUNDBETWEENELDERLYAWAITINGNHPL

19、ACEMENTANDNHRESIDENTSREGARDINGPSYCHIATRICSYMPTOMSBOTHGROUPSHADA3HIGHPREVALENCEOFPSYCHIATRICSYMPTOMSINTERMSOFEMOTIONALPSYCHIATRICSYMPTOMS,ELDERLYAWAITINGNHPLACEMENTTENDEDTOHAVEMORESYMPTOMSTHANNHRESIDENTSWEFOUNDITCLINICALLYSIGNIFICANTTHATABOUTONEHALFOFELDERLYAWAITINGNHPLACEMENTWERESADANDONEFIFTHCRIEDD

20、AILYORWEEKLY,POSSIBLYINDICATINGDIFFICULTLIFESITUATIONSORLABILEEMOTIONALRESPONSESINADDITION,THEPREVALENCEOFPSYCHIATRICSYMPTOMSFORELDERLYAWAITINGNHPLACEMENTCANACTUALLYBEHIGHERTHANREPORTED,POSSIBLYBECAUSESOMEELDERLYMAYHAVEDESIREDTOHIDETHEIRTEARSFROMTHENURSES,ANDTHEREFORECRIEDONLYWHENBEINGALONEOURRESULT

21、SARECONTRARYTOSTUDIESTHATREPORTEDNHRESIDENTSWEREMOREDEPRESSEDTHANCOMMUNITYDWELLINGELDERLYELDERLYAWAITINGNHPLACEMENTINOURSTUDYWEREPROBABLYFRAILERANDHADMOREDIFFICULTLIFESITUATIONSTHANCOMMUNITYDWELLINGELDERLYINTHESESTUDIESNURSESWORKLOADSNURSESPHYSICALANDPSYCHOLOGICALWORKLOADSWERESIMILARWHETHERWORKINGIN

22、HOMEHEALTHCAREORINANHHOWEVER,NURSESWORKLOADSTENDEDTOBESLIGHTLYHIGHERTHANWORKLOADSREPORTEDBYSANDMANETALINTHEIRSTUDYFROM1988,WHICHUSEDTHEMDDASTOASSESS3600ELDERLYLIVINGINDIFFERENTLONGTERMCAREINSTITUTIONSINSWEDENHIGHERWORKLOADINDICATESFRAILERRESIDENTSORLOWERSTAFFINGLEVELSTHEREARETWOIMPORTANTREASONSFORLO

23、WERFUNCTIONALLEVELSAMONGNORWEGIANNHRESIDENTSDURINGRECENTYEARSANINCREASINGNUMBEROFELDERLYANDSTRENGTHENINGOFHOMEHEALTHCAREASAPUBLICPRIORITYAREASINCETHE1980STODAY,THENORWEGIANGOVERNMENTFINANCIALLYSUPPORTSBUILDINGNEWNH,BUTSTILLALACKOFNHBEDSMUSTBECONTENDEDWITHFORMANYYEARSACONSEQUENCEOFHIGHERWORKLOADCANBE

24、HIGHERRNTURNOVERRATESANDLACKOFQUALIFIEDNURSESINNORWAY,TURNOVERRATESANDLONGTERMILLNESSESAREVERYHIGHAMONGNHANDHOMEHEALTHCARESTAFFINAMERICA,HIGHTURNOVERWASFOUNDDIRECTLYRELATEDTOLOWSTAFFINGLEVELSIN2006,78OFTHENURSESWORKINGINNORWEGIANNHASSESSEDTHEIRSTAFFINGLEVELSASTOOLOWHOWEVER,TURNOVERCANALSOBERELATEDTO

25、THEAVAILABILITYOFALTERNATIVEJOBSINNORWEGIANRURALMUNICIPALITIES,NHANDHOMEHEALTHCAREAREOFTENTHEONLYJOBPOSSIBILITIESFORTHEHEALTHPERSONNELASTUDYPUBLISHEDIN2007,REVEALEDTHATFORNORWEGIANNURSINGSTUDENTS,WORKINGINELDERLYCAREINSTITUTIONSREMAINEDUNPOPULARTHROUGHOUTTHEIRENTIRESTUDYPERIOD4DIFFERENCESMOTORFUNCTI

26、ONSTWOMOTORFUNCTIONSSHOWEDELDERLYAWAITINGNHPLACEMENTHADSTATISTICALLYSIGNIFICANTHIGHERFUNCTIONALLEVELSCOMPAREDWITHTHENHRESIDENTSELDERLYAWAITINGNHPLACEMENTNEEDEDLESSASSISTANCERISINGFROMCHAIRSANDWALKINGUPANDDOWNSTAIRSAREMAININGQUESTIONISHOWOFTENNHRESIDENTSCANENGAGEINACTIVITYTOMAINTAINTHEIRMOBILITYINWAL

27、KINGANDMANEUVERINGSTAIRSBEHAVIORALSYMPTOMSREGARDINGBEHAVIORALSYMPTOMS,STATISTICALLYSIGNIFICANTDIFFERENCESWEREFOUNDBETWEENELDERLYAWAITINGNHPLACEMENTANDNHRESIDENTSFORTWOVARIABLESRESIDENTSINNHSPITMEDICATIONANDROLLEDUPTABLECLOTHSMOREOFTENTHANELDERLYAWAITINGNHPLACEMENTWEASSUMETHATITISMUCHEASIERFORELDERLY

28、AWAITINGNHPLACEMENTTOREFUSEMEDICATIONBECAUSETHEIRMEDICATIONSAREOFTENSELFADMINISTEREDAREASONFORTHEDIFFERENCEINROLLINGUPTABLECLOTHSCANBETHATTHISKINDOFBEHAVIORISMUCHMOREOBSERVABLEBYNURSESINNHTHANHOMEHEALTHNURSESVISITINGELDERLYINTHEIRHOMESPSYCHIATRICSYMPTOMSREGARDINGPSYCHIATRICSYMPTOMS,THEONLYSTATISTICA

29、LLYSIGNIFICANTDIFFERENCEWASTHATELDERLYAWAITINGNHPLACEMENTCOMPLAINEDMOREOFTENTHANNHRESIDENTSITISPOSSIBLETHATTHEYHADVALIDREASONSFORCOMPLAINING,EGNOTRECEIVINGTHEINSTITUTIONALCAREASSESSEDTHATTHEYNEEDEDDURINGTHEWAITINGPERIOD,THEYMAYHAVEEXPERIENCEDLIMITEDASSISTANCE,ACOMMONEXPERIENCEAMONGNORWEGIANELDERLYHO

30、WEVER,NHRESIDENTSMAYALSOHAVEHADVALIDREASONSFORCOMPLAININGIFTHEYHADPREVIOUSLYCOMPLAINED,PERHAPSTHEIRCOMPLAINTSWERENOTTAKENSERIOUSLY,ASCOMMUNICATIONBETWEENNHRESIDENTSANDNHSTAFFCANBELIMITEDADLFUNCTIONSCOMPAREDWITHTHEELDERLYAWAITINGNHPLACEMENT,NHRESIDENTSWERESTATISTICALLYSIGNIFICANTLYLESSCAPABLEOFCARRYI

31、NGOUTADLFUNCTIONSWITHOUTASSISTANCEALLNHRESIDENTSNEEDEDASSISTANCEWITHMORNINGCAREALSOANAMERICANSTUDYSHOWEDTHATNHRESIDENTSWEREMOREDISABLEDANDNEEDEDMOREASSISTANCEWITHADLFUNCTIONSTHANHOMECARECLIENTSANINTERESTINGRELATEDQUESTIONISHOWMANYOPPORTUNITIESDONHRESIDENTSHAVETOREMAININDEPENDENTINASWEDISHSTUDY,KIHLG

32、RENETALSHOWEDTHATELDERLYWITHADDWHORECEIVEDINTEGRITYPROMOTINGCARE5SHOWEDIMPROVEMENTSINMOSTOFTHEIRFUNCTIONSINOURSTUDY,STATISTICALLYSIGNIFICANTLYMORENHRESIDENTSNEEDEDANENEMA,THANAMONGELDERLYAWAITINGNHPLACEMENTWEDIDNOTINVESTIGATETHEUSEOFLAXATIVES,DIET,ORMOBILITY,BUTINAFINNISHNH,553OFALLNHRESIDENTSRECEIV

33、EDLAXATIVESREGULARLYAREVIEWOFTHELITERATURESHOWEDELDERLYWITHCONSTIPATIONOFTENHADFAECALINCONTINENCEALTHOUGHINOURSTUDY,FEWELDERLYAWAITINGNHPLACEMENTNEEDEDENEMAS,THEYMAYHAVEBEENCONSTIPATED,ASINASWEDISHSTUDY,22OFTHECOMMUNITYDWELLINGELDERLYWOMENREPORTEDTHATTHEYREGULARLYUSEDLAXATIVESBECAUSEOFCONSTIPATIONPE

34、RHAPSTHEFAECALFREQUENCYOFELDERLYAWAITINGNHPLACEMENTWASDIFFICULTFORNURSESTOMONITORWHILETHEYLIVEDATHOMEWHENTHENEEDFORMOREASSISTANCEANDENEMASBECAMEEVIDENT,NHPLACEMENTBECAMEAMOREVIABLEOPTIONSTATISTICALLYSIGNIFICANTLYMORENHRESIDENTSHADLOSTSPEECHANDUSEDONLYNONVERBALSOUNDSTOCOMMUNICATETHANELDERLYAWAITINGNH

35、PLACEMENTTHISDIFFERENCEINDICATESDIFFICULTYLIVINGATHOMEWITHGREATCARENEEDSANDLACKOFABILITYTOCOMMUNICATE,WHICHHASBEENREPORTEDTOBEASTRONGPREDICTOROFNHPLACEMENTORIENTATIONABILITYCOMPAREDWITHELDERLYAWAITINGNHPLACEMENT,NHRESIDENTSWERESTATISTICALLYSIGNIFICANTLYLESSORIENTATEDTOTIME,PLACE,ANDPERSONTHISINDICAT

36、ESMOREMEMORYDISTURBANCES,COGNITIVEIMPAIRMENT,ANDADDAMONGNHRESIDENTS,YETMANYELDERLYAWAITINGNHPLACEMENTHADGREATPROBLEMSWITHTHEIRORIENTATIONABILITY,ASWELLLESSTHANHALFOFTHEMKNEWTHECORRECTMONTHANDYEARHOWEVER,ORIENTATIONTOTIMEISOFTENOFLESSCONCERNINTERMSOFMENTALSTATUSTHANORIENTATIONTOPLACEANDPERSONCONCLUSI

37、ONSTHISSTUDYREPORTEDSIMILARITIESANDDIFFERENCESINFUNCTIONALLEVELSANDNURSESWORKLOADSBETWEENTWOSAMPLESASAMPLEOFFRAILELDERLYAWAITINGNHPLACEMENTANDASAMPLEOFNHRESIDENTSSTATISTICALLYSIGNIFICANTDIFFERENCESWEREFOUNDFORTWOMOTORFUNCTIONS,INTHEADLFUNCTIONS,NEEDFORENEMAS,ABILITYTOSPEAK,ANDORIENTATIONABILITYCLINI

38、CALLYSIGNIFICANTSIMILARITIESWEREFOUNDFORFIVEMOTOR6FUNCTIONS,BEHAVIORALANDPSYCHIATRICSYMPTOMS,ANDNURSESWORKLOADS,INDICATINGTHEFRAILTYOFELDERLYAWAITINGNHPLACEMENTTHEYWEREALMOSTASFRAILANDNEEDEDALMOSTASMUCHASSISTANCEASNHRESIDENTSELDERLYAWAITINGNHPLACEMENTHADAHIGHPREVALENCEOFSADNESSANDFEARFULNESS,PERHAPS

39、INDICATINGTHEIRLIFESITUATIONWASBEINGEXPERIENCEDASDIFFICULTTHEIREMOTIONALRESPONSESMAYBEIMPORTANTTOATTENDTOSOURCEBYFJELLTUNAM,HENRIKSENN,NORBERGA,GILJEF,NORMANNHK,SCANDINAVIANJOURNALOFCARINGSCIENCESSCANDJCARINGSCI,ISSN14716712,2009DECVOL234,PP73647PMID197401137译文一项针对等待安置进入养老院的老人和已居住在养老院的老人的职能水平和护理工作量对

40、比研究本研究的目的是双重的比较等待安置进入养老院的老人和已居住在养老院的老人的功能水平,并比较他们护理的生理和心理的工作量。在挪威,养老院的需求布局有了大幅度的增长。老年人养老可以是居家养老或者从他们的家人那儿得到关怀和照顾。记录老人的水平，可以反映护理人员的工作量的程度与在养老期间所需要的帮助。这项研究是在2005年在挪威北部针对两组进行的，它使用多维痴呆评估量表用来评估功能水平,一组是针对还等待安置进入养老院的老人，另一组是针对已经居住在养老院的老人来进行的评估。护理人员也反映生理和心理的工作量对于照顾这些老人。比较比较等待进入养老院的老人和已居住在养老院的老人的功能水平显示，在统计上具有

41、明显的不同。养老院的居住者有两个较低的运动功能,在日常生活中需要更多的帮助,能更经常地灌肠管理，他们经常无法说话,表现出较低的取向的水平。通过临床诊断发现显著的相似之处在五个运动机能,包括在从床上坐着,站起来及走路,和行为和精神症状。两组的老人都有的悲伤和恐惧。这项研究的结果表明,还未居住养老院的老人和已居住在养老院的老人是一样的脆弱。这些结果强调老年人的所需的援助,揭示了在养老院需要更多更多的床位。不管是居家养老还是在养老院养老，同样都需要定额的生理和心理工作量。尽可能多的每天24小时的保姆照料,这些结果也反映了在养老期间这些护理老人的人们需要做什么。当老人变得太脆弱而不能在家正常自理或者当

42、他们的护理人不能照顾他们了,他们或他们的护理人就需要NH布置。医生和居家养老服务的护理管理者则针对他们的需要进行全面专业的评估。讨论相似点我们的评估包括了在NH的所有居住者,还包括最近进入NH的那些处于生命快结束的老人们。因此,我们早已预料到,会发现两组评估群体之间的较大差异。我们的预期是那些未进入NH养老院的老人的职能水平，将会接近那些最近进入8NH的老人们。我们讨论变量显示统计上无显著差异相似之处。对这些变量,我们认为等待安置进入养老院的老人和已居住在养老院的老人一样脆弱。然而,对于许多这些变量,包括五个运动机能,有这样清晰的趋势，未进入NH养老院的老年人比起已经居住在NH的居住者有较高的

43、功能水平。然而,各组之间的相似之处是通过临床诊断是显著的，并且说明那些未进入NH的老人的脆弱。尽管如此,我们认为,大多数倾向将成为统计上显著性有较大的样本。此外,NH搬迁调整到新环境,这样对NH的居住者的功能水平也会造成积极或者负面的影响。根据美国心理学家LAWTON的观点，环境影响人类的行为能力、健康、认知、社会行为,以及他们的精神健康和生活质量。运动机能。两组结果表明,在相似运动机能从躺下到坐下的能力有提高,上升了床,无协助地走路和借助工具的帮助的行走。这表明未居住在NH的老年人比已经在NH的居住者，在一天内从床上倒椅子上的过程，需要更多的帮助。一个重要的差别是考虑到,当NH的居住者需要帮

44、助时,通过一些设备让身体状况调整以适应他们的性能，如机械电梯。此外,两个护理人员通过机动性去帮助老人在NH经常是最合适的。未居住在NH的老人会接受到和他们在养老院几乎一样等量的服务。养老院提供的帮助主要是看护者和社区护理人员,他经常在早上来协助老年人起床。在白天,看护者不得不帮助照料老人，在社区护理人员没有空的时候。协助老人从躺下到坐下来,从床上起来,然后行走，这些都是生理上的要求,另外适当的设备,例如机械电梯、一些稀缺商品在养老院中。行为的症状。对于大多数变量,等待安置进入养老院的老人和已居住在养老院的老人有相同的普遍存在的行为症状。这些典型的行为症状伴随着认知障碍一起发生,这是NH养老院的

45、一项有力的预测。四分之三的等待安置到养老院的老人也有记忆障碍。许多已经居住在NH的居住者不断寻求注意的护理人员的注意，在挪威的NH养老院，那里的居住者很少互相之间沟通交流,而主要是与养老院的职工在护理和吃饭时间进行交流。其余休息的时间,许多NH的居住者试图谋求工作人员的注意。这些居住者和工作人员之间有限的交流可能是由于低员工水平，因此,获得满意的对话的时间缺乏。在目前的这项调查中,普遍的口头威胁和物理打击是高比例的,尤其是在NH的居住者之间。我们没有探讨NH的居住者和员工9的沟通数量,而且不满意的互动，威胁和打击存在的普遍性会增加，这样将会导致于护理工作压力的增加。在瑞典NH684的护理人员报

46、告说他们在过去一年中遇到过暴力。一些澳大利亚的护士有经验的高压力的工作来自于那些有认知障碍的居住者,尤其是如果她们的行为被认为是危险的。精神病症状。等待安置进入养老院的老人和已居住在养老院的老人关于精神症状。两组患精神病症状有很多相似之处,这两个群体都有很高的发病率。从情感上的精神病症状,等待安置进入养老院的老人比已居住在养老院的老人往往有更多的症状。我们发现大约一半的临床显著发现等待进入NH的老人是很痛苦的,他们每日或每周五分之一的时间在哭泣,可能表明了艰难的生活条件和易变的情绪反应。此外,对于等待进入NH的老人普遍存在精神症状的状况实际可能要比报道的要高，可能是因为一些老人可能想要隐藏他们

47、的泪水对护理人员,因此只有当他们孤独一人时才哭泣。我们的结果都是与研究报告显示相反的，报道显示居住在NH的老年人比起社区居家养老的老人更沮丧。在我们的研究中，等待进入NH的老人比起社区居家养老的老人可能更加虚弱，生活条件更困难。护理工作量。护理人员的生理和心理工作量都是相似的，无论是社区养老服务还是在NH养老院。然而,根据SANDMAN等人在1988年的研究中表明，护理人员的工作量实际比报道出来的还要略高。在瑞典不同的长期护理机构采用MDDAS评估3600个老人的生活。较高的工作量表明那些居住者更脆弱，还有低的护理人员水平。有两个重要的原因,在近几年来在挪威NH居住者们中存在较低的职能水平在1

48、980年代以后越来越多的老年人和加强居家养老作为一项公共优先领域。今天,挪威政府财政支持建立新的NH,但是NH的床位一直以来很多年还是存在紧缺的问题。由于更高的工作量可能会有更高的注册护士人员流动比率和缺少合格护士。在挪威，人员流动率和长期疾病是非常高的在NH和社区居家养老的工作人员中。在美国,高的离职率被发现直接关系到低的人员配备水平。在2006年,有78的护士工作在挪威NH评估他们员工水平显示也较低。然而,人员流动率也与选择的工作的实用性有关。挪威农村的市民，在NH养老院和社区居家养老服务通常是唯一的可能性对于卫生工作人员。在2007年公布的一项研究,结果表明挪威的护理实习生透露,在老年护

49、理机构工作仍然是不受欢迎的，在他们整个实习期间。10不同点运动机能。两个运动机能显示等待进入NH的老人比起已经在NH的居住者而言统计显示更高的职能水平。等待进入NH的老人需要较少的帮助，比如从椅子上站起来，行走，上下楼梯。余下的问题是NH的居住者们多长时间去活动一次，来保持他们的走路移动性和操纵楼梯。行为症状。关于行为症状,统计上的显著性差异是，等待安置进入养老院的老人和已居住在养老院的老人从两个变量来反映NH的居住老人比起等待安置到NH的老人更经常出现会吐药物和把桌布卷起来这类现象。我们假定等待安置到NH的老人拒绝药物是容易的,因为他们的药物都是自行管理的。这个区别的原因在NH老人卷桌布这种行为更需要进一步观察,比起社区的家庭护理人员去拜访住在家里的老人。精神症状。关于精神症状，唯一的显著性差异是等待安置的老人比起在NH的老人更经常抱怨。他们可能有正当的原因对于这些抱怨，比如，抱怨他们需要接受的制度性的服务。在等候期间,他们可能会经历了有限的协助,这在挪威的老人中是普遍的经历。然而，NH的居住者也许有正当的理由来抱怨。如果他们曾抱怨,也许他们的抱怨并没有受到重视，NH养老院的居住者和员工之间的交流可能是被受限制的。ADL日常生活自理能力。比较等待安置进入养老院的老人和已居住在养老院的老人而言，统计资料显著表明他们在没有帮助的条件下，较无法进行日常