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Obstacles to implementing research outcomes in community settings
- Authors:
- BALL Karlene, WADLEY Virginia, ROENKER Daniel
- Journal article citation:
- Gerontologist, 43(Special Issue), March 2003, pp.29-36.
- Publisher:
- Oxford University Press
This American article argues that in contrast to controlled laboratory or clinic-based research that can fail to capture the real-world behaviors of older adults, field research offers the best opportunity for ecological validity. However, the tradeoff inherent in field studies is the potential sacrifice of scientific rigour. Applied research presents a unique set of challenges that vary with context. This article discusses these challenges along with possible solutions. Examples are drawn from an ongoing, longitudinal study of driving competence that is being conducted in Department of Motor Vehicles field sites. The challenges faced at each stage of the project are discussed. Methodological issues include identifying field collaborators, approaching administrators with the research proposal, producing a battery that is manageable and acceptable while maintaining scientific merit, training indigenous personnel to administer this battery, introducing the research and consenting potential participants, and managing large data sets offsite. Additional issues include quality control, the importance of distinguishing between individuals who consent and those who decline participation, and the collection of follow-up data via telephone.
Practically relevant research: capturing real world tasks, environments, and outcomes
- Authors:
- CZAJA Sara J., SHARIT Joseph
- Journal article citation:
- Gerontologist, 43(Special Issue), March 2003, pp.9-18.
- Publisher:
- Oxford University Press
Development of strategies to optimise the functional performance of older adults requires understanding the behaviour of older people doing tasks in real-world settings and capturing these interactions in research protocols. This is a major challenge as there is some degree of tension between capturing the contextual variables and constraints that operate in the real world and the scale of research that can be realistically conducted within controlled experimental settings. This article presents a research approach that can be used to help ensure the ecological validity of research protocols. The intent is to demonstrate how an ecologically valid approach affords greater insight into the performance of older adults in real world settings. The approach involves techniques such as task analysis and simulation. Examples from two research projects examining aging and the performance of real-world computer-based work tasks are used to demonstrate the application of this approach. The article demonstrates how an ecologically valid research approach yields information about human performance that can be translated into solutions for real-world problems.
Adequacy of care: the concept and its measurement
- Authors:
- MORROW-HOWELL Nancy, PROCTOR Enola K, DORE Peter
- Journal article citation:
- Research on Social Work Practice, 8(1), January 1998, pp.86-102.
- Publisher:
- Sage
This article presents a methodology for measuring the adequacy of care, both formal and informal, and how well they meet the needs of the elderly living in the community. The measure of adequacy of care derives an assessment of need and assistance received in 14 activities of daily living. In each activity area where the elderly need assistance, assessments are made of the quantity and quality of care received from formal and informal sources. Describes how the scores can be useful to social workers for both clinical and research purposes.
Resident outcomes of Medicaid-funded community residential care
- Authors:
- HEDRICK Susan C., et al
- Journal article citation:
- Gerontologist, 43(4), August 2003, pp.473-482.
- Publisher:
- Oxford University Press
Washington State's initiatives to increase the availability and quality of community residential care presented an opportunity to describe clients entering adult family homes, adult residential care, and assisted living and to identify outcomes of care. We enrolled 349 residents, 243 informal caregivers, and 299 providers in 219 settings. We conducted interviews at enrollment and 12 months later, and we collected data from state databases. The average resident was a 78yearold woman reporting dependence in two of six activities of daily living. Residents in adult family homes demonstrated significantly more disability. Seventy-eight percent of residents survived at the 12-month follow-up. In analyses that controlled for differences at enrollment, residents in the three types of settings were very similar in health outcomes at follow-up. State policies should reflect the wide range of needs of residents seeking care in these settings. Choices among type of setting can be based on the match of needs to individual preferences.
Beyond the medical model the Eden Alternative(r) in practice: a Swiss experience
- Author:
- MONKHOUSE Christa
- Journal article citation:
- Journal of Social Work in Long-Term Care, 2(3/4), 2003, pp.339-353.
- Publisher:
- Taylor and Francis
- Place of publication:
- London
The medical or institutional model of care has been the standard in most of the 1300 nursing homes in Switzerland. Consequently, staffing problems, increasing costs, and poor reputation have become the norm. This case study describes two 60-resident homes in Zollikon, Switzerland, which implemented the Eden Alternative(r), beginning in 2000. Based on this model, they are committed to the eradication of resident loneliness, helplessness, and boredom. Their tools are companionship, spontaneity, and the opportunity to give care to each other, staff, children, animals, and plants. The change from a medical model was precipitated by a care and financial crisis. Since then, three steps have been taken. The first, the crisis intervention step, was followed by the implementation of total quality management resulting in significant improvements in clinical outcomes and financial stability. Ultimately, the Eden Alternative was successfully introduced. It was perceived as "the missing link" and appears, at this early stage, to meet the real needs of residents and staff. The change process is described and outcomes are presented and discussed. (Copies of this article are available from: Haworth Document Delivery Centre Haworth Press Inc., 10 Alice Street Binghamton, NY 13904-1580)