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Understanding the hospital environment and older people: a social ecological analysis

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dc.contributor.author Parke, Belinda Bernice
dc.date.accessioned 2010-02-22T23:24:52Z
dc.date.available 2010-02-22T23:24:52Z
dc.date.copyright 2007 en
dc.date.issued 2010-02-22T23:24:52Z
dc.identifier.uri http://hdl.handle.net/1828/2263
dc.description.abstract The complex health profile of older adults entering hospital presents staff and administrators with new challenges. In a climate of fiscal restraint, competing priorities and public pressure. it is necessary for acute care hospitals to rethink their views of caring for older adults. This critical ethnographic study applies a social ecological perspective using the concept of person-environment fit to illuminate how problems arise from conflict between needs and expectations. Constant comparative analysis and coding techniques take account of hospital operations and the perspectives of hospital employees and older people together. Data included hospital observations, and interviews with older adults (N=11) and hospital employees (N=14). Procedures to ensure rigor included continuous reflexivity. participant selection, triangulating data sources, peer debriefing, multiple checks. and an audit trail. Findings yield four areas of poor fit: architectural features, bureaucratic conditions. chaotic atmosphere, and hospital employee attitude. These environmental features act in independent and cumulative ways to produce a disempowering synergy that erodes independence and confidence: produces stress, worry, and anxiety; and enhances disabilities when functional impairments exist. Incongruent relationships emerge only when non-ideal older people enter the hospital's cultural space. A lack of fit exists for those considered different either because of their personal functional attribute or because hospital employees judge them to be unsuitable or inappropriate for the unit or service. Being different is key to lack of fit in the hospital environment and the construction of problems. The study also contributes groundwork for identifying indicators of older adult-hospital environment fit. and by doing so. aids in defining quality of hospital services based on what older people need and expect compared with what the hospital provides and the demands it places on older people. This research has the potential to set the stage for assessing hospitals and ensuring policies are better suited to the needs of older people. en
dc.language English eng
dc.language.iso en en
dc.rights Available to the World Wide Web en
dc.subject older people en
dc.subject hospital care en
dc.subject health and hygiene en
dc.subject Canada en
dc.subject.lcsh UVic Subject Index::Humanities and Social Sciences::Sociology en
dc.subject.lcsh UVic Subject Index::Humanities and Social Sciences::Social Sciences::Social service en
dc.subject.lcsh UVic Subject Index::Sciences and Engineering::Health Sciences::Nursing en
dc.title Understanding the hospital environment and older people: a social ecological analysis en
dc.type Thesis en
dc.contributor.supervisor Chappell, Neena L.
dc.degree.department Dept. of Sociology en
dc.degree.level Doctor of Philosophy Ph.D. en


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