Special Care units : the policy practice interface
Date
1993
Authors
Frost, Ellenor M.
Journal Title
Journal ISSN
Volume Title
Publisher
Abstract
This is a study of practice and policy in Special Care Units. Special Care Units (SCU's) are planned therapeutic environments in long term care facilities. These units are designed for the particular needs of elderly residents with moderate to severe cognitive impairment, principally those with Alzheimer's Disease and Related Disorders (ADRD).
The problem addressed by this study is that the knowledge and experience of staff working in Special Care Units has received little attention in the research and from policy makers. Special Care policy is developing without benefit from practitioner experience. The purpose of the study is to provide information about Special Care Units from the standpoint of front-line nurses, to describe the interface between the nurses' knowledge and experience and the larger policy context and to suggest the policy implications for Special Care Units arising from practitioner knowledge.
There are three research questions: 1. What are the key features, characteristics and components of Special Care Units? 2 . What are the congruencies and incongruities between the nurses' knowledge and experience and the larger policy context? 3. What are the policy implications for Special Care Units suggested by the data?
A research perspective (rather than a theoretical framework) has guided the data selection and how the data is viewed. Two concepts make up the research perspective: standpoint and policy/practice interface. The principle data used in the study are interviews with nurses working in Special Care Units, supportive literature and policy documents. The study uses a flexible research design which combines interpretive and policy oriented methods. The interpretive, policy oriented approach is based on the perspective that reality is both constructed and contextually embedded. The knowledge thus created is a function of the researcher interacting with the participants and the participants bringing their own perspective into the process.
Interpretive analysis identifies four main categories (and several sub-categories) which describe the key features and characteristics of Special Care Units. The four categories are: Clients Created Elsewhere, The Dumping Ground, Coping as Care, and Creating a Community. The four categories are a construction and interpretation of the interface between the larger policy context and front-line Special Care practice. The congruencies and incongruencies between nurses' knowledge and experience and the larger policy context are described. The policy implications (problems, goals/objectives, strategies and resources) suggested by the findings conclude the study.