The Essence of Accommodating Older Adults into the Social Care Sector in Malaysia

Population ageing puts pressure on the workforce and increase the demands for aged workforce.The demographic shifts have made the issue of healthier workers,especially those of advanced age and physically related job scopes,a fundamental aspect to employing older workers.Hence,this study aimed to explore the best practices to employ older adults into the social care sector.The social care sector was chosen in view of the nature of job and declining demand among younger workers.A qualitative study was conducted involving series of focus group discussions(FGD)with social care workers of long-term care centers in the peninsular Malaysia.Data was collected using a validated and pre-tested semi-structured interview protocol.Each focus group discussions and in-depth interviews were lasted between 45 min to 1 h.A total of 57 workers were consented for the study which was divided into young and old workers based on the mean age of 41.43[SD±9.97]years old.The content of the interviews was transcribed verbatim and thematic analysis was performed to inductively identify the coding and themes within the data related to the challenges employing older workers into the social care sector.Three categories of coding were identified(individual,environmental and management factors),leading to the identification of two important themes which are healthy workplace and work autonomy.The findings indicate the needs for work culture transformations to cultivate healthy working environment and freedom of speech particularly among the older workers.

Identifying Where the Values Come from IT-Innovations in Health and Social Care

Studies aimed to capture the effects of IT-innovations in health and social care have shown that there is a gap between expected and factual outcomes. Many decision makers feel the need to articulate an ideal end-state for their organiza-tions. Striking the balance between novelty and believability of such an ideal end-state is often tricky and they become neither satisfied with the ideal not the visioning. In this study, we explore the contribution of IT-innovations to health and social care. The results showed that coherence between context and IT-innovation is important to capture effects and outcomes. Being coherent rather than visionary contributes to identify where you are, as an organization, and to capture effects and outcomes that “make sense” in the context in question. The paper makes an exposition from the model building, algorithm design to performance analysis and contributes to the academic prosperity in Intelligent In-formation Management The knowledge generated is expected to provide input when identifying goals that IT-investments are supposed to achieve.

Expanding Older Adults’ Care Choices Utilizing the Proceeds of Reciprocated Volunteerism: Capitalizing on Ghana’s Digitalization Artillery

Ghana has been a collectivistic society. However, due to social change, this value is fast being replaced by individualistic tendencies with implications for age-oriented care provision and receipt. This paper investigates the participation in the socially productive strategy of using ageing-oriented volunteerism to leverage the receipt of care in later life utilizing a quantitative dataset. The results show that volunteering may be undertaken with old age in sight. This needs to take place under circumstances of good communication skills among others. The accumulated time needs to be recorded in a time bank and redeemed with a time bank card in later life. Two-dimensional leveraging points pertain in this context: first, leveraging volunteerism for short or long-term care in the nearest future;second, technological innovation’s facilitation of the same. Volunteerism in this context has the attribute of low levels of depression, with implications for quality of life. These are discussed in the light of the social care pillar of ageing social policy. The paper argues that adopting volunteerism with reciprocation as the ultimate goal constitutes a kickback model for care receipt in later life. It served as a choice of care in later life which is a shock absorber to inadequate formal support infrastructure and individualistic social tendencies in Ghana. It is reminiscent of resistance to the shrinkage of older persons’ social integration in their social world.

Improvement in social skills in patients with schizophrenia following 6 months of day-care treatment

Using role-playing tests simulating real-life situations, we investigated improvement in the social skills, especially information processing, of patients with schizophrenia in response to day-care in psychiatry and social skills training. From 20 pair-matched schizophrenia patients, 10 were assigned to a day-care/SST group and 10 to a control group undergoing usual treatment. After 6 months, sending and receiving skills were assessed by means of role-playing tests, psychiatric symptoms, social function, and cognitive function. The day-care/SST group showed a significant improvement and a large effect size in sending skills. Receiving skills also improved, showing a medium effect size, but the difference from the control group was not statistically significant. No statistically significant changes were observed in the other measures. That no changes occurred in social function, psychiatric symptoms, or cognitive function leads to two conclusions: 1) cognition targeted, specialized training and comprehension of cognitive remediation, psychiatric rehabilitation, and social skill development are necessary for improvement in other domains, especially symptoms and social functions;and 2) improvement resulting from day-care in psychiatry and SST alone is limited. In addition, further investigations over a longer observation period and a greater sample size are needed.

Inter-organizational cooperation: A rehabilitation project based on cooperation between health care and three social service agencies

Purpose: Cooperation between organizations is an often-suggested remedy for handling unsolved borderland problems. However, actual projects aiming at cooperation are seldom very successful. The purpose here is to highlight obstacles related to cooperation between different organizations based on a case study of a rehabilitation project where health care and several social service organizations (social insurance, social welfare, and the local employment agency) were involved. Data were gathered through participation and interviews. Findings: It seems that efficient cooperation requires an understanding of the participating organizations’ differences in work logic as well as work practices. Furthermore, only certain fairly standardized “normal” problems may be handled through organized cooperation while non-routine exceptional problem requires a more fully integrated work organization. Implications: Obstacles to cooperation are highlighted and ways to improve the possibilities of cooperation between organizations are suggested although such possibilities are generally hampered by differences in work logic.

The HIV Infection: Clarification of Its Legal Classification of Transmission and Measures to Protect Societies from Burdening Caused by Social and Medical Care Services for the Coming Decades

This article addresses issues regarding the transmission of HIV;without the combination antiretroviral treatment (cART), HIV causes a fatal outcome of those infected in most cases. First, legal issues: For years, controversial discussions have dealt with the subject of the legal classification of HIV infection, such as “… criminalization of HIV exposure might limit access to and uptake of HIV prevention services…” Based on the rule of law of a constitutional state, we explain the legal principles that serve to protect the legal rights of its citizens. The state has to protect its citizens from harm by other people. The prosecution and conviction of a specific person for a proven HIV infection are legal. Therefore, general decriminalization of HIV infection would undermine the right of thereby harmed citizens to compensation. Second, HIV prevention strategies: Based on the Test and Treatment Strategy (TASP)1, controlled studies were undertaken to find out which framework conditions could improve their benefit. We outline concepts that can help to curb the still ongoing spread of HIV: By providing early HIV diagnosis and ongoing HIV care services as part of updated education and prevention campaigns. Also, concerted, comprehensive campaigns are required to demonstrate further impacts of HIV infection: Both on the quality of life of infected individuals due to the development of non-communicable diseases and the increasing burden to societies as a whole.

老年慢性病住院患者老老照护者的照护能力现状研究

目的了解老年慢性病住院患者亲情老老照护者的家庭照护能力现状,分析其影响因素,为制定针对性的干预措施提高家庭照护能力提供参考。方法采用中文版老年患者家庭照护能力量表对181名老年慢性病住院患者的家庭照护者进行调查。结果照护者的家庭照护能力总分为(33.04±4.98)分。多元线性回归分析结果显示,照护者月均收入、文化程度、婚姻状况、自我感知健康状况是亲情老老照护者的家庭照护能力的主要影响因素(均P<0.05),共解释照护者家庭照护能力总分87.4%的差异。结论老年慢性病住院患者亲情老老照护者的家庭照护能力不容乐观,相关部门应高度重视老龄化社会背景下老老照护这一普遍现象,完善相应政策与举措,为老老照护者提供安全保障。

中国安宁疗护服务体系历史发展、制度化困境与国家政策框架

从现代社会福利制度化建设角度看,中国社会福利服务体系尤其是儿童与老人安宁疗护服务发展缓慢。中国现代安宁疗护服务制度建设的政策框架是“以医院为基础,以社区为中心,以居家为补充”;战略是现代社会主义福利国家制度建设;策略是正式社区照顾服务、健康照顾服务与社会照顾服务体系一体化;路径是解放思想,更新价值观念,明确国家主体福利责任,完善社会福利服务财政制度,加快专门立法,发挥专业社会工作作用等。现代社会福利制度建设是国家、社会现代化的主体与主题。现代社会福利制度质量状况既决定社会政策与全民社会生活质量,又决定生命与死亡质量,其核心是国家权力与公民权利、国家责任与公民义务、个人福利与社会福利责任的社会划分,其实质是全民美好生活需要满足与国家治理制度现代化,其目标是中华民族伟大复兴和中国现代社会主义美好社会。

差序整合:农村互助养老实现的机制分析

农村互助养老作为居家养老和机构养老的重要补充,是解决农村深度老龄化问题的有效路径。基于差序格局理论,在“关系—制度”分析框架和“差序整合”概念下,通过对河南省W县农村互助养老实践的考察发现,当地基层党组织成功借助乡土社会关系的差序规则,有序动员老人的亲友、邻里、同乡等为其提供养老服务。究其实现机制,具体包括以重塑认知为重点的制度嵌入、以均衡互利为核心的关系整合、以满足需求为关键的行动激励、以责任践履为要求的多方问责机制,差序整合为农村互助养老的可持续发展提供了规引制度、关系基础、参与动力和履责保障,实现了社会关系、制度规约、行动主体的全面整合,推动了农村养老服务高质量发展。

我国残疾人社会保障与关爱服务的系统性优化研究——以需要为本的社会政策为视角

我国残疾人社会政策进入优化发展新阶段,将系统思维贯彻至残疾人社会政策优化是现实所需。文章提出残疾人社会政策以需要为本的目标导向,聚焦社会保障制度和关爱服务体系的目标集成、政策集成,推动残疾人兜底型和发展型社会政策的效果集成,进一步提出建立健全残疾人家庭需求的多维识别和综合研判机制、持续追踪和动态预警机制,并围绕残疾人家庭的能力提升、残疾人关爱共同体建设这两个重点,来促进残疾人社会政策的协同。

撬动全民主动健康:新加坡健康战略及其对我国的启示

新加坡卫生绩效长期居世界前列,2022年推出的更健康的新加坡(Healthier Singapore,HSG)战略旨在将新加坡卫生健康体系从传统的“被动医疗”向“主动健康”转变,引导民众重塑健康行为与生活习惯。HSG战略白皮书着重强调了在老龄化社会中基层医疗保健体系建设以及一级预防对居民健康的重要性,与我国极力推进家庭医生、分级诊疗制度以及建设以人民健康为中心的高品质健康服务体系的目标高度一致。本文主要回顾新加坡医疗服务体系的背景,以及HSG战略发布之前新加坡政府在卫生健康领域的重要规划,介绍HSG战略核心内容,揭示新加坡推动实现全民“主动健康”的政策演进与外部支撑环境建设,以期为我国加强基层医疗卫生事业建设提供借鉴。

社会工作在机构养老服务中的三重嵌合

在公共养老领域采取自上而下政府购买社会工作专业服务的嵌入策略,成了国家回应公共院舍养老需求的一种重要方式。社会工作机构嵌入老年院舍专业化服务后,专业力量可通过自身能动效力“成功”嵌入,再造院舍内部专业化服务供给秩序。但嵌入后仍面临着三重挑战:结构嵌入无法消解购买政策不确定性、认知嵌入不足以建构专业化服务体系、文化嵌入限制了院舍内生动力的生成。案例的进一步实践表明:长期稳定的社会工作老年院舍服务机制的维持需要社会工作机构从单向嵌入转向与公共院舍融合的嵌合式发展,从价值嵌合、行动嵌合和主体嵌合三个维度来找寻双方共融价值、塑造共同实践面向和促成身份双向认同,从而实现一般意义上的服务路径转向。

嵌入性视角下农村互助养老政策的实践困境与优化路径——基于河南省H县的田野调查

伴随互助养老从社会自发发展阶段迈向国家视野下的积极统筹阶段,互助养老政策的现实重要性由此凸显出来。基于嵌入性视角,互助养老政策下乡必然受到诸多内生性因素影响,在此情形下,政策需要积极调适自身并推进认知、文化、组织和政策的社会嵌入,才能取得良好的政策效果。然而,由于注重硬件投入和追求标准化服务、互助文化式微和养老观念变迁、缺乏社会动员和组织体系建设、量化指标推进和行政控制权强化,当前互助养老政策存在认知脱嵌、文化脱嵌、组织脱嵌和政策脱嵌等结构性困境。作为改进,应加快协商平台构建和服务评估优化、强化养老政策宣传和家庭政策支持、加强社会精英吸纳和组织体系构建、优化治理主体合作和考核体系改善,塑造出良好的嵌入性环境,助推互助养老政策的认知、文化、组织和政治嵌入,真正实现低成本、高福利、可持续的互助养老服务生产。

社会支持视角下农村老年人互助养老行为及影响因素研究

老龄化“城乡倒置”、养老资源“分布倒挂”现象加剧,互助养老成为解决我国农村养老问题的新途径。基于社会支持理论,运用CHARLS2018年数据,考察社会支持对农村老年人互助养老行为的影响,研究发现:正式社会支持中助推型公共政策能通过“减少策略”和重构互助环境显著发挥促进作用;非正式社会支持中隔代照料正向作用显著;与农村老年人经济条件相关的变量均起到负向作用,互助养老行为的根本驱动与经济困境有关;非正式社会支持与正式社会支持存在交互效应,助推政策与照料孙子女具有互补性;低龄、无配偶且受教育水平较高的农村老年女性互助养老行为更强。研究结论有助于揭示互助养老行为影响因素以及柔性助推在其中的作用。

数智化时代老年人社会参与的挑战与应对策略——基于MOA理论的实证研究

随着积极应对人口老龄化国家战略的实施,养老观念正发生转变,从传统单纯地为老年人生活提供支持,逐步转向鼓励老年人继续参与社会活动,即进行积极的社会参与。数智化技术既给老年人积极社会参与带来更多的机遇,也是未来老年人社会参与的必由之路。基于MOA理论对20位老年人开展为期14天的日记研究,结果表明,数智化技术确实为老年人带来了更多社会参与的机会,但也造成老年人在社会参与时面临“想参与但无从参与”“有机会但参与困难”与“参与但获得感不强”三大挑战。要改善这一现状,首先,要完善制度设计,通过出台老年人社会参与统一平台建设、技术赋能老年社会参与的相关政策,保障参与环境;其次,要建设统一平台,构建包含老年人、养老服务机构(企业)和医疗(健康)服务机构等不同主体共同聚合的生态系统,保障老年人的社会参与机会;再次,推动技术赋能,在做好高频应用适老化改造的基础上,加强对智能化功能的建设,对技术使用的门槛做减法,为技术应用形式做加法;最后,要积极鼓励和推广以志愿服务、银发网红、再就业等为代表形式的“老有所为”活动,支持老年人继续发挥余热,使晚年生活更充实、更有意义。

社会投资视角下农村留守儿童社会支持政策的反思与构建

“以儿童为中心”的社会投资战略已成为发达国家社会政策的新趋向。因城镇化巨大的虹吸效应,农村传统差序格局下以血缘、地缘为主的先赋性儿童照料资源日趋消解,农村留守家庭劳动力再生产能力不足,以“农村留守儿童关爱体系”为主要内容的社会政策进入公共政策领域。然而,从社会投资的视角来看,我国农村留守儿童政策尚缺乏“支持家庭”“多元共治”等理念,“事后补缺型”的制度设计难以满足农村留守儿童和家庭的发展性需求,可能会通过降低未来人力资本增加贫困代际传递的风险。要实现“社会救助”向“社会投资”的理念转变,应以提升农村留守儿童及其家庭发展能力为根本,从导致亲子分离的制度根源入手,利用服务供给、时间补偿等“支持家庭”手段,构建政府、家庭、社会等“多中心协同治理”的社会支持体系,为农村留守儿童及其家庭提供普惠性的公共资源,以切断先赋性弱势与“留守事件”的链接机制。

乳腺癌病人社交焦虑和病耻感在家庭关怀度与孤独感间的中介作用

目的:探讨乳腺癌病人社交焦虑和病耻感在家庭关怀度与孤独感间的作用机制,为乳腺癌病人孤独感干预提供参考。方法:选取2021年12月—2022年7月在安徽省8所医院就诊的乳腺癌病人328例为研究对象,采用社交焦虑量表、社会影响量表、家庭关怀度指数问卷、孤独感量表对其进行调查。结果:乳腺癌病人社交焦虑、病耻感、家庭关怀度、孤独感总分分别为(11.72±5.33)分、(59.51±12.98)分、(6.84±3.67)分、(49.20±9.14)分。乳腺癌病人家庭关怀度与孤独感呈负相关(P<0.05),社交焦虑、病耻感与孤独感呈正相关(均P<0.05)。社交焦虑和病耻感在家庭关怀度与孤独感间起中介作用。结论:乳腺癌病人家庭关怀度可通过社交焦虑和病耻感的链式中介作用间接影响孤独感。

Assessment on self-care, mobility and social function of children with spina bifida in Turkey

The aim of the study was to investigate the functional performance in children with spina bifida, using the Pediatric Evaluation of Disability Inventory （PEDI） to look into capacity of twen- ty-eight children with spina bifida with lesions at different levels in different dimensions of self- care, mobility and social function. Mean age of the patients was 3.5 ± 2.3 （1-10） years. In the muscle test carried out, 13 patients （44.8%） had no movements including pelvic elevation in lower extremity muscles and they were at level 5. Sixteen patients （54%） were non-ambulatory according to the Hoofer ambulation classification. Raw and scale scores in the self-care, mobil- ity and social function domains both in the functional skill scale and in the caregiver scale were found to be lower compared to the data of the normal population. A statistically significant correlation was observed in the self-care values of the Functional Skills Scales and the Caregiver Assistance Scale measurements, which was positive for age and negative for Functional Ambu- lation Scale and muscle test （P 〈 0.05）. A positive relation was found between the Functional Skills Scales-mobility area and age while a negative relation was observed between Functional Ambulation Scale and muscle test （P 〈 0.005）. A negative relation was also found between Care- giver Assistance Scale-mobility and Functional Ambulation Scale and muscle test （P 〈 0.005）. In our study, the functional performance of the children was found to be low. Low-level lesions, encouraging muscular strength and independence in mobility are all very important factors for functional independence.

社会支持网络推动农村养老高质量发展的对策研究

随着农村老龄化加剧,农村老龄人口数量激增。但由于经济发展水平相对较低、医疗资源有限、精神慰藉缺失、应急保障不足等原因,农村养老面临着巨大的挑战。解决农村养老存在的问题,有利于保障广大农村老年人的基本生活权益,关系到农村的繁荣稳定和乡村振兴。因此,必须结合农村实际充分发挥政府、社区、家庭等社会支持主体的作用,建立完善的社会支持网络,改善老年人生活质量,提升其幸福感。

五社联动背景下社区养老服务模式创新探索——以D市J区S社区为例

“五社联动”背景下社区养老服务模式是我国在为应对日益严重的老龄化问题,弥补家庭养老和机构养老短板的实践过程中探索出的养老服务新模式。该模式主要通过社区、社会工作者、社区社会组织、社区志愿者和社区公益慈善资源的联动来满足养老服务的多样化需求。D市J区S社区通过形成多元参与格局、扩展养老服务内容和发掘养老新主体等举措,推动了社区养老的发展,取得一定进展。但由于欠缺服务专业性和基础设施等原因,社区养老发展缓慢,陷入困境。基于此,针对各主体,分别提出打造舒适社区环境和搭建联系各方协作网、建立高素质专业化的社会工作者队伍、提高社会组织公共服务能力、推进社区志愿者服务制度化、推进“互联网+公益”新模式的运用等举措,更好的推动社区养老服务模式的发展。