Influence of home nursing service on life quality of disabled seniors in Bratislava and Vienna Living conditions have a decisive influence on the process of weakening solidarity with others. We know from the findings that the low standard of living of immobile seniors in Bratislava brings with it many restrictions on physical, psychological and social activities. Immobile seniors are provided with a high degree of social support by their relatives in Vienna. Our priority intention is based on the assessment of the social consequences of the immobilization syndrome and targeted intervention.
Satisfaction with life is the most basic goal that people try to achieve. Immobility affects all organ systems. Psychological and social factors also have a significant impact on the development, course and prognosis of diseases. The social dimension of illnesses is manifested by social isolation, change in social status, loss of communication, loss of sense of necessity with a high risk of adaptation failure (Poledníková et al., 2006).
The support of the social environment is subsequently defined by Kaplan et al. (1996) as "number of social contacts or satisfaction with them." The family plays an important supporting role, which is supposed to provide the old person with a background, a sense of security and belonging. In other cases, caregivers enter the families to provide care (Fulmeková et al., 2012).
An important determinant affecting the survival of seniors is, as Uher (2014) states, "free time, because there is a significant connection between an active lifestyle and a person's healthy state." According to Zrubáková et al. (2012), "the caregiver is mainly responsible for the quality provision of nursing care in the conditions of the home environment."
If it is only a time-limited scope of care, then the content of her work is also narrowed. In this regard, the relationship with the client takes on a completely different character, and that is why we focused our attention precisely on comparing the quality of home nursing care for immobile seniors in Bratislava and 24-hour service in Vienna.
Methodology
We involved immobile seniors in Bratislava and Vienna in an anonymous survey of participants' satisfaction with the quality of care services. The first group (A) are immobile seniors, aged over 65, in Bratislava and the second group (B) are in Vienna. In total, we conducted 26 interviews, including 13 interviews in Bratislava and 13 interviews in Vienna.
It was implemented in the period from April 18, 2015 to September 28, 2015. We asked for cooperation and support from the leading coordinators of the nursing service in Bratislava and the managers of the 24-hour service in Vienna. To answer the research questions for these two groups, we chose the method of individual in-depth interview. The task of the participants in both target groups was, using a 5-point Likert scale, to evaluate their level of agreement or disagreement. To evaluate the research questions from the in-depth interview, we used two methods: first, a simple analysis of variance (one-way ANOVA), as well as through Spearman's correlation coefficient. In all the tests used, we worked with a significance level of alpha (p) of 0.05. (Chajdiak, 2009).
Research Objective
Our main goal is to find out the level of satisfaction of immobile seniors with home nursing care in Bratislava and Vienna. Another goal is to find out what factors influence the life satisfaction of immobile seniors in Bratislava and Vienna.
Results
What is the level of quality of social services provided in Bratislava and Vienna?
Quality of social services used by participants in Bratislava
Source: Author of the thesis
Immobile seniors in Bratislava only use care services and food delivery from social services, which also reflects their satisfaction with the quality of these provided social services. Participants in Bratislava increasingly perceive negatively, above all, the expensive price tariff for services, the low availability of medicines and special medical materials and aids, as well as the impaired accessibility of the family environment and transport, which represented one of the most problematic areas of meeting their individual needs in connection with a severe disability. Participants in Bratislava stated that they do not have the opportunity to be equipped with barrier-free facilities in their home environment.
The quality of social services used by participants in Vienna
Source: Author of the work
From the resulting values in the comparison (group A with group B), it follows that the satisfaction of immobile seniors with the provided social services is higher in Vienna. Immobile seniors in Vienna also make extensive use of mobile social services, e.g. mobile nursing care, help at home or mobile physical therapy. The participants in Vienna expressed excellent satisfaction with the 24-hour care. They appreciated the professional approach of Slovak babysitters and their personality traits. A statistically significant difference was confirmed by the relationship p = 0.014 < α =0.05.
What is the standard of living of immobile seniors in Bratislava and Vienna?
It follows from our findings that the low financial resources of the participants in Bratislava affect their quality of life, because it is negatively reflected in their way of life.
Standard of living of participants in Bratislava and Vienna
Source: Author of the work
From the point of view of evaluating the standard of living for both target groups, it was confirmed to us that the immobile seniors in Vienna perceive that their standard of living is high compared to the low standard of living of the participants in Bratislava. We can say that immobile seniors in Vienna are not only able to make do with money, but also have the opportunity to financially support their loved ones.
From our findings, we evaluate very positively the fact that immobile seniors in Vienna have facilities facilitating their mobilization, e.g. barrier-free vehicles, electromechanical lifting equipment, revolving steps, ergonomic belts or an electric device for strengthening the lower limbs. Are relatives actively interested in an immobile senior in Bratislava and Vienna?
From the point of view of the age category of the participants (group A and group B), the analysis showed that the participation of relatives among immobile seniors in Bratislava and Vienna differs considerably.
Active interest of relatives in immobile seniors in Bratislava and Vienna
Source: Author of the work
By comparing the two target groups in Bratislava and Vienna, we found out, according to the calculation of the arithmetic mean of the answers, that the level of help from relatives within their co-participation in the care of immobile seniors in Bratislava is decreasing.
The provision of care by the family of an immobile senior in Bratislava is manifested by a negative effect of care. Relatives often have health problems, problems with mental health and in the social field.
On the contrary, the active interest of relatives in Vienna in their seriously ill parents is probably influenced by the mutual deeper emotional bond between the immobile senior and the relative, as well as the fact that the immobile senior must be in the center of the action, i.e. the center of attention and expects intervention activities from his family members.
Does caregivers' care for their own health and hygiene affect immobile seniors in Bratislava and Vienna?
We were particularly interested in the view of immobile seniors on caregivers in taking care of their health and hygiene. Guidance for caregivers to self-care for their health and hygiene is a necessity, and therefore it is necessary to follow a healthy way of life and thus prevent possible complications at the workplace.
The impact of feedback on caregivers' care for health and hygiene
Source: Author of the work
Based on the calculation determined as the arithmetic mean of the answers (in the ratio 3.23:1.00), it follows that the higher the caregiver's care for his own health and hygiene, the better the feedback of the immobile senior in terms of his subjective perception in Vienna, because effective self-management support means more than just telling the client what to do. The validity of the relationship p= 0.039 <α = 0.05 showed a statistically significant difference.
We found that mutual positive relations between an immobile senior and a caregiver are one of the important factors that not only influence the behavior, moods, and feelings of the caregivers, but also reflect the positive results of their work commitment.
Conclusion
We can formulate several generalizing findings from the research results. The first is the level of quality of social services used by immobile seniors in Bratislava and Vienna. By comparison, we found that the level of quality of 24-hour care in Vienna is higher than in Bratislava. Participants in Vienna cite greater satisfaction with the accessibility of additional mobile services as a reason compared to Bratislava, where these transport services are absent.
The satisfaction of immobile seniors in Vienna is manifested on the basis of several factors. One of them is the high level of participation of relatives in their individual needs, as in Bratislava. We can say that the intervention activities of relatives also depend on the financial self-sufficiency of seniors. Therefore, an immobile senior in Bratislava loses prestige for the interest of his relatives.
We came to the conclusion that the caregiver in the home environment of immobile seniors in Bratislava should have the required level of self-knowledge and care for their own health, i.e. follow a healthy lifestyle (e.g. physical activity, rational nutrition, personal hygiene, harmonious relationships, elimination of harmful habits, etc.).
Finally, it must be noted that there is still a discrepancy between the average amount of pensions (income) of potential users of nursing services and the payments for social services provided. Based on foreign practice, we propose that the sovereignty of the individual be strengthened by preferring and applying the principle of "subsidy per person", i.e. strengthening the income of a person who, according to the expert assessment of the assessment committee, needs the service.
As a result of disturbed generational relations, poor social adaptation and other factors, an immobile senior in Bratislava becomes lonely. Therefore, we suggest that caregivers actively engage the immobile senior with some activity, which will be reflected in all its dimensions: physical, psychological, social and spiritual. Furthermore, we recommend that the coordinators of the caregiving service in Bratislava focus more on the prevention of the mental health of caregivers in the form of professional seminars.
Authors: PhDr. Zuzana Kurkinová, Mgr. Veronika Reháková, PhD. List of bibliographic references
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