Boka remasangano rinotungamirwa neBritish Geriatrics Society (BGS) rakaparura chirongwa mwedzi uno kuona kuti vanhu vanotambura mudzimba dzevanochengeta uye muzvipatara vanokwanisa kushandisa chimbuzi muchivande.Mushandirapamwe uyu, une musoro unoti 'Behind Closed Doors', unosanganisira bhuku rekushandisa rakanakisa rinosanganisira rubatsiro rwekuita sarudzo, chishandiso chevanhuwo zvavo kuti vaite ongororo yezvakatipoteredza muzvimbuzi, mitemo yakakosha, hurongwa hwekuita nemapepa (BGS et al, 2007) .
Zvinangwa zvemushandirapamwe
Chinangwa chemushandirapamwe ndechekusimudzira ruzivo rwekodzero dzevanhu munzvimbo dzese dzekuchengeta, zvisinei nezera ravo uye kugona kwemuviri, yekusarudza kushandisa chimbuzi pachivande.Yakatsigirwa neruzhinji rwemasangano anosanganisira Age Concern England, Carers UK, Batsira Vakwegura uye RCN.Varatidziri vanoti kudzorera vanhu kutonga pamusoro peichi chiitiko chakavanzika kunosimudzira rusununguko uye kugadzirisa, kuderedza hurefu hwekugara uye kukurudzira continence.Chirongwa chacho chinosimbisa kukosha kwezvakatipoteredza pamwe chete nemaitiro ekuchengetedza uye zvichabatsira mune ramangwana kutumwa kwezvivako (BGS et al, 2007).BGS inopokana kuti mushandirapamwe uyu uchapa makomisheni, vatungamiri vakuru uye vaongorori mwero wekuita kwakanaka uye kutonga kwekiriniki.Sosaiti inoti maitiro emuchipatara azvino anowanzo 'kutadza'.
Kuwana: Vanhu vese, zvisinei nezera ravo uye kugona kwemuviri, vanofanirwa kukwanisa kusarudza nekushandisa chimbuzi vari voga, uye midziyo yakakwana inofanira kuwanikwa kuita izvi.
Nguva Yakakodzera: Vanhu vanoda rubatsiro vanofanirwa kukumbira uye kugamuchira rubatsiro rwakakodzera nguva uye nekukurumidza, uye havafanirwe kusiiwa pane commode kana pani yekurara kwenguva yakareba kupfuura zvakakodzera..
Midziyo yekufambisa uye yekufambisa: Midziyo yakakosha yekupinda muchimbuzi inofanirwa kuwanikwa nyore uye kushandiswa nenzira inoremekedza chiremera chemurwere uye kudzivirira kuratidzwa kusingadiwi.
Kuchengeteka: Vanhu vasingakwanise kushandisa chimbuzi vari voga zvakachengetedzeka kazhinji vanofanirwa kupihwa chimbuzi chine midziyo yakakodzera yekuchengetedza uye nekutarisirwa kana zvichidikanwa.
Sarudzo: Murwere / mutengi sarudzo yakakosha;maonero avo anofanira kutsvakwa nekuremekedzwa.Kuvanzika: Kuvanzika uye chiremera zvinofanirwa kuchengetedzwa;vanhu vakasungwa pamubhedha vanoda kunyatsotarisirwa.
Hutsanana: Zvimbuzi zvese, macommodes nemapakurau emubhedha zvinofanirwa kunge zvakachena.
Hutsanana: Vanhu vese munzvimbo dzese vanofanirwa kugoneswa kubuda muchimbuzi nepasi rakachena uye kugeza maoko.
Mutauro une ruremekedzo: Hurukuro nevanhu dzinofanira kuva neruremekedzo neruremekedzo, kunyanya maererano nezvikamu zvekusazvidzora.
Environmental audit: Masangano ese anofanira kukurudzira munhuwo zvake kuti aite ongororo yekuongorora zvimbuzi.
Kuremekedza chiremerera uye kuvanzika kwevarwere vakura, vamwe vacho vari panjodzi huru munharaunda.Inoti vashandi dzimwe nguva vanofuratira zvikumbiro zvekushandisa chimbuzi, kuudza vanhu kuti vamirire kana kushandisa incontinence pads, kana kusiya vanhu vasina kunyorova kana kusvibiswa.Chimwe chidzidzo chine nyaya inotevera yemumwe munhu akura: 'Handizivi.Vanoita nepavanogona napo asi vanoshaya zvekushandisa zvakanyanya semibhedha nemacommodes.Pane kuvanzika kushoma.Ungabatwa sei zvine chiremerera wakarara mukoridho yechipatara?'(Dignity and Older Europeans Project, 2007).Behind Closed Doors chikamu chemushandirapamwe weBGS 'Dignity' uyo une chinangwa chekuzivisa vanhu vakwegura nezvekodzero dzavo dzevanhu munzvimbo iyi, vachidzidzisa nekukurudzira vachengeti nevanodzika mitemo.Varatidziri vanoronga kushandisa mukana wekuwana zvimbuzi uye kugona kuzvishandisa kuseri kwemasuo akavharwa sechiratidzo chakakosha chechiremera uye kodzero dzevanhu pakati pevakanyanya kutambudzika.
Policy context
Chirongwa cheNHS (Department of Health, 2000) chakasimbisa kukosha kwe'kuwana zvakakosha' uye nekuvandudza ruzivo rwemurwere.Essence of Care, yakatangwa mu2001 uye yakazogadziridzwa, yakapa chishandiso chekubatsira varapi kutora nzira yakatarisana nemurwere uye yakarongeka yekugovana uye kuenzanisa maitiro (NHS Modernization Agency, 2003).Varwere, vachengeti nenyanzvi vakashanda pamwechete kuti vabvumirane nekutsanangura kutarisirwa kwemhando yepamusoro uye maitiro akanakisa.Izvi zvakakonzera mabhenji anofukidza nzvimbo sere dzekuchengeta, kusanganisira continence uye dundira uye bowel care, uye kuvanzika uye chiremerera (NHS Modernization Agency, 2003).Zvisinei, BGS inotaura gwaro reDH pamusoro pekushandisa National Service Framework yevakwegura (Philp naDH, 2006), iyo yakataura kuti kunyange zvazvo kusarura kwezera kwakanyanya kusingawanzoitiki muhurongwa hwekuchengeta, kuchine mafungiro asina kunaka uye maitiro akadzika midzi kune vanhu vakuru. vanhu.Gwaro iri rakakurudzira kuti pave nevatungamiri vanokwanisa kuzivikanwa kana mazita avo vanozove nemhosva yekuona kuti chiremera chevakwegura chinoremekedzwa.Chirevo cheRoyal College of Physicians 'National Audit yeContinence Care yeVakuru Vanhu vakawana kuti avo vanoshanda munzvimbo dzehutano vanonzwa kuvanzika uye chiremera zvakachengetwa zvakanaka (kutarisirwa kwekutanga 94%; zvipatara 88%; hutano hwepfungwa 97%; uye dzimba dzevanochengeta 99 %) (Wagg et al, 2006).Zvisinei, vanyori vakawedzera zvingave zvinonakidza kuziva kana varwere / vashandisi vakabvumirana nekuongorora uku, vachiratidza kuti 'zvaizivikanwa' kuti vashomanana chete vebasa vaiva neboka revashandisi (primary care 27%; zvipatara 22%; hutano hwehutano hwepfungwa. 16%; uye dzimba dzekuchengeta 24%).Ongororo iyi yakasimbisa kuti kunyangwe matrust mazhinji aiti ane hunyanzvi hwekutonga nyika, chokwadi ndechekuti 'kutarisira kuperevedza pamaitiro aidiwa uye kuti kushaikwa kwemagwaro kunoreva kuti vazhinji havana nzira yekuziva zvinoshomeka'.Yakasimbisa kuti kune mienzaniso yakawanda yakasarudzika yemaitiro akanaka uye chikonzero chakakura chekufadzwa nemhedzisiro yeongororo mukusimudzira ruzivo uye mwero wekutarisira.
Zviwanikwa zvemushandirapamwe
Pakati pemushandirapamwe weBGS gadziriro yemitemo gumi yekuona kuti kuvanzika kwevanhu uye chiremerera zvakachengetedzwa (ona bhokisi, p23).Izvo zviyero zvinofukidza nzvimbo dzinotevera: kuwana;timeliness;midziyo yekufambisa uye yekufambisa;kuchengeteka;choice;zvakavanzika;utsanana;utsanana;mutauro unoremekedza;uye kuongorora kwezvakatipoteredza.The toolkit inosanganisira sarudzo yekubatsira kushandisa chimbuzi pachivande.Izvi zvinotsanangura nhanho nhanhatu dzekufamba uye nhanho dzekuchengetedza pakushandisa chimbuzi chete, paine kurudziro kune yega yega nhanho yekufamba uye chengetedzo.Semuenzaniso, kumurwere kana mutengi ari pamubhedha uye anoda kurongwa dundira uye ura, mwero wekuchengetedza unotsanangurwa se'kusina kuchengetedzeka kugara kunyangwe uine rutsigiro'.Kune varwere ava rubatsiro rwesarudzo runokurudzira kushandisa mubhedha kana kurongwa rectal evacuation sechikamu chechirongwa chekuchengeta dundira kana ura, kuve nechokwadi chekuvhenekwa kwakakwana nezviratidzo zve 'Usavhiringidze'.Rubatsiro rwesarudzo runoti kushandiswa kwemakomidhi kunogona kuve kwakakodzera mukamuri inogarwa pamba kana munzvimbo yekuchengeta chero ichishandiswa pachivande, uye kuti kana hoist ichizoshandiswa ipapo matanho ese ekuchengetedza kuzvininipisa anofanira kutorwa.Chishandiso chevanhuwo zvavo kuti vaite ongororo yezvemamiriro ekunze ezvimbuzi mune chero marongero chinobata nyaya dzakasiyana siyana dzinosanganisira nzvimbo yechimbuzi, upamhi hwemusuwo, kuti gonhi rinogona kuvhurwa nekuvharika nyore nekukiiwa here, midziyo yekubatsira uye kana bepa rechimbuzi riri mukati. nyore kusvika kana wakagara pachimbuzi.Mushandirapamwe wakagadzira hurongwa hwekuita kune rimwe nerimwe remapoka mana akakosha: vashandi vechipatara/vanochengeta kumba;zvipatara/mamaneja ekuchengeta dzimba;vagadziri vemitemo nevatongi;uye veruzhinji nevarwere.Mameseji akakosha evashandi vekuchipatara nevanochengeta vekumba ndeaya anotevera: l Adopt the Behind Closed Doors standards;2 Ongorora maitiro achipesana nezviyero izvi;l Itai shanduko mukuita kuti ive nechokwadi chekuti dzinowanikwa;3 Ita kuti mapepa avepo.
Mhedziso
Kusimudzira chiremerera neruremekedzo kuvarwere chinhu chinokosha pakuchengetwa kwakanaka kwoukoti.Mushandirapamwe uyu unopa maturusi anobatsira uye nhungamiro yekubatsira vashandi vehukoti kuvandudza mwero munzvimbo dzakasiyana dzekuchengetedza.
Nguva yekutumira: Jun-11-2022