Pub Date : 2021-06-01DOI: 10.1177/10848223211021840
H. Byon, Soojung Ahn, Virginia T. LeBaron, G. Yan, Ronald M. Grider, M. Crandall
Electronic health records (EHR) are an important, but underutilized source for home health care research and practice improvement. Although the use of EHR is more efficient than prospective data collection, an analysis of EHR data can be complex and time-consuming. To demonstrate the overall process, we describe a secondary analysis of EHR data that explored the prevalence of home health care patients with a substance use history (SUH) and a venous access device (VAD). We detail our process of EHR data extraction, management, and analysis to assist researchers and clinicians interested in similar work. The example analysis showed that that 10.6% of adult home health care patients had a SUH, 8.8% had a long-term VAD, and 1.3% had both. EHRs can be a valuable data source for home health care research and quality improvement projects, but a systematic and thoughtful strategy is needed to fully leverage their potential.
{"title":"Demonstration of an Analytic Process using Home Health Care Electronic Health Records: A Case Example Exploring the Prevalence of Patients with a Substance Use History and a Venous Access Device","authors":"H. Byon, Soojung Ahn, Virginia T. LeBaron, G. Yan, Ronald M. Grider, M. Crandall","doi":"10.1177/10848223211021840","DOIUrl":"https://doi.org/10.1177/10848223211021840","url":null,"abstract":"Electronic health records (EHR) are an important, but underutilized source for home health care research and practice improvement. Although the use of EHR is more efficient than prospective data collection, an analysis of EHR data can be complex and time-consuming. To demonstrate the overall process, we describe a secondary analysis of EHR data that explored the prevalence of home health care patients with a substance use history (SUH) and a venous access device (VAD). We detail our process of EHR data extraction, management, and analysis to assist researchers and clinicians interested in similar work. The example analysis showed that that 10.6% of adult home health care patients had a SUH, 8.8% had a long-term VAD, and 1.3% had both. EHRs can be a valuable data source for home health care research and quality improvement projects, but a systematic and thoughtful strategy is needed to fully leverage their potential.","PeriodicalId":45762,"journal":{"name":"Home Health Care Management and Practice","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/10848223211021840","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41525081","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-05-28DOI: 10.1177/10848223211021393
S. Bigger, L. Haddad, Sangeeta C. Ahluwalia, L. Glenn
Advance care planning is a conversation about personal values, future treatment choices, and designation of a surrogate decision-maker, that someone has in advance of a health crisis. Most existing studies on advance care planning have taken place outside of home health among populations with HIV/AIDS, cancer, dementia, and end stage renal disease. The U.S. home health population is living longer with chronic conditions such as pulmonary and cardiovascular illnesses, and hospitalization is a poor outcome. In 2016, Medicare implemented the Home Health Value-Based Purchasing Model, in which reimbursement rates for agencies in 9 regionally representative states were dependent on quantitative measures of quality performance. Part of the program was a process-level mandate requiring agencies to report on advance care planning. The aim of this study was to examine the relationship of home health advance care planning protocols with hospitalization rates. Descriptive and regression analyses were conducted on survey data of protocols and agency data of demographics and outcomes. Statistical significance was found in the positive correlation between advance care planning protocols and hospitalization. Recommendations are made for broadening the scope of evaluation of quality in home health to include goal-concordant care and transitions to appropriate services.
{"title":"Advance Care Planning Protocols and Hospitalization Rates in Home Health Value-Based Purchasing","authors":"S. Bigger, L. Haddad, Sangeeta C. Ahluwalia, L. Glenn","doi":"10.1177/10848223211021393","DOIUrl":"https://doi.org/10.1177/10848223211021393","url":null,"abstract":"Advance care planning is a conversation about personal values, future treatment choices, and designation of a surrogate decision-maker, that someone has in advance of a health crisis. Most existing studies on advance care planning have taken place outside of home health among populations with HIV/AIDS, cancer, dementia, and end stage renal disease. The U.S. home health population is living longer with chronic conditions such as pulmonary and cardiovascular illnesses, and hospitalization is a poor outcome. In 2016, Medicare implemented the Home Health Value-Based Purchasing Model, in which reimbursement rates for agencies in 9 regionally representative states were dependent on quantitative measures of quality performance. Part of the program was a process-level mandate requiring agencies to report on advance care planning. The aim of this study was to examine the relationship of home health advance care planning protocols with hospitalization rates. Descriptive and regression analyses were conducted on survey data of protocols and agency data of demographics and outcomes. Statistical significance was found in the positive correlation between advance care planning protocols and hospitalization. Recommendations are made for broadening the scope of evaluation of quality in home health to include goal-concordant care and transitions to appropriate services.","PeriodicalId":45762,"journal":{"name":"Home Health Care Management and Practice","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2021-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/10848223211021393","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49001224","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-05-26DOI: 10.1177/10848223211012727
Sara Hazrati Gonbad, M. Zakerimoghadam, Shahzad Pashaeypoor, S. Haghani
Self-care education (SCE) through home visit is one of the methods with potential effects on self-care. This study aimed to evaluate the effects of home-based SCE on blood pressure and self-care behaviors among middle-aged patients with primary hypertension in Iran. This randomized controlled trial was conducted on 110 middle-aged patients with hypertension recruited from public healthcare centers in the south of Tehran, Iran in September 2019. After convenience sampling, Participants were simple randomly allocated to control and intervention groups. Intervention group received a 2-month home-based SCE while control group received routine care services. Before and 2 months after the intervention, self-care behaviors were assessed using the Hypertension Self-Care Activity Level Effects (H-SCALE). Data were analyzed using the SPSS software (v. 16.0) at a significance level of less than .05. After 2 months, the posttest mean scores of self-care behaviors in medication adherence (17.42 ± 1.03 vs 14.49 ± 1.01, p = .04), physical activity (8.16 ± 0.39 vs 6.47 ± 0.52, p = .01), low-salt diet (52.51 ± 3.8 vs 35.36 ± 3.47, p = .001), and blood pressure control (3.47 ± 0.22 vs 2.42 ± 1.89, p = .001), in the intervention group were significantly greater than the control group. However, there were no significant between-group differences respecting the posttest mean scores of the weight management (p = .06) and smoking cessation (p = .2). Also, the mean blood pressure between the 2 groups changed after the intervention, but this difference was not statistically significant. This study suggests the effectiveness of home-based SCE in significantly improving self-care behaviors among patients with hypertension. But more studies are needed to measure the effectiveness of intervention on blood pressure. IRCT code: IRCT20190623043985N1. Registered 06/30/2019, https://fa.irct.ir/trial/40351.
通过家访进行自我保健教育是一种对自我保健有潜在影响的方法。本研究旨在评估家庭SCE对伊朗中年原发性高血压患者血压和自我护理行为的影响。该随机对照试验于2019年9月在伊朗德黑兰南部的公共医疗中心招募了110名中年高血压患者。经方便抽样后，将参与者简单随机分为对照组和干预组。干预组接受为期2个月的居家生活自理，对照组接受常规护理服务。干预前和干预后2个月，采用高血压自我保健活动水平效应(H-SCALE)量表评估自我保健行为。数据分析采用SPSS软件(v. 16.0)，显著性水平小于0.05。2个月后，干预组在药物依从性(17.42±1.03 vs 14.49±1.01,p = 0.04)、体力活动(8.16±0.39 vs 6.47±0.52,p = 0.01)、低盐饮食(52.51±3.8 vs 35.36±3.47,p = 0.001)、血压控制(3.47±0.22 vs 2.42±1.89,p = 0.001)方面的自我保健行为后测平均分均显著高于对照组。然而，在体重管理(p = .06)和戒烟(p = .2)的后测平均分方面，组间差异无统计学意义。干预后两组的平均血压也有变化，但差异无统计学意义。本研究提示以家庭为基础的自我护理对改善高血压患者的自我护理行为有显著效果。但需要更多的研究来衡量干预血压的有效性。IRCT代码:IRCT20190623043985N1。2019年6月30日注册，https://fa.irct.ir/trial/40351。
{"title":"The Effects of Home-Based Self-Care Education on Blood Pressure and Self-Care Behaviors among Middle-Aged Patients with Primary Hypertension in Iran: A Randomized Clinical Controlled Trial","authors":"Sara Hazrati Gonbad, M. Zakerimoghadam, Shahzad Pashaeypoor, S. Haghani","doi":"10.1177/10848223211012727","DOIUrl":"https://doi.org/10.1177/10848223211012727","url":null,"abstract":"Self-care education (SCE) through home visit is one of the methods with potential effects on self-care. This study aimed to evaluate the effects of home-based SCE on blood pressure and self-care behaviors among middle-aged patients with primary hypertension in Iran. This randomized controlled trial was conducted on 110 middle-aged patients with hypertension recruited from public healthcare centers in the south of Tehran, Iran in September 2019. After convenience sampling, Participants were simple randomly allocated to control and intervention groups. Intervention group received a 2-month home-based SCE while control group received routine care services. Before and 2 months after the intervention, self-care behaviors were assessed using the Hypertension Self-Care Activity Level Effects (H-SCALE). Data were analyzed using the SPSS software (v. 16.0) at a significance level of less than .05. After 2 months, the posttest mean scores of self-care behaviors in medication adherence (17.42 ± 1.03 vs 14.49 ± 1.01, p = .04), physical activity (8.16 ± 0.39 vs 6.47 ± 0.52, p = .01), low-salt diet (52.51 ± 3.8 vs 35.36 ± 3.47, p = .001), and blood pressure control (3.47 ± 0.22 vs 2.42 ± 1.89, p = .001), in the intervention group were significantly greater than the control group. However, there were no significant between-group differences respecting the posttest mean scores of the weight management (p = .06) and smoking cessation (p = .2). Also, the mean blood pressure between the 2 groups changed after the intervention, but this difference was not statistically significant. This study suggests the effectiveness of home-based SCE in significantly improving self-care behaviors among patients with hypertension. But more studies are needed to measure the effectiveness of intervention on blood pressure. IRCT code: IRCT20190623043985N1. Registered 06/30/2019, https://fa.irct.ir/trial/40351.","PeriodicalId":45762,"journal":{"name":"Home Health Care Management and Practice","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2021-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/10848223211012727","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41710852","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-05-24DOI: 10.1177/10848223211016416
Mei-Ju Chen, Feng-Hsia Kao
In response to population aging, there is an increase in demand for the coverage of and the necessary services provided by home health care and home care for socially vulnerable groups. This study explored whether the instructions and recommendations offered by pharmacists during their home visits play a key role in the factors that influence a patient’s prognosis. A home health care database was analyzed in this study. The subjects received home visits from pharmacists. There were 262 subjects following the exclusion of closed cases that were not due to improved outcomes or death. To validate the research framework, multiple regression analysis was employed for model validation. The level of consciousness and Barthel Index score mediated the effects of multimorbidities, and these mediating effects significantly affected patient outcomes (improvement or death). The medication-related knowledge and instructions for correct medication use provided by pharmacists did not exhibit significant moderating effects on the influence of a patient’s level of consciousness and Barthel Index score on their improved outcomes. However, the pharmacists’ provision of instructions and recommendations for patient self-care had significant moderating effects on the path by which patients with multimorbidities experienced improved outcomes through higher total Barthel Index scores. In comparison with physician home visits, which merely cover the treatments for diseases, pharmacists also play a vital role in home health care. Pharmacists provide patients with medication-related knowledge and instructions for correct medication use. This study addressed aspects that have not been considered in previous studies.
{"title":"The Role of Pharmacists in Home Health Care: A Study Set in a Regional Hospital in Taipei City","authors":"Mei-Ju Chen, Feng-Hsia Kao","doi":"10.1177/10848223211016416","DOIUrl":"https://doi.org/10.1177/10848223211016416","url":null,"abstract":"In response to population aging, there is an increase in demand for the coverage of and the necessary services provided by home health care and home care for socially vulnerable groups. This study explored whether the instructions and recommendations offered by pharmacists during their home visits play a key role in the factors that influence a patient’s prognosis. A home health care database was analyzed in this study. The subjects received home visits from pharmacists. There were 262 subjects following the exclusion of closed cases that were not due to improved outcomes or death. To validate the research framework, multiple regression analysis was employed for model validation. The level of consciousness and Barthel Index score mediated the effects of multimorbidities, and these mediating effects significantly affected patient outcomes (improvement or death). The medication-related knowledge and instructions for correct medication use provided by pharmacists did not exhibit significant moderating effects on the influence of a patient’s level of consciousness and Barthel Index score on their improved outcomes. However, the pharmacists’ provision of instructions and recommendations for patient self-care had significant moderating effects on the path by which patients with multimorbidities experienced improved outcomes through higher total Barthel Index scores. In comparison with physician home visits, which merely cover the treatments for diseases, pharmacists also play a vital role in home health care. Pharmacists provide patients with medication-related knowledge and instructions for correct medication use. This study addressed aspects that have not been considered in previous studies.","PeriodicalId":45762,"journal":{"name":"Home Health Care Management and Practice","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2021-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/10848223211016416","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42324084","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-05-06DOI: 10.1177/10848223211011710
G. Cankaya, Rabia Sağlam
This study was conducted to determine the symptoms experienced by women at home and self-care agency after breast-conserving surgery. The study was carried out in a public hospital in Istanbul between January and June 2018. The sample of the study consisted of 65 women. The data were collected through face-to-face interviews using Patient Description Form, Symptom Check List and Self-Care Agency Scale during outpatient check-ups in the first and third weeks following discharge. The mean age of the women was 52.68 ± 13.24. Fatigue, weakness, pain and insomnia were mostly experienced symptoms in the first and third weeks after discharge while fever, discharge from the wound area and nausea-vomiting symptoms were the least experienced symptoms in these weeks. It was determined that women had moderate self-care agency in the first and third weeks of discharge. Women who were married and whose income was equal to their expenses had higher self-care agency, and those living alone had lower self-care agency than those living with their spouses and children (p < 0.05). The self-care agency scores of those who did not have a chronic disease were higher than those with chronic diseases (p < 0.05). It is found that women with breast-conserving surgery experience symptoms related to the operation in the first and third weeks of discharge. Women’s self care agency was moderate during the follow up period, meaning that these patients should be supported by nurses with regard to self care agency and symptoms experienced at home.
{"title":"Symptoms Experienced by Women at Home and Self-Care Agency after Breast-Conserving Surgery","authors":"G. Cankaya, Rabia Sağlam","doi":"10.1177/10848223211011710","DOIUrl":"https://doi.org/10.1177/10848223211011710","url":null,"abstract":"This study was conducted to determine the symptoms experienced by women at home and self-care agency after breast-conserving surgery. The study was carried out in a public hospital in Istanbul between January and June 2018. The sample of the study consisted of 65 women. The data were collected through face-to-face interviews using Patient Description Form, Symptom Check List and Self-Care Agency Scale during outpatient check-ups in the first and third weeks following discharge. The mean age of the women was 52.68 ± 13.24. Fatigue, weakness, pain and insomnia were mostly experienced symptoms in the first and third weeks after discharge while fever, discharge from the wound area and nausea-vomiting symptoms were the least experienced symptoms in these weeks. It was determined that women had moderate self-care agency in the first and third weeks of discharge. Women who were married and whose income was equal to their expenses had higher self-care agency, and those living alone had lower self-care agency than those living with their spouses and children (p < 0.05). The self-care agency scores of those who did not have a chronic disease were higher than those with chronic diseases (p < 0.05). It is found that women with breast-conserving surgery experience symptoms related to the operation in the first and third weeks of discharge. Women’s self care agency was moderate during the follow up period, meaning that these patients should be supported by nurses with regard to self care agency and symptoms experienced at home.","PeriodicalId":45762,"journal":{"name":"Home Health Care Management and Practice","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2021-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/10848223211011710","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46542154","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-05-01DOI: 10.1177/1084822321992380
William Cabin
There is significant data on the adverse impact of COVID-19 on persons who were poor, minorities, had compromised physical or mental health, or other vulnerabilities prior to the COVID-19 pandemic. A significant portion of the overall Medicare population has such vulnerabilities. The Medicare home health beneficiary population is even more vulnerable than the overall Medicare population based on gender, race, income level, living alone status, and number of chronic conditions. A literature review indicates there is only 1 study on the impact of COVID-19 in Medicare home health on home care workers and none on the impact on home health beneficiaries. The current study is a qualitative study based on interviews of a convenience sample of 48 home care nurses from 9 different home health agencies in New York City between April 1 and August 31, 2020. Six major themes emerged: need for social service supports increased; loneliness and depression increased among patients; physical and mental health conditions became exacerbated; substance use and abuse increased; evidence of domestic violence against patients increased; and there was a limited amount of staff and equipment to care for patients.
{"title":"Pre-Existing Inequality: The Impact of COVID-19 on Medicare Home Health Beneficiaries.","authors":"William Cabin","doi":"10.1177/1084822321992380","DOIUrl":"10.1177/1084822321992380","url":null,"abstract":"<p><p>There is significant data on the adverse impact of COVID-19 on persons who were poor, minorities, had compromised physical or mental health, or other vulnerabilities prior to the COVID-19 pandemic. A significant portion of the overall Medicare population has such vulnerabilities. The Medicare home health beneficiary population is even more vulnerable than the overall Medicare population based on gender, race, income level, living alone status, and number of chronic conditions. A literature review indicates there is only 1 study on the impact of COVID-19 in Medicare home health on home care workers and none on the impact on home health beneficiaries. The current study is a qualitative study based on interviews of a convenience sample of 48 home care nurses from 9 different home health agencies in New York City between April 1 and August 31, 2020. Six major themes emerged: need for social service supports increased; loneliness and depression increased among patients; physical and mental health conditions became exacerbated; substance use and abuse increased; evidence of domestic violence against patients increased; and there was a limited amount of staff and equipment to care for patients.</p>","PeriodicalId":45762,"journal":{"name":"Home Health Care Management and Practice","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2021-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7871046/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41777400","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-04-12DOI: 10.1177/10848223211008435
Agata Wilk, Lisa LaSpina, L. Boyd, Jared Vineyard
This study aimed to explore the level of perceived oral health literacy (OHL) among caregivers of the homebound population in the Chicago metropolitan area and how caregivers’ OHL impacts their oral care to the homebound population. The relationships between demographic characteristics, perceived OHL levels, personal oral health behaviors, and oral health care to clients were also assessed. This cross-sectional survey research examined 69 caregivers of the homebound population employed by home health agencies. The OHL was determined by the validated Health Literacy in Dentistry Scale (HeLD-14). Independent t-tests, chi-square tests set at p < .05 significance level, and logistic regressions were used for analysis. The mean age of participants was 43. The HeLD-14 scores indicated a high perceived OHL among this group. Caregivers came from diverse groups, and the majority spoke a second language at home. About 93% performed oral self-care the recommended amount of time or more, while only 57% did it for their clients. Those who cleaned clients’ mouth twice a day had a higher OHL score (M = 23 compared to M = 19). About 43% did not check for sores in the client’s mouth, and those who checked had a higher OHL score (M = 25 compared to M = 19). Controlling for OHL, age was a good predictor of oral care frequency to clients. These findings provide current evidence and add to the body of knowledge on OHL among homebound individuals. The results provide insights for designing a preventive approach in oral health care to the homebound population.
{"title":"Perceived Oral Health Literacy, Behaviors, and Oral Health Care among Caregivers to the Homebound Population","authors":"Agata Wilk, Lisa LaSpina, L. Boyd, Jared Vineyard","doi":"10.1177/10848223211008435","DOIUrl":"https://doi.org/10.1177/10848223211008435","url":null,"abstract":"This study aimed to explore the level of perceived oral health literacy (OHL) among caregivers of the homebound population in the Chicago metropolitan area and how caregivers’ OHL impacts their oral care to the homebound population. The relationships between demographic characteristics, perceived OHL levels, personal oral health behaviors, and oral health care to clients were also assessed. This cross-sectional survey research examined 69 caregivers of the homebound population employed by home health agencies. The OHL was determined by the validated Health Literacy in Dentistry Scale (HeLD-14). Independent t-tests, chi-square tests set at p < .05 significance level, and logistic regressions were used for analysis. The mean age of participants was 43. The HeLD-14 scores indicated a high perceived OHL among this group. Caregivers came from diverse groups, and the majority spoke a second language at home. About 93% performed oral self-care the recommended amount of time or more, while only 57% did it for their clients. Those who cleaned clients’ mouth twice a day had a higher OHL score (M = 23 compared to M = 19). About 43% did not check for sores in the client’s mouth, and those who checked had a higher OHL score (M = 25 compared to M = 19). Controlling for OHL, age was a good predictor of oral care frequency to clients. These findings provide current evidence and add to the body of knowledge on OHL among homebound individuals. The results provide insights for designing a preventive approach in oral health care to the homebound population.","PeriodicalId":45762,"journal":{"name":"Home Health Care Management and Practice","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2021-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/10848223211008435","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49076438","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-03-19DOI: 10.1177/10848223211002849
A. Gerolamo, M. Pogorzelska-Maziarz, A. Gentsch, A. Traczuk, TingAnn Hsiao, G. Amadio, T. Haddad, K. Rising
Lack of recognition and treatment of mental health disorders in the home healthcare (HHC) population has been recognized as a national public health problem. However, there is a gap in understanding the behavioral health needs of HHC patients and caregivers from the perspectives of HHC patients, caregivers, and HHC personnel. These perspectives are critical for informing an acceptable and scalable integrated care model. We conducted semi-structured interviews with HHC patients, caregivers, and HHC personnel to assess the unmet behavioral health needs of HHC patients and their caregivers. Participants were recruited from a Medicare-certified HHC agency that is part of a large health system on the east coast. We completed a total of 31 interviews between January and May 2020. Findings suggest that HHC patients have significant unmet behavioral health and social needs and their caregivers are emotionally and physically drained. Reasons that patients may not be receiving adequate behavioral health services include denial, cost, culture, lack of awareness of available resources, lack of transportation, and homebound status. While most patients discussed the emotional toll of their illness, few were connected to services. HHC personnel offered suggestions on how to meet the behavioral health needs of patients, with the primary focus on providing in-home options. Gaps in meeting the needs of the HHC population necessitate integrated care models that can effectively address the behavioral health and social needs of HHC patients and their families. Future research should develop and test patient and caregiver-directed integrated care models in the HHC setting.
{"title":"Unmet Behavioral Health and Social Needs of Home Healthcare Patients and Their Caregivers","authors":"A. Gerolamo, M. Pogorzelska-Maziarz, A. Gentsch, A. Traczuk, TingAnn Hsiao, G. Amadio, T. Haddad, K. Rising","doi":"10.1177/10848223211002849","DOIUrl":"https://doi.org/10.1177/10848223211002849","url":null,"abstract":"Lack of recognition and treatment of mental health disorders in the home healthcare (HHC) population has been recognized as a national public health problem. However, there is a gap in understanding the behavioral health needs of HHC patients and caregivers from the perspectives of HHC patients, caregivers, and HHC personnel. These perspectives are critical for informing an acceptable and scalable integrated care model. We conducted semi-structured interviews with HHC patients, caregivers, and HHC personnel to assess the unmet behavioral health needs of HHC patients and their caregivers. Participants were recruited from a Medicare-certified HHC agency that is part of a large health system on the east coast. We completed a total of 31 interviews between January and May 2020. Findings suggest that HHC patients have significant unmet behavioral health and social needs and their caregivers are emotionally and physically drained. Reasons that patients may not be receiving adequate behavioral health services include denial, cost, culture, lack of awareness of available resources, lack of transportation, and homebound status. While most patients discussed the emotional toll of their illness, few were connected to services. HHC personnel offered suggestions on how to meet the behavioral health needs of patients, with the primary focus on providing in-home options. Gaps in meeting the needs of the HHC population necessitate integrated care models that can effectively address the behavioral health and social needs of HHC patients and their families. Future research should develop and test patient and caregiver-directed integrated care models in the HHC setting.","PeriodicalId":45762,"journal":{"name":"Home Health Care Management and Practice","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2021-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/10848223211002849","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45879772","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-03-14DOI: 10.1177/10848223211000048
R. Amini, N. Kalvandi, Masoud Khodaveisi, Leili Tapak
Home injuries are among the causes of death and disability in toddlers. Preventing home injuries is an essential part of the child health care program. Using education-based models interventions can promote mothers’ practices regarding home injuries. This study aimed to investigate the effect of education based on the theory of planned behavior (TPB) on the mothers’ preventive practices regarding toddler home injuries. A quasi-experimental study was conducted on 116 mothers referred to comprehensive health centers (58 mothers in each experimental and control group), who were selected using the cluster sampling method. Data were collected using a researcher-developed TPB questionnaire, which was validated by I-CVI (≥0.78), and CVR (≥0.79). Its reliability also confirmed by Cronbach’s alpha coefficients (.52-.93). Afterward, educational intervention was implemented in the experimental group based on TPB in four 45 to 60 minute sessions. After 2 months, the data were recollected from the two groups and analyzed using SPSS software version 16. Comparing the scores of TPB constructs (i.e., perceived behavioral control, behavioral intention, and subjective norms), and mothers’ preventive practices regarding toddler home injuries revealed no statistically significant difference between the 2 groups pre-intervention. However, after the intervention, significant differences were observed between the 2 groups in terms of awareness, the TPB constructs (except for subjective norms), and preventive practices of the mothers (p < .001). Mothers’ preventive practices regarding toddler home injuries were improved after applying TPB; hence, it is suggested a larger study be completed to confirm the results of this theory-based education.
{"title":"Investigation of the Effect of Education Based on the Theory of Planned Behavior on the Mothers’ Preventive Practices Regarding Toddler Home Injuries","authors":"R. Amini, N. Kalvandi, Masoud Khodaveisi, Leili Tapak","doi":"10.1177/10848223211000048","DOIUrl":"https://doi.org/10.1177/10848223211000048","url":null,"abstract":"Home injuries are among the causes of death and disability in toddlers. Preventing home injuries is an essential part of the child health care program. Using education-based models interventions can promote mothers’ practices regarding home injuries. This study aimed to investigate the effect of education based on the theory of planned behavior (TPB) on the mothers’ preventive practices regarding toddler home injuries. A quasi-experimental study was conducted on 116 mothers referred to comprehensive health centers (58 mothers in each experimental and control group), who were selected using the cluster sampling method. Data were collected using a researcher-developed TPB questionnaire, which was validated by I-CVI (≥0.78), and CVR (≥0.79). Its reliability also confirmed by Cronbach’s alpha coefficients (.52-.93). Afterward, educational intervention was implemented in the experimental group based on TPB in four 45 to 60 minute sessions. After 2 months, the data were recollected from the two groups and analyzed using SPSS software version 16. Comparing the scores of TPB constructs (i.e., perceived behavioral control, behavioral intention, and subjective norms), and mothers’ preventive practices regarding toddler home injuries revealed no statistically significant difference between the 2 groups pre-intervention. However, after the intervention, significant differences were observed between the 2 groups in terms of awareness, the TPB constructs (except for subjective norms), and preventive practices of the mothers (p < .001). Mothers’ preventive practices regarding toddler home injuries were improved after applying TPB; hence, it is suggested a larger study be completed to confirm the results of this theory-based education.","PeriodicalId":45762,"journal":{"name":"Home Health Care Management and Practice","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2021-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/10848223211000048","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42124886","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-03-14DOI: 10.1177/10848223211002166
Alireza Nikbakht Nasrabadi, L. Mardanian Dehkordi, F. Taleghani
Transitional care is a designed plan to ensure the continuity of care received by patients as they transfer between different locations or levels of care. The aim of this paper is to explore nurses’ experiences of transitional care in multiple chronic conditions. A qualitative method with a conventional content analysis approach was utilized. The study was conducted at university hospitals in 2 big cities (Isfahan and Tehran) of Iran. This study is performed from November 2018 to December 2019 using deep, semi-structured, and face-to-face interviews which are focused on nurses’ experiences of transitional care. Data collection continued until saturation was reached. Finally, 15 nurses take part in this study. Data collection and data analysis were conducted concurrently. Data were analyzed using Graneheim and Lundman’s techniques. Two main themes providing a descriptive summary of the major elements of transitional care identified: “threat to patient safety” and “Care breakdown”. Findings showed an exclusive image of unsafe transitional care which was done unplanned without appropriate delegating care to family and threat patient safety. There is still a gap in the transition from hospital to home. Nursing managers can address this issue by creating a culture of teamwork, training competent nurses by continuum education, and more supervision of nursing care. Policymakers can ensure continuity of care by developing policies and programs about transitional care.
{"title":"Nurses’ Experiences of Transitional Care in Multiple Chronic Conditions","authors":"Alireza Nikbakht Nasrabadi, L. Mardanian Dehkordi, F. Taleghani","doi":"10.1177/10848223211002166","DOIUrl":"https://doi.org/10.1177/10848223211002166","url":null,"abstract":"Transitional care is a designed plan to ensure the continuity of care received by patients as they transfer between different locations or levels of care. The aim of this paper is to explore nurses’ experiences of transitional care in multiple chronic conditions. A qualitative method with a conventional content analysis approach was utilized. The study was conducted at university hospitals in 2 big cities (Isfahan and Tehran) of Iran. This study is performed from November 2018 to December 2019 using deep, semi-structured, and face-to-face interviews which are focused on nurses’ experiences of transitional care. Data collection continued until saturation was reached. Finally, 15 nurses take part in this study. Data collection and data analysis were conducted concurrently. Data were analyzed using Graneheim and Lundman’s techniques. Two main themes providing a descriptive summary of the major elements of transitional care identified: “threat to patient safety” and “Care breakdown”. Findings showed an exclusive image of unsafe transitional care which was done unplanned without appropriate delegating care to family and threat patient safety. There is still a gap in the transition from hospital to home. Nursing managers can address this issue by creating a culture of teamwork, training competent nurses by continuum education, and more supervision of nursing care. Policymakers can ensure continuity of care by developing policies and programs about transitional care.","PeriodicalId":45762,"journal":{"name":"Home Health Care Management and Practice","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2021-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/10848223211002166","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41485347","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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