HOME HEALTH CARE SERVICES QUARTERLY最新文献

Home health aides face a range of stressors that may result in departing the workforce. One stressor that has emerged in multiple qualitative studies as potentially influencing retention is client death. Using 2019 data from a single agency in New York City employing approximately 1700 aides, we used logistic and linear regression to explore case and aide factors associated with workforce outcomes after client death. We found that longer case length (Beta = 0.01, p < .001) was associated with longer return to work for aides experiencing client death and longer job tenure (Beta = -0.002, p = .002) was associated with shorter return to work (n = 67). We found no difference in retention between aides who experienced client death and those who did not (n  216). This analysis suggests the importance of research on the period of time following client death and of offering support to aides after clients die, particularly after longer cases.

The Pilot Scheme on Community Care Service Vouchers for the Elderly (CCSVs) from 2013 onward aims at empowering users with autonomy in choosing services and service providers, enhancing financial sustainability of community care services (CCSs) and encouraging participation by service providers. This article analyses the effectiveness of the CCSVs in terms of utilization rate, attrition rate and reasons for withdrawal, and provides sound short-, medium- and long-term recommendations for CCSs. Secondary data from the annual survey conducted by the Social Welfare Department with all voucher holders in the first (2013-2017) and second phases (2016-2020) were used. The utilization rate of the CCSVs in the first phase was satisfactory, but the second phase was constrained by a low utilization rate, as 17%-35% of the CCSV holders did not use their vouchers to purchase CCSs. Moreover, the high attrition rate of CCSV holders in both phases warrants special attention.

For virtual care models to be able to improve the safety and quality of care, it is essential to identify the strengths and weaknesses of virtual care. In this Scoping review, literature published on virtual care was identified using international databases. The results of the included studies were summarized using a predefined taxonomy. In total, 20 studies were included in the present review. Extracting the findings of the articles showed four main topics, including "virtual care delivery models," "Video conference software platforms to provide virtual care," "virtual care delivery challenges," and "virtual care implementation facilitators." Therefore, with the development of emerging digital technologies, unique opportunities to provide virtual care and improve the provision of health services have been created in the health care system worldwide. Multifunctional video conference software platforms using specific models for each scope of care practice should be considered.

This integrative review identified challenges for interprofessional home care and provided recommendations for improving geriatric home care. A search of six databases identified 982 articles; 11 of them met the review's eligibility criteria and were included in the review. Quality appraisal of the included studies was performed using two tools (Critical Appraisal Skills Program for Qualitative Research and Mixed Methods Appraisal Tool), and their overall methodological quality was found to be satisfactory. After applying D'Amour et al.'s framework, four "challenge" themes emerged: (1) lack of sharing, (2) lack of partnership, (3) limited resources and interdependency, and (4) power issues. Recommendations included providing practical multidisciplinary training guided by a standardized model, establishing streamlined communication protocols and a communication platform reflecting the actual needs of users by involving them in its design, and asking interprofessional team members to commit to home care planning and to cultivate a collaborative culture and organizational support.

Globally, the number of people living with dementia is expected to triple by 2050 owing primarily to the aging population. Dementia is a chronic and progressive disease that affects an estimated 5-8% of the general population aged 60 and above at any given time. This qualitative study aimed to investigate caregivers' overall perceptions, challenges, and coping strategies in dementia care in Singapore. Purposive sampling was used to select the study's sample. Eight Singaporeans were interviewed in semi-structured, in-depth interviews. Three themes emerged from the data analysis for each research question: overall perceptions (i.e. less freedom, strained family relationships, and improved self-competency), challenges (i.e. managing dementia symptoms, emotional drain, and decision-making), and coping mechanisms (i.e. making time for myself, religious belief, and seeking external support). Knowing about these challenges and coping mechanisms allows practitioners to help caregivers to reduce personal struggles, thus improving the patient's and caregiver's quality of life.

As many as 70% of Australian patients report they would prefer to die at home, yet only 14% achieve this goal and this hospitalization adds to overall healthcare expenditure. Providing caregivers with practical means for managing symptoms at home facilitates home deaths for palliative care patients and reduces the financial healthcare burden. The aim of this paper is to understand the experience of caregivers administering subcutaneous medications at home to palliative care patients. An integrative review search of the literature revealed five common themes: positive caregiver experiences and caregiver concerns, symptom management, specialist palliative care support needs, educational requirements, and supporting patients to remain at home. Evidence strongly suggests that with support and education from a palliative care team, caregivers find their experience is empowering and positive. Without support and education, patients are more likely to present to hospital leading to admission and subsequent death not in their place of preference.

Understanding the process as well as the challenges and successes of matching homecare workers with older care receivers from differing cultural backgrounds may enhance practices that maximize quality-of-care outcomes and perceptions of quality of life for older adults, especially those "aging in place." Guided by a person-centered, consumer directed care model, this paper outlines the need for research that specifically aims to describe the matching process used by care coordinators when assigning homecare workers to older care receivers of different cultural backgrounds and how the needs and preferences of care receivers are balanced with the characteristics, skills, and capacities of the available pool of homecare workers.

This study aims to explore how relationships with parents during childhood can influence an individual's attitude toward caregiving later in life. The qualitative data came from 47 respondents who care for adult loved ones, with a caregiver mean age of 46.7. The respondents reflected on their recent experience of providing care for their loved ones and how experiences with their caregivers growing up may have influenced their caregiving attitudes. Using a codebook thematic analysis, themes were generated linking childhood experiences to current attitudes toward caregiving. Themes included reciprocating good care, performing obligatory care, and stopping the generational transference of negative care. For most participants, providing quality care for adult loved ones happened regardless of whether the one's childhood experiences with caregivers were positive or negative. Knowledge about the impact of childhood experiences can help health professionals develop interventions to support family caregivers that consider childhood experiences with parents.

While home health agencies (HHAs) can seek accreditation to recognize their quality of service, it is unknown whether agencies with accreditation perform better in providing care than those without accreditation. Using 5-year data from national data sources, the aims of this study were: 1) to depict characteristics of HHAs with and without accreditation; and 2) to examine the relationship between accreditation status and HHA performance on quality-of-care metrics. This study analyzed 7,697 agencies in the US and found that 1) agencies that were for-profit, urban, not-hospital-affiliated, single-branch, Medicare enrolled only, and without hospice program were more likely to have accreditation; and 2) overall, accredited agencies performed better on the three commonly used quality indicators, timely initiation of care, hospitalization, and emergency department visit, though not all the observed differences were substantial in absolute value. Our results provide unique empirical information to agencies considering seeking accreditation.

Support workers are an underrepresented profession that receives less attention with a high degree of responsibilities. The aim of this study was to explore the lived experiences of healthcare support workers within the care sector during the COVID-19 pandemic. This is a qualitative semi-structured interview study using an interpretative phenomenology (IP) framework. Fifteen (15) support workers were interviewed while all COVID-19 restrictions from the government were still in place. We identified five main themes: (1) challenging experiences; (2) coping mechanisms; (3) emotions and behaviors arising from the COVID-19 pandemic; (4) external interest on support worker's health; (5) take-home message from the COVID-19 pandemic. The organization selected for the research is a good representative of how care organizations operate within the UK both in terms of policies and staff selection.