HOME HEALTH CARE SERVICES QUARTERLY最新文献

The aim was to investigate the views of stakeholders on the practical relevance of a broad quality of life (QoL) outcome tool for care in older adults: the Extended Quality of Life Tool (EQLT). We conducted individual interviews and focus groups with a variety of stakeholders involved in the care for older adults which were analyzed using a framework analysis. Stakeholders considered relevant: focus on the client perspective; perspective on QoL broader than health; the possibility to take diversity into account; and the possibility to determine a minimum level of QoL. Three facilitators for implementation of the tool were mentioned as well as four barriers. The EQLT can support conversations with clients about their needs and wishes, thus enabling decisions about care services based on a broad set of domains of QoL. Implementation of the tool should take into account the facilitators and barriers identified in the current study.

Little is known about the financial risks of unpaid caregiving. This is, in part, due to challenges in identifying people who are caregivers and limitations in capturing all aspects of spending related to caregiving in existing approaches to public data collection. To fill these gaps, we developed a composite survey informed by validated instruments that assesses the types and magnitude of out-of-pocket expenditures caregivers incur in the provision of homebased care for someone living with a long-term health condition, and their impact across various domains of financial risk. This paper discusses the development of this survey currently in circulation in a Canadian province, and reflects on considerations in the engagement of unpaid caregivers in participatory research. Given its replicability and adaptability, this survey may inform future research in other developed or high-income settings and guide policy attention toward understanding how to protect unpaid caregivers from the financial risks of caring.

Research on professional burnout during the pandemic has focused on hospital-based health care workers. This study examined the psychological impact of the pandemic on home-based primary care (HBPC) providers. We interviewed 13 participants from six HBPC practices in New York City including medical/clinical directors, program managers, nurse practitioners, and social workers and analyzed the transcripts using inductive qualitative analysis approach. HBPC providers experienced emotional exhaustion and a sense of reduced personal accomplishment. They reported experiencing grief of losing many patients at once and pressure to adapt to changing circumstances quickly. They also reported feeling guilty for failing to protect their patients and reduced confidence in their professional expertise. Strategies to combat burnout included shorter on-call schedules, regular condolence meetings to acknowledge patient deaths, and peer support calls. Our study identifies potential resources to improve the well-being and reduce the risk of burnout among HBPC providers.

Background: Burn injuries have negative impacts on all dimensions of the quality of life of burn victims. This study aimed to explore the lived experiences of burn survivors after a 6-month period of home care following hospital discharge.Method: This is a qualitative study with a phenomenological approach. Sixteen burn survivors from a university hospital in Kermanshah province participated in the study. Qualitative data were analyzed by Colaizzi's descriptive phenomenological approach.Results: "Rehabilitation in the process of life" was the main theme of the study with four sub-themes, including "conducting process", "caring bridge", "humanitarian commitment for human revival", and "healing care".Conclusions: Home care is necessary for burn survivors after discharge from the hospital. The connection of healthcare services between home and hospital, safety feeling in the patient and his/her family, cost-effectiveness of healthcare services, and encouraging the patient to perform self-care can be achieved by home care follow-ups.

Heart failure (HF) is complex and prevalent cardiac condition associated with high hospitalization rates and mortality. Early recognition and risk categorization of vulnerable patients is essential prior to discharge. Following the recent death of Diego A. Maradona, the 60 year old universally known soccer player, we highlighted critical aspects of ambulatory home care after hospital discharge. We raised three relevant clinical questions regarding home care services: its effectiveness in patients with HF while also providing practical summary tables for the identification of high-risk patients with HF and critical elements for an effective ambulatory home care delivery. A comprehensive home care program for high-risk patients with HF requires the coordination of multiple health services, including personal and nursing care, cardiac monitoring, physio- and occupational therapy, pharmacists, as well as nutritional and emotional support to avoid recurrent hospitalizations while improving clinical outcomes.