Pub Date : 2024-07-28DOI: 10.1177/10848223241262439
Patrick Engel, Mark Vorensky, Allison Squires, Simon Jones
This paper is an examination of the relationship between continuity of care with home health physical therapists following hospitalization and the likelihood of readmission. We conducted a retrospective cohort study. Using rehospitalization as the dependent variable, a continuity of care indicator variable was analyzed with a multivariable logistic regression. The indicator variable was created using the Bice-Boxerman Index to measure physical therapist continuity of care. The mean of the index (0.81) was used to separate between high continuity (0.81 or greater) of care and low continuity of care (lower than 0.81). The sample included 90,220 patients, with data coming from the linking of the Outcome Assessment and Information Set (OASIS) and an administrative dataset. All subjects lived in the NYC metro area. Inclusion criteria was a patient’s admission to their first home health care site following discharge occurring between 2010 and 2015, and individuals who identified as Male or Female. In comparison to low continuity of physical therapy, high continuity of physical therapy significantly decreased hospital readmissions (OR = 0.74, 95% CI 0.71-0.76, p ≤ .001, AME = −4.28%). Interpersonal continuity of physical therapy care has been identified as a key factor in decreasing readmissions from the home care setting. The research suggests an increased emphasis in preserving physical therapist continuity following hospitalization should be explored, with the potential to reduce hospital readmissions.
{"title":"Using Interpersonal Continuity of Care in Home Health Physical Therapy to Reduce Hospital Readmissions","authors":"Patrick Engel, Mark Vorensky, Allison Squires, Simon Jones","doi":"10.1177/10848223241262439","DOIUrl":"https://doi.org/10.1177/10848223241262439","url":null,"abstract":"This paper is an examination of the relationship between continuity of care with home health physical therapists following hospitalization and the likelihood of readmission. We conducted a retrospective cohort study. Using rehospitalization as the dependent variable, a continuity of care indicator variable was analyzed with a multivariable logistic regression. The indicator variable was created using the Bice-Boxerman Index to measure physical therapist continuity of care. The mean of the index (0.81) was used to separate between high continuity (0.81 or greater) of care and low continuity of care (lower than 0.81). The sample included 90,220 patients, with data coming from the linking of the Outcome Assessment and Information Set (OASIS) and an administrative dataset. All subjects lived in the NYC metro area. Inclusion criteria was a patient’s admission to their first home health care site following discharge occurring between 2010 and 2015, and individuals who identified as Male or Female. In comparison to low continuity of physical therapy, high continuity of physical therapy significantly decreased hospital readmissions (OR = 0.74, 95% CI 0.71-0.76, p ≤ .001, AME = −4.28%). Interpersonal continuity of physical therapy care has been identified as a key factor in decreasing readmissions from the home care setting. The research suggests an increased emphasis in preserving physical therapist continuity following hospitalization should be explored, with the potential to reduce hospital readmissions.","PeriodicalId":512411,"journal":{"name":"Home Health Care Management & Practice","volume":"21 7","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141796597","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 : 2024-06-06DOI: 10.1177/10848223241257498
Kristina Rosengren, Charlotta Szemberg
Safe medication management is crucial for maintaining health and well-being, particularly among older adults who often take multiple medications prescribed by different healthcare providers. The aim of this study was to identify factors related to medication safety among older adults using the Safe Medication Assessment (SMA) tool during home visits conducted by mobile care teams in the western part of Sweden. A quantitative pilot study was conducted. Safe Medication Assessment was used at baseline (n = 18) and follow-ups at 1 month (n =13) and 3 months (n = 13) to measure medication management. The study presented numbers and proportions (%) of identified similarities and differences in medication management among participants. The study identified several common risk factors associated with unsafe medication management among older adults, for example taking 5 or more medications (95%), having prescriptions from different prescribers (70%), and dealing with the complexity of medication management (39%). Protective factors that contributed to safe medication management included use of methods to remember medication schedules (95%), securely storing medications (95%), and having knowledge about prescribed drugs (77%). Implementing Safe Medication Assessment (SMA) during home visits offers a proactive approach to enhancing safe medication management among older adults living at home. Addressing risk factors such as polypharmacy, comorbidities, and cognitive function, along with use of protective factors like medication storage and patient education, can optimize medication therapy, minimize risks, and enhance treatment outcomes. Mobile care units play a vital role as a bridge for integrated care between different care providers, facilitating improved treatment outcomes for older adults managing complex medication regimens at home.
{"title":"Ensuring Safe Medication Assessment for Older Adults: A Pilot Study","authors":"Kristina Rosengren, Charlotta Szemberg","doi":"10.1177/10848223241257498","DOIUrl":"https://doi.org/10.1177/10848223241257498","url":null,"abstract":"Safe medication management is crucial for maintaining health and well-being, particularly among older adults who often take multiple medications prescribed by different healthcare providers. The aim of this study was to identify factors related to medication safety among older adults using the Safe Medication Assessment (SMA) tool during home visits conducted by mobile care teams in the western part of Sweden. A quantitative pilot study was conducted. Safe Medication Assessment was used at baseline (n = 18) and follow-ups at 1 month (n =13) and 3 months (n = 13) to measure medication management. The study presented numbers and proportions (%) of identified similarities and differences in medication management among participants. The study identified several common risk factors associated with unsafe medication management among older adults, for example taking 5 or more medications (95%), having prescriptions from different prescribers (70%), and dealing with the complexity of medication management (39%). Protective factors that contributed to safe medication management included use of methods to remember medication schedules (95%), securely storing medications (95%), and having knowledge about prescribed drugs (77%). Implementing Safe Medication Assessment (SMA) during home visits offers a proactive approach to enhancing safe medication management among older adults living at home. Addressing risk factors such as polypharmacy, comorbidities, and cognitive function, along with use of protective factors like medication storage and patient education, can optimize medication therapy, minimize risks, and enhance treatment outcomes. Mobile care units play a vital role as a bridge for integrated care between different care providers, facilitating improved treatment outcomes for older adults managing complex medication regimens at home.","PeriodicalId":512411,"journal":{"name":"Home Health Care Management & Practice","volume":"93 11","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141378092","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 : 2024-05-20DOI: 10.1177/10848223241253839
Nathan Windle, Azeem Alam, Horus Patel, Jonathan M. Street, Megan Lathwood, Tessa Farrington, M. Maruthappu
Preventable hospital admissions in elderly home care residents are a major socioeconomic burden, whilst early detection of deterioration may improve outcomes. Our goal was to develop and validate a machine learning-based algorithm to predict hospitalization risk among home care users. Our primary outcome was hospitalization. An existing risk score (1-5) was assessed for its discriminatory capacity over time. We subsequently developed a new machine learning model using carer concerns, service user demographics, and other home care data between January and July 2021. We randomly selected 150 service user records for validation, which were evaluated by both the model and 10 clinicians (9 doctors and 1 nurse) to compare prediction time and accuracy to human experts. Comparison between model and human was via area under the receiver operating characteristic curve (AUC). A score of 5 conferred an 8x higher likelihood of hospitalization in the subsequent 7 days (15.4% vs 1.8%, p < .05), compared to a score of 1. The new model and risk score increased performance, detecting 182 hospitalizations/month (3.7x chance). The AUC for the model was significantly higher than for clinicians (0.87 vs 0.41-0.57, respectively; p < .05). The model took <1 minute, while clinicians typically took over 40 minutes. A risk prediction model using carer concerns and other home care data features detects 3.7x more hospitalizations than chance. The model is faster and more accurate than human clinicians, enabling low-cost scale-up. This study supports linking the model to a triage and intervention service to reduce preventable hospitalizations in the home care sector.
{"title":"Predicting Hospitalization Risk Among Home Care Residents in the United Kingdom: Development and Validation of a Machine Learning-Based Predictive Model","authors":"Nathan Windle, Azeem Alam, Horus Patel, Jonathan M. Street, Megan Lathwood, Tessa Farrington, M. Maruthappu","doi":"10.1177/10848223241253839","DOIUrl":"https://doi.org/10.1177/10848223241253839","url":null,"abstract":"Preventable hospital admissions in elderly home care residents are a major socioeconomic burden, whilst early detection of deterioration may improve outcomes. Our goal was to develop and validate a machine learning-based algorithm to predict hospitalization risk among home care users. Our primary outcome was hospitalization. An existing risk score (1-5) was assessed for its discriminatory capacity over time. We subsequently developed a new machine learning model using carer concerns, service user demographics, and other home care data between January and July 2021. We randomly selected 150 service user records for validation, which were evaluated by both the model and 10 clinicians (9 doctors and 1 nurse) to compare prediction time and accuracy to human experts. Comparison between model and human was via area under the receiver operating characteristic curve (AUC). A score of 5 conferred an 8x higher likelihood of hospitalization in the subsequent 7 days (15.4% vs 1.8%, p < .05), compared to a score of 1. The new model and risk score increased performance, detecting 182 hospitalizations/month (3.7x chance). The AUC for the model was significantly higher than for clinicians (0.87 vs 0.41-0.57, respectively; p < .05). The model took <1 minute, while clinicians typically took over 40 minutes. A risk prediction model using carer concerns and other home care data features detects 3.7x more hospitalizations than chance. The model is faster and more accurate than human clinicians, enabling low-cost scale-up. This study supports linking the model to a triage and intervention service to reduce preventable hospitalizations in the home care sector.","PeriodicalId":512411,"journal":{"name":"Home Health Care Management & Practice","volume":"53 14","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141121904","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 : 2024-05-20DOI: 10.1177/10848223241247837
Brydne M. Edwards, Emma Perera, Emily C. King, Sandra M. McKay, Arlinda Ruco
Background: Physical activity is a safe, evidence-based self-management strategy for older adults (aged 65+) with cognitive impairment. Although homecare occupational therapists (OTs) and physiotherapists (PTs) are well positioned to support the growing number of older adults living at home with cognitive impairment, physical activity is rarely recommended as a strategy to manage cognition. Objective: To increase OTs’ and PTs’ knowledge of physical activity recommendations, as well as increase the range of physical activity recommendations for older adults living at home with cognitive impairment. Methods: This quality improvement project used a pre-post intervention approach. Data was collected through a pre-post clinician survey and pre-post chart audit to evaluate the impact of a multimodal education intervention on OT and PT knowledge and practice. The intervention included educational sessions and the development of four client handouts. Results: Post-intervention, OT and PT survey results showed a non-significant improvement in knowledge, and a greater range of physical activity recommendations. The PT chart audit demonstrated a statistically significant increase in PTs providing education about the role of physical activity in relation to cognitive impairment. For OTs, there was a non-significant increase in physical activity recommendations. Conclusions: This multimodal education resulted in non-significant improvements in knowledge for OTs and PTs, however there were significant practice changes for PTs when providing education to patients about the impact of physical activity on cognition. Future research could refine the targeting of this intervention to better meet the needs of OTs and incorporate an evaluation of patient outcomes.
{"title":"Enhancing Physical Activity Recommendations to Support Cognition in Homecare: A Quality Improvement Project","authors":"Brydne M. Edwards, Emma Perera, Emily C. King, Sandra M. McKay, Arlinda Ruco","doi":"10.1177/10848223241247837","DOIUrl":"https://doi.org/10.1177/10848223241247837","url":null,"abstract":"Background: Physical activity is a safe, evidence-based self-management strategy for older adults (aged 65+) with cognitive impairment. Although homecare occupational therapists (OTs) and physiotherapists (PTs) are well positioned to support the growing number of older adults living at home with cognitive impairment, physical activity is rarely recommended as a strategy to manage cognition. Objective: To increase OTs’ and PTs’ knowledge of physical activity recommendations, as well as increase the range of physical activity recommendations for older adults living at home with cognitive impairment. Methods: This quality improvement project used a pre-post intervention approach. Data was collected through a pre-post clinician survey and pre-post chart audit to evaluate the impact of a multimodal education intervention on OT and PT knowledge and practice. The intervention included educational sessions and the development of four client handouts. Results: Post-intervention, OT and PT survey results showed a non-significant improvement in knowledge, and a greater range of physical activity recommendations. The PT chart audit demonstrated a statistically significant increase in PTs providing education about the role of physical activity in relation to cognitive impairment. For OTs, there was a non-significant increase in physical activity recommendations. Conclusions: This multimodal education resulted in non-significant improvements in knowledge for OTs and PTs, however there were significant practice changes for PTs when providing education to patients about the impact of physical activity on cognition. Future research could refine the targeting of this intervention to better meet the needs of OTs and incorporate an evaluation of patient outcomes.","PeriodicalId":512411,"journal":{"name":"Home Health Care Management & Practice","volume":"26 25","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141119163","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}
At-home respite services seem too rigid to meet the needs of older adults and their caregivers. It is critical to develop service flexibility, as it allows for personalized care, adapted to health conditions, preferences, and evolving needs. While no prior studies used coconstruction methods to increase flexibility, this study could offer a better understanding of flexible respite for stakeholders. Using a living lab approach, this article aimed to (1) empirically determine the characteristics of this type of respite model and (2) document the levers and obstacles to consider for its implementation. Starting from a pre-existing flexible respite model named ANAAIS, the research team led workshops and interviews. First, the team carried out 2 workshops (TRIAGE and persona-scenario) with a total of 3 caregivers and 8 homecare professionals or managers. Second, a team member conducted interviews with 3 caregivers and 6 homecare professionals or managers. Content analysis was used on the data. The stakeholders coconstructed a Québec version of ANAAIS, a web application allowing caregivers to request an affordable respite, at the time wanted, and offered by a qualified care worker, through a simple application. Levers and barriers to its deployment are linked to the model’s characteristics as well as its internal and external context. For example, relations and connexions were perceived as a lever to deployment, while the lack of resources was considered an obstacle. This living lab project showed the feasibility and pragmatism of coconstructing a flexible and applicable respite service model.
{"title":"Coconstructing a Flexible At-Home Respite Model For and With Caregivers of Older Adults: A Living Lab Approach","authors":"Maude Viens, Annie Carrier, Sonia Leclerc, Dominique Giroux, Véronique Dubé, Sophie Éthier, Mélisa Audet, Véronique Provencher","doi":"10.1177/10848223241244480","DOIUrl":"https://doi.org/10.1177/10848223241244480","url":null,"abstract":"At-home respite services seem too rigid to meet the needs of older adults and their caregivers. It is critical to develop service flexibility, as it allows for personalized care, adapted to health conditions, preferences, and evolving needs. While no prior studies used coconstruction methods to increase flexibility, this study could offer a better understanding of flexible respite for stakeholders. Using a living lab approach, this article aimed to (1) empirically determine the characteristics of this type of respite model and (2) document the levers and obstacles to consider for its implementation. Starting from a pre-existing flexible respite model named ANAAIS, the research team led workshops and interviews. First, the team carried out 2 workshops (TRIAGE and persona-scenario) with a total of 3 caregivers and 8 homecare professionals or managers. Second, a team member conducted interviews with 3 caregivers and 6 homecare professionals or managers. Content analysis was used on the data. The stakeholders coconstructed a Québec version of ANAAIS, a web application allowing caregivers to request an affordable respite, at the time wanted, and offered by a qualified care worker, through a simple application. Levers and barriers to its deployment are linked to the model’s characteristics as well as its internal and external context. For example, relations and connexions were perceived as a lever to deployment, while the lack of resources was considered an obstacle. This living lab project showed the feasibility and pragmatism of coconstructing a flexible and applicable respite service model.","PeriodicalId":512411,"journal":{"name":"Home Health Care Management & Practice","volume":"95 15","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140984416","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 : 2024-05-08DOI: 10.1177/10848223241252931
Natalie J. Bransgrove, Joanne E Porter, Blake Peck, Jaclyn Bishop
To determine the barriers, benefits, and enablers of acute home-based care in Australia for older people (aged 65 and over). A systematic review for people aged 65 and over receiving acute home-based care in Australia was conducted using various databases (CINAHL, Medline, PsycINFO, SCOPUS, Web of Science, PubMed, Informit) and citation searching in September 2023. The Critical Appraisal Skills Program (CASP) was used to assess the quality of the evidence and a thematic analysis approach was utilized to narratively synthesize results. Ten studies were included, consisting mostly of cohort studies in metropolitan areas. Barriers included inefficacy, patient demographics, and carers. Benefits included efficacy, high satisfaction, and medical management. Enablers included education, holistic assessments, and support interventions. Within the literature there was a significant research gap regarding HITH for older people in rural areas of Australia. Patient outcomes were closely aligned with admission pathways.
{"title":"Barriers, Benefits, and Enablers of Acute Home-Based Care (Hospital In The Home) in Australia for Older People: A Systematic Review","authors":"Natalie J. Bransgrove, Joanne E Porter, Blake Peck, Jaclyn Bishop","doi":"10.1177/10848223241252931","DOIUrl":"https://doi.org/10.1177/10848223241252931","url":null,"abstract":"To determine the barriers, benefits, and enablers of acute home-based care in Australia for older people (aged 65 and over). A systematic review for people aged 65 and over receiving acute home-based care in Australia was conducted using various databases (CINAHL, Medline, PsycINFO, SCOPUS, Web of Science, PubMed, Informit) and citation searching in September 2023. The Critical Appraisal Skills Program (CASP) was used to assess the quality of the evidence and a thematic analysis approach was utilized to narratively synthesize results. Ten studies were included, consisting mostly of cohort studies in metropolitan areas. Barriers included inefficacy, patient demographics, and carers. Benefits included efficacy, high satisfaction, and medical management. Enablers included education, holistic assessments, and support interventions. Within the literature there was a significant research gap regarding HITH for older people in rural areas of Australia. Patient outcomes were closely aligned with admission pathways.","PeriodicalId":512411,"journal":{"name":"Home Health Care Management & Practice","volume":" 82","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141000681","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 : 2024-04-25DOI: 10.1177/10848223241247192
S. Schmaltz, Jamie Patrianakos, B. A. Longo, Scott C. Williams
Accreditation seeks to improve the quality of health care, 1 dimension of which is patient experience. The Home Health Consumer Assessment of Healthcare Practitioners and Systems (HHCAHPS) survey collects patient care experience data in home health agencies (HHAs). This study examined the association between accreditation and the consistency and sustainability of high patient experience ratings between Joint Commission (TJC)-accredited and non-TJC accredited HHAs. This multi-year observational study analyzed HHCAHPS star rating performance data from 2015 to 2019. The 5 measures included are based on the 3 publicly reported composite measures, the global measure, and a Star Summary measure. Each measure receives a star rating from 1 to 5. A total of 7230 HHAs reported star rating data between 2015 and 2019, with 4099 (56.7%) having data spanning all 5 years. Of these, 959 (23.4%) were TJC-accredited and 3140 (76.6%) were not. A star rating score of 4 or 5 was considered high performing. TJC-accredited (vs non-TJC accredited) organizations had a higher proportion of HHAs with all 5 years with a high rating ( p < .05 for all measures). Among those HHAs who were in the top rating category the previous year, TJC-accredited (vs non-TJC accredited) HHAs had an even higher probability of sustaining the top rating category in the current year ( p < .001 for all measures). These findings suggest that TJC accreditation is associated with consistently high HHCAHPS star ratings over time. This association was strongest for the Specific Care Issues measure where the concepts addressed by the measure overlapped with topics addressed by accreditation standards.
{"title":"Consistency and Sustainability of Home Health Agency Patient Experience Star Rating Performance and the Association With Joint Commission Accreditation","authors":"S. Schmaltz, Jamie Patrianakos, B. A. Longo, Scott C. Williams","doi":"10.1177/10848223241247192","DOIUrl":"https://doi.org/10.1177/10848223241247192","url":null,"abstract":"Accreditation seeks to improve the quality of health care, 1 dimension of which is patient experience. The Home Health Consumer Assessment of Healthcare Practitioners and Systems (HHCAHPS) survey collects patient care experience data in home health agencies (HHAs). This study examined the association between accreditation and the consistency and sustainability of high patient experience ratings between Joint Commission (TJC)-accredited and non-TJC accredited HHAs. This multi-year observational study analyzed HHCAHPS star rating performance data from 2015 to 2019. The 5 measures included are based on the 3 publicly reported composite measures, the global measure, and a Star Summary measure. Each measure receives a star rating from 1 to 5. A total of 7230 HHAs reported star rating data between 2015 and 2019, with 4099 (56.7%) having data spanning all 5 years. Of these, 959 (23.4%) were TJC-accredited and 3140 (76.6%) were not. A star rating score of 4 or 5 was considered high performing. TJC-accredited (vs non-TJC accredited) organizations had a higher proportion of HHAs with all 5 years with a high rating ( p < .05 for all measures). Among those HHAs who were in the top rating category the previous year, TJC-accredited (vs non-TJC accredited) HHAs had an even higher probability of sustaining the top rating category in the current year ( p < .001 for all measures). These findings suggest that TJC accreditation is associated with consistently high HHCAHPS star ratings over time. This association was strongest for the Specific Care Issues measure where the concepts addressed by the measure overlapped with topics addressed by accreditation standards.","PeriodicalId":512411,"journal":{"name":"Home Health Care Management & Practice","volume":"53 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140655849","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}
Family caregivers care for individuals in the home environment. Family caregivers of individuals with chronic obstructive pulmonary disease (COPD) observe breathlessness in the care recipient. Breathlessness is a main symptom of COPD, and watching breathlessness creates emotional distress and a toll on family caregivers. The purpose of this integrative review was to explore the literature on family caregivers and witnessed breathlessness in individuals with COPD. An understanding of family caregiver experiences of breathlessness will allow for further development of evidence-based practice and research. An integrative review was performed using the five-step process of the Whittemore and Knafl Integrative Review Model. Literature search results were reported using the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. An overarching theme of constant care and burden resulted from the 18 studies on family caregivers and witnessed breathlessness in individuals with COPD. Three themes: psychosocial implications of caregivers, response ambiguity, and knowledge of interventions represented family caregivers and breathlessness in the care recipient among the studies. This integrative review provides insight on family caregivers and witnessed breathlessness in individuals with COPD. An understanding of the family caregiver perception of breathlessness in the care recipient can help home healthcare professionals empathize with and offer support specific to the needs of family caregivers of individuals with breathlessness from COPD, heart failure, and other chronic diseases.
{"title":"Family Caregivers and Breathlessness in Individuals with Chronic Obstructive Pulmonary Disease","authors":"Kimberly Sloop, Pamela Spigelmyer, Melanie Turk, Kimberly Price","doi":"10.1177/10848223241248178","DOIUrl":"https://doi.org/10.1177/10848223241248178","url":null,"abstract":"Family caregivers care for individuals in the home environment. Family caregivers of individuals with chronic obstructive pulmonary disease (COPD) observe breathlessness in the care recipient. Breathlessness is a main symptom of COPD, and watching breathlessness creates emotional distress and a toll on family caregivers. The purpose of this integrative review was to explore the literature on family caregivers and witnessed breathlessness in individuals with COPD. An understanding of family caregiver experiences of breathlessness will allow for further development of evidence-based practice and research. An integrative review was performed using the five-step process of the Whittemore and Knafl Integrative Review Model. Literature search results were reported using the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. An overarching theme of constant care and burden resulted from the 18 studies on family caregivers and witnessed breathlessness in individuals with COPD. Three themes: psychosocial implications of caregivers, response ambiguity, and knowledge of interventions represented family caregivers and breathlessness in the care recipient among the studies. This integrative review provides insight on family caregivers and witnessed breathlessness in individuals with COPD. An understanding of the family caregiver perception of breathlessness in the care recipient can help home healthcare professionals empathize with and offer support specific to the needs of family caregivers of individuals with breathlessness from COPD, heart failure, and other chronic diseases.","PeriodicalId":512411,"journal":{"name":"Home Health Care Management & Practice","volume":" 15","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140686448","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 : 2024-04-15DOI: 10.1177/10848223241247197
Jiyoun Song, Lynette Ramlogan, Sasha Vergez, A. Davoudi, Sridevi Sridharan, Hannah Cho, June Stanley, M. McDonald, Kathryn H. Bowles, Jingjing Shang, Patricia W. Stone, Maxim Topaz
Palliative care offers undeniable advantages to elderly patients with multiple chronic illnesses in managed long-term care. However, only approximately 14% of those who require palliative care actually receive it. To investigate factors influencing decision-making regarding palliative care acceptance, and healthcare providers’ communication strategies, which patients or family caregivers perceive during managed long-term care. Qualitative thematic content analysis study. Two data sources from home and community-based health care organization in a metropolitical city in the Northeastern United States were used: (a) retrospectively collected 79 phone call audio recordings between patients and/or family caregivers with healthcare providers when initiate palliative care option, and (b) prospectively collected 10 exploratory qualitative interviews with patients and/or family caregivers for this study purpose. From a total of 89 conversations, 7 themes emerged during palliative care decision-making: (a) capability for self-management; (b) symptom severity; (c) perceptions of chronic disease; (d) satisfaction with current health services; (e) code status; (f) caregiver burden and (g) other reasons, including financial considerations and service affiliations. In addition, from 10 qualitative interviews, 4 key themes in healthcare providers’ communication that optimize palliative care conversations were indicated: (i) trust and relationship dynamics; (ii) positive reinforcement and personal connection; (iii) conversation setting and initiator; and (iv) collaborative approach to care coordination. Enhancing decision-making around palliative care and improving acceptance of palliative care services may be improved through the integration of personalized care plans, empathetic communication, use of symptom-inclusive assessments for timely care, and proactively addressing caregiver burden.
{"title":"The Paradox of Choice in Palliative Care Decision-Making in Managed Long-Term Care: A Qualitative Study","authors":"Jiyoun Song, Lynette Ramlogan, Sasha Vergez, A. Davoudi, Sridevi Sridharan, Hannah Cho, June Stanley, M. McDonald, Kathryn H. Bowles, Jingjing Shang, Patricia W. Stone, Maxim Topaz","doi":"10.1177/10848223241247197","DOIUrl":"https://doi.org/10.1177/10848223241247197","url":null,"abstract":"Palliative care offers undeniable advantages to elderly patients with multiple chronic illnesses in managed long-term care. However, only approximately 14% of those who require palliative care actually receive it. To investigate factors influencing decision-making regarding palliative care acceptance, and healthcare providers’ communication strategies, which patients or family caregivers perceive during managed long-term care. Qualitative thematic content analysis study. Two data sources from home and community-based health care organization in a metropolitical city in the Northeastern United States were used: (a) retrospectively collected 79 phone call audio recordings between patients and/or family caregivers with healthcare providers when initiate palliative care option, and (b) prospectively collected 10 exploratory qualitative interviews with patients and/or family caregivers for this study purpose. From a total of 89 conversations, 7 themes emerged during palliative care decision-making: (a) capability for self-management; (b) symptom severity; (c) perceptions of chronic disease; (d) satisfaction with current health services; (e) code status; (f) caregiver burden and (g) other reasons, including financial considerations and service affiliations. In addition, from 10 qualitative interviews, 4 key themes in healthcare providers’ communication that optimize palliative care conversations were indicated: (i) trust and relationship dynamics; (ii) positive reinforcement and personal connection; (iii) conversation setting and initiator; and (iv) collaborative approach to care coordination. Enhancing decision-making around palliative care and improving acceptance of palliative care services may be improved through the integration of personalized care plans, empathetic communication, use of symptom-inclusive assessments for timely care, and proactively addressing caregiver burden.","PeriodicalId":512411,"journal":{"name":"Home Health Care Management & Practice","volume":"275 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140703821","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 : 2024-04-15DOI: 10.1177/10848223241247293
Kristina Rosengren, Charlotta Szemberg
Collaboration across hospital-primary-community healthcare continuum is crucial to ensuring secure medication management at home, particularly among elderly persons. The study aim was to describe older adult’s experiences of medication assessment using Safe Medication Assessment (SMA) in connection to home visits. A study was conducted, with data from 44 participants analyzed through qualitative content analysis (semi-structured interviews) at baseline, 1-month, and 3-month follow-ups based on SMA’s 20 items. The results include 1 theme “Personcentredness due to medication management,” and 2 categories, “Systematic approach towards safe medication at home” and “Taking control over prescribed drugs.” SMA ensures a systematic work approach during home visits conducted by mobile team units, working in partnership with all involved parties (elderly, care providers, relatives) improving safe medication management at home.
{"title":"Safe Medication Assessment Toward Patient Safety in Home Health Care: A Qualitative Study","authors":"Kristina Rosengren, Charlotta Szemberg","doi":"10.1177/10848223241247293","DOIUrl":"https://doi.org/10.1177/10848223241247293","url":null,"abstract":"Collaboration across hospital-primary-community healthcare continuum is crucial to ensuring secure medication management at home, particularly among elderly persons. The study aim was to describe older adult’s experiences of medication assessment using Safe Medication Assessment (SMA) in connection to home visits. A study was conducted, with data from 44 participants analyzed through qualitative content analysis (semi-structured interviews) at baseline, 1-month, and 3-month follow-ups based on SMA’s 20 items. The results include 1 theme “Personcentredness due to medication management,” and 2 categories, “Systematic approach towards safe medication at home” and “Taking control over prescribed drugs.” SMA ensures a systematic work approach during home visits conducted by mobile team units, working in partnership with all involved parties (elderly, care providers, relatives) improving safe medication management at home.","PeriodicalId":512411,"journal":{"name":"Home Health Care Management & Practice","volume":"49 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140702664","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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