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To promote home death, it is necessary to clarify the institutional barriers to conducting end-of-life (EOL) care and consider strategies to deal with this process. This study aims to clarify institution-related factors associated with the provision of home-based EOL care cases, and to compare them among three different types of home-care agencies.
Are home nurses (also known as community nurses) ready for their changing role in primary care? A quantitative study was performed in home nursing in Flanders, Belgium, to explore the activity profile of home nurses and health care assistants, using the 24-hour recall instrument for home nursing. Seven dates were determined, covering each day of the week and the weekend, on which data collection would take place. All the home nurses and health care assistants from the participating organisations across Flan...
Palliative care (PC) is no longer offered with preference to cancer patients (CA), but also to patients with non-malignant, progressive diseases. Taking current death statistics into account, PC in Europe will face a growing number of patients dying from non-cancer diseases (NCA). More insights into specialized palliative home care (SPHC) in NCAs are needed.
The effectiveness of home hospice care was helping patients to die at home, and reducing symptom burden.
In Japan, palliative home care is subject to increasing demand from patients. However, the number of deaths at home is still not as high as that of palliative home care users.
The present study is a follow-up study of factors contributing to an undesirable quality of work environment and sick leave rate in the home care services in a Norwegian municipality. The underlying assumption is that organizational discrepancies in the perceptions and appraisals of significant factors and processes in an organization have detrimental effects on the management of the organization and on work environment conditions. Thus, the study aim is to explore potential organizational discrepancies in ...
Although the Patient Centered Medical Home is a considered an optimal model for care, some children still do not receive care in this model. Beyond the clinical and practitioner factors known to affect having a medical home, family and environmental risks [referred to as adverse childhood experiences (ACE)] may also be associated with having a medical home. This study's purpose was to examine whether family and environment risks are associated with children having a medical home.
How sad to read that care home nursing is seen as 'something people do when they cannot get a job elsewhere' (News, April 29). I chose care home nursing straight out of university.
In countries with ageing populations, home care (HC) aides are among the fastest growing jobs. There are few quantitative studies of HC occupational safety and health (OSH) conditions. The objectives of this study were to: (1) assess quantitatively the OSH hazards and benefits for a wide range of HC working conditions, and (2) compare OSH experiences of HC aides who are employed via different medical and social services systems in Massachusetts, USA.
The low number of medical trainees entering primary care is contributing to the lack of access to primary care services in many countries. Despite the need for primary care physicians in the Middle East, there is limited information regarding trainees' career choices, a critical determinant in the supply of primary care physicians.
Inpatient hospice care can reduce futile treatment and medical costs. However, the cost trimming effect of home-based hospice care in hospital has yet not been explored. This study evaluates the impact of home-based hospice care on end-of-life expenditure in hospitals with different spending intensity.This is a population-based retrospective study in Taiwan. Cancer decedents were identified in the National Health Insurance Research Database (NHIRD) from 2009 to 2011. They are categorized by hospital spendin...
The neurological disease amyotrophic lateral sclerosis (ALS) requires pain palliation during end-of-life stages. From the view point of a home-care doctor who assists patients with their final wishes to die at home, I summarize the issues involving the section of medical treatments, the extent and frequency of end-of-life pain, the methodology of pain palliation, and the facts of end-of-life care at home. I also present several clinical cases of end-of-life home care and discuss its demand and problems.
Good interprofessional work (IPW) is essential to provide quality home-based end-of-life (EOL) care. The purpose of this study was to explore the factors of "good collaboration," as evaluated separately by home care nurses (HNs), home helpers (HHs), and care managers (CMs). The relationship was examined between their evaluation of good collaboration and their recent actual experience of interprofessional collaborative work for a home-based EOL case. The questionnaire was returned nationwide by 378 HNs, 305 ...
This study was carried out as an intervention study to determine the effect of nursing care provided at home with the self-care model on the self-efficacy of patients with chronic obstructive pulmonary disease in northern Turkey.
As home care utilization increases, information technology (IT) becomes a critical tool for providing quality home care. However, most home health agencies (HHAs) in the United States are in a position to adopt and leverage IT solutions in budget-constrained settings, where it is crucial to address important and pressing challenges and opportunities for achieving effectiveness in IT adoption.
Immigrant children in the United States historically experience lower-quality health care. Such disparities areconcerning for immigrant children with special health care needs (CSHCNs). Our study assesses the medical home presence for CSHCN by immigrant family type and evaluates which medical home components are associated with disparities.
Home artificial nutrition includes application of enteral and parenteral nutrition in home environment, in cases of natural nutrition access failure. Home enteral nutrition uses various modality and ways, when persist the functional bowel. Chronic intestinal failure indicates dependence of home parenteral nutrition and is aplicated with central venous accesses. Home artificial nutrition improves patient´s quality of life and is more economical compared with hospital care.Key words: home artificial nutritio...
This study examined demographic and practice characteristics that affect the career satisfaction of obstetrician-gynecologists. Data were retrieved from the 2008 Health Tracking Physician Survey, conducted by the Center for Studying Health System Change. The survey consisted of a nationally representative sample of physicians belonging to the American Medical Association. A final sample of 290 obstetrician-gynecologists was obtained from the study. Results indicated more than 80% of obstetrician-gynecologis...
Purpose To evaluate the effectiveness of a modified home care model in China. Methods First-time stroke survivors were recruited from a comprehensive teaching hospital in China. Subjects in the intervention group (n = 168) received modified home care involving detailed pre-discharge preparation and post-discharge follow-up lasting one month. The following outcomes were assessed at the end of follow-up: length of hospital stay, satisfaction with acute hospitalisation, medication compliance, complications...
This study is seeking to establish the factors influencing foundation doctors' decision-making when applying for speciality training. A questionnaire was sent to all foundation doctors in Scotland (n = 1602, response rate 34%) asking them about their career intention in relation to General Practice, whether they received career advice and the extent to which certain factors influenced their career choice. For the majority of trainees, General Practice was not their first choice but just under half were co...
Home care clinicians often have to transport supplies to patients' homes, and remove and transport items from the home after care is provided. This article will provide guidelines and best practices for the proper methods of managing and storing infection prevention and control supplies and regulated medical waste in a home care clinician's personal vehicle.
Health care is shifting out of hospitals into community settings. In Ontario, Canada, home care organizations continue to experience challenges recruiting and retaining nurses. However, factors influencing home care nurse retention that can be modified remain largely unexplored. Several groups of factors have been identified as influencing home care nurse intent to remain employed including job characteristics, work structures, relationships and communication, work environment, responses to work, and condit...
The Flinders University Telehealth in the Home (FTH) trial was an action research initiative that introduced and evaluated the impact of telehealth services on palliative care patients living in the community, home-based rehabilitation services for the elderly, and services to the elderly in residential aged care. The aim of this study was to understand the issues encountered during the provision of technology services that supported this trial.
Burdensome symptoms and potentially inappropriate care practices are common at the end of life for nursing home residents. Appropriately managing symptoms and limiting aggressive care practices is key to high-quality end-of-life care. Little research is available, however, on the opinions of nursing home care providers about the impact of symptoms and practices for both residents and care facilities. Our objectives were to (1) identify common burdensome symptoms and potentially inappropriate practices at th...
Hospital organisations based on the level of care intensity have clearly revealed a concept, that of care complexity, which has been widely used for decades in the healthcare field. Despite its wide use, this concept is still poorly defined and it is often confused with and replaced by similar concepts such as care intensity or workload. This study aims to describe the meaning of care complexity as perceived by nurses in their day-to-day experience of hospital clinical care, rehabilitation, home care, and o...