Healthcare

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12 pages, 728 KiB

Open AccessArticle

Consequences of the Early Phase of the COVID-19 Pandemic for Home-Healthcare Recipients in Norway: A Nursing Perspective

by Line Melby, Merete Lyngstad and Solveig Osborg Ose

Healthcare 2023, 11(3), 346; https://doi.org/10.3390/healthcare11030346 - 25 Jan 2023

Cited by 1 | Viewed by 1250

Abstract

Municipal home-healthcare services are becoming increasingly important as growing numbers of people are receiving healthcare services in their home. The COVID-19 pandemic represented a challenge for this group, both in terms of care providers being restricted in performing their duties and care receivers [...] Read more.

Municipal home-healthcare services are becoming increasingly important as growing numbers of people are receiving healthcare services in their home. The COVID-19 pandemic represented a challenge for this group, both in terms of care providers being restricted in performing their duties and care receivers declining services for fear of being infected. Furthermore, preparedness plans were not always in place. The purpose of this study is to investigate the consequences for recipients of home healthcare in Norway of the actual level of COVID-19 infection spread in the local population, as observed by licensed nurses working in home-healthcare services. Approximately 2100 nurses answered the survey. The most common adverse consequences for home-healthcare recipients were increased isolation and loneliness, increased health concerns, and the loss of respite care services. An increased burden for relatives/next of kin and fewer physical meetings with service providers were frequently observed and reported as well. This study shows that there were more adverse consequences for service users in municipalities with higher levels of contagion than in those with lower levels of contagion. This indicates that the municipalities adapted measures to the local rate of contagion, in line with local municipal preparedness strategies. Full article

(This article belongs to the Special Issue Home Health Care for the Future)

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15 pages, 317 KiB

Open AccessArticle

Quality of Life and Anxiety Levels in Latin American Immigrants as Caregivers of Older Adults in Spain

by Francisco Javier Fernández-Carrasco, Erika Marbely Molina-Yanes, Irene Antúnez-Calvente, Luciano Rodríguez-Díaz, Francisco Javier Riesco-González, Juan Gómez-Salgado, Rocío Palomo-Gómez and Juana María Vázquez-Lara

Healthcare 2022, 10(12), 2342; https://doi.org/10.3390/healthcare10122342 - 22 Nov 2022

Cited by 1 | Viewed by 1333

Abstract

Increased life expectancy in Spain has highlighted the need for formal caregivers who care for older adults who live at home. In many cases, families choose to hire immigrants from Latin America who, on many occasions, have been forced to emigrate, which causes [...] Read more.

Increased life expectancy in Spain has highlighted the need for formal caregivers who care for older adults who live at home. In many cases, families choose to hire immigrants from Latin America who, on many occasions, have been forced to emigrate, which causes a considerable psychological impact on them. To this, other factors such as precarious working conditions, loneliness, or high workload are added, which leads to many caregivers becoming sick. The aim of this study was to assess the quality of life and the level of anxiety derived from the workload of Latin American immigrants who come to Spain to care for older adults. A descriptive cross-sectional study was carried out using two validated questionnaires to measure this relationship. A correlation was also established between quality of life and anxiety as expressed by the participants. The sample consisted of a total of 426 subjects. One of the main results showed that the lower the caregiver’s quality of life, the higher their level of anxiety (OR = 1.06; 95% CI). Live-in caregivers had a lower quality of life than people who did not live in the same house as the cared-for person (OR = 2.22; 95% CI). Working long hours and having a high workload was associated with poorer quality of life and higher levels of anxiety. Assessing immigrants who are formal caregivers and providing them with the support that helps to improve their quality of life is suggested to reduce the occurrence of anxiety disorders. Full article

(This article belongs to the Special Issue Home Health Care for the Future)

14 pages, 283 KiB

Open AccessArticle

“The Devices Themselves Aren’t the Problem”—Views of Patients and Their Relatives on Medical Technical Aid Supply in Home Mechanical Ventilation: An Explorative Qualitative Study

by Michael Ewers and Yvonne Lehmann

Healthcare 2022, 10(8), 1466; https://doi.org/10.3390/healthcare10081466 - 4 Aug 2022

Cited by 3 | Viewed by 1894

Abstract

(1) The supply of medical technical aids and the instructions on using them is critical for home-mechanically ventilated patients and their relatives. However, limited evidence exists on the needs-based nature of this care. (2) Aim: To gain insights into users’ views on this [...] Read more.

(1) The supply of medical technical aids and the instructions on using them is critical for home-mechanically ventilated patients and their relatives. However, limited evidence exists on the needs-based nature of this care. (2) Aim: To gain insights into users’ views on this form of care, to identify key challenges, and to derive empirically sound preliminary recommendations for its future design. (3) Methods: An explorative qualitative interview study was performed in Germany. Semi-structured interviews were conducted with home-mechanically ventilated patients and their relatives. Patients were selected through purposive sampling. Interviews were audio-recorded, transcribed, and analysed using a content analysis approach. (3) Results: 27 patients and 9 relatives were interviewed. From their point of view, ventilation-specific equipment is generally reliable and is seen as a belonging of the patient. However, if the patient lacks competence in using the technology or if information or instructions are neglected, ambiguous and unsafe situations easily arise. (4) Conclusions: The present study is one of the first to provide insights into technical aid supply in home-mechanical ventilation from the users’ point of view. It highlights the need for continuous professional support and for evidence-based educational strategies that promote safety among the users of technical aids in home care. Full article

(This article belongs to the Special Issue Home Health Care for the Future)

14 pages, 11506 KiB

Open AccessArticle

Addressing the Gap in Data Communication from Home Health Care to Primary Care during Care Transitions: Completeness of an Interoperability Data Standard

by Paulina Sockolow, Edgar Y. Chou and Subin Park

Healthcare 2022, 10(7), 1295; https://doi.org/10.3390/healthcare10071295 - 13 Jul 2022

Cited by 1 | Viewed by 2048

Abstract

In a future where home health care is no longer an information silo, patient information will be communicated along transitions in care to improve care. Evidence-based practice in the United States supports home health care patients to see their primary care team within [...] Read more.

In a future where home health care is no longer an information silo, patient information will be communicated along transitions in care to improve care. Evidence-based practice in the United States supports home health care patients to see their primary care team within the first two weeks of hospital discharge to reduce rehospitalization risk. We sought to identify a parsimonious set of home health care data to be communicated to primary care for the post-hospitalization visit. Anticipating electronic dataset communication, we investigated the completeness of the international reference terminology, Logical Observation Identifiers Names and Codes (LOINC), for coverage of the data to be communicated. We conducted deductive qualitative analysis in three steps: (1) identify home health care data available for the visit by mapping home health care to the information needed for the visit; (2) reduce the resulting home health care data set to a parsimonious set clinicians wanted for the post-hospitalization visit by eliciting primary care clinician input; and (3) map the parsimonious dataset to LOINC and assess LOINC completeness. Our study reduced the number of standardized home health care assessment questions by 40% to a parsimonious set of 33 concepts that primary care team physicians wanted for the post-hospitalization visit. Findings indicate all home health care concepts in the parsimonious dataset mapped to the information needed for the post-hospitalization visit, and 84% of the home health care concepts mapped to a LOINC term. The results indicate data flow of parsimonious home health care dataset to primary care for the post-hospitalization visit is possible using existing LOINC codes, and would require adding some codes to LOINC for communication of a complete parsimonious data set. Full article

(This article belongs to the Special Issue Home Health Care for the Future)

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11 pages, 612 KiB

Open AccessArticle

Informal Caregivers’ Experiences with Performing Telemonitoring in Heart Failure Care at Home—A Qualitative Study

by Ina Thon Aamodt, Irene Lie, Edita Lycholip, Anna Strömberg, Tiny Jaarsma, Jelena Celutkiene and Ragnhild Hellesø

Healthcare 2022, 10(7), 1237; https://doi.org/10.3390/healthcare10071237 - 2 Jul 2022

Cited by 3 | Viewed by 2039

Abstract

Informal caregivers have an important role in caring for family members at home. Supporting persons with a chronic illness such as heart failure (HF) in managing their self-care is reported to be a challenge and telemonitoring has been suggested to be of support. [...] Read more.

Informal caregivers have an important role in caring for family members at home. Supporting persons with a chronic illness such as heart failure (HF) in managing their self-care is reported to be a challenge and telemonitoring has been suggested to be of support. Aim: to explore informal caregivers’ experiences with performing non-invasive telemonitoring to support persons with HF at home for 30 days following hospital discharge in Norway and Lithuania. Methods: A qualitative explorative study of informal caregivers performing non-invasive telemonitoring using lung-impedance measurements and short message service (SMS). Data was collected using semi-structured interviews with informal caregivers of persons with HF in NYHA class III-IV in Norway and Lithuania. Results: Nine interviews were conducted with informal caregivers of persons with HF who performed non-invasive telemonitoring at home. A sequential process of three categories emerged from the data: access to support, towards routinizing, and mastering non-invasive telemonitoring. Conclusion: Informal caregivers performed non-invasive telemonitoring for the first time in this study. Their experiences were of a sequential process that included access to support from health care professionals, establishing a routine together, and access to nurses or physicians in HF care as part of mastering. This study highlights involving informal caregivers and persons with HF together in the implementation and future research of telemonitoring in HF care. Full article

(This article belongs to the Special Issue Home Health Care for the Future)

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17 pages, 318 KiB

Open AccessArticle

Rural Family Caregiving: A Closer Look at the Impacts of Health, Care Work, Financial Distress, and Social Loneliness on Anxiety

by Tanya L’Heureux, Jasneet Parmar, Bonnie Dobbs, Lesley Charles, Peter George J. Tian, Lori-Ann Sacrey and Sharon Anderson

Healthcare 2022, 10(7), 1155; https://doi.org/10.3390/healthcare10071155 - 21 Jun 2022

Cited by 7 | Viewed by 3133

Abstract

Even before the COVID-19 pandemic, earlier acute care patient discharges, restricted admissions to long-term care, and reduced home care services increased the amount and complexity of family caregivers’ care work. However, much less is known about rural caregivers’ experiences. Thus, our aim in [...] Read more.

Even before the COVID-19 pandemic, earlier acute care patient discharges, restricted admissions to long-term care, and reduced home care services increased the amount and complexity of family caregivers’ care work. However, much less is known about rural caregivers’ experiences. Thus, our aim in this sequential mixed-methods study was to understand how COVID-19 affected rural family caregivers. Thematically analyzed interviews and linear regression on survey data were used to understand family caregiver stress. Fourteen rural caregivers participated in interviews. They acknowledged that they benefitted from the circle of support in rural communities; however, they all reported having to cope with fewer healthcare and social services. 126 rural caregivers participated in the online survey. About a third (31%) of these caregivers had moderate frailty, indicating that they could benefit from support to improve their health. In linear regression, frailty, social loneliness, financial hardship, and younger age were associated with caregiver anxiety. Contrary to the qualitative reports that people in rural communities are supportive, over two-thirds of the rural caregivers completing the survey were socially lonely. Rural family caregivers are vulnerable to anxiety and social loneliness due to the nature of caregiving and the lack of healthcare and social service supports in rural areas. Primary healthcare and home care teams are well-positioned to assess caregivers’ health and care situation as well as to signpost them to needed supports that are available in their areas. Full article

(This article belongs to the Special Issue Home Health Care for the Future)

11 pages, 239 KiB

Open AccessArticle

How Is Quality of Care in Home Healthcare Created? A Qualitative Study of Health Professionals’ Perspectives

by Sigrid Nakrem and Katrine Kvanneid

Healthcare 2022, 10(6), 1021; https://doi.org/10.3390/healthcare10061021 - 31 May 2022

Cited by 4 | Viewed by 2193

Abstract

The demographic challenges with an increase in older adults in need of nursing care has put home healthcare services under pressure. However, research on what constitutes quality of home healthcare services and what factors influence good nursing care and patient safety is scarce. [...] Read more.

The demographic challenges with an increase in older adults in need of nursing care has put home healthcare services under pressure. However, research on what constitutes quality of home healthcare services and what factors influence good nursing care and patient safety is scarce. The aim of this study was to gain insight into health professionals’ perceptions of how quality of care in home healthcare is created and what factors put patient safety at risk. The present study was a qualitative study with semi-structured interviews of eight health professionals working in home healthcare services. Qualitative content analysis was used. Four categories of factors the staff thought had to be present to provide good quality services were identified: (1) A workplace with adequate competence; (2) Communication, information flow and collaboration; (3) Continuity and organisation of care; and (4) Resources. Conclusions: The healthcare professionals perceived that the quality of the services overall was good, and if important factors were present, quality of care was achieved. However, they pointed out some factors that were important to prevent inadequate care and improve services, as quality of care was at risk when deficiencies in these areas occurred. Full article

(This article belongs to the Special Issue Home Health Care for the Future)

12 pages, 633 KiB

Open AccessArticle

After Hospital: Should Older Care-Needing Patients Be Transferred to Their Homes or to an Intermediate Care Institution?

by Heidi Gautun, Linda Aimée Hartford Kvæl and Christopher Bratt

Healthcare 2022, 10(3), 475; https://doi.org/10.3390/healthcare10030475 - 3 Mar 2022

Cited by 2 | Viewed by 2387

Abstract

Background: In most European countries, communities need to provide health and social care services to an increasing number of severely ill patients discharged from hospitals. We investigated whether nurses in hospitals and in the communities’ health and social care services experienced that the [...] Read more.

Background: In most European countries, communities need to provide health and social care services to an increasing number of severely ill patients discharged from hospitals. We investigated whether nurses in hospitals and in the communities’ health and social care services experienced that the administration in the municipalities allocated older patients the right type of services after hospital discharge. Methods: We used data from Norway, with a qualitative pilot study and quantitative analysis (structural equation modeling) of surveys involving 2431 nurses on inpatient wards in acute hospitals and 4312 nurses working in nursing homes or home nursing. Results: Dissatisfaction was widespread with the use of patients’ homes the first days after hospital discharge. Among nurses working in hospitals, 38% were commonly or very commonly disagreeing with the use of the patient’s home after hospital discharge, 25% among home nurses, and 18% among nurses in nursing homes. Home nurses were more prone to oppose the use of patients’ homes if they also experienced that their service had inadequate staffing or inadequate medical equipment. Conclusions: This research indicates conflicting priorities between the bureaucracy and nurses involved in actual work with older patients. From the nurses’ perspective, the municipalities’ administration was offering too few older patients short-term-stay in an intermediate care institution as part of the clinical pathway from hospital to home. However, providing more recourses to home nursing would improve their ability to provide sufficient care to older patients discharged from hospital. Full article

(This article belongs to the Special Issue Home Health Care for the Future)

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13 pages, 234 KiB

Open AccessArticle

Managing Multiple Medications and Their Packaging for Older People in Home Care Nursing: An Interview Study

by Giana Carli Lorenzini

Healthcare 2021, 9(10), 1265; https://doi.org/10.3390/healthcare9101265 - 25 Sep 2021

Cited by 4 | Viewed by 2178

Abstract

Home care nurses assist older people in their daily living and well-being, including medication management. Medication management can be challenging for older people with functional constraints and several chronic conditions. This paper presents how home care nurses manage medications and their packaging for [...] Read more.

Home care nurses assist older people in their daily living and well-being, including medication management. Medication management can be challenging for older people with functional constraints and several chronic conditions. This paper presents how home care nurses manage medications and their packaging for older people at their homes. This study followed an explorative qualitative research design, in which semi-structured interviews were conducted with home care nurses in Sweden (n = 14). The study revealed that home care nurses need to coordinate a multitude of interrelated tasks, with documentation being paramount. Regarding medication management, automated systems were preferred, as they reduce medication errors and facilitate dispensing of medications for each patient when compared with analogue systems still in use (i.e., dosing boxes), commonly used by older people. Importantly, the lack of a common journal system for updates on prescribed medication among health care providers and analogue communication still in place creates space for outdated prescription of medications for patients. There are opportunities for further investigation on how technology can help home care nurses in coordinating medication management tasks with other health care providers, and on receiving updates about medication intake by older patients when the nurse is not at their homes. Full article

(This article belongs to the Special Issue Home Health Care for the Future)

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