Contributing factors involved in the safety of elderly people with chronic illness in home healthcare: a qualitative study.

INTRODUCTION: Patients receiving home care are often elderly people with chronic illnesses that increasingly experience patient safety barriers due to special care needs. OBJECTIVE: The present study was conducted to determine the factors involved in the safety of elderly patients with chronic illnesses receiving home care. METHODS: A qualitative study with a conventional content analysis method was conducted in home care agencies of Tehran, Iran from August 2020 to July 2022. For data generation, semistructured interviews were conducted with 11 nurses, 2 nurse assistants, 1 home care inspector (an expert working at the deputy of treatment) and 3 family caregivers. Moreover, four observational sessions were also held. Data analysis was done using the five-step Graneheim and Lundman method. RESULTS: According to the results, the facilitators of the safety of the elderly patients with chronic illnesses included the family's participation, nurse's competence, efficiency of the home care agency management and patient's participation in patient safety. The barriers to patient safety included problems created by the family, nurse's incompetence, inefficiency of the home care agency, patient's prevention of patient safety, home care setting limitations and health system limitations. CONCLUSION: The majority of the factors involved in the safety of elderly patients with chronic diseases receiving home care had dual roles and could serve as a double-edged sword to guarantee or hinder patient safety. Identification of the facilitators and barriers can assist nurses and the healthcare system in planning and implementing patient safety improvement programmes for elderly patients with chronic illnesses.

Concept analysis of patient safety in home care: a hybrid model.

BACKGROUND: Patient safety in home care is a fundamental and complex concept in nursing. This concept includes a number of challenges in patient care. Studies have shown that there is no clear and uniform definition for this concept. OBJECTIVE: The objective of the present study was to analyse patient safety in home care in Iran. METHODS: The study was done using a hybrid model at three phases, including theoretical, field work and the final analysis. We searched valid databases including MEDLIN and CINHAL; electronic references including Web of Science, Scopus, Ovid, ProQuest, PubMed and Persian databases including Magiran, IranDoc and SID during 2008-2022, using these Persian and English keywords: Patient Safety, Safety, Home Care Service, Domiciliary Care, Home Care and Home Health Care. A total of 16 articles were searched in the theoretical phase and then analysed by content analysis. In field work phase, nine participants were interviewed (nurse, family and patient) and then the interviews were analysed by the content analysis method. In the final analysis phase, a general analysis of the previous two phases was performed and after determining the attributes, antecedents and consequences, a final definition of patient safety in home care in Iran was presented. FINDINGS: Based on different studies, patient safety in home care is a multifaceted concept, which encompasses physical, mental, social and practical dimensions. Evaluation, prevention, participation and commitment to the safety culture are the core features of this concept. The patient care concept depends on the commitment of the involved participants, adequate resources, environmental conditions, support of the involved centres (home care agency, hospital and the insurance), self-efficacy and the ability of the caregivers (nurses). CONCLUSION: Defining the concept of patient safety in home care provides a basis for the development of a safe patient care system at home. This concept analysis for patient safety in home care could be a guide for future studies.

The effects of a Namaste care program on quality of life: A pilot study in Iranian women with late-stage Alzheimer's disease.

The current study aimed to investigate the effects of a Namaste care program on the quality of life of 25 women with late-stage Alzheimer's disease. The program was implemented two hours daily and four days per week for six months in a nursing facility, Tehran, Iran. Women's quality of life was measured using the Persian version of the Quality of Life in Late-Stage Dementia scale before and after the program implementation. After a six-month intervention with the Namaste care program, the total score of quality of life significantly decreased (17.79 ± 1.10 at the end of trial compared with 24.67 ± 1.62 at baseline, P = 0.01), indicating improved quality of life. This effect was obtained after controlling for demographic variables and comorbidities. Hence, it seems that the Namaste care program might be an effective supportive method to improve the quality of life of women with late-stage Alzheimer's disease in Iranian culture. However, further large-sample studies are needed to investigate the generalizability of the findings.