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2.
Stud Health Technol Inform ; 264: 1159-1163, 2019 Aug 21.
Artigo em Inglês | MEDLINE | ID: mdl-31438107

RESUMO

Patient safety is a critical component of health care services; however, it has beent mostly conceptualized for the hospital sector. As home health care expands, it is important to examine the concept of patient safety in the home and identify opportunity for personal health information management (PHIM) tools to support and maximize patient safety. The goal of this study is to explore how PHIM can be a facilitator for patient safety in the home. We explore a comprehensive framework of patient safety in the home and identify the role of PHIM in this context. We analyzed the coded transcripts of in-depth interviews with 88 older adults (60 year and older), 56 family members or informal caregivers and 27 clinicians. Findings demonstrate the physical, emotional, social and functional dimensions of patient safety in the home and concrete ways for informatics tools to maximize safety aspects.


Assuntos
Gestão da Informação em Saúde , Registros de Saúde Pessoal , Serviços de Assistência Domiciliar , Cuidadores , Humanos , Pessoa de Meia-Idade , Segurança do Paciente
3.
Stud Health Technol Inform ; 264: 1688-1689, 2019 Aug 21.
Artigo em Inglês | MEDLINE | ID: mdl-31438294

RESUMO

This paper presents findings from a series of focus groups which is exploring the implications of, and stakeholder requirements for, integrating social media technologies and 'smart home' technologies to connect older adults with their formal support networks (i.e. to healthcare and social service providers) thus enabling them to live independently at home.


Assuntos
Serviços de Assistência Domiciliar , Mídias Sociais , Idoso , Assistência à Saúde , Grupos Focais , Humanos , Tecnologia
4.
Psychiatr Prax ; 46(5): 249-255, 2019 Jul.
Artigo em Alemão | MEDLINE | ID: mdl-31269518

RESUMO

OBJECTIVE: To investigate the clinical effectiveness of "Home Treatment" (HT) together with intensive outpatient treatment (IAB) in comparison to the usual psychiatric inpatient treatment. METHODS: In a retrospective controlled pre-post-study 83 patients receiving HT plus IAB were matched with 83 patients receiving inpatient treatment as usual. Routine data were compared with regard to length of stay and hospital readmission rate in a follow-up period of 6 and 12 months respectively. RESULTS: There was no significant reduction of the length of stay of the first hospital admission. However, there was a significant, notable reduction with regard to length of stay and hospital readmission rate in the intervention group in a follow-up period of 6 and 12 months respectively. CONCLUSION: HT plus intensive outpatient treatment is an effective complement to the usual psychiatric inpatient treatment. It can reduce the risk of hospital readmission and the length of stay for eligible patients.


Assuntos
Serviços de Assistência Domiciliar , Pacientes Ambulatoriais , Berlim , Alemanha , Humanos , Pacientes Internados , Tempo de Internação , Readmissão do Paciente , Estudos Retrospectivos , Resultado do Tratamento
5.
Rev. pesqui. cuid. fundam. (Online) ; 11(4): 944-950, jul.-set. 2019. il
Artigo em Inglês, Português | LILACS, BDENF - Enfermagem | ID: biblio-1005772

RESUMO

Objetivo: Compreender as experiências de cuidadores familiares com sobrecarga e desconforto emocional, ao cuidarem de idosos dependentes no domicílio. Métodos: Pesquisa realizada com o método da grounded theory, da qual participaram nove cuidadores, considerando-se a saturação teórica. Os dados foram coletados em visita domiciliar por entrevista aberta e analisados pelos processos de codificação, aberta, axial e seletiva. Resultados: Substantivamente, obteve-se que o idoso dependente com necessidades de cuidados no domicílio estimulou movimento na família, pelo qual um familiar tornou-se cuidador. Com a vivência desse papel, desenvolveu sobrecarga, desgaste emocional, repercutindo na qualidade de vida, demandando atenção, apoio e capacitação. Produziu saberes e experiências de cuidado ao persistir no desempenho do papel. Conclusões: Cuidadores familiares necessitam de recursos assistenciais do sistema de saúde, suporte emocional e aprendizagem de processos. São necessárias pesquisas sobre planos de cuidados interprofissionais aos cuidadores familiares no âmbito de políticas e serviços de atenção domiciliar


Objective: To understand the experiences of family caregivers in distress with role overload providing care for elderly dependent home care patient. Methods: Research carried out based on grounded theory with the participation of nine caregivers, considering theoretical saturation. Data were collected during home visits with open interview and were analyzed by processes of open axial and selective coding. Results: It was considerably found that the elderly dependent with specific home care needs triggered a shift in the family system when a family member becomes a caregiver. Experiencing this new role, the family caregiver feels overwhelmed and emotional exhaustion, causing impact on quality of life and requiring attention, support and training. Caregiver has produced knowledge and care experiences by persisting in playing such a role. Conclusions: Family caregivers need health care resources coming from health system, emotional support and process learning. Further research is needed on interprofessional care plans for family caregivers in the context of home care policies and services


Objetivo: Comprensión de las experiencias de cuidadores familiares con sobrecarga e incomodidad emocional, por cuidar a mayores dependientes en domicilio. Métodos: Investigación realizada con el método de grounded theory, de dicha investigación participaron nueve cuidadores, se consideró la saturación teórica. Los datos se obtuvo por medio de visitación domiciliaria y entrevistas abiertas, y se los analizó por procesos de codificación abierta, axial y selectiva. Resultados: Sustancialmente, se verificó que los mayores dependientes con necesidades de atención a domicilio provocaron movilización en la família, por los cuales un familiar se quedó su cuidador. A partir de la vivencia en este papel, dicho familiar desarolló sobrecarga, desgaste emocional, repercutiendo en su calidad de vida, demandando atención, apoyo y capacitación. El familiar produzco saberes y experiencias de cuidado al persistir en el desarrollo de su papel. Conclusiones: Cuidadores familiares necesitan de recursos asistenciales del sistema de salud, de soporte emocional y de aprendizaje de procesos. Se necesitan investigaciones sobre planos de cuidados interprofesionales a los cuidadores familiares en el ámbito de políticas y servicios de atención domiciliaria


Assuntos
Humanos , Masculino , Feminino , Idoso , Idoso de 80 Anos ou mais , Idoso Fragilizado , Cuidadores , Estresse Psicológico , Relações Familiares , Serviços de Assistência Domiciliar , Cuidados de Enfermagem
6.
Schmerz ; 33(4): 320-328, 2019 Aug.
Artigo em Alemão | MEDLINE | ID: mdl-31267168

RESUMO

OBJECTIVE: This study examines the perspectives of patients and family caregivers on outpatient palliative care networks. It contrasts primary palliative care (AAPV) and specialized outpatient care (SAPV) services, particularly in regard to pain management. METHODS: The study is based on 27 semi-structured, problem-focussed interviews with 21 patients and 19 informal caregivers. Recruitment was based on purposive sampling in two regions of Brandenburg, Germany. The data were analysed using qualitative content analysis. RESULTS: In AAPV, the general practitioner (GP) is both the central point of contact as well as the coordinator of the care network. In SAPV, the GP plays a less important role. This can lead to conflicts between GPs and health care professionals of the palliative care team. Compared to AAPV, palliative care teams are attributed greater intervention capacities in acute situations as well as expertise in pain therapy. Thus, the option of parenteral administration of opioids is considered a benefit of specialized care. The use of nursing services varies considerably depending on the individual care network-in some cases care is completely taken over by relatives. Relatives are the closest to the patient within the care network and perform key tasks. CONCLUSION: The personal and professional composition of networks of outpatient palliative care varies individually according to care situation and form. Care networks of AAPV and SAPV differ with regard to the accessibility of health care professionals and pain therapy. Home-based palliative care is often made possible by informal care givers in the first place.


Assuntos
Serviços de Assistência Domiciliar , Cuidados Paliativos , Assistência Ambulatorial , Cuidadores/estatística & dados numéricos , Alemanha , Serviços de Assistência Domiciliar/estatística & dados numéricos , Humanos , Entrevistas como Assunto , Cuidados Paliativos/estatística & dados numéricos
7.
Soins Pediatr Pueric ; 40(309): 10-13, 2019.
Artigo em Francês | MEDLINE | ID: mdl-31331594

RESUMO

In-home hospital care provides a good vantage point from which to understand the evolution of paediatric care. It is in fact in line with the main ambitions of paediatrics today, by ensuring that children can remain with their parents in their familiar environment. The model may seem ideal. There are however constraints, such as the risk of confinement for the children and their parents and the difficulty, for the caregivers, of entering a private space which has not been designed for healthcare ergonomics.


Assuntos
Serviços de Assistência Domiciliar/organização & administração , Pediatria/organização & administração , Cuidadores , Criança , Humanos , Pais
8.
Soins ; 64(837): 49-51, 2019.
Artigo em Francês | MEDLINE | ID: mdl-31345311

RESUMO

Health professionals working in patients' homes are confronted with the isolation and vulnerability of the people they support. Prevention is therefore essential. It must integrate innovative solutions to improve users' quality of life and safety in their home.


Assuntos
Serviços de Assistência Domiciliar/organização & administração , Segurança do Paciente , Difusão de Inovações , Humanos , Qualidade de Vida , Isolamento Social , Populações Vulneráveis
10.
Nihon Koshu Eisei Zasshi ; 66(6): 287-294, 2019.
Artigo em Japonês | MEDLINE | ID: mdl-31231098

RESUMO

Objective The aim of this nationwide study was to estimate the duration of formal long-term care, provided by Japanese long-term care insurance (LTCI) services, among frail Japanese elderly people living in the community.Methods The study subjects were 2,188,397 (men: 579,422, women: 1,124,022, age≥65 years) beneficiaries who used LTCI services for community living in June 2013. The duration of LTCI services for community living per diem per capita was estimated by converting the benefit amount to duration of care using the code for service in claims bills according to gender and care levels, which are a nationally certified classification of individual needs for long-term care (care level 1: lowest need, care level 5: highest need). Subsequently, LTCI services for community living were categorized into respite services and community services. Community services were further subcategorized into home visiting services and daycare services.Results The overall average duration of formal care per diem per capita for men and women were 97.4 and 112.7 minutes for care level 1, 118.3 and 149.1 for care level 2, 186.9 and 246.4 for care level 3, 215.2 and 273.2 for care level 4, and 213.1 and 261.4 for care level 5, respectively. Length of respite services increased gradually with care level, whereas duration of community services peaked at care level 3 and decreased at care levels 4 and 5. With regard to the community service subcategories, duration of home visiting services increased with care level, but duration of daycare services peaked at care level 3.Conclusion Although the care levels in the LCTI system are designed to assess the need for formal care in terms of duration of care, our results suggest that the use of formal LTCI services for community living is not vertically equitable. Services that efficiently increase duration of formal care for those with higher needs for care may improve the equity and sustainability of formal long-term care services for community living.


Assuntos
Serviços de Saúde Comunitária/estatística & dados numéricos , Idoso Fragilizado/estatística & dados numéricos , Revisão da Utilização de Seguros/estatística & dados numéricos , Seguro de Assistência de Longo Prazo/economia , Seguro de Assistência de Longo Prazo/estatística & dados numéricos , Assistência de Longa Duração/estatística & dados numéricos , Tempo , Idoso , Idoso de 80 Anos ou mais , Serviços de Saúde Comunitária/economia , Feminino , Serviços de Assistência Domiciliar/economia , Serviços de Assistência Domiciliar/estatística & dados numéricos , Humanos , Revisão da Utilização de Seguros/economia , Japão/epidemiologia , Assistência de Longa Duração/economia , Masculino
11.
Nihon Koshu Eisei Zasshi ; 66(6): 317-326, 2019.
Artigo em Japonês | MEDLINE | ID: mdl-31231101

RESUMO

Objectives The importance of social capital in promoting interprofessional collaborations is well known. This study examined the effects of an interprofessional educational program for homecare professionals on building social capital in terms of homecare in an urban area.Methods The program was conducted at Kita Ward, Tokyo, from July 2014 to January 2015. We used a self-administered questionnaire before and after the program to collect data from homecare professionals in the ward, as well as from those who were interested in providing homecare. Physicians attended a five-day program, while other professionals attended a four-and-a-half-day program. Participants' attitude toward homecare practices was assessed to evaluate their motivation level for the job (i.e., the formation of a practical view of homecare and efficacy to engage in homecare practices). Regarding social capital, we assessed trust and norm of reciprocity for those in the same profession as the respondent (bonding and cognitive social capital) as well as for those in a different profession (bridging and cognitive social capital). Additionally, to professionals other than physicians, we asked about trust and norm of reciprocity regarding physicians (bridging and cognitive social capital) and collaborative conditions with physicians, which included the two sub-domains of cooperation and interaction (bridging and structural social capital). A generalized estimating equation was used to detect the effect size.Results Of the 54 program participants, 52 (including two physicians) completed both the pre- and post-program questionnaires. Participants' practical view of homecare was formed after the program, although their efficacy for homecare practices was unchanged. With regard to social capital, scores for both trust and norm of reciprocity for the same profession (bonding and cognitive social capital) increased, while those for different professions (bridging and cognitive social capital) were unchanged. Scores for both trust and norm of reciprocity regarding physicians and cooperation with physicians (bridging and cognitive social capital, and bridging and structural social capital) also increased. Finally, trust and norm of reciprocity for the participants improved after the program.Conclusion The interprofessional educational program for homecare professionals may foster social capital among the participants. The study results imply that this program can be a possible strategy to foster social capital in the field of homecare.


Assuntos
Currículo , Educação Profissionalizante/métodos , Serviços de Assistência Domiciliar , Visitadores Domiciliares/educação , Colaboração Intersetorial , Capital Social , Serviços Urbanos de Saúde , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Inquéritos e Questionários , Tóquio
12.
Sr Care Pharm ; 34(3): 146, 2019 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-31155022
14.
Sultan Qaboos Univ Med J ; 19(1): e15-e18, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31198590

RESUMO

Objectives: Haematopoietic stem cell transplantation (HSCT) in Oman started in 1994 at Sultan Qaboos University Hospital (SQUH), Muscat, Oman. Previous studies have suggested that longer driving time to the transplant centre (DTC) independently correlates with worse overall survival (OS). Therefore, this study aimed to examine the impact of DTC on OS and acute graft-versus-host disease (aGvHD). Methods: This retrospective study included all patients who underwent HSCT between February 2006 and December 2016 at SQUH. The DTC was determined using Google Maps (Google LLC., Mountain View, California, USA). The probability of OS was estimated using a Kaplan-Meier estimator and the impact of DTC on OS was compared using a Cox model. Results: A total of 170 patients were included in this study of which 52% were male and 28% were from the Al Batinah region. The mean age was 14.2 ± 12.2 years. The mean haemoglobin, platelet and white blood cell counts before the HSCT were 10.3 ± 1.7 g/dL, 207 ± 131 × 109/L and 5.1 ± 5.9 × 109/L, respectively. The median DTC for those with aGvHD was 84 minutes, which is similar to patients without aGvHD (P = 0.918). The hazard ratio for DTC as a predictor of OS was 1.0 (P = 0.901). Conclusion: In this single centre study, DTC did not impact aGvHD or OS in patients post-HSCT. The study was limited by its retrospective design and the small sample size. It is recommended that these results be confirmed in a prospective study.


Assuntos
Transplante de Medula Óssea/métodos , Cuidado Transicional/normas , Resultado do Tratamento , Adolescente , Adulto , Transplante de Medula Óssea/normas , Criança , Pré-Escolar , Feminino , Serviços de Assistência Domiciliar/normas , Humanos , Masculino , Omã , Modelos de Riscos Proporcionais , Estudos Prospectivos , Estudos Retrospectivos , Análise de Sobrevida
15.
BMC Public Health ; 19(1): 766, 2019 Jun 17.
Artigo em Inglês | MEDLINE | ID: mdl-31208383

RESUMO

BACKGROUND: No studies have examined distribution, retention and use of maternal and child health (MCH) home-based records (HBRs) in the poorest women in low income countries. Our primary objective was to compare distribution of the new Afghanistan MCH HBR (the MCH handbook) to the poorest women (quintiles 1-2) with the least poor women (quintiles 3-5). Secondary objectives were to assess distribution, retention and use of the handbook across wealth, education, age and parity strata. METHODS: This was a population based cross sectional study set in Kama and Mirbachakot districts of Afghanistan from August 2017 to April 2018. Women were eligible to be part of the study if they had a child born in the last 6 months. Multivariable logistic regression models were constructed to adjust for clustering by district and potential confounders decided a priori (maternal education, maternal age, parity, age of child, sex of child) and to calculate adjusted odds ratios (aOR), 95% confidence intervals (95% CI) and corresponding p values. Principal components analysis was used to create the wealth quintiles using standard methods. Wealth categories were 'poorest' (quintiles 1,2) and 'least poor' (quintiles 3,4,5). RESULTS: 1728/1943 (88.5%) mothers received a handbook. The poorest women (633, 88.8%) had similar odds of receiving a handbook compared to the least poor (990, 91.7%) (aOR 1.26, 95%CI [0.91-1.77], p value 0.165). Education status (aOR 1.03, 95%CI [0.63-1.68], p value 0.903) and age (aOR 1.39, 95%CI [0.68-2.84], p value 0.369) had little effect. Multiparous women (1371, 91.5%) had a higher odds than primiparous women (252, 85.7%) (aOR 1.83, 95%CI [1.16-2.87], p value 0.009). Use of the handbook by health providers and mothers was similar across quintiles. Ten (0.5%) women reported that they received a book but then lost it. CONCLUSIONS: We were able to achieve almost universal coverage of our new MCH HBR in our study area in Afghanistan. The handbook will be scaled up over the next three years across all of Afghanistan and will include close monitoring and assessment of coverage and use by all families.


Assuntos
Registros de Saúde Pessoal , Serviços de Assistência Domiciliar/estatística & dados numéricos , Serviços de Saúde Materno-Infantil/estatística & dados numéricos , Mães/estatística & dados numéricos , Pobreza , Adolescente , Adulto , Afeganistão , Estudos Transversais , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Gravidez , Adulto Jovem
16.
Adv Gerontol ; 32(1-2): 243-249, 2019.
Artigo em Russo | MEDLINE | ID: mdl-31228397

RESUMO

Due to the introduction of new medical technologies, there is an increase in the number of people, including the elderly and senile age, who have extended their lives, but who need constant care from medical and social services at home. In the study of age differences of biological needs in home care, it was found that for middle-aged people the greatest difficulties and contribution to the reduction of quality of life brought insufficient nutrition, limited independence in the performance of household manipulations due to joint damage, pain and other biological causes, as well as hypothermia syndrome compared with elderly and senile age. For people of older age groups was characterized by the need to bridge the lack of communication; enhancing the role of the family in the implementation of care; increased confidence in caregivers; increased availability of medicines; and increased availability of religious services. Developed on the basis of identified age-based determinants of quality of life, the original model of the bio-psychosocial activating care for the geriatric contingent of patients at home, the difference from traditional approaches is the use of activating kinesitherapy and cognitive exercises, contributes to the achievement of a higher level of functionality and independence of the geriatric patient, which is accompanied by improving the quality of life.


Assuntos
Doença de Alzheimer , Serviços de Assistência Domiciliar , Qualidade de Vida , Idoso , Doença de Alzheimer/reabilitação , Humanos , Pessoa de Meia-Idade , Serviço Social
17.
Gan To Kagaku Ryoho ; 46(Suppl 1): 101-103, 2019 May.
Artigo em Japonês | MEDLINE | ID: mdl-31189827

RESUMO

Patients who receive home visits by pharmacists show a wide range of diseases.The patients are mainly elderly people with chronic diseases, children with some diseases or disabilities, and cancer patients receiving palliative care.Such patients request various pharmaceutical care at home from pharmacies.Pharmacies are essentially medical facilities and they must receive prescriptions from all patients, but depending on each pharmacy, there are few cases of a pharmacy refusing to receive prescriptions.Pharmacies participating in home pharmaceutical care need to establish a system incorporating 1 ) sufficient number of pharmacists, 2 ) pharmacy aseptic unit, 3 ) stockpiling of medical narcotics, and 4 ) stockpiling of medical supplies.However, because individual pharmacies have different situations, such as the intention of the founder, size of the facility, and experience and regionality of pharmacists, it is impossible for all pharmacies to participate in home pharmaceutical care in the same way.An increasing number of home patients with high dependence on medical care is expected in the future.For these patients, pharmacists need high clinical experiences, and at the same time, the burden on pharmacies to stockpile medicines will increase.Therefore, evaluation of pharmacies for home care patients with high dependence on medical care should be considered as an advanced pharmaceutical management function.


Assuntos
Serviços Comunitários de Farmácia , Serviços de Assistência Domiciliar , Farmácias , Farmácia , Humanos , Farmacêuticos
18.
Gan To Kagaku Ryoho ; 46(Suppl 1): 104-106, 2019 May.
Artigo em Japonês | MEDLINE | ID: mdl-31189828

RESUMO

"The Vision for Patient-centered Pharmacies," published by the Ministry of Health, Labour and Welfare(MHLW)in October 2015 specifies three functions of family pharmacies, including home medical care. In 1994, home-visits by pharmacists officially began; however, before then, we had already visited patients whose medications and life situations were of concern, at their homes. Based on that experience, as we were planning to undertake home-visits after their institutionalization, we conducted a study of a system that would promote home care using pharmacists handling various duties, including prescriptions and health consulting. Considering the pharmacists' years of experience and work shifts, efficiency/productivity, and the role of a family pharmacy, we developed a home medical care support system by allocating two pharmacists to each patient's home. Thus, we concluded that if the entire pharmacy would be involved in home-visiting services along with outpatient prescription dispensing services as part of continuous follow-up of patients from hospital visits to home care, the pharmacy would eventually serve as a family pharmacy in the community.


Assuntos
Serviços Comunitários de Farmácia , Serviços de Assistência Domiciliar , Farmácias , Visita Domiciliar , Humanos , Farmacêuticos
19.
Gan To Kagaku Ryoho ; 46(Suppl 1): 107-109, 2019 May.
Artigo em Japonês | MEDLINE | ID: mdl-31189829

RESUMO

At the start of home-visit nutritional guidance by managerial dietician, we investigated nutritional status of patients receiving home care. Subjects included 76 patients receiving home care who started care between May 2018 and July 2018. Among the patients, 85.5%were aged 75 years or older. Serum albumin(Alb)values were used for nutritional assessment. Medium to high risk of malnutrition were found in 35 patients(46%). We want to engage in multi-professional support for those cared persons by giving home-visit nutritional guidance.


Assuntos
Serviços de Assistência Domiciliar , Desnutrição , Idoso , Avaliação Geriátrica , Visita Domiciliar , Humanos , Avaliação Nutricional , Estado Nutricional
20.
Gan To Kagaku Ryoho ; 46(Suppl 1): 110-112, 2019 May.
Artigo em Japonês | MEDLINE | ID: mdl-31189830

RESUMO

A medical plan reflectsthe current state of a region. The purpose of thisres earch isto analyze medical plansby text mining and examine geographical features using a geographic information system. From the medical plans of 47 prefectures, nationwide, 6 regional divisions', and four age groups' text fileswere prepared. Further, wordswere extracted and subsequently, their relevance wasanalyzed. Additionally, we examined the geographical featuresus ing a color-dividing Japanese map by the word appearance rate of"Mitori"(end-of-life care), which is an important task. In the aggregate nationwide text files, 214,716 words were extracted. The top frequent words were medical care, home, support, nursing care, visit, medical treatment, and cooperation. In the co-occurrence network, medical care- home- nursing care- cooperation were connected with organization- construction. There was a link between human resources- training in Kanto and Kinki."Mitori"frequently occurred in areaswith a high aging rate, and there wasa human resources- training- securing connection in areas with a low aging rate. The frequency of"Mitori"was high in western Japan. The results suggested that collaboration between medical care and nursing care is emphasized in medical planning. Further,"Mitori"was emphasized in western Japan or areas with a high aging rate while human resourcesdevelopment wasemphas ized in areaswith a low aging rate.


Assuntos
Sistemas de Informação Geográfica , Serviços de Assistência Domiciliar , Mineração de Dados , Humanos , Japão , Relatório de Pesquisa
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