PO442 8-Year Follow-up of a Health Coaching Intervention Effects on Health and Social Care Service Use, Cost of Care and Clinical Endpoints

Global Heart ◽  
2018 ◽  
Vol 13 (4) ◽  
pp. 469
Author(s):  
I. Hörhammer ◽  
M. Linna ◽  
E. Oksman
BMJ Open ◽  
2019 ◽  
Vol 9 (5) ◽  
pp. e024645 ◽  
Author(s):  
Hanyuying Wang ◽  
Emily Zhao ◽  
Jane Fleming ◽  
Tom Dening ◽  
Kay-Tee Khaw ◽  
...  

ObjectivesThe present study aimed to examine the impact of loneliness on health and social care service use in the oldest old over a 7-year follow-up.DesignProspective study.SettingUK population-based cohort.Participants713 people aged 80 years or older were interviewed at wave 3 of the Cambridge City over-75s Cohort Study. Of these, 665 provided data on loneliness. During 7 years’ follow-up, 480 participants left the study, of which 389 due to death. 162 still in the study answered the loneliness question.Main outcome measureUse of health and social care services, assessed at each wave from wave 3 to wave 5.ResultsAt wave 3, of 665 participants who had data on loneliness, about 60% did not feel lonely, 16% felt slightly lonely and 25% felt lonely. Being slightly lonely at wave 3 was associated with a shorter time since last seeing a general practitioner (β=−0.5, 95% CI: −0.8 to –0.2); when examining the association between time-varying loneliness and health and social care usage, being lonely was associated with three times greater likelihood of having contact with community nurses and using meals on wheels services (community nurse contact: incidence rate ratio (IRR)=3.4, 95% CI: 1.4 to 8.7; meals on wheels service use: IRR=2.5, 95% CI: 1.1 to 5.6). No associations between loneliness and other health and social care services use were found.ConclusionLoneliness was a significant risk factor for certain types of health and social care utilisations, independently of participants’ health conditions, in the oldest old. Study findings have several implications, including the need for awareness-raising and prevention of loneliness to be priorities for public health policy and practice.


2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Sharon J. Davenport

PurposeHealth and social care services should demonstrate the quality of their interventions for commissioners, patients and carers, plus it is a requirement for occupational therapists to measure and record outcomes. Use of the “Therapy Outcome Measure” (TOMs) standardised tool was implemented by an occupational therapy adult social care service to demonstrate outcomes from April 2020, following integration to a community NHS Trust.Design/methodology/approachThe aim was to demonstrate occupational therapy outcomes in adult social care through a local audit of the TOMs. The objective was to determine if clients improved following occupational therapy intervention in the four domains of impairment, activity, participation and wellbeing/carer wellbeing. 70 cases were purposively sampled over a 2-month timeframe, extracting data from the local electronic recording system.FindingsOccupational therapy in adult social care clearly makes an impact with their client group and carers. Evidence from the dataset demonstrates clinically significant change, as 93% of clients seen by adult social care occupational therapy staff showed an improvement in at least one TOMs domain during their whole episode of care. 79% of activity scores, 20% of participation scores and 50% of wellbeing scores improved following intervention. 79% of carer wellbeing scores improved following occupational therapy.Research limitations/implicationsThe audit did not collect data on uptake from the separate teams (equipment, housing, STAR and adult social care work) in occupational therapy adult social care. Potential sampling bias occurred as cases with completed scores only were purposively sampled. Sampling was not random which prevented data gathering on uptake of TOMs across the separate teams. Additionally, the audit results can only be applied to the setting from which the data was collected, so has limited external validity.Originality/valueThese novel findings illustrate the valuable and unique impact of occupational therapy in this adult social care setting. The integration of adult social care into an NHS Community Trust has supported the service to measure outcomes, by utilising the same standardised tool in use by allied health professions across the Trust.


2017 ◽  
Vol 32 (1) ◽  
pp. 36-45 ◽  
Author(s):  
Caroline Shulman ◽  
Briony F Hudson ◽  
Joseph Low ◽  
Nigel Hewett ◽  
Julian Daley ◽  
...  

Background: Being homeless or vulnerably housed is associated with death at a young age, frequently related to medical problems complicated by drug or alcohol dependence. Homeless people experience high symptom burden at the end of life, yet palliative care service use is limited. Aim: To explore the views and experiences of current and formerly homeless people, frontline homelessness staff (from hostels, day centres and outreach teams) and health- and social-care providers, regarding challenges to supporting homeless people with advanced ill health, and to make suggestions for improving care. Design: Thematic analysis of data collected using focus groups and interviews. Participants: Single homeless people ( n = 28), formerly homeless people ( n = 10), health- and social-care providers ( n = 48), hostel staff ( n = 30) and outreach staff ( n = 10). Results: This research documents growing concern that many homeless people are dying in unsupported, unacceptable situations. It highlights the complexities of identifying who is palliative and lack of appropriate places of care for people who are homeless with high support needs, particularly in combination with substance misuse issues. Conclusion: Due to the lack of alternatives, homeless people with advanced ill health often remain in hostels. Conflict between the recovery-focused nature of many services and the realities of health and illness for often young homeless people result in a lack of person-centred care. Greater multidisciplinary working, extended in-reach into hostels from health and social services and training for all professional groups along with more access to appropriate supported accommodation are required to improve care for homeless people with advanced ill health.


BMJ ◽  
2020 ◽  
pp. m1465 ◽  
Author(s):  
Allyson M Pollock ◽  
Luke Clements ◽  
Louisa Harding-Edgar

2016 ◽  
Vol 24 (2) ◽  
Author(s):  
Rowan Jasper ◽  
Mark Wilberforce ◽  
Hilde Verbeek ◽  
David J Challis

Purpose To examine the association between multi-agency working and psychosocial characteristics of work, practitioner time-use and job satisfaction. Design/methodology/approach A comparison of practitioners working in multi-agency (health and social care) and single-agency (social care only) teams, using data from the 2008 evaluation of Individual Budgets pilots in England. Participants worked in care manager roles supporting adult social care service users, and comprised social workers and a smaller number of health professionals. Data was collected using a self-completed questionnaire. Findings Data were returned from 249 respondents (a 29 per cent response rate), with two-thirds working in single-agency teams. No significant differences were found between team type and job satisfaction. Respondents in multi-agency teams reported greater decision autonomy but poorer supervisory support than those in single-agency teams. The latter finding was robust to further exploration using regression to control for confounding factors. Research limitations/implications These data were not specifically collected for the study and response rates were relatively low due to organisational upheaval at the time of data collection, which may affect interpretation. Practical implications Government policy is dedicated to extending integrated forms of working, including multi-agency teamwork. This research suggests that such structures need careful planning for them to work effectively, with particular attention to supervision arrangements. Originality/value This research gives a systematic and objective exploration of the relationship between job characteristics, time-use and satisfaction of practitioners in single as compared to multi-agency teams.


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