Palliative sedation for cancer patients included in a home care program: A retrospective study

2014 ◽  
Vol 13 (3) ◽  
pp. 619-624 ◽  
Author(s):  
Claudio Calvo-Espinos ◽  
Estefania Ruiz de Gaona ◽  
Cristina Gonzalez ◽  
Lucia Ruiz de Galarreta ◽  
Cristina Lopez
Keyword(s):  
Home Care ◽  
Lung Tumor ◽  
Family Members ◽  
Care Program ◽  
Tumor Location ◽  
Palliative Sedation ◽  
Cross Sectional ◽  
Home Setting ◽  
Diagnosis And Prognosis ◽  
At Home

AbstractObjective:Palliative sedation is a common treatment in palliative care. The home is a difficult environment for research, and there are few studies about sedation at home. Our aim was to analyze this practice in a home setting.Method:We conducted a retrospective cross-sectional descriptive study in a home cohort during 2011. The inclusion criteria were as follows: 18 years or older and enrolled in the Palliative Home Care Program (PHCP) with advanced cancer. The variables employed were: sex, age, primary tumor location, and place of death. We also registered indication, type, drug and dose, awareness of diagnosis and prognosis, consent, survival, presence or absence of rales, painful mouth, and ulcers in patients sedated at home. We also collected the opinions of family members and professionals about the suffering of sedated patients.Results:A total of 446 patients (56% at home) of the 617 admitted to the PHCP between January and December of 2011 passed away. The typical patient in our population was a 70-year-old man with a lung tumor. Some 35 (14%) home patients required sedation, compared to 93 (49%) at the hospital. The most frequent indication was delirium (70%), with midazolam the most common drug (mean dose, 40 mg). Survival was around three days. Rales were frequent (57%) as well as awareness of diagnosis and prognosis (77 and 71%, respectively). Perception of suffering after sedation was rare among relatives (17%) and professionals (8%). In most cases, the decision was made jointly by professionals and family members.Significance of Results:Our study confirmed the role of palliative sedation as an appropriate therapeutic tool in the home environment.

The Herth Hope Index—A Psychometric Study Among Cognitively Intact Nursing Home Patients

2013 ◽  
Vol 21 (3) ◽  
pp. 378-400 ◽  
Author(s):  
Gørill Haugan ◽  
Britt Karin Støen Utvær ◽  
Unni Karin Moksnes
Keyword(s):  
Factor Analysis ◽  
Nursing Home ◽  
Home Care ◽  
Well Being ◽  
Nursing Home Care ◽  
Cross Sectional ◽  
Home Setting ◽  
Nursing Home Patients ◽  
Herth Hope Index ◽  
Cognitively Intact

Background and Purpose: Hope is seen as the act by which the temptation of despair is actively overcome and has thus been interpreted as an inner strength and an available resource for living in the present. An understanding of hope and its meaning in the lives of institutionalized older adults may aid in developing interventions to enhance hope and well-being in the nursing home setting. This study aimed to investigate the psychometric properties of the Norwegian version of the Herth Hope Index among cognitively intact nursing home patients. Methods: Cross-sectional data was obtained in 2008 and 2009 from 202 of 250 patients who met the inclusion criteria in 44 different nursing homes. Results: Exploratory factor analysis revealed 3 internal consistent dimensions of hope, explaining 51.2% of the variance. The 1-factor, 2-factor, and the originally 3-factor solutions of the Herth Hope Index were tested by means of confirmatory factor analysis. A 2-factor construct comprising 11 items came out with the best model fit. Conclusions: The Herth Hope Index was found to be a reliable and valid instrument for assessing hope in nursing home patients. The 2-factor structure was psychometrically superior the original 3-factor construct of hope in this particular sample. The Herth Hope Index might be used to assess hope and changes in the hope process during long-term nursing home care. An enhanced understanding of hope in this population might contribute to increased quality of nursing home care.

scholarly journals Connected care for endocarditis and heart failure patients: a hospital-at-home programme

2021 ◽  
Author(s):  
J. van Ramshorst ◽  
M. Duffels ◽  
S. P. M de Boer ◽  
A. Bos-Schaap ◽  
O. Drexhage ◽  
...  
Keyword(s):  
Heart Failure ◽  
Home Care ◽  
Nurse Practitioners ◽  
Care Group ◽  
Proof Of Concept ◽  
Home Setting ◽  
Curative Care ◽  
Care At Home ◽  
Hospital At Home ◽  
At Home

Abstract Background Healthcare expenditure in the Netherlands is increasing at such a rate that currently 1 in 7 employees are working in healthcare/curative care. Future increases in healthcare spending will be restricted, given that 10% of the country’s gross domestic product is spent on healthcare and the fact that there is a workforce shortage. Dutch healthcare consists of a curative sector (mostly hospitals) and nursing care at home. The two entities have separate national budgets (€25 bn + €20 bn respectively) Aim In a proof of concept, we explored a new hospital-at-home model combining hospital cure and nursing home care budgets. This study tests the feasibility of (1) providing hospital care at home, (2) combining financial budgets, (3) increasing workforces by combining teams and (4) improving perspectives and increasing patient and staff satisfaction. Results We tested the feasibility of combining the budgets of a teaching hospital and home care group for cardiology. The budgets were sufficient to hire three nurse practitioners who were trained to work together with 12 home care cardiovascular nurses to provide care in a hospital-at-home setting, including intravenous treatment. Subsequently, the hospital-at-home programme for endocarditis and heart failure treatment was developed and a virtual ward was built within the e‑patient record. Conclusion The current model demonstrates a proof of concept for a hospital-at-home programme providing hospital-level curative care at home by merging hospital and home care nursing staff and budgets. From the clinical perspective, ambulatory intravenous antibiotic and diuretic treatment at home was effective in safely achieving a reduced length of stay of 847 days in endocarditis patients and 201 days in heart-failure-at-home patients. We call for further studies to facilitate combined home care and hospital cure budgets in cardiology to confirm this concept.

scholarly journals Hubungan Kebiasaan Merokok di dalam Rumah dengan Kejadian Pneumonia pada Anak Usia 1-4 Tahun

2020 ◽  
Vol 7 (2) ◽  
pp. 108
Author(s):  
Nuniek Tri Wahyuni ◽  
Heni Fa'riatul Aeni ◽  
Muhammad Azizudin
Keyword(s):  
Statistical Tests ◽  
Smoking Habit ◽  
Family Members ◽  
Severe Pneumonia ◽  
Smoking Habits ◽  
P Value ◽  
Chi Square ◽  
Cross Sectional ◽  
Presence Of People ◽  
At Home

ABSTRAK Pneumonia merupakan penyebab dari 15% kematian pada balita. Keberadaan anggota keluarga yang merokok di dalam rumah merupakan salah satu faktor penyebab terjadinya masalah kesehatan pada sistem pernafasan khususnya Pneumonia pada anak. Tujuan penelitian ini adalah untuk mengetahui hubungan kebiasaan merokok di dalam rumah dengan kejadian Pneumonia pada anak usia 1-4 tahun. Jenis penelitian ini adalah penelitian analitik dengan pendekatan cross sectional. Populasi penelitian ini adalah anggota keluarga yang memiliki anak usia 1-4 tahun yang terkena Pneumonia sebanyak 110 dengan jumlah sampel 86 responden menggunakan accidental sampling. Pengumpulan data diperoleh dengan menggunakan kuesioner dan dianalisis secara statistik menggunakan uji Chi Square. Berdasarkan hasil uji statistik dari 86 responden yang memiliki keberadaan orang yang merokok di dalam rumah sebanyak 52 orang (60,47%) sedangkan keberadaan orang yang tidak merokok di dalam rumah sebanyak 34 (39,53%).  Responden dengan kategori mengalami Pneumonia sebanyak 75 orang (87,21%), yang mengalami Pneumonia berat sebanyak 7 orang  (8,14%) dan yang mengalami Pneumonia sangat berat sebanyak 4 orang (4,63 %) dengan  P value = 0,016 (< 0,05). Terdapat hubungan kebiasaan merokok  dengan kejadian Pneumonia pada anak usia 1-4 tahun.    Kata kunci  : kebiasaan merokok; pneumonia; anak  CORRELATION BETWEEN SMOKING HABITS AT HOME AND THE INCIDENT OF PNEUMONIA AMONG CHILDREN AGED 1-4 YEARS  ABSTRACT Pneumonia is the cause of 15% of deaths in children under five. The presence of family members who smoke in the house is one of the causal factors of health problems in the respiratory system, especially pneumonia among children. This study was aimed to determine the correlation between smoking habits at home and the incidence of pneumonia among children aged 1-4 years. This was an analytic study with cross sectional approach. The population of this study were family members who had children aged 1-4 years with pneumonia as many as 110 people. The number of samples was taken through the Slovin sample size formula totally 86 respondents and the determination of the samples used Accidental Sampling. Data were collected using a questionnaire and analyzed statistically using the Chis Square test. Based on the results of statistical tests, it was revealed that of 86 respondents, 52 people (60.47%) had the presence of people who smoked in the house while 34 (39.53%) did not have had the presence of people who smoked in the house.  75 respondents (87.21%) had pneumonia, 7 people experienced severe pneumonia (8.14%) and 4 people experienced very severe pneumonia (4.63%). Chi Square test results obtained a P value=0.016 (<0.05), which meant that there is a relationship between smoking habit at home and the incidence of pneumonia among children aged 1-4 years. Keywords: Smoking habit; pneumonia; children

scholarly journals . Sobrecarga do cuidador de pacientes atendidos na atenção domiciliar

2020 ◽  
Vol 14 ◽  
Author(s):  
Monique Évellin Alves Cruz ◽  
Daniel Vinícius Alves Silva ◽  
Júlia Rocha do Carmo ◽  
Gabriel Dias de Araújo ◽  
Luiza Rodrigues Camisasca ◽  
...  
Keyword(s):  
Home Care ◽  
Statistical Significance ◽  
Care Program ◽  
Home Care Services ◽  
Cross Sectional Study ◽  
Common Finding ◽  
Bivariate Analysis ◽  
Daily Routine ◽  
Cross Sectional ◽  
Zarit Burden Interview

Objetivo: avaliar a sobrecarga de cuidadores de pacientes atendidos por um programa de atenção domiciliar público. Método: trata-se de um estudo quantitativo, descritivo, transversal, com 127 cuidadores de pacientes atendidos pelo Programa Melhor em Casa. Coletaram-se dados sociodemográficos e clínicos e aplicaram-se também a Escala Zarit Burden Interview reduzida e a Escala de Desesperança de Beck. Realizou-se análise descritiva e bivariada de dados. Resultados: verificou-se que, dos 127 cuidadores, a maioria era do sexo feminino (114=89,8%), de cor parda (81=63,8%); composta por solteiros (56=44,1%) e a média de idade foi de 46,66 anos. Destaca-se que 38,6% (49) apresentaram sobrecarga de moderada a grave, 78,7% (110) afirmaram que houve mudanças em sua rotina diária, 59,8% (76) dizem ter sofrido alguma mudança no estado emocional após iniciar o cuidado do paciente e 56,7% (72) sentem dores no corpo. Confirmaram-se, na análise bivariada, 15 variáveis independentes que obtiveram significância estatística. Conclusão: conclui-se que a sobrecarga do cuidador de pacientes da atenção domiciliar é um achado comum e cuidados para a sua prevenção devem ser estabelecidos. Descritores: Cuidadores; Esgotamento Psicológico; Serviços de Assistência Domiciliar; Assistência Domiciliar; Pacientes Domiciliares; Enfermagem.AbstractObjective: to assess the burden of caregivers of patients treated by a public home care program. Method: this is a quantitative, descriptive, cross-sectional study, with 127 caregivers of patients treated by the Melhor em Casa Program. Sociodemographic and clinical data were collected, and the reduced Zarit Burden Interview Scale and the Beck Hopelessness Scale were also applied. Descriptive and bivariate data analyses were performed. Results: of the 127 caregivers, the majority was female (114=89.8%), pardos (81=63.8%); composed of unmarried (56=44.1%) and the mean age was 46.66 years. Importantly, 38.6% (49) had moderate to severe burden, 78.7% (110) stated the occurrence of changes in their daily routine, 59.8% (76) mentioned having suffered some change in emotional state after starting the care with the patients and 56.7% (72) have body ache. The bivariate analysis confirmed the statistical significance of 15 independent variables. Conclusion: the burden of caregivers of homebound patients is a common finding, requiring care actions for its prevention. Descriptors: Caregivers; Burnout, Psychological; Home Care Services; Home Nursing; Homebound Persons; Nursing. ResumenObjetivo: evaluar la sobrecarga de los cuidadores de pacientes tratados mediante un programa de atención domiciliaria público. Método: se trata de un estudio cuantitativo, descriptivo, transversal, con 127 cuidadores de pacientes tratados por el Programa Melhor em Casa. Recogieron datos sociodemográficos y clínicos y se aplicaron la escala Zarit Burden Interview reducida y la Escala de Desesperanza de Beck. Se realizó el análisis descriptivo y bivariado de los datos. Resultados: se constató que, de 127 cuidadores, la mayoría eran mujeres (114=89,8%), pardos (81=63,8%); compuesto de solteros (56=44,1%) y el promedio de edad fue de 46.66 años. Cabe destacar que el 38,6% (49) presentó sobrecarga moderada a severa, el 78,7% (110) declaró que ha habido cambios en su rutina diaria, el 59,8% (76) afirmó tener sufrido algún cambio en el estado emocional después de iniciar los cuidados del paciente, y el 56,7% (72) siente dolor en el cuerpo. Se confirman, en el análisis bivariado, 15 variables independientes que tuvieron significación estadística. Conclusión: se concluye que la sobrecarga de los cuidadores de pacientes en atención domiciliaria es un hallazgo común y cuidados en su prevención deben ser establecidos. Descriptores: Cuidadores; Agotamiento Psicológico; Servicios de Atención de Salud a Domicilio; Atención Domiciliaria de Salud; Personas Imposibilitadas; Enfermería.

scholarly journals Physical restraint in elderly in home care: a cross-sectional study

2021 ◽  
Vol 42 ◽  
Author(s):  
Cristiane da Silva Gabriel Capeletto ◽  
Rosimere Ferreira Santana ◽  
Lívia Maria da Silva Souza ◽  
Keila Mara Cassiano ◽  
Ana Carolina Siqueira de Carvalho ◽  
...  
Keyword(s):  
Home Care ◽  
Physical Restraint ◽  
Care Program ◽  
The Elderly ◽  
Structured Interview ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Mechanical Restraint ◽  
Care Practices

ABSTRACT Objective To estimate the prevalence of mechanical restraint and factors associated with its practice in elderly in Home Care. Methods This was a cross-sectional study with 162 elderly randomly assigned to a home care program in Rio de Janeiro, from March 2018 to July 2018. Used as a technique for data collection and direct observation and structured interview of elderly clinical data. Data were analyzed descriptively and inferentially. Results There was a 13% prevalence of mechanical restraint in elderly in home care. The most frequent restraints were the use of bandage, tissues and sheets in the arms/legs and chests of the elderly, and the justification for their use were control of aggressive behavior (28.6%), prevention of falls (19%) and protection (19%). Of the total elderly participants, 42.9% remained contained for more than 24 hours, and in 85.7% of the cases, the individuals were confined to a room. Conclusion It is necessary to expand the training of formal and informal caregivers, recommending the rehabilitation of care practices that preserve the elderly's autonomy, giving them dignity, respecting gerontological and home care principles.

A Specialized Home Care Team Does Make a Difference

1992 ◽  
Vol 5 (3) ◽  
pp. 38-41
Author(s):  
Dorothy Larson ◽  
Ralph Odegard ◽  
N.E. Brown
Keyword(s):  
Health Care ◽  
Home Care ◽  
Health Care System ◽  
Care Program ◽  
Care Team ◽  
Research Facility ◽  
Teaching And Research ◽  
The Cost ◽  
Care System ◽  
At Home

Results of a study done in a large teaching and research facility in Alberta reveal that a specialized home care team can substantially lower the cost of caring for people who are ventilator dependent. With the assistance of a pulmonary physician, the Respiratory Home Care program has shown excellent results. Patients report that they “feel as safe at home as in the hospital”, and the savings to the health care system are estimated to be about $2,000,000 per year.

Considerations in the Treatment of Acquired Immunodeficiency Syndrome Patients at Home

1990 ◽  
Vol 3 (1) ◽  
pp. 60-65
Author(s):  
Sandra A. Matsumoto ◽  
Mary Frances Seideman
Keyword(s):  
Home Care ◽  
Acquired Immunodeficiency Syndrome ◽  
Health Care Professionals ◽  
Opportunistic Infections ◽  
Treatment Options ◽  
Home Setting ◽  
Extended Care ◽  
Acquired Immunodeficiency ◽  
Immunodeficiency Syndrome ◽  
At Home

The rapidly growing acquired immunodeficiency syndrome (AIDS) population faces frequent, expensive hospitalization due to the debilitating sequelae of the disease. Home care offers these patients an opportunity to receive or complete their therapy in comfortable surroundings, allowing them to realize the psychosocial and financial benefits of outpatient care. A myriad of sophisticated drug therapies has been successfully administered in the home setting. Therapy for frequently occurring opportunistic infections often requires treatment with highly toxic drugs such as amphotericin, pentamidine, and ganciclovir. With thorough patient training and diligent monitoring by the home-care pharmacist and nurse, these agents can be safely administered at home. Conventional and investigational chemotherapy and immunomodulator therapy, such as interferon or erythropoeitin, can also be administered at home. Providing total parenteral nutrition to AIDS patients is a controversial treatment modality, but if indicated, it can also be accomplished at home. Outpatient pain management has allowed many patients with terminal or chronic illnesses to minimize time spent in hospitals or extended care facilities, and it can offer the same advantages to patients with AIDS. The psychosocial ramifications of AIDS and its impact on patients and health care professionals must be understood in order to effectively provide total patient care at home. The challenge to the homecare pharmacist is to acquire and maintain a comprehensive knowledge of the treatment options currently available for the management of AIDS.

scholarly journals ICNP® nursing diagnostics for people in-home care

2021 ◽  
Vol 74 (1) ◽  
Author(s):  
Ingryd Nathany Mendes Sousa ◽  
Daniel Vinícius Alves Silva ◽  
Júlia Rocha do Carmo ◽  
Joanilva Ribeiro Lopes ◽  
Nuno Damácio de Carvalho Félix ◽  
...  
Keyword(s):  
Home Care ◽  
Home Health Care ◽  
Care Program ◽  
Cross Sectional Study ◽  
Clinical Findings ◽  
Cross Sectional ◽  
Human Needs ◽  
Practice Teaching ◽  
Body Care ◽  
Nursing Diagnoses

ABSTRACT Objectives: to identify ICNP® nursing diagnoses in people attended in a home care program. Methods: cross-sectional study with 131 patients of Home Health Care in a northern municipality of Minas Gerais, Brazil, applied a questionnaire based on Basic Human Needs. It was performed the identification and validation by consensus of specialists with support in Risner's diagnostic reasoning, of the nursing diagnoses of ICNP®, version 2019. Results: from 77 nursing diagnoses, most are inserted in the psychobiological needs (n = 66) and refer to the domains Nutrition; Hydration and electrolytic regulation; Cutaneous-mucous integrity; Locomotion, body mechanics and mobility; Body care; and Learning, Sociability, Recreation, and leisure. From total, forty are negative, followed by positive formulations (n = 15), clinical findings (n = 15) and risk (n = 7). Conclusions: a profile of the nursing phenomena common to home care is presented, which can be used by nurses in clinical practice, teaching, research, and management.

scholarly journals Cuidado ao familiar após acidente vascular encefálico

2018 ◽  
Vol 12 (3) ◽  
pp. 599
Author(s):  
Fernanda Misawa ◽  
Rafaely De Cássia Nogueira Sanches ◽  
Anderson Da Silva Rêgo ◽  
Cremilde Aparecida Trindade Radovanovic
Keyword(s):  
Home Care ◽  
Family Members ◽  
Care Practice ◽  
Care Experience ◽  
Home Care Nursing ◽  
The Family ◽  
Qualitative Descriptive ◽  
Study Participants ◽  
Care Nursing ◽  
At Home

RESUMOObjetivo: compreender a vivência dos familiares no cuidado domiciliar após a alta hospitalar de um familiar acometido por Acidente Vascular Encefálico. Método: estudo qualitativo, descritivo, do tipo convergente assistencial, com quatro famílias. O cenário do estudo foi o domicílio, com média de 16 visitas por família, uma vez por semana ou quando houvesse necessidade de assistência. Para a análise dos dados, utilizou-se a técnica de Análise de Conteúdo, na modalidade Análise Temática. Resultados: evidenciou-se que a experiência de cuidar no domicílio levou os membros da família a lidarem com sentimentos como o medo, a tristeza, a angústia e a fragilidade e os membros adoecidos relataram ansiedade, desânimo, frustração e revolta por estarem adoecidos. Conclusão: o estudo permitiu a compreensão da experiência de cuidar no domicílio e a vivência das famílias de familiar acometido por Acidente Vascular Encefálico oportunizando que a prática assistencial e a pesquisa ocorressem ao mesmo tempo e, assim, proporcionou a oportunidade de interação e criação de vínculo com os participantes do estudo e a compreensão da experiência e a repercussão do cuidado no domicílio entre os familiares. Descritores: Acidente Vascular Encefálico; Família; Assistência Domiciliar; Cuidados De Enfermagem; Enfermagem; Doenças Crônicas.ABSTRACT Objective: to understand the experience of family members in home care after hospital discharge from a family member affected by stroke. Method: qualitative, descriptive, convergent type study with four families. The study scenario was the household, with an average of 16 visits per family, once a week or when there was a need for assistance. For the analysis of the data, the technique of Content Analysis was used in the Thematic Analysis modality. Results: It was evidenced that the experience of caring at home led family members to deal with feelings such as fear, sadness, anguish and frailty, and the sick members reported anxiety, discouragement, frustration and revolt at being sick. Conclusion: the study allowed the understanding of the home care experience and the family life of the family members affected by stroke, allowing care practice and research to occur at the same time and, thus, provided the opportunity for interaction and bonding with study participants and the understanding of the experience and the repercussion of care at home among the family members. Descritores: Cerebrovascular Accident; Family; Home Care; Nursing Care; Nursing; Chronic Disease.RESUMEN Objetivo: comprender la vivencia de los familiares en el cuidado domiciliar después del alta hospitalaria de un familiar acometido por Accidente Vascular Encefálico. Método: estudio cualitativo, descriptivo, del tipo convergente asistencial, con cuatro familias. El escenario del estudio fue el domicilio, con promedio de 16 visitas por familia, una vez por semana o cuando hubiera necesidad de asistencia. Para el análisis de los datos, se utilizó la técnica de Análisis de Contenido, en la modalidad Análisis Temático. Resultados: se evidenció que la experiencia de cuidar en el domicilio llevó a los miembros de la familia a lidiar con sentimientos como el miedo, la tristeza, la angustia y la fragilidad y los miembros enfermos relataron ansiedad, desánimo, frustración y revuelta por estar enfermos. Conclusión: el estudio permitió la comprensión de la experiencia de cuidar en el domicilio y la vivencia de las familias de familiar acometido por Accidente Vascular Encefálico, posibilitando que la práctica asistencial y la investigación ocurrieran al mismo tiempo, y así, proporcionó la oportunidad de interacción y creación de vínculo con los participantes del estudio y la comprensión de la experiencia y la repercusión del cuidado en el domicilio entre los familiares. Descritores: Accidente Vascular Encefálico; Familia; Asistencia Domiciliar; Atención de Enfermería; Enfermería; Enfermedad Crónica.

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