scholarly journals Postacute-Stroke Management Problems in Home Care Service: A Qualitative Single-Centered Study in Yogyakarta, Indonesia

2022 ◽  
Author(s):  
Paryono Paryono ◽  
Mawaddah Ar Rochmah ◽  
Ismail Setyopranoto ◽  
Laksono Trisnantoro
Keyword(s):  
Health Care ◽  
Human Resources ◽  
Home Care ◽  
Care Service ◽  
Health Care Service ◽  
Structured Interview ◽  
Home Care Service ◽  
Hospital Personnel ◽  
Stroke Management ◽  
Management Problems

Abstract Objective This study explores the postacute-stroke management problems, particularly for patients with total dependency (Barthel Index <20), in home care service of Dr. Sardjito Hospital (SH) from the hospital personnel's and caregiver's points of view. Materials and Methods In-depth interviews with a semi-structured interview guide were conducted with hospital personnel and patients' caregivers based on the purposeful sampling. There were 10 hospital personnel that were interviewed: the director of medical service, head of home care unit, neurologists, general practitioners, nurses, and physiotherapist. There were eight caregivers who participated in the study. Statistical Analysis Data from the interviews were analyzed using systematic text condensation using Nvivo 12 plus. Results Our findings showed that all health personnel in SH agreed that home care service is a part of an integrated health care service for continuation of care. However, the preparedness by the hospital management is still lacking in infrastructures, such as standardized operational procedure, quality control, and financial system, as well as in terms of competent human resources and their welfare. In addition, the patient's family and caregiver are lacking in knowledge and independency to take care of the patients with the need of home care services' monitoring to deliver the expected home care for postacute-stroke's patient regularly. Conclusion Home care service is an act of implementing hospital obligation to fulfill the patients' rights. An established hospital policy to ensure a comprehensive home care service delivery is necessary. The capability and welfare of the health care personnel should be put into account for the standardized human resources.

scholarly journals Practices used by a home care team: implications for caregivers

2021 ◽  
Vol 74 (2) ◽  
Author(s):  
Yara Cardoso Silva ◽  
Kênia Lara Silva ◽  
Isabela Silva Câncio Velloso
Keyword(s):  
Health Care ◽  
Discourse Analysis ◽  
Qualitative Study ◽  
Home Care ◽  
Home Health Care ◽  
Care Service ◽  
Health Care Service ◽  
Home Health ◽  
Care Team ◽  
Power Relationship

ABSTRACT Objectives: to analyze the practices of a home care team and their implications for caregivers’ performance. Methods: qualitative study with data obtained from observation of 21 users, 30 caregivers and 6 professionals from the home health care service in a municipality in Minas Gerais, from February to June 2018. The material was analyzed from the perspective of discourse analysis according to Michel Foucault. Results: team interference upon caregivers is exercised by disciplinary practices and prescriptive, authoritative and surveilling behaviors. The team’s knowledge-power relationship determines caregivers’ acceptance through convincing or through difficulty of understanding assigned orientations. Educational practices would enable caregivers to be constituted as active, participative, empowered and reflective subjects. Final Considerations: team practices interfere with caregivers’ ways of acting and being and they have implications in objectification and subjectification processes.

scholarly journals “There Is a Lot of Community Spirit Going On.” Middle Managers' Stories of Innovation in Home Care Services

2019 ◽  
Vol 5 ◽  
pp. 237796081984436
Author(s):  
Rita Sørly ◽  
Martin Sollund Krane ◽  
Geir Bye ◽  
May-Britt Ellingsen
Keyword(s):  
Health Care ◽  
Home Care ◽  
New Public Management ◽  
Middle Managers ◽  
Care Service ◽  
Research Question ◽  
Home Care Services ◽  
Home Care Service ◽  
Policy Changes ◽  
Care Services

Background: There is a need for qualitative studies on imposed innovation in home care services in welfare societies. The municipalities are key actors in the field of innovation in the public sector. As innovations often are interpreted to be in conflict with values in health care, we need knowledge on how policy changes and imposed innovations are understood and handled by middle managers working in the sector. Aim: We aim to explore how middle managers react to imposed innovation in health services through their storytelling. The research question was “What can middle managers' stories of imposed innovation tell us about their role in, and some important prerequisites for, innovation processes in municipal health-care services?” Methods: A narrative study of experiences with municipal innovation among middle managers in Norway. In this article, we do a thematic analysis of interviews with seven female middle managers who work in a home care service department. Findings: The study develops an understanding of which frameworks are required within a home care service to meet constant demands for innovation. Innovations are understood by the managers as results of policy changes and new public management demands and as a troublesome burden. We find the prerequisites for implementing innovations to be (1) trust-based management, (2) flexibility and dynamics, (3) continuity of care, and (4) emphasis on competence. These prerequisites are further interpreted in relation to dominant discourses on innovation at the macro, meso, and micro levels within the storytelling contexts. Conclusion: Imposed innovations require a negotiating practice in cross-disciplinary environments at all levels in the organization.

Dying of amyotrophic lateral sclerosis

Neurology ◽  
2019 ◽  
Vol 93 (23) ◽  
pp. e2083-e2093 ◽  
Author(s):  
Jocelyn Zwicker ◽  
Danial Qureshi ◽  
Robert Talarico ◽  
Pierre Bourque ◽  
Mary Scott ◽  
...  
Keyword(s):  
Health Care ◽  
Amyotrophic Lateral Sclerosis ◽  
Home Care ◽  
Home Visit ◽  
Care Service ◽  
Health Care Service ◽  
Large Population ◽  
Population Based ◽  
Cost Of Care ◽  
Lateral Sclerosis

ObjectiveTo describe health care service utilization and cost for decedents with and without amyotrophic lateral sclerosis (ALS) in the last year of life.MethodsUsing linked health administrative data, we conducted a retrospective, population-based cohort study of Ontario, Canada, decedents from 2013 to 2015. We examined demographic data, rate of utilization, and cost of health care services in the last year of life.ResultsWe identified 283,096 decedents in Ontario, of whom 1,212 (0.42%) had ALS. Decedents with ALS spent 3 times as many days in an intensive care unit (ICU) (mean 6.3 vs 2.1, p < 0.001), and twice as many days using complex continuing care (mean 12.7 vs 6.0, p < 0.001) and home care (mean 99.1 vs 41.3, p < 0.001). A greater percentage of decedents with ALS received palliative home care (44% vs 20%, p < 0.001) and palliative physician home visits (40% vs 18%, p < 0.001) than decedents without ALS. Among decedents with ALS, a palliative physician home visit in the last year of life was associated with reduced adjusted odds of dying in hospital (odds ratio 0.65, 95% confidence interval 0.48–0.89) and fewer days spent in the ICU. Mean cost of care in the last year of life was greater for those with ALS ($68,311.98 vs $55,773.48, p < 0.001).ConclusionsIn this large population-based cohort of decedents, individuals with ALS spent more days in the ICU, received more community-based services, and incurred higher costs of care in the last year of life. A palliative care physician home visit was associated with improved end of life outcomes; however, the majority of patients with ALS did not access such services.

scholarly journals Stroke and Telerehabilitation: A Brief Communication (Preprint)

2020 ◽  
Author(s):  
Ayisha Bashir
Keyword(s):  
Health Care ◽  
Home Care ◽  
Disease Transmission ◽  
Care Service ◽  
Quality Care ◽  
Health Care Service ◽  
Daily Monitoring ◽  
Care Services ◽  
Severely Handicapped

UNSTRUCTURED This rapid communication highlights stroke telerehabilitation, a health care service that provides daily monitoring of the care of patients recovering from stroke, delivering convenient and immediate feedback for patients, family, and caregivers. The delivery, management, and coordination of nursing care services, provided via telecommunications technology, is a convenient method of delivering health care to patients recovering from stroke. It is important to assess the service quality of the telehealth process and to establish the role of telehealth nursing and related technologies in the care of patients recovering from stroke. Studies show that even though both health professionals and participants have reported high levels of satisfaction and acceptance of telerehabilitation interventions, the quality of the evidence on telerehabilitation in poststroke care remains low. Conducting a quality study of telehealth rehabilitation for patients recovering from stroke will help assess if home health agencies with telehealth capabilities caring for patients recovering from stroke and patients with chronic diseases can provide quality care to patients in their home and fill this health care gap. Patients that are severely handicapped and impaired and unable to reside in their home environment are not included in telerehabilitation services provided by the home care agency. It would be informative to study the benefits of telerehabilitation and the care provided to patients recovering from stroke within nursing homes, given the need for social distancing to reduce disease transmission during the current coronavirus disease (COVID-19) global health pandemic. Using telerehabilitation would mean that patients have a lower risk of exposure to infectious agents. Further research into telehealth interventions and stroke management in home care is crucial.

scholarly journals Effect of Integrated Supportive Supervision on the Quality of Health-Care Service Delivery in Katsina State, Northwest Nigeria

2019 ◽  
Vol 6 ◽  
pp. 233339281987861 ◽  
Author(s):  
Shafique Sani Nass ◽  
Murtala Bindawa Isah ◽  
Aminu Sani
Keyword(s):  
Health Care ◽  
Human Resources ◽  
Human Resources For Health ◽  
Care Service ◽  
Health Care Service ◽  
Supportive Supervision ◽  
Number Of Children ◽  
Primary Health ◽  
Post Hoc

Background: Katsina State Government in Northern Nigeria introduced integrated supportive supervision (ISS) in primary health centers. The study was guided by the Primary Health Care Performance Initiative Conceptual Framework. The goal of the study was to measure the impact of ISS on the quality of primary health-care delivery. The outcome variables measured include infrastructure, basic equipment, human resources for health, essential drugs, the number of pregnant women screened for HIV, and the number of children receiving immunization. Methods: The study was a cross-sectional survey of 34 health facilities. Kruskal-Wallis nonparametric test followed by Dunn post hoc test and analysis of variance followed by Tukey post hoc test were both employed to compare the mean values of various indicators obtained over 6 visits of the ISS program from July 2018 to December 2018. Findings: The study shows the positive effect of the ISS on infrastructure, human resources for health, essential drugs, and the number of pregnant women screened for HIV ( P < .05). Human resources for health and the number of children receiving immunization were both not affected by ISS ( P > .05). Conclusion: Integrated supportive supervision need to be embedded into the 3 levels (primary, secondary, and tertiary) of health-care service delivery. Implications: Integrated supportive supervision will strengthen the Katsina State health system, ensure efficient use of the health facility assets and resources utilization, and improve patient/client satisfaction.

scholarly journals Stroke and Telerehabilitation: A Brief Communication

10.2196/18919 ◽  
2020 ◽  
Vol 7 (2) ◽  
pp. e18919
Author(s):  
Ayisha Bashir
Keyword(s):  
Health Care ◽  
Home Care ◽  
Disease Transmission ◽  
Care Service ◽  
Quality Care ◽  
Health Care Service ◽  
Daily Monitoring ◽  
Care Services ◽  
Severely Handicapped

This rapid communication highlights stroke telerehabilitation, a health care service that provides daily monitoring of the care of patients recovering from stroke, delivering convenient and immediate feedback for patients, family, and caregivers. The delivery, management, and coordination of nursing care services, provided via telecommunications technology, is a convenient method of delivering health care to patients recovering from stroke. It is important to assess the service quality of the telehealth process and to establish the role of telehealth nursing and related technologies in the care of patients recovering from stroke. Studies show that even though both health professionals and participants have reported high levels of satisfaction and acceptance of telerehabilitation interventions, the quality of the evidence on telerehabilitation in poststroke care remains low. Conducting a quality study of telehealth rehabilitation for patients recovering from stroke will help assess if home health agencies with telehealth capabilities caring for patients recovering from stroke and patients with chronic diseases can provide quality care to patients in their home and fill this health care gap. Patients that are severely handicapped and impaired and unable to reside in their home environment are not included in telerehabilitation services provided by the home care agency. It would be informative to study the benefits of telerehabilitation and the care provided to patients recovering from stroke within nursing homes, given the need for social distancing to reduce disease transmission during the current coronavirus disease (COVID-19) global health pandemic. Using telerehabilitation would mean that patients have a lower risk of exposure to infectious agents. Further research into telehealth interventions and stroke management in home care is crucial.

Health care–associated infection and hospital readmission in a home care service for children

2012 ◽  
Vol 40 (3) ◽  
pp. 282-283 ◽  
Author(s):  
André Ricardo Araujo da Silva ◽  
Cristina Vieira de Souza ◽  
Mario Eduardo Viana ◽  
Guilherme Sargentelli ◽  
Maria José de Andrada Serpa ◽  
...  
Keyword(s):  
Health Care ◽  
Home Care ◽  
Hospital Readmission ◽  
Care Service ◽  
Home Care Service ◽  
Health Care Associated Infection

scholarly journals Home Care Service and Health Care Networks / Serviço de Atenção Domiciliar e as Redes de Atenção à Saúde

2019 ◽  
Vol 11 (5) ◽  
pp. 1117
Author(s):  
Juliana Marques Weykamp ◽  
Hedi Crecencia Heckler De Siqueira ◽  
Diana Cecagno ◽  
Adriane Calvetti De Medeiros ◽  
Saul Ferraz De Paula ◽  
...  
Keyword(s):  
Health Care ◽  
Home Care ◽  
Care Service ◽  
Rio Grande ◽  
Home Care Service ◽  
Rio Grande Do Sul ◽  
Health Care Networks

Objetivou-se conhecer a inter-relação do Serviço de Atenção Domiciliar nas modalidades 2 e 3 com as Redes de Atenção à Saúde nos municípios do Rio Grande do Sul. Método: Estudo descritivo, exploratório, qualitativo, realizado em 06 Serviços de Atenção Domiciliar no período de 23 à 30 de outubro de 2015. Participaram da pesquisa 04 coordenadores e 09 enfermeiros. A coleta de dados ocorreu por meio de entrevista semiestruturada e para análise utilizou-se a Análise de Conteúdo de Bardin. Resultados e discussão: A articulação das práticas em saúde, aliadas às Redes de Atenção à Saúde representam um elemento benéfico e inovador, possibilitando a prestação de uma assistência contínua e dinâmica para a população. Conclusão: O funcionamento do Serviço de Atenção Domiciliar e a dinâmica das redes necessitam estar organizada, esclarecida, articulada e desenvolvida em cooperação entre os serviços e instituições de saúde, visando a importância na reestruturação produtiva na saúde.

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