scholarly journals The experience of patients and family caregivers during Hospital-at-Home in France

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
H Rossinot ◽  
O Marquestaut ◽  
M De Stampa
Keyword(s):  
Health Care ◽  
Family Caregivers ◽  
Health Care Professionals ◽  
Health Care Services ◽  
University Hospitals ◽  
Subacute Care ◽  
Care Services ◽  
Hospital At Home ◽  
Zarit Burden Inventory ◽  
At Home

Abstract Background Public health policies tend to generalize the use of Hospital-At-Home (HAH) to answer the growing will of patients to be treated or to die at home. HAH is a model of care that provides acute-level services in the patient’s home with the interventions of variety of health care professionals. Relatives participate also in the interventions by helping for sick patients at home, but we lack data on the care of patients and caregivers in HAH. The aim of this study was to make an inventory of the experiences of patients and family caregivers in HAH. Methods The research was qualitative using nineteen semi-directed interviews from nine patients and ten caregivers of one care unit of Greater Paris University Hospitals’ HAH, and the grounded theory was used to analyze the transcripts. Caregivers were also asked, after the interview, to fill in the Zarit Burden Inventory. Results HAH remained mostly unknown for patients and caregivers before the admission proposition and the outlook of being admitted in HAH was perceived as positive, for both of them. Caregivers had a versatile role throughout HAH, leading to situations of suffering, but also had sources of support. The return home was considered satisfactory by both caregivers and patients, related to the quality of care and increased morale despite HAH’s organizational constraints. We noted an impact of HAH on the relationship between the patient and the caregiver(s), but caused by multiple factors: the fact that the care takes places at home, its consequences but also the disease itself. Conclusions HAH strongly involved the patient’s caregiver(s) all along the process. HAH’s development necessitates to associate both patients and caregivers and to take into account their needs at every step. This study highlights the need to better assess the ability of the caregiver to cope with his or her relative in HAH with acute and subacute care at home. Key messages Health care services need to take into account family caregivers. Hospital at home services should be developped worldwide.

scholarly journals Health-care Workforce Training to Effectively Support Family Caregivers of Seniors in Care

2020 ◽  
Vol 23 (2) ◽  
pp. 160-171
Author(s):  
Rachel Fisher ◽  
Jasneet Parmar ◽  
Wendy Duggleby ◽  
Peter George J. Tian ◽  
Wonita Janzen ◽  
...  
Keyword(s):  
Health Care ◽  
Family Caregivers ◽  
Health Care Professionals ◽  
Health Care Services ◽  
Well Being ◽  
Workforce Training ◽  
Community Dwelling ◽  
Canadian Health Care System ◽  
Care Services ◽  
Qualitative Thematic Analysis

Introduction Family caregivers (FCGs) play an integral, yet often invisible, role in the Canadian health-care system. As the population ages, their presence will become even more essential as they help balance demands on the system and enable community dwelling seniors to remain so for as long as possible. To preserve their own well-being and capacity to provide ongoing care, FCGs require support to the meet the challenges of their daily caregiving responsibilities. Supporting FCGs results in better care provision to community-dwelling seniors receiving health-care services, as well as enhancing the quality of life for FCGs. Although FCGs rely upon health-care professionals (HCPs) to provide them with support and services, there is a paucity of research pertaining to the type of health workforce training (HWFT) that HCPs should receive to address FCG needs. Programs that train HCPs to engage with, empower, and support FCGs are required. Objective To describe and discuss key findings of a caregiver symposium focused on determining components of HWFT that might better enable HCPs to support FCGs. Methods A one-day symposium was held on February 22, 2018 in Edmonton, Alberta, to gather the perspectives of FCGs, HCPs, and stakeholders. Attendees participated in a series of working groups to discuss barriers, facilitators, and recommendations related to HWFT. Proceedings and working group discussions were transcribed, and a qualitative thematic analysis was conducted to identify key themes. Results Participants identified the following topic areas as being essential to training HCPs in the provision of support for FCGs: understanding the FCG role, communicating with FCGs, partnering with FCGs, fostering FCG resilience, navigating healthcare systems and accessing resources, and enhancing the culture and context of care. Conclusions FCGs require more support than is currently being provided by HCPs. Training programs need to specifically address topics identified by participants. These findings will be used to develop HWFT for HCPs.

scholarly journals Caring for One’s Wife With Dementia—at Home: Older Husbands’ Experiences With Managing Challenges of Everyday Life

SAGE Open ◽  
2019 ◽  
Vol 9 (1) ◽  
pp. 215824401983445
Author(s):  
Linda Rykkje ◽  
Oscar Tranvåg
Keyword(s):  
Health Care ◽  
Health Care Services ◽  
Qualitative Interviews ◽  
Care Services ◽  
People With Dementia ◽  
Memory Clinics ◽  
Male Caregivers ◽  
Caregiving Roles ◽  
Caregiver Role ◽  
At Home

More than 80,000 Norwegians live with dementia. Most caregivers for people with dementia are spouses, and women outnumber men. Due to an aging population, and women’s higher risk of dementia as well as men’s increased life expectancy, the number of male caregivers will rise. There are some differences in the caregiving roles of men and women. Research suggest that males report lower burden and depression than female caregivers, but some men struggle to adjust to the caregiver role, and men are less likely to access health care services. The aim of this study is to explore the experiences of husbands engaged in caregiving for their home-dwelling spouse with dementia. This knowledge will add to the growing body of research about men in the context of dementia care and may raise gender awareness. The method is qualitative interviews with hermeneutical interpretation. The participants are five husbands recruited from two Hospital Memory Clinics in Norway. The results portray how the husbands managed their everyday challenges, and how they adapted to changes, experiences of loss and bereavement, and how they redefined personal freedom and expanded their responsibilities. Acknowledging the rewards of caregiving, the husbands found their life meaningful and they were thriving in their caregiving role. Health care personnel should recognize and respect the challenging life situation caregiving husbands may experience, calling for personnel to learn from, care for, and collaborate with them, enabling the couple to live a meaningful life together at home as long as possible.

scholarly journals Older people living at home: experiences of healthy ageing

2021 ◽  
Vol 22 ◽  
Author(s):  
Astrid Fjell ◽  
Kristin Ådnøy Eriksen ◽  
Monica Hermann ◽  
Anne-Marie Boström ◽  
Seiger Berit Cronfalk
Keyword(s):  
Health Care ◽  
Older People ◽  
Older Persons ◽  
Health Care Services ◽  
Healthy Ageing ◽  
Group Discussions ◽  
Care Services ◽  
Manifest Content ◽  
Professional Perspective ◽  
At Home

Abstract Aim: The purpose of this study was to investigate how old persons perceived their life to be, how they viewed the ageing process and their need of health care and societal support. Background: The purpose of WHO’s Healthy Ageing strategy and development of age-friendly environments is to support physiological and psychosocial changes in old persons by facilitating basic needs. Interventions to operationalize these needs in older people living at home are often developed from a professional perspective and to a small extent involves the perceptions, experience and expectations of the older persons. Method: This qualitative study has an explorative design using focus group discussions to collect data. In all, 34 persons between 69 and 93 years of age participated in seven group discussions. The interviews were analyzed using inductive manifest content analysis. Findings: The main results suggest that most old persons enjoyed life and wished it to continue for as long as possible. Important was to sustain networks and to feel useful. Unexpected changes were described as threats and the need to use health care services was associated with illness and being dependent. The result is presented in three categories with sub-categories: ‘Embracing life’, ‘Dealing with challenges’ and ‘Considering the future’.

“Safety at Home”: Experiences From Testing of Video Communication Between Patients and Home Health Care Personnel

SAGE Open ◽  
2017 ◽  
Vol 7 (4) ◽  
pp. 215824401774490 ◽  
Author(s):  
Linda Rykkje ◽  
Gunhild H. B. Hjorth
Keyword(s):  
Health Care ◽  
Home Health Care ◽  
Health Care Services ◽  
Video Communication ◽  
Health Care Personnel ◽  
Chronic Obstructive ◽  
Second Phase ◽  
Obstructive Pulmonary Disease ◽  
Care Services ◽  
At Home

The implementation of welfare technology in Norwegian municipals is a governmental priority, but there is little research on transfer of technological solutions into regular health care services. The aim of the project “Safety at home” was to test and evaluate the use of video communication between patients and health care personnel. There were two test periods, with the initial phase focusing on patients with chronic obstructive pulmonary disease (COPD). The second phase focused on patients who most likely would benefit from video communication. Nine patients tested the equipment, and they were interviewed afterward. In addition, nursing personnel evaluated the project through focus group interviews. The results identified that the equipment was user friendly and contributed to the patients’ feelings of safety. However, there were concerns about video calls replacing the “human touch” of home visits. The personnel also experienced that the technological solution had limitations, and new tasks added to their workload. The choice of focusing on COPD patients was considered a disadvantage, and we recommend that future projects should not be restricted by diagnosis and should target the most eligible candidates.

scholarly journals Public psychiatric services: job satisfaction evaluation

2007 ◽  
Vol 30 (1) ◽  
pp. 38-41 ◽  
Author(s):  
Sergio Ishara ◽  
Marina Bandeira ◽  
Antonio Waldo Zuardi
Keyword(s):  
Health Care ◽  
Service Quality ◽  
Health Care Professionals ◽  
Health Care Services ◽  
Psychiatric Hospitals ◽  
Work Conditions ◽  
Satisfaction Scale ◽  
Care Services ◽  
Satisfaction Evaluation ◽  
Student’S T

OBJECTIVE: To investigate the satisfaction of health-care professionals in inpatient and outpatient psychiatric hospitals of a Brazilian medium-sized city. METHOD: The study evaluated 136 health-care professionals from six hospitals; of which two were outpatient hospitals, two general hospitals, and two psychiatric hospitals. All professionals answered the Brazilian Mental Health Services' Staff Satisfaction Scale. RESULTS: An average satisfaction score of 3.26 was observed, which is situated between indifference (level 3) and satisfaction (level 4). Factors "service quality" (3.48) and "relationships at work" (3.48) showed higher scores compared to "service participation" (3.20) and "work conditions" (2.97) (p < 0.001). The female patient unit in the psychiatric hospital presented lower satisfaction scores (p < 0.001). Satisfaction was higher in the category "technicians" compared to "physicians" and "nurses" (p = 0.004). Moreover, day workers reported higher satisfaction compared to night workers regarding "service quality" and "service participation" (Student's t, p = 0.01 and p = 0.007). DISCUSSION AND CONCLUSION: Results show an intermediate level between indifference and satisfaction with services, with higher scores regarding care provided to the patients. Comparisons among the studied facilities revealed the numerous factors involved in determining one's satisfaction. They suggest advancements and reform measures likely to occur in the region's psychiatric health-care services. Monitoring satisfaction proved useful in predicting service quality improvements.

scholarly journals Being Heard, Exerting Influence, or Knowing How to Play the Game? Expectations of Client Involvement among Social and Health Care Professionals and Clients

2020 ◽  
Vol 17 (16) ◽  
pp. 5653
Author(s):  
Elina Weiste ◽  
Sari Käpykangas ◽  
Lise-Lotte Uusitalo ◽  
Melisa Stevanovic
Keyword(s):  
Health Care ◽  
Conversation Analysis ◽  
Cultural Change ◽  
Health Care Professionals ◽  
Health Care Services ◽  
Focus Group Research ◽  
Care Services ◽  
Significant Movement ◽  
Client Involvement ◽  
Actual Decision

Contemporary social and health care services exhibit a significant movement toward increasing client involvement in their own care and in the development of services. This major cultural change represents a marked shift in the client’s role from a passive patient to an active empowered agent. We draw on interaction-oriented focus group research and conversation analysis to study workshop conversations in which social and health care clients and professionals discussed “client involvement”. Our analysis focuses on the participants’ mutually congruent or discrepant views on the topic. The professionals and clients both saw client involvement as an ideal that should be promoted. Although both participant groups considered the clients’ experience of being heard a prerequisite of client involvement, the clients deviated from the professionals in that they also highlighted the need for actual decision-making power. However, when the professionals invoked the clients’ responsibility for their own treatment, the clients were not eager to agree with their view. In addition, in analyzing problems of client involvement during the clients’ and professionals’ meta-talk about client involvement, the paper also shows how the “client involvement” rhetoric itself may, paradoxically, sometimes serve to hinder here-and-now client involvement.

Videoconferencing and Dietitian Services: In Rural Ontario Communities

2012 ◽  
Vol 73 (4) ◽  
pp. 176-180
Author(s):  
Diana Stenlund
Keyword(s):  
Health Care ◽  
Rural Communities ◽  
Health Care Professionals ◽  
Access To Health Care ◽  
Health Care Services ◽  
Future Research ◽  
Short Supply ◽  
Care Services ◽  
Alternative Approach ◽  
Access To Health

Registered dietitians (RDs) are regulated health professionals in short supply in Ontario and throughout Canada. Projected workforce studies indicate the situation will likely worsen. Accessing these nutrition specialists is an even greater concern for residents living in rural or remote regions of the province. Smaller communities are increasingly using telehealth as a way to deliver health care services and to improve access to health care professionals. The adoption of interactive videoconferencing as a telehealth application is examined as an alternative approach for accessing RDs in rural communities. While valid reasons exist for implementing videoconferencing, other issues must be considered. These include costs, technological requirements, organizational readiness, and legal and ethical concerns. Future research must fully address the concept of videoconferencing in relation to the Canadian dietetic workforce and practice requirements.

Addressing inequities in access to primary health care: lessons for the training of health care professionals from a regional medical school

2011 ◽  
Vol 17 (4) ◽  
pp. 362 ◽  
Author(s):  
Sarah Larkins ◽  
Tarun Sen Gupta ◽  
Rebecca Evans ◽  
Richard Murray ◽  
Robyn Preston
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Professional Education ◽  
Health Care Professionals ◽  
Health Care Services ◽  
Underserved Populations ◽  
Health Sector ◽  
Care Services ◽  
Primary Health ◽  
Primary Health Care Services

Attention to the inequitable distribution and limited access to primary health care resources is key to addressing the priority health needs of underserved populations in rural, remote and outer metropolitan areas. There is little high-quality evidence about improving access to quality primary health care services for underserved groups, particularly in relation to geographic barriers, and limited discussion about the training implications of reforms to improve access. To progress equity in access to primary health care services, health professional education institutions need to work with both the health sector and policy makers to address issues of workforce mix, recruitment and retention, and new models of primary health care delivery. This requires a fundamental shift in focus from these institutions and the health sector, to each view themselves as partners in an integrated teaching, research and service-oriented health system. This paper discusses the challenges and opportunities for primary health care professionals, educators and the health sector in providing quality teaching and clinical experiences for increasing numbers of health professionals as a result of the reform agenda. It then outlines some practical strategies based on theory and evolving experience for dealing with some of these challenges and capitalising on opportunities.

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