scholarly journals New Models for Home Health Care under Uncertainty with Consideration of the Coordinated Development of Economy and Environment

Complexity ◽  
2021 ◽  
Vol 2021 ◽  
pp. 1-15
Author(s):  
Yan Cui ◽  
Lijun Zhang ◽  
Qiuye Gao ◽  
Bohao Li ◽  
Yumei Hou

With the aggravation of population aging, home health care (HHC) services are paid more and more attention by the elderly. Previous studies aim at improving service quality and reducing cost, ignoring the coordinated and sustainable development of the economy and environment. From the perspective of sustainable development, this paper first establishes a linear optimization (LO) model considering transportation, time, and carbon emission costs. However, the uncertainty of service demand is a very difficult problem for HHC research. Most of the previous studies only consider the deterministic model, which has difficulty dealing with the uncertain situation. Therefore, a robust optimization (RO) model is proposed to resist uncertain disturbances by introducing a robust uncertain set response. The experimental results show that the increase of low-carbon transition cost only increases the total cost of the LO model but has a significant positive impact on the RO model. With the increase of uncertainty, the robust model will pay the cost of robustness, but it can obtain a higher service level (93.20% to 93.38%). In addition, when the carbon tax increases, the total transportation cost does not increase but decreases, thus obtaining environmental benefits. When the carbon tax increases by 25%, the average total cost of using the RO model is reduced by 8.274%. The research results of this paper can provide enlightenment and reference for the low-carbon transformation of HHC enterprises.

BMC Nursing ◽  
2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Vicki Koltsida ◽  
Lise-Lotte Jonasson

Abstract Background The work of registered nurses in home health care is complicated and extensive, and information technology (IT) is used in everyday activities. Coordination between care and resource efficiency is important. There is a wealth of information that supports the notion of sustainable development, but what sustainable development means from the perspective of the registered nurse in home health care when using IT is limited. The term “sustainable development” is not clearly defined and is poorly researched in nursing. Sustainable development in this study includes the ecological, economic, social, technical and ethical dimensions. The aim of this study was to describe registered nurses’ experience of IT use in home health care through a sustainable development model. Methods This study was conducted using ten semi-structured lifeworld interviews with registered nurses. The method employed was a qualitative content analysis with a deductive approach. The deductive approach consisted of a model of sustainable development. Results Analysis of the interviews and the model of sustainable development provided categories: using IT from an ecological dimension, the registered nurses experienced reduced consumption and damage to the environment; using IT in the economical dimension, saving of time and resources was experienced; the use of IT affected social aspects such as the work environment and patient safety, and positive consequences, such as accessibility, were also mentioned; using IT from a technical dimension was characterized by the nurse’s attitude towards it – the registered nurses felt it improved the quality of care and gave users an overview of the organization; and from an ethical dimension, the registered nurses expressed the need for IT to be adaptable to the patient’s well-being and indicated that more awareness of risks in the care meeting may be needed. Conclusion The findings are discussed based on the synergies and conflicts that arise between the different dimensions of sustainable development. IT intertwines and overlaps with, and within, the environment, economy, society, technology and ethics. Registered nurses in home health care want to conduct good and safe care, while using IT could benefit patients.


2020 ◽  
Author(s):  
Abdulaziz A Alodhayani ◽  
Marwah Mazen Hassounah ◽  
Fatima R Qadri ◽  
Noura A Abouammoh ◽  
Zakiuddin Ahmed ◽  
...  

BACKGROUND There is growing evidence of the need to consider cultural factors in the design and implementation of digital health interventions. However, there is still inadequate knowledge pertaining to what aspects of the Saudi Arabian culture need to be considered in the design and implementation of digital health programs, especially in the context of home health care services for chronically and terminally ill patients. OBJECTIVE This study aims to explore the specific cultural factors relating to patients and their caregivers from the perspective of physicians, nurses, and trainers that have influenced the pilot implementation of Remotely Accessible Healthcare At Home (RAHAH); a connected health program in the Home Health Care Department at King Saud University Medical City, Riyadh, Saudi Arabia. METHODS A qualitative study design was adopted to conduct a focus group discussion (FGD) in July 2019 using a semi-structured interview guide with 3 female and 4 male participants working as nurses, family physicians, and information technologists. Qualitative data obtained were analyzed using a thematic framework analysis. RESULTS Two categories emerged from the FGD that influenced the experiences of digital health program intervention: (1) culture-related factors including language and communication, cultural views on using cameras during consultation, non-adherence to online consultations, and family role and commitment (2) caregiver characteristics in telemedicine that includes their skills and education and electronic literacy. Participants of this study revealed that indirect contact with the patients and their family members may work as a barrier to proper communication through RAHAH. CONCLUSIONS We recommend exploring the use of interpreters in digital health, creating awareness among the local population regarding privacy in digital health, and actively involving the direct family members with the healthcare providers.


2019 ◽  
Vol 7 (4) ◽  
pp. 561-569
Author(s):  
Jo-Ana D Chase ◽  
David Russell ◽  
Meridith Rice ◽  
Carmen Abbott ◽  
Kathryn H Bowles ◽  
...  

Background: Post-acute home health-care (HHC) services provide a unique opportunity to train and support family caregivers of older adults returning home after a hospitalization. To enhance family-focused training and support strategies, we must first understand caregivers’ experiences. Objective: To explore caregivers’ experiences regarding training and support for managing older adults’ physical functioning (PF) needs in the post-acute HHC setting. Method: We conducted a qualitative descriptive study using semi-structured telephone interviews of 20 family caregivers. Interviews were recorded, transcribed, and analyzed using conventional content analysis. Results: We identified the following primary categories: facilitators to learning (eg, past experience, learning methods), barriers to learning (eg, learning on their own, communication, timing/logistics, preferred information and timing of information delivery), and interactions with HHC providers (eg, positive/negative interactions, provider training and knowledge). Conclusion: Caregivers were responsive to learning strategies to manage older adults’ PF needs and, importantly, voiced ideas to improve family-focused training and support. HHC providers can use these findings to tailor training and support of family caregivers in the post-acute HHC setting.


2021 ◽  
Vol 8 (1) ◽  
pp. 205510292110009
Author(s):  
Bente Nordtug ◽  
Wenche K Malmedal ◽  
Rigmor Einang Alnes ◽  
Kari Blindheim ◽  
Gunn Steinsheim ◽  
...  

This qualitative study explores informal caregivers’ experiences of supporting persons with dementia’s everyday life coping. In the future, there will be fewer health personnel, increased dementia prevalence and limited nursing home availability. Accordingly, close relatives may be compelled to assume greater care responsibilities. Knowledge concerning persons with dementia’s everyday coping from the perspective of informal caregivers remains insufficient, despite these people’s importance for those with dementia. This investigation analyses informal caregivers’ perceived challenges and pleasures in providing care, how home health care affects everyday life coping and the factors that are most important to informal caregivers in supporting care receivers.


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