scholarly journals Potential quality indicators for seriously ill home care clients: a cross-sectional analysis using Resident Assessment Instrument for Home Care (RAI-HC) data for Ontario

2019 ◽  
Vol 18 (1) ◽  
Author(s):  
Lisa E. Harman ◽  
Dawn M. Guthrie ◽  
Joachim Cohen ◽  
Anja Declercq ◽  
Kathryn Fisher ◽  
...  
Keyword(s):  
Home Care ◽  
Quality Indicators ◽  
Assessment Instrument ◽  
Cross Sectional ◽  
Cross Sectional Analysis ◽  
Resident Assessment ◽  
Sectional Analysis ◽  
Seriously Ill ◽  
Resident Assessment Instrument

scholarly journals Selecting home care quality indicators based on the Resident Assessment Instrument-Home Care (RAI-HC) for Switzerland: A public health and healthcare providers' perspective

PLoS ONE ◽  
2020 ◽  
Vol 15 (12) ◽  
pp. e0244577
Author(s):  
Aylin Wagner ◽  
Franziska Zúñiga ◽  
Peter Rüesch ◽  
René Schaffert ◽  
Julia Dratva ◽  
...  
Keyword(s):  
Public Health ◽  
Home Care ◽  
Quality Indicators ◽  
Healthcare Providers ◽  
Care Quality ◽  
Assessment Instrument ◽  
Healthcare Sector ◽  
Resident Assessment ◽  
Resident Assessment Instrument ◽  
Home Care Nurses

Background Despite an increasing importance of home care, quality assurance in this healthcare sector in Switzerland is hardly established. In 2010, Swiss home care quality indicators (QIs) based on the Resident Assessment Instrument-Home Care (RAI-HC) were developed. However, these QIs have not been revised since, although internationally new RAI-HC QIs have emerged. The objective of this study was to assess the appropriateness of RAI-HC QIs to measure quality of home care in Switzerland from a public health and healthcare providers’ perspective. Methods First, the appropriateness of RAI-HC QIs, identified in a recent systematic review, was assessed by a multidisciplinary expert panel based on the RAND/UCLA Appropriateness Method taking into account indicators’ public health relevance, potential of influence, and comprehensibility. Second, the QIs selected by the experts were afterwards rated regarding their relevance, potential of influence, and practicability from a healthcare providers’ perspective in focus groups with home care nurses based on the Nominal-Group-Technique. Data were analyzed using median scores and the Disagreement Index. Results 18 of 43 RAI-HC QIs were rated appropriate by the experts from a public health perspective. The 18 QIs cover clinical, psychosocial, functional and service use aspects. Seven of the 18 QIs were subsequently rated appropriate by home care nurses from a healthcare providers’ perspective. The focus of these QIs is narrow, because three of seven QIs are pain-related. From both perspectives, the majority of RAI-HC QIs were rated inappropriate because of insufficient potential of influence, with healthcare providers rating them more critically. Conclusions The study shows that the appropriateness of RAI-HC QIs differs according to the stakeholder perspective and the intended use of QIs. The findings of this study can guide policy-makers and home care organizations on selecting QIs and to critically reflect on their appropriate use.

Changes in social engagement and depression predict incident loneliness among seriously ill home care clients

2017 ◽  
Vol 16 (2) ◽  
pp. 170-179 ◽  
Author(s):  
Samantha Fernandes ◽  
Jacob G.S. Davidson ◽  
Dawn M. Guthrie
Keyword(s):  
Home Care ◽  
Social Engagement ◽  
Multivariate Regression ◽  
Average Length ◽  
Assessment Instrument ◽  
Multivariate Regression Model ◽  
Symptoms Of Depression ◽  
Resident Assessment ◽  
Seriously Ill ◽  
Resident Assessment Instrument

ABSTRACTObjective:This study identified the predictors of incident loneliness in a group of seriously ill older adults (aged 65+) receiving home care.Method:Existing data collected with the Resident Assessment Instrument for Home Care (RAI–HC) were utilized. A cohort of clients (N = 2,499) with two RAI–HC assessments and no self-reported loneliness at time 1 were included. Self-reported loneliness, upon reassessment, was the outcome of interest. Clients with a prognosis of less than six months or severe health instability were included.Results:The average length of time between assessments was 5.9 months (standard deviation = 4.10). During that time, 7.8% (n = 181) of the sample developed loneliness. In a multivariate regression model, worsening symptoms of depression, a decline in social activities, and not living with a primary caregiver all increased the risk of loneliness.Significance of results:These results highlight how changes in psychosocial factors over time can contribute to loneliness, which can inform clinicians as they seek to identify those who may be at risk for loneliness.

scholarly journals Factors associated with daily opioid use among aged home care clients: a cross-sectional analysis of Resident Assessment Instrument data

2021 ◽  
Author(s):  
Heidi Mörttinen-Vallius ◽  
Sirpa Hartikainen ◽  
Heini Huhtala ◽  
Lauri Seinelä ◽  
Esa Jämsen
Keyword(s):  
Cognitive Impairment ◽  
Depressive Symptoms ◽  
Home Care ◽  
Activities Of Daily Living ◽  
Daily Living ◽  
Assessment Instrument ◽  
Opioid Use ◽  
Cross Sectional ◽  
Resident Assessment ◽  
Resident Assessment Instrument

Abstract Purpose To examine which client characteristics and other factors, including possible adverse effects, identified in the Resident Assessment Instrument—Home Care (RAI-HC) are associated with daily opioid use among aged home care clients. Methods The study sample comprised 2584 home care clients aged ≥ 65 years, of which 282 persons used opioids daily. Clients using opioids less than once daily were excluded. The cross-sectional data were gathered from each client’s first assessment with the RAI-HC during 2014. Multivariable logistic regression was used to study associations of daily opioid use with the clients’ characteristics and symptoms. Results Cognitive impairment was associated with less frequent opioid use after adjusting for pain-related diseases, disabilities and depressive symptoms (OR 0.43, 95% CI 0.32–0.58). The association was not explained by the estimated severity of pain. Osteoporosis, cancer within previous 5 years and greater disabilities in Instrumental Activities of Daily Living (IADL) were associated with daily opioid use regardless of the estimated severity of pain. Depressive symptoms and Parkinson’s disease were associated with daily opioid use only among clients with cognitive impairment, and disabilities in Activities of Daily Living, cancer, arthritis, fractures and pressure ulcers only among clients without cognitive impairment. Constipation was the only adverse effect associated with daily opioid use. Conclusion The pain of home care clients with cognitive impairment may not be treated optimally, whereas there might be prolonged opioid use without a sufficient evaluation of current pain among clients with osteoporosis, cancer within previous 5 years and disabilities in IADLs.

Profil des personnes âgées souffrant d’insuffisance cardiaque soignées à domicile en Ontario

2011 ◽  
Vol 31 (2) ◽  
pp. 57-66
Author(s):  
AD Foebel ◽  
JP Hirdes ◽  
GA Heckman ◽  
SL Tyas ◽  
EY Tjam
Keyword(s):  
Home Care ◽  
Nous Avons ◽  
Assessment Instrument ◽  
Services De Santé ◽  
Soins Infirmiers ◽  
Soins À Domicile ◽  
Base De Données ◽  
Resident Assessment ◽  
Resident Assessment Instrument ◽  
Vieillissement De La Population

Introduction Le vieillissement de la population canadienne s’accompagne d’un accroissement du fardeau que représente l’insuffisance cardiaque (IC), affection associée à un taux de morbidité et de mortalité important ainsi qu’à un recours fréquent aux services de santé. Méthodologie Nous avons extrait les données de la base de données du Resident Assessment Instrument-Home Care (RAI-HC) de l’Ontario pour tous les clients bénéficiant de soins à domicile de longue durée et âgés de 65 ans et plus, afin 1) de décrire les caractéristiques démographiques et cliniques des clients de soins à domicile souffrant d’insuffisance cardiaque et 2) d’examiner le recours aux services de santé par les clients de soins à domicile souffrant d’insuffisance cardiaque. Résultats Par rapport aux autres clients de soins à domicile, ceux qui souffrent d’insuffisance cardiaque présentent un état de santé plus instable, consomment davantage de médicaments, affichent un taux plus élevé de comorbidité et ont besoin d’un volume significativement plus élevé de soins infirmiers, ainsi que de services ménagers et culinaires. Ils sont hospitalisés plus fréquemment et font un usage significativement plus élevé des services d’urgence et des soins de première urgence. Analyse Les clients souffrant d’insuffisance cardiaque constituent un groupe plus complexe que les clients des soins à domicile en général. La manière dont les patients prennent en main leur santé doit être adaptée à leurs caractéristiques cliniques, à leurs schémas habituels d’utilisation des services et aux obstacles auxquels ils doivent faire face. Ce constat est particulièrement vrai chez les patients plus âgés, frêles et au profil médical complexe qui souffrent d’insuffisance cardiaque, et ils sont nombreux parmi ceux qui requièrent des services à domicile. Cette étude peut servir d’assise à des initiatives de base permettant d’aider ces clients aux besoins particulièrement grands à gérer leur insuffisance cardiaque à domicile grâce à de l’aide et à des services adaptés.

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