Community paramedicine home visits: patient perceptions and experiences

2021 ◽  
Vol 13 (6) ◽  
pp. 248-257
Author(s):  
Stephen Hughes ◽  
Christopher Seenan
Keyword(s):  
Home Visit ◽  
Home Visits ◽  
Patient Perceptions ◽  
Patient Acceptance ◽  
Model Of Care ◽  
Structured Interviews ◽  
Community Based ◽  
Community Paramedicine ◽  
Strategic Value ◽  
Skills Education

Background: Community paramedicine (CP) is an emerging model of community-based healthcare delivered around the world by paramedics with additional skills, education and training. There is a lack of qualitative research on patient perceptions and experiences of this phenomenon. Aims: The study aimed to explore patient perceptions and experiences of CP home visits delivered by specialist paramedics (SPs) in a Scottish urban general practice home-visit setting. Patient acceptance and CP primary-care strategic value were examined. Methods: An explorative qualitative study using purposive sampling, semi-structured interviews and thematic analysis. Findings: Five main themes were identified: provide a well-communicated, professional, knowledgeable and comprehensive home visit consultation; SP-patient relationship and continuity of care; acceptance of SP home visits in place of GP home visits; quicker response and an increased possibility of a home visit; and limitations of the SP role. Conclusion: Patient perceptions and experience of CP were positive, with patients accepting this model of care. Opportunities to improve healthcare, including better continuity or care and health monitoring, were found.

scholarly journals Postnatal home visits by health extension workers in rural areas of Ethiopia: a cross-sectional study design

2020 ◽  
Author(s):  
Yemane Berhane Tesfau ◽  
Alemayehu Bayray Kahsay ◽  
Tesfay Gebregzabher Gebrehiwot ◽  
Araya Abrha Medhanyie ◽  
Hagos Godefay
Keyword(s):  
Community Health ◽  
Community Health Workers ◽  
Home Visit ◽  
Health Workers ◽  
Home Visits ◽  
Cross Sectional Study ◽  
Northern Ethiopia ◽  
Health Extension Workers ◽  
Community Based ◽  
Cross Sectional

Abstract Background : In low-income countries like Ethiopia, where families have poor access to or do not utilize the services of formal health care systems, community health workers provide postnatal care services through home visits. However, the extent and effectiveness of home-based postnatal visits by community health workers such as the Ethiopian health extension workers (HEWs) are not well explored. This community -based study aimed to determine the coverage, contents of postnatal home visits and associated factors by health extension workers in Northern Ethiopia. Methods : We conducted a community based cross-sectional study in the rural Districts in Northern Ethiopia from August to September 2018. A total of 705 mothers who gave a live birth in the year preceding the survey were selected using multistage random sampling. A structured questionnaire was applied to collect data by interviewing the mothers. Data were analyzed using SPSS version 22 statistical software. Association of postnatal home visits with possible explanatory variables was investigated using logistic regression. Results : One hundred and two (14.5%) mothers and newborns received PNC home visit within three days after birth from HEW and 170(24.1%) reported postnatal home visits within 42 days. Among the mothers who received postnatal home visits, 6.5% measured their blood pressure, 11.2% measured their temperature, 20% counseled about family planning, 16.5% counseled on newborn danger signs, 11.2% counseled on the skin to skincare of the newborn and 14.1% of their newborns were measured their weight at home. Mothers who received at least one home visit during pregnancy (AOR, 7.49; CI 3.55-15.80), participated in pregnant women forum (AOR, 3.16; CI 1.67-5.99), notified their birth (AOR, 6.16; CI 3.50-10.84) and those members of community health insurance (AOR, 1.87; CI 1.13-3.10) were factors associated with postnatal home visit by a health extension worker. Conclusion : The coverage of postnatal home visits by health extension workers remains low in rural districts of Northern Ethiopia. The existing health systems should consider interventions that improve pregnancy and birth notification strategies and more efforts should be made at improving community-based participation and linkages with community health workers.

scholarly journals Postnatal home visits by health extension workers in rural areas of Ethiopia: a cross-sectional study design

2020 ◽  
Author(s):  
Yemane Berhane Tesfau ◽  
Alemayehu Bayray Kahasay ◽  
Tesfay Gebregzabher Gebrehiwot ◽  
Araya Abrha Medhanyie ◽  
Hagos Godefay
Keyword(s):  
Community Health ◽  
Community Health Workers ◽  
Home Visit ◽  
Health Workers ◽  
Home Visits ◽  
Cross Sectional Study ◽  
Northern Ethiopia ◽  
Health Extension Workers ◽  
Community Based ◽  
Cross Sectional

Abstract Background : In low-income countries like Ethiopia, where families have poor access to or do not utilize services of formal health care systems, community health workers provide postnatal care services through home visits. However, the extent and effectiveness of home-based postnatal visits by community health workers such as the Ethiopian health extension workers (HEWs) are not well explored. This community -based study aimed to determine the coverage, contents of postnatal home visits and associated factors by health extension workers in Northern Ethiopia.Methods : We conducted a community based cross-sectional study in the rural Districts in Northern Ethiopia from August to September 2018. A total of 705 mothers who gave a live birth in the year preceding the survey were selected using multistage random sampling. A structured questionnaire was applied to collect data by interviewing mothers. Data were analyzed using SPSS version 22 statistical software. Association of postnatal home visits with possible explanatory variables was investigated using logistic regression.Results : One hundred two (14.5%) mothers and newborns received PNC home visit within three days after birth from HEW and 170(24.1%) reported postnatal home visits within 42 days. Among the mothers who received postnatal home visits, 6.5% measured their blood pressure, 11.2% measured their temperature, 20% counseled about family planning, 16.5% counseled on newborn danger signs, 11.2% counseled on the skin to skincare of the newborn and 14.1% of their newborns were measured their weight at home. Mothers who received at least one home visit during pregnancy (AOR, 7.58; CI 3.59-15.98), participated in pregnant women forum (AOR, 3.21; CI 1.70-6.05), notified their birth (AOR, 6.15; CI 3.50-10.80) and those member of community health insurance (AOR, 1.88; CI 1.14-3.12) were significantly associated factors with postnatal home visit by a health extension worker.Conclusion : The coverage of postnatal home visits by health extension workers remains low in rural districts of Northern Ethiopia. Existing health systems should consider interventions that improve pregnancy and birth notification strategies and more efforts should be made at improving community-based participation and linkages with community health workers.

Maternal and child health nurses’ experiences of implementing two community-based breastfeeding interventions in Victoria, Australia: A mixed methods process evaluation

2019 ◽  
Vol 16 (1) ◽  
pp. 4-14 ◽  
Author(s):  
Rhian L Cramer ◽  
Helen L McLachlan ◽  
Touran Shafiei ◽  
Lisa H Amir ◽  
Meabh Cullinane ◽  
...  
Keyword(s):  
Child Health ◽  
Maternal And Child Health ◽  
Randomised Trial ◽  
Cluster Randomised Trial ◽  
Breastfeeding Initiation ◽  
Structured Interviews ◽  
Breastfeeding Support ◽  
Community Based ◽  
Significant Drop ◽  
And Child Health

Despite high rates of breastfeeding initiation in Australia, there is a significant drop in breastfeeding rates in the early postpartum period, and Australian government breastfeeding targets are not being met. The Supporting breastfeeding In Local Communities (SILC) trial was a three-arm cluster randomised trial implemented in 10 Victorian local government areas (LGAs). It aimed to determine whether early home-based breastfeeding support by a maternal and child health nurse (MCH nurse) with or without access to a community-based breastfeeding drop-in centre increased the proportion of infants receiving ‘any’ breast milk at four months. Focus groups, a written questionnaire and semi-structured interviews were undertaken to explore the interventions from the perspective of the SILC-MCH nurses (n=13) and coordinators (n=6), who established and implemented the interventions. Inductive thematic analysis was used to identify themes, then findings further examined using Diffusion of Innovations Theory as a framework. SILC-MCH nurses and coordinators reported high levels of satisfaction, valuing the opportunity to improve breastfeeding in our community; and having focused breastfeeding time with women in their own homes. They felt the SILC interventions offered benefits to women, nurses and the MCH service. Implementing new interventions into existing, complex community health services presented unforeseen challenges, which were different in each LGA and were in part due to the complexity of the individual LGAs and not the interventions themselves. These findings will help inform the planning and development of future programs aimed at improving breastfeeding and other interventions in MCH.

Implementing Cancer Exercise Rehabilitation: An Update on Recommendations for Clinical Practice

2019 ◽  
Vol 15 (2) ◽  
pp. 100-109 ◽  
Author(s):  
Kirsten Suderman ◽  
Carolyn McIntyre ◽  
Christopher Sellar ◽  
Margaret L. McNeely
Keyword(s):  
Cancer Survivors ◽  
Research Evidence ◽  
Clinical Care ◽  
Preliminary Evidence ◽  
Model Of Care ◽  
Community Based ◽  
Exercise Rehabilitation ◽  
Barriers To Exercise ◽  
Growing Body ◽  
After Cancer

A growing body of research evidence supports the benefit of exercise for cancer survivors both during and after cancer treatment. The purpose of this paper is to provide an update on our previously published review in 2006 on the state of the evidence supporting exercise for survivors of cancer as well as guidelines for integrating exercise programming in the cancer clinical setting. First, we provide a brief overview on the benefits of exercise as well as preliminary evidence supporting the implementation of community-based exercise programs. Second, we summarize the principles and goals of exercise, and the identified barriers to exercise among cancer survivors. Finally, we propose an interdisciplinary model of care for integrating exercise programming into clinical care including guidelines for medical and pre-exercise screening, exercise testing and programming considerations.

The Integration of ERM and Strategy: Implications for Corporate Governance

2017 ◽  
Vol 31 (2) ◽  
pp. 69-82 ◽  
Author(s):  
Therese R. Viscelli ◽  
Dana R. Hermanson ◽  
Mark S. Beasley
Keyword(s):  
Corporate Governance ◽  
Boards Of Directors ◽  
Implementation Process ◽  
Structured Interviews ◽  
Executive Management ◽  
Strategic Direction ◽  
Strategic Value ◽  
Enterprise Risk ◽  
Leadership Structure ◽  
Risk Oversight

SYNOPSIS Since the early 2000s, expectations have increased for organizations to strengthen corporate governance with enterprise risk management (ERM) processes, with the accounting profession playing a major role in these efforts. The ultimate goal of an effective ERM process is to help boards and senior executives to manage risks in the context of strategy so that the organization is more likely to achieve its key objectives. We conduct semi-structured interviews of 15 ERM champions to provide insights about whether the ERM process is integrated with the strategic-planning and execution processes of the firm. We find that while the decision to launch ERM often is based on a desire for ERM to provide strategic value, the integration of ERM with strategy typically is limited. We then examine the ERM implementation process to identify possible ERM implementation practices limiting ERM's integration with strategy. We find that organizations' (1) culture and approach to preparing for ERM's launch, (2) ERM leadership structure, and (3) management of key risks appear to limit the intersection of ERM and strategy. Our summary of key findings highlights important considerations for boards of directors, executive management, and auditors as they assess the effectiveness of their risk oversight efforts in overseeing the strategic direction of the enterprise.

scholarly journals Paramedics assessing patients with complex comorbidities in community settings: results from the CARPE study

CJEM ◽  
2021 ◽  
Author(s):  
Matthew S. Leyenaar ◽  
Brent McLeod ◽  
Aaron Jones ◽  
Audrey-Anne Brousseau ◽  
Eric Mercier ◽  
...  
Keyword(s):  
Home Care ◽  
Support Services ◽  
Home Visit ◽  
Community Care ◽  
Community Support ◽  
Community Dwelling ◽  
Living Alone ◽  
Care Providers ◽  
Community Paramedicine ◽  
Community Support Services

Abstract Objectives The aim for this study was to provide information about how community paramedicine home visit programs best “navigate” their role delivering preventative care to frequent 9-1-1 users by describing demographic and clinical characteristics of their patients and comparing them to existing community care populations. Methods Our study used secondary data from standardized assessment instruments used in the delivery of home care, community support services, and community paramedicine home visit programs in Ontario. Identical assessment items from each instrument enabled comparisons of demographic, clinical, and social characteristics of community-dwelling older adults using descriptive statistics and z-tests. Results Data were analyzed for 29,938 home care clients, 13,782 community support services clients, and 136 community paramedicine patients. Differences were observed in proportions of individuals living alone between community paramedicine patients versus home care clients and community support clients (47.8%, 33.8%, and 59.9% respectively). We found higher proportions of community paramedicine patients with multiple chronic disease (87%, compared to 63% and 42%) and mental health-related conditions (43.4%, compared to 26.2% and 18.8% for depression, as an example). Conclusion When using existing community care populations as a reference group, it appears that patients seen in community paramedicine home visit programs are a distinct sub-group of the community-dwelling older adult population with more complex comorbidities, possibly exacerbated by mental illness and social isolation from living alone. Community paramedicine programs may serve as a sentinel support opportunity for patients whose health conditions are not being addressed through timely access to other existing care providers. Protocol registration ISRCTN 58273216.

scholarly journals Homeless on Main Street: Using Photovoice to Highlight Older Adults Among the Hidden Homeless

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 728-728
Author(s):  
H Shellae Versey
Keyword(s):  
Older Adults ◽  
Rural Areas ◽  
Meaning Making ◽  
Small Towns ◽  
Photo Elicitation ◽  
Service Agency ◽  
Structured Interviews ◽  
Community Based Interventions ◽  
Community Based ◽  
Formerly Homeless

Abstract Homelessness is a reality for a growing number of Americans living in small towns and rural areas. However, unlike in cities, housing instability may be less visible. Using a photo-elicitation method (i.e., Photovoice), this study explores the meaning of place and obscured visibility to currently and formerly homeless older adults living in a small town in central Connecticut. Participants (N = 27) were recruited from a local service agency, given cameras and asked to photograph areas around town that were meaningful to them. Photographs were developed and followed by in-person, semi-structured interviews with participants in which photos and experiences during the project were discussed. Primary themes included belonging, generativity, social isolation, and place-making as meaning-making. The study culminated in a community photography exhibition in which photographs from the project were displayed in public spaces around town. Implications for community-based interventions to reach homeless groups in rural areas are discussed. Part of a symposium sponsored by the Qualitative Research Interest Group.

scholarly journals A Multiple Stakeholder Perspective for Evaluating Community-Based Dementia Care

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 60-61
Author(s):  
Johan Suen
Keyword(s):  
Dementia Care ◽  
Structural Constraints ◽  
Care Provision ◽  
Care Providers ◽  
Structured Interviews ◽  
Community Based ◽  
Relational Factors ◽  
Care Relationships ◽  
The Individual ◽  
The Impact

Abstract For holistic interventions and research on dementia, it is fundamental to understand care experiences from the perspectives of carers, care recipients, and care professionals. While research on care dyads and triads have highlighted the effects of communication and interactional aspects on care relationships, there is a lack of knowledge on how individual-contextual and relational factors shape the provision and receipt of care in terms of decision-making processes, resource allocation, and expectations of care outcomes. Thus, this paper sheds light on (i) how carers negotiate care provision with other important life domains such as employment, household/family roles and conflicts, as well as their own health problems, life goals, values, and aspirations for ageing; (ii) how older adults with dementia perceive support and those who provide it; (iii) the structural constraints faced by care professionals in delivering a team-based mode of dementia care; and, taken together, (iv) how community-based dementia care is impeded by barriers at the individual, relational, and institutional levels. Findings were derived from semi-structured interviews and observational data from fieldwork conducted with 20 persons with dementia (median age = 82), 20 of their carers (median age = 60), and 4 professional care providers. All respondents were clients and staff of a multidisciplinary and community-based dementia care system in Singapore. Our analysis indicates the impact of dementia care is strongly mediated by the interplay between institutional/familial contexts of care provision and the various ‘orientations’ to cognitive impairment and seeking support, which we characterised as ‘denial/acceptance’, ‘obligated’, ‘overprotective’, and ‘precariously vulnerable’.

Implementation of Home Visit Programs in Improving Nutritional Status of Under-Five Children in Developing Countries: A Scoping Review

2020 ◽  
Author(s):  
Siti Zakiah Zulfa ◽  
◽  
Cesa Septiana Pratiwi ◽  
Keyword(s):  
Developing Countries ◽  
Nutritional Status ◽  
Scoping Review ◽  
Home Visit ◽  
Home Visits ◽  
Severe Malnutrition ◽  
Severe Problem ◽  
Under Five ◽  
Under Five Children ◽  
Review Question

Background: In developing country, malnutrition of under five children was still a severe problem because it may have an impact on the quality of human resources in the future. Various program has been tried in many places to overcome this problem, one of which is through a home visit program, which is very necessary for educational purposes to manage malnutrition. This study aimed to determine how to implement a home visit program to improve the nutritional status of under five children in developing countries. Subjects and Method: A scoping review method was conducted using Arksey and O’malley (2005) framework with five steps: (1) Identify the scoping review question; (2) Identify relevant articles; (3) Article selection; (4) Mapping; (5) Present the results, discussion and conclusion. The search included Pubmed, Wiley, Ebsco, Science Direct, and Google scholar databases. The inclusion criteria were original articles in Indonesian and English from developing countries published from 2010 to 2019. The data were reported by PRISMA flow chart. Results: Five of the 159 articles were selected, and found that five themes were summarized, namely: (1) effective implementation of home visits, (2) types of rehabilitation of nutritional status of under-five children on home visits, (3) home visit officers 4) time and activities for conducting home visits and 5 ) constraints on home visits for malnutrition education purposes. Conclusion: Home visit program is an effective and significant strategy to reduce the incidence of underweight, moderate and severe malnutrition, stunting and wasting in under five children only when combined with other programs. Several knowledge gaps identify which confirm through further research. Keywords: home visit, nutritional status of under-five children, malnutrition, developing countries Correspondence: Siti Zakiah Zulfa. Universitas ‘Aisyiyah Yogyakarta. Jl. Ringroad Barat No.63, Mlangi, Nogotirto, Gamping, Sleman, Yogyakarta. Email: [email protected]. Mobile: 085641349694. DOI: https://doi.org/10.26911/the7thicph.02.11

Library services enriching community engagement for dementia care: The Tales & Travels Program at a Canadian Public Library as a case study

2021 ◽  
pp. 096100062110651
Author(s):  
Jiamin Dai ◽  
Joan C. Bartlett ◽  
Karyn Moffatt
Keyword(s):  
Public Libraries ◽  
Public Library ◽  
Well Being ◽  
Dementia Care ◽  
Future Research ◽  
Library Services ◽  
Structured Interviews ◽  
Community Based ◽  
People With Dementia

Growing dementia-friendly library services are contributing to community-based dementia care. Emerging community programs in libraries and museums provide notable opportunities for promoting engagement and inclusivity, but these programs have yet to receive in-depth assessments and analyses to guide future research and practice. This paper presents a case study examining a social and storytelling program for people with dementia run by a Canadian public library. It investigates two research questions: How can public library programs contribute to community-based dementia care? And what are public libraries’ strengths and challenges in running programs for people with dementia? The study involves participant observations of the program and semi-structured interviews with people with dementia, caregivers, and program facilitators (librarians and Alzheimer Society coordinators). Through thematic analysis of fieldnotes and transcripts, the study reveals how this inclusive platform supports engagement, fosters relationships, helps caregivers, and reaches broader communities. This research further uncovers the librarians’ diversified roles as demonstrated through their collaboration with professionals, preparation and research, and facilitation of the sessions. This paper advances librarianship research on enriching community-based dementia care, including furthering inclusivity and engagement and extending accessible library services. By analyzing library programming for the dementia community and assessing its strengths and challenges, the paper highlights librarians’ awareness of the community’s evolving needs and their collaboration with other professionals. It offers practical insights on useful resources and emerging best practices that will hopefully inspire other initiatives in which information professionals can help improve the well-being of vulnerable populations.

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