CARACTERIZAÇÃO CLÍNICA E EPIDEMIOLÓGICA DE PACIENTES ATENDIDOS POR UM PROGRAMA PÚBLICO DE ATENÇÃO DOMICILIAR

Objetivo: caracterizar clínica e epidemiologicamente os pacientes atendidos por um programa público de atenção domiciliar na cidade de Montes Claros, Minas Gerais, Brasil. Métodos: Estudo transversal e exploratório, realizado entre junho de 2017 e janeiro de 2018, com 131 pacientes cadastrados e atendidos pelo Serviço de Atenção Domiciliar - Melhor em Casa. Para o levantamento dos dados utilizou-se um instrumento contendo variáveis sociodemográficas, clínicas e funcionais. Os dados foram analisados por estatística descritiva. Resultados: A maioria dos pacientes eram idosos (67,9%), do sexo feminino (55%), pardos (47,3%), casados (31,3%) e/ou solteiros (31,3%), restritos ao leito (71%) e alimentavam-se via oral (68,7%). As doenças vasculares (42%) foram as mais prevalentes, 45,8% dos pacientes apresentavam lesão por pressão e o atendimento domiciliar foi realizado principalmente pelo enfermeiro (83,2%) e médico (82,4%). Conclusão: A identificação do perfil clínico e epidemiológico é fundamental para planejar e implementar cuidados adequados às necessidades específicas dos pacientes.Descritores: Pacientes Domiciliares; Serviços de Assistência Domiciliar; Perfil de Saúde; Idoso.CLINICAL AND EPIDEMIOLOGICAL CHARACTERIZATION OF PATIENTS TREATED BY A PUBLIC HOME CARE PROGRAMObjective: to characterize clinically and epidemiologically the patients attended by a public home care program in the city of Montes Claros, Minas Gerais, Brazil. Methodology: A cross - sectional and exploratory study was carried out between June 2017 and January 2018, with 131 patients enrolled and attended by the Home Care Service - Better at Home. Data were collected using an instrument containing sociodemographic, clinical and functional variables and were analyzed by descriptive statistics. Results: The majority of the patients were elderly (67.9%), female (55%), brown (47.3%), married (31.3%) and / or unmarried to bed (71%) and were fed orally (68.7%). Vascular diseases (42%) were the most prevalent, 45.8% of the patients had pressure lesions, and home care was performed mainly by the nurse (83.2%) and the physician (82.4%). Conclusion: The characterization of the profile, besides describing problems, contributes to patient care, impacting on the planning and implementation of appropriate interventions.Descriptors: Homebound Persons; Home Care Services; Health Profile; Aged.CARACTERIZACIÓN CLÍNICA Y EPIDEMIOLÓGICA DE PACIENTES ATENDIDOS POR UN PROGRAMA PÚBLICO DE ATENCIÓN DOMICILIARIAObjetivo: caracterizar clínica y epidemiológicamente a los pacientes atendidos por un programa público de atención domiciliaria en la ciudad de Montes Claros, Minas Gerais, Brasil. Metodología: Estudio transversal y exploratorio, realizado entre junio de 2017 y enero de 2018, con 131 pacientes catastrados y atendidos por el Servicio de Atención Domiciliar - Mejor en Casa. Para el levantamiento de los datos se utilizó un instrumento que contenía variables sociodemográficas, clínicas y funcionales, analizados por estadística descriptiva. Resultados: La mayoría de los pacientes eran ancianos (67,9%), del sexo femenino (55%), pardos (47,3%), casados (31,3%) y / o solteros (31,3%), restringidos al lecho (71%) y se alimentaban vía oral (68,7%). Las enfermedades vasculares (42%) fueron las más prevalentes, el 45,8% de los pacientes presentaban lesión por presión y la atención domiciliaria fue realizada principalmente por el enfermero (83,2%) y médico (82,4%). Conclusión: La caracterización del perfil, además de describir problemas, contribuye al cuidado del paciente, impactando en la planificación e implementación de intervenciones adecuadas.Descriptores: Personas Imposibilitadas; Servicios de Atención de Salud a Domicilio; Anciano.

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People diagnosed with dementia in Sweden: What type of home care services and housing are they granted? A cross-sectional study

Scandinavian Journal of Public Health ◽

10.1177/1403494818755600 ◽

2018 ◽

Vol 47 (2) ◽

pp. 229-239 ◽

Cited By ~ 8

Author(s):

Elzana Odzakovic ◽

Lars-Christer Hydén ◽

Karin Festin ◽

Agneta Kullberg

Keyword(s):

Home Care ◽

Older People ◽

Care Service ◽

Home Care Services ◽

Cross Sectional Study ◽

Home Care Service ◽

Sectional Study ◽

Dementia Diagnosis ◽

Cross Sectional ◽

Care Services

Aims: This study aims to examine what types of home care services and housing are granted to people with a dementia diagnosis and how these types are associated with socio-demographic factors (sex, age, marital status, native or foreign born, and regional area). Methods: A cross-sectional study of all people diagnosed with dementia in three Swedish counties was conducted from the medical records in 2012. Logistic regression analysis was carried out to investigate associations between home care services and housing and socio-demographic variables. Results: In total, 17,405 people had a dementia diagnosis, and the majority were women, aged 80+ years, and unmarried. Some 72% were living in ordinary housing and 28% lived in special housing. Of those who lived in ordinary housing, 50% did not receive any home care service. Not receiving any type of home care services was less common for older people and was also associated with being married and living in rural municipalities. The most common home care services granted were home help and personal care. Special housing was more common for older people, unmarried persons, and those living in rural municipalities. Conclusions: Most people with a dementia diagnosis were living in ordinary housing, and, surprisingly, half of those did not receive any type of home care service. This knowledge is essential for making the living conditions and needs of people living with dementia more visible and to provide good home care services for people with dementia and their families.

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Being A Caregiver In Home Care: Choosing Between The Duty And The Moral Desire Of Taking Care

10.21203/rs.2.18806/v1 ◽

2019 ◽

Author(s):

Yara Cardoso Silva ◽

Kênia Lara Silva

Keyword(s):

Home Care ◽

Care Service ◽

Care Program ◽

Home Care Services ◽

Two Dimensions ◽

Human Beings ◽

Heavy Load ◽

Care Services ◽

Belo Horizonte ◽

Taking Care

Abstract Background: to analyze the process of development of the caregiver in a home care program, focusing on the attributes, feeling and needs of those individuals. Methods: regarding our method, we made use of a qualitative research, which has been carried out at the Home Care Service of Belo Horizonte. The data has been collected through interviews performed with all the 7 caregivers and 6 healthcare practitioners. All the info has been analyzed under the scope of the the discourse analysis research method. Results: the caregiver acts with his/her heart, he/she listens and looks very carefully and attentively. Care is characterized by an intense and permanent process of conflict between the duty due to the assingned functions and the moral desisre of taking care of other human beings. Those two dimensions can be expressed sometimes by affection, gratitude and solidarity, but, in other times, it is guided by duty, resulting in work overload and concerns that make the caregiver unique in his/her moral condition. Conclusion: the person in charge of being a caregiver finds himself/herself surrounded by feelings and responsibilities, in a heavy load of relationships that are shaped by the subjective and subjectfying experiences, which makes critical the implementation of supportive social networks to aid the caregivers. keywords: Caregiver; Home Care Services; Home Care.

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‘They just came with the medication dispenser’- a qualitative study of elderly service users’ involvement and welfare technology in public home care services

BMC Health Services Research ◽

10.1186/s12913-021-06243-4 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Heidi Snoen Glomsås ◽

Ingrid Ruud Knutsen ◽

Mariann Fossum ◽

Kristin Halvorsen

Keyword(s):

Qualitative Study ◽

Home Care ◽

Health Care Quality ◽

Care Service ◽

User Involvement ◽

Home Care Services ◽

Care Quality ◽

Service Users ◽

Care Services ◽

Welfare Technology

Abstract Background Public home care for the elderly is a key area in relation to improving health care quality. It is an important political goal to increase elderly people’s involvement in their care and in the use of welfare technology. The aim of this study was to explore elderly service users’ experience of user involvement in the implementation and everyday use of welfare technology in public home care services. Method This qualitative study has an explorative and descriptive design. Sixteen interviews of service users were conducted in five different municipalities over a period of six months. The data were analysed using reflexive thematic analysis. Results Service users receiving public home care service are not a homogenous group, and the participants had different wishes and needs as regards user involvement and the use of welfare technology. The analysis led to four main themes: 1) diverse preferences as regards user involvement, 2) individual differences as regards information, knowledge and training, 3) feeling safe and getting help, and 4) a wish to stay at home for as long as possible. Conclusion The results indicated that user involvement was only to a limited extent an integral part of public home care services. Participants had varying insight into and interest in welfare technology, which was a challenge for user involvement. User involvement must be facilitated and implemented in a gentle way, highlighting autonomy and collaboration, and with the focus on respect, reciprocity and dialogue.

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Person-centered dementia care in home care services – highly recommended but still challenging to obtain: a qualitative interview study

BMC Health Services Research ◽

10.1186/s12913-021-06722-8 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Kari-Anne Hoel ◽

Anne Marie Mork Rokstad ◽

Ingvild Hjorth Feiring ◽

Bjørn Lichtwarck ◽

Geir Selbæk ◽

...

Keyword(s):

Decision Making ◽

Home Care ◽

Shared Decision Making ◽

Care Service ◽

Home Care Services ◽

Shared Decision ◽

Care Services ◽

Person Centered Care ◽

People With Dementia ◽

Centered Care

Abstract Background Dementia is one of the main causes of disability and dependence in older people, and people with dementia need comprehensive healthcare services, preferably in their own homes. A well-organized home care service designed for people with dementia is necessary to meet their needs for health- and social care. Therefore, it is important to gain knowledge about how people with dementia experience the home care service and if the service responds to their wishes and needs. The aim of this study was to explore the experience of home care services among people with dementia, to understand the continuity in services, how the service was adapted to people with dementia, and how the patient experienced person-centered care and shared decision-making. Methods We used a qualitative, exploratory design based on a phenomenological-hermeneutic approach and performed individual in-depth interviews with persons with dementia. A convenience sample of 12 persons with moderate to severe degrees of dementia from four Norwegian municipalities participated in the study. The interviews were conducted in February 2019. Results The findings identified that the participants appreciated the possibility to stay safely in their own homes and mostly experienced good support from staff. They expressed various views and understanding of the service and experienced limited opportunities for user involvement and individualized, tailored service. The overall theme summarizing the findings was: “It is difficult for people with dementia to understand and influence home care services, but the services facilitate the possibility to stay at home and feel safe with support from staff.” Conclusion The participants did not fully understand the organization of the care and support they received from the home care services, but they adapted to the service without asking for changes based on their needs or desires. Although person-centered care is recommended both nationally and internationally, the participants experienced little inclusion in defining the service they received, and it was perceived as unclear how they could participate in shared decision-making.

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The Reform of Home Care Services in Ontario: Opportunity Lost or Lesson Learned?

Canadian Journal of Occupational Therapy ◽

10.1177/000841740707400309 ◽

2007 ◽

Vol 74 (3) ◽

pp. 208-216 ◽

Cited By ~ 1

Author(s):

Glen Randall

Keyword(s):

Home Care ◽

Physical Therapists ◽

Critical Role ◽

Care Program ◽

Home Care Services ◽

Rehabilitation Services ◽

Hospital Discharges ◽

Rehabilitation Professionals ◽

Care Services ◽

Commission Report

Background. With the release of the Romanow Commission report, Canadian governments are poised to consider the creation of a national home care program. If occupational and physical therapists are to have input in shaping such a program, they will need to learn from lost opportunities of the past. Purpose. This paper provides an overview of recent reforms to home care in Ontario with an emphasis on rehabilitation services. Method. Data were collected from documents and 28 key informant interviews with rehabilitation professionals. Results. Home care in Ontario has evolved in a piecemeal manner without rehabilitation professionals playing a prominent role in program design. Practice Implications. Rehabilitation services play a critical role in facilitating hospital discharges, minimizing readmissions, and improving the quality of peoples' lives. Canadians will benefit if occupational and physical therapists seize the unique opportunity before them to provide meaningful input into creating a national home care program.

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Facilitators and Barriers to Accepting Long Term Care at Home: An Analysis of Licensed Home Care Service Agency Websites

Home Health Care Management & Practice ◽

10.1177/1084822321994779 ◽

2021 ◽

pp. 108482232199477

Author(s):

Tracy Chippendale ◽

Patricia Gentile

Keyword(s):

Home Care ◽

Care Service ◽

Home Care Services ◽

Home Care Service ◽

Service Agency ◽

Term Care ◽

Age In Place ◽

Care Services ◽

Facilitators And Barriers ◽

Website Content

Most people prefer to age in place. However, there is a growing body of literature to suggest a reluctance to accept supportive services in the home due to concerns about trust, privacy, cost, and fear of being a burden. The purpose of this study was to examine potential facilitators and barriers to accepting home care services in the website content of Licensed Home Care Service Agencies (LHSCA). In this linguistic analysis study, the written content from 88 randomly selected LHCSA websites was examined. We used LIWC2015 and Microsoft® Word software to analyze websites for relevant word categories that reflect older adult identified facilitators and barriers to the acceptance of home care services. Results revealed that the summary score for clout (i.e., confidence and leadership reflected in the writing) was high. Some of the most commonly used word categories were positive emotions, present focused, and affiliation. The word category money was included, but to a lesser degree. However, Burden and related words were highly prevalent in the writing sample. In summary, LHCSA website content contains both facilitators and barriers to the acceptance of home care services. Given the importance of home care services in promoting the ability of older adults to age in place, greater attention may be needed regarding the way services are presented and advertised to consumers.

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. Sobrecarga do cuidador de pacientes atendidos na atenção domiciliar

Revista de Enfermagem UFPE on line ◽

10.5205/1981-8963.2020.244235 ◽

2020 ◽

Vol 14 ◽

Author(s):

Monique Évellin Alves Cruz ◽

Daniel Vinícius Alves Silva ◽

Júlia Rocha do Carmo ◽

Gabriel Dias de Araújo ◽

Luiza Rodrigues Camisasca ◽

...

Keyword(s):

Home Care ◽

Statistical Significance ◽

Care Program ◽

Home Care Services ◽

Cross Sectional Study ◽

Common Finding ◽

Bivariate Analysis ◽

Daily Routine ◽

Cross Sectional ◽

Zarit Burden Interview

Objetivo: avaliar a sobrecarga de cuidadores de pacientes atendidos por um programa de atenção domiciliar público. Método: trata-se de um estudo quantitativo, descritivo, transversal, com 127 cuidadores de pacientes atendidos pelo Programa Melhor em Casa. Coletaram-se dados sociodemográficos e clínicos e aplicaram-se também a Escala Zarit Burden Interview reduzida e a Escala de Desesperança de Beck. Realizou-se análise descritiva e bivariada de dados. Resultados: verificou-se que, dos 127 cuidadores, a maioria era do sexo feminino (114=89,8%), de cor parda (81=63,8%); composta por solteiros (56=44,1%) e a média de idade foi de 46,66 anos. Destaca-se que 38,6% (49) apresentaram sobrecarga de moderada a grave, 78,7% (110) afirmaram que houve mudanças em sua rotina diária, 59,8% (76) dizem ter sofrido alguma mudança no estado emocional após iniciar o cuidado do paciente e 56,7% (72) sentem dores no corpo. Confirmaram-se, na análise bivariada, 15 variáveis independentes que obtiveram significância estatística. Conclusão: conclui-se que a sobrecarga do cuidador de pacientes da atenção domiciliar é um achado comum e cuidados para a sua prevenção devem ser estabelecidos. Descritores: Cuidadores; Esgotamento Psicológico; Serviços de Assistência Domiciliar; Assistência Domiciliar; Pacientes Domiciliares; Enfermagem.AbstractObjective: to assess the burden of caregivers of patients treated by a public home care program. Method: this is a quantitative, descriptive, cross-sectional study, with 127 caregivers of patients treated by the Melhor em Casa Program. Sociodemographic and clinical data were collected, and the reduced Zarit Burden Interview Scale and the Beck Hopelessness Scale were also applied. Descriptive and bivariate data analyses were performed. Results: of the 127 caregivers, the majority was female (114=89.8%), pardos (81=63.8%); composed of unmarried (56=44.1%) and the mean age was 46.66 years. Importantly, 38.6% (49) had moderate to severe burden, 78.7% (110) stated the occurrence of changes in their daily routine, 59.8% (76) mentioned having suffered some change in emotional state after starting the care with the patients and 56.7% (72) have body ache. The bivariate analysis confirmed the statistical significance of 15 independent variables. Conclusion: the burden of caregivers of homebound patients is a common finding, requiring care actions for its prevention. Descriptors: Caregivers; Burnout, Psychological; Home Care Services; Home Nursing; Homebound Persons; Nursing. ResumenObjetivo: evaluar la sobrecarga de los cuidadores de pacientes tratados mediante un programa de atención domiciliaria público. Método: se trata de un estudio cuantitativo, descriptivo, transversal, con 127 cuidadores de pacientes tratados por el Programa Melhor em Casa. Recogieron datos sociodemográficos y clínicos y se aplicaron la escala Zarit Burden Interview reducida y la Escala de Desesperanza de Beck. Se realizó el análisis descriptivo y bivariado de los datos. Resultados: se constató que, de 127 cuidadores, la mayoría eran mujeres (114=89,8%), pardos (81=63,8%); compuesto de solteros (56=44,1%) y el promedio de edad fue de 46.66 años. Cabe destacar que el 38,6% (49) presentó sobrecarga moderada a severa, el 78,7% (110) declaró que ha habido cambios en su rutina diaria, el 59,8% (76) afirmó tener sufrido algún cambio en el estado emocional después de iniciar los cuidados del paciente, y el 56,7% (72) siente dolor en el cuerpo. Se confirman, en el análisis bivariado, 15 variables independientes que tuvieron significación estadística. Conclusión: se concluye que la sobrecarga de los cuidadores de pacientes en atención domiciliaria es un hallazgo común y cuidados en su prevención deben ser establecidos. Descriptores: Cuidadores; Agotamiento Psicológico; Servicios de Atención de Salud a Domicilio; Atención Domiciliaria de Salud; Personas Imposibilitadas; Enfermería.

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

SAGE Open Nursing ◽

10.1177/2377960819844367 ◽

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.

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A Qualitative Exploration of the Needs of Community-Dwelling Patients Living with Moderate Dementia

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18178901 ◽

2021 ◽

Vol 18 (17) ◽

pp. 8901

Author(s):

Tzu-Pei Yeh ◽

Hsing-Chia Chen ◽

Wei-Fen Ma

Keyword(s):

Home Care ◽

Service Providers ◽

Care Service ◽

Home Care Services ◽

Community Dwelling ◽

End Of Life Decisions ◽

Face To Face ◽

Care Services ◽

Moderate Dementia ◽

Qualitative Exploration

Few studies have focused on developing a better understanding of the needs of patients with moderate-stage dementia. This study aimed to explore the needs of people living with moderate dementia and receiving home-care services from a local mental hospital. The study adopted a descriptive qualitative approach with purposive sampling to recruit patients with moderate dementia and receiving home-care services. Data were collected by face-to-face interviews and content analysis was used to interpret the experiences in the dialogue data. The results showed that the needs of people living with moderate dementia receiving home-care services contained four themes: the demand for company and care, the wish to recall familiar images, the need of reaffirming life purpose and value through reflection and reminiscence, and the desire for making autonomous end-of-life decisions. In addition to daily care, people living with moderate dementia crave companionship, expect meaningful exchanges of experiences to share their life, and have demands to have a voice in going through the final stage of life. The participants tended to focus more on issues related to the connections between living and dying. The results provide caregivers and home-care service providers with some insights into offering better care for people living with moderate dementia.

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Patient Safety Culture in Primary and Home Care Services

10.21203/rs.3.rs-23098/v2 ◽

2020 ◽

Author(s):

Letícia Lousada ◽

Francisco Clécio Dutra ◽

Beatriz Silva ◽

Natália Oliveira ◽

Ismael Bastos ◽

...

Keyword(s):

Health Care ◽

Patient Safety ◽

Primary Health Care ◽

Home Care ◽

Safety Culture ◽

Care Service ◽

Patient Safety Culture ◽

Home Care Services ◽

Care Services ◽

Primary Health

Abstract Background: Safety culture in primary care and home care services is still poorly studied, although this levels of care are the gateways to health services. This study aims to evaluate the culture of patient safety in Primary and Home Care Services. Methods: This is an observational cross-sectional study carried out with 147 professionals from nine district linked to the Home Care Program and six primary health care units. For the evaluation of culture, the Safety Attitudes Questionnaire (SAQ) was used, which considers a positive patient safety culture with scores ≥ 75. Results: Men who work in home care with time of professional experience of three to four years scored better for the Safety Climate, Job Satisfaction, Teamwork Climate and Total SAQ. Perception of management and Working Conditions received lower scores from professionals with long time of experience.Conclusions: It is concluded that the safety culture evaluation was better in the home care service when compared to the primary health care service.

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