scholarly journals The active involvement of the person being treated by the nursing clinic and with home-based care in the local context of local District n. 1, of the ASUGI of Trieste

ABOUTOPEN ◽  
2020 ◽  
Vol 7 (1) ◽  
pp. 58-61 ◽  
Author(s):  
Raffaela Fonda ◽  
Daniela Ortolan
Keyword(s):  
Care Pathway ◽  
Care Plan ◽  
Local Context ◽  
Evaluation Tool ◽  
Home Setting ◽  
Personalized Care ◽  
Active Involvement ◽  
Home Based ◽  
Home Based Care

Introduction: This contribution describes four different experiences of active engagement along the care pathway of people with chronic illness, performed at home and at the nursing clinic of the ASUGI Health District n. 1 in Trieste by a local care team. Case description: The Home Nursing Service, named SID, of the Local Districts of Trieste is based on the principle of improving the quality of life of citizens by providing adequate home care in the logic of continuity of care, consistently with the needs of the person, after a multidimensional assessment and the construction of a personalized care plan, aimed at increasing engagement and participation. ù Conclusions: This experience contributed to the cultural growth of professionals and to the systematic introduction of the PHE-S® evaluation tool in the home setting, improving also their relational skills.

scholarly journals Telehealth Use in a Home-Based Dementia Care-Coordination Program

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 195-196
Author(s):  
Deirdre Johnston ◽  
Melissa Reuland ◽  
Kelly Marshall ◽  
Inga Antonsdottir ◽  
Morgan Bunting ◽  
...  
Keyword(s):  
Clinical Supervision ◽  
Unmet Need ◽  
Dementia Care ◽  
Care Plan ◽  
Home Setting ◽  
Home Team ◽  
Individualized Care ◽  
Home Based ◽  
Increased Risk ◽  
At Home

Abstract In the coming decades, greater numbers of people will either have Alzheimer’s Disease or a related dementia or will take care of a family member with dementia. The dementia syndromes are associated with increased risk of medical, social, and behavioral complications in both the person with dementia (PWD) and the caregiver (CG), many of which are preventable. These complications, and the dementia itself, can impede access to care and ultimately hasten residential care placement, which can be both undesirable and costly. A nearly universal unmet need in PWD/CG dyads is dementia-specific education. Therefore, it is vital we find ways to support and provide education to CG/PWD dyads to manage dementia in the community and home setting. MIND at Home is a dementia-care model developed and tested at Johns Hopkins University School of Medicine to minimize dementia complications and delay institutionalization by training non-clinical Memory Care Coordinators (MCCs) working under clinical supervision to support and guide PWD/CG dyads in the community. MCCs collaborate with CGs and PWDs in the community using an individualized care plan structured around the dyads’ specific dementia-related needs. This presentation will describe how the MIND at Home team used handheld tablets to connect MCCs to clinicians from participants’ homes, and will report on challenges encountered, strategies to address them, and participant and caregiver satisfaction with the telehealth experience.

scholarly journals Planning Implementation Success of Syncope Clinical Practice Guidelines in the Emergency Department Using CFIR Framework

2021 ◽  
Author(s):  
Jing Li ◽  
Susan S. Smyth ◽  
Jessica Miller Clouser ◽  
Colleen A. McMullen ◽  
Vedant Gupta ◽  
...  
Keyword(s):  
Emergency Department ◽  
Clinical Practice ◽  
Family Caregivers ◽  
Implementation Strategy ◽  
Care Pathway ◽  
Implementation Strategies ◽  
Mobile App ◽  
Care Plan ◽  
Local Context ◽  
Successful Implementation

Background and Objectives: Overuse and inappropriate use of testing and hospital admission are common in syncope evaluation and management. Though guidelines are available to optimize syncope care, study suggested that the current clinical guidelines have not significantly impacted resource utilization surrounding emergency department (ED) evaluation of syncope. Matching implementation strategies to barriers and facilitators and tailoring strategies to local context hold significant promise for a successful implementation of clinical practice guideline (CPG). Our team applied implementation science principles to develop a stakeholder-based implementation strategy. Methods and Materials: We partnered with patients, family caregivers, frontline clinicians and staff, and health system administrators at four health systems to conduct quantitative surveys and qualitative interviews for context assessment. The identification of implementation strategies was done by applying the CFIR-ERIC Implementation Strategy Matching Tool and soliciting stakeholders’ inputs. We then co-designed with patients and frontline teams, developed and tested specific strategies. Results: 114 clinicians completed surveys and 32 clinicians and stake-holders participated in interviews. Results from the surveys and interview indicated low awareness of syncope guidelines, and communication challenges with patients, lack of CPG protocol integration into ED workflows, and organizational process to change were recognized as major barriers. Thirty-one patients and their family caregivers participated in interviews and ex-pressed their expectations: clarity regarding their diagnosis, context surrounding care plan and diagnostic testing, and a desire to feel cared about. After identifying change methods to address those barriers, the multilevel, multicomponent implementation strategy, MISSION, included pa-tient educational materials, mentored implementation, academic detailing, Syncope Optimal Care Pathway and corresponding Mobile App, and Lean quality improvement methods. The pilot of MISSION demonstrated feasibility, acceptability and initial success on appropriate testing. Con-clusions: Effect multifaceted implementation strategies that target individuals, teams, and healthcare systems can be employed to plan successful implementation and promote adherence to syncope CPGs.

scholarly journals An Exploration of Factors Related to Quality of Life in Indonesian Care Workers in Home-Based Care Settings

2019 ◽  
Vol 27 (5) ◽  
pp. e47
Author(s):  
Shu-Fen LO ◽  
Li-Jung CHANG ◽  
Mark HAYTER ◽  
An-Chi O YANG
Keyword(s):  
Quality Of Life ◽  
Home Based ◽  
Care Workers ◽  
Home Based Care

scholarly journals Engagement in the local context: the active involvement of the person suffering from long-term pathologies

ABOUTOPEN ◽  
2020 ◽  
Vol 7 (1) ◽  
pp. 62-63 ◽  
Author(s):  
Bianca Lenardoni ◽  
Ernesto Natale
Keyword(s):  
Quality Of Life ◽  
Nursing Staff ◽  
Local Context ◽  
Case Description ◽  
Outpatient Services ◽  
Local District ◽  
Active Involvement ◽  
Clinical Relationship

Introduction: In 2017 the nursing staff of Health Local District no. 2 of Trieste followed 67 patients in charge at both the home and the outpatient services for long-term pathologies starting from the hospitalization. Case description: The Service administered the PHE-S® scale to these 67 patients, in the light of a strategical consideration of the importance of monitoring the levels of patients’ engagement and of personalizing dedicated initiatives to promote the active involvement of the patients, also thanks to the improvement of the clinical relationship. The level of engagement was measured at zero, one and four months after hospitalization. In the four months after discharge, the nursing staff applied specific strategies to promote engagement. Conclusions: This study shows that engagement of patients with long-term illnesses is strategically important to improve care and quality of life.

Caregiver stress: Clinical evaluation and intervention strategies for caregiver burden prevention.

2017 ◽  
Vol 35 (31_suppl) ◽  
pp. 22-22 ◽  
Author(s):  
Laura Velutti ◽  
Carlotta Pavesi ◽  
Chiara Poggio ◽  
Beatrice Carettoni ◽  
Annalisa Saetta ◽  
...  
Keyword(s):  
Caregiver Burden ◽  
Care Pathway ◽  
Structured Interview ◽  
Qualitative Assessment ◽  
Published Data ◽  
Inpatient Setting ◽  
Home Setting ◽  
Basic Care ◽  
Home Based ◽  
Weekly Meeting

22 Background: Caregivers (CGs) of advanced cancer patients (pts/ACPs) experience a higher incidence of medical and psychological conditions compared to general population. Methods: We conducted a prospective assessment of the caregiver burden (CGB) - a term describing the physical, psychological, emotional, social, and financial problems often experienced by CGs - to identify potential risk management strategies. We used the Caregiver Burden Inventory (CBI), a multi-dimensional questionnaire with 5 subscales: Time Dependent, Developmental, Physical, Social, Emotional CGB, as a quantitative tool to investigate the level of stress of our pts CGs. Also, we used a semi-structured interview with 5 questions as a qualitative tool. Results: From Dec 2016 to Feb 2017 we administered the CBI and the interview to 37 CGs (F/M 31/6) of ACPs in 3 different settings: inpatient (9 CGs), outpatient (15 CGs), home-based (13 CGs). The quantitative data analysis showed that CGs had a variable emotional load, mostly of moderate level. In particular, the level of stress of our pts CGs of outpatients and inpatients was higher in the physical dimension, while was higher in the time dimension for CGs of home-based pts. Semi-structured interviews showed that CGs of home-based pts did not feel adequate to provide assistance to their relatives, and had partial or poor knowledge of basic care, especially of in-bed mobilization and hygiene techniques. In the other 2 settings, CGs showed a higher level of stress due to the lack of a professional contact person throughout the care pathway, and experienced the need of psychological support. Overall, the qualitative assessment showed that CGs lives were strongly affected by caregiving. Conclusions: Our results confirm published data showing that assisting ACPs is a particularly difficult task for the CGs. Therefore, we implemented potential improvement strategies: in the home setting, specific attention to the educational aspects of basic care; in the inpatient setting, a weekly meeting for physicians, nurses, and psychologists, to discuss the most difficult cases; in the outpatient setting, a 25% increase in the number of visits for pain and supportive therapy to offer a better continuity of care.

scholarly journals Home-Based Care and Perceived Quality of Life Among People Living with HIV in Ho Chi Minh City, Viet Nam

2018 ◽  
Vol 22 (S1) ◽  
pp. 85-91
Author(s):  
Quyen Thi Tu Bui ◽  
Deborah Bain Brickley ◽  
Van Thi Thu Tieu ◽  
Nancy K. Hills
Keyword(s):  
Quality Of Life ◽  
Perceived Quality ◽  
Ho Chi Minh City ◽  
People Living With Hiv ◽  
Viet Nam ◽  
Home Based ◽  
Perceived Quality Of Life ◽  
Living With Hiv ◽  
Home Based Care

Relationship between emotional distress in caregivers and health status in persons with multiple sclerosis

2004 ◽  
Vol 10 (4) ◽  
pp. 442-446 ◽  
Author(s):  
C Pozzilli ◽  
L Palmisano ◽  
C Mainero ◽  
V Tomassini ◽  
F Marinelli ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Health Status ◽  
Mood State ◽  
Psychological Morbidity ◽  
Home Based ◽  
Sf 36 ◽  
Psychological Impairment ◽  
One Year ◽  
Home Based Care

Caregivers of persons with multiple sclerosis (MS) exhibit less satisfaction with quality of life with respect to the general population. To assess the relationship between depression in caregivers and health status profiles of MS patients, we examined data from 133 patients and their respective caregivers, as a part of a prospective randomized trial aimed to investigate the effectiveness of home-based care. Patients were evaluated at baseline and one year later with measures of physical and psychological impairment and health status (SF-36 Health Survey). Caregivers’ psychological morbidity was assessed by the Profile of Mood State (POMS) at the same time points. An improvement of patients’ health status as measured in four out of eight SF-36 dimensions was observed over the study period, while psychological morbidity of their caregivers did not change significantly. Depression in caregivers was related to physical, emotional and health status of the patients at baseline and/or at 12-month follow-up. Changes in the degree of depression of caregivers were also associated with changes in disability and health status of the patients. This study confirms and extends in a home-care setting previous findings on relationships between patients’ status and depression in caregivers. It suggests that the caregiver is an appropriate and independent target for more focused therapeutic strategies.

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