Usage of a Web-Based Platform for Home Care Providers in the Pandemic Context

The paper presents the usage of a platform for home care providers that integrates telemonitoring functionalities in the context of the recent COVID-19 pandemic.

Crossing knowledge boundaries: health care providers’ perceptions and experiences of what is important to achieve more person-centered patient pathways for older people

Background Improving the transitional care of older people, especially hospital-to-home transitions, is a salient concern worldwide. Current research in the field highlights person-centered care as crucial; however, how to implement and enact this ideal in practice and thus achieve more person-centered patient pathways remains unclear. The aim of this study was to explore health care providers’ (HCPs’) perceptions and experiences of what is important to achieve more person-centered patient pathways for older people. Methods This was a qualitative study. We performed individual semistructured interviews with 20 HCPs who participated in a Norwegian quality improvement collaborative. In addition, participant observation of 22 meetings in the quality improvement collaborative was performed. Results A thematic analysis resulted in five themes which outline central elements of the HCPs’ perceptions and experiences relevant to achieving more person-centered patient pathways: 1) Finding common ground through the mapping of the patient journey; 2) the importance of understanding the whole patient pathway; 3) the significance of getting to know the older patient; 4) the key role of home care providers in the patient pathway; and 5) ambiguity toward checklists and practice implementation. Conclusions The findings can assist stakeholders in understanding factors important to practicing person-centered transitional care for older people. Through collaborative knowledge sharing the participants developed a more shared understanding of how to achieve person-centered patient pathways. The importance of assuming a shared responsibility and a more holistic understanding of the patient pathway by merging different ways of knowing was highlighted. Checklists incorporating the What matters to you? question and the mapping of the patient journey were important tools enabling the crossing of knowledge boundaries both between HCPs and between HCPs and the older patients. Home care providers were perceived to have important knowledge relevant to providing more person-centered patient pathways implying a central role for them as knowledge brokers during the patient’s journey. The study draws attention to the benefits of focusing on the older patients’ way of knowing the patient pathway as well as to placing what matters to the older patient at the heart of transitional care.

Development and testing of the Geriatric Care Assessment Practices (G-CAP) survey

Background While the Resident Assessment Instrument-Home Care (RAI-HC) tool was designed to support comprehensive geriatric assessment in home care, it is more often used for service allocation and little is known about how point-of-care providers collect the information they need to plan and provide care. The purpose of this pilot study was to develop and test a survey to explore the geriatric care assessment practices of nurses, occupational therapists (OTs) and physiotherapists (PTs) in home care. Methods Literature review and expert consultation informed the development of the Geriatric Care Assessment Practices (G-CAP) survey—a 33 question, online, self-report tool exploring assessment and information-sharing methods, attitudes, knowledge, experience and demographic information. The survey was pilot tested at a single home care agency in Ontario, Canada (N = 27). Test-retest reliability (N = 20) and construct validity were explored. Results The subscales of the G-CAP survey showed fair to good test-retest reliability within a population of interdisciplinary home care providers [ICC2 (A,1) (M ICC = 0.58) for continuous items; weighted kappa (M kappa = 0.63) for categorical items]. Statistically significant differences between OT, PT and nurse responses [M t = 3.0; M p = 0.01] and moderate correlations between predicted related items [M r = |0.39|] provide preliminary support for our hypotheses around survey construct validity in this population. Pilot participants indicated that they use their clinical judgment far more often than standardized assessment tools. Client input was indicated to be the most important source of information for goal-setting. Most pilot participants had heard of the RAI-HC; however, few used it. Pilot participants agreed they could use assessment information from others but also said they must conduct their own assessments and only sometimes share and rarely receive information from other providers. Conclusions The G-CAP survey shows promise as a measure of the geriatric care assessment practices of interdisciplinary home care providers. Findings from the survey have the potential to inform improvements to integrated care planning. Next steps include making adaptations to the G-CAP survey to further improve the reliability and validity of the tool and a broad administration of the survey in Ontario home care.

Characteristics and well-being of urban informal home care providers during COVID-19 pandemic: a population-based study

ObjectivesGlobally, the COVID-19 pandemic has overwhelmed many healthcare systems, which has hampered access to routine clinical care during lockdowns. Informal home care, care provided by non-healthcare professionals, increases the community’s healthcare capacity during pandemics. There is, however, limited research about the characteristics of informal home care providers and the challenges they face during such public health emergencies.DesignA random, cross-sectional, population-based, RDD, telephone survey study was conducted to examine patterns of home care, characteristics of informal home care providers and the challenges experienced by these care providers during this pandemic.SettingData were collected from 22 March to 1 April 2020 in Hong Kong, China.ParticipantsA population representative study sample of Chinese-speaking adults (n=765) was interviewed.Primary and secondary outcome measuresThe study examined the characteristics of informal home care providers and self-reported health requirements of those who needed care. The study also examined providers’ self-perceived knowledge to provide routine home care as well as COVID-19 risk reduction care. Respondents were asked of their mental health status related to COVID-19.ResultsOf the respondents, 25.1% of 765 provided informal home care during the studied COVID-19 pandemic period. Among the informal home care providers, 18.4% of respondents took leave from school/work during the epidemic to provide care for the sick, fragile elderly and small children. Care providers tended to be younger aged, female and housewives. Approximately half of care providers reported additional mental strain and 37.2% reported of challenges in daily living during epidemic. Although most informal home care providers felt competent to provide routine care, 49.5% felt inadequately prepared to cope with the additional health risks of COVID-19.ConclusionDuring public health emergencies, heavy reliance on informal home healthcare providers necessitates better understanding of their specific needs and increased government services to support informal home care.

In the Pursuit of an Identity: Analysing the Case of Male Health Care Providers

Being a female-concentrated job, nursing has forgotten the place of men within the profession despite their contribution since time immemorial. The heightened efforts of Florence Nightingale to transform nursing into a respectable female occupation denied men the opportunity to enter this domain. Despite their growing representation, they are still a minority in nursing in countries across the globe. When the occupational roles do not conform to the gender-appropriate roles prescribed by the society, the ‘male’ nurses’ prestige and self-esteem are at risk since others recognize them neither as true nurses nor as real men. Drawing majorly from secondary sources and data gathered from an anthropological study of in-home care providers in the South Indian state of Kerala, this paper on the predicament of men in nursing throws light on the ‘spoiled identity’ they carry; the work stress, gender stereotyping, stigma and discrimination they encounter by always being suspected and their very identity and sexual orientation questioned. A note on the strategies employed by them to overcome the problems is also within the purview of this paper.