Control of Elderly Hypertension with Merona Program

Hypertension is a silent killer is the most common health problem experienced by the elderly. Control of hypertension in the elderly is very necessary to reduce complications of hypertension. Based on these conditions, the MERONA Program was developed. The purpose is to provide an overview of the implementation of the blush program in the elderly with hypertension. The method used is a family case study and an aggregate using a family and community nursing process approach involving 10 foster families and 60 elderly people in the community selected using cluster random sampling. This program is an integration of hypertension self-management and relaxation therapy, namely music therapy, progressive muscle relaxation, and deep breathing relaxation which is carried out for 12 weeks. Evaluation of changes in behavior and family independence was carried out at the end of the 12th week using a questionnaire. Blood pressure measurements were carried out at weeks 4, 8, and 12. The results of the implementation were an increase in the behavior of the elderly, an increase in the level of family independence, and a significant decrease in systolic and diastolic blood pressure (p<0.05). The MERONA program is recommended to be applied in community health services.

Community-based support for children who are next-of-kin for a parent experiencing illness or disability – a scoping review

Introduction Children who are next-of-kin, for a parent who experience illness or disability, need support. In Norway, guidelines, routines and structured approaches in the community health services are lacking regarding involving children in the care of a parent and for services when supporting children as next-of-kin. Additionally, no existing international review has focused on support from community health and social services for children who are next-of-kin to a parent regardless of the specific illness or disability. Aims This scoping review examined the current knowledge regarding the types of community health and social services support to children 0 to 17 years old living with a parent experiencing illness or disability. The review also identified children’s support preferences and needs. Methods The scoping review involved five stages; identifying research question; identifying relevant articles; selecting articles; charting the data and finally, collating, summarizing and reporting the results. Results Articles which included community health and social services interventions and children’s preferences or needs for support were included. The foci of interventions included preventive education, peer support, psychosocial support, and interventions focusing on family communication and recovery planning. Articles focusing on children’s preferences or need for support described their wish to be recognized as a next-of-kin, having someone to talk to and professional and peer support. Conclusion The review highlighted the importance of children receiving support according to their preferences. It is important to elicit children’s voices, to ensure community health and social services are developed for and tailored to this population.

Optimalisasi program perkesmas dengan kunjungan rumah terhadap tingkat kemandirian keluarga serta peningkatan pengetahuan perawat dalam penulisan askep keluarga

Program Indonesia Sehat Pendekatan Keluarga (PISPK) is necessary to have continuous intervention and become a integrated program at the Public Health Center (Puskesmas). The aim purposes of this activities was to analyzed The desired objectives are to optimize home visits to increase the level of family independence and to optimize the competence of nurses in writing and documentation of family nursing care plan integrated with Nanda, Noc and Nic. The implementation phase includes home visits conducted 2-4 times and carrying out cross-program activities and the evaluation phase includes recompiling and analyzed data. There are 18 heads of households who are respondents. This activity showed that home visits through providing family nursing care and education in the family gave change the family independence level. In the future, it is expected that home visits will become priority of Public Health Center (Puskesmas) activities to improve community health status, In addition, the guidelines and modules are able to increase the knowledge, attitudes, skills, and activities of nurses in the implementation of community health services which increase the use of health facilities by families and as a complement to the community health services module in order to improve the performance of Nurse in Public Health center.

Optimalisasi program perkesmas dengan kunjungan rumah terhadap tingkat kemandirian keluarga serta peningkatan pengetahuan perawat dalam penulisan askep keluarga

Program Indonesia Sehat Pendekatan Keluarga (PISPK) is necessary to have continuous intervention and become a integrated program at the Public Health Center (Puskesmas). The aim purposes of this activities was to analyzed The desired objectives are to optimize home visits to increase the level of family independence and to optimize the competence of nurses in writing and documentation of family nursing care plan integrated with Nanda, Noc and Nic. The implementation phase includes home visits conducted 2-4 times and carrying out cross-program activities and the evaluation phase includes recompiling and analyzed data. There are 18 heads of households who are respondents. This activity showed that home visits through providing family nursing care and education in the family gave change the family independence level. In the future, it is expected that home visits will become priority of Public Health Center (Puskesmas) activities to improve community health status, In addition, the guidelines and modules are able to increase the knowledge, attitudes, skills, and activities of nurses in the implementation of community health services which increase the use of health facilities by families and as a complement to the community health services module in order to improve the performance of Nurse in Public Health center.

Evaluation of the costing methodology of published studies estimating costs of surgical site infections: A systematic review

Objectives: Surgical site infections (SSIs) are associated with increased length of hospitalization and costs. Epidemiologists and infection control practitioners, who are in charge of implementing infection control measures, have to assess the quality and relevance of the published SSI cost estimates before using them to support their decisions. In this review, we aimed to determine the distribution and trend of analytical methodologies used to estimate cost of SSIs, to evaluate the quality of costing methods and the transparency of cost estimates, and to assess whether researchers were more inclined to use transferable studies. Methods: We searched MEDLINE to identify published studies that estimated costs of SSIs from 2007 to March 2021, determined the analytical methodologies, and evaluated transferability of studies based on 2 evaluation axes. We compared the number of citations by transferability axes. Results: We included 70 studies in our review. Matching and regression analysis represented 83% of analytical methodologies used without change over time. Most studies adopted a hospital perspective, included inpatient costs, and excluded postdischarge costs (borne by patients, caregivers, and community health services). Few studies had high transferability. Studies with high transferability levels were more likely to be cited. Conclusions: Most of the studies used methodologies that control for confounding factors to minimize bias. After the article by Fukuda et al, there was no significant improvement in the transferability of published studies; however, transferable studies became more likely to be cited, indicating increased awareness about fundamentals in costing methodologies.

Community frailty team workforce development – a personal reflection

PurposeThis paper represents a personal view of a newly appointed consultant practitioner trainee in frailty. This role was created as a result of a rapid workforce review of a Frailty Support Team (FST) in response to the COVID-19 pandemic.Design/methodology/approachThe FST traditionally worked alongside other community services. A “One Team” approach was developed whereby prior silos of community nursing, therapy and frailty teams became a single, locality based and mutually supportive integrated community service. This significantly increased capacity for an urgent community response for older people with complex needs and improved clinical management and coordination of care. As a workforce review identified the need for skills development, new roles for trainee advanced frailty practitioners (AFPs) and a consultant practitioner trainee in frailty were established.FindingsStaff experience of the “One Team” model was positive. The changes were thought to encourage closer and more efficient working between primary care and a range of community health services. The improved communication between professionals enabled more personalised care at home, reducing pressure on emergency hospital services. A rapid review of the workforce model has enabled the enhanced team capacity to cover a wider geographical area and improved recruitment and retention of staff by introducing a new pathway for career progression within the expanding specialism of frailty.Originality/valueThe challenge of COVID-19 has prompted rapid service redesign to create an enhanced “One Team in the community.” The innovative workforce model looks beyond traditional roles, values the experience and capabilities of staff and develops the skills and confidence required to provide a more integrated and person-centred specialist community pathway for people living with frailty.

The Work Competence of General Practitioners Working in Shanghai’s Community Health Services: A Cross-Sectional Study based on Self-assessment

Background: The aim of the study was to investigate the work competence of GPs in community health services(CHS) in Shanghai, China. Methods: A questionnaire was designed on the basis of a previous capacity evaluation indicator system. We adopted a stratified and proportional cluster sampling method in this self-assessment and cross-sectional study. We collected data on GPs demographic variables and work competence which was separated as patient care ability, teaching ability, communication skill and coordination ability, using the questionnaire. Results: A total of 2954 GPs were sampled from 116 CHS in Shanghai. The median score of patient care ability, teaching ability, communication skill and coordination ability were 80[70-88.75], 76[60-80] and 80[70-85] on a scale of 100, respectively. GPs who were 30-39 years old, worked in urban CHS, and participated in GP trainer’s training or had teaching experience got higher scores in patient care ability. GPs who worked for 5-20 years in CHS, worked in training CHSs and participated in GP trainer’s training program had higher scores in teaching ability. As for communication skill and coordination ability, GPs who were older than 30-39 years old and with a senior professional title, worked in training CHS, participated in GP trainer’s training and had teaching experiences in CHS got higher scores. Conclusions: The work competence of GPs in Shanghai’s CHS largely meets the requirements of daily practice, but there is still great improving space in the aspect of teaching ability.

The Role of Leadership and its Relationship with the Performance of Community Health Volunteer: A Survey in Rural Indonesia

Background: Community Health Volunteers (CHVs) are the manifestation of community participation to solve health issues of the community, which is reflected through Integrated Services Post or known as Posyandu activities. Therefore, CHVs selection criteria need to be upgraded to support their performance in delivering community health services. This research aimed at identifying the relationship between the role of leadership and their performance in Posyandu activities. Method: This was a cross-sectional study conducted in Purwomartani village, Sleman, with a total of 68 respondents. Data were collected using validated questionnaires to evaluate the leadership and performance of healthy volunteers. The data were analyzed using Spearman's rank correlation. Results: The respondents comprised 100% females, 71.3% were aged above 41, and 82.4% were housewives, and 83.3% completed their education up to senior high school. The study revealed that 57.4% of respondents showed excellent performance before, during, and after the Posyandu activities. Bivariate analysis revealed that the role of leadership has a significant relationship with the performance of health volunteers (p<0.05). Conclusion: Training on leadership and effective communication is needed to support the role of CHVs to motivate the community to use the facilities for better health status.