Home healthcare nowPub Date : 2024-05-01Epub Date: 2024-05-06DOI: 10.1097/NHH.0000000000001260
Konrad J Dias, Abigail McPherson, Katherine Mason, Kelsey Dowling, Lauren P Smith-Beaver, Dustin R Nadler
{"title":"Assessment of Exercise Capacity in Home Healthcare: Differences in Three Self-Paced Tests.","authors":"Konrad J Dias, Abigail McPherson, Katherine Mason, Kelsey Dowling, Lauren P Smith-Beaver, Dustin R Nadler","doi":"10.1097/NHH.0000000000001260","DOIUrl":"10.1097/NHH.0000000000001260","url":null,"abstract":"<p><p>Submaximal functional tests of endurance are ubiquitous in clinical practice. This investigation compared cardiovascular responses, perceived exertion, and performance measures following the completion of three self-paced, 2-minute, functional tests of endurance. A pilot prospective, observational, cross-sectional design with 16 community-dwelling older participants compared heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), rating of perceived exertion (RPE), and performance measures following the completion of three randomly allocated self-paced activities. The three activities included 2 minutes of stepping in standing (2MSTD), 2 minutes of seated stepping (2MSIT), and a 2-minute walk test (2MWT). A within-subjects repeated measures ANOVA analyzed differences in change scores for cardiovascular and RPE responses. Pearson's correlations assessed associations in performance measures between the three tests. Standing stepping compared to seated stepping produced statistically higher change scores in HR, SBP, DBP, and RPE (p < .05). Further, 2MSTD revealed statistically higher SBP and RPE scores compared to 2MWT (p < .05). Large and moderate correlations were observed between number of steps completed in sitting and standing (r = 0.83, p < .01) and between standing steps and distance walked (r = 0.56, p = .02), respectively. This pilot investigation informs home care physical therapists that 2 minutes of self-paced stepping in standing produced the greatest change scores in all cardiovascular and perceived exertion responses. No significant differences were noted in HR between self-paced walking and standing stepping, and between standing and seated stepping. For patients unable to walk or step in standing, self-paced seated stepping may be a viable alternative.</p>","PeriodicalId":37842,"journal":{"name":"Home healthcare now","volume":"42 3","pages":"150-160"},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140871464","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Home healthcare nowPub Date : 2024-05-01Epub Date: 2024-05-06DOI: 10.1097/NHH.0000000000001262
Zainab Toteh Osakwe, Ana L Res, Carol Seymour, Sarah Fabry, Donna Michi, Sandra Maldonado, Tami Videon, Daniel B Kaplan
{"title":"Teamwork and Nurse Care Coordination in Home Healthcare.","authors":"Zainab Toteh Osakwe, Ana L Res, Carol Seymour, Sarah Fabry, Donna Michi, Sandra Maldonado, Tami Videon, Daniel B Kaplan","doi":"10.1097/NHH.0000000000001262","DOIUrl":"https://doi.org/10.1097/NHH.0000000000001262","url":null,"abstract":"<p><p>Home healthcare agencies provide interdisciplinary care to millions of individuals annually. Care is typically led by registered nurses who often determine additional disciplines need to be included in the plan of care. We found that, although persons living with dementia represent about 30% of the home healthcare population, data from our home healthcare system showed that over a 1-year period with 36,443 home care episodes, only 29.6% had one or more social worker visits. Recognizing Alzheimer's disease-related dementia as a terminal condition and shifting toward a palliative care approach can be a challenge in home healthcare where care is focused on restorative care or rehabilitative goals with a primary focus on improvement in condition. The goal of this article is to present insights into nurse-led care coordination and teamwork and provide implications for practice.</p>","PeriodicalId":37842,"journal":{"name":"Home healthcare now","volume":"42 3","pages":"179-183"},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140861207","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Home healthcare nowPub Date : 2024-05-01Epub Date: 2024-05-06DOI: 10.1097/NHH.0000000000001257
Sara Arena
{"title":"Rehabilitation Management of Heart Failure in Home Care.","authors":"Sara Arena","doi":"10.1097/NHH.0000000000001257","DOIUrl":"https://doi.org/10.1097/NHH.0000000000001257","url":null,"abstract":"","PeriodicalId":37842,"journal":{"name":"Home healthcare now","volume":"42 3","pages":"185-186"},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140872597","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Home healthcare nowPub Date : 2024-05-01Epub Date: 2024-05-06DOI: 10.1097/NHH.0000000000001255
Halah Almulla, Nathan F Dieckmann, Rana Halabi Najjar, Dena Hassouneh
{"title":"Palliative Care Practices and Knowledge of Home Care Nurses in Saudi Arabia: A Cross-Sectional Study.","authors":"Halah Almulla, Nathan F Dieckmann, Rana Halabi Najjar, Dena Hassouneh","doi":"10.1097/NHH.0000000000001255","DOIUrl":"https://doi.org/10.1097/NHH.0000000000001255","url":null,"abstract":"<p><p>Palliative Care (PC) is an interdisciplinary specialty focused on relieving symptoms and optimizing quality of life for people living with serious illnesses and their families. A great need for PC exists in Saudi Arabia due to its aging population and prevalence of cancer and other chronic diseases. Home healthcare can make PC more accessible to patients, but clinicians must be equipped with the PC knowledge and skills to perform their roles. This study was a descriptive, correlational examination of PC practices and knowledge of home care nurses recruited from military hospitals in Saudi Arabia. We surveyed participants using the Palliative Care Quiz for Nursing (PCQN) and the Modified Global Home Health Nursing Care Assessment Questionnaire. The mean PCQN score was 8.40, indicating low levels of PC knowledge. A nurses' demographic and physical, spiritual, religious, cultural, linguistic, ethical, and legal aspects of care revealed significant associations. Given the low levels of PC knowledge and skills, we recommend focusing on education, training, and research. Universities should review their curriculum to ensure PC content. Hospitals should provide training programs focused on all aspects of PC, specifically emotional and spiritual, without limiting training to physical aspects of care. Future research is also needed to inform policy in this area.</p>","PeriodicalId":37842,"journal":{"name":"Home healthcare now","volume":"42 3","pages":"168-178"},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140860808","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Home healthcare nowPub Date : 2024-05-01Epub Date: 2024-05-06DOI: 10.1097/NHH.0000000000001253
Sara K Arena, Christopher M Wilson, Lori Boright, Brant Cassidy, Sarah Fedorow, Sheilah Hallman, Hannah Rager
{"title":"Safe Fall Recovery Education for Older Adults.","authors":"Sara K Arena, Christopher M Wilson, Lori Boright, Brant Cassidy, Sarah Fedorow, Sheilah Hallman, Hannah Rager","doi":"10.1097/NHH.0000000000001253","DOIUrl":"https://doi.org/10.1097/NHH.0000000000001253","url":null,"abstract":"<p><p>High fall rates among older adults in combination with prolonged time on the floor after a fall have created an urgent need to preventatively address fall recovery strategies. The purpose of this study is to describe the outcomes of a novel safe fall recovery (SFR) educational module provided by physical therapists to older adults in their homes. A pre- and post-test descriptive study used a convenience sample to recruit 30 adults (≥65 years). A baseline assessment and SFR in-home education were provided. Pre- and post-education measures included the Steps for Safe Fall Recovery (Steps for SFR) tool, the Activity Specific Balance Confidence (ABC) scale, and a fall confidence survey. The Wilcoxon matched-pairs signed-rank test determined significance (P < .05). Participants were age 77.2 (6.8) years and 20 females. Eight reported a fall during the prior year. Statistically significant improvements were identified in the Steps to SFR tool (P = .001), the ABC scale (P = .004), and the fall recovery confidence survey (P = .001). Integration of an SFR educational intervention delivered to an older adult population in their home demonstrated improved safety and confidence to recover from a fall.</p>","PeriodicalId":37842,"journal":{"name":"Home healthcare now","volume":"42 3","pages":"130-139"},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140869898","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Home healthcare nowPub Date : 2024-05-01Epub Date: 2024-05-06DOI: 10.1097/NHH.0000000000001249
Mary C Vrtis
{"title":"Multiple Myeloma.","authors":"Mary C Vrtis","doi":"10.1097/NHH.0000000000001249","DOIUrl":"10.1097/NHH.0000000000001249","url":null,"abstract":"<p><p>Multiple myeloma (MM) is a cancer that arises from plasma cells in bone marrow. Approximately 35,730 Americans received a new diagnosis and MM will claim the lives of an estimated 12,590 people in 2023. Complications of the disease process include anemia, leukopenia, thrombocytopenia, renal failure, severe pain, bone loss, and hypercalcemia. Patients with MM have a high risk for pathological fractures. For most forms of MM there are effective treatments that may result in long-term remission using multi-drug regimens. Although the medications approved in the United States to treat MM generally produce good outcomes, they have serious, and potentially life-threatening adverse effects. In addition, patients with specific genetic variations are at high risk for relapse. Communication with the oncology team and early intervention in the event of adverse effects of medications, complications of the disease process, or evidence of relapse are important to obtain the best possible outcome. Patients are easily overwhelmed with a three- to four-drug treatment regimen with some drugs given intravenously and/or subcutaneously at the clinic, and others taken orally at home on specific days of each 28-day cycle. Home care nursing is needed to assess for tolerance, adverse effects, and to address patient concerns. Medication management and teaching are very important in guiding patients to safely manage a schedule that changes daily. In addition, the high risk of pathological fractures and serious injury if the patient should fall supports the need for physical and occupational therapy fall prevention and safety education and exercise programs to help avert decline in functional status and combat cancer-related fatigue.</p>","PeriodicalId":37842,"journal":{"name":"Home healthcare now","volume":"42 3","pages":"140-149"},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140856135","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Home healthcare nowPub Date : 2024-05-01Epub Date: 2024-05-06DOI: 10.1097/NHH.0000000000001245
Fatemeh Bahramnezhad, Alun C Jackson, Maryam Mousavi, Zohreh Sadat Mirmoghtadaie, Amir Asgari
{"title":"A Randomized Controlled Trial Comparing the Effect of Tracheostomy Training using Mannequin-Based Simulation and Smartphone Application on Self-Efficacy and Anxiety of Caregivers.","authors":"Fatemeh Bahramnezhad, Alun C Jackson, Maryam Mousavi, Zohreh Sadat Mirmoghtadaie, Amir Asgari","doi":"10.1097/NHH.0000000000001245","DOIUrl":"10.1097/NHH.0000000000001245","url":null,"abstract":"<p><p>Inefficient education is a cause of anxiety and low self-efficacy among caregivers, especially for those caring for patients with tracheostomy. This randomized controlled trial aimed to compare the outcomes of tracheostomy care education by mannequin-based simulation and smartphone application. The participants were 126 primary caregivers of tracheostomy patients being discharged home from hospitals affiliated with Tehran University of Medical Sciences. The control group received routine care. Caregiver self-efficacy was assessed using the Caregiver Inventory and the Hamilton Anxiety Rating Scale prior to the education and 1 month after. There were significant differences among the three groups regarding the mean scores of self-efficacy and anxiety. There was a significant increase in self-efficacy (P ≤ .0001) and a significant decrease in anxiety (P ≤ .0001) scores after the intervention. The intergroup comparison showed a significant difference between the intervention groups and the control group in terms of changes in the anxiety and self-efficacy scores of caregivers (P < .001).</p>","PeriodicalId":37842,"journal":{"name":"Home healthcare now","volume":"42 3","pages":"161-167"},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140865333","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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