HOME HEALTH CARE SERVICES QUARTERLY最新文献

{"title":"Realist evaluation of a pilot intervention implementing interprofessional and interinstitutional processes for transitional care.","authors":"Séverine Schusselé Filliettaz,&nbsp;Stéphane Moiroux,&nbsp;Gregory Marchand,&nbsp;Ingrid Gilles,&nbsp;Isabelle Peytremann-Bridevaux","doi":"10.1080/01621424.2021.1989356","DOIUrl":"https://doi.org/10.1080/01621424.2021.1989356","url":null,"abstract":"<p><p>In 2016, in Switzerland, we implemented transitional interprofessional and interinstitutional shared decision-making processes (IIPs) between a short-stay inpatient care unit (SSU) and primary care professionals. Between 2018 and 2019, we evaluated this intervention using a realist design to answer the following questions: for whom, with whom, in which context and how have IIPs been implemented? Our initial theory was tested via interviews with patients, primary care professionals and staff from the SSU. Results showed that a patient's stay at the SSU, with actors committed to facilitating IIPs, reinforced the perceived appropriateness and implementation of those IIPs. However, this appropriateness varied according to different contextual elements, such as the complexity of needs, preexisting collaborative practices and the purpose of the inpatient stay. Since IIPs occurred in a context of fragmented practices, proactive and sustained efforts are required of the actors implementing them and the organizations supporting them.</p>","PeriodicalId":45875,"journal":{"name":"HOME HEALTH CARE SERVICES QUARTERLY","volume":"40 4","pages":"302-323"},"PeriodicalIF":1.4,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39551264","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}

{"title":"Association between home health agency ownership status and discharge to community among Medicare beneficiaries.","authors":"Rashmita Basu,&nbsp;Bei Wu,&nbsp;Huabin Luo,&nbsp;Leeanna Allgood","doi":"10.1080/01621424.2021.1984360","DOIUrl":"https://doi.org/10.1080/01621424.2021.1984360","url":null,"abstract":"<p><p>To investigate the association of ownership status, discharge rate and length of stay (LOS) of home health care (HH) services under the prospective payment system (PPS). We used 2016-2018 Outcome Assessment and Information Set (OASIS) data sets for Medicare beneficiaries. Two outcome variables were investigated: rate of discharge from an HH agency and LOS. Our main independent variable was ownership status: for-profit (FP) versus not-for-profit (NFP). FP agencies were 4.2% (<i>p</i> <.01) less likely to discharge patients to the community but more likely (7.3%; <i>p</i> <.001) to have longer LOS (>99 days) compared to NFPs. Findings that FP agencies were less likely to discharge patients to the community and more likely to have a longer length of stay than NFP agencies have implications for quality of care initiatives by the Medicare Post-Acute Transformation Act 2014.</p>","PeriodicalId":45875,"journal":{"name":"HOME HEALTH CARE SERVICES QUARTERLY","volume":"40 4","pages":"340-354"},"PeriodicalIF":1.4,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39559528","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}

{"title":"Enhancing care transitions intervention with peer support to improve outcomes among older adults with co-occurring clinical depression: a pilot study.","authors":"Kyaien O Conner,&nbsp;Amber M Gum,&nbsp;Lawrence Schonfeld,&nbsp;Kristin Kosyluk,&nbsp;Erica Anderson,&nbsp;Jamie Baker-Douglan,&nbsp;Jason Beckstead,&nbsp;Hongdao Meng,&nbsp;Charlotte Brown,&nbsp;Charles F Reynolds","doi":"10.1080/01621424.2021.1967249","DOIUrl":"https://doi.org/10.1080/01621424.2021.1967249","url":null,"abstract":"<p><p>The Care Transitions Intervention (CTI) is an evidence-based intervention aimed at supporting the transition from hospital back to the community for patients to ultimately reduce preventable re-hospitalization. In a pilot randomized controlled trial, we examined the preliminary effectiveness of an Enhanced Care Transitions Intervention (ECTI), CTI with the addition of peer support, for a racially/ethnically diverse sample of older adults (age 60+) with co-morbid major depression. We observed a significant decline in health-related quality of life (HRQOL) after being discharged from the hospital among those who received CTI. Additionally, those who received ECTI either maintained HRQOL scores, or, saw improvement in HRQOL scores. Findings suggest the Enhanced Care Transitions Intervention can maintain or improve HRQOL and reduce disparities for older participants from diverse racial/ethnic backgrounds with clinical depression.</p>","PeriodicalId":45875,"journal":{"name":"HOME HEALTH CARE SERVICES QUARTERLY","volume":"40 4","pages":"324-339"},"PeriodicalIF":1.4,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39374043","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}

{"title":"'Implementing a broad quality of life tool for determining care wishes and needs of older adults living at home.","authors":"M S Van Loon,&nbsp;G Widdershoven,&nbsp;K Van Leeuwen,&nbsp;J Bosmans,&nbsp;S Metselaar,&nbsp;R Ostelo","doi":"10.1080/01621424.2021.1968986","DOIUrl":"https://doi.org/10.1080/01621424.2021.1968986","url":null,"abstract":"<p><p>The aim was to investigate the views of stakeholders on the practical relevance of a broad quality of life (QoL) outcome tool for care in older adults: the Extended Quality of Life Tool (EQLT). We conducted individual interviews and focus groups with a variety of stakeholders involved in the care for older adults which were analyzed using a framework analysis. Stakeholders considered relevant: focus on the client perspective; perspective on QoL broader than health; the possibility to take diversity into account; and the possibility to determine a minimum level of QoL. Three facilitators for implementation of the tool were mentioned as well as four barriers. The EQLT can support conversations with clients about their needs and wishes, thus enabling decisions about care services based on a broad set of domains of QoL. Implementation of the tool should take into account the facilitators and barriers identified in the current study.</p>","PeriodicalId":45875,"journal":{"name":"HOME HEALTH CARE SERVICES QUARTERLY","volume":"40 4","pages":"262-275"},"PeriodicalIF":1.4,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39372884","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}

{"title":"Development of a web-based survey on the financial risks of unpaid caregiving: approach and lessons learned from a Canadian perspective.","authors":"Husayn Marani,&nbsp;Sara Allin,&nbsp;Gregory P Marchildon","doi":"10.1080/01621424.2021.1976344","DOIUrl":"https://doi.org/10.1080/01621424.2021.1976344","url":null,"abstract":"<p><p>Little is known about the financial risks of unpaid caregiving. This is, in part, due to challenges in identifying people who are caregivers and limitations in capturing all aspects of spending related to caregiving in existing approaches to public data collection. To fill these gaps, we developed a composite survey informed by validated instruments that assesses the types and magnitude of out-of-pocket expenditures caregivers incur in the provision of homebased care for someone living with a long-term health condition, and their impact across various domains of financial risk. This paper discusses the development of this survey currently in circulation in a Canadian province, and reflects on considerations in the engagement of unpaid caregivers in participatory research. Given its replicability and adaptability, this survey may inform future research in other developed or high-income settings and guide policy attention toward understanding how to protect unpaid caregivers from the financial risks of caring.</p>","PeriodicalId":45875,"journal":{"name":"HOME HEALTH CARE SERVICES QUARTERLY","volume":"40 4","pages":"276-301"},"PeriodicalIF":1.4,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39466577","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}

{"title":"\"I felt useless\": a qualitative examination of COVID-19's impact on home-based primary care providers in New York.","authors":"Ksenia Gorbenko, Emily Franzosa, Sybil Masse, Abraham A Brody, Orla Sheehan, Bruce Kinosian, Christine S Ritchie, Bruce Leff, Jonathan Ripp, Katherine A Ornstein, Alex D Federman","doi":"10.1080/01621424.2021.1935383","DOIUrl":"10.1080/01621424.2021.1935383","url":null,"abstract":"<p><p>Research on professional burnout during the pandemic has focused on hospital-based health care workers. This study examined the psychological impact of the pandemic on home-based primary care (HBPC) providers. We interviewed 13 participants from six HBPC practices in New York City including medical/clinical directors, program managers, nurse practitioners, and social workers and analyzed the transcripts using inductive qualitative analysis approach. HBPC providers experienced emotional exhaustion and a sense of reduced personal accomplishment. They reported experiencing grief of losing many patients at once and pressure to adapt to changing circumstances quickly. They also reported feeling guilty for failing to protect their patients and reduced confidence in their professional expertise. Strategies to combat burnout included shorter on-call schedules, regular condolence meetings to acknowledge patient deaths, and peer support calls. Our study identifies potential resources to improve the well-being and reduce the risk of burnout among HBPC providers.</p>","PeriodicalId":45875,"journal":{"name":"HOME HEALTH CARE SERVICES QUARTERLY","volume":" ","pages":"1-15"},"PeriodicalIF":1.4,"publicationDate":"2021-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8783921/pdf/nihms-1759167.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10567714","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"O17.3 Maintaining Services, Responding to Need: The Kingston (Ontario) Quick Test Clinic","authors":"B. Stoner, J. Prouse, E. Nolan, C. Wowk, H. Guan","doi":"10.1136/sextrans-2021-sti.148","DOIUrl":"https://doi.org/10.1136/sextrans-2021-sti.148","url":null,"abstract":"Background In early 2020, routine STI clinical services ground to a halt across Canada as a result of COVID-19 shutdowns, yet the need for STI screening, testing, and treatment continued unabated. We report on an innovative model for maintaining high-volume, low-barrier STI services during the pandemic. Approach The Quick Test Clinic was established in June, 2020 by Kingston, Frontenac and Lennox & Addington (KFL&A) Public Health to facilitate nucleic acid amplification testing (NAAT) for gonorrhea (GC) and chlamydia (CT). Operating two half-days per week, the clinic invited clients to complete an intake form and submit a self-collected urine or swab specimen [rectal, meatal, vaginal, pharyngeal] without seeing a healthcare provider. Results were communicated by telephone, and persons with documented infection were promptly treated. Outcomes/Impact During the first six months of operation (19 June 2020 – 18 Jan 2021), the clinic provided 383 STI screenings to 347 unique individuals (mean age 27.9 years [IQR 21.0–32.0]) and a total of 864 self-collected specimens were tested. GC was detected in 13/184 (7.0%) males vs. 4/163 (2.5%) females (p = 0.47). CT was detected in 30/184 males (16.3%) vs. 17/163 (10.4%) females (p =0.11). A total of 4 persons were co-infected with GC and CT. Overall positivity with either GC or CT was 5.8%. Sample site positivity was highest for self-collected rectal specimens (6/46, 13.0%), followed by genital (55/664, 8.3%) and pharyngeal (5/88, 5.7%) specimens. Innovation and Significance Findings demonstrate the ongoing need for sexual health services during the COVID crisis, and the feasibility of no-exam, drop-off testing of self-collected specimens. Gonococcal and chlamydial positivity rates exceeded that of standard pre-COVID clinic operations, supporting wider expansion of the Quick Test Clinic model. Future innovations may include text messaging and web-based applications for results notification and treatment referral.","PeriodicalId":45875,"journal":{"name":"HOME HEALTH CARE SERVICES QUARTERLY","volume":"35 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78875750","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}

{"title":"O17.6 Risk factors for STI versus testing rates in a Dutch multicultural area: opportunities for increasing sexual health care accessibility?","authors":"D. Twisk, A. Meima, J. Richardus, H. Götz","doi":"10.1136/SEXTRANS-2021-STI.151","DOIUrl":"https://doi.org/10.1136/SEXTRANS-2021-STI.151","url":null,"abstract":"D Twisk*, A Meima, J Richardus, H Götz. Department of Infectious Disease Control, Municipal Public Health Service Rotterdam-Rijnmond, Rotterdam, the Netherlands; Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands; Department Research and Business Intelligence, Municipality of Rotterdam, the Netherlands; Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands","PeriodicalId":45875,"journal":{"name":"HOME HEALTH CARE SERVICES QUARTERLY","volume":"8 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91293135","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}

{"title":"Home care for burn survivors: A phenomenological study of lived experiences.","authors":"Nastaran HeydariKhayat,&nbsp;Tahereh Ashktorab,&nbsp;Camelia Rohani","doi":"10.1080/01621424.2020.1749206","DOIUrl":"https://doi.org/10.1080/01621424.2020.1749206","url":null,"abstract":"<p><p><b>Background</b>: Burn injuries have negative impacts on all dimensions of the quality of life of burn victims. This study aimed to explore the lived experiences of burn survivors after a 6-month period of home care following hospital discharge.<b>Method</b>: This is a qualitative study with a phenomenological approach. Sixteen burn survivors from a university hospital in Kermanshah province participated in the study. Qualitative data were analyzed by Colaizzi's descriptive phenomenological approach.<b>Results: \"</b>Rehabilitation in the process of life\" was the main theme of the study with four sub-themes, including \"conducting process\", \"caring bridge\", \"humanitarian commitment for human revival\", and \"healing care\".<b>Conclusions</b>: Home care is necessary for burn survivors after discharge from the hospital. The connection of healthcare services between home and hospital, safety feeling in the patient and his/her family, cost-effectiveness of healthcare services, and encouraging the patient to perform self-care can be achieved by home care follow-ups.</p>","PeriodicalId":45875,"journal":{"name":"HOME HEALTH CARE SERVICES QUARTERLY","volume":"40 3","pages":"204-217"},"PeriodicalIF":1.4,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/01621424.2020.1749206","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37812210","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}

{"title":"O17.4 First clinical evaluation of a 30-minute point-of-care-test for Chlamydia trachomatis and Neisseria gonorrhoeae infection in UK sexual health clinics","authors":"Sebastian S Fuller, M. Furegato, L. Phillips, E. Harding-Esch, A. Pacho, E. H. De-Allie, E. Mabonga, R. Malek, S. Barnes, J. Sherrard, K. Marriott, S. T. Sadiq","doi":"10.1136/SEXTRANS-2021-STI.149","DOIUrl":"https://doi.org/10.1136/SEXTRANS-2021-STI.149","url":null,"abstract":"Background As part of a programme of work seeking to facilitate adoption of multi-STI POCTs in English sexual health services (SHS), we implemented an approach to facilitate adoption of the binx health io CT/NG Assay (‘binx POCT’). This included supporting analysis and interpretation of data following clinical validation and routine use of the binx POCT as implemented into clinical care, prior to SHS adoption decisions. Methods Binx POCT diagnostic accuracy was compared to locally-used laboratory-based nucleic acid amplification tests (NAATs) and expressed as positive (PPA) and negative percentage agreement (NPA), with 95% confidence intervals (95% CI). Individual SHS reported turnaround time (TAT) from sample collection to patient receipt of results, before and after binx POCT implementation. Results Three SHS participated, and were a mix of high, medium and low-throughput in south England. Of N=417 patients across all services, n=396 (195 women and 201 men) were successfully tested with both the binx POCT and SHS routine NAATs. CT: male PPA 92.5% (79.6–98.4), NPA 99.4% (96.6–100.0); female PPA 82.1% (63.1–94.0), NPA 98.2 (94.8–99.6). NG: male PPA 91.7% (61.5–99.8), NPA 100% (98.1–100.0); female PPA 90.9% (58.7–99.8), NPA 100% (2.0–100.0). Median TAT decreased from 5 days (IQR 3–7.25) pre-implementation, to 1 day (1=same-day (IQR 1–2)) during implementation; p Conclusion Binx POCT PPA and NPA, as compared to participating SHS routine NAATs, were largely within expected ranges of the diagnostic evaluation conducted in the United States for FDA approval, and there was significant decrease in TAT time across all services. The binx POCT was not available for purchase directly following the programme’s end, however, local data gave confidence to SHS to use the test in routine care, and all indicated interest in adoption. Providing services the ability to test new POCTs in local settings prior to purchase could help facilitate their wider implementation.","PeriodicalId":45875,"journal":{"name":"HOME HEALTH CARE SERVICES QUARTERLY","volume":"9 6","pages":""},"PeriodicalIF":1.4,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/SEXTRANS-2021-STI.149","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72481640","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}