Read by QxMD icon Read

Home Health Care Services Quarterly

Edward Alan Miller, Orna Intrator, Emily Gadbois, Stefanie Gidmark, James L Rudolph
Little is known about how the extended care referral process-its structure and participants-influences Veterans' use of home and community-based services (HCBS) over nursing home care within the Veterans Health Administration (VHA). This study thus characterizes the extended care referral process within the VHA and its impact on HCBS versus nursing home use at hospital discharge. Data derive from 35 semistructured interviews at 12 Veterans Affairs Medical Centers (VAMCs). Findings indicate that the referral process is characterized by a commitment by care teams to consider HCBS if possible, varied practice depending on the clinician that most heavily influences care team recommendations, and care team emphasis on respecting Veteran/family preferences even when they are contrary to care team recommendations...
June 12, 2017: Home Health Care Services Quarterly
Jeongkyu Park, Seokwon Yoon, Sung Seek Moon, Kyoung Hag Lee, Jueun Park
A large and growing population of elderly Koreans with chronic conditions necessitates an increase in long-term care. This study is aimed at investigating the effects of occupational stress, work-centrality, self-efficacy, and job satisfaction on intent to leave among long-term care workers in Korea. We tested the hypothesized structural equation model predicting the intention to quit among long-term care workers in Korea. Survey data were collected from 532 long-term care workers in Seoul, Korea. Results showed that occupational stress was positively associated with intention to leave the job...
May 23, 2017: Home Health Care Services Quarterly
Atipong Pimdee, Nomjit Nualnetr
Home health care is an essential service for home-bound patients in Thailand. In this action research study, we used the International Classification of Functioning, Disability and Health (ICF) framework to modify home health care services provided by a university hospital. Staff responsible for delivering the services (physical therapist, nurses, and Thai traditional medicine practitioners) participated in the development of an ICF-based assessment tool and home health care service procedure. After an 8-month trial of implementing these changes, professional satisfaction and empowerment were high among the home health care team members...
May 8, 2017: Home Health Care Services Quarterly
Yujun Liu, Christina Voskanova Tyhurst, Shannon E Jarrott
Adult day services (ADS) professionals have begun to explore assessment systems focused on participants. Barriers include inadequate technology, software costs, and personnel requirements. We present data from staff interviews at an ADS with an electronic participant information system. Contrary to reports about difficulties learning to use electronic systems, staff found the system manageable and data meaningful. We identify ways that community-based centers can build partnerships and utilize software to integrate assessment and electronic records to improve center performance and participant outcomes...
February 7, 2017: Home Health Care Services Quarterly
Keith A Anderson, Kate P Chapin, Zachary Reimer, Gina Siffri
Green care farms (GCF) provide unique opportunities to persons with disabilities to engage in meaningful and therapeutic activities in farm settings. In this pilot study, the researchers examined the feasibility and impact of the first GCF in the United States. Qualitative interviews (N = 19) and thematic analysis were conducted. GCF participants and family members were enthusiastic about participation and identified benefits such as respite and improved mood. Administrators and farmers indicated that GCF challenged the status quo of funding, programming, and farming...
February 7, 2017: Home Health Care Services Quarterly
Dari Alhuwail, Güneş Koru, Mary Etta Mills
In the US, home care clinicians often start the episode of care devoid of relevant fall-risk information. By collecting and analyzing qualitative data from thirty clinicians in one home health agency, this case study aimed to understand how the currently adopted information technology solutions supported the clinicians' fall-risk management (FRM) information domains, and explored opportunities to adopt other solutions to better support FRM. The currently adopted electronic health record system and fall-reporting application served only some information domains with a limited capacity...
January 3, 2017: Home Health Care Services Quarterly
Laura M Smith, Wayne L Anderson, Lisa M Lines, Cristalle Pronier, Vanessa Thornburg, Janelle P Butler, Lori Teichman, Debra Dean-Whittaker, Elizabeth Goldstein
We examined the effects of provider characteristics on home health agency performance on patient experience of care (Home Health CAHPS) and process (OASIS) measures. Descriptive, multivariate, and factor analyses were used. While agencies score high on both domains, factor analyses showed that the underlying items represent separate constructs. Freestanding and Visiting Nurse Association agencies, higher number of home health aides per 100 episodes, and urban location were statistically significant predictors of lower performance...
January 2017: Home Health Care Services Quarterly
Amanda Sonnega, Kristen Robinson, Helen Levy
We report on the use of home and community-based services (HCBS) and other senior services and factors affecting utilization of both among Americans over age 60 in the Health and Retirement Study (HRS). Those using HCBS were more likely to be older, single, Black, lower income, receiving Medicaid, and in worse health. Past use of less traditional senior services, such as exercise classes and help with tax preparation, were found to be associated with current use of HCBS. These findings suggest use of less traditional senior services may serve as a "gateway" to HCBS that can help keep older adults living in the community...
January 2017: Home Health Care Services Quarterly
Christine Tocchi, Ruth McCorkle, Jane Dixon
There is limited knowledge on differences in frailty among residents in assisted living facilities (ALF) and home and community-based services (HCBS). This study used a retrospective cross-sectional design to compare frailty determinants in two long-term care settings. The HCBS setting had a greater proportion of positive responses to 9 of 14 frailty indicators. The ALF setting had a greater proportion to only 2 or the 14 frailty indicators. The finding that the HCBS setting had a significantly greater proportion of participants with positive frailty indicators as compared to the ALF setting suggests the degree of frailty risk is different by health care setting...
November 30, 2016: Home Health Care Services Quarterly
Tim Pauley, Judith Gargaro, Glen Chenard, Helen Cavanagh, Sandra M McKay
This study evaluated paraprofessional-led diabetes self-management coaching (DSMC). Subjects were randomized to standard care or standard care plus coaching. Measures included the Diabetes Self-Efficacy Scale (DSES), Insulin Management Self-Efficacy Scale (IMDSES), and Hospital Anxiety and Depression Scale (HADS). Both groups improvement in DSES (6.6 + 1.5 vs. 7.2 + 1.5, p < .001) and IMDSES (113.5 + 20.6 vs. 125.7 + 22.3, p < .001); there were no between-groups differences. There were no between-groups differences in anxiety (p > ...
November 29, 2016: Home Health Care Services Quarterly
Kathleen Abrahamson, Jaclyn Myers, Greg Arling, Heather Davila, Christine Mueller, Brian Abery, Yun Cai
The objective of this study was to explore Home and Community-based Service (HCBS) providers' perspectives of organizational readiness for quality improvement (QI). Data was obtained from a survey of participants (N = 56) in a state-sponsored HCBS QI initiative. Quality Improvement challenges included lack of time and resources, staff apprehension or resistance, resistance from consumers and families, and project sustainability. Support from leadership was viewed as an important factor in participating organizations' decision to engage in QI...
November 29, 2016: Home Health Care Services Quarterly
Cynthia Williams, Thomas T H Wan
In this study, we examine the cost per outcomes of remote monitoring services in home health care. The methodology followed case matched design via retrospective chart reviews. Results of the chi-square test suggest that there were no significant associations between the intervention and hospital readmissions, χ(2) = (1, n = 210, p-value = .71, phi = .71). An independent t-test compared group means of the number of skilled nursing visits and agency costs, p-value of .002 and .000, respectively, favoring the standard of care group...
August 23, 2016: Home Health Care Services Quarterly
Perla Werner, Adi Hess
Studies have shown that courtesy stigma is common among informal caregivers of persons with Alzheimer's disease. Guided by Attribution Theory and using focus group methodology, we examined this topic among 12 foreign health-care workers. Findings revealed that stigma is noticeable in the everyday reality of foreign workers caring for persons with dementia and that its management is shaped by beliefs and knowledge about the disease in their original countries, and by knowledge gained as caregivers. Greater understanding of stigma among foreign workers is crucial for advancing knowledge in the area and for improving the care provided to persons with Alzheimer's disease...
August 23, 2016: Home Health Care Services Quarterly
Aimee Milliken, Ellen K Mahoney, Kevin J Mahoney
The Veteran-Directed Home and Community Based Services Program (VD-HCBS) operates using a participant-direction approach, allowing Veterans to self-direct services. Only a small body of literature has explored the impact of these programs on caregivers. This study aimed to explore the experiences of caregivers in VD-HCBS. Telephone focus groups and interviews were conducted with caregivers (n = 23; 52.2% spouses; 8.7% male). Conventional content analysis revealed five categories: Coming home and staying home; Taking the pressure off; Providing security; Giving us time as a couple; and Importance of choice...
August 23, 2016: Home Health Care Services Quarterly
Laurie Bladen, Robin McAtee
Embodied nursing knowledge and its effects on patient outcomes are understudied in home health. The researcher performed a descriptive correlational study, in nine home health agencies in Ohio, to consider the effects of embodied nursing knowledge in expert practice in 107 registered nurses working in Medicare certified home health agencies. While statistical significance was not noted, findings of this study add to the understanding or research and the outcome improvement scores in home health. Findings also pose the question that the concepts used in acute care to improve mortality rates and patient outcome improvements may be different in home health...
August 23, 2016: Home Health Care Services Quarterly
Kristin T L Huang, Tracy J Lu, Forootan Alizadeh, Arash Mostaghimi
Telemedicine holds promise in bridging the gap between homebound patients and high quality health care, but uptake of such technology remains limited. Qualitative interviews conducted with 17 homebound patients found two major barriers to telemedicine. First, participants who lack familiarity with technology are hesitant about telemedicine, as baseline use of technology in the home is limited, participants did not feel capable of learning, and the advantages of telemedicine were unclear. Second, homebound patients place a high value on in-office visits due to therapeutic benefit, face-to-face communication, and the social aspect of medical appointments...
July 2016: Home Health Care Services Quarterly
Lisa C Lindley, Sandra J Mixer, Jennifer W Mack
Families desire to bring their children home at end of life, and this creates a variety of unique care needs at home. This study analyzed the child and family factors associated with hospice versus home health care use in the last year of life among children with multiple complex chronic conditions. Using the Andersen Behavioral Healthcare Utilization Model, the predisposing, enabling, and need factors of the child and family were shown to be significant predictors of hospice and home health care use. Hospice and home health care have advantages, and families may wish to use the service that best fits their needs...
July 2016: Home Health Care Services Quarterly
April Feld, Rose Madden-Baer, Ruth McCorkle
The Centers for Medicare and Medicaid Services Innovation Center's Episode-Based Payment initiatives propose a large opportunity to reduce cost from waste and variation and stand to align hospitals, physicians, and postacute providers in the redesign of care that achieves savings and improve quality. Community-based organizations are at the forefront of this care redesign through innovative models of care aimed at bridging gaps in care coordination and reducing hospital readmissions. This article describes a community-based provider's approach to participation under the Bundled Payments for Care Improvement initiative and a 90-day model of care for congestive heart failure in home care...
April 2016: Home Health Care Services Quarterly
Jo-Ann Mary Moore
Frequent exacerbations of symptoms and financial penalties for 30-day hospital readmissions of patients with congestive heart failure (CHF) have led to new disease management approaches. A nurse practitioner (NP)-led interdisciplinary program for CHF management that included home telemonitoring and early NP assessments and interventions was piloted by a home health agency. A 4-month evaluation of the efficacy of a clinical pathway for CHF patients resulted in the enrollment of 22 CHF patients in the program...
January 2016: Home Health Care Services Quarterly
Medha Iyer, Grishma P Bhavsar, Kevin J Bennett, Janice C Probst
This study examined the intensity of home health services, as defined by the number of visits and service delivery by rehabilitation specialists, among Medicare beneficiaries with stroke. A cross-sectional secondary data analysis was conducted using 2009 home health claims data obtained from the Centers for Medicare and Medicaid Services' Research Data Assistance Center. There were no significant rural-urban differences in the number of home health visits. Rural beneficiaries were significantly less likely than urban beneficiaries to receive services from rehabilitation specialists...
January 2016: Home Health Care Services Quarterly
Fetch more papers »
Fetching more papers... Fetching...
Read by QxMD. Sign in or create an account to discover new knowledge that matter to you.
Remove bar
Read by QxMD icon Read

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"