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Home Health Care Services Quarterly

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https://www.readbyqxmd.com/read/27925859/home-and-community-based-service-and-other-senior-service-use-prevalence-and-characteristics-in-a-national-sample
#1
Amanda Sonnega, Kristen Robinson, Helen Levy
We report on the use of home- and community-based services and other senior services and factors affecting utilization of both among Americans over age 60 in the Health and Retirement Study. Those using home- and community-based services were more likely than 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 are associated with current use of home- and community-based services...
December 7, 2016: Home Health Care Services Quarterly
https://www.readbyqxmd.com/read/27901402/frailty-determinants-in-two-long-term-settings-assistant-living-facilities-and-home-and-community-based-programs
#2
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
https://www.readbyqxmd.com/read/27897469/a-randomized-controlled-trial-investigating-a-paraprofessional-led-self-management-coaching-program-for-community-dwelling-patients-with-type-2-diabetes-prescribed-insulin
#3
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
https://www.readbyqxmd.com/read/27897466/homebound-patients-perspectives-on-technology-and-telemedicine-a-qualitative-analysis
#4
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...
November 29, 2016: Home Health Care Services Quarterly
https://www.readbyqxmd.com/read/27897462/capacity-and-readiness-for-quality-improvement-among-home-and-community-based-service-providers
#5
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
https://www.readbyqxmd.com/read/27552654/a-cost-analysis-of-remote-monitoring-in-a-heart-failure-program
#6
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, X(2) = (1, n = 210, p value = 0.71, phi = 0.71). An independent t-test compared group means of the number skilled nursing visits and agency costs, p-value of 0.002 and 0.000 respectively, favoring the standard of care group...
August 23, 2016: Home Health Care Services Quarterly
https://www.readbyqxmd.com/read/27551972/examining-courtesy-stigma-among-foreign-health-care-workers-caring-for-persons-with-alzheimer-s-disease-a-focus-group-study
#7
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
https://www.readbyqxmd.com/read/27551912/-it-just-took-the-pressure-off-the-voices-of-veterans-family-caregivers-in-a-participant-directed-program
#8
Aimee Milliken, Ellen K Mahoney, Kevin J Mahoney
The Veteran-Directed Home & 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 & Staying Home; Taking the Pressure Off; Providing Security; Giving Us Time as a Couple; and The Importance of Choice...
August 23, 2016: Home Health Care Services Quarterly
https://www.readbyqxmd.com/read/27551773/relationship-of-embodied-nursing-knowledge-and-client-outcomes-in-home-health
#9
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
https://www.readbyqxmd.com/read/27383451/home-care-for-children-with-multiple-complex-chronic-conditions-at-the-end-of-life-the-choice-of-hospice-versus-home-health
#10
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, 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 6, 2016: Home Health Care Services Quarterly
https://www.readbyqxmd.com/read/27158856/evolution-of-a-90-day-model-of-care-for-bundled-episodic-payments-for-congestive-heart-failure-in-home-care
#11
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 Payment for Care Improvement Initiative and a 90-day model of care for congestive heart failure in home care...
May 9, 2016: Home Health Care Services Quarterly
https://www.readbyqxmd.com/read/27064361/evaluation-of-the-efficacy-of-a-nurse-practitioner-led-home-based-congestive-heart-failure-clinical-pathway
#12
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
https://www.readbyqxmd.com/read/27064307/disparities-in-home-health-service-providers-among-medicare-beneficiaries-with-stroke
#13
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
https://www.readbyqxmd.com/read/27018745/problems-experienced-by-informal-caregivers-with-older-care-recipients-with-and-without-cognitive-impairment
#14
Sytske Van Bruggen, Jacobijn Gussekloo, Christina Bode, Dorothea P Touwen, Dick P Engberts, Jeanet W Blom
The care of older persons can have negative impact on the caregiver. The objective of this population-based observational study is to identify problems experienced by informal caregivers, and the extent of related difficulties, in their care of older care-dependent recipients with and without cognitive impairment. Caregivers (n = 2,704) caring for a home-dwelling person aged ≥ 75 years responded to a questionnaire with 23 questions on problems and related difficulties by mail. Prevalence of self-reported problems and related difficulties was calculated...
January 2016: Home Health Care Services Quarterly
https://www.readbyqxmd.com/read/26833177/what-makes-home-health-workers-think-about-leaving-their-job-the-role-of-physical-injury-and-organizational-support
#15
Ahyoung Anna Lee, Yuri Jang
Based on the job demands-resources (JD-R) model, this study explored the role of physical injury and organizational support in predicting home health workers' turnover intention. In a sample of home health workers in Central Texas (n = 150), about 37% reported turnover intention. The logistic regression model showed that turnover intention was 3.23 times more likely among those who had experienced work-related injury. On the other hand, organizational support was found to reduce the likelihood of turnover intention...
January 2016: Home Health Care Services Quarterly
https://www.readbyqxmd.com/read/25894688/a-hybrid-process-fidelity-assessment-in-a-home-based-randomized-clinical-trial
#16
RANDOMIZED CONTROLLED TRIAL
Mary H Wilde, Dianne Liebel, Eileen Fairbanks, Paula Wilson, Margaret Lash, Shivani Shah, Margaret V McDonald, Judith Brasch, Feng Zhang, Eileen Scheid, James M McMahon
A process fidelity assessment was conducted as a nested study within a home-based randomized clinical trial teaching self-management to 101 long-term indwelling urinary catheter users in the treatment group. Our hybrid model combined external assessments (outside observations and tape recordings) with internal evaluation methods (through study nurse forms and notes) for a comprehensive process fidelity assessment. Barriers, patient-related issues, and nurse perspectives were identified demonstrating the complexity in home care intervention research...
April 2015: Home Health Care Services Quarterly
https://www.readbyqxmd.com/read/25894592/impact-of-home-care-management-on-the-involvement-of-informal-caregivers-by-formal-caregivers
#17
Marieke van Wieringen, Marjolein I Broese van Groenou, Peter Groenewegen
This study explores the link between management characteristics of home care agencies and the involvement of informal caregivers in caregiving. Based on a study of policy documents of two agencies and semi-structured interviews with five team managers and 31 formal caregivers, we conclude that, although the importance of involving informal caregivers is emphasized in official documentation, actual contact with informal caregivers is often lacking. Comparison of the work processes of the two agencies shows that contact with informal caregivers and their potential involvement are enhanced by smaller teams, less task division, and clarity about the responsibilities of formal caregivers...
April 2015: Home Health Care Services Quarterly
https://www.readbyqxmd.com/read/25894489/beyond-respite-the-role-of-adult-day-services-in-supporting-dementia-caregivers
#18
Keith A Anderson, Holly I Dabelko-Schoeny, Noelle L Fields, James R Carter
Adult day services (ADS) are the leading provider of community-based care for persons with dementia and their caregivers. While the provision of caregiver respite is well-documented, little is known about the provision of other forms of dementia caregiver support. Logistic regression analyses of ADS providers (N = 297) in the MetLife Study indicated that the number of hours of social work support was a significant predictor of case management services, while nonprofit status was a significant predictor of caregiver education and support groups...
April 2015: Home Health Care Services Quarterly
https://www.readbyqxmd.com/read/25894328/caregiver-stress-does-states-expenditure-on-home-and-community-based-services-matter
#19
Michin Hong, Banghwa Lee Casado
This study examined how state expenditure on home- and community-based services (HCBS) and individual factors are associated with caregiver stress. A total of 1,849 cases from the 2004 National Long-Term Care Survey were included. Gender, education, perceived physical strain, and economic hardship, as well as the number of limitations in instrumental activities of daily living (IADL) for the care recipient, were associated with caregiver stress. The cross-level interaction between service utilization and state expenditure on HCBS was significant, suggesting that living in states with a higher expenditure on HCBS is associated with reduced stress regardless of service utilization...
April 2015: Home Health Care Services Quarterly
https://www.readbyqxmd.com/read/26566582/self-management-of-heart-disease-in-older-adults
#20
Anh-Luu T Huynh-Hohnbaum, Lia Marshall, Valentine M Villa, Gi Lee
The American Heart Association estimates that 81% of people who die of coronary heart disease are 65 years old or older. The leading risk health behaviors include physical inactivity, poor diet, smoking, and binge drinking. Using the 2011-2012 California Health Interview Survey (CHIS), this study looked at how self-management, which includes a plan developed by a medical professional and the confidence to manage one's disease, may decrease negative risk behaviors in older adults. The presence of a plan and increased self-efficacy decreased engagement in negative dietary behaviors and low physical activity...
2015: Home Health Care Services Quarterly
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