Bakground: Palliative care is based on the concept that a person at the end of life should still have agood life quality. The care received should also be based on the sick persons wishes and preferences. During palliative care the person cared for should be able to chose where they want to receive the care and a lot of people want to die at home. Aim: The aim of this study is to describe the experiences of people receiving palliative care at home. Method: This is a literature study with a qualitative approach that follows Polit and Beck's nine-stepmodel. Ten articles were identified and analyzed using a thematic analysis. Results: The results show two themes and four subtemes: Communication with subtemes Accessibility and Partnership. Well-being with subtemes Comprehensive care and Security & Insecurity. Conclusions: People who receive palliative care at home are in need of feeling safe and being seen asa whole person in nursing. It is important for the sick people to have a good relationship with their caregivers based on partnership and accessibility. Home care should be well-planned and organizedas poor communication can lead to insecure care. / Bakgrund: Den palliativa vården grundar sig på att personen som är i livets slutskede ska ha en god livskvalitet under sin sista tid i livet. Vården ska även anpassas utifrån den döende personens önskan och preferenser. När en person vårdas palliativt ska hen ha möjlighet att välja var vården ska utföras. En stor del människor som vårdas i livets slutskede vill vårdas och dö i sitt hem. Syfte: Syftet med denna studie är att beskriva erfarenheter från personer av palliativa vården i hemmet. Metod: En litteraturstudie med kvalitativ ansats. Studien följde Polit och Becks niostegsmodel förlitteraturstudier. Tio artiklar identifierades och analyserades med tematisk analys. Resultat: Resultat redovisar i två teman och fyra sudteman: kommunikation med subteman vårdpersonalens tillgänglighet och partnerskap. Välbefinnande med subteman helhetsvård och trygghet & otrygghet. Slutsats: Personer som får palliativ vård hemma är i behov av att känna sig trygga och bli sedda somen hel människa vid omvårdnad. Det är viktigt för de sjuka personerna att ha en god relation med sinavårdgivare som baseras på partnerskap och tillgänglighet. Vården i hemmet bör vara välplanerad och organiserad då dålig kommunikation kan leda till en osäker för vård.

The quality of care of residents in nursing homes receive is an important issue facing our society, and reliable methods to assess and measure important indicators of quality of care are necessary to ensure that nursing homes are providing adequate services. Previous researchers have developed methodologies to evaluate indicators of quality of care, including environmental conditions, resident conditions, resident activities, and staff activities using momentary-time sampling procedures across a variety of settings and populations. The purpose of the present study was to replicate and extend the time-sampling methodology used in previous research in two units in a nursing home.

Because of the high cost of some wound management regimens, payors may require that moist wound therapies be used before other treatment approaches, such as negative pressure wound therapy (NPWT), are implemented but few studies have investigated the effect of delayed initiation of NPWT on patient outcomes. To examine the impact of early versus late initiation of NPWT on patient length of stay in home health care, a nonrandomized, retrospective analysis was performed on the Outcome and Assessment Information Set (OASIS) information for home care patients with NPWT-treated Stage III or Stage IV pressure ulcers (N = 98) or surgical wounds (N = 464) gathered between July 2002 and September 2004. Early initiation of NPWT following the start of home care was defined as <30 days for pressure ulcers and <7 days for surgical wound patients. Median duration of NPWT was 31 days (range 3 to 169) for pressure ulcers and 27 days (range 5 to 119) for the surgical wound group. Median lengths of stay in the early treatment groups were 85 days (range 11 to 239) for pressure ulcers and 57 days (range 7 to 119) for the surgical group versus 166 days (range 60 to 657) and 87 days (range 31 to 328), respectively, for the late treatment pressure ulcer and surgical groups (P <0.0001). After controlling demographic patient variables, regression analysis indicated that for each day NPWT initiation was delayed, almost 1 day was added to the total length of stay (β = 0.96, P <0.0001 [pressure ulcers]; β = 0.97, P <0.0001 [surgical wounds]). Early initiation of NPWT may be associated with shorter length of stay for patients receiving home care for Stage III or Stage IV pressure ulcers or surgical wounds. Additional studies to ascertain the cost-effectiveness of treatments and treatment approaches in home care patients are needed.

No description available.

Chronic constipation is a very common problem that negatively affects the quality of life of patients, especially the elderly population. It can also lead to significant health care expenditure. Careful assessment by obtaining a thorough history and physical examination with limited indicated diagnostic testing is important to identify potential underlying etiologies and to treat effectively.

This paper will cover the following subject areas: a brief history of attitudes toward and treatment of the retarded, to give an historical perspective to current developments; a review of current research of attitudes toward the retarded; a statement of the research question and the research design; the results of this research; and a concluding discussion.

No description available.

Thesis advisor: Marilynn S. Johnson / This dissertation explores the labor and collective organization of domestic workers in metropolitan Boston to uncover the new labor activism of the last half century. In 2014, Massachusetts became the fourth state in the U.S. to pass a Domestic Workers’ Bill of Rights. The law, the nation’s most comprehensive at the time, signaled a remarkable triumph for household employees whose collective activism anchored in Boston over four years achieved basic labor protections for tens of thousands. While the tale of this recent success has been captured by journalists and a handful of scholars, my study uncovers a multi-generational history of domestic workers’ fight for dignity and economic justice. I locate the origins of the 2014 victory in the grassroots organizing of pioneering Black, Caribbean, and Latinx women decades earlier. Local domestic workers and their allies sustained three separate waves of collective action during a half century marked by growing economic inequality, a decline in trade unionism, and mounting xenophobia. As I demonstrate, they developed a savvy repertoire of strategies that transformed household employment from a seemingly private, hidden affair into a societal concern requiring government intervention. Ultimately, my dissertation explains the emergence of a powerful and unexpected form of labor organizing--the new labor activism--that is community-based, multi-issue oriented, and propelled by working-class women of color. In directing critical attention to the relatively obscure history of domestic worker organizing, my study joins scholarship that expands analysis beyond the realm of the white male industrial worker to reconsider what constituted work, who comprised organized labor, and how we characterize recent labor history. By examining this particular workers’ movement, I present new insights into the groundswell of labor mobilization that erupted in American cities during the later twentieth century. Historians have accurately cast the period as one of organized labor’s weakness, dormancy, and decline. Even so, by prioritizing community-based campaigns anchored by immigrant and non-white women employed as domestic workers, I demonstrate that they also made it a time of hope and agitation, of rebirth and revival rather than repose. With appreciation for complexity, I gauge their activism not merely in terms of wins and losses, but also in regard to workers’ evolving sense of empowerment alongside their ability to spark larger public policy conversations concerning labor standards, the care economy, and the role of government. / Thesis (PhD) — Boston College, 2023. / Submitted to: Boston College. Graduate School of Arts and Sciences. / Discipline: History.

Bakgrund: Allt fler patienter med palliativt vårdbehov vårdas i hemmet. Detta kan skapa en komplex situation för den närstående då det kan upplevas betungande att vårda en svårt sjuk familjemedlem. Det är därmed värdefullt att vårdpersonal har kunskap om bemötandet av närståendes behov för att kunna ge anpassat stöd att hantera sin och den sjuke familjemedlemmens situation. Detta gör det betydelsefullt att undersöka närståendes upplevelser av vilka åtgärder och insatser denne är i behov av.  Syfte: Att beskriva närståendes behov av stöd när en familjemedlem vårdas med palliativ vård i hemmet. Metod: Studien genomfördes som en litteraturöversikt. En deduktiv analysprocess genomfördes där kodningen skedde utefter ett befintligt teoretiskt ramverk av Andershed och Ternestedt (1999) som sedan prövades gentemot aktuell forskning. Resultat: Att närstående kunde få möjlighet att förbereda sig genom information kring palliativ vård men också kring praktiska åtgärder och sjukdomsförlopp möjliggjorde en ökad trygghet hos närstående. Att få bekräftelse och bli sedd var något närstående ansåg som betydande. Vårdpersonalens tillgänglighet under dygnets alla timmar var av vikt men även att de tog tid för patient och närstående. Hjälp med praktiska göromål var av vikt då närståendes möjlighet att få tid för sig själv och avlastning visade sig vara en bärande punkt. Även samordning med andra professioner och vårdgivare ansågs värdefullt, liksom optimering av hemmiljön för att underlätta vården. Slutsats: Om de närstående får stöd anpassat efter deras behov underlättas deras situation och känsla av utsatthet kan minska. Generellt behöver närstående kunskap, trygghet och avlastning. Palliativ vård ställer krav på vårdpersonals förmåga att möta de närstående på en individanpassad nivå där denne befinner sig för att kunna möta de närstående med insatser efter deras behov.

Home health services are increasing for elderly individuals diagnosed with chronic diseases which are often treated by diet modification. This study was undertaken to evaluate the diabetic homebound client's understanding of and compliance to his/her prescribed diet. An interviewer assisted modified food frequency and food habit questionnaire was completed by 20 male and 28 female home care clients, ranging in age from 51 to 91 years. Living in a metropolitan area, these respondents met the Medicare definition of homebound and were diagnosed with diabetes mellitus. Computer driven dietary analysis was completed from questionnaire responses to estimate the food and nutrient intake of the home care clients. Calculated food intake was compared to physician diet orders taken from the home care medical record and to respondents' verbalization of their diet orders. This comparison was based on the composite diet and the components of energy, sodium, and cholesterol or fat. These findings were evaluated according to sex, age, length of time respondent had been diagnosed as diabetic, and a vulnerability index based on living situation using Chi square methods. / Master of Science