Home health aides' performance can help home health clients achieve quality of life. This quantitative, cross-sectional study examined which work-related factors of home health aides influence home health clients' quality of life. A socioecological perspective was used to understand influences on behaviors. Participants in this study were 400 home health clients who received services from home health agencies. A binary logistic model was used to determine the predictor variables of home health aides that contributed to home health clients' quality of life. Findings indicated that psychosocial skills were among the most predicted work-related performance of home health aides that lead to quality of life for home health clients. All independent variables (professional care; teaching clients about medication management, pain, and home safety; and social and communication skills) showed significance (p < .05). The implications of this study for positive social change include contributing evidence to support improving home health practices and informing policies, which might increase the quality of life for home health clients.

Thesis (Ph.D.)--University of Nebraska-Lincoln, 2006. / Title from title screen (site viewed on August 28, 2006). PDF text of dissertation: 206 p. : ill. ; 1.54Mb. UMI publication number: AAT 3208077. Includes bibliographical references. Also available in microfilm, microfiche and paper format.

Diss. (sammanfattning) Linköping : Linköpings universitet, 2006. / Härtill 4 uppsatser.

The purpose of this study was to explore the impact of training and employment as a health care aide on the personal and public lives of nine immigrants, eight of whom were women. These individuals had successfully completed a combined skills and ESL training program for Home Support or Home Support/Resident Care Attendant at an immigrant settlement agency on the west coast of Canada approximately one to two years prior to the study. The program trained the individuals to work as care aides in private homes or long term care facilities as well as provided training in English skills. A qualitative approach was chosen in order to explore the issues and themes that were relevant to the participants, from their own perspectives, with regard to the impact of training and employment as a health care aide on their lives. The findings revealed that participation in a training program had a significant impact on the individuals' lives. Acquiring an occupational skill for the health professions gave some of the individuals an occupational identity as well as personal fulfillment. For others, this training helped them to find meaningful employment and facilitated their integration into Canadian society. However, finding full-time employment proved to be a challenge for most of the participants. They encountered many barriers to employment for example, the need to work on-call and the resultant lack of a stable income; conflicts between domestic responsibilities and work outside the home; transportation limitations; and personal barriers, such as age, work experience, and education. On the positive side, participation in the training program helped the individuals to improve their English skills which increased their confidence, independence, autonomy, and self-esteem. Improvement in English skills also facilitated the individuals' settlement and integration into Canadian society. In addition, knowledge of health care had a positive impact on the individuals' ability to care for their family members. Overall, participation in a skills and language training program had a significant impact on the individuals' identity, family life, and settlement in Canada.

The purpose of this study was to explore the impact of training and employment as a health care aide on the personal and public lives of nine immigrants, eight of whom were women. These individuals had successfully completed a combined skills and ESL training program for Home Support or Home Support/Resident Care Attendant at an immigrant settlement agency on the west coast of Canada approximately one to two years prior to the study. The program trained the individuals to work as care aides in private homes or long term care facilities as well as provided training in English skills. A qualitative approach was chosen in order to explore the issues and themes that were relevant to the participants, from their own perspectives, with regard to the impact of training and employment as a health care aide on their lives. The findings revealed that participation in a training program had a significant impact on the individuals' lives. Acquiring an occupational skill for the health professions gave some of the individuals an occupational identity as well as personal fulfillment. For others, this training helped them to find meaningful employment and facilitated their integration into Canadian society. However, finding full-time employment proved to be a challenge for most of the participants. They encountered many barriers to employment for example, the need to work on-call and the resultant lack of a stable income; conflicts between domestic responsibilities and work outside the home; transportation limitations; and personal barriers, such as age, work experience, and education. On the positive side, participation in the training program helped the individuals to improve their English skills which increased their confidence, independence, autonomy, and self-esteem. Improvement in English skills also facilitated the individuals' settlement and integration into Canadian society. In addition, knowledge of health care had a positive impact on the individuals' ability to care for their family members. Overall, participation in a skills and language training program had a significant impact on the individuals' identity, family life, and settlement in Canada. / Education, Faculty of / Language and Literacy Education (LLED), Department of / Graduate

The focus of this research study is glycemic control in the presence of multiple morbidities and polypharmacy in homebound individuals with Type 2 diabetes aged 65 years and older. The research method is a quantitative retrospective cohort study of discharged patients of a nonprofit community-based home health agency from January 1, 2010, to December 31, 2011, using OASIS data. Glycemic control is assessed using the hA1C laboratory test following the recommendation of the American Diabetes Association. The study documents a moderate significant association between glycemic control, polypharmacy and comorbid conditions, indicating that homebound individuals with Type 2 diabetes aged 65 years and older are less likely to have optimal glycemic control in the presence of multiple morbidities and polypharmacy. There continues to be a need for scientific research in this population cohort; and the dose-response association between antidiabetic therapy interventions designed to lower blood glucose levels in the presence of chronic disease and polypharmacy.

Chronic obstructive pulmonary disease (COPD) is a collection of chronic conditions that results in irreparable lung damage and stress to patients. COPD also has considerable financial impacts on health care entities due to frequent hospital readmissions of COPD patients. The Centers for Medicare and Medicaid Services penalize care entities for 30-day hospital readmissions. Many rehospitalizations attributed to COPD are due to exacerbations, often preceded by physiologic and emotional changes that can be monitored, allowing action to be taken to prevent readmissions. The practice problem for this quality improvement project explored whether the use of remote home monitoring of COPD patients discharged to home health care, coupled with the use of a medication rescue pack, would reduce rehospitalizations within 30 days after discharge. The purpose of the project was to evaluate the effectiveness of telehealth remote monitoring and initiation of a medication rescue pack in decreasing 30-day readmissions of COPD patients. The self-efficacy model was used to encourage health-promoting actions that are necessary for chronic disease management. Data from the project agency's records of COPD patients were evaluated for readmission rates. Analysis of the data from 8 preintervention patients showed that 3 (38%) were readmitted. Postintervention data showed that of the 9 participants, only 1 was readmitted (11%). Comparison of the data showed a 27% decrease in readmissions because of the intervention. The results of this project have the potential to bring about positive social change by improving care management remotely in real time, thus decreasing rehospitalization in COPD patients.

Uppsatsen är gjord som en systematisk litteraturstudie med en kvalitativ ansats där nio artiklar analyserades. Litteraturstudiens syfte var att beskriva patientens upplevelse av att befinna sig i den sena fasen av den palliativa vården. Vårt resultat visade att patienter som befinner sig i den palliativa vården ville ha kontroll över livet, uppleva trygghet och värderade saker annorlunda. Trygghet upplevdes t.ex. när patienter kunde vårdas i det egna hemmet. Våra fynd visade att förtroende skapar en känsla av trygghet vilket leder till att välbefinnande förstärks och sjuksköterskan får bättre kunskap om patienten och patientens livsvärld. För att fördjupa oss i patientens upplevelse av den palliativa vården har vi använt oss av livsvärldsteori och teori om att finna mening med livet.

In the 21st century, the rapid developments and growth of information and communication technology have triggered a new wave of Healthcare Industry. This study utilizes the secondary data analysis to analyze and generalize the processes, contents and models of health care management. In addition, discuss the changes in both healthcare informatics and medical related processes based on the innovations for the traditional models to the new home health care management models. Further, the standard of the evaluation are according to the expert consultations, to see the critical impacts of the innovations on the stakeholders: healthcare customers, healthcare providers and healthcare regulators are identified, so as to explore the core capabilities in these dimensions of the innovation. These results indicate that the innovations for home health management care are differences in the technological knowledge and business model aspects. We further identify five home health management models and their core business capabilities that are necessary for the stakeholders to cope with the changes, each appearing to address either technical or care aspects of the transformation. The findings have the potential to contribute to the understanding of impacts occurring in the change associated with the innovation in the care process and offer rich insights for the stakeholders to exploit the opportunities.

This study had two purposes: 1) to compare the difference between home health care only and home health care plus telemonitoring on heart failure patients' symptom burden, self-care of heart failure and re-hospitalization; and 2) to explore which patient characteristics might moderate telemonitoring's impact.Heart failure has emerged as a major public health burden. Like other chronic conditions, heart failure patients have an important role to play in the day-to-day management of their condition. One of the principal reasons for introducing telemonitoring in home health care was to increase heart failure patients' capacity to self-manage their conditions at home.This study used a prospective, non-experimental, comparative, descriptive design. A total of 68 participants were recruited with 34 in each group. Symptom burden and self-care of heart failure were measured on enrollment and 40 days later. Hospitalization was measured as an event that either occurred or did not occur.Although no between-group differences in symptom burden were found, both groups showed significant decreased symptom burden over the 40-day period. Of the three self-care measures, only self-care maintenance differed significantly between the two groups at the 40-day follow-up (p<.05). Only the participant's functional status had significant moderator effect on the relation between type of service received and self-care maintenance (p<.05).The addition of telemonitoring produced similar outcomes to regular home health care, except for self-care maintenance. Like most prior study, this study focused on evaluating the overall relationship between telemonitoring and outcomes without concern for the transformation process. Although these evaluation were able to provide an overall assessment of whether or not the telemonitoring program worked, they cannnot identify the underlying mechanisms that generate the effects. Without knowing what make the program work or not work, it is difficult to pinpoint what needs to be done for future improvement. A theory-oriented evaluation will be needed in future research. Theory-oriented evaluation not only allow reseachers to clarify the connection between a program's operation and its effect, but also to specify intermediate effects of a program that might become evident and measurable.