Home Care Personnel Research Articles

Stress from working conditions among home care personnel with musculoskeletal symptoms.

A large proportion of the working population experiences musculoskeletal symptoms, which affect the individual's quality of life. Neck/shoulder and/or low back complaints are common among home care personnel. This occupational sector is characterized by high physical and psychosocial demands and the staff is typically female. The aim of this qualitative study was to gain a deeper understanding of those factors in the work environment of home care personnel that the individuals perceive as demanding and problematic. Eight employees in the home care service were interviewed in depth. Each interview was transcribed and Grounded Theory was applied. Stress, related to demanding physical and psychosocial working conditions, emerged as the core variable that probably contributed to the development and maintenance of musculoskeletal symptoms. Financial cut-backs at the municipality was seen as a cause of the demanding working conditions. In future studies it is important to evaluate prevention programmes focused upon coping strategies against stress.

The relationships between spinal sagittal configuration, joint mobility, general low back mobility and segmental mobility in female homecare personnel.

The aim of this study was to investigate joint mobility, segmental and general spinal mobility and their interrelationship in 607 women working as homecare personnel. Joint mobility (mainly peripheral) was estimated using the "Beighton" score. Spinal posture and mobility were measured by Debrunner's kyphometer. Passive segmental mobility and pain provocation were estimated manually. Reliability tests between two physiotherapists of segmental mobility and pain provocation (n = 150 subjects) were performed. Positive correlations were found between joint mobility, sagittal thoraco-lumbar mobility and segmental mobility. Hyperlordosis (>39 degrees) was associated with greater lumbar mobility. The reliability of manual segmental mobility and segmental pain provocation was good, especially in the lowest back segments (kappa approximately 0.7). Joint mobility, general mobility and segmental spinal mobility intercorrelated. Segmental mobility manually estimated showed intertester reliability. The good positive correlation between sagittal lumbar mobility and manually tested segmental mobility indicates criterion validity for the latter.

Physical and Psychosocial Work-related Risk Factors Associated with Musculoskeletal Symptoms among Home Care Personnel

Physical and Psychosocial Work-related Risk Factors Associated with Musculoskeletal Symptoms among Home Care Personnel

Physical and Psychosocial Work‐related Risk Factors Associated with Musculoskeletal Symptoms among Home Care Personnel

The aim of this cross-sectional study was to investigate physical and psychosocial aspects of the work environment, sociodemographic data and certain lifestyle factors, and the relationship between these variables and complaints in the shoulder/neck and low back area among female home care personnel. A questionnaire was completed by 361 randomly selected women. Multiple logistic regression analyses were conducted to evaluate the importance of several exposure factors for complaints in the shoulder/neck and low back areas. The results of this study clearly indicate that 'standing in forward-bent and twisted postures' can be viewed as a risk factor for shoulder/neck pain. A combination of this physical exposure and 'no possibility of influencing the planning of work' gave an increase in odds ratio, indicating an interaction between these two exposure indices. However, this interaction was not found for low back pain. 'Standing in forward-bent and twisted postures', 'standing in awkward positions' and whether the subject had children staying at home were significantly correlated to complaints about the low back. In fact, the latter factor decreased the risk of having complaints. The results indicated that certain physical and psychosocial work risk factors could influence shoulder/neck and low back pain.

Prevalence of long term sick leave among female home care personnel in Northern Sweden

The aim of this cross-sectional study was to investigate the occurrence, cause, and degree of long term sick leave among home care personnel. Home care personnel were compared with child caretakers, nursery school teachers, and teachers. The source population was residents in the four most northern counties in Sweden. Cases were persons on long-term sick leave (>29 days), and information was collected from the local insurance offices. The prevalence of long-term sick leave was highest among home care personnel, and an increase with age was also found within this group. Musculoskeletal complaints were very common as an underlying cause of long-term sick leave among home care personnel. Finally, full-time sick leave was the most common type of sick leave, especially among home care personnel.

Care for frail elders: developing community solutions

[List of] Tables Foreword by James J. Callahan, Jr. Introduction What Is Long-Term Care and Who Needs It? State Infrastructure for Long-Term Care: Criteria for Adequacy Understanding and Measuring Quality of Care Practice and Design Variations in Community Care Management Home-Care Personnel Issues: The Hidden Challenge in Community Care Aging Differently: Issues of Gender and Race Program Benefits and Costs: What We Cover and How We Pay Social Benefits and Costs: Public Responsibility for Community Care and How It Should Be Borne Private Insurance Methods National Medicaid and Medicare Strategies Conclusion Glossary References Index

Mechanical performance, level of continuous contraction and muscle pain symptoms in home care personnel

The interrelationships between reported complaints, clinical status, mechanical performance and EMG pattern of the shoulder flexors and the knee extensors, respectively, during maximum dynamic contractions were investigated. A group of 97 randomly selected women employed in the home care service participated. Those who reported complaints had more clinical findings, such as reduced mobility, tender points and muscle tightness, than non-complainers. The level of muscle activity during the passive part of the contraction cycle was significantly higher in the shoulder flexors than in the knee extensors. Subjects without reported complaints who had been employed for more than ten years had a significantly lower activity level in the shoulder muscles than subjects without complaints who had been employed for a shorter time. We suggest that a high muscle tension level between contractions might precede muscle pain. A cluster analysis including sociodemographic, clinical and physiological variables revealed different subgroups, which points to the need to investigate the work situation in a multivariate way.

Outpatient management of amyotrophic lateral sclerosis.

The patient with ALS can be managed almost entirely as an outpatient by a team consisting of a nurse, physiotherapist, occupational therapist, speech pathologist, nutritionist, respirologist, social worker, and certain other consultants from time to time. The team's goal is to maintain physical function and extend the useful life of the patient through the skills that the team members are trained to provide. Pulmonary function tests, especially spirometry, should be done at regular intervals and a modified barium swallow should also be done at least once in cases with dysphagia. It is possible with these tests to anticipate and even correct a number of hazards, such as upper airway obstruction and aspiration. Some patients are candidates for gastrostomy and tympanic and chorda tympani neurectomy, but full knowledge of their pulmonary function is essential before undertaking any operative procedure. Death in ALS is due to pulmonary failure and the choice of respirator care requires careful deliberation with the family. The neurologist and ALS team should work in close cooperation with the home care personnel in the patient's own community. Does the care of the ALS patient in any way affect survival? In the attempt to answer this question we have estimated the survival of ALS patients in southwestern Ontario, most of whom have visited our clinic over the period of 1978 to 1985, inclusive. As shown in Figure 4, there was an apparent decline in the annual mortality rate over this period, although there was no significant change in the incidence of ALS in this region.(ABSTRACT TRUNCATED AT 250 WORDS)

Infection control at home. A guideline for caregivers to follow.

By early 1986, over 16,000 people had been diagnosed with AIDS in the United States. It has been estimated that between 5percent and 15 percent of these are hospitalized at any given time. Of the 80 to 95percent who are living at home, some are experiencing few symptoms and independent in their activities of daily living. However, approximately 20 to 25 percent of those living at homeexperience chronicor acute symptoms associated with AIDS, requiring intervention by the home team. Home care agencies throughout the country have provided services to people with AIDS in the home utilizing basic, standard precautions for infection control. This article will provide information regarding disease transmission, both to allay the anxieties of homecare personnel concerned aboutworking with AIDS patients, and to enable them to utilize appropriate precautions to prevent the transmission of AIDS and the associated opportunistic infections.

Setting Educational Standards for Gerontological Home Care Personnel

While home care programs for older people have gradually established themselves as one of the more popular interventive strategies of the day, surprisingly little discussion has centered on establishing educational guidelines for program personnel in this field of service. A survey study of the work experience and opinions of administrative and direct service program staff (N = 91) in three Older Americans Act-funded home care programs in New York City sheds light on issues of training and education in home health care. Findings reveal considerable agreement among both agency-based and home-based staff as to a desirable set of educational attainment levels necessary for the performance of distinct home care jobs. High school cducation was generally seen as satisfying the requirements of performing such service functions as intake/ application, housekeeping, personal care and household management. College level preparation was seen as desirable in satisfying the demands of supervision, case management, and medically-related service tasks. Some degree of formal education beyond college was prescribed for the task of social counseling. Significant difference of opinion was voiced by administrative and direct service staff as to the relative level of formal education that should be required of both home care trainers and directors, with administrators registering more strict standards of achievement. Study results are seen to have implications for designing specialized educational and training models in the field of gerontological home care which are sensitive to workers with varying levels of formal education and divergent service responsibilities.