Home Health Care Management Research Articles

Providing Physical Assistance for Family or Friends: An Overview for the Home Health Care Professional—Part 2

This article is Part 2 of a 2-part series of articles addressing the needed educational and training support for informal caregivers who provide physical assistance in the home. Part 1, which was presented in a previous edition of Home Health Care Management & Practice (HHCMP), covered contemporary research on informal caregiver burden and addressed special challenges linked to provision of physical mobility assistance. Part 2, presented here, offers specific training recommendations for informal caregivers that may be provided by home health care professionals.

Providing Physical Assistance for Family or Friends: An Overview for the Home Health Care Professional—Part 1

Informal caregivers in the community provide assistance for loved ones in a number of ways, depending on the needs of the individual receiving care. Assistance provided can include managing medications, assisting with physical mobility such as walking and transfers, and generally monitoring health conditions. Informal caregivers provide a crucial societal need, as without this assistance healthcare facilities would be unable to meet the broad-based demand for services. This 2-part article summarizes contemporary research on informal caregiving and makes recommendations for lessening this burden within home health environments. Part 1—covered here—addresses the impact of informal caregiver burden and needed educational and training support for informal caregivers who provide physical assistance in the home. Part 2—covered in a subsequent issue of Home Health Care Management & Practice (HHCMP)—addresses—within a framework of contemporary leadership theory—suggestions for successfully lessening informal caregiver burden in home health environments.

Assessment of Parents' Knowledge about Home Health Care Management to Children with Beta Thalassemia Major

Thalassemia is a hereditary condition that affects the formation of globin chains. Beta thalassemia is characterized by either a total loss of manufacture globin (β-thalassemia major) or a partial loss of globin manufacture (β-thalassemia minor). This type of inherited anemias is found in Mediterranean and Southeast Asian communities. Objective: Assessment of parents' knowledge regarding home health care management related to children with β-Thalassemia Major. Methodology: A descriptive study design was carried out at Thalassemia Center in Al-Najaf City during the periods 25 ͭͪ February 2021 to 15 ͭͪ March 2022. Non-probability (purposive) sample of (35) parents were selected from thalassemia center (22 mothers and 13 fathers). Results: The finding shows that 77.1% of parents are resident in urban. The monthly income, over than half (54.3%) of parents consider their income to be barely sufficient. The sources of information about disease among parents; (88.6%) of parents are getting information from medical team. The parents are demonstrating poor knowledge level in most domains about home health care management of child with beta thalassemia major. Conclusion: The current study shows that there is a significant inadequacy in the parents' knowledge of the child with beta thalassemia major. Recommendation: Providing educational guidelines, posters, pamphlets and manuals about thalassemia and should be available at each parents in wards and encourage parents to get use from them.

Patient Satisfaction with the Nursing Care Quality in a Home Health Care Center in Madinah Region, Saudi Arabia: A Cross-Sectional Article

Home health care services are provided to more than 2,900 patients in the Madinah region in Saudi Arabia, and vary according to the patient’s needs and level of care required. The home health care center in Medina alone provides services to more than 700 patients. Nursing care is considered one of the main pillars of home health care, and all home health care centers depend on nurses to provide service. This makes the quality of nursing services in home health care one of the most important means of identifying the level of service quality in general in-home health care. In this article, the researcher aimed to determine the quality of nursing services based on patient and family caregiver satisfaction with the services provided; identify the most important factors that affect patients’ and family caregivers’ level of satisfaction; and determine whether there is a relationship between service quality, patient satisfaction, and improvement of the patient’s health in general. A cross-sectional method was used in this article; the Home Nursing Quality Scale (HNQS) questionnaire was translated into Arabic and distributed to participants via Google Forms. There were 267 participants in this article; the majority were female (54.7%), whereas only 45.3% were male. The patients’ and family caregivers’ level of education was one of the strongest factors affecting the extent of patient satisfaction, where satisfaction decreased with an increase in education level, i.e., patients and family caregivers with postgraduate degrees had mean scores of 3.83 (standard deviation [SD] = 1.17) and patients and family caregivers with primary degree had mean scores of 4.68 (SD = 0.76). Likewise, the age factor also affected the level of satisfaction: older patients and family caregivers were more satisfied, where patients and family caregivers aged >65 years had mean scores of 4.84 (SD = 0.37). There was a strong and positive relationship between nursing care quality and level of satisfaction among patients and family caregivers with home health care, which reflected the health status of the patients. Moreover, nursing managers and home health care managers must implement interventions to empower patients and caregivers to be more aware and capable of understanding the level of quality in the care provided by home health care nurses. Keywords: Patient Satisfaction, Nursing Care, Quality DOI: 10.7176/JHMN/100-08 Publication date: May 31 st 2022

Impact of an educational program on parents' knowledge about chelation therapy & nutrition of their children with beta thalassemia major

The study aimed to determine the effect of an educational program on parents' knowledge about chelation therapy, and nutrition of their children with beta thalassemia major. A quasi experimental study was carried out at Thalassemia Center in Al-Najaf City during the periods 25 ͭ ͪ February 2021 to 15 ͭ ͪ March 2022. Non-probability (purposive) sample of (70) parents were selected from thalassemia center (38 mothers and 32 fathers).The result of the study findings indicate that education program about home health care management was highly effective on parents’ knowledge in the study group evidenced by high significance associated with “Greenhouse-Geisser” correction at p-value=0.001. Also there is a significant relationship between parents’ knowledge with regard to affected father with disease at p-value= .049.

Home health care routing and scheduling problem with different groups of patients and health workers

PurposeIn this study, the authors investigate a different routing and scheduling problem in the field of home health care (HHC) management system. The purpose of this paper is to route and schedule the workday of health workers, assign the patients to suitable health workers, make accurate decisions to minimize costs, provide timely services and, in general, enhance the efficiency of HHC centers.Design/methodology/approachA mixed-integer linear programming model is developed to assign health workers to patients. The model considers health professionals with different skills, namely nurses and physicians. Additionally, three groups of patients are considered: patients who need a nurse, patients who need a physician and patients who need both. In the third group, the nurse must be present at the patient’s home following the physician’s visit in order to perform the required tasks.FindingsThe results of this study show a reduction in costs which results from the fewer health workers employed and dispatched in comparison with traditional approaches. With the help of our solution approach and model, HHC centers may not only successfully reduce their costs but also manage to meet their patients’ demands by assigning suitable nurses and physicians.Originality/valuePrevious studies have often focused on problems involving only one group of health professionals and rarely address problems involving multiple groups. The authors consider this a shortcoming, because in many cases, patients should be visited several times and by various health professionals.

Effectiveness of an Educational Program on Parents' Knowledge about Home Health Care Management to Children with Beta Thalassemia-Major at Thalassemia Center in Al-Zahra Teaching Hospital for Maternity and Children in Al-Najaf City

Background Thalassemia is a hereditary condition that affects the formation of globin chains. Children with βeta-thalassemia major have a complete absence of globin production. βeta thalassemia- major is a severe type of disease that require life-long blood transfusions for survival. Objectives: To evaluate the effectiveness of an educational program on parents' knowledge regarding home health care management related to children with Beta Thalassemia-Major Methodology: A quasi experimental study was carried out at Thalassemia Center in Al-Najaf City during the periods 25 February 2021 to 20 March 2022. Non-probability (purposive) sample of (70) parents were selected from thalassemia center (38 mothers and 32 fathers). Results: The study findings show that there are high significant difference in overall main domains relating parents' knowledge of beta-thalassemia major between pre and post-tests 1&2 in the study group. In addition there is a statistical relationship between parental knowledge with regard to their age. Also there is high statistical significant relationship during parents’ knowledge with regard to their educational level Conclusion: The study finds that the efficacy of an educational program to improving parents' knowledge of home health care management for children with β-Thalassemia Major is high Keyword: Educational Program, Beta thalassemia, Children, AL-Najaf City

Long Term Implications of Home Healthcare Management on Mortality in Older Adults with Functional Difficulties in the Saudi Community.

Background: This study aims to investigate whether certain demographic factors of patients receiving home healthcare (HHC) interventions have any positive impact on mortality. Methods: the study included all patients who were enrolled in the HHC program in a referred medical complex, Jeddah, Saudi Arabia between the years 2017 and 2020 (593 patients). Results: A total of 6548 HHC visits were received during the study period. From the total number of visits, 3592 (54.9%) HHC visits were scheduled in the year 2020 compared to 157 (2.4%) scheduled HHC visits in 2017 (p < 0.001). The most successful HHC visits were provided in 2020 compared with the year 2017 (2193 vs. 132; p < 0.001). The cancelled HHC visits were observed to be the lowest (194) in 2019. Three explanatory variables of mortality [age, having a major diagnosis (diabetes mellitus, cerebrovascular diseases, and bedridden), and having more cancelled visits] made a statistically significant contribution to the logistic regression model after controlling for other variables. Suffering from cerebrovascular diseases and/or bedridden were the strongest predictor of death in patients receiving HHC. Conclusions: During the 2020 pandemic, there was a sharp increase in HHC compared to previous years. Three significant explanatory variables of mortality [age, having a major diagnosis (diabetes mellitus, cerebrovascular diseases, and bedridden), and having more cancelled visits] were reported.

Analyzing the effect of using a simulation-based pharmaceutical home healthcare management education program

Analyzing the effect of using a simulation-based pharmaceutical home healthcare management education program

A solution approach to the orienteering problem with time windows and synchronisation constraints

The orienteering problem with time windows and synchronisation constraints, known as the Cooperative Orienteering Problem with Time Windows (COPTW), is a class of problems with some important applications such as in home health care and emergency logistics management, and yet has received relatively little attention. In the COPTW, a certain number of team members are required to collect the associated reward from each node simultaneously and cooperatively. This requirement to have one or more team members simultaneously available at a vertex to collect the reward poses a challenging task. It means that while multiple paths need to be determined as in the team orienteering problem with time-windows (TOPTW), there is the additional requirement that certain paths must meet at some of the vertices. Exact methods are too slow for operational purposes and they are not able to handle large scale instances of the COPTW. In this paper, we address the problem of finding solutions to the COPTW in times that make the approach suitable for use in certain emergency response situations. This is achieved by developing new merit-based heuristics as elements of an Adaptive Large Neighbourhood Search (ALNS) algorithm. We validate the performance of this new approach through an extensive computational study. The computational results show that the proposed method is effective in obtaining high quality solutions in times that are suitable for operational purposes.

Development of an Interprofessional Home Healthcare Management Service: Within an Urban Housing Development.

In response to the need for increased access to primary care services for a low-income, at-risk community, two local universities partnered with a nonprofit Housing and Urban Development affiliated provider of affordable housing to launch a primary care clinic within an urban public housing community. Although the establishment of this clinic represented progress in meeting many healthcare needs of the target population, an interprofessional team also identified a need for the initiation of a new home-based service line. The goal of this project was to establish an innovative, sustainable, and cost-effective healthcare delivery method that would improve the health of this population. The project focused on a literature review, needs-assessment, and development of a comprehensive medical home visit program to serve the homebound, frail elderly, and other at-risk adults with complex medical conditions who reside in this community. The medical needs of potential recipients were assessed by conducting interviews with key support staff including a health service coordinator, health advocates, and housing provider service coordinators. Residents were also interviewed using a newly developed health perception and information survey. The data derived from the needs-assessment and pertinent literature were used to draft an initial program guideline. Because the needs-assessment indicated this population would not derive maximum benefit from a traditional house calls program, the project team developed a Home Healthcare Management service with an expanded scope to provide enhanced care coordination, house visits (medical and nonmedical), and community outreach.

Clinical effectiveness, cost effectiveness and acceptability of community-based treatment of hepatitis C virus infection: Amixed method systematic review.

Several community-based models for treating hepatitis C virus (HCV) infection have been implemented to improve treatment accessibility and health outcomes. However, there is a lack of knowledge regarding how well these models achieve the desired goals. We conducted a mixed-method systematic review of quantitative and qualitative evidence about clinical effectiveness, cost effectiveness and acceptability of community-based HCV treatment models. Seventeen databases were researched for published and unpublished studies. Methodological quality was assessed using The Joanna Briggs Institute Critical Appraisal tools. Quantitative findings were synthesized in narrative form and qualitative findings were synthesized using meta-synthesis. Forty-two quantitative and six qualitative studies were included. No relevant cost effectiveness studies were found. Five categories of community-based models were identified: telehealth, integration of HCV and addiction services, integration of HCV and HIV services, integration of HCV and primary care, and implementation by a home care and health care management company. The range of reported outcomes included; end of treatment response: 48.7% to 96%, serious side effects: 3.3% to 27.8%, sustained virological response: 22.3% to 95.5%, relapse: 2.2% to 16.7%, and treatment completion: 33.4% to 100%. Inconsistent measures of uptake and adherence were used; uptake ranged from 8.3% to 92%, and 68.4% to 100% of patients received ≥80% of prescribed doses. Patient reported experiences included trusted and supportive care providers, safe and trusted services, easily accessible care, and positive psychological and behavioural changes. The clinical effectiveness and acceptability reported from the included studies are similar to or better than reported outcomes from systematic reviews of studies in tertiary settings. Studies of the cost effectiveness of community-based models for treating HCV are needed.

Research on Home Healthcare Management System Based on the Improved Internet of Things Architecture

This paper designs an improved internet of things architecture to redefine the internet of things architecture into the node domain, the network domain and the application domain so as to design and implement a home healthcare management system based on this improved internet of things architecture. In this way, all of the equipments characterized with Zigbee communication function in the blood pressure measuring node, the blood oxygen measuring node and the ECG measuring node can be connected to the internet through the Zigbee-Wifi gateway. Meanwhile data uploaded by the users can be stored and analyzed on the backend server of the internet of things so that the users can review their health data and control the node devices through the intelligent terminals such as cell phone etc. Taking the blood pressure measurement as an instance, the experiment has proved the feasibility and reliability of this system.

Home Health Care (HHC) Managers Perceptions About Challenges and Obstacles that Hinder HHC Services in Jordan.

Home care aims at supporting people with various degrees of dependency to remain at home rather than use residential, long-term, or institutional-based nursing care. Demographic, epidemiological, social, and cultural trends in Jordan as in other countries are changing the traditional patterns of care with growing emphasis on home care. The purpose of this study is to highlight the most common challenges related to home health care (HHC) services in Jordan as perceived by the managers of HHC agencies. Methods: a descriptive qualitative design that depends on focus group discussions has been used to collect data from a sample of 18 managers who met the selection criteria and who are willing to participate, the study found that, the main challenges of HHC services as perceived by managers were: shortage of female staff, lack of governance and regulation, poor management, unethical practices, lack of referral systems, and low accessibility of the poor and less privileged as HHC services are not included in health insurance schemes, it concludes also that the home health care industry in Jordan is facing many challenges and problems that may have negative effects on the effectiveness, efficiency, equity and quality of services and should be addressed by health policy makers.

ACL Tears

This article is the second in a two-part series that addresses the scientific literature on the contributing factors and preventive strategies for anterior cruciate ligament (ACL) injuries. Part 1, which was presented in a previous edition of Home Health Care Management &amp; Practice ( HHCMP), covered contemporary research on the functional anatomy of the knee and precipitating factors to ACL injuries. Part 2, presented here, addresses contemporary trends evident in the peer-reviewed literature on the topic of the rehabilitation of ACL injuries, and it offers suggestions home health care professionals may find useful in the prevention and rehabilitation of this injury.

ACL Tears

This article addresses the scientific literature on contributing factors and preventive strategies for anterior cruciate ligament (ACL) injuries, and it offers suggestions home health care professionals may find useful in the prevention and rehabilitation of this injury. More specifically, this two-part article summarizes contemporary research on the functional anatomy of the knee, precipitating factors to ACL injuries, and current strategies in the rehabilitation of these injuries. Part 1—covered here—addresses the knee’s functional anatomy and precipitating factors to ACL injuries noted in the scientific literature. Part 2—covered in a subsequent issue of Home Health Care Management &amp; Practice ( HHCMP)—addresses contemporary trends evident in the peer-reviewed literature on the topic of the rehabilitation of ACL injuries.

On the Borderland of Medical and Disability History: A Survey of the Fields

This essay explores the multiple sites where disability appears in the history of medicine and suggests ways in which medical historians can self-consciously incorporate a disability perspective into their own work. Just as medical historians have much to learn from disability historians, disability historians could benefit from looking more closely at the history of medicine. While disability cannot (and should not) be reduced to disease, the fact remains that some forms of disability are brought about by disease processes, and some require daily regimes of home health care, therapy, and pain management. How the disabled have interacted with health care institutions, caretakers, and the medical establishment is too significant to be written out of its history.

A study on the application of internet based home healthcare management system in Korean older adults

This paper propose a new internet based home healthcare system and frame of reference that might permit the development of a better understanding of management system that is the development of home healthcare service in Korean national longtermcare insurance. We applied our developed system to 506 older adults for 14 month from July 2011 to August 2012. And we measured the physical ability, mental ability, service time, and safety checkup results before and after applying the home healthcare management system. Consequently, there is not difference in total service time and physical, mental ability before and after applying home healthcare management system. After the applying home healthcare management system, safety checkup results were significantly increased include daily activity and social activity safeties. Our developed home healthcare management system could improve the safety management of caregivers who engage the national longtermcare insurance service to Korean older adults.

A solution framework to provide management services for wireless communications in the digital home

The future digital home (DH) is envisioned as a place where a plethora of diverse personal and machine-to-machine communications will coexist to support different applications in areas such as information and entertainment, home automation, home health care and home security and management. Wireless technologies are usually the preferred solution to cope with DH communications for their ease of installation and use. However, expected capacity demand and the lack of coordination between an increasing number of diverse wireless devices in use within the DH is seriously challenging the performance and usability of wireless technologies. This article outlines a novel technical solution intended to enhance capacity and quality of DH wireless communications. The proposed solution establishes a radio-independent coexistence framework where key operational radio settings of DH devices are coordinately determined, and new spectrum sources other than traditional ISM bands can be exploited for DH communications. The addressed solution enables a business player to offer management services for DH wireless communications so that ordinary users can be relieved of complex management tasks likely to arise within the DH. The article discusses how potential management service providers could benefit from the proposed solution. Besides, the functional architecture of the proposed solution together with the set of procedures necessary for the management of the DH wireless communications are outlined. A realistic indoor scenario is presented as an illustrative use case to show how proper decision making logic in managing the DH could improve the efficiency by selecting the most suitable spectrum for in-house wireless communications. Finally, the main implementation issues are identified and discussed in order to outline a feasible roadmap

Antibiotic Use in Home Health

Cost containment measures within hospital systems push for earlier discharges on stable patients. Due to patient placement difficulties and costs associated with skilled facilities, antibiotic use in home health care settings is becoming a common occurrence. This trend will likely increase as care continues to shift to outpatient areas. Lack of sufficient serum drug concentrations needed in severe infections and increasing resistance to many of the oral options often necessitates the use of the intravenous (IV) route. Home health care practitioners may have minimal information on patients or limited experience with IV antibiotics that may impact quality of care. This review summarizes key points relevant to IV antibiotics routinely used by home health prescribers, nurses, technicians, and care managers. This review will focus on antibacterial agents including vancomycin, aminoglycosides, beta-lactams, daptomycin, tigecycline, and telavancin. Appropriate dosing, indications, adverse events, monitoring parameters, and feasibility of using IV antibiotics are discussed.