Home-like Environment Research Articles

Home Quarantine Among COVID Positive Health Professionals: A Cross-Sectional Study From Hyderabad Pakistan

Objective: To determine the preference for home quarantine and its reasons among health professionals during the COVID-19 pandemic.
 Study Design: Cross-sectional study.
 Place and Duration: Department of Obstetrics/Gynecology, Liaquat University of Medical and Health Sciences Jamshoro, and other affiliated hospitals with LUMHS, from Apr to Sep 2021.
 Methodology: Eighty home-quarantined health professionals (HPs) at our institute following the exposure to confirm COVID-19 cases were included. A pre-designed questionnaire was used to analyze its reliability using Cronbach's alpha value in SPSS after completing the home quarantine period and analyzed.
 Results: We enrolled 80 health professionals. 43 (53.8%) were PG Trainees, followed by consultant (20%), doctors (20.0%), nurses (6.2%), and technicians (6.9%). The mean quarantined period was 15.72 ± 6.15 days (7-20 days). Doctors, PG trainees, and nurses perceived a greater level of irritability than the other health professionals. We found an association between irritability and advanced age, confinement, and being single. Generally, PG Trainee revealed higher physical activity (p= <0.001). Physical activity was significantly lower among respondents who were unmarried (p= 0.004).
 Conclusion: Increased satisfaction and a more homelike environment, less aggravation of symptoms, and a mild level of depression and anxiety among health care professionals were associated with home quarantine measures during the COVID19 pandemic.

Levels of Automation for a Mobile Robot Teleoperated by a Caregiver

Caregivers in eldercare can benefit from telepresence robots that allow them to perform a variety of tasks remotely. In order for such robots to be operated effectively and efficiently by non-technical users, it is important to examine if and how the robotic system’s level of automation (LOA) impacts their performance. The objective of this work was to develop suitable LOA modes for a mobile robotic telepresence (MRP) system for eldercare and assess their influence on users’ performance, workload, awareness of the environment, and usability at two different levels of task complexity. For this purpose, two LOA modes were implemented on the MRP platform: assisted teleoperation (low LOA mode) and autonomous navigation (high LOA mode). The system was evaluated in a user study with 20 participants, who, in the role of the caregiver, navigated the robot through a home-like environment to perform control and perception tasks. Results revealed that performance improved in the high LOA when task complexity was low. However, when task complexity increased, lower LOA improved performance. This opposite trend was also observed in the results for workload and situation awareness. We discuss the results in terms of the LOAs’ impact on users’ attitude towards automation and implications on usability.

Reconsidering patients with chronic kidney psychological needs: optimizing hemodialysis room design

Chronic kidney failure (CKF) and its treatment often manifest in anxiety and fear in patients. The present study aimed to gain an in-depth understanding of how hospital interior design, hemodialysis rooms, in particular, can exacerbate or alleviate anxiety and fear in patients with CKF. Specifically, it reviews relevant literature to unveil to what extent a home-like environment in CKF healthcare centers might minimize anxiety and fear compared to an institutional design. Findings revealed patients with CKF delineate into three groups based on their psychological response to their disease and their ability to adapt to the new situation. Based on these classifications, the researcher proposed three models for the dialysis room to reduce anxiety and fear in each category. Crucially, while a homey environment in healthcare centers helps to mitigate anxiety and fear in a subset of patients with CKF, other patients may feel more anxious and fearful in such an environment.

‘Your home—away from home’: Tourist homes and hospitality as resistance

Tourist homes, private residences that rented rooms to traveling guests, were once a popular form of tourist accommodation in the United States. Reaching their peak in the early 20th century, tourist homes largely became obsolete as hotels and motels were able to provide relatively inexpensive and standardized forms of hospitality. As a result of their meteoric rise and fall, and the private nature of the lodging, tourist homes have been neglected in studies of historical tourism and hospitality. However, tourist homes occupied an important position in providing welcome and other forms of hospitality to travelers, particularly Black Americans, in the first half of the 20th century, and this role deserves to be recovered and recognized. An exploration of tourist homes listed in the Green Book, a Black American-centric travel guide published during the Jim Crow Era, reveals that tourist homes not only lodged travelers overnight, but also significantly contributed to forms of mobile resistance against white supremacy. Specifically, through a conceptualization of hospitality as resistance, tourist homes enabled opportunities for Black Americans to gain economic and social capital through processes of welcoming and establishing ‘Black counterpublic spaces’. Particularly through constructions of home-like environments, tourist homes presented spaces that served as moorings within larger mobility networks, countering white supremacist attempts to immobilize and disadvantage Black Americans. Given these contributions to resistance and Black mobility, tourist homes deserve to be included in studies of tourism, hospitality, and Black geographies as important sites of welcoming, resistance, and resilience.

Turning the ordinary into the extraordinary – Experiences of providing farm-based day care for people with dementia

This study aims to give in-depth knowledge about how service providers of farm-based day care for people with dementia work. Seven semi-structured interviews resulted in five main themes showing that providers focused on incorporating the naturally stimulating, yet relaxing nature setting, keeping a welcoming, home-like environment, while tailoring the service to fit attendees’ needs and functional level. These core elements also laid the foundation for providing activities with rippling effects, a positive social setting, and possibilities for mindspace and personal focus. Providers therefore utilize the ordinary aspects of the farm context to create an extraordinary person-centered tailored service.

LEGAL ASPECTS OF THE CHILD GUARDIANSHIP REGULATION

The relevance of this study. The institute for the care of minors is receiving a great deal of attention nationally, as the state’s priority is the growth of the child in the family. According to the report on the activities of the Adoption Rights Protection Authority in 2021, is noted that in 2021 the number of children in guardianship in Lithuania was 963 of them in temporary guardianship 921 children, with a permanent population of 42 children indicating that the need for care is high. It is in the interest of the valet that children grow up in a family and the state initiative is undergoing a care reform aimed at abolishing institutional care homes and creating conditions for children to grow up in a family. The main problems. The article examines the issues in the context of guardianship. The most frequent reason for the loss of guardianship of a child is the alcoholism of the parents, neglect of the child an d violation of their interests, which is manifested in three different ways: 1. Failure to respect the principle of guardianship by separating brother and sister. 2. Transferring a child deprived of parental care to a health authority if no illnesses are detected. 3. A small number of guardianship due to low awareness. The following tasks: 1. Define the concept of child guardianship. 2. To analyse EU international and Lithuanian national legal acts regulating child guardianship. 3. Identify case law on the legal regulation of the child guardianship. The aim of this work: to analyse the aspects of the legal regulation of the institution of child guardianship to ensure the best interests of the child. The paper concluded: The analysis of national legal acts and case law has shown that the Civil Code of the Republic of Lithuania must be applied in a mandatory manner when applying the principles the child guardianship. The novelty – In Lithuania, the Civil Code of the Republic of Lithuania is the main legal act regulating the institute of child guardianship, but the peculiarities of the principles of child guardianship are not clearly disclosed, as each situation depends on its own individual variant. The article analyses all the principles governing the custody of a minors with a view to highlighting the peculiarities of the custody institute and preventing violations of the child’s interests. As the result – In Lithuania, there are situations when a child is removed from parental care and transferred to health care institutions with the hope of finding a safe place for him/her quickly, but for a healthy child, this is not an appropriate solution, as the child’s best interests are at stake – a health care institution is not a home-like environment. The Civil Code of the Republic of Lithuania establishes the procedure for location fostering a child, and a health care institution is not a suitable place for fostering. It has been established that failure to respect the order of priority causes violations of the child’s best interests and causes severe stress for the child deprived of parental care. The used methodology the work applies the analysis of scientific literature, which helps to deepen the specifics of this institution, analyses the legal acts regulating the institute of custody, and analyses the case law related to the institute of child c ustody.

Staff Training and Stress in Long Term Care Facilities Special Care Units for Alzheimer's Elders

Objective:Special Care Units (SCU) in long term care health facilities are named to indicate "unique to diagnosis" or a level of care. The purpose of this study was to explore perceptions among caregivers and licensed nurses in selected nursing homes in Ohio and Pennsylvania and New York, as they pertained to the differences in care to Alzheimer's elders in SCUs. It examined the education and experience of staff and the satisfaction of this staff as it pertained to stress and wages.
 Background:Long-term caregivers often experience stress, resulting in "burn-out" as a consequence of limited training, levels of care required, cognitive decline of elders and family expectations. The caregivers, on SCUs, environmentally designed for the elders with cognitive decline, need specialized training in the physical and mental dimensions of the various forms of dementia, Alzheimer's type.
 Methods:The study used a qualitative research design with a survey questionnaire and one-on-one interviews with administrators and human resource directors. A pilot study of SCUs in Ohio and Pennsylvania and New York was initiated. The population was the employees of these SCU. The levels of employees questioned included: Executive director/Administrator, nurses, nurse aides, housekeepers and activities staff, laundry and social service workers. The procedure was standardized to enhance the reliability of the data. The respondents were notified in advance of the specific application of their answers and were afforded the opportunity to receive a monetary donation to the SCU of their respective facilities.An Eden Alternative Home, with a program of goals and missions characterizing enhancement of an elder's life, a home-like environment and family-centered staff and care, in a very rural area of Pennsylvania, was also engaged to contrast and compare the hypotheses of the study.
 Results:On the SCU, less than 5 percent of the staff had received training specific to the care of the Alzheimer's elders. In the Eden Home, 100 percent of the staff had received training specific to the care of the Alzheimer's elders. On the SCU, less than 18 percent were satisfied with the quality and quantity of specialized and extensive training. In the Eden Home, 100 percent of the staff was satisfied with their specific training. On the SCU, using a Leiken scale, more than 55 percent felt that they should receive higher wages. In the Eden home, the results were the same. However, the longevity of the employees was 13.5 years as opposed to only 3.25 years in the SCU in other homes.
 Conclusion:These findings suggest there is a need to examine, expand and intensify the training of all caregivers on a special unit for the elders afflicted with dementia, Alzheimer's type.

Role of Physical Environment in Quality of Life among Residents in Dementia Care Facilities through a Longitudinal Observational Study : For Facilities in Canada and South Korea

This longitudinal observational study aims to examine whether residents with dementia in long-term care facilities with variability in physical environment qualities in Vancouver (N=11), Canada and Seoul (N=9), South Korea had a difference in their quality of life (QoL). Physical environmental assessment was conducted using the Therapeutic Environment Screening Survey for Nursing Homes (TESS-NH). QoL was assessed three times over one year using Dementia Care Mapping tool. The results of the study demonstrated that the residents with dementia living in an institutional large-scale setting showed statistically more withdrawn behavior and spent more time to be negative mood or affect compared to the ones in a small-scale setting. This study also found that the number of potential positive behaviors of residents in a small-scale setting was three times higher than that of residents in an institutional large-scale setting. When looking at the distinction between two countries in the behavior category with a large average time difference, the residents with dementia in Korea had shorter meal/dessert times compared to those in Canada. The study supports that the small-scale homelike environment is intensely associated with a therapeutic environment for older adults with dementia.

Infection Control in Small Residential Care Settings: Insights From a National Survey and Washington State Data

Peripheral artery disease (PAD) is a chronic, progressive atherosclerotic disease resulting in worse functional status. It is an important factor that affects mobility and quality of life in older adults with PAD. This study aimed to identify the functional status and its associated factors of older adults diagnosed with PAD. We conducted a cross-sectional study among older adults aged 65 above diagnosed with PAD at a tertiary hospital in Seoul, Korea. Participants' functional status was measured using a Walking Impairment Questionnaire (WIQ) which consisted of distance, speed, and stair-climbing. We measured cardiac health behavior, social support, health perception, and clinical manifestation through self-administered questionnaires. Among 94 participants, the mean age was 74.98±6.21 years, and 91.5% were male. The mean score of WIQ was 0.59±0.30 out of 1; the mean scores for distance, speed, and stair-climbing of WIQ were 0.67±0.40, 0.45±0.27, and 0.64±0.37, respectively. Participants' functional status was significantly associated with age (β=-0.012, P=.002), sex (β=-0.284, P=.001), ulcers of the lower extremity (LE) (β=-0.242, P=.031), using a walking-assist device (β=-0.240, P=.002), walking difficulty due to pain of LE (β=-0.142, P=.006), and health behavior about physical activity (β=0.099, P=.021). This regression model predicted 53.5% of participants' functional status (F=8.63, P<.001). This study indicated that younger age, female, independent walking, no ulcers of LE, no walking difficulty, and higher physical activity behavior were significantly associated with better functional status in older adults with PAD. Therefore, healthcare professionals should develop and provide interventions to promote physical activity and alleviate symptoms to enhance functional status.

Infection Control in Small Residential Care Settings: Insights From a National Survey and Washington State Data

Infection control is a vital issue in long-term care, and the increasing popularity of small residential care facilities (SRCF) raises questions about the effectiveness of this model for preventing facility-acquired infections. In SRCF, care is provided in a residential home to a small number of residents. The setting lacks common terminology, and states license SRCF under various titles including Adult Family Homes, Adult Foster Homes and Family Care Homes. To better inform infection control efforts in this unique setting type, DOH staff conducted a comprehensive search to locate states that license SRCF. A total of 24 states were identified and approached to participate in a qualitative research study; 21 responded, three declined and nine were unable to participate due to staff time constraints. Between March 12th and April 15th, 2021, ten public health and regulatory staff from nine states completed semi-structured telephonic interviews on infection control in SRCF. Infection control licensing requirements and public health oversight for SRCF varied significantly across participating states. Data from these interviews was analyzed and compared with two Washington State Adult Family Home (AFH) sources: 1) online survey of AFH providers 2) Infection Control Assessment and Response evaluations conducted by public health staff. Four themes were identified in all three data sets: access to personal protective equipment, environmental safety, staffing issues and knowledge deficits. SRCF are valued by states that license them. Despite the challenges of implementing infection control in the home-like environment, extraordinary opportunities exist for improving care and preventing infections in this setting.

Defining Appropriate Resources for Nursing Homes to Reduce Potentially Avoidable Transfers After a Fall

Falls are common in nursing home (NH) residents and are the predominant reason for an emergency department (ED) transfer. Falls are responsible for 25% - 87% of ED transfers, a proportion of which are potentially avoidable. INTERCARE – an implementation science study reducing unplanned hospitalizations (2018 – 2020) – involved experts to identify potentially avoidable fall-related transfers. Focus group and stakeholder survey enabled identification of resources to safely manage some falls in NHs. 25.9% of fall-related transfers were potentially avoidable based on using root-cause analysis and discharge reports. Avoidability was associated to ED visit, compared to hospitalizations. Appropriate resources identified by stakeholders included timely access to outpatient services for diagnostic imaging (e.g., X-Ray) and clinical skills’ training in suturing and wound care for registered or specialist nurses. Although NHs are striving for a home-like environment, better access to basic diagnostic and treatment services within NHs should be possible.

Characteristics of peer respites in the United States: Expanding the continuum of care for psychiatric crisis.

Peer respites are recovery-oriented services where people who identify as having lived experience of extreme mental health states (peers) support individuals experiencing, or at risk of, crises in a homelike environment. This brief report describes data from the Peer Respite Essential Features survey, conducted biannually from 2014 to 2020, which explores the peer respite model and program challenges. Peer respites nationwide were invited to participate if they met specific guidelines, resulting in 32 programs across 14 states in 2020. Results focus on the data collected in 2020 and compare past reports where applicable. Characteristics including funding, guest accommodations and policies, and how the programs were impacted by the COVID-19 pandemic are discussed. More research is needed to understand the relationship between program characteristics and effectiveness of peer respites compared to other crisis diversion services and how to better support these growing programs. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Piloting a Diversity, Equity, and Inclusion Needs Assessment to Explore Patron Perceptions at a University Health Science Library

Objective:&#x0D; A pilot diversity, equity, and inclusion (DEI) needs assessment was conducted at a health sciences library. The objectives were to 1) quantitatively assess patrons’ attitudes towards the existing DEI climate in the library and 2) qualitatively identify contextual factors influencing patrons’ perceptions.&#x0D; Population:&#x0D; The assessment was led by a DEI Team at the University of Florida’s Health Science Center Libraries (HSCL). HSCL serves the university’s six health science colleges from two sites, Gainesville and Jacksonville. HSCL Gainesville was selected as the study location, due to higher annual footfall within the physical library.&#x0D; Methods:&#x0D; Two “HappyOrNot” customer satisfaction machines were placed by library exits. Twelve DEI-related questions were displayed on the machines, one question per week, for the duration of 12 weeks total. Additionally, a box for open-ended comments was placed by each machine.&#x0D; Findings:&#x0D; The total number of responses was 3,445, with 7 written comments. Overall, respondents felt happiest with the library’s welcoming and home-like environment. The library was perceived by many as a physically safe space. Most also felt that the library demonstrates a commitment to DEI and that they are treated fairly, equitably, and with respect by library staff. Areas of concern were a perceived lack of respect from other library visitors, as well as library services for patrons with disabilities and non-native English language speakers.&#x0D; Conclusions:&#x0D; The project enabled the HSCL to gather important information concerning patrons’ perceptions of the library’s DEI climate and their associated needs. The HappyOrNot machines provided a straightforward and convenient method for patron feedback, resulting in an impressive number of responses. However, limitations of the pilot included the inability to obtain participants’ demographic information, as well as the anecdotal evidence indicating that some respondents did not read the questions. Future plans therefore involve a follow-up online survey with detailed demographic questions.

Perceptions of Risk: Perspectives on Crime and Safety in Public Housing for Older Adults.

An increasing number of older adults are aging in place in public housing. Public housing is perceived to have higher rates of crime that have detrimental impacts on health and well-being. We used a qualitative approach to understand the experiences of safety and unsafety for older adults in public housing. Participants included older adult tenants (n = 58) as well as service providers (n = 58) who offer supports directly in the buildings. Semistructured qualitative interviews and focus groups were used to explore (a) what makes the buildings feel unsafe, (b) how safety concerns affect access to support services, and (c) strategies used to promote safety. Participants acknowledged the importance of safety for creating a home-like environment; however, many described feeling unsafe at home or work. Participants described extreme examples of antisocial behaviors that were pervasive and viewed as commonplace. Lack of building security was a key issue, which was compounded by a perceived lack of accountability. While service providers were willing to accept a certain level of risk, many acknowledged that unsafe situations forced them to withdraw in-home services or stop community programs, further contributing to feelings of unsafety. In the absence of effective formal security, participants described several measures taken to mitigate risk. Our findings point to the need for enhanced physical and environmental safety infrastructure, improved building management, increased on-site security, as well as other proactive measures to reduce risk by creating a greater sense of connection and community within the buildings.

Cops, Clinicians, or Both? Collaborative Approaches to Responding to Behavioral Health Emergencies.

How a community responds to behavioral health emergencies is both a public health issue and social justice issue. Individuals experiencing a behavioral health crisis often receive inadequate care in emergency departments (EDs), boarding for hours or days while waiting for treatment. Such crises also account for a quarter of police shootings and >2 million jail bookings per year. Racism and implicit bias magnify these problems for people of color. Growing support for reform provides an unprecedented opportunity for meaningful change, but solutions to this complex issue will require comprehensive systemic approaches. As communities grapple with behavioral health emergencies, the question is not just whether law enforcement should respond to behavioral health emergencies but how to reduce unnecessary law enforcement contact and, if law enforcement is responding, when, how, and with what support. This policy article reviews best practices for law enforcement crisis responses, outlines the components of a comprehensive continuum-of-crisis care model that provides alternatives to law enforcement involvement and ED use, and offers strategies for collaboration and alignment between law enforcement and clinicians toward common goals. Finally, policy considerations regarding stakeholder engagement, financing, data management, legal statutes, and health equity are presented to assist communities interested in taking steps to build these needed solutions.

Contactless Gait Assessment in Home-like Environments.

Gait analysis is an important part of assessments for a variety of health conditions, specifically neurodegenerative diseases. Currently, most methods for gait assessment are based on manual scoring of certain tasks or restrictive technologies. We present an unobtrusive sensor system based on light detection and ranging sensor technology for use in home-like environments. In our evaluation, we compared six different gait parameters, based on recordings from 25 different people performing eight different walks each, resulting in 200 unique measurements. We compared the proposed sensor system against two state-of-the art technologies, a pressure mat and a set of inertial measurement unit sensors. In addition to test usability and long-term measurement, multi-hour recordings were conducted. Our evaluation showed very high correlation () with the gold standards across all assessed gait parameters except for cycle time (). Similarly, the coefficient of determination was high () for all gait parameters except cycle time. The highest correlation was achieved for stride length and velocity (). Furthermore, the multi-hour recordings did not show the systematic drift of measurements over time. Overall, the unobtrusive gait measurement system allows for contactless, highly accurate long- and short-term assessments of gait in home-like environments.

SPN 2021 Poster Abstract Awards

SPN 2021 Poster Abstract Awards

The influence of the built environment in enacting a household model of residential aged care for people living with a mental health condition: A qualitative post-occupancy evaluation

This study undertakes a spatial analysis of an Australian aged care setting where residents receive person-centred support in a specially-designed home-like environment. Focus groups were conducted with staff to explore the impact of the built environment in a new residential aged care setting that has implemented a Household Model of care for people living with mental health conditions. Drawing on Actor-Network Theory and proxemics, we mapped how the built environment supports improved behaviours and care practices in four areas: food preparation and dining, sleep and self-care, site layout, and relationships.

No place like home? Producing and consuming eldercare design

As the American eldercare industry prepares to attract and receive consumers from the “baby boomer” generation, facility designers and administrators are increasingly concerned with catering to the lifestyles and taste preferences of aging adults perceived to be more “active,” affluent, and accustomed to “choice” than previous generations. This article considers these trends in terms of their material, aesthetic, and discursive impacts on the socio-material construction of space in residential eldercare facilities. The study draws on discourse and visual analysis of winning entries in published design competitions sponsored by the architecture, interior design, and eldercare industries. Through this analysis, eldercare spaces emerge as sites of consumption where designers privilege both “household/home-like” and “commercial/hospitality” aesthetics and atmospheres. In recent years, placemaking strategies to create home-like environments increasingly overlap with social spaces inspired by the hospitality industry. Our discussion demonstrates how these strategies materialize in structures and interiors increasingly open to the non-resident public and integrated into their surrounding communities. As such, we argue that the negotiation of degrees and kinds of “publicness” and “privateness” in spaces of care reflect shifting views of the roles and characteristics of acts of consumption and consumers in these facilities and in the broader healthcare industry.

Returning to rural communities following transitional rehabilitation after spinal cord injury.

Spinal cord injury (SCI) is a lifelong condition requiring integrated hospital-based and community-based rehabilitation services to support the individual from acute injury to long-term community living. In Australia, transitional rehabilitation has been used to support the transition from hospital to home for people with SCI,1, 2 providing multidisciplinary rehabilitation using a client-centred and goal-directed approach. Inclusive of physiotherapy, occupational therapy, social work and nursing support, transitional rehabilitation is provided for 8–12 weeks following discharge from hospital using direct therapy, education and environmental modification. Located within a metropolitan city, urban clients are supported in their own homes, and rural clients in a homelike environment, using accommodation supplied by the service. However, previous research suggests that discharge planning remains complex, compromised by reduced client participation; difficulties in the identification, education, coordination and funding of local care providers; reduced family involvement; restricted contact with and access to social and community supports; limited specialist support; and challenges with skill acquisition and transfer of learning.3 Despite transitional rehabilitation approaching 20 years of service in Australia, the need remains to develop more effective models of rehabilitation for rural clients. The current study aimed to examine the challenges facing people with SCI returning to rural locations following transitional rehabilitation to inform service delivery.