Home Care Training Research Articles

QUALITY OF LIFE OF ONCOLOGICAL PATIENTS: PSYCHOLOGICAL AND SOCIAL ASPECTS OF CANCER

Cancer has a profound impact on patients’ lives, requiring approaches that go beyond physical treatment to include psychological, social, and spiritual dimensions. This narrative review explores how these aspects influence the quality of life of cancer patients, highlighting the importance of a multidisciplinary and humanized approach. Studies indicate that cancer diagnosis and treatment often generate high levels of anxiety and depression, aggravated by bodily changes and stigmas, affecting self-esteem and social interaction. Social and family support are identified as essential for coping, while spirituality offers comfort and resilience, promoting adaptation and acceptance. The review also emphasizes the need for public policies that ensure access to comprehensive and humanized support, such as home care programs and training of professionals for emotional and spiritual care. It is concluded that comprehensive cancer care is essential for a full quality of life and for healthy coping with cancer.

Community empowerment through home care training to improve the quality of life of patients

Community empowerment is one of the effective strategies to improve patient's quality of life by increasing the capacity of families and communities to provide home care. This service aims to evaluate the impact of home care training on the quality of life of patients with chronic health conditions treated at home. The methods used in the training include theory, practical simulations, and group discussions. The evaluation results showed that the trainees experienced an increase in knowledge and skills in providing home care, which positively impacted patients' quality of life. The program empowers families to treat patients more effectively and reduces the burden on the formal health system by optimizing care at home. This activity concludes that home care training is an effective strategy for community empowerment to improve patients' quality of life and support the sustainability of health care in the community

Evaluation of the effectiveness of the training on "Home care of COVID-19 positive/suspicious patients" given to nursing students: A quasi-experimental study.

This study aims to evaluate the effects of education on home care of infected or suspected COVID-19 patients on the levels of knowledge, anxiety, and awareness of nursing students in Turkey. The study is in quasi-experimental design. A sample of 158 volunteer students studying nursing at a private university in Turkey was formed. Data were collected using, descriptive information form, "Coronavirus Anxiety Scale," "COVID-19 Awareness Scale," and the "Knowledge of COVID-19 Home Care Test." Pre-test was performed before the participants received education. Post-test was performed seven days after the intervention. SPSS version 25.0 was used for data analysis. "TREND checklist" was used for quasi-experimental/non-randomized evaluations to report the findings of the study. Anxiety levels decreased and the levels of awareness and knowledge on COVID-19 increased after receiving education on home care of infected or suspected COVID-19 patients (p < 0.001), indicating the effectiveness of the education. Education on home care of infected or suspected COVID-19 patients was an effective method to reduce anxiety and increase knowledge and awareness in nursing students. To contribute to community health, home care training can be given to nursing students, other people receiving home care, or providing home care to COVID-19 patients, infected or suspected COVID-19 patients.

Pelvic floor muscle contraction automatic evaluation algorithm for pelvic floor muscle training biofeedback using self-performed ultrasound

IntroductionNon-invasive biofeedback of pelvic floor muscle training (PFMT) is required for continuous training in home care. Therefore, we considered self-performed ultrasound (US) in adult women with a handheld US device applied to the bladder. However, US images are difficult to read and require assistance when using US at home. In this study, we aimed to develop an algorithm for the automatic evaluation of pelvic floor muscle (PFM) contraction using self-performed bladder US videos to verify whether it is possible to automatically determine PFM contraction from US videos.MethodsWomen aged ≥ 20 years were recruited from the outpatient Urology and Gynecology departments of a general hospital or through snowball sampling. The researcher supported the participants in their self-performed bladder US and videos were obtained several times during PFMT. The US videos obtained were used to develop an automatic evaluation algorithm. Supervised machine learning was then performed using expert PFM contraction classifications as ground truth data. Time-series features were generated from the x- and y-coordinate values of the bladder area including the bladder base. The final model was evaluated for accuracy, area under the curve (AUC), recall, precision, and F1. The contribution of each feature variable to the classification ability of the model was estimated.ResultsThe 1144 videos obtained from 56 participants were analyzed. We split the data into training and test sets with 7894 time series features. A light gradient boosting machine model (Light GBM) was selected, and the final model resulted in an accuracy of 0.73, AUC = 0.91, recall = 0.66, precision = 0.73, and F1 = 0.73. Movement of the y-coordinate of the bladder base was shown as the most important.ConclusionThis study showed that automated classification of PFM contraction from self-performed US videos is possible with high accuracy.

“Qualitative evaluation of a digital software solution for documentation and training in 24-hour home care”

ABSTRACT Owing to its cost-efficiency, 24-hour home care is increasing and represents a cornerstone in the care of elder people in Austria. A software solution to support 24-hour caregivers in their daily routine was developed facilitating a user-centered design process. It includes electronic documentation, an e-learning platform, emergency management, and a communication tool. To evaluate the usability and acceptance of the developed software solution, a qualitative survey including focus groups (FG), a group interview (GI), and a usability walkthrough (UW) were conducted. This paper describes the findings of the qualitative survey which indicate that the e-learning platform as well as the e-documentation support 24-hour caregivers in their daily work with their clients. Participants with less technical affinity needed support to use the tool proficiently. 24-hour caregivers appreciate the fact that the solution unites all the needed information in one place.

A study of factors affecting the length of hospital stay (LOS) of COVID-19 patients: A qualitative evidence in Iranian hospital

BACKGROUND: The present study aimed to identify the administrators' and physicians' experiences and viewpoints about the factors affecting the length of stay (LOS) of COVID-19 patients and provide valid operational evidence. MATERIALS AND METHODS: The current study was carried out qualitatively and phenomenologically on experts, officials, and administrators of hospitals in 2021. Purposeful sampling was performed with the maximum diversity. To achieve a comprehensive view, snowball sampling was conducted. Twenty-one experts in the field of healthcare and emerging diseases participated in this study. Semi-structured interviews were used to collect the data. The study sites were universities of medical sciences and hospitals of the Ministry of Health of Iran. The interview questions included questions about the factors affecting the LOS and strategies for controlling the LOS of COVID-19 patients in infectious units. Text analysis was performed through the content analysis method in MAXQDA-10 software. RESULTS: Based on the experts' viewpoints, several factors affected the LOS in COVID-19 patients. These factors were divided into five clinical, preclinical, economic, social, and management subcategories. The proposed solutions included policy solutions (supportive policies, development of home care services, training and culture building, and establishment of clinical guidelines) and operational solutions (drug management, promotion of equipment and facilities, telehealth or telemedicine services, and promotion of clinical and support processes). CONCLUSION: One of the main tasks of hospital administrators is identifying the factors affecting the reduction of LOS. Among these factors, clinical and management factors in the hospital are more important and need more planning and attention by hospital officials.

Pediatric Tracheostomy: A Quality-of-Life Assessment Study in Saudi Arabia.

The pediatric population undergoes tracheostomy for a variety of reasons. For a child and their family, having a tracheostomy means learning a new way of life and facing several social, psychological, medical, and economic challenges.Our analysis of the literature indicates that this is the first study of its kind, using the Pediatric Tracheotomy Health Status Instrument (PTHSI) tool to assess the quality of life (QoL) following tracheostomy in pediatric patients and their caregivers in the Kingdom of Saudi Arabia (KSA). This was a descriptive cross-sectional study for tracheostomized children's QoL evaluation. The medical records of the Maternity and Children Hospital, Dammam, KSA, were used to identify the patients and their caregivers. A higher score on the validated PTHSI indicated a better result. From a total of 56 patients, 24 were included in this study. Based on the PTHSI tool, the overall mean score was 93.3/150 (62.28%) and this indicated a good QoL score. Analysis of the correlation between the PTHSI score and other variables indicated no association between the total PTHSI score and the age or gender of the patient or the duration of the tracheostomy (p-value > 0.05). However, we found families of children with major medical comorbidities had lower scores (p-value = 0.03) and their QoL was affected much more than families of patients who did not have major medical comorbidities. Tracheostomy care for pediatric patients can significantly affect the QoL of patients and their families. Our findings using the validated PTHSI tool showed poorer QoL compared to other studies, suggesting the need for future home care training programs to support tracheostomized children and their families, particularly those with comorbidities, who tend to have lower QoL scores and require more organized support.

Design, Implementation, and Evaluation of an Educational Mobile Application for Home Care After Surgery of Pediatrics With Congenital Heart Disease: A Protocol Study

Background &amp; Aims The numerous problems of children with congenital heart disease (CHD) and their care burden can reduce the quality of life of parents, especially mothers. Compliance with treatment after discharge from the hospital is crucial. It is necessary to provide home care educational programs for them. Given the advance of technology and the popularity of mobile phone use, this study aims to design an educational mobile application for home care after surgery to improve the quality of life and adherence to treatment in mothers of children with CHD in Iran. Materials &amp; Methods This is a study protocol on 72 mothers of children with CHD referred to the Children’s Medical Center of a hospital (affiliated to Tehran University of Medical Sciences) for surgery. The data collection tools will be a demographic form, the 36-Item Short Form Health Survey (SF-36), and Fatemi et al.’s Adherence to Treatment Questionnaire. Data collection will be done before and one month after the intervention. The collected data will be analyzed using mean and standard deviation, independent t-test, paired t-test, chi-square test, Fisher’s exact test, and Mann-Whitney U test. Results The results will be analyzed to assess the effectiveness of the mobile-based educational intervention in improving the quality of life and adherence to treatment of mothers of children with CHD. Conclusion This is the protocol of a study that examines the effect of a mobile-based post-surgery home care training application on the quality of life and adherence to treatment of mothers. The results of such studies can help identify the faster, easier and more effective methods of patient education.

Evaluation of the efficiency of application of president sensitive toothpaste in dental hyperesthesia after professional diode laser whitening

Taking into account the high demand for professional teeth whitening in patients, as well as a significant high percentage of hyperesthesia after this medical manipulation, the urgency of solving this problem becomes obvious. Our study was carried out in 17 patients aged 20 to 35 years with complaints of hyperesthesia after professional teeth whitening with a diode laser with a wavelength of 810 nm using President Sensitive toothpaste with potassium nitrate and strontium chloride at home. All patients underwent professional oral hygiene before teeth whitening, recommended toothpaste and a brush, and received training in home care and teeth cleaning. According to our research, the toothpaste with potassium nitrate and strontium chloride has a pronounced desensitive effect and corresponds to the declared parameters. Thus, after professional whitening with a diode laser with a wavelength of 810 nm and subsequent application of toothpaste with potassium nitrate and strontium chloride, a decrease in tooth sensitivity, remineralization of hard tissues and suppression of bacterial growth were revealed. However, the selection should be individualized, taking into account all medical indications and properties of hygiene products.

Personal care assistants' lived experience of working in the home setting with children and adults on mechanical ventilation.

Working as a personal care assistant (PCA) with children and adults on mechanical ventilation in a home setting may be complex and challenging due to the physical and mental working conditions. To explore the lived experience of working as a (PCA) with patients, children and adults on mechanical ventilation in the home setting. A qualitative study using a phenomenological-hermeneutic approach. Data collection involved semi-structured individual interviews with 20 PCAs (n=15 women and n=5men) in Denmark in 2020. Their work experience with patients on home mechanical ventilation ranged from 8months to 25years (median 8years).The Consolidated Criteria for Reporting Qualitative Research checklist was used as a guideline. Four main themes emerged from the structural analysis: Being a fly on the wall or part of the family, Always being in a state of readiness is exhausting, Being a team player and Mutual respect is key in the work relationship. PCAs had to balance on a knife's edge when working with children and adults on mechanical ventilation in the home setting and try to strike a happy medium. Enduring the job required a proper physical and mental work environment, and thorough preparation, achieved not only through technical training, but also through learning how to be part of a professional relationship characterised by mutual respect and matched expectations. The findings provide clinical practice with important insights into how to inform, prepare and educate PCAs working with patients on mechanical ventilation in the home setting. Further research into home care education and training programmes with a patient- and family-centred care approach is needed.

Disparities in Utilization of Psychiatry Services Among Home Care Clients: The Tale of Two Canadian Jurisdictions.

Publicly funded home care in Canada supports older adults in the community to delay institutional care, which results in complex care populations with multimorbidity that includes mental health problems. The purpose of this study is to examine prevalence of psychiatric diagnoses and other mental health symptoms among older clients in two publicly funded Home Care (HC) Programs and their psychiatry service utilization (psychiatrist visits) after being admitted to home care. This retrospective cohort study examines clients age 60 years and older in the two Canadian provinces of Manitoba (MB), specifically the Winnipeg Regional Health Authority (WRHA) (n = 5,278), and Nova Scotia (NS) (n = 5,323). Clients were admitted between 2011 and 2013 and followed up to 4 years. Linked data sources include the InterRAI Resident Assessment Instrument for Home Care (RAI-HC), physician visit/billing data and hospital admission data. Both regions had similar proportions (53%) of home care clients with one or more psychiatric diagnoses. However, we observed over 10 times the volume of psychiatry visits in the WRHA cohort (8,246 visits vs. 792 visits in NS); this translated into a 4-fold increased likelihood of receiving psychiatry visits (17.2% of WRHA clients vs. 4.2% of NS clients) and 2.5 times more visits on average per client (9.1 avg. visits in MB vs. 3.6 avg. visits in NS). The location of psychiatry services varied, with a greater number of psychiatry visits occurring while in hospital for WRHA HC clients compared to more visits in the community for NS HC clients. Younger age, psychotropic medication use, depressive symptoms, dementia, and having an unstable health condition were significantly associated with receipt of psychiatry visits in both cohorts. Access to psychiatric care differed between the cohorts despite little to no difference in need. We conclude that many home care clients who could have benefitted from psychiatrist visits did not receive them. This is particularly true for rural areas of NS. By linking the RAI-HC with other health data, our study raises important questions about differential access to psychiatry services by site of care (hospital vs. community), by geographical location (MB vs. NS and urban vs. rural) and by age. This has implications for staff training and mental health resources in home care to properly support the mental health needs of clients in care. Study results suggest the need for a mental health strategy within public home care services.

The Effect of Home Care Training on Anxiety and Vital Signs Levels in Coronary Artery Bypass Grafting Patients: A Randomized Clinical Trial

PurposePatients after coronary artery bypass grafting (CABG) require special care at home, and not being aware of this need before surgery can result in anxiety. This study aimed to determine the effect of home care training on the level of anxiety and vital signs in CABG patients. DesignThe study was a randomized clinical trial study. MethodsThe study included 80 patients undergoing CABG surgery in January 2020. Samples were selected by convenience sampling and were randomly divided into intervention and control groups. The control group received only routine training, whereas the intervention group received two additional training sessions on home care. Data were collected using the Spielberger situational anxiety questionnaire and a checklist of vital signs, and then analyzed using descriptive and inferential statistics. FindingsResults showed that before the intervention, the mean anxiety scores, heart rate, respiratory rate, temperature, and systolic and diastolic blood pressure between the two groups were not significantly different (P > .05). However, after the intervention, the mean anxiety score, heart rate, respiratory rate, and systolic and diastolic blood pressure in the intervention group was significantly (P < .05) lower than the control group, but the mean temperature of the two groups showed no significant difference (P > .05). ConclusionsHome care training before surgery reduces anxiety and improves vital signs. The use of home care training before surgery is recommended for this patient population.

Individual specialist physical activity assessment and intervention in advanced cancer patients on a palliative care ward; the 3STEPS-study.

The aim of this prospective study was to evaluate the feasibility and outcome of an activity assessment and intervention on a specialized palliative care ward. All patients admitted between May 2017 and April 2018 were screened for basic assessment (Step 1). Whenever possible the Tinetti-mobility test (TT) was performed by a physiotherapist. A comparison between physician and nurse-led assessment and patient report was performed (Step 2), followed by a low-intensity individually adapted activity intervention (Step 3). Physical function and global quality of life was measured at intervention start and at discharge. Home care training adherence was controlled by phone call. In total, 437 patients were admitted in one year. In 248 patients, a basic assessment was done of which 131 performed a TT. In this group, median age was 63 years. Types of cancer were gastrointestinal (n=39), lung (n=27), urogenital (n=20), non-cancer (n=26) and other (n=26). Median length of stay was 13 days. Correlations between assessment methods were low to moderate, the highest between the TT and the nurse led assessment. Six patients started the intervention. Four patients completed the intervention, of which two continued with the home based training. In all four patients, an improvement in outcomes was measured. In conclusion in around a quarter of patients on a palliative care ward a TT could be performed. The TT correlated to most with nurse led mobility assessment. In the few accrued patients, the activity intervention showed an effect.

"Ready SIM Go": An Adapted Simulation "Service Line" for Patients and Caregivers.

Changing healthcare systems and efforts to decrease medical costs have resulted in many more patients and caregivers (PCs) needing to manage life-sustaining therapies on their own. Given the potential for underpreparedness to result in increased morbidity and mortality, developing safe and efficient homecare training methods for PCs is essential. Medical simulation with PCs is an underused tool, which has the potential to decrease anxiety and increase preparedness through opportunities for repeated practice of medical procedures within a safe, controlled environment. This article describes the development of a hospital-based simulation service line for PCs, leveraging lessons learned from training for 250 patients and 450 caregivers in 14 different departments and subspecialties, and explains adaptations of standard simulation methods necessary for safe and effective use of simulation with this unique population. Process blueprint, examples of specific programs, as well as feedback from participants and clinicians are included.

The Lack of Systematic Training for Health Care Providers, A Challenge for Providing Pediatric Palliative Home Care: A Comparative Study

Background: The growing prevalence of chronic diseases in children has increased their need for palliative care. We aimed to compare pediatric palliative care and home care training in Iran and in the selected countries. Materials and Methods: This comparative study was conducted based on the classifications of palliative care for children and using databases such as Scopus, Science Direct, Ovid, ProQuest and Medline, websites affiliated with communities and associated with palliative care and home care services and according to the framework of World Health Organization’s Public Health Road Map. The selected countries consist of England, Canada, Australia and South Africa, where home care services are provided for children in addition to palliative care. Results There is a pediatric palliative care training program for doctors in the selected countries. Home care is part of these programs in these countries. Despite the lack of an independent nursing course in postgraduate education in England, Canada, and Australia, community health nurses are responsible for providing care responsible to provide care for children with life-threatening diseases in the community and at home. In South Africa, a home-based palliative care training and support package for children was designed for community care workers. In Iran, pediatric palliative care is in the early stages and home care is evolving as a need. Conclusion Education is the most important factor for integrating home care and pediatric palliative care into the health system. In countries with advanced pediatric palliative care, the knowledge and skills of care providers have been considered. In Iran, revising medical and nursing curriculums and the integration of palliative care and home care programs into the curriculum are essential.

National Home Care Initiative in Jordan: A Demonstration Project

Background and context: The home healthcare market in Jordan is nascent with little service offered. It suffers from a highly fragmented and underregulated landscape. The limited access to qualified trustworthy home care services, lack of professional home care training, and lack of home health care insurance coverage have added to the heavy in-patient bed demand and delayed hospital discharges especially for disabled or terminally ill patients. Aim: To establish a comprehensive national home care program to improve the delivery of palliative and home care services in Jordan, and to conduct a situational analysis and generate policy recommendations. Strategy/Tactics: We used multiple strategies to reach our objectives. 1. Expansion of home care services at King Hussein Cancer Center (KHCC) to create a local demonstration project. 2. Building health care professional capacity by offering variety of educational programs. 3. Improving quality of service delivery by generating clinical practice guidelines, such as standards operating procedures and patient and family educational materials. 4. Use the pilot operational and financial data to generate an economic model to inform the development of similar home health care units in hospitals across Jordan. 5. National advocacy and building effective partnership with all related stakeholders to advance national policy. Program/Policy process: Between May 2016 and May 2017, 7818 home care visits were conducted by KHCC. For capacity building; 678 health care professionals were trained in palliative and home care, out of which 366 participants were females (54%). Palliative care was successfully recognized as a specialty by the Jordan Nursing Council and recognized as a subspecialty by the Jordan Medical Council. The palliative and home care standards of practice were included in the health care accreditation council. The analysis of economic evaluation data suggested that home care services decreased in-patient utilization and costs which is advantageous to a country with limited resources. As a result of the advocacy stream and a collaborative network, the national palliative and home care strategic framework was generated, and endorsed by the Ministry of Health. Outcomes: The NHCI resulted in a very successful pilot project and achieved specialty and subspecialty recognition. Furthermore, we were able to build the capacity of health care professionals and policy makers in the palliative and home care sector from public, private and academic institutions. In the advocacy and policy dimension, the Minister of Health officially approved and adapted the palliative and home care strategic framework that was developed by this initiative. What was learned: Cross-sector collaboration and effective partnership resulted in system change and policy advancement. Developing effective economic systems is essential in low resourced countries. The initiative was supported by a joint grant from the USAID and KHCC.

Digital continuous healthcare and disruptive medical technologies: m-Health and telemedicine skills training for data-driven healthcare

Introduction Disruptive medical technologies, wearable devices and new diagnostic solutions have been shaping the future of healthcare, and the health informatics skills gap has become a major problem for technology-centric healthcare applications. This study evaluated the relationships between a specific practical skills training method and students' confidence in using wireless monitoring devices along with the attitude towards technology adoption. Methods Six practical exercises were developed to provide health informatics technical skills to transfer medical information and display multi-channel biological signals. Two hundred and six undergraduate nursing students received a telemedicine and homecare training course. Their familiarity with various data formats and likelihood to recommend telemedicine and remote monitoring applications were measured. Results The skills training session changed students' attitudes towards remote patient monitoring, and the majority of students provided positive feedback about their confidence in using wireless monitoring devices after the training session. Students stated their plans to use the technology when they start practising and to educate their patients to promote the use of telemedicine. Conclusion We propose a skills training framework that covers (a) telemedicine, (b) m-Health and connected health, (c) health informatics application development, (d) health informatics device innovation, and (e) data science.

The self-reported and observed competence of nursing staff in mobility care based on Kinaesthetics in nursing homes - A cross-sectional study.

The majority of care-dependent persons living in nursing homes have mobility impairment affecting the physical, psychological, and social aspects of the persons' lives. Therefore, nursing staff needs competence to provide good mobility enhancing care. This study assesses the self-reported and observed competence of nursing home staff in mobility care based on Kinaesthetics in order to increase attention about nursing staff's impact on nursing home residents' mobility. A cross-sectional study design involving a survey and an observational study was employed. Survey data were collected using the Kinaesthetics Competence Self-Evaluation (KCSE) scale. For the observational study, data were collected with a video camera and rated using the Kinaesthetics Competence Observation (KCO) instrument. Data were analysed using descriptive statistics, correlation methods and a generalised linear model. The majority of survey participants (n = 180) indicated their competence in mobility care based on Kinaesthetics as very good (mean score 13, SD 1.44, on a scale from 4 to 16). The observed competence of nursing staff (n = 40) was good (mean score 10.8, SD 2.44, out of a possible score from 4 to 16). Positive correlations were found between self-reported or observed competence in mobility care based on Kinaesthetics and employment rate, work experience in nursing home care and Kinaesthetics training. A combined assessment of self-evaluation and observation is recommended in order to get a comprehensive picture of knowledge, skills, attitude and dynamic state of nursing staffs' competence in mobility care based on Kinaesthetics.

The feasibility of employing a home healthcare model for education and treatment of opioid overdose using a naloxone auto-injector in a private practice pain medicine clinic

Objectives: The purpose of this study was to determine if employing a home healthcare model for education and treatment of opioid overdose using the Evzio (Naloxone) auto-injector in a private practice pain clinic.Methods: A prospective survey was used to determine the feasibility of integrating a naloxone auto-injector within the patient’s home with a home care training model. Twenty moderate or high-risk patients were enrolled from the chronic pain clinic. Patients who were moderate or high risk completed an evaluation survey. The naloxone auto-injector was dispensed to all patients meeting criteria. The treating provider after prescribing the naloxone auto-injector then consulted home health per standard clinical practice. All patients had home health consulted to perform overdose identification and rescue training. A Cochran’s Q test was conducted to examine differences in patient knowledge pre- and post-training. The post training test was done 2–4 weeks later.Results: Forty subjects enrolled after meeting inclusion/exclusion criteria. Twenty withdrew because their insurance declined coverage for the naloxone auto-injector. Those completing home health showed a statistically significant difference in their ability to correctly identify the steps needed to effectively respond to an overdose (p = .03).Discussion: Preliminary evidence would suggest training on overdose symptom recognition and proper use of prescription naloxone for treatment in the home setting by home health staff would prove more beneficial than the clinic setting, but feasibility was hindered by unaffordable costs related to insurance coverage limitations.

Training in home care and kinaesthetics in Belarus

Introduction: Out of 9,5 million people in Belarus there is 19,9% people over 60 years old and 5,8% people with disabilities. 17% of 'lonely' and 6,3% of 'living alone' seniors are in need of external care. BRC is the only organization providing training in home care and kinaesthetics. Short description of practice change implemented: BRC provides training courses in home care, as well as main concepts and principles of kinaesthetics for informal caregivers and, recently, professional nurses and social workers. Around 400 informal caregivers and 150 social and medical workers have been trained. More than 5,000 consultations were given for relatives. Targeted population: Bed-ridden beneficiaries having difficulties with movement, as well as increases independence of beneficiaries with movement limitations while decreasing physical burden on caregivers. Aim of and theory behind change: Improving the quality of life by increasing the motion competence/independence of disabled and chronically ill beneficiaries. Stakeholders: Healthcare and social protection institutions (care homes, nursing hospitals and hospices). Highlights: (innovation, Impact and outcomes) Main characteristics of the training: - Uniqueness: The BRC is the only provider of home care training in Belarus and the only organizer of the training for trainers level II in kinaesthetics in the Commonwealth of Independent States (CIS); - Flexibility: The 16-hour program can be split into modules: decubitus prevention, kinaesthetics, feeding in bed, etc. Otherwise caregivers are consulted and trained at a patient's bed; - Supporting government in ensuring quality home care: Promotion of obligatory home care course for social workers; incorporation of kinaesthetics components into postgraduate courses for nurses. - Integration of kinaesthetics into home care training. Nurses applying kinaesthetics in their work (246 beneficiaries) register increase in beneficiaries’ movement competence: independent walking, bath taking. Comments on sustainability: - 2-level program for trainers (more than 20 trainers in home care); - nine level 2 trainers in kinaesthetics expected by mid-2017; - business-plan on paid trainings in home care and kinaesthetics for individuals and organisations. Comments on transferability: 100% country coverage by the BRC and trainers on home care in every regional branch; Standard programme and guidelines. Conclusions: (comprising key findings) - Training in home care with kinaesthetics elements for non-formal caregivers fills the gap in provision of professional medico-social services at home; - Practical benefit from integration of elements and principles of kinaesthetics in home care training (both for “recipients” of care and caregivers); Discussions: With growing demand for home care training what is the best way of scaling it up: advocating for official recognition of the BRC programme as a standard one for the country or incorporating it into existing graduate and postgraduate curricula for nurses and social workers? Lessons learned: Possibilities: - demand exceeds supply; scaling up within BRC may be needed including provision of paid services; - kinaesthetics as a science demands a long time of assimilation and training. A further search for an optimal format and volume of integrating kinaesthetics elements and principles into home care training is necessary.