Various Types Of Care Research Articles

Perceived Higher Unmet Care Needs among Adults in Permanent Supportive Housing.

This study is original in that it assesses various types of care needs, barriers to care, and factors associated with higher unmet needs among 308 permanent supportive housing (PSH) residents in Quebec (Canada). Data from structured interviews that featured the Perceived Need for Care Questionnaire were collected from 2020 to 2022, controlling for the COVID-19 pandemic period. Eight types of care (e.g., information, counseling) were accounted for. Based on the Behavioral Model for Vulnerable Populations, predisposing, need, and enabling factors associated with higher unmet care needs were assessed using a negative binomial regression model. The study found that 56% of adult PSH residents, even those who had lived in PSH for 5 + years, had unmet care needs. Twice as many unmet needs were due to structural (e.g., care access) rather than motivational barriers. Living in single-site PSH, in healthier neighborhoods, having better quality of life and self-esteem, and being more satisfied with housing and outpatient care were associated with fewer unmet care needs. PSH residents with co-occurring mental disorders (MD)and substance use disorders (SUD), and with moderate or severe psychological distress were likely to have more unmet needs. Better access to care, counseling and integrated treatment for co-occurring MD-SUD might be improved, as well as access to information on user rights, health and available support. Welfare benefits could be increased, with more peer support and meaningful activities, especially in single-site PSH. The quality of the neighborhoods where PSH are located might also be better monitored.

Understanding policy amenable risk factors: Alcohol consumption and long-term care use among people over 65 years old

ObjectivesThis study aims to explore the effect of past alcohol consumption frequency on formal and informal long-term care (LTC) use in old age and explore the different channels through which it may affect LTC use. MotivationThe existing literature has mainly focused on risk factors associated with a nursing home entry, but this evidence is outdated, not UK-focused, and does not look into other types of care, such as informal care. The results of this study will help in modelling the future demand for various types of care and the corresponding public spending. MethodsWe use the English Longitudinal Study of Ageing (ELSA) (2002–2017) dataset to conduct longitudinal, individual-level analysis. We explore how the previous frequency of alcohol consumption affects formal and informal care use. We focus on people aged 65 and over with no previous LTC use and run regressions with and without instrumental variables (IV) to estimate how alcohol consumption patterns in the previous wave (2 years before) affect formal and informal care use. For IV regressions, we use the polygenic score for alcohol use, available for a subsample of ELSA respondents, as an instrument while also accounting for sociodemographic characteristics, lifestyle choices, and health conditions. ResultsThe main IV estimates suggest that frequent alcohol consumption has a weakly significant positive effect on the onset of formal LTC care use compared to none/rare drinking. This relationship diminishes and is not statistically significant when we directly control for health status. We find no statistically significant effect towards informal LTC use. These results contrast with the estimates without IV, which suggest that frequent alcohol consumption is negatively associated with informal care use and no or weakly negative association with formal care use. DiscussionOur findings suggest that unobserved confounding is important when studying the relationship between alcohol consumption and LTC. We hypothesise that primarily alcohol effects LTC through its adverse effect on health. In addition, unobserved factors like preferences towards seeking care, social behaviour may be related to alcohol consumption and affect access to care. We speculate alcohol may have a damaging effect on personal relationships and could indicate the burden eventually falling on formal care. In as far as the polygenic score IV can account for unobserved preference-behaviour differences, the results (weakly) support the hypothesis that these latter processes are relevant, especially for informal care use.

The Perpetual Pivot: Understanding Care Partner Experiences in Ontario Long-Term Care Homes during the COVID-19 Pandemic.

Long-term care homes (LTCHs) were impacted during the COVID-19 pandemic. With their ever-changing conditions and restrictions, care partners' roles in LTCHs changed drastically. In this cross-sectional study, an electronic survey was used to examine the experiences of care part-ners who were caring for one or more adults in an Ontario LTCH during the pandemic. The survey was circulated through social media (convenience sample) which produced a convenience sample of 81 caregiver participants. Visit characteristics and a comparison in the quality of care in LTCHs was analyzed before the pandemic as well as during the most restrictive times. Visitation lengths and frequencies, other sources of communication such as phone and video calls, and various types of care provided by caregivers such as personal grooming and personal care all decreased significantly during the pandemic. Care partners also reported that the health of their care recipients decreased significantly during restrictive visitation times. Through thematic analysis, we identified three themes: restrictions and changing LTCH conditions created (1) social isolation and an erosion of connection, (2) a communication breakdown, and (3) a lack of person-centered care. Findings from this research can promote the health and wellbeing of residents and care partners within LTCHs.

DESIGN AND ORGANIZATION OF AN INTERPROFESSIONAL NETWORK FOR HOME MANAGEMENT OF PATIENTS IMPLEMENTED DURING COVID-19 PANDEMIC AT ASL NAPOLI 2 NORD, SUITABLE ALSO IN THE DAILY MANAGEMENT OF CHRONIC PATIENTS LIVING IN THE SAME AREA

Introduction: The Coronavirus SARS-CoV-2 pandemic has altered the perception of the current National Health Service (SSN). On one hand, the importance of a free and always accessible SSN for everyone has been strengthened. On the other hand, the fragility of a system with a too specialized and hospital-centered approach has become evident. In the pandemic context, the need to reverse the model by focusing on the needs of the community has become clear, with the main aim of promoting home-based management as much as possible for both chronic and acute conditions. This can be achieved through the creation of an integrated network involving all stakeholders in the care and assistance process, utilizing new technologies and telemedicine systems.Materials and Methods: The aim of this activity was to delve into an integrated network model for home care of Covid patients, within ASL Napoli 2 Nord. This model utilizes interconnected and functionally integrated structures and nodes, with defined pathways and operational procedures based on dedicated telemedicine platforms. These platforms facilitate the comprehensive management and care of Covid-19 patients by all network stakeholders. Results were monitored using specific and dedicated indicators, collecting and analysing data from the period when the care of positive Covid patients began (November 2020), whose management did not require hospitalization.Results: From November 2020 to December 2021, the number of patients living in the ASL Napoli 2 Nord territory under home management included Home Health Care Units (USCA), non-ambulatory residential facilities undergoing non-pharmacological therapy (TNF), non-ambulatory vaccinated individuals receiving home vaccination, and vaccinated individuals in residential facilities, amounted to 38,223. Among these, 37.8% (14,476) tested positive for Covid.The total number of accesses during this period was approximately 94,000, encompassing various types of care provided (TNF at home, TNF in facilities, home management of Covid+ patients, vaccinations in facilities, vaccinations at home for non-ambulatory patients). The shift has been significant, transitioning from managing the entirety of patients in hospitals to slightly over 4.5% of the total managed from December 2020 to December 2021. Conclusions: The sensitivity of healthcare managers during the pandemic period translated into the realization that the focus of the National Health System (SSN) and the Regional Health System (SSR) needed to shift, directing efforts increasingly towards the implementation of local healthcare policies.The high number of hospitalizations recorded was not solely due to the increased number of infections, but also to the challenges faced in providing home care. Creating, developing, and continually implementing an interdisciplinary and interprofessional network, coupled with the development of technological infrastructures and more, ensured the ability to address the emergency. This guaranteed that all citizens received the necessary care and assistance to navigate this historically critical and unexpected moment.The reproducibility of this system assures the possibility of further network implementation, not only in emergencies but also for the daily management of chronic patients. Moreover, in a time when, among other things, Mission 6 of the National Recovery and Resilience Plan (PNRR) has allocated resources amounting to 15.63 billion euros to be invested in the healthcare sector, most of which are dedicated to revolutionizing our SSN and ensuring its greater efficiency and effectiveness in the territor.

Multivocal Stories About Caring During the War in Ukraine, as Told by Polish Researchers

The text introduces the idea of a “new normal” in connection with the ongoing war in Ukraine, which affects not only those who are directly involved but also those who experience it indirectly. The study used collective autoethnography to identify common motives and patterns of action. There were presented statements of three women—university lecturers from three Polish universities who struggled with worries and conflict of conscience regarding the war in Ukraine and the Ukrainian refugees. The contexts of the limits of one’s ability to care for others and take steps to preserve one’s own well-being were given. The importance of thinking about a common future and perceiving the impact of history on the present was emphasized, taking into account memories of the Volhynian Massacre and prejudice against Ukrainians resulting from the negative experiences of ancestors and neighbors. Emotional involvement in various types of care was juxtaposed with human solidarity, a sense of common purpose and a human bond beyond divisions.

Principi solidarnosti i uzajamnosti u obaveznom socijalnom osiguranju zanatlija, trgovaca i rudara u 19. veku u Srbiji

Solidarnost i uzajamnost su bili osnova udruživanja različitih skupina lica sa zajedničkim interesom za pokrićem od različitih rizika. U ovom radu se ukratko analizira značenje pojmova „solidarnost” i „uzajamnost” kao osnovama socijalnog osiguranja, a zatim nastanak socijalnog osiguranja i današnji ustavni okvir Republike Srbije i prava Evropske unije. U posebnim delovima se istražuje sadržina i obim solidarnosti i uzajamnosti organizovanih kroz kase uzajamne pomoći zanatlija i trgovaca po Uredbi o esnafima iz 1847. godine i rudarsko-bratinske kase rudara iz Rudarskog zakonika iz 1866. godine. Istorijskim metodom prate se različiti vidovi zbrinjavanja i pomoći i ukratko objašnjavaju razlozi koji su doveli do njihovog nastanka, a kasnije i institucije socijalnog osiguranja, dok se logičkim metodama izvlače zaključci o obeležjima uzajamnog osiguranja zanatlija, trgovaca i rudara po navedenim propisima. Prilikom istraživanja autori se bave analizom sadržaja i značenja samo onih odredbi i pravila koji su relevantni za temu ovog rada.

How Marital Status Shapes Grandparenting Children With Disabilities

How does marital status shape grandparent care work when grandchildren have disabilities? Based on 50 in-depth interviews with grandparents who provide various types of care for grandchildren with disabilities, we find that marital status shapes care work in three distinct ways: (1) Many who are married describe both grandparents working as a team to provide vital care; (2) Some who are married describe spouses, primarily grandfathers, who are either unable or unwilling to provide care; and (3) Many who are not married, primarily grandmothers, describe providing relatively high levels of care and support despite relatively low resources. While nearly all report a great deal of joy and satisfaction with their care work, those who are single, have greater care responsibilities, and fewer resources are more likely to report adverse social, emotional, physical, and financial impacts. More robust social policies could alleviate the impact of marital status on grandparent care work.

The modern approaches to rating of medical organizations on the basis of sustainable development of health care institution

The article analyzes modern approaches to the rating of medical organizations based on national and foreign publications. The study identified groups of indices that are responsible for effectiveness of health care organizations from the point of view of consumers of medical services and state boards of public health management. According analyzed publications, rating values consider effectiveness of particular processes, rather than organization as a whole. This became the basis for scientific search for assessment system that can reflect the performance of medical organization contributing into its sustainable development. In 2012-2018, the Novosibirsk State Medical University carried out the study of potential of sustainable development of health care organizations. On the basis of normative legal analysis, sociological and expert survey of opinions of managers, the key areas of activities that contributed to improving efficiency of medical organizations were identified. The article presents the original approach to comparative assessment of health care organizations that provide various types of care of population based on concept of sustainable development using the T. L. Saati hierarchy analysis methodology. The strategy of sustainable development presumes achievement of long-term goals of medical organization, including not only indices of patient satisfaction with quality of medical care and organization of safe environment for their stay in health care institution, but also optimization of all processes, rational resource support, monitoring and analysis of internal environment of organization for continuous development of functioning, personnel training, implementation of organizational innovations. The medical organizations implementing strategy of sustainable development demonstrated the best results in such areas as resource management, increasing consumer satisfaction with quality and safety of medical care, optimization of processes of increasing number of treated patients. Thus, health care organizations having clear-cut plan of actions and set of management practices to achieve long-term goals acquire ability to improve both medical social indices and population health indices.

CARING MASCULINITY OR HYBRID MASCULINITY? AN ANALYSIS OF RESEARCH RESULTS ON MALE NURSES IN POLAND


 In studies on men and masculinities, there is an increasing number of theories, which result from development, discussions and criticism in the area. However, in the context of this paper, two ways of describing masculinities are taken into account, i.e. caring masculinities and hybrid masculinities. The article analyses research results on male nurses in Poland, which were performed by means of in-depth interviews, according to theoretical assumptions on caring and hybrid masculinities. The interviews revealed varying ways of perceiving masculinities in the context of care. Out of the ways identified by the Author, the study focuses on the analysis of how to define masculinity as a belief that masculinity is accomplished by ensuring hegemonic masculinity. It also shows how this way of defining masculinity is related to the assumptions of hybrid masculinity. As a result, the analyses show that caring masculinities are not only diverse but also that the very term is disputable with regard to masculinities involved in various types of care.

Oral manifestation of a possible eating disorder in a minor patient

Oral manifestation of a possible eating disorder in a minor patient

Long-Term Care Determinants of Care Arrangements for Older People in Europe: Evidence from SHARE

European countries differ greatly in the proportions of people who receive various types of care. They also differ considerably regarding the societal characteristics of care such as the availability of formal care within the country. We explored the explanatory potential of contextual characteristics of the provision of formal home care, and barriers to using long-term care services for older people’s care arrangements across Europe. We employed data from Wave 5 of the Survey of Health, Ageing and Retirement in Europe, and analyze the data using a multinomial logistic model. Less involvement and lower national governance in the integration of home care policy decreases the use of formal care alone, and in combination with informal care. Higher integration and coordination in delivering home-care services increases the use of formal services. In countries with higher shares of reported barriers to using their long-term care systems there is a smaller probability of formal services being used.

CAREGIVER BURDEN AMONG ADULT CHILDREN ASSOCIATED WITH OLDER ADULTS’ CARE NEEDS

Adult children are often involved in caring for older adults in the family. Literature has evidenced the negative consequences of caregiving tasks on the well-being of caregivers. Little is known about the distinctive role of each specific caregiving burden on the well-being and burden of adult caregivers. Thus, we considered two types of caregiver burden (i.e., ADL related and IADL related) and their associations with caregiving difficulties. Using the recent panel data from the National Health and Aging Trends Study (NHATS) and the National Study of Caregiving (NSOC), we examined the links between caregiver tasks and difficulties in caregiving. Our findings showed that adult children caregivers reported higher CG difficulties when care recipients reported both higher ADL-related and IADL-related needs. Our findings have implications for the needs of adult children caregivers who provide various types of care for their aging parents.

Qui traite les pathologies somatiques et les troubles associés des enfants autistes ?

This study highlights the conditions that limit access to primary care: the severity of autistic disorders, the implicit sidestepping of tasks by physicians, exhaustion of families who fail to coordinate the various types of care and tense relationships between professionals.</ce:para>.

Palliative Care for Institutionalized Elderly Persons: Experience of Caregivers

Abstract The number of elderly persons institutionalized in residential facilities that provide various types of care is increasing all the time. Care is provided by caregivers who, often unknowingly, are delivering palliative care, and in doing so, are accompanying the elderly persons to their death. The aim of the present study was to investigate how terminal illness and death are experienced by caregivers. A qualitative explorative-descriptive study was carried out, featuring a phenomenological approach, in accordance with Giorgi. The sample was comprised of nine individuals who worked in residential facilities, with data collected through a semi-structured interview. Following data analysis, eight categories were defined: relationship with the elderly person; positive experiences, positive feelings, negative experiences, negative feelings, strategies, consequences and training. These categories were then divided into subcategories. It can be concluded that the caregivers experienced great difficulty when dealing with suffering at the end of life. This did not prevent them from enjoying their work, and a number of positive aspects of their relationships with the elderly were mentioned. The need to provide more support for these professionals, whether through further training or the level of psychological support provided, is also fundamental in this area of palliative care, as only in this way will individuals feel more able and confident about performing their tasks, brining greater benefit for the elderly persons.

Dyadic recruitment in complementary therapy studies: experience from a clinical trial of caregiver-delivered reflexology

PurposeAs home-based care continues to be a growing trend in health care, involvement of friend and family caregivers in the management of illness becomes essential. However, before nurses can prepare caregivers to engage in various types of care, an evidence base needs to be established via randomized controlled trials (RCTs). Research suggests that recruiting cancer patients and their friend or family caregivers into RCTs presents challenges. The purpose of this paper is to illustrate the barriers to recruitment of patient–caregiver dyads into a RCT of caregiver-delivered reflexology and to recommend strategies to address such barriers. MethodsThis paper reports on a nurse-directed RCT that involved recruitment efforts unique to a caregiver-delivered reflexology protocol for advanced-stage breast cancer patients. Ineligibility due to caregiver-related reasons, consent among eligible patients (out of 551 approached patients), and reasons for refusal were analyzed. ResultsAlmost one-third of patients were found to be ineligible due to the lack of a caregiver to participate with them and provide this form of social support. Among eligible patients, the consent rate for this dyadic study is much lower than that of previous RCTs of reflexologist-delivered reflexology that enrolled just patients, not dyads. ConclusionImplications for nursing practice and research include addressing the need for greater social support for patients and strategies for problem-solving refusal reasons during study enrollment.

Frail, Independent, involved? Care and the Category of the Elderly in Japan

This article examines how the category of the elderly in Japan is constructed through diverse forms of care, understood as moral practices intrinsic to peoples’ senses of self. It offers an analysis of a range of informal as well as institutional configurations of care in the Japanese urban context, highlighting the complexity as well as the overlapping nature of these diverse arrangements. It also explores ethnographically how older people experience these arrangements as they move through different sites of care, and how they negotiate the conflicting demands on their sense of self. The various types of care at work in these settings all contribute to different understandings of older persons, and different constructions of the category of the elderly: as clients; as visitors or guests; as fragile ‘struggling persons’; as ‘grannies’ in familial relations; as (caring) neighbours. More than a handful of labels, these variable configurations of personal identity affect care practices and social relationships in direct and tangible ways.

Employment in Long-Term Care. Report on Poland

The report discusses the formal long-term care workforce in Poland. It presents past and future trends in the development of LTC employment. Authors collected scattered statistical information, estimated lacking data and projected future growth in the number of employed in care services. Performed analysis includes employment in the health and social sector and across various types of care. Projections of the demand for care and supply of the LTC workforce base on the demographic prognosis of the population size and changes in the age structure taking into account different scenarios for demographic development. Results show the growing gap between demand and supply in the LTC employment. The policy towards aging in Poland will must take up the challenge of growing care needs, family changes and lower opportunities for provision of informal care.

Adolescents' use of care for behavioral and emotional problems: types, trends, and determinants.

ObjectiveWhile adolescents use various types of care for behavioral and emotional problems, evidence on age trends and determinants per type is scarce. We aimed to assess use of care by adolescents because of behavioral and emotional problems, overall and by type, and its determinants, for ages 10–19 years.MethodsWe obtained longitudinal data on 2,230 adolescents during ages 10–19 from four measurements regarding use of general care and specialized care (youth social care and mental healthcare) in the preceding 6 months, the Child Behavior Checklist (CBCL) and Youth Self-Report, and child and family characteristics. We analyzed data by multilevel logistic regression.ResultsOverall rates of use increased from 20.1% at age 10/11 to 32.2% at age 19: general care was used most. At age 10/11 use was higher among boys, at age 19 among girls. Use of general care increased for both genders, whereas use of specialized care increased among girls but decreased among boys. This differential change was associated with CBCL externalizing and internalizing problems, school problems, family socioeconomic status, and parental divorce. Preceding CBCL problems predicted more use: most for mental health care and least for general care. Moreover, general care was used more frequently by low and medium socioeconomic status families, with odds ratios (95%-confidence intervals): 1.52 (1.23;1.88) and 1.40 (1.17;1.67); youth social care in case of parental divorce, 2.07 (1.36;3.17); and of special education, 2.66 (1.78;3.95); and mental healthcare in case of special education, 2.66 (1.60;4.51).DiscussionAdolescents with behavioral and emotional problems use general care most frequently. Overall use increases with age. Determinants of use vary per type.

Adolescent use of care for behavioural and emotional problems: types, determinants and trends

SA Reijneveld, PA Wiegersma, DEMC Jansen Department of Health Sciences, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands Contact: s.a.reijneveld@umcg.nl Background Adolescents frequently have behavioural and emotional problems, that limit their daily functioning. A minority of them receives care. Evidence on determinants and types of care used, including the role of specialized vs. general care is lacking. Objective: To assess the use of various types of care by adolescents because of behavioural and emotional problems, the determinants of this use, and to what extent these determinants explain trends in use by age, for ages 10-19 years. Design/Methods We obtained longitudinal data on 2,230 adolescents during ages 10-19 years in four measurement waves. Data concerned use of various types of care (general including paediatric care, and specialized car i.e. youth social care, and youth mental healthcare) in the preceding 6 months, behavioural and emotional problems (CBCL), and child and family characteristics. We used multilevel logistic regression to analyse the effects of determinants on use per type of care. Results At all ages, use of general care was higher than of specialized care. Overall rates of use increased from 20.1% at age 10/11 to 32.2%. at 19. At age 10/11 use was higher among boys than among girls, but towards age 19, it more than doubled among girls while being rather stable among boys. Use of general care increased among both genders, whereas use of specialized care increased among girls but decreased among boys. This differential change could partially be accounted for by a few factors, being CBCL externalizing and internalizing problems, school problems, family socioeconomic status (SES) and parental divorce. Moreover, use of general care was more likely among low and medium SES families (odds ratios, OR: 1.52 (1.23; 1.88) and 1.40 (1.17;1.67). Use of social care was more likely in case of parental divorce (OR 2.07 (1.36; 3.17) and special education, OR 2.66 (1.78; 3.95), and use of mental healthcare in special education, OR 2.66 (1.60; 4.51). Conclusions Adolescents with behavioural and emotional problems most frequently use general care provided by e.g. general practitioners and child health physicians. Overall use increases with age in girls. Social care or mental health care is used relatively more frequently if adolescents have more behavioral and emotional problems, and receive special education. Key messages Adolescents with behavioural and emotional problems most frequently use general care provided by e.g. general practitioners and child health physicians. Overall use increases in particular in girls from age 11 to age 19, and increases in behavioral and emotional problems explain this partially.

The Brief Assessment Checklists (BAC-C, BAC-A): Mental health screening measures for school-aged children and adolescents in foster, kinship, residential and adoptive care

Abstract More than half of children and young people in foster, kinship, and residential care, as well as those subsequently adopted from care, have mental health difficulties that require clinical formulation and intervention. While an increasing number of alternate care jurisdictions are instituting universal mental health screening, existing measures may not adequately screen for a range of attachment- and trauma-related mental health difficulties observed among these populations. The Brief Assessment Checklist for Children (BAC-C), and the Brief Assessment Checklist for Adolescents (BAC-A) are 20-item caregiver-report psychiatric rating scales designed to: 1. screen for and monitor clinically-meaningful mental health difficulties experienced by children and adolescents in various types of care; and 2. be safely administered and interpreted by health and social care professionals other than child and adolescent mental health clinicians. The BAC-C/A were also designed to be used as brief casework monitoring tools by foster care and adoption agencies, and for treatment monitoring in CAMHS. The BAC-C and BAC-A were derived from the Assessment Checklist for Children (ACC, 120 items) and Assessment Checklist for Adolescents (ACA, 105 items) respectively. Internal consistency of BAC-C (N = 347) and BAC-A (N = 230) scores were 0.89 and 0.87 respectively. The BAC-C/A were highly accurate in screening for clinical range ACC and ACA scores (area under the curve (AUC) ranging from 0.96 to 0.99), as well as for CBCL clinical range scores (AUCs: BAC-C = 0.89 to 0.92; BAC-A = 0.93 to 0.94). They were moderately accurate in screening for children that caregivers reported had been referred to mental health services (AUCs: BAC-C = 0.74; BAC-A = 0.79). Initial BAC-C/A psychometric properties compare favourably with that of existing screening instruments, including the Strengths and Difficulties Questionnaire and the Brief Problem Monitor (CBCL short form).