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|The health promotion and health education literature has references to health counselling. Yet, beyond the field of health, coaching has become a popular method to enhance and facilitate individual and group performance in business, sports, and personal areas of life. This paper focuses on the recent development of healthcoaching by…
BackgroundWhile voice is integral to sports coaching, currently there is a dearth of research considering coaches' occupational vocal health.ObjectiveTo investigate football coaches' occupational voice use and vocal health (including the role of voice in coaching and the identification and management of workplace risk factors).DesignA mixed-methodological approach (interviews, a questionnaire and acoustic voice measurement) using descriptive statistics and thematic analyses.SettingOn-site at
... Printer Friendly Download Reader Online Chat HomeHealth Care What is HomeHealth Care? How Do I ... About HomeHealth Care? What is HomeHealth Care? Homehealth care helps seniors live independently for ...
Purpose: This article describes and evaluates a long distance coaching course aimed at improving nutritional care in nursing homes (NHs). The course was structured to provide more support than traditional training programs offer. Methods: In a series of 6 monthly teleconferences led by an expert in NH nutritional care, participating NH staff…
Rahman, Anna N.; Simmons, Sandra F.; Applebaum, Robert; Lindabury, Kate; Schnelle, John F.
Health care professionals are increasingly aware that persons are complex and live in relation with other complex human communities and broader systems. Complex beings and systems are living and evolving in nonlinear ways through a process of mutual influence. Traditional standardized approaches in chronic disease management do not address these non-linear linkages and the meaning and changes that impact day-to-day life and caring for self and family. The RN healthcoach role described in this paper addresses the complexities and ambiguities for persons living with chronic illness in order to provide person-centered care and support that are unique and responsive to the context of persons' lives. Informed by complexity thinking and relational inquiry, the RN healthcoach is an emergent innovation of creative action with community and groups that support persons as they shape their health and patterns of living.
PURPOSE Poor blood pressure control is common in the United States. We conducted a study to determine whether healthcoaching with home titration of antihypertensive medications can improve blood pressure control compared with healthcoaching alone in a low-income, predominantly minority population. METHODS We randomized 237 patients with poorly controlled hypertension at a primary care clinic to receive either home blood pressure monitoring, weekly healthcoaching, and home titration of blood pressure medications if blood pressures were elevated (n = 129) vs home blood pressure monitoring and healthcoaching but no home titration (n = 108). The primary outcome was change in systolic blood pressure from baseline to 6 months. RESULTS Both the home-titration arm and the no–home-titration arm had a reduction in systolic blood pressure, with no significant difference between them. When both arms were combined and analyzed as a before-after study, there was a mean decrease in systolic blood pressure of 21.8 mm Hg (P <.001) as well as a decrease in the number of primary care visits from 3.5 in the 6 months before the study to 2.6 during the 6-month study period (P <.001) and 2.4 in the 6 months after the study (P <.001). The more coaching encounters patients had, the greater their reduction in blood pressure. CONCLUSIONS Blood pressure control in a low-income, minority population can be improved by teaching patients to monitor their blood pressure at home and having nonprofessional healthcoaches assist patients, in particular, by counseling them on medication adherence. The improved blood pressure control can be achieved while reducing the time spent by physicians.
Margolius, David; Bodenheimer, Thomas; Bennett, Heather; Wong, Jennifer; Ngo, Victoria; Padilla, Guillermo; Thom, David H.
BACKGROUND: Mental ill health, especially depression, is recognised as an important health concern, potentially with greater impact in rural communities. This paper reports on a project, Coach the Coach, in which Australian rural football clubs were the setting and football coaches the leaders in providing greater mental health awareness and capacity to support early help seeking behaviour among young males
David Pierce; Siaw-Teng Liaw; Jennifer Dobell; Rosemary Anderson
...COMMISSION [File No. 500-1] Consolidated Energy, Inc., Diamond Home Services, Inc., Goran Capital Inc., Kingsley Coach...current and accurate information concerning the securities of Diamond Home Services, Inc. because it has not filed any...
Homehealth market growth suggests the need for models explaining homehealth utilization. We have previously explained state-level Medicare homehealth visits with reference to nursing home markets. Here we introduce a model whereby state level Medicare homehealth use is a function of nursing home queues and other demand and supply factors. Medicare homehealth users per state population
|Introduction: In recent years, coaching, as a supplement to professional development, has received increased attention, especially in nursing. Still, only little is known about how health professionals experience participating in coaching sessions. The purpose of this pilot study was to describe and analyze health professionals' experiences from…
Coaching is a dynamic field in which many forms of health promotion occur directly and indirectly on a daily basis. It would therefore be of interest to determine the extent to which research-based data has been collected pertaining to health promotion and its influence throughout coaching. Thus, the purpose of this study was to inductively…
Abstract Previous models,of dismissals,of sports coaches,do not adequately,capture,the complex,effects of tenure and organizational,expectations,on probability of dismissal. I rectify this by examining,the determinants of dismissals,of college football coaches,over 1983-2006. Using a discrete-time hazard,model,I show,that strong performances,from as recently as three years prior hurt a coach’s chance,of retention. The effect of tenure is complex, in particular in its interaction with race and
Increasing attention has been given to the identification and description of variables associated with health and social services needed, sought and used by the elderly. Little is known, however, about the homehealth care needs of the elderly. Moreover, since the inception of the diagnostic related group concept, no one has determined the elderly's perception of HomeHealth Care. The
Coaching has attracted much attention from health professionals interested in collaborative, person-centred approaches to motivating behaviour change. Whilst initial research supports the efficacy of coaching in health contexts, more theoretical and empirical work is needed. Based on recent work demonstrating the important role that mindfulness plays in self-regulation, it was hypothesised that the efficacy of healthcoaching could be enhanced
Gordon B. Spence; Michael J. Cavanagh; Anthony M. Grant
The present study develops and tests a causal model of homehealth care utilization by the Lucas County elderly. Path analysis was employed to evaluate the model on an area probability sample of 400 Ohio elderly. The findings indicate that the predictors of homehealth care are more diverse than was expected with the need factor (need for care, use
|Objectives: The purpose of this study is to test whether increasing the exposure to coaching by adding an in-home component to clinic-delivered Parent-Child Interaction Therapy (PCIT) will increase the speed of parenting skill acquisition and show greater improvements in children's behaviors and parental stress. Methods: Seventy-three…
Timmer, Susan G.; Zebell, Nancy M.; Culver, Michelle A.; Urquiza, Anthony J.
Background Despite pharmacologic advances, medication non-adherence continues to challenge primary care providers in blood pressure (BP) management. Methods Medical, nursing and pharmacy students (n = 11) were recruited and trained as healthcoaches for uninsured, hypertensive patients (n = 25) of a free clinic in an uncontrolled open trial. Pre-post analysis was conducted on BP, medication adherence, frequency of home BP monitoring, and healthy behavior (e.g., diet, exercise). Patient satisfaction and feasibility of a student coach model was qualitatively evaluated. Results In the 12 patients who completed the intervention, an increase in medication adherence as measured by the Brief Medication Questionnaire was observed (P < 0.01), with a 11 mmHg reduction in systolic BP (P = 0.03). Qualitative data showed patient satisfaction with the intervention and other healthy behavior change. Conclusions This feasibility study shows use of student healthcoaches to combat medication non-adherence in uninsured, hypertensive adults is promising.
Leung, Lucinda B.; Busch, Andrew M.; Nottage, Sarah L.; Arellano, Naira; Glieberman, Eva; Busch, Nicholas J.; Smith, Stephen R.
A theoretical framework for a psychology of coaching was developed. First, the literature on cognitive approaches to coaching, behavioral approaches to coaching, and combinations of the cognitive and behavioral approaches was reviewed. Next, two studies examined the development and validation of a new measure of private self-consciousness called…
Objectives: To examine homehealth nurses' attitudes towards physician capabilities in homehealth care, and whether nurses' attitudes are associated with their experience, practice setting, degree of physician interaction, or use of homehealth guidelines.Design: A multiple regression analysis of a 90 item survey on agency characteristics, degree of interaction with physicians, and ratings of physicians' capabilities across multiple dimensions
Background Mental ill health, especially depression, is recognised as an important health concern, potentially with greater impact in rural communities. This paper reports on a project, Coach the Coach, in which Australian rural football clubs were the setting and football coaches the leaders in providing greater mental health awareness and capacity to support early help seeking behaviour among young males experiencing mental health difficulties, especially depression. Coaches and other football club leaders were provided with Mental Health First Aid (MHFA) training. Method Pre-post measures of the ability of those club leaders undertaking mental health training to recognise depression and schizophrenia and of their knowledge of evidence supported treatment options, and confidence in responding to mental health difficulties were obtained using a questionnaire. This was supplemented by focus group interviews. Pre-post questionnaire data from players in participating football clubs was used to investigate attitudes to depression, treatment options and ability to recognise depression from a clinical scenario. Key project stakeholders were also interviewed. Results Club leaders (n = 36) who were trained in MHFA and club players (n = 275) who were not trained, participated in this evaluation. More than 50% of club leaders who undertook the training showed increased capacity to recognise mental illness and 66% reported increased confidence to respond to mental health difficulties in others. They reported that this training built upon their existing skills, fulfilled their perceived social responsibilities and empowered them. Indirect benefit to club players from this approach seemed limited as minimal changes in attitudes were reported by players. Key stakeholders regarded the project as valuable. Conclusions Rural football clubs appear to be appropriate social structures to promote rural mental health awareness. Club leaders, including many coaches, benefit from MHFA training, reporting increased skills and confidence. Benefit to club players from this approach was less obvious. However, the generally positive findings of this study suggest further research in this area is desirable.
Coaching is emerging as one of the major forms of personal and profes- sional development used by executives. Organisations and individuals use coaching to develop skills, enhance performance, develop leadership and personal functioning, and to remediate unhelpful patterns of behaviour. As such, coaching and therapy share some ground and some techniques. It is often said that one of the key
Nurse coaching is gaining acceptance as a legitimate, holistic enhancement to Western medicine. Thirteen research studies that looked at nurse coaching interventions in patients with various chronic conditions were reviewed and the outcomes discussed. All but 2 of these studies reported at least some statistically significant positive health outcomes. PMID:23580101
Objective: To examine effects of a teacher consultation and coaching program delivered by school and community mental health professionals on change in observed classroom interactions and child functioning across one school year. Method: Thirty-six classrooms within 5 urban elementary schools (87% Latino, 11% Black) were randomly assigned to intervention (training + consultation\\/coaching) and control (training only) conditions. Classroom and child
Elise Cappella; Bridget K. Hamre; Ha Yeon Kim; David B. Henry; Stacy L. Frazier; Marc S. Atkins; Sonja K. Schoenwald
Background/Aims Healthcoaching programs, delivered by trained non-medical and medical personnel, and focused on diet and lifestyle counseling, have proven beneficial in primary and secondary prevention of cardiovascular disease. These coaching programs, however, have not been tested or validated in South Asians, who have unique dietary and lifestyle habits, and increased risk of coronary artery disease. Methods We examined lipid values in participants who were enrolled in the Heart HealthCoaching Program at the South Asian Heart Center at El Camino Hospital. Trained volunteer coaches contacted participants throughout the year by phone and email to deliver culturally-competent health education on diet, physical activity, and stress reduction. Participants were categorized, based on their level of participation, into three groups: those who did not enroll (non-coached, N=33), those who received some coaching (partially coached, N = 145), and those who completed one full year of the program (fully coached, N = 558). Fasting lipid measurements were obtained with mean differences being calculated from their baseline and last available follow-up lab test. Paired t-test was used for comparison of baseline and follow-up labs within each group. Multivariate age-adjusted analyses incorporated MANOVA to detect for differences between groups. Results There were no significant differences in mean age(43, 42 and 43), mean BMI(25.8, 26.5 and 26.2), or baseline lipid values across the three groups (fully-coached, partially coached, and non-coached respectively). There were significant improvements in total cholesterol(TC) (?5.5±28.4mg/dl), LDL(?4.1±24.3), HDL (1.9±6.4), triglycerides(?16.1±67.3), and TC/HDL ratio(?0.31±0.83) in the fully coached group (P <0.001 for all). The partially coached group demonstrated reductions in total cholesterol(?5.2±27.8, p=0.03), LDL(?8.1±28.0mg/dl, P <0.001), and TC/HDL ratio (?0.42±1.01, P <0.001) with a trend towards increased HDL (4.9±31.3, P = 0.06). Non-coached participants did not have any statistically significant differences for any lipid measurement. Coached participants were more likely to improve lipid values than partially coached and non-coached participants (P <0.001). Conclusions Our results suggest the benefit of a volunteer culturally-competent coaching program for South Asians in improving their lipid profile. Benefit was obtained even for partially coached participants. Non-medically trained healthcoaches may be an effective method to deliver culturally appropriate cardiovascular health messages for South Asians at risk for developing coronary artery disease.
Background/Aims Healthcoaching programs, delivered by trained non-medical and medical personnel, and focused on diet and lifestyle counseling, have proven beneficial in primary and secondary prevention of cardiovascular disease. These coaching programs, however, have not been tested or validated in South Asians, who have unique dietary and lifestyle habits, and increased risk of coronary artery disease. Methods We examined lipid values in participants who were enrolled in the Heart HealthCoaching Program at the South Asian Heart Center at El Camino Hospital. Trained volunteer coaches contacted participants throughout the year by phone and email to deliver culturally-competent health education on diet, physical activity, and stress reduction. Participants were categorized, based on their level of participation, into three groups: those who did not enroll (non-coached, N=33), those who received some coaching (partially coached, N = 145), and those who completed one full year of the program (fully coached, N = 558). Fasting lipid measurements were obtained with mean differences being calculated from their baseline and last available follow-up lab test. Paired t-test was used for comparison of baseline and follow-up labs within each group. Multivariate age-adjusted analyses incorporated MANOVA to detect for differences between groups. Results There were no significant differences in mean age(43, 42 and 43), mean BMI(25.8, 26.5 and 26.2), or baseline lipid values across the three groups (fully-coached, partially coached, and non-coached respectively). There were significant improvements in total cholesterol(TC) (-5.5±28.4mg/dl), LDL(-4.1±24.3), HDL (1.9±6.4), triglycerides(-16.1±67.3), and TC/HDL ratio(-0.31±0.83) in the fully coached group (P <0.001 for all). The partially coached group demonstrated reductions in total cholesterol(-5.2±27.8, p=0.03), LDL(-8.1±28.0mg/dl, P <0.001), and TC/HDL ratio (-0.42±1.01, P <0.001) with a trend towards increased HDL (4.9±31.3, P = 0.06). Non-coached participants did not have any statistically significant differences for any lipid measurement. Coached participants were more likely to improve lipid values than partially coached and non-coached participants (P <0.001). Conclusions Our results suggest the benefit of a volunteer culturally-competent coaching program for South Asians in improving their lipid profile. Benefit was obtained even for partially coached participants. Non-medically trained healthcoaches may be an effective method to deliver culturally appropriate cardiovascular health messages for South Asians at risk for developing coronary artery disease. PMID:24086010
... Related Links Accessibility NCHS Home FastStats HomeHomeHealth Care (Data are for the U.S.) Number of current ... diabetes, 11 percent of discharges (2007) Source: HomeHealth Care and Discharged Hospice Care Patients: United States, 2000 ...
Objectives: The outcomes of the California Public Employees Retirement System’s Health Matters program, a replication of a health promotion and fitness program known as the Senior Wellness Program (SWP), are reported. Method: A randomized controlled design (n = 504) was used. Eligibility included one or more qualifying chronic health conditions, age 65 or older, member of a participating health plan,
Stephen K. Holland; Jay Greenberg; Lynette Tidwell; Joelyn Malone; Joseph Mullan; Robert Newcomer
Intensive Health Care at Home Kids can need intensive health care at home after they have been in the hospital ... dolls to help you practice different procedures. HomeHealth Care Assistance The hospital social worker can help families ...
There is a need for programs tailored to train the approximately 300 new local health officials (LHOs) who emerge each year with the knowledge and skills needed to build, maintain, and enhance public health capacity and infrastructure. The Survive and Thrive program incorporates a curriculum that is designed to address the challenges faced by a new LHO. The Survive and Thrive program seeks to address these issues by leveraging the expertise of the current generation of local public health leadership by incorporating experienced LHOs as coaches. Coaching, mentoring, and peer assistance by seasoned LHOs is critical to these new learning opportunities. This article highlights aspects of the coaching component of Survive and Thrive program. Actual examples of its relevance to the professional growth and development of new LHOs and the coaches themselves are presented. The article also describes the novel approach of including coaches in evaluating program effectiveness. The Survive and Thrive program's coaching component can serve as a template for other public health leadership programs and related workforce development initiatives as well as a model to help facilitate lifelong learning of LHOs. PMID:20150793
Henry, Vonna; Sarpy, Sue Ann; Green, Rachel; Kaplan, Seth; Bonzon, Ramon
This paper presents an overview of the challenges in developing health smart homes targeting, in particular, elderly and impaired people. As such, it identifies the current endeavors as well as the main areas of research.
... Share Back to Top Footer Home A federal government website managed by the Centers for Medicare & Medicaid Services 7500 Security Boulevard, Baltimore, MD 21244 Sign Up / Change Plans Your Medicare Costs What Medicare Covers Drug Coverage (Part D) Supplements & ...
SUMMARY The purpose of this article is to examine the current health promotion orientation of youth sports clubs in Finland in view of the standards created previously for the health promoting sports club (HPSC). Ninety-seven youth sports clubs participated, and 273 sports club offi- cials and 240 coaches answered the questionnaires. To describe clubs health promotion orientations, an HPSC index
... is very important. If you have been prescribed oxygen therapy, you shouldn’t smoke while using oxygen, and no one near you should smoke either. ... in your home where you will be using oxygen. Because oxygen supports combustion, you should stay at ...
... Health Benefits News VA Resuming Normal Operations as Government Shutdown Ends October 17, 2013 WASHINGTON – Employees at the ... and resolve during this difficult period.” During the government shutdown, VA medical centers, clinics, and other health services ...
BACKGROUND Given increasing interest in helping consumers choose high-performing (higher quality, lower cost) physicians, one approach chosen by several large employers is to provide assistance in the form of a telephonic “healthcoach” — a registered nurse who assists with identifying appropriate and available providers. OBJECTIVE To evaluate the healthcoach’s influence on provider choice and the quality of the user experience in the early introduction of this service. DESIGN Cross-sectional survey of 3490 employees and covered dependents of a large national firm that offered healthcoach services to all employees and covered dependents. The survey began in September 2007 with proportionate stratified sampling of 1750 employees and covered dependents who used the services between October 2007 and February 2008, and 1740 non-users. PARTICIPANTS Insured adults (ages 21–64) employed by a large national firm or covered dependents of employees. MEASUREMENTS Awareness of the service, reason for using service, visits to providers recommended by service, use of health advice provided by service, user satisfaction. MAIN RESULTS The primary reason for using the service was to obtain provider referrals (73%). Fifty-two percent of users sought a specialist referral, 33% a PCP referral and 9% a hospital referral. Eighty-nine percent of users seeking a provider referral were referred in-network; 81% of those referred visited the referred provider. Measures of satisfaction with both the service and the care delivered by recommended providers were over 70%. CONCLUSIONS Customers largely follow the provider recommendation of the healthcoach. Users express general satisfaction with existing healthcoach services, but differences in performance between vendors highlight the need for the services to be well implemented. Electronic supplementary material The online version of this article (doi:10.1007/s11606-010-1428-4) contains supplementary material, which is available to authorized users.
Rao, Sowmya R.; Rogers, Robert S.; Mailhot, Johanna R.; Galvin, Robert
Fifty-four California homehealth agencies participated in a utilization review project. The purposes were to develop objective methods of utilization review applicable to homehealth, based on a health information statistical data base. Two major activit...
... Public Health Emergency Home Preparation Instructions for Doxycycline. The following home preparation instructions for ... More results from www.fda.gov/drugs/emergencypreparedness/bioterrorismanddrugpreparedness
Objective To examine effects of a teacher consultation and coaching program delivered by school and community mental health professionals on change in observed classroom interactions and child functioning across one school year. Method Thirty-six classrooms within five urban elementary schools (87% Latino, 11% Black) were randomly assigned to intervention (training + consultation/coaching) and control (training only) conditions. Classroom and child outcomes (n = 364; 43% girls) were assessed in the fall and spring. Results Random effects regression models showed main effects of intervention on teacher-student relationship closeness, academic self-concept, and peer victimization. Results of multiple regression models showed levels of observed teacher emotional support in the fall moderated intervention impact on emotional support at the end of the school year. Conclusions Results suggest teacher consultation and coaching can be integrated within existing mental health activities in urban schools and impact classroom effectiveness and child adaptation across multiple domains.
Cappella, Elise; Hamre, Bridget K.; Kim, Ha Yeon; Henry, David B.; Frazier, Stacy L.; Atkins, Marc S.; Schoenwald, Sonja K.
|This curriculum guide provides materials for a five-unit homehealth aide course. Each unit contains 4 to 36 lesson plans. Unit topics and representative lesson plan topics are as follows: (1) introduction (ethical and legal responsibilities, time management, reporting and recording); (2) communication (techniques, meeting the public, therapeutic…
Objective: To examine effects of a teacher consultation and coaching program delivered by school and community mental health professionals on change in observed classroom interactions and child functioning across one school year. Method: Thirty-six classrooms within 5 urban elementary schools (87% Latino, 11% Black) were randomly assigned to…
Cappella, Elise; Hamre, Bridget K.; Kim, Ha Yeon; Henry, David B.; Frazier, Stacy L.; Atkins, Marc S.; Schoenwald, Sonja K.
|Objective: To examine effects of a teacher consultation and coaching program delivered by school and community mental health professionals on change in observed classroom interactions and child functioning across one school year. Method: Thirty-six classrooms within 5 urban elementary schools (87% Latino, 11% Black) were randomly assigned to…
Cappella, Elise; Hamre, Bridget K.; Kim, Ha Yeon; Henry, David B.; Frazier, Stacy L.; Atkins, Marc S.; Schoenwald, Sonja K.
... MAP | EN ESPAÑOL Healthcare > HomeHealth and Personal Care Aides FONT SIZE: PRINTER-FRIENDLY Summary What They ... What They Do -> What HomeHealth and Personal Care Aides Do About this section Aides provide light ...
The increasing percentage of frail, chronically ill elderly in Wisconsin combined with a shift in the site of care delivery from institution to homes has created an increased need for nonskilled homehealth services. Despite recent increases in homehealth expenditures these increases in need are even greater. Tightening interpretations of Medicare eligibility criteria, the expansion of health maintenance organizations,
Despite a history that coincides with the medicare funded homehealth program the private nonprofit (PNP) homehealth agency does not appear to have been the focus of any extensive or objective examination. Herein that task is undertaken. First, the PNP is positioned within the context of the other four nonprofit provider forms comprising homehealth's \\
The Hospital Infection Control Practices Advisory Committee published guidelines for prudent use of vancomycin to combat increasing resistance to antimicrobial drugs. Studies examining compliance with these guidelines primarily involve hospitalized patients. The growing practice of home use of antimicrobial drugs led to this retrospective cohort study that evaluated parenteral vancomycin use in patients receiving it through a homecare agency. We found that 39.2% of outpatients received vancomycin outside the guidelines, mainly because of prolonged empiric therapy, dosing convenience, and prolonged use after surgery. Patients were more likely to receive vancomycin appropriately if they were >65 years of age, had a history of malignancy, or were discharged from a medical service. In addition, obtaining wound cultures and attempting a microbiologic diagnosis led to more appropriate vancomycin use. Recommendations for prudent vancomycin use are often overlooked when selecting antimicrobial drugs for home infusion. The public health impact of this practice remains unknown. PMID:16318696
Fraser, Thomas G; Stosor, Valentina; Wang, Qiong; Allen, Anne; Zembower, Teresa R
|Ironically, at a time when coaching seems to have come into its own as a way to improve teacher practice, school districts across the United States are experiencing funding cuts and eliminating coaching positions. The threats that budget woes pose to established school coaching programs led the authors to ask themselves what practices schools and…
Ironically, at a time when coaching seems to have come into its own as a way to improve teacher practice, school districts across the United States are experiencing funding cuts and eliminating coaching positions. The threats that budget woes pose to established school coaching programs led the authors to ask themselves what practices schools and…
Healthy Homes programs seek to integrate the evaluation and management of a multitude of health and safety risks in households. The education of physicians in the identification, evaluation, and management of these homehealth and safety issues continues to be deficient. Healthy Homes programs represent a unique opportunity to educate physicians in the home environment and stimulate ongoing, specific patient-physician discussions and more general learning about home environmental health. The Case Healthy Homes and Patients Program addresses these deficiencies in physician training while providing direct services to high-risk households. Pediatric and family practice resident physicians participate in healthy home inspections and interventions for their primary care patients and follow up on identified risks during health maintenance and acute illness visits.
Zickafoose, Joseph S.; Greenberg, Stuart; Dearborn, Dorr G.
Early release from the hospital of the elderly ill patient may lead to failure of the home care plan and rapid rehospitalization. Review of 330 consecutive admissions to a large urban homehealth agency in 1980 revealed that 43 patients (13%) were rehospitalized within 2 weeks of admission. This high risk patient population is contrasted with the average home care
This paper describes a study designed to assess the impacts of passive health status monitoring technology in homehealth. Monitoring systems were installed in the homes of 13 homehealth clients to track physiological parameters (heart rate, breathing rate, and gait), the activities of daily living (ADLs) and key alert conditions of residents, such as falls. Activity reports and alert
Majd Alwan; David C. Mack; Siddharth Dalal; Steve Kell; Beverely Turner; Robin A. Felder
This article describes components of a qualitative research study that investigated the process of how acute care nurses successfully transition into homehealth nursing practice. The sequences of activities in choosing homehealth as a specialty to practice and the phases of successful transition from acute care practice to homehealth practice are described. The sequence of activities and phases
Tuberculosis (TB) is on the rise. An estimated 10 to 15 million people in the United States are infected. This resurgence poses a challenge to all health care providers, including homehealth care professionals, where many patients fall into the \\
Cognitive impairment is a serious and pervasive problem for ill elderly uersons in the institutional setting. Older individuals exit these facilities quickly, often requiring continued formal health care services in their homes. The prevalence of delirium and\\/ or dementia in older, medically ill homehealth clients has not been investigated. It was the purpose of this descriptive study to systematically
Homehealth care (HHC) is a regulated program of care delivered by a multidisciplinary team in the patient’s home. It is of high demand in Saudi Arabia; however there are shortages in health care personnel. Moreover, current internship programs do not address the concepts and unique skills involved in HHC practice. The purpose of this article is to present a
Many home-based and leisure activities can generate hazardous respirable exposures. Routine domestic activities and a variety of hobbies, avocations, and leisure pursuits have been associated with a spectrum of respiratory tract disorders. Indoor environments present a special risk for high-intensity exposures and adverse health effects. There are important knowledge gaps regarding the prevalence of specific health hazards within and across communities, exposure-response effects, population and individual susceptibilities, best management strategies, the adverse health effects of mixed exposures, and long-term clinical outcomes following exposures. The home environment presents special health risks that should be part of the health assessment. PMID:23153611
|THE HOMEHEALTH AIDE PERFORMS SIMPLE PERSONAL CARE FUNCTIONS UNDER NURSING SUPERVISION IN THE HOME CARE OF AN ILL OR DISABLED PERSON. THE PROJECT OBJECTIVES WERE TO TRAIN AS AIDES 30 MEN AND WOMEN AGE 45 YEARS AND OLDER WITH LIMITED INCOMES TO MEET A COMMUNITY EMPLOYMENT NEED AND TO EXPERIMENT IN RECRUITMENT, SELECTION, TRAINING, AND EMPLOYMENT…
Three automated monitoring systems used for homehealth care of 1) body and excreta weight in lavatory, 2) ECG in bathtub and 3) ECG in bed without utilizing body surface electrodes in a non-conscious manner at a pilot house called “Welfare Techno House” were designed. For the evaluation of these automated health monitoring systems, long continuous measurements of the health
A. Kawarada; A. Tsakada; K. Sasaki; M. Ishijima; T. Tamura; T. Togawa; K. Yamakoshi
The growing number of the elderly in industrialised countries is increasing the pressure on respective health care systems. This is one reason for recent trends in the development and expansion of homehealth care organisations. With Internet access available to everyone and the advent of wireless technologies, advanced telehomecare is a possibility for a large proportion of the population. In the near future, one of the authors plans to implement a homehealth care infrastructure for patients with congestive heart failure and patients with chronic obstructive pulmonary disease. The system is meant to support regular and ad-hoc measurements of medical parameters in patient homes and transmission of measurement data to the homehealth care provider. In this paper we look at network technologies that connect sensors and input devices in the patient home to a homehealth care provider. We consider wireless and Internet technologies from functional and security-related perspectives and arrive at a recommendation for our system. Security and usability aspects of the proposed network infrastructures are explored with special focus on their impact on the patient home. PMID:12697950
... that are ordered as part of your care • Durable medical equipment (like a walker) CAN I GET ... 0 for Medicare-approved homehealth services. For durable medical equipment (like a walker, wheelchair, or oxygen ...
The decision of a homehealth nurse to remain employed at an agency is certainly influenced by a number of factors, one being how much support or encouragement that nurse is receiving from colleagues. The homehealth nurse does interact with peers at the office and over the telephone, but such an act as calling down the hall to another registered nurse to help with a client is not possible. PMID:8226027
We evaluated the Veterans Health Administrations (VHA) community nursing home (nursing home) program to determine if nursing homes met eligibility requirements. VHAs Office of Finance reported nursing home program expenditures totaled $614 million in FY 2...
Community health centers (CHCs) seek effective strategies to address obesity. MidWest Clinicians’ Network partnered with [an academic medical center] to test feasibility of a weight management quality improvement (QI) collaborative. MidWest Clinicians’ Network members expressed interest in an obesity QI program. This pilot study aimed to determine whether the QI model can be feasibly implemented with limited resources at CHCs to improve weight management programs. Five health centers with weight management programs enrolled with CHC staff as primary study participants; this study did not attempt to measure patient outcomes. Participants attended learning sessions and monthly conference calls to build QI skills and share best practices. Tailored coaching addressed local needs. Topics rated most valuable were patient recruitment/retention strategies, QI techniques, evidence-based weight management, motivational interviewing. Challenges included garnering provider support, high staff turnover, and difficulty tracking patient-level data. This paper reports practical lessons about implementing a weight management QI collaborative in CHCs.
Wilkes, Abigail E.; John, Priya M.; Vable, Anusha M.; Campbell, Amanda; Heuer, Loretta; Schaefer, Cynthia; Vinci, Lisa; Drum, Melinda L.; Chin, Marshall H.; Quinn, Michael T.; Burnet, Deborah L.
Early indications are that the Medicare homehealth prospective payment system (PPS) has controlled Medicare homehealth expenditures. However, studies indicate many unresolved questions about whether PPS improves patient quality of care and is cost-effective. The article reviews effective home-based palliative care interventions and presents the views of seven homehealth care nurses regarding the impact of Medicare requirements on
This paper is on coaching farmers in (re)designing a farm. It describes how farmers can become inspired to design a sustainable farm by the way medical doctors look at the human being and his health. Sustainability in farm management is usually strived for in such a way that damage to People, Planet or Profit is prevented. However, preventing such damage
Homehealth care has changed dramatically over the years. Recent federal policy changes have made a drastic impact on the homehealth care industry, including homehealth social work. It is imperative social workers strive to affect policy changes rather than adjust to policy changes. The following article will provide a brief review of the history of homehealth care
Executive coaching is often seen as higher grade coaching that is the sole prerogative of the high-flying executive, accompanied on hallowed ground by the mystical executive coach. However, the foundation stones for executive coaching – quality integrated thinking, confidentiality, trust – are equally important to all its people if an organisation is to perform well financially and sustainably. Although much
The Hospital Infection Control Practices Advisory Committee published guidelines for prudent use of van- comycin to combat increasing resistance to antimicrobial drugs. Studies examining compliance with these guidelines primarily involve hospitalized patients. The growing prac- tice of home use of antimicrobial drugs led to this retro- spective cohort study that evaluated parenteral vancomycin use in patients receiving it through a
Thomas G. Fraser; Valentina Stosor; Qiong Wang; Anne Allen; Teresa R. Zembower
|Nursing homes are considered lagging behind in adopting health information technology (HIT). Many studies have highlighted the use of HIT as a means of improving health care quality. However, these studies overwhelmingly do not provide empirical information proving that HIT can actually achieve these improvements. The main research goal of this…
Standards pertaining to the licensure of homehealth agencies are outlined. They are contained in a report prepared by the New Jersey State Department of Health and issued in October, 1977. The standards are organized according to 11 major areas: definiti...
Background Health related behaviour is an important determinant of chronic disease, with a high impact on public health. Motivating and assisting people to change their unfavourable health behaviour is thus a major challenge for health professionals. The objective of the study was to develop a structured programme of counselling in primary care practice, and to test its feasibility and acceptance among general practitioners (GPs) and their patients. Methods Our new concept integrates change of roles, shared responsibility, patient-centredness, and modern communication techniques—such as motivational interviewing. A new colour-coded visual communication tool is used for the purpose of leading through the 4-step counselling process. As doctors’ communication skills are crucial, communication training is a mandatory part of the programme. We tested the feasibility and acceptance of the “HealthCoaching” programme with 20 GPs and 1045 patients, using questionnaires and semistructured interviewing techniques. The main outcomes were participation rates; the duration of counselling; patients’ self-rated behavioural change in their areas of choice; and ratings of motivational, conceptual, acceptance, and feasibility issues. Results In total, 37% (n=350) of the patients enrolled in step 1 completed the entire 4-Step counselling process, with each step taking 8–22 minutes. 50% of ratings (n=303) improved by one or two categories in the three-colour circle, and the proportion of favourable health behaviour ratings increased from 9% to 39%. The ratings for motivation, concept, acceptance, and feasibility of the “HealthCoaching” programme were consistently high. Conclusions Our innovative, patient-centred counselling programme for health behaviour change was well accepted and feasible among patients and physicians in a primary care setting. Randomised controlled studies will have to establish cost-effectiveness and promote dissemination.
Background Although self-management support improves diabetes outcomes, it is not consistently provided in health care settings strained for time and resources. One proposed solution to personnel and funding shortages is to utilize peer coaches, patients trained to provide diabetes education and support to other patients. Coaches share similar experiences about living with diabetes and are able to reach patients within and beyond the health care setting. Given the limited body of evidence that demonstrates peer coaching significantly improves chronic disease care, this present study examines the impact of peer coaching delivered in a primary care setting on diabetes outcomes. Methods/Design The aim of this multicenter, randomized control trial is to evaluate the effectiveness of utilizing peer coaches to improve clinical outcomes and self-management skills in low-income patients with poorly controlled diabetes. A total of 400 patients from six primary health centers based in San Francisco that serve primarily low-income populations will be randomized to receive peer coaching (n = 200) or usual care (n = 200) over 6 months. Patients in the peer coach group receive coaching from patients with diabetes who are trained and mentored as peer coaches. The primary outcome is change in HbA1c. Secondary outcomes include change in: systolic blood pressure, body mass index (BMI), LDL cholesterol, diabetes self-care activities, medication adherence, diabetes-related quality of life, diabetes self-efficacy, and depression. Clinical values (HbA1c, LDL cholesterol and blood pressure) and self-reported diabetes self-efficacy and self-care activities are measured at baseline and after 6 months for patients and coaches. Peer coaches are also assessed at 12 months. Discussion Patients with diabetes, who are trained as peer healthcoaches, are uniquely poised to provide diabetes self management support and education to patients. This study is designed to investigate the impact of peer healthcoaching in patients with poorly controlled diabetes. Additionally, we will assess disease outcomes in patients with well controlled diabetes who are trained and work as peer healthcoaches. Trial Registration ClinicalTrials.gov identifier: NCT01040806
Homehealth care nurses are at risk of needlesticks and blood exposures, yet few studies have been conducted related to such exposures in the homehealth care setting. This article describes a cross sectional prevalence pilot study of needlesticks and blood exposures conducted among three homehealth care agencies in the San Francisco Bay area. Needlestick and blood exposure reports from 1993 to 1996 were submitted from three homehealth care agencies. The exposures were categorized using an existing categorization system and compiled into a composite report. A total of 52 exposures occurred; nurses sustained 92% of exposures. Twenty-three percent occurred before, during, or after needle disposal; 17% from manipulating intravenous/access ports; 15% from improper disposal; and 13.5% during or after blood draw. Needle safety devices need to be specifically designed for the unique homehealth care setting and for a standardized rate of calculating needlestick injuries in this setting. PMID:15068100
This article provides nurses, homehealth care practitioners, health educators, social workers, and therapists with information about homehealth care issues concerning Asian-American populations. It covers homehealth care, demographic background, and health risks, with discussion of case examples in their cultural context and related cultural competency and communication perspectives.
Text Version... Nursing Homes, and Other Health Care Facilities ... Nursing Homes, and Other Health Care Facilities FDA PUBLIC HEALTH ADVISORY ... More results from www.fda.gov/downloads/drugs/guidancecomplianceregulatoryinformation
National health policy regulates the delivery of Medicare homehealth services. These services have grown exponentially over the past several years. Current challenges to service delivery revolve around attempts to contain costs while ensuring quality of and access to care. To meet these challenges, providers must be aware of the societal and ideological influences on national health policies that impact
The American Academy of Pediatrics (AAP) supports development and universal implementation of a comprehensive electronic infrastructure to support pediatric information functions of the medical home. These functions include (1) timely and continuous management and tracking of health data and services over a patient's lifetime for all providers, patients, families, and guardians, (2) comprehensive organization and secure transfer of health data during patient-care transitions between providers, institutions, and practices, (3) establishment and maintenance of central coordination of a patient's health information among multiple repositories (including personal health records and information exchanges), (4) translation of evidence into actionable clinical decision support, and (5) reuse of archived clinical data for continuous quality improvement. The AAP supports universal, secure, and vendor-neutral portability of health information for all patients contained within the medical home across all care settings (ambulatory practices, inpatient settings, emergency departments, pharmacies, consultants, support service providers, and therapists) for multiple purposes including direct care, personal health records, public health, and registries. The AAP also supports financial incentives that promote the development of information tools that meet the needs of pediatric workflows and that appropriately recognize the added value of medical homes to pediatric care. PMID:21518710
|Evidence-based and highly effective, "coaching" helps early childhood practitioners support other professionals and families as they enhance existing knowledge, develop new skills, and promote healthy development of young children. This hands-on guide shows professionals how to conduct skillful coaching in any setting--home, school, or community.…
Evidence-based and highly effective, "coaching" helps early childhood practitioners support other professionals and families as they enhance existing knowledge, develop new skills, and promote healthy development of young children. This hands-on guide shows professionals how to conduct skillful coaching in any setting--home, school, or community.…
This study examines the likelihood of nursing home and homehealth care use for childless older Americans. Four research questions are addressed: (1) Are the childless elderly at a greater risk of nursing home and homehealth care use? (2) Is it childlessness per se or not having children with particular characteristics that affects the likelihood of using these formal
American Nursing Care (ANC) conducted retrospective chart reviews to assess the potential of new home telemedicine technology as a way to control health care costs. Using the functionality of the Home Assisted Nursing Care (HANC) network as the home telemedicine system, ANC estimated that 31 % of a selected group of homehealth care patients and 67% of the patients
Theresa M. Crist; Stephen B. Kaufman; Kathleen R. Crampton
Abstract. The growing,number,of the elderly in industrialised countries is increasing the pressure on respective health care systems. This is one reason for recent trends in the development,and expansion,of home,health care organisations. With Internet access available to everyone and the advent of wireless technologies, advanced telehomecare is a possibility for a large proportion of the population. In the near future, one
The concept of Health Smart House aims at giving an autonomous life, in their own home, to people who would normally be placed in institutions: patients suffering from a chronic disease, handicapped people, and also fragile elderly. We propose an overview of the researches on the concept. It then presents the main trends in each the technological fields of concern-Information
Norbert Noury; Gilles Virone; Pierre Barralon; Jingchun Ye; Vincent Rialle; Jacques Demongeot
When a professor leaves a long-time teaching position in baccalaureate nursing to work in a nursing staff position in homehealth care, this change engenders certain, perhaps conflicting, expectations from the professor and the agency. Tension may exist because of differences between the two roles in the level of independent functioning, the level of authority, communicating with physicians, professional competence,
This study examined factors related to falls among elderly homehealth clients living in rural southern Illinois. Forty-five clients who fell were demographically matched with 45 controls. Logistic regression analysis revealed that previous falls, frailty, physical inactivity, balance problems, absence of handrails, and uneven floors were related to a fall in this sample. Medications commonly taken by clients were not
Fred Isberner; Dale Ritzel; Paul Sarvela; Kristine Brown; Ping Hu; Debbie Newbolds
u Abstract This study exemplifies the integration of IS behavioral science in the area of technology adoption and diffusion into the design science process. We first identify the computer-mediated paradox, as it exists in the tele-homehealth care setting. Specifically, we address the challenges of providing quality patient inclusive of affective assessment. From the design science perspective, we then introduce
The objective of this research study was twofold; 1) to explore and identify health supportive design factors in Swedish elderly care homes and 2) to understand their usefulness and suggest implication in Korean elderly care settings. A descriptive and explorative method was applied using a combination of field studies and semi-structured interviews. Three study trips were carried out during Sept.
Sookyoung Lee; Alan Dilani; Agneta Morelli; Hearyung Byun
In Japan, the focus on health care has been shifted from hospital-based to community- based care. In nursing fields, homehealth care nursing is expected to become well implemented. Although our society is facing the problem of care for the elderly population, the target patients of homehealth care nursing range from children to the elderly. In homehealth care
Ikuko Miyabayashi; Betty K. Mitsunaga; Mihoko Miyawaki
The primary goals of homehealth care nursing and rehabilitation nursing are strikingly similar. Rehabilitation nursing principles should guide homehealth care nurses as they formulate and deliver quality patient care. Homehealth care agencies eager to keep up with the emerging trends in health care delivery are encouraged to recruit and hire rehabilitation nurses. This article discusses the principles
Objectives: The purpose of this study was to identify core journals in homehealth nursing and to determine how well these journals were covered by indexing and abstracting services. The study was part of the project for mapping the nursing literature of the Medical Library Association's Nursing and Allied Health Resource Section. Methods: A citation analysis of two core journals was done to determine distribution of references by format types and age of citations and dispersion of the literature, according to Bradford's Law of Scattering. The analysis of indexing coverage for Zone 1 and 2 was also provided. Results: The study showed that 64.2% of citations came from journals, versus 22.9% from books and 12.9% from other publications. PubMed/ MEDLINE rated highest in average indexing coverage of Zone 1 and 2 journals, followed by CINAHL. PsycINFO, SocioAbstracts, and EBSCO Health Business FullTEXT showed practically no coverage for the homehealth nursing literature. Conclusion: As expected, journal articles were found to be the primary source for referencing and books, the secondary source. In regard to bibliographic control, no databases provided full coverage of the journals in the field of homehealth nursing. PubMed/MEDLINE and CINAHL gave better results in combination, because CINAHL tended to cover more nursing journals, while PubMed/MEDLINE did better with medical titles.
Variations in the cost of homehealth care by illiness episode were studied, with cost defined to include skilled nursing, physical therapy, speech therapy, occupational therapy, social, and homehealth aide services. Utilization and cost information was ...
Three projects involving the utilization of homemaker and homehealth aide services are described. The projects were designed to provide supportive homemaker and homehealth aide services to handicapped individuals in Bangor, Maine, Detroit, Mich., and Sa...
During the period 1980 to 1985, growth in the number of persons served by Medicare homehealth was the largest source of growth in Medicare homehealth expenditures. Population growth was in part responsible for the increase in beneficiaries using Medicare homehealth, but more important was growth in the number of persons served per 1000 elderly population. Cost per
Objective: Despite the growth of geriat- ric homehealth services, little is known about the mental health needs of geriat- ric patients seen in their homes. The au- thors report the distribution, correlates, and treatment status of DSM-IV major de- pression in a random sample of elderly patients receiving homehealth care for medical or surgical problems. Method: Geriatric patients
Martha L. Bruce; M. P. H. Gail; J. McAvay; M. S. Patrick; J. Raue; Ellen L. Brown; Barnett S. Meyers; Denis J. Keohane; M. S. David; R. Jagoda; Carol Weber
This study examined homehealth care workers' attitudes toward the elderly and their elderly clients. Data were collected from a convenience sample of 106 homehealth care workers in South Central Florida in October 1994, using the Attitudes Toward the Elderly Questionnaire (ATE). Estimated internal consistency reliability of the scale was .60, using Cronbach's alpha. Findings suggest that homehealth
Recent advances in ubiquitous computing have evoked the prospect of real-time monitoring of people’s health in context-aware\\u000a homes. Home is the most private place for people and health information is of highly intimate nature. Therefore, users-at-home must have means to benefit from home healthcare and preserve privacy as well. However, most smart home healthcare systems\\u000a currently lack support for privacy
|This article describes the application of the Diagnostic Intervention Model and its effects in two case studies of 3-year-old boys, Rolf and Ruud, using individual interaction coaching with their mothers. Positive effects were found for all the target categories in both cases, although an interaction that used materials appeared to be more…
Janssen, Marleen J.; Riksen-Walraven, J. Marianne; van Dijk, Jan P. M.; Ruijssenaars, Wied A. J. J. M.
This paper presents a home sensor network for wireless health monitoring, including a wireless sensor network, client for controlling the sensor network, and a data storage server. A common software and hardware microcontroller-sensor interface was defined to enable joint use of sensor technologies developed in three different projects. IEEE 802.15.4 RF-transceiver based radio-boards and ZigBee network software were designed and
Sakari Junnila; Irek Defée; Mari Zakrzewski; Antti-matti Vainio; Jukka Vanhala
Homehealth care programs are generally able to meet a wide variety of older persons’ medical care needs, but are often unable to provide for the specialized needs of those patients who are experiencing emotional problems. This situation is most problematic in rural communities where services to meet the mental health needs of homebound elders are often not available. This
Allan V. Kaufman; Forrest R. Scogin; Eileen E. MaloneBeach; Lorin A. Baumhover; Nancy McKendree-Smith
While homehealth services have traditionally been an underused component of the health care system, current trends suggest the desirability of expanding these services. These trends include an increase in the number of elderly who need the benefits of home care, the recognition that long-term chronic illnesses require appropriate management at home, and concern that patients have access to care at the level most appropriate to their illnesses. In New Hampshire, 41 certified homehealth agencies offer services. Little systematic research has been conducted on the kinds of services they provide and the patients seen by their staffs. Patient encounter data were collected from a sample of eight agencies for a 4-week period. Staff of the agencies used the patient contact record developed by the National Functional Task Analysis Cooperative Study to collect data. The data reflected differences among the agencies in the size of the populations they serve, organizational characteristics, reasons for patients' visits, expected sources of the revenue that supported them, and the diagnosis of the patients they cared for. The agencies served areas with populations ranging from 1,000 to 40,000. The staffs ranged from 1 to 14 full-time persons. Two were public agencies; the others had voluntary sponsorship. When data on reasons for visits were averaged for the eight agencies, it was shown that 72% of the visits were made for disease control activities such as care for a chronic or acute condition or for treatment or a laboratory test. Disease prevention activities such as a checkup for adults, children, prenatal or postnatal care, or health education accounted for only 24% of the visits. This result may indicate that, in areas short of physician manpower, the community health nurse is taking on increasing responsibility for medical care as well as health and education. Reimbursement for the visits came from Medicare, 25%; Medicaid-welfare, 14%; the patients, 18%; and health insurance, 3%. For 35% of the visits there was no charge; they were underwritten by community resources.
An information revolution is occurring in homehealth care documentation processes and systems. The federally mandated Outcomes and Assessment Information Set (OASIS) for patient assessment and the use of electronic patient medical records will significantly affect the conduct of nursing research in homehealth care. The purposes of this article are to inform potential home care nurse researchers about the
Mary Ann Anderson; Elizabeth A. Madigan; Lelia B. Helms
A survey of role perceptions of nurses and social workers employed in homehealth carc in Washington State indicated potential turf conflict in a number of roles involved in home carc of elderly patients. Nurses tended to perceive themselves capable of all patient-directed tasks and perceived few professional tasks in homehealth care as the unique domain of social work.
The development of a comprehensive homehealth care program in Muskegon County, Michigan, is described. It is noted that, in the continuum of medical care, coordinated home care programs provide fleaxible and comprehensive patient-centered care for those ...
Rochester's Healthy Home was a hands-on home environmental health museum that educated over 3500 visitors between June 2006 and December 2009. The Healthy Home provided visitors with the tools, resources, and motivation to make their homes healthier by reducing environmental hazards. The Healthy Home focused on empowering low-income renters to protect their families from homehealth risks, but served a broad audience. Based on the Healthy Home's initial successes with diverse visitors, in 2009 the county health department provided funding for a six-month project to educate 200 recently arrived refugees. This report summarizes the project's innovative approach to homehealth education, presents evaluation data on impacts on refugees and other visitors, suggests implications for resettlement agencies, and provides guidelines for those interested in replicating this approach in their own community.
Secondary prevention programmes can be effective in reducing morbidity and mortality from coronary heart disease (CHD). In particular, UK guidelines, including those from the Department of Health, emphasize physical activity. However, the effects of secondary prevention programmes with an exercise component are moderate and uptake is highly variable. In order to explore patients' experiences of a pre-exercise screening and healthcoaching programme (involving one-to-one consultations to support exercise behaviour change), semi-structured telephone interviews were undertaken with 84 CHD patients recruited from primary care. The interviews focused on patients' experiences of the intervention including referral and any recommendations for improvement. A thematic analysis of transcribed interviews showed that the majority of patients were positive about referral. However, patients also identified a number of barriers to attending and completing the programme, including a belief they were sufficiently active already, the existence of other health problems, feeling unsupported in community-based exercise classes and competing demands. Our findings highlight important issues around the choice of an appropriate point of intervention for programmes of this kind as well as the importance of appropriate patient selection, suggesting that the effectiveness of healthcoaching may be under-reported as a result of including patients who are not yet ready to change their behaviours. PMID:22313621
Shaw, R; Gillies, M; Barber, J; MacIntyre, K; Harkins, C; Findlay, I N; McCloy, K; Gillie, A; Scoular, A; MacIntyre, P D
Introduction: Homehealth care is the fastest growing sector in the health care industry, with an anticipated growth of 66 percent over the next 10 years and with over 7 million patients served each year. With the increasing acuteness of care provided in homehealth care and the increasing number of frail elderly that make up this patient population, it
Robyn R. M. Gershon; Monika Pogorzelska; Kristine A. Qureshi; Patricia W. Stone; Allison N. Canton; Stephanie M. Samar; Leah J. Westra; Marc R. Damsky; Martin Sherman
The aging of the population in Japan is proceeding more rapidly than in other countries. Under this circumstances, an advent of homehealth care supporting system is desired strongly. This paper introduces a research project about a homehealth care system for elderly. The targets of this system are aged people who live alone with comparatively good health condition. In
|Defining the role of the homemaker/homehealth aide, the volume presents a comprehensive treatment of the principles and procedures for recruiting, training, and directing the activities of these essential health workers. In addition to providing an analysis of the contribution that the homemaker/homehealth aide can make to patient care, the…
Homehealth aides are at the front line of the homehealth industry, raising quality of care issues and human resource (HR) management challenges. Total quality management (TQM) provides a framework to help meet those challenges. The authors investigated the relationship between TQM and HR effectiveness in homehealth agencies. Results suggest that TQM practices are related to HR effectiveness. Suggestions are offered to make human resource management consistent with a TQM culture. PMID:8968324
The Centers for Medicare and Medicaid Services (CMS) certifies approximately 17,000 nursing homes per year. When a facility does not meet a standard, a deficiency citation is issued. Using 1998 citations, we examined the structure and process characteristics of nursing homes that were associated with mental health deficiencies. Our findings showed that (a) some nursing homes have a high number
Health monitoring at home could be an important element of care and support environment for older people. Diversity of diseases and different needs of users require universal design of a home platform. In this work the design of multimodal platform for communication, training and patient monitoring at home is presented and discussed. Two specific problems were investigated: visually guided human-computer
|This study investigates the discourse of elementary school reading coaches and teachers during coaching interactions in four Alabama schools. Coach/teacher dyads recorded naturally occurring coaching dialogue over periods of 3 to 6 weeks. Each participant shared her views on coaching and commented on the recorded discourse during post-interviews…
An aging population, financial and technical changes, and consumer preference will drive the increase in the types and volume of service clients receive at home. Financial and technical changes will influence the structure of home care services, but homehealth agencies will continue to partner with primary, acute, and long-term institutional care to provide a continuum of services. However, the health care system will need to allocate sufficient resources to homehealth if it is to serve an increasing number of more frail and unstable clients. Lacking such resources, home care may not able to contribute appropriately to the continuum of care, and the effectiveness of the overall health care system may be compromised. Challenges to homehealth agencies' successful operations include decreased resources, changing payment methods, staff shortages, and structural changes in health care systems that fragment care of decrease attention to homehealth. Homehealth care's traditional goals of serving clients and caregivers directly and educating them toward health and independence can continue if these problems are resolved. PMID:10162593
|Includes "Now More than Ever" (Fahy); "Healing at Home" (photo essay); "Amelia Greenwald: Pioneer in International Public Health Nursing" (Mayer); "Alaska's Watched Pot" (Nord); and "Gertrude Weld Peabody: Unsung Patron of Public Health Nursing Education" (Doona). (JOW)|
This study explored barriers to using homehealth aide services as perceived by family caregivers of relatives with dementia. The authors analyzed data collected from interviews of 32 family caregivers of relatives with dementia. The major findings included the recurrent theme of cost/expectation, which emerged as a major barrier to using homehealth aide services. Caregivers in many cases indicated that the price paid for services outweighed benefits; however they continued to use homehealth aide services. Implications for home healthcare nurses are discussed. PMID:8698595
The use of context-aware technology in the home enables new ways to stimulate elderly in increasing their exercise levels, and consequently prevent age-related health issues amongst an increasing elderly population. This paper describes the design of a persuasive virtual coach that encourages seniors to walk more. In order to incorporate the user values and needs in the design concept, a
Ifiaki Merino Albaina; Thomas Visser; M. H. Vastenburg
Utilization of acute health care services accounts for a substantial proportion of health expenditures in Canada, and is associated with compromised health and autonomy for older persons. Using the Resident Assessment Instrument for Home Care (RAI-HC), this cross-sectional study of 683 elderly home care recipients sought to distinguish clients who were more likely to use acute health care services; i.e.,
This article presents a summary and critique of the published empirical evidence between the years 2002 and 2011 regarding rehospitalization among Medicare-reimbursed, skilled homehealth recipients. The knowledge gained will be applied to a discussion regarding ACH among geriatric homehealth recipients and areas for future research. The referenced literature in MEDLINE, PubMed and Cochrane databases was searched using combinations
This study describes the homehealth experience of 295 Medicare elderly persons following hospitalization. While a subset of persons improve medically and functionally during the homehealth service period, some declined on one or both dimensions and many showed not change. The most heavily utilized, non-Medicare, services were personal care and homemaker\\/chore, reflecting the functional needs of some posthospital elderly.
Medicare spending on homehealth totaled $12.9 billion in 2006, up 44 percent from 2002. Concerns have been raised that improper payments from practices indicating fraud and abuse may have contributed to Medicare homehealth spending and utilization. The ...
|Responses from 132 of 350 homehealth nurses identified techniques and skills associate degree nurses (ADNs) should acquire to work for homehealth agencies. Accredited ADN programs reported that only 24 of the techniques are taught in all programs and 55 of the skills are taught in 90% of the programs. (SK)|
|This package contains materials intended for use in a new homehealth aide curriculum that is designed to be presented as a two-quarter program at Tacoma Community College in Tacoma, Washington. Included in the package are a final report outlining the objectives and outcomes of the project to develop a homehealth aide curriculum that would meet…
The need for homehealth care has been increasing in Japan and the application of various techniques such as medical informatics are desired to support homehealth care services. Therefore, we developed an information system for health evaluation of the elderly including patients at home by applying a multifunctional telephone set and an IC memory card, by which complaints, symptoms,
H. Inada; H. Horio; K. Nakazawa; Y. Sekita; T. Yamanaka; E. Harasawa; H. Hosaka; K. Ishikawa
Home e-health systems and services are revealed as one of the most important challenges to promote quality of life related to health in the information society. Leading companies have worked on e-health systems although the majority of them are addressed to hospital or primary care settings. The solution detailed in this paper offers a personal health system to be integrated
I. Pau; F. Seoane; K. Lindecrantz; M. A. Valero; J. Carracedo
Background The aim was to evaluate the effect of a 12-month individualized healthcoaching intervention by telephony on clinical outcomes. Methods An open-label cluster-randomized parallel groups trial. Pre- and post-intervention anthropometric and blood pressure measurements by trained nurses, laboratory measures from electronic medical records (EMR). A total of 2594 patients filling inclusion criteria (age 45?years or older, with type 2 diabetes, coronary artery disease or congestive heart failure, and unmet treatment goals) were identified from EMRs, and 1535 patients (59%) gave consent and were randomized into intervention or control arm. Final analysis included 1221 (80%) participants with data on primary end-points both at entry and at end. Primary outcomes were systolic and diastolic blood pressure, serum total and LDL cholesterol concentration, waist circumference for all patients, glycated hemoglobin (HbA1c) for diabetics and NYHA class in patients with congestive heart failure. The target effect was defined as a 10-percentage point increase in the proportion of patients reaching the treatment goal in the intervention arm. Results The proportion of patients with diastolic blood pressure initially above the target level decreasing to 85?mmHg or lower was 48% in the intervention arm and 37% in the control arm (difference 10.8%, 95% confidence interval 1.5–19.7%). No significant differences emerged between the arms in the other primary end-points. However, the target levels of systolic blood pressure and waist circumference were reached non-significantly more frequently in the intervention arm. Conclusions Individualized healthcoaching by telephony, as implemented in the trial was unable to achieve majority of the disease management clinical measures. To provide substantial benefits, interventions may need to be more intensive, target specific sub-groups, and/or to be fully integrated into local health care. Trial registration ClinicalTrials.gov Identifier: NCT00552903
The U.K. government has committed to an 80% reduction in carbon emissions by 2050, with housing accounting for 27% of total current emissions. There are several drivers both to reduce emissions from homes and to reduce fuel poverty, promoting a range of building and behavioural measures in homes. The health benefits of warmer homes in winter have been described, but there has been less consideration of the potential negative impacts of some of these measures. We examine the changes in U.K. homes, and the possible consequences for health. The main concerns for health surround the potential for poor indoor air quality if ventilation is insufficient and the possible risks of overheating in heatwave conditions. This paper notes a limited evidence base and the need for further research on the health effects of energy-efficient homes, particularly with regard to ventilation. PMID:21086820
...Certification Requirements for HomeHealth Agencies and...Correction of final rule...Certification Requirements for HomeHealth Agencies and Hospices'' final rule (75 FR 70372...Certification Requirements for HomeHealth Agencies and...Page 81139
...text in the final rule that appeared in the...Medicare Program; HomeHealth Prospective...Certification Requirements for HomeHealth Agencies and Hospices'' final rule (75 FR 70372...Certification Requirements for HomeHealth Agencies and Hospices'' final rule. Accordingly,...
Nominal research has examined sexual harassment and workplace violence against home care workers within consumer-driven home care models such as those offered in Oregon. This study examined home care workers' experiences of violence while providing care to consumer employers, the patients who hire and manage home care workers. Focus groups and interviews were conducted in Oregon with 83 home care workers, 99 Oregon Department of Human Services (DHS) employees, and 11 consumer employers. Home care workers reported incidents of workplace physical violence (44%), psychological abuse (65%), sexual harassment (41%), and sexual violence (14%). Further, three themes were identified that may increase the risk of workplace violence: (1) real and perceived barriers to reporting violence; (2) tolerance of violence; and (3) limited training to prevent violence. To ensure worker safety while maintaining quality care, safety policies and training for consumer employers, state DHS employees, and home care workers must be developed. [Workplace Health Saf 2013;61(10):441-450.]. PMID:24053217
Background: Long-term care providers across the United States are building innovative environments called "Green House" or small-house nursing homes that weave humanistic person-centered philosophies into clinical care, organizational policies, and built environments. Purpose: To compare and contrast trajectories of at-homeness and health over…
As in many health sectors, in home care there have been significant investments made in electronic health information systems (EHIS) and accompanying standardized assessment instruments. While the potential of these systems to enhance the quality of care has been recognized, it has yet to be fully realized in Canadian home care settings. Data on EHIS barriers and facilitators were collected using a survey (n = 22).The results were discussed at a workshop (n = 30) and a "world café" session was held to consider strategies and interventions for improving health information exchange, with a focus on home care rehabilitation. PMID:23789525
Santi, Selena M; Hinton, Stephanie; Berg, Katherine; Stolee, Paul
The ageing of the population, the growth of chronic diseases, and the explosion of healthcare costs jeopardise the sustainability of healthcare systems in many European countries. This opens opportunities for innovative prevention and healthcare services supported by information and communication technologies (ICT). The natural focus for providing such services is the home. However, the e-health services provided in the home so far are limited in scope and fragmented. This paper suggests a comprehensive service model for home-based e-health services in Europe, which aims to overcome the current service fragmentation. The Health@Home model integrates disease prevention and healthcare for different groups of citizens at different stages on the health scale. The technical challenge of this model is the national and Europe-wide integration of heterogeneous systems and services in a way that makes them reliable and easy to use for all citizens, particularly those with low technical abilities and severe impairments.
Executive coaching has become a popular leadership development tool over the past decade. To be effective, coaches need to reflect on the lessons from counselling research from the past four decades and on the emerging coaching research to develop coaching models that are evidenced based.
|The policies and procedures stated in this handbook are to be used as a guide in the performance of duties and responsibilities by the Director of Athletics and athletic coaches at Imperial Valley College (California). This handbook supplements the Faculty Handbook, the district policy manual, the California Junior College Association Athletic…
This manual focuses on the coach's relationships and interactions with students, school personnel, civic groups, and community agencies. The first chapter examines how athletics, as an integral part of education, can make a significant contribution (a) to the development of the individual, (b) in meeting society's needs, and (c) in transmitting…
National Council of Secondary School Athletic Directors, Washington, DC.
Medical Home practice has been shown to deliver effective health care to children. This practice model calls for providing patient-centered care that is compassionate, culturally effective, coordinated, integrated, safe, of high quality, and accessible. This study shows that children in the states with a higher amount of Medical Home received childhood vaccinations at a higher rate than others. However, Medical
A look at a wellness-focused approach to aging, this article presents homehealth care from a new perspective. Client-centered physician partnering in caring for the aging at home is featured in this article on meeting the independence needs of the elderly.
A previous study used aggregate (region-level) data to investigate whether homehealth care serves as a substitute for inpatient hospital care, and concluded that “there is no evidence that services provided at home replace hospital services.” However, that study was based on a cross-section of regions observed at a single point of time, and did not control for unobserved regional
A previous study used aggregate (region-level) data to investigate whether homehealth care serves as a substitute for inpatient hospital care and concluded that “there is no evidence that services provided at home replace hospital services.” However, that study was based on a cross-section of regions observed at a single point of time and did not control for unobserved regional
... aides because family members or friends were also homehealth aides. + Aides aged 25–34 were more likely than those under age 25 to become aides because they provided care to a friend or relative (81.0% compared ...
\\u000a \\u000a Michelle entered the evening Free Clinic in the church basement to see someone about her earache. For the past 3 days, the\\u000a pain in her ear had gotten worse, especially after working all day. Without any health insurance, the emergency room was too\\u000a expensive and getting an appointment at a doctor’s office in the evening was impossible. The volunteer nurse
|Instructional coaching guru Jim Knight suggests that how we think about coaching can enhance or interfere with our success as a coach. He suggests that coaches take a partnership approach to collaboration and adopt seven principles that define how coaches interact with collaborating teachers: equality, choice, voice, reflection, dialogue, praxis,…
This article may be used as an immediate, functional resource. It is a summary of issues including information on over-the-counter drugs, interactions and adverse reactions, and guidelines for medication management in home care.
This study reports on the design and testing of an integrated suite of vocabulary training games for Nintendo[TM] collectively designated "My Word Coach" (Ubisoft, 2008). The games' design is based on a wide range of learning research, from classic studies on recycling patterns to frequency studies of modern corpora. Its general usage and learning…
|This study reports on the design and testing of an integrated suite of vocabulary training games for Nintendo[TM] collectively designated "My Word Coach" (Ubisoft, 2008). The games' design is based on a wide range of learning research, from classic studies on recycling patterns to frequency studies of modern corpora. Its general usage and…
...Payment for homehealth services, for medical and other health services furnished...SERVICES MEDICARE PROGRAM SUPPLEMENTARY MEDICAL INSURANCE (SMI) BENEFITS Payment of...Payment for homehealth services, for medical and other health services...
The emerging clinical community health worker model integrates community health workers as integral members of primary care teams inside a medical home. This evaluation documents the case management services provided by 2 clinical community health worker programs at La Clínica del Cariño in Hood River, Oregon, and how they affected the care team's ability to deliver efficient, effective primary care. Clinical community health workers have the potential to make a significant impact on clinical efficiency and effectiveness as ambulatory primary care clinics strive to transform into high-quality, patient-centered medical homes and become linchpins in accountable care organizations. PMID:21673521
Over the last decade, cost-containment pressures, health care reform debates, movement to case-managed health care, and reductions\\u000a in health care benefits have required most families to be responsible for selecting specific health care services that keep\\u000a costs to a minimum. As Eddy [17-20] discussed in a series of articles on making decisions in health care, the consensus among\\u000a health care
Carol E. Smith; Susan V. M. Kleinbeck; Karen Fernengel; Linda S. Mayer
Despite high rates of mental illness, very few homebound older adults receive treatment. Comorbid mental illness exacerbates physical health conditions, reduces treatment adherence, and increases dependency and medical costs. Although effective treatments exist, many homehealth agencies lack capacity to effectively detect and treat mental illness. This article critically analyzes barriers within the Medicare homehealth benefit that impede access
This paper describes a unique homehealth aide program developed by the Visiting Nurse Association of Cleveland. The intent of the program was to promote retention of homehealth aides, increase homehealth aide self?esteem, improve the quality of care to patients, and increase support to caregivers. The history of service provided by the homehealth aides program and the
Francine P. Hekelman; Mary E. Segall; May L. Wykle
Sound in smart home are usually encountered for friendly man- machine interfaces, but sound information extraction is a complex task because of environmental noise and of multichannel processing need. A multichannel sound processing system capable to detect and identify sound events in noisy conditions is presented in this paper. The multichannel sound processing allows us to localize the sound in
Dan ISTRATE; Michel VACHER; Eric CASTELLI; Cong-Phuong NGUYEN
Among homehealth patients, depression is a debilitating and treatable psychiatric condition that often remains undiagnosed and reduces quality of life, social interactions, daily functioning, and treatment adherence. Untreated major depression increases functional decline; costly medical, emergency, and mental health visits; and reliance on disability or welfare. In the worst case, many patients decide that life is not worth living
|Material developed for a national conference of leaders in the applied and theoretical sectors of gerontology, mental health, and nursing home administration is provided in these proceedings. The purposes of the conference were to: develop priorities for populations for whom training would be offered; identify mental health content that is…
National Inst. of Mental Health (DHEW), Rockville, MD.
Purpose: It is widely believed that physical restraint use causes mental and physical health decline in nursing home residents. Yet few studies exist showing an association between restraint initiation and health decline. In this research, we examined whether physical restraint initiation is associated with subsequent lower physical or mental…
Engberg, John; Castle, Nicholas G.; McCaffrey, Daniel
The use of health and social services is influenced by economic, community, geographic, organizational, societal, and environmental factors. A study was conducted to examine predisposing, enabling, and need-for-care factors related to the use of homehealth care services by a stratified random sample of 400 older adults. Predisposing factors…
The primary purposes of this descriptive and prospective pilot study was to test the feasibility of a nursing and dental hygiene team to measure specific oral health indices in a sample of older adults residing in nursing homes (NHs). The secondary purpose was to determine the relationship between plaque and dentate status. Oral health indicators, functional status scores, and behavioral
Rita A. Jablonski; Tammy Swecker; Cindy Munro; Mary Jo Grap; Mary Ligon
|Purpose: It is widely believed that physical restraint use causes mental and physical health decline in nursing home residents. Yet few studies exist showing an association between restraint initiation and health decline. In this research, we examined whether physical restraint initiation is associated with subsequent lower physical or mental…
Engberg, John; Castle, Nicholas G.; McCaffrey, Daniel
Cross-sectional analyses of all 4,235 ADL/IADL impaired respondents, age 60+, in the 1984 National Health Interview Survey on Aging (SOA) revealed that certain ADL/IADL limitations were most strongly associated with HomeHealth Care (HHC) use. Those with ...
The objective of this article is to provide an overview of the general factors that have contributed to the growth in the homehealth care segment of the US health care industry. These factors are related to the demographic imperative, technology, and government regulations. The demands of the aging population for intermittent care have a significant impact on the demographic
George Munchus; Velma Roberts; Patrick Asubonteng Rivers; Barbara Stover Gingerich
Career development for full-time Health Sciences academics through to doctoral studies is a monumental task. Many academics have difficulty completing their studies in the minimum time as well as publishing after obtaining their degree. As this problem is particularly acute in the Health Sciences, the PhD Acceleration Programme in Health Sciences…
\\u000a Home telecare systems are improving the current level of quality in healthcare services. This paper describes an eHealth system\\u000a designed to support people living in their homes. The approach introduces a flexible system architecture that is running on\\u000a a common residential gateway. The architecture provides basic services and openness to integrate dedicated telecare services.\\u000a Special attention is paid to the
Jaime Martín; Mario Ibáñez; Natividad Martínez Madrid; Ralf Seepold
St. Lukes Episcopal Church Home Care Program is a private nonprofit organization that operates 14 facilities across Puerto Rico, including a facility in Juana Diaz, Puerto Rico that provides homehealth services throughout Juana Diaz and surrounding munic...
We explored health literacy in parents as an underlying construct that develops through social interaction and reflection and involves an array of skills that enable a parent to manage personal and child health and healthcare. We hypothesized that depression impairs health literacy and impedes efforts to promote health literacy through home visitation. We analyzed an AHRQ/NIH database of 2,572 parent/child dyads compiled in a 2006-2008 quasi-experimental six-site nationwide study using multiple waves of measurement and a matched comparison group. Cohort families participated in home visitation programs augmented to develop parents' reflective skills. Visitors monitored depression, health- and healthcare-related practices, and surrounding family conditions at baseline and 6-month intervals for up to 36 months using the Life Skills Progression instrument. We examined differences in initial depression ratings for demographic subgroups and explored patterns of change in health literacy among depressed versus not-depressed parents. Correlation analysis showed that at each of four assessments better depression scores were consistently and positively correlated with use of information and services (r = 21-22, P < .001) and with self-management of personal and child health (r = 42-49, P < .001). Overall, parents made significant improvements in health literacy (P < .001). As expected, depressed parents demonstrated lower baseline health literacy scores than not-depressed parents; however, they achieved greater gains (P < .001). While depression is linked with lower parental health literacy, after 1 year of enhanced home visitation, vulnerable parents were better able to manage personal and family health and healthcare, especially if depressed. Enhanced home visitation could be an effective channel to develop health literacy as a life skill, and to improve depression. PMID:22120425
A study examined coaches' behavior and classified the types and rates of coaches' behavior by time of athletic season (early or late), win/loss record, and throughout the time frame within a single contest. Subjects included all the volunteer coaches in a 13 team, softball program for 10-12 year old girls. The season consisted of a double…
As attention is increasingly devoted to U.S. society's needs for access to health care and health care delivery, one change that requires immediate attention concerns the many aspects of care that are migrating out of formal medical facilities and into th...
|Despite limited scientific study on ADHD coaching as an intervention for adults with ADHD, the field of ADHD coaching has grown significantly and gained popularity in recent years. ADHD coaching is becoming a bona fide profession where one must advance through a rigorous training process, in order to be certified as a professional ADHD coach.…
Murphy, Kevin; Ratey, Nancy; Maynard, Sandy; Sussman, Susan; Wright, Sarah D.
Of all the things sales managers do to develop salespeople, many people believe the most important one is coaching. Coaching is defined as using skills, experience, and direction to help someone improve their performance. Coaching consists primarily of giving people feedback to reinforce what they do well while suggesting ways and means to improve. Coaching implies that everybody can improve
Purpose – This paper aims to show how polarity coaching can foster meaningful change among executive clients through sponsoring a deeper understanding and acceptance of interdependent opposites. Design\\/methodology\\/approach – The study explores what is required from the coach and the coaching relationship and how clients can be supported in overcoming polarity traps. A social constructionist and sense-making approach to coaching
The Omnibus Budget Reconciliation Act of 1993, together with cost-limit reductions and wage-index changes published in the Federal Register, have resulted in a substantial reduction in Medicare cost limits, particularly as they apply to hospital-based homehealth agencies. This article examines specific changes in homehealth agency cost limits, reviews strategies to identify the bottom-line impact of the Medicare cost-limit reductions, and discusses methods that may be applied to minimize the negative impact of the reduced cost limits. PMID:10146080
A series of focus groups with homehealth aides experienced in caring for patients with stroke or brain injury provided insight into how they experience their work and their relationship to family caregivers. Two issues merit more attention. First, aides reported that they do not always have all of the information, including diagnosis or previous history, which they need to
Alene Hokenstad; Andrea Y. Hart; David A. Gould; Deborah Halper; Carol Levine
|Lower costs, new technology, and expanded Medicare benefits are some of the reasons for the rapid increase in employment in homehealth services. Employment in the drugs manufacturing industry has increased despite recessions and structural changes in the economy. (Author/JOW)|
Background Patients with diabetes are at increased risk for depression, compounding the burden of disease. When comorbid with diabetes, depression leads to poorer health outcomes and often complicates diabetes self-management. Unfortunately, treatment options for these complex patients are limited and comprehensive services are rarely available for patients in rural settings. Methods A small open trial was conducted to test the acceptability, feasibility and preliminary outcomes of a telephone-delivered coaching intervention for rural-dwelling older adults with uncontrolled diabetes and comorbid, clinically significant depressive symptoms. A total of eight older adults were enrolled in Healthy Outcomes through Patient Empowerment (HOPE), a 10-session (12-week), telephone-based coaching intervention. Primary study constructs included measures of diabetes control (Hemoglobin [Hb] A1c), depressive symptoms (Patient Health Questionnaire-9 [PHQ-9]), and diabetes-related distress (Problem Areas in Diabetes Scale [PAID]). Assessments were conducted at baseline, post-intervention, and 6-month follow-up. Acceptability and feasibility were evaluated using patient surveys, focused exit interviews, and session attendance data. Results Clinically significant improvements were realized post-intervention and at 6-month follow-up for outcomes related to diabetes and depression. Effect sizes using Cohen's d were determined post-intervention and at 6-month follow-up, respectively, for HbA1c (d=0.36; d=0.28), PHQ-9 (d=1.48; d=1.67, and PAID (d=1.50; d=1.06) scores. Among study participants, HbA1c improved from baseline by a mean (M) of 1.13 (SD=1.70) post-intervention and M=0.84 (SD=1.62) at 6?months. Depression scores, measured by the PHQ-9, improved from baseline by M=5.14 (SD=2.27) post-intervention and M=7.03 (SD=4.43) at 6-month follow-up. PAID scores also improved by M=17.68 (SD=10.7) post-intervention and M=20.42 (SD=20.66) from baseline to 6-month follow-up. Case examples are provided for additional context and to more fully articulate salient intervention concepts. Conclusion Although preliminary, data from this small open trial suggest that HOPE holds the potential to improve both physical (diabetes) and emotional (diabetes distress, depression) health outcomes and that changes can be maintained over a 6-month time period. As envisioned by the authors, HOPE may function as an extension of traditional primary care for rural-dwelling older adults with multiple comorbidities. A future randomized clinical trial will test HOPE’s broader effectiveness with rural-dwelling older adults. Trial registration NCT01274715
An effective retention plan will be a critical component of a homehealth care agency's leap into the year 2000. Assessing current turnover and retention rates for your agency, surveying exiting and current staff, identifying the internal factors that lead to turnover, addressing these factors, and measuring the effects of your action plan at regular intervals are all key components
A health promotion program called Easy Does It Yoga for Older People has been implemented and evaluated at senior centers, congregate living facilities, and other community sites. This program was implemented and evaluated, for the first time, at nursing homes. An analysis of variance did not support the three research hypotheses: treatment group members will improve their ability for self-care,
This paper presents a non-intrusive load monitoring system for determining the operation schedule of multiple electrical devices, operated simultaneously, in a health smart home. Profiling the usage of electrical devices can be used as a method for determining an occupant's activities of daily living, which can support independent living of older adults. The proposed non-intrusive load monitoring system determines the
We collected data from 548 rural homehealth care workers in Southern Illinois in 1990 to replicate a study conducted in 1988 designed to identify and assess the attitudes of those workers toward the elderly and their elderly clients. Subjects were asked to respond to a fifteen item, self-report questionnaire. Reliability of the scale was estimated at .79, using Cronbach's
Discharges to homehealth services (HHS) increased dramatically for the elderly after Medicare's prospective payment system (PPS) was enacted in October 1983. A longitudinal study of fourth quarter South Carolina discharge abstracts from 68 of 71 short term acute care hospitals in the state were analyzed to appraise hospital responses to implementation of this significant change in Medicare's reimbursement system.
E. Greer Gay; Jennie J. Kronenfeld; Samuel L. Baker
We propose a constitution technique of small-scale HomeHealth Care system for family doctor that has been developed by applying various API of JAVA. One function is vital data transmission which allows a family doctor to check the data of elderly persons with ease via Internet. Vital data is encrypted and transmitted for the purpose of security. The other function
The summary describes the key elements of a project which was developed to assist physician assistant (PA) educators to develop and implement training experiences in homehealth care appropriate to the PA's clinical role. The project was carried out as a ...
The homehealth care industry has recently undergone tremendous change. How providers of care are adapting to the changes in their environment and the effect this has on nurses’ job satisfaction has not been explored. Nurses’ job satisfaction provides an indicator of a change in the system’s ability to deliver quality patient care and to attract and retain staff. The
Purpose: To examine osteoporosis prevention and treatment among homehealth care (HHC) patients at risk of fragility fracture in a large, Midwestern integrated HHC system. Methods: All patients who received HHC services in 2006 were identified. International Classification of Diseases, Ninth Revision (ICD-9) diagnosis codes and pharmaceutical data were examined between January 1, 2004 and December 31, 2005 to determine
Julie A. Switzer; Sharon J. Rolnick; Jody M. Jackson; Nicole K. Schneider; Jeanne E. Dutkowski; Denise R. Edgett
|The great majority of children receiving intervention from child welfare and protection services (CWS) in Norway live at home. The purpose of this study was to assess mental health problems among these children. Data stem from a population-based study, the Bergen child study, conducted in 2006. Of a sample consisting of 4,162 children in the…
Social work is one of the least understood services in homehealth care. Frequently, social work ers are limited to the provision of concrete services, such as linkage with community resources or long-term planning. Social workers are capable of providing a wide range of services beyond community resources, including short-term therapy and crisis intervention. Clear understand ing and interpretation of
The purpose of this study was to determine the feasibility of a health maintenance team (HMT) providing care for patients over 59 who had a chronic or disabling condition and for whom it was medically feasible to be maintained at home with periodic nursin...
Examines the policies and procedures that homehealth care agencies have developed to handle incapacitated patients and life-sustaining treatment decisions. Although most directors, staff, and patients agree that patients know their legal rights, only 67% of agencies reported having existing policies on advance directives, and only 41.5% had…
The authors of this article present a grass-roots approach to the instruction of homehealth care aides in caring for PWAs. Much of the information presented could be applied to other care providers as well. The goal of the educational process, which advocates facilitating the learning process rather than lecturing, is to better prepare the aides to care for their
A homehealth care agency's infection control program is at the heart of every aspect of its operations, from the human resources\\/application process to the actual provision of patient care, including the working environment for all of the employees of the agency. Each employee has a part in making the program successful.
The implementation of the Prospective Payment System (PPS) in Medicare homehealth care has raised concern about health outcomes of elderly patients since its intention is to curb spending. This study examines the unmet needs of older diabetic patients while receiving homehealth care and post-discharge from homehealth care (N = 129) in order to explore any effects of
The purpose of this study was to discover more about high school coaches' knowledge of disordered eating behavior in female athletes. In a sample of 98 coaches from Minnesota, it was found that the majority of coaches were not familiar with the Female Athlete Triad, a phenomenon describing three interrelated health problems: disordered eating, amenorrhea, and osteoporosis. However, coaches provided
This study aimed at describing and analyzing family carers' experiences in taking care of chronic patients at home. It is a qualitative research, developed in Service of HomeHealth Care of Santa Maria's University Hospital (SIDHUSM), Rio Grande do Sul, Brazil, to which 15 family carers contributed. In order to produce data, one made use of Creative-Sensitive Method as well as the dynamics of creativity and sensitivity: Life Line, Body-Knowledge and Almanac. Data were analyzed according to the conceptual premises of discourse analysis. Thus, there were developed the following themes: the care as an inherent experience to human beings; the experience of taking care in a disease situation; the learning with the experience of being a carer. The results pointed to the necessity of valuing the care activities developed by home carers at patients' home, and they also highlighted the home care as a modality of humanizing and innovating attention which aims to invert health professionals' logic of action. PMID:20027951
There are many perspectives to agile coaching including: growing coaching expertise, selecting the appropriate coach for your context; and eva luating value. A coach is often an itinerant who may observe, mentor, negotiate, influence, lead, and/or architect everything from team organization to system architecture. With roots in diverse fields ranging from technology to sociology coaches have differing motivations and experience bases. This panel will bring together coaches to debate and discuss various perspectives on agile coaching. Some of the questions to be addressed will include: What are the skills required for effective coaching? What should be the expectations for teams or individu als being coached? Should coaches be: a corporate resource (internal team of consultants working with multiple internal teams); an integral part of a specific team; or external contractors? How should coaches exercise influence and au thority? How should management assess the value of a coaching engagement? Do you have what it takes to be a coach? - This panel will bring together sea soned agile coaches to offer their experience and advice on how to be the best you can be!
The hospital home care social worker has a unique opportunity to develop a home-keeping, health-promoting group for frail elderly couples within his or her caseload. Through home visits, working as a filial professional, the worker enters, then strengthens the couples' pre-illness formal and informal support networks, and then goes on to create an additional informal peer support group, that meets
|A recent survey of coaches ranks team cohesion as the most critical problem coaches face. Optimal interpersonal relationships among athletes and their coaches can maximize collective performance. Team dynamics are discussed and coaching tips are provided. (MT)|
BACKGROUND: The PEACH study is based on an innovative 'telephone coaching' program that has been used effectively in a post cardiac event trial. This intervention will be tested in a General Practice setting in a pragmatic trial using existing Practice Nurses (PN) as coaches for people with type 2 diabetes (T2D). Actual clinical care often fails to achieve standards, that
Doris Young; John Furler; Margarite Vale; Christine Walker; Leonie Segal; Patricia Dunning; James Best; Irene Blackberry; Ralph Audehm; Nabil Sulaiman; James Dunbar; Patty Chondros
Running is an enjoyable exercise for many people today. Trainers help people to reach running goals. However, today’s busy and nomadic people are not always able to attend running classes. A combination of a virtual and physical coach should be useful. A virtual coach (MyCoach) was designed to provide this support. MyCoach consists of a mobile phone (real time) and a web application, with a focus on improving health and well-being. A randomised controlled trial was performed to evaluate MyCoach. The results indicate that the runners value the tangible aspects on monitoring and capturing their exercise and analysing progress. The system could be improved by incorporating running schedules provided by the physical trainer and by improving its usability. Extensions of the system should focus on the real-time aspects of information sharing and “physical” coaching at a distance.
From Harvard@Home, this website presents more than seven hours of video clips from the Radcliffe Institute for Advanced Study's third-annual conference on women, gender, and society held in October of 2004. Titled _Reproductive Health in the 21st Century_, the "conference examines a broad array of issues surrounding reproductive health and features panels of distinguished physicians, scholars, and health policy advocates discussing the scientific, ethical, and social dimensions of medical and technological advances in the field and their global implications." Conference topics include The Politics and Ethics of Bodily Integrity; In Vitro Fertilization in the Muslim Middle East; Women Workers as Reproducers; and The Moral Issue of Sex Selection, to name a few. In addition to the video clips, the website contains topic summaries, short biographies of the numerous panelists, a feedback survey form, and links to related Harvard@Home programs. This site is also reviewed in the February 4, 2005_NSDL Life Sciences Report_.
Nursing educators are challenged to prepare practitioners to move out of acute care and perform competently in nontraditional settings. Faculty from a university college of nursing and registered nurse preceptors from 13 homehealth agencies formed an alliance to serve as co-educators for junior-level baccalaureate nursing students in a 35-hour, two-semester homehealth clinical rotation. The outcomes of this alliance were evaluated with a qualitative descriptive study that evaluated the effectiveness of the model. Content analysis of students' journal reflections revealed that the collaborative alliance in homehealth enabled students to integrate practice with theory and to view the new practice environment as a meaningful learning experience. Nurse preceptors serving as co-educators in the home setting were viewed as valuable role models who provided opportunities for active participation of students. In addition, this collaborative alliance enhanced students' assimilation of the principles of nontraditional practice and facilitated the personal and professional growth they needed to prepare them for nursing practice in the future. PMID:10401400
Gonzalez, L O; Webb, M S; Lowry, L W; Lengacher, C A
...respiration. (iv) Basic infection control procedures. (v) Basic...must be in the provision of homehealth care. Other individuals may be...must be in the provision of homehealth care. (iii) Subject...
...respiration. (iv) Basic infection control procedures. (v) Basic...must be in the provision of homehealth care. Other individuals may be...must be in the provision of homehealth care. (iii) Subject...
...Services of residents in skilled nursing facilities and homehealth agencies...Services of residents in skilled nursing facilities and homehealth agencies...requirements: (1) Skilled nursing facility. Payment to a...
...Services of residents in skilled nursing facilities and homehealth agencies...Services of residents in skilled nursing facilities and homehealth agencies...requirements: (1) Skilled nursing facility. Payment to a...
Number 38 n April 27, 2011 HomeHealth Care and Discharged Hospice Care Patients: United States, 2000 and 2007 by Christine ... on how unknowns were handled. Results Homehealth care patients Characteristics + Each day in 2007, there were ...
Background The challenge of an aging population in the society makes it important to find strategies to promote health for all. The aim of this study is to evaluate if repeated healthcoaching in terms of motivational interviewing, and an offer of wide range of activities, will contribute to positive lifestyle modifications and health among persons aged 60–75 years, with moderately elevated risk for cardiovascular disease (CVD), diabetes, or mild depression. Methods/Design Men and women between 60 and 75 are recruited in four regions in Sweden if they fulfill one or more of the four inclusion criteria. •Current reading of blood pressure (140-159/90-99) without medication. •Current reading of blood sugar (Hba1c 42–52 mmol/mol) without medication. •A current waist-circumference of ?94 cm for men and ?80 for women. •A minor/mild depression (12–20 points) according to Montgomery-Åsberg Depression Rating Scale without medication. Individuals with a worse result than inclusion criteria are treated according to regular guidelines at the PHCs and therefore not included. Exclusion criteria for the study are dementia, mental illness or other condition deemed unsuitable for participation. All participants fill out a questionnaire at baseline, and at the 6-, 12- and 18-month follow-ups containing questions on demographic characteristics, social life, HRQoL, lifestyle habits, general health/medication, self-rated mental health, and sense of coherence. At the 12-month follow-up, the healthcoach will give each participant a second questionnaire to capture attitudes and perceptions related to healthcoaching and venues/activities offered. Qualitative data will be collected twice to obtain a deeper understanding of perceptions and attitudes related to health and lifestyle/lifestyle modifications. A health economic assessment will be performed. Individual costs for health care utilisation will be collected and QALY-scores will be estimated. Discussion Several drawbacks can be identified when conducting research in real life. However, many of the identified problems can diminish the positive results of the intervention and if the intervention shows positive effects they might be underestimated. Trial registration Current Controlled Trials ISRCTN01396033.
While executive coaching continues to mushroom as a practice area, there has been little outcome research. This articles presents the results of a study that explored factors influencing the choice of a coach, executives' reactions to working with a coach, the pros and cons of both internal and external coaches, the focus of executive coaching engagements, indications of successful coaching
Training health care professionals to work together in managing the problems of elderly patients is an area where the homehealth care industry can make a crucialand substantial contribution. Since 1996, Rush Home Care Network, an affiliate agency of Rush-Presbyterian-St. Luke’s Medical Center in Chicago, has served as a clinical training site for an interdisciplinary education program. This program, the
Kathryn Christiansen; Steven K. Rothschild; Lois Halstead
This study explores the differences in patient characteristics, homehealth service use, and discharge outcomes between Asian\\/Pacific Islanders (API) (n = 408) and White elderly homehealth care patients (n = 2,480) with a primary diagnosis of diabetes, hypertension or cardiovascular disease. Outcomes Assessment Information Set and administrative data from a large urban homehealth agency located in the Northeast
Prior to independence in 1991, no formal homehealth care system existed in Lithuania. However, various services were provided in homes, including off-hours urgent care; social and health care services for the disabled and elderly through a voluntary organization; and the provision of medications and treatments by polyclinic nursing staffs. After independence, a number of additional homehealth care services
Using 1994 National Long Term Care Survey data, we estimated logistic regressions of formal and informal homehealth care use and hours. Homehealth care use and intensity were differentially impacted by chronic conditions, are higher for Medicaid enrollees and rural or small town residents, but lower for HMO enrollees. Decreases in the probability of homehealth care use increased
Homehealth care is long-term care, primarily skilled nursing, delivered in a home setting. Its provision may increase the likelihood that the elderly, the vast majority of which are homeowners, can live independently and maintain their desired residential status even if in relatively poor health. We provide empirical evidence on the extent to which homehealth care benefits affect the
This study examines the issue of economies of scale for homehealth agencies. A quadratic cost function is estimated utilizing a 1982 national data set based on Medicare Cost Reports for 2000 homehealth agencies. This paper concludes that neither economies of scale nor scope are substantial in the provision of homehealth services. PMID:10312164
|Excerpts from journal of superintendent of Kenai Peninsula Borough School District in Alaska and reflections on her executive coach, a friend and former superintendent. Describes executive coach's efforts to help superintendent build an effective leadership team. (PKP)|
We propose a constitution technique of small-scale HomeHealth Care system for family doctor that has been developed by applying various API of JAVA. One function is vital data transmission which allows a family doctor to check the data of elderly persons with ease via Internet. Vital data is encrypted and transmitted for the purpose of security. The other function is telecommunication with voice and face image for care consulting.
Objective. Centrally installed ultraviolet (UV) irradiation units were investigated to determine the potential health benefits in mold-sensitized asthmatic children. Methods. Nineteen mold-sensitized asthmatic children 5 to 17 years of age with home central ventilation systems were enrolled in a 28-week double-blinded placebo controlled cross-over trial. Clinical outcome measurements included morning and evening peak expiratory flow rates (PEFR), PEFR variability, change
Jonathan A. Bernstein; R. Carter Bobbitt; Linda Levin; Roger Floyd; Michael S. Crandall; Robert A. Shalwitz; Anand Seth; Mark Glazman
The homehealth nursing movement is expanding rapidly. Homehealth nursing agencies (HHNAs) are expected to demonstrate that the care provided does make a difference for the client receiving the services. The purpose of this study was to explore client outcomes from homehealth nursing. Outcome indicators include: Services utilized (emergency services, re-hospitalization), physiological status (catheter indwelling status, consciousness level, wound severity-number and wound stages) and functional status (reflected by Barthel Index). A prospective research design was used to collect the results. Five hospital-based HHNAs were invited to participate in this research. Clients newly admitted to HHNAs and diagnosed as non-cancer patients were recruited, and the researchers gathered outcome indicators over a six-month period. Data were analyzed using SPSS 8.0 computer software. There were 75 clients in this study. Results showed that most of the clients (64.0%) received service for more than 180 days. The client characteristics were dominated by elderly (66.6% age above 70), female (53.3%) and married (74.7%). The three leading care needs were NG tubing service (84.0%), Foley tubing service (45.3%) and wound care (38.7%). The Kruscal Wallis Test revealed that there was no difference in emergency service frequency and re-hospitalization between clients who received service for more than 180 days and those who received service for less than 180 days. The Wilcoxon Sign rank test showed that within one half-year, catheter indwelling status, functional status, and wound severity were not significantly different, with the exception only of conscious level (p = .001). The results of this study can be viewed as preliminary data to assist in shaping homehealth nursing services in Taiwan. PMID:11789134
We present an automated coaching system for elderly population living in assisted homes. The system guides its users through a sequence of exercises and tests. Each exercise is demonstrated by a pre-recorded video of a coach, checked for correct execution and qualitatively evaluated. Automatic coaching advices are generated in order to improve the execution. Performance measurements are shown as an immediate feedback to the user, and stored and evaluated over time. The system is designed to allow for a remote interaction with a coach, and, to bolster social aspect of the exercise, for concurrent exercise of two (or eventually multiple) remote users. PMID:23400176
|Coaching has become ubiquitous in organizations. Despite its growth in popularity, the concept remains largely untested through empirical inquiry. This study examined the skills and behaviors associated with managerial coaching. Results indicate a link between specific managerial skills, behaviors, and coaching. (Contains 4 tables.)|
Coaching has become ubiquitous in organizations. Despite its growth in popularity, the concept remains largely untested through empirical inquiry. This study examined the skills and behaviors associated with managerial coaching. Results indicate a link between specific managerial skills, behaviors, and coaching. (Contains 4 tables.)
Institutionalised elderly often report oral and dental problems which reduce nutrition ability and compromise significantly quality of life. The main objective of this study was to assess the prevalence of oral diseases in a group of residential homes elderly and to evaluate the association between degree of edentulism and some individual characteristics. From November 2004 to April 2005 448 subjects living in 10 residential homes of the city of Rome were enrolled in a special dental health programme in Lazio (Central Italy). The median age was 83.2 yrs, 47.3% of the subjects were edentulous, while 24.8% had 1 to 9 teeth, 63.1% of whom didn't have denture. 57.1% of subjects reported one or more oral disorders. Multivariate analysis showed a significant association between edentulism and the following factors: age > or = 75 yrs (Odds Ratio [OR] = 3.16 CI 95% 2.11-4.74) permanence of stay in the residential home > or = 3 yrs (OR = 1.96 CI 95% 1.13-3.40), lack of routine dental visits (OR = 1.71 CI 95% 1.14-2.58). The study findings confirmed that institutionalised elderly subjects, together with several chronic diseases, also show a poor oral health. Consequently greater attention should be paid to improve actively oral health services in this care setting. PMID:18210776
|Purpose: The Veterans Affairs or VA health care system is in the process of significantly expanding homehealth care (HOC) nationwide. We describe VA HHC use in 2003 for all VA HHC users from 2002; we examine whether VA utilization across a broad spectrum of services differed for a sample of VA HHC users and their propensity-score-matched…
Van Houtven, Courtney Harold; Jeffreys, Amy S.; Coffman, Cynthia J.
|This document contains a task analysis for health occupations (homehealth aid) in the nursing cluster. For each task listed, occupation, duty area, performance standard, steps, knowledge, attitudes, safety, equipment/supplies, source of analysis, and Illinois state goals for learning are listed. For the duty area of "providing therapeutic…
Lake County Area Vocational Center, Grayslake, IL.
The purpose of this study was to use a health information network and innovative technology to coordinate tuberculosis care. An innercity medical center, a local health department, and a home care nurse service in northern Manhattan were used. The organizations were linked with computer networks. An automated decision support system with a natural language processor was used to detect tuberculosis
George Hripcsak; Charles A. Knirsch; Nilesh L. Jain; Richard C. Stazesky; Ariel Pablos-Mendez; Terry Fulmer
Purpose: The Veterans Affairs or VA health care system is in the process of significantly expanding homehealth care (HOC) nationwide. We describe VA HHC use in 2003 for all VA HHC users from 2002; we examine whether VA utilization across a broad spectrum of services differed for a sample of VA HHC users and their propensity-score-matched…
Van Houtven, Courtney Harold; Jeffreys, Amy S.; Coffman, Cynthia J.
Ubiquitous home healthcare systems have been playing an increasingly significant role in the treatment and management of chronic diseases, such as diabetes and hypertension, but progress has been hampered by the lack of standardization in the exchange of medical health care information. In an effort to establish standardization, this paper proposes a home healthcare monitoring system data exchange scheme between the HL7 standard and the IEEE1451 standard. IEEE1451 is a standard for special sensor networks, such as industrial control and smart homes, and defines a suite of interfaces that communicate among heterogeneous networks. HL7 is the standard for medical information exchange among medical organizations and medical personnel. While it provides a flexible data exchange in health care domains, it does not provide for data exchange with sensors. Thus, it is necessary to develop a data exchange schema to convert data between the HL7 and the IEEE1451 standard. This paper proposes a schema that can exchange data between HL7 devices and the monitoring device, and conforms to the IEEE 1451 standard. The experimental results and conclusions of this approach are presented and show the feasibility of the proposed exchange schema. PMID:22319296
Ubiquitous home healthcare systems have been playing an increasingly significant role in the treatment and management of chronic diseases, such as diabetes and hypertension, but progress has been hampered by the lack of standardization in the exchange of medical health care information. In an effort to establish standardization, this paper proposes a home healthcare monitoring system data exchange scheme between the HL7 standard and the IEEE1451 standard. IEEE1451 is a standard for special sensor networks, such as industrial control and smart homes, and defines a suite of interfaces that communicate among heterogeneous networks. HL7 is the standard for medical information exchange among medical organizations and medical personnel. While it provides a flexible data exchange in health care domains, it does not provide for data exchange with sensors. Thus, it is necessary to develop a data exchange schema to convert data between the HL7 and the IEEE1451 standard. This paper proposes a schema that can exchange data between HL7 devices and the monitoring device, and conforms to the IEEE 1451 standard. The experimental results and conclusions of this approach are presented and show the feasibility of the proposed exchange schema.
The U Special Kids (USK) programme at the University of Minnesota provides intensive care coordination and case management services to children with complex special health-care needs. We conducted a one-year pilot study to evaluate the feasibility of videoconferencing between the USK office and family homes. To ensure easy installation, families were provided with prepackaged equipment and software. However, the families had different Internet providers, different modems and/or routers and different firewall software, which required case-by-case resolution during home visits by the project coordinator. Five families participated in 3-5 videoconferencing sessions with a USK nurse. All connections with urban families had clear audio and video, whereas connections with rural families had clear audio, but unclear video. All of the scheduled virtual visits were rated by nurses as providing information that was similar to a telephone call. However, the unscheduled virtual visits were rated by the nurses as providing more information than a telephone call, suggesting that home-based videoconferencing may be useful in the management of children with complex special health-care needs. PMID:18534949
Purpose The purpose of the study was to discover which patient and support system characteristics and interventions documented by homehealth clinicians were associated with improvement in urinary and bowel incontinence contrasting logistic regression and data mining approaches. Subjects and Setting 1,793 patients in this study had 2,072 episodes of care representing all non-maternity patients who were ages 18 or older and receiving skilled homehealth services in 2004 from a convenience sample of 15 homehealth agencies. Design This study is a secondary analysis of data from 15 homehealth agencies' electronic health records. Instruments Data for this study were documented by home care clinicians using the Outcome and Assessment Information Set (OASIS) structured assessment form and the Omaha System interventions, which is a standardized terminology. Results There were 684 patients with urinary incontinence and 187 with bowel incontinence. By discharge 38% improved in urinary incontinence and 45% improved their bowel incontinence. Using logistic regression, no patient or support system characteristics were associated with improvement in either urinary or bowel incontinence, only a limited number of interventions were significant. A data mining decision tree was producible only for bowel incontinence, demonstrating a combination of patient and support system factors as well as selected interventions were important in determining whether patients would improve in bowel incontinence. Conclusions Homehealth patients have complex comorbid conditions requiring home care nurses to have broad, generalized knowledge. Future research is needed to determine if the inclusion of a certified wound, ostomy, and continence nurse would improve outcomes.
Westra, Bonnie L.; Savik, Kay; Oancea, Cristina; Choromanski, Lynn; Holmes, John H.; Bliss, Donna
|The purpose of this paper was to use athletes' and former athletes' memories of their favorite coach to improve coach education curriculum. Player preferences of coaching behavior can affect both their attitudes toward their sport experiences and team performance. By identifying positive coaching behaviors as recalled by athletes, coach educators…
Describes a questionnaire sent to 11 of the 66 nursing homes in the Brighton Health Authority to compare the quality of care provided. These homes care for 242 patients (representing 13 per cent of the 1,728 places in Brighton nursing homes). Questions dealt with residential environment, occupational health, care and control of medicines, clerical services, procedures for prevention and control
Medicare homehealth care policy does not incorporate research evidence of effective palliative home care interventions for Alzheimer's disease and dementia patients and caregivers. This article examines the dissonance between the needs and burdens of Alzheimer's disease patients and caregivers, research results on medical and palliative care interventions, and medicalized public policy in the Medicare homehealth benefit. The article
An alternative to conventional hospitalisation, homehealth care involves technical procedures which can carry a high risk of infection. In the home, infection prevention is a central element of safety of care. A homehealth care structure in the Lille region is working to raise awareness among freelance nursing partners and encourage them to follow a quality improvement approach. PMID:23477090
Objective: To study the effect of early intervention in health problems identified by home helps. Design: Open study with quasi-experimental design. Randomization took place at the level of the organizational units of home helps. Setting: Community health services and a hospital-based general practice. Subjects: Home help clients, 75 years or older, 113 in the intervention group and 161 in the
|The author reviewed the literature to identify the variables associated with homehealth care utilization using the Andersen-Newman model as a framework for analysis. Sixty-four studies published between 1985 and 2000 were identified through PUBMED, Sociofile, and PsycINFO databases. Homehealth care was defined as in-home skilled nursing,…
Purpose of study: The direct care workforce continues to rank as one of the most frequently injured employee groups in North America. Occupational health and safety studies have shown that workplace injuries translate into negative outcomes for workers and their employers. The National Institute for Occupational Safety and Health (NIOSH)…
|Purpose of study: The direct care workforce continues to rank as one of the most frequently injured employee groups in North America. Occupational health and safety studies have shown that workplace injuries translate into negative outcomes for workers and their employers. The National Institute for Occupational Safety and Health (NIOSH)…
With the rate of diabetes increasing in the elderly, homehealth care agencies must creatively approach disease management in this high-risk population. Specialized training programs, standardized policies and procedures, and strategic staffing patterns support agencies to systematically and effectively manage diabetes in the home. Collaboration with endocrinology providers assists agencies to incorporate and appropriately use national standards in diabetes care.
Amy Hartman; Michelle L. Litchman; Pat Reed; Robert E. Burr
|Evaluation and coaching should not be linked, these authors argue. Although it's tempting for evaluators to identify deficiencies and then specify coaching as a remediation strategy, doing so turns coaching into a consequence of a poor evaluation and termination into a consequence of failed coaching. Another mistake is to use coaching as a data…
Evaluation and coaching should not be linked, these authors argue. Although it's tempting for evaluators to identify deficiencies and then specify coaching as a remediation strategy, doing so turns coaching into a consequence of a poor evaluation and termination into a consequence of failed coaching. Another mistake is to use coaching as a data…
Qualitative and quantitative guidelines for the development of a system of homehealth services are presented. A brief background of home care is offered, followed by definitions of relevant terms. Guidelines are provided in the areas of administration an...
\\u000a This paper reports a Wizard-of-Oz (WOZ) experiment for elderly in the homehealth care system we have developed. We collect\\u000a dialogue examples of elderly users through the WOZ experiment and conduct a recognition experiment for collected elderly speech.\\u000a The experimental result demonstrates that user’s responses following system’s questions tend to consist not bare Yes\\/No answers\\u000a but content words without Yes\\/No
...governing payment for other non-VA health care providers. Because the newly applicable...methodology for in- and outpatient health care professional services provided...FR 78901. We explained: HomeHealth Care and Hospice Care [T]he...
...Administration and Management; Care Coordination and...and Behavioral Health and Social Support...Assistant and HomeHealth Aide (NAHHA...administration and management, care coordination and...and behavioral health and social...
Patient-centered approach is critical in current team-medication, and the importance of the approach is broadly accepted among the medical workers including pharmacists. Nevertheless, based on the experience as a communication trainer for medical workers and a faculty at the pharmacy school, many of pharmacists and/or pharmacy students have certain mental model for the pharmacist-patient relationship similar to the paternalism. Active concern to the decision-making and the health behavior for the patients' own medication is the key for patient-centered approach. Heron's six categories of intervention model show the need for caregivers to support their clients' autonomy with facilitative approach. Coaching, client-centered, behavior-focus support communication method would be useful for the pharmacists to implement the facilitative approach in medical context, especially on the primary care. PMID:21139386
Home care visits can last several hours. Home care workers are often at a loss on how to fill time spent in homes of clients. The challenge is how to use this time in ways that are productive and engaging for both clients and homehealth workers. The authors trained homehealth aides to implement Montessori-based activities while interacting with clients who have dementia. The results were amazing. Among other positive results, the authors found a statistically significant increase in the amount of pleasure displayed by clients after health workers received training. PMID:12557465
\\u000a In Chap. 12, Keizer and Nandram present the concept of Integral Transformational Coaching based on the concept of Flow and its effects on work performance. Integral Transformational Coaching is a method that prevents\\u000a and cures unhealthy stress and burnout. They draw on some tried and tested spiritually based insights from the schools of\\u000a mindfulness, coaching, and mental fitness. Their model
Health care disparities pose an ongoing challenge to the nation. The patient-centered medical home (PCMH) model presents a unique opportunity for community health centers (CHCs) to improve the health of medically underserved communities and reduce health care disparities. Community health centers face ongoing financial and operational challenges, but are well positioned to adopt the PCMH. Health centers have experience collaborating
Staff members and residents of nursing homes and old people's homes were interviewed about the facilities and provision of oral health care. Clinical examinations were performed to obtain data about the oral health status of the institutionalised elderly. Results show that in most cases the oral health care facilities were insufficient to give care to persons with natural teeth. Of
H. Kalsbeek; A. A. Schuller; M. M. Kivit; C. de Baat
A body sensor network can be used in a homehealth care system to monitor the elderly or patients with chronic diseases. The security and requirements of the homehealth care system is complex. We show how genetic design methodology models the requirements of the health care system. In our system, physiological data can be used to establish keys amongst
A new trend is emerging in homehealth care—specialty programs. With the emphasis on dis ease management, homehealth agencies must develop programs that focus on specific patient groups with similar diagnoses or problems. Health care providers, such as managed care compa nies, demand better patient outcomes. Specialty programs target specific populations by using advance practice personnel as primary caregivers
Although trends in health care point to the increasing use of homehealth services in caring for the chronically ill elderly, little attention has been focused on assessing the specific services that these patients perceive as most needed. Twenty eight elderly patients with chronic illness who had been referred for homehealth agency service self reported their functional status using
Racial\\/ethnic disparities in health have been well-documented. However, we know little about the existence of or mechanisms that contribute to disparities in homehealth care. This article proposes a conceptual framework, based on a comprehensive review of the literature, to guide research to understand whether and how disparities emerge in homehealth care. The framework outlines the patient, agency, practice,
...governing payments for certain non-VA health care, 38 CFR 17.56, applicable to...rule, we estimate that each homehealth care and hospice provider that does...negotiated contracts offer homehealth care or hospice care to veterans...
The relationship between the average cost of homehealth care and the case mix of patients served by the homehealth agency is investigated using 1983 data from Wisconsin's homehealth care agencies. In contrast to previous work, case mix is shown to have a significant effect on the homehealth agency's average costs. The methods used in the previous work are evaluated, and differences between the earlier study and the present study are discussed to explain the divergent results. Also, average costs are shown to decrease with output, to increase with the proportion of private patients served by the agency, and to be higher if the homehealth agency is located in an urban area or if it has a proprietary charter. The implications of this research for the design of an appropriate homehealth reimbursement policy are discussed. Primarily, it is argued that, although future research might confirm the relationship between average costs and case mix for homehealth agencies, we cannot necessarily conclude that reimbursement rates must be adjusted to account for differences in case mix as many States are now doing for nursing home reimbursement. Policies must take into account the fundamental differences between homehealth agencies and nursing homes, and their respective markets, in order to be effective.
Objective: To examine the added benefit of homehealth services for elderly patients with hip fracture discharged home after inpatient rehabilitation.Data: Medicare claims from 1% of 1986 beneficiaries followed until 1992.Study Population: Persons hospitalized with hip fracture at 70 years or older who had no major Medicare claims during the year before hospitalization and who were discharged home after inpatient
...DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare...Face-to-Face Requirements for HomeHealth Services; Policy Changes and Clarifications Related to HomeHealth AGENCY: Centers for Medicare &...
Objective To evaluate the effectiveness of goal focused telephone coaching by practice nurses in improving glycaemic control in patients with type 2 diabetes in Australia. Design Prospective, cluster randomised controlled trial, with general practices as the unit of randomisation. Setting General practices in Victoria, Australia. Participants 59 of 69 general practices that agreed to participate recruited sufficient patients and were randomised. Of 829 patients with type 2 diabetes (glycated haemoglobin (HbA1c) >7.5% in the past 12 months) who were assessed for eligibility, 473 (236 from 30 intervention practices and 237 from 29 control practices) agreed to participate. Intervention Practice nurses from intervention practices received two days of training in a telephone coaching programme, which aimed to deliver eight telephone and one face to face coaching episodes per patient. Main outcome measures The primary end point was mean absolute change in HbA1c between baseline and 18 months in the intervention group compared with the control group. Results The intervention and control patients were similar at baseline. None of the practices dropped out over the study period; however, patient attrition rates were 5% in each group (11/236 and 11/237 in the intervention and control group, respectively). The median number of coaching sessions received by the 236 intervention patients was 3 (interquartile range 1-5), of which 25% (58/236) did not receive any coaching sessions. At 18 months’ follow-up the effect on glycaemic control did not differ significantly (mean difference 0.02, 95% confidence interval ?0.20 to 0.24, P=0.84) between the intervention and control groups, adjusted for HbA1c measured at baseline and the clustering. Other biochemical and clinical outcomes were similar in both groups. Conclusions A practice nurse led telephone coaching intervention implemented in the real world primary care setting produced comparable outcomes to usual primary care in Australia. The addition of a goal focused coaching role onto the ongoing generalist role of a practice nurse without prescribing rights was found to be ineffective. Trial registration Current Controlled Trials ISRCTN50662837.
Objectives: To determine the frequency of home visits during the postpartum period among women discharged within 24 hours after childbirth, to identify characteristics of women who received at least one home visit, and to examine whether a home visit was related to postpartum experiences. Method: Women who were enrolled in a Prudential HealthCare® plan and had a recent normal vaginal
Medicare homehealth care plays an important role in providing cost effective care for the chronically ill and elderly. Long seen as a cost effective substitute for nursing home care, home care has become even more important with expenditures increasing by 31.4% from 1990 to 1996. The purpose of this paper is to provide a short run cost analysis of
Cynthia Dudzinski; O. Homer Erekson; Andrea Ziegert
BackgroundThe Japanese have become the longest-lived nation population in the world, and numbers of elderly who require medical and nursing care are increasing. The capacity of nursing homes and nursing institutions is sharply limited in Japan; further, as a group, elderly Japanese patients prefer home care to institutional care. For these reasons, the homehealth care system in Japan has
BACKGROUND: Home visiting programs have been developed aimed at improving the health and independent functioning of older people. Also, they intend to reduce hospital and nursing home admission and associated cost. A substantial number of studies have examined the effects of preventive home visiting programs on older people living in the community; the findings have been inconsistent. The objective of
Ans Bouman; Erik van Rossum; Patricia Nelemans; Gertrudis IJM Kempen; Paul Knipschild
This paper explores the response of the Massachusetts state-funded home care program for the elderly when its clients encountered barriers to the receipt of homehealth services because of HMO enrollment and the implementation of the Balanced Budget Act of 1997. Clients of three regional case management agencies serving the Massachusetts state home care program whose home care services were
Francis G. Caro; Frank W. Porell; Donna M. Sullivan; Clare E. Safran-Norton; Helen Miltiades
The role of school leadership--of principals and coaches--must be played out on a systems level to get widespread and sustainable improvement. Successful, whole-system education reform relies on capacity building, teamwork, pedagogy, and systemic reform. The strategies of good coaches and the right drivers for whole-system reform go hand in hand.…
|School-based coaching for literacy teachers has taken on an important role in school reform in recent years. Although the literature contains numerous and compelling descriptions of the perceived, positive effects of mentoring, reviews of the literature base on mentoring and/or coaching over the past 20 years have consistently identified the need…
Our research on coaching refers to one autonomous agent providing advice to another autonomous agent about how to act. In past work, we dealt with advice-receiving agents with fixed strategies, and we now consider agents which are learning. Further, we consider agents which have various limitations, with the hypothesis that if the coach adapts its advice to those limitations, more
|The role of school leadership--of principals and coaches--must be played out on a systems level to get widespread and sustainable improvement. Successful, whole-system education reform relies on capacity building, teamwork, pedagogy, and systemic reform. The strategies of good coaches and the right drivers for whole-system reform go hand in hand.…
If he is indeed wise he does not bid you enter the house of wisdom, but rather leads you to the threshold of your own mind'. (Gibran, 1991). Executive coaching, as a form of developmental intervention aptly reflects the wise words above of the Lebanese philosopher Khalil Gibran. However while coaching may be becoming widespread in some sectors, its application
|One dominant factor in the success or failure of a coach of athletics is the use of the "we" approach, which emphasizes flexibility, patience, and effective communication. A checklist is included for coaches to rate their typical reactions to athletic situations. (CJ)|
An innovative position, a Student Success Coach, was created in response to a newly developed undergraduate-degree program on the recently established University of Minnesota Rochester campus. Student Success Coaches serve as the link between the academic and student affairs sides of the campus. They interact closely with students and faculty to…
Outcomes of this empirical study demonstrated that executive coaching is an effective method of leadership development. One hundred fourteen executives and 42 coaches were surveyed using instruments designed to gather both quantitative and qualitative data. Results indicated that executive change occurred in 5 areas: people management, relationships with managers, goal setting and prioritization, engagement and productivity, and dialogue and communication.
Francis A. Kombarakaran; Julia A. Yang; Mila N. Baker; Pauline B. Fernandes
|This article describes an educational intervention designed to promote the ability and willingness of MBA students to lead through coaching. MBA leadership students are trained to serve as coaches for undergraduate business students in a developmental assessment center. In this compelling context, their main source of influence is the ability to…
Benchmarking outcome data and constructing "best practices" to meet patient care needs are emerging trends and new mandates on the horizon in home care. The Arizona Association for Home Care Continuous Quality Improvement Forum embarked on a journey to develop standards to define and monitor urinary tract infections in the home. A collaborative process among six home care agencies allowed for comparison of urinary tract infection rates and a beginning step toward establishing benchmarking standards in home care. PMID:10661987
Objective: To survey self-reported knowledge of homehealth care (HHC) services of health care professionals in Al-Khobar and Al-Dammam. Methods: A specially developed questionnaire was used to conduct a cross-sectional study to find out how knowledgeable 11 hospital administrators, 16 PHHC medical directors, and 637 health care team were of HHC services. Results: When asked whether they knew of HHC services, 90.9% of medical directors, 62.5% of primary health care center directors, 83.1% of physicians, 92.9% of nurses, 98.6% of physiotherapists, 95.9% of social workers, and 57.6% of the health team members replied that they did, although this knowledge was very scanty. Health care workers’ source of information on HHC services was hospital work (65.0%) while administrators’ sources were journals (65.0%). Only 11.1% of the administrators and 30.3% of the health team members indicated having had HHC training from university, and 3.7% of administrators and 20.4% of health team members indicated having attended a HHC lecture or symposium. The only finding with significant difference of responses (p<0.001) was on the knowledge of HHC services among health care professionals. All other responses showed no significant differences between them. No significant differences in the responses were found between the two groups of administrators. Conclusions: Health professionals and administrators showed little knowledge of HHC services. The main source of HHC information for health professionals was from their hospital experience while administrators learned more about HHC services from medical journals. Recommendations: HHC training centers must be set up in Saudi Arabia. Homehealth care concepts and skills should be part of the regular health science undergraduate curriculum.
This final rule updates the HomeHealth Prospective Payment System (HH PPS) rates, including the national standardized 60-day episode rates, the national per-visit rates, the low-utilization payment amount (LUPA), the non-routine medical supplies (NRS) conversion factor, and outlier payments under the Medicare prospective payment system for homehealth agencies effective January 1, 2013. This rule also establishes requirements for the HomeHealth and Hospice quality reporting programs. This final rule will also establish requirements for unannounced, standard and extended surveys of homehealth agencies (HHAs) and sets forth alternative sanctions that could be imposed instead of, or in addition to, termination of the HHA's participation in the Medicare program, which could remain in effect up to a maximum of 6 months, until an HHA achieves compliance with the HHA Conditions of Participation (CoPs) or until the HHA's provider agreement is terminated. PMID:23139947
This booklet is the product of a conference of the American Association of Health, Physical Education, and Recreation, the purpose of which was to revise professional preparation quidelines in dance, physical education, recreation education, and health and safety education. This report includes sections on physical education and coaching and on…
American Association for Health, Physical Education, and Recreation, Washington, DC.
IntroductionHaving a health care home has been shown to be associated with positive health outcomes for children with special health care needs (CSHCN), but its relationship to parental coping has not been established. The purpose of this study was to explore the health care home as a process of care related to parental coping with day-to-day demands of raising a
Youth sport is a social institution designed to help improve the health and wellness of the athletes and provide an opportunity for positive youth development. Coaches have a strong influence upon the benefits experienced by youth athletes. Given the importance of the coaching role, the purpose of this article is to outline several positive steps that coaches can take to
|This book contains strategies for effective literacy coaching of teachers in districts and schools. Whether it's your job to start a literacy coaching initiative or to be an effective literacy coach to your colleagues, this guide has all the steps and strategies you need: (1) Roles and responsibilities of literacy coaches; (2) Keys to building…
The current case study was designed to further the utility of Attention-Deficit\\/Hyperactivity Disorder (ADHD) coaching for college students. Seven college or graduate students underwent eight weeks of an ADHD coaching intervention, and resulting qualitative data was analyzed by the researcher. Results showed that all participants who completed the coaching process felt ADHD coaching was just as or more beneficial than
ABSTRACTWhen environmental health researchers study hazards in the home, they often discover information that may be relevant to protecting the health and safety of the research subjects and occupants. This article describes the ethical and legal basis for a duty to warn research subjects and occupants about hazards in the home and explores the extent of this duty. Investigators should
Heart failure is one of the most common reasons for admission to homehealth care among older adults Patients with heart failure present complex challenges for homehealth care agency staff, given the chronic yet variable nature of the disease and the importance of behavioral factors in long-term management of heart failure. The purpose of this study was to examine
Patricia J. Moulton; Amy M. McGrane; Theresa L. Beck; Nancy L. Holland; Mary Ann Christopher
A wireless sensor network can be used in a homehealth care system to monitor the elderly or patients with chronic diseases. The quality of security of the homehealth care system is an important requirement. If the security services or servers malfunction then the system itself may become compromised. We show that with multi--server protocols, even if one or
Homehealth care have an important meaning of life guarantee for the elderly and sub-healthy groups. In this paper, it is adopted to design a new model of homehealth care system that wearable wireless data acquisition technology and emotion recognition algorithm-based on physiological signals. Test results show that the system realized physiological signal acquisition under the natural state, physical
Zhaohui Jiang; Lili Lu; Xiaowei Huang; Chunjie Tan
|Training and satisfaction with training were examined using data from nationally representative samples of 2,897 certified nursing assistants (CNAs) from the National Nursing Assistant Survey and 3,377 homehealth aides (HHAs) from the National HomeHealth Aide Survey conducted in 2004 and 2007, respectively. This article focuses on the…
Sengupta, Manisha; Ejaz, Farida K.; Harris-Kojetin, Lauren D.
This study evaluates bacterial contamination rates of homehealth care nurses' bags and the patient care equipment found inside. Nurses' bags--a ubiquitous fomite in the homehealth care environment--may serve as a potential reservoir for multidrug-resistant organisms. PMID:19556036
The number of children in homehealth care services is increasing, and there is a need for infection control regulation in this environment. We describe the main causes of infection and hospitalization in children assisted by a pediatric homehealth care service in Rio de Janeiro, Brazil. PMID:21570739
Araujo da Silva, André Ricardo; de Souza, Cristina Vieira; Viana, Mario Eduardo; Sargentelli, Guilherme; de Andrada Serpa, Maria José; Gomes, Marisa Zenaide Ribeiro
The practice implications of the Centers for Medicare & Medicaid Services hospital payment policy change are likely to influence the relationships between homehealth care agencies and their referring\\/receiving hospitals. Maintaining infection control measures can be difficult in the home environment, which was not designed for health care provision and where family members, friends, and pets are present. In addition
This article describes an innovative learning program, designed for associate degree nurse (ADN) graduates, developed at the visiting Nurse Service of New York (VNSNY) to expand its hiring pool of potential applicants to homehealth care nursing positions. The program, “Transitions to HomeHealth Care,” provides a strong emphasis on independent judgment, assessment skills, and collaboration with other professions and
Joan Chaya; Margaret Reilly; Denise Davin; Mari Moriarty; Valerie Nero-Reid; Peri Rosenfeld
A research study was conducted during the summer of 1974 to evaluate the utilization of homehealth care in three southwestern States (Texas, Oklahoma, and Alabama). The study was performed to explore reasons for the underutilization of homehealth care i...
BACKGROUND: In Australia, the Home and Community Care (HACC) program provides services in the community to frail elderly living at home and their carers. Surprisingly little is known about the health of people who use these services. In this study we sought to describe health-related factors associated with use of HACC services, and to identify potential opportunities for targeting preventive
Louisa R Jorm; Scott R Walter; Sanja Lujic; Julie E Byles; Hal L Kendig
BACKGROUND: Research that examines the quality of homehealth care is complex because no gold standard exists for measuring adverse outcomes, and because the patient and clinician populations are highly heterogeneous. The objectives in this study are to develop models to predict functional decline for three indices of functional status as measures of adverse events in homehealth care and
Tanya Pollack Scharpf; Natalie Colabianchi; Elizabeth A Madigan; Duncan Neuhauser; Timothy Peng; Penny H Feldman; John FP Bridges
In a randomised controlled study, 41 executives in a public health agency received 360-degree feedback, a half-day leadership workshop, and four individual coaching sessions over 10 weeks. The coaching used a cognitive-behavioural solution-focused approach. Quantitative and qualitative measures were taken. This is the first published randomised controlled study in which coaching was conducted by professional executive coaches external to the
Anthony M. Grant; Linley Curtayne; Geraldine Burton
Over the last decade, new hospitals are integrating Information and Communication Technologies (ICTs) in their facilities. Although e-health is a relatively recent term for healthcare practice supported by electronic processes, ubiquitous healthcare monitoring, also known as m-health, is already an emerging research area. Patient monitoring in diverse environments, such as nursing homes or assisted living, are gaining importance. Traditional methods present some problems, as they don't allow enough patient mobility. In this situation, real time transmission of multiple medical data, wearable computing, wireless access in ubiquitous systems and wearable devices for pervasive healthcare can meet the needs of these environments. However, the software and infrastructure deployed in hospitals is not easy to migrate to wireless systems. In some cases, the migration to new technologies can be costly. This paper focuses on the design of a modular, scalable and economical framework to improve the monitoring and checking of patients in different contexts. The challenge is to produce a system to transmit the patient's biomedical data directly to a hospital for monitoring or diagnosis using new communication modules. The modular designed adopted is intended to provide a future-proofed system, whose functionality may be upgraded by modifying the hardware or software. The modules have been validated in different contexts to prove their versatility. PMID:23367314
Torrado-Carvajal, Angel; Rodriguez-Sanchez, Maria Cristina; Rodriguez-Moreno, Alberto; Borromeo, Susana; Garro-Gomez, Cesar; Hernandez-Tamames, Juan Antonio; Luaces, Maria
"Virtual Coach" refers to a coaching program or device aiming to guide users through tasks for the purpose of prompting positive behavior or assisting with learning new skills. This article reviews virtual coach interventions with the purpose of guiding rehabilitation professionals to comprehend more effectively the essential components of such interventions, the underlying technologies and their integration, and example applications. A design space of virtual coach interventions including self-monitoring, context awareness, interface modality, and coaching strategies were identified and discussed to address when, how, and what coaching messages to deliver in an automated and intelligent way. Example applications that address various health-related issues also are provided to illustrate how a virtual coach intervention is developed and evaluated. Finally, the article provides some insight into addressing key challenges and opportunities in designing and implementing virtual coach interventions. It is expected that more virtual coach interventions will be developed in the field of rehabilitation to support self-care and prevent secondary conditions in individuals with disabilities. PMID:19951785
Home Care Basic Facts & Information Role of Health Care Professionals in Home Care Your physician is the leader of an interdisciplinary ... travel to see the healthcare team. Is Home Care Right for You? Home care is especially useful ...
Two surveys of private nursing homes, designated geriatric wards, and a sample of social service part III homes were carried out in the Brighton Health District using questionnaires supplemented (in the second survey) by some interviews. The dependency of old people in the private nursing homes was more like that of long stay hospital patients rather than that of residents in social services homes. In the private nursing homes, however, a smaller proportion of patients were in the medium to heavy nursing category (178 (31%) compared with 158 (63%) in the hospital long stay wards) and a larger proportion in the heavy nursing category (170 (30%) compared with 44 (17%) in the long stay wards). Of the patients in private nursing homes, 401 (82%) were local residents, 488 (86%) were long stay, and 459 (88%) were women; their mean age was 88 years. Two thirds of the patients were over 80. There were no significant differences between the private nursing homes and the wards in nursing workloads or staffing, except for a slightly higher provision of state registered nurses in the private sector. In the private nursing homes 348 (63%) of the patients had fees paid by private funds, 26 (5%) were in contract beds paid for by the National Health Service, and 176 (32%) were subsidized by the Department of Health and Social Security. Private nursing homes make a substantial contribution to the care of the elderly in the Brighton Health District, and the health authority should develop a more active partnership with this sector.
There has been a paradigm shift in community health nursing. In 1992, visiting nursing stations were first introduced. In 1994, the Community Health Act came into force and in recent years public health care insurance has become a major issue. In this paradigm shift, one of the roles of nursing in the community is to train people to become more autonomous as consumers of health care services, and to design and implement a system that enhances community members' health and provides support when they are ill. In 1990 and 1996, the national nursing curriculum was revised to reflect changes in the age of the population. Community health nursing now faces the challenge of developing a new nursing model that is in tune with Japanese cultural values. Dr. Katsunuma (1996) proposed two alternative approaches to health care services: the public health approach and the clinical approach. In this paper, it is suggested that home care offers a third alternative, which integrates the clinical approach with the public health approach. This third approach provides a paradigm for community health nursing that integrates individual health care with community health care. New roles and specialties for public health nurses include care management, care planning, community health nursing administration, and supervision. Community-based nursing centers that cooperate with schools of nursing will provide a setting and a concept for community health nursing. PMID:9444239
|The health status of 206 female caregivers supporting adults with intellectual and developmental disabilities at home was investigated using objective (i.e., presence of chronic health conditions and activity limitations) and subjective (i.e., self-perceived health status) health measures compared with those of women in the general population in…
Purpose: This study examines population-based trends in home care service utilization, alone and in conjunction with hospitalizations, during a period of health reform in Canada. It focuses on the extent to which observed trends suggest enhanced community-based care relative to three competing hypotheses: cost-cutting, medicalization, and…
Penning, Margaret J.; Brackley, Moyra E.; Allan, Diane E.
Qualities of character and physical capability are essential for the success of a homehealth aide. The aide needs to be prepared by the organization to provide expert care in various home settings, with patients and families whose personalities, lifestyles, ages, cultural background, and socioeconomic status may be vastly different from those the aide has experienced. This article explores the history of homehealth aide services as a backdrop to understanding the creative forces in recruitment and education methods, as well as support and team efforts that contribute to having successful careers as aides in the home care setting. PMID:22743530
BACKGROUND:: Health care leaders have called for the development of communication and leadership skills to improve manager-employee relationships, employee job satisfaction, quality care, and work environments. PURPOSES:: The aim of the study reported here was to pilot how a 2-day coaching workshop ("Coaching for Impressive CARE") conducted as a leadership development strategy influenced frontline care managers' coaching practices in residential long-term care (LTC) settings. We had four objectives: (a) to identify managers' perceptions of their role as a coach of employee performance in LTC facilities, (b) to understand managers' intentions to coach employee performance, (c) to examine opportunities and factors that contributed to or challenged implementation of workshop coaching skills in daily leadership/management practice, and (d) to examine managers' reports of using coaching practices and employee responses after the workshop. METHODS:: We used an exploratory/descriptive design involving pre-/post-workshop surveys, e-mail reminders, and focus groups to examine participation of 21 LTC managers in a 2-day coaching workshop and their use of coaching practices in the workplace. FINDINGS:: Focus group findings provided examples of how participants used their coaching skills in practice (e.g., communicating empathy) and how staff responded. Factors contributing to and challenging implementation of these coaching skills in the workplace were identified. Attitudes and intentions to be a coach increased significantly, and some coaching skills were used more frequently after the workshop, specifically planning for performance change with employees. PRACTICE IMPLICATIONS:: The coaching workshop was feasible to implement, well received by participants, influenced their willingness to become coaches, and had some noted impact on their use of coaching behaviors in the workplace. Coaching skills by managers to improve staff performance with residents in LTC facilities can be learned. PMID:23624830
Objective This report provides updated estimates on use of electronic medical records (EMRs) in US homehealth and hospice (HHH) agencies, describes utilization of EMR functionalities, and presents novel data on telemedicine and point of care documentation (PoCD) in this setting. Design Nationally representative, cross-sectional survey of US HHH agencies conducted in 2007. Measurements Data on agency characteristics, current use of EMR systems as well as use of telemedicine and PoCD were collected. Results In 2007, 43% of US HHH agencies reported use of an EMR system. Patient demographics (40%) and clinical notes (34%) were the most commonly used EMR functions among US HHH agencies. Only 20% of agencies with EMR systems had health information sharing functionality and about half of them used it. Telemedicine was used by 21% of all HHH agencies, with most (87%) of these offering homehealth services. Among homehealth agencies using telemedicine, greater than 90% used telephone monitoring and about two-thirds used non-video monitoring. Nearly 29% of HHH agencies reported using electronic PoCD systems, most often for Outcome and Assessment Information Set (OASIS) data capture (79%). Relative to for-profit HHH agencies, non-profit agencies used considerably more EMR (70% vs 28%, p<0.001) and PoCD (63% vs 9%, p<0.001). Conclusions Between 2000 and 2007, there was a 33% increase in use of EMR among HHH agencies in the US. In 2007, use of EMR and PoCD technologies in non-profit agencies was significantly higher than for-profit ones. Finally, HHH agencies generally tended to use available EMR functionalities, including health information sharing.
This webpage contains tools for math coaches and math specialists to utilize before, during, and after teacher observations. These tools are built upon NCSM's PRIME Leadership Framework to enable math specialists and coaches to build relationships and encourage leadership in others and created by The Robert Noyce Foundation in conjunction with Silicon Valley Mathematics Initiative (SMVI). Each tool can be previewed on the left by clicking the name of the tool and can be viewed in full by clicking beneath the tool name.
Initiative, Silicon V.; Foster, David; Foundation, The R.
GoalsUndertreatment of cancer pain remains a major health-care problem. We utilized focus groups of hospice and home-health nurses and patients to elucidate factors contributing to inadequate pain management and to generate solutions for closing the gap between the current reality and optimal pain management.Patients and methodsFocus groups were conducted among hospice and home-health-care nurses (two groups; n=22) and patients (six
Elizabeth Randall-David; Judy Wright; Deborah S. Porterfield; Glenn Lesser
The health care costs in developed countries are increasing fast due to the aging of the population. In-home monitoring of health is becoming more and more attractive both because of expected cost-savings and technical development of suitable measurement devices and wireless sensor networks. In this paper, we present on-going work about embedding health monitoring devices into ordinary homes. The developed
Mari Zakrzewski; Sakari Junnilal; Antti-Matti Vainio; Harri Kailanto; Irek Defée; Jukka Lekkala; Jukka Vanhala; Jari Hyttinen
NIOSH received a confidential employee request for an HHE at the Huntington Coach Corporation bus repair and body shops, Huntington Station, New York, in November 2006. Employees were concerned that exposures to cleaning solvents, paint vapors, diesel exh...
This paper focuses on the processes by which people become high school coaches. Occupational choice, professional socialization, and organizational socialization are examined, using qualitative data drawn from naturally occurring observations of coaches and informal discussions and in-depth interviews with them. Over 50% of the coaches had decided that they wanted to become a coach before entrance into college. The decision to become a coach was subjectively warranted by personal characteristics and experiences in sports, a devotion to sport, and a desire to work with young people. Youth sport coaching and student teaching which involved coaching constituted the only formal professional socialization that most of the coaches received. However, because almost all of the coaches participated in organized youth and/or high school athletics, they had a first-hand opportunity to observe their own coaches and acquire some informal images and impressions about the coaching occupation from them. Regardless of whether a neophyte began as an assistant or a head coach, technical aspects of the job and the occupation's culture were acquired by observing and listening to more experienced coaches. Through these experiences, collective understandings began to form, and the shared meanings about the occupational culture took shape. Reality shock for most novice coaches came in the form of understanding the importance the coaching culture assigns to long hours and hard work and to the realization that coaching does take an enormous amount of time. By the end of the first season, a symbolic transformation takes place and internalization of institutional expectations occurs as the neophyte begins to understand what coaching is all about. PMID:2489828
Because of the high proportion of nursing home residents with a mental illness other than dementia, the quality of mental health care in nursing homes is a major clinical and policy issue. The authors apply Donabedian's framework for assessing quality of care based on the triad of structure, process, and outcome-based measures in reviewing the literature on the quality of mental health care in nursing homes. Quality measures used within the literature include mental health consultations and hospitalizations, inappropriate use of medications, and mental health survey deficiencies. Factors related to the resident's welfare (nurse staffing), provider norms (locality), and financial factors (payer mix) were associated with the quality of mental health care. Although future research is necessary, the extant literature suggests that persons with mental illness are frequently admitted to nursing homes and their care is often of poor quality and related to a series of resident and facility factors.
Grabowski, David C.; Aschbrenner, Kelly A.; Rome, Vincent F.; Bartels, Stephen J.
This article reports on preliminary impacts during the first year of a demonstration in which homehealth agencies (HHAs) were paid a prospectively set rate for each Medicare homehealth visit rendered, rather than being reimbursed for costs. Forty-seven agencies in five States participated. The evaluation compared the experiences of randomly assigned treatment agencies and their patients with those of control agencies and their patients and found no compelling evidence of any demonstration impact on agency cost per visit, the volume of homehealth services, agency revenue and profit, patient selection and retention, quality of care, or use and cost of Medicare services. PMID:10140160
Phillips, B R; Brown, R S; Bishop, C E; Klein, A C; Ritter, G A; Schore, J L; Skwara, K C; Thornton, C V
The health condition of small-age children brought up at children's homes of Ivanovo Region was in the focus of the case study. An overwhelming majority of the examinees had abnormalities in the physical and nervous-psychic development; 4.5 deviations were on the average diagnosed in one child. The poor health indices of inmates in children's homes necessitate better medical care for the discussed category of children. There is also a need in state contribution to it. Main trends are defined for the children's homes in optimizing the health and physical development of their inmates. PMID:15606039
Fil'kina, O M; Vorob'eva, E A; Konova, S R; Abrosimova, T S
The home care industry is the fastest growing industry in the United States. The number of elderly that will depend on long term care will double from about 7 to 14 million Americans by the year 2020. Many of these elders elect to stay at home and are abl...
A portfolio is a well-organized document containing critical analyses and evidence related to a coach's background, context(s) of coaching, approach to coaching, coaching accomplishments, and goals for further development. Here, the authors describe different types of coaching portfolios as well as strategies for developing a coaching portfolio.…
A literature search revealed diverse descriptions of the coaching\\/therapy boundary. In an attempt to gain greater definition, organisational coaches were surveyed to discover how they made decisions about the boundary in their practice. Responses indicated that practising coaches viewed coaching as differing from therapy in being future-orientated, short-term, less deep, goal-orientated, appropriate for clients who are mentally healthy, and organisationally
The nursing homes, where home adaptations (environmental improvements) and assistive technology (AT) are provided, represent an increasingly attractive mean of helping elderly people to maintain their independence and enhancing their quality of life. Doctors and specialists are involved in order to provide personalized health care services to elderly people so as to have a better life and treatment. The main
Nikolidakis Stefanos; Dimitrios D. Vergados; Ioannis Anagnostopoulos
Objective. We evaluated the effectiveness of professional oral health care (POHC) given by dental hygienists once a week for 24 months to 141 elderly persons needing daily care and living in 2 nursing homes. Study design. Elderly subjects with POHC and without POHC living in 2 nursing homes were examined for 24 months to detect any fevers of 37.8°C or
We endeavor to provide a novel tool to evaluate environmental comfort level in health smart home (HSH). HSH is regarded a good alternative for the independent life of elders and people with disability. Numerous intelligent devices, installed within a home environment, can provide the resident with continuous monitoring and comfortable environment. In this paper, a novel method of evaluating environmental
The history of long-term homehealth care (HHC) for aging persons in the United States is one of alternating successes and of dashed hopes for persons wishing to remain in their own homes during their last years. Personal issues and public policy issues are woven into a maze of challenges faced by individuals and families wrestling with the difficult choice
The purpose of this article is to describe the role and foci of care of the geropsychiatric clinical nurse specialist (GCNS) through a case example representative of the aged mentally ill who receive care at home. A historical look at the evolution of homehealth care of mentally ill elderly reveals the recognition of need in these persons as early
The Balanced Budget Act of 1997 (BBA'97) dramatically decreased reimbursements in the Medicare homehealth program. The first phase of BBA'97, the Interim Payment System (IPS), slashed reimbursements to 1993 levels and established a new capitated reimbursement. To identify potential moderating influences of these changes on the relationship between patient impairment and home care use, we compared 1996 and 1998
The Balanced Budget Act of 1997 dramatically decreased reimbursements for traditional Medicare homehealth patients. A multivariate analysis of Medicare Current Beneficiary Survey data showed that African American and “other” users experienced greater decreases in home care between 1996 and 1998 than did White users. These results suggest (a) race\\/ethnicity is an independent factor in determining service use post-BBA and
As the need for high-technology services for the home care patient becomes increasingly more critical, it has become necessary for homehealth care agencies to meet these needs by providing highly specialized nursing services. The benefits of this emerging specialty are numerous, both within the nursing agency and to the community. Nursing specialties can enhance your agency's visibility by increasing
When the Chair of the Statewide Health Coordinating Council, commissioned the Special Committee on the Need for Nursing Home Beds in October 1984, he charged the committee to review the nursing home bed target within the context of the long term care chap...
Appropriate and efficient provision of services at home requires more than skilled personnel; effective communication between the primary care provider and the agency is an often overlooked but essential tool for maintaining the patient's health in the community. A method was developed to create home care orders (the “e-485”) that guides the physician through the order writing process, uploads data
Eugenia L. Siegler; Christopher M. Murtaugh; Robert J. Rosati; Theresa Schwartz; Renee Razzano; Sally Sobolewski; Mark Callahan
|Using 2003 nursing home data from the Minimum Data Set (MDS) database, this study investigated the role of family support among nursing homes serving residents with a mental health history. Exploratory factor analysis was used to create and test a conceptual model of family support using indicators located within the MDS database. Families were…
Frahm, Kathryn; Gammonley, Denise; Zhang, Ning Jackie; Paek, Seung Chun
The training of care staff in care homes for older people is important to ensure the maintenance of evidence-based and effective care. Moreover, training can assist in changing attitudes and promoting improved quality care for residents.To this end the Allied Health Professional (AHP) Care Homes Training Team provides training to care staff throughout the greater Glasgow area. This study sought
Objective. We evaluated the effectiveness of professional oral health care (POHC) given by dental hygienists once a week for 24 months to 141 elderly persons needing daily care and living in 2 nursing homes. Study Design. Elderly subjects with POHC and without POHC living in 2 nursing homes were examined for 24 months to detect any fevers of 37.8°C or
Mieko Adachi; Kazuyuki Ishihara; Shu Abe; Katsuji Okuda; Tatsuya Ishikawa
The objective of this study was to evaluate the efficacy of a home-based intervention targeted to parents with intellectual disability to promote child health and home safety in the preschool years. A total of 63 parents were recruited for the study with 45 parents (40 mothers and 5 fathers) from 40 families completing the project. The research design permitted comparison
Gwynnyth Llewellyn; David McConnell; Anne Honey; Rachel Mayes; Domenica Russo
This case report describes an 83 year-old immobilised patient with multiple diseases and on polypharmacy. Nursing care is developed at home. The patient is included in patient care programs for the anticoagulated and polymedicated patient. Nursing assessments were made using the Marjory Gordon functional health patterns, by which we identified, among others, problems related to non-compliance with the pharmacological treatment. The Nurse's Diagnosis was: Ineffective Management of own health. With the support of NANDA, NOC and NIC taxonomy we determined the nursing objectives and interventions. The expected results of the Care Plan were achieved. Polypharmacy in the elderly can lead to treatment problems, increasing hospital admissions, morbidity and mortality and health expenditure Nursing care at home is a continuous development process and is increasing due to aging of the population, the prevalence of chronic diseases, as well as the increased life expectancy. It is estimated that in 2030, 24% of the Spanish population will be over 64 years. The physical, sensory, cognitive and chronic disabilities of aging make this type of care necessary. It is a major element in the comprehensive care of these patients, by checking the correct use of medication, symptom control, helping them to be autonomous in managing their disease and establishing a fluid relationship between the patients and their family. PMID:22284363
The Olympic environment has been identified as particularly stressful and unlike any other in terms of the media attention and focus placed on the competition. While the potential negative consequences of stress for coaches and their athletes have been explored, relatively little is known about the factors underpinning successful Olympic coaching performance. We explored elite coaches' perceptions of the factors
Peter Olusoga; Ian Maynard; Kate Hays; Joanne Butt
The Olympic environment has been identified as particularly stressful and unlike any other in terms of the media attention and focus placed on the competition. While the potential negative consequences of stress for coaches and their athletes have been explored, relatively little is known about the factors underpinning successful Olympic coaching performance. We explored elite coaches' perceptions of the factors
Peter Olusoga; Ian Maynard; Kate Hays; Joanne Butt
|This qualitative case study investigated middle grades literacy coaches' perspectives on their efforts to facilitate teacher change and impact classroom practice. Data were collected from three coaches as they worked with a variety of teachers in middle school settings, using field observation and interviews with coaches, teachers, and…
The National Advisory Board for the Literacy Coaching Clearinghouse have identified a number of considerations that it believed needed further discussion as schools, districts, and states embrace literacy coaching. It negotiated and discussed a number of issues surrounding coaching and agreed on 10 key ideas that should be part of the discussions…
Homehealth care is enjoying increased use and popularity. Unfortunately, in today's cost-cutting environment, home healthcare is also subject to increased scrutiny and inevitable reimbursement limitations. This is borne out by the impact on home healthcare as a result of the Balanced Budget Act of 1997. Berke (1998) reports that those at greatest risk for cutbacks in care are those that can least afford it--the oldest, sickest, poorest, and most frail. Compounding the financial dilemma that homehealth care clients face are multiple providers of care, an unrealistic media presentation of health care, and less time for anyone to provide psychosocial-focused care (Simmons, 1990). Homehealth care clients have a desperate need for an advocate to provide expert navigation through the health care system. Homehealth care providers are aware of and often responsible for bridging gaps in health, medical benefits, and social services. This article describes a process for determining the relevance of a certification to community nursing clinical practice--using the Advanced Certification in Continuity of Care (A-CCC) exam as the example. PMID:10695177
Preceptorship and mentorship programs are used in the health care sector to educate nurses, enhance their leadership skills, and improve their quality of work life. Recognizing the importance of these initiatives, Saint Elizabeth Health Care sought funding to create an innovative model of preceptorship\\/mentorship that meets the unique needs of homehealth care nurses. The methods utilized included focus groups,
CONTEXT.The receipt of health care in a medical home is increasingly touted as a fundamental basis for improved care for persons with chronic conditions, yet the evidence for this claim has not been systematically assessed. OBJECTIVE.Our goal was to determine the evidence for the federal Maternal and Child Health Bureau recommendation that children with special health care needs receive ongoing
Charles J. Homer; Kirsten Klatka; Diane Romm; Karen Kuhlthau; Sheila Bloom; Paul Newacheck; James M. Perrin
Health delivery practices are shifting towards home care. The reasons are the better possibilities for managing chronic care, controlling health delivery costs, increasing quality of life and quality of health services and the distinct possibility of predicting and thus avoiding serious complications. For the above goals to become routine, new telemedicine and information technology (IT) solutions need to be implemented
Nikolaos Maglaveras; Vassilis Koutkias; Ioanna Chouvarda; Dimitrios Goulis; A. Avramides; D. Adamidis; George Louridas; E. Andrew Balas
This weblog by Elena Aguilar details important issues about coaching teachers. The topics in the entries vary in content, but are always centered around the idea of transforming instruction through coaching.
The purpose of the study was to determine home environmental and health-related factors among home fallers and recurrent fallers in community dwelling older Korean women. The study population included 438 older women aged 65 years and over. Measures included a checklist of home environments and health-related items. Risk indicators for accidental falls and recurrent falling were analysed using logistic regression. Logistic regression analysis revealed that chronic disease (odds ratio (OR) = 2.02, P = 0.007), poor night light (OR = 1.97, P = 0.032) and obstacle of door sill (OR = 1.76, P = 0.021) were predictors of accidental falls, and physical inactivity (OR = 2.34, P = 0.018) and slippery floor in the bathroom (OR = 0.41, P = 0.034) were predictors of recurrent falling. The findings have implications for strategies and suggest the need to modify home environmental context in systematic and consistent ways and the need to maintain physical activities to prevent falls and recurrent falling. PMID:23009377
It’s difficult to start a new process, but a coach can make this easier. A coach is part developer and part manager. Coaches\\u000a help a team stay on process and they help the team learn. A coach brings in some outside perspective to help a team see themselves\\u000a more clearly.\\u000a \\u000a We’ll use a combination of lectures, games, and exercises to
Purpose: This study explored similarities and differ- ences in social support, homehealth service utiliza- tion, and health outcomes across four racial-ethnic groups of elders. Design and Methods: 1999 Out- comes Assessment Information Set records for 7,374 home care recipients who were 75 years of age or older and who were discharged to self-care were selected for bivariate and multivariate
Timothy R. Peng; Maryam Navaie-Waliser; Penny H. Feldman
Current advances in connectivity, sensor technology, computing power and the development of complex algorithms for processing\\u000a health-related data are paving the way for the delivery of innovative long-term health care services in the future. Such technological\\u000a developments will, in particular, assist the elderly and infirm to live independently, at home, for much longer periods. The\\u000a home is, in fact, becoming
Ann Cavoukian; Angus Fisher; Scott Killen; David A. Hoffman
The Department of Veterans Affairs (VA) amends its regulations concerning the billing methodology for non-VA providers of homehealth services and hospice care. Because the newly applicable methodology cannot supersede rates for which VA has specifically contracted, this rulemaking will only affect homehealth and hospice care providers who do not have existing negotiated contracts with VA. This rule also rescinds internal guidance documents that could be interpreted as conflicting with this final rule. PMID:23646376
|Formative coaching, an approach that uses student work as the foundation for mentoring and professional development, can help principals become more effective instructional leaders. In formative coaching, teaches and coaches analyze student work to determine next steps for instruction. This article shows how a principal can use the steps of the…
|The term "coaching" applies to a variety of types of test preparation programs which vary in length, instructional method, and content. Most research on the effectiveness of coaching has examined the Scholastic Aptitude Test (SAT), a measure of academic abilities used to predict college performance. This ERIC Digest reviews studies of coaching…
After briefly reviewing the existing literature on team coaching, we propose a new model with three distinguishing features. The model (1) focuses on the functions that coaching serves for a team, rather than on either specific leader behaviors or lead- ership styles, (2) identifies the specific times in the task performance process when coaching interventions are most likely to have
This article discusses the dramatic injury incidence in high school athletics, the lack of medical support for these injuries, and coaches' lack of knowledge and preparation regarding these injuries. It then considers implications of this situation for the coaching profession and for physical education programs that prepare coaches. (IAH)
|This handbook was generated by a survey of the specific needs of the coaching community serving young children as athletic coaches. The survey revealed a need for information that addresses the needs of beginning level volunteer coaches. The first section discusses the benefits of competitive sports for children and youth and the role of the…
|Studies indicate that many athletic coaches do not possess adequate knowledge of training and conditioning programs or treatment of athletic injuries. A shortage of qualified teachers able to coach allows for employment of underqualified individuals. Certification of professionals to coach interscholastic sports is suggested. (DF)|
|This article discusses the dramatic injury incidence in high school athletics, the lack of medical support for these injuries, and coaches' lack of knowledge and preparation regarding these injuries. It then considers implications of this situation for the coaching profession and for physical education programs that prepare coaches. (IAH)|
At some point in their lives, nearly one-half of all American children will have a behavioral health condition. Many will not receive the care they need from a fragmented health delivery system. The patient-centered medical home is a promising model to improve their care; however, little evidence exists. Our study aim was to examine the association between several behavioral health indicators and having a patient-centered medical home. 91,642 children's parents or guardians completed the 2007 National Survey of Children's Health. An indicator for patient-centered medical home was included in the dataset. Descriptive statistics, bivariate tests, and multivariate regression models were used in the analyses. Children in the sample were mostly Male (52 %), White (78 %), non-Hispanic (87 %), and did not have a special health care need (80 %). 6.2 % of the sample had at least one behavioral health condition. Conditions ranged from ADHD (6 %) to Autism Spectrum Disorder (ASD) (1 %). Frequency of having a patient-centered medical home also varied for children with a behavioral health condition (49 % of children with ADHD and 33 % of children with ASD). Frequency of having a patient-centered medical home decreased with multiple behavioral health conditions. Higher severity of depression, anxiety, and conduct disorder were associated with a decreased likelihood of a patient-centered medical home. Results from our study can be used to target patient-centered medical home interventions toward children with one or more behavioral health conditions and consider that children with depression, anxiety, and conduct disorder are more vulnerable to these disparities. PMID:23108741
In order to provide efficient and effective home care, we developed a collaboration system: “Yuitori Network” for health, welfare and medical works in home care. It is a groupware for workers in home care; public health nurses, helpers, nurses and doctors. It facilitates collaboration among workers by providing functions to plan a visiting schedule of workers, to store their visit
T. Mitsuishi; Y. Kimura; A. Ogawa; H. Kamata; J. Sasaki; Y. Funyu
The burgeoning costs of healthcare and growth in consumer use of the Internet to attain health-related information to better manage their health-care, coupled with demographic changes in the industrialized countries, strongly argues for the use of tele-health applications that can lower costs and improve the quality of healthcare delivery. Despite its potential, telehealth and digital home-health, has not progressed as
Objectives: To examine the influence of (a) proposed sources of efficacy information on dimensions of coaching efficacy and (b) coaching efficacy on coaching behavior and team variables.Design: A field correlational design tested relationships at two time points: near the beginning and at three-fourths of the way through a season of competition.Method: At Time 1, head coaches (n=135) completed a questionnaire
Nicholas D. Myers; Tiffanye M. Vargas-Tonsing; Deborah L. Feltz
|Secondary prevention programmes can be effective in reducing morbidity and mortality from coronary heart disease (CHD). In particular, UK guidelines, including those from the Department of Health, emphasize physical activity. However, the effects of secondary prevention programmes with an exercise component are moderate and uptake is highly…
Shaw, R.; Gillies, M.; Barber, J.; MacIntyre, K.; Harkins, C.; Findlay, I. N.; McCloy, K.; Gillie, A.; Scoular, A.; MacIntyre, P. D.
This report provides nationally representative data on policies, storage, and implementation of advance directives (ADs) in homehealth and hospice (HHH) agencies in the United States using the National Home and Hospice Care Survey. Federally mandated ADs policies were followed in >93% of all agencies. Nearly all agencies stored ADs in a file at the agency, but only half stored them at the patient's residence. Nearly all agencies informed staff about the AD, but only 77% and 72% of homehealth agencies informed the attending physician and next-of-kin, respectively. Homehealth and hospice agencies are nearly universally compliant with ADs policies that are required in order to receive Medicare and Medicaid payments, but have much lower rates of adoption of ADs policies beyond federally mandated minimums. PMID:21398271
Resnick, Helaine E; Hickman, Susan E; Foster, Gregory L
The health status of 48 families providing home care for their medically fragile children was studied. Mothers, as the primary caregivers, experienced a greater decline in their physical health than did fathers or siblings. When the financial burden of providing care was greater and when the relationship with care providers was more strained, families had more physical illness symptoms. Who provided home care services for the medically fragile child influenced the psychosocial impact on the family. Care provided by homehealth aides was associated with greater negative impact, whereas care from professional nurses reduced the negative impact. The trend toward home care for medically fragile children has been accelerating; this study points to the importance of studying the impact on the family of this kind of care. Policy implications regarding the amount and quality of services and payment for them are discussed. PMID:1506462
Ice hockey is a high-risk sport for concussion. It is important that coaches have an understanding of concussion, although previous studies have demonstrated poor knowledge of concussion recognition and management by youth coaches. A cross-sectional survey with 7 case scenarios was completed by 314 youth hockey coaches. Each case scenario described a player with a concussion during a game, and scores reflected how the coach would respond to each scenario. Although most coaches would not allow a player to continue participating in a game after suffering a concussion, there was a small percentage that would. Statistical analysis found an inverse relationship between the coaches' age and consideration of continued participation. This places athletes at significant risk for further injury and is not consistent with current concussion guidelines. USA Hockey should provide additional concussion training for their coaches as well as mandatory health care clearance following a concussion. PMID:21937746
Bramley, Harry; Kroft, Christopher; Polk, David; Newberry, Ty; Silvis, Matthew
Ninety-five percent (95 percent) of the elderly live in the community. At least five million of them need help with activities of daily living. Eighty percent have one or more chronic illness. Eighteen to 25 percent of the elderly have significant mental symptomatology. Only four percent of the elderly visit the community mental health centers (Ernst 1977; Talbott 1985). The primary providers of mental health services to the elderly are the general practitioners, the primary health care nurse, the homehealth aide psychiatric social workers, members of the family, and a few clinical geropsychologists (German 1987). Over half of the homehealth care clients are elderly. The primary homehealth care providers are "challenged" in providing comprehensive health services to the elderly in their homes--often because of a lack of training of the primary homehealth care provider or because of lack of access because of agencies' policies regarding the acceptance of patients with behavioral, social and mental disorders, including Alzheimer's disease. In this paper, I have profiled the behavioral, social and mental health needs of the elderly with physical illnesses as well as those with behavioral, social and mental disorders. I have dealt with those specific conditions which homehealth care providers and families find specifically challenging and worrisome, namely: Delirium (confusional states) Suicidal ideation and attempts Psychological assessment Dementia of Alzheimer's type Depression Delirium: (confusion and other behavioral problems associated with hip fractures) Psychotropic drug interaction Wandering Every effort must be made to respect the privacy of the elderly, protect the elderly from research risk, get informed consent when indicated, provide counseling and always assure a high quality of care and supervision. There must be a current plan of care in which both the patient and family participate when feasible. Every effort and plan of care must focus on the maintenance of independence and self-care capabilities and prevention of excessive disabilities. PMID:10303290
We discuss health monitoring as a potential application field for wearable sensors. We present some usage models for health monitoring and discuss the technical requirements for the health-monitoring system based on wearable and ambient sensors, which measure health-related data in daily environments of the users or patients. The presentation is by no means complete, but it aims to give an
|Purpose: The purpose of this work was to, among frail dually eligible older adults, determine risk factors for the likelihood of using Medicare homehealth and Medicaid homehealth services and to, among service users, determine correlates of Medicare homehealth, Medicaid homehealth, and Medicaid waiver service expenditures. Design and Methods:…
Fortinsky, Richard H.; Fenster, Juliane R.; Judge, James O.
Objective The objectives of this study were: to evaluate carers' knowledge of oral health; to provide a high quality, consistent, oral health training programme for carers in residential homes; to evaluate the quality of this programme by examining both carers' changes in knowledge and any changes in carers' behaviour as reported by residents and to assess any changes in the
D Simons; P Baker; B Jones; E A M Kidd; D Beighton
Chronic, long-term exposure to indoor air pollutants is increasingly being recognized as a threat to health. Vulnerable populations, such as those with cognitive disabilities, the elderly, and children, are frequently at increased risk from these hazards. This study assessed home environmental health hazards, home characteristics, and household practices that create risk in a sample of community-based group homes. A survey
|Good nutrition is important for optimal athletic performance. Adolescent athletes often depend on their coaches for nutritional information on weight management, dietary supplements, and dietary practices. Some dietary practices, such as vegetarianism, have the potential to be harmful to the adolescent athlete if not followed with careful…
|This volume is based on the premise that professional preparation for coaching should include viable experiences in drug education, with particular reference to coping with drug-related problems. The first section provides general information on the purposes and effects of drugs, controls, and concepts of doping. The second section deals with…
Objective: Although the medical home is promoted by the American Academy of Pediatrics and the Affordable Care Act, its impact on children without special health care needs is unknown. We examined whether the medical home is associated with beneficial health care utilization and health-promoting behaviors in this population. Methods: This study was a secondary data analysis of the 2003 National Survey of Children’s Health. Data were available for 70?007 children without special health care needs. We operationalized the medical home according to the National Survey of Children’s Health design. Logistic regression for complex sample surveys was used to model each outcome with the medical home, controlling for sociodemographic characteristics. Results: Overall, 58.1% of children without special health care needs had a medical home. The medical home was significantly associated with increased preventive care visits (adjusted odds ratio [aOR]: 1.32 [95% confidence interval (CI): 1.22–1.43]), decreased outpatient sick visits (aOR: 0.71 [95% CI: 0.66–0.76), and decreased emergency department sick visits (aOR: 0.70 [95% CI: 0.65–0.76]). It was associated with increased odds of “excellent/very good” child health according to parental assessment (aOR: 1.29 [95% CI: 1.15–1.45) and health-promoting behaviors such as being read to daily (aOR: 1.46 [95% CI: 1.13–1.89]), reported helmet use (aOR: 1.18 [95% CI: 1.03–1.34]), and decreased screen time (aOR: 1.12 [95% CI: 1.02–1.22]). Conclusions: For children without special health care needs, the medical home is associated with improved health care utilization patterns, better parental assessment of child health, and increased adherence with health-promoting behaviors. These findings support the recommendations of the American Academy of Pediatrics and the Affordable Care Act to extend the medical home to all children.
Bauchner, Howard; Sege, Robert D.; Cabral, Howard J.; Garg, Arvin
The Environmental Health\\/Home Safety Education Project (Proyecto de Salud Ambiental y Seguridad en el Hogar) has been developed in response to a wide array of severe and often preventable environmental health issues occurring in and around homes on the U.S.—Mexico border. Utilizing well-trained community members, called promotoras , homes are visited and assessed for potential environmental hazards, including home fire
Susan C. Forster-Cox; Thenral Mangadu; Benjamín Jacquez; Lynne Fullerton
This study employed a conceptual model to examine the relationship processes and mediating role of client-coach relationship between client-coach match criteria and coaching outcomes to advance the understanding of client- coach relationship's impact on l...
Objective: Contemporary health care places enormous health information management demands on laypeople. Insights into their skills and habits complements current developments in consumer health innovations, including personal health records. Using a five-element human factors model of work, health information management in the household (HIMH) is characterized by the tasks completed by individuals within household organizations, using certain tools and technologies in a given physical environment. Design: We conducted a descriptive-exploratory study of the work of HIMH, involving 49 community-dwelling volunteers from a rural Midwestern community. Measurements: During in-person interviews, we collected data using semistructured questionnaires and photographs of artifacts used for HIMH. Results: The work of HIMH is largely the responsibility of a single individual, primarily engaged in the tasks of acquiring, managing, and organizing a diverse set of health information. Paper-based tools are most common, and residents develop strategies for storing information in the household environment aligned with anticipated use. Affiliative relationships, e.g., parent-child or spousal, within the household serve as the organization that gives rise to health information management practices. Synthesis of these findings led to identification of several storage strategies employed in HIMH. These strategies are labeled “just-in-time,” “just-because,” “just-in-case,” and “just-at-hand,” reflecting location of the artifacts of health information and anticipated urgency in the need to retrieve it. Conclusion: Laypeople develop and employ robust, complex strategies for managing health information in the home. Capitalizing on these strategies will complement and extend current consumer health innovations to provide functional support to people who face increasing demands to manage personal health information.
Diabetes has become an epidemic in the United States and home healthcare clinicians are taking care of more patients with diabetes than ever. It takes an interdisciplinary team to provide the complicated care needed to keep patients with diabetes out of the hospital. Understanding the oral diabetes medications available is crucial for clinicians in improving outcomes for patients. PMID:23238625
The objective of the study was to create a data base that will aid in further describing technology-dependent children being cared for in their homes. Specific aims are to: (1) Identify selected demographic characteristics of technology-dependent children...
This article illustrates several key components regarding caring for adult oncology patients at home, such as focusing on the oncology nurse as the patient care coordinator (PCC) instead of utilizing today's terminology as the case manager. Oncology nurses are of a rare breed. They must have extensive skill, knowledge, compassion, and insight to manage patients with devastating diseases, which sets
This article briefly describes the mandate for evidence-based practice in social work, the basic principles of evidence-based social work practice, systemic obstacles to evidence-based social work practice in home care, and suggestions for removing these obstacles.
People around the world come together on Dec. 1 each year for World AIDS Day, a time to commemorate those lost to the deadly disease and to celebrate progress made to stop its spread. One way of preventing the spread of the disease is early detection of the HIV virus, which some say could be more easily done at home.
BACKGROUND: Despite the many antihypertensive medications available, two-thirds of patients with hypertension do not achieve blood pressure control. This is thought to be due to a combination of poor patient education, poor medication adherence, and \\
Heather Bennett; Kelsey Laird; David Margolius; Victoria Ngo; David H Thom; Thomas Bodenheimer
To conduct a systematic review of the evidence associating the medical home with beneficial health outcomes in healthy children. The English-language pediatric literature 1975-2011 was searched via PubMed, Embase and CINAHL. Inclusion criteria (the medical home as an independent variable, individual-level quantitative analysis, outpatient setting in the US, healthy children) and exclusion criteria (age >18, medical home operationalized with only one American Academy of Pediatrics component) were determined a priori. Presence of a medical home was examined in relation to three outcome measures: primary care services, health care utilization, and child well-being. Of 4,856 unique citations, 9 studies were included in the final systematic review, amassing 290,180 children from 6 data sources. Two drew on prospective cohort data; the remainder, on cross-sectional design. Children with a medical home were more likely to receive preventive medical care (2 studies), anticipatory guidance (1 study), and developmental screening (1 study); to have higher health-related quality of life (1 study); and were less likely to seek care in the emergency department (2 studies). The medical home was associated with full immunization status in only 1 of 4 studies examining this outcome. No protective effect of the medical home was found with regard to preventable hospitalization (1 study). The medical home is associated with beneficial health outcomes among healthy children. However, the evidence is limited in comparison with that for children with special health care needs. As healthy children represent the majority of the pediatric population, this lack of evidence represents a significant knowledge gap. PMID:23784614
Medicare Part B payments for mental health services during non-Part A nursing home stays continue to be an area of concern. Our results are consistent with prior OIG reports that have identified inappropriately paid mental health services. Thirty-nine per...
Education, training, and competency assessment of homehealth care personnel is receiving increased attention due to the demands of managed care, health care reform, cost containment initiatives, accreditation, and regulatory bodies. Staff development educators carry the burden of competency assessment and therefore are in need of a method to analyze staff's perceived level of knowledge prior to beginning a competency
Terasa M. Astarita; Gayle E. Materna; Christine Savage
Designing Smart Health Care; Technology into the Home of the Future Steve Warren, Ph.D. and Richard L. Craft, Sandia National Laboratories, P.O. Box 5800, Albuquerque, NM87185. Abstract This editorial paper presents a vision for intelligent health care in...
Nursing home assistants have physically and emotionally challenging jobs, and they often work demanding schedules in order to provide 24-h care. While the physical effects of demanding work schedules have been studied, little is known about the impact on mental health. This study explored the relationship between demanding scheduling variables and mental health indicators of depression, anxiety and somatization. A
Jeanne Geiger-brown; Carles Muntaner; Jane Lipscomb; Alison Trinkoff
|In 1997, American Evaluation Association member George Grob, now retired from the U.S. Department of Health and Human Services (HHS) and currently President of the Center for Public Program Evaluation, made a testimony on Medicare homehealth care fraud and abuse before the U.S. Senate Special Committee on Aging. The occasion was to announce the…
Since 2002 and the introduction of outcome-based quality improvement reports by the Centers for Medicare and Medicaid Services, all homehealth professionals have recognized a heightened importance in the measurement of change in the daily functioning of patients from onset to discharge of the agency's service. As health care professionals whose expertise focuses on safe and meaningful participation in occupations
The Patient Protection and Affordable Care Act (PPACA) was passed into legislation in March 2010, making health care reform a reality. Perhaps the most well-developed model of primary care that aligns with the PPACA's agenda is the patient-centered medical home (PCMH). Integrated care, as defined by collaborative care between mental health and primary care providers and systems, will undoubtedly play
A new concept is revolutionizing the way companies and consumers communicate in the digital age. That concept is social media—online communication that is interactive, collaborative, and democratic. Things that you will learn from this article are the following: What is social media and what does it have to offer the health care community? More important, how can homehealth care
In this paper, we examine the association between caregiver staffing levels and mental health outcomes in approximately 17,000 U.S. nursing homes. As outcomes, we focus on deficiency citations available in the Center for Medicare and Medicaid Services’ Online Survey, Certification, And Recording data. We examine nurse aide, licensed practical nurse, registered nurse, and mental health provider staffing. Our results show
In 2007, about 5,900 of the 14,500 providers of homehealth or hospice care (41%) had electronic medical records (EMRs), and an additional 2,200 (15%) planned to have EMRs within the next year. Providers who offered both hospice and homehealth care were more likely to have EMRs than providers offering only homehealth care, but did not differ from providers of hospice care only. Among providers with EMRs, 98% used components for recording patient demographics and 83% for clinical notes, and over one-half used clinical decision support systems or computerized physician order entry. Nonprofit and government providers, providers jointly owned or operated with other health care organizations, and providers with over 150 patients were more likely to have EMRs. PMID:21050535
Coaching Corner is a section of the website of the National Council of Supervisors of Mathematics. This page is designed to support specialists, coaches and leaders of coaching programs as they progress through the stages of leadership growth. Coaching Corner points to key aspects of knowledge that specifically apply to coaches and coaching programs and provides resources to support a specialist, coach or leader in gaining such knowledge. Sections include Resources for Coaches, Resources for Coaching Leaders, Professional Learning Opportunities, FAQs, and links to supportive websites.
OBJECTIVE: To describe coaches' education in injury care and management and their club's access to medical care, to describe coaches' perceptions of how family physicians care for sports injuries, and to describe strategies used for overcoming perceived poor advice. DESIGN: A telephone survey using both closed and open-ended questions was conducted. Information was collected as background information to a larger study investigating coaches' decisions about allowing injured athletes to compete. SETTING: All 28 competitive gymnastics clubs in the province of Alberta. The clubs trained athletes for all competitive levels. PARTICIPANTS: All 70 coaches registered with the Alberta Gymnastics Federation as working with female gymnasts were approached; 64 coaches were interviewed. MAIN OUTCOME MEASURES: Injury education, access to medical care, perceptions of sports-injury treatment provided by family physicians, strategies employed for overcoming perceived poor advice. RESULTS: Education in injury care and management was varied, as was access to medical care. Direct access to sport-specific medical care was available at three of the five elite-level clubs, an arrangement stemming from dissatisfaction with the conventional health care system. At all competitive levels, most coaches were dissatisfied with the recommendations they received from family physicians. Various strategies were employed to acquire more suitable advice. CONCLUSIONS: The results point to a need for improved communication between family physicians and coaches.
We evaluated whether combining asthma trigger reduction with housing structural repairs, device disbursement and education in low-income households with children would improve self-reported respiratory health and reduce housing-related respiratory health and injury hazards (convenience sample of n=67 homes with 63 asthmatic and 121 non-asthmatic children). At baseline, a visual assessment of the home environment and a structured occupant interview were used to examine 29 potential injury hazards and 7 potential respiratory health hazards. A home-specific intervention was designed to provide the children's parents or caretakers with the knowledge, skills, motivation, supplies, equipment, and minimum housing conditions necessary for a healthy and safe home. The enrolled households were primarily Hispanic and owned their homes. On average, 8 injury hazards were observed in the homes at baseline. Four months following intervention, the average declined to 2.2 hazards per home (p<0.001), with 97% of the parents reporting that their homes were safer following the interventions. An average of 3.3 respiratory health hazards were observed in the homes at baseline. Four months following intervention, the average declined to 0.9 hazards per home (p<0.001), with 96% of parents reporting that the respiratory health of their asthmatic children improved. A tailored healthy homes improvement package significantly improves self-reported respiratory health and safety, reduces respiratory health and injury hazards, and can be implemented in concert with a mobile clinical setting.
Dixon, Sherry L. [National Center for Healthy Housing, 10320 Little Patuxent Parkway, Suite 500, Columbia, MD 21044 (United States)], E-mail: firstname.lastname@example.org; Fowler, Cecile [City of Phoenix, Neighborhood Services Department, Phoenix, AZ (United States); Harris, Judy; Moffat, Sally [Phoenix Children's Hospital, Phoenix, AZ (United States); Martinez, Yolanda [City of Phoenix, Neighborhood Services Department, Phoenix, AZ (United States); Walton, Heather; Ruiz, Bernice [Phoenix Children's Hospital, Phoenix, AZ (United States); Jacobs, David E. [National Center for Healthy Housing, 10320 Little Patuxent Parkway, Suite 500, Columbia, MD 21044 (United States)
Background Home visiting programs have been developed aimed at improving the health and independent functioning of older people. Also, they intend to reduce hospital and nursing home admission and associated cost. A substantial number of studies have examined the effects of preventive home visiting programs on older people living in the community; the findings have been inconsistent. The objective of this review was to assess the effectiveness of intensive home visiting programs targeting older people with poor health or otherwise with functional impairments. Methods A search for literature was based on included trials from four reviews on the effectiveness of home visits published after 2000 and on a database search of Cinahl, the Cochrane Central Register of Controlled Trials, Embase, Medline and PsycINFO from 2001 onwards. We also manually searched reference lists from potentially relevant papers. Randomized controlled trials were included assessing the effectiveness of intervention programs consisting of at least four home visits per year, an intervention duration of 12 months or more, and targeting older people (aged 65 years and over) with poor health. Two reviewers independently abstracted data from full papers on program characteristics and outcome measures; they also evaluated the methodological quality. Results The search identified 844 abstracts; eight papers met the inclusion criteria. Seven trials were of sufficient methodological quality; none of the trials showed a significant favorable effect for the main analysis comparing the intervention group with the control group on mortality, health status, service use or cost. The inclusion of less-intensive intervention programs for frail older persons would not have exerted a great influence on the findings of our review. Conclusion We conclude that home visiting programs appear not to be beneficial for older people with poor health within the health care setting of Western countries.
Bouman, Ans; van Rossum, Erik; Nelemans, Patricia; Kempen, Gertrudis IJM; Knipschild, Paul
Office home care workers provide support to visiting staff, although their work tends to be invisible in many respects. This paper focuses on managers, supervisors, coor dinators, case managers and office administrative staff in home care. We examine the effects of workplace flexibility and worker insecurity on office home care workers' occupational health, particularly their self-reported stress and musculoskeletal disorders. Data come from our survey of 300 home care office staff in a mid-sized city in Ontario. Results show that workers' perceptions of insecurity are positively associated with musculoskeletal disorders but not workplace flexibility measures. We recommend that managers and other decision-makers in the home care field pay attention to the perceptions of workers' insecurity in initiating workplace flexibility measures. PMID:20436813
Zeytinoglu, Isik U; Denton, Margaret; Davies, Sharon; Plenderleith, Jennifer Millen
Office home care workers provide support to visiting staff, although their work tends to be invisible in many respects. This paper focuses on managers, supervisors, coor dinators, case managers and office administrative staff in home care. We examine the effects of workplace flexibility and worker insecurity on office home care workers' occupational health, particularly their self-reported stress and musculoskeletal disorders. Data come from our survey of 300 home care office staff in a mid-sized city in Ontario. Results show that workers' perceptions of insecurity are positively associated with musculoskeletal disorders but not workplace flexibility measures. We recommend that managers and other decision-makers in the home care field pay attention to the perceptions of workers' insecurity in initiating workplace flexibility measures.
Zeytinoglu, Isik U.; Denton, Margaret; Davies, Sharon; Plenderleith, Jennifer Millen
BACKGROUND: This study examined the effects of health education on modification of health belief and intention among pregnant women to have smoke free home. METHODS: In this randomized controlled study, 91 pregnant women completed the study in two groups. Intervention group was educated about the harms of environmental tobacco smoke (ETS) exposure. The Health Belief Model (HBM) was a framework for analyzing the beliefs. After 10-12 weeks, the HBM constructs and weekly ETS exposure at home were compared between the two groups. RESULTS: After performing educational program, the subjects in intervention group perceived more susceptibility and severity and reported lower weekly ETS exposure at home than subjects in control group; but, the self efficacy and perceived barrier were not different. The relationships between HBM constructs and weekly ETS exposure were significant; but, there was no significant difference in point prevalence of having smoke free home. CONCLUSIONS: This study indicated that the health education about ETS exposure can modify health belief and reduce EST exposure among pregnant women, but cannot affect the self efficacy and perceived barrier. To have smoke free home, they need to increase their self efficacy.
The purpose of this descriptive study was to assess homehealth care nurses' exposure to bloodborne pathogens, evaluate Medicare Certified Home Healthcare Agency (MCHHA) and hospice organization practices related to the Occupational Safety and Health Administration's (OSHA) Bloodborne Pathogens Standard and the Needlestick Safety and Prevention Act, and link the two to recommend safety improvements. This study evaluated the experiences of 355 homehealth care nurses and 30 MCHHA and hospice employers in one mid-Atlantic state regarding bloodborne pathogen programs and practices and blood and sharps contact. An index was developed to evaluate employer compliance with OSHA's Bloodborne Pathogens Standard. Employer policies and nurse practice related to the OSHA Bloodborne Pathogens Standard did not meet all requirements despite identified risk. Thirty-eight homehealth care nurses from 12 of the 30 employers reported needlestick injuries within the past year, yet employers reported only 18 nurse needlestick injuries within the same year. Using the bloodborne pathogen compliance index, employers can review and revise their exposure control plans to ensure compliance. This intervention should benefit both employer policies and nurse practice to improve safety and decrease the risks from bloodborne pathogens in the homehealth care setting. PMID:19639859
Scharf, Barbara B; McPhaul, Kathleen M; Trinkoff, Alison; Lipscomb, Jane
With the aging of the population and the increasing patient preference for receiving care in their own homes, remote home care is one of the fastest growing areas of health care in Taiwan and many other countries. Many remote home-monitoring applications have been developed and implemented to enable both formal and informal caregivers to have remote access to patient data so that they can respond instantly to any abnormalities of in-home patients. The aim of this technology is to give both patients and relatives better control of the health care, reduce the burden on informal caregivers and reduce visits to hospitals and thus result in a better quality of life for both the patient and his/her family. To facilitate their widespread adoption, remote home-monitoring systems take advantage of the low-cost features and popularity of the Internet and PCs, but are inherently exposed to several security risks, such as virus and denial-of-service (DoS) attacks. These security threats exist as long as the in-home PC is directly accessible by remote-monitoring users over the Internet. The purpose of the study reported in this paper was to improve the security of such systems, with the proposed architecture aimed at increasing the system availability and confidentiality of patient information. A broker server is introduced between the remote-monitoring devices and the in-home PCs. This topology removes direct access to the in-home PC, and a firewall can be configured to deny all inbound connections while the remote home-monitoring application is operating. This architecture helps to transfer the security risks from the in-home PC to the managed broker server, on which more advanced security measures can be implemented. The pros and cons of this novel architecture design are also discussed and summarized. PMID:16621655
OBJECTIVE: To investigate charge and payment differentials for homehealth services across different payors. DATA SOURCES: The 1992 National Home and Hospice Care Survey, a nationally representative survey of home and hospice care agencies and their patients, collected by the National Center for Health Statistics. STUDY DESIGN: We compare the average charge for a Medicare homehealth visit to the average charge for patients with other sources of payment. In making such comparisons, we control for differences across payors in service mix and agency characteristics. PRINCIPAL FINDINGS: Agencies charge various payors different amounts for similar services, and Medicare is consistently charged more than other payors. CONCLUSIONS: Findings imply the potential existence of payment differentials across payors for homehealth services, with Medicare and privately insured patients likely to be paying more than others for similar services. Such conclusions raise the possibility that, as in other segments of the healthcare market, cost-shifting and price discrimination might exist within the homehealth industry. Future research should explore these issues, along with the question of whether Medicare is paying too much for homehealth services.
The Preventive Health Education and Medical Home Project (PHEMHP) is a predictive and contextual model intended to reduce low levels of health services utilization and improve preventive health techniques and disease self-management for low-income families in South Central Los Angeles, with the ultimate goal of attaching each child to a medical home. The model is designed to be implemented through
David B. Tataw; Frederick James; Shahrzad Bazargan
The purpose of this article is to review the literature on and discuss how interactions between bio-behavioral aging, nursing home environments, and social forces shaping current health care policies have contributed to oral health disparities in frail and functionally dependent elders who reside in nursing homes. Emerging empirical evidence suggests links between poor oral health with dental plaque deposition and
Rita A. Jablonski; Cindy L. Munro; Mary Jo Grap; Ronald K. Elswick
This paper discuss the ability to obtain a reliable pervasive information at home from a network of localizing sensors allowing\\u000a to follow the different locations at which a dependent (elderly or handicapped) person can be detected. The data recorded\\u000a can be treated as the sequence of color coding numbers of balls (symbolizing activity-stations) taken in a Polya’s urn, in\\u000a which
Yannick Fouquet; Nicolas Vuillerme; Jacques Demongeot
We present a simple but effective handoff protocol that enables continuous monitoring of ambulatory patients at home by means of resource-limited sensors. Our proposed system imple- ments a 2-tier network: one created by wearable sensors used for vital signs collection, and another by a point-to-point link estab- lished between the body sensor network coordinator device and a fixed access point
Sergio González-Valenzuela; Min Chen; Victor C. M. Leung
This editorial paper presents a vision for intelligent health care in the home of the future, focusing on technologies with the highest potential payoff given targeted government funding over the next ten years. A secure, plug-and-play information framework provides the starting point for identifying technologies that must be developed before home-based devices can know their context and assimilate information to support care decisions.
Background Cancer-related pain is common and under-treated. This article describes a study designed to test the effectiveness of a theory-driven, patient-centered coaching intervention to improve cancer pain processes and outcomes. Methods/Design The Cancer Health Empowerment for Living without Pain (Ca-HELP) Study is an American Cancer Society sponsored randomized trial conducted in Sacramento, California. A total of 265 cancer patients with at least moderate pain severity (Worst Pain Numerical Analog Score >=4 out of 10) or pain-related impairment (Likert score >= 3 out of 5) were randomly assigned to receive tailored education and coaching (TEC) or educationally-enhanced usual care (EUC); 258 received at least one follow-up assessment. The TEC intervention is based on social-cognitive theory and consists of 6 components (assess, correct, teach, prepare, rehearse, portray). Both interventions were delivered over approximately 30 minutes just prior to a scheduled oncology visit. The majority of visits (56%) were audio-recorded for later communication coding. Follow-up data including outcomes related to pain severity and impairment, self-efficacy for pain control and for patient-physician communication, functional status and well-being, and anxiety were collected at 2, 6, and 12 weeks. Discussion Building on social cognitive theory and pilot work, this study aims to test the hypothesis that a brief, tailored patient activation intervention will promote better cancer pain care and outcomes. Analyses will focus on the effects of the experimental intervention on pain severity and impairment (primary outcomes); self-efficacy and quality of life (secondary outcomes); and relationships among processes and outcomes of cancer pain care. If this model of coaching by lay health educators proves successful, it could potentially be implemented widely at modest cost. Trial Registration [Clinical Trials Identifier: NCT00283166
Medical homes deliver primary care that is accessible, continuous, comprehensive, family centered, coordinated, compassionate and culturally effective. Children with special health care needs (CSHCN) require a wide range of support to maintain health, making medical home access particularly important. We sought to understand independent risk factors for lacking access. We analyzed Ohio, USA data from the National Survey of Children with Special Health Care Needs (2005-2006). Among CSHCN, 55.6% had medical home access. The proportion achieving each medical home component was highest for having a personal doctor/nurse and lowest for receiving coordinated care, family-centered care and referrals. Specific subsets of CSHCN were significantly and independently more likely to lack medical home access: Hispanic (AOR=3.08), moderate/high severity of difficulty (AOR=2.84), and any public insurance (AOR=1.60). Efforts to advance medical home access must give special attention to these CSHCN populations and improvements must be made to referral access, family-centered care, and care coordination. PMID:23242811
Conrey, Elizabeth J; Seidu, Dazar; Ryan, Norma J; Chapman, Dj Sam
BACKGROUND: Preventive home visits to elderly people by public health nurses aim to maintain or improve the functional status of elderly and reduce the use of institutional care services. A number of trials that investigated the effects of home visits show positive results, but others do not. The outcomes can depend on differences in characteristics of the intervention programme, but
Ans Nicolaides-Bouman; Erik van Rossum; Gertrudis IJM Kempen; Paul Knipschild
Objective To investigate socioeconomic disparities in access to homehealth visits and durable medical equipment by persons enrolled in two Medicare managed care health plans. Data Sources A telephone survey of 4,613 Medicare managed care enrollees conducted between April and October of 2000 and linked to administrative claims for a subsequent 12-month period. Study Design We estimated a series of logistic regression models to determine which socioeconomic factors were related to homehealth visits and the use of durable medical equipment (DME) among Medicare managed care enrollees. Principal Findings Controlling for health and demographic differences, Medicare managed care enrollees in the lowest tertile for nonhousing assets had 50 percent greater odds than those in the highest tertile of having one or more homehealth visits. All else equal, enrollees with less than a high school education had 30 percent lower odds than those who had graduated from high school of using durable medical equipment. Conclusions Medicare managed care enrollees of low socioeconomic status do not appear to have reduced access to homehealth visits; however, use of durable medical equipment is considerably lower for enrollees with less than a high school education. Physicians and therapists working with Medicare managed care enrollees may want to actively target DME prescriptions to those with educational disadvantages.
Freedman, Vicki A; Rogowski, Jeannette; Wickstrom, Steven L; Adams, John; Marainen, Jonas; Escarce, Jose J
The US health care industry is experiencing a substantial paradigm shift with regard to home care due to the convergence of several technology areas. Increasingly-capable telehealth systems and the internet are not only moving the point of care closer to the patient, but the patient can now assume a more active role in his or her own care. These technologies, coupled with (1) the migration of the health care industry to electronic patient records and (2) the emergence of a growing number of enabling health care technologies (e.g., novel biosensors, wearable devices, and intelligent software agents), demonstrate unprecedented potential for delivering highly automated, intelligent health care in the home. This editorial paper presents a vision for the implementation of intelligent health care technology in the home of the future, focusing on areas of research that have the highest potential payoff given targeted government funding over the next ten years. Here, intelligent health care technology means smart devices and systems that are aware of their context and can therefore assimilate information to support care decisions. A systems perspective is used to describe a framework under which devices can interact with one another in a plug-and-play manner. Within this infrastructure, traditionally passive sensors and devices will have read/write access to appropriate portions of an individual's electronic medical record. Through intelligent software agents, plug-and-play mechanisms, messaging standards, and user authentication tools, these smart home-based medical devices will be aware of their own capabilities, their relationship to the other devices in the home system, and the identity of the individual(s) from whom they acquire data. Information surety technology will be essential to maintain the confidentiality of patient-identifiable medical information and to protect the integrity of geographically dispersed electronic medical records with which each home-based system will interact.
This study examined Florida Medicaid mental health expenditures for children in out-of-home care. Child welfare and Medicaid administrative databases were analyzed using two-part models to identify characteristics associated with expenditures. Mental health expenditures were higher for older children, boys, children who were abused or lost their caregivers, or with a longer length of stay in out-of-home care. In contrast, African American children were less likely to have positive expenditures than White children, but among youth with positive expenditures, African Americans had higher expenditures. In addition, among youth with positive expenditures, substance use and affective disorders were associated with higher expenditures. PMID:21116702
Clark, Colleen; Yampolskaya, Svetlana; Robst, John
This tutorial gives you a lead on becoming or redefining yourself as an Agile Coach. Introduction to elements and dimensions of state-of-the-art Agile Coaching. How to position the agile coach to be effective in a larger setting. Making the agile transition - from a single team to thousands of people. How to support multiple teams as a coach. How to build a coaches network in your company. Challenges when the agile coach is a consultant and the organization is large.
For community engagement to be successful, the interests of the community must be taken into account and researchers must become facilitators. Patience is required. Meaningful and sustainable relationships that have been developed over time promote mutual learning and capacity building among the partners (Elders, community members, health care providers, and researchers). In addition, community engagement leads to the sharing of available resources (eg, human, time, and financial) and to a sustained commitment by the partners. This mutual commitment makes future projects easier to develop and complete. Thus, authentic transformative health development, informed by participatory health research, becomes an ongoing process. PMID:24029518
This monograph was developed to be used as a teaching aid in an interdisciplinary clinical training program for health professions students. It is based on the recognition that for professionals of various disciplines to work well together, the discipline...
This article is based on the invited presentation by the author at the American Psychological Association's Annual Convention, August 4-7, 2011, upon his receipt of the Joseph D. Matarazzo Award for Distinguished Contributions to Psychology in Academic Health Centers presented by the Association of Psychologists in Academic Health Centers. This article relates the history, roles, and responsibilities of psychologists in academic health centers to the ultimate survival and success of professional psychology. It describes implications of the Patient Protection and Affordable Care Act (ACA) on the institutional practice of psychology including how psychology's place in academic health centers positions the field well for the future of healthcare reform. The article provides several recommendations to help professional psychology prepare for that future of integrated, interprofessional healthcare. PMID:22592297
The 1965 Standards for Homemaker - Health Aide Services of the National Council for Homemaker Services are supplemented and amplified. The primary objective of homemaker services is to help maintain, safeguard, and enrich family life. Four important aspec...
This final rule sets forth updates to the homehealth prospective payment system (HH PPS) rates, including: the national standardized 60-day episode rates; the national per-visit rates; and the low utilization payment amount (LUPA) under the Medicare PPS for homehealth agencies effective January 1, 2012. This rule applies a 1.4 percent update factor to the episode rates, which reflects a 1 percent reduction applied to the 2.4 percent market basket update factor, as mandated by the Affordable Care Act. This rule also updates the wage index used under the HH PPS, and further reduces homehealth payments to account for continued nominal growth in case-mix which is unrelated to changes in patient health status. This rule removes two hypertension codes from the HH PPS case-mix system, thereby requiring recalibration of the case-mix weights. In addition, the rule implements two structural changes designed to decrease incentives to upcode and provide unneeded therapy services. Finally, this rule incorporates additional flexibility regarding face-to-face encounters with providers related to homehealth care. PMID:22059280
Post-partum depression affects 10-13% of Japanese women, but many do not receive appropriate treatment or support. This intervention study evaluated the effectiveness of home visits by mental health nurses for Japanese women with post-partum depression. Eighteen post-partum women met the inclusion criteria and were randomly allocated into the intervention (n = 9) or control (n = 9) group at 1-2 months after giving birth. The intervention group received four weekly home visits by a mental health nurse. Control group participants received usual care. Two women in the intervention group did not complete the study. Depressive symptoms and quality of life were measured at 1 and 6 weeks' postintervention. In addition, participants completed an open-ended questionnaire on satisfaction and meaning derived from the home visits. Women in the intervention group had significant amelioration of depressive symptoms over time and reported positive benefits from the home visits, but there were no statistically significant differences between groups. Significant differences (P < 0.05) were observed at times 2 and 3 between groups in terms of increased median scores of physical, environmental, and global subscales, and the total average score of the World Health Organization/quality of life assessment instrument. On the psychological subscale, significant differences (P = 0.042) were observed between groups at time 2. The qualitative analysis of comments about home visitation revealed four categories related to 'setting their mind at ease', 'clarifying thoughts', 'improving coping abilities', and 'removing feelings of withdrawal from others'. These results suggest that home visits by mental health nurses can contribute to positive mental health and social changes for women with post-partum depression. A larger trial is warranted to test this approach to care. PMID:19128289
Background One area where the use of information and communication technology (ICT), or eHealth, could be developed is the homehealth care of premature infants. The aim of this randomized controlled study was to investigate whether the use of video conferencing or a web application improves parents’ satisfaction in taking care of a premature infant at home and decreases the need of home visits. In addition, nurses’ attitudes regarding the use of these tools were examined. Method Thirty-four families were randomized to one of three groups before their premature infant was discharged from the hospital to homehealth care: a control group receiving standard homehealth care (13 families); a web group receiving homehealth care supplemented with the use of a web application (12 families); a video group with homehealth care supplemented with video conferencing using Skype (9 families). Families and nursing staff answered questionnaires about the usefulness of ICT. In addition, semi-structured interviews were conducted with 16 families. Results All the parents in the web group found the web application easy to use. 83% of the families thought it was good to have access to their child’s data through the application. All the families in the video group found Skype easy to use and were satisfied with the video calls. 88% of the families thought that video calls were better than ordinary phone calls. 33% of the families in the web group and 75% of those in the video group thought the need for home visits was decreased by the web application or Skype. 50% of the families in the web group and 100% of those in the video group thought the web application or the video calls had helped them feel more confident in caring for their child. Most of the nurses were motivated to use ICT but some were reluctant and avoided using the web application and video conferencing. Conclusion The families were satisfied with both the web application and video conferencing. The families readily embraced the use of ICT, whereas motivating some of the nurses to accept and use ICT was a major challenge.
Sicker patients with greater care needs are being discharged to their homes to assume responsibility for their own care with fewer nurses available to aid them. This situation brings with it a host of human factors and ergonomic (HFE) concerns, both for the home care nurse and the home dwelling patient, that can affect quality of care and patient safety. Many of these concerns are related to the critical home care tasks of information access, communication, and patient self-monitoring and self-management. Currently, a variety of health information technologies (HITs) are being promoted as possible solutions to those problems, but those same technologies bring with them a new set of HFE concerns. This paper reviews the HFE considerations for information access, communication, and patients self-monitoring and self-management, discusses how HIT can potentially mitigate current problems, and explains how the design and implementation of HIT itself requires careful HFE attention.
Or, Calvin K.L.; Valdez, Rupa S.; Casper, Gail R.; Carayon, Pascale; Burke, Laura J.; Brennan, Patricia Flatley; Karsh, Ben-Tzion
Objective To examine the effects of electronic health information technology (HIT) on nursing home residents. Methods The study evaluated the impact of implementing a comprehensive HIT system on resident clinical, functional, and quality of care outcome indicators, as well as measures of resident awareness of and satisfaction with the technology. The study used a prospective, quasi-experimental design, directly assessing 761 nursing home residents in 10 urban and suburban nursing homes in the greater New York City area. Results No statistically significant impact of the introduction of HIT on residents was found on any outcomes, with the exception of a significant negative effect on behavioral symptoms. Residents' subjective assessment of the HIT intervention were generally positive. Discussion The absence of effects on most indicators is encouraging for the future development of HIT in nursing homes. The single negative finding suggests that further investigation is needed on possible impact on resident behavior.
Pillemer, Karl; Meador, Rhoda H.; Teresi, Jeanne A.; Chen, Emily K.; Henderson, Charles R.; Lachs, Mark S.; Boratgis, Gabriel; Silver, Stephanie; Eimicke, Joseph P.
|There is much variability in coach preparation across the United States. No one model of coach development seems to fit the needs of all levels of sport competition or the wide variety of consumers. Moreover, there are many entities involved in prescribing requirements such as national governing bodies, state legislatures and boards of…
|Why do some athletic coaches succeed every season while others suffer loss after loss? This book describes the beliefs, behaviors, and attitudes of great athletic coaches. Where do they focus their attention? How do they spend their time and energy? And how can others gain the same advantages? Here, Rob Haworth and Todd Whitaker describe the…
|The author, a high school teacher and forensics coach, describes ways to teach writing--including on-demand essays--that draw on successful practices she developed in coaching. Students learn the importance of using personal conviction and qualified thesis statements to build arguments, as well as learning "The Debater Four-Step," an effective…
Background Influenza virus infection poses a major threat to the elderly people in residential care. We sought to describe the extent to which local public health services in England were positioned to detect and respond effectively to influenza-like illness (ILI) in nursing homes. Methods A questionnaire-based survey was conducted in all 34 Health Protection Units (HPUs) regarding the 2004-05 influenza
R. K. Gupta; H. Zhao; M. Cooke; R. Harling; M. Regan; L. Bailey; J. S. Nguyen-Van-Tam
Purpose – This paper aims to employ a conceptual model to examine the relationship processes and mediating role of client-coach relationship between client-coach match criteria and coaching outcomes to advance the understanding of client-coach relationship's impact on leadership coaching. Design\\/methodology\\/approach – Data collected from 74 client-coach pairs participating in a voluntary leadership coaching program at a military service academy during
This document introduces COACH UNILANG, a standard language for coaching (Robo)Soccer teams. This language was developed with\\u000a two main objectives: to coach FC Portugal 2001 team and as a proposal to be used in Fukuoka 2002 RoboCup coach competition.\\u000a This language enables high-level and low-level coaching through coach instructions. High-level coaching includes changing\\u000a tactics, formations used in each situation and
Abstract Objective To determine whether home visits for neonatal care by community health workers can reduce infant and neonatal deaths and stillbirths in resource-limited settings. Methods We conducted a systematic review up to 2008 of controlled trials comparing various intervention packages, one of them being home visits for neonatal care by community health workers. We performed meta-analysis to calculate the pooled risk of outcomes. Findings Five trials, all from south Asia, satisfied the inclusion criteria. The intervention packages included in them comprised antenatal home visits (all trials), home visits during the neonatal period (all trials), home-based treatment for illness (3 trials) and community mobilization efforts (4 trials). Meta-analysis showed a reduced risk of neonatal death (relative risk, RR: 0.62; 95% confidence interval, CI: 0.44–0.87) and stillbirth (RR: 0.76; 95% CI: 0.65–0.89), and a significant improvement in antenatal and neonatal practice indicators (>?1 antenatal check-up, 2 doses of maternal tetanus toxoid, clean umbilical cord care, early breastfeeding and delayed bathing). Only one trial recorded infant deaths (RR: 0.41; 0.30–0.57). Subgroup analyses suggested a greater survival benefit when home visit coverage was ??50% (P?0.001) and when both preventive and curative interventions (injectable antibiotics) were conducted (P?=?0.088). Conclusion Home visits for antenatal and neonatal care, together with community mobilization activities, are associated with reduced neonatal mortality and stillbirths in southern Asian settings with high neonatal mortality and poor access to facility-based health care.
The research findings from Tamaki's (2008) study are important to EBNP for both maternity and psychiatric-mental health nurses. Although the findings demonstrated that mental health visits showed improvement in women with postpartum depression, one suggestion would be to implement a study with a larger sample population and in multiple cultures. With support supplied by numerous quantitative and qualitative studies, such as Tamaki's (2008) study, postpartum depression could be treated with a new non-pharmaceutical measure that would be more beneficial and effective to women and their babies. It will also open new doors for EBNP in mental health and revolutionize homehealth nursing. PMID:23367653
Neonatal deaths account for 43% of under-5 childhood deaths in Kenya. Most infants are born at home, and many of them die at home unaccounted for, often during the first week of life. Previous studies in which community health workers (CHWs) were trained to provide neonatal care reported reductions in neonatal mortality. These programmes required more resources than may be available in some resource-poor settings. We implemented a brief and inexpensive programme to train rural Kenyan CHWs to evaluate newborn infants for signs of severe illness during the first week of life and refer the ill infants to a health facility. During the first 12 months, 20 CHWs visited 702 infants, and all three visits were completed for 93% of the infants. There were five neonatal deaths, none after the first week of life. A brief low-cost training programme for CHW home visitation of newborns is feasible for rural Kenya and the larger African setting. PMID:22907999
Purpose: To develop a questionnaire assessing vision-targeted health-related quality of life in older adults residing in nursing homes. Methods: Using content previously identified through structured interviews with nursing home residents, the 57-item Nursing Home Vision-Targeted Health-Related Quality of Life questionnaire (NHVQoL) was drafted with nine subscales—general vision, reading, ocular symptoms, mobility, psychological distress, activities of daily living, activities\\/hobbies, adaptation\\/coping and
L. E. Dreer; G. Mcgwin JR; K. Scilley; G. C. Meek; A. Dyer; D. Seker; C. Owsley
With the increase of the aging society worldwide, hospitals, medical practitioners and health insurers are now increasingly seeking ways to reduce the cost of healthcare while maitaining its quality. One solution subject to attention from gouvernement and healthcare providers is the U-Health Smart Home that aims to provide non-intrusive and non-invasive monitoring and assistance to the elderly directly in their
Jin Kim; Hyeok-soo Choi; Hui Wang; Nazim Agoulmine; M. Jamal Deerv; James Won-Ki Hong
The purpose of the present longitudinal study was to examine the role of negative work–home interference (WHI) in the classical stressor–strain sequence. First, the predominant time-lagged path between WHI and job stressors was investigated. Furthermore, the direct and indirect (mediating) process of WHI, job stressors, and employee health was examined. The sample consisted of 383 health care employees. Results showed
Maria C. W. Peeters; Jan de Jonge; Peter P. M. Janssen; Sjaak van der Linden
Objective:Whether postpartum visits by trained community health workers (CHWs), reduce newborn breastfeeding problems.Method:Community health workers made antenatal and postpartum home visits promoting newborn care practices including breastfeeding. CHWs assessed neonates for adequacy of breastfeeding and provided hands-on support to mothers to establish breastfeeding. History and observation data of 3495 neonates were analyzed to assess effects of CHW visitation on feeding
I Mannan; S M Rahman; A Sania; H R Seraji; S E Arifeen; P J Winch; G L Darmstadt; A Baqui
Accountingfor a patient's emotional state is integ ral in medical care. Tele-health research attests to the challenge clinicians must overcome in assessing patient emotional state when modalities are limited (J. Adv. Nurs. 36(5) 668). The extra effort involved in addressingthis challenge requires attention, skill, and time. Large caseloads may not afford tele-homehealth- care (tele-HHC) clinicians the time and focus
Background: The presence and severity of the chronic pain syndrome fibromyalgia (FM) is associated with unresolved stress and emotional\\u000a regulation difficulties. Written emotional disclosure is intended to reduce stress and may improve health of people with FM.Purpose: This study tests the effects of at-home, written emotional disclosure about stressful experiences on the health of people\\u000a with FM and uses multiple
Mazy E. Gillis; Mark A. Lumley; Angelia Mosley-Williams; James C. C. Leisen; Timothy Roehrs
International health research conducted under extreme conditions in low- income countries may question assumptions which are also important in high-income countries. Examples are given of how observations in Guinea- Bissau have led to reinterpretation of the decline in measles mortality in the industrialised countries, the polio model and the impact of stopping vaccin- tions after eradication.
The Health Integrated Smart Home Information System (HIS²) has been developed in the TIMC laboratory for the remote monitoring of the health status of an elderly person during daily life at home. This aims at improving patients' life conditions and at reducing the costs of the long hospitalization. The design of this system is based on a CAN network linked
Gilles Virone; Michel Vacher; Eric Castelli; Jean-François Serignat
I examine how decreases in government coverage of homehealth care visits to the elderly in the United States have affected their living arrangements. Specifically, I exploit geographic variation in the Medicare HomeHealth Care reimbursement rate that arose as a result of legislation passed in 1997 and I identify its impact on the living arrangements of older Medicare beneficiaries.
An exploratory study investigated ethical conflicts over access to services for elderly patients and social work practice activities within the context of the Medicare Prospective Payment System (PPS) in homehealth care. Questionnaires (n = 77) were distributed to attendees at the annual conference of the American Network of HomeHealth Care Social Workers in October, 2001 (response rate =
Transcripts of papers given at a 1979 Symposium on homehealth care in Rhode Island are presented. The goal of the symposium was to present possible regulations and provisions for certificate-of-need procedures regarding homehealth care. The participants...
The primary care medical home has been promoted to integrate and improve patient care while reducing health care spending but with little formal study of the model or evidence of its efficacy. ProvenHealth Navigator (PHN), an intensive multidimensional medical home model that addressed care delivery and financing was introduced into 11 different primary care practices. The goals were to improve
Background. The aim of this study was to determine the effect of an improved ambiance of food consumption on health and nutritional status of Dutch nursing home elderly residents (n = 38) in a 1-year intervention study.Methods. A parallel group intervention study was performed. Improvement of ambiance focused on three points: (1) physical environment and atmosphere of the dining room,
Marie-Françoise A. M Mathey; Vincent G. G Vanneste; Cees de Graaf; Lisette CPGM de Groot; Wija A van Staveren
|The development of four paper-and-pencil tests, useful in assessing the effectiveness of inservice training provided to either nurses aides or homehealth aides, was described. These tests were designed for utilization in employment selection and case assignment. Two tests of 37 multiple-choice items and two tests of 10 matching items were…
|A program training senior citizens as homehealth aides for the elderly is evaluated, using a variety of procedures (questionnaires, interviews, and observation) and involving many related persons. Primary outcome variables center on graduate employment and graduate and patient satisfaction. Quality of instruction, interorganization cooperation,…
The US health care industry is experiencing a substantial paradigm shift with regard to home care due to the convergence of several technology areas. Increasingly-capable telehealth systems and the internet are not only moving the point of care closer to ...
Among older adults, the challenges of maintaining mobility and cognitive function make it increasingly difficult to remain living alone independently. As a result, many older adults are forced to seek residence in costly clinical institutions where they can receive constant medical supervision. A home-based automated system that monitors their health and well- being while remaining unobtrusive would provide them with
Amaya Arcelus; Megan Howell Jones; Rafik Goubran; Frank Knoefel
We present a framework for a wireless health monitoring system within a smart home using ZigBee technology. Vital signals are collected and processed using a 3-tiered architecture. The first stage is the mobile device carried on the body that runs a number of wired and wireless probes. This device is also designed to perform some basic processing such as the
|This document demonstrates the relationships among four Florida nursing education programs (homehealth aide, nursing assistant, patient care assistant, and practical nursing) by listing student performance standards and indicating which ones are required in each program. The 268 student performance standards are arranged in 23 areas of…
Florida State Univ., Tallahassee. Center for Instructional Development and Services.
The authors address several issues in the dilemma of providing skilled homehealth services to the chronically ill pulmonary patient. The restrictions of current reimburse ment plus the fear of future methods make the professional a patient advocate who needs to be creative in establishing care plans and assertive in negotiating reimbursement with the insurance carriers. The authors provide excellent
African American elders are more likely to have type 2 diabetes compared to White elders. Many suffer from complications and face stressors related to the disease that often leads them to an acute episode, and ultimately into homehealth care (HHC). This study compares African American (n = 76) and White (n = 31) elders and identifies unique socio-demographic and
Background:Previous medication management research has focused on hospital and long-term care facility settings, where drug-utilization reviews are used to reduce medication errors. Patients receiving homehealth care (HHC) are without the benefit of systematic drug-utilization reviews.
Katrina T. Cannon; Maryann M. Choi; Miguel A. Zuniga
A study was conducted using a cross-sectional design to determine the attitudes and knowledge of elderly homehealth care clients toward community resources. The clients were asked to rank ser vices in degree of importance and to identify the services they were not familiar with. Two hypoth eses were tested: (1) the geriatric population would rank the direct personal care
Accounting for a patient's emotional state is integral in medical care. Telehealth research attests to the challenge clinicians must overcome in assessing patient emotional state when modalities are limited (Pettinari and Jessopp, 2001). The extra effort involved in addressing this challenge requires attention, skill, and time. Large caseloads may not afford tele-homehealth care clinicians the time and focus necessary
We use the 1993 wave of the AHEAD data set to estimate a game- theoretic model of families' decisions concerning time spent caring for elderly individuals and Þnancial transfers for homehealth care. The out- come is a Nash equilibrium where each family member jointly determines his or her consumption, transfers for formal care, and time allocation — informal care,
David Byrne; Michelle S. Goeree; Bridget Hiedemann; Steven Stern
This study is a secondary analysis of data for 107 homehealth care heart failure patients. The authors investigate the impact of patient characteristics and nursing visit intensity on change in activities of daily living (ADL) status and instrumental activities of daily living (IADL) status and improvement\\/stabilization of dyspnea. Prior hospital stay (ß = .38, p = .001) and nursing
Jennifer S. Riggs; Elizabeth A. Madigan; Richard H. Fortinsky
|Context: Availability of Medicare-certified homehealth care (HHC) to rural elders can prevent more expensive institutional care. To date, utilization of HHC by rural elders has not been studied in detail. Purpose: To examine urban-rural differences in Medicare HHC utilization. Methods: The 2002 100% Medicare HHC claims and denominator files were…
Hartman, Lacey; Jarosek, Stephanie L.; Virnig, Beth A.; Durham, Sara
|This national survey examined the job satisfaction of 228 homehealth social workers in the restrictive reimbursement environment of the Medicare interim payment system. Administrators' helpfulness in resolving ethical conflicts between patient access to services and agency financial priorities contributed significantly to greater satisfaction in…
Objective: To examine the effects of electronic health information technology (HIT) on nursing home residents. Methods: The study evaluated the impact of implementing a comprehensive HIT system on resident clinical, functional, and quality of care outcome indicators as well as measures of resident awareness of and satisfaction with the technology. The study used a prospective, quasi-experimental design, directly assessing 761
Karl Pillemer; Rhoda H. Meador; Jeanne A. Teresi; Emily K. Chen; Charles R. Henderson; Mark S. Lachs; Gabriel Boratgis; Stephanie Silver; Joseph P. Eimicke
The document maintains that the world is filled with health hazards and the best a person can do is to assess the danger of individual products, learn the risks, weigh the risks against the benefits, and decide whether or not to personally take these risks or to subject family members to them. This perspective begins in the home. This book…
Problem statement: This study was designed to identify predictors of the use of homehealth care services by elders in different ethnic groups. Approach: A cross-sectional study was conducted with convenient sample of Anglo elders (N = 57), Mexican American elders (N = 56) and elders in South Korea (N = 83). Hierarchical multip le regression analysis was conducted. Results:
Myunghan Choi; Janice D. Crist; Marianne McCarthy; Seon Hae Woo
The purpose of this project is to integrate the technologies of wireless sensor networks and public communication networks to construct a healthcare system for senior citizens at home without interfering their daily activities. This system provides 4 main functionalities, including indoor monitoring, outdoor monitoring, activity and health state decision, emergency decision and alarm. JTH has developed a prototype of wireless
Hongwei Huo; Youzhi Xu; Hairong Yan; S. Mubeen; Hongke Zhang
Objectives. We quantified risks of sharp medical device (sharps) injuries and other blood and body fluid exposures among homehealth care nurses and aides, identified risk factors, assessed the use of sharps with safety features, and evaluated underreporting in workplace-based surveillance. Methods. We conducted a questionnaire survey and workplace-based surveillance, collaborating with 9 homehealth care agencies and 2 labor unions from 2006 to 2007. Results. Approximately 35% of nurses and 6.4% of aides had experienced at least 1 sharps injury during their homehealth care career; corresponding figures for other blood and body fluid exposures were 15.1% and 6.7%, respectively. Annual sharps injuries incidence rates were 5.1 per 100 full-time equivalent (FTE) nurses and 1.0 per 100 FTE aides. Medical procedures contributing to sharps injuries were injecting medications, administering fingersticks and heelsticks, and drawing blood. Other contributing factors were sharps disposal, contact with waste, and patient handling. Sharps with safety features frequently were not used. Underreporting of sharps injuries to the workplace-based surveillance system was estimated to be about 50%. Conclusions. Sharps injuries and other blood and body fluid exposures are serious hazards for homehealth care nurses and aides. Improvements in hazard intervention are needed.
Markkanen, Pia K.; Galligan, Catherine J.; Kriebel, David; Chalupka, Stephanie M.; Kim, Hyun; Gore, Rebecca J.; Sama, Susan R.; Laramie, Angela K.; Davis, Letitia
This study addresses the relationship between caregiver burden and the use of homehealth services among older adults with cognitive impairment. Analyses draw on data from personal interviews conducted with 327 older adults with cognitive impairment and living in the community of their primary caregivers. Using the Andersen-Newman framework, the results of ordinary least squares and logistic regression analyses reveal
Context: Availability of Medicare-certified homehealth care (HHC) to rural elders can prevent more expensive institutional care. To date, utilization of HHC by rural elders has not been studied in detail. Purpose: To examine urban-rural differences in Medicare HHC utilization. Methods: The 2002 100% Medicare HHC claims and denominator files were…
Hartman, Lacey; Jarosek, Stephanie L.; Virnig, Beth A.; Durham, Sara
The purpose of this report is to assist legislative aides and other non-health professionals involved in nursing home placement to understand better the issues involved in admission to long-term care. Some areas being examined are: community alternatives ...
This handbook is one of seven in a series describing specific services needed by the elderly. The handbook presents the state-of-the-art in homemaker and homehealth services for the elderly to assist State and area agencies on aging to fulfill goals of s...
A variety of environmental health issues occur within homes along the US\\/Mexico border region. Individuals living in this region are often not aware that specific issues, including pesticide safety, occur in their homes and may not understand the potential adverse effects of pesticide use on their families' health. The Environmental Health\\/Home Safety Education Project created by the Southern Area Health
Susan C. Forster-Cox; Thenral Mangadu; Benjamín Jacquez; Adriana Corona
|Because the author and his colleagues at the Center for Leadership and Learning Communities believe that instructional coaching is one of the most exciting developments in education in a long time, they have examined the questions this new strategy has raised for education leaders: Should coaching replace some traditional forms of teacher…
In this brief article Ben Johnson discusses the process of educational coaching. The form of coaching that Johnson refers to, involves peer teachers, supervisors, and principals asking open-ended questions of their colleagues in order to bring about change in the classroom.
Because the author and his colleagues at the Center for Leadership and Learning Communities believe that instructional coaching is one of the most exciting developments in education in a long time, they have examined the questions this new strategy has raised for education leaders: Should coaching replace some traditional forms of teacher…
Sexual harassment in sport has become an active research field within the past decade yet we know relatively little about the characteristics of the harassing coach. How are harassing coaches characterised by their victims, that is, the athletes themselves? Do they demonstrate specific kinds of behaviours? One purpose of this article is to address…
Sexual harassment in sport has become an active research field within the past decade yet we know relatively little about the characteristics of the harassing coach. How are harassing coaches characterised by their victims, that is, the athletes themselves? Do they demonstrate specific kinds of behaviours? One purpose of this article is to address these types of questions. Another is
This 8-page PDF details strategies used by math coaches in the Silicon Valley Mathematics Initiative where the focus is on studentsâ thinking and on their work products. This document includes various approaches that coaches may use with teachers to gain trust and important pre-observation and post observation questioning and reflection techniques.
|Sexual harassment in sport has become an active research field within the past decade yet we know relatively little about the characteristics of the harassing coach. How are harassing coaches characterised by their victims, that is, the athletes themselves? Do they demonstrate specific kinds of behaviours? One purpose of this article is to…
This monograph documents the speeches presented at the 1988 Symposium on Sports Psychology and the Coach. Presentations ranged from empirical research studies to anecdotal methodologies for coping with problems of anxiety. The following presentations are included: (1) "The Coach as Psychologist: When and How" (Robert Rotella); (2) "Psychology for…
In Quebec (Canada), homehealth aides are gradually being involved in choosing bathing equipment for community-dwelling clients with bathing difficulties, a task traditionally performed by occupational therapists. OBJECTIVE: This article explores the support homehealth aides want in assuming this clinical task. PARTICIPANTS: Three homehealth aides having previously intervened with clients with bathing difficulties. METHODS: Homehealth aides were first observed while performing an assessment, followed by an in-depth individual interview. RESULTS: Results indicate that participants wish to be trained to acquire further knowledge about bathing equipment and learn to use a tool that would guide and document their observations. They sought partnership with a designated occupational therapist, who would be available to answer questions and assess clients with a complex clinical situation. CONCLUSIONS: These results suggest that needs of homehealth aides are not currently met and highlight clinical as well as organizational implications. PMID:23324694
Objective To track the trend of the ability of U.S. nursing homes to provide on-site mental health services after the Omnibus Budget Reconciliation Act (OBRA) mandated mental illness detection and treatment for nursing home patients, and to determine cross-sectional correlates of service availability and models of services. Methods Retrospective analyses of the 1995-2004 National Nursing Home Surveys (NNHS) periodically conducted by the Centers for Disease Control and Prevention. Longitudinal trend of mental health service provision was analyzed for all and subgroups of facilities. Multivariate regression determined facility and geographic correlates in 2004. Results Representing the nation’s approximately 17,000 nursing homes, the NNHS suggested that roughly 80% of facilities provided on-site mental health services each year and over time. In 2004, roughly a quarter of all facilities provided each model of services – regular (25%), on call (28%), or both regular and on call (24%) services – with the remaining 23% facilities providing no on-site mental health services. Multivariate analyses found that largest facilities (?200 beds) were more able to serve the mentally ill (odds ratio=3.80, p=.024) than small facilities (<100 beds); facilities with mass coverage by Medicare/Medicaid programs, in the northeast region, or in metropolitan areas were more likely than their counterparts to provide on-site services. Similar correlates were found for alternative service models available. Conclusions The overall availability of nursing home-based mental health services did not improve over time during the post-OBRA era. Service availability is more problematic for certain facilities such as small or rural ones. Financial, regulatory, and system-level efforts are needed to address this issue.
Changes in the social organization of home care work due to health care restructuring have affected the job stress and job dissatisfaction of home care workers. This article reports the results of a survey of 892 employees from three nonprofit home care agencies in a medium-sized city in Ontario, Canada. Survey results are complemented by data from 16 focus groups with 99 employees. For the purposes of this study, home care workers include both office workers (managers, supervisors, coordinators, office support staff, and case managers) and visiting workers (nurses, therapists, and visiting homemakers). Focus group participants indicated that health care restructuring has resulted in organizational change, budget cuts, heavier workloads, job insecurity, loss of organizational support, loss of peer support, and loss of time to provide emotional laboring, or the "caring" aspects of home care work. Analyses of survey data show that organizational change, fear of job loss, heavy workloads, and lack of organizational and peer support lead to increased job stress and decreased levels of job satisfaction. PMID:12067035
Denton, Margaret; Zeytinoglu, Isik Urla; Davies, Sharon; Lian, Jason
Background: Municipal home care workers provide high-quality services to an increasing proportion of elderly people living in private homes. The work environments and working conditions of these workers vary to a great extent, implying rapid priority-making among both employers and employees to ensure that the work can be performed in a safe way. Objectives: This study aims to examine home care workers’ perceptions of health, risks, working conditions, and risk management within their organization. Method: The study was based on cross-sectional data collected from home care service staff in a municipality in the north of Sweden. Nursing assistants and care aides (n?=?133) replied to a self-administered questionnaire. Descriptive statistics and between-group differences were analysed. Results: Home care work was perceived to require high levels of professional skill and ingenuity, a good psychosocial work situation, but required a high physical workload. The general health, the capacity and self-efficacy of the staff in relation to work were good. Difficulty in performing risk assessments and following safety regulations due to lack of time, equipment, and information were identified. Conclusion: There is a need to increase participation in risk assessments among the staff, improve management support, structures, and cooperation with other divisions of the social services and the medical care organizations.
People who are engaged in homehealth care services often have to transfer clients while in a half standing posture using repetitious movement including gravitational changes. Transferring heavy patients at homes for the severely mental and physical handicapped is equivalent to the care giving work, listed in the "guideline for prevention of lower back pain in work places" (1994/9/6). The purpose of this study was to investigate incidences of lower back pain and injuries among home helpers as well as to determine the relationship between their level of protective knowledge and prevalence of lower back pain. The results of the study revealed that home helpers complained of a mild type of lower back pain. Although almost all of them had the protective knowledge for lower back injuries that was taught in their training courses, they still felt the need for more knowledge through continuous education regarding protective measures for lower back injuries and pain. Regarding the method of teaching, they want to learn by TV programs, books, texts and self-learning materials. Few of them wanted to learn by computer assisted instructions or the internet. Based upon the results of this study, we have developed new teaching materials for home helpers which explain adequate postures in home care through utilizing their protective knowledge to avoid lower back pain. PMID:15038072
The purpose of the present study was to gather information from coaches regarding their monitoring\\/management of athlete eating and weight, knowledge of nutritional health issues, availability of prevention\\/intervention services for athletes at their school, expience with athletes exhibiting symptoms of eating and body image disturbances, and their attitudes toward eating and weight in the sport. A total of 303 coaches
Jaimee L. Heffner; Benjamin M. Ogles; Ellsa Gold; Kimberlyann Marsden; Michael Johnson
Burnout is probably a remote concern for the coach who is establishing a foren- sics program. Experienced forensic researchers challenge forensic philosophy and practices, contending that burnout threatens the value of forensic activity and negatively affects the health of coaches and students alike. A review of forensic research reveals that while much is written about burnout, the phenomenon has yet
BACKGROUND: Food and drink are important determinants of physical and social health in care home residents. This study explored whether a pragmatic methodology including routinely collected data was feasible in UK care homes, to describe the health, wellbeing and nutritional status of care home residents and assess effects of changed provision of food and drink at three care homes on
Andrea Kenkmann; Gill M Price; Joanne Bolton; Lee Hooper
Background: Coach education has been identified as a key vehicle for raising the standard of coaching practice. However, the existing body of literature suggests that coach education has had a limited impact on the learning and development of coaching practitioners. In this respect, it has been contended that coach educations ills might be partially attributed to the ‘top-down’ approach of
Background: Large-scale coach education programs have been developed in many countries around the world to help prepare coaches for their important role. Coaches have said that they also learn to coach from experience, starting from when they were young athletes until their current coaching positions. Finally, in the last decade, Internet resources have begun to be promoted as valuable tools
The interactions of professional football coaches and teams in the National Football League (NFL) form a complex social network. This network provides a great opportunity to ana- lyze the influence that coaching mentors have on their pro- teges. In this paper, we use this social network to identify notable coaches and characterize championship coaches. We also utilize the coaching network
Osteoporosis is a growing health concern as the number of senior adults continues to increase worldwide. Falls and fractures are very common among frail older adults requiring homehealth and long-term care. Preventative strategies for reducing falls have been identified and many therapies (both prescription and non-prescription) with proven efficacy for reducing fracture risk are available. However, many practitioners overlook the fact that a fragility fracture is diagnostic for osteoporosis even without knowledge of bone mineral density testing. As a result, osteoporosis is infrequently diagnosed and treated in the elderly after a fracture. Based on existing literature, we have developed an algorithm for the assessment and treatment of osteoporosis among persons with known prior fracture(s) living in long-term care facilities or receiving homehealth care.
There is a fine distinction between being an independent contractor and being an employee. The advantages of being self-employed as a community health nurse are many. Self-employment suits new parents, graduate students, people in transition, with more than one profession, and who don't want a fixed schedule. However, this type of nursing is not for everyone. A broker such as CHN can help nurses become successfully self-employed. At a time when hospitals are downsizing and home care is becoming more in demand, brokers such as CHN provide a framework in which busy, experienced, community health nurses can work when and where they want. Good clinical and communication skills and a wish to be autonomous are necessities. A willingness to travel to different agencies and a reliable car are also important. A love for variety, flexibility, and independence make self-employment as a homehealth nurse a clinician's dream. PMID:9335699
During the past few years, a lot of effort has been invested in research and development of eHealth tele-monitoring systems that will provide many benefits for healthcare delivery from the healthcare provider to the patient's home. However, there is a plethora of security requirements in eHealth tele-monitoring systems. Data integrity of the transferred medical data is one of the most important security requirements that should be satisfied in these systems, since medical information is extremely sensitive information, and even sometimes life threatening information. In this paper, we present a data integrity mechanism for eHealth tele-monitoring system that operates in a smart home environment. Agent technology is applied to achieve data integrity with the use of cryptographic smart cards. Furthermore, the overall security infrastructure and its various components are described. PMID:19964802
|This study followed 16 principals in an urban district who were assigned leadership coaches for 6 months. Coaches were provided to principals who were of low-performing schools or new to the position. The study was part of a descriptive evaluation to examine (1) what principals and coaches actually did and (2) what impact the coaching experience…
The purpose of this study is to explore the process of coaching a mentor of experienced teachers. In particular, we sought to determine if coaching would help a mentor to compare her espoused beliefs about mentoring to her mentoring behaviors and possibly resolve any dissonance. The mentor and coach (the co?researchers) participated in a platform conference, three coaching conferences, and
|The purpose of this study was to explore strategies for the development of aspiring female coaches based on the ideas of existing high-performance female coaches. Drawing on semi-structured interviews with national-level female coaches in the United Kingdom, four recurrent ideas for developing female coaches in a male-dominated profession…
Objective To assess whether a model of care with augmented services within an existing medical home could improve immunization rates\\u000a for Children with Special Health Care Needs (CSHCN) and to evaluate the influence of family and practice characteristics on\\u000a these children’s immunization rates.\\u000a \\u000a \\u000a \\u000a Method Participants were six general pediatric practices, CSHCN, and their families. Enhancements were added to the medical home\\u000a for
Ronald C. Samuels; Jihong Liu; Lisa A. Sofis; Judith S. Palfrey
ObjectivesUsing the Dualistic Model of Passion [Vallerand et al. (2003). Les passions de l’âme: on obsessive and harmonious passion. Journal of Personality and Social Psychology, 85, 756–767], this study examined the role of coaches’ passion for coaching in athletes’ perceptions of the quality of the coach–athlete relationship. Moreover, we hypothesized that coaches’ harmonious and obsessive passion toward coaching should shape the
Marc-André K. Lafrenière; Sophia Jowett; Robert J. Vallerand; Noémie Carbonneau
This paper describes the process of undertaking a dental health needs assessment of older people resident in care homes in the North East of England and the challenges involved. It illustrates many competency areas of interest to dental public health practitioners: oral health surveillance, dental public health intelligence and collaborative working. PMID:23550499
Pesticide regulation is examined in the context of Health Canada’s Pest Management Regulatory Agency’s assessment of the chlorophenoxy herbicide 2,4-dichlorophenoxyacetic acid (2,4-D) for turf. 2,4-D is the most common herbicide used to kill weeds in grass. The medical literature does not uniformly indicate harms from herbicides. However, the balance of epidemiological research suggests that 2,4-D can be persuasively linked to cancers, neurological impairment and reproductive problems. These may arise from 2,4-D itself, from breakdown products or dioxin contamination, or from a combination of chemicals. Regulators rely largely on toxicology, but experiments may not replicate exposures from 2,4-D application to lawns because environmental breakdown products (eg, 2,4-dichlorophenol) may not accumulate and selected herbicides are possibly less contaminated. Dioxins are bioaccumulative chemicals that may cause cancer, harm neurological development, impair reproduction, disrupt the endocrine system and alter immune function. No dioxin analyses were submitted to the Pest Management Regulatory Agency, and the principal contaminants of 2,4-D are not among the 17 congeners covered in pesticide regulation. Independent assessment of all dioxins is needed, in tissues and in the environment. The 2,4-D assessment does not approach standards for ethics, rigour or transparency in medical research. Canada needs a stronger regulator for pesticides. Potentially toxic chemicals should not be registered when more benign solutions exist, risks are not clearly quantifiable or potential risks outweigh benefits. Until landscaping pesticides are curtailed nationally, local bylaws and Quebec’s Pesticide Code are prudent measures to protect public health. Physicians have a role in public education regarding pesticides.
Sears, Meg; Walker, C Robin; van der Jagt, Richard HC; Claman, Paul
The study was conceived in relation to a concern over the growing gap between the needs of chronic patients and the availability of care from the current health care system in Korea. Patients with agonizing chronic pain, discomfort, despair and disability are left with helplessly unprepared families with little help from the acute care oriented health care system after discharge from hospital. There is a great need for the development of an alternative means of quality care that is economically feasible and culturally adaptable to our society. Thus, the study was designed to demonstrate the effectiveness of homehealth care as an alternative to bridge the existing gap between the patients' needs and the current practice of health care. The study specifically purports to test the effects of home care on health expenditure, readmission, job retention, compliance to health care regime, general conditions, complications, and self-care knowledge and practices. The study was guided by the operations research method advocated by the Primary Health Care Operations Research Institute (PRICOR) which constitutes 3 stages of research: namely, problem analysis solution development, and solution validation. The first step in the operations research was field preparation to develop the necessary consensus and cooperation. This was done through the formation of a consulting body at the hospital and a steering committee among the researchers. For the stage of problem analysis, the Annual Report of Seoul National University Hospital and the patients records for last 5 years were reviewed and selective patient interviews were conducted to find out the magnitude of chronic health problems and areas of unmect health care needs to finally decide on the kinds of health problems to study. On the basis of problem analysis, the solution development stage was devoted to home care program development asa solution alternative. Assessment tools, teaching guidelines and care protocols were developed and tested for their validity. The final stage was the stage of experimentation and evaluation. Patients with liver diseases, hemiplegic and diabetic conditions were selected as study samples. Discharge evaluation, follow up home care, measurement and evaluation were carried out according to the protocols of care and measurement plan for each patient for the period of 6 months after discharge. The study was carried out for the period from Jan. 1987 to Dec. 1989. The following are the results of the study presented according to the hypotheses set forth for the study; 1.(ABSTRACT TRUNCATED AT 400 WORDS) PMID:2232446
Hong, Y S; Lee, E O; Lee, S W; Kim, M J; Hong, K J
Background Researchers and medical practitioners have long sought the ability to continuously and automatically monitor patients beyond the confines of a doctor's office. We describe a smart home monitoring and analysis platform that facilitates the automatic gathering of rich databases of behavioral information in a manner that is transparent to the patient. Collected information will be automatically or manually analyzed and reported to the caregivers and may be interpreted for behavioral modification in the patient. Method Our health platform consists of five technology layers. The architecture is designed to be flexible, extensible, and transparent, to support plug-and-play operation of new devices and components, and to provide remote monitoring and programming opportunities. Results The smart home-based health platform technologies have been tested in two physical smart environments. Data that are collected in these implemented physical layers are processed and analyzed by our activity recognition and chewing classification algorithms. All of these components have yielded accurate analyses for subjects in the smart environment test beds. Conclusions This work represents an important first step in the field of smart environment-based health monitoring and assistance. The architecture can be used to monitor the activity, diet, and exercise compliance of diabetes patients and evaluate the effects of alternative medicine and behavior regimens. We believe these technologies are essential for providing accessible, low-cost health assistance in an individual's own home and for providing the best possible quality of life for individuals with diabetes.
Pain is the most common health-related complaint in older persons. International estimations mention up to 80% of nursing home residents suffering from pain. In the meantime, no reliable epidemiological data on pain in nursing home residents are available for Germany, because of restricted access to the nursing-home population. This pilot study aimed to evaluate whether routine data from a German statutory health insurance fund can be used to generate data on pain prevalence and analgesic therapy in nursing home residents. To this end, data of all insured persons of Deutsche BKK who received long-term care insurance benefits for nursing-home care between April and June 2007 were selected anonymously. These data were combined with data on diagnoses and analgesic prescriptions. 3 pain-related diagnoses were selected: R 52 (pain, not elsewhere classified), M 16 (coxarthrosis) and G 53.0 (postherpetic neuralgia) and analysed for corresponding prescriptions. The study sample shows similar characteristics regarding age distribution and care needs in terms of long-term care insurance benefits compared to the official data on nursing-home residents for Germany in 2007. The rate of dementia was within the expected range, too. Therefore, external validity of the sample is assumed. One of the 3 selected diagnoses had been documented in 15% of the sample. About 58% of those received an analgesic prescription. Deficits were discovered regarding the documentation of postherpetic neuralgia, the combination of different analgesics and prescriptions for adjuvant drugs. Prevalence rate and numbers of prescriptions were as frequent as expected. The routine method for this analysis proved to be practicable and reliable. Data quality is deemed sufficient so that the main study will proceed to include a longer period of time and additional data. PMID:20661849
Kopke, K; Fischer, Th; Kölzsch, M; Hofmann, W; Kuhlmey, A; Kreutz, R; Dräger, D
BACKGROUND: The effects of psychosocial risk factors on population health and health inequalities has featured prominently in epidemiological research literature as well as public health policy strategies. We have conducted a meta-review (a review of reviews) exploring how psychosocial factors may relate to population health in home and community settings. METHODS: Systematic review (QUORUM) of literature reviews (published in any
Matt Egan; Carol Tannahill; Mark Petticrew; Sian Thomas
Background Staff who provide support services to older adults are in a unique position to detect depression and offer a referral for mental health treatment. Yet integrating mental health screening and recommendations into aging services requires staff learn new skills to integrate mental health and overcome client barriers to accepting mental health referrals. This paper describes client rates of depression and a novel engagement intervention (Open Door) for homebound older adults who are eligible for home delivered meals and screened for depression by in-home aging service programs. Methods Homebound older adults receiving meal service who endorsed depressive symptoms were interviewed to assess depression severity and rates of suicidal ideation. Open Door is a brief psychosocial intervention to improve engagement in mental health treatment by collaboratively addressing the individual level barriers to care. The intervention targets stigma, misconceptions about depression, and fears about treatment, and is designed to fit within the roles and responsibilities of aging service staff. Results Among 137 meal recipients who had symptoms when screened for depression as part of routine home meal service assessments, half (51%) had Major Depressive Disorder and 13% met criteria for minor depression on the SCID. Suicidal ideation was reported by 29% of the sample, with the highest rates of suicidal ideation (47%) among the subgroup of individuals with Major Depressive Disorder. Conclusion Individuals who endorse depressive symptoms during screening are likely to have clinically significant depression and need mental health treatment. The Open Door intervention offers a strategy to overcome barriers to mental health treatment engagement and to improve the odds of quality care for depression.
Sirey, Jo Anne; Greenfield, Alexandra; DePasquale, Alyssa; Weiss, Nathalie; Marino, Patricia; Alexopoulos, George S; Bruce, Martha L
|Outcomes of peer coaching in two Ann Arbor, Michigan, schools show that the 41 teachers became comfortable with the process and found it useful in improving collegiality, experimentation, and student learning. (MLF)|