Many youth in out-of-home care (OOHC) have experienced victimization in their lifetime making them vulnerable to mental health problems and further victimization. However, little is known about ...mechanisms behind this continuing victimization, e.g. in the form of bullying victimization, and about possible mediating and moderating factors.
This study examined the association between lifetime poly-victimization and later bullying victimization, as well as mediation by internalizing problems, and moderation by OOHC.
In total n = 226 youth (n = 117 OOHC, n = 109 biological families) participated, with one of their social/biological caregivers when possible, resulting in subsamples of n = 159 participants (11–21 years) for self-report, and n = 210 participants (8–21 years) for caregiver report.
An online survey assessed self-report of bullying victimization in the past six months, as well as self-report and caregiver report of lifetime poly-victimization and internalizing problems.
Based on both self-report and caregiver report, youth in OOHC showed higher levels of poly-victimization and internalizing problems than youth in biological families. In self-report, a conditional direct effect of lifetime poly-victimization on bullying victimization was found for youth in OOHC, c′ = 0.18, SE = 0.07, p = .007, while the association was mediated by internalizing problems for youth in biological families, ab = 0.13, 95 % CI 0.020; 10.805. In the caregiver report, there was neither a direct nor a mediated effect of lifetime poly-victimization on bullying victimization.
The results stress the importance of considering the high impact of poly-victimization in predicting bullying victimization, particularly for youth in OOHC. For youth in biological families, a mediating effect of internalizing problems was found.
Full text
Available for:
GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
The study’s rationale
The need for home care among older persons is increasing, and mHealth is evolving to help meet the challenge. When developing an app to help maintain their health, it is ...essential to incorporate older persons’ preferences.
Aims and objectives
To describe and evaluate the experiences of self‐care support and sense of security among older persons using an interactive app to report health concerns.
Methodological design and justification
The study had a descriptive and evaluative design. Qualitative and quantitative methods were applied to achieve a broader understanding.
Ethical issues and approval
Ethical approval was obtained from the Regional Ethical Review Board. The older persons received verbal and oral information about the study and gave written informed consent.
Research methods
Questionnaires (n = 17 older persons) answered at baseline, end of the intervention and at a 6‐month follow‐up were analysed with statistical analysis. Interviews (n = 17 older persons) conducted at the end of the intervention were analysed using a qualitative directed approach.
Measurements and intervention
The questionnaire included the Appraisal of Self‐care Agency Scale and a question concerning sense of security. For 3 months, the older persons used an app for regular reporting of health concerns. The app included self‐care advice, graphs and a risk assessment model that generated alerts directly to the nurses.
Results
The older persons described how self‐care and sense of security increased at the end of intervention, but statistically, it was shown to decrease afterwards.
Study limitations
The small sample size for statistical analysis.
Conclusions
This study shows that an app can be a complementary tool to conventional home care that can increase older persons’ sense of security and self‐care ability. The results mirror the older persons’ awareness that the support they received with the app was only temporary. Larger studies are needed for generalisation.
Full text
Available for:
BFBNIB, DOBA, FZAB, GIS, IJS, IZUM, KILJ, NLZOH, NUK, OILJ, PILJ, PNG, SAZU, SBCE, SBMB, SIK, UILJ, UKNU, UL, UM, UPUK, VSZLJ
Summary Background & aims Old persons are more likely to suffer from malnutrition, which may result in higher dependency in activities of daily living. We aimed to provide a quantitative synthesis of ...prevalence data on malnutrition and its risk as assessed by the Mini Nutritional Assessment across different healthcare settings. The association between nutritional status and setting-related level of dependence was also investigated. Methods Non-interventional studies published as full-text articles in English up to 31th December 2014 were searched for in PubMed and by reviewing references of eligible articles. Meta-analysis and meta-regression of potential sources of heterogeneity were conducted. Results A total of 240 studies/795 citations – providing 258 setting-specific prevalence estimates (113,967 subjects) - fulfilled inclusion criteria for meta-analysis. Prevalence of malnutrition differed significantly across the healthcare settings considered: community, 3.1% (95%CI, 2.3–3.8); outpatients, 6.0% (95%CI, 4.6–7.5); home-care services, 8.7% (95%CI, 5.8–11.7); hospital, 22.0% (95%CI, 18.9–22.5); nursing homes, 17.5% (95%CI, 14.3–20.6); long-term care, 28.7% (95%CI, 21.4–36.0); rehabilitation/sub-acute care, 29.4% (95%CI, 21.7–36.9). For every setting significant heterogeneity in individual study results was observed ( I 2 ≥80%, P < 0.001) and meta-regression showed that study quality was the most important determinant. Finally, meta-regression of all the studies included showed that both malnutrition and its risk were directly associated with the setting-related level of dependence (P < 0.001). However, despite multiple adjustments, residual heterogeneity remained high. Conclusion We provided updated estimates of malnutrition and its risk in different healthcare settings. Although the level of dependence appears to be an important determinant, heterogeneity in individual study results remained substantially unexplained. The cause–effect relationship between nutritional status and level of dependence deserves further investigation.
Full text
Available for:
GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK, ZRSKP
Background: An important goal of home health care is to assist patients to remain in community living arrangements. Yet home care often fails to prevent hospitalizations and to facilitate discharges ...to community living, thus putting patients at risk of additional health challenges and increasing care costs. Objectives: To determine the relationship between home health agency work environments and agency-level rates of acute hospitalization and discharges to community living. Methods and Design: Analysis of linked Center for Medicare and Medicaid Services Home Health Compare data and nurse survey data from 118 home health agencies. Robust regression models were used to estimate the effect of work environment ratings on between-agency variation in rates of acute hospitalization and community discharge. Results: Home health agencies with good work environments had lower rates of acute hospitalizations and higher rates of patient discharges to community living arrangements compared with home health agencies with poor work environments. Conclusion: Improved work environments in home health agencies hold promise for optimizing patient outcomes and reducing use of expensive hospital and institutional care.
Full text
Available for:
BFBNIB, CMK, INZLJ, NMLJ, NUK, PNG, UL, UM, UPUK, ZRSKP
In Norway, changes in life expectancy have led to increased attention to older people who are ageing at home, by means of home care services, adapted technology and informal caregivers. The caring ...situation has become difficult for many caregivers. The use of telecare has now offered them the possibility to receive support at home. The purpose of this study was to explore how nurses provide support and care at a distance, using a web camera and a web forum in a closed telecare network for caregivers to persons suffering from stroke and dementia.
The study had an explorative design with a qualitative approach. The data sources consisted of interviews with nurses and excerpts from posts in a closed telecare network. Content analysis was used to analyse the text from the interviews and the text from the web forum.
The main theme, "Balancing asymmetric and symmetric relationships" described nurses' relationship with caregiver. Two categories, "Balancing personal and professional qualities" and "Balancing caregivers' dependence versus independence" were identified. The first describing the tension in their dialogue, the second describing how nurses provided the caregivers with a sense of security as well as strengthening them to master their daily lives.
The nurses provided long distance support and care for the caregivers, by using computer-meditated communication. This communication was characterized by closeness as well as empathy. To strengthen the caregivers' competence and independence, the nurses were easy accessible and provided virtual supervision and support. This study increases the knowledge about online dialogues and relationship between nurses and caregivers. It contributes to knowledge about balancing in the relationship, as well as knowledge about bridging the gap between technologies and nursing care as potential conflicting dimensions. Maintenance of ethical principles are therefore critical to be aware of.
Full text
Available for:
CEKLJ, DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
The GeroCovid Study is a multi-setting, multinational, and multi-scope registry that includes the GeroCovid home and outpatients' care cohort. The present study aims to evaluate whether outpatient ...and home care services with remote monitoring and consultation could mitigate the impact of the COVID-19 pandemic on mental and affective status, perceived well-being, and personal capabilities of outpatients and home care patients with cognitive disorders.
Prospectively recorded patients in an electronic web registry provided by BlueCompanion Ltd. Up to October 31, 2020, the sample included 90 patients receiving regular care from the Center for Cognitive Disorders and Dementia in Catanzaro Lido, Italy. It was made of 52 ambulatory outpatients and 38 home care patients, mean age 83.3 ± 7.54 years. Participants underwent a multidimensional assessment at baseline (T0) and after 90 days (T1). For each patient, we administered the Mini-Mental State Examination (MMSE) for cognitive functions, the Activities of Daily Living (ADL) and Instrumental ADL (IADL) scales for functional capabilities, the Cumulative Illness Rating Scale (CIRS) for comorbidities and their impact on patients' health, the 5-items Geriatric Depression Scale (GDS) for mood, and the Euro Quality of Life (EuroQoL) for perceived quality of life. Contacts with both ambulatory and home care patients were managed in person or via telephone, preferably through video calls (WhatsApp or FaceTime).
Contacts with patients were kept at T0 through telephone. At T1, visits were made in person for over 95% out of the cases. The ADL, IADL, CIRS, GDS, MMSE, and EuroQoL changed slightly between T0 and T1. Most of the patients were clinically stable over time on the majority of the scales explored, but behavioral changes were found in 24.4% of patients and anxiety and insomnia in 17.7% of patients.
Our study suggests that contacts through telephone and video consultations are likely associated with a health status preservation of the patients.
Objective: This study aimed to evaluate the nursing functions of home health services.
Methods: The study was planned retrospectively and descriptively in a state hospital’s Home Health Care Unit. ...The study sample consists of all files of patients who received home health services between 16.01.2019 and 16-07.2019. Data Registration Form and Nursing Functions Evaluation Form were used in collecting the data. Kolmogorov-Smirnov test to test compliance with normal distribution in data analysis, descriptive statistics such as frequency, percentage, arithmetic mean, t-test and Mann Whitney U test in independent groups of 2, One-way ANOVA (Post-hoc Tamhane’s T2 test if the difference between groups was significant) and Kruskal-Wallis test were used in groups of 3.
Results: As a result of the data analysis, it was determined that there is a statistically significant difference between the independent, semidependent, and dependent function scores applied by nurses in patients with diabetes, recent operations, and heart failure(p
Semistructured interviews with nurses working for home health care agencies in five states raise serious questions about the deleterious effects of Medicare policies and procedures on depression ...care. The agencies have strong incentives to limit nursing time in a given payment episode and to increase volume, making it difficult to provide high-quality depression care for homebound patients. Some nurses felt forced to “abandon” many patients with depression. The authors call for incremental policy changes in several key areas.
ObjectiveDepression affects one in four older adults receiving home health care. Medicare policies are influential in shaping home health practice. This study aimed to identify Medicare policy areas that are aligned or misaligned with improving the quality of depression care in home health care.MethodsThis qualitative study was based on semistructured interviews with nurses and administrators from five home health care agencies in five states (N=20). Digitally recorded interviews were transcribed and analyzed by using the grounded theory method. A multidisciplinary team iteratively developed a codebook from interview data to identify themes.ResultsSeveral important Medicare policies are largely misaligned with depression care quality improvement in home health care. Medicare eligibility requirements for patients to remain homebound and to demonstrate a need for skilled care restrict nurses’ ability to follow up with depressed patients for a sufficient time. Lack of explicit recognition of nursing time and quality of care in the home health prospective payment system provides misaligned incentives for depression care. Incorporation of a two-item depression screening tool in Medicare-mandated comprehensive patient assessment has raised clinician awareness of depression; however, inclusion of the tool at the start of care only but not at other follow-up points limits its potential in helping nurses manage depression care. Underdevelopment of clinical decision support for depression care in vendor-developed electronic health records constitutes an important barrier to improvement of depression care.ConclusionsSeveral influential Medicare policies and regulations for home health practice may be misaligned with evidence-based depression care for home health patients.
Pathways into care-homes have been under-researched. Individuals who move-in to a care-home from hospital are clinically distinct from those moving-in from the community. However, it remains unclear ...whether the source of care-home admission has any implications in term of costs. Our aim was to quantify hospital and care-home costs for individuals newly moving-in to care homes to compare those moving-in from hospital to those moving-in from the community.
Using routinely-collected national social care and health data we constructed a cohort including people moving into care-homes from hospital and community settings between 01/04/2013-31/03/2015 based on records from the Scottish Care-Home Census (SCHC). Individual-level data were obtained from Scottish Morbidity Records (SMR01/04/50) and death records from National Records of Scotland (NRS). Unit costs were identified from NHS Scotland costs data and care-home costs from the SCHC. We used a two-part model to estimate costs conditional on having incurred positive costs. Additional analyses estimated differences in costs for the one-year period preceding and following care-home admission.
We included 14,877 individuals moving-in to a care-home, 8,472 (57%) from hospital, and 6,405 (43%) from the community. Individuals moving-in to care-homes from the community incurred higher costs at £27,117 (95% CI £ 26,641 to £ 27,594) than those moving-in from hospital with £24,426 (95% CI £ 24,037 to £ 24,814). Hospital costs incurred during the year preceding care-home admission were substantially higher (£8,323 (95% CI£8,168 to £8,477) compared to those incurred after moving-in to care-home (£1,670 (95% CI£1,591 to £1,750).
Individuals moving-in from hospital and community have different needs, and this is reflected in the difference in costs incurred. The reduction in hospital costs in the year after moving-in to a care-home indicates the positive contribution of care-home residency in supporting those with complex needs. These data provide an important contribution to inform capacity planning on care provision for adults with complex needs and the costs of care provision.
Full text
Available for:
CEKLJ, DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
You have reached the maximum number of search results that are displayed.
For better performance, the search offers a maximum of 1,000 results per query (or 50 pages if the option 10/page is selected).
Consider using result filters or changing the sort order to explore your results further.
PDF
