Dissertations / Theses: 'Advanced health care at home'

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Andersson, Agneta. "Health economic studies on advanced home care." Doctoral thesis, Linköping : Univ, 2002. http://www.ep.liu.se/diss/health_society/2002/002/index.html.

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Afroze, Tonima, and Gardell Moa Rosén. "Algorithm Construction for Efficient Scheduling of Advanced Health Care at Home." Thesis, KTH, Skolan för teknik och hälsa (STH), 2015. http://urn.kb.se/resolve?urn=urn:nbn:se:kth:diva-170392.

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Providing advanced health care at home rather than in a hospital creates a greater quality of life for patients and their families. It also lowers the risk of hospital-acquired infections and accelerates recovery. The overall cost of care per patient is decreased. Manual scheduling of patient visits by health care professionals (HCPs) has become a bottleneck for increased patient capacity at SABH, a ward providing advanced pediatric health care at home (“Sjukhusansluten Avancerad Barnsjukvård i Hemmet” in Swedish), since many parameters need to be taken into account during scheduling. This thesis aims to increase the efficiency of SABH’s daily scheduling of personnel and resources by designing an automated scheduler that constructs a daily schedule and incorporates changes in it when needed in order to remove scheduling as a limitation for increased patient capacity. Requirements on a feasible schedule are identified in cooperation with SABH and literature is investigated about similar areas where the scheduling process has been automated. The scheduling is formulated as a computerized problem and investigated from the perspective of theoretical computer science. We show that the scheduling problem is NP-hard and can therefore not be expected to be solved optimally. The algorithm for scheduling the visits minimizes violations of time windows and travel times, and maximizes person continuity and workload balancing. The algorithm constructs an initial solution that fulfills time constraints using a greedy approach and then uses local search, simulated annealing, and tabu search to iteratively improve the solution. We present an exact rescheduling algorithm that incorporates additional visits after the original schedule has been set. The scheduling algorithm was implemented and tested on real data from SABH. Although we found the algorithm to be efficient, automatic transfer of data from the patient journal system is an imperative for the scheduler to be adopted.
Barn som får avancerad sjukvård hemma istället för på sjukhus tillfrisknar ofta snabbare och risken för vårdrelaterade infektioner minskar. Barnen och deras familjer blir mer välmående av att få vistas i sin hemmiljö. På Astrid Lingrens barnsjukhus i Stockholm erbjuds avancerad hemsjukvård av avdelningen Sjukhusansluten Avancerad Barnsjukvård i Hemmet (SABH). För att schemalägga när patienterna ska besökas av sjukvårdspersonalen behöver många olika faktorer beaktas, detta sker idag helt manuellt. Den manuella schemaläggningen utgör en naturlig begränsning av SABHs patientkapacitet. Denna uppsats syftar till att effektivisera schemaläggningsprocessen hos SABH genom att föreslå en automatiserad lösning som hanterar koordinering av personal och resurser och dem förändringar som behöver göras i schemat under dagen, för att få bort schemaläggningsprocessen som ett hinder mot ökad patientkapacitet. Krav på schemaläggningen identifieras i diskussion med SABH och genom att studera litteratur kring liknande områden där schemaläggning lösts automatiserat. Vi formulerar schemaläggningen som ett datologiskt problem och analyserar det med utgångspunkt i teoretisk datalogi. Vi visar att problemet är NP-svårt och därför inte kan förväntas lösas optimalt inom rimlig tid. Vår lösning approximerar istället fram ett rimligt svar, där fokus hos algoritmen är att patienterna ska besökas de tider de behöver, personalens restider ska vara så korta som möjligt samtidigt som arbetsbördan hos personalen ska vara så lika fördelad som möjligt och patienterna ska, i den mån det är möjligt, få vård av samma personal. Med en girig algoritm konstrueras ett initialt schema som uppfyller de grundläggande kraven, detta schema förbättras med lokalsökning, simulated annealing och tabusökning. En exakt lösning framställs för uppdatering av schemat. Algoritmen för att lägga ett dagligt schema (utan uppdateringar) implementerades och testades med riktigt data från SABH. Vår algoritm visade sig vara effektiv, men för att kunna göra hela schemaläggningsprocessen effektiv behöver den integreras med journalsystemet.

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Fex, Angelika. "From Novice Towards Self-Care Expert : Studies of self-care among persons using advanced medical technology at home." Doctoral thesis, Linköpings universitet, Omvårdnad, 2010. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-63742.

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The use of advanced medical technology at home has increased in most industrialized countries. The overall aim of this thesis was to develop knowledge of self-care and transition and issues that influence daily life and health among persons using advanced medical technology at home. Three qualitative studies were performed to describe the structure of self-care (I) and elucidate meanings of health-illness transition experiences among persons using long-term oxygen, or a ventila-tor, or performing blood or peritoneal dialysis (II), and to gain a deeper understanding of the meaning of living with an adult family member in this context (III). Ten interviews with adult patients (I-II) and ten with adult next of kin (III) in this context were performed and analysed with descriptive phenome-nological (I), phenomenological hermeneutical (II) and hermeneutical (III) methods. A quantitative, descriptive, comparative, cross-sectional design was used to describe and find factors that influence self-care agency and perceived health in a larger group of persons (180 patients) using the enumerated types of advanced medical technology at home (IV). In the results, (I) self-care among persons using long-term oxygen, a ventilator, or equipment for blood or peritoneal dialysis at home was described at a generic level, independent of the specific type of technology used. The general description of self-care in this context involved prerequisites for, activities for and consequences of self-care; (II) the health-illness transition among adult persons in this context was interpreted as contentment at being part of the active and conscious process towards transcending into a new state of living, in which the individual and the technology were in tune. The successful and healthy transition experience was characterized by human growth and becoming; (III) living with a family member who is using advanced medical technology at home was interpreted as meaning rhythmical patterns of being closely connected to but also separated from him or her, and of sorrow versus reconciliation. Dependence on others was reflected in a need for support from the healthcare professionals and significant others; (IV) health-related and technology-related variables in daily life were rated as satisfactory to quite a high extent, but participants using long-term oxygen perceived their health as significantly lower compared to the other technology groups. Further, a significant difference in sense of coherence was found between users of long-term oxygen and peri-toneal dialysis. Factors that contributed to self-care agency and sense of coherence were found. In conclusion, self-care in a high-tech home context means more than simply mastering the technology. With the goal of maintaining an active, social life, the health-illness transition involves a learning process of accepting and integrating the technology into daily life. With knowledge and support, patients and next of kin are able to assume substantial responsibility for self-care/dependent-care. Daily life seems to be manageable for patients using this kind of technology at home.

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Bigger, Sharon, and Lisa Haddad. "Advance Care Planning in Home Health: A Review of the Literature." Digital Commons @ East Tennessee State University, 2019. https://dc.etsu.edu/etsu-works/8513.

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The purpose of this article is to synthesize the evidence on advance care planning (ACP), determine what is applicable to the home health (HH) setting, and find where gaps in knowledge may exist. An integrative review methodology was chosen. Although there is ample literature on the topic of ACP, most research has been conducted in the acute care, outpatient, and general community settings. There is limited literature regarding ACP with patients living with chronic cardiovascular and pulmonary illnesses, who comprise the majority of the HH population. Some literature has been published regarding the interprofessional team's role in ACP in the HH setting. A gap in knowledge exists regarding ACP in HH, and recommendations for future research are provided.

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Bigger, Sharon. "Advance Care Planning Protocols and Hospitalization, Rehospitalization, and Emergency Department Use in Home Health." Digital Commons @ East Tennessee State University, 2021. https://dc.etsu.edu/etd/3858.

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Aim. The aim of this study was to examine the relationship of advance care planning protocols with hospitalization, rehospitalization, and emergency department use rates in U. S. home health agencies (HHA). Background. Since 2003, CMS has required HHAs to report on quality outcomes such as hospitalization, rehospitalization, and emergency department use rates, made publicly available online. Advance care planning (ACP) is a conversation about beliefs, goals, values, future treatment choices, and designation of a surrogate decision-maker, that someone has in advance of a health crisis. Most existing studies on ACP have taken place outside of HHAs among populations with serious illnesses such as HIV/AIDS, cancer, dementia, and end stage renal disease. Meanwhile, the U.S. home health population is living longer with chronic conditions such as pulmonary and cardiovascular illnesses. Effective January 1, 2016, the Center for Medicare and Medicaid Innovation implemented the Home Health Value-Based Purchasing (HHVBP) Model among home health agencies (HHAs) in nine states representing each geographic region in the United States. Agencies in these states began competing on value in the HHVBP model, and reimbursement rates began to be tied to quality performance (innovation.cms.gov). As part of HHVBP, CMS implemented an additional process-level mandate requiring them to report on ACP, though this data is not publicly available. It is currently unknown how ACP protocols in HHAs may affect agencies’ overall rates of acute care services use. Methods. Electronic surveys about ACP protocols were distributed to HHAs. Existing data about demographics, diagnoses, hospitalization, rehospitalization, and ED use were accessed online via CMS websites. Descriptive and regression analyses were conducted using the electronic survey results and the existing data. Results. Associations between the variables were observed and compared to the hypotheses. Statistical significance was found in the relationship between ACP protocols and hospitalization, where one increased the other increased. Several trends were found: Agencies with increased total percentage of cardiac and pulmonary diagnoses tended to have increased hospitalization rates; agencies with increased average age of patients tended to have increased ACPP scores; and agencies with increased proportion of Black patients tended to have higher hospitalization rates.

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Morrison, Jessica. "Reducing preventable hospitalizations: A study of two models of transitional care." ScholarWorks @ UVM, 2016. http://scholarworks.uvm.edu/graddis/468.

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Purpose: Transitional care is an emerging model of health care designed to decrease preventable adverse events and associated utilization of healthcare through temporary follow-up after hospital discharge. This study describes the approach and outcomes of two transitional care programs: one is provided by masters-prepared clinical nurse specialists (CNS) with a chronic disease self-management focus, another by physicians specializing in palliative care (PPC). Existing research has shown that transitional care programs with intensive follow up reduce hospitalizations, emergency room visits, and costs. Few studies, however, have included side-by-side comparisons of the efficacy of transitional care programs varying by health care providers or program focus. Design: This is a retrospective cohort study comparing the number of Emergency Department (ED) visits and hospitalizations in the 120 days before and after the intervention for patients enrolled in each transitional care program. Each program included post-hospitalization home visits, but included difference in program focus (chronic disease vs. palliative), assessment and interventions, and population (rural vs. urban). Data from participants in the CNS program 9/2014 ' 12/2014 were analyzed (n=98). The average age of participants was 69 and they were 65% female. Data was collected from patients from the PC program from 9/2014 to 4/2015 (n=71). Thirty participants died within 120 days after the intervention and were excluded, the remaining 41 were included in the analysis. Participants had an average age of 81 and were 63% female. Methods: For the CNS program, a secondary analysis of existing data was performed. For the PC program, a review of patient charts was done to collect encounters data. A Wilcoxon Matched-Pair Signed-Rank test was performed to test for significance. Findings: Patients in the CNS intervention had significantly fewer ED visits (p Conclusions: Both transitional programs have value in decreasing health care utilization. The CNS intervention had a more significant effect on ED visits for their target population than the PC program. Further study with randomized control trails is needed to allow for a better understanding of the healthcare workforce best fitted to enhance transitional care outcomes. Future study to examine the cost savings of each of the interventions is also needed.

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Mbakpuo, Ndidiamaka Ezinne. "Improving the Completion Rate of Advance Directives in Home Health Agencies." ScholarWorks, 2016. https://scholarworks.waldenu.edu/dissertations/2992.

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The number of individuals aged more than 65 years in the United States and their life expectancy has been increasing in the past decades. In spite of the presence of federal and accreditation policies recommending completion of advance directive documents by patients admitted to health care settings, advance directive completion rates are low in most health care organizations. The purpose of this study was to determine the level of advance directive completion among home health patients. The health belief model provided the theoretical framework that guided this study. A retrospective chart review was carried out in a home health agency with about 51 patients. Demographic details, including age, gender, ethnicity, nature of illness and type of health insurance were collected. Descriptive statistics were used to determine the percentage of home health patients with existing advance directives and those who do not have an advance directive. The study revealed that only 25% of the patients in the home health care agency had a completed advance directive. The finding indicate a disconnect between the recommended and the actual practice with regards to end of life issues. There is a pressing need for more complete documentation of the patient's desires and wishes regarding end of life care at home health care facilities. Documenting the patient's end of life preferences and wishes may potentially ease the decision-making process, making the end of life days less stressful for the patients and their families at the same time promoting the provision of personalized health care at the end of life.

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Touza, Kaitlin Kyna. "Intensive treatment near the end of life in advanced cancer patients." Thesis, Purdue University, 2016. http://pqdtopen.proquest.com/#viewpdf?dispub=10151629.

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Many advanced cancer patients receive intensive treatment near the end of life (EOL). Intensive treatment near the EOL is often associated with worse outcomes, such as worse quality of life (QOL), greater distress in patients and caregivers, and higher health care costs. For cancers typically unresponsive to chemotherapy such as lung and gastro-intestinal (GI), the side effects of intensive treatment are endured without increasing survival time. To date, research on EOL care in advanced cancer patients has focused on patient prognostic understanding, physician communication, and patient distress. These factors do not fully explain why many patients receive intensive treatment near the EOL when there is no hope for cure. Hence, there is a need to better understand the factors that influence EOL treatment in order to improve patient and caregiver outcomes. Self-Regulation Theory (SRT) provides a framework that may help explain motivations and care decisions in this population. This study had two aims: 1) to examine the associations between EOL clinical encounters (i.e., EOL conversations with a physician) and treatment intensity in advanced cancer patients near the EOL; and 2) to examine the associations between important SRT constructs (i.e., goal flexibility, hope, and optimism) and treatment intensity in advanced cancer patients near the EOL. A sample of 76 advanced lung and GI cancer patients was recruited from Indiana University Simon Cancer Center. Hope predicted receiving chemotherapy closer to death (β = -.41, t (66) = -2.31, p = .025), indicating more intensive treatment near EOL. Other predictor variables were not significantly associated with intensive treatment. Implications and methodological limitations are discussed.

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Ström, Anna. "Samverkan för trygg hemgång : Ett förbättringsarbete om övergången mellan geriatrik, ASIH och primärvård för den multisjuka patienten." Thesis, Hälsohögskolan, Högskolan i Jönköping, HHJ. Kvalitetsförbättring och ledarskap inom hälsa och välfärd, 2018. http://urn.kb.se/resolve?urn=urn:nbn:se:hj:diva-42022.

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Introduktion: Multisjuka patienter är individer med många sjukdomar och komplexa vårdbehov. För denna grupp är vikten av kontinuitet för att öka känslan av trygghet stor. Syfte med förbättringsarbetet: : Att skapa en trygg och möjlig ASIH-vård för multisjuka äldre genom att utveckla arbetssätt som möjliggör anslutning och en trygg utskrivning för multisjuka äldre. Syftet med studie av förbättringsarbetet: Att undersöka och analysera medarbetares gemensamma erfarenheter. Metod: Förbättringsarbetet genomfördes med stöd av Nolans förbättringsmodell. Studien av förbättringsarbetet genomfördes med en fallstudie med kvalitativ innehållsanalys. Resultat: Förbättringsarbetet resulterade i ett jämnt inflöde av remisser och kortare anslutningstid till ASIH. Patientens upplevelse av trygghet skattades i en enkät till 76%. Möjlighet till återanslutning till ASIH fick 7 patienter mellan 1-7 gånger under förbättringsprojektet. Studien av förbättringsarbetet sammanfattades i temat: ”Villkor för samverkan mot det gemensamma målet” då ett tydligt mönster framkom i fokusgruppsintervjuerna. Följande villkor sågs som betydelsefulla: kontinuitet, lärande, samarbete och kommunikation.. Diskussion: ASIH är en alternativ vårdform som kan bidra till att skapa trygghet och underlätta övergången till hemmet för gruppen multisjuka äldre. I bästa fall också minska behov av vård på akutsjukhus vid försämring. För att möjliggöra denna vård krävs återkoppling som skapar lärande genom tydliga mål och mätbara resultat.
Introduction: Patients with multiple illnesses are individuals with complex needs of care. For this group of patients, continuity of care and their sense of security is is of great importance. Improvement work objective: To create secure and accessible ASIH for elders with multiple illnesses by¨develop ways of working to enable re-admittance and secure discharges for this group of patients. Case study objective: To Investigate and analyze team members’ common experiences. Method: Implementation using Nolan’s improvement model. A case study using qualitative contents analysis. Result: The improvement work resulted in an even flow of referrals and shortened admission times to ASIH. Patients’ sense of security were rated to 76%. Seven Seven patients had the possibility towere be re-admitted 1-7 times 1-7 times during the project. Casestudy summary: ”Conditions for cooperationfor a common goal”. A clear pattern with the following significant conditions emerged from the focusgroups interviews: continuity, learning, cooperation, and communication. Discussion: ASIH can be an option to facilitate the transition home for elderly patients with multiple illnesses. ASIH provides a sense of security and may prevent re-hospitalization. This model of cooperation requires clear, common goals and opportunities for feedback to enable learning contributes to measurable results.

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Benzarti, Emna. "Home Health Care Operations Management : Applying the districting approach to Home Health Care." Phd thesis, Ecole Centrale Paris, 2012. http://tel.archives-ouvertes.fr/tel-00718914.

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Within the framework of economic constraints and demographic changes which the health care sector is confronted to, the Home Health Care (HHC) which has been created sixty years ago, has known an important growth during this last decade. The main objective of this alternative to the traditional hospitalization consists in solving the problem of hospitals' capacity saturation by allowing earlier discharge of patients from hospital or by avoiding their admission while improving or maintaining the medical, psychological and social welfare of these patients. In this thesis, we are interested in the operations management within the HHC structures. In the first part of this thesis, we develop a qualitative analysis of the operations management in the HHC context. More specifically, we identify the complexity factors that operations management has to face up within this type of structures. For each complexity factor, we discuss how it can affect the organization of the care delivery. These factors pertain to the diversity of the services proposed, the location of care delivery, the uncertainty sources, etc. Thereafter, we survey operations management based models proposed in the literature within the HHC context. Based on this literature review, we identify several emerging issues, relevant from an organizational point of view, that have not been studied in the literature and thus represent unexplored opportunities for operations management researchers. In the second part of this thesis, we are interested in the partitioning of the area where the HCC structure operates into districts. This districting approach fits the policies of improvement of the quality of care delivered to patients and the working conditions of care givers as well as costs' reduction. We begin by proposing a classification of the different criteria that may be considered in the districting problem. We then propose two mathematical formulations for the HHC districting problem for which we consider criteria such as the workload balance, compactness, compatibility and indivisibility of basic units. After that, we present a numerical analysis of the computational experiments carried out on randomly generated instances to validate these two models. We also present two possible exploitations of these models and propose two extensions to these basic formulations. After formulating the problem with a static approach, we also develop a dynamic extension which allows the integration of the different variations that can be observed within the activities of an HHC structure from period to period. We then introduce a new partitioning criterion that concerns the continuity of care evaluated on the basis of two sub-criteria. Depending on the preferences of the decision-makers concerning the sub-criteria related to the continuity of care in the districting problem, we then distinguish three scenarios for which we propose the associated mathematical formulations.

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Bennett, Ashlea R. "Home health care logistics planning." Diss., Georgia Institute of Technology, 2009. http://hdl.handle.net/1853/33989.

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This thesis develops quantitative methods which incorporate transportation modeling for tactical and operational home health logistics planning problems. We define home health nurse routing and scheduling (HHNRS) problems, which are dynamic periodic routing and scheduling problems with fixed appointment times, where a set of patients must be visited by a home health nurse according to a prescribed weekly frequency for a prescribed number of consecutive weeks during a planning horizon, and each patient visit must be assigned an appointment time belonging to an allowable menu of equally-spaced times. Patient requests are revealed incrementally, and appointment time selections must be made without knowledge of future requests. First, a static problem variant is studied to understand the impact of fixed appointment times on routing and scheduling decisions, independent of other complicating factors in the HHNRS problem. The costs of offering fixed appointment times are quantified, and purely distance-based heuristics are shown to have potential limitations for appointment time problems unless proposed arc cost transformations are used. Building on this result, a new rolling horizon capacity-based heuristic is developed for HHNRS problems. The heuristic considers interactions between travel times, service times, and the fixed appointment time menu when inserting appointments for currently revealed patient requests into partial nurse schedules. The heuristic is shown to outperform a distance-based heuristic on metrics which emphasize meeting as much patient demand as possible. The home health nurse districting (HHND) problem is a tactical planning problem which influences HHNRS problem solution quality. A set of geographic zones must be partitioned into districts to be served by home health nurses, such that workload is balanced across districts and nurse travel is minimized. A set partitioning model for HHND is formulated and a column generation heuristic is developed which integrates ideas from optimization and local search. Methods for estimating district travel and workload are developed and implemented within the heuristic, which outperforms local search on test instances.

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Hale-Hanes, Heidi A. "Hand In Hand Home Health Care." Thesis, California State University, Long Beach, 2016. http://pqdtopen.proquest.com/#viewpdf?dispub=10164122.

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The need for home health care is a growing need in the United States due to the shift of the “baby-boomers” into the post retirement years. However, there is a growing niche market within this aging population: the lesbian, gay, bisexual and transgendered (LGBT) elders who have lived their adult lives “out of the closet” and who are facing difficulty receiving care which is compassionate and culturally sensitive at the same time. The mission of Hand-In-Hand Home Health Care is to provide exceptional home health care with a team of professionals that provide patient-centered care which is culturally sensitive and compassionate, achieved with employee training developed by SAGE (Services & Advocacy for GLBT Elders). Hand-In-Hand Home Health Care will achieve economic viability within the first year through optimal cash flow management with Axxess client software and the initial capital assistance with a 7a Small Business Loan.

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Lundqvist, Pontus, and Anton Mathson. "Oral Health Care in Home Care Service – Personnels’ Perspective." Thesis, Umeå universitet, Tandläkarutbildning, 2014. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-97909.

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Elderly nowadays stay longer in their own home. This raises the standards on home care service to contribute to the maintenance of elderly’s general and oral health. Our objective is therefore to explore attitudes about how home care workers view oral health care and the importance of good oral health for elderly clients. 8 subjects (22 to 61 years of age) were selected for the study working in home care service, which all gave their informed consent. Semi-structured interviews were performed, recorded and transcribed verbatim before evaluation, using qualitative content analysis. From the interviews, a result of total 19 categories and 41 subcategories were assigned which were the bases for the 10 evolved themes. The four themes best representing the study’s purpose are more thoroughly described. At a low level of abstraction attitudes such as reminding the clients to brush their teeth and importance of practical help with oral hygiene are expressed as important. Difficulties occur in forms of lack of accessibility to the oral cavity and the client’s unwillingness to co-operate. The participants also require better contact with dental services. On the emotional level, feelings such as alienation, powerlessness and fear of breaking the client’s integrity occur along with feelings of distantness and lack of interest. This leading to a conclusion of a low level of awareness together with lack of knowledge about oral care and oral health is seen among personnel in home care service, while the personnel themselves are requesting more knowledge and better contact with dental health care services.

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Lundberg, Stefan. "Facilities Management and Health Care at Home." Doctoral thesis, Stockholm : Technology and Health, KTH, 2007. http://urn.kb.se/resolve?urn=urn:nbn:se:kth:diva-4306.

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Williamson, Kathleen M. "Home health care nurses' perceptions of empowerment." Access to citation, abstract and download form provided by ProQuest Information and Learning Company; downloadable PDF file, 150 p, 2005. http://proquest.umi.com/pqdweb?did=954038861&sid=5&Fmt=2&clientId=8331&RQT=309&VName=PQD.

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Vasudevan, Sridhar. "Secure telemedicine system for home health care." Morgantown, W. Va. : [West Virginia University Libraries], 2000. http://etd.wvu.edu/templates/showETD.cfm?recnum=1254.

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Thesis (M.S.)--West Virginia University, 2000.
Title from document title page. Document formatted into pages; contains vi, 94 p. : ill. (some col.). Includes abstract. Includes bibliographical references (p. 92-93).

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Mani, Kartik M. 1978. "Computer support for home-based health care." Thesis, Massachusetts Institute of Technology, 2001. http://hdl.handle.net/1721.1/86818.

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Thesis (M.Eng.)--Massachusetts Institute of Technology, Dept. of Electrical Engineering and Computer Science, 2001.
Includes bibliographical references (leaves 75-76).
by Kartik M. Mani.
M.Eng.

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Maeser, Donna Lee. "In-home health care and hospitalization status." CSUSB ScholarWorks, 1996. https://scholarworks.lib.csusb.edu/etd-project/1202.

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The purpose of the study was to describe the relationship between in-home health care services for elderly patients who were recently discharged from inpatient care and re-hospitalization rates. The design was descriptive and the hypothesis was that the provision of in-home health care services would mitigate a decline in the health status, of an elderly patient, following discharge from inpatient care and prevent re-hospitalization.

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Gaikwad, Neha Kiran. "Easy care home health agency -- Business plan." Thesis, California State University, Long Beach, 2016. http://pqdtopen.proquest.com/#viewpdf?dispub=10118894.

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Home health care has become a popular long term care option as most seniors prefer to age and heal in the comfort of their homes and among their loved ones. With the advent of the Affordable Care Act (ACA) and a rise in baby boomers, home health care has become an integral part of the health care delivery system. Additionally, these have led to an increased demand for Home Health Agencies - HHA’s, and created a good market for the home health business. The following business plan is developed for the establishment of a Home Health Agency, in Long Beach, California. Chapter 1 Market analysis discusses the market structure and potential for the Home health business and analysis of the company, customers, and competitors. It also presents the marketing strategies, goals and objectives. Chapter 2 Feasibility and SWOT Analysis explains the operational feasibility and financial viability of the business plan. This chapter also explores the strengths and weaknesses of the business, opportunities for the business and threats to the business. Chapter 3 Legal and Regulatory issues, describes various legal aspects and regulatory requirements in a home health agency business. Chapter 4 Financial Analysis, gives detailed explanation of the financial plan and structure for the business like costs, expenses, budget and compensation.

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Tilmon-Kellum, Rosemary. "RTK Home Health Service." Thesis, California State University, Long Beach, 2017. http://pqdtopen.proquest.com/#viewpdf?dispub=10599915.

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Home health care is heavily utilized to assist homebound clientele with a variety of medical needs. Home health services greatest population is the baby boomers. This population has multiple chronic medical problems that requires surgical intervention, disabilities that limit mobility, many suffer from a loss of mental capacities, or they suffer from depression which affects their physical and mental well-being. Because this population will continue to grow over the next several years, there will continue to be a growing need for home health care. RTK Home Health Services proposes to improve the home care delivered to this population by introducing a new psychological concept that is currently helpful in Psychiatry. The goal is to introduce this service during therapy sessions to decrease the emotional perception of pain by meditating. The full name of this service is Mindfulness Based Stress Reduction Techniques. It is accomplished by instituting meditation prior to therapy to convince the client to control and manipulate their perception to pain during therapy.

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Logan, Lori W. "Companion dog therapy home care provider." Thesis, California State University, Long Beach, 2016. http://pqdtopen.proquest.com/#viewpdf?dispub=10147300.

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The American healthcare system is being overwhelmed with chronic illnesses. These illnesses account for a significant amount of total healthcare expenditures. Medicare/Medicaid and Managed Care Organizations (MCO’s) are seeking innovative treatment at cost savings. Disease Management (DM) is an intervention intended to reduce healthcare expenditures and advance the quality of life for persons with chronic conditions by preventing or reducing the effects of the disease through integrated care. Companion Pet Therapy 4 U is proposing Complementary and Alternative Medicine (CAM) which is a fluctuating set of diagnostic and therapeutic modalities that are considered to be unconventional. This approach utilizes a combination of Alternative Therapy (AT) and Disease Management (DM) home care services to elderly chronically ill homebound patients. A companion dog/ trainer and a care coordinator/nurse will visit homebound patients, review patient care plans, and educate patients on DM. Companion Pet Therapy 4 U will reduce healthcare expenditures, produce cost savings by empowering chronically ill homebound elderly patients to become pro-active in the treatment process.

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Wambugu, Peniel Mugo. "Client-Centered Care Approach to Group Home Care." ScholarWorks, 2015. https://scholarworks.waldenu.edu/dissertations/1948.

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Scholars since the 19th century have focused on the provision of care in group homes and have demonstrated that structure (that is, the staff, facilities, and equipment), is critical in the delivery of care. The researchers, however, advocate doing for, rather than doing with the clients the activities that address the clients' welfare. The purpose of this study is to investigate how a client-centered approach would affect the quality of care delivered to the mentally challenged individuals (MCIs) in a group home. The study employed the quality-care framework in which the emphasis is on structure (skills), process (efficiency), and outcome (results). The research questions examined operational values underpinning company sanctioned work processes, how personal values underpin work processes of the direct caregivers, configuration of personal values the caregivers believe should be supported in the group home context, and how critical incidents shaped the value set of direct caregivers in regard to care processes. Using structured questionnaires and observing staff as they delivered care to their clients, data were collected from participants who were direct caregivers (n = 7), a facility administrator, and a nurse. The data were coded, categorized, and analyzed for emergent themes. The results of the analysis indicated that there was discord between staff and the organizational leadership. This discord could be improved through increased interaction between the mentioned stakeholders. The results further depicted that client-centered care may have a positive impact on the health of the MCIs that would enable the MCIs to make notable contributions to social change.

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Hernandez, Dora Luz. "Conversations from Home Telemental Health." Thesis, California State University, Long Beach, 2018. http://pqdtopen.proquest.com/#viewpdf?dispub=10690917.

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Each year, approximately 10,000 baby boomers will reach age 65. The baby boomer generation encompasses 26% of the total U.S. Population. As members of the baby boomer generation reach older adulthood, they continue to experience mental health issues such as depression, anxiety, as well as medication and alcohol abuse. These mental health conditions are associated with higher rates of health care usage. In addition, an older adult may jointly suffer from a lower quality of life, increased complex illnesses, disability, and mortality/increased risk of suicide. If an older adult does not have the appropriate mental health support services, he or she may overuse the healthcare system. Obtaining mental health services is still considered taboo for some, while for others the services may not be accessible. Conversations from Home Telemental Health aims to employ innovative technology in telehealth to improve mental health delivery services for the baby boomer population. Its mission is to provide accessible and effective evidence-based therapy designed to engage baby boomers, address their mental health needs, and minimalize premature institutionalization. Conversations from Home’s goal as a non-profit organization is to become a leading provider of telemental health services to individuals aged 50 and older in the Westside of Los Angeles and the South Bay. This proposal will provide a detailed evaluation of how Conversations from Home will accomplish these objectives.

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Mulligan, Julia C. A. "Dying at home : an evaluation of specialist home care services." Thesis, Cardiff University, 1989. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.293069.

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Bossaer, John B., and David Cluck. "Home Health Care of Patients With Febrile Neutropenia." Digital Commons @ East Tennessee State University, 2013. https://dc.etsu.edu/etsu-works/2319.

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Febrile neutropenia is a potentially life-threatening oncologic emergency characterized by a dangerously low neutrophil count that places the patient at great risk. In these patients, fever may be the only sign of infection, which requires prompt treatment. With the increasing focus in shifting health care from inpatient centers to outpatient arenas, home health care clinicians will likely have an increased role in the care of neutropenic fever patients in the future. The article describes both the pharmacologic treatment and nonpharmacologic support required of these patients with particular attention to treatment that may be required in the patient?s home.

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Ogawa, Keiko. "Workload of Home Health Care Nurses in Japan." Case Western Reserve University School of Graduate Studies / OhioLINK, 2008. http://rave.ohiolink.edu/etdc/view?acc_num=case1207180785.

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Scharpf, Tanya Pollack M. S. "Functional Status and Quality in Home Health Care." Case Western Reserve University School of Graduate Studies / OhioLINK, 2005. http://rave.ohiolink.edu/etdc/view?acc_num=case1112905040.

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Mong, Sherry Newcomb. ""Discharged": Labor Processes in Skilled Home Health Care." The Ohio State University, 2012. http://rave.ohiolink.edu/etdc/view?acc_num=osu1342634405.

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Lindblom, Johan, and Jonas Rosquist. "Non-disruptive value-chains in home health care." Thesis, Blekinge Tekniska Högskola, Institutionen för programvaruteknik och datavetenskap, 2002. http://urn.kb.se/resolve?urn=urn:nbn:se:bth-3293.

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Treatment of elderly people and citizens in need of professional care is one of the most important aspects of any society to consider that aims at support for quality of life. Support for such qualitative aspects of a modern society often manifests itself by means of value-chains. However, all activities that a business or organization uses are not included in the value-chain, it is only the activities and information that generate any kind of value for the users in a particular organization that are included in the value-chains. To that end, the locality of health care related information primarily exists at the hospital and, therefore, the care of patients is most efficiently carried out at the hospital. However, if the involved information can be accessed anywhere throughout the value-chain, a possible situation would be to keep the patients in their homes without disrupting already established work practice and related value-chains. In principle, introducing new technology must not disrupt a value-chain; it must preserve or, even better, improve it. Health care is becoming more mobile and needs support for such behavior. The quantitative value to the user is quantified by means of value-chains, so it is important that they remain non-disrupted. Consequently, the fundamental concepts dealt with in this thesis are; value-chains, health care and mobile technology. The problem domain is distributed health care and we have chosen to focus on sustainability of the involved value-chains. In essence, we want to add new technology to the domain without disrupting already existing value-chains. This in order to make the distributed health care apparatus more efficient and cost effective. The main problem we have identified is regarding how medical doctors and nurses could access the same information in patients' homes as they can at the hospital.

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Lee, Hyang Yuol. "Quality of care: Impact of nursing home characteristics." Diss., Search in ProQuest Dissertations & Theses. UC Only, 2009. http://gateway.proquest.com/openurl?url_ver=Z39.88-2004&rft_val_fmt=info:ofi/fmt:kev:mtx:dissertation&res_dat=xri:pqdiss&rft_dat=xri:pqdiss:3352465.

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Thesis (Ph.D.)--University of California, San Francisco, 2009.
Source: Dissertation Abstracts International, Volume: 70-04, Section: B, page: 2206. Advisers: Mary A. Blegen; Charlene A. Harrington. Includes supplementary digital materials.

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Manuel, Eric R. "Physically active centered medical home." Thesis, California State University, Long Beach, 2015. http://pqdtopen.proquest.com/#viewpdf?dispub=1599186.

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Under the provision of the United States Department of Health and Human Services, the patient centered medical home is a model of primary care transformation that seeks to meet the variety of healthcare needs of patients and to improve patient and staff experiences, outcomes, safety, and system efficiency. Serving the medically underserved and primary care clinic shortage area of Long Beach, California, the Physically Active Centered Medical Home (PAC MH) will be a safe haven for healthy and physically active individuals who are required to avail of health insurance coverage as mandated by the Patient Protection and Accountable Care Act of 2010 (PPACA). PAC MH will offer comprehensive and integrated services that will keep its members healthy and away from the burden of repeated clinical visits. PAC MH understands that medical coverage is the least of the priorities for healthy adults. Hence, PAC MH’s payment system is made simple. The value-based care provided at PAC MH will reward the healthcare team for achieving and exceeding the pre-established benchmarks for quality care.

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Bell, Mary Ann 1953. "Perceptions of quality of care in the nursing home." Thesis, The University of Arizona, 1992. http://hdl.handle.net/10150/291785.

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The purpose of this study was to determine the perceptions of residents, family members, and nursing staff regarding quality of care and the physical environment in the nursing home. Relationships among quality of care, the physical environment, and selected organizational characteristics were then described. The Quality of Care Scale (QoCS) and the Environment Description Scale (EDS) were given to a convenience sample of 100 subjects. A significant difference in perceptions of quality of care was found between the nurse assistants and residents. Significant relationships were obtained between perceptions of quality of care and the physical environment for Registered Nurses, Licensed Practical Nurses, and families. Defining quality of care and determining the significance of the physical environment from the consumer perspective may contribute to both quality of life and quality of care in the nursing home.

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Kaye, Debra Anne. "Women's perceptions of telephone nursing care within an antenatal home care program." Thesis, University of Ottawa (Canada), 2006. http://hdl.handle.net/10393/26308.

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Purpose/problem. Telephone nursing care (TNC) has replaced some home visits to increase efficiency of The Ottawa Hospital Antenatal Home Care Program (AHCP). There is limited published research addressing TNC in similar settings to guide program development. Therefore, chose an evaluation strategy to explore the clients' the researchers and organization perceptions of TNC. Objectives. (1) Perform a systematic literature review of TNC in the high risk antenatal population. (2) Profile high risk antenatal population receiving telephone nursing care. (3) Describe clients' perceptions of telephone nursing care. (4) Explore the feasibility of this methodology for continuous program evaluation and informing development and improvement. Method. A mixed methods approach was used. Two surveys and a semi-structured interview were completed by 13 participants. Data were analyzed using descriptive statistics and constant comparative analysis. Results. Sample was similar to the population in diagnosis, maternal and fetal outcomes. Anxiety scores were high and women identified the highest needs related to high risk pregnancy, psychological and information domains. Four main themes emerged: the experience of being at home, perceptions of the telephone care, perceived benefits, and perceived health systems issues.

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Harvey, C. Froggatt S. Lightowler B. and Hodge A., C. Harvey, S. Froggatt, Bryan Lightowler, and A. Hodge. "The ambulance service advanced practitioner's role in supporting care homes: a qualitative study of care staff experiences." Mark Allen Group, 2020. http://hdl.handle.net/10454/18604.

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No
The demand from care homes on NHS services continues to rise, with little evidence of ambulance service contribution in this area. The Yorkshire Ambulance Service provides an advanced practitioner model to support care homes in Sheffield, as an alternative to calling 999. This study investigated the experiences and needs of the care home staff who use the ambulance service advanced practitioner model. This qualitative study conducted semi-structured, face-to-face interviews with 19 staff members from 10 different care home settings. Thematic analysis using a combination of NVivo and manual coding was undertaken. The three key themes from the interviews were variations in service demand, the service user’s expectations and experience, and benefits to residents. Participants reported that good community services reduced the need to call 999, empowering carers to support residents to remain in the community. Care homes require comprehensive services that meet their needs. The advanced practitioner model provided by the ambulance service supports this, preventing unnecessary 999 calls and fitting with other community service provision.

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Romana, Joanna M. "Aideready| A Mobile App-Based Home Care Agency." Thesis, California State University, Long Beach, 2018. http://pqdtopen.proquest.com/#viewpdf?dispub=10751625.

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With projected increase in the numbers of senior citizens in the coming decades, it is imperative to develop technological solutions that will address their needs and wants. AideReady is a home care agency that recruits certified nursing assistants and home care aides to provide high quality companion care and basic assistance to senior citizens. What sets AideReady apart from a traditional home care agency is the utilization of a digital platform for employees and clients to access staffing requests and services. AideReady will be available to its employees and patients on mobile devices and a website which is meant to provide convenience and ease for all users. Through its innovative and industry-disruptive concept, AideReady aims to empower all clients and employees by giving flexibility for aides and excellent, patient-centered care for its clients.

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Steeg, Jörg Michael. "Mathematical models and algorithms for home health care services." Tönning Lübeck Marburg Der Andere Verl, 2008. http://d-nb.info/994324375/04.

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Yankah, Andrina. "Leadership Skills for Success of Home Health Care Agencies." ScholarWorks, 2016. https://scholarworks.waldenu.edu/dissertations/3078.

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Small business managers often lack the leadership skills necessary to sustain their businesses beyond 5 years. The United States Small Business Administration reported that more than 65% of small business owners, including home health care agency managers, fail within the first 5 years of operation. Guided by Burns and Bass's transformational leadership theory, this multiple case study explored leadership skills that managers in home health care agencies need to sustain their new businesses beyond 5 years. The purposeful sample comprised of 3 managers from 3 different home health care agencies within a 75-mile radius of Baltimore, Maryland, that had demonstrated success in surviving past 5 years. Semistructured interviews, agencies' quality assurance plans and policies were reviewed, and procedural documents related to leadership skills were gathered as data. Yin's 5-step data analysis technique was used to identify key themes. Member checking enhanced the credibility of data interpretation. Themes that emerged from data analysis were business management, knowledge and performance, and transformational leadership. Study findings may contribute to positive social change by providing practical guidance to home health care managers, which may improve their agencies' viability and delivery of patient care. Business implications include the provision of long-term employment to workers and safety assurance to patients' families.

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Sharma, Ekta. "HealthElixir home healthcare solutions business plan." Thesis, California State University, Long Beach, 2016. http://pqdtopen.proquest.com/#viewpdf?dispub=10124505.

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Given the ever increasing population of elderly in U.S, home healthcare agencies (HHA) serve as a model of continuous quality and affordable care. HHA hold a promise to boost economy and reduce healthcare expenditures to a significant level. This business plan examines the business potential of a home healthcare startup in downtown LA. Chapter 1 deals with market analysis, providing detailed information on the company, its organization, services, market definition, customer analysis, target population, and service demand. Chapter 2 deals with feasibility analysis and strategic planning, including SWOT, to sell our services. In chapter 3, we have discussed the legal issues and regulations, and defined policies to abide by state and federal rules and regulations. Finally, chapter 4 is about financial analysis, providing detailed pricing structure, other expenditures and revenues and the overall potential of the business to strive profitability and survive market competition. In conclusion, the Health Elixir Home Healthcare business has shown potential for success in the market.

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Riggs, Jennifer Sue. "The Influence of Home Care Nursing Visit Pattern on Heart Failure Patient Outcomes." Case Western Reserve University School of Graduate Studies / OhioLINK, 2009. http://rave.ohiolink.edu/etdc/view?acc_num=case1244663522.

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Williams, Cynthia. "Home Care Quality Effects of Remote Monitoring." Doctoral diss., University of Central Florida, 2014. http://digital.library.ucf.edu/cdm/ref/collection/ETD/id/6383.

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Despite concerted efforts to decrease costs and increase public health, the embattled U.S. health care system continues to struggle to alleviate these widespread issues. Because the problem of hospital utilizations among patients with heart failure is posited to increase as the population ages, innovative methodologies need to be explored to mitigate adverse events. Remote monitoring harnesses the strength of advanced information and communication technology to affect positive changes in health care quality and cost. By reaching across geographical boundaries, remote monitoring may support increased access to less costly services and improve the quality of home health care. The purpose of the study was to examine the home care quality effects of remote monitoring technology in patients with heart failure and to provide an economic justification for its adoption and diffusion. It compared remote monitoring as a potential intervention strategy to a standard no-intervention group (without remote monitoring). Specifically, it analyzed remote monitoring as a viable strategy to decrease hospital readmissions and emergency department visits. It also compared the cost of remote monitoring against the current standard-of-care. The theoretical framework of Donabedian's Quality Model was used in the evaluation of remote monitoring. A retrospective posttest only, case control study design was used to test the degree which remote monitoring was effective in promoting health care quality (hospital readmissions and decreased emergency department visits). Retrospective chart reviews were performed using electronic medical records (EMR). Analysis of Variance, Path Analysis, Automatic Interaction Detector Analysis (Dtreg), and Cost Outcomes Ratio were used to test the hypotheses and validate the proposed theoretical model. No significant difference was noted in remote monitoring and usual care groups. Results suggested that remote monitoring does not statistically lead to a decrease in heart failure-related hospital readmissions and all-cause emergency department visits. Results of the cost ratio analysis suggested that there was no statistically significant difference in the net income between usual care and remote monitoring; however, data suggest that there were significant increases in cost and intensity of nursing utilization for the remote monitoring intervention. The Automatic Interaction Detector Analysis showed that the unfavorable results in hospital readmissions were due to a decrease in collaborative care and patient education prior to the recommendation for hospitalization. The role of nursing care, whether in hospital or community-based care, in heart failure management is critical to quality outcomes. As the field continues to consider the use of technology in health care, decision makers should think through the process of patient care such that preventable hospital readmissions are decreased and patients received quality care.
Ph.D.
Doctorate
Health and Public Affairs
Public Affairs; Health Services Management and Research Track

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41

Buckley, Ernest Graham. "Health assessment of the elderly at home." Thesis, University of Edinburgh, 1989. http://hdl.handle.net/1842/19456.

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42

Kidambi, Supriya. "WeCare Home Healthcare Support Services Business Plan." Thesis, California State University, Long Beach, 2017. http://pqdtopen.proquest.com/#viewpdf?dispub=10261395.

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Considering the expanding populace of elderly in the United States of America, there has been a significant growth in demand for home healthcare organizations which serve to deliver continuous quality care. Home healthcare organizations guarantee to support our economy and decrease healthcare costs to a huge level. This marketable business plan inspects the business capability of a home healthcare services startup located in San Diego Downtown.

This business plan has been broken down into several compartments where chapter 1 accounts on the market analysis of our business providing marketing strategies and intricate details of our company and its analysis, services provided, services in demand, customer and competitor analysis, marketing potential and demand. Chapter 2 deals with feasibility and SWOT analysis, to evaluate pros and cons, and to get a better idea of the organizational structure of the business plan. In Chapter 3, we talk about the legal aspects concerning State and Federal laws. Chapter 4 explains about the financial assumptions and analysis, annual expenditures as well as monthly expenses with the overall potential of home healthcare services to survive market competition.

We conclude that WeCare home healthcare services plan showed great potential to withstand the competitive market and drive towards success.

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43

McClement, Susan. "Nutritional care in advanced cancer, the experiences of patients, families, and health care providers." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 2001. http://www.collectionscanada.ca/obj/s4/f2/dsk3/ftp05/NQ62654.pdf.

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44

Lagerstedt, Marianne. "Komplexa operationer i en komplex vårdform : om ledning, ledningsbehov och möjligheter till ledning för säkrare vård i hemmet." Licentiate thesis, KTH, Patientsäkerhet, 2012. http://urn.kb.se/resolve?urn=urn:nbn:se:kth:diva-95388.

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Advanced home care (ASIH) enables the patient to stay at home rather than to stay hospitalized in connection with severe medical conditions, while simultaneously this Thesis demonstrates that this is in fact not completely unproblematic and without risk. This partly because ASIH proves to be a complex form of care with many different kind of collaterally ongoing care contacts and efforts of care and concern, partly since ASIH concurrently can assume an overview over the treatment process and collaboration or cooperation between several treatment agents from different kinds of organizations and/or operations during all hours. This composes a relatively new heterogenetic and multifaceted context of care which to the professional practice means both new and less known problems within patient safety, which substantially can obstruct and rule out both the completion and the implementation of a safe home care. The Thesis is based upon an exploratory case study of problems within patient safety in correlation with an advanced home care, and where the research study has had its starting position in the professional practice with an interactive and qualitative research approach. The case study houses two part studies which show that the patient safety problems can be related to an intermediary and multi-organizational form of care, rather than an single operation. A command and control view upon the problems of patient safety, which the professional practice faces, show that missions within the frame of the care form ASIH can be regarded as either a complicated and not rarely a complex operation consistent with Alberts & Hayes (2007) and Brehmers (2008a; 2009c) terminology and where the assignments includes dynamic decision tasks. The case study reveals that the patient safety problems which concretely can obstruct and rule out the completion or implementation of the assignments in a safe way, can be considered related to the layout of the description of the assignments and also a lack of operative and tactical command and control level (of the handling and care of patients) in correlation with the different sorts of assignments that prevails – coincidentally as there is no suitable organization (forums of cooperation) and no appropriate IT-resources for the liaisons which effectively manages to promote and support the forms of cooperation that the character of the assignments also needs. The implicit system of conduct which comes forth through the analysis indicates that there is a need of improvement in order to enable effective command and control for a safer care, since the form of the system of conduct according to Brehmer´s (2006a,b; 2007a,b; 2008a,b; 2009c, 2010, 2011) model fails to satisfy the needs set by the function of command and control. The conclusion of the case study is that advanced home care should be regarded as an intermediary and multi-organizational care form which includes dynamic decision tasks and character wise complex operations contemplated per patient, thus demanding substantial command and control resources, a new point of view upon management and new auxiliary means of management in order to maintain a safe care during the implementation. The hypothesis which has been crystallized during the conclusions of the case study is that a more effective control and command and appropriate auxiliary means of command and control in real time, concerning primarily the handling of patients at the time of a change in care form, can improve the conditions of work in the professional practice and also result in more patient time, which consequently can be expected to contribute to concept of “Good care” i.g. cost effective, patient safe and dignified care.

QC 20120525

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45

Warren, L. A. "Home care and elderly people : the experiences of home helps and old people in Salford." Thesis, University of Salford, 1988. http://usir.salford.ac.uk/14794/.

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My study is concerned not simply with the what and the how of hone care for the elderly but also with the I ask about how the domiciliary services operate: what home helps do for elderly people and how they feel about their caring role, and, what the circumstances of elderly people needing care are and how they feel about using help. But I also want to know why home help operates in this way: why home helps care in the way they do and why elderly people feel as they do about using that care? Such an approach cannot fail to take into consideration the wider ecological and structural context within which elderly people and home helps live and work. Part one of my thesis, composed of three chapters, therefore provides this backcloth. I use it to introduce the location of the study, to present a brief history and discussion of the development of domiciliary services for the elderly in Britain, and 10 describe the philosophy and policy shaping domiciliary provision within Salford Social Services Department. As I shall show, current Government economic policy is inextricably woven into the fabric of this backcloth. In Part Two, I detail the findings of my fieldwork, painting a picture of the lives of the frail and impaired elderly people using domiciliary care, and of the work of the home helps providing that care. As far as possible, I have used the interviewees' own words to explain perceptions of (in)dependence and need, of stiqma and taboo, of material and ideological motivations, and of emotional involvements and commitments. A number of writers have argued that dependency - a concept at the centre of inquiries into the care of the elderly - is a socially constructed relationship, both with respect to elderly users and female providers of care. In Part Three, I question whether and in what way the evidence supports or denies this claim. I ask what are the implications of my findings for social policy. I also justify the use of anthropological perspectives in policy-related research. Finally, I present an account of my experience as a researcher which can be approached from a number of different levels., At a'basic level, it represents an immediate account of doing fieldwork. It is also my account, as a post-graduate, of the experience of writing-up a thesis. I consider the effect of the passing of time on context and consciousness and hci this feeds into the analysis and presentation, of work. And I attempt to address concerns with the writer/reader/subject relationship which pose questions to do with communication.

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46

Lee, Sang-Young. "The role of design in home-based health-care equipment." Thesis, De Montfort University, 2000. http://hdl.handle.net/2086/4807.

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47

Athorp, Ann. "Empirical Investigation of Efficacy in Home-Based Mental Health Care." DigitalCommons@USU, 1997. https://digitalcommons.usu.edu/etd/3633.

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The current study consisted of two experiments to examine the impact of home-based therapy on mental illness in multiproblem families. Review of the literature focused on the interplay between poverty and mental illness in defining multiproblem families and the utilization of home-based therapy with this population and others. Experiment 1 focused on delineating the type and severity of psychological distress in families characterized as multiproblem. Subjects were 58 participants in the Community-Family Partnership, a Comprehensive Child Development Program located at Utah State University in Logan, Utah. In this sample, serious psychological distress was evident with depression in both women and men as a primary symptom. Female participants in Experiment 1 showed psychological distress across more subscales and higher standardized mean difference effect sizes on the global subscales of the Symptom Checklist-90-Revised than male participants. Significant distress was also evident on the Somatization and Obsessive-Compulsive subscales for female participants and on the Hostility subscale for male participants. In a corollary to Experiment 1, participants in this study also fit the description of multiproblem based on their demographic characteristics. Experiment 2 implemented a home-based therapy program based on Sherman's Action Counseling model and evaluated its effectiveness in terms of reduction of psychological distress. Six individuals drawn from the Experiment 1 sample participated in Experiment 2. At pretest, they were not demographically different from the Experiment 1 sample, and they exhibited severe psychological symptoms such that their score profiles on the Symptom Checklist 90-Revised met both definitions of caseness for that instrument. These subjects participated in nine weekly sessions of home-based therapy based on the Action Counseling model. Therapy was very successful for one subject, moderately successful for four subjects, and not successful for one subject using reduction of psychological distress as the measure of effectiveness. Additionally, Experiment 2 examined elements of the therapy that contributed to effectiveness. Mastery of and implementation of the 10 Action Counseling steps appeared to contribute to therapy success. Limitations were discussed with respect to internal and external validity in the current study. Recommendations for future work were provided.

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Troini, Rita. "A home ventilation health care education program for patient empowerment." Mémoire, Université de Sherbrooke, 1996. http://hdl.handle.net/11143/11210.

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A pilot program designed to facilitate patients requiring ventilatory support to return home, was developed through a Montreal based hospital. One year after the inception of this pilot program, this study was undertaken to evaluate what role, if any, patient empowerment played in the successful reintegration of this clientele back into their community. Six patients which underwent the transition from hospital respiratory services to home care services were interviewed regarding their experience. Semi-structured interviews were done on 3 female patients and 3 male patients, all with degenerative neuromuscular diseases at different levels of onset and severity. The subjects were asked to describe their experience with the Home Ventilation Program in terms of empowerment with a specific emphasis on the educational programs. Overall the results indicated that the experience was a very positive one. All the subjects interviewed described feeling empowered by the Home Ventilation Program in one way or another. Five main categories of empowerment emerged from the data. They are: empowerment through Advocacy, Consent, Education, Choice and Accommodation with Advocacy being the most predominant theme. All six patients reported a high degree of satisfaction with the services offered as well as an increase in their quality of life as a direct result of these services. The results of the study imply that educational programs which serve to prepare patients for their own care are more apt to be successful if empowerment strategies are an inherent part of the program.

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Atilano, Edwin. "La Paz Home Care Agency| A Business Plan." Thesis, California State University, Long Beach, 2018. http://pqdtopen.proquest.com/#viewpdf?dispub=10831022.

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There exists a blatant need in the Gateway City region of Los Angeles County to serve the Hispanic population in their caregiving needs. In serving a prominently Hispanic population, La Paz Home Care Agency will be distinctive as it will present specialty, expertise, and cultural sensitivity to clients’ home health and caregiving needs. As with national trends, there exists a growing demand for home health providers in the Los Angeles County and Orange County metropolitan region. Home health care services allow a person with special needs stay in their home as they are getting older, are chronically ill, recovering from surgery, or are disabled. Laz Paz Home Health Agency will meet the growing demand for caregiver services by providing services like bathing, dressing, meal preparation, assistance with self-care such as grooming, using the toilet, assisting with ambulation, transfer, light housekeeping, laundry, errands, medication reminders, escorting to appointments, hobby engagement, and supervision for someone with dementia or Alzheimer’s disease. In this business plan a detailed account of La Paz Home Care’s competitive environment, aims, and operations will be covered in detail.

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Tillett, Marsha Jane 1952. "The effect of postpartum home teaching on knowledge of infant care." Thesis, The University of Arizona, 1992. http://hdl.handle.net/10150/278075.

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This study investigated the effect of postpartum home teaching on primiparous women's knowledge of infant care. Twenty-one low-risk primigravidae women were randomly placed in a control or experimental group. Subjects in the experimental group viewed a videotaped program on infant care a second time, at home on the third day postpartum. Tests were administered prior to hospital discharge, on the third day postpartum, and at 28-32 days postpartum. A short interview was conducted to obtain opinions regarding videotaped educational materials. The subjects (n = 21) retained most of the information presented after the first viewing and expressed satisfaction with the educational format. The results were not statistically significant, though mean test scores increased over the three test intervals.

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Dissertations / Theses on the topic 'Advanced health care at home'

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