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Tikkanen, Irma, and Anne Silvan. "Developing the service process of municipal home care catering." Nutrition & Food Science 42, no. 5 (September 5, 2012): 315–23. http://dx.doi.org/10.1108/00346651211266827.
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Rostad, Hanne Marie, and Randi Stokke. "Integrating Welfare Technology in Long-term Care Services: Nationwide Cross-sectional Survey Study." Journal of Medical Internet Research 23, no. 8 (August 16, 2021): e22316. http://dx.doi.org/10.2196/22316.
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Background Welfare technologies are often described as a solution to the increasing pressure on primary health care services. However, despite initiating welfare technology projects in the health care sector and different government incentives, research indicates that it is difficult to integrate welfare technology innovations in a complex and varying setting, such as long-term care. Objective We aim to describe the types of welfare technology and the extent to which welfare technology is provided in long-term care (ie, nursing homes and home care services); examine whether the extent of welfare technology provision differs on the basis of municipal characteristics (ie, population size, centrality, the proportion of older inhabitants, and income); and identify how local governments (ie, municipalities) describe their efforts toward integrating welfare technologies in long-term care. Methods Quantitative and qualitative data about welfare technology from a larger cross-sectional survey about the provision of long-term care services in Norwegian municipalities were combined with registry data. Representatives of 422 Norwegian municipalities were invited to participate in the survey. Frequencies were used to describe the distribution of the types and extent of welfare technologies, whereas the Fisher exact test and Kruskal-Wallis one-way analysis of variance were used to determine the association between the extent of welfare technology and municipal characteristics. Free-form text data were analyzed using thematic analysis. Results A total of 277 municipalities were surveyed. Technology for safety was the most widespread type of welfare technology, whereas technology for social contact was the least prevalent. Two-thirds of the sample (183/277, 66.1%) in nursing home and (197/277, 71.1%) in home care services reported providing one or two different types of welfare technology. There was a statistically significant association between the extent of welfare technology and population size (in both nursing homes and home care services: P=.01), centrality (nursing homes: P=.01; home care services: P<.001), and municipal income (nursing homes: P=.02; home care services: P<.001). The extent of welfare technology was not associated with the proportion of older adults. The municipalities described being in a piloting phase and committing to future investment in welfare technology. Monetary resources were allocated, competency development among staff was initiated, and the municipalities were concerned about establishing collaborations within and between municipalities. Home care services seem to have a more person-centered approach in their efforts toward integrating welfare technologies, whereas nursing homes seem to have a more technology-centered approach. Conclusions Many municipalities provide welfare technologies; however, their extent is limited and varies according to municipal characteristics. Municipal practices still seem dominated by piloting, and welfare technologies are not fully integrated into long-term care services. Innovation with welfare technology appears top-down and is influenced by national policy but also reflects creating a window of opportunity through the organization of municipal efforts toward integrating welfare technology through, for example, collaborations and committing personnel and financial resources.
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Sørly, Rita, Martin Sollund Krane, Geir Bye, and May-Britt Ellingsen. "“There Is a Lot of Community Spirit Going On.” Middle Managers' Stories of Innovation in Home Care Services." SAGE Open Nursing 5 (January 2019): 237796081984436. http://dx.doi.org/10.1177/2377960819844367.
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Background: There is a need for qualitative studies on imposed innovation in home care services in welfare societies. The municipalities are key actors in the field of innovation in the public sector. As innovations often are interpreted to be in conflict with values in health care, we need knowledge on how policy changes and imposed innovations are understood and handled by middle managers working in the sector. Aim: We aim to explore how middle managers react to imposed innovation in health services through their storytelling. The research question was “What can middle managers' stories of imposed innovation tell us about their role in, and some important prerequisites for, innovation processes in municipal health-care services?” Methods: A narrative study of experiences with municipal innovation among middle managers in Norway. In this article, we do a thematic analysis of interviews with seven female middle managers who work in a home care service department. Findings: The study develops an understanding of which frameworks are required within a home care service to meet constant demands for innovation. Innovations are understood by the managers as results of policy changes and new public management demands and as a troublesome burden. We find the prerequisites for implementing innovations to be (1) trust-based management, (2) flexibility and dynamics, (3) continuity of care, and (4) emphasis on competence. These prerequisites are further interpreted in relation to dominant discourses on innovation at the macro, meso, and micro levels within the storytelling contexts. Conclusion: Imposed innovations require a negotiating practice in cross-disciplinary environments at all levels in the organization.
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Szatmari, Andrea, and Istvan Hoffman. "The Transformation of the Municipal Social Care System in Hungary – In the Light of the Provision of Home Care Services." Lex localis - Journal of Local Self-Government 18, no. 4 (October 29, 2020): 691–712. http://dx.doi.org/10.4335/18.3.691-712(2020).
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Municipalities play a significant role in the field of social care services. The basic social services are primarily provided by local governments. The Hungarian municipalities have strong social powers and duties, but their role is in a permanent transformation. The strongly decentralised system established in the early 1990s has since been centralised and the majority of specialised social services has been nationalised in the last decade. This has resulted in a new model; a mixed system having evolved after 2013. The provision of the specialised services has been mainly centralised, while the basic services have remained the responsibility of the municipal bodies. In this article, the impacts of this reform are analysed. The centralisation of the specialised services and the reforms of the financial support of municipal basic social services significantly transformed the former accessibility. The accessibility to these services depends on several factors: it depends on the central regulation of the entitlement rules, of the central funding of the municipal tasks and partly that of the economic power of the municipality. The central regulation and the central support of these services play a very important role in this system.
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Sobis, Iwona. "Comparison of Public and Private Home Care Services for Elderly in Gothenburg Region, Sweden 2013." Central European Public Administration Review 11, no. 3-4 (May 9, 2014): 25–55. http://dx.doi.org/10.17573/ipar.2013.3-4.a02.
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The purpose of this study is to compare and evaluate the public and private home care services for elderly given economic limitations after delegating them to municipality in the Gothenburg Region. The additional aim is to make politicians conscious about this development. The theoretical model of delegation and decentralization by Cristiano Castelfranchi and Rino Falcone (1998) and the Resource Dependency Theory by Pfeffer and Salancik (1978) constitute the theoretical reference frame. The study is based on an analysis of state regulation, policy documents and semi-structured interviews with the chief responsible for public and private home care services for elderly at the municipal level. This study reveals that the delegation of care for elderly to the municipalities faced some serious problems not to be solved until 2013 and surprisingly that these problems are especially seen where the recipients of such care don’t have a choice on their service provider. The lesson drawn from the research is that if politicians or other authorities take away the right from people to make their own decisions about their own lives, this inevitably results in dissatisfaction and subsequent reforms.
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Chen, Yan-Yan, Honglin Chen, and Priscilla Song. "Promises and pitfalls of integrating home-based health services into Shanghai's elder-care system." Ageing and Society 40, no. 3 (August 28, 2018): 480–500. http://dx.doi.org/10.1017/s0144686x18001095.
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AbstractFaced with the dramatic pace of population ageing, the Shanghai municipal government launched a pilot programme in 2013 designed to address this and to strengthen ageing-in-place arrangements by providing basic in-home medical services for residents above the age of 80. Yet after a two-year trial run, the ‘Home-Based Medical Care Scheme for the Oldest-Old’ (HBMCSOO) policy remained significantly under-utilised despite the increasing demand for medical services. Our multi-disciplinary research team of social workers and anthropologists identified two key factors impeding the implementation of home-based medical care services: (a) the distortion of policy implementation and (b) the inadequate professionalisation of community-based elder-care workers. Based on our evaluation of the pilot programme, the Shanghai municipal government made several practical adjustments to improve the subsequent city-wide policy implemented in 2016. While these changes mostly focused on minor adjustments to improve in-home medical services for the oldest-old, they represent an encouraging first step towards our call for a holistic integrated care system whose design and delivery takes into account local political and social contexts, including existing institutional infrastructure and cultural expectations about care-giving responsibilities. The challenges of implementing Shanghai's HBMCSOO policy ultimately provide instructive lessons on best practices for integrating medical and social services in order to improve ageing-in-place measures in diverse local settings around the world.
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Demaerschalk, Melanie F., Lut E. Vanden Boer, Joost L. Bronselaer, Geert Molenberghs, and Anja G. Declercq. "The influence of municipal characteristics on the use of informal home care and home care services by the elderly Flemish." European Journal of Public Health 23, no. 2 (June 8, 2012): 241–46. http://dx.doi.org/10.1093/eurpub/cks068.
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Karlsson, Sofie, Ann Ridbäck, Elisabeth Brobeck, and Margaretha Norell Pejner. "Health Promotion Practices in Nursing for Elderly Persons in Municipal Home Care: An Integrative Literature Review." Home Health Care Management & Practice 32, no. 1 (July 13, 2019): 53–61. http://dx.doi.org/10.1177/1084822319863308.
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Elderly patients sometimes seek emergency services unnecessarily. Emergency clinics can be detrimental to the elderly. The purpose of this study was to find health promotion practices that enable a registered nurse in community health to reduce the need for home care clients to seek emergency care. The method of integrative literature review was used. Through health promotion work in the home, the registered nurses in community health (in conjunction with other professionals) can strengthen patients’ self-esteem and reduce their emergency care visits. Patient involvement is part of this work, and the registered nurses in community health needs to get to know patients to learn their health needs, design individual care plans, and find out whether they need education about their own health and/or health care services available to them. Registered nurses in community health experience difficulties in performing health promotion because they perceive that other tasks have higher priority.
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Støme, Linn Nathalie, Tron Moger, Kristian Kidholm, and Kari J. Kværner. "A Web-Based Communication Platform to Improve Home Care Services in Norway (DigiHelse): Pilot Study." JMIR Formative Research 4, no. 1 (January 20, 2020): e14780. http://dx.doi.org/10.2196/14780.
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Background Home care service in Norway is struggling to meet the increasing demand for health care under restricted budget constraints, although one-fourth of municipal budgets are dedicated to health services. The integration of Web-based technology in at-home care is expected to enhance communication and patient involvement, increase efficiency and reduce cost. DigiHelse is a Web-based platform designed to reinforce home care service in Norway and is currently undergoing a development process to meet the predefined needs of the country’s municipalities. Some of the main features of the platform are digital messages between residents and the home care service, highlighting information on planned and completed visits, the opportunity to cancel visits, and notifications for completed visits. Objective This study aimed to test the usability and economic feasibility of adopting DigiHelse in four districts in Oslo by applying registry and behavioral data collected throughout a one-year pilot study. Early health technology assessment was used to estimate the potential future value of DigiHelse, including the predictive value of behavior data. Methods Outcome measures identified by stakeholder insights and scenario drafting in the project’s concept phase were used to assess potential socioeconomic benefits. Aggregated data were collected to assess changes in health consumption at baseline, and then 15 and 52 weeks after DigiHelse was implemented. The present value calculation was updated with data from four intervention groups and one control group. A quasi-experimental difference-in-difference design was applied to estimate the causal effect. Descriptive behavioral data from the digital platform was applied to assess the usability of the platform. Results Over the total study period (52 weeks), rates increased for all outcome estimates: the number of visits (rate ratio=1.04; P=.10), unnecessary trips (rate ratio=1.37; P=.26), and phone calls (rate ratio=1.24; P=.08). A significant gap was found between the estimated value of DigiHelse in the concept phase and after the one-year pilot. In the present pilot assessment, costs are expected to exceed potential savings by €67 million (US $75 million) over ten years, as compared to the corresponding concept estimates of a potential gain of €172.6 million (US $193.6 million). Interestingly, behavioral data from the digital platform revealed that only 3.55% (121/3405) of recipients actively used the platform after one year. Conclusions Behavioral data provides a valuable source for assessing usability. In this pilot study, the low adoption rate may, at least in part, explain the inability of DigiHelse to perform as expected. This study points to an early assessment of behavioral data as an opportunity to identify inefficiencies and direct digital development. For DigiHelse, insight into why the recipients in Oslo have not made greater use of the Web-based platform seems to be the next step in ensuring the right improvement measures for the home care service.
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DUNÉR, ANNA, PÄR BJÄLKEBRING, and BOO JOHANSSON. "Merely a rhetorical promise? Older users' opportunities for choice and control in Swedish individualised home care services." Ageing and Society 39, no. 4 (October 26, 2017): 771–94. http://dx.doi.org/10.1017/s0144686x17001210.
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ABSTRACTA policy shift has taken place in Sweden towards individualised elder-care and consumer choice. The aim of the study is to investigate how older users of home care services view and experience their opportunities of exerting influence and having choice and control in their everyday living, in terms of receiving preferred services that are flexible and responsive to their actual needs and priorities. The study was conducted in three local elder-care authorities, reflecting diverse present models of organising home care services in Sweden. Data consisted of responses to a postal survey (N = 2,792) and reports from qualitative interviews (N = 28) with older users. Our findings point to similarities rather than differences between the views and experiences of the users in the three participating local municipal elder-care authorities. A majority of users were positive about their home care services. The experiences ranged from being active and enabled to choose between providers and services, to being more or less passive dependants having to rely on the decisions of family and staff. The importance of supportive relationships, and interdependence between older people and their formal as well as informal support networks, became clear. Our findings may guide policy makers in refining home care services, irrespective of preferred model. In particular, efforts to facilitate staff continuity and prevent high staff turnover need to be prioritised.
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Svensson, Ann. "Challenges in Using IT Systems for Collaboration in Healthcare Services." International Journal of Environmental Research and Public Health 16, no. 10 (May 20, 2019): 1773. http://dx.doi.org/10.3390/ijerph16101773.
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Frail elderly people refer to multi-diseased and vulnerable patients in need of medication and healthcare. These patients require healthcare from several different healthcare organizations, including hospital care, primary care, and municipal care services. This situation is challenging the capacity of healthcare organizations to manage inter-professional collaboration for person-centered care. This paper aims to identify challenges associated with collaboration between different healthcare organizations, related to the use of IT systems in the daily work practice. The paper was based on a qualitative study, which included three focus group interviews, each lasting for two hours. Each focus group consisted of a hospital physician, a primary care physician, a hospital nurse, a primary care nurse, a municipal home care nurse or an assistant officer, a physical or occupational therapist, and a family member representative. The interviews were analyzed with thematic analysis. Challenges identified in the study include insufficient information exchange, inconsistencies in communication, differences in the use of IT systems, and deficient coordination. The work processes that aim to promote collaboration between different healthcare organizations need to be better organized, and the use of IT systems needs to be better aligned.
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Udesen, Stine Emilie Junker, Dorthe Susanne Nielsen, Nina Andersen, Christina Østervang, and Annmarie Touborg Lassen. "Municipal acute care teams as a flexible solution for the treatment of acutely ill patients at-home: a mixed-method study of patients’ and caregivers’ experiences with an acute care team." BMJ Open 11, no. 8 (August 2021): e049945. http://dx.doi.org/10.1136/bmjopen-2021-049945.
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ObjectiveDevelopment of initiatives to reduce hospitalisations is a major focus of healthcare planning. Strengthening the community with municipal acute care teams or units is a newly implemented Danish initiative aimed at preventing hospitalisations and supporting more flexible services. This study aims to describe patients treated by a municipal acute care team and to explore patients’ and caregivers’ experiences with at-home treatment.DesignA mixed-method study consisting of descriptive statistics of patients treated by an acute care team, and quantitative and qualitative data from follow-up telephone questionnaires with patients and caregivers.SettingThe acute care team, ‘Acute Team Odense’ (ATO), in the Odense Municipality, Denmark.ParticipantsPatients treated by ATO and their caregivers. ATO treated 3231 patients (5676 contacts) in the period of 2018–2019.ResultsAverage number of new contacts per day was 7.8, and the median treatment-length was 1 day. Patients were referred by various healthcare providers and most often by general practitioners, municipal staff and hospital staff. The median age of the patients was 80 years, and 20% were independent before the treatment. In total, 787/5676 contacts received at-home intravenous therapy, which corresponded to 3.6 hospital beds saved per day. The questionnaires were completed by 307/478 patients and 168/254 caregivers. Most respondents stated they would prefer at-home treatment in future similar situations as it enabled them to maintain their lives. Several respondents also experienced that ATO avoided hospitalisations or reduced hospital stays, which was described as a relief.ConclusionATO was frequently used, indicating the demand for community-based acute healthcare. The patients and caregivers experienced that this solution avoided hospitalisations and allowed them to maintain their lives, and this was described as less burdensome. As a result of these findings, this initiative has been continued with an ongoing focus on searching for possibilities aimed to prevent hospitalisations.
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Tomlinson, Richard. "Prevention of Hiv/Aids-Associated Opportunistic Infections Through Housing and Municipal Services." Open House International 33, no. 4 (December 1, 2008): 43–52. http://dx.doi.org/10.1108/ohi-04-2008-b0006.
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The background to this paper is the increasing interest in the relationship between housing and municipal services and HIV/AIDS. The purpose of this paper is to clarify what, precisely, one has in mind when thinking that housing and municipal services might prevent HIV infection and associated opportunistic infections. The focus is not on the socioeconomic dimensions but on the modes of transmission associated with specific opportunistic infections. That is, the paper first disputes the relevance of housing and services to HIV prevention, but then demonstrates that housing and municipal services are important for (a) the prevention of certain opportunistic infections to which people affected by HIV/AIDS are particularly vulnerable, and (b) for the provision of home-based care. In addition to the medical focus of the paper, there is attention to the empirical backdrop on the relation between housing, municipal services and HIV/AIDS, analysing survey findings regarding among whom and where HIV prevalence is highest, and projections regarding the extent of HIV infections and AIDS based on the World Health Organization clinical staging system. Using Johannesburg as a case study, it is demonstrated that the number of persons having AIDS is smaller than one might expect and also that the number is already declining, which has implications for the provision of home-based care. However, it is also shown that the number of households that lost one or several members is increasing rapidly. In this context, labour force surveys are employed to identify the impacts on specific categories of households. At this stage, a defining unknown is the scale, nature and location of these reconstituted households and what this means for housing policy. Finally, a feature of the research was the extent to which medical practitioners viewed housing as a quixotic sideline within the broader struggle for HIV prevention and the provision of treatment. In sum, the paper provides an argument for incorporating housing and municipal services into both HIV and AIDS prevention and treatment programmes.
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Hausken, MF, and M. Graue. "Developing, implementing and evaluating diabetes care training for nurses and nursing aides in nursing homes and municipal home-based services." European Diabetes Nursing 10, no. 1 (February 2013): 19–24. http://dx.doi.org/10.1002/edn.219.
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Devik, Siri Andreassen, Ingela Enmarker, and Ove Hellzen. "Nurses’ experiences of compassion when giving palliative care at home." Nursing Ethics 27, no. 1 (April 25, 2019): 194–205. http://dx.doi.org/10.1177/0969733019839218.
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Background: Compassion is seen as a core professional value in nursing and as essential in the effort of relieving suffering and promoting well-being in palliative care patients. Despite the advances in modern healthcare systems, there is a growing clinical and scientific concern that the value of compassion in palliative care is being less emphasised. Objective: This study aimed to explore nurses’ experiences of compassion when caring for palliative patients in home nursing care. Design and participants: A secondary qualitative analysis inspired by hermeneutic circling was performed on narrative interviews with 10 registered nurses recruited from municipal home nursing care facilities in Mid-Norway. Ethical considerations: The Norwegian Social Science Data Services granted permission for the study (No. 34299) and the re-use of the data. Findings: The compassionate experience was illuminated by one overarching theme: valuing caring interactions as positive, negative or neutral, which entailed three themes: (1) perceiving the patient’s plea, (2) interpreting feelings and (3) reasoning about accountability and action, with subsequent subthemes. Discussion: In contrast to most studies on compassion, our results highlight that a lack of compassion entails experiences of both negative and neutral content. Conclusion: The phenomenon of neutral caring interactions and lack of compassion demands further explorations from both a patient – and a nurse perspective.
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Han, Shengnan, Gustaf Juell-Skielse, Åsa Smedberg, Parisa Aasi, and Anders G. Nilsson. "BENEFITS OF MOBILE REPORTING SYSTEMS IN SOCIAL HOME CARE: THE CASE OF SEVEN SWEDISH MUNICIPALITIES." International Journal of Technology Assessment in Health Care 30, no. 4 (October 2014): 409–15. http://dx.doi.org/10.1017/s026646231400052x.
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Objectives: Mobile systems are widely adopted in healthcare services. Mobile reporting systems have been recently introduced for social home care by municipalities in Sweden. The study aims to assess the benefits of using these systems.Methods: We followed an expert survey approach. Data were collected by means of telephone interviews with the experts in charge of managing and implementing the systems at the municipalities. In addition, several workshops were organized for assessing the economic value of the systems at one municipality. We performed thematic analysis and cost-benefit analysis of the data.Results: The thematic analysis showed the three main benefits of using the mobile reporting systems in social home care: municipal benefits, care providers’ benefits, and care recipients’ benefits. The cost-benefit analysis indicated that the systems could bring substantial long-term economic value for municipalities. The results also revealed the difficulties encountered at the early stage of the deployment and implementation of the systems.Conclusions: The mobile systems yield benefits for all the actors, that is, municipalities, care recipients and care providers. These enhance the public-private coordination and cooperation in social home care in Sweden. The municipalities are called upon to address change management and technical challenges in the implementation.
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Dobanovacki, Dusanka, Milan Breberina, Bozica Vujosevic, Marija Pecanac, Nenad Zakula, and Velicko Trajkovic. "Reminiscence on the municipal out-of-hospital Maternity unit and the Motherhood Home in Novi Sad." Medical review 66, no. 1-2 (2013): 93–97. http://dx.doi.org/10.2298/mpns1302093d.
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Introduction. In the mid-twentieth century, the health care of women and children was inadequate in the post-war Yugoslavia, including the city of Novi Sad, due to the severe post-war reality: poverty in the devastated country, shortage of all commodities and services and especially of medical supplies, equipment and educated staff. Out-of-Hospital Maternity Unit. One of the serious problems was parturition at home and morbidity and mortality of the newborns and women. Soon after the World War II the action programme of improving the women?s health was realized on the state level by establishing out-of-hospital maternity units but under the expert supervision. The Maternity unit at 30 Ljudevita Gaja Street in Novi Sad played a great role in providing skilled birth attendance at mainly normal deliveries. With a minimal number of medical staff and modest medical equipment, about 2000 healthy babies were born in this house. Motherhood Home. After 5 years of functioning in that way, this unit was transformed into the Motherhood Home and became a social and medical institution for pregnant women and new mothers. Regardless of the redefined organization concept the curative and preventive health care as well as women and children social protection programmes were provided successfully for the next 12 years. Although the Motherhood Home was moved into the Women Health Centre of Novi Sad and later into the former Maternity Hospital in Sremski Karlovci, its great importance for women and children?s health care remained unchanged. In 1979 the overall social situation and mostly economic issues led to its closing. Epilogue. The house in Gajeva Street is now used as the municipality office. However, this house with its story recommends itself to become a house for a special social function, such as a museum of medical history of Novi Sad. A small investment could make it possible to collect, preserve and display the valuable records of our past, which is something we do owe to the generations to come.
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Breitholtz, Agneta, Ingrid Snellman, and Ingegerd Fagerberg. "Living with Uncertainty: Older Persons’ Lived Experience of Making Independent Decisions over Time." Nursing Research and Practice 2013 (2013): 1–8. http://dx.doi.org/10.1155/2013/403717.
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The aim of the study was to illuminate the meaning of older persons’ independent decision making concerning their daily care. Autonomy when in care is highly valued in the western world. However, research shows that autonomy can give rise to problematic issues. The complexity of independence and dependence for older people when living at home with help has also been highlighted. In Sweden, older people are increasingly expected to live at home with help from municipal home care services, and study into this aspect of care is limited. This study is a part of an ongoing project and has a qualitative life world perspective. Audiotaped narrative interviews were conducted and analysed using a phenomenological hermeneutic method. Findings revealed a main theme: “living with uncertainty as to how to relate one’s own independence and dependence with regard to oneself, and others.” This involves a constant process of relating to one’s independence controlled by others or oneself, and adjusting one’s independence and dependence with regard to oneself and others. The conclusion is that professional carers need to acknowledge the changing vulnerability of dependent older persons over time. The implication is a relational approach to autonomy beyond the traditional individualistic approach.
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Fæø, Stein Erik, Frøydis Kristine Bruvik, Oscar Tranvåg, and Bettina S. Husebo. "Home-dwelling persons with dementia’s perception on care support: Qualitative study." Nursing Ethics 27, no. 4 (January 27, 2020): 991–1002. http://dx.doi.org/10.1177/0969733019893098.
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Background Over the last years, there has been a growth in care solutions aiming to support home-dwelling persons with dementia. Assistive technology and voluntarism have emerged as supplements to traditional homecare and daycare centers. However, patient participation is often lacking in decision-making processes, undermining ethical principles and basic human rights. Research objective This study explores the perceptions of persons with dementia toward assistive technology, volunteer support, homecare services, and daycare centers. Research design A hermeneutical approach was chosen for this study, using a semi-structured interview guide to allow for interviews in the form of open conversations. Participants and research context Twelve home-dwelling persons with dementia participated in the study. The participants were recruited through municipal daycare centers. Ethical considerations Interviews were facilitated within a safe environment, carefully conducted to safeguard the participants’ integrity. The Regional Committee for Medical and Health Research Ethics, Western Norway (Project number 2016/1630) approved the study. Findings The participants shared a well of reflections on experience and attitudes toward the aspects explored. They described assistive technology as possibly beneficial, but pointed to several non-beneficial side effects. Likewise, they were hesitant toward volunteer support, depending on how this might fit their individual preferences. Homecare services were perceived as a necessary means of care, its benefits ascribed to a variety of aspects. Similarly, the participants’ assessments of daycare centers relied on specific aspects, with high individual variety. Discussion and conclusion The study indicates that the margins between whether these specific care interventions were perceived as supportive or infringing may be small and details may have great effect on the persons’ everyday life. This indicates that patient participation in decision-making processes for this group is—in addition to be a judicial and ethical requirement—crucial to ensure adequate care and support.
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Hektoen, Liv Faksvåg, Ingvild Saltvedt, Olav Sletvold, Jorunn L. Helbostad, Hilde Lurås, and Vidar Halsteinli. "One-year health and care costs after hip fracture for home-dwelling elderly patients in Norway: Results from the Trondheim Hip Fracture Trial." Scandinavian Journal of Public Health 44, no. 8 (October 23, 2016): 791–98. http://dx.doi.org/10.1177/1403494816674162.
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Aim: The aim of this study was to estimate the one-year health and care costs related to hip fracture for home-dwelling patients aged 70 years and older in Norway, paying specific attention to the status of the patients at the time of fracture and cost differences due to various patient pathways after fracture. Methods: Data on health and care service provision were extracted from hospital and municipal records and from national registries; data on unit costs were collected from the municipalities, hospital administrations and previously published studies. Four different patient pathways were identified and the total costs for subgroups of patients according to age, sex, fracture type and instrumental activity of daily living at fracture incidence were calculated. Descriptive statistics were used to identify cost estimates. Results: The mean total one-year costs per patient were EUR 68,376 and the costs for patients alive one year after hip fracture were EUR 71,719. The patients’ age and pre-fracture functional status contributed most to the total cost. Conclusions: On average, care costs accounted for more than 50% of the total cost; even for patients with good functional status before hip fracture, care costs accounted for 40% of the total cost compared with hospital costs of 38%. To reduce the financial costs of hip fractures in the care sector, the results point to the importance of preventive programmes to reduce the risk of hip fracture, but also to the importance of comprehensive geriatric care in the initial phase after a hip fracture.
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Mistry, Ankit R., Parth Gupta, Sagar R. Bhimani, Kamlesh P. Patel, Supriya D. Malhotra, and Pratik R. Patel. "An observational study to evaluate psychological experience and social stigmas in COVID-19 patients: a prospective study on home isolated patients." International Journal Of Community Medicine And Public Health 8, no. 9 (August 27, 2021): 4518. http://dx.doi.org/10.18203/2394-6040.ijcmph20213562.
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Background: Coronavirus disease 2019 (COVID-19) has caused significant distress. Apart from evident physical symptoms in infected cases, it has caused serious damage to public mental health. The present study was carried out to assess disease burden, fear and stigma associated in home isolated patients.Methods: A Prospective, observational study of 8 weeks began after IEC approval in diagnosed COVID 19 patients who were home isolated and visited by the researcher as part of Sanjeevni home care service launched by the municipal corporation. Number of patients turning symptomatic from asymptomatic was recorded. Frequency for transmission was also noted. Fear and social stigma by Fear of COVID 19 scale (FCV-19S) and Stigma scale was measured respectively.Results: A total of 746 patients were included in the study (mean age: 40.2±16.2 years). About 105 patients (14.07%) suffered from co-morbidities like Hypertension, Diabetes, Obesity. About 38.47% were asymptomatic while 61.53% were symptomatic during their home isolation period. Among asymptomatic patients, 48.78% became symptomatic during their period of home isolation and follow up. A family member being found positive was 35.19% from asymptomatic patients while 34.85% from symptomatic patients. The mean score of the patients for fear and stigma in our study was 14.74±5.13 and 35.13±8.48 respectively.Conclusions: Both symptomatic as well as asymptomatic patients can transmit the disease with equal frequency. Asymptomatic at diagnosis also converts to symptomatic in almost half of the population. This further highlights the importance of home isolation. This was the first time we have used a Stigma and Fear scale in patients affected by COVID 19 who were home isolated. Higher score of Fear scale was seen in >50 years of age.
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Konapur, Kavita S., and Jayanthi Srikanth. "Maternal biosocial factors influencing new born birth weight at a municipal corporation maternity home in Bangalore city." International Journal Of Community Medicine And Public Health 4, no. 7 (June 23, 2017): 2395. http://dx.doi.org/10.18203/2394-6040.ijcmph20172830.
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Background: Birth weight of new born is known to be influenced by several maternal biosocial factors. The study was undertaken to find association of various maternal biosocial factors influencing birth weight of the new born.Methods: The study subjects were 150 postnatal women and their new born delivered in an Urban Municipal Corporation Maternity Home. Study subjects were chosen by purposive sampling. Socio demographic and pregnancy related information was collected by interview method and from antenatal records.Results: The proportion of low birth weight noted was 8.6%. Statistically significant association was noted between new born birth weight and maternal health status during pregnancy which includes weight gain during pregnancy, intake of iron and folic tablets and antenatal check-up. Maternal haemoglobin levels had a positive correlation with new born birth weight.Conclusions: Maternal health is vital for new born wellbeing. Birth weight of new born has shown steady improvement over a period of time and this is as a result of availability of better maternal health care services in urban corporation maternity home.
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Martinez-Mardones, Francisco, Antonio Ahumada-Canale, Loreto Gonzalez-Machuca, and Jose C. Plaza-Plaza. "Primary health care pharmacists and vision for community pharmacy and pharmacists in Chile." Pharmacy Practice 18, no. 3 (August 28, 2020): 2142. http://dx.doi.org/10.18549/10.18549/pharmpract.2020.3.2142.
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The Chilean healthcare system is composed of public and private sectors, with most of the higher-income population being covered privately. Primary healthcare in the public system is provided in more than 2,500 public primary care centers of different sizes with assigned populations within territories. Private insurance companies have their own healthcare networks or buy services from individual health providers. Patients from the public system receive most medications free of charge in primary care pharmacies embedded in each care center. Private patients must purchase their medicines from community pharmacies. Some government policies subsidize part of the cost of medications, but original medicines remain as the most expensive of Latin America. Three chain pharmacies have more than 90% of the market share, and these pharmacies have negative public perception because of price collusion court sentences. A non-profit, municipal pharmacy model was developed but has limited implementation. Most privately owned independent and chain community pharmacies do not provide pharmaceutical services as there is no remuneration or cover by insurers. The limited number of publicly owned Municipal pharmacies could implement pharmaceutical services in community settings as they are non-profit establishments and have full-time pharmacists but are not resourced for these services. A limited number of pharmaceutical services are almost exclusively provided in public primary care, including medication reviews, pharmaceutical education, home visits and pharmacovigilance services, but several barriers to their implementation remain. A risk-based multimorbidity care model was implemented in 2020 for public primary care with additional employment of part-time pharmacists to provide services. We believe that this model will help pharmacists to optimize their time by prioritizing the much-needed clinical tasks. We propose within this multimorbidity care model that the more time-consuming services are provided to higher risk patients. Pharmacy prescribing i.e. amending or approving changes in medications in primary care for chronic conditions could also be useful for the health system, but pharmacists would require additional training. The landscape for pharmaceutical services for primary care in Chile is promising, but the integration with community pharmacies will not be possible until they are funded by public and private insurance, and the public perception of these establishments is improved.
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Siverskog, Anna, and Håkan Jönson. "Vart är äldreomsorgen på väg?" Socialvetenskaplig tidskrift 27, no. 1 (December 21, 2020): 91–110. http://dx.doi.org/10.3384/svt.2020.27.1.3414.
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Many Swedish municipalities approve home-care services for persons above a particular age without individual need assessment (FBH) and following a change in the Social Service Act 2018, this policy is likely to increase. How can this development be understood in relation to larger trends within Swedish eldercare policy and practice? This article is based on an interview study with 50 representatives for municipal social services and aims to explore argument for and against FBH, and how these arguments represent differences in views on eldercare. Toulmin’s model of argumentation was used to sort data and Bacchi’s What’s the Problem Represented to be approach was used to relate findings to the development of eldercare. A striking finding was that arguments for and against FBH in several cases were based on the same warrants: user participation, independence and efficient use of resources. FBH was however also presented as a means to base services on trust, and to avoid the intrusive and blunt character of needs assessments. Arguments against FBH suggested that evaluated needs rather than age should be the foundation of services. A conclusion of the study is that FBH introduces a partly new concept of needs that is based on self-evaluation of older persons. This development could in one sense be regarded as empowering, but in another sense as part of the ongoing marketization of eldercare, where services are defined as commodities.
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Sparre, Sara Lei, and Mikkel Rytter. "Between Care and Contract: Aging Muslim Immigrants, Self-appointed Helpers and Ambiguous Belonging in the Danish Welfare State." Anthropology & Aging 42, no. 1 (May 11, 2021): 112–28. http://dx.doi.org/10.5195/aa.2021.279.
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In Europe, a growing population of aging citizens have migrant background, and many have their origin in non-Western countries. Often, care arrangements in these families are different from those of the majority populations. In Denmark, a growing number of immigrant families utilise an option in the Social Service Act, under which municipalities can contract a family member to take care of an elderly citizen at home. Due to the special construct of the ‘self-appointed helper arrangement’, the caregiver is both a professional care worker, formally employed by the municipality, and a close relative. As such, the arrangement provides a unique opportunity to examine ideas and practices of care at the intersection of the immigrant family and the state.Based on data from interviews with and observations among both immigrant families and municipal care managers, we explore consequences of this care scheme for aging citizens and their self-appointed helpers. Drawing on the concept of ‘lenticular subject positions’, we show how both the self-appointed helpers and the care managers adopt two different, often contradictory, perspectives or subject positions simultaneously.In all, we argue that the self-appointed helper arrangement constitutes a grey zone in the Danish public health care system, since both care managers and helpers seem to neglect the national legislation and standard procedures, in relation to the elders and the general work environment. The consequences are most severe for the self-appointed helpers who end up in a particular precarious position at the margins of the Danish labor market.
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Syhyda, Liubov, Paulína Srovnalíková, and Alla Onda. "Estimation Of Quality Of Medical Care." Health Economics and Management Review 1, no. 1 (2020): 93–105. http://dx.doi.org/10.21272/hem.2020.1-09.
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This paper summarizes the arguments and counterarguments within the scientific discussion on the issue of quality of medical care. The main purpose of the research is to analyze the quality of medical care in dispensary №1 of municipal non-profit enterprise «Shostka city center of primary health care» and determine recommendations for its improvement in the context of «MEDSTAR» medical information system implementation. The research methods authors used in the article were systematic analysis, comparative research, and patients’ survey. As the information sources, the authors used internal documentation of the dispensary № 1 (data for September 2018) and its electronic documentation from the MEDSTAR medical information system (data for September 2020). First, the authors analyzed and compared the number of patients who visited the dispensary №1, and the number of patients visited by doctors at home in September 2020 and September 2018. Second, the authors determined the number of referrals for examination issued to patients in September 2020 and September 2018. Third, the authors surveyed the patients on their satisfaction with the quality of medical care. The results of the research showed that the total number of patients’ visits at the dispensary №1 decreased by 32.4%, and the rate of home visits decreased by 5.12% in September 2020 compared to September 2018. The same situation is with the number of referrals for examination. In September 2018 763 patients got referrals for further examinations, and in September 2020 the number of referrals was 169. The survey showed that patients are dissatisfied with some aspects of the quality of medical care, particularly, with the automation of medicine, focus of medicine, as well as with the conditions of appointment and accessibility of conventional medical services. In total, the results of the research helped to highlight problems in the work of family doctors caused by healthcare reform and medical information systems implementation which reduce the quality of medical care. The recommendations for problems solving were suggested. The authors’ research will be useful for further research in the quality of medical care.
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Häkkinen, Unto, Fanny Goude, Terje P. Hagen, Marie Kruse, Tron Moger, Mikko Peltola, and Clas Rehnberg. "A performance comparison of patient pathways in Nordic capital areas – a pilot study for ischaemic stroke patients." Scandinavian Journal of Public Health 48, no. 3 (January 9, 2020): 275–88. http://dx.doi.org/10.1177/1403494819863523.
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Aims: This article describes and discusses the extension of performance measurement using an episode-based approach so that the measurement includes primary care, and social and long-term-care services. By using data on incident stroke patients from the capital areas of four Nordic countries, this pilot study: (a) extended the disease-based performance analysis to include new indicators that better describe patient care pathways at different levels of care; (b) described and compared the performance of care given in the four areas; (c) evaluated how additional information changed the rankings of performance between the areas; and (d) described the trends in performance in the capital areas. Methods: The construction of data was based on a common protocol that used routinely collected national registers and statistics linked with local municipal registers. We created new variables describing the timing of discharge to home and institutionalisation, as well as describing the use and cost of primary and social hospital services. Risk adjustment was performed with four different sets of confounders. Results: Differences existed in various performance indicators between the four metropolitan areas. The ranking was sensitive to the risk-adjustment method. The study showed that for stroke patients a performance comparison with data that are only from secondary and tertiary care, and without a valid severity measure, is not sufficient for international comparisons. Conclusions: Extending and deepening international performance analysis in order to cover patient pathways, including primary care and social services, is very useful for benchmarking activities when focusing on diseases affecting older people.
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Häkkinen, Unto, Terje P. Hagen, and Tron Anders Moger. "Performance comparison of hip fracture pathways in two capital cities: Associations with level and change of integration." Nordic Journal of Health Economics 6, no. 2 (January 22, 2019): 80–98. http://dx.doi.org/10.5617/njhe.4836.
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Finland and Norway have health care systems that have a varying degree of vertical integration. In Finland the financial responsibility for all patient treatment is placed at the municipal level, while in Norway the responsibility for patients is divided between the municipalities (primary and long-term care) and state-owned hospitals. From 2012, the Norwegian system became more vertically integrated following the introduction of the Coordination Reform. The aim of the paper is to analyse the associations between different modes of integration and performance indicators. The data included operated hip fracture patients from the years 2009–2014 residing in the cities of Oslo and Helsinki. Data from routinely collected national registers, also including data from primary health and long-term-care services, were linked. Performance indicators were compared at baseline (before the Coordination Reform, i.e., 2009–2011), and trends were described and analysed by difference-in-difference methods. The baseline study indicated that hip fracture patients in Oslo, compared with those in Helsinki, had longer stays in acute hospitals. They used less institutional care outside of hospitals as well as more GP services and fewer other outpatient services. Mortality was lower, and the probability of being discharged to home within 90 days from the index day was higher. After the Coordination Reform, the length of stay in hospital was shorter and the length of the first institutional episode in Oslo was longer than before the Reform, demonstrating that the shorter hospital stays were more than compensated for by longer stays in long-term-care institutions. The number of patients institutionalised 90 days from the index day increased and the number of patients discharged to home within 90 days from the index day decreased in Oslo after the Reform while the opposite trends were observed in Helsinki. After the Reform, the performance differences between the two regions had decreased. Published: Online December 2018. In print January 2019.
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Tsarenko, A. V., A. A. Babskiy, Yu V. Krynychniy, and Yu Yu Shchetko. "The experience of the "Program of palliative care in an outpatient setting in the Dnipro City for 2018-2021" implementation: the problems and prospects." Health of Society 10, no. 2 (August 20, 2021): 61–67. http://dx.doi.org/10.22141/2306-2436.10.2.2021.238582.
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Background. Many Ukrainian authors noted that an innovative System of Palliative and Hospice Care (PHC) and Social Services for Palliative Care (SSPC) the creation and implementation are the most important medical and social tasks of the Government and society in Ukraine today which appreciate the civilization and humanity of our state and society. PHC are a modern patient-family-oriented humanitarian approach that contributes to the preservation of the human dignity of palliative care patients (PCP) and can ensure the proper quality of life of PCP and their relatives. According to the WHO and the Council of Europe Committee of Ministers Recommendations, palliative care should be one of the priorities of the Health Care Government Policy in the European region. The purpose of the study: the "Program of palliative care in an outpatient setting in Dnipro City for 2018-2021" the implementation analysis. Materials and methods. The work used national and international legal documents and literature sources, data from medical statistics, methods of systemic and structural-functional analysis, bibliosemantic and statistical research methods. Results. The international and national legal documents and scientific literature a content analysis showed that in accordance with modern approaches and standards, PHC is provided taking into account the PCP and its family members needs, wishes and consent, depending on medical, demographic, socio-economic and cultural ethnic features of the region. A comparative analysis of the PHC state in Ukraine and Dnipro City showed some regional features, in particular, the significant need to provide PHC and SSPC to patients at home and the need and ensure a mechanism of cooperation between primary health care physicians, inpatient health care and social care institutions to develop. In 2017, the “Program of outpatient palliative care in Dnipro City for 2018–2021” (hereinafter - the Program) was developed and approved at the City Council session, which allowed the PHC and SSPC multidisciplinary and interagency approaches implementation, effective interdepartmental coordination, cooperation and the continuity of PHC and SSPC to ensure. The Multidisciplinary Mobil Specialized Palliative Care Team has been working in close contact with family doctors and social workers in the city since June 2019. As part of the Program, PCP are provided with medicines, technical and other means of care and rehabilitation free of charge or on preferential terms. In addition, the Palliative Care Team provides PCP, if indicated, oxygen concentrators and anti-decubitus mattresses. The Program creates points for renting medical care for PCP (wheelchairs, walkers, anti-decubitus mattresses, crutches, etc.), as well as providing patients with medical care at home (urine and feces, diapers, etc.). In 2020, UAH 300,000 was allocated from the Program budget for the Palliative Care Team with medical equipment, medicines and rehabilitation technical means complete set. In total, it is planned to allocate over UAH 40 million from the Dnipro City Budget for the Program implementation. Conclusions. 1. Thus, today in Dnipro City the Comprehensive Palliative Care System at home is implemented due to co-financing from the State Budget and due to the "Program of palliative care in outpatient conditions in Dnipro City for 2018-2021", approved by the Dnipro City Council the deputies. 2. An important condition for comprehensive provision of the Dnipro City population needs in PHC and SSPC is the Dnipro City Council support to create a modern accessible, high-quality and efficient PHC and SSPC service, which an effective interagency coordination, continuity and cooperation between health care providers and social care institutions provides, Multidisciplinary Mobil Specialized Palliative Care Team creation and development of in each the city district, the coordination and continuity of inpatient PHC in the city health provides. 3. There is both the Government support and municipal or regional budgets support for PHC Programs in many developed countries. The international PHC standards and experience implementation can significantly the provision of needs and the quality of life of both PCP and their families improve.
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Ghetti, Claire, Łucja Bieleninik, Mari Hysing, Ingrid Kvestad, Jörg Assmus, Renee Romeo, Mark Ettenberger, et al. "Longitudinal Study of music Therapy’s Effectiveness for Premature infants and their caregivers (LongSTEP): protocol for an international randomised trial." BMJ Open 9, no. 8 (August 2019): e025062. http://dx.doi.org/10.1136/bmjopen-2018-025062.
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IntroductionPreterm birth has major medical, psychological and socioeconomic consequences worldwide. Music therapy (MT) has positive effects on physiological measures of preterm infants and maternal anxiety, but rigorous studies including long-term follow-up are missing. Drawing on caregivers’ inherent resources, this study emphasises caregiver involvement in MT to promote attuned, developmentally appropriate musical interactions that may be of mutual benefit to infant and parent. This study will determine whether MT, as delivered by a qualified music therapist during neonatal intensive care unit (NICU) hospitalisation and/or in home/municipal settings following discharge, is superior to standard care in improving bonding between primary caregivers and preterm infants, parent well-being and infant development.Methods and analysisDesign:international multicentre, assessor-blind, 2×2 factorial, pragmatic randomised controlled trial; informed by a completed feasibility study.Participants:250 preterm infants and their parents.Intervention:MT focusing on parental singing specifically tailored to infant responses, will be delivered during NICU and/or during a postdischarge 6-month period.Primary outcome:changes in mother–infant bonding at 6-month corrected age (CA), as measured by the Postpartum Bonding Questionnaire.Secondary outcomes: mother–infant bonding at discharge and at 12-month CA; child development over 24 months; and parental depression, anxiety and stress, and infant rehospitalisation, all over 12 months.Ethics and disseminationThe Regional Committees for Medical and Health Research Ethics approved the study (2018/994/REK Nord, 03 July 2018). Service users were involved in development of the study and will be involved in implementation and dissemination. Dissemination of findings will apply to local, national and international levels.Trial registration numberNCT03564184
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G??tz, Hannelore M., Christian J. P. A. Hoebe, Jan E. A. M. Van Bergen, Irene K. Veldhuijzen, Jan Broer, F. De Groot, M. J. C. Verhooren, D. T. Van Schaik, A. J. J. Coenen, and Jan H. Richardus. "Management of Chlamydia Cases and Their Partners: Results From a Home-Based Screening Program Organized by Municipal Public Health Services With Referral to Regular Health Care." Sexually Transmitted Diseases 32, no. 10 (October 2005): 625–29. http://dx.doi.org/10.1097/01.olq.0000175397.82962.d5.
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Monteiro, Claudete Ferreira de Souza. "Violence against women and the walk of public policy/Violência contra a mulher e o caminhar das políticas públicas/La violencia contra las mujeres y el paseo de las políticas públicas." Revista de Enfermagem da UFPI 3, no. 4 (April 13, 2015): 1. http://dx.doi.org/10.26694/reufpi.v3i4.3324.
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For centuries, violence against women was restricted to the privacy of the home, the observation of neighbors and interference of a few family members. Is configured in a complex and controversial issue that involves moral concepts, dynamics of power/affection, subordination/domination, therefore "private" and difficult to approach. In this context, the home becomes therefore, scenary to fights, jealousy, aggression scenes in which the only spectators are the children. This space, preserved as inviolable, does not allow others to interfere, leaving increasingly confined women to this situation. Violence against women is associated with high economic costs, social, and health, making it a complex and comprehensive phenomenon, both because of issues related to the domination/submission involving gender relations, as those pertaining to physical and mental health of victimized women. The latter are not always displayed but expressed through psychosomatic symptoms which may be prolonged and chronic. The data of this violence become more visible as they seek public service to women care, and have shown alarming proportions, given the 2014 Balance Call 180, available in March 2015, presenting a total of 52,957 reports of violence against women. Of these, 51.68% refers to physical violence; 31.81% to psychological violence; 9.68% to moral violence; 1.94% to financial abuse; 2.86% sexual violence; 1.76% to imprisonment; and 0.26% human trafficking¹. In terms of public policy, by 2003, Brazil had the Special Police and shelter homes to care for women in situations of violence. Notably, in the last 10 years, the country has invested more in these policies, such as the creation in 2003 of the Secretariat on Policies for Women; in 2005, the National Plan of Policies for Women and the implementation of Call Center Women through Dial 180 and the following year with Law 11.340/2006, called Maria da Penha Law, through which actually creates mechanisms for prevent domestic and family violence against women¹. The Call 180, is now considered the main door of access to services that integrate the National Network to Fight Violence Against Women and privileged database for the formulation of policies of the Federal Government in this area. Started as a channel for advice on public rights and services aimed at female population across the country and from the Law No. 13,025/2014 began to perform the reception and orientation, directing complaints to the competent organs of research, with the assaulted woman's consent and, more recently, expanding the services to other countries such as Portugal, Spain and Italy. Other efforts have also been announced, such as the National Pact to Combat Violence against Women, launched in 2007. This is an agreement between the Federal Government and the state governments and Brazilian Municipal planning actions that enable the consolidation of National Policy on Combating Violence against Women. In 2011 launches the Fight Network violence against women and, more recently, in 2013, by Decree No. 8086, instituted the program "Woman: live without violence", whose axes include, among others, the implementation of the House of Brazilian Women, the organization and humanization of care for victims of sexual violence, the implementation and maintenance of the service to Women centers in the regions of dry border, continued awareness campaigns and mobile units for assistance to women in situations of violence the county and in forest². Giving reinforcement, especially to sexual violence against women, the Government launched in March 2015, the Interministerial Ordinance no. 288/2015 laying down guidelines for the organization and integration of care for victims of sexual violence by law enforcement professionals and health professionals of the Unified Health System (SUS) about the humanization of care and the registration of information and collection of traces². Many are government efforts to deal with violence against women. However, the effectiveness of these policies still needs better coordination with the assistance and legal network, training of health professionals for the recognition of such violence and adequacy of services to make more humane care and work on this issue in schools, with adolescents and women and men in all living spaces. Violence against women is a cruel and unjust reality that needs space in nursing reflections so that professionals are fully aware of the repercussions of this phenomenon and give emphasis to a new way of thinking and acting. These professionals can provide link to support women, whether in health issues and in the guidance to find own ways or direct it to other services in order to contribute to improving the life of this woman.
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Vechorko, Valery I., Viktoriya A. Gorbacheva, and Oxana A. Kostenko. "Organizing experience in an epidemiological service in the context of urgent conversion of a general hospital to manage patients with SARS-CoV-2 infection." Health Care of the Russian Federation 64, no. 5 (November 6, 2020): 230–35. http://dx.doi.org/10.46563/0044-197x-2020-64-5-230-235.
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February 11, 2020, World Health Organization (WHO) declared a pandemic of the new coronavirus and assigned the official name of the infection caused by the new coronavirus - COVID-19 («Coronavirus disease 2019»). On February 11, 2020, the International Committee on Virus Taxonomy gave the official name to the infectious agent as SARS-CoV-2. A new coronavirus infection caused by SARS-CoV-2 has become a challenge for the healthcare system as in Russia as over the world. The medical community has focused its efforts on fighting the pandemic. On March 20, 2020, there the O. M. Filatov Municipal clinical hospital was decided to be redesigned, and this general hospital, including maternity wards, became an infection hospital. One of the main reasons for redesigning was multidisciplinary medical care, including working with patients with a new coronavirus infection, the presence of a maternity home with boxes and own reanimation, the presence of a transition connecting for all three buildings, a large area, with ability to organize routes and placements additional temporary buildings. In the first place there were solved problems as a device of sanitary systems with the gateway, division to the «red» and «green» zones in all buildings of the clinics, development of detailed routing the patients including infectious requirements, navigation inside buildings and on hospital territories for the separation of medical personal, transport, the realization of a plan with the requirements, submitted by Federal Service for Oversight of Consumer Protection and Welfare to medical institutions, working with a new coronavirus infection, in terms of sanitary standards: disinfection of areas and surfaces and transport, creation inventory curative diagnostic (including reanimation) equipment, sufficient number of oxygen points, medicines, disinfection products and personal protective equipment. One of the scale tasks were about care for the health safety of medical personal. Changes to the work concerned various aspects: legal regulation, ethical problems, features practical work and education, interaction with all of them structural departments of the hospital. Within a week task, which put the Department of health of the city of Moscow, was resolved by management of hospital, and on March 27, 2020, the hospital accepted the first patients as an infectious disease hospital.
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Akimova, Svetlana L. "Finnish Innovations in Medicine and Social Sphere." Pediatrician (St. Petersburg) 8, no. 1 (March 15, 2017): 120–29. http://dx.doi.org/10.17816/ped81120-129.
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The article presents data collected during the tour dedicated to the medical and social institutions of Finland about new solutions and Finnish innovations in medicine and the social sphere. The article describes the principles of the Finnish health care system, including the work of maternal and child welfare clinics, as well as common European approaches in geriatrics. Thе article describes the features of geriatric services in Finland. It reflects the role of the municipal social services to provide residents of barrier-free environment in their regions. The article presents the facts from the personal experience exploring the Finnish system of medical and social support to older generation focused on the application of the latest scientific developments. The article presents innovative products for comfortable living of older people, including a traveling exhibition of technologies for older people, specialized furniture and household items available in the functional building DoMedi and others. This article describes the function of public and private Finnish services and the Finnish Centre for Elderly, including a Finnish non-profit organization Valli. The article presents the features of a private home for the elderly “Wilhelmiina” in Helsinki and scientific developments behalf Miyna Sillanpää Foundation. The article describes the innovative products, created in the Health Innovation Village at the Finnish office of GE: vacuum therapy device for the treatment of edema, a portable device for the treatment of depression, a sensor for measuring the electrical activity of muscles. The paper presents the solutions offered by the Finnish university hospitals, including personalized medicine technology for patients with cancer, developed at the Institute of Molecular Medicine, University of Helsinki. The article describes the work of one of the divisions of the institute - Biobank. The article describes the general approach to reform the health care system in Finland.
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Gjestsen, Martha Therese, Siri Wiig, and Ingelin Testad. "What are the key contextual factors when preparing for successful implementation of assistive living technology in primary elderly care? A case study from Norway." BMJ Open 7, no. 9 (September 2017): e015455. http://dx.doi.org/10.1136/bmjopen-2016-015455.
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ObjectiveTo identify contextual factors at different organisational levels to guide the implementation of an assistive living technology intervention in Norwegian primary home care.DesignA single embedded case study design was carried out in an urban municipality in Western Norway to get an overview of key contextual factors from the municipality’s perspective.Data collection and analysisThe data collection was based on a triangulation of methods involving document analysis, semi-structured individual interviews and focus group interviews to get a broad insight when preparing for an intervention. Data were collected on three levels of the healthcare system: (1) national policy documents and regulations (macro), (2) five individual interviews with senior managers and municipal strategy documents (meso) and (3) two focus group interviews with nurses and nurse managers in direct patient care (micro). The Model for Understanding Success in Quality framework was used as a guide in the data analysis.ResultsThe main contextual factors identified were external motivators and project sponsorship (macro level); leadership, workforce focus and maturity (meso level);and motivation to change and maturity (micro level). Strategies developed in policy documents affected upper management in the municipality, but healthcare personnel at the micro level were not so familiar with strategies and emphasis on assistive living technologies. Healthcare personnel in our study were motivated to use technological solutions, but lack of data infrastructure and resource availability hindered this.ConclusionsAligning interests across multiple stakeholders remain a challenge when planning for an assistive living technology intervention in primary care. In the studied municipality, integration of technological solutions into healthcare services was more a vision than a reality because of a low level of organisational readiness.
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Kim, Hong K., Mai Takematsu, Rana Biary, Nicholas Williams, Robert S. Hoffman, and Silas W. Smith. "Epidemic Gasoline Exposures Following Hurricane Sandy." Prehospital and Disaster Medicine 28, no. 6 (November 15, 2013): 586–91. http://dx.doi.org/10.1017/s1049023x13009023.
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AbstractIntroductionMajor adverse climatic events (MACEs) in heavily-populated areas can inflict severe damage to infrastructure, disrupting essential municipal and commercial services. Compromised health care delivery systems and limited utilities such as electricity, heating, potable water, sanitation, and housing, place populations in disaster areas at risk of toxic exposures. Hurricane Sandy made landfall on October 29, 2012 and caused severe infrastructure damage in heavily-populated areas. The prolonged electrical outage and damage to oil refineries caused a gasoline shortage and rationing unseen in the USA since the 1970s. This study explored gasoline exposures and clinical outcomes in the aftermath of Hurricane Sandy.MethodsProspectively collected, regional poison control center (PCC) data regarding gasoline exposure cases from October 29, 2012 (hurricane landfall) through November 28, 2012 were reviewed and compared to the previous four years. The trends of gasoline exposures, exposure type, severity of clinical outcome, and hospital referral rates were assessed.ResultsTwo-hundred and eighty-three gasoline exposures were identified, representing an 18 to 283-fold increase over the previous four years. The leading exposure route was siphoning (53.4%). Men comprised 83.0% of exposures; 91.9% were older than 20 years of age. Of 273 home-based calls, 88.7% were managed on site. Asymptomatic exposures occurred in 61.5% of the cases. However, minor and moderate toxic effects occurred in 12.4% and 3.5% of cases, respectively. Gastrointestinal (24.4%) and pulmonary (8.4%) symptoms predominated. No major outcomes or deaths were reported.ConclusionsHurricane Sandy significantly increased gasoline exposures. While the majority of exposures were managed at home with minimum clinical toxicity, some patients experienced more severe symptoms. Disaster plans should incorporate public health messaging and regional PCCs for public health promotion and toxicological surveillance.KimH,TakematsuM,BiaryR,WilliamsN,HoffmanR,SmithS.Epidemic gasoline exposures following Hurricane Sandy.Prehosp Disaster Med.2013;28(6):1-6.
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Bessa, Ellen Roberta Lima, Luciane Dias de Oliveira, Ana Bessa Muniz, Giselle Diniz Guimarães da Silva, Ormezinda Celeste Cristo Fernandes, and Fernando José Herkrath. "Epidemiology of oral candidiasis: a household-based population survey in a medium-sized city in Amazonas." Research, Society and Development 10, no. 10 (August 7, 2021): e127101018664. http://dx.doi.org/10.33448/rsd-v10i10.18664.
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There was an increase in the number of elderly people in Brazil and, along with this fact, there was an increase in the incidence of oral candidiasis in this population, so the early identification of the disease and the etiologic agent for effective intervention is essential. The study aimed to describe the prevalence of oral candidiasis and its clinical manifestations, identifying Candida yeast species and their prevalence in the palatine mucosa and dentures in the palatine mucosa and dentures, comparing these factors in rural and urban elderly people in this city. The study was conducted in the city of Tefé, Amazonas, with elderly people aged 65 to 74 years old registered in primary health care services in urban and rural areas, where through sample calculation we had a total sample of 484 elderly people after losses and refusals. These elderly people were randomly selected from within the entire public service network, which enabled the samples to be collected in all municipal Basic Health Units. Data collection included clinical oral examinations (use, duration, and need for dental prosthesis) and collection of biological material with swabs, which were stored in CHROMAgar™ Candida medium, during home visits to determine the prevalence of the species through staining and colony morphology. Statistical analysis was performed with Stata MP software, using relative and absolute frequencies. The prevalence of oral candidiasis was found in 20.7% of the elderly in the different areas of residence studied. A greater number of cases and clinical manifestations of the disease were found in elderly people living in urban areas (p < 0.05). The odds ratios for developing the disease were higher in women, edentulous elderly, and users of dental prostheses. Candida albicans species were prevalent in infection and colonization of prostheses, while oral colonization showed similar percentages among Candida non-albicans (p = 0.657). As for the prevalence of species about the studied area of residence, Candida albicans prevailed in the urban area and Candida non-albicans in the rural area (p <0.05). In conclusion, this study identified a high prevalence of oral candidiasis in elderly participants in the research, who were mainly infected with Candida albicans species, but when comparing the living areas of the elderly, those living in the urban area had more prevalent colonization in the area. urban and Candida non-albicans in the rural area, therefore, species differentiation was found regarding the place where the elderly person lives.
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Hafenbrack, A., I. Nussbaumer, H. Stoll, and W. Weber. "Oncology Home Care Service." Supportive Care in Cancer 6, no. 3 (April 27, 1998): 195–96. http://dx.doi.org/10.1007/s005200050153.
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Pino, M. S., L. Brogi, G. Spinelli, and L. Fioretto. "Supportive home care service: A home-based simultaneous care intervention." Annals of Oncology 27 (October 2016): vi459. http://dx.doi.org/10.1093/annonc/mdw384.18.
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Suga, Takeo. "Dental care service for home-care elderly." Nippon Ronen Igakkai Zasshi. Japanese Journal of Geriatrics 45, no. 1 (2008): 36–38. http://dx.doi.org/10.3143/geriatrics.45.36.
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Hagen, Terje P., and Laila Tingvold. "Planning future care services: Analyses of investments in Norwegian municipalities." Scandinavian Journal of Public Health 46, no. 4 (September 15, 2017): 495–502. http://dx.doi.org/10.1177/1403494817730996.
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Aims: To analyse whether the Norwegian Central Government’s goal of subsidizing 12,000 places in nursing homes or sheltered housing using an earmarked grant was reached and to determine towards which group of users the planned investments were targeted. Methods: Data from the investment plans at municipal level were provided by the Norwegian Housing Bank and linked to variables describing the municipalities’ financial situation as well as variables describing the local needs for services provided by Statistics Norway. Using regression analyses we estimated the associations between municipal characteristics and planned investments in total and by type of care place. Results: The Norwegian Central Government reached its goal of giving subsidies to 12,000 new or rebuilt places in nursing homes and sheltered housing. A total of 54% of the subsidies (6878 places) were given to places in nursing homes. About 7500 places were available by the end of the planning period and the rest were under construction. About 50% of the places were planned for user groups aged <67 years and 23% of the places for users aged <25 years. One-third of the places were planned for users with intellectual disabilities. Investments in nursing homes were correlated with the share of the population older than 80 years and investments in sheltered houses were correlated with the share of users with intellectual disabilities. Conclusions: Earmarked grants to municipalities can be adequate measures to affect local resource allocation and thereby stimulate investments in future care. With the current institutional setup the municipalities adapt investments to local needs.
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Gudnadottir, Margret, Kristin Bjornsdottir, and Sigridur Jonsdottir. "Integrated Home Care Service: Qualitative Study on Collaboration between Home Care Nursing and Social Service." International Journal of Integrated Care 17, no. 5 (October 17, 2017): 332. http://dx.doi.org/10.5334/ijic.3650.
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Roche, Eddie, and Thomas Wyatt. "Care Home Assessment and Review Service: coordinated, proactive care home primary care delivery." British Journal of General Practice 67, no. 656 (February 23, 2017): 136–37. http://dx.doi.org/10.3399/bjgp17x689821.
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Mäkimattila, Martti, Helinä Melkas, and Tuomo Uotila. "Redesign of Home Care Service Delivery." International Journal of Information Systems and Social Change 8, no. 2 (April 2017): 1–24. http://dx.doi.org/10.4018/ijissc.2017040101.
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This paper delineates how systemic innovations coevolve with organisations in the context of home care and describes the dynamics in shared innovation activities when information technology (IT) systems are developed for such services. Innovation literature is presented from the system perspective to highlight non-technological characteristics. The case study of home-care services in Finland in 2010–2014 shows that systemic innovations result from collaborative actions because the complexity of these innovations requires knowledge and skills from different fields, which no single entity possesses. The multi-level dynamics challenges the management alternatives that focus either on larger development platforms for transitions, or product-based diffusion – then facing later obstacles related to fragmented solutions when merging IT systems and processes. This study contributes by exploring the complexity of developing innovative solutions under dynamic conditions, when actors have different focuses, interests and interdependencies.
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Steiner, M., R. Borovik, E. Muller, O. Gilbar, and S. Palti. "Home hospice care, an oncology service." European Journal of Cancer 29 (January 1993): S203. http://dx.doi.org/10.1016/0959-8049(93)91757-c.
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Gill, K., and H. Kruijff. "G.P. consultative service in home care." European Journal of Cancer 29 (January 1993): S203. http://dx.doi.org/10.1016/0959-8049(93)91760-i.
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Verberk, Janneke D. M., Sibyl A. Anthierens, Sarah Tonkin-Crine, Herman Goossens, John Kinsman, Marieke L. A. de Hoog, Julia A. Bielicki, Patricia C. J. L. Bruijning-Verhagen, and Nina H. Gobat. "Experiences and needs of persons living with a household member infected with SARS-CoV-2: A mixed method study." PLOS ONE 16, no. 3 (March 31, 2021): e0249391. http://dx.doi.org/10.1371/journal.pone.0249391.
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Background Households are important sites for transmission of SARS-CoV-2 and preventive measures are recommended. This study aimed to 1) investigate the impact of living with a person infected with SARS-CoV-2; 2) understand how household members implemented infection control recommendations in their home; and 3) identify the information and support needs of household members. Methods For this observational mixed-methods study, households with a person with confirmed SARS-CoV-2 infection were recruited via drive-through testing sites of Municipal Health Services, healthcare worker screening or hospital emergency visits in the University Medical Centre Utrecht, the Netherlands and via primary care physicians, hospital emergency visits or preoperative screening in the University Hospital of Antwerp, Belgium. We recorded household characteristics, including characteristics of all household members, together with their views on prevention measures. In a subset of households one adult household member was asked to participate in an interview investigating their views on preventive measures. Survey data were analysed using descriptive statistics and interview data by rapid framework analysis. A triangulation protocol was used to integrate findings. Results Thirty-four households (120 household members) were included in the quantitative survey. Twenty-two households were invited to be interviewed, of which 18 completed an interview (response 81.8%). Survey data showed that almost all households implemented some preventive measures, the use of face masks being least frequently reported. Measures taken depended on what was physically possible, the perceived severity of illness of the index patient and to what extent household members were willing to limit social interaction. Respondents did not believe in the effectiveness of wearing face masks within the house, and from the interviews this was explained by media coverage of face masks, impracticality and the stigma associated with wearing masks. Interviewees reported that quarantine had a high emotional burden and wished to have more information about the exact duration of quarantine, their own COVID-19 status, symptoms and when to seek medical help. Conclusion People were willing to implement prevention measures, however actual adherence depended on perceived severity of illness and the perceived risk of becoming infected. Homes are social environments and recommendations for infection prevention should account for this context. Incorporating our findings into policy making could provide households with more relevant and actionable advice.
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Røhne, Mette, Torjus Sandåker, Dag Ausen, and Lisbet Grut. "Integrated planning tool for optimisation in municipal home care." International Journal of Integrated Care 16, no. 5 (November 9, 2016): 35. http://dx.doi.org/10.5334/ijic.2584.
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Tyrell K., Kate. "The Home Care Service: managing diabetes in the home setting." International Journal of Diabetes and Metabolism 13, no. 3 (2005): 170–71. http://dx.doi.org/10.1159/000497587.
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KAUFMAN, M. "An Example of Hospice Home Care Service." JAPANES JOURNAL OF MEDICAL INSTRUMENTATION 65, no. 1 (January 1, 1995): 36–40. http://dx.doi.org/10.4286/ikakikaigaku.65.1_36.
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