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Objective:To explore the effect of hospital-community-family trinity linkage home visiting on quality of life of convalescent patients with traumatic brain injury.Methods:A total of 100 convalescence patients with traumatic brain injury admitted to Shanghai Yangzhi Rehabilitation Hospital from January 2019 to January 2020 were selected as the research objects, and randomly divided into the intervention group ( n=51) and the control group ( n=49) by random number table method. The control group received routine rehabilitation nursing guidance. Patients in the intervention group were treated with hospital-community-family triple linkage family visit for nursing intervention for 10 months. The Medical Outcomes Study 36-Item Short-Form (SF-36), General Self-Efficacy Scale (GSES) and Exercise of Self Care Agency Scale (ESCA) were used to compare the quality of life of 2 groups before intervention, 1, 4, 6, 8 and 10 months after intervention. Results:After 6 months of the intervention, eight dimensions of SF-36 such as physiological function, role-physical, body pain, general health, vitality, social function, role-emotional, and mental health scored 29.61 ± 9.21, 38.73 ± 14.42, 41.96 ± 8.25, 38.63 ± 8.43, 50.10 ± 8.03, 42.40 ± 18.28, 43.14 ± 15.34, 38.31 ± 8.88 in the intervention group, and 35.92 ± 8.02, 52.04 ± 14.29, 50.00 ± 11.90, 47.76 ± 9.08, 56.12 ± 7.66, 56.99 ± 19.40, 55.10 ± 16.03, 44.96 ± 7.73 in the control group. The difference between two groups showed significant difference ( t values were -5.21--3.81, all P<0.05). The GSES scores and ESCA scores after 1,4,6,8,10 months of the intervention showed an distinct advantage in the intervention group than the control group ( t values were -20.99-11.55, all P<0.05). Conclusions:The hospital-community-family trinity linkage home visiting could improve the quality of life, self-efficacy, and self-care ability of patients with traumatic brain injury, and promote their rehabilitation effect when they returned to family and society.
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Objective: In Japan, home-visiting nurse (HVN) stations are at the frontline of providing home-based medical care and end-of-life care. The nursing authorities aim to establish an education program that allows new graduate nurses to become home-visiting nurses. However, previous studies have indicated gaps in education between new graduates recently employed as HVNs and experienced home-visiting nurses. The present study further investigates the factors influencing the recruitment of new graduates as home-visiting nurses.Methods: Self-administered questionnaires were sent to 2,000 HVN stations randomly selected from the 5,565 registered home-visiting nurse stations throughout Japan. The survey covered three main areas, namely, those concerning the respondent (6 items), the home-visiting nurse station (8 items), and the nursing services provided (12 items).Results: Four of the 26 items were statistically significant, and only one of these was determined by multivariate logistic regression analysis to be an independent factor for accepting new graduates as home-visiting nurses. This factor was undergraduate home-visiting nurse training for student nurses (OR=1.916, CI=1.124–3.267).Conclusion: To increase the recruitment of new graduates as home-visiting nurses, these findings suggest that nursing schools nationwide and home-visiting nurse stations should further cooperate with the specific aim of increasing the provision of practical training at home-visiting nurse stations for pre-graduation student nurses.
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Abstract Objectives: to describe the process of development and the structure of an action-oriented guide for home visits (HVs) to mothers and infants by Community Health Workers (CHWs). The guide was adopted in a controlled trial aimed at assessing its efficacy in improving CHWs' performance. Methods: steps to develop the guide included: 1) Review of international and national standards and recommendations for community interventions for maternal and child care; 2) Assessment of perceived needs of CHWs and other Family Health professionals regarding prenatal and postnatal HVs; 3) Identification of elements to construct the guide. Results: the Guide provides action-oriented instructions for 10 HVs during prenatal and postnatal period up to 9 months instead of the 18 HVs currently recommended by Ministry of Health. Specific tasks for each visit including assessment and promotion of early child development (ECD) and an action-oriented risk classification are introduced as standardized operational practice. Conclusions: the described approach to guide construction allows adapting the guide contents to the health system context in Brazil and other countries interested in improving quality of HVs by CHWs. The guide, by identifying tasks to be carried out and actions to be taken at each HV, provides an innovative approach and represents a requisite for a more efficient and effective use of their time.
Resumo Objetivos: descrever o processo de desenvolvimento e a estrutura de um guia orientado por ações para visitas domiciliares (VDs) a mães e crianças por Agentes Comunitários de Saúde (ACSs). O guia foi aplicado em um estudo controlado visando avaliar sua eficácia em melhorar o desempenho dos ACSs. Métodos: os passos para desenvolvimento do guia incluíram: 1)Revisão das recomendações nacionais e internacionais para intervenções na comunidade em saúde materno-infantil; 2) Avaliação das necessidades de ACSs e outros profissionais das Equipes de Saúde da Família sobre VDs nos períodos pré e pós-natal; 3)Identificação dos princípios para construir o guia. Resultados: o Guia traz instruções para 10 VDs nos períodos pré e pós natal até os 9 meses, ao invés de 18 VDs atualmente recomendadas pelo Ministério da Saúde. Tarefas específicas para cada visita incluindo avaliação e promoção do desenvolvimento da primeira infância (DPI) e classificação de risco orientada por ações foram introduzidas como prática padronizada. Conclusões: a abordagem descrita para a construção do guia permite adaptar os conteúdos ao contexto do sistema de saúde do Brasil e de outros países interessados em melhorar a qualidade das VDs por ACSs. O guia, identificando tarefas e ações a serem realizadas a cada VD, oferece uma abordagem inovadora e representa um requisito para utilização mais eficiente e efetiva do tempo.
Subject(s)
Child Development , Community Health Workers/education , House Calls/trends , Postnatal Care , Prenatal Care , Child , Pregnant Women , Maternal-Child Health ServicesABSTRACT
Objective To evaluate the effects of home visiting on care burden and positive experience in caregivers of cerebral apoplexy patients.Methods The recruited 80 caregivers of cerebral apoplexy patients were randomly divided into the experimental group and the control group,with 40 cases in each group;the experimental group received nursing intervention of home visiting,while the control group received routine nursing guidance.Zarit Caregiver Burden Interview (ZBI) and Positive Aspects of Caregiver (PAC) were used to evaluate the care burden and positive experience in caregivers of cerebral apoplexy patients after 24 weeks.Results After the intervention,the burden of care of caregivers in the experimental group was significantly lower and the positive experience in the experimental group was significantly higher than those in the control group,and the differences were both statistically significant (P＜0.01).Conclusion Nursing intervention of home visiting can decrease caregiver burden and increase positive experience of caregivers of cerebral apoplexy patients.
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<p><b>Objective: </b>The government has been promoting further contribution to home care by pharmacists since almost all homebound patients are prescribed more than one medicine. However, little information is available on the adverse drug reactions (ADRs) in home care setting. This study was conducted to describe the ADRs reported by pharmacists in home care and examine factors related to their reports.</p><p><b>Design: </b>Questionnaire survey</p><p><b>Methods: </b>We requested patient-visiting pharmacists at community pharmacies throughout Japan to answer questions about their patients. Main questions included patient characteristics, number of drugs taken, presence of ADRs and details, and pharmacists' workload related to home-visiting.</p><p><b>Results: </b>Data on 5,447 patients were collected from 1,890 pharmacies. The percentage of patients in whom the visiting pharmacists found ADRs was 14.4%. ADRs reported in 10 or more cases covered 12 categories, accounting for 85.2% of all ADRs. The top five categories were: dizziness, grogginess, or lightheadedness; gastrointestinal disturbances; clinical test value abnormality; altered mentation; and cutaneous symptoms. In seven of the 12 ADR categories, central nervous system drugs such as sleeping pills, antianxiety drugs, and psychoneurosis drugs were in the top three suspected drugs. Additionally, patients' gender, residential situation, and the number of drugs taken were implied as factors related to ADRs.</p><p><b>Conclusion</b>：Our study indicated that, while the percentage of ADR occurrences in home-visiting service in Japan was at the same level as outpatients in other countries, drugs for the central nervous system accounted for a higher percentage of suspected drugs. Further, occurrence of ADRs was associated with the use of more than 6 concomitant drugs. These results suggest that physicians and pharmacists need to collaborate in decreasing the number and dose of central nervous system drugs.</p>
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Objective:This article discusses the status of the health behaviors of rural people with diabetes, to explore effect of doctors’ home-visiting on the behavior of patients with diabetes in rural areas, and to promote chronic disease management and public health service equalization in rural areas . Methods:Junan, Liangshan, and Pingyin counties in Shandong province were sampled using a multi-stage stratified sampling method, and data was collected from 401 questionnaires issued to people with diabetes. A chi-square test and multivariate logistic regression were used to analyze the determinants. Results:Only 52. 0% of diabetes patients received home-visiting from doctors in the surveyed rural areas. Doctors’ visiting works on medication behavior on time and appropriate exercise of patients with diabetes in rural areas was statistically significant, but did not work on measuring blood glucose and periodic review and other health-related behaviors. Conclusion:The rate of doctor home-visiting is low, and the effect is not obvious. More attention should be paid to the content and quality of doctors’ home visiting, and strong policies should support and guide it. According to the characteristics of the rural and patients behavior changing, it is necessary to take flexi-ble modes of health service, improve the diabetes management in rural areas, and promote the equalization of public health service.
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The purpose of the study was to implement and evaluate a nutrition capacity training program for dietitians and other professionals working at customized home visiting health services (CHVHS). This program focused on nutrition services for hypertension or diabetes mellitus patients including topics regarding CHVHS, and composed of 10 sessions with lectures, discussion and practice. Dietitians (n = 54) and other professionals (n = 20) participated in the program and completed the questionnaire to assess their understanding of nutritional management, nutrition services and CHVHS before and after the program, and to examine program satisfaction and education needs. Subjects were mostly women (98.6%) and college or university graduates (93.2%). Total score (p < 0.001), as well as all items (p < 0.001 or p < 0.01) of understanding regarding nutritional management, nutrition services and CHVHS, were significantly increased after the program both in dietitians and in other professionals. Subjects were generally satisfied with the program, showing more satisfaction with items regarding subject's participation, acquiring new knowledge, usefulness of the program for CHVHS, and education materials. In future nutrition capacity training programs, subjects wanted to have classes regarding nutrition services for specific chronic diseases, development of education materials, methods for dietary life education, modifying eating habits and so on. Other professionals compared to dietitians, showed higher education needs in meal management (p < 0.01) and nutrition counseling skills (p < 0.05). This study showed the effectiveness of a nutrition capacity training program for home-visiting dietitians and other professionals, and suggests the need and direction for future nutrition capacity training programs.
Subject(s)
Female , Humans , Chronic Disease , Counseling , Diabetes Mellitus , Eating , Education , Health Services , House Calls , Hypertension , Lecture , Meals , Nutritionists , Surveys and QuestionnairesABSTRACT
OBJECTIVES: The purpose of this study was to investigate recognition, dietary attitude and education needs for reducing sodium intakes of dietitian at customized home visiting health service (CHVHS). METHODS: The subjects were 75 dietitian at CHVHS. We investigated several variables (recognition, dietary attitude, education needs for reducing sodium intakes) and determined sodium intakes level of subjects as 'low', 'middle' and 'high' by Dish Frequency Questionnaire 25 (DFQ 25). Also, we assessed the differences in recognition, dietary attitude, sodium intake level and education needs by dietitian career period (under 3 yrs vs. over 3 yrs) at CHVHS. RESULTS: In recognition related reducing sodium intake, they showed 'checking a sodium content in nutrition labeling' score 2.5/4.0 and 'perception difference between sodium and salt' score 3.1/4.0. There was no difference in the recognition between under 3yrs' group and over 3yrs' group. In dietary attitude related reducing sodium intake, they showed 'palatability for salty taste' score 0.8/1.0, 'attitude in related soups' 0.7/1.0, 'attitude in related using natural spice' 0.6/1.0. There was a difference in 'attitude in related soups' between under 3yrs' group and over 3yrs' group (0.6 vs. 0.7). In sodium intake level by DFQ 25, they showed 'low group' 41.3%, 'middle group' 41.3% and 'high group' 17.3%. There was no difference in the distribution of sodium intake level by the career. In education needs related reducing sodium intakes, there were 'teaching experience' 93.3%, 'have a difficulty in teaching about reducing sodium intakes' 86.6%, and 'necessity of education for CHVHS dietitians' 100.0%. 'Needed education contents for CHVHS dietitians' were ranked as 'cooking way to reduce sodium intake' 58.7%, 'relation between hypertension and sodium' 17.3%, 'composing way to reduce sodium intake' 17.3%. There was a difference in needed education contents 'relationship between hypertension and sodium' (33.3% vs. 2.6%) and 'The cooking way to reduce sodium intake' (38.9% vs. 76.9%) by the career. CONCLUSIONS: The results suggested that a capacity training program for reducing sodium intake may be needed for dietitians at CHVHS to improve health of the community elderly. For effective training program related reducing sodium intake for dietitians at CHVHS, it may be necessary to consider the career period as dietitians at CHVHS.
Subject(s)
Aged , Humans , Cooking , Education , Health Services , House Calls , Hypertension , Nutritionists , Surveys and Questionnaires , SodiumABSTRACT
Aim:To examine any relations of workload and outcomes of pharmacists’ home visiting service for medication management and guidance. Survey Target:Managing pharmacists and home-visiting pharmacists from community pharmacies of the Osaka Pharmaceutical Association’s Yao and Toyonaka branches as of March, 2012. Methods:Survey forms regarding drug management and guidance at patients’ homes were mailed, requesting mail or online response. Workload indexes were visit frequency and work time on site. The relation of workload and its outcomes was examined using univariate analysis regarding three items:change in unused medication amount;detection of side effects during visits;change in prescription. SPSS ver. 20 for Windows was used for statistical analysis. Results:90 of 201 pharmacies responded (collection rate 44.8%), and 110 home patients’ data were analyzed. 5-to-15-minute actual work time scored highest (57.4%), followed by less than 5 minutes and 15 to 30 minutes, both at 21.3%. Visit frequency of twice a month scored highest (70.4%), followed by once a week (19.4%), once a month (7.4%), and once in more than one month (2.8%). 5-minute or longer patient visits had a tendency of higher percentage of patients whose unused medication decreased after visits started than less-than-5-minute visits (<i>P</i>=0.072). “Once a week” visits had a tendency of higher percentage of pharmacists detecting side effects than less frequent visits (<i>P</i>=0.061) and changing in prescription (<i>P</i>=0.085). Conclusion:The results above implied the relationship between workload and outcomes incurred by pharmacists’ home visits for medication safety management and guidance.
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Este estudo teve por objetivo avaliar um programa longitudinal de apoio à transição para a parentalidade por meio da avaliação de necessidades e de processo. Um casal participou de uma intervenção longitudinal, com nove visitas domiciliares, focadas no desenvolvimento de habilidades parentais e empoderamento da dupla. As interações pais-bebê e reações do casal à intervenção foram gravadas em vídeo e posteriormente registradas no Protocolo de Avaliação de Processo. A análise dos dados evidencia que o casal sentiu-se satisfeito com o programa e fez uso das informações e estratégias recebidas, com impacto positivo nas dimensões da conjugalidade, com melhor comunicação e solução de problemas interpessoais e da parentalidade, com a construção de conhecimentos sobre o desenvolvimento do bebê, mudanças em crenças sobre práticas educativas parentais violentas, responsividade na relação com o bebê e menor estresse parental. São recomendadas replicações deste estudo em amostras maiores e avaliação de follow-up.
This paper describes a needs assessment and a process evaluation of a longitudinal support program to first-time parents. A couple participated in a longitudinal intervention, with nine home visits, focused on the development of parental skills and couple empowerment. The baby-parents interaction and the couple's reactions to the intervention were video recorded and afterwards registered into the Process Evaluation Protocol. Data analysis showed that the couple felt satisfied with the program and used the information and strategies received, with a positive impact on the dimensions of conjugality, better communication and interpersonal problem solving and parenthood, development of knowledge on the infant's development, change in beliefs related to violent parental educational practices and responsiveness in the relationship between the baby and the parents, besides lower parental stress. Replications of this study in bigger samples with follow-up evaluations are recommended.
La finalidad de este artículo fue evaluar un programa longitudinal de apoyo a la transición hacia la parentalidad mediante la evaluación de necesidades y proceso. Una pareja participó en una intervención longitudinal que constituye una serie de nueve visitas domiciliares, focalizadas en el desarrollo de habilidades parentales y empoderamiento de la pareja. Las interacciones padres-bebé y las reacciones de la pareja a la intervención fueron grabadas en video y posteriormente registradas en el protocolo de evaluación de proceso. El análisis de los datos demostró satisfacción de la pareja con el programa y la utilización de las informaciones y estrategias recibidas, con impacto positivo en las dimensiones de la conyugalidad, con mejor comunicación y solución de problemas interpersonales; y de la parentalidad, con la construcción de conocimientos sobre el desarrollo del bebé, cambios en creencias sobre las prácticas educativas parentales violentas, sensibilidad en la relación con el bebé y menor estrese parental. Se recomienda que el estudio sea reaplicado en muestras con más participantes y con evaluaciones de seguimiento.
Subject(s)
Humans , Male , Female , Adult , Family , Object Attachment , Program Evaluation , Domestic Violence/prevention & controlABSTRACT
A Estratégia Saúde da Família (ESF) busca se confirmar como intervenção emancipadora e transformadora dos sujeitos, consideradas a preocupação com o acolhimento e a especificidade da atenção, como no caso mães adolescentes. O objetivo deste trabalho foi estudar as condições para a implantação de um programa de visitadoras domiciliares para adolescentes puérperas em parceria com ESF. O trabalho teve como participantes 84 moradores e 15 profissionais de saúde, ao longo de 51 encontros e reuniões. Os resultados revelam mulheres e funcionários que se acusam mutuamente de "invasores", confrontando duas perspectivas em relação ao lugar da ação de saúde: a "UBS", marcada pelo controle técnico-institucional, e o "Posto", patrimônio da comunidade. Concluímos que a formação especifica de profissionais e estudos sobre as histórias das relações entre a comunidade e os serviços públicos são pontos de partida que profissionais e comunidade possam se reconhecer como parceiros das ações de saúde
The Family Health Strategy intends to be a liberating and transforming action for social subjects, dealing with clients' reception and specific attention, as in the case of teenage mothers. The aim of this work was to study the conditions for conducting a home visiting program for adolescent mothers in partnership with a FHS team. The study participants were 84 residents and 15 health professionals, over 51 meetings and gatherings. The results reveal that women and health professionals accuse each other of "invaders", comparing two approaches in relation to the place of a health action: the "Unidade Basica de Saude", within a technical and institutional remark, and the "Posto", a community heritage. We conclude that specific professional training must join studies about the history of relationships between community and public health services are a starting point to conduct professionals and community residents as partners of health actions
La Estrategia Salud de la Familia busca una acción liberadora de los sujetos sociales, considerando la preocupación por la acogida y la especificidad de la atención, como en el caso de adolescentes madres. El objetivo de esta investigación fue estudiar las condiciones para la aplicación de un programa de visitas domiciliarias para adolescentes puérperas, en colaboración con equipo ESF. Los participantes del estudio fueran 84 moradoras y 15 profesionales de salud, durante 51 encuentros. Los resultados revelan que las mujeres y los empleados se acusan mutuamente de "invasores", construyendo lugares para la acción sanitaria: la "UBS", marcada por el control técnico, y el "Posto", patrimonio de la comunidad. Así, entendemos la importancia de unirse la formación profesional específica y lo estudio de las historias de relaciones entre la comunidad y los servicios públicos como punto de partida para que los profesionales y la comunidad pueden ser socios de las acciones de salud
Subject(s)
Humans , Male , Female , Adolescent , Adult , Primary Health Care , Parenting , National Health Strategies , House Calls , BrazilABSTRACT
BACKGROUND: We were interested in getting feedback from physical therapists practicing in individualized home health programs about the present situation and the problems of home-based rehabilitation therapy services. METHODS: We recruited 110 physical therapists practicing in individualized home-visiting health programs offered at health centers. They each completed a 15-item self-administered questionnaire including personal information, therapy environments, characteristics of patients, treatment outcomes and suggestions. RESULTS: Of the 110 respondents, 66 (60%) were engaged in home-based rehabilitation therapy services with other duties. Sixty (54.5%) indicated that >25% of patients improved with home-based therapy and 90% of patients were satisfied with the services they received. Eighty-three (75.5%) respondents indicated that the amount of therapy provided was insufficient, 82 (74.5%) thought that there were no measurement tools to use except for the rehabilitation therapy services records and 27 (24.6%) had evaluation meetings with other medical service members for >50% of their patients. CONCLUSION: The majority of the physical therapists in our study indicated that the home-based rehabilitation therapy services satisfied the needs of patients and improved their functional abilities. However, amount of therapy, use of measurement tools for outcome evaluations and comprehensive team approach were indicated as insufficient. We conclude that increasing the number of physical therapists and systematizing the home-based rehabilitation therapy services would improve the present situation.
Subject(s)
Humans , Surveys and Questionnaires , Physical TherapistsABSTRACT
Entendendo as visitas domiciliárias enquanto tecnologia de interação no cuidado à saúde da família, este artigo teve por objetivo compreender os significados atribuídos por essas famílias à visita domiciliária realizada pela Estratégia Saúde da Família (ESF), com a intenção de reconhecer as dificuldades e potencialidades dessa prática. Nessa perspectiva, utilizou-se abordagem qualitativa, em que os dados foram coletados através de entrevista aberta e analisados segundo a Teoria das Representações Sociais. A pesquisa foi realizada no território de abrangência de uma Unidade Básica de Saúde da Família (UBSF) localizada na zona leste do município de São Paulo, sendo selecionadas cinco famílias aleatoriamente (sorteio). Os resultados mostraram que a visita domiciliária, apesar de apresentar limitações devido à concentração em torno de práticas curativistas direcionadas aos indivíduos, que tornam secundárias a produção de autonomia e a corresponsabilização das famílias no cuidado à saúde, foi concebida como importante meio de aproximação entre as famílias e a ESF, favorecendo o acesso às ações e aos serviços de saúde, sendo apontada como instrumento de humanização da atenção à saúde ao propiciar a construção de novas relações entre usuários e profissionais e a formação de vínculo entre esses.
Understanding home visiting as interaction technology in family healthcare, this article aimed to apprehend the meanings attributed by these families to the home visiting performed by Estratégia Saúde da Família (ESF - Family Health Strategy), with the purpose of recognizing the difficulties and potentialities of this practice. In this perspective, a qualitative approach was used. Data were collected through open interviews and analyzed in accordance with Social Representations Theory. The research was carried out in the catchment area of a Primary Family Health Care Unit, which is located in the east zone of the city of São Paulo, and five families were randomly selected (through a draw). The results showed that home visiting presents limitations because of curative practices directed to individuals, which makes autonomy production and accountability of the families in taking care of their health become secondary. However, home visiting was considered an important way of making the families and ESF become closer, favoring the access to health actions and services. It was pointed as a humanization instrument in healthcare, as home visiting enables the construction of new relationships between users and professionals and the formation of links among them.
Subject(s)
National Health Strategies , Home Health AidesABSTRACT
PURPOSE: This study was conducted to compare health-related characteristics and self-care behavior between a controlled group and a non-controlled group of hypertension patients in a customized home visiting health service. METHODS: This study was conducted as cross-sectional research. The subjects were 1,317 hypertension-controlled patients and 555 non-controlled ones. Data were collected using a structured questionnaire and analyzed by descriptive statistics, chi2-test, and t-test using the SPSS WIN 15.0 program. RESULTS: Socio-demographic characteristics and self-care behavior were not significantly correlated between the groups. According to health-related characteristics, the health status was significantly higher in the hypertension-controlled group than in the non-controlled group. The cholesterol level was significantly lower in the hypertension-controlled group than in the non-controlled group. CONCLUSION: Attention should be paid to patients who are not in good health status in order to control their hypertension. Also, it is necessary to educate the patients in order for them to manage their hypertension and cholesterol.
Subject(s)
Humans , Cholesterol , Health Services , House Calls , Hypertension , Self Care , Surveys and QuestionnairesABSTRACT
PURPOSE: The purpose of this study was to determine the effects of low intensity exercise program with telephone coaching on the physical fitness of elderly people who are receiving home visiting nursing care. METHOD: This study was conducted using a non-equivalent control group pretest-posttest design. The participants were 61 elders. Elders (34) in the experimental group performed low intensity exercise and of these 16 received telephone coaching. The low intensity exercise program consisted of stretching, muscle strengthening with an elastic band, massage, and ball exercise, five days a week, for sixteen weeks. Data were collected from July 2007 to December 2007. chi-square-test, ANCOVA with SPSS WIN 11.0 program were used to analyse the data. RESULTS: There were statistical differences in the right grasping power in the right hand (p=0.021), Raising behind of right arm (p=0.006), Raising behind of left arm (p=0.007). CONCLUSION: These results indicate, that a low intensity exercise program with telephone coaching can help improve physical fitness in elders receiving served home visiting nursing care.
Subject(s)
Aged , Humans , Arm , Hand , Hand Strength , House Calls , Massage , Muscles , Nursing Care , Physical Fitness , TelephoneABSTRACT
This study was conducted to evaluate the effects of home-visiting nutrition education for the elderly with high fasting glucose level in an urban community. The study subjects were 40 elderly people, whose information on general characteristics, anthropometric measurement, biochemical indices, nutrition knowledge, nutrition attitude, dietary habit, food intake and nutrient intake were obtained at baseline. The education group received 6 weekly visits of home-visiting nutrition education from 15 March to 25 April 2004. In the baseline-survey, the education group and non-education group showed no differences in their general characteristics, health-related characteristics, anthropometric measurements, biochemical indices, nutrition knowledge, nutrition attitudes, dietary habits, and food and nutrient intake levels. The difference of mean change of nutrition knowledge, nutrition attitude and dietary habit after home-visiting nutrition education had been studied. The nutrition knowledge score increased by 1.4 in the education group; however, those in the non-education group which increased by 0.4, thus, the differences of mean change were statistically significant (p<0.05). The nutrition attitude score increased by 1.2 in the education group; however, those in the non-education group decreased by 0.4, thus, the differences of mean change were statistically significant (p<0.01). The dietary habit score increased by 1.7 in the education group; however, those in the non-education group decreased by 2.8, thus, the differences of mean change were statistically significant (p<0.01). The difference of mean change of anthropometric indices and biochemical indices in education group and the non-education group was not significant. Looking over the zcereals and their products, vegetables, seaweeds, meats and their products, and fish than the non-education group. The MAR increased by 0.06 in the education group; however, that in the non-education group increased by 0.01, thus, the differences of mean change were statistically significant (p<0.05). The differences of mean change of fasting blood glucose and biochemical indices after home-visiting nutrition education were studied. Fasting blood glucose decreased by 7.6 mg/dL in the education group; however, in the non-education group which increased by 0.4 mg/dL, the difference of mean change was not significant (p=0.051). The above findings suggest that home visiting nutrition education increases the nutrition knowledge and nutrition attitude, as well as, it is effective to change dietary habits. If the education period is extended, not fasting blood glucose improvement was insignificant, but fasting blood glucose improvement ability could be found by changing dietary habits.
Subject(s)
Aged , Humans , Blood Glucose , Eating , Education , Fasting , Feeding Behavior , Glucose , House Calls , Meat , Nutrition Assessment , Vegetables , Surveys and QuestionnairesABSTRACT
PURPOSE: This study defines a vulnerable group in a community that has become the main target of a national health project also, it is descriptive research to suggest an evidence-based direction to meet their deficit health-related needs. METHOD: This research examined 833 families and 1,835 family members of the financially vulnerable class that was registered in a home visiting program of a public health center. Among them, 892 persons who had health problems, and their family members were examined in detail to find out their characteristics of vulnerability and health needs by assessment during a nurses home visit. Frequency distribution, stepwise-regression and factor analysis were used to analyze the data. RESULT: The vulnerable group that was defined with social indexes set as standards, involved substantial characteristics of vulnerability. The characteristics of demand showed tendencies of being clustered in 5 factors needs of intensive nursing care, chronic nursing care problems and helplessness, maintenance of family functioning with a disability, deficient problem solving ability, and simple financial fragility. CONCLUSION: Categorization of needs is an evidence-based estimator of workload in nurse home visiting services, and can be used as a basic resource for direction to meet the deficit needs of a vulnerable group.
Subject(s)
Humans , Community Health Nursing , Family Health , House Calls , Needs Assessment , Poverty , Vulnerable PopulationsABSTRACT
The article reports the process, contents and strategies in the development of community based-heath care management program for high-risk infants and family, which was based on literature review, empirical needs assessment from pilot study. The program was divided into two emphasis areas: (1) identification and home visiting nursing care program, and (2) the construction of self-supporting group. The contents of home visiting nursing care were developed from the pilot study of the direct home visiting to premature infants after discharge. The documentation form for home care was standardized, including the demographic data, birth history, home care services, education and counsels, and visiting schedules. The integrated education protocol was elaborated to enhance the body of knowledge as well as clinical competency in caring high-risk infants and family by the supports of neonatologists, nursing scholar, and clinical specialists. In addition, the process and strategies in developing self-supporting group, consisting the high-risk infants and family, and any significant others were addressed. Emphases were given to the role of public health center and the recycling health care referral system to maximize the growth and development of high-risk infants on the community-base, which in turn, contributing to decrease the postneonatal mortality rate.
Subject(s)
Humans , Infant , Infant, Newborn , Appointments and Schedules , Delivery of Health Care , Education , Growth and Development , Home Care Services , House Calls , Infant Mortality , Infant, Premature , Needs Assessment , Nursing , Nursing Care , Pilot Projects , Public Health , Recycling , Referral and Consultation , Reproductive History , Specialization , Child HealthABSTRACT
PURPOSE: To evaluate the effects of planned visiting nursing services for homebound disabled persons in the community who have had a cerebrovascular accident METHODS: One group pre-test and post-test research deign was applied to 61 disabled persons who were undergoing rehabilitation with visiting nursing services to evaluate the effects on the health status (SF-36) and activity daily living (ADL/IADL) from March to August, 2001. RESULTS: The health status score by SF-36 of homebound disabled people was significantly improved; the average score was 28.56+/-21.24 before service, 34.29+/-22.30 at 3 months after, and 40.84+/-=27.41 at 6 months after. The activity daily living score by OASIS II was also significantly increased (z= -6.09, p=.000; z= -6.04, p= .000) at 3 months and 6 months after home visiting nursing services. CONCLUSION: The strategy plan for developing a visiting nursing service in health centers should be prepared to develop community based rehabilitation (CBR) programs as well as to improve the level of health status and ADL/IADL for homebound disabled people in the community.