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Introduction: In Japan, multifunctional long-term care in small group homes and home-visit nursing (MLSH) was created for elderly people who continue to live in the community as one of the long-term care insurance services. The aim of this study was to clarify the benefits and challenges of, and ideas for nursing in MLSH.Methods: A semi-structured interview survey was administered to 11 nurses carrying out MLSH in the Kansai region, and the responses were analyzed qualitatively and descriptively.Results: The benefits of nursing were divided into five categories, including "nurses' expertise and ingenuity can be utilized" and "nursing can continue to support home life even in difficult cases." There were seven categories of challenges, including "difficult to judge, educate, and collaborate; this burdens nurses" and "difficult to educate and collaborate with care workers." There were six categories of nursing ideas, including "utilize knowledge and connections from study sessions, and external training at facilities" and "ensure that nurses and care workers can provide unified care." Conclusion: Although nurses considered it an advantage to support patients' home-based life in cooperation with patients' family members using professional originality, it was difficult for them to judge, learn, and collaborate with others. Moreover, nurses faced burdens. Strategies must be developed to provide nurses with training inside and outside of the facility, and also to strengthen connections with external resources. It is necessary to further review the system and disseminate knowledge about MLSH.
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Objectives: To clarify the current status of education and training at home-visit nursing service agencies, and to compare them by size.Methods: A convergent mixed method design was employed to analyze national administrative data of home-visit nursing service agencies in Tokyo in 2015. The categories regarding the training institution and its themes were created based on the detailed description of the training. For qualitative analysis, the corresponding analysis was conducted for the size of the agencies, and the utilization rate and scale of training for each theme were analyzed quantitatively. The qualitative and quantitative results were then integrated.Results: A total of 311 agencies were included in the analysis. Eight categories for training institutions, such as "medical institutions", were identified among the medium-sized agencies, with the smaller agencies having higher utilization rates. Among the 38 categories for training themes, "psychiatric nursing" and "child health nursing" were found among medium-sized or larger agencies. Moreover, larger agencies had higher utilization rates of training for these themes.Conclusions: We identified the training institutions and the themes of the home-visit nursing service agencies in Tokyo. Home-visit nursing service agencies used many training institutions, regardless of size, whereas the themes were related to agency size.
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Purpose: To clarify the strengths and problems of nursing in multifunctional long-term care in a small group home and home-visit nursing (MLSH).Methods: Selected case reports using Ichushi, the Current Index to Japanese Nursing Literature, and DiaL were extracted and categorized based on the descriptions of the strengths and issues of service in MLSH.Results: Strengths included "flexible and continual? users / family support", "care of users with high medical needs, including end-of-life care", "support for a smooth transition from hospital to home with consecutive stay", "reduction of economic burden of users using a fixed monthly system", and "cooperation between nurses and care workers, and growth by learning from each other". Problems included "difficulty in dealing with diverse needs", "economic burden of low-income users and welfare equipment", and "insufficient cooperation with other occupations inside and outside the office".Conclusion: The strengths of service in MLSH were demonstrated via the support of users with high medical needs and support during the transition period at home. The economic burden of users and cooperation with other occupations are both strengths and problems to be addressed. Support according to user characteristics and public awareness of the existence and strengths of MLSH are required.
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Introduction: This study examined the perspectives of quality surveyors employed by the local government regarding the quality evaluation of agencies for visiting nurses.Methods: The participants were six surveyors. We carried out semi-structured interviews concerning the quality of agencies for visiting nurses. We conducted a qualitative analysis and derived several categories inductively.Results: The surveyors found little difference in the quality between for-profit and non-profit agencies for visiting nurses. In addition, they considered the following characteristics to represent good quality agencies: "availability of home-visit nursing 24 hours per day", "information disclosure and maintenance of quality records", and "the nurse manager understands and promotes an integrated community care system".Conclusion: Eleven categories were identified for the qualitative evaluation of agencies for visiting nurses. The present findings may be used useful for maintaining the quality of agencies for visiting nurses.
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OBJECTIVE : The aims of this study were to clarify the characteristics of outpatients with schizophrenia receiving psychiatric nursing at home and to evaluate factors related to re-hospitalization. <br>METHODS : The subjects were 55 outpatients with schizophrenia who were receiving psychiatric home visits and 31 non-users. An interview was conducted based on a questionnaire on age, gender, family members, psychiatric symptoms, attitude to drug use, and self-assessment of efficacy etc.; and we examined factors related to re-hospitalization. <br>RESULTS : Most subjects (86%) lived with their families. The percentage that lived alone was higher among those receiving nursing visits than non-recipients. Of the average age of the nursing recipients was higher than that of the non-recipients, the mean period of hospitalization was longer and the period after discharge was shorter than for the latter. The self-assessed score for efficacy among the nursing recipients who were re-hospitalized was higher than among those who were not re-hospitalized. <br>CONCLUSIONS : It is suggested that schizophrenia patients with serious symptoms or without family support can live in the community by using home visits by psychiatric nurses. The visiting nurses are requested to advise the patients so that they are able to assess their own capabilities and to control their own condition.
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Since 2000 we have used a home-visit nursing program for fifth-year medical students at Gifu University to examine the significance of domiciliary and geriatric medicine. We used questionnaires before and after the program to evaluate its effects on students. The desire of students to be involved with both domiciliary and geriatric medicine as phys iciansincreased after the program. Greater increases were observed among students who knew less before the program about the significance of home and elder care. The program was effective for encouraging medical students to think about domiciliary and geriatric medicine.
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In 1996 we started an early exposure program of nursing and care for medical school freshmen at University of Tsukuba. The program consisted of out-of-hospital practice and in-hospital practice; 195 medical students completed the program in the 1999-2000 academic year. We analyzed students' questionnaires about satisfaction with the program after each practice and studied better settings for early exposure. Students were randomized to three out-ofhospital settings (nursing home, facilities for the elderly, and home-visit nursing) and also randomized the order of the practice (in-hospital or out-of-hospital first). The mean satisfaction score for setting was the highest for the home-visit nursing and lowest for nursing homes. The mean satisfaction score for order of practice was higher when in-hospital practice was done first.