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Introduction: Studies of older women's life transitions is rare but gains relevance as the aging population, with older women as the majority, expands. Purpose: To explore the meaning of a good life for older widows with extensive home care needs. Materials and methods: Semi-structured interviews were carried out with eleven women, aged 80 and over (82–95 years, mean 90) residing at home with extensive care needs (≥4 daily sessions, averaging 2.5–6 hours, mean 3). Data were analysed by reflexive thematic analysis. Results: The theme "This Day in My Home, the frame of my life" reflects the women's experience of a good life. A good day imbued them with hope, trust and security, carrying them forward with the assurance that night would usher in a new day. However, there were moments when life was merely about navigating daily challenges. During such days, the women felt trapped in time, unsafe and lonely. Conclusion: A day at home may seem static, yet it mirrors life's dynamism, evolving with shifting circumstances. Older widows navigate challenges while maintaining their sense of self, independence, and connection to home. These findings have implications for aged care, recognizing the multifaceted aspects of life and the centrality of home. [ABSTRACT FROM AUTHOR]

The scope and standards of professional nursing practice define and guide high-quality nursing care. This article describes the collaboration between the International Home Care Nurses Organization and the American Nurses Association to develop evidence-based scope and standards of practice relevant to home-based nursing around the world. This article describes the collaboration between the International Home Care Nurses Organization and the American Nurses Association to develop evidence-based scope and standards of practice relevant to home-based nursing around the world. [ABSTRACT FROM AUTHOR]

Based on literature analysis, the paper systematically summarizes the development history, grouping and payment mode of the Home Health Prospective Payment System (HHPPS) in the United States. The HHPPS has developed three versions since its establishment, and the grouping results are more refined and scientific, from the initial 80 home health resource groups to 432 home health resource groups. This method can effectively control expenses, but it requires a large amount of home health care data, scientific and complete expense settlement system and medical record management system. There are still some difficulties in the promotion and implementation in our country at this stage. Our country should learn from the HHPPS of the American, establish a unified and standardized evaluation system, develop and improve the home medical service information collection system, promote the development of home care services in various aspects, and finally realize the establishment of a scientific and effective payment model, so as to enable the sustainable development of home care service.

Aim: The aim of the study was to identify and synthesize the contents and the psychometric properties of the existing instruments measuring home‐based care (HBC) nurses' competencies. Design: A hybrid systematic narrative review was performed. Review Methods: The eligible studies were reviewed to identify the competencies measured by the instruments for HBC nurses. The psychometric properties of instruments in development and psychometric testing design studies were also examined. The methodological quality of the studies was evaluated using the Medical Education Research Study Quality Instrument and COSMIN checklist accordingly. Data Sources: Relevant studies were searched on CINAHL, MEDLINE (via PubMed), EMBASE, PsychINFO and Scopus from 2000 to 2022. The search was limited to full‐text items in the English language. Results: A total of 23 studies reporting 24 instruments were included. 12 instruments were adopted or modified by the studies while the other 12 were developed and psychometrically tested by the studies. None of the instruments encompassed all of the 10 home‐based nursing care competencies identified in an earlier study. The two most frequently measured competencies were the management of health conditions, and critical thinking and problem‐solving skills, while the two least measured competencies were quality and safety, and technological literacy. The content and structural validity of most instruments were inadequate since the adopted instruments were not initially designed or tested among HBC nurses. Conclusion: This review provides a consolidation of existing instruments that were used to assess HBC nurses' competencies. The instruments were generally not comprehensive, and the content and structural validity were limited. Nonetheless, the domains, items and approaches to instrument development could be adopted to develop and test a comprehensive competency instrument for home‐based nursing care practice in the future. Impact: This review consolidated instruments used to measure home‐based care nurses' competency. The instruments were often designed for ward‐based care nurses hence a comprehensive and validated home‐based nursing care competency instrument is needed. Nurses, researchers and nursing leaders could consider the competency instruments identified in this review to measure nurses' competencies, while a home‐based nursing care competency scale is being developed. Patient or Public Contribution: No patient or public contribution was required in this review. [ABSTRACT FROM AUTHOR]

Introduction Studies of older women’s life transitions is rare but gains relevance as the aging population, with older women as the majority, expands. Purpose To explore the meaning of a good life for older widows with extensive home care needs. Materials and methods Semi-structured interviews were carried out with eleven women, aged 80 and over (82–95 years, mean 90) residing at home with extensive care needs (≥4 daily sessions, averaging 2.5–6 hours, mean 3). Data were analysed by reflexive thematic analysis. Results The theme “This Day in My Home, the frame of my life” reflects the women’s experience of a good life. A good day imbued them with hope, trust and security, carrying them forward with the assurance that night would usher in a new day. However, there were moments when life was merely about navigating daily challenges. During such days, the women felt trapped in time, unsafe and lonely. Conclusion A day at home may seem static, yet it mirrors life’s dynamism, evolving with shifting circumstances. Older widows navigate challenges while maintaining their sense of self, independence, and connection to home. These findings have implications for aged care, recognizing the multifaceted aspects of life and the centrality of home.

Abstract Background The Internet Plus Nursing Service (IPNS) is being instigated in all provincial-level regions throughout China, in which registered nurses (with more than five years of experience from qualified medical institutions) will provide services to those in their communities or homes after receiving online applications. The growing shortage of human resources in nursing is a critical issue for this project, so effective policies for recruiting and retaining nurses are critical. Objective This study aims to pinpoint the significant job characteristics that play a crucial role in shaping the job decisions of sharing nurses in the IPNS program, and to estimate the strength of job attributes. Methods A discrete choice experiment (DCE) was used to assess job attributes influencing sharing nurses’ preferences. A qualitative design, including in-depth interview and focus interview methods, was conducted to determine the inclusion of attributes. The final included six attributes were: work modes, duration per visit, income per visit, personal safety, medical risk prevention, and refresher training. This study was conducted at 13 hospitals in Guangdong Province, China, from April to June 2022, and a total of 220 registered sharing nurses participated in the survey. The multinomial logit model explored attributes and relative valued utility. Preference heterogeneity is explored via latent class analysis (LCA) models. Results A total of 220 participants answered the questionnaire. Income was the most influential characteristic of a sharing nursing position, followed by personal safety management, duration per visit, medical risk prevention, and refresher training, and nurses’ preferences differed among different types of classes. Conclusions Sharing nurses place most value on income and personal safety with career-related decisions, which indicates an urgent need to develop complete security for personal safety. This study can be helpful to decision-makers in the Chinese government.

Aim: To explore how nurses' professional discretion is operationalized in home care services that follow a purchaser–provider organization in Norway. Design: A qualitative descriptive study. Methods: Semi‐structured interviews with open‐ended questions were used, and data were collected from in‐depth interviews with 15 registered nurses working in home care in four Norwegian local authority areas between April and November 2020. Braun and Clark's six‐step analysis was used to analyse the empirical data. Results: The analysis yielded two main themes, namely 'The purchaser's instructions: facilitating and constraining care' and 'Professional discretion meets the purchaser–provider organisation of healthcare,' with five associated codes. Conclusion: Nurses are dependent on an organizational framework due to the complexity of health care services and the number of tasks involved. At the same time, they perform considerable compensatory work and need the ability to be flexible to enable this work and to perform actions related to the unforeseen needs of individual patients or those involving professional discretion. Impact: The purchaser–provider model both facilitates and constrains nursing practice and professional responsibility in home nursing. Home nursing services need to be well organized because of their complexity and the wide variety of tasks they involve. In this context, the element of constraint is associated with the need for flexibility and professional discretion. Despite a strict framework, the nurses perform additional and compensatory tasks. Reforms inspired by 'New Public Management,' such as the purchaser–provider split, limit the workload for nurses; however, there is still a need to exercise discretion. The findings of this study may help home care managers and health policy‐makers understand the interaction between management logic and health care logic, leading to a more appropriate organization of health care services where the nurses, as actors, gain more trust. Implications: This study highlights home care nurses' opportunities to exercise discretion in an organizational framework that strives towards standardization. The nurses' ability to exercise discretion is important for individual and holistic patient care. At the same time, an organizational framework is needed because nurses cannot attend to all the needs the patients may have, as this will overload both home health services and the nurses. [ABSTRACT FROM AUTHOR]

Introduction: Considering Japan's aging society, the number of older individuals who die at home is expected to increase. In Japan, there are challenges in utilizing and promoting home‐visit nursing services at the end of life for community‐dwelling older adults. We examined the use of home‐visit nursing services at the end of patients' lives and the recommended use patterns of this service (utilization, timing of initiation, and continuity) that contribute to reducing the medical care and long‐term care costs (total costs) in the last 3 months of life. Design: This was a retrospective cohort study. Methods: We examined 33 municipalities in Japan, including depopulated areas. The analysis included 22,927 people aged 75 or older who died between September 2016 and September 2018. We used monthly medical care and long‐term care insurance claims data. Participants were classified into five groups based on their history of home‐visit nursing service use: (1) early initiation/continuous use, (2) early initiation/discontinued or fragment use, (3) not‐early initiation/continuous use, (4) not‐early initiation/fragment use, and (5) no use. Univariate and multivariate linear regression analyses were performed to examine the association between total costs in the last 3 months of life and patterns of home‐visit nursing service use. Results: Overall, the median age was 85, and 12,217 participants were men (53.3%). In the last half year before death, 5424 (23.7%) older adults used home‐visit nursing services. Multivariable linear regression analysis of the log10‐transformed value of total costs revealed that compared with the no use group, the early initiation/continuous use group was estimated to have 0.88 times (95% confidence interval: 0.84, 0.93) the total costs in the last 3 months of life (p < 0.001). Conclusion: Early initiation use of home‐visit nursing services may contribute to reducing total costs in the last 3 months of life for Japanese people aged 75 years or older living at home as they approach the end of life. Clinical relevance: When approaching the end of life, many older adults require daily life care and palliative care. Policymakers are strengthening end‐of‐life care for community‐dwelling older adults in Japan. Although the current results do not demonstrate the effectiveness of home‐visit nursing services, they provide a perspective from which to assess the use of home‐visit nursing services and its impact on older adults. The findings can be helpful in considering how to provide nursing care in home‐care settings for older adults who prefer to spend their final days at home. [ABSTRACT FROM AUTHOR]

Despite considerable research on nursing turnover, few studies have considered turnover among nurses working in home health care. Using novel administrative data from one of the largest home health care organizations in the United States, this study examined turnover among home health nurses, focusing on the role of schedule volatility. We estimated separation rates among full-time and part-time registered nurses and licensed practical nurses and used daily visit logs to estimate schedule volatility, which was defined as the coefficient of variation of the number of daily visits in the prior four weeks. Between 2016 and 2019, the average annual separation rate of home health nurses was over 30%, with most separations occurring voluntarily. Schedule volatility and turnover were positively associated for full-time nurses, but not for part-time nurses. These results suggest that reducing schedule volatility for full-time nurses could mitigate nursing turnover in home health care.

Abstract Background The role of visiting health services has been proven to be effective in promoting the health of older populations. Hence, developing a web system for nurses may help improve the quality of visiting health services for community-dwelling frail older adults. This study was conducted to develop a web application that reflects the needs of visiting nurses. Methods Visiting nurses of public health centers and community centers in South Korea participated in the design and evaluation process. Six nurses took part in the focus group interviews, and 21 visiting nurses and community center managers participated in the satisfaction evaluation. Focus group interviews were conducted to identify the needs of visiting nurses with respect to system function. Based on the findings, a web application that can support the effective delivery of home visiting services in the community was developed. An artificial intelligence (AI) algorithm was also developed to recommend health and welfare services according to each patient’s health status. After development, a structured survey was conducted to evaluate user satisfaction with system features using Kano’s model. Results The new system can be used with mobile devices to increase the mobility of visiting nurses. The system includes 13 features that support the management of patient data and enhance the efficiency of visiting services (e.g., map, navigation, scheduler, protocol archives, professional advice, and online case conferencing). The user satisfaction survey revealed that nurses showed high satisfaction with the system. Among all features, the nurses were most satisfied with the care plan, which included AI-based recommendations for community referral. Conclusions The system developed from the study has attractive features for visiting nurses and supports their essential tasks. The system can help with effective case management for older adults requiring in-home care and reduce nurses' workload. It can also improve communication and networking between healthcare and long-term care institutions.

BACKGROUND: This study aims to evaluate the effects of education on home care of infected or suspected COVID-19 patients on the levels of knowledge, anxiety, and awareness of nursing students in Turkey. MATERIALS AND METHODS: The study is in quasi-experimental design. A sample of 158 volunteer students studying nursing at a private university in Turkey was formed. Data were collected using, descriptive information form, “Coronavirus Anxiety Scale,” “COVID-19 Awareness Scale,” and the “Knowledge of COVID-19 Home Care Test.” Pre-test was performed before the participants received education. Post-test was performed seven days after the intervention. SPSS version 25.0 was used for data analysis. “TREND checklist” was used for quasi-experimental/non-randomized evaluations to report the findings of the study. RESULTS: Anxiety levels decreased and the levels of awareness and knowledge on COVID-19 increased after receiving education on home care of infected or suspected COVID-19 patients (p < 0.001), indicating the effectiveness of the education. Education on home care of infected or suspected COVID-19 patients was an effective method to reduce anxiety and increase knowledge and awareness in nursing students. CONCLUSIONS: To contribute to community health, home care training can be given to nursing students, other people receiving home care, or providing home care to COVID-19 patients, infected or suspected COVID-19 patients.

BACKGROUND: La comunicazione riveste un ruolo fondamentale nell'ambito dell'assistenza infermieristica. L’OMS sottolinea l’importanza dell’utilizzo delle competenze comunicative da parte dell’infermiere nel garantire un elevato standard di assistenza. La comunicazione terapeutica mira a promuovere il benessere della persona con le sue esigenze, facilitare l'adesione al percorso di assistenza e instaurare una relazione di fiducia e rispetto reciproco tra l'infermiere e la persona. Questa forma di comunicazione rappresenta il fondamento cruciale su cui si basa un'assistenza domiciliare efficace. OBIETTIVI: L’obiettivo di questo progetto è analizzare le modalità con cui l’assistenza infermieristica domiciliare concorre nell’instaurare una relazione terapeutica con la persona assistita, la famiglia e il caregiver. METODI: Sono stati identificati l’ambito e il quesito di ricerca, quindi è stato formulato il PIO. Successivamente, è stata condotta una ricerca bibliografica attraverso la consultazione delle banche dati biomediche di CINAHL, EMBASE, Ovid MEDLINE(R) e SCOPUS per la ricerca degli articoli. RISULTATI: Sono stati inclusi 10 articoli. In ciascuno di essi, sono state individuate e messe in luce le varie modalità comunicative da parte dell’infermiere domiciliare nel contesto di assistenza domiciliare. CONCLUSIONI: Dai risultati emerge l'importanza della comunicazione terapeutica nel contesto dell'assistenza domiciliare; sono stati evidenziati i potenziali ostacoli che gli infermieri possono incontrare nell’attuare la comunicazione. Si viene a sottolineare la necessità di studi qualitativi in Italia per esplorare le tematiche emerse e approfondire la comprensione dell'effetto della comunicazione terapeutica sul benessere delle persone assistite.

Background: The role of visiting health services has been proven to be effective in promoting the health of older populations. Hence, developing a web system for nurses may help improve the quality of visiting health services for community-dwelling frail older adults. This study was conducted to develop a web application that reflects the needs of visiting nurses. Methods: Visiting nurses of public health centers and community centers in South Korea participated in the design and evaluation process. Six nurses took part in the focus group interviews, and 21 visiting nurses and community center managers participated in the satisfaction evaluation. Focus group interviews were conducted to identify the needs of visiting nurses with respect to system function. Based on the findings, a web application that can support the effective delivery of home visiting services in the community was developed. An artificial intelligence (AI) algorithm was also developed to recommend health and welfare services according to each patient's health status. After development, a structured survey was conducted to evaluate user satisfaction with system features using Kano's model. Results: The new system can be used with mobile devices to increase the mobility of visiting nurses. The system includes 13 features that support the management of patient data and enhance the efficiency of visiting services (e.g., map, navigation, scheduler, protocol archives, professional advice, and online case conferencing). The user satisfaction survey revealed that nurses showed high satisfaction with the system. Among all features, the nurses were most satisfied with the care plan, which included AI-based recommendations for community referral. Conclusions: The system developed from the study has attractive features for visiting nurses and supports their essential tasks. The system can help with effective case management for older adults requiring in-home care and reduce nurses' workload. It can also improve communication and networking between healthcare and long-term care institutions. [ABSTRACT FROM AUTHOR]

Early identification and follow-up of sub-acute and acute functional decline in older persons living with multimorbidity at home require integrated and proactive care by interdisciplinary health personnel. Yet, in the context of the task-oriented and fragmented home healthcare services, early identification is challenging. Therefore, the aim of this study was to identify preconditions for the success of a proactive and interdisciplinary follow-up of older recipients of home healthcare. We conducted a qualitative secondary analysis of data from 6 focus group interviews with registered nurses and nurse leaders. In addition, we performed and analyzed data from 2 new focus group interviews with general practitioners and RNs who had a role as super users in a developmental project which introduced a clinical instrument for early identification of sub-acute and acute functional decline (sub-acute functional decline in the elderly—SAFE). Their experiences with using SAFE constituted the backdrop for the study. In total, 41 representatives of the interprofessional primary care staff of 3 city districts participated. Having a common goal, sharing tasks and having reciprocal understanding of each health profession's contribution, systems and tools and clinical leadership were all seen as important factors for succeeding in the proactive and interdisciplinary follow-up of older recipients of home healthcare. Clinical leadership was deemed the strongest precondition, and clear leadership which promotes integrative and proactive care by facilitating interdisciplinary collaboration appears to be the main key for success. [ABSTRACT FROM AUTHOR]

Children with medical complexity (CMC) dependent on invasive mechanical ventilation (IMV) often require private duty home nursing; however, there are ubiquitous shortages. Home health is an especially vulnerable nursing sector because of less competitive wages and less prominence during nursing education. We sought to understand nurses' perspectives on gaps and opportunities for recruiting home care nurses for children with IMV. Home health nurses experienced with children with IMV were recruited for semi-structured interviews. The interview guide served as the initial codebook which was iteratively modified as themes emerged. This study presents an analysis of quotes related to field entry and home health experiences. Twenty interviews were completed with primarily female (95%) participants. The majority worked full-time (60%) and had an average of 11 years of experience. During nursing education, participants described a lack of exposure to private duty home health nursing. Many entered the field serendipitously, because of a passion for care of CMC or to continue care for a hospitalized patient. Challenges to employment included lack of competitive wages and benefits. Nurses remained in the field because of the rewarding work with patients and families, schedule flexibility, slower pace, and one-on-one care. Home health nurses for IMV describe lack of employment benefits. However, the opportunity to work longitudinally and individually with patients was rewarding. Creative solutions must be explored to recruit and sustain this essential workforce, including exposure during nursing education, improved training and benefits, and targeted recruiting. • Nurses report little or no exposure to home health during nursing education. • Many home health nurses are recruited by a family they met while inpatient. • Continuity with patients over time is a rewarding aspect of home healthcare. • Home health nurses value flexibility in their work schedule in home health. • Home health nurses report a lack of benefits and competitive pay. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic affected information-based applications that became critical tools for survival. Nursing information behavior (NIB) during the pandemic was analyzed through textual data culled from news videos and interviews with frontline homecare nurses in terms of how they practiced home care in the midst of COVID-19. Did the NIB conceptual framework change for nurses during COVID-19? There were shifts in concentrations in the taxonomic facets during the pandemic. The present study aimed to explain the contextual changes in emphasis in the various processes and taxonomic facets in home health nursing, as influenced by the pandemic. Outcomes of the qualitative analysis of video transcripts offer the readers an understanding of how nurses adapted to the pandemic. Co-word analysis of the video transcripts was used to map twenty new terms to the Core Taxonomy-NIB (CT-NIB). The addition to the core taxonomy of an emotive layer combined with pandemic-specific nursing practices suggests certain shifts, cultural and otherwise, in NIB. The significance of this research lies in the "intertwining" of knowledge organization (KO) and NIB--two disciplines creating a synergistic effect to not only describe the effect of the pandemic but also to advance the knowledge base of home health nursing. [ABSTRACT FROM AUTHOR]

Aim: To examine the patterns of the visiting nurse services provided to older adults in a type of residential facility in Japan and to identify associated factors. Methods: This secondary analysis used past survey data from visiting nurse service agencies providing services to older adults in residential facilities with few nurses, known as non‐specified facilities in Japan. Approximately 515 cases were used to determine the patterns of visiting nurse services using latent class analysis. Multinomial logistic regression analysis examined the relationships between identified classes, residents' characteristics, facilities, and services provided by visiting nurses. Results: Three service patterns were identified as follows: Class 1, observational and follow‐up care (37.1%); Class 2, chronic disease care (35.7%); and Class 3, end‐of‐life care (27.2%). Class 1 comprised fewer nursing services than the other classes and primarily involved the observation of medical conditions, whereas Classes 2 and 3 involved higher care‐need levels and provided diverse nursing care support. Specifically, Class 3 was associated with the inclusion of family (odds ratio: 2.42) and a visiting nurse at the attached facility (odds ratio: 4.88). Conclusions: The three identified classes describe the older residents' healthcare needs. Additionally, the factors associated with the end‐of‐life care class suggest that older residents with these factors may have difficulty accessing end‐of‐life care by visiting nurses. Geriatr Gerontol Int 2023; 23: 326–333. [ABSTRACT FROM AUTHOR]

This study aimed to identify the characteristics of home health care (HHC) patients, main diagnoses, service type, home visit patterns, and primary caregiver type from a major tertiary hospital in South Korea to provide basic data for tailored nursing care. We used Electronic Health Records (EHRs) data of 1776 patients, from 2011 to 2020, from a premier tertiary hospital in South Korea and conducted secondary data analysis using descriptive statistics, a chi-squared test, and an independent samples t-test. Patients' mean age (i.e., 50.9% men and 49.1% women) was 74.50 ± 15.48 years. Further, admission to HHC via the outpatient and inpatient department comprised 1047 (59.0%) and 729 patients (41.0%), respectively. Based on the Korean Standard Classification of Diseases, neoplasms (49.9%) were identified as the most common main diagnosis, followed by diseases of the nervous system (10.3%) and musculoskeletal system and connective tissue disease (6.2%). An average of 2.2 homecare nursing services were provided per visit, with lab sampling (43.9%), other intravenous injections (31.0%), and ventilator care (23.0%) being the most frequent services. The total HHC service period for patients via the outpatient department was 76.88 days longer (292.24 vs 215.36 days) than those from the inpatient department. Younger patients were cared for by parents and siblings and older patients by spouses, offspring, and formal caregivers. It is pivotal to identify general characteristics of HHC patients through long-term monitoring and retrospective analysis to provide high-quality and tailored interventions to them. [ABSTRACT FROM AUTHOR]

Abstract Aims This paper analyses the factors that influence home care employees’ intention to introduce robots. Background The introduction of different kinds of care robots is a topical issue in elderly care now and in the near future. Methods Cross‐sectional research conducted through a questionnaire. The survey data (N = 162) were collected in five locations around Finland in 2019. The analysis was carried out by regression analysis, Sobel test and by Hayes’ bootstrapping method. Results The results show that self‐efficacy is pivotal in the willingness to introduce care robots. Employees’ age increases the enthusiasm to introduce robots but reduces self‐efficacy. Work engagement does not correlate with self‐efficacy or behavioural intention related to the introduction of care robots. Conclusions The present paper reveals the significance of attitudes, cognitive factors and age in the adoption of care robots in home care facilities. Practical implications It is important to pay attention to supporting the employees’ sense of technology management and the construction of a robot‐positive atmosphere when introducing care robots, and the development of skills of older employees and employees with a lower educational level should be supported.

Hospital readmission is an important indicator of inpatient care quality and a significant driver of increasing medical costs. Therefore, it is important to explore the effects of postdischarge information, particularly from home healthcare notes, on enhancing readmission prediction models. Despite the use of Natural Language Processing (NLP) and machine learning in prediction model development, current studies often overlook insights from home healthcare notes. This study aimed to develop prediction models for 30-day readmissions using home healthcare notes and structured data. In addition, it explored the development of 14- and 180-day prediction models using variables in the 30-day model. A retrospective observational cohort study. This study was conducted at Ajou University School of Medicine in South Korea. Data from electronic health records, encompassing demographic characteristics of 1819 participants, along with information on conditions, drug, and home healthcare, were utilized. Two distinct models were developed for each prediction window (30-, 14-, 180-day): the traditional model, which utilized structured variables alone, and the common data model (CDM)-NLP model, which incorporated structured and topic variables extracted from home healthcare notes. BERTopic facilitated topic generation and risk probability, representing the likelihood of documents being assigned to specific topics. Feature selection involved experimenting with various algorithms. The best-performing algorithm, determined using the area under the receiver operating characteristic curve (AUROC), was used for model development. Model performance was assessed using various learning metrics including AUROC. Among 1819 patients, 251 (13.80 %) experienced 30-day readmission. The least absolute shrinkage and selection operator was used for feature extraction and model development. The 15 structured features were used in the traditional model. Moreover, five additional topic variables from the home healthcare notes were applied in the CDM-NLP model. The AUROC of the traditional model was 0.739 (95 % CI: 0.672–0.807). The AUROC of the CDM-NLP model was high at 0.824 (95 % CI: 0.768–0.880), which indicated an outstanding performance. The topics in the CDM-NLP model included emotional distress, daily living functions, nutrition, postoperative status, and cardiorespiratory issues. In extended prediction model development for 14- and 180-day readmissions, the CDM-NLP consistently outperformed the traditional model. This study developed effective prediction models using both structured and unstructured data, thereby emphasizing the significance of postdischarge information from home healthcare notes in readmission prediction. [ABSTRACT FROM AUTHOR]

Abstract Aim Inefficient management is one of the major barriers to development of in‐home care in the society. Accordingly, the present study aims to identify the barriers to efficient management of home care nursing using a qualitative approach. Design The present study is a qualitative‐descriptive work of research. Method Data were collected using semi‐structured, in‐depth, individual interviews with 19 nurses from November 2020 to May 2021. The collected data were analysed using Graneheim and Lundman's method. Results The findings of the study were categorized into four main themes, namely lack of effective standards, ineffective interactions, inappropriate cultural/social context and professional issues, and 15 subthemes. Conclusion In‐home care nurses in Iran experience various problems in their practice. Creating an appropriate cultural/social context in Iranian societies, providing the necessary infrastructure, including insurance, providing comprehensive, clear guidelines for in‐home care, encouraging teamwork and organizing workshops to promote effective interactions between the personnel and patients can improve the quality of in‐home care nursing.

Background: Health care is delivered to patients in the community, frequently in their own homes. New graduates need to be prepared for this unique nursing role to care for patients in the home health setting. Purpose: The purpose of this study was to assess student satisfaction with an innovative pedagogy to teach home health nursing using an immersion experience. The immersion experience delivered the home health nursing activity using 360-degree footage and zoom in pictures presented via a web platform. Methods: This study used a descriptive cross-sectional design with convenience sampling of 81 nursing students enrolled in the third semester of an associate degree program. Data were collected through an online survey eliciting anonymous feedback. Results: Participant feedback revealed this new pedagogy engaged nursing students and received overwhelmingly positive responses. A review of student feedback through written comments provided further support that this immersion experience exceeded expectations. Conclusion: The 360-degree immersion home care experience provided problem-based learning that positively impacted student self-reported satisfaction and perceived learning. [ABSTRACT FROM AUTHOR]

Aim: The aim of this work is to explore home‐based care nurses' practice experiences in order to understand their competency and needs. Background: The demand for home‐based care is increasing in many countries. Nurses perform a broader range of competencies with a significant degree of independence in home‐based care. However, little is known about nurses' day‐to‐day experiences and their perceived competency and needs. Methods: The study adopted a descriptive phenomenological design. Individual interviews with 17 nurses from four service providers were performed. Colaizzi's analysis method was used for data analysis. Reflective diary approaches were adopted to guide the bracketing process. Results: Following data analysis, four themes emerged: (1) Full spectrum of patient care, (2) autonomy in nursing practice, (3) beliefs in person‐centred care and (4) enhancing supportive systems. Conclusion: Findings suggest a need for better understanding of the broader scope of nursing practice in home‐based care to improve nurses' transition experience. This includes performing autonomous assessments, making decisions and managing social related matters. Implications for nursing management: It should be a priority to identify a clear scope of practices in home‐based nursing care in order for organizations to improve nurses' readiness for and experiences in home‐based care. Nursing leaders should also expand practical experience opportunities in home‐based care to transitioning nurses with supportive workplace systems. [ABSTRACT FROM AUTHOR]

Aim: To illuminate nurses' experiences of communicating with families in home health care., Design: A qualitative inductive approach., Background: An increasing number of ageing and sick people are being granted home health care. Nurses' duties involve caring for both patients and their families, which includes the important task of meeting and talking with them., Methods: Fourteen registered nurses working in home health care in Sweden participated in individual narrative semistructured interviews. The interviews were analysed with content analysis. To make sure all components of the study were clear, the Standards for Reporting Qualitative Research checklist was used as a guide., Result: Communication with families was viewed as a crucial action for building rapport to facilitate the involvement and support of families in difficult situations. The nurses highlighted the struggles they sometimes faced in communication when they found it difficult to reach the family. When the communication was supportive for the family, the nurses felt that they were empowering the family members to empower themselves., Conclusion: This study highlights the vital role of communication in home health care nursing. Effective communication fosters trust and enables nurses to meet family needs., Implications for the Profession: Effective communication between nurses and families in home health care is crucial from a health care perspective. Building reciprocal relationships fosters trust, enabling nurses to efficiently identify and address family needs and enhancing the quality of care., Patient or Public Contribution: No patient or public contribution., (© 2024 The Author(s). Nursing Open published by John Wiley & Sons Ltd.)

To identify the association between home health nursing (HHN) and hospital readmissions for patients discharged after tracheostomy placement, we conducted a single-center prospective cohort study of children ages 0 to 21 years who underwent tracheostomy placement at Children's Hospital Los Angeles between 12/2016 and 2/2023 and were discharged to home. We collected demographic, clinical, and discharge variables for the index hospitalization to test the association between our primary exposure, HHN after discharge, and 30-day same-hospital all-cause, adjusting for potential confounders. Our population of 130 children was primarily male, of Hispanic/Latino ethnicity, and on public insurance. The majority of patients (57%) received HHN on discharge and the 30-day readmission rate was 14.6%. On multivariable analysis, HHN was not associated with readmission for children discharged on home mechanical ventilation [HMV; adjusted OR (aOR = 1.11; 95% CI: 0.30-4.02)] but was associated with lower odds of all-cause 30-day readmission in children discharged without HMV (aOR = 0.12; 95% CI: 0.02-0.81). Our findings support consideration for HHN as a hospital-to-home bridge for children after tracheostomy placement to decrease hospital readmissions and support parents and caregivers during this transition period., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

An expanding body of literature suggests that informal caregiver burden is a growing issue that negatively impacts care recipients, informal caregivers, and formal care providers. Costs associated with informal caregiver burden include risk to the informal caregiver's physical, emotional, and psychological well-being and increased potential to perpetrate violence. By identifying interventions to support informal caregivers, home healthcare nurses can help decrease the risk of negative outcomes and reduce the burden on informal caregivers. This paper examines home healthcare nurses' role in helping reduce the impact of informal caregiver burden, thereby reducing the risk for violence. By prioritizing caregiver burden as a critical area of focus in reducing violence risk, home healthcare organizations and the nurses who work for them can help address gaps in care while also recognizing the informal caregivers' critical role in caring for their loved ones., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Background/Aims: Various factors, including the ageing population, have led to an increasing demand for healthcare delivered in the patient's own home. This study explored perceptions of home care among nurses, including the potential benefits to patients and nursing careers. Methods: A cross-sectional exploratory study was performed. A questionnaire was designed and distributed to 200 home healthcare nurses from one agency in India, of which 152 responded. The questionnaire asked respondents to rate their agreement to 12 items regarding their perceptions of home healthcare on a 5-point Likert scale. Factor analysis was carried out to identify themes. Mean scores were calculated for each questionnaire item to determine levels of agreement. Results: Respondents generally had a positive view of home healthcare, with most agreeing that it allowed the nurse to carry out a holistic assessment of the patient (4.40/5) and provide preventative care (4.33/5). Many also agreed that home healthcare could prevent hospitalisation (4.15/5). However, respondents were less sure about the appropriateness of home healthcare for patients with terminal illnesses (3.96/5) and stated that home healthcare providers and hospitals needed to work together to ensure continuity of care (4.47/5). Conclusions: Home healthcare is a promising field and nurses within this profession are generally aware of the potential benefits to patients. It is important to raise the profile of home healthcare in India to make it more accessible and ensure that other healthcare professionals are able to refer patients when appropriate. [ABSTRACT FROM AUTHOR]

In a future where home health care is no longer an information silo, patient information will be communicated along transitions in care to improve care. Evidence-based practice in the United States supports home health care patients to see their primary care team within the first two weeks of hospital discharge to reduce rehospitalization risk. We sought to identify a parsimonious set of home health care data to be communicated to primary care for the post-hospitalization visit. Anticipating electronic dataset communication, we investigated the completeness of the international reference terminology, Logical Observation Identifiers Names and Codes (LOINC), for coverage of the data to be communicated. We conducted deductive qualitative analysis in three steps: (1) identify home health care data available for the visit by mapping home health care to the information needed for the visit; (2) reduce the resulting home health care data set to a parsimonious set clinicians wanted for the post-hospitalization visit by eliciting primary care clinician input; and (3) map the parsimonious dataset to LOINC and assess LOINC completeness. Our study reduced the number of standardized home health care assessment questions by 40% to a parsimonious set of 33 concepts that primary care team physicians wanted for the post-hospitalization visit. Findings indicate all home health care concepts in the parsimonious dataset mapped to the information needed for the post-hospitalization visit, and 84% of the home health care concepts mapped to a LOINC term. The results indicate data flow of parsimonious home health care dataset to primary care for the post-hospitalization visit is possible using existing LOINC codes, and would require adding some codes to LOINC for communication of a complete parsimonious data set. [ABSTRACT FROM AUTHOR]

Background: Recent studies have demonstrated the efficiency of collaborative dementia care, which aims to improve post-diagnostic support. However, tasks carried out of such models are currently unknown, hindering its implementation.Objective: To describe tasks of a collaborative model of dementia care, analyze the association between specific task subgroups and number of tasks with patients' and caregivers' characteristics and the impact of specific tasks on health-related quality of life (HRQoL).Methods: The analysis was based on 183 persons with dementia (PwD) who received dementia care management conducted by dementia-specific qualified nurses. A standardized, computer-assisted assessment was used to identify patients' and caregivers' unmet needs. Tasks carried out to address unmet needs were documented, categorized, and descriptively analyzed. We used multivariate regression models to identify socio-demographic and clinical factors associated with a specific subgroup of tasks or a higher number of tasks.Results: On average, 20.5 tasks were carried out per dyad (PwD and caregiver). 41% of tasks were categorized to cooperation with other healthcare providers, 39% to nursing care, and 19% to social support. Lower HRQoL and higher age, cognitive impairment, deficits in daily living activities, and depressive symptoms were significantly associated with a higher number of tasks. A higher number of cooperation tasks were associated with a higher gain in HRQoL.Conclusion: Patients' characteristics and HRQoL significantly determine the intensity of collaborative care interventions. Variability of the intensity should be considered in developing future studies and in the implementation into routine care.Clinicaltrials: gov Identifier: NCT01401582. [ABSTRACT FROM AUTHOR]

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There is an urgent need to provide personalized care more efficiently to patients with Parkinson's disease (PD) who live at home. To understand the impact of patient attributes and features on nursing care time, we assessed the amount of time required to perform home visits to patients with PD and identified patient characteristics related to differences in nursing care time. Twenty patient (median age 78.0 years) visits were video-recorded. Nursing care activities were categorized, while time spent on them was measured to identify differences in care time by patient. Correlations between patient characteristics and care times were calculated. The median time per visit was 49 min and 7 s. Time was mostly spent on daily living assistance (76.0%), followed by medical care assistance (10.0%) and record keeping and administration (14.0%). Results suggested that patient care was characterized by longer time spent on patient comfort, physical therapy, and patient consultation or education. In general, time per visit increased with patients' age. The variation in care implementation time tended to be large in daily living assistance and small in medical care assistance. These data may be useful for providing and managing personalized care for patients. These data can also contribute to making nurse care more specialized. [ABSTRACT FROM AUTHOR]

Aims: This paper analyses the factors that influence home care employees' intention to introduce robots. Background: The introduction of different kinds of care robots is a topical issue in elderly care now and in the near future. Methods: Cross‐sectional research conducted through a questionnaire. The survey data (N = 162) were collected in five locations around Finland in 2019. The analysis was carried out by regression analysis, Sobel test and by Hayes' bootstrapping method. Results: The results show that self‐efficacy is pivotal in the willingness to introduce care robots. Employees' age increases the enthusiasm to introduce robots but reduces self‐efficacy. Work engagement does not correlate with self‐efficacy or behavioural intention related to the introduction of care robots. Conclusions: The present paper reveals the significance of attitudes, cognitive factors and age in the adoption of care robots in home care facilities. Practical implications: It is important to pay attention to supporting the employees' sense of technology management and the construction of a robot‐positive atmosphere when introducing care robots, and the development of skills of older employees and employees with a lower educational level should be supported. [ABSTRACT FROM AUTHOR]

Aim: Inefficient management is one of the major barriers to development of in‐home care in the society. Accordingly, the present study aims to identify the barriers to efficient management of home care nursing using a qualitative approach. Design: The present study is a qualitative‐descriptive work of research. Method: Data were collected using semi‐structured, in‐depth, individual interviews with 19 nurses from November 2020 to May 2021. The collected data were analysed using Graneheim and Lundman's method. Results: The findings of the study were categorized into four main themes, namely lack of effective standards, ineffective interactions, inappropriate cultural/social context and professional issues, and 15 subthemes. Conclusion: In‐home care nurses in Iran experience various problems in their practice. Creating an appropriate cultural/social context in Iranian societies, providing the necessary infrastructure, including insurance, providing comprehensive, clear guidelines for in‐home care, encouraging teamwork and organizing workshops to promote effective interactions between the personnel and patients can improve the quality of in‐home care nursing. [ABSTRACT FROM AUTHOR]

Introduction. Home health patients, who are members of minority and vulnerable groups, suffer disparate outcomes. Patient-centered care (PCC) and culturally-competent care (CCC) aim to facilitate high-quality, equitable care. How home health nurses incorporate PCC and CCC principles into their assessment and care-planning practices has not been -investigated. This study answers the question, " What is the process by which home health nurses develop their culture-sensitive/patient-centered assessment and care planning skills? " Methods. Home health nurses (n= 20) were recruited into this grounded theory study from agencies around the United States via flyers, websites, and contacts. We conducted in-depth recorded interviews using a semi-structured interview guide to ask questions about nurses' assessment and care-planning practices, their understanding of CCC and PCC principles, and facilitators/barriers to CCC and PCC practice. Results. Participants primarily gained their CCC and PCC assessment and care-planning skills through a "seat of your pants," trial-and-error process, with little educational or agency assistance. They combined caring, diverse patient experiences, and critical, creative self-reflection on their experiences to gradually learn helpful, though not optimal, CCC and PCC strategies. However, they reported numerous barriers that discouraged or distressed them in their quest to deliver culturally-competent and patient-centered care. Only a few nurses demonstrated the resilience to overcome these challenges creatively and happily. Conclusion. If we accept that patient-centered care and culturally competent care are key elements of high-quality, equitable care, this grounded theory may help home healthcare clinicians, administrators, educators, and policy-makers identify impact points for enhancing CS/PC practices. [ABSTRACT FROM AUTHOR]

Background: Home health clinicians report a need for family caregiver assistance during the majority of skilled home health care episodes. Since 2018, the Medicare Conditions of Participation has required home health agencies to provide training to family caregivers. However, little is known regarding current practices of family caregiver assessment and training during home health care. Methods: Qualitative research relying on semistructured key informant interviews with registered nurses and physical therapists (n = 19), hereafter "clinicians," from four home health agencies. Interviews were recorded and transcribed, then analyzed using directed content analysis to identify relevant themes and concepts. Results: Three agencies were not‐for‐profit and one was for‐profit; three were urban and one was rural; two operated on a local scale, one on a regional scale, and one on a national scale. Key informants had an average of 9.3 years of experience in home health care and an average age of 45.0 years. Clinicians described a cyclic process of family caregiver training including four major phases: initial assessment, education, reassessment, and adjustment. Initial assessment was informal and holistic; education was delivered via demonstration and teach‐back; reassessment was used to evaluate caregiver progress and inform adjustments to the care plan. Clinicians noted that their perceptions regarding the success of family caregiver training efforts influenced decisions relating to clinical practice, including the number of visits provided and whether to discharge the patient. Conclusions: Caregiver training is currently integrated into clinician workflows in home health care and helps determine visit intensity and discharge timing, but clinicians face a lack of structured assessment instruments or training materials. Efforts by policymakers and home health agencies to facilitate clinicians' training efforts could positively affect the cost and quality of Medicare‐funded home health care. [ABSTRACT FROM AUTHOR]

Background: This study aims to evaluate the effects of education on home care of infected or suspected COVID-19 patients on the levels of knowledge, anxiety, and awareness of nursing students in Turkey., Materials and Methods: The study is in quasi-experimental design. A sample of 158 volunteer students studying nursing at a private university in Turkey was formed. Data were collected using, descriptive information form, "Coronavirus Anxiety Scale," "COVID-19 Awareness Scale," and the "Knowledge of COVID-19 Home Care Test." Pre-test was performed before the participants received education. Post-test was performed seven days after the intervention. SPSS version 25.0 was used for data analysis. "TREND checklist" was used for quasi-experimental/non-randomized evaluations to report the findings of the study., Results: Anxiety levels decreased and the levels of awareness and knowledge on COVID-19 increased after receiving education on home care of infected or suspected COVID-19 patients (p < 0.001), indicating the effectiveness of the education. Education on home care of infected or suspected COVID-19 patients was an effective method to reduce anxiety and increase knowledge and awareness in nursing students., Conclusions: To contribute to community health, home care training can be given to nursing students, other people receiving home care, or providing home care to COVID-19 patients, infected or suspected COVID-19 patients., Competing Interests: There are no conflicts of interest., (Copyright: © 2024 Journal of Education and Health Promotion.)

This study explores the role of home care nurses in managing long-term illnesses (L-TI) within the French healthcare system, utilizing data from the SNDS. Focused on data from 2022, it categorizes nursing actions into medical procedures, care procedures, and nursing processes, revealing significant involvement in patient care. The findings highlight the crucial, evolving role of home care nurses in addressing the complex needs of millions suffering from chronic conditions like diabetes and cardiovascular diseases in France.

Introduction: The aging of the population requires an appropriate knowledge of the type of care that needs to be provided to inform healthcare policies. In Italy, neither home care nursing, nor the patient experiences have ever been described., Objectives: To describe the characteristics of nurses and care recipients involved in home care., Methods: A descriptive cross-sectional study conducted in 18 Italian Regions. Between April and October 2023, data from nurses and patients involved in home care were collected through two surveys. Psychosocial conditions in workplaces, missed care, and care experiences were assessed using validated tools. Descriptive statistics and Pearson's correlations were performed., Results: A total of 46 local healthcare units were included in this study, with a total of 2549 nurses and 4709 care recipients. Nurses (mean age 46.60; 79.48% female; 44.68% regional nursing diploma as the highest qualification) reported good working conditions (42.37; SD = 12.25; range = 0-100) and a high mean number of missed care activities (5.11; SD = 3.19; range 0-9). Most nurses (83.41%) reported high levels of job satisfaction, while 20.28% intended to leave their job. Patients (mean age 75.18; 57.57% female; 36.95% primary school), on the other hand, rated positively the care they had received (8.23; range = 0-10)., Conclusions: Despite the perception of critical issues at work and some missed care, satisfaction in nurses and patients was high. These data constitute a preliminary snapshot of the studied phenomena, which will be investigated through more in-depth analyses., (© 2024 Wiley Periodicals LLC.)

Objective: Analyze the factors that interfere with the quality of care given by primary healthcare nurses to the elderly domiciled. Methods: Qualitative study conducted with eleven nurses from basic health units in the municipality of Boa Vista, Roraima. The strategy adopted for data collect was through a semi-structured interview via the digital platform. Bardin's content analysis technique was applied to the findings. Results: The data records units were interpreted into four areas: bonding between the nurses and patients; family involvement and distance in the provision of care offered by nurses; and elderly people who live alone in the home. Conclusion: The intervening factors involved in the nurses' care for the elderly domiciled were: bonding; mediated by relationships of trust, closeness and exchange of experiences; performance, collaboration, attention, adherence, not understanding health guidelines, denial of care offered, distance, lack of support from family members, and elderly people who live alone. [ABSTRACT FROM AUTHOR]

Objective: To describe the caring realized by the nurse of the primary health care to the elderly in a residential space. Methods: Qualitative study fulfilled with eleven nurses of Boa Vista's primary health units. The adopted strategy for data collection was a semi-structured interview using the Zoom Platform. The data collected was analyzed and it was organized into categories. Results: The register units were decoded in two dimensions: domestic nursery evaluation inducing preventive orientation of accidents on elderly and care actions by the nurse on the elderly's body at his residence. Conclusion: In this article were produced preventive orientations about domestic cleaning, the arrangement of objects and people inside the house aiming the decreasing of falls. The caretaking procedures involved the verification of vital parameters, medication orientation, skincare, personal hygiene, bandage realization, passing and changing catheter on domestic situations elderly. [ABSTRACT FROM AUTHOR]

BackgroundReturning home after the hospital is a primary aim for healthcare; however, additional postacute care (PAC) services are sometimes necessary for returning stroke patients to their pre-event status. Recent trends in hospital discharge disposition specifying PAC use have not been examined across age groups or health insurance types.Methods and resultsWe examined trends in discharge to inpatient rehabilitation facilities (IRFs), skilled nursing facilities (SNFs), home with home health (HH), and home without services for 849 780 patients ≥18 years of age with ischemic or hemorrhagic stroke at 1687 hospitals participating in Get With The Guidelines-Stroke. Multivariable analysis was used to identify factors associated with discharge to any PAC (IRF, SNF, or HH) versus discharge home without services. From 2003 to 2011, there was a 2.1% increase (unadjusted P=0.001) in PAC use after a stroke hospitalization. Change was greatest in SNF use, an 8.3% decrease over the period. IRF and HH increased 6.9% and 3.6%, respectively. The 2 strongest clinical predictors of PAC use after acute care were patients not ambulating on the second day of their hospital stay (ambulation odds ratio [OR], 3.03; 95% confidence interval [CI], 2.86 to 3.23) and those who failed a dysphagia screen or had an order restricting oral intake (OR, 2.48; 95% CI, 2.37 to 2.59).ConclusionsFour in 10 stroke patients are discharged home without services. Although little has changed overall in PAC use since 2003, further research is needed to explain the shift in service use by type and its effect on outcomes.

Returning home after the hospital is a primary aim for healthcare; however, additional postacute care (PAC) services are sometimes necessary for returning stroke patients to their pre-event status. Recent trends in hospital discharge disposition specifying PAC use have not been examined across age groups or health insurance types. We examined trends in discharge to inpatient rehabilitation facilities (IRFs), skilled nursing facilities (SNFs), home with home health (HH), and home without services for 849 780 patients ≥18 years of age with ischemic or hemorrhagic stroke at 1687 hospitals participating in Get With The Guidelines-Stroke. Multivariable analysis was used to identify factors associated with discharge to any PAC (IRF, SNF, or HH) versus discharge home without services. From 2003 to 2011, there was a 2.1% increase (unadjusted P=0.001) in PAC use after a stroke hospitalization. Change was greatest in SNF use, an 8.3% decrease over the period. IRF and HH increased 6.9% and 3.6%, respectively. The 2 strongest clinical predictors of PAC use after acute care were patients not ambulating on the second day of their hospital stay (ambulation odds ratio [OR], 3.03; 95% confidence interval [CI], 2.86 to 3.23) and those who failed a dysphagia screen or had an order restricting oral intake (OR, 2.48; 95% CI, 2.37 to 2.59). Four in 10 stroke patients are discharged home without services. Although little has changed overall in PAC use since 2003, further research is needed to explain the shift in service use by type and its effect on outcomes.

Objective: to analyze the association of global functionality with the main functional systems and the sociodemographic variables of older adults followed by Home Care in Primary Health Care. Method: a cross-sectional study with 124 older people developed through home interviews. Functionality was assessed by Basic Activities of Daily Living (Barthel) and Instrumental Activities of Daily Living (Lawton and Brody); the main functional systems were assessed using the Mini-Mental State Exam, by the Timed Up and Go test, by the Geriatric Depression Scale (15 items), and questionnaire with sociodemographic variables. Bivariate and multivariate analyses were applied (Poisson Regression). Results: 46% of the older adults showed moderate/severe/total dependence for basic activities and instrumental activities had a median of 12. In the multivariate analysis, there was an association between moderate/severe/total dependence on basic activities with cognitive decline (p=0.021) and bedridden/wheelchair users (p=0.014). Regarding the dependence on instrumental activities, there was an association with age ≥80 years (p=0.006), single/divorced marital status (p=0.013), cognitive decline (p=0.001), bedridden/wheelchair (p=0.020), and Timed Up and Go ≥20 seconds (p=0.048). Conclusion: the decline in cognitive and mobility was associated with poor functionality in basic and instrumental activities. The findings highlight the need to monitor Home Care for these individuals and serve as guidelines for health actions.

Purpose: The National Health Insurance Service implemented a tele-consultation pilot project for in-home care using Information and Communication Technologies (ICTs). This study aims to investigate nurses’, doctors’, and families’ perceptions on the project. Methods: Using the pilot project database and perception survey data, this study provides a description of the satisfaction, re-participation motivation, and experiences of nurses, doctors, and families. Results: Tele-consultation for home-visit nursing was used to monitor health conditions and problems, such as pain and blood pressure, or health counseling for home-care beneficiaries. The beneficiaries' families showed higher levels of satisfaction than the service providers. Nurses and doctors had relatively positive perceptions about the usefulness of sharing information about beneficiaries, timeliness of providing nursing care, and convenience of communication. Meanwhile, nurses and doctors had negative perceptions of the sufficiency and accuracy of information obtained from tele-consultation, implying the necessity of adopting more advanced ICTs. Conclusion: This study suggests what must be considered when designing a tele-consultation service model in long-term care settings, especially in the home-visit nursing care setting. Innovative approaches using ICTs should be taken to improve home-visit nursing care quality in the era of super-aging and COVID-19. [ABSTRACT FROM AUTHOR]

ABSTRACT Objective: To synthesize the knowledge produced on best nursing practices in long-term care for elderly at home, in order to promote healthy aging. Method: A systematic review, based on the Joanna Briggs Institute’s proposal: without restriction of dates; in the English, Portuguese and Spanish languages; conducted in PubMed, CINAHL, LILACS, Embase and Scopus databases. Results: Among 453 articles identified, 16 were included in the review: seven qualitative and nine quantitative, published between 1996 and 2015. The synthesis of the data identified as best practices identifies a premise of care centered on the elderly and the inclusion of the elderly, family and nurses as agents of this care. Conclusion: According to evidence, good practices in gerontological and nursing home care fundamentally depend on constant planning and reorganization, so that they are indeed comprehensive and contextualized. Thus, providing care will be reasoned by and driven to the elderly, based on their specific and global needs, favoring a process of healthy and active aging.

ObjectivesHome-based nursing care services have increased over the past decade. However, accountability and privacy issues as well as security concerns become more challenging during care provider visits. Because of the heterogeneous combination of mobile and stationary assistive medical care devices, conventional systems lack architectural consistency, which leads to inherent time delays and inaccuracies in sharing information. The goal of our study is to develop an architecture that meets the competing goals of accountability and privacy and enhances security in distributed home-based care systems.MethodsWe realized this by using a context-aware approach to manage access to remote data. Our architecture uses a public certification service for individuals, the Japanese Public Key Infrastructure and Health Informatics-PKI to identify and validate the attributes of medical personnel. Both PKI mechanisms are provided by using separate smart cards issued by the government.ResultsContext-awareness enables users to have appropriate data access in home-based nursing environments. Our architecture ensures that healthcare providers perform the needed home care services by accessing patient data online and recording transactions.ConclusionsThe proposed method aims to enhance healthcare data access and secure information delivery to preserve user's privacy. We implemented a prototype system and confirmed its feasibility by experimental evaluation. Our research can contribute to reducing patient neglect and wrongful treatment, and thus reduce health insurance costs by ensuring correct insurance claims. Our study can provide a baseline towards building distinctive intelligent treatment options to clinicians and serve as a model for home-based nursing care.