Self-management of the health care regimen: a comparison of nurses' and cardiac patients' perceptions

How much is enough? Perspectives of care recipients and professionals on the sufficiency of in-home care

PURPOSE OF THE STUDY

This study sought to increase knowledge about the impact of rater role on the assessment of in-home supportive care. The authors compared the perspectives of care recipients and professionals on one aspect of the broad concept of quality of care in home care-the sufficiency of the amount of care provided by informal and formal caregivers.

DESIGN AND METHOD

Sufficiency of home care was assessed through concurrent elderly persons' self-report through telephone interview and nurse clinical report based on in-home interviews with the elder. Care was assessed in terms of the sufficiency of the amount of informal and formal assistance received to meet functional dependency needs. Statistical analyses compared the ratings of elder and professional.

RESULTS

Professional ratings of the sufficiency of care were significantly lower than those of the elderly care recipients. From the perspective of both care recipients and professionals, sufficiency of care was significantly related to coresidence of elder and caregiver, and to caregiver health.

IMPLICATIONS

Consistent with previous literature, rater role was found to influence the assessment of the sufficiency of in-home care. Researchers and providers should recognize that care recipient and professional ratings are not interchangeable.

Changes in functional health status of older women with heart disease: evaluation of a program based on self-regulation

OBJECTIVES

This study involving 570 women aged 60 years or older with heart disease, assessed the effects of a disease management program on physical functioning, symptom experience, and psychosocial status.

METHODS

Women were randomly assigned to control or program groups. Six to eight women met weekly with a health educator and peer leader over 4 weeks to learn self-regulation skills with physical activity as the focus. Evaluative data were collected through telephone interviews, physical assessments, and medical records at baseline and 4 and 12 months post baseline.

RESULTS

At 12 months, compared with controls, program women were less symptomatic (p < .01), scored better on the physical dimension of the Sickness Impact Profile (SIP; p < 0.05), had improved ambulation as measured by the 6-minute walk (p < 0.01), and lost more body weight (p < .001). No differences related to psychosocial factors as measured by the SIP were noted.

CONCLUSION

A self-regulation-based program that was provided to older women with heart disease and that focused on physical activity and disease management problems salient to them, improved their physical functioning and symptom experience. Psychosocial benefit was not evident and may be a result of measurement error or due to insufficient program time spent on psychosocial aspects of functioning.

Co-production--an approach to cardiac rehabilitation from a service management perspective

AIM

The aim of the study was to describe and analyse the hospital delivery system for patients recovering from myocardial infarction, applying the offering and value concepts from service management theory.

BACKGROUND

In Nordic hospital care patients traditionally played a minor role. But changes have taken place. By means of information giving and systematic education from the staff many chronically ill patients are now taking a significant part in their treatment and care.

METHOD

The method was a case study including 12 individual interviews.

CONCLUSIONS

The principal conclusion is that the short and intense periods of hospital inpatient stay make it advantageous to consider the patient a member of the health care team taking an active part in the caring process.