Family transition through the termination of private duty home care nursing

Gaining Experience Over Time: The Family Caregivers' Perception of Patients with a Tracheostomy in Home Care

Background

The transition of tracheostomy patients to the home poses many challenges for both the patient and the family. Identifying and understanding the experiences of family caregivers pave the road for discovering and meeting care needs. This study has been aimed to explain the experiences of family caregivers of patients with a tracheostomy about patient care at home.

Materials and Methods

This qualitative study was conducted using a conventional content analysis approach from September 2018 to January 2019. Participants included nine family caregivers and one professional caregiver who were selected through purposive sampling method. The in-depth interviews were conducted at home or in health centers using field notes. Data were recorded manually and analyzed using the five-step method proposed by Granehim and Lundman.

Results

The data led to the emergence of 1591 initial codes, 23 subcategories, and 6 categories. Categories include the need for training, the need for receiving care support, care challenges, care burden, gaining experience, hope, and inner satisfaction.

Conclusions

In this study, the family caregivers faced with lots of challenges in caring patients with tracheostomy so that they were in needs of training and support from professionals. Although they got skillful in care and endure burden, they were so hopeful and satisfied with their attempts. Hence, there is a need for official nongovernmental organizations with the aim of maintaining care and protecting their families.

Technology Dependence in Home Care: Impact on Patients and Their Family Caregivers

BACKGROUND

The purpose of this review is to explore how home technology care affects patients, family caregivers, and quality of life (QOL).

METHODS

A literature search was conducted to identify studies of home parenteral nutrition (HPN) and other technology prescribed home care.

RESULTS

Technology dependence influences health-related QOL. Patients and their family caregivers must balance the positive aspects of being in the home environment with the challenges of administering complex therapies at home. Patients and caregivers need additional support to reduce the physical, emotional, social, and financial burdens they experience.

CONCLUSIONS

More research is needed to address effective interventions to reduce patient and caregiver burdens and to improve outcomes for technology-dependent individuals. A greater level of preparedness for managing home technology and technology-related problems may improve quality of life.

Family caregiver research and the HIPAA factor

Research in family caregiving recently has become more challenging because of the strict protection of privacy mandated in the Health Insurance Portability and Accountability Act (HIPAA) of 1996. We ask when should Institutional Review Boards (IRBs) follow HIPAA rules to the letter and when might they use the waiver option? What is the appropriate balance between the goals of protecting the privacy of patients' personal health information and facilitating family-caregiver research that may benefit them and others? More particularly, should patients be gatekeepers for caregiver participation in minimal-risk research? We describe one approach that successfully met HIPAA criteria and also allowed high-quality research. In developing protocols and applying for IRB approval, researchers must be as familiar with HIPAA regulations as they are with IRB standards. Finally, we recommend changes in the review process that may facilitate research efforts with family caregivers while protecting important privacy interests.

Community neonatal nursing work

BACKGROUND

A neonatal community nursing service may help families to cope with the early transfer of small, vulnerable infants to home. The previous literature has relied on self-reports to explore this kind of work.

AIM

This paper reports a study exploring the work of a community neonatal nursing team in order to describe the strategies and interventions used to support families of preterm infants.

METHOD

A qualitative case study design was adopted. Data were collected using fieldwork observations, semi-structured interviews and documentary analysis with a team of four community neonatal nurses. A nursing model of transition was explored as a possible framework for practice.

FINDINGS

Thematic data analysis yielded two broad themes: Working with Mothers and Working with Others. Subcategories of Working with Mothers consisted of Baby Well; Mum Happy; Keeping in Touch and One of the Family. Working with Others focussed on multidisciplinary liaison activities.

DISCUSSION

The complexity of nursing work was interdependent with maternal caregiving and dependent upon effective liaison with other health care professionals. The nursing model of transition requires further development to offer a sufficiently coherent practice model to direct neonatal nursing care delivery.

Rearing the child who is technology dependent: perceptions of parents and home care nurses

ISSUES AND PURPOSE

Most children who are dependent on technology for survival live with their families at home. This study explores the perceptions of parents and home care nurses regarding rearing the technology-dependent child.

DESIGN AND METHODS

In this qualitative study, interviews were conducted with 16 parents whose child is technology dependent and 15 registered nurses who provided home care.

RESULTS

Rearing the child who is technology dependent is similar to but different from raising other children. Parental communication and negotiation of child-rearing expectations with home care nurses is essential.

PRACTICE IMPLICATIONS

Improved collaboration and communication between parents and nurses may reduce parental stress and enhance development for children who are dependent on technology.