The effectiveness of the around-the-clock in-home care system: did it prevent the institutionalization of frail elderly?

Efficacy of Government-Sponsored Community Health Programs for Older Adults: A Systematic Review of Published Evaluation Studies

Objective: Population aging is an ongoing challenge for global health policy and is expected to have an increasing impact on developing economies in years to come. A variety of community health programs have been developed to deliver health services to older adults, and evaluating these programs is crucial to improving service delivery and avoiding barriers to implementation. This systematic review examines published evaluation research relating to public and community health programs aimed at older adults throughout the world.

Methods: A literature search using standardized criteria yielded 58 published articles evaluating 46 specific programs in 14 countries.

Results: Service models involving sponsorship of comprehensive facilities providing centralized access to multiple types of health services were generally evaluated the most positively, with care coordination programs appearing to have generally more modest success, and educational programs having limited effectiveness. Lack of sufficient funding was a commonly-cited barrier to successful program implementations.

Conclusion: It is important to include program evaluation as a component of future community and public health interventions aimed at aging populations to better understand how to improve these programs.

Fragilidade no idoso: o que vem sendo produzido pela enfermagem

Este trabalho visa identificar a produção científica desenvolvida pela enfermagem frente à fragilidade no idoso, a partir de uma revisão integrativa da literatura, realizada nas bases Scientific Electronic Library Online (SciELO), Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS) e Scopus. Foram incluídos no estudo 16 artigos, sendo dois publicados em periódicos brasileiros e 14 em periódicos estrangeiros. Constata-se que, dos artigos analisados, 37,5% (6) enfocam a mudança de paradigma quanto ao modelo assistencial e 26,7% (4) destacam a família como cuidadora no contexto do idoso frágil. Pontua-se que o enfermeiro desempenha um papel impar no contexto da fragilidade, no desenvolvimento do cuidado individual e no suporte aos familiares e aos cuidadores dos idosos frágeis.

Internal and external environmental factors affecting the performance of hospital-based home nursing care

BACKGROUND

Numerous studies on HNC services have been carried out by signifying their needs, efficiency and effectiveness. However, no study has ever been performed to determine the critical factors associated with HNC's positive results despite the deluge of positive studies on the service.

METHODS

This study included all of the 89 training hospitals that were practising HNC service in Korea as of November 2006. The input factors affecting the performance were classified as either internal or external environmental factors. This analysis was conducted to understand the impact that the corresponding factors had on performance. Data were analysed by using multiple linear regressions.

RESULTS

The internal and external environment variables affected the performance of HNC based on univariate analysis. The meaningful variables were internal environmental factors. Specifically, managerial resource (the number of operating beds and the outpatient/inpatient ratio) were meaningful when the multiple linear regression analysis was performed. Indeed, the importance of organizational culture (the passion of HNC nurses) was significant.

CONCLUSION

This study, considering the limited market size of Korea, illustrates that the critical factor for the development of hospital-led HNC lies with internal environmental factors rather than external ones. Among the internal environmental factors, the hospitals' managerial resource-related factors (specifically, the passion of nurses) were the most important contributing element.

Municipal night nurses' experience of the meaning of caring

The aim of this study was to elucidate municipal night registered nurses' (RNs) experiences of the meaning of caring in nursing. The research context involved all night duty RNs working in municipal care of older people in a medium-sized municipality located in central Sweden. The meaning of caring in nursing was experienced as: caring for by advocacy, superior responsibility in caring, and consultative nursing service. The municipal night RNs' experience of caring is interpreted as meanings in paradoxes: 'being close at distance', the condition of 'being responsible with insignificant control', and 'being interdependently independent'. The RNs' experience of the meaning of caring involves focusing on the care recipient by advocating their perspectives. The meaning of caring in this context is an endeavour to grasp an overall caring responsibility by responding to vocational and personal demands regarding the issue of being a RN, in guaranteeing ethical, qualitative and competent care for older people.