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Al-Surimi K, Al-Harbi I, El-Metwally A, Badri M. Quality of life among home healthcare patients in Saudi Arabia: household-based survey. Health Qual Life Outcomes 2019; 17:21. [PMID: 30683116 PMCID: PMC6347790 DOI: 10.1186/s12955-019-1095-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Accepted: 01/17/2019] [Indexed: 11/25/2022] Open
Abstract
Background The need for home healthcare programs is an increasingly becoming important common component of healthcare worldwide, as an alternative to hospitalization, owing to the growing elderly population, chronic and acute diseases that need continuous monitoring and care. The overall aim of this study was to describe and assess the quality of life (QOL) and associated determinants among patients enrolled in the Home Health Care (HHC) program affiliated with the Ministry of National Guard Health Affairs in Riyadh, Saudi Arabia. Methods This cross-sectional study was conducted among patients enrolled at the HHC program. The World Health Organization QOL questionnaire (WHOQOL-BREF) was used to collect data about the different domains of patients’ QOL. Logistic regression models were fitted to determine factors associated with QOL low score. Results The study included 253 patients. Mean age was 67.05 (± 20.0). The overall QOL for HHC patients was significantly affected by both socio-demographic and morbid characteristics. In the final Multivariate logistic regression models, marital status, and having psychological problems, stroke and number illness were independently associated with the overall QOL of HHC patients (p = .022, p = .002, p = .031, .057 respectively). The physical health domain score was significantly associated with education level, having psychological problems and stroke (p = .028, p = .002, p = .007 retrospectively) whereas the psychological domain score was significantly associated with age (p = < 0.001) and three types of chronic diseases: pulmonary (p = .002), psychological problems (p = < 0.001). The social domain score was significantly associated only with the marital status (p = .026). The environmental domain was significantly associated with the education level and having stroke (p = .017 vs .027). Conclusions The overall QOL and its domains are significantly associated with several different factors. Many of these factors can be monitored and enhanced by improving quality of HHC services, thus improving the QOL of patients.
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Affiliation(s)
- Khaled Al-Surimi
- Department of Health Systems and Management, College of Public Health and Health Informatics, King Abdullah International Medical Research Center, King Saud ben Abdulaziz University for Health Sciences, Ministry of the National Guard Health Affairs, Riyadh, Kingdom of Saudi Arabia. .,King Abdullah International Medical Research Center, Riyadh, Kingdom of Saudi Arabia. .,Primary Care and Public Health Department, School of Public health, Imperial College London, Riyadh, UK.
| | - Iman Al-Harbi
- Department of Health Systems and Management, College of Public Health and Health Informatics, King Abdullah International Medical Research Center, King Saud ben Abdulaziz University for Health Sciences, Ministry of the National Guard Health Affairs, Riyadh, Kingdom of Saudi Arabia
| | - Ashraf El-Metwally
- Department of Epidemiology and Biostatistics, College of Public Health and Health Informatics, King Abdullah International Medical Research Center, King Saud ben Abdulaziz University for Health Sciences, Ministry of the National Guard Health Affairs, Riyadh, Kingdom of Saudi Arabia
| | - Motasim Badri
- Department of Epidemiology and Biostatistics, College of Public Health and Health Informatics, King Abdullah International Medical Research Center, King Saud ben Abdulaziz University for Health Sciences, Ministry of the National Guard Health Affairs, Riyadh, Kingdom of Saudi Arabia
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Stacey D, Ludwig C, Truant T, Carley M, Bennis C, Gifford W, Kuziemsky C, Nichol K, Lafreniere-Davis N, Owens G, Roscoe D, Roberts P, Verhaegen M. Implementing Practice Guides to Improve Cancer Symptom Management in Homecare: A Comparative Case Study. HOME HEALTH CARE MANAGEMENT AND PRACTICE 2018. [DOI: 10.1177/1084822318817896] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Symptoms experienced by clients with cancer often occur at home and can become life-threatening, posing serious safety concerns. This study evaluated implementation of evidence-informed symptom practice guides to enhance quality of cancer symptom support by homecare nurses. A comparative case study was conducted using the Knowledge to Action Framework. Case were created for each of six agencies providing nursing care within a regional homecare authority. A team of researchers and knowledge users (e.g., managers, educators, family member): (1) assessed factors influencing practice guide use (survey, interviews) at six agencies, (2) adapted 15 practice guides for local use, (3) implemented with interventions to address barriers, and (4) monitored use. Analysis was within and across cases. Of six nursing agencies, one withdrew and five participated. In the baseline survey, 51% of nurses reported using guidelines but nurses did not describe using them in their current practice during the interviews. To overcome barriers, 489 nurses in five agencies were trained in how to use the practice guides, principles were established for documenting cancer symptom management, and practice guides were made available in various formats. Success with implementation varied across the participating cases. Chart audits conducted in three agencies revealed evidence of practice guide use for 16%, 22%, and 70% client visits, respectively. Implementation of evidence-informed practice guides in nursing required an approach tailored for each agency. Training, integration in documentation, and easy access to practice guides increased use for some nurses but ongoing support and reinforcement from nurse leaders is required.
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Affiliation(s)
- Dawn Stacey
- The University of Ottawa, ON, Canada
- Ottawa Hospital Research Institute, ON, Canada
| | | | - Tracy Truant
- The University of British Columbia, Vancouver, Canada
| | - Meg Carley
- Ottawa Hospital Research Institute, ON, Canada
| | - Cindy Bennis
- Bayshore Home Care Solutions, Cornwall, ON, Canada
| | | | | | | | - Nicole Lafreniere-Davis
- pan-Canadian Oncology Symptom Triage and Remote Support (COSTaRS) Homecare Study, Ottawa, ON, Canada
| | - Glenda Owens
- Champlain Local Health Integration Network, Ottawa, ON, Canada
| | - Diane Roscoe
- Carefor Health & Community Services, Ottawa, ON, Canada
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Megaritis C, Sakellari E, Psychogiou M, Tzenalis A, Krepia V, Charalambous G, Sapountzi-Krepia D. Exploring home care nurses' perceptions regarding their services in economic crisis: A qualitative approach. Nurs Forum 2018; 53:521-528. [PMID: 29968259 DOI: 10.1111/nuf.12281] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
This article explores the home care nurses' perceptions on the services they provide in Cyprus, which has been hit by a financial crisis. Semistructured interviews were conducted in Greek at the home care nurses' offices. Data were analyzed using qualitative content analysis. The participants' perceptions are described in terms of provision of home care nursing, administration of homecare nursing, job satisfaction, financial issues, and suggesting improvements. The financial crisis influences the home care services with regard to workload increase, staff shortage, and lack of resources. Home care nurses are well engaged in the provision of proper services in order to address the patients' needs. However, the financial crisis has set obstacles in the provision of care.
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Affiliation(s)
| | - Evanthia Sakellari
- Department of Public and Community Health, University of West Attica, Athens, Greece
| | - Maria Psychogiou
- Department of Nursing Science, University of Eastern Finland, Kuopio, Finland
| | | | - Vassiliki Krepia
- School of Human Movement and Quality of Life Sciences, Faculty of Nursing, University of Peloponnese, Sparta, Greece.,Sismanogleion Hospital of Attica, Marousi, Greece
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Siclovan DM. The effectiveness of home health care for reducing readmissions: an integrative review. Home Health Care Serv Q 2018; 37:187-210. [DOI: 10.1080/01621424.2018.1472702] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Ang K, Hepgul N, Gao W, Higginson IJ. Strategies used in improving and assessing the level of reporting of implementation fidelity in randomised controlled trials of palliative care complex interventions: A systematic review. Palliat Med 2018; 32:500-516. [PMID: 28691583 DOI: 10.1177/0269216317717369] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
BACKGROUND Implementation fidelity is critical in evaluating effectiveness of interventions. AIM Identifying and summarising strategies to improve and assess the level of reporting of implementation fidelity in randomised controlled trials of palliative care complex interventions. DESIGN Systematic review. DATA SOURCES Published and completed randomised controlled trials from 2000 to current evaluating effectiveness of specialised palliative care services on patient-centred outcomes in adult patients were examined. MEDLINE was searched from 2008 to 29 September 2015 and supplemented by randomised controlled trials identified in a 2008 systematic review. RESULTS Altogether, 20 randomised controlled trials involving 8426 patients were reviewed using 40 subcomponents of five elements of implementation fidelity (resulting in 20 × 40 = 800 items). Over 88 strategies were identified, classified under the following elements: 'treatment design', 'training providers', 'delivery of treatment', 'receipt of treatment' and 'enactment of treatment skills'. No single overarching strategy was discovered. Strategies under 'treatment design' aimed to ensure equivalent treatment dose between and within intervention and control groups, and delivery of necessary ingredients. Ongoing 'training (of) providers' included supervision and ensuring skill acquisition. Use of treatment manuals and implementation checklists aimed to aid 'delivery of treatment'. Research teams aimed to improve 'receipt of treatment' by transmitting clear information and verifying understanding, while improving 'enactment of treatment skills' by reviewing and reinforcing prior content. Only 26% of the items received sufficient reporting; 34% were either not used or reported on. CONCLUSION Implementation fidelity in palliative care is under-recognised. A table to collate these strategies to improve implementation fidelity in palliative care research and clinical practice is proposed.
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Affiliation(s)
- Kexin Ang
- 1 Department of Neurology, National Neuroscience Institute, Singapore.,2 Cicely Saunders Institute of Palliative Care, Policy & Rehabilitation, Faculty of Life Sciences and Medicine, King's College London, London, UK
| | - Nilay Hepgul
- 2 Cicely Saunders Institute of Palliative Care, Policy & Rehabilitation, Faculty of Life Sciences and Medicine, King's College London, London, UK
| | - Wei Gao
- 2 Cicely Saunders Institute of Palliative Care, Policy & Rehabilitation, Faculty of Life Sciences and Medicine, King's College London, London, UK
| | - Irene J Higginson
- 2 Cicely Saunders Institute of Palliative Care, Policy & Rehabilitation, Faculty of Life Sciences and Medicine, King's College London, London, UK
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Bilgin S, Gozum S. Effect of nursing care given at home on the quality of life of patients with stomach cancer and their family caregivers' nursing care. Eur J Cancer Care (Engl) 2016; 27:e12567. [PMID: 28008704 DOI: 10.1111/ecc.12567] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/10/2016] [Indexed: 11/29/2022]
Abstract
In Turkey, the high incidences of stomach and oesophageal cancers in East and high incidence of stomach cancer in Northeast regions are remarkable. This study was conducted to identify homecare needs of patients with stomach cancer and their caregivers and the effect of family supportive nursing care on the quality of life of patients and families. The patient and his/her caregiver were assessed with respect to their daily life activities and NANDA was used for the identified nursing diagnoses, NIC for the appropriate interventions and NOC for assessment of the results. This study was conducted in a pre-test, post-test, controlled trial model to identify. The sample of the investigation consisted of 72 patients and 72 caregivers. As a data-collecting instrument, the Quality of Life Scale and Caregiver Quality of Life Index-Cancer were used. The overall quality of life, global health status and emotional and cognitive functions of the patients in the experimental group improved after the interventions. The overall quality of life and global health status was found to be poorer in the control group patients at post-test as compared to pre-test and their physical, role and social functions deteriorated. The caregivers' quality of life in the control group was affected more negatively with respect to the "Disruption in Daily Life" subscale as compared to pre-test values.
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Affiliation(s)
- S Bilgin
- Department of Public Health Nursing, Ataturk University Faculty of Health Science, Erzurum, Turkey
| | - S Gozum
- Department of Public Health Nursing, Akdeniz University Faculty of Nursing, Antalya, Turkey
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Nichol K, Stacey D, Kuziemsky C, Gifford W. Cancer symptom management in the home: A scoping review. Can Oncol Nurs J 2016; 26:4-10. [PMID: 31148698 DOI: 10.5737/23688076261411] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
The aim of this scoping review was to examine interventions used by nurses in the home setting for symptom management of adults with cancer. Databases were searched (CINAHL, Medline, PubMed, EBM Reviews, Joanna Briggs Institute EBP) with key words cancer, home, nursing, symptom, and protocol. Out of 390 identified citations, five met the inclusion criteria. Studies were conducted from 1989 to 2009. Findings revealed that home care nursing services improved symptom management, promoted independence, maintained quality of life, and decreased use of health care services. Two studies used evidence-based guidelines for cancer symptom management. Although few studies have explored nursing interventions for cancer symptom management in the home setting, their evidence suggests some improved client- and system-level outcomes.
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Affiliation(s)
- Kathryn Nichol
- Palliative Care Nurse Specialist, The Ottawa Hospital, 501 Smyth Road, Room 5235, Ottawa, ON K1H 8L6 613-737-8940;
| | - Dawn Stacey
- Professor, University of Ottawa, Faculty of Health Sciences, 451 Smyth Road, Ottawa, ON K1H 8M5 613-562-5800 ext 8419;
| | - Craig Kuziemsky
- Associate Professor, University of Ottawa, Telfer School of Management, 55 Laurier Avenue East, Ottawa, ON 613-562-5800 ext 4792;
| | - Wendy Gifford
- Assistant Professor, University of Ottawa, Faculty of Health Sciences, 451 Smyth Road, Ottawa, ON K1H 8M5 613-562-5800 ext. 8975;
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Nichol K, Stacey D, Kuziemsky C, Gifford W, Mackenzie S. Knowledge Tools for Cancer Treatment–Related Symptom Management by Home Care Nurses. HOME HEALTH CARE MANAGEMENT AND PRACTICE 2015. [DOI: 10.1177/1084822315607231] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
A mixed methods descriptive study explored 38 nurses’ perceptions of usability and factors influencing the use of 13 symptom management protocols when caring for patients with cancer in the home. Descriptive analysis of the usability survey revealed protocols had high readability, right amount of information, appropriate terms, and were self-evident to complete. Thematic analysis of transcripts identified barriers to using the protocols including lack of time, paper-based documentation systems, and length of the protocols. Facilitating factors included high usability of the protocols, integration of a remote symptom support nursing role, and the usefulness for education and training. In summary, the protocols were described as a useful resource and beneficial for nursing orientation but required support to overcome some barriers and improve fit with clinical workflow.
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