A Place-based Evaluation of a Healthy Homes Initiative

ISSUE ADDRESSED

Limited qualitative evaluations of healthy homes initiatives exist in the literature and even fewer look past physical health benefits to wider health outcomes. A qualitative evaluation of Manawa Ora, a healthy homes initiative implemented by a Māori health provider in Northland, New Zealand, was conducted to ascertain the wider health benefits a healthy homes initiative.

METHODS

Participants of Manawa Ora were recruited, their experiences were analysed through qualitative semi-structured interviews.

RESULTS

Two main themes emerged from the semi-structured interviews. "Becoming active actors" pertains to improved health, both physical and mental, following the programme. It also describes the way participants have redirected their focus from their illness to broader, more purposeful activity. "From a simple space to a place with meaning" highlights the way Manawa Ora improved the home environment by creating a 'place' that holds meaning.

CONCLUSIONS

Healthy homes initiatives can improve physical health as well as wider health outcomes. Through the provision of beds, bedding, insulation and heating Manawa Ora has created a 'therapeutic place' out of the home that promotes healing and wellbeing.

SO WHAT

Greater focus on connections to place in public health initiatives may bring about wider health gains.

'I'm not just a number on a sheet, I'm a person': Domiciliary care, self and getting older

Social care funding is reducing in spite of a growing older population. Within this context, domiciliary services are increasingly failing to deliver care that respects the individuality and heterogeneity of older people. To date, there has been limited research in the U.K. that explores, from the older person's perspective, how care practices interact with self. Using biographical-narrative methodology, this study takes a constructionist approach to understand the individual's lived experience of care and how it interacts with sense of self. A three-stage model of data collection was used, beginning with a narrative biographic enquiry, exploring with participants (65 yrs +, n = 17) their journeys into care and any possible relationship to personal identity. Stage 2 involved a two-week period of diary completion, with participants recording daily reflections on their care experiences. In stage 3, a semi-structured interview explored the diary entries, linking back to the narrative biographic enquiry to reveal ways in which specific care practices interacted with the sense of self. The findings reveal that a strong relationship between older person and formal carer, forged through familiarity, regularity and consistency, plays a significant role in promoting feelings of autonomy. Furthermore, such relationship mediates against the loss of executional autonomy that often accompanies increasing disability. Maintaining autonomy and control was a recurring theme, including in relation to home, privacy and dignity. Feelings of autonomy are also promoted when formal carers understand the unique ways in which individuals experience ageing and being in the cared-for relationship. This paper suggests that a care approach should be based on two tenets. First, a knowledge and insight into the importance of understanding and respecting the older person's continuing development of self, and second applying this knowledge to care through a positive, stable and consistent relationship between the older person and the carer.

Use of Video Consultations for Patients With Hematological Diseases From a Patient Perspective: Qualitative Study

Background

The need for the use of telemedicine is expected to increase in the coming years. There is, furthermore, a lack of evidence about the use of video consultations for hematological patients, and how the use of video consultations is experienced from the patients’ perspective.

Objective

This study aimed to identify patients’ experiences with the use of video consultations in place of face-to-face consultations, what it means to the patient to save the travel time, and how the roles between patients and health care professionals are experienced when using video consultation. This study concerns stable, not acutely ill, patients with hematological disease.

Methods

The study was designed as an exploratory and qualitative study. Data were collected through participant observations and semistructured interviews and analyzed in a postphenomenological framework.

Results

The data analysis revealed three categories: “Intimacy is not about physical presence,” “Handling technology,” and “Technology increases the freedom that the patients desire.”

Conclusions

This study demonstrates what is important for patients with regards to telemedicine and how they felt about seeing health care professionals through a screen. It was found that intimacy can be mediated through a screen and physical presence is not as important to the patient as other things. The study further pointed out how patients valued being involved in the planning of their treatment. The patients also valued the freedom associated with telemedicine and actively took responsibility for their own course of treatment. Patients felt that video consultations allowed them to be free and active, despite their illness.

Temporally and spatially shaped meanings of at-homeness among people 85 years and over with severe illness

AIMS AND OBJECTIVES

The aim of the study was to illuminate how meanings of at-homeness are temporally and spatially shaped by older people with severe illness.

BACKGROUND

At-homeness can be understood as a feeling of being metaphorically at-home while experiencing well-being. The research field of at-homeness among older people with severe illness is under researched and knowledge about how at-homeness is shaped by time and place is limited.

METHOD

Narrative interviews were conducted in Sweden with a total of twenty men and women who were aged 85 years or over and affected by severe illness. The narrative interviews were analysed based on a phenomenological hermeneutical method.

RESULTS

Meanings of at-homeness that were shaped temporally and spatially were interpreted, where time and place were shaped individually by other aspects and also interwoven. Two main inter-related themes were constructed: shaping at-homeness through relying on a familiar place and shaping at-homeness through continuous balancing between the past, present and future.

CONCLUSION AND IMPLICATIONS

At-homeness is temporally and spatially shaped in two ways: through a process over time, or momentarily, where older people's earlier experiences and expectations are interwoven with their experiences of place and the people around them. The results of this study would be applicable to similar societal contexts. For future research, it is important to continue to study how at-homeness can be promoted for severely ill older people, in specific situations and over time.