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Ito N, Moriyama N, Furuyama A, Saito H, Sawano T, Amir I, Sato M, Kobashi Y, Zhao T, Yamamoto C, Abe T, Tsubokura M. Why Do They Not Come Home? Three Cases of Fukushima Nuclear Accident Evacuees. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4027. [PMID: 36901038 PMCID: PMC10002345 DOI: 10.3390/ijerph20054027] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 02/12/2023] [Accepted: 02/21/2023] [Indexed: 06/18/2023]
Abstract
Many people wish to return to where they used to live after evacuation due to disaster. After the Fukushima nuclear accident in 2011, many residents were forced to evacuate due to concerns about radiation. Subsequently, the evacuation order was lifted, and the government promoted a return policy. However, it has been reported that a considerable number of residents living in evacuation sites or other areas wish to return but are unable to do so. Here, we report three cases of Japanese men and one woman who evacuated after the 2011 nuclear accident in Fukushima. These cases reveal the rapid aging of residents and their health issues. These issues suggest that enhancing medical supply systems and access to medical care can aid in post-disaster reconstruction and residents' returning.
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Affiliation(s)
- Naomi Ito
- Department of Radiation Health Management, School of Medicine, Fukushima Medical University, 1 Hikariga-oka, Fukushima 960-1295, Japan
| | - Nobuaki Moriyama
- Department of Public Health, School of Medicine, Fukushima Medical University, 1 Hikariga-oka, Fukushima 960-1295, Japan
| | - Ayako Furuyama
- Health Promotion Center, Fukushima Medical University, 1 Hikariga-oka, Fukushima 960-1295, Japan
| | - Hiroaki Saito
- Department of Radiation Health Management, School of Medicine, Fukushima Medical University, 1 Hikariga-oka, Fukushima 960-1295, Japan
- Department of Internal Medicine, Soma Central Hospital, Okinouchi, Soma, Fukushima 976-0016, Japan
| | - Toyoaki Sawano
- Department of Radiation Health Management, School of Medicine, Fukushima Medical University, 1 Hikariga-oka, Fukushima 960-1295, Japan
- Department of Surgery, Jyoban Hospital of Tokiwa Foundation, Fukushima 972-8322, Japan
| | - Isamu Amir
- Department of Radiation Health Management, School of Medicine, Fukushima Medical University, 1 Hikariga-oka, Fukushima 960-1295, Japan
| | - Mika Sato
- Department of Health Nursing of International Radiation Exposure, School of Medicine, Fukushima Medical University, 1 Hikariga-oka, Fukushima 960-1295, Japan
| | - Yurie Kobashi
- Department of Radiation Health Management, School of Medicine, Fukushima Medical University, 1 Hikariga-oka, Fukushima 960-1295, Japan
- Department of General Internal Medicine, Hirata Central Hospital, Hirata, Ishikawa District, Fukushima 963-8202, Japan
| | - Tianchen Zhao
- Department of Radiation Health Management, School of Medicine, Fukushima Medical University, 1 Hikariga-oka, Fukushima 960-1295, Japan
| | - Chika Yamamoto
- Department of Radiation Health Management, School of Medicine, Fukushima Medical University, 1 Hikariga-oka, Fukushima 960-1295, Japan
| | - Toshiki Abe
- Department of Radiation Health Management, School of Medicine, Fukushima Medical University, 1 Hikariga-oka, Fukushima 960-1295, Japan
| | - Masaharu Tsubokura
- Department of Radiation Health Management, School of Medicine, Fukushima Medical University, 1 Hikariga-oka, Fukushima 960-1295, Japan
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Inloes JB, Brown A, Rettell Z, Fick DM, Bell SA. Home-Based Care Provider Perspectives on Care Refusal During the COVID-19 Pandemic. J Gerontol Nurs 2023; 49:35-41. [PMID: 36594910 DOI: 10.3928/00989134-20221206-02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Acute and chronic disease management continues to shift toward a health care in the home model, yet literature discussing continuity of home-based care services during public health emergencies, such as infectious disease pandemics, is scant. In the current study, we used semi-structured telephone interviews with 27 home-based care providers (HBCPs) from Medicare-certified home health care agencies located in eight U.S. counties to explore older adults' decision making around home-based care service continuation during the coronavirus disease 2019 (COVID-19) pandemic. Four themes emerged, including two related to older adults' decision making around refusal of in-home care and two related to HBCPs' responses to care refusals. Fear of COVID-19 infection motivated older adults to make care-related decisions that were incongruent with their health needs, including refusal of care in the home, despite receiving education from HBCPs. These data highlight a need for tools to help HBCPs better support patients through decision-making processes about care continuation during COVID-19 and future infectious disease pandemics. [Journal of Gerontological Nursing, 49(1), 35-41.].
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Barriers and facilitators to providing home-based care in a pandemic: policy and practice implications. BMC Geriatr 2022; 22:234. [PMID: 35313830 PMCID: PMC8936035 DOI: 10.1186/s12877-022-02907-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Accepted: 03/02/2022] [Indexed: 01/07/2023] Open
Abstract
Objective The purpose of this study is to describe the experiences of home-based care providers (HBCP) in providing care to older adults during the pandemic in order to inform future disaster planning, including during pandemics. Design Qualitative inquiry using an abductive analytic approach. Setting and participants Home-based care providers in COVID-19 hotspots. Methods Telephone interviews were conducted with 27 participants (administrators, registered nurses and other members of the allied healthcare team), who provided in-home care during the pandemic in Medicare-certified home health agencies. Interviews focused on eliciting experiences from HBCP on challenges and successes in providing home-based care to older adults, including barriers to care and strategies employed to keep patients, and providers, safe in their homes during the pandemic. Results Data was distilled into four major themes that have potential policy and practice impact. These included disrupted aging-in-place resources, preparedness actions contributing to readiness for the pandemic, limited adaptability in administrative needs during the pandemic and challenges with unclear messaging from public health officials. Conclusions Home-based care plays an essential role in maintaining the health of older adults in disaster contexts, including pandemics. Innovative solutions, informed by policy that generate evidence-based best practices to support HBCP are needed to reduce barriers and increase protective factors, in order to maintain continuity of care for this vulnerable population during disruptive events.
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Peterson LJ, Dobbs D, June J, Dosa DM, Hyer K. "You Just Forge Ahead": The Continuing Challenges of Disaster Preparedness and Response in Long-Term Care. Innov Aging 2021; 5:igab038. [PMID: 34805555 PMCID: PMC8600546 DOI: 10.1093/geroni/igab038] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Protecting nursing home and assisted living community residents during disasters continues to be a challenge. The present study explores the experiences of long-term care facilities in Florida that were exposed to Hurricane Irma in 2017. RESEARCH DESIGN AND METHODS We used an abductive approach, combining induction and deduction. Interviews and focus groups beginning in May 2018 were conducted by telephone and in person with 89 administrative staff members representing 100 facilities (30 nursing homes and 70 assisted living communities). Analyses identified themes and subthemes. Findings were further analyzed using the social ecological model to better understand the preparedness and response of nursing homes and assisted living communities to Hurricane Irma. RESULTS 3 main themes were identified including: (1) importance of collaborative relationships in anticipating needs and planning to shelter in place or evacuate; (2) efforts required to maintain safety and stability during an unprecedented event; and (3) effects, repercussions, and recommendations for change following the disaster. DISCUSSION AND IMPLICATIONS Preparing for and managing disasters in nursing homes and assisted living communities involves actions within multiple environments beyond the residents and facilities where they live. Among these, community-level relationships are critical.
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Affiliation(s)
- Lindsay J Peterson
- Florida Policy Exchange Center of Aging, School of Aging Studies, University of South Florida, Tampa, Florida, USA
| | - Debra Dobbs
- Florida Policy Exchange Center of Aging, School of Aging Studies, University of South Florida, Tampa, Florida, USA
| | - Joseph June
- Florida Policy Exchange Center of Aging, School of Aging Studies, University of South Florida, Tampa, Florida, USA
| | - David M Dosa
- Center of Innovation in Long-Term Services and Supports, Providence Veterans Affairs Medical Center, Providence, Rhode Island, USA
- School of Public Health, Brown University, Providence, Rhode Island, USA
| | - Kathryn Hyer
- Florida Policy Exchange Center of Aging, School of Aging Studies, University of South Florida, Tampa, Florida, USA
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