Teses / dissertações: "Home care services – Japan"

1

Fujita, Kenji. "The development of quality indicators for home pharmaceutical care in Japan". Thesis, University of Sydney, 2020. https://hdl.handle.net/2123/22994.

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Taking into account the challenges posed by an ageing society, Japan, one of the most rapidly ageing countries in the world, has recently seen a shift in focus of its health delivery system for the elderly from hospital care to home healthcare. In Japan, home pharmaceutical care (HPC) is provided to home-bound elderly who have difficulties in accessing a community pharmacy, for regular medicine supplies and medication management. Although the number of HPC services provided has increased, little is known about the quality of care provided. Quality indicators (QIs) are a recognised mechanism for evaluating the quality of health services, if they have been robustly developed and their measurement properties scientifically tested. The overall aim of the research described in this thesis was to develop a set of QIs for HPC in Japan and assess their measurement properties. A 4-step QI development procedure was applied. First, the results of a qualitative study regarding what constitutes ‘quality’ in HPC revealed that multiple stages of the home care pathway should be covered in order to comprehensively evaluate the quality of HPC. Second, in line with the determined scope, 52 QIs were developed based on the following three sources; 1) national guidelines, 2) existing QIs, and 3) healthcare professionals’ experiences and opinions. Third, appropriateness of the preliminary set of 52 QIs was assessed using the RAND/UCLA appropriateness method. Of these, 45 QIs were judged as ‘appropriate’ by the expert panel. Fourth, a 6-month observational study followed by semi-structured interviews were carried out to evaluate measurement properties of each QI (feasibility, applicability, improvement potential, discriminatory capacity, sensitivity to change, acceptability and implementation issues). As a result, 9 QIs met all measurement properties. A set of QIs for HPC was rigorously developed and tested. This QI set may be useful in evaluating the quality of HPC services in Japan.

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Ogawa, Keiko. "Workload of Home Health Care Nurses in Japan". Case Western Reserve University School of Graduate Studies / OhioLINK, 2008. http://rave.ohiolink.edu/etdc/view?acc_num=case1207180785.

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3

Mulligan, Julia C. A. "Dying at home : an evaluation of specialist home care services". Thesis, Cardiff University, 1989. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.293069.

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4

O'Connor, Denise F. "The governance of home care in Ontario and England: contracts, markets and the effects on service providers, clients and workers in an era of balanced budgets /". *McMaster only, 2005.

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5

King, Anna Irene Ivy. "Creating sustainable home care services for older people". Thesis, University of Auckland, 2010. http://hdl.handle.net/2292/5765.

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Background: The population is ageing and recent years have revealed substantial increases in expenditure and demand for home care services. However, provision of home care is fraught with quality issues such as high staff turnover rates, inadequate staff training, a lack of coordinator support and reduced continuity of care. Consequently, ensuring the sustainability of home care services remains a critical area of concern. Objective: To evaluate the impact of a restorative home care service, for older people with varying levels of need, in relation to improving quality and sustainability. Design: Randomised controlled trial with cluster randomisation. Older people and their support workers were identified via a home care agency and cluster randomised to receive either the restorative home care service (intervention=93) or usual home care (control=93). Intervention: The restorative home care service involved goal facilitation, repetitive activity of daily living exercises, and an in-depth initial assessment for older people; experiential training for support workers; care management role and enhanced skill and competency level for the coordinator. Participants: Older people (65+ years), living in their own homes, who received assistance from a home care agency in South Auckland, New Zealand. Methods: Face-to-face interviews were conducted with older people at baseline, four and seven months. The primary outcome was change in health related quality of life measured by the Short Form 36 Health Survey. Other scale measurements were utilised to assess physical, mental and social wellbeing. Informal carer stress was assessed with the Carer Reaction Assessment. Focus groups were held with support workers at baseline and 14 months to ascertain their opinions. Coordinator perceptions were established via one-on-one interviews at 14 months. A basic comparison of costs for the two groups was undertaken. Results: Compared with usual care, restorative home care demonstrated a statistically significant improvement in health related quality of life over time for older people (P=0.05). There were no changes in other scale measurements for older people in both groups over time. Support worker turnover was 42.5 and 17.9 percent for the control and intervention group, respectively, and job satisfaction improved within the intervention group in comparison to the control group. Value adding costs increased, while, non-value adding costs were reduced. Key aspects of the intervention contributing to these findings included goal facilitation and development of personalised support plans, the coordinators enhanced input and support and the improved training for support workers. Conclusions: This study demonstrated a restorative home care service can enhance the quality of service provision to benefit both older people and support worker staff. Further amendments are addressed, such as improving support worker employment conditions and raising the eligibility criteria for home care, to ensure future sustainability.

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6

Kidambi, Supriya. "WeCare Home Healthcare Support Services Business Plan". Thesis, California State University, Long Beach, 2017. http://pqdtopen.proquest.com/#viewpdf?dispub=10261395.

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Considering the expanding populace of elderly in the United States of America, there has been a significant growth in demand for home healthcare organizations which serve to deliver continuous quality care. Home healthcare organizations guarantee to support our economy and decrease healthcare costs to a huge level. This marketable business plan inspects the business capability of a home healthcare services startup located in San Diego Downtown.

This business plan has been broken down into several compartments where chapter 1 accounts on the market analysis of our business providing marketing strategies and intricate details of our company and its analysis, services provided, services in demand, customer and competitor analysis, marketing potential and demand. Chapter 2 deals with feasibility and SWOT analysis, to evaluate pros and cons, and to get a better idea of the organizational structure of the business plan. In Chapter 3, we talk about the legal aspects concerning State and Federal laws. Chapter 4 explains about the financial assumptions and analysis, annual expenditures as well as monthly expenses with the overall potential of home healthcare services to survive market competition.

We conclude that WeCare home healthcare services plan showed great potential to withstand the competitive market and drive towards success.

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7

Steeg, Jörg Michael. "Mathematical models and algorithms for home health care services". Tönning Lübeck Marburg Der Andere Verl, 2008. http://d-nb.info/994324375/04.

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Yu, Mei-yuk Doris. "The perceptions of home help services recipients towards institutional services". Hong Kong : University of Hong Kong, 1997. http://sunzi.lib.hku.hk/hkuto/record.jsp?B19470289.

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9

Wing, Donna Marie. "The use of political strategies for resource acquisition and allocation for home health care a comparative field study of Central Thames, United Kingdom, and Energytown, United States /". Access abstract and link to full text, 1987. http://0-wwwlib.umi.com.library.utulsa.edu/dissertations/fullcit/8712610.

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10

Pham, Misty Mong-Xuan. "Flymed Pharmacy, LLC, Home Delivery Services a Business Plan". Thesis, California State University, Long Beach, 2017. http://pqdtopen.proquest.com/#viewpdf?dispub=10601380.

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With advances in technology and science, life expectancy is increasing, but most of the elders must take care of themselves or live in assisted home. Between 2015 and 2060, the U.S. Census Bureau predicts that the population adult aged 65 to 84 will grow to 89%; meanwhile, the number of adult 85 and older are expected to more than triple and about 11 million people age sixty-five and older are predicted to live alone, which is almost a third of the American population. They may have problems to receive essential medications because they are unable to drive or do not have access to public transportations. The FlyMed Pharmacy will assist the elderly by providing home delivery services such as emergency or maintenance medications. Consultations and advice will be provided through a mobile app, DeliverMyMed.

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11

Hurley, Sarah. "Factors affecting long-term outcomes following intensive in-home services". View the abstract Download the full-text PDF version (on campus access only), 2008. http://etd.utmem.edu/ABSTRACTS/2008-050-Hurley-index.htm.

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Thesis (Ph.D.)--University of Tennessee Health Science Center, 2008.
Title from title page screen (viewed on February 18, 2008). Research advisor: Teresa M. Waters, Ph.D. Document formatted into pages (viii, 88 p. : ill.). Vita. Abstract. Includes bibliographical references (p. 67-79).

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Vasudevan, Sridhar. "Secure telemedicine system for home health care". Morgantown, W. Va. : [West Virginia University Libraries], 2000. http://etd.wvu.edu/templates/showETD.cfm?recnum=1254.

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Thesis (M.S.)--West Virginia University, 2000.
Title from document title page. Document formatted into pages; contains vi, 94 p. : ill. (some col.). Includes abstract. Includes bibliographical references (p. 92-93).

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13

Anderson, Mindi S. "Integrating Emergency Medical Services Into the Patient-Centered Medical Home". Thesis, Capella University, 2017. http://pqdtopen.proquest.com/#viewpdf?dispub=10288192.

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Abstract Emergency medical services (EMS) for nonemergent or low-acuity calls is a new normal. EMS agencies spend a majority of time providing primary care services through the 911 system. They are utilized currently to fill the primary care gap subconsciously. The EMS system is activated as a patient navigator for primary care services. EMS agencies in the state where the research occurred have responded to the gap in care management by creating innovative programs such as community health emergency medical services (CHEMS). Creation of CHEMS programs have become one of the most monumental concepts for change in the field on both a state and national level. EMS has sought ways to meet the goals of the Triple Aim by exploring CHEMS as the state transitions to value-based care. Leaders are searching for innovative ways to close the gap in the primary health care system through a patient-centered medical home (PCMH) model. The action research study stimulated innovative thinking to support coordinated care across the evolving continuum of the health care system. The study captured the current awareness from community health care leaders who have had a recent opportunity to explore the idea of integrating EMS into the PCMH model through semi-structured interview sessions. Major findings in the thematical analysis discovered the current way both EMS and a PCMH function in a silo system that could potentially utilize each other to effectively provide managed care. Joint efforts could offset overutilization of EMS services for calls that have no apparent life threats. EMS would allow for a PCMH to conform to the Patient Protection and Affordable Care Act standards of care management, contributing to the integration of Triple Aim objectives. Collaboratively, EMS and an established PCMH will impact the delivery of preventative, quality and cost-efficient care. The theory of organizational culture change is based on three common characteristics: culture is shared, is intangible, and affects human behavior. The conceptual framework of the research study was based on the chronic care model. Patients with comorbidities potentially utilize the health care system more than a healthy patient to seek reassurance that their health is managed.

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Dow, Briony. "The invisible contract : care-giving in home-based rehabilitation". Thesis, The Author [Mt.Helen, Vic.] :, 2003. http://researchonline.federation.edu.au/vital/access/HandleResolver/1959.17/41782.

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15

Pengelly, G. "Hard times : A study of home help organisers". Thesis, University of Bristol, 1988. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.330201.

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16

Bennett, Ashlea R. "Home health care logistics planning". Diss., Georgia Institute of Technology, 2009. http://hdl.handle.net/1853/33989.

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This thesis develops quantitative methods which incorporate transportation modeling for tactical and operational home health logistics planning problems. We define home health nurse routing and scheduling (HHNRS) problems, which are dynamic periodic routing and scheduling problems with fixed appointment times, where a set of patients must be visited by a home health nurse according to a prescribed weekly frequency for a prescribed number of consecutive weeks during a planning horizon, and each patient visit must be assigned an appointment time belonging to an allowable menu of equally-spaced times. Patient requests are revealed incrementally, and appointment time selections must be made without knowledge of future requests. First, a static problem variant is studied to understand the impact of fixed appointment times on routing and scheduling decisions, independent of other complicating factors in the HHNRS problem. The costs of offering fixed appointment times are quantified, and purely distance-based heuristics are shown to have potential limitations for appointment time problems unless proposed arc cost transformations are used. Building on this result, a new rolling horizon capacity-based heuristic is developed for HHNRS problems. The heuristic considers interactions between travel times, service times, and the fixed appointment time menu when inserting appointments for currently revealed patient requests into partial nurse schedules. The heuristic is shown to outperform a distance-based heuristic on metrics which emphasize meeting as much patient demand as possible. The home health nurse districting (HHND) problem is a tactical planning problem which influences HHNRS problem solution quality. A set of geographic zones must be partitioned into districts to be served by home health nurses, such that workload is balanced across districts and nurse travel is minimized. A set partitioning model for HHND is formulated and a column generation heuristic is developed which integrates ideas from optimization and local search. Methods for estimating district travel and workload are developed and implemented within the heuristic, which outperforms local search on test instances.

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17

Barrowman, Gwynedd. "Factors influencing the outcome of community care in a quick response trial in St. John's, Newfoundland". Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1998. http://www.collectionscanada.ca/obj/s4/f2/dsk2/tape17/PQDD_0028/MQ34162.pdf.

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18

Park, Sun-Young. "Child Care Services: Two Statistical/Econometric Approaches to Household Choice and Demand /". The Ohio State University, 1995. http://rave.ohiolink.edu/etdc/view?acc_num=osu1487931512617121.

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19

梁振聲 e Chun-sing Anthony Leung. "Old People's community: care home". Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2001. http://hub.hku.hk/bib/B31985919.

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20

Svensson, Lembke Mattias. "Tokyo intergenerational day care center". Thesis, KTH, Arkitektur, 2013. http://urn.kb.se/resolve?urn=urn:nbn:se:kth:diva-122911.

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Japan is facing a great demographic shift, where by 2050 more than 40% of it's inhabitants will be over the age of 65 years. The womens emencipation from the role of stay at home mothers has allowed them to have careers of their own, although a good thing it does not leave a lot of room for starting a family in Japan's hard working climate. This new cultural norm has collided with the the long tradition of family care and Japan is now facing a large cultural collision, where there is a great lack of working solutions for child and senior care. The project suggests a prototypical intergenerational day care center for elderly and children in Tokyos dense now-rise residential neighborhoods. This form of care started being built in America during the 90's and has prooven to provide some of the best care availible for elderly and children.
Japan möter i dagsläget ett stort demografiskt skifte, till år 2050 kommer mer än 40% av befolkningen att vara över 65 år gamla. Kvinnornas frigörelse från hemmet har tillåtit dem att påbörja egna arbetsliv och karriärer, vilket inte lämnar mycket rum för att starta egen familj i Japans hårda arbetsklimat. Denna nya kulturella norm har kolliderat med den traditionella familjevården och Japan står idag utan en bra lösning för barn- och äldrevård. Det föreslagna projektet är ett prototypiskt intergenerationellt dagvårdscenter för barn och seniorer i Tokyos täta lågbebyggda bostadsområden. Intergenerationell vård började byggas under 90-talet i USA och har visat sig ge bland den bästa vården tillgänglig för barn och äldre.

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21

Pawlak, Rosalyn Joy. "Reasons Persons with Stroke Seek Health Care Services After Discharge Home". University of Toledo Health Science Campus / OhioLINK, 2006. http://rave.ohiolink.edu/etdc/view?acc_num=mco1147807021.

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22

Lau, Wai-kwan Dianna. "The utilisation of home care and residential care services by seniors in Canada: critical appraisal". Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2011. http://hub.hku.hk/bib/B4693862X.

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23

Milberg, Anna. "Family members' experience of palliative home care /". Linköping : Univ, 2003. http://www.bibl.liu.se/liupubl/disp/disp2003/med821s.pdf.

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24

Piercy, Kathleen Walsh. "Family ties and care for aged parents at home". Diss., This resource online, 1996. http://scholar.lib.vt.edu/theses/available/etd-06062008-154400/.

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25

Ndalambo, Kanku Tshibola. "Utilisation of home-based care services by the community of Caprivi Region in Namibia". Thesis, University of Limpopo (Medunsa Campus), 2010. http://hdl.handle.net/10386/698.

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Thesis (MPH) -- University of Limpopo, 2010.
Background Namibia is one of the country most affected by HIV/AIDS epidemic in the world and in Sub¬Sahara Africa with an adult prevalence of 19,7 %, and 210.000 people estimated to be living with HIV/AIDS at the end of 2003. The Caprivi region adult prevalence in adult pregnant wom~n is estimated at 43%. The health care services are overstrained with patients and home-based care (HBC) is seen a possible solution. The scale up of HBC and expansion of coverage to patients has lessened the burden of public hospitals to deal with all these chronically ill patients. The challenges that volunteers are facing impact in the quality of care people living with HIV I AIDS receive. Objectives This study assessed the utilization of home-based care service, knowledge and perception of People living with HIV and AIDS (PL WHA) toward home-based care services. The views of volunteers towards home-based care service are also reported. Methods This is a qualitative study that utilized Focus Group Discussions (FGDs) for the home-based care-givers and in-depth interview with the clients accessing antiretroviral treatment at Katima State Hospital. A total of four focus group discussions were organized with care-givers comprising 31 adult participants (15 males and 16 females) and 18 in-depth interviews were conducted with the people living with HIV and AIDS accessing antiretroviral treatment (ART) at Katima State Hospital. All FGDs were tape recorded and one-to-one interview was hand written. Result The study demonstrates that most of the participants have positive attitudes toward utilization of HBC service. However, few people are still afraid to disclose their health status. In general, the community participation has tremendously reduced stigmatization. The self-reported health status by the HBC givers in order to have access to nutrition support may have played a role in reducing the stigma associated with HIV and thus increased the number of people utilizing the HBC service. The HIV -positive participants valued the assistance received from the volunteers and volunteers appreciate the training received to enable them to undertake their duties with more confidence. The dress code of volunteers when visiting patients was perceived to disclose HIV status but did not influence patient attitude to access the service. Conclusion The improvement in community knowledge about HIV and HBC service has enhanced the positive attitude toward utilization of home-based care service which has consequently reduced the stigma associated with HIV. Advocacy is required to improve the working condition of volunteer care-givers home-based care by policy markers. The collaboration between different stakeholders will advance and sustain the HBC service in focusing on prevention of HIV infection.

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26

Smith, Margaret Anne. "Home parenteral nutrition in British Columbia". Thesis, University of British Columbia, 1987. http://hdl.handle.net/2429/26536.

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Parenteral nutrition is a therapy that supplies patients with all their nutritional requirements intravenously, thus eliminating the need for oral alimentation. The therapy was first introduced in the United States to hospitalized patients in the late 1960's. The benefit of long-term parenteral nutrition was soon recognized, and a program for ambulatory or home parenteral nutrition (HPN) was developed. In British Columbia, the first HPN patient was begun on such therapy in 1972. Since then, more than 50 British Columbians have received HPN. In March 1986, there were 24 patients on the program. The average annual cost per patient was $29,278 and the total 1986 operating budget was $702,660, not including costs for equipment or hospital training. Up to now, there has been no analytical assessment of the HPN program in B.C. This thesis describes the current home parenteral nutrition situation in B.C. and makes recommendations for its improvement. It looks at overall clinical outcomes (both physiological and psychosocial), at the results with different subgroups of the population, and at the cost of the HPN program in B.C., and also considers the potential of this therapy for children. In Chapter 2, the literature is reviewed and organized to cover a general description of HPN therapy, a summary of the results obtained from a number of academic centers, a review of HPN therapy in childhood and the psychosocial issues of concern to HPN patients. Chapter 3 provides a detailed description of the current HPN situation in B.C. The study methodology is described in Chapter 4 and the results in Chapter 5. The study is a descriptive analysis. Due to the lack of any obvious control group, a comparative evaluation per se was not possible. However, a Seattle study by Robb, reported in 1983, does allow for some comparison. The main sources of data were: 1. A Patient Questionnaire: The questionnaire was modelled on that used by the Seattle group. 23 B.C. patients, either on HPN at the time of questioning, or previously on the therapy, were surveyed. 19 (83%) responded. 2. A Health Professional Questionnaire: This questionnaire was compiled especially for and sent to all known health care workers in B.C. in the HPN field. 19 professionals, including physicians, nurses, pharmacists, dieticians, and administrators, were surveyed. 17 responded for a response rate of 89%. The patient survey provided basic demographic information, a description of HPN therapy received, as well as data on clinical outcomes, both physiological and psychosocial. Results showed that patient age, length of time on HPN, numbers of hours per week devoted to HPN, occupation and place of residence were the most important variables for predicting patient outcomes. Thus, patients that were older, had been on HPN less than one year, or spent more than 80 hours per week preparing and administering HPN solutions, had more physiological complaints and showed interference with more daily activities and personal relationships. Patients who were employed, rated the HPN experience more positively. Overall, patients found the HPN experience to be a positive one, although this was not true for a small group of patients. Data also indicated that B.C. patients achieved physiological results similar to the Seattle group, and to other centers reported in the literature, but appeared to have more interference with daily activities and personal relationships than did patients from the Seattle study. The health professional survey indicated that professionals considered the current situation in B.C. to be good with respect to patient training and the complication rate achieved. However, patient follow-up and the psychosocial support provided to patients were rated only fair to poor. These health care professionals cited problems with the program's organization, the need to standardize service to all patients, and the need to provide patients with pre-mixed solutions. In conclusion, some recommendations are made for improvement in the B.C. HPN program.
Medicine, Faculty of
Population and Public Health (SPPH), School of
Graduate

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27

Kong, Juo-Yi. "The caregivers' experience of the effect of multiple therapies at home". Diss., Online access via UMI:, 2006.

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28

Grenier, Amanda. "Home care : evaluation of a case management model". Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1998. http://www.collectionscanada.ca/obj/s4/f2/dsk1/tape11/PQDD_0023/MQ50698.pdf.

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Peoples, Paula Beth. "Pay-per-visit for Home Health Agency nurses". CSUSB ScholarWorks, 1997. https://scholarworks.lib.csusb.edu/etd-project/1410.

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Tran, Thi Hanh Wirat Kamsrichan. "Home care status for the elderly in Omon District, Cantho City, Vietnam /". Abstract, 2005. http://mulinet3.li.mahidol.ac.th/thesis/2548/cd376/4737969.pdf.

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31

Gustafsson, Gerd. "En omsorgstriad : om relationer mellan omsorgsmottagare, vårdbiträden och hemtjänstassistenter /". Göteborg : Göteborgs universitet, Institutionen for socialt arbete, 1999. http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&doc_number=008432323&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA.

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32

Baker, Kay Stouffer. "Home care clients' perceptions of nursing invasiveness, territorial control, and satisfaction with nursing care". Thesis, The University of Arizona, 1987. http://hdl.handle.net/10150/276586.

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This descriptive correlational study describes the relationships among 30 home care clients' perceptions of nursing invasiveness, territorial control, and satisfaction with nursing care. The self-report data were collected using a Nursing Invasiveness Scale (NIS), Index of Patient Territorial Control Perceptions (IPTCP), and Patient Satisfaction Instrument (PSI). The subjects were males and females, aged 23 to 93 years, who were receiving home care nursing. Analysis of the data suggests that the subjects perceived a low level of invasiveness by home care nurses, "much control" within their homes (their primary territories), and were highly satisfied with their nursing care. There was a significant negative correlation (r = -0.79) between perceptions of nursing invasiveness and satisfaction with nursing care. The relationships between perceptions of nursing invasiveness and territorial control (r = -0.02) and between perceived territorial control and satisfaction with nursing care (r = 0.14) were not significant.

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Yu, Mei-yuk Doris, e 余美玉. "The perceptions of home help services recipients towards institutionalservices". Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 1997. http://hub.hku.hk/bib/B31978393.

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34

Damberg, Jonas. "Availability of primary care physicians in nursing homes and home care nursing services and associations with emergency care consumption". Thesis, Örebro universitet, Institutionen för medicinska vetenskaper, 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-61585.

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35

Forbat, Liz. "Exploring accounts of care : two sides to the story". n.p, 2001. http://library7.open.ac.uk/abstracts/page.php?thesisid=84.

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36

Ellis, Kimberly R. "Foster parents' perceptions of independent living services for youth who age out of the system". Menomonie, WI : University of Wisconsin--Stout, 2004. http://www.uwstout.edu/lib/thesis/2004/2004ellisk.pdf.

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37

Johnson, Lula Juanita. "The effects of home based primary care with chronically ill older adults on visits to the emergency department, hospitalization, and bed days of care". free to MU campus, to others for purchase, 2004. http://wwwlib.umi.com/cr/mo/fullcit?p1422981.

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Heston, Jennifer L. "The Role of Direct Care Workers in Person-Centered Home Care". Miami University / OhioLINK, 2017. http://rave.ohiolink.edu/etdc/view?acc_num=miami1491987309873559.

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39

Gurumurthy, Prakash. "Dynamic stochastic vehicle routing model in home healthcare scheduling /". free to MU campus, to others for purchase, 2004. http://wwwlib.umi.com/cr/mo/fullcit?p1426064.

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Hodge, Patricia Ann. "The family support services study". CSUSB ScholarWorks, 1989. https://scholarworks.lib.csusb.edu/etd-project/547.

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41

Shozi, Nobubele Angel. "Factors affecting the use of mobile devices for remote data collection in home community based care". Thesis, Nelson Mandela Metropolitan University, 2012. http://hdl.handle.net/10948/d1012621.

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The health care systems of developing countries, which are already weak, have to carry an additional strain brought on by the burden of infectious diseases. This added strain means that the health care provided is not of the highest quality. The use of home community based care (HCBC) was introduced as an attempt to provide basic health care services to people through the services of community health care workers (CHCW). With the development of HCBC in developing countries and the CHCW playing a vital role in ensuring that the lives of people living with diseases are improved, the need for information and communication technology (ICT) solutions is increased. The information that is collected by the CHCW is paper-based and it cannot be analysed and used efficiently and effectively. This study embraces the adoption of a socio-technical perspective when an ICT solution is introduced in an environment. A socio-technical perspective focuses on three dimensions: the user, the environment and the technology used. These three need to be in coherence to ensure that the technology is used effectively by the user within the environment. Therefore the objective of this study is to identify a list of socio-technical factors that affect CHCWs when they are using mobile phones for data collection purposes in home community based care. In order to achieve this it was necessary to understand how the socio-technical subsystems of the HCBC environment are constituted. The study followed a qualitative approach, including interviews and observations, to collect the data which will best enable the researcher to understand the home community based care environment, its people and the use of the technology to collect data in this environment, in particular mobile phones. A qualitative content analysis approach was followed to analyse the data and constitute a list of factors affecting the use of mobile devices for remote data collection in home community based care. It is hoped that this research will assist to inform the design of appropriate mobile health applications to both ease the burden of CHCWs (i.e. it should be faster and easier to use than paper) and improve the healthcare service provided through enabling access to patient records to all partners in the care continuum.

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42

Chaava, Thebisa Hamukoma. "Skills, training and support for carers in HIV/AIDS community home-based care: a case study of carers in Chikankata, Zambia". Thesis, University of the Western Cape, 2005. http://etd.uwc.ac.za/index.php?module=etd&amp.

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The high prevalence of HIV/AIDS in Zambia has led to the development of innovative ways of coping with sickness related to this infection. HIV/AIDS home-based care is one such innovation designed in Chikankata Hospital in 1987. Home-based care depends on the availability of family members and community volunteers in the provision of care and support for People Living with HIV/AIDS (PLWHA).

This minithesis is based on a qualitative descriptive case study exploring perspectives regarding skills, supervision and support mechanisms for carers in the Chikankata HIV/AIDS Community-Home Based Care (CHBC) program. The study utilized documented research, focus group discussions with carers and structured interviews with local CHBC supervisors, national experts in CHBC, and PLWHA and their families, to collect data from 32 study participants.

The findings were that CHBC was being delivered by community volunteers with limited involvement from the local health services
that carers were highly motivated, personally and collectively mobilizing resources to meet the needs of CHBC clientele
that local arrangements for training, skills and support of carers were not aligned to national guidelines regarding process, content and duration of programmes
and that carers acquired skills in CHBC through formal and informal training processes and were facing challenges related to inadequate skills, poor infrastructure and extreme poverty in households caring for PLWHA.

Based on the findings the local arrangements for coordination of CHBC need to be strengthened and linked to formal processes for technical support, financial resources and materials for delivery of CHBC in line with existing guidelines on CHBC. The picture of the real situation of the carers that emerges from this qualitative study might inform the supervising organizations and policymakers on the gaps in the training and support of this crucial cadre in the provision of quality care for People Living with HIV/AIDS (PLWHA) at community level.

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Abraham, Warren. "Community participation in health: Home/community-based care as an alternative strategy to institutional care – a case study of Dunoon home-based caregivers". University of the Western Cape, 2011. http://hdl.handle.net/11394/5223.

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Magister Artium (Development Studies) - MA(DVS)
In South Africa, since 2000, an increase of awareness in community involvement has become apparent, owing to the response from people to the need to be more engaged in decisions pertaining to their community. This positive move echoes an increasing acknowledgement by those in authority that community participation is essential to the main demands of renewing democracy, expanding service provision and constructing robust communities. The development of innovative patterns of participation development means that local communities should be empowered to participate in decision making, whilst government establishments need to have the determination and ability to respond to various community needs. The Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome (HIV/AIDS) pandemic has placed an enormous responsibility on public health services, such as South African hospitals, which are already functioning with limited resources. This has shifted the load of nursing to family members and communities as public health services are often stretched beyond their limits. Several community or home-based care programmes and facilities have materialised in reply to this necessity. In the context of participation of communities, the duty of community involvement in health plays a vital role in the future of public health in South Africa. Accordingly, this research was conducted to explore the nature and extent of community participation within the HIV/AIDS context in the Dunoon suburb in the Western Cape. An empirical research design, which consisted of qualitative methods, was used in this exploratory study to investigate the nature and extent of home-based care as an alternative strategy to institutional care. The research population was comprised of community members at the Dunoon informal settlement, the home-based workers employed at Heavenly Promise NGO, as well as staff and management of the Caltex/Chevron Refinery, members of Project Management 4 Africa (PM4A) and representatives of the Department of Social Development (DSD), which together constitute the partnership that is dedicated to combating the spread of HIV/AIDS in Dunoon. In general, the research findings demonstrate that home-based caregivers displayed strong levels of participation right from the outset of the project. The findings also established that participation among the community members was a combination of passive, weak and non-participatory, whereas home-based carers displayed a level of active participation. Furthermore, home-based care staff played a key role in decision making, while carers essentially undertook the work in the community. Hence, home-based care and communities participating in health matters are considered to be substantial as home care focuses primarily on palliative care of the patient at home, with the support of the family and the immediate community. Consequently, it is hoped that this research will prove significant and will enhance the existing knowledge of the potential benefits of home-based care as an alternative strategy to institutional care.

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Yalcindag, Semih. "Human resource planning models for home health care services : assignment and routing problems". Thesis, Châtenay-Malabry, Ecole centrale de Paris, 2014. http://www.theses.fr/2014ECAP0041.

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L'affectation des patients aux soignants et le séquencement des visites à effectuer par les soignants sont deux problématiques intéressantes observées dans les établissements de soins décentralisés tels que les établissements d'HAD (Hospitalisation à Domicile), de SSIAD (Soins et services infirmiers à Domicile) ou de MAD (Maintien à Domicile). Le premier problème consiste en effet à décider quels soignants fourniront quels services (visites) à quels patients, tandis que le second vise à déterminer la séquence de visites de chaque soignant. Du point de vue de la modélisation, ces deux problèmes peuvent être résolus par une approche séquentielle qui comprend deux étapes ou une approche simultanée. Bien que les résultats de l'approche simultanée soient plus précis en raison de la résolution des problèmes d'affectation et de routage en même temps, son application semble être peu adaptée à des situations réelles, souvent de grande échelle. Dans cette thèse, nous nous concentrons sur l'approche en deux étapes qui considère successivement le problème d'affectation (assignment) et de séquencement (routing) afin de comparer ses performances à celles obtenues par l'approche simultanée. Ainsi, plusieurs variantes de modèles mathématiques sont développées en tenant compte de : (1) la compatibilité de compétences entre les patients et les opérateurs, (2) périodes de planification uniques ou multiples, (3) contraintes au niveau des capacités disponibles des soignants. Le verrou scientifique au niveau de l'approche en deux étapes concerne essentiellement l'estimation de la durée des déplacements des soignants, estimations qui sont nécessaires pour résoudre le problème d'affectation. A cette fin, nous proposons une méthode utilisant des données empiriques basée sur la technique de régression de Kernel (Kernel Regression Technique) permettant d'estimer les durées de déplacement. Cette méthode utilise des données historiques sur les durées de déplacement qui intègrent plusieurs facteurs réalistes concernant les conditions cliniques des patients et les conditions géographiques, ou encore les préférences personnelles des soignants afin d'estimer la durée nécessaire pour visiter un ensemble de patients situés dans la zone de service donnée. Des études numériques basées sur des données réelles en provenance d'un établissement d'HAD italien sont réalisées pour analyser les performances de la méthode d'estimation proposée. Les résultats obtenus montrent que cette nouvelle méthode d'estimation ainsi que l'approche en deux étapes sont des approches prometteuses pour traiter des problématiques de planification de ressources humaines dans les établissements d' HAD, SSIAD ou MAD
The care givers' assignment and routing problems are relevant issues for Home Health Care (HHC) service providers. The first problem consists of deciding which care givers will provide services to which patients, whereas the second aims at determining the visiting sequences of care givers. From a modelling perspective, these problems can be solved with either a two-stage approach or a simultaneous approach. Although the currently most known simultaneous approach yields more accurate results by solving the assignment and routing problems at the same time, its resolution remains computationally difficult and not viable for large scale applications. In this thesis, we focus on the two-stage approach that sequentially solves an assignment and a routing problem in order to compare its performances to those of the simultaneous approach. Hence, several variants of mathematical models are developed by taking into account: (1) the skill compatibilities between patients and operators; (2) single or multiple planning periods; (3) imposed or released operator capacity restrictions. An important point regarding the two stage approach concerns the estimation of care givers' travel times that are required to solve the assignment problem. For this purpose, we propose an empirical data-driven method that is based on the Kernel Regression technique to estimate travel times. Such a method uses care givers' historical travel times that integrate several realistic factors such as cared patients' clinical conditions and locations or care givers' personal preferences to estimate the time necessary for visiting a set of patients located in the HHC service area. Numerical studies based on realistic problem instances are used to analyze the performances of the proposed data-driven travel time estimation method and the two-stage approach. Results obtained show that both the newly developed travel time estimation method and the two-stage models are promising approaches for the HHC human resource planning process

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45

Chang-ChengHsieh e 謝昌成. "To identify the association between home care services and the outcomes of home care clients". Thesis, 2010. http://ndltd.ncl.edu.tw/handle/60765939463921983584.

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碩士
國立成功大學
老年學研究所
98
Due to the growing of ageing population, the impact of disability and the need of long term care became more significant in Taiwan. The home care service under the payment of national health insurance is the way to achieve continuous care and ageing in place for patients who need nursing skill service. The aim of the study is to identify the demographic and clinical characters of the home care clients, and to investigate the associated factors and possible affect factors related to the changes of outcome indexes during the period of receiving home care services. The study duration was from Sep 2, 2009 to Mar 22, 2010. The study sample was the new cases of home care services in a regional teaching hospital at Chia-yi. The study design was retrospective cohort study with the manner of chart review. We used the structured questionnaire to collect the data from 156 charts. Total 128 cases (82%) were included and 28 cases (18%) were excluded according to the inclusion and exclusion criteria. The study results showed the average age of clients was 73.30±14.97 years old and 79.7% of the clients were older than 65 years old. The dominant demographic characters of clients were female gender, married status, low education level, referred from hospital, used national health insurance as the main medical support, fair economical status and the child was the main resource of economical support. The clinical characteristics of clients including circulatory system disease as the main disease diagnosis, moderate disease severity, alert consciousness, nearly total dependence (the score of Barthel index was zero point in 84.4% of the clients). The care need were nasogastric tube care/change, Foley catheter care/change, pressure sore care and tracheostomy tube care/change in sequence. The class of clients’ mini nutritional assessment was malnutrition, the class of serum albumin deficiency was mild and the body mass index was normal in most clients. The demographic characters of main caregiver were female gender, foreign nursing worker and being full-time. Half of the caregiver was Taiwanese and the other wasn’t. Almost foreign caregiver were foreign nursing worker. In the aspect of client’s family and social network, most of the clients lived with others and had someone lived nearby could help to care them. The main service received was solely home care service and the extra-service received was nutrition consultation. In the aspect of outcome index, the number of admission was 0.32±0.65 and receiving emergency service was 0.38±0.70 within four months. Comparing the baseline data, no outcome index has difference, except the area of pressure sore (p=0.000), the score of mini nutritional assessment (p=0.000) and the level of albumin (p=0.001) had significant improvement. We used the linear regression model to analyze the results and showed “the area of pressure sore in baseline” was the affected factor of pressure sore improvement. The affected factors of improvement of mini nutritional assessment were “the referred source of clients” and “the score of mini nutritional assessment in baseline”. The affected factor of improvement of the level of albumin was “the baseline albumin level”. We hoped the study results could be the foundation for improvement of clients’ outcome and quality of home care services.

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46

Macmillan-Scattergood, Donna Jean. "Organizational factors associated with home care agencies' care of the indigent /". 1988. http://wwwlib.umi.com/dissertations/fullcit/8919077.

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Lo, Hsien-Hao, e 羅顯灝. "Development of Home-Care Services in Smart Homes". Thesis, 2017. http://ndltd.ncl.edu.tw/handle/81729957048913456981.

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碩士
國立中興大學
資訊科學與工程學系
105
The aging country population structure has caused huge long-term influences. On the basis of the past experience of life, many elders need life care and health care. Even elders with capability of taking care of himself, they still suffer from inconvenience in their daily life. The people who need to be taken care also include persons with disabilities or injuries, e.g., the people whose need to wheelchairs. These people could suffer from difficulties even for switching lights actions in homes. In this work, we design an application of intelligent home devices based on Amazon Echo system. We use the Alexa Skill Kit to develop a voice control system for the home appliances. The system employs RFID for security authentication to keep strangers from manipulating private devices. We also integrate fall detection with the system to monitor the safety of elderly or patients. When a fall is detected, the system informs the caregiver immediately for promptly medical care.

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48

Kuo, Ya-hui, e 郭雅惠. "Program Evaluation of Home Care Services for Elderly". Thesis, 2008. http://ndltd.ncl.edu.tw/handle/73152976437802721448.

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碩士
雲林科技大學
全球運籌管理研究所碩士班
96
The purpose of this study is to find out the factors influencing the elder’s satisfaction through questionnaire. Moreover, this study was to explore the factors of influencing outcomes and quality by in-depth interviewing. Study subjects were drawn from some association in the central area of Taiwan. This study investigated 83 elders, and 81 questionnaires were completed. The mean score of the situation of service attendants were 4.07 and the mean score of the attitude of service attendants were 4.05. Overall, participants felt satisfied with both home help services and the subsidy program provided by the government for long-term care. The mean score were 3.53. The main findings of the qualitative study were summarized as follows: The offering of the service is full of considerate and supportive for elders. The satisfaction of elders were affected by solved method and reaction time. While the resource is limited, the government should subsidize for needful and poor elders. The results of the study may provide some information for improvement.

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49

Legault, Mary Theresa Frances. "Home care nurses’ contribution to the integration of palliative care services". Thesis, 2001. http://hdl.handle.net/2429/12836.

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The purpose of this study was to explore and interpret the contribution of nurses in the development and provision of integrated palliative care services for diverse populations. This issue has emerged as a relevant policy challenge. Many researchers and policy makers have recognized barriers to access and gaps in the utilization of services. The specific elements of quality palliative care in the home are not well understood. Ethical issues are challenging for nurses and families. Another major gap was to determine appropriate services to meet the care requirements for marginalized populations. Ethnographic approaches are ideally suited to the study of health services, such as palliative home care, to develop a narrative description and analysis of the experiences of a particular group of people, as well as events, and trends. In total, there were 52 participants including home care clients, their family members, home care and shift care nurses, clinical nurse specialists, nursing administrators, and a hospice physician. Data collection methods included participant observation, fieldnotes, interviews, and documentary review during fieldwork that occurred over a two-year period. Findings of this study are organized into three major themes that emerged from the data. The first was that home care nurses made valuable contributions to quality of life and quality of palliative care through coordination and integration of services amidst the complexities and challenges of the health care system. The second theme illustrated dramatic differences in quality of life and quality of care for mainstream and marginalized populations as reflected in the client and family experiences, nursing practice, and program models of care. Critical tensions within the health care system comprised the third theme, which showed that current programs are unable to keep pace with the rising expectations and demands for services. By examining these findings in the context of the existing empirical and theoretical literature, several issues became evident. The nature of palliative care is dynamic and changing. Within the mainstream context, programs must be responsive to specific needs of extended segments of the population including people with long-term and chronic illness, the elderly, and cultural minorities. For marginalized people, the challenge will be to provide specialized services based on the principles of harm reduction for primary care, crisis care, hospice care, and long term care. The complexity of home care nursing practice is reflected in the multiple dimensions of personal qualities and competencies required for providing quality palliative care and coordinating and integrating services. A vision of integration for community-based palliative care services entails the development of regional networks that address the needs of diverse populations and ensure accountability for resources and quality of care, within the framework of national initiatives for the reform of health care and social policies. Building family and community capacity and strengthening the ability of home care nurses to contribute their knowledge and expertise will ensure future development and integration of quality palliative care services. These challenges are consistent with the need to continually renew and adapt all aspects of the health care system to address the changing nature of society and its evolving health concerns through public participation and active involvement of nurses.

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Hunter, Nina. "Measuring and valuing unpaid care work : assessing the gendered implications of South Africa's home-based care policy". Thesis, 2010. http://hdl.handle.net/10413/1000.

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Teses / dissertações sobre o tema "Home care services – Japan"

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