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[1384 house calls to elderly patients in family practice. From diagnosis-prescriptions-examination in Møre and Romsdal]

https://arctichealth.org/en/permalink/ahliterature72638
Source
Tidsskr Nor Laegeforen. 1997 Nov 10;117(27):3984-7
Publication Type
Article
Date
Nov-10-1997
Author
J. Straand
H. Sandvik
Author Affiliation
Seksjon for allmennmedisin, Universitetet i Bergen.
Source
Tidsskr Nor Laegeforen. 1997 Nov 10;117(27):3984-7
Date
Nov-10-1997
Language
Norwegian
Publication Type
Article
Keywords
Aged
Cardiovascular Diseases - diagnosis - drug therapy - epidemiology
English Abstract
Family Practice - statistics & numerical data
Female
Health Services for the Aged - statistics & numerical data
Home Care Services - statistics & numerical data
House Calls - statistics & numerical data
Humans
Male
Mental Disorders - diagnosis - drug therapy - epidemiology
Musculoskeletal Diseases - diagnosis - drug therapy - epidemiology
Norway - epidemiology
Prescriptions, Drug - statistics & numerical data
Registries
Respiratory Tract Diseases - diagnosis - drug therapy - epidemiology
Abstract
Over a period of two months in 1988 and 1989 all general practitioners in the Norwegian county of Møre and Romsdal recorded all contacts with their patients. We report data from 1,384 house calls to elderly patients (65 years and older). House calls made up 11.3% of all face-to-face contacts between general practitioners and elderly patients. 59% of the visits were to female patients, and 60% were to patients 75 years and older. 23% of the house calls took place during weekends, and new diagnoses were made in 58% of the cases. The most common groups of diagnoses were cardiovascular (21%), respiratory (16%), and musculoskeletal diseases (13%). Drugs were prescribed for 42% of the house calls. 28% of all drugs prescribed were for the nervous system, while 26% were antibiotics for systemic use. Most house calls were made because of acute illnesses. Our results suggest that preventive home visits to the elderly are rarely, if ever, performed in general practice.
PubMed ID
9441428 View in PubMed
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Ability to estimate oral health status and treatment need in elderly receiving home nursing--a comparison between a dental hygienist and a dentist.

https://arctichealth.org/en/permalink/ahliterature62818
Source
Swed Dent J. 2000;24(3):105-16
Publication Type
Article
Date
2000
Author
T. Nederfors
G. Paulsson
R. Isaksson
B. Fridlund
Author Affiliation
Oral Health Centre, Central Hospital, Halmstad, Sweden.
Source
Swed Dent J. 2000;24(3):105-16
Date
2000
Language
English
Publication Type
Article
Keywords
Aged
Comparative Study
Dental Care for Aged - methods - statistics & numerical data
Dental Hygienists - statistics & numerical data
Dentists - statistics & numerical data
Diagnosis, Oral - methods - statistics & numerical data
Health Services Needs and Demand - statistics & numerical data
Home Care Services - statistics & numerical data
Humans
Observer Variation
Oral Health
Research Support, Non-U.S. Gov't
Statistics, nonparametric
Sweden
Abstract
The aim of this study was to compare the estimation ability of a dental hygienist to that of a dentist when, independently, recording the oral health status and treatment need in a population of elderly, receiving home nursing. Seventy-three persons, enrolled in a home nursing long-time care programme, were recruited. For the oral examination a newly developed protocol with comparatively blunt measurement variables was used. The oral examination protocol was tested for construct validity and for internal consistency reliability. Statistical analyses were performed using Wilcoxon matched pairs signed rank sum test for testing differences, while inter-examiner agreement was estimated by calculating the kappa-values. Comparing the two examiners, good agreement was demonstrated for all mucosal recordings, colour, form, wounds, blisters, mucosal index, and for the palatal but not the lingual mucosa. For the latter, the dental hygienist recorded significantly more changes. The dental hygienist also recorded significantly higher plaque index values. Also regarding treatment intention and treatment need, the dental hygienist's estimation was somewhat higher. In conclusion, when comparing the dental hygienist's and the dentist's ability to estimate oral health status, treatment intention, and treatment need, some differences were observed, the dental hygienist tending to register "on the safe side", calling attention to the importance of inter-examiner calibration. However, for practical purpose the inter-examiner agreement was acceptable, constituting a promising basis for future out-reach activities.
PubMed ID
11061208 View in PubMed
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Adequacy of nutrient intake among elderly persons receiving home care.

https://arctichealth.org/en/permalink/ahliterature154657
Source
J Nutr Elder. 2008;27(1-2):65-82
Publication Type
Article
Date
2008
Author
C Shanthi Johnson
Monirun Nessa Begum
Author Affiliation
Faculty of Kinesiology and Health Studies, University of Regina, Regina, Saskatchewan, Canada. shanthi.johnson@uregina.ca
Source
J Nutr Elder. 2008;27(1-2):65-82
Date
2008
Language
English
Publication Type
Article
Keywords
Age Distribution
Aged
Aged, 80 and over
Diet - methods - statistics & numerical data
Eating
Female
Frail Elderly - statistics & numerical data
Geriatric Assessment - methods - statistics & numerical data
Health status
Home Care Services - statistics & numerical data
Humans
Male
Nutrition Assessment
Nutritional Status
Ontario
Questionnaires
Risk assessment
Risk factors
Sex Distribution
Abstract
This study examines the adequacy of the dietary intake based on age, sex, and level of nutritional risk among 98 frail elderly persons receiving home care through Community Care Access Centres. The dietary intakes were measured using 24-hour recalls and were compared with the dietary reference intake. The participants' intakes of both macronutrients and micronutrients were found to be inadequate. On average, elderly persons were consuming more than the recommended amount of protein, but the average intakes of many vitamins and minerals were less than optimal based on the average intakes. Paradoxically, more than half of elderly participants were overweight or obese. The results highlight the need for appropriate nutrition, education, and support for elderly persons receiving home care.
PubMed ID
18928191 View in PubMed
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Adverse events experienced by homecare patients: a scoping review of the literature.

https://arctichealth.org/en/permalink/ahliterature145478
Source
Int J Qual Health Care. 2010 Apr;22(2):115-25
Publication Type
Article
Date
Apr-2010
Author
Paul Masotti
Mary Ann McColl
Michael Green
Author Affiliation
Centre for Health Services and Policy Research, Queen's University, Kingston, ONT, Canada. masottip@queensu.ca
Source
Int J Qual Health Care. 2010 Apr;22(2):115-25
Date
Apr-2010
Language
English
Publication Type
Article
Keywords
Accidental Falls - statistics & numerical data
Bacterial Infections - epidemiology
Canada
Drug-Related Side Effects and Adverse Reactions - epidemiology
Health Services Research
Home Care Services - statistics & numerical data
Humans
Incidence
Medication Adherence
Pressure Ulcer - epidemiology
Prevalence
Public Policy
Safety Management
Wounds and Injuries - epidemiology
Abstract
The paper summarizes the results of a scoping review that focused on the occurrence of adverse events experienced by homecare patients.
The literature search covered published and grey literature between 1998 and 2007. Databases searched included: MEDLINE, EMBASE, CINAHL and EBM REVIEWS including the Cochrane Library, AGELINE, the National Patient Safety Foundation Bibliography, Agency for Healthcare Research and Quality and the Patient Safety Net bibliography.
Papers included research studies, review articles, policy papers, opinion articles and legal briefs. Inclusion criteria were: (i) homecare directed services provided in the home by healthcare professionals or caregivers; (ii) addressed a characteristic relevant to patient experienced adverse events (e.g. occurrences, rates, definitions, prevention or outcomes); and (iii) were in English. Data extraction A pool of 1007 articles was reduced to 168 after analysis. Data were charted according to six categories: definitions, rates, causes, consequences, interventions and policy.
Eight categories emerged: adverse drug events, line-related, technology-related, infections and urinary catheters, wounds, falls, studies reporting multiple rates and other. Reported overall rates of adverse events ranged from 3.5 to 15.1% with higher rates for specific types. Few intervention studies were found. Adverse events were commonly associated with communication problems. Policy suggestions included the need to improve assessments, monitoring, education, coordination and communication.
A standardized definition of adverse events in the homecare setting is needed. Prospective cohort studies are needed to improve estimates and intervention studies should be undertaken to reduce the risk that homecare patients will experience adverse events.
Notes
Comment In: Int J Qual Health Care. 2010 Apr;22(2):75-720144941
PubMed ID
20147333 View in PubMed
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The amount of informal and formal care among non-demented and demented elderly persons-results from a Swedish population-based study.

https://arctichealth.org/en/permalink/ahliterature70588
Source
Int J Geriatr Psychiatry. 2005 Sep;20(9):862-71
Publication Type
Article
Date
Sep-2005
Author
G. Nordberg
E. von Strauss
I. Kåreholt
L. Johansson
A. Wimo
Author Affiliation
Aging Research Center (ARC), Box 6401, 113 82 Stockholm, Sweden. Gunilla.Nordberg@neurotec.ki.se
Source
Int J Geriatr Psychiatry. 2005 Sep;20(9):862-71
Date
Sep-2005
Language
English
Publication Type
Article
Keywords
Activities of Daily Living
Aged
Aged, 80 and over
Cognition Disorders - etiology - nursing
Dementia - nursing - psychology
Female
Health Services Research
Health Services for the Aged - statistics & numerical data
Home Care Services - statistics & numerical data
Home Nursing - statistics & numerical data
Humans
Longitudinal Studies
Male
Psychiatric Status Rating Scales
Research Support, Non-U.S. Gov't
Rural Health Services - statistics & numerical data
Sweden
Abstract
BACKGROUND: Developed countries are experiencing a dramatic increase in the proportion of elderly persons, as well as a progressive aging of the elderly population itself. Knowledge regarding the amount of formal and informal care and its interaction at population-based level is limited. OBJECTIVES: To describe the amount of formal and informal care for non-demented and demented persons living at home in a population-based sample. METHODS: The population consisted of all inhabitants, 75 + years, living in a rural community (n = 740). They were clinically examined by physicians and interviewed by nurses. Dementia severity was measured according to Washington University Clinical Dementia Rating Scale (CDR). Informal and formal care was examined with the RUD (Resource Utilization in Dementia) instrument. RESULTS: The amount of informal care was much greater than formal care and also greater among demented than non-demented. There was a relationship between the severity of the cognitive decline and the amount of informal care while this pattern was weaker regarding formal care. Tobit regression analyses showed a clear association between the number of hours of informal and formal care and cognitive decline although this pattern was much stronger for informal than formal care. CONCLUSIONS: Informal care substitutes rather than compliments formal care and highlights the importance of future studies in order to truly estimate the amount of informal and formal care and the interaction between them. This knowledge will be of importance when planning the use of limited resources, and when supporting informal carers in their effort to care for their intimates.
PubMed ID
16116583 View in PubMed
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Assessing adverse events among home care clients in three Canadian provinces using chart review.

https://arctichealth.org/en/permalink/ahliterature112470
Source
BMJ Qual Saf. 2013 Dec;22(12):989-97
Publication Type
Article
Date
Dec-2013
Author
Régis Blais
Nancy A Sears
Diane Doran
G Ross Baker
Marilyn Macdonald
Lori Mitchell
Stéphane Thalès
Author Affiliation
Department of Health Administration, University of Montreal, , Montréal, Québec, Canada.
Source
BMJ Qual Saf. 2013 Dec;22(12):989-97
Date
Dec-2013
Language
English
Publication Type
Article
Keywords
Aged
Canada - epidemiology
Confidence Intervals
Home Care Services - statistics & numerical data
Humans
Logistic Models
Medical Audit
Medical Errors - statistics & numerical data - trends
Patient Safety
Quality of Health Care
Retrospective Studies
Wounds and Injuries - epidemiology
Abstract
The objectives of this study were to document the incidence rate and types of adverse events (AEs) among home care (HC) clients in Canada; identify factors contributing to these AEs; and determine to what extent evidence of completion of incident reports were documented in charts where AEs were found.
This was a retrospective cohort study based on expert chart review of a random sample of 1200 charts of clients discharged in fiscal year 2009-2010 from publicly funded HC programmes in Manitoba, Quebec and Nova Scotia, Canada.
The results show that 4.2% (95% CI 3.0% to 5.4%) of HC patients discharged in a 12-month period experienced an AE. Adjusting to account for clients with lengths of stay in HC of less than 1 year, the AE incidence rate per client-year was 10.1% (95% CI 8.4% to 11.8%); 56% of AEs were judged preventable. The most frequent AEs were injuries from falls, wound infections, psychosocial, behavioural or mental health problems and adverse outcomes from medication errors. More comorbid conditions (OR 1.15; 95% CI 1.05 to 1.26) and a lower instrumental activities of daily living score (OR 1.54; 95% CI 1.16 to 2.04) were associated with a higher risk of experiencing an AE. Clients' decisions or actions contributed to 48.4% of AEs, informal caregivers 20.4% of AEs, and healthcare personnel 46.2% of AEs. Only 17.3% of charts with an AE contained documentation that indicated an incident report was completed, while 4.8% of charts without an AE had such documentation.
Client safety is an important issue in HC, as it is in institutionalised care. HC includes the planned delivery of self-care by clients and care provision by family, friends and other individuals often described as 'informal' caregivers. As clients and these caregivers can contribute to the occurrence of AEs, their involvement in the delivery of healthcare interventions at home must be considered when planning strategies to improve HC safety.
Notes
Cites: Ann Pharmacother. 1999 Nov;33(11):1147-5310573310
Cites: BMJ. 2001 Mar 3;322(7285):517-911230064
Cites: J Am Geriatr Soc. 2001 Jun;49(6):719-2411454109
Cites: N Z Med J. 2002 Dec 13;115(1167):U27112552260
Cites: CMAJ. 2004 May 25;170(11):1678-8615159366
Cites: Gerontologist. 2004 Oct;44(5):665-7915498842
Cites: Biometrics. 1977 Mar;33(1):159-74843571
Cites: N Engl J Med. 1991 Feb 7;324(6):370-61987460
Cites: Med J Aust. 1995 Nov 6;163(9):458-717476634
Cites: Jt Comm J Qual Improv. 1995 Oct;21(10):541-88556111
Cites: J Eval Clin Pract. 1999 Feb;5(1):5-1210468379
Cites: Qual Saf Health Care. 2006 Feb;15(1):39-4316456208
Cites: Healthc Q. 2006;9 Spec No:127-3417087182
Cites: BMJ. 2007 Jan 13;334(7584):7917175566
Cites: Home Healthc Nurse. 2007 Mar;25(3):191-717353712
Cites: Int J Qual Health Care. 2008 Apr;20(2):130-518158294
Cites: J Nurs Manag. 2009 Mar;17(2):165-7419416419
Cites: J Patient Saf. 2010 Dec;6(4):247-5021500613
Cites: Int J Qual Health Care. 2013 Feb;25(1):16-2823283731
PubMed ID
23828878 View in PubMed
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Assessing venous ulcer population characteristics and practices in a home care community.

https://arctichealth.org/en/permalink/ahliterature185512
Source
Ostomy Wound Manage. 2003 May;49(5):32-4, 38-40, 42-3
Publication Type
Article
Date
May-2003
Author
Karen R Lorimer
Margaret B Harrison
Ian D Graham
Elaine Friedberg
Barbara Davies
Author Affiliation
Clinical Epidemiology Program, Ottawa Health Research Institute, Canada. klorimer@ohri.ca
Source
Ostomy Wound Manage. 2003 May;49(5):32-4, 38-40, 42-3
Date
May-2003
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Female
Home Care Services - statistics & numerical data
Humans
Male
Middle Aged
Ontario - epidemiology
Physician's Practice Patterns - statistics & numerical data
Varicose Ulcer - epidemiology - therapy
Abstract
To plan for a new community leg ulcer service in one Ontario region, venous ulcer population characteristics and current community care practices were obtained from a home care cohort of people with venous ulcers. A secondary analysis was conducted on the venous ulcer cohort using data collected during a Regional Prevalence and Profile Study. Patients were identified based on the clinical syndrome for venous disease criteria described in the Royal College of Nurses clinical practice guidelines and by the presence of an ankle-brachial pressure index 0.8. The Regional Prevalence and Profile Study identified 263 people with leg ulcers for a rate of 2.0 per 1,000 people >25 years of age. One hundred, seven ulcers (41%) were the result of venous disease; of these, 83 (78% of cases) were associated with a single nursing agency and formed the study cohort. Most patients (51, 61%) were female and 65 years old. Thirty-eight (46%) had 4 comorbid conditions, 63 spoke English, 29 lived alone, 38 did not require physical aids or assistance for mobility, and 81 (98%) were able to travel outside of their home. The current ulcer had been present for an average of 15 months (median 6 months), 51 participants had a previous leg ulcer, and 22 had episodes of ulceration for > 5 years. Of the 121 ulcers in the study, 48 (41%) were located at the ankle, and the majority (85%) were > 1 cm2. General practitioners were the main medical care providers for 48 participants, and 52 (62%) had seen a specialist physician for their current ulcer. These findings are similar to large studies conducted in other industrialized countries and confirm that venous ulcers are a chronic problem in a population with complex health needs.
PubMed ID
12732756 View in PubMed
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Canada's disabled population in institutions.

https://arctichealth.org/en/permalink/ahliterature103659
Source
Health Rep. 1990;2(1):27-36
Publication Type
Article
Date
1990
Author
J M Dowler
D A Jordan-Simpson
Source
Health Rep. 1990;2(1):27-36
Date
1990
Language
English
French
Publication Type
Article
Keywords
Activities of Daily Living
Adolescent
Adult
Age Factors
Aged
Canada
Disabled persons - statistics & numerical data
Female
Health Services Needs and Demand - statistics & numerical data
Health status
Home Care Services - statistics & numerical data
Humans
Long-Term Care - statistics & numerical data
Male
Middle Aged
Abstract
One percent of Canada's population are long-term residents of health care institutions. Of this group an estimated 97% have a disabling condition. This article profiles disabled people living in institutions using data from the Health and Activity Limitation Survey (HALS) undertaken by Statistics Canada. HALS collected data on: the nature, number and severity of disabilities; the underlying causes of the disabilities; and the degree of assistance required for daily activities. For the institutional component of HALS, a sample of 19,000 disabled individuals from 1,100 institutions was used. The institutional survey indicated that almost 80% of the disabled population in institutions were aged 65 or older, while about 90% had mobility and/or agility-related disabilities. The most frequently cited underlying cause of disability for respondents living in both institutions and households was disease or illness. Among young adults in institutions, mental retardation was the main disabling condition. Among the elderly, diseases of the musculoskeletal system and connective tissue (including arthritis) were most common. Most respondents in institutions required daily help with personal care, shopping and personal finances.
PubMed ID
2151686 View in PubMed
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Cancer patients who prefer to die at home. Characterizations of municipalities with several or few occurrences of home deaths.

https://arctichealth.org/en/permalink/ahliterature20638
Source
Scand J Caring Sci. 1999;13(2):102-8
Publication Type
Article
Date
1999
Author
L W Sørbye
Author Affiliation
Research Department, Diakonhjemmets College, Oslo, Norway.
Source
Scand J Caring Sci. 1999;13(2):102-8
Date
1999
Language
English
Publication Type
Article
Keywords
Choice Behavior
Death
Home Care Services - statistics & numerical data
Humans
Neoplasms - mortality - nursing - psychology
Norway - epidemiology
Nursing Methodology Research
Patient satisfaction
Research Support, Non-U.S. Gov't
Terminal Care - methods - psychology - statistics & numerical data
Abstract
This article presents a descriptive study based on quantitative and qualitative methods. We wished to determine factors that promote or restrict home deaths. The Norwegian Central Bureau of Statistics released non-identifiable data for the time period 1990-1994 for all municipalities in Norway. Relevant health and social data from the Norwegian Social Science Data Service for the 24 municipalities, which had more than 20% or less than 10% of the cancer patients dying in their own homes, were analysed. Key persons in the home care teams were interviewed. There were few occurrences of home deaths in municipalities with a local hospital, good capacity in nursing homes or a larger percentage of one-person households. Indicators for several occurrences of home deaths were openness, good co-operation with physicians, and a stable, flexible staff. In addition, the patient had to have a strong desire to die at home. Finally, the employees had to be professionally confident and willing to go beyond the prescribed shift hours.
PubMed ID
10633740 View in PubMed
Less detail

[Care for the elderly--elderly persons needing care should select residential community carefully].

https://arctichealth.org/en/permalink/ahliterature205985
Source
Tidsskr Sykepl. 1998 Mar 10;86(5):54-7
Publication Type
Article
Date
Mar-10-1998
Author
H K Otterstad
H. Tønseth
Author Affiliation
Statistisk sentralbyrå, Oslo.
Source
Tidsskr Sykepl. 1998 Mar 10;86(5):54-7
Date
Mar-10-1998
Language
Norwegian
Publication Type
Article
Keywords
Aged
Home Care Services - statistics & numerical data - utilization
Homes for the Aged - statistics & numerical data - utilization
Humans
Norway
PubMed ID
9544132 View in PubMed
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87 records – page 1 of 9.