RESUMEN

SNOMED CT was chosen as reference terminology for standardisation of homecare nursing documentation to make reporting comparable across the 98 Danish municipalities. The method outlined in this paper for developing a Danish national homecare nursing SNOMED CT subsets is a pragmatic approach to build new SNOMED CT subsets drawing on existing and available SNOMED CT subsets. Combining this approach with awareness of hierarchical coherency in SNOMED CT subsets makes effective retrieval of data possible.

Asunto(s)

RESUMEN

The aim of the study was to examine the effect of informal care levels on overall discontinuation of living at home, all-cause death, hospital admission, and long-term care placement for community-dwelling older people using various community-based services during a 3-year period. Prospective cohort study of 1582 community-dwelling disabled elderly and paired informal caregivers was conducted. Baseline data included the recipients and caregivers' demographic characteristics, comorbidities, informal care levels (sufficient, moderate, and insufficient care), which were evaluated by trained visiting nurses, and the level of formal community-based service use. Among 1582 participants, 97 died at home, 692 were admitted to hospitals, 318 died during their hospital stay, and 117 were institutionalized in long-term care facilities during 3 years of follow-up. A multivariate Cox hazard model demonstrated that when compared with a sufficient informal care level, an insufficient informal care level was associated with overall discontinuation of living at home, all-cause mortality, hospitalization, and institutionalization during 3 years of follow-up (hazard ratio: 1.65, 95% confidence interval: 1.15-2.36; 1.98, 1.17-3.34; 1.56, 1.04-2.35; 2.93, 1.25-6.86, respectively). The results suggested that informal caregiving is an important factor in the prevention of overall discontinuation of living at home in a population of disabled older people.

Asunto(s)

RESUMEN

In December 2002, a national workshop was held in Ottawa to guide research directions for the caregiving of people with Alzheimer's disease in Canada. Prior to the workshop, a search was conducted to identify Canadian-based investigators who have conducted research related to caregiving of individuals with cognitive impairment, Alzheimer's disease and other dementia, identify relevant Canadian research studies, and provide an overview of results and themes emerging from this research. This paper summarizes findings from our search for Canadian studies, research themes identified at the national workshop in Ottawa, and recommendations from the workshop. The report first outlines patterns of caregiving and subsequently focusses on the impact of different ways of assisting Alzheimer's caregivers. It concludes by outlining the methodological challenges of observational and intervention studies related to Alzheimer's caregiving and recommendations on how to increase Canada's capacity to conduct research on Alzheimer's caregiving.

Asunto(s)

RESUMEN

The present article explores professional attitudes to family members supporting an older person newly diagnosed with dementia. It draws on professional perspectives derived from a series of 24 multidisciplinary workshops held in the UK, analysed using a typology developed by Twigg in 1989. The primary care workers' understanding of carers' needs and circumstances fitted best with Twigg's models of carers as resources and co-workers, but showed limited awareness of carers' responses and attitudes to caring. It is argued that professional assumptions about family members' roles when dementia is recently recognised among older people expand definitions of carers, but still confirm their instrumental role.

Asunto(s)

RESUMEN

More than ever before, caregiving has become a salient public policy issue. A number of recent and anticipated demographic, economic and social changes have occurred that make it imperative for researchers to critically examine the impact of caregiving on family caregivers' health, behavior, emotions, and social status. Researchers at the University of Iowa College of Nursing are working to classify standardized nursing-sensitive patient outcomes for use in language development, practice, research, and education to evaluate the effectiveness of nursing interventions and clinical nursing services. This article focuses on family caregiving and the analysis of caregiver role performance in both direct and indirect care, linking outcomes and indicators, to enable nurses to promote the health of caregivers.

Asunto(s)

Asunto(s)

RESUMEN

The specific aims of this study were to examine two organizing principles for caregiver planning and the consistency with which four nurses independently classified 1,096 caregiving decisions into one of 12 categories of a taxonomic structure. The typology for classification consisted of a coordinate for goal structure made up of three categories and a coordinate for human need orientation-made up of four categories. The 3-by-4 classification schema was used to develop a coding manual of theoretical and operational definitions for 12 mutually exclusive cell categories of caregiver planning. The criterion for consistency of the nurses' classification judgments was the assignment of a caregiving decision to a cell category identical to the a priori assignment of the principal investigator. The findings from the study provide initial support for content validity of the organizing principles for caregiver planning and interrater reliability of the nurses' judgments when controlling for the effect of chance agreements. The nurses "correctly" classified 63.75% of the targeted caregiving decisions and did not "incorrectly" classify 83.74% of the decisions. The respective coefficient kappas for agreements made on the basis of goal structure and human need orientation were .72 and .65.

Asunto(s)

RESUMEN

The meanings attributed to the concept of care are considered. It is argued that whilst nursing has paid considerable attention to care in a professional (nursing) context, it has virtually ignored care as it is defined and construed by family carers. A new typology of family care is described which builds on the limited existing conceptual work in this area. It is further suggested that interventions which are intended to assist carers form a continuum ranging from services which are facilitative to those which are actually obstructive. In the light of these discussions, the implications of the new typology for nurses working with family carers are addressed briefly.

Asunto(s)

RESUMEN

Differences in the scalability of formal and informal in-home care to elderly are examined. A Guttman scale showed that exclusive use of informal in-home care was hierarchically scalable, but not when services were provided by any formal sources. There was some clustering of formal services, for example, a large number of those who received meals also used homemaker services. However, a large number of those who received nursing did not receive personal care. There was no overall pattern to the use of formal services. Implications of these findings as related to service planning and delivery are discussed.

Asunto(s)

RESUMEN

Predicting which rehabilitation patients will ultimately be discharged to a nursing home is a difficult task because methods used to evaluate preexisting home environment and quantify social support have been inadequate. To address this problem, the Beaumont Lifestyle Inventory of Social Support (BLISS) was developed. This questionnaire examines the family's willingness to care for, supervise and provide financial assistance to the patient. Organized into 10 weighted questions, BLISS results in a maximum score of 12. A prospective study was conducted to determine the correlation of the BLISS score with discharge disposition. Prior to rehabilitation admission, continuing care coordinators administered the BLISS to an involved family member of each patient. After 6 months, all BLISS forms were scored and compared with discharge disposition. Seventy-nine patients were included in this study and six (7.6%) were discharged to nursing homes. Comparison of BLISS scores obtained in patients discharged home versus nursing home revealed averages of 9.3 and 4.0, respectively (P less than 0.0006). These findings indicate that BLISS can quantify a patient's social situation and provide a predetermination of the social factors that lead to nursing home discharge. Consequently, BLISS will be a useful screening tool during the rehabilitation selection process.

Asunto(s)