Utilization of Home Health Care Services by Elderly Patients with Heart Failure

Moulton, Patricia J.; McGrane, Amy M.; Beck, Theresa L.; Holland, Nancy L.; Christopher, Mary Ann

doi:10.1177/089780189801000414

Cited by 7 publications

(6 citation statements)

References 17 publications

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“…The studies were published from 1998 to 2017 in journals that focused on home care and management, nursing, and health services research. The majority (n=5) of the included studies were observational, 27 – 31 of which two were descriptive in nature 27 , 28 and three used retrospective cohort designs. 29 – 31 One study was a quasi-experimental study with pre- and post-intervention design.…”

Section: Resultsmentioning

confidence: 99%

“…One study was missing outcome data 32 and several were missing demographic and clinical information on study participants. Two studies 27 , 28 found interesting trends but did not perform statistical analyses to discern whether these trends were statistically significant. Finally, reverse causality limited the validity and generalizability of the three studies that examined the effect of HCWs on readmission rates, since they did not attempt to adjust for HF patients’ severity of disease or their caregiving needs.…”

Section: Resultsmentioning

confidence: 99%

“…Two studies (Anderson et al 27 and Moulton et al 28 ) characterized the utilization of HHC services, including HHAs, among adults with HF. Both were descriptive in design, collected data via chart review, derived study samples from single home care agencies, and included HF patients who were ≥65 years of age and insured by Medicare.…”

Section: Resultsmentioning

confidence: 99%

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Home care workers in heart failure: a systematic review

Sterling¹,

Shaw²,

Leung³

et al. 2018

JMDH

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BackgroundHome care workers (HCWs), which include home health aides and personal care aides, are increasingly used by heart failure (HF) patients for post-acute care and long-term assistance. Despite their growing presence, they have largely been left out of HF research and interventions. This systematic review was aimed to 1) describe utilization patterns of HCWs by adults with HF, 2) examine the effect of HCWs on HF outcomes, and 3) review HF interventions that involve HCWs.MethodsFive electronic databases (Ovid MEDLINE, Ovid EMBASE, Cochrane Library [Wiley], CINAHL [EBSCO], and AgeLine [EBSCO]) were searched from inception through August 4, 2017. The yield was screened using prespecified inclusion and exclusion criteria. Two authors independently reviewed references and a third reviewer acted as an arbitrator when needed. Data were extracted from articles that met the inclusion criteria. The Downs and Black checklist was used for quality assessment. Due to study heterogeneity, a narrative synthesis was conducted.ResultsOf the 7,032 studies screened, 13 underwent full-text review, and six met the inclusion criteria. Two descriptive studies found that adults with HF who live alone and have functional and cognitive deficits utilize HCWs. While three retrospective cohort studies examined the association between having an HCW post-HF hospitalization and readmission rates, their findings were conflicting. One quasi-experimental study found that an HCW-delivered educational intervention improved HF patients’ self-care abilities. Overall, despite some significant findings, the studies assessed were of poor-to-fair quality (Downs and Black score range: 10–16 [28 total points]), with most lacking methodological rigor.ConclusionAlthough HCWs are quite common, the literature on these paraprofessionals in HF is limited. Given the paucity of research in this area and the low quality of studies reviewed here, additional research is warranted on the potential role of HCWs in HF self-care and on outcomes among adults with HF.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Home care workers in heart failure: a systematic review

Sterling¹,

Shaw²,

Leung³

et al. 2018

JMDH

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“…The second contextual factor, functional status, is defined as elders' ability to perform ADLs and IADLs independently. It is usually operationalized as functional limitations and has often been shown to be the strongest predictor of use of home care services by Anglo elders (Alkema et al, 2006;McCusker et al, 2001;Moulton, McGrane, Beck, Holland, & Christopher, 1998) and Mexican American elders (Burnette & Mui, 1995;Wallace et al, 1998), with a variety of diagnoses. We expected a negative relationship between functional status and use of home care services.…”

Section: Contextual Factorsmentioning

confidence: 99%

A Comparison of the Use of Home Care Services by Anglo-American and Mexican American Elders

Crist

Woo²,

Choi

2007

J Transcult Nurs

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Elders' use of home care services varies globally. The authors tested the relationship of cultural/ethnic, contextual, and social structural factors with elders' use of home care services in the United States. Fifty-seven non-Hispanic White or "Anglo" and 56 Mexican American elders participated. Use of services significantly correlated with Anglo and Mexican American elders' cultural/ethnic and contextual factors. Perceived need and service awareness were the two factors that were significant for both groups and that the authors believe would be amenable to change in future transcultural nursing interventions to decrease use of services disparities.

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“…Changes in the acuity of the patient population due to decreased hospital length of stay have required increased accountability in the standards of home health care. Nurses are now caring for patients with more complex medical and technological needs and are providing care in the home for patients much earlier in their disease process (Ellenbecker & Warren, 1998;Moulton, McGrand, Beck, Holland, & Christopher, 1998). As the expectations and level of care have advanced, so has the need for autonomous critical thinking and anticipatory problem solving with patient and family dynamics.…”

Section: Early Development Of the Cvspmentioning

confidence: 99%

Blending the Roles of Home Care Nursing and Cardiovascular Specialties: A Model for Nursing Practice in the Community

Guthaus

White

2002

Home Health Care Management & Practice

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Changes in reimbursement and advances in technology have resulted in a decreased hospital stay for patients undergoing cardiac surgery. These patients are being discharged into the community setting earlier, resulting in an increased demand for transitional specialty home care. This article relates the experience of a Midwest home care agency charged with the development of specialty home care for these complex patients. It offers a new practice model for professional nursing staff delivering this level of care. This model challenges traditional beliefs that cardiac specialty home care can best be provided by nurses with critical care or acute care cardiology background. This agency was successfully able to use the specialty roles of generalist home care as a foundation for advanced cardiovascular practice in the home care setting due to the agency’s commitment to support this process with an on-site advanced practice nurse skilled in both cardiovascular nursing and home health care.

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Utilization of Home Health Care Services by Elderly Patients with Heart Failure

Cited by 7 publications

References 17 publications

Home care workers in heart failure: a systematic review

Home care workers in heart failure: a systematic review

A Comparison of the Use of Home Care Services by Anglo-American and Mexican American Elders

Blending the Roles of Home Care Nursing and Cardiovascular Specialties: A Model for Nursing Practice in the Community

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