What makes a home? Designing home personas to represent the homes of families caring for children with medical complexity

Barton, Hanna J; Pflaster, Ellen; Loganathar, Shanmugapriya; Werner, Allison Z.; Tarfa, Adati; Wilkins, David M.; Ehlenbach, Mary L.; Katz, Barbara; Coller, Ryan J.; Valdez, Rupa S.; Werner, Nicole E.

doi:10.1016/j.apergo.2022.103900

Cited by 6 publications

(3 citation statements)

References 36 publications

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“…The safety of care in the home appears largely unknown within the scholarly literature, despite family caregivers of CMC and their nurses often being discharged home with complex medication regimens, 104,105 equipment and devices. 106,107 A concerted effort, conducted with a diversity of family partners, is needed to develop approaches to better understand where specific gaps in clinical management can be improved at home. Without better understanding of home healthcare effectiveness at preventing costly hospitalizations or how to reduce potential safety events in the home, states may continue to be incentivized to keep home healthcare eligibility thresholds high, despite being legally entitled services, and for healthcare systems to prioritize improvements to in-hospital care over in-home care.…”

Section: Discussionmentioning

confidence: 99%

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Access and Quality of Pediatric Home Healthcare: A Systematic Review

Foster

Morales

Fawcett

et al. 2023

Home Health Care Management & Practice

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Despite the rising prevalence of children with medical complexity who need extensive medical care at home, the literature evaluating pediatric home healthcare has not been well summarized. Our objective was to systematically review the evidence-base of pediatric home healthcare to understand what is currently know about access and quality of home healthcare for children. Pubmed, Ovid Medline, Embase, CINAHL, Cochrane Library, Proquest Dissertations and Theses Global were searched for studies in the United States, United Kingdom, Canada, and Australia English publications (1980-2020) regarding children (≤18 years) using shift-based home healthcare services. Blinded independent review was conducted followed by extraction of study characteristics including how each study examined access and/or quality, which was categorized using the National Academy of Medicine quality dimensions. Of 9533 abstracts, 101 were included. Most were US (82%) and regional (72%) studies. Half (54%) focused on home nursing followed by home services generally (43%). The majority (77%) evaluated access and patient-family centeredness (62%); their results identified consistent limitations in access and quality resulting in negative impacts on patients and families. Less than 20% of publications addressed safety, effectiveness or equity. Bias scoring found that quantitative studies were universally weak, but qualitative studies were mostly moderate or strong. Results are limited by design heterogeneity and exclusion of training research. While research in pediatric home healthcare has increased, studies remain observational and rarely evaluate quality in reproducible ways. More rigorous measures and interventional research are needed to improve this healthcare sector for children.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Access and Quality of Pediatric Home Healthcare: A Systematic Review

Foster

Morales

Fawcett

et al. 2023

Home Health Care Management & Practice

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“…‘The interaction one has with their home environment is critical in shaping their health behaviors’ (Barton et al. 2023, 2). Therefore, there is an inevitable need to focus on older adults' bathroom priority perspective, to gain in‐depth data on areas of immediate attention and to create older‐friendly and fall‐free bathrooms that match well with the needs of older adults.…”

Section: Introductionmentioning

confidence: 99%

Exploring the Importance and Performance Priorities of Older Adults With a User‐Centred Approach to Create a Fall‐Free Bathroom

Afacan,

Barshan

2024

Int J Older People Nursing

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BackgroundFall hazards in bathroom spaces constitute one of the most critical issues in the daily lives of older adults. Bathroom falls are somewhat different and constrained in nature than those in other parts of a home environment.ObjectivesThis study aimed to adopt a user‐centred approach to explore older adults' general bathroom needs, with a specific focus on showers and bathtubs as the designated activity area.MethodsThe authors employed an extended importance–performance analysis (IPA) with a mixed‐method research design. Three hundred and eleven older adults participated in a face‐to‐face IPA questionnaire for the quantitative phase of the study. The authors gathered the qualitative data through open‐ended questions from 59 older adults.ResultsThe authors found positive correlation between older adults' attitudes towards an older‐friendly bathroom and the potential for their bathrooms to be fall‐free. The IPA calculations identify three key items with higher ratings in both importance and performance: The presence of appropriate artificial lighting, efficient mechanical ventilation and an accessible inside towel rail. Thematic analysis yields four themes: comfort, ease of access, error‐proof design and emergency management.ConclusionsThe IPA calculations and thematic analysis confirm that older adults' rankings of importance and performance and their corresponding priority levels within the overarching themes indicate the need for these aspects to perform well and justify ongoing investments. The study concludes that addressing fall prevention requires not only designing specific solutions but also utilising appropriate technology in bathing and toileting activities.Implications for PracticePractitioners in geriatric and gerontological nursing, design, architecture and health care can use the importance and performance priority levels of older adults to guide the development and implementation of fall‐free bathroom design. Policymakers can leverage the insights from this research to inform guidelines and regulations related to building codes, accessibility standards and healthcare policies.

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