Older adults experiences of rehabilitation in acute health care

Rehabilitation is a key component of nursing and allied healthcare professionals’ roles in most health and social care settings. This paper reports on stage 2 of an action research project to ascertain older adult's experience of rehabilitation. Twenty postdischarge interviews were conducted and the interview transcripts were analysed using thematic content analysis. All older adults discharged from an acute older acute rehabilitation ward to their own homes in the community were eligible to participate. The only exclusion criterion was older adults who were thought to be unable to give consent to participate by the nurse in charge and the researcher. Whilst 92 older adults were eligible to participate in this research study, only 20 were interviewed. The findings from this study suggest that older adults valued communication with health professionals but were aware of their time constraints that hindered communication. This study suggests that both nurses and allied health professionals are not actively providing rehabilitative services to promote health and well-being, which contradicts the focus of active ageing. Furthermore, there was evidence of unmet needs on discharge, and older adults unable to recall the professions that were involved in their interventions and the rationale for therapy input. It is suggested that further research is needed to explore the effectiveness of allied health rehabilitation in the acute setting. This study highlights the need for further research into older adults’ perceptions of the rehabilitation process in the acute setting

Living with hope: developing a psychosocial supportive program for rural women caregivers of persons with advanced cancer

<p>Abstract</p> <p>Background</p> <p>Hope is defined by caregivers as the inner strength to achieve future good and to continue care giving. Pilot test findings of a Living with Hope Program (LWHP) suggested it is an acceptable and feasible intervention for use by family caregivers. Although it shows promise in potentially increasing hope and quality of life, further testing and development is needed. Questions remain as to: a) what are the mechanisms through which the LWHP affects outcomes and b) how long it is effective? <it>The overall purpose of this time series mixed method study is the further development and testing of the LWHP by</it>:</p> <p indent="1">a. Determining the mechanisms of the LWHP by testing a LWHP conceptual model in which self-efficacy, and loss/grief are hypothesized intermediary variables for changes in hope, and subsequently quality of life among rural women caring for persons with advanced cancer, and;</p> <p indent="1">b. Exploring the longitudinal effects of the LWHP on hope, quality of life and health services utilization among rural women caring for persons with advanced cancer.</p> <p>Methods/Design</p> <p>Using a time-series embedded mixed method design, data will be collected from 200 rural women caregivers. Following the collection of baseline and outcome variables, the intervention (LWHP) is applied to all subjects. Subjects are followed over time with repeated measures of outcome variables (1 wk, 2 wk, 3, 6 and 12 months). The journals that are completed as part of the LWHP comprise the qualitative data. Health services utilization data will be collected from the Saskatchewan Health Administrative Database for all subjects one year prior and one year after study enrolment.</p> <p>Path analysis will be used to test the model post LWHP, at 1 and 2 weeks. Two-factor ANCOVA will determine patterns over time and Cortazzi's narrative analysis will be used to analyze subjects journals completed as part of the LWHP.</p> <p>Discussion</p> <p>Data Collection began January 2009 and is expected to be completed within 2 years time. Monthly meetings with data collectors and site collaborators have been instrumental in revisions to the original study protocol such as identifying and adding additional study sites.</p> <p>Trial Registration</p> <p>Trial Registration; Clinical Trials.Gov. NCT01081301</p

Seniors' experiences of living in special housing accommodation

This article presents a hermeneutic phenomenological analysis of interview material in which 12 seniors living in Special Housing Accommodation (SHA) facilities reflect on the experience of living in such facilities. Of particular interest in the analysis is living in a SHA as a phenomenon. The finding shows that the phenomenon of lived experience in a SHA seems to be a state of ambiguity regarding one's existence, which is made up of several constituents (elements of meaning). The analysis contributes to the understanding of how the phenomenon of SHA living is coming into existence as a need, due to an individual's failing health; however, the SHA is not considered to be a true home. Accordingly, this has consequences to the subject position for the seniors in that they have to navigate between existing and not existing. The seniors learn to cope with living in the SHA by lowering their expectations of life and existence while the SHA provides the prerequisites for their existence. An implication for promoting care is to support the seniors to enable a full existence of life within SHA living

Denken over technologie, gezondheid, voeding en diëtetiek

Cliënten, hun naasten en voedingsprofessionals (diëtisten en voedingskundigen) worden geconfronteerd met technologieën gericht op het verbeteren of behouden van gezondheid en/of kwaliteit van leven. Technologieën worden tevens ingezet om de efficiëntie en/of kosteneffectiviteit van zorg te verbeteren. Voorbeelden hiervan zijn beeldschermzorg en ziekte specifieke apps voor de smartphone. De perspectieven van alle betrokkenen in een praktijksituatie in de gezondheidszorg bepalen hoe technologieën gebruikt worden. In dit hoofdstuk worden verschillende perspectieven op technologie, gezondheid en zorg bediscussieerd en worden dilemma’s beschreven die hieruit kunnen ontstaan. Theorie en praktijk tonen het belang van bewust nadenken over de eigen, persoonlijke perspectieven op technologie, gezondheid, voeding en zorg en over perspectieven van anderen. Conclusie: diëtisten en voedingskundigen hebben de verantwoordelijkheid om sensitiviteit te ontwikkelen voor potentiële dilemma’s bij het gebruik van technologieën om daar in de praktijk zorgvuldig mee om te gaan