Cull, Brooke J; Rosenkranz, Sara K; Dzewaltowski, David A; Teeman, Colby S; Knutson, Cassandra K; Rosenkranz, Richard R
Childhood obesity is a major public health problem, with one third of America's children classified as either overweight or obese. Obesity prevention and health promotion programs using components such as wellness coaching and home-based interventions have shown promise, but there is a lack of published research evaluating the impact of a combined home-based and wellness coaching intervention for obesity prevention and health promotion in young girls. The main objective of this study is to test the feasibility of such an intervention on metrics related to recruitment, intervention delivery, and health-related outcome assessments. The secondary outcome is to evaluate the possibility of change in health-related psychosocial, behavioral, and biomedical outcomes in our sample of participants. Forty girls who are overweight or obese (aged 8-13 years) will be recruited from a Midwestern college town. Participants will be recruited through posted flyers, newspaper advertisements, email, and social media. The volunteer convenience sample of girls will be randomized to one of two home-based wellness coaching interventions: a general health education condition or a healthy eating physical activity skills condition. Trained female wellness coaches will conduct weekly hour-long home visits for 12 consecutive weeks. Assessments will occur at baseline, post-intervention (3 months after baseline), and follow-up (6 months after baseline) and will include height, weight, waist circumference, body composition, pulmonary function, blood pressure, systemic inflammation, physical activity (Actical accelerometer), and self-reported survey measures (relevant to fruit and vegetable consumption, physical activity, and quality of life). This study will evaluate the feasibility of home-based wellness coaching interventions for overweight and obese girls and secondarily assess the preliminary impact on health-related psychosocial, behavioral, and biomedical outcomes. Results will provide
Full Text Available The purpose of the study was to pilot test a model to reduce hospital readmissions and emergency department use of rural, older adults with chronic diseases discharged from home health services (HHS through the use of volunteers. The study’s priority population consistently experiences poorer health outcomes than their urban counterparts due in part to lower socioeconomic status, reduced access to health services, and incidence of chronic diseases. When they are hospitalized for complications due to poorly managed chronic diseases, they are frequently readmitted for the same conditions. This pilot study examines the use of volunteer community members who were trained as Health Coaches to mentor discharged HHS patients in following the self-care plan developed by their HHS RN; improving chronic disease self-management behaviors; reducing risk of falls, pneumonia, and flu; and accessing community resources. Program participants increased their ability to monitor and track their chronic health conditions, make positive lifestyle changes, and reduce incidents of falls, pneumonia and flu. Although differences in the ED and hospital admission rates after discharge from HHS between the treatment and comparison group (matched for gender, age, and chronic condition were not statistically significant, the treatment group’s rate was less than the comparison group thus suggesting a promising impact of the HC program (90 day: 263 comparison vs. 129 treatment; p = 0.65; 180 day 666.67 vs. 290.32; p = 0.19. The community health coach model offers a potential approach for improving the ability of discharged older home health patients to manage chronic conditions and ultimately reduce emergent care.
Full Text Available Yeon-Hwan Park,1,2 HeeKyung Chang31College of Nursing, 2The Research Institute of Nursing Science, Seoul National University, Seoul, South Korea; 3Seoul Women’s College of Nursing, Seoul, South KoreaBackground and aims: Although a growing number of older people are suffering from multimorbidity, most of the health problems related to multimorbidity can be improved by self-management. The aim of this study was to examine the effectiveness of a health coaching self-management program for older adults with multimorbidity in nursing homes. Methods: Older adults with multimorbidity from one nursing home in Korea were randomly allocated to either an intervention group (n=22 or conventional group (n=21. Participants in the intervention group met face to face with the researchers twice a week for 8 weeks, during which time the researchers engaged them in goal setting and goal performance using the strategies in the health coaching self-management program. Regular care was provided to the other participants in the conventional group. Results: Participants in the intervention group had significantly better outcomes in exercise behaviors (P=0.015, cognitive symptom management (P=0.004, mental stress management/relaxation (P=0.023, self-rated health (P=0.002, reduced illness intrusiveness (P<0.001, depression (P<0.001, and social/role activities limitations (P<0.001. In addition, there was a significant time-by-group interaction in self-efficacy (P=0.036. According to the goal attainment scales, their individual goals of oral health and stress reduction were achieved.Conclusion: The health coaching self-management program was successfully implemented in older adults with multimorbidity in a nursing home. Further research is needed to develop and evaluate the long-term effects of an intervention to enhance adherence to self-management and quality of life for older adults with multimorbidity.Keywords: chronic diseases, nursing intervention, older adults
Park, Yeon-Hwan; Moon, Sun-Hee; Ha, Ji-Yeon; Lee, Min-Hye
Little is known about whether a self-management program for nursing-home residents (NHR) with cognitive impairment is likely to have an impact on the care of this growing population. This study aimed to evaluate the effects of the health-coaching self-management program for NHR (HCSMP-NHR) on 1) self-efficacy and goal attainment scaling (GAS), 2) health status and quality of life (QoL) among older people, including those with cognitive impairment, in Korean nursing homes. This was a cluster-randomized controlled trial. Participants in the intervention group (n=43, mean age =80.91±7.65 years) received the HCSMP-NHR intervention, composed of group health education and individual coaching, for 8 weeks. Conventional care was provided to the conventional group (n=47, mean age =80.19±7.53 years) during the same period. The effects of the HCSMP-NHR were measured three times: at baseline, week 9, and week 20. The intervention group showed better results for self-efficacy ( P =0.007), health distress ( P =0.007), depression ( P <0.001), and QoL ( P =0.04) at week 9. Mean GAS score of the intervention group gradually increased from -0.38 to 0.74. The time × group interaction showed that the intervention group had significant improvements in QoL ( P =0.047), and significant reductions in health distress ( P =0.016) and depression ( P <0.001), while showing no deterioration in shortness of breath ( P <0.001). Our study findings indicate that the HCSMP-NHR improved self-efficacy and GAS and enhanced the health status and QoL of NHR with chronic conditions who also had mild-to-moderate cognitive impairment. Moreover, these effects were successfully maintained over the 5 months of the trial. Further research is needed to establish the optimum intervention period and to assess the possibility of nationwide implementation of the HCSMP-NHR.
Jimison, Holly B; Klein, Krystal A; Marcoe, Jennifer L
Previous studies have shown that social ties enhance both physical and mental health, and that social isolation has been linked to increased cognitive decline. As part of our cognitive training platform, we created a socialization intervention to address these issues. The intervention is designed to improve social contact time of older adults with remote family members and friends using a variety of technologies, including Web cameras, Skype software, email and phone. We used usability testing, surveys, interviews and system usage monitoring to develop design guidance for socialization protocols that were appropriate for older adults living independently in their homes. Our early results with this intervention show increased number of social contacts, total communication time (we measure email, phone, and Skype usage) and significant participant satisfaction with the intervention.
Jimison, Holly B.; Klein, Krystal A.; Marcoe, Jennifer L.
Previous studies have shown that social ties enhance both physical and mental health, and that social isolation has been linked to increased cognitive decline. As part of our cognitive training platform, we created a socialization intervention to address these issues. The intervention is designed to improve social contact time of older adults with remote family members and friends using a variety of technologies, including Web cameras, Skype software, email and phone. We used usability testing, surveys, interviews and system usage monitoring to develop design guidance for socialization protocols that were appropriate for older adults living independently in their homes. Our early results with this intervention show increased number of social contacts, total communication time (we measure email, phone, and Skype usage) and significant participant satisfaction with the intervention. PMID:24111362
Fossey, Jane; Garrod, Lucy; Guzman, Azucena; Testad, Ingelin
Objectives This study explored the experiences of a range of health and social care professionals employed in the role of trainer/coaches to support care home staff to implement a psychosocial intervention for residents living with dementia. It aimed to identify the factors which are pertinent to these roles, in the context of a cascade model of training. Method A focus group was convened involving dementia trainer/coaches and supervisors who had worked on Well-being and Health for people with Dementia randomised control trial. Twelve participants explored their preparedness for and experiences of their role as 'Well-being and Health for people with Dementia therapists'. They reflected on their perceptions of the resources and support required. The data were transcribed verbatim and subjected to inductive thematic analysis. Results Three main themes emerged from the data. Within the theme of 'skills in relationship building' were two subthemes of developing trust and getting to know individual staff and each care home. In the second main theme of 'making use of tangible resources' two subthemes relating to using the Well-being and Health for people with Dementia manuals and the supervision of the therapists arose. The third theme, 'being an agent for change' contained three subthemes: effective training methods, creating opportunities for Dementia Champions to reflect and therapists' perceived rewards of their role. Conclusion The findings provide new insights into the trainer/coach role applicable to the practices of services recruiting, training and providing ongoing professional support to practitioners in-reaching into care homes.
Huffman, Melinda H
The increasing demand for health coaches and wellness coaches in worksite health promotion and the marketplace has resulted in a plethora of training programs with wide variations in coaching definitions, content, attributes, and eligibility of those who may train. It is in the interest of public awareness and safety that those in clinical practice take the lead in this discussion and offer a reasonable contrast and comparison focusing on the risks and responsibilities of health coaching in particular. With the endorsement of the American Association of Occupational Health Nurses (AAOHN), the National Society of Health Coaches, whose membership is primarily nurses, discusses the issue and states its position here. © 2016 The Author(s).
Krick Oborn, Kellie M.; Johnson, LeAnne D.
Recommended practices for Part C early childhood special education home visitors encourage use of caregiver coaching strategies to enhance learning opportunities within the natural routines of infants and toddlers. The purpose of this study was to evaluate the effects of a multicomponent professional development intervention on home visitors' use…
Wolever, Ruth Q; Caldwell, Karen L; Wakefield, Jessica P; Little, Kerry J; Gresko, Jeanne; Shaw, Andrea; Duda, Linda V; Kosey, Julie M; Gaudet, Tracy
The aim of this study was to describe integrative health (IH) coaching as developed in three different interventions offered through a major medical center, as a step toward further defining the field of health coaching. An organizational case study was conducted with document analysis and interviews. Interviewees were the first six IH coaches at Duke Integrative Medicine who provided 360 clients with individual and/or group coaching (two to 28 sessions) in a randomized clinical study and two work-site wellness programs. Qualitative analysis using the constant comparative method was conducted. Integrative health coaching is characterized by a process of self-discovery that informs goal setting and builds internal motivation by linking clients' goals to their values and sense of purpose. Time, commitment, and motivation are necessary in the IH coaching process. The underpinnings of IH coaching are distinct from the medical model, and the process is distinct from health education, executive coaching, and psychotherapy. Integrative health coaching fits well with the assumptions of integrative medicine and has a role in supporting behavior change. Copyright © 2011. Published by Elsevier Inc.
Dominick P Trombetta, Pharm.D
Full Text Available Chronic diseases are the main contributor to both health care costs and mortality in the United States, with medication non-adherence and lifestyle modifications being leading causes. To motivate patients with several co-morbidities, the longitudinal care class was used to educate on maintaining adherence to prescribed regimens. Twenty pharmacy students were trained in health coaching and motivational interviewing methods. Specifically, students were to provide patients with education sheets, apply the teach-back method, and motivate the patient to develop and reach SMART goals made with the pharmacy student over a course of one academic school year. Conflict of Interest We declare no conflicts of interest or financial interests that the authors or members of their immediate families have in any product or service discussed in the manuscript, including grants (pending or received, employment, gifts, stock holdings or options, honoraria, consultancies, expert testimony, patents and royalties. Type: Note
Polak, Rani; Pober, David M; Budd, Maggi A; Silver, Julie K; Phillips, Edward M; Abrahamson, Martin J
This case series describes and examines the outcomes of a remote culinary coaching program aimed at improving nutrition through home cooking. Participants (n = 4) improved attitudes about the perceived ease of home cooking (p culinary skills (p = 0.02); and also improved in confidence to continue online learning of culinary skills and consume healthier food. We believe this program might be a viable response to the need for effective and scalable health-related culinary interventions.
- The likelihood of the participant to consider general coaching for health and wellness, designed and tailored for them, on a 5-point Likert scale from 1- “extremely unlikely” to 5 – “extremely likely”, where 24.72% chose the “extremely likely” option. The perceived role of technology accounted for 13.5% (F(5,4880=152.86,p<.001 of the variance in the perceived usefulness of a digital coach. Post-hoc Tukey's HSD tests showed that participants who saw the role of technology as “coach” were significantly more likely to perceive digital coaching as useful (p<.01 for all group comparisons. New technology adopter levels accounted for 9.9% (F(4, 4878 = 134.70, p <.001 of the variance in the perceived usefulness of a digital coach. Post-hoc Tukey’s HSD tests showed that participants who reported to be “first adopters” were more likely to perceive digital coaching as useful (p<.001 for all group comparisons. Willingness to receive general health and wellness coaching, including programs tailored and designed for each specific user accounted for 25.3% (F(4, 4887 = 414.49, p<.001 and 22.1% (F(4, 4881 = 346.52, p<.001 respectively. For both factors, participants who ranked highest in their willingness to consider general health coaching found digital coaching more useful than other groups (p<.001 for all group comparisons. Gender, age, country of origin, income, reported state of general health, and other factors had negligible to no effect. Conclusions Our research shows that the perception of digital coaching does not vary between clean cut demographic groups, defined by gender or country of origin. Neither does the general health state pay a decisive factor. The factors that do impact user perception on digital coaching are mostly related to their attitude towards health coaching in general. Another set of influential factors are their opinion in digital technology and their readiness to explore new technological solutions.
The health promotion and health education literature has references to health counselling. Yet, beyond the field of health, coaching has become a popular method to enhance and facilitate individual and group performance in business, sports, and personal areas of life. This paper focuses on the recent development of health coaching by practitioners…
Johnson, Christopher; Saba, George; Wolf, Jessica; Gardner, Heather; Thom, David H
To examine activities of health coaches during patient medical visits and when meeting one-on-one with patients at 3 urban federally qualified health centers. Encounters were videotaped and transcribed. Data was analyzed using a matrix analysis approach that allowed a priori identification of expected categories of activity, based on the health coach training model and previously developed conceptual framework, which were modified based on activities observed. A total of 10 medical visits (patient, clinician and health coach), and 8 patient-coach visits were recorded. We identified 9 categories common to both medical and patient-coach visits and 2 categories unique to the medical visit. While observed activities were generally consistent with expected categories, some activities were observed infrequently or not at all. We also observed additional activity categories, including information gathering and personal conversation. The average amount of time spent on some categories of coaching activities differed substantially between medical visits and patient-coach visits. Health coaching activities observed differed in several respects to those expected, and differed between medical visits and coaching only visits. These results provide insights into health coaching behaviors that can be used to inform training and improve utilization of health coaches in practice. Copyright © 2017 Elsevier B.V. All rights reserved.
Godfrey, Marjorie M; Andersson-Gare, Boel; Nelson, Eugene C; Nilsson, Mats; Ahlstrom, Gerd
To investigate health care improvement team coaching activities from the perspectives of coachees, coaches and unit leaders in two national improvement collaboratives. Despite numerous methods to improve health care, inconsistencies in success have been attributed to factors that include unengaged staff, absence of supportive improvement resources and organisational inertia. Mixed methods sequential exploratory study design, including quantitative and qualitative data from interprofessional improvement teams who received team coaching. The coachees (n = 382), coaches (n = 9) and leaders (n = 30) completed three different data collection tools identifying coaching actions perceived to support improvement activities. Coachees, coaches and unit leaders in both collaboratives reported generally positive perceptions about team coaching. Four categories of coaching actions were perceived to support improvement work: context, relationships, helping and technical support. All participants agreed that regardless of who the coach is, emphasis should include the four categories of team coaching actions. Leaders should reflect on their efforts to support improvement teams and consider the four categories of team coaching actions. A structured team coaching model that offers needed encouragement to keep the team energized, seems to support health care improvement. © 2013 John Wiley & Sons Ltd.
Buckley, Katie L; O'Halloran, Paul D; Oates, Jennifer M
To explore the occupational voice use and vocal health of elite football coaches. This pilot study explored coaches' voice use patterns and vocal demands across workplace environments. Each coach's experiences of voice symptoms and voice problems were also investigated. Twelve Australian professional football coaches participated in a mixed-methods data collection approach. Data were collected through acoustic voice measurement (Ambulatory Phonation Monitor), semistructured interviews, and a voice symptom questionnaire (Voice Capabilities Questionnaire). Acoustic measures suggested heavy vocal loads for coaches during player training. All participants reported experiencing voice symptoms. They also suggested that the structure of their working week, workplace tasks, and vocal demands impacted on their voices. Despite this, participants reported little previous reflection or awareness of what impacted on their voices. Coaches typically did not consider how to support their voices during daily work and discussed experiencing voice symptoms as an inevitable part of their jobs. This study demonstrates that occupational vocal demands may negatively impact on sports coaches' vocal health. This is particularly important, considering coaches' heavy vocal loads across coaching tasks and reported negative occupational vocal health experience. Furthermore, coaches' limited insight into voice use and vocal health management may impact on their vocal performance and health. Given the exploratory nature of this study, further research into coaches' occupational vocal health is warranted. Copyright © 2015 The Voice Foundation. Published by Elsevier Inc. All rights reserved.
26. Ammentorp J, Uhrenfeldt L, Angel F, Ehrensvärd, Carlsen E, Kofoed P-E. Can life coaching improve health outcomes? – A systematic review of intervention studies. Poster presented at the International Conference on Communication in Healthcare, Montreal Canada, 30 Sept 2013.......26. Ammentorp J, Uhrenfeldt L, Angel F, Ehrensvärd, Carlsen E, Kofoed P-E. Can life coaching improve health outcomes? – A systematic review of intervention studies. Poster presented at the International Conference on Communication in Healthcare, Montreal Canada, 30 Sept 2013....
Escoffery, Cam; Mullen, Patricia; Genkin, Brooke; Bundy, Lucja; Owolabi, Shade; Haardörfer, Regine; Williams, Rebecca; Savas, Lara; Kegler, Michelle
Few community interventions exist to reduce secondhand exposure to tobacco smoke in the home. This study presents the coaching process of a larger intervention to promote smoke-free homes across an efficacy and 2 effectiveness trials. It furthers assesses the coaching call's reach and participants' satisfaction with the call across three…
Gail J. Mitchell
Full Text Available Health care professionals are increasingly aware that persons are complex and live in relation with other complex human communities and broader systems. Complex beings and systems are living and evolving in nonlinear ways through a process of mutual influence. Traditional standardized approaches in chronic disease management do not address these non-linear linkages and the meaning and changes that impact day-to-day life and caring for self and family. The RN health coach role described in this paper addresses the complexities and ambiguities for persons living with chronic illness in order to provide person-centered care and support that are unique and responsive to the context of persons’ lives. Informed by complexity thinking and relational inquiry, the RN health coach is an emergent innovation of creative action with community and groups that support persons as they shape their health and patterns of living.
Armstrong, Colin; Wolever, Ruth Q; Manning, Linda; Elam, Roy; Moore, Margaret; Frates, Elizabeth Pegg; Duskey, Heidi; Anderson, Chelsea; Curtis, Rebecca L; Masemer, Susan; Lawson, Karen
There is great need for cost effective approaches to increase patient engagement and improve health and well-being. Health and wellness coaching has recently demonstrated great promise, but the majority of studies to date have focused on individual coaching (ie, one coach with one client). Newer initiatives are bringing a group coaching model from corporate leadership development and educational settings into the healthcare arena. A group approach potentially increases cost-effective access to a larger number of clients and brings the possible additional benefit of group support. This article highlights some of the group coaching approaches currently being conducted across the United States. The group coaching interventions included in this overview are offered by a variety of academic and private sector institutions, use both telephonic and in-person coaching, and are facilitated by professionally trained health and wellness coaches as well as trained peer coaches. Strengths and challenges experienced in these efforts are summarized, as are recommendations to address those challenges. A working definition of "Group Health and Wellness Coaching" is proposed, and important next steps for research and for the training of group coaches are presented.
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... SECURITIES AND EXCHANGE COMMISSION [File No. 500-1] Consolidated Energy, Inc., Diamond Home Services, Inc., Goran Capital Inc., Kingsley Coach, Inc. (The), Knockout Holdings, Inc., and Kuhlman Co... securities of Kingsley Coach, Inc. (The) because it has not filed any periodic reports since the period ended...
Wolever, Ruth Q.; Manning, Linda; Elam, Roy; Moore, Margaret; Frates, Elizabeth Pegg; Duskey, Heidi; Anderson, Chelsea; Curtis, Rebecca L.; Masemer, Susan; Lawson, Karen
There is great need for cost effective approaches to increase patient engagement and improve health and well-being. Health and wellness coaching has recently demonstrated great promise, but the majority of studies to date have focused on individual coaching (ie, one coach with one client). Newer initiatives are bringing a group coaching model from corporate leadership development and educational settings into the healthcare arena. A group approach potentially increases cost-effective access to a larger number of clients and brings the possible additional benefit of group support. This article highlights some of the group coaching approaches currently being conducted across the United States. The group coaching interventions included in this overview are offered by a variety of academic and private sector institutions, use both telephonic and in-person coaching, and are facilitated by professionally trained health and wellness coaches as well as trained peer coaches. Strengths and challenges experienced in these efforts are summarized, as are recommendations to address those challenges. A working definition of “Group Health and Wellness Coaching” is proposed, and important next steps for research and for the training of group coaches are presented. PMID:24416678
Merrill, R M; Aldana, S G; Bowden, D E
This study will evaluate the effectiveness of an interactive health coaching intervention at lowering weight. The study involved 5405 overweight or obese employees aged 18-85, who entered the program sometime during 2001-2008. Average body mass index (BMI) significantly decreased from 32.1 at baseline to 31.4 at 3 months, 31.0 at 6 months, and 30.6 at 12 months. Decreasing BMI was more pronounced in older age groups and among women, those using weight loss medication, those with higher BMI, and those with higher motivation and confidence to make behavior changes. When the effects of these variables on the decreasing trend in BMI were simultaneously estimated, only baseline classifications of BMI, health status, and confidence remained significant. Change in BMI through 12 months was -0.7% for those with normal weight, -2.0% for overweight, -3.6% for obese, and -7.1% for morbidly obese individuals at baseline. Among morbidly obese individuals, decrease in BMI through 12 months was -7.6% for those with "high" confidence to lose weight at baseline vs -4.4% for those with low confidence. Better health status at baseline was also related to more pronounced weight loss. Interactive health coaching significantly lowered BMI among participants through 3, 6, and 12 months of follow-up.
U.S. Department of Health & Human Services — Home Health Compare has information about the quality of care provided by Medicare-certified home health agencies throughout the nation. Medicare-certified means the...
Pedersen, Elsebet Frydendal
kravet om ansvar for egen læring nye krav til lærerne på uddannelsesstederne, til pædagogikken og til læringsprocessen. Rapporten er en sammenskrivning af baggrundsviden om coaching og teorier, der relaterer sig til dette, især læringsprocesser. Derudover indgår nogle konkrete anvisninger til...... gennemførselen af selve coaching forløbet....
Staufenbiel, Kathrin; Lobinger, Babett; Strauss, Bernd
In soccer, home teams win about 67% of decided games. The causes for this home advantage are still unresolved. There is a shortage of research on the psychological states of actors involved. In this study, we examined soccer coaches' expectations, goal setting and tactical decisions in relation to game location. Soccer coaches (N = 297) with different expertise levels participated in an experimental, online management game and were randomly assigned to one of two groups, "home game (HG)" or "away game." Participants received information on the game for which they were asked to make decisions in multiple points. The only differing information between groups was game location. Regardless of expertise, HG coaches had higher expectations to win, set more challenging goals and decided for more offensive and courageous playing tactics. Possible consequences of these findings concerning home advantage in soccer are discussed.
Liddy, Clare; Johnston, Sharon; Irving, Hannah; Nash, Kate; Ward, Natalie
Abstract Objective To assess patients’ experiences with and perceptions of health coaching as part of their ongoing care. Design A qualitative research design using semistructured interviews that were recorded and transcribed verbatim. Setting Ottawa, Ont. Participants Eleven patients (> 18 years of age) enrolled in a health coaching pilot program who were at risk of or diagnosed with type 2 diabetes. Methods Patients’ perspectives were assessed with semistructured interviews. Interviews were conducted with 11 patients at the end of the pilot program, using a stratified sampling approach to ensure maximum variation. Main findings All patients found the overall experience with the health coaching program to be positive. Patients believed the health coaching program was effective in increasing awareness of how diabetes affected their bodies and health, in building accountability for their health-related actions, and in improving access to care and other health resources. Conclusion Patients perceive one-on-one health coaching as an acceptable intervention in their ongoing care. Patients enrolled in the health coaching pilot program believed that there was an improvement in access to care, health literacy, and accountability, all factors considered to be precursors to behavioural change. PMID:25932483
Wong-Rieger, Durhane; Rieger, Francis P
To effectively manage diabetes mellitus, patients must adhere to treatment recommendations and healthy lifestyle behaviors, but research shows many patients do not do this. Education is effective when combined with self-management support but peer-support programs do not lead to lasting changes. Health coaching, or professional support, can be highly effective if it focuses on developing self-efficacy and skills such as goal-setting, problem-solving and managing cognitive and emotional barriers. This overview discusses the benefits of patient self-management for chronic conditions such as diabetes, core competencies for health coaching, theoretical bases and principles of health coaching interventions, delivery methods and the evidence that health coaching works for diabetes self-management. Copyright © 2013 Canadian Diabetes Association. Published by Elsevier Inc. All rights reserved.
Willging, Cathleen E; Israel, Tania; Ley, David; Trott, Elise M; DeMaria, Catherine; Joplin, Aaron; Smiley, Verida
Lesbian, gay, bisexual, transgender, and queer or questioning (LGBTQ) people are affected by mental health disparities, especially in rural communities. We trained peer advocates in rural areas in the fundamentals of mental health, outreach, education, and support for this population. The peer advocates were coached by licensed mental health professionals. We evaluated this process through iterative qualitative analysis of semi-structured interviews and written logs from coaches and advocates. The six major themes comprising the results centered on (1) coaching support, (2) peer advocate skills and preparation, (3) working with help seekers, (4) negotiating diversity, (5) logistical challenges in rural contexts, and (6) systemic challenges. We concluded that peer advocacy for LGBTQ people with mental distress offers an affirmative, community-based strategy to assist the underserved. To be successful, however, peer advocates will likely require ongoing training, coaching, and infrastructural support to negotiate contextual factors that can influence provision of community resources and support to LGBTQ people within rural communities.
U.S. Department of Health & Human Services — Under prospective payment, Medicare pays home health agencies (HHAs) a predetermined base payment. The payment is adjusted for the health condition and care needs of...
Amhøj, Christa Breum
Coaching vinder mere og mere indpas i den danske folkeskole og udpeges som løsning på forskellige problemer. Eksempelvis som løsning på hvordan skolelederen kan sætte sig fri fra irrationelle og automatpilotiske reaktionsmønstre og lede sine medarbejdere til at lede sig selv; som løsning på hvordan...... for statiske og kontrollerende læringsstrukturer. Artiklen påstår, at det fælles for disse ledelsesmæssige problemer er, at coaching udpeges som en styringsteknologi, der kan bruges til at styre det mulighedsrum, der skabes, når den traditionelle skole bliver erstattet af mere komplekse tilblivelses- og...... disciplineringsformer og nye krav fra omverden. Der er en mængde forskellige styringsteknologier, der konkurrerer om at skabe og styre de indbyggere, der søger at befolke den tomme plads, der opstår, når den traditionelle skole trækkes tilbage. Artiklen påstår, at coaching er en styringsteknologi, der muliggør ledelse...
Timmer, Susan G.; Zebell, Nancy M.; Culver, Michelle A.; Urquiza, Anthony J.
Objectives: The purpose of this study is to test whether increasing the exposure to coaching by adding an in-home component to clinic-delivered Parent-Child Interaction Therapy (PCIT) will increase the speed of parenting skill acquisition and show greater improvements in children's behaviors and parental stress. Methods: Seventy-three parent-child…
Clean and well-maintained homes can prevent many illnesses and injuries. This podcast discusses how good health begins at home. Created: 3/30/2009 by Coordinating Center for Environmental Health and Injury Prevention (CCEHIP). Date Released: 3/30/2009.
U.S. Department of Health & Human Services — The instrument-data collection tool used to collect and report performance data by home health agencies is called the Outcome and Assessment Information Set (OASIS)....
U.S. Department of Health & Human Services — A list of all Home Health Agencies that have been registered with Medicare. The list includes addresses, phone numbers, and quality measure ratings for each agency.
U.S. Department of Health & Human Services — Abt Associates July 21, 2010 Analysis of 2000-2008 Home Health Case-mix Change Report estimates the extent to which the observed increases in average case-mix were...
U.S. Department of Health & Human Services — These are the official datasets used on the Medicare.gov Home Health Compare Website provided by the Centers for Medicare and Medicaid Services. These data allow you...
Hackshaw, Kevin V; Plans-Pujolras, Marcal; Rodriguez-Saona, Luis E; Moore, Margaret A; Jackson, Erika K; Sforzo, Gary A; Buffington, C A Tony
The purpose of this study was to test the hypothesis that a health and wellness coaching (HWC)-based intervention for fibromyalgia (FM) would result in sustained improvements in health and quality of life, and reductions in health care utilization. Nine female subjects meeting American College of Rheumatology criteria for a diagnosis of primary FM were studied. The HWC protocol had two components, which were delivered telephonically over a twelve-month period. First, each patient met individually with a coach during the 12 month study at the patient's preference of schedule and frequency (Range:22-32 × 45-min sessions). Coaches were health professionals trained in health and wellness coaching tasks, knowledge, and skills. Second, each patient participated in bimonthly (first six months) and monthly (second six months) group classes on self-coaching strategies during the 12 month study. Prior to the intervention, and after 6 months and 12 months of coaching, the Revised Fibromyalgia Impact Questionnaire (FIQR) was used to measure health and quality of life, and the Brief Pain Inventory-Short Form (BPI) was used to measure pain intensity and interference with function. Total and rheumatology-related health encounters were documented using electronic medical records. Data were analyzed using repeated measures ANOVA. All nine patients finished the HWC protocol. FIQR scores improved by 35 % (P = 0.001). BPI scores decreased by 32 % overall (P = 0.006), 31 % for severity (P = 0.02), and 44 % for interference (P = 0.006). Health care utilization declined by 86 % (P = 0.006) for total and 78 % (P life measures (FIQR), pain (BPI), and marked reductions in health care utilization. Such improvements do not typically occur spontaneously in FM patients, suggesting that HWC deserves further consideration as an intervention for FM.
Eom, Sun Ok; Lee, Insook
This study was designed to determine the effects of health coaching and mediating variables on quantitative aspect of health in low-income hypertensive people. The experimental group for the current study consisted of 21 clients who received health coaching services, and the control group consisted of 22 clients who received home-visiting nursing services. Two groups received health coaching or homevisiting nursing services once a week for 8 weeks. The evaluation variables were self-efficacy, nutrition management, health behaviors, self-rated health, and quality of life. The results revealed that the level of nutrition management was significantly higher in the experimental group than the control group (F=10.33, p=.005). These results confirm that health coaching is a useful strategy that encourages clients to continuously maintain their own health behaviors. Thus, the findings of the current study provide useful data for establishing measures for the health management of those afflicted with chronic disease, such as hypertension. Furthermore, health coaching may be developed into useful intervention strategies for dealing with chronic diseases and improving home-visiting nursing. © 2017 Korean Society of Nursing Science
Blackman, Anna; Franklin, Richard C; Rossetto, Allison; Gray, David E
In the U.S. and Australia, agriculture is consistently ranked as one of the most hazardous industries. The cost of injuries and deaths on Australian farms is significant, estimated to be between AU$0.5 billion and AU$1.2 billion per year. Death and injury in agriculture also place a significant financial and social burden on the family and friends of the injured, the community, and the health system. This article proposes that if farmers were to employ coaching in their businesses, they would benefit from advances in safety practices, resulting in associated improvements in overall farm productivity and a reduction in injury costs to the wider community. A coaching model is presented to demonstrate what an effective coaching process would need to include. An agenda for future research areas is also provided.
Hedin, G.; Bendix, Lars Gotfred; Magnusson, B.
We have developed a tandem of undergraduate courses for teaching XP and coaching of XP teams. This paper focuses on the coaching course and the coaching practices we have developed. The tandem of courses enables us to give a challenging and interesting course for the coaches, and, at the same time......, allows us to afford on-site coaches for the younger students, providing them with a high quality environment for learning XP. We also describe our experiences from the first instance of the courses and how we have tackled the boot-strapping problem....
Olsen, Jeanette M; Nesbitt, Bonnie J
Chronic diseases account for 70% of U.S. deaths. Health coaching may help patients adopt healthy lifestyle behaviors that prevent and control diseases. This integrative review analyzed health coaching studies for evidence of effectiveness and to identify key program features. Multiple electronic databases were utilized, yielding a final sample of 15 documents. The search was limited to peer-reviewed research articles published between 1999 and 2008. Studies were further analyzed if they (1) specifically cited coaching as a program intervention, and (2) applied the intervention to research. Articles describing various quantitative and qualitative methodologies were critically analyzed using a systematic method. Data were synthesized using a matrix format according to purpose, method, intervention, findings, critique, and quality rating. All 15 studies utilized nonprobability sampling, 7 (47%) with randomized intervention and control groups. Significant improvements in one or more of the behaviors of nutrition, physical activity, weight management, or medication adherence were identified in six (40%) of the studies. Common features of effective programs were goal setting (73%), motivational interviewing (27%), and collaboration with health care providers (20%). Health coaching studies with well-specified methodologies and more rigorous designs are needed to strengthen findings; however, this behavioral change intervention suggests promise.
Wang, Chi-Jane; Fetzer, Susan J; Yang, Yi-Ching; Wang, Jing-Jy
It is a challenge for rural health professionals to promote medication safety among older adults taking multiple medications. A volunteer coaching program to promote medication safety among rural elders with chronic illnesses was designed and evaluated. A community-based interventional study randomly assigned 62 rural elders with at least two chronic illnesses to routine care plus volunteer coaching or routine care alone. The volunteer coaching group received a medication safety program, including a coach and reminders by well-trained volunteers, as well as three home visits and five telephone calls over a two-month period. All the subjects received routine medication safety instructions for their chronic illnesses. The program was evaluated using pre- and post-tests of knowledge, attitude and behaviors with regard to medication safety. Results show the volunteer coaching group improved their knowledge of medication safety, but there was no change in attitude after the two-month study period. Moreover, the group demonstrated three improved medication safety behaviors compared to the routine care group. The volunteer coaching program and instructions with pictorial aids can provide a reference for community health professionals who wish to improve the medication safety of chronically ill elders. Copyright © 2013 Mosby, Inc. All rights reserved.
Vale, Margarite J; Jelinek, Michael V; Best, James D; Dart, Anthony M; Grigg, Leeanne E; Hare, David L; Ho, Betty P; Newman, Robert W; McNeil, John J
Disease management programs in which drugs are prescribed by dietitians or nurses have been shown to improve the coronary risk factor profile in patients with coronary heart disease. However, those disease management programs in which drugs are not prescribed by allied health professionals have not improved coronary risk factor status. The objective of the Coaching patients On Achieving Cardiovascular Health (COACH) study was to determine whether dietitians or nurses who did not prescribe medications could coach patients with coronary heart disease to work with their physicians to achieve the target levels for their total cholesterol (TC) and other risk factors. Multicenter randomized controlled trial in which 792 patients from 6 university teaching hospitals underwent a stratified randomization by cardiac diagnosis within each hospital: 398 were assigned to usual care plus The COACH Program and 394 to usual care alone. Patients in The COACH Program group received regular personal coaching via telephone and mailings to achieve the target levels for their particular coronary risk factors. There was one coach per hospital. The primary outcome was the change in TC (DeltaTC) from baseline (in hospital) to 6 months after randomization. Secondary outcomes included measurement of a wide range of physical, nutritional, and psychological factors. The analysis was performed by intention to treat. The COACH Program achieved a significantly greater DeltaTC than usual care alone: the mean DeltaTC was 21 mg/dL (0.54 mmol/L) (95% confidence interval [CI], 16-25 mg/dL [0.42-0.65 mmol/L]) in The COACH Program vs 7 mg/dL (0.18 mmol/L) (95% CI, 3-11 mg/dL [0.07-0.29 mmol/L]) in the usual care group (PCOACH Program group than in the usual care group. Coaching produced substantial improvements in most of the other coronary risk factors and in patient quality of life. Coaching, delivered as The COACH Program, is a highly effective strategy in reducing TC and many other coronary risk
McKanna, James A; Pavel, Misha; Jimison, Holly
Assessment of cognitive functionality is an important aspect of care for elders. Unfortunately, few tools exist to measure divided attention, the ability to allocate attention to different aspects of tasks. An accurate determination of divided attention would allow inference of generalized cognitive decline, as well as providing a quantifiable indicator of an important component of driving skill. We propose a new method for determining relative divided attention ability through unobtrusive monitoring of computer use. Specifically, we measure performance on a dual-task cognitive computer exercise as part of a health coaching intervention. This metric indicates whether the user has the ability to pay attention to both tasks at once, or is primarily attending to one task at a time (sacrificing optimal performance). The monitoring of divided attention in a home environment is a key component of both the early detection of cognitive problems and for assessing the efficacy of coaching interventions.
Oksman, Erja; Linna, Miika; Hörhammer, Iiris; Lammintakanen, Johanna; Talja, Martti
The burden of chronic disease and multimorbidity is rapidly increasing. Self-management support interventions are effective in reduce cost, especially when targeted at a single disease group; however, economical evidence of such complex interventions remains scarce. The objective of this study was to evaluate a cost-effectiveness analysis of a tele-based health-coaching intervention among patients with type 2 diabetes (T2D), coronary artery disease (CAD) and congestive heart failure (CHF). A total of 1570 patients were blindly randomized to intervention (n = 970) and control (n = 470) groups. The intervention group received monthly individual health coaching by telephone from a specially trained nurse for 12-months in addition to routine social and healthcare. Patients in the control group received routine social and health care. Quality of life was assessed at the beginning of the intervention and follow-up measurements were made after 12 months health coaching. The cost included all direct health-care costs supplemented with home care and nursing home-care costs in social care. Utility was based on a Health Related Quality of Life (HRQoL) measurement (15D instrument), and cost effectiveness was assessed using incremental cost-effectiveness ratios (ICERs). The cost-effectiveness of health coaching was highest in the T2D group (ICER €20,000 per Quality-Adjusted Life Years [QALY]). The ICER for the CAD group was more modest (€40,278 per QALY), and in the CHF group, costs increased with no marked effect on QoL. Probabilistic sensitivity analysis indicated that at the societal willingness to pay threshold of €50,000 per QALY, the probability of health coaching being cost effective was 55% in the whole study group. The cost effectiveness of health coaching may vary substantially across patient groups, and thus interventions should be targeted at selected subgroups of chronically ill. Based on the results of this study, health coaching improved the QoL of
Owen, Jason E; Jaworski, Beth K; Kuhn, Eric; Makin-Byrd, Kerry N; Ramsey, Kelly M; Hoffman, Julia E
A majority of Americans (58%) now use smartphones, making it possible for mobile mental health apps to reach large numbers of those who are living with untreated, or under-treated, mental health symptoms. Although early trials suggest positive effects for mobile health (mHealth) interventions, little is known about the potential public health impact of mobile mental health apps. The purpose of this study was to characterize reach, use, and impact of "PTSD Coach", a free, broadly disseminated mental health app for managing posttraumatic stress disorder (PTSD) symptoms. Using a mixed-methods approach, aggregate mobile analytics data from 153,834 downloads of PTSD Coach were analyzed in conjunction with 156 user reviews. Over 60% of users engaged with PTSD Coach on multiple occasions (mean=6.3 sessions). User reviews reflected gratitude for the availability of the app and being able to use the app specifically during moments of need. PTSD Coach users reported relatively high levels of trauma symptoms (mean PTSD Checklist Score=57.2, SD=15.7). For users who chose to use a symptom management tool, distress declined significantly for both first-time users (mean=1.6 points, SD=2.6 on the 10-point distress thermometer) and return-visit users (mean=2.0, SD=2.3). Analysis of app session data identified common points of attrition, with only 80% of first-time users reaching the app's home screen and 37% accessing one of the app's primary content areas. These findings suggest that PTSD Coach has achieved substantial and sustained reach in the population, is being used as intended, and has been favorably received. PTSD Coach is a unique platform for the delivery of mobile mental health education and treatment, and continuing evaluation and improvement of the app could further strengthen its public health impact.
Benzo, Roberto P; Kirsch, Janae L; Hathaway, Julie C; McEvoy, Charlene E; Vickers, Kristin S
We recently demonstrated in a randomized study the feasibility and effectiveness of telephone-based health coaching using motivational interviewing on decreasing hospital readmissions and improving quality of life at 6 and 12 months after hospital discharge. In this qualitative study, we sought to explore the health-coaching intervention as seen from the perspective of the participants who received the intervention and the coaches who delivered it. Semistructured participant interviews ( n = 24) and a focus group of all health coaches ( n = 3) who participated in this study were conducted. Interviews and focus group were recorded and transcribed verbatim. Transcripts were analyzed using coding and categorizing techniques and thematic analysis. Mixed-method triangulation was used to merge quantitative and qualitative data. Content analysis revealed 4 predominant themes of the coaching intervention: health-coaching relationship, higher participant confidence and reassurance (most related to improvement in physical quality of life), improved health-care system access (most related to decreased hospital readmissions), and increased awareness of COPD symptoms (most related to improvement in emotional quality of life). The strongest theme was the relationship with the health coach, including coach style and motivational interviewing approach. Health coaches' focus group also noted the importance of the coaching relationship as the most significant theme. This study provided themes to further inform the delivery and implementation of health-coaching interventions in patients with COPD after hospital discharge. Health coaching forged partnerships and created a platform for patient engagement, which was confirmed by both participants and health coaches. Copyright © 2017 by Daedalus Enterprises.
Fox, C.D.; Kron, T.; Winton, J.R.S.; Rothwell, R.
Full text: Respiratory-gated radiotherapy requires consistent breathing. Therefore, we developed a system that will assess breathing consistency and allow patients to train themselves at home. Real-time feedback is to be provided visually to patients against a reference breathing track derived from their own breathing pattern. The system would need to generate the reference track and to use this reference track for coaching. The system should be simple, robust and affordable, without complex setup. Results The system uses a net book with a USB connected data acquisition module (DAQ). The patient's breathing is sampled by the DAQ, measuring intra-nasal pressure through nasal prongs. Software was written in collaboration with the Victorian eResearch Strategic Initiative (YERSi). The system is used to collect a patient reference breathing track. This track is processed to generate a 'golden breathing cycle' (GBC), normalised in both amplitude and duration, containing the shape of the breathing cycle. After training, the patient takes the system home for a number of sessions of coaching and assessment. In coaching mode the patient is asked to maintain a graphic representation of their current state of breathing in close correlation to the golden breathing cycle as it moves across the screen. Displayed GBC amplitude and duration respond dynamically to the patient's breathing rhythm. Statistics are collected measuring the patient's ability to conform to the GBC and may be used to decide suitability for gated therapy. Conclusion The DAQ hardware is completed, and software is approaching completion. Sample data has been collected from volunteers.
Liddy, Clare; Johnston, Sharon; Nash, Kate; Ward, Natalie; Irving, Hannah
Health coaching is a new intervention offering a one-on-one focused self-management support program. This study implemented a health coaching pilot in primary care clinics in Eastern Ontario, Canada to evaluate the feasibility and acceptability of integrating health coaching into primary care for patients who were either at risk for or diagnosed with diabetes. We implemented health coaching in three primary care practices. Patients with diabetes were offered six months of support from their health coach, including an initial face-to-face meeting and follow-up by email, telephone, or face-to-face according to patient preference. Feasibility was assessed through provider focus groups and qualitative data analysis methods. All three sites were able to implement the program. A number of themes emerged from the focus groups, including the importance of physician buy-in, wide variation in understanding and implementing of the health coach role, the significant impact of different systems of team communication, and the significant effect of organizational structure and patient readiness on Health coaches' capacity to perform their role. It is feasible to implement health coaching as an integrated program within small primary care clinics in Canada without adding additional resources into the daily practice. Practices should review their organizational and communication processes to ensure optimal support for health coaches if considering implementing this intervention.
Dye, Cheryl J; Williams, Joel E; Evatt, Janet Hoffman
Approximately two thirds of those older than 60 years have a hypertension diagnosis. The aim of our program, Health Coaches for Hypertension Control, is to improve hypertension self-management among rural residents older than 60 years through education and support offered by trained community volunteers called Health Coaches. Participants received baseline and follow-up health risk appraisals with blood work, educational materials, and items such as blood pressure monitors and pedometers. Data were collected at baseline, 8 weeks, and 16 weeks on 146 participants who demonstrated statistically significant increases in hypertension-related knowledge from baseline to 8 weeks that persisted at 16 weeks, as well as significant improvements in stage of readiness to change behaviors and in actual behaviors. Furthermore, clinically significant decreases in all outcome measures were observed, with statistically significant changes in systolic blood pressure (-5.781 mmHg; p = .001), weight (-2.475 lb; p definition of controlled hypertension at baseline, the proportion of participants meeting this definition at 16 weeks postintervention increased to 51.0%. This article describes a university-community-hospital system model that effectively promotes hypertension self-management in a rural Appalachian community. © 2014 Society for Public Health Education.
Lawson, Karen L; Jonk, Yvonne; O'Connor, Heidi; Riise, Kirsten Sundgaard; Eisenberg, David M; Kreitzer, Mary Jo
Health coaching is a client-centric process to increase motivation and self-efficacy that supports sustainable lifestyle behavior changes and active management of health conditions. This study describes an intervention offered as a benefit to health plan members and examines health and behavioral outcomes of participants. High-risk health plan enrollees were invited to participate in a telephonic health coaching intervention addressing the whole person and focusing on motivating health behavior changes. Outcomes of self-reported lifestyle behaviors, perceived health, stress levels, quality of life, readiness to make changes, and patient activation levels were reported at baseline and upon program completion. Retrospectively, these data were extracted from administrative and health coaching records of participants during the first 2 full years of the program. Less than 7% of the 114 615 potential candidates self-selected to actively participate in health coaching, those with the highest chronic disease load being the most likely to participate. Of 6940 active participants, 1082 fully completed health inventories, with 570 completing Patient Activation Measure (PAM). The conditions most often represented in the active participants were depression, congestive heart failure, diabetes, hyperlipidemia, hypertension, osteoporosis, asthma, and low back pain. In 6 months or less, 89% of participants met at least one goal. Significant improvements occurred in stress levels, healthy eating, exercise levels, and physical and emotional health, as well as in readiness to make change and PAM scores. The types of client-selected goals most often met were physical activity, eating habits, stress management, emotional health, sleep, and pain management, resulting in improved overall quality of life regardless of condition. Positive shifts in activation levels and readiness to change suggest that health coaching is an intervention deserving of future prospective research studies to
Suess, Alyssa N.; Romani, Patrick W.; Wacker, David P.; Dyson, Shannon M.; Kuhle, Jennifer L.; Lee, John F.; Lindgren, Scott D.; Kopelman, Todd G.; Pelzel, Kelly E.; Waldron, Debra B.
We conducted a retrospective, descriptive evaluation of the fidelity with which parents of three children with autism spectrum disorders conducted functional communication training (FCT) in their homes. All training was provided to the parents via telehealth by a behavior consultant in a tertiary-level hospital setting. FCT trials coached by the…
Ammentorp, Jette; Uhrenfeldt, Lisbeth; Angel, Flemming
BACKGROUND In recent years, coaching has received special attention as a method to improve healthy lifestyle behaviours. The fact that coaching has found its way into healthcare and may provide new ways of engaging the patients and making them accountable for their health, justifies the need for ...... suggest that the description and categorisation of the coaching methods are described more comprehensively, and that research into this area is supplemented by a more qualitative approach....... between health coaching and life coaching. In this review, we will only focus on the latter method and on that basis assess the health related outcomes of life coaching. METHODS Intervention studies using quantitative or qualitative methods to evaluate the outcome of the life coach interventions were......BACKGROUND In recent years, coaching has received special attention as a method to improve healthy lifestyle behaviours. The fact that coaching has found its way into healthcare and may provide new ways of engaging the patients and making them accountable for their health, justifies the need...
Dijkstra, H Paul; Pollock, N; Chakraverty, R; Alonso, J M
Elite athletes endeavour to train and compete even when ill or injured. Their motivation may be intrinsic or due to coach and team pressures. The sports medicine physician plays an important role to risk-manage the health of the competing athlete in partnership with the coach and other members of the support team. The sports medicine physician needs to strike the right ethical and operational balance between health management and optimising performance. It is necessary to revisit the popular delivery model of sports medicine and science services to elite athletes based on the current reductionist multispecialist system lacking in practice an integrated approach and effective communication. Athlete and coach in isolation or with a member of the multidisciplinary support team, often not qualified or experienced to do so, decide on the utilisation of services and how to apply the recommendations. We propose a new Integrated Performance Health Management and Coaching model based on the UK Athletics experience in preparation for the London Olympic and Paralympic Games. The Medical and Coaching Teams are managed by qualified and experienced individuals operating in synergy towards a common performance goal, accountable to a Performance Director and ultimately to the Board of Directors. We describe the systems, processes and implementation strategies to assist the athlete, coach and support teams to continuously monitor and manage athlete health and performance. These systems facilitate a balanced approach to training and competing decisions, especially while the athlete is ill or injured. They take into account the best medical advice and athlete preference. This Integrated Performance Health Management and Coaching model underpinned the Track and Field Gold Medal performances at the London Olympic and Paralympic Games.
Bennell, Kim L; Campbell, Penny K; Egerton, Thorlene; Metcalf, Ben; Kasza, Jessica; Forbes, Andrew; Bills, Caroline; Gale, Janette; Harris, Anthony; Kolt, Gregory S; Bunker, Stephen J; Hunter, David J; Brand, Caroline A; Hinman, Rana S
To investigate whether simultaneous telephone coaching improves the clinical effectiveness of a physiotherapist-prescribed home-based physical activity program for knee osteoarthritis (OA). A total of 168 inactive adults ages ≥50 years with knee pain on a numeric rating scale ≥4 (NRS; range 0-10) and knee OA were recruited from the community and randomly assigned to a physiotherapy (PT) and coaching group (n = 84) or PT-only (n = 84) group. All participants received five 30-minute consultations with a physiotherapist over 6 months for education, home exercise, and physical activity advice. PT+coaching participants also received 6-12 telephone coaching sessions by clinicians trained in behavioral-change support for exercise and physical activity. Primary outcomes were pain (NRS) and physical function (Western Ontario and McMaster Universities Osteoarthritis Index [WOMAC; score range 0-68]) at 6 months. Secondary outcomes were these same measures at 12 and 18 months, as well as physical activity, exercise adherence, other pain and function measures, and quality of life. Analyses were intent-to-treat with multiple imputation for missing data. A total of 142 (85%), 136 (81%), and 128 (76%) participants completed 6-, 12-, and 18-month measurements, respectively. The change in NRS pain (mean difference 0.4 unit [95% confidence interval (95% CI) -0.4, 1.3]) and in WOMAC function (1.8 [95% CI -1.9, 5.5]) did not differ between groups at 6 months, with both groups showing clinically relevant improvements. Some secondary outcomes related to physical activity and exercise behavior favored PT+coaching at 6 months but generally not at 12 or 18 months. There were no between-group differences in most other outcomes. The addition of simultaneous telephone coaching did not augment the pain and function benefits of a physiotherapist-prescribed home-based physical activity program. © 2016, American College of Rheumatology.
Wolever, Ruth Q.; Lawson, Karen; Moore, Margaret
The purpose of this article is twofold: (1) to announce the findings of the job task analysis as well as national training and education standards for health and wellness coaching (HWC) that have been developed by the large-scale, collaborative efforts of the National Consortium for Credentialing Health and Wellness Coaches (NCCHWC) and (2) to invite commentary from the public. The rapid proliferation of individuals and organizations using the terms of health and/or wellness coaches and the propagation of private industry and academic coach training and education programs endeavoring to prepare these coaches has created an urgent and pressing need for national standards for use of the term health and wellness coach, as well as minimal requirements for training, education, and certification. Professionalizing the field with national standards brings a clear and consistent definition of health and wellness coaching and accepted practice standards that are uniform across the field. In addition, clear standards allow for uniform curricular criteria to ensure a minimal benchmark for education, training, and skills and knowledge evaluation of professional health and wellness coaches. PMID:25984418
Almondes, Nadja; Downie, Denise; Cinar, Ayse B; Richards, Derek; Freeman, Ruth
This is a protocol for a systematic review of the impact of health coaching on changing the health behaviour of offenders. Prisoners are more likely to suffer from health-related issues when compared to the general population. Health coaching has been shown to influence health outcomes of patients with chronic conditions. This review, therefore, aims to assess the effectiveness of health coaching interventions on the health of adolescent and adult offenders in custodial institutions. We plan to conduct a systematic review of the current literature on health coaching interventions delivered in the prison setting. We will include randomised controlled trials and observational studies that compare health coaching to the usual care or other alternative interventions. The ideal interventions will be delivered either by health professionals or peer coaches, and the outcomes extracted in the data collection will be disease-specific, clients' life and self-management skills, behavioural and psychosocial outcomes. If appropriate, a meta-analysis of the data collected will be carried out on the last stage of the review. This systematic review will identify and gather evidence on the impact of health coaching interventions delivered in the prison setting and can function as a supporting material for health professionals, prison staff, the healthcare system, and public health departments when considering delivering health coaching. PROSPERO CRD42016053237 .
Sherifali, Diana; Viscardi, Virginia; Bai, Johnny-Wei; Ali, R Muhammad Usman
Diabetes health coaching has not been adequately assessed in individuals with type 2 diabetes. The objective of this review was to synthesize the evidence of health coaching for individuals with diabetes to determine the effects of coaching on diabetes control, specifically on glycated hemoglobin (A1C) levels. The EMBASE, MEDLINE, CINAHL, PsychINFO and Cochrane Central Register of Controlled Trials databases were searched from inception to January 2015. Reference lists from important publications were also reviewed. At least 2 evaluators independently screened and extracted data from eligible studies. A total of 8 trials met the selection criteria, which included 724 adult participants; 353 participants were randomized to a diabetes health coaching intervention, and 371 were randomized to usual care. The pooled effect of diabetes health coaching overall was a statistically significant reduction of A1C levels by 0.32 (95% CI, -0.50 to -0.15). Longer diabetes health coaching exposure (>6 months) resulted in a 0.57% reduction in A1C levels (95% CI, -0.76 to -0.38), compared to shorter diabetes health coaching exposure (≤6 months) (-0.23%; 95% CI, -0.37 to -0.09). Across all studies, diabetes health coaching consisted of goal setting, knowledge acquisition, individualized care and frequent follow up. Diabetes health coaching has an emerging role in healthcare that facilitates self-care, behaviour change and offers frequent follow up and support. This review finds that health coaching for those with diabetes is an effective intervention for improving glycemic control, which may be of greater benefit when offered in addition to existing diabetes care. Copyright © 2015 Canadian Diabetes Association. Published by Elsevier Inc. All rights reserved.
This article highlights how the multimodal approach (Lazarus, 1989) has been adapted to the field of coachingand coaching psychology. It covers the basic theories underpinning the multimodal approach and illustratesthe link between the theory and practice. Key multimodal strategies are covered including modalityprofiles, structural profiles, tracking and bridging.
Full Text Available This article highlights how the multimodal approach (Lazarus, 1989 has been adapted to the field of coachingand coaching psychology. It covers the basic theories underpinning the multimodal approach and illustratesthe link between the theory and practice. Key multimodal strategies are covered including modalityprofiles, structural profiles, tracking and bridging.
Liddy, Clare; Johnston, Sharon; Irving, Hannah; Nash, Kate; Ward, Natalie
To assess patients' experiences with and perceptions of health coaching as part of their ongoing care. A qualitative research design using semistructured interviews that were recorded and transcribed verbatim.Setting Ottawa, Ont. Eleven patients (> 18 years of age) enrolled in a health coaching pilot program who were at risk of or diagnosed with type 2 diabetes. Patients' perspectives were assessed with semistructured interviews. Interviews were conducted with 11 patients at the end of the pilot program, using a stratified sampling approach to ensure maximum variation. All patients found the overall experience with the health coaching program to be positive. Patients believed the health coaching program was effective in increasing awareness of how diabetes affected their bodies and health, in building accountability for their health-related actions, and in improving access to care and other health resources. Patients perceive one-on-one health coaching as an acceptable intervention in their ongoing care. Patients enrolled in the health coaching pilot program believed that there was an improvement in access to care, health literacy, and accountability,all factors considered to be precursors to behavioural change.
Boehmer, Kasey R; Barakat, Suzette; Ahn, Sangwoo; Prokop, Larry J; Erwin, Patricia J; Murad, M Hassan
Chronic conditions are increasingly more common and negatively impact quality of life, disability, morbidity, and mortality. Health coaching has emerged as a possible intervention to help individuals with chronic conditions adopt health supportive behaviors that improve both quality of life and health outcomes. We planned a systematic review and meta-analysis of the contemporary health coaching literature published in the last decade to evaluate the effect of health coaching on clinically important, disease-specific, functional, and behavioral outcomes. We will include randomized controlled trials or quasi-experimental studies that compared health coaching to alternative interventions or usual care. To enable adoption of effective interventions, we aim to explore how the effect of intervention is modified by the intervention components, delivering personnel (i.e., health professionals vs trained lay or peer persons), dose, frequency, and setting. Analysis of intervention outcomes will be reported and classified using an existing theoretical framework, the Theory of Patient Capacity, to identify the areas of patients' capacity to access and use healthcare and enact self-care where coaching may be an effective intervention. This systematic review and meta-analysis will identify and synthesize evidence to inform the practice of health coaching by providing evidence on components and characteristics of the intervention essential for success in individuals with chronic health conditions. PROSPERO CRD42016039730.
We conducted and evaluated a coaching intervention aimed at encouraging menopausal women's engagement in goal-oriented actions, self-efficacy enhancement, menopausal symptom alleviation, and quality of life improvement. The study was a randomized controlled trial comprising women aged 40-60 who were not receiving hormone therapy. The intervention group received leaflets and three monthly coaching sessions. Instruments included the Simplified Menopausal Index, Medical Outcome Study 36-Item Short Form Health Survey, and goal achievement scale. Participants were measured preintervention, immediately postintervention, and three months postintervention. A 3-month coaching intervention to enhance menopausal women's health increased their self-efficacy. This effect was not maintained 3 months postintervention.
Van Hoye, Aurélie; Heuzé, Jean-Philippe; Van den Broucke, Stephan; Sarrazin, Philippe
As major actors in sports activities, sports coaches can play a significant role in health education and contribute to the psychological well-being of young people. However, not all participants in sports activities experience sports positively, which reduces the potential benefits for health. The present study investigates if coaches' efforts to promote health increase young athletes' enjoyment, self-esteem and perceived health in daily life and decrease sport dropout. To control for the variability between teams and between clubs, multilevel modeling was applied. A sample of 342 young football players completed questionnaires assessing their perceptions of coaches' Health Promotion (HP) activities, enjoyment of sports, dropout intentions, self-esteem and perceived health in daily life. HP general score was positively related to enjoyment and perceived health as well as negatively dropout intentions. Players perceiving their coaches as promoting fair and play (Respect for oneself and others) scored higher on their perceptions of enjoyment in sport, self-esteem and self-reported health, and lower on dropout intentions. Moreover, players recognizing their coaches as encouraging their healthy lifestyle also reported higher perceptions of sport enjoyment, whereas player's perceived coaches' activities on substance use were associated with lower participants' enjoyment. These results support the importance of developing HP in sports clubs. Especially, promoting respect of oneself and others seems to be the more beneficial to sport participants. Copyright Â© 2016 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.
Collins, David A; Thompson, Kirsten; Atwood, Katharine A; Abadi, Melissa H; Rychener, David L; Simmons, Leigh Ann
Although studies of health coaching for behavior change in chronic disease prevention and management are increasing, to date no studies have reported on what concepts and skills providers integrate into their clinical practice following participation in health coaching courses. The purpose of this qualitative study was to assess Veterans Health Administration (VHA) providers' perceptions of the individual-level and system-level changes they observed after participating with colleagues in a 6-day Whole Health Coaching course held in 8 VHA medical centers nationwide. Data for this study were from the follow-up survey conducted with participants 2 to 3 months after completing the training. A total of 142 responses about individual-level changes and 99 responses about system-level changes were analyzed using content analysis. Eight primary themes emerged regarding individual changes, including increased emphasis on Veterans' values, increased use of listening and other specific health coaching skills in their clinical role, and adding health coaching to their clinical practice.Four primary themes emerged regarding system-level changes, including leadership support, increased staff awareness/support/learning and sharing, increased use of health coaching skills or tools within the facility, and organizational changes demonstrating a more engaged workforce, such as new work groups being formed or existing groups becoming more active. Findings suggest that VHA providers who participate in health coaching trainings do perceive positive changes within themselves and their organizations. Health coaching courses that emphasize patient-centered care and promote patient-provider partnerships likely have positive effects beyond the individual participants that can be used to promote desired organizational change.
Barakat, Suzette; Boehmer, Kasey; Abdelrahim, Marwan; Ahn, Sangwoo; Al-Khateeb, Abdulrahman A; Villalobos, Neri Álvarez; Prokop, Larry; Erwin, Patricia J; Fleming, Kirsten; Serrano, Valentina; Spencer-Bonilla, Gabriela; Murad, Mohammad Hassan
Interventions that grow patient capacity to do the work of health care and life are needed to support the health of cancer survivors. Health coaching may grow capacity. This systematic review of health coaching interventions explored coaching's ability to grow capacity of cancer survivors. The authors included randomized trials or quasi-experimental studies comparing coaching to alternative interventions, and adhered to PRISMA reporting guidelines. Data were analyzed using the Theory of Patient Capacity (BREWS: Capacity is affected by factors that influence ability to reframe Biography ["B"], mobilize or recruit Resources ["R"], interact with the Environment of care ["E"], accomplish Work ["W"]), and function Socially ["S"]). The authors reviewed 2210 references and selected 12 studies (6 randomized trials and 6 pre-post). These studies included 1038 cancer survivors, mean age 57.2 years, with various type of cancers: breast, colorectal, prostate, and lung. Health coaching was associated with improved quality of life, mood, and physical activity but not self-efficacy. Classified by potential to support growth in patient capacity, 67% of included studies reported statistically significant outcomes that support "B" (quality of life, acceptance, spirituality), 75% "R" (decreased fatigue, pain), 67% "W" (increased physical activity), and 33% "S" (social deprivation index). None addressed changing the patient's environment of care. In cancer survivors, health coaching improved quality of life and supported patient capacity by several mechanisms, suggesting an important role for "Capacity Coaching." Future interventions that improve self-efficacy and patients' environments of care are needed. Capacity Coaching may improve health and quality of life of cancer survivors.
Sharma, Anjana E; Willard-Grace, Rachel; Hessler, Danielle; Bodenheimer, Thomas; Thom, David H
Health coaching is effective for chronic disease self-management in the primary care safety-net setting, but little is known about the persistence of its benefits. We conducted an observational study evaluating the maintenance of improved cardiovascular risk factors following a health coaching intervention. We performed a naturalistic follow-up to the Health Coaching in Primary Care Study, a 12-month randomized controlled trial (RCT) comparing health coaching to usual care for patients with uncontrolled diabetes, hypertension, or hyperlipidemia. Participants were followed up 24 months from RCT baseline. The primary outcome was the proportion at goal for at least 1 measure (hemoglobin A1c, systolic blood pressure, or LDL cholesterol) that had been above goal at enrollment; secondary outcomes included each individual clinical goal. Chi-square tests and paired t-tests compared dichotomous and continuous measures. 290 of 441 participants (65.8%) participated at both 12 and 24 months. The proportion of patients in the coaching arm of the RCT who achieved the primary outcome dropped only slightly from 47.1% at 12 to 45.9% at 24 months (P = .80). The proportion at goal for hemoglobin A1c dropped from 53.4% to 36.2% (P = .03). All other clinical metrics had small, nonsignificant changes between 12 and 24 months. Results support the conclusion that most improved clinical outcomes persisted 1 year after the completion of the health coaching intervention. © 2016 Annals of Family Medicine, Inc.
Hood, Leroy; Lovejoy, Jennifer C; Price, Nathan D
The Hundred Person Wellness Project (HPWP) is a 10-month pilot study of 100 'well' individuals where integrated data from whole-genome sequencing, gut microbiome, clinical laboratory tests and quantified self measures from each individual are used to provide actionable results for health coaching with the goal of optimizing wellness and minimizing disease. In a commentary in BMC Medicine, Diamandis argues that HPWP and similar projects will likely result in 'unnecessary and potential harmful over-testing'. We argue that this new approach will ultimately lead to lower costs, better healthcare, innovation and economic growth. The central points of the HPWP are: 1) it is focused on optimizing wellness through longitudinal data collection, integration and mining of individual data clouds, enabling development of predictive models of wellness and disease that will reveal actionable possibilities; and 2) by extending this study to 100,000 well people, we will establish multiparameter, quantifiable wellness metrics and identify markers for wellness to early disease transitions for most common diseases, which will ultimately allow earlier disease intervention, eventually transitioning the individual early on from a disease back to a wellness trajectory.
Henry, Vonna; Sarpy, Sue Ann; Green, Rachel; Kaplan, Seth; Bonzon, Ramon
There is a need for programs tailored to train the approximately 300 new local health officials (LHOs) who emerge each year with the knowledge and skills needed to build, maintain, and enhance public health capacity and infrastructure. The Survive and Thrive program incorporates a curriculum that is designed to address the challenges faced by a new LHO. The Survive and Thrive program seeks to address these issues by leveraging the expertise of the current generation of local public health leadership by incorporating experienced LHOs as coaches. Coaching, mentoring, and peer assistance by seasoned LHOs is critical to these new learning opportunities. This article highlights aspects of the coaching component of Survive and Thrive program. Actual examples of its relevance to the professional growth and development of new LHOs and the coaches themselves are presented. The article also describes the novel approach of including coaches in evaluating program effectiveness. The Survive and Thrive program's coaching component can serve as a template for other public health leadership programs and related workforce development initiatives as well as a model to help facilitate lifelong learning of LHOs.
Ammentorp, Jette; Uhrenfeldt, Lisbeth; Angel, Flemming; Ehrensvärd, Martin; Carlsen, Ebbe B; Kofoed, Poul-Erik
In recent years, coaching has received special attention as a method to improve healthy lifestyle behaviours. The fact that coaching has found its way into healthcare and may provide new ways of engaging the patients and making them accountable for their health, justifies the need for an overview of the evidence regarding coaching interventions used in patient care, the effect of the interventions, and the quality of the studies published. However, in order to provide a clear definition of the coaching interventions selected for this review, we have found it necessary to distinguish between health coaching and life coaching. In this review, we will only focus on the latter method and on that basis assess the health related outcomes of life coaching. Intervention studies using quantitative or qualitative methods to evaluate the outcome of the life coach interventions were identified through systematic literature searches in PubMed, Embase, Psycinfo, and CINAHL. The quality of the methodology was independently assessed by three of the authors using a criteria list. A total of 4359 citations were identified in the electronic search and five studies were included; two of them were randomized controlled trials and met all quality criteria. The two studies investigating objective health outcomes (HbA1c) showed mixed but promising results, especially concerning the patient group that usually does not benefit from intensified interventions. Because of the very limited number of solid studies, this review can only present tendencies for patient outcomes and a preliminary description of an effective life coaching intervention.The coaching method used in these studies aims to improve self-efficacy and self-empowerment. This may explain why the studies including disadvantaged patients showed the most convincing results. The findings also indicate that some patients benefit from being met with an alternative approach and a different type of communication than they are used to
Human health is influenced by pollutants in the air. Since people spend over 80% of their time indoors, indoor air quality may be more related to health problems than outdoor air qual-ity. Indoor air quality is deteriorating because of energy conservation
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Menon, Jyothi; Paulet, Mindy; Thomas, Joseph
Association between wellness coaching and changes in health-related quality of life over 1 year and 2 years was assessed. Difference-in-differences analysis of covariance assessed association between coaching and change in 8-item short-form health survey (SF-8) summary scores. Ordered logistic models assessed coaching and change in SF-8 individual domain scores. This was a case-control study. Participants in at least one coaching program were more likely to have increases in social functioning after 1 year and less likely to have increases in role physical after 2 years. Participants in nutrition coaching had more positive change in mental component summary scores after 1 year. Participants in stress management had more negative change in mental component summary scores after 1 year and after 2 years and had more negative change in physical component summary scores after 2 years. Findings were mixed regarding association between coaching and change in health-related quality of life.
Hill, Briony; Richardson, Ben; Skouteris, Helen
To systematically review health coaching interventions regarding effectiveness of health coaching for specific outcomes, optimal intervention approaches, and identification of specific techniques associated with effectiveness. Articles were sourced from CINAHL, Global Health, PsycINFO, Academic Search Complete, Health Source, Psychology and Behavioral Sciences Collection, and Medline. Randomized controlled trials were included if the study (1) employed health coaching according to a predefined criterion; (2) clearly reported the use of health coaching; or (3) incorporated the use of coaching. Aims, participants, approach, behavior change techniques (BCTs), and findings pertaining to each study were summarized. BCTs were classified according to the CALO-RE taxonomy. Data were synthesized by cross-tabulation of BCTs with study outcomes. Fifteen of 16 eligible studies reported a positive intervention effect in at least one outcome. Nine studies (56%) did not define health coaching; the number of intervention sessions provided ranged from 2 to 48; and in three studies, one or more intervention details were unclear. It was hence difficult to synthesize the studies to adequately address our research questions. Health coaching is a promising strategy for health improvements; however, future research should ensure clarity in reporting intervention details, clearer definitions of health coaching/theoretical bases, consistency in reporting BCTs, and the inclusion of process variables as outcome measures.
The purpose of this article is to explore health coaching as an effective intervention in times of health crisis for patients, families, and health-care staff. The pause that a health crisis creates in the activities of normal life allows for deeper questions about a person's life to emerge. Health coaching provides a safe space for clients to engage with these life questions while facilitating a connection with their sense of personal empowerment and innate inner wisdom. The result is a more meaningful and resilient life despite the outcome of the health crisis.
Cappella, Elise; Hamre, Bridget K.; Kim, Ha Yeon; Henry, David B.; Frazier, Stacy L.; Atkins, Marc S.; Schoenwald, Sonja K.
Objective To examine effects of a teacher consultation and coaching program delivered by school and community mental health professionals on change in observed classroom interactions and child functioning across one school year. Method Thirty-six classrooms within five urban elementary schools (87% Latino, 11% Black) were randomly assigned to intervention (training + consultation/coaching) and control (training only) conditions. Classroom and child outcomes (n = 364; 43% girls) were assessed in the fall and spring. Results Random effects regression models showed main effects of intervention on teacher-student relationship closeness, academic self-concept, and peer victimization. Results of multiple regression models showed levels of observed teacher emotional support in the fall moderated intervention impact on emotional support at the end of the school year. Conclusions Results suggest teacher consultation and coaching can be integrated within existing mental health activities in urban schools and impact classroom effectiveness and child adaptation across multiple domains. PMID:22428941
Cappella, Elise; Hamre, Bridget K; Kim, Ha Yeon; Henry, David B; Frazier, Stacy L; Atkins, Marc S; Schoenwald, Sonja K
To examine effects of a teacher consultation and coaching program delivered by school and community mental health professionals on change in observed classroom interactions and child functioning across one school year. Thirty-six classrooms within 5 urban elementary schools (87% Latino, 11% Black) were randomly assigned to intervention (training + consultation/coaching) and control (training only) conditions. Classroom and child outcomes (n = 364; 43% girls) were assessed in the fall and spring. Random effects regression models showed main effects of intervention on teacher-student relationship closeness, academic self-concept, and peer victimization. Results of multiple regression models showed levels of observed teacher emotional support in the fall moderated intervention impact on emotional support at the end of the school year. Results suggest teacher consultation and coaching can be integrated within existing mental health activities in urban schools and impact classroom effectiveness and child adaptation across multiple domains. © 2012 American Psychological Association
Van Hoye, Aurélie; Sarrazin, Philippe; Heuzé, Jean-Philippe; Kokko, Sami
Background: Given the benefits of participating in sport, sports clubs have been recognised as health promoting organizations. To examine health-promotion activities in Finnish sports clubs, Kokko et al. developed a set of standards for health-promoting sports clubs (HPSC). Objective: The present study extends this line of research, by (1)…
Grant, Anthony M; Studholme, Ingrid; Verma, Raj; Kirkwood, Lea; Paton, Bronwyn; O'Connor, Sean
Purpose There is limited empirical literature on the effectiveness of leadership coaching in healthcare settings. The purpose of this paper is to explore the efficacy of leadership coaching for individuals implementing strategic change in the Australian public health system. Design/methodology/approach Using a within-subjects (pre-post) design, participants ( n=31) undertook six one-hour coaching sessions. Coaching was conducted by professional leadership coaches. Both quantitative and qualitative data were collected. Findings Participation was associated with significant improvements in goal attainment, solution-focused thinking, leadership self-efficacy, perspective-taking capacity, self-insight and resilience, and ambiguity tolerance. There were significant reductions in stress and anxiety. The benefits of coaching transferred from the workplace to the home. Many participants reported being able to use insights gained in coaching in their personal lives, and reported better work/life balance, less stress and better quality relationships at home. Originality/value Few studies have provided evaluation of leadership coaching in healthcare setting. Leadership coaching in the public health system may be an important methodology for facilitating goal attainment and fostering resilience in this vital social sector, benefiting workers in the health services, their families and ultimately their patients and the broader community.
Gorski, Lisa A
In 1986, the American Nurses Association (ANA) published the first Standards of Home Health Practice. Revised in 1992 and expanded in 1999 to become Home Health Nursing: Scope and Standards of Practice, it was revised in 2008 and again in 2014. In the 2014 edition, there are 6 standards of home healthcare nursing practice and 10 standards of professional performance for home healthcare nursing. The focus of this article is to describe the home healthcare standards and to provide guidance for implementation in clinical practice. It is strongly encouraged that home healthcare administrators, educators, and staff obtain a copy of the standards and fully read this essential home healthcare resource.
Wilson, Jonathan [National Center for Healthy Housing (NCHH), Columbia, MD (United States); Jacobs, David [National Center for Healthy Housing (NCHH), Columbia, MD (United States); Reddy, Amanda [National Center for Healthy Housing (NCHH), Columbia, MD (United States); Tohn, Ellen [Tohn Environmental Strategies, Wayland, MA (United States); Cohen, Jonathan [Dept. of Energy (DOE), Washington DC (United States); Jacobsohn, Ely [Dept. of Energy (DOE), Washington DC (United States)
Evidence in a new, groundbreaking U.S. Department of Energy report, Home Rx: The Health Benefits of Home Performance, shows that home performance upgrades can improve the quality of a home’s indoor environment by reducing the prevalence of harmful indoor air pollutants and contaminants. Until recently, no systematic review of this evidence had been conducted, limiting full understanding of the link between home performance and health. This new report summarizes current knowledge and identifies research gaps. The design characteristics and results of each of the 40 studies considered in the report are summarized in a searchable matrix.
Full Text Available Objetivo: Analizar las aportaciones que los participantes en una actividad formativa elaboraron respecto la viabilidad del coaching en el ámbito sanitario. Método: Estudio cualitativo de las aportaciones de los 18 participantes en el «Taller sobre aplicaciones del coaching en el ámbito sanitario» llevado a cabo en marzo de 2002 en el Institut d'Estudis de la Salut (IES. Resultados: Las aportaciones versaron sobre: a las oportunidades de aplicación: la potenciación de profesionales asistenciales que pasan a ejercer funciones directivas y como estrategia de ayuda para el cambio de cultura organizativa, y b los inconvenientes: resistencia al cambio, riesgo de utilización como castigo, resultados difícilmente objetivables. Conclusiones: La metodología del coaching es susceptible de aplicarse en personas que deben ejercer un papel clave en una organización sanitaria, sobre todo en proceso de cambio.Objective: To analyse the contributions that the participants in a formative activity elaborated respect the viability of the coaching in the health environment. Method: Qualitative study of the contributions of the 18 participants in the workshop upon applications of the coaching in the health environment carried out the month of March 2002 at the Institute of Health Studies (IHS. Results: The contributions deal with: a the opportunities: help to healthcare professionals that become to exercise directive responsibilities and strategies to help for the cultural change, and b the objections: resistance to change, utilization as punishment, results difficult to measure. Conclusions: The methodology of the coaching is susceptible of being applied in persons that they should exercise a key paper in a health organization, above all in process of change.
Prestia, Mindy; Murphy, Susan; Yoder, Marian
In an effort to address the home care nursing shortage, this pilot study was designed to measure nursing students' attitudes toward home health nursing and to test the Home Health Attitude Questionnaire developed specifically for this study based on the Theory of Planned Behavior. Senior undergraduate nursing students and registered nursing to bachelor of science in nursing students completed the questionnaire.
Widmer, Geraldine; And Others
Findings from a study of home care services in one New York district document the value and relatively modest costs of home health care for the chronically ill and dependent elderly. Professional nurses coordinated the care, but most of the direct services were provided by home health aides and housekeepers. (MF)
Pauley, Tim; Gargaro, Judith; Chenard, Glen; Cavanagh, Helen; McKay, Sandra M
This study evaluated paraprofessional-led diabetes self-management coaching (DSMC) among 94 clients with type 2 diabetes recruited from a Community Care Access Centre in Ontario, Canada. Subjects were randomized to standard care or standard care plus coaching. Measures included the Diabetes Self-Efficacy Scale (DSES), Insulin Management Diabetes Self-Efficacy Scale (IMDSES), and Hospital Anxiety and Depression Scale (HADS). Both groups showed improvement in DSES (6.6 + 1.5 vs. 7.2 + 1.5, p .05 for all) or depression scores (p > .05 for all), or anxiety (p > .05 for all) or depression (p > .05 for all) categories at baseline, postintervention, or follow-up. While all subjects demonstrated significant improvements in self-efficacy measures, there is no evidence to support paraprofessional-led DSMC as an intervention which conveys additional benefits over standard care.
Landers, Steven; Madigan, Elizabeth; Leff, Bruce; Rosati, Robert J.; McCann, Barbara A.; Hornbake, Rodney; MacMillan, Richard; Jones, Kate; Bowles, Kathryn; Dowding, Dawn; Lee, Teresa; Moorhead, Tracey; Rodriguez, Sally; Breese, Erica
The Future of Home Health project sought to support transformation of home health and home-based care to meet the needs of patients in the evolving U.S. health care system. Interviews with key thought leaders and stakeholders resulted in key themes about the future of home health care. By synthesizing this qualitative research, a literature review, case studies, and the themes from a 2014 Institute of Medicine and National Research Council workshop on “The Future of Home Health Care,” the authors articulate a vision for home-based care and recommend a bold framework for the Medicare-certified home health agency of the future. The authors also identify challenges and recommendations for achievement of this framework. PMID:27746670
African Journal for the Psychological Study of Social Issues. Journal Home · ABOUT · Advanced Search · Current Issue · Archives · Journal Home > Vol 1, No 2 (1994) >. Log in or Register to get access to full text downloads. Username, Password, Remember me, or Register. DOWNLOAD FULL TEXT Open Access ...
Sears, Lindsay E; Coberley, Carter R; Pope, James E
The aim of this study was to examine the direct and mediated effects of a telephonic health coaching program on changes to healthy behaviors, life satisfaction, and optimism. This longitudinal correlational study of 4881 individuals investigated simple and mediated relationships between participation in a telephonic health risk coaching program and outcomes from three annual Well-being Assessments. Program participation was directly related to improvements in healthy behaviors, life satisfaction and optimism, and indirect effects of coaching on these variables concurrently and over a one-year time lag were also supported. Given previous research that improvements to life satisfaction, optimism, and health behaviors are valuable for individuals, employers, and communities, a clearer understanding of intervention approaches that may impact these outcomes simultaneously can drive greater program effectiveness and value on investment.
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Boccio, Mindy; Sanna, Rashel S.; Adams, Sara R.; Goler, Nancy C.; Brown, Susan D.; Neugebauer, Romain S.; Ferrara, Assiamira; Wiley, Deanne M.; Bellamy, David J.; Schmittdiel, Julie A.
Purpose Many Americans continue to smoke, increasing their risk of disease and premature death. Both telephone-based counseling and in-person tobacco cessation classes may improve access for smokers seeking convenient support to quit. Little research has assessed whether such programs are effective in real-world clinical populations. Design Retrospective cohort study comparing wellness coaching participants with two groups of controls. Setting Kaiser Permanente, Northern California (KPNC), a large integrated health care delivery system. Subjects 241 patients who participated in telephonic tobacco cessation coaching from 1/1/2011–3/31/2012, and two control groups: propensity-score matched controls, and controls who participated in a tobacco cessation class during the same period. Wellness coaching participants received an average of two motivational interviewing based coaching sessions that engage the patient, evoke their reason to consider quitting and help them establish a quit plan. Measures Self-reported quitting of tobacco and fills of tobacco cessation medications within 12 months of follow-up. Analysis Logistic regressions adjusting for age, gender, race/ethnicity, and primary language. Results After adjusting for confounders, tobacco quit rates were higher among coaching participants vs. matched controls (31% vs. 23%, PCoaching participants and class attendees filled tobacco-cessation prescriptions at a higher rate (47% for both) than matched controls (6%, Pcoaching was as effective as in-person classes and was associated with higher rates of quitting compared to no treatment. The telephonic modality may increase convenience and scalability for health care systems looking to reduce tobacco use and improve health. PMID:26559720
REPORT: Annual PREPARED FOR: U.S. Army Medical Research and Materiel Command Fort Detrick, Maryland 21702-5012 DISTRIBUTION STATEMENT...ACRONYM(S) U.S. Army Medical Research and Materiel Command Fort Detrick, Maryland 21702-5012 11. SPONSOR/MONITOR’S REPORT NUMBER(S) 12...the intervention and obtaining quantitative health outcome data. 15. SUBJECT TERMS Veterans, suicide, psychological well-being, health coaching
Kramer, A M; Shaughnessy, P W; Pettigrew, M L
Case-mix differences between 653 home health care patients and 650 nursing home patients, and between 455 Medicare home health patients and 447 Medicare nursing home patients were assessed using random samples selected from 20 home health agencies and 46 nursing homes in 12 states in 1982 and 1983. Home health patients were younger, had shorter lengths of stay, and were less functionally disabled than nursing home patients. Traditional long-term care problems requiring personal care were more...
Latham, Nancy K; Quintiliani, Lisa M
Background Long-term engagement in exercise and physical activity mitigates the progression of disability and increases quality of life in people with Parkinson disease (PD). Despite this, the vast majority of individuals with PD are sedentary. There is a critical need for a feasible, safe, acceptable, and effective method to assist those with PD to engage in active lifestyles. Peer coaching through mobile health (mHealth) may be a viable approach. Objective The purpose of this study was to develop a PD-specific peer coach training program and a remote peer-mentored walking program using mHealth technology with the goal of increasing physical activity in persons with PD. We set out to examine the feasibility, safety, and acceptability of the programs along with preliminary evidence of individual-level changes in walking activity, self-efficacy, and disability in the peer mentees. Methods A peer coach training program and a remote peer-mentored walking program using mHealth was developed and tested in 10 individuals with PD. We matched physically active persons with PD (peer coaches) with sedentary persons with PD (peer mentees), resulting in 5 dyads. Using both Web-based and in-person delivery methods, we trained the peer coaches in basic knowledge of PD, exercise, active listening, and motivational interviewing. Peer coaches and mentees wore FitBit Zip activity trackers and participated in daily walking over 8 weeks. Peer dyads interacted daily via the FitBit friends mobile app and weekly via telephone calls. Feasibility was determined by examining recruitment, participation, and retention rates. Safety was assessed by monitoring adverse events during the study period. Acceptability was assessed via satisfaction surveys. Individual-level changes in physical activity were examined relative to clinically important differences. Results Four out of the 5 peer pairs used the FitBit activity tracker and friends function without difficulty. A total of 4 of the 5 pairs
Colón-Semenza, Cristina; Latham, Nancy K; Quintiliani, Lisa M; Ellis, Terry D
Long-term engagement in exercise and physical activity mitigates the progression of disability and increases quality of life in people with Parkinson disease (PD). Despite this, the vast majority of individuals with PD are sedentary. There is a critical need for a feasible, safe, acceptable, and effective method to assist those with PD to engage in active lifestyles. Peer coaching through mobile health (mHealth) may be a viable approach. The purpose of this study was to develop a PD-specific peer coach training program and a remote peer-mentored walking program using mHealth technology with the goal of increasing physical activity in persons with PD. We set out to examine the feasibility, safety, and acceptability of the programs along with preliminary evidence of individual-level changes in walking activity, self-efficacy, and disability in the peer mentees. A peer coach training program and a remote peer-mentored walking program using mHealth was developed and tested in 10 individuals with PD. We matched physically active persons with PD (peer coaches) with sedentary persons with PD (peer mentees), resulting in 5 dyads. Using both Web-based and in-person delivery methods, we trained the peer coaches in basic knowledge of PD, exercise, active listening, and motivational interviewing. Peer coaches and mentees wore FitBit Zip activity trackers and participated in daily walking over 8 weeks. Peer dyads interacted daily via the FitBit friends mobile app and weekly via telephone calls. Feasibility was determined by examining recruitment, participation, and retention rates. Safety was assessed by monitoring adverse events during the study period. Acceptability was assessed via satisfaction surveys. Individual-level changes in physical activity were examined relative to clinically important differences. Four out of the 5 peer pairs used the FitBit activity tracker and friends function without difficulty. A total of 4 of the 5 pairs completed the 8 weekly phone
Miyamoto, Sheridan; Dharmar, Madan; Fazio, Sarina; Tang-Feldman, Yajarayma; Young, Heather M
Chronic diseases, including diabetes mellitus, are the leading cause of mortality and disability in the United States. Current solutions focus primarily on diagnosis and pharmacological treatment, yet there is increasing evidence that patient-centered models of care are more successful in improving and addressing chronic disease outcomes. The objective of this clinical trial is to evaluate the impact of a mobile health (mHealth) enabled nurse health coaching intervention on self-efficacy among adults with type-2 diabetes mellitus. A randomized controlled trial was conducted at an academic health system in Northern California. A total of 300 participants with type-2 diabetes were scheduled to be enrolled through three primary care clinics. Participants were randomized to either usual care or intervention. All participants received training on use of the health system patient portal. Participants in the intervention arm received six scheduled health-coaching telephone calls with a registered nurse and were provided with an activity tracker and mobile application that integrated data into the electronic health record (EHR) to track their daily activity and health behavior decisions. All participants completed a baseline survey and follow-up surveys at 3 and 9 months. Primary and secondary outcomes include diabetes self-efficacy, hemoglobin A 1c (HbA 1c ), and quality of life measures. Data collection for this trial, funded by the Patient-Centered Outcomes Research Institute, will be completed by December 2017. Results from the trial will be available mid-2018. This protocol details a patient-centered intervention using nurse health coaching, mHealth technologies, and integration of patient-generated data into the EHR. The aim of the intervention is to enhance self-efficacy and health outcomes by providing participants with a mechanism to track daily activity by offering coaching support to set reasonable and attainable health goals, and by creating a complete feedback
Clark, Matthew M; Bradley, Karleah L; Jenkins, Sarah M; Mettler, Emily A; Larson, Brent G; Preston, Heather R; Liesinger, Juliette T; Werneburg, Brooke L; Hagen, Philip T; Harris, Ann M; Riley, Beth A; Olsen, Kerry D; Vickers Douglas, Kristin S
Purpose . This project examined potential changes in health behaviors following wellness coaching. Design . In a single cohort study design, wellness coaching participants were recruited in 2011, data were collected through July 2012, and were analyzed through December 2013. Items in the study questionnaire used requested information about 11 health behaviors, self-efficacy for eating, and goal-setting skills. Setting . Worksite wellness center. Participants . One-hundred employee wellness center members with an average age of 42 years; 90% were female and most were overweight or obese. Intervention . Twelve weeks of in-person, one-on-one wellness coaching. Method . Participants completed study questionnaires when they started wellness coaching (baseline), after 12 weeks of wellness coaching, and at a 3-month follow-up. Results . From baseline to week 12, these 100 wellness coaching participants improved their self-reported health behaviors (11 domains, 0- to 10-point scale) from an average of 6.4 to 7.7 (p coaching.
Lenneke Van Genugten
The results show that the structured, partly automated approach can be used in a telehealth context by means of health coaches. MAY appeared to be a suitable tool for providing input for psychosocial care. HCs attitudes towards the structured approach were positive, which is crucial to the success of the implementation of MAY. Based on these results, we recommend to continue this approach as it may strengthen the wellbeing of patients (to be evaluated in future work. However, improvements are necessary. The tool should get a better fit in the current working procedures, and support the translation from recommendations to action. Further automation may facilitate this. In conclusion, this study shows that it is possible for HCs to implement structured psychosocial care in a telehealth program but that combining digitalized and human efforts in one structure is a challenge. The appreciation of the health coaches is an important first step in this process.
Jarrín, Olga; Flynn, Linda; Lake, Eileen T; Aiken, Linda H
An important goal of home health care is to assist patients to remain in community living arrangements. Yet home care often fails to prevent hospitalizations and to facilitate discharges to community living, thus putting patients at risk of additional health challenges and increasing care costs. To determine the relationship between home health agency work environments and agency-level rates of acute hospitalization and discharges to community living. Analysis of linked Center for Medicare and Medicaid Services Home Health Compare data and nurse survey data from 118 home health agencies. Robust regression models were used to estimate the effect of work environment ratings on between-agency variation in rates of acute hospitalization and community discharge. Home health agencies with good work environments had lower rates of acute hospitalizations and higher rates of patient discharges to community living arrangements compared with home health agencies with poor work environments. Improved work environments in home health agencies hold promise for optimizing patient outcomes and reducing use of expensive hospital and institutional care.
U.S. Department of Health & Human Services — The Home Health Agency PUF contains information on utilization, payment (Medicare payment and standard payment), and submitted charges organized by CMS Certification...
Kokko, Sami; Selänne, Harri; Alanko, Lauri; Heinonen, Olli J; Korpelainen, Raija; Savonen, Kai; Vasankari, Tommi; Kannas, Lasse; Kujala, Urho M; Aira, Tuula; Villberg, Jari; Parkkari, Jari
Sports clubs form a potential setting for health promotion, but the research is limited. The aim of the Health Promoting Sports Club (HPSC) study was to elucidate the current health promotion activities of youth sports clubs and coaches, and to investigate the health behaviours and health status of youth participating in sports clubs compared to non-participants. The study design employs cross-sectional multilevel and multimethod research with aspirations to a prospective cohort study in the next phase. The setting-based variables at sports clubs and coaching levels, and health behaviour variables at the individual level, are investigated using surveys; and total levels of physical activity are assessed using objective accelerometer measurements. Health status variables will be measured by preparticipation screening. The health promotion activity of sports clubs (n=154) is evaluated by club officials (n=313) and coaches (n=281). Coaches and young athletes aged 14-16 (n=759) years evaluate the coaches' health promotion activity. The survey of the adolescents' health behaviours consist of two data sets-the first is on their health behaviours and the second is on musculoskeletal complaints and injuries. Data are collected via sports clubs (759 participants) and schools 1650 (665 participants and 983 non-participants). 591 (418 athletes and 173 non-athletes) youth, have already participated in preparticipation screening. Screening consists of detailed personal medical history, electrocardiography, flow-volume spirometry, basic laboratory analyses and health status screening, including posture, muscle balance, and static and dynamic postural control tests, conducted by sports and exercise medicine specialists. The HPSC study is carried out conforming with the declaration of Helsinki. Ethical approval was received from the Ethics Committee of Health Care District of Central Finland. The HPSC study is close-to-practice, which generates foundations for development work
Olga L. Zadvornaya
Full Text Available Purpose: to study and evaluate the motivational and psychological readiness of health managers to introduce and use tools and approaches to develop and improve professional performance in the context of the modernization of the health-care system, the growing need for highly skilled management skills.Based on proven methods of research, international experience and our own research, the authors proved the feasibility of using coaching as a technology of training on cycles of training, ensuring the formation and development of valuable personal qualities and professional competencies of the heads of medical organizations.Methods: in the present study, the following methods were used: systemic approach, content analysis, methods of social diagnosis (questionnaires, interviews, comparative analysis, method of expert evaluations, method of statistical processing of information.Results: reviewed and proposed approaches to use modern technology management training of health aimed at improving the efficiency of healthcare organizations.Conclusions and Relevance: heads of the medical organizations have a high level of motivation and psychological readiness for professional development, effectiveness of professional activity, to achieve the goals of the success of the activities of medical organizations in modern conditions.Coaching is one of the effective combining of different methods and techniques instrument affecting the results of the activities of individuals and the organization as a whole. In scientific research, devoted to increase of efficiency of activity of managerial staff in the healthcare, not defined methodological approaches to the use of coaching in professional development and improving professional activity of heads of medical organizations. Coaching in educational activities based on interdisciplinary scientific and practical achievements, the range of effective educational methodologies, techniques and approaches that can be
Farrar, Francisca Cisneros
Telehealth technology is an evidence-based delivery model tool that can be integrated into the plan of care for mental health patients. Telehealth technology empowers access to health care, can help decrease or prevent hospital readmissions, assist home health nurses provide shared decision making, and focuses on collaborative care. Telehealth and the recovery model have transformed the role of the home health nurse. Nurses need to be proactive and respond to rapidly emerging technologies that are transforming their role in home care. Copyright © 2015 Elsevier Inc. All rights reserved.
Derks, Youri P.M.J.; De Visser, Tessa; Bohlmeijer, Ernst T.; Noordzij, Matthijs L.
mHealth applications aim to 'coach' users in achieving a better life. However, many of these e-coaches are not based on sound background knowledge of those in need of support. One such group is patients with a borderline personality disorder (BPD). Patients with BPD experience great difficulties in
Benzo, Roberto; Vickers, Kristin; Novotny, Paul J; Tucker, Sharon; Hoult, Johanna; Neuenfeldt, Pamela; Connett, John; Lorig, Kate; McEvoy, Charlene
Hospital readmission for chronic obstructive pulmonary disease (COPD) has attracted attention owing to the burden to patients and the health care system. There is a knowledge gap on approaches to reducing COPD readmissions. To determine the effect of comprehensive health coaching on the rate of COPD readmissions. A total of 215 patients hospitalized for a COPD exacerbation were randomized at hospital discharge to receive either (1) motivational interviewing-based health coaching plus a written action plan for exacerbations (the use of antibiotics and oral steroids) and brief exercise advice or (2) usual care. We evaluated the rate of COPD-related hospitalizations during 1 year of follow-up. The absolute risk reductions of COPD-related rehospitalization in the health coaching group were 7.5% (P = 0.01), 11.0% (P = 0.02), 11.6% (P = 0.03), 11.4% (P = 0.05), and 5.4% (P = 0.24) at 1, 3, 6, 9, and 12 months, respectively, compared with the control group. The odds ratios for COPD hospitalization in the intervention arm compared with the control arm were 0.09 (95% confidence interval [CI], 0.01-0.77) at 1 month postdischarge, 0.37 (95% CI, 0.15-0.91) at 3 months postdischarge, 0.43 (95% CI, 0.20-0.94) at 6 months postdischarge, and 0.60 (95% CI, 0.30-1.20) at 1 year postdischarge. The missing value rate for the primary outcome was 0.4% (one patient). Disease-specific quality of life improved significantly in the health coaching group compared with the control group at 6 and 12 months, based on the Chronic Respiratory Disease Questionnaire emotional score (emotion and mastery domains) and physical score (dyspnea and fatigue domains) (P coaching may represent a feasible and possibly effective intervention designed to reduce COPD readmissions. Clinical trial registered with www.clinicaltrials.gov (NCT01058486).
Swan, J H; Benjamin, A E
Rapid increases in the size and costs of the home health market, unknown impacts of Medicare's DRG hospital reimbursement on the posthospital market, and general lack of knowledge about factors that explain interstate variation in home health utilization all suggest the importance of developing and testing models of Medicare home health use. This article proposes and tests a model of state home health utilization as a function of the nursing home market. This model proposes that home health u...
Dimas, Isabel Dórdio; Renato Lourenço, Paulo; Rebelo, Teresa
The purpose of this study was to examine the effects of coaching behaviours provided by peers and by the leader on the emotions experienced by interprofessional health and social care teams and on members' satisfaction with the team, as well as on team performance. Data were obtained from a survey among 344 employees working in 52 interprofessional health and social care teams from nine Portuguese organizations. The results show that leader coaching and peer coaching have a positive effect on the level of team members' satisfaction with the team and on positive emotions, and a negative effect on negative emotions. Furthermore, coaching provided by peers presents a positive effect on team performance as assessed by the leader of the team. Our findings put forward the importance of engaging in coaching behaviours to promote quality of the team experience, as well as the achievement of team performance objectives. Further studies should explore how coaching behaviours impact the patient, whose well-being is the ultimate objective of a team in the health and social care system, namely in terms of the patient's perception of quality care or patient outcomes.
Rao, Sowmya R.; Rogers, Robert S.; Mailhot, Johanna R.; Galvin, Robert
BACKGROUND Given increasing interest in helping consumers choose high-performing (higher quality, lower cost) physicians, one approach chosen by several large employers is to provide assistance in the form of a telephonic “health coach” — a registered nurse who assists with identifying appropriate and available providers. OBJECTIVE To evaluate the health coach’s influence on provider choice and the quality of the user experience in the early introduction of this service. DESIGN Cross-sectional survey of 3490 employees and covered dependents of a large national firm that offered health coach services to all employees and covered dependents. The survey began in September 2007 with proportionate stratified sampling of 1750 employees and covered dependents who used the services between October 2007 and February 2008, and 1740 non-users. PARTICIPANTS Insured adults (ages 21–64) employed by a large national firm or covered dependents of employees. MEASUREMENTS Awareness of the service, reason for using service, visits to providers recommended by service, use of health advice provided by service, user satisfaction. MAIN RESULTS The primary reason for using the service was to obtain provider referrals (73%). Fifty-two percent of users sought a specialist referral, 33% a PCP referral and 9% a hospital referral. Eighty-nine percent of users seeking a provider referral were referred in-network; 81% of those referred visited the referred provider. Measures of satisfaction with both the service and the care delivered by recommended providers were over 70%. CONCLUSIONS Customers largely follow the provider recommendation of the health coach. Users express general satisfaction with existing health coach services, but differences in performance between vendors highlight the need for the services to be well implemented. Electronic supplementary material The online version of this article (doi:10.1007/s11606-010-1428-4) contains supplementary material, which is available
Linking High Risk Postpartum Women with a Technology Enabled Health Coaching Program to Reduce Diabetes Risk and Improve Wellbeing: Program Description, Case Studies, and Recommendations for Community Health Coaching Programs.
Athavale, Priyanka; Thomas, Melanie; Delgadillo-Duenas, Adriana T; Leong, Karen; Najmabadi, Adriana; Harleman, Elizabeth; Rios, Christina; Quan, Judy; Soria, Catalina; Handley, Margaret A
Background . Low-income minority women with prior gestational diabetes mellitus (pGDM) or high BMIs have increased risk for chronic illnesses postpartum. Although the Diabetes Prevention Program (DPP) provides an evidence-based model for reducing diabetes risk, few community-based interventions have adapted this program for pGDM women. Methods . STAR MAMA is an ongoing randomized control trial (RCT) evaluating a hybrid HIT/Health Coaching DPP-based 20-week postpartum program for diabetes prevention compared with education from written materials at baseline. Eligibility includes women 18-39 years old, ≥32 weeks pregnant, and GDM or BMI > 25. Clinic- and community-based recruitment in San Francisco and Sonoma Counties targets 180 women. Sociodemographic and health coaching data from a preliminary sample are presented. Results . Most of the 86 women included to date (88%) have GDM, 80% were identified as Hispanic/Latina, 78% have migrant status, and most are Spanish-speaking. Women receiving the intervention indicate high engagement, with 86% answering 1+ calls. Health coaching callbacks last an average of 9 minutes with range of topics discussed. Case studies presented convey a range of emotional, instrumental, and health literacy-related supports offered by health coaches. Discussion . The DPP-adapted HIT/health coaching model highlights the possibility and challenge of delivering DPP content to postpartum women in community settings. This trial is registered with ClinicalTrials.gov NCT02240420.
This study assessed 11 determinants of health coaching program participation. A cross-sectional study design used secondary data to assess the role of six employee-level and five worksite-level variables on telephone-based coaching enrollment, active participation, and completion. Data was provided by a national provider of worksite health promotion program services for employers. A random sample of 34,291 employees from 52 companies was selected for inclusion in the study. Survey-based measures included age, gender, job type, health risk status, tobacco risk, social support, financial incentives, comprehensive communications, senior leadership support, cultural support, and comprehensive program design. Gender-stratified multivariate logistic regression models were applied using backwards elimination procedures to yield parsimonious prediction models for each of the dependent variables. Employees were more likely to enroll in coaching programs if they were older, female, and in poorer health, and if they were at worksites with fewer environmental supports for health, clear financial incentives for participation in coaching, more comprehensive communications, and more comprehensive programs. Once employees were enrolled, program completion was greater among those who were older, did not use tobacco, worked at a company with strong communications, and had fewer environmental supports for health. Both worksite-level and employee-level factors have significant influences on health coaching engagement, and there are gender differences in the strength of these predictors.
Alamgir, Hasanat; Drebit, Sharla; Li, Helen Guiyun; Kidd, Catherine; Tam, Helen; Fast, Catherine
To reduce the risk of patient handling-related musculoskeletal injury, overhead ceiling lifts have been installed in health care facilities. To increase ceiling lift usage for a variety of patient handling tasks, a peer coaching and mentoring program was implemented among the direct care staff in the long-term care subsector in British Columbia, Canada. They received a 4-day training program on body mechanics, ergonomics, patient-handling techniques, ceiling lift usage, in addition to coaching skills. A questionnaire was administered among staff before and after the intervention to evaluate the program's effectiveness. There were 403 and 200 respondents to the pre-intervention and post-intervention questionnaires. In general, staff perceived the peer-coaching program to be effective. The number of staff who reported to be using ceiling lifts "often and always" went higher from 64.5% to 80.5% (<0.001) after coaching program implementation. Furthermore, staff reported that they were using the ceiling lifts for more types of tasks post-intervention. Staff reported that the peer coaching program has increased their safety awareness at work and confidence in using the ceiling lifts. The findings suggest that this educational model can increase the uptake of mechanical interventions for occupational health and safety initiatives. It appears that the training led to a greater awareness of the availability of or increased perceptions of the number of ceiling lifts, presumably through coaches advocating their use. Copyright © 2011 Wiley-Liss, Inc.
Kokko, Sami; Selänne, Harri; Alanko, Lauri; Heinonen, Olli J; Korpelainen, Raija; Savonen, Kai; Vasankari, Tommi; Kannas, Lasse; Kujala, Urho M; Aira, Tuula; Villberg, Jari; Parkkari, Jari
Introduction Sports clubs form a potential setting for health promotion, but the research is limited. The aim of the Health Promoting Sports Club (HPSC) study was to elucidate the current health promotion activities of youth sports clubs and coaches, and to investigate the health behaviours and health status of youth participating in sports clubs compared to non-participants. Methods and analysis The study design employs cross-sectional multilevel and multimethod research with aspirations to a prospective cohort study in the next phase. The setting-based variables at sports clubs and coaching levels, and health behaviour variables at the individual level, are investigated using surveys; and total levels of physical activity are assessed using objective accelerometer measurements. Health status variables will be measured by preparticipation screening. The health promotion activity of sports clubs (n=154) is evaluated by club officials (n=313) and coaches (n=281). Coaches and young athletes aged 14–16 (n=759) years evaluate the coaches’ health promotion activity. The survey of the adolescents’ health behaviours consist of two data sets—the first is on their health behaviours and the second is on musculoskeletal complaints and injuries. Data are collected via sports clubs (759 participants) and schools 1650 (665 participants and 983 non-participants). 591 (418 athletes and 173 non-athletes) youth, have already participated in preparticipation screening. Screening consists of detailed personal medical history, electrocardiography, flow-volume spirometry, basic laboratory analyses and health status screening, including posture, muscle balance, and static and dynamic postural control tests, conducted by sports and exercise medicine specialists. Ethics and dissemination The HPSC study is carried out conforming with the declaration of Helsinki. Ethical approval was received from the Ethics Committee of Health Care District of Central Finland. The HPSC study is
Hartanto, D.; Brinkman, W.P.; Kampmann, I.L.; Morina, N.; Emmelkamp, P.G.; Neerincx, M.A.
Current developments of virtual reality exposure therapy (VRET) system focus mainly on systems that can be used in health clinics under the direct supervision of a therapist. Offering patients however the possibility to do this treatment at home would make VRET more accessible. In this paper we
Business Award Flu Season Media button unselected Media button selected Data Stats button unselected Data unselected Contact Us button selected Start Talking Help Me Grow WIC (Women, Infants & Children) Office , sleep-related deaths and birth defects. Makes it easier for Ohio families to identify lead-safe homes
Stulginsky, Maryfran McKenzie
Defines home health nursing as meeting the acute and chronic care needs of patients and their families in the home environment. Offers examples of situations in which home health nurses find themselves and their reactions to them. (JOW)
Full Text Available Abstract Background The Happy Life Club™ is an intervention that utilises health coaches trained in behavioural change and motivational interviewing techniques to assist with the management of type 2 diabetes mellitus (T2DM in primary care settings in China. Health coaches will support participants to improve modifiable risk factors and adhere to effective self-management treatments associated with T2DM. Methods/Design A cluster randomised controlled trial involving 22 Community Health Centres (CHCs in Fengtai District of Beijing, China. CHCs will be randomised into a control or intervention group, facilitating recruitment of at least 1320 individual participants with T2DM into the study. Participants in the intervention group will receive a combination of both telephone and face-to-face health coaching over 18 months, in addition to usual care received by the control group. Health coaching will be performed by CHC doctors and nurses certified in coach-assisted chronic disease management. Outcomes will be assessed at baseline and again at 6, 12 and 18 months by means of a clinical health check and self-administered questionnaire. The primary outcome measure is HbA1c level. Secondary outcomes include metabolic, physiological and psychological variables. Discussion This cluster RCT has been developed to suit the Chinese health care system and will contribute to the evidence base for the management of patients with T2DM. With a strong focus on self-management and health coach support, the study has the potential to be adapted to other chronic diseases, as well as other regions of China. Trial Registration Current Controlled Trials ISRCTN01010526
Owen, Jason E; Jaworski, Beth K; Kuhn, Eric; Makin-Byrd, Kerry N; Ramsey, Kelly M; Hoffman, Julia E
Background A majority of Americans (58%) now use smartphones, making it possible for mobile mental health apps to reach large numbers of those who are living with untreated, or under-treated, mental health symptoms. Although early trials suggest positive effects for mobile health (mHealth) interventions, little is known about the potential public health impact of mobile mental health apps. Objective The purpose of this study was to characterize reach, use, and impact of ?PTSD Coach?, a free, ...
Full Text Available Frances Early,1 Jane S Young,2 Elizabeth Robinshaw,3 Emma Z Mi,4 Ella Z Mi,4 Jonathan P Fuld1 1Centre for Self Management Support, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK; 2Faculty of Health, Social Care and Education, School of Nursing and Midwifery, Anglia Ruskin University, Cambridge, UK; 3Gloucestershire Hospitals NHS Foundation Trust, Gloucester, UK; 4School of Clinical Medicine, University of Cambridge, Cambridge, UK Background: COPD has significant psychosocial impact. Self-management support improves quality of life, but programs are not universally available. IT-based self-management interventions can provide home-based support, but have mixed results. We conducted a case series of an off-the-shelf Internet-based health-promotion program, The Preventive Plan (TPP, coupled with nurse-coach support, which aimed to increase patient activation and provide self-management benefits. Materials and methods: A total of 19 COPD patients were recruited, and 14 completed 3-month follow-up in two groups: groups 1 and 2 with more and less advanced COPD, respectively. Change in patient activation was determined with paired t-tests and Wilcoxon signed-rank tests. Benefits and user experience were explored in semistructured interviews, analyzed thematically. Results: Only group 1 improved significantly in activation, from a lower baseline than group 2; group 1 also improved significantly in mastery and anxiety. Both groups felt significantly more informed about COPD and reported physical functioning improvements. Group 1 reported improvements in mood and confidence. Overall, group 2 reported fewer benefits than group 1. Both groups valued nurse-coach support; for group 1, it was more important than TPP in building confidence to self-manage. The design of TPP and lack of motivation to use IT were barriers to use, but disease severity and poor IT skills were not. Discussion: Our findings demonstrate the feasibility of combining
Knudsen, Karin Bæk; Pressler, Tacjana; Mortensen, Laust Hvas
-term physical health. Treatment guidelines recommend interventions to improve adherence and self-management. The aim of this study was to test the feasibility of a life coaching intervention for young adults with CF. Methods: A randomized, controlled feasibility study was conducted at the CF Center...... at Copenhagen University Hospital, Rigshospitalet. Participants were young adults with CF, aged 18-30 years without severe intellectual impairments. Participants were randomized to either life coaching or standard care. The intervention consisted of up to 10 individual, face-to-face or telephone coaching......-to-face coaching were convenient for participants, with 50% receiving the maximum offered coaching sessions. However, the dropout rate early in the intervention was a concern. In future studies, eligible participants should be screened for their interest and perceived need for support and life coaching before...
... of care + Share widget - Select to show Whatâs home health care? What's home health care? Home health care is a wide ... or skilled nursing facility (SNF). Examples of skilled home health services include: Wound care for pressure sores ...
Lystbæk, Christian Tang
Bidraget sammenfatter pointerne fra min ph.d.-afhandling: Kollegial Coaching - Filosoferende fællesskaber i professionspraksis. Bidraget fokuserer på: 1. Kontekstualisering af coaching i feltet for praksislæring 2. Konfigurering af coaching som ramme for filosoferende fællesskaber 3....... Konceptualisering af coaching som modus for evidensreflekteret praksis...
Williamson, Kathleen M
This exploratory study involved the triangulation of qualitative (interview and observation) and quantitative methods (Psychological Empowerment Instrument). This study examined the individual home care nurses' perception of empowerment and how it influences decisions in the home clinical setting. Fifteen nurses were self-selected to participate. All completed an interview, and were observed and given Likert Instrument to complete. A framework analysis was performed to identify mutually exclusive and exhaustive emergent themes and patterns within the data. Home care nurses described that enpowerment is in the interaction between nurse and patient, and nurse and health care provider. Empowered is defined as being independent, confident, trusting, and comfortable with providing quality care. Home health care nurses believe that having the ability to practice collaboratively and build professional relationships was essential. Nurses in this study perceived empowerment as having meaning, choice, and competence in their job.
Nursing homes are considered lagging behind in adopting health information technology (HIT). Many studies have highlighted the use of HIT as a means of improving health care quality. However, these studies overwhelmingly do not provide empirical information proving that HIT can actually achieve these improvements. The main research goal of this…
Objectives: The purpose of this study was to identify core journals in home health nursing and to determine how well these journals were covered by indexing and abstracting services. The study was part of the project for mapping the nursing literature of the Medical Library Association's Nursing and Allied Health Resource Section.
Skouteris, Helen; McPhie, Skye; Hill, Briony; McCabe, Marita; Milgrom, Jeannette; Kent, Bridie; Bruce, Lauren; Herring, Sharon; Gale, Janette; Mihalopoulos, Cathrine; Shih, Sophy; Teale, Glyn; Lachal, Jennifer
The objectives of this study were to evaluate the efficacy of a health coaching (HC) intervention designed to prevent excessive gestational weight gain (GWG), and promote positive psychosocial and motivational outcomes in comparison with an Education Alone (EA) group. Randomized-controlled trial. Two hundred and sixty-one women who were <18 weeks pregnant consented to take part. Those allocated to the HC group received a tailored HC intervention delivered by a Health Coach, whilst those in the EA group attended two education sessions. Women completed measures, including motivation, psychosocial variables, sleep quality, and knowledge, beliefs and expectations concerning GWG, at 15 weeks of gestation (Time 1) and 33 weeks of gestation (Time 2). Post-birth data were also collected at 2 months post-partum (Time 3). There was no intervention effect in relation to weight gained during pregnancy, rate of excessive GWG or birth outcomes. The only differences between HC and EA women were higher readiness (b = 0.29, 95% CIs = 0.03-0.55, p < .05) and the importance to achieve a healthy GWG (b = 0.27, 95% CIs = 0.02-0.52, p < .05), improved sleep quality (b = -0.22, 95% CIs = -0.44 to -0.03, p < .05), and increased knowledge for an appropriate amount of GWG that would be best for their baby's health (b = -1.75, 95% CI = -3.26 to -0.24, p < .05) reported by the HC at Time 2. Whilst the HC intervention was not successful in preventing excessive GWG, several implications for the design of future GWG interventions were identified, including the burden of the intervention commitment and the use of weight monitoring. What is already known on the subject? Designing interventions to address gestational weight gain (GWG) continues to be a challenge. To date, health behaviour change factors have not been the focus of GWG interventions. What does this study add? Our health coaching (HC) intervention did not reduce GWG more so than education alone (EA). There was an intervention effect
Pludwinski, Sarah; Ahmad, Farah; Wayne, Noah; Ritvo, Paul
We investigated the experience of individuals diagnosed with type 2 diabetes mellitus (T2DM) who participated in an intervention in which the key elements were the provision of a smartphone and self-monitoring software. The interviews focused on use of a smartphone and the effects on motivation for health behavior change. This was a qualitative evaluation of participants in a larger T2DM self-management randomized controlled trial (RCT) conducted at the Black Creek Community Health Centre (BCCHC) in Toronto, Canada (ClinicalTrials.gov Identifier: NCT02036892). The study is based on semi-structured interviews (n = 11) that were audio taped and analyzed with a thematic analytic approach. The RCT compared the effectiveness of six months of smartphone-based self-monitoring and health coaching with a control group who received health coaching without internet or smartphone-based assistance. Qualitative data analyses resulted in derivation of four major themes that describe participant experience: (a) 'smartphone and software', describes smartphone use in relation to health behavior change; (b) 'health coach' describes how client/health coach relationships were assisted by smartphone use; (c) 'overall experience' describes perceptions of the overall intervention; and (d) 'frustrations in managing chronic conditions' describes difficulties with the complexities of T2DM management from a patient perspective. Findings suggest that interventions with T2DM assisted by smartphone software and health coaches actively engage individuals in improved hemoglobin A1c (HbA1c) control. © The Author(s) 2015.
health and home instability among couples in Ibadan, Nigeria. Descriptive survey ... importance of reproductive health education and home stability to health and general ..... extramarital affair in Nepal due to economic factors such as foreign ...
This study evaluated the application of the Comprehensive Conflict Coaching model in a hospital environment. Conflict coaching involves a coach working with a client to improve the client's conflict understanding, interaction strategies and/or interaction skills. The training of nurse managers as conflict coaches is an innovative continuing education programme that partially addresses conflict-related concerns in nursing. Twenty nurse managers trained as conflict coaches and each coached a supervisee. Qualitative data were gathered from nurse managers, supervisees and senior nursing leaders over an 8-month period and organized using standard programme evaluation themes. Benefits included supervisor conflict coaching competency and enhanced conflict communication competency for nurse managers and supervisees facing specific conflict situations. Challenges included the management of programme tensions. Additional benefits and challenges are discussed, along with study limitations. Conflict coaching was a practical and effective means of developing the conflict communication competencies of nurse managers and supervisees. Additional research is needed. Conflict is common in nursing. Conflict coaching is a new conflict communication and supervision intervention that demonstrates initial promise. Conflict coaching seems to work best when supported by a positive conflict culture and integrated with other conflict intervention processes. © 2010 The Author. Journal compilation © 2010 Blackwell Publishing Ltd.
Corrieri, Sandro; Conrad, Ines; Riedel-Heller, Steffi G
Mental disorders in children and adolescents are common and have serious consequences. Schools present a key opportunity to promote mental health and implement prevention measures. Four school coaches in five German schools were enlisted to engage students, teachers and parents in building a sustainably healthy school and classroom climate. Altogether, 58 focus groups with students (N=244), parents (N=54) and teachers (N=62) were conducted longitudinally. Topics included: (1) the development of the school and classroom climate, (2) the role of mental health in the regular curriculum, and (3) the role of school coaches in influencing these aspects. Over time, school coaches became trusted reference persons for an increasing number of school system members. They were able to positively influence the school and classroom climate by increasing the awareness of students, teachers and parents of mental health in daily routines. Nevertheless, topics like bullying and student inclusion remained an issue at follow-up. Overall, the school coach intervention is a good model for establishing the topic of mental health in everyday school life and increasing its importance. Future efforts will focus on building self-supporting structures and networks in order to make these efforts sustainable.
Kröse, B.; van Hoof, J.; Demiris, G.; Wouters, E.J.M.
This chapter focuses on the analysis of data that is collected from sensors in the home environment. First we discuss the need for a good model that relates sensor data (or features derived from the data) to indicators of health and well-being. Then we present several methods for model building. We
Schrevel, Samuel J C; Dedding, Christine; Broerse, Jacqueline E W
For this qualitative case study, 23 semistructured interviews were conducted with clients of a private coaching center in the Netherlands. We explored why adults with attention deficit/hyperactivity disorder (ADHD) prefer coaching, which is financed out-of-pocket, over public mental health care and
Garnham-Lee, Katy; Trigwell, Joanne; McGee, Ciara E.; Knowles, Zoe; Foweather, Lawrence
This study evaluated the impact and acceptability of a three-hour bespoke training workshop for sports coaches and teachers to subsequently deliver a sport-for-health smoking prevention intervention in primary schools. Questionnaires were completed pre- and post-training by both teachers (N = 24) and coaches (N = 8), and post-intervention by…
Scattergood, Donna M
The Essential Vitality Program blends holistic nursing, functional medicine, and health coaching to promote lifestyle changes that modify risk factors of costly chronic disease. Karl is a client who experienced enhanced vitality, decreased chronic pain and medications use, and improved meaningful functioning, by partnering with a holistic nurse coach.
Wolever, Ruth Q; Jordan, Meg; Lawson, Karen; Moore, Margaret
The pressing need to manage burgeoning chronic disease has led to the emergence of job roles such as health and wellness coaches (HWCs). As use of this title has increased dramatically, so has the need to ensure consistency, quality and safety for health and wellness coaching (HWC) provided in both practice and research. Clear and uniform role definitions and competencies are required to ensure appropriate scope of practice, to allow best practices to emerge, and to support the implementation of well-designed, large scale studies to accumulate a rigorous evidence base. Since the nascent field is replete with heterogeneity in terms of role delineations and competencies, a collaborative volunteer non-profit organization, the National Consortium for Credentialing Health and Wellness Coaches (NCCHWC), has been built over the past six years to support professionalization of the field. In 2014, a professionally led Job Task Analysis (JTA) was conducted with 15 carefully selected subject matter experts (SMEs) with diverse education and professional backgrounds who were practicing HWC in a wide variety of settings. After establishing a thorough list of specific tasks employed during HWC, the expert panel discussed the knowledge and skills necessary to competently perform the tasks. Subsequently, a large validation survey assessed the relative importance and frequency of each identified job task in conducting HWC. The JTA identified 21 job tasks as essential to HWC. In the subsequent validation survey, 4026 practicing health and wellness coaches were invited to rate each of the 21 job tasks in terms of their importance and frequency. A response rate of 25.6 % provided a diverse sample (n = 1031) in terms of background, and represented a wide variety of training programs from academia, industry, the private sector and associations. Per best practices, the subset of practicing HWCs (n = 885) provided importance and frequency ratings to be used to calculate task and
Lee, Teresa; Schiller, Jennifer
In addition to providing high-quality care to vulnerable patient populations, home healthcare offers the least costly option for patients and the healthcare system, particularly in postacute care. As the baby boom generation ages, policymakers are expressing concerns about rising costs, variation in home healthcare service use, and program integrity. The Alliance for Home Health Quality and Innovation seeks to develop a research-based strategic framework for the future of home healthcare for older Americans and those with disabilities. This article describes the initiative and invites readers to provide comments and suggestions.
Santoso, Bedjo; Eko Ningtyas, Endah Aryati; Fatmasari, Diyah
Stomatitis often occurs in elderly at nursing home. They need nursing home staff assistance to maintain their dental and oral health. Therefore, nursing home staff need dental health education. Lecture or discussion methods, which are more effective to improve knowledge, attitude and skill of nursing home staff was the purpose of this research. The research design was quasi-experiment research and pretest-posttest with control group. The sample was 42 nursing home staffs and 74 elderlies, div...
This chapter explores how coaching equips managers and supervisors to be successful in the 21st-century workplace. Coaching has benefited these professionals by providing them with viable tools to enhance the leadership and managerial tools they already possess.
Nagy, Annaliese; McMahon, Anne; Tapsell, Linda; Deane, Frank; Arenson, Danielle
The psychological construct of 'therapeutic alliance' can be used to better understand the effectiveness of consultations, particularly goal setting for weight management. We analysed audio-recorded health coaching sessions during a weight loss trial to explore relationships between therapeutic alliance and various contextual factors. Audio recordings of 50 health coaching sessions were analysed. After assessing fidelity to the protocol, therapeutic alliance was measured using an adapted Working Alliance Inventory Observer-rated Short Version (WAI-O-S), and examined by (i) identifying relationships between contextual factors and WAI-O-S scores (Spearman's coefficients); (ii) testing the impact of preparatory exercises and body mass index on WAI-O-S scores (one-way analysis of variance and least-squared differences tests) and (iii) comparing differences in WAI-O-S scores based on relationship status, gender and follow-up session completion (independent samples t-tests). Fidelity was high (mean 88%). WAI-O-S total scores ranged from 55 to 70 (out of 84). Session duration was significantly correlated with WAI-O-S component of 'Bond' (r = 0.42, P = 0.002). Those who completed preparatory exercises had significantly higher total WAI-O-S scores, 'Goal' and 'Task' scores. Participants who completed the follow-up session scored significantly higher for 'Goal' compared to no follow-up. Spending more time in a session appears related to increased bonding, a key component of therapeutic alliance. Preparatory work may help build therapeutic alliance and agreement on goals appears to influence follow-up completion. These exploratory findings provide directions for research addressing the professional relationship in dietetic consultations for weight loss. © 2018 Dietitians Association of Australia.
... an acute illness to avoid the recipient's transfer to a nursing facility. (d) “Home health agency... 42 Public Health 4 2010-10-01 2010-10-01 false Home health services. 440.70 Section 440.70 Public...) MEDICAL ASSISTANCE PROGRAMS SERVICES: GENERAL PROVISIONS Definitions § 440.70 Home health services. (a...
... Provisions § 441.15 Home health services. With respect to the services defined in § 440.70 of this subchapter, a State plan must provide that— (a) Home health services include, as a minimum— (1) Nursing services... 42 Public Health 4 2010-10-01 2010-10-01 false Home health services. 441.15 Section 441.15 Public...
Full Text Available Abstract Background Although self-management support improves diabetes outcomes, it is not consistently provided in health care settings strained for time and resources. One proposed solution to personnel and funding shortages is to utilize peer coaches, patients trained to provide diabetes education and support to other patients. Coaches share similar experiences about living with diabetes and are able to reach patients within and beyond the health care setting. Given the limited body of evidence that demonstrates peer coaching significantly improves chronic disease care, this present study examines the impact of peer coaching delivered in a primary care setting on diabetes outcomes. Methods/Design The aim of this multicenter, randomized control trial is to evaluate the effectiveness of utilizing peer coaches to improve clinical outcomes and self-management skills in low-income patients with poorly controlled diabetes. A total of 400 patients from six primary health centers based in San Francisco that serve primarily low-income populations will be randomized to receive peer coaching (n = 200 or usual care (n = 200 over 6 months. Patients in the peer coach group receive coaching from patients with diabetes who are trained and mentored as peer coaches. The primary outcome is change in HbA1c. Secondary outcomes include change in: systolic blood pressure, body mass index (BMI, LDL cholesterol, diabetes self-care activities, medication adherence, diabetes-related quality of life, diabetes self-efficacy, and depression. Clinical values (HbA1c, LDL cholesterol and blood pressure and self-reported diabetes self-efficacy and self-care activities are measured at baseline and after 6 months for patients and coaches. Peer coaches are also assessed at 12 months. Discussion Patients with diabetes, who are trained as peer health coaches, are uniquely poised to provide diabetes self management support and education to patients. This study is designed to
Russell, David; Oberlink, Mia R; Shah, Shivani; Evans, Lauren; Bassuk, Karen
To describe the design and participants of a program that employed health coaches and community health workers to address the social, health, and long-term disaster recovery needs of Rockaway residents roughly 2 years after Hurricane Sandy made landfall. Baseline and exit questionnaires, containing demographic, health, and health care utilization measures, were administered to participants at the start and end of the program. Enrollment and encounter information was captured in program administrative records. Descriptive statistics were used to summarize participant characteristics, personal goals, referrals to local organizations and agencies, and outcomes. Qualitative analyses were used to identify recurring themes in challenges faced by participants and barriers to health and wellness. The program served 732 community residents, of whom 455 (62%) completed baseline and exit questionnaires. Participants were directly and/or indirectly impacted by Hurricane Sandy through property damage, closures of health care facilities, limited employment opportunities, and trouble securing affordable housing. Furthermore, many participants faced considerable adversities and struggled to manage chronic health conditions. Personal goals set by participants included locating health care and other resources (44%), weight management and healthy eating (35%), and self-management of chronic conditions (24%). Health coaches and community health workers engaged participants an average of 4 times-providing counseling and referrals to local organizations and services, including medical and dental services (29%), city-issued identification cards (27%), and health insurance and other entitlements (23%). Comparisons of baseline and exit surveys indicated significant improvements in self-reported health, health care utilization, and confidence managing health issues. No significant improvement was observed in the use of preventive health care services. The program represents a model for
The purpose of this study was to identify core journals in home health nursing and to determine how well these journals were covered by indexing and abstracting services. The study was part of the project for mapping the nursing literature of the Medical Library Association's Nursing and Allied Health Resource Section. A citation analysis of two core journals was done to determine distribution of references by format types and age of citations and dispersion of the literature, according to Bradford's Law of Scattering. The analysis of indexing coverage for Zone 1 and 2 was also provided. The study showed that 64.2% of citations came from journals, versus 22.9% from books and 12.9% from other publications. PubMed/ MEDLINE rated highest in average indexing coverage of Zone 1 and 2 journals, followed by CINAHL. PsycINFO, SocioAbstracts, and EBSCO Health Business FullTEXT showed practically no coverage for the home health nursing literature. As expected, journal articles were found to be the primary source for referencing and books, the secondary source. In regard to bibliographic control, no databases provided full coverage of the journals in the field of home health nursing. PubMed/MEDLINE and CINAHL gave better results in combination, because CINAHL tended to cover more nursing journals, while PubMed/MEDLINE did better with medical titles.
Skeels, S E; Pernigotti, D; Houlihan, B V; Belliveau, T; Brody, M; Zazula, J; Hasiotis, S; Seetharama, S; Rosenblum, D; Jette, A
A process evaluation of a clinical trial. To describe the roles fulfilled by peer health coaches (PHCs) with spinal cord injury (SCI) during a randomized controlled trial research study called 'My Care My Call', a novel telephone-based, peer-led self-management intervention for adults with chronic SCI 1+ years after injury. Connecticut and Greater Boston Area, MA, USA. Directed content analysis was used to qualitatively examine information from 504 tele-coaching calls, conducted with 42 participants with SCI, by two trained SCI PHCs. Self-management was the focus of each 6-month PHC-peer relationship. PHCs documented how and when they used the communication tools (CTs) and information delivery strategies (IDSs) they developed for the intervention. Interaction data were coded and analyzed to determine PHC roles in relation to CT and IDS utilization and application. PHCs performed three principal roles: Role Model, Supporter, and Advisor. Role Model interactions included CTs and IDSs that allowed PHCs to share personal experiences of managing and living with an SCI, including sharing their opinions and advice when appropriate. As Supporters, PHCs used CTs and IDSs to build credible relationships based on dependability and reassuring encouragement. PHCs fulfilled the unique role of Advisor using CTs and IDSs to teach and strategize with peers about SCI self-management. The SCI PHC performs a powerful, flexible role in promoting SCI self-management among peers. Analysis of PHC roles can inform the design of peer-led interventions and highlights the importance for the provision of peer mentor training.
Heeke, Sheila; Wood, Felecia; Schuck, Jennifer
A task force at a multihospital health care system partnered with home health agencies to improve gaps during the discharge transition process. A standardized order template for home health nursing and remote telemonitoring was developed to decrease discrepancies in communication between hospital health care providers and home health nurses caring for patients with heart failure. Pilot results showed significantly improved communication with no readmissions, using the order template.
Full Text Available Chronic diseases, like diabetes mellitus, heart disease and cancer are leading causes of death and disability. These conditions are at least partially preventable or modifiable, e.g. by enhancing patients' self-management. We aimed to examine the effectiveness of telephone-based health coaching (TBHC in chronically ill patients.This prospective, pragmatic randomized controlled trial compares an intervention group (IG of participants in TBHC to a control group (CG without TBHC. Endpoints were assessed two years after enrolment. Three different groups of insurees with 1 multiple conditions (chronic campaign, 2 heart failure (heart failure campaign, or 3 chronic mental illness conditions (mental health campaign were targeted. The telephone coaching included evidence-based information and was based on the concepts of motivational interviewing, shared decision-making, and collaborative goal setting. Patients received an average of 12.9 calls. Primary outcome was time from enrolment until hospital readmission within a two-year follow-up period. Secondary outcomes comprised the probability of hospital readmission, number of daily defined medication doses (DDD, frequency and duration of inability to work, and mortality within two years. All outcomes were collected from routine data provided by the statutory health insurance. As informed consent was obtained after randomization, propensity score matching (PSM was used to minimize selection bias introduced by decliners. For the analysis of hospital readmission and mortality, we calculated Kaplan-Meier curves and estimated hazard ratios (HR. Probability of hospital readmission and probability of death were analysed by calculating odds ratios (OR. Quantity of health service use and inability to work were analysed by linear random effects regression models. PSM resulted in patient samples of 5,309 (IG: 2,713; CG: 2,596 in the chronic campaign, of 660 (IG: 338; CG: 322 in the heart failure campaign, and of
Liu, Lili; Stroulia, Eleni; Nikolaidis, Ioanis; Miguel-Cruz, Antonio; Rios Rincon, Adriana
Around the world, populations are aging and there is a growing concern about ways that older adults can maintain their health and well-being while living in their homes. The aim of this paper was to conduct a systematic literature review to determine: (1) the levels of technology readiness among older adults and, (2) evidence for smart homes and home-based health-monitoring technologies that support aging in place for older adults who have complex needs. We identified and analyzed 48 of 1863 relevant papers. Our analyses found that: (1) technology-readiness level for smart homes and home health monitoring technologies is low; (2) the highest level of evidence is 1b (i.e., one randomized controlled trial with a PEDro score ≥6); smart homes and home health monitoring technologies are used to monitor activities of daily living, cognitive decline and mental health, and heart conditions in older adults with complex needs; (3) there is no evidence that smart homes and home health monitoring technologies help address disability prediction and health-related quality of life, or fall prevention; and (4) there is conflicting evidence that smart homes and home health monitoring technologies help address chronic obstructive pulmonary disease. The level of technology readiness for smart homes and home health monitoring technologies is still low. The highest level of evidence found was in a study that supported home health technologies for use in monitoring activities of daily living, cognitive decline, mental health, and heart conditions in older adults with complex needs. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.
Spaten, Ole Michael; Imer, Anna; Palmer, Stephen
Praksis-modellen er inspireret og udviklet på baggrund af den engelsksprogede Practice model. Modellen anvendes især som et centralt redskab for problemløsning i coaching og terapi. Men praksis modellen kan anvendes bredere og som redskab til at hjælpe coachée mod at opnå mål i coaching og især...
A field study was conducted by Health Canada and Natural Resources Canada (NRCan) to evaluate self-reported health symptoms by residents of R-2000 and conventional homes in Nova Scotia and New Brunswick. It involved 52 energy efficient R-2000 and 50 conventionally built houses. Health Canada collected and analyzed data concerning changes in occupant health after moving into R-2000 houses and similar conventional houses. Definite trends in improvements of respiratory symptoms of occupants in R-2000 houses were revealed, compared to the results obtained for occupants of conventional houses. New occupants of R-2000 houses reported significant improvement in indoor air quality in 94 per cent of cases, while only 77 per cent of conventional homeowners reported similar results. Fifty six per cent of the occupants of R-2000 homes reported a general improvement in their health, compared to 32 per cent in conventional houses. The testing of houses in other regions is being planned by Health Canada. tabs
Dufour, Sinéad Patricia; Graham, Shane; Friesen, Josh; Rosenblat, Michael; Rous, Colin; Richardson, Julie
To evaluate a program in support of chronic disease self-management (CDSM) that is founded on a health coaching (HC) approach, includes supervised exercise and mindfulness-based stress reduction components and is delivered within a private practice physiotherapy setting. An explanatory mixed method design, framed by theory-based program evaluation, was employed to evaluate an eight-week group-based program. Standardized self-rated and performance measures were evaluated pre- and post intervention. Additionally, participant focus groups were conducted following the intervention period. An inductive thematic approach was undertaken to analyze the qualitative data. Seventeen participants (N = 17) completed the study. Improvements were seen in both self-report and performance outcomes. Participants explained how and why they felt the program was beneficial. Six themes were generated: (1) group dynamic; (2) learning versus doing; (3) holism and comprehensive care; (4) self-efficacy and empowerment; (5) previous solutions versus new management strategies; and (6) healthcare provider support. This study established that a group program in support of CDSM founded on a HC approach demonstrated potential value from participants as well as favorable outcomes. A pragmatic randomized control trial is required to determine efficacy of this intervention.
Manton, Kenneth G.; Hausner, Tony
Developing a case-mix methodology for home health services is more difficult than developing one for hospitalization and acute health services, because the determinants of need for home health care are more complex and because of the difficulty in defining episodes of care. To evaluate home health service case mix, a multivariate grouping methodology was applied to records from the 1982 National Long-Term Care Survey linked to Medicare records on home health reimbursements. Using this method, six distinct health and functional status dimensions were identified. These dimensions, combined with factors describing informal care resources and local market conditions, were used to explain significant proportions of the variance (r2 = .45) of individual differences in Medicare home health reimbursements and numbers of visits. Though the data were not collected for that purpose, the high level of prediction strongly suggests the feasibility of developing case-mix strategies for home health services. PMID:10312187
Full Text Available Home health services is to give examination, diagnosis,treatment, and rehabilitation services to the patients whobedridden, have difficulties to access health facility due toa variety of chronic or malignant disease by professionalhealth care team. Family physicians that providing healthcare in primary care is responsible for to determine whowill need home health care services, and to make homevisit on a regular basis among registered patients in theirpopulations. It is seems that the biggest shortcoming thecontent and scope of this service is not yet a standard. Inthis article, how home health services should be given willbe discussed.Key words: Primary health care, home health care, bedriddenpatient
Işıklar Pürçek, Kadriye
Coaching, especially in the United States in the world measured by million dollar industry has become. The aim of coaching in organizations, providing increased performance and potential targeting personalized emergence process of growing. Nowadays, in various fields (psychological support, training, personal development, work life, art, sports, etc.) Is often used, is still trying to establish the scientific infrastructure, is a concept somewhat worn.Coaching is used in a wide area in the wo...
Smith, Shannon Bright; Alexander, Judith W
The study's purpose was to determine nurses' opinions of sending patients from the hospital to home with home health services. The study occurred in the Charleston, South Carolina, Tricounty area (Berkeley, Charleston, and Dorchester counties). Home health agencies and hospitals were invited to participate. The study used a survey design to gather information on nursing perceptions of current practices and needed changes to improve transition of patients. The population was nurses (licensed practical nurses (LPNs) and registered nurses (RNs)) employed at inpatient hospitals or home health agencies in the area. Thirty-four RNs responded with no LPNs respondents. Agency administrators/chief nursing officers agreed for their agencies to participate and distributed the survey using a Research Electronic Data Capture (REDCap) Internet-based survey tool. Using the survey results and information from a literature review, the study developed a list of propositions, which participating administrators reviewed, for improving transitions to home. Both home health and hospital nurses reported a need to improve the process of sending patients from hospital to home with home health services. This study provides hospitals and home health agencies with propositions to facilitate the establishment of a process to communicate effectively patients care needs and streamline the discharging patients from the hospital to home health care; thus, improving patient transition. Case managers and discharge planners will need interagency collaboration along with evidence-based interventions to transition patients from the hospital to home with home health services with various populations. Direct patient care nurses in both hospital and home health settings should share the same accountability as case managers to ensure successful transitions.
Orfaly Cadigan, Rebecca; Stevenson, David G; Caudry, Daryl J; Grabowski, David C
To explore the impact of nursing home acquisition by private investment firms on nursing home costs, revenue, and overall financial health. Merged data from the Medicare Cost Reports and the Online Survey, Certification, and Reporting system for the period 1998-2010. Regression specification incorporating facility and time fixed effects. We found little impact on the financial health of nursing homes following purchase by private investment companies. However, our findings did suggest that private investment firms acquired nursing home chains in good financial health, possibly to derive profit from the company's real estate holdings. Private investment acquired facilities are an important feature of today's nursing home sector. Although we did not observe a negative impact on the financial health of nursing homes, this development raises important issues about ownership oversight and transparency for the entire nursing home sector. © Health Research and Educational Trust.
Mahler, Marianne; Sarvimäki, Anneli; Clancy, Anne
promotion care. As official guidelines in the Nordic countries state that home is the best place to grow old, it is essential that older persons keep their health and functional capacity in order to be able to live at home for as long as possible. As current policy emphasises living at home, home care......The number and the proportion of older persons is growing in the Nordic Countries. The growth in the older population has a clear impact on the care system for older persons. One trend is to prioritise home care instead of care in institutions. Another trend is to emphasise preventive and health......, preventive work and health promotion it becomes essential to study the home as a health promotion setting. Objective: The aim of this study was to reach a new understanding of home as a health promotion setting for older persons. Study design: The method used was a literature reflection and analysis...
Breslin, Gavin; Shannon, Stephen; Haughey, Tandy; Donnelly, Paul; Leavey, Gerard
The aim of the current study was to conduct a systematic review determining the effect of sport-specific mental health awareness programs to improve mental health knowledge and help-seeking among sports coaches, athletes and officials. The second aim was to review the study quality and to report on the validity of measures that were used to determine the effectiveness of programs. Sport-specific mental health awareness programs adopting an experimental or quasi-experimental design were included for synthesis. Six electronic databases were searched: PsycINFO, MEDLINE (OVID interface), Scopus, Cochrane, CINAHL and SPORTDiscus. Each database was searched from its year of inception to October 2016. Risk of bias was assessed using the Cochrane and QATSQ tools. Ten studies were included from the 1216 studies retrieved: four comprising coaches or service providers, one with officials, four with athletes, and one involved a combination of coaches and athletes. A range of outcomes was used to assess indices of mental health awareness and well-being. Mental health referral efficacy was improved in six studies, while three reported an increase in knowledge about mental health disorders. However, seven studies did not report effect sizes for their outcomes, limiting clinically meaningful interpretations. Furthermore, there was substantial heterogeneity and limited validity in the outcome measures of mental health knowledge and referral efficacy. Seven studies demonstrated a high risk of bias. Further, well-designed controlled intervention studies are required. Researchers, practitioners and policy makers should adhere to available methodological guidance and apply the psychological theory of behaviour change when developing and evaluating complex interventions. PROSPERO CRD42016040178.
Mental illness is common, under detected and often poorly managed in residential aged care facilities. These concerns have achieved greater prominence as the worldwide population ages. Over 80% of people in nursing home care fulfill criteria for one or more psychiatric disorders in an environment that often presents significant difficulties for assessment and treatment. This article aims to provide an overview of the important mental health issues involved in providing medical care for patients with behavioural and psychological problems in residential aged care facilities. Recent developments in education and training, service development and assessment and treatment strategies show some promise of improving the outcome for aged care residents with mental health problems. This is of especial relevance for primary care physicians who continue to provide the bulk of medical care for this population.
Cadigan, Rebecca Orfaly; Stevenson, David G; Caudry, Daryl J; Grabowski, David C
Objective To explore the impact of nursing home acquisition by private investment firms on nursing home costs, revenue, and overall financial health. Data Sources Merged data from the Medicare Cost Reports and the Online Survey, Certification, and Reporting system for the period 1998–2010. Study Design Regression specification incorporating facility and time fixed effects. Principal Findings We found little impact on the financial health of nursing homes following purchase by private investment companies. However, our findings did suggest that private investment firms acquired nursing home chains in good financial health, possibly to derive profit from the company’s real estate holdings. Conclusions Private investment acquired facilities are an important feature of today’s nursing home sector. Although we did not observe a negative impact on the financial health of nursing homes, this development raises important issues about ownership oversight and transparency for the entire nursing home sector. PMID:25104476
Shaughnessy, Peter W.; Crisler, Kathryn S.; Schlenker, Robert E.; Arnold, Angela G.; Kramer, Andrew M.; Powell, Martha C.; Hittle, David F.
The growth in home health care in the United States since 1970, and the exponential increase in the provision of Medicare-covered home health services over the past 5 years, underscores the critical need to assess the effectiveness of home health care in our society. This article presents conceptual and applied topics and approaches involved in assessing effectiveness through measuring the outcomes of home health care. Definitions are provided for a number of terms that relate to quality of care, outcome measures, risk adjustment, and quality assurance (QA) in home health care. The goal is to provide an overview of a potential systemwide approach to outcome-based QA that has its basis in a partnership between the home health industry and payers or regulators. PMID:10140157
Freitag, E M
Home health marketing brings special problems and opportunities. One cannot rely on physical factors such as the physical plant and food service of a hospital or on the durability of a consumer product to judge home health. Opportunities exist within home health to identify activities that carry marketing value. Applying marketing principles to activities such as intake, customer service and public relations allows the home health agency to build referrals by meeting the wants and needs of the market. The home health organization needs to consider different wants and needs of those involved in the home health transaction: the decision maker, the purchaser, and the user. The success of the marketing function in meeting the organization's objectives will be aided by the placement of marketing at the senior management level.
Zeltzer, Barry B; Kohn, Robert
This study examined the practices of home care agencies and home health nursing agencies in the management and treatment of homebound clients with behavioral problems, dementia, and undiagnosed mental illnesses. A survey was mailed to all 54 directors of agencies in Rhode Island in 2003; 53 responded, either by mail or telephone. Data indicated a lack of psychiatric services, a reluctance to address behavioral problems, and a failure to identify undiagnosed disorders. There was also a bias against accepting individuals with primary psychiatric disorders. Although the population of homebound elders with mental illness is increasing, their needs are not being met by these agencies.
Smith, Linda L; Lake, Noelle H; Simmons, Leigh Ann; Perlman, Adam; Wroth, Shelley; Wolever, Ruth Q
To describe the evolution, training, and results of an emerging allied health profession skilled in eliciting sustainable health-related behavior change and charged with improving patient engagement. Through techniques sourced from humanistic and positive psychology, solution-focused and mindfulness-based therapies, and leadership coaching, Integrative Health Coaching (IHC) provides a mechanism to empower patients through various stages of learning and change. IHC also provides a method for the creation and implementation of forward-focused personalized health plans. Clinical studies employing Duke University Integrative Medicine's model of IHC have demonstrated improvements in measures of diabetes and diabetes risk, weight management, and risk for cardiovascular disease and stroke. By supporting and enabling individuals in making major lifestyle changes for the improvement of their health, IHC carries the potential to reduce rates and morbidity of chronic disease and impact myriad aspects of healthcare. As a model of educational and clinical innovation aimed at patient empowerment and lifestyle modification, IHC is aligned well with the tenets and goals of recently sanctioned federal healthcare reform, specifically the creation of the first National Prevention and Health Promotion Strategy. IHC may allow greater patient-centricity while targeting the lifestyle-related chronic disease that lies at the heart of the current healthcare crisis.
This study compares quality measures among nursing homes that have adopted different levels of clinical health information technology (HIT) and examines the perceived barriers and benefits of the adoption of electronic health records as reported by Nursing Home Administrators and Directors of Nursing. A cross-sectional survey distributed online to…
Boccio, Mindy; Sanna, Rashel S; Adams, Sara R; Goler, Nancy C; Brown, Susan D; Neugebauer, Romain S; Ferrara, Assiamira; Wiley, Deanne M; Bellamy, David J; Schmittdiel, Julie A
Many Americans continue to smoke, increasing their risk of disease and premature death. Both telephone-based counseling and in-person tobacco cessation classes may improve access for smokers seeking convenient support to quit. Little research has assessed whether such programs are effective in real-world clinical populations. Retrospective cohort study comparing wellness coaching participants with two groups of controls. Kaiser Permanente Northern California, a large integrated health care delivery system. Two hundred forty-one patients who participated in telephonic tobacco cessation coaching from January 1, 2011, to March 31, 2012, and two control groups: propensity-score-matched controls, and controls who participated in a tobacco cessation class during the same period. Wellness coaching participants received an average of two motivational interviewing-based coaching sessions that engaged the patient, evoked their reason to consider quitting, and helped them establish a quit plan. Self-reported quitting of tobacco and fills of tobacco cessation medications within 12 months of follow-up. Logistic regressions adjusting for age, gender, race/ethnicity, and primary language. After adjusting for confounders, tobacco quit rates were higher among coaching participants vs. matched controls (31% vs. 23%, p Coaching participants and class attendees filled tobacco-cessation prescriptions at a higher rate (47% for both) than matched controls (6%, p coaching was as effective as in-person classes and was associated with higher rates of quitting compared to no treatment. The telephonic modality may increase convenience and scalability for health care systems looking to reduce tobacco use and improve health.
Thom, David H; Willard-Grace, Rachel; Hessler, Danielle; DeVore, Denise; Prado, Camille; Bodenheimer, Thomas; Chen, Ellen
Lack of concordance between medications listed in the medical record and taken by the patient contributes to poor outcomes. We sought to determine whether patients who received health coaching by medical assistants improved their medication concordance and adherence. This was a nonblinded, randomized, controlled, pragmatic intervention trial. English- or Spanish-speaking patients, age 18 to 75 years, with poorly controlled type 2 diabetes, hypertension, and/or hyperlipidemia were enrolled from 2 urban safety net clinics and randomized to receive 12 months of health coaching versus usual care. Outcomes included concordance between medications documented in the medical record and those reported by the patient and adherence based on the patient-reported number of days (of the last 7) on which patient took all prescribed medications. The proportion of medications completely concordant increased in the coached group versus the usual care group (difference in change, 10%; P = .05). The proportion of medications listed in the chart but not taken significantly decreased in the coached group compared with the usual care group (difference in change, 17%; P = .013). The mean number of adherent days increased in the coached but not in the usual care group (difference in change, 1.08; P coaching by medical assistants significantly increases medication concordance and adherence. © Copyright 2015 by the American Board of Family Medicine.
Pau, I; Seoane, F; Lindecrantz, K; Valero, M A; Carracedo, J
Home e-health systems and services are revealed as one of the most important challenges to promote Quality of Life related to Health in the Information Society. Leading companies have worked on e-health systems although the majority of them are addressed to hospital or primary care settings. The solution detailed in this paper offers a personal health system to be integrated with Smart Home services platform to support home based e-care. Thus, the home e-health system and architecture detailed in this research work is ready to supply a seamless personal care solution both from the biomedical data analysis, service provision, security guarantee and information management s point of view. The solution is ready to be integrated within the Accessible Digital Home, a living lab managed by Universidad Politécnica de Madrid for R&D activities.
Newbould, Louise; Mountain, Gail; Hawley, Mark; Ariss, Steve
A survey was developed to map provision, knowledge, attitudes and views towards videoconferencing in care homes in Yorkshire and The Humber. The survey was sent to 859 care homes, with a 14% response rate. Twelve homes reported using videoconferencing. Non-users appeared skeptical, managers using the system reported improvements in outcomes.
Davitt, Joan K.
Medicare home health care provides critical skilled nursing and therapy services to patients in their homes, generally after a period in an inpatient facility or nursing home. Disparities in access to, or outcomes of, home health care can result in patient deterioration and increased cost to the Medicare program if patient care needs intensify.…
Bjarnadottir, Ragnhildur I; Herzig, Carolyn T A; Travers, Jasmine L; Castle, Nicholas G; Stone, Patricia W
While electronic health records have emerged as promising tools to help improve quality of care, nursing homes have lagged behind in implementation. This study assessed electronic health records implementation, associated facility characteristics, and potential impact on quality indicators in nursing homes. Using national Centers for Medicare & Medicaid Services and survey data for nursing homes, a cross-sectional analysis was conducted to identify variations between nursing homes that had and had not implemented electronic health records. A difference-in-differences analysis was used to estimate the longitudinal effect of electronic health records on commonly used quality indicators. Data from 927 nursing homes were examined, 49.1% of which had implemented electronic health records. Nursing homes with electronic health records were more likely to be nonprofit/government owned (P = .04) and had a lower percentage of Medicaid residents (P = .02) and higher certified nursing assistant and registered nurse staffing levels (P = .002 and .02, respectively). Difference-in-differences analysis showed greater quality improvements after implementation for five long-stay and two short-stay quality measures (P = .001 and .01, respectively) compared with those who did not implement electronic health records. Implementation rates in nursing homes are low compared with other settings, and better-resourced facilities are more likely to have implemented electronic health records. Consistent with other settings, electronic health records implementation improves quality in nursing homes, but further research is needed to better understand the mechanism for improvement and how it can best be supported.
Shaw, R; Gillies, M; Barber, J; MacIntyre, K; Harkins, C; Findlay, I N; McCloy, K; Gillie, A; Scoular, A; MacIntyre, P D
Secondary prevention programmes can be effective in reducing morbidity and mortality from coronary heart disease (CHD). In particular, UK guidelines, including those from the Department of Health, emphasize physical activity. However, the effects of secondary prevention programmes with an exercise component are moderate and uptake is highly variable. In order to explore patients' experiences of a pre-exercise screening and health coaching programme (involving one-to-one consultations to support exercise behaviour change), semi-structured telephone interviews were undertaken with 84 CHD patients recruited from primary care. The interviews focused on patients' experiences of the intervention including referral and any recommendations for improvement. A thematic analysis of transcribed interviews showed that the majority of patients were positive about referral. However, patients also identified a number of barriers to attending and completing the programme, including a belief they were sufficiently active already, the existence of other health problems, feeling unsupported in community-based exercise classes and competing demands. Our findings highlight important issues around the choice of an appropriate point of intervention for programmes of this kind as well as the importance of appropriate patient selection, suggesting that the effectiveness of health coaching may be under-reported as a result of including patients who are not yet ready to change their behaviours.
Bao, Yuhua; Casalino, Lawrence P; Pincus, Harold Alan
Discussions of health care delivery and payment reforms have largely been silent about how behavioral health could be incorporated into reform initiatives. This paper draws attention to four patient populations defined by the severity of their behavioral health conditions and insurance status. It discusses the potentials and limitations of three prominent models promoted by the Affordable Care Act to serve populations with behavioral health conditions: the Patient-Centered Medical Home, the Health Home initiative within Medicaid, and the Accountable Care Organization. To incorporate behavioral health into health reform, policymakers and practitioners may consider embedding in the reform efforts explicit tools-accountability measures and payment designs-to improve access to and quality of care for patients with behavioral health needs.
Bao, Yuhua; Eggman, Ashley A.; Richardson, Joshua E.; Sheeran, Thomas; Bruce, Martha L.
Objective To assess any gaps between published best practices and real-world practices of treating depression in home health care (HHC), and barriers to closing any gaps. Methods A qualitative study based on semi-structured interviews with HHC nurses and administrators from five home health agencies in five states (n=20). Audio-recorded interviews were transcribed and analyzed by a multi-disciplinary team using grounded theory method to identify themes. Results Routine home health nursing care overlapped with all functional areas of depression care. However, there were reported gaps between best practices and real-world practices. Gaps were associated with perceived scope of practice by HHC nurses, knowledge gaps and low self-efficacy in depression treatment, stigma attached to depression, poor quality of antidepressant management in primary care, and poor communication between HHC and primary care. Conclusions Strategies to close gaps between typical and best practices need to enhance HHC clinician knowledge and self-efficacy with depression treatment and improve the quality of antidepressant management and communication with primary care. PMID:26423098
Rehman, Hamid; Karpman, Craig; Vickers Douglas, Kristin; Benzo, Roberto P
Improving quality of life (QOL) is a key goal in the care of patients with COPD. Pulmonary rehabilitation (PR) has clearly been shown to improve QOL, but is not accessible to many eligible patients. There is a need for alternative programs designed to improve patient well-being that are accessible to all patients with COPD. Our goal was to pilot test a simple, telephone-based health-coaching intervention that was recently shown to decrease readmission among hospitalized COPD patients and stable COPD patients eligible for PR. Subjects received a 3-month intervention consisting of 10 health-coaching telephone calls based on motivational interviewing principles. Outcome measures included dyspnea level, measured by the modified Medical Research Council scale, and QOL, measured by the Chronic Respiratory Questionnaire and a single-item general self-rated health status. Fifty subjects with moderate to severe COPD were enrolled in the study. Forty-four subjects (86%) completed the study intervention. Dyspnea measured by the modified Medical Research Council score improved significantly after the intervention ( P = .002). The domains of fatigue, emotional function, and mastery on the Chronic Respiratory Disease Questionnaire and the single-item QOL question also improved significantly after the 3 months of health coaching ( P = .001, P = .001, P = .007, and P = .03, respectively). Thirty-six (71%) subjects had a clinically meaningful improvement in at least 1 study end point (either in the severity of dyspnea or a domain of QOL). Thirty subjects (58%) had an improvement of ≥0.5 points, the minimum clinically important difference in at least 1 component of the Chronic Respiratory Disease Questionnaire. A telephone-delivered motivational interviewing-based coaching program for COPD patients is a feasible, well-accepted (by both participants and providers), simple, and novel intervention to improve the well-being of patients with COPD. This pilot study provides insight into
Manzi, Anatole; Hirschhorn, Lisa R; Sherr, Kenneth; Chirwa, Cindy; Baynes, Colin; Awoonor-Williams, John Koku
Despite global efforts to increase health workforce capacity through training and guidelines, challenges remain in bridging the gap between knowledge and quality clinical practice and addressing health system deficiencies preventing health workers from providing high quality care. In many developing countries, supervision activities focus on data collection, auditing and report completion rather than catalyzing learning and supporting system quality improvement. To address this gap, mentorship and coaching interventions were implemented in projects in five African countries (Ghana, Mozambique, Rwanda, Tanzania, and Zambia) as components of health systems strengthening (HSS) strategies funded through the Doris Duke Charitable Foundation's African Health Initiative. We report on lessons learned from a cross-country evaluation. The evaluation was designed based on a conceptual model derived from the project-specific interventions. Semi-structured interviews were administered to key informants to capture data in six categories: 1) mentorship and coaching goals, 2) selection and training of mentors and coaches, 3) integration with the existing systems, 4) monitoring and evaluation, 5) reported outcomes, and 6) challenges and successes. A review of project-published articles and technical reports from the individual projects supplemented interview information. Although there was heterogeneity in the approaches to mentorship and coaching and targeted areas of the country projects, all led to improvements in core health system areas, including quality of clinical care, data-driven decision making, leadership and accountability, and staff satisfaction. Adaptation of approaches to reflect local context encouraged their adoption and improved their effectiveness and sustainability. We found that incorporating mentorship and coaching activities into HSS strategies was associated with improvements in quality of care and health systems, and mentorship and coaching represents an
Bao, Yuhua; Casalino, Lawrence P.; Pincus, Harold Alan
Discussions of health care delivery and payment reforms have largely been silent about how behavioral health could be incorporated into reform initiatives. This paper draws attention to four patient populations defined by the severity of their behavioral health conditions and insurance status. It discusses the potentials and limitations of three prominent models promoted by the Affordable Care Act to serve populations with behavioral health conditions: the Patient Centered Medical Home, the H...
Hahn, A D
Changes authorized by the Balanced Budget Act of 1997 have removed many of the payment benefits that motivated past home health agency acquisition activity and temporarily have slowed the rapid pace of acquisitions of home health agencies. The act required that Medicare's cost-based payment system be replaced with a prospective payment system (PPS) and established an interim payment system to provide a framework for home health agencies to make the transition to the PPS. As a consequence, realistic valuations of home health agencies will be determined primarily by cash flows, with consideration given to operational factors, such as quality of patient care, service territory, and information systems capabilities. The limitations imposed by the change in payment mechanism will cause acquisition interest to shift away from home health agencies with higher utilization and revenue expansion to agencies able to control costs and achieve operating leverage.
This final rule updates the Home Health Prospective Payment System (HH PPS) payment rates, including the national, standardized 60-day episode payment rates, the national per-visit rates, and the non-routine medical supply (NRS) conversion factor; effective for home health episodes of care ending on or after January 1, 2017. This rule also: Implements the last year of the 4-year phase-in of the rebasing adjustments to the HH PPS payment rates; updates the HH PPS case-mix weights using the most current, complete data available at the time of rulemaking; implements the 2nd-year of a 3-year phase-in of a reduction to the national, standardized 60-day episode payment to account for estimated case-mix growth unrelated to increases in patient acuity (that is, nominal case-mix growth) between CY 2012 and CY 2014; finalizes changes to the methodology used to calculate payments made under the HH PPS for high-cost "outlier" episodes of care; implements changes in payment for furnishing Negative Pressure Wound Therapy (NPWT) using a disposable device for patients under a home health plan of care; discusses our efforts to monitor the potential impacts of the rebasing adjustments; includes an update on subsequent research and analysis as a result of the findings from the home health study; and finalizes changes to the Home Health Value-Based Purchasing (HHVBP) Model, which was implemented on January 1, 2016; and updates to the Home Health Quality Reporting Program (HH QRP).
Molony, Sheila L.; Evans, Lois K.; Jeon, Sangchoon; Rabig, Judith; Straka, Leslie A.
Background: Long-term care providers across the United States are building innovative environments called "Green House" or small-house nursing homes that weave humanistic person-centered philosophies into clinical care, organizational policies, and built environments. Purpose: To compare and contrast trajectories of at-homeness and health over…
Full Text Available Objectives: Survey about the issues and problems related to elderly in order to improve their quality of life of this increasing population has become a universal concern.This study was performed by the purpose of comparing the sleep quality and general health among the Elderly Residing at Home and Old People's Homes. Methods & Materials: This study is descriptive-analytic type. Population of this investigation consisted of elderly men and women (upper than 60 years old living at personal home and at nursing home in Tabriz. Sample group composed of 100 elderly (50 men and 50 women 50 living at home and 50 living at nursing home who were selected through available sampling method. For collecting data, Goldberg General Health Questionnaire and Pittsburgh Sleep Quality Index were used. Data were analyzed by Multivariate analysis of variance (MANOVA. Results: Findings showed that In terms of general health and its components (Physical symptoms, anxiety, social dysfunction and depression and Sleep quality and its components (Subjective quality of sleep, time for sleep, total sleep time, sleep efficiency, routine, sleep disorders, sleep medications and daily dysfunction there were significant differences between nursing home residents and elderly residents in nursing homes (P=0.001. Conclusion: Findings indicated that elderly residents in nursing home are experiencing more symptoms of anxiety, depression, physical symptoms and social dysfunction Compared with the elderly whom resident at home. Also the results showed that the elderly residents of nursing homes have poor sleep quality than ones whom residents at home. On the other hand Future development of elderly care institution is inevitable. Therefore, more attention to the living conditions of elderly residents of institutions seems necessary.
Corrieri, Sandro; Conrad, Ines; Riedel-Heller, Steffi G
How did the work of four school coaches in five Saxonian schools influence children's and adolescents' psychosocial development? At three points in time, students at intervention (N = 292) and control schools (N = 300) were evaluated concerning their social distance towards mentally ill people and their help-seeking behavior in case of crisis. The survey also included teachers (N = 323) and parents (N = 370). Data analysis was done descriptively and with random effects models. The social distance of the intervention schools declined significantly compared to the control schools. Having heard or read about mental illnesses, or personally knowing somebody affected by mental illness, led to less social distance and more empathy. Information increased the confidence to receive help from a professional consultant. Friends and family were the main reference groups. The school coaches were accepted as confidential persons and helped with school and private issues. The school coaches' work showed positive influence on all members of the school system. © Georg Thieme Verlag KG Stuttgart · New York.
Smith, Sheila; Robbins, Taylor; Schneider, Will; Kreader, J. Lee; Ong, Christine
Quality Rating Improvement Systems (QRISs) commonly offer on-site technical assistance (TA) and coaching to help early care and education settings achieve quality improvements and a higher QRIS rating. In surveys of administrators overseeing statewide QRISs, almost all states reported the use of on-site TA and coaching in both center-based and…
Rahman, Momotazur; Galarraga, Omar; Zinn, Jacqueline S; Grabowski, David C; Mor, Vincent
Over the past two decades, nursing homes and home health care agencies have been influenced by several Medicare and Medicaid policy changes including the adoption of prospective payment for Medicare-paid postacute care and Medicaid-paid long-term home and community-based care reforms. This article examines how spending growth in these sectors was affected by state certificate-of-need (CON) laws, which were designed to limit the growth of providers and have remained unchanged for several decades. Compared with states without CON laws, Medicare and Medicaid spending in states with CON laws grew faster for nursing home care and more slowly for home health care. In particular, we observed the slowest growth in community-based care in states with CON for both the nursing home and home health industries. Thus, controlling for other factors, public postacute and long-term care expenditures in CON states have become dominated by nursing homes. © The Author(s) 2015.
Third generation coaching unfolds a new universe for coaching and coaching psychology in the framework of current social research, new learning theories and discourses about personal leadership. Third generation coaching views coaching in a societal perspective. Coaching has become important...... transformation. Coaching thus facilitates new reflections and perspectives, as well as empowerment and support for self-Bildung processes. Third generation coaching focuses on the coach and the coachee in their narrative collaborative partnership. Unlike first generation coaching, where the goal is to help...
Stone, Robyn; Sutton, Janet P; Bryant, Natasha; Adams, Annelise; Squillace, Marie
The demand for home health aides is expected to rise, despite concerns about the sustainability of this workforce. Home health workers receive low wages and little training and have high turnover. It is difficult to recruit and retain workers to improve clinical outcomes. This study presents national estimates to examine how home health workers and the subgroup of workers differ in terms of sociodemographic characteristics, compensation, benefits, satisfaction, and retention. Hospice aides fare better than other categories of workers and are less likely to leave their job. Policymakers should consider strategies to increase the quality and stability of this workforce.
Boer, M.E. de; Leemrijse, C.J.; Ende, C.H.M. van den; Ribbe, M.W.; Dekker, J.
Purpose. To determine the availability of allied health care in nursing homes in the Netherlands, and its dependency on characteristics of the nursing home. Methods. Structured surveys by telephone were carried out in a sample of 100 from a country total of 286 somatic (for somatic patients only)
Gayed, Aimée; Bryan, Bridget T.; Petrie, Katherine; Deady, Mark; Milner, Allison; LaMontagne, Anthony D.; Calvo, Rafael A.; Mackinnon, Andrew; Christensen, Helen; Mykletun, Arnstein; Glozier, Nicholas; Harvey, Samuel B.
Background Within high income countries, mental health is now the leading cause of long term sickness absence in the workplace. Managers are in a position to make changes and decisions that have a positive effect on the wellbeing of staff, the recovery of employees with mental ill health, and potentially prevent future mental health problems. However, managers report addressing workplace mental health issues as challenging. The aim of the HeadCoach trial is to evaluate the effectiveness of a ...
Huang, Beatrice; Willard-Grace, Rachel; De Vore, Denise; Wolf, Jessica; Chirinos, Chris; Tsao, Stephanie; Hessler, Danielle; Su, George; Thom, David H
Chronic obstructive pulmonary disease (COPD) severely hinders quality of life for those affected and is costly to the health care system. Care gaps in areas such as pharmacotherapy, inhaler technique, and knowledge of disease are prevalent, particularly for vulnerable populations served by community clinics. Non-professionally licensed health coaches have been shown to be an effective and cost-efficient solution in bridging care gaps and facilitating self-management for patients with other chronic diseases, but no research to date has explored their efficacy in improving care for people living with COPD. This is multi-site, single blinded, randomized controlled trial evaluates the efficacy of health coaches to facilitate patient self-management of disease and improve quality of life for patients with moderate to severe COPD. Spirometry, survey, and an exercise capacity test are conducted at baseline and at 9 months. A short survey is administered by phone at 3 and 6 months post-enrollment. The nine month health coaching intervention focuses on enhancing disease understanding and symptom awareness, improving use of inhalers; making personalized plans to increase physical activity, smoking cessation, or otherwise improve disease management; and facilitating care coordination. The results of this study will provide evidence regarding the efficacy and feasibility of health coaching to improve self-management and quality of life for urban underserved patients with moderate to severe COPD. ClinicalTrials.gov identifier NCT02234284 . Registered 12 August 2014.
Mao, Alice Yuqing; Chen, Connie; Magana, Candy; Caballero Barajas, Karla; Olayiwola, J Nwando
The prevalence of obesity and associated metabolic conditions continue to be challenging and costly to address for health care systems; 71% of American adults were overweight, with 35% of men and 40% of women diagnosed with obesity in 2014. Digital health coaching is an innovative approach to decreasing the barriers of cost and accessibility of receiving health coaching for the prevention and management of chronic disease in overweight or obese individuals. To evaluate the early impact of a mobile phone-based health coaching service on weight loss and blood pressure management in a commercially insured population. This was a retrospective study using existing registry data from a pilot commercial collaboration between Vida Health and a large national insurance provider, which enrolled adult members who were overweight (body mass index >25 kg/m2) and able to engage in a mobile phone-based coaching intervention. Participants received 4 months of intensive health coaching via live video, phone, and text message through the Vida Health app. Participants were also provided with a wireless scale, pedometer, and blood pressure cuff. Of the 1012 enrolled, 763 (75.40%) participants had an initial weight upon enrollment and final weight between 3 and 5 months from enrollment; they served as our intervention group. There were 73 participants out of the 1012 (7.21%) who had weight data 4 months prior to and after Vida coaching, who served as the matched-pair control group. Participants in the intervention group lost an average of 3.23% total body weight (TBW) at 4 months of coaching and 28.6% (218/763) intervention participants achieved a clinically significant weight loss of 5% or more of TBW, with an average of 9.46% weight loss in this cohort. In the matched-pair control group, participants gained on average 1.81% TBW in 4 months without Vida coaching and lost, on average, 2.47% TBW after 4 months of Vida coaching, demonstrating a statistically significant difference of 4
Willard-Grace, Rachel; Chen, Ellen H; Hessler, Danielle; DeVore, Denise; Prado, Camille; Bodenheimer, Thomas; Thom, David H
Health coaching by medical assistants could be a financially viable model for providing self-management support in primary care if its effectiveness were demonstrated. We investigated whether in-clinic health coaching by medical assistants improves control of cardiovascular and metabolic risk factors when compared with usual care. We conducted a 12-month randomized controlled trial of 441 patients at 2 safety net primary care clinics in San Francisco, California. The primary outcome was a composite measure of being at or below goal at 12 months for at least 1 of 3 uncontrolled conditions at baseline as defined by hemoglobin A1c, systolic blood pressure, and low-density lipoprotein (LDL) cholesterol. Secondary outcomes were meeting all 3 goals and meeting individual goals. Data were analyzed using χ(2) tests and linear regression models. Participants in the coaching arm were more likely to achieve both the primary composite measure of 1 of the clinical goals (46.4% vs 34.3%, P = .02) and the secondary composite measure of reaching all clinical goals (34.0% vs 24.7%, P = .05). Almost twice as many coached patients achieved the hemoglobin A1c goal (48.6% vs 27.6%, P = .01). At the larger study site, coached patients were more likely to achieve the LDL cholesterol goal (41.8% vs 25.4%, P = .04). The proportion of patients meeting the systolic blood pressure goal did not differ significantly. Medical assistants serving as in-clinic health coaches improved control of hemoglobin A1c and LDL levels, but not blood pressure, compared with usual care. Our results highlight the need to understand the relationship between patients' clinical conditions, interventions, and the contextual features of implementation. © 2015 Annals of Family Medicine, Inc.
Molly-Søholm, Thorkil; Storch, Jacob; Juhl, Andreas
Hvordan coacher man som leder? Når jeg sidder i kursuslokalet og træner spørgeteknikker, går det fint, men når jeg skal bruge det hjemme i min organisation, fungerer det slet ikke. Skal coaching kunne fungere som et ledelsesværktøj, må det tilpasses de spilleregler, der gælder for arbejdskonteksten...... - det er udgangspunktet for denne bog. Forfatternes argument er, at der er sket en kortslutning i den måde, coaching er overført fra idrættens og terapiens verden til den organisatoriske hverdag. I denne bog giver forfatterne indgående beskrivelser af coachingværktøjer omsat til en ledelsesmæssig...... kontekst, og de byder på en række praktiske anvisninger til, hvordan man tilegner sig en coachende ledelsesstil. Ledelsesbaseret coaching henvender sig til ledere på alle niveauer, der ønsker at bringe coaching et skridt videre ind i organisationerne som en ledelsesform, der rummer stort potentiale...
Lopiano, Donna; And Others
A collection of articles provides current instructional information to softball players and coaches. Topics discussed in the series include practice, basic skills, defense, pitching, catching, offense, and warm-up exercises to be used in conjunction with other conditioning drills. (JN)
Chenoweth, Lynn; Stein-Parbury, Jane; White, Danielle; McNeill, Georgene; Jeon, Yun-Hee; Zaratan, Beverley
Maintaining the health and well-being of family carers of people with dementia is vital, given their potential for experiencing burden associated with the role. The study aimed to help dementia carers develop self-efficacy, be less hassled by the caring role and improve their health and well-being with goal-directed behaviour, by participating in an eight module carer coaching program. The study used mixed methods in a pre/post-test/follow-up design over 24 months, with assignment of consented dementia carers to either individualised (n = 16) or group coaching (n = 32), or usual carer support services (n = 43), depending on preference. Care-giving self-efficacy and hassles, carer health, well-being and goal-directed behaviours were assessed over time. Analysis of Variance (ANOVA) was used to compare changes over time and the effects of coaching on carer self-efficacy, hassles and health, using the Univariate General Linear Model (GLM). All carers were hassled by many aspects of caring at baseline. Participants receiving coaching reported non-significant improvements in most areas of self-efficacy for caring, hassles associated with caring and self-reported health at post-test and follow-up, than did carers receiving usual carer support. Group coaching had greater success in helping carers to achieve their goals and to seek help from informal and formal support networks and services. The study outcomes were generally positive, but need to be interpreted cautiously, given some methodological limitations. It has been shown, however, that health staff can assist dementia carers to develop self-efficacy in better managing their family member's limitations and behaviour, seek help from others and attend to their health. Teaching carers to use goal-directed behaviour may help them achieve these outcomes.
intersect as Attack Wing leaders change roles The 112th COS postured as cyber shield for Pa. infrastructure 111th Attack Wing 111th Attack Wing 21st Century Guard Airmen Home News Photos Art Video Resources - The Balance Search 111th Attack Wing: COMMUNITY/ENVIRO May 16, 2018; Pa. Department of Health update
Tiede, Michel; Dwinger, Sarah; Herbarth, Lutz; Härter, Martin; Dirmaier, Jörg
Introduction The * Equal contributors. health-status of heart failure patients can be improved to some extent by disease self-management. One method of developing such skills is telephone-based health coaching. However, the effects of telephone-based health coaching remain inconclusive. The aim of this study was to evaluate the effects of telephone-based health coaching for people with heart failure. Methods A total sample of 7186 patients with various chronic diseases was randomly assigned to either the coaching or the control group. Then 184 patients with heart failure were selected by International Classification of Diseases (ICD)-10 code for subgroup analysis. Data were collected at 24 and 48 months after the beginning of the coaching. The primary outcome was change in quality of life. Secondary outcomes were changes in depression and anxiety, health-related control beliefs, control preference, health risk behaviour and health-related behaviours. Statistical analyses included a per-protocol evaluation, employing analysis of variance and analysis of covariance (ANCOVA) as well as Mann-Whitney U tests. Results Participants' average age was 73 years (standard deviation (SD) = 9) and the majority were women (52.8%). In ANCOVA analyses there were no significant differences between groups for the change in quality of life (QoL) . However, the coaching group reported a significantly higher level of physical activity ( p = 0.03), lower intake of non-prescribed drugs ( p = 0.04) and lower levels of stress ( p = 0.02) than the control group. Mann-Whitney U tests showed a different external locus of control ( p = 0.014), and higher reduction in unhealthy nutrition ( p = 0.019), physical inactivity ( p = 0.004) and stress ( p = 0.028). Discussion Our results suggest that telephone-based health coaching has no effect on QoL, anxiety and depression of heart failure patients, but helps in improving certain risk behaviours and changes the locus
Burrows, Alison; Coyle, David; Gooberman-Hill, Rachael
This article explores how people negotiate borders and boundaries within the home, in the context of health and the introduction of new technologies. We draw on an ethnographic study involving a socially diverse group of people, which included people with experience of telecare or smart home energy systems. Participants engaged in various strategies to regulate the borders of their home, even though new technologies have begun to change the nature of these borders. Participants managed health conditions but also their use of technology through boundary work that permitted devices to be more or less visible and integrated within the home. Findings highlight that if smart healthcare technologies are to be accepted in the home then there is a need for mechanisms that allow people to control the interpretation of data and flow of information generated about them and their households. Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.
Bruce, Martha L
Depression is common in older home health patients and increases their risk of adverse outcomes. Depression screening is required by Medicare's Outcome and Assessment Information Set. The Depression Care for Patients at Home (CAREPATH) was developed as a feasible strategy for home health nurses to manage depression in their patients. The protocol builds on nurses' existing clinical skills and is designed to fit within routine home visits. Major components include ongoing clinical assessment, care coordination, medication management, education, and goal setting. In a randomized trial, Depression CAREPATH patients had greater improvement in depressive symptoms compared to usual care. The difference between groups was significant at 3 months, growing larger and more clinically meaningful over 1 year. The intervention had no impact on patient length of stay, number of home visits, or duration of visits. Thus, nurses can play a pivotal role in the long-term course and outcomes of patients with depression. Copyright 2015, SLACK Incorporated.
van Vugt, M.; de Wit, M.; Sieverink, Floor; Roelofsen, Y.; Hendriks, S.H.; Bilo, H.J.G.; Snoek, F.J.
We studied the use, uptake, and effects of e-Vita, a personal health record, with self-management support and personalized asynchronized coaching, for type 2 diabetes patients treated in primary care. Patients were invited by their practice nurse to join the study aimed at testing use and effects of
Full Text Available Abstract Background The aim was to evaluate the effect of a 12-month individualized health coaching intervention by telephony on clinical outcomes. Methods An open-label cluster-randomized parallel groups trial. Pre- and post-intervention anthropometric and blood pressure measurements by trained nurses, laboratory measures from electronic medical records (EMR. A total of 2594 patients filling inclusion criteria (age 45 years or older, with type 2 diabetes, coronary artery disease or congestive heart failure, and unmet treatment goals were identified from EMRs, and 1535 patients (59% gave consent and were randomized into intervention or control arm. Final analysis included 1221 (80% participants with data on primary end-points both at entry and at end. Primary outcomes were systolic and diastolic blood pressure, serum total and LDL cholesterol concentration, waist circumference for all patients, glycated hemoglobin (HbA1c for diabetics and NYHA class in patients with congestive heart failure. The target effect was defined as a 10-percentage point increase in the proportion of patients reaching the treatment goal in the intervention arm. Results The proportion of patients with diastolic blood pressure initially above the target level decreasing to 85 mmHg or lower was 48% in the intervention arm and 37% in the control arm (difference 10.8%, 95% confidence interval 1.5–19.7%. No significant differences emerged between the arms in the other primary end-points. However, the target levels of systolic blood pressure and waist circumference were reached non-significantly more frequently in the intervention arm. Conclusions Individualized health coaching by telephony, as implemented in the trial was unable to achieve majority of the disease management clinical measures. To provide substantial benefits, interventions may need to be more intensive, target specific sub-groups, and/or to be fully integrated into local health care. Trial registration
Full Text Available The aim of the research was to assess healthy living behaviors of archery coaches and boxing coaches in terms of sportive branch, sportive experience and gender. The study was conducted with boxing coaches (n=119 and archery coaches (n=131. As the data collection tool; “ The Health - Promoting Lifestyle Profile II (HPLP - II which was developed by Walker et al . and validity and reliability tests of which were performed by Bahar et al . (2008 was employed. In the study; it was found out that mean score of boxing coaches on P hysical activity subscale was higher than archery coaches . Besides; no statistically significant difference s existed between archery coaches and boxing coaches in terms of gender and sportive experience.
Spaten, Ole Michael; O'Broin, Alanna; Løkken, Lillith Olesen
In the coaching context of an ongoing search for evidence-based research, and increasing interest in the ‘active ingredients’ of coaching the impetus for ‘the coaching relationship – and beyond’ was the quest for deeper understanding of the coaching relationship as well as its influence...... on the outcomes of coaching. It is a presentation, on factors specifically related to engagement of the coachee and building effective coaching relationships: (a) a study examining the power relations between employee coachee and coach from the middle manager coach perspective, highlighting coaching relationship...... quality as a necessity for moments of symmetry and equality in fruitful coaching; (b) a study on the diversity factor of coach age, finding that age was not significant in executive coachées coach selection, however age signified credibility and experience, with possible implications for young executive...
Cobb, Tom; Horst, Marlise
This study reports on the design and testing of an integrated suite of vocabulary training games for Nintendo[TM] collectively designated "My Word Coach" (Ubisoft, 2008). The games' design is based on a wide range of learning research, from classic studies on recycling patterns to frequency studies of modern corpora. Its general usage…
Docheff, Dennis M.; Gerdes, Dan
This article challenges coaches to address the more personal, human elements of coaching--the HEART of coaching. While there is much research on numerous aspects of coaching, this article provides ideas that make a lasting impact on the hearts of athletes. Using HEART as an acronym, five elements of effective coaching are presented: Humility,…
Instructional coaching guru Jim Knight suggests that how we think about coaching can enhance or interfere with our success as a coach. He suggests that coaches take a partnership approach to collaboration and adopt seven principles that define how coaches interact with collaborating teachers: equality, choice, voice, reflection, dialogue, praxis,…
Oliveira, Juliana S; Sherrington, Catherine; Amorim, Anita B; Dario, Amabile B; Tiedemann, Anne
Physical inactivity is common in older age, yet increased activity benefits older people in terms of preventing chronic disease and maximising independence. Health coaching is a behaviour change intervention that has been shown to increase physical activity in clinical populations. This systematic review and meta-analysis investigated the effect of health coaching on physical activity, mobility, quality of life and mood in older people. MEDLINE, EMBASE, CENTRAL, PsycINFO, PEDro, SPORTDiscus, LILACS and CINAHL databases were used to identify randomised controlled trials which evaluated the effect of health coaching on physical activity (primary outcome) among people aged 60+. Secondary outcomes were mobility, quality of life and mood. We calculated standardised mean differences (SMDs, Hedges' g) with 95% CIs from random effects meta-analyses. 27 eligible trials were included. Health coaching had a small, statistically significant effect on physical activity (27 studies; SMD = 0.27; 95% CI 0.18 to 0.37; pcoaching on mobility (eight studies; SMD = 0.10; 95% CI -0.03 to 0.23; p=0.13), quality of life (eight studies; SMD = 0.07; 95% CI -0.06 to 0.20; pcoaching significantly increased physical activity in people aged 60+. There was no evidence of an effect of health coaching on quality of life, mobility and mood, so different approaches may be required to impact on these outcomes. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
Dyess, Susan MacLeod; Sherman, Rose; Opalinski, Andra; Eggenberger, Terry
Health care environments are complex and chaotic, therein challenging patients and professionals to attain satisfaction, well-being, and exceptional outcomes. These chaotic environments increase the stress and burnout of professionals and reduce the likelihood of optimizing success in many dimensions. Coaching is evolving as a professional skill that may influence the optimization of the health care environment. This article reflects on three coaching programs: Gallup Strengths-Based Coaching, Dartmouth Microsystem Coaching, and Health and Wellness Nurse Coaching. Each approach is presented, processes and outcomes are considered, and implications for educators are offered. Continuing education departments may recognize various coaching approaches as opportunities to support staff professionals achieve not only the triple aim, but also the quadruple aim. J Contin Educ Nurs. 2017;48(8):373-378. Copyright 2017, SLACK Incorporated.
Karhula, Tuula; Vuorinen, Anna-Leena; Rääpysjärvi, Katja; Pakanen, Mira; Itkonen, Pentti; Tepponen, Merja; Junno, Ulla-Maija; Jokinen, Tapio; van Gils, Mark; Lähteenmäki, Jaakko; Kohtamäki, Kari; Saranummi, Niilo
There is a strong will and need to find alternative models of health care delivery driven by the ever-increasing burden of chronic diseases. The purpose of this 1-year trial was to study whether a structured mobile phone-based health coaching program, which was supported by a remote monitoring system, could be used to improve the health-related quality of life (HRQL) and/or the clinical measures of type 2 diabetes and heart disease patients. A randomized controlled trial was conducted among type 2 diabetes patients and heart disease patients of the South Karelia Social and Health Care District. Patients were recruited by sending invitations to randomly selected patients using the electronic health records system. Health coaches called patients every 4 to 6 weeks and patients were encouraged to self-monitor their weight, blood pressure, blood glucose (diabetics), and steps (heart disease patients) once per week. The primary outcome was HRQL measured by the Short Form (36) Health Survey (SF-36) and glycosylated hemoglobin (HbA1c) among diabetic patients. The clinical measures assessed were blood pressure, weight, waist circumference, and lipid levels. A total of 267 heart patients and 250 diabetes patients started in the trial, of which 246 and 225 patients concluded the end-point assessments, respectively. Withdrawal from the study was associated with the patients' unfamiliarity with mobile phones—of the 41 dropouts, 85% (11/13) of the heart disease patients and 88% (14/16) of the diabetes patients were familiar with mobile phones, whereas the corresponding percentages were 97.1% (231/238) and 98.6% (208/211), respectively, among the rest of the patients (P=.02 and P=.004). Withdrawal was also associated with heart disease patients' comorbidities—40% (8/20) of the dropouts had at least one comorbidity, whereas the corresponding percentage was 18.9% (47/249) among the rest of the patients (P=.02). The intervention showed no statistically significant benefits over
Blackburn, Justin; Locher, Julie L; Kilgore, Meredith L
To compare acute care outcomes and costs among nursing home residents with community-dwelling home health recipients. A matched retrospective cohort study of Alabamians aged more than or equal to 65 years admitted to a nursing home or home health between March 31, 2007 and December 31, 2008 (N = 1,291 pairs). Medicare claims were compared up to one year after admission into either setting. Death, emergency department and inpatient visits, inpatient length of stay, and acute care costs were compared using t tests. Medicaid long-term care costs were compared for a subset of matched beneficiaries. After one year, 77.7% of home health beneficiaries were alive compared with 76.2% of nursing home beneficiaries (p Home health beneficiaries averaged 0.2 hospital visits and 0.1 emergency department visits more than nursing home beneficiaries, differences that were statistically significant. Overall acute care costs were not statistically different; home health beneficiaries' costs averaged $31,423, nursing home beneficiaries' $32,239 (p = .5032). Among 426 dual-eligible pairs, Medicaid long-term care costs averaged $4,582 greater for nursing home residents (p nursing home or home health care. Additional research controlling for exogenous factors relating to long-term care decisions is needed. © The Author 2014. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: email@example.com.
Dawadi, Prafulla N; Cook, Diane J; Schmitter-Edgecombe, Maureen; Parsey, Carolyn
The goal of this work is to develop intelligent systems to monitor the wellbeing of individuals in their home environments. This paper introduces a machine learning-based method to automatically predict activity quality in smart homes and automatically assess cognitive health based on activity quality. This paper describes an automated framework to extract set of features from smart home sensors data that reflects the activity performance or ability of an individual to complete an activity which can be input to machine learning algorithms. Output from learning algorithms including principal component analysis, support vector machine, and logistic regression algorithms are used to quantify activity quality for a complex set of smart home activities and predict cognitive health of participants. Smart home activity data was gathered from volunteer participants (n=263) who performed a complex set of activities in our smart home testbed. We compare our automated activity quality prediction and cognitive health prediction with direct observation scores and health assessment obtained from neuropsychologists. With all samples included, we obtained statistically significant correlation (r=0.54) between direct observation scores and predicted activity quality. Similarly, using a support vector machine classifier, we obtained reasonable classification accuracy (area under the ROC curve=0.80, g-mean=0.73) in classifying participants into two different cognitive classes, dementia and cognitive healthy. The results suggest that it is possible to automatically quantify the task quality of smart home activities and perform limited assessment of the cognitive health of individual if smart home activities are properly chosen and learning algorithms are appropriately trained.
Arend R. van Stenis
Full Text Available Although the role of health care professionals is known to have changed over the last years, few formal efforts have been made to examine this change through means of a scientific review. Therefore, the goal of this paper was to investigate the changing role of health care professionals in nursing homes, as well as the conditions that make this change possible. A systematic review of health care literature published in the last decade (2007–2017 was utilized to address these goals. Our findings suggest that although health care in nursing homes is shifting from task-oriented care to relation-oriented care (e.g., through an increased focus on patient dignity, various obstacles (e.g., negative self-image, work pressure, and a lack of developmental opportunities, needs (e.g., shared values, personal development, personal empowerment, team development, and demonstrating expertise, and competences (e.g., communication skills, attentiveness, negotiation skills, flexibility, teamwork, expertise, and coaching and leadership skills still need to be addressed in order to successfully facilitate this change. As such, this paper provides various implications for health care research, health care institutions, practitioners, HR professionals and managers, and occupational health research.
van Stenis, Arend R; van Wingerden, Jessica; Kolkhuis Tanke, Isolde
Although the role of health care professionals is known to have changed over the last years, few formal efforts have been made to examine this change through means of a scientific review. Therefore, the goal of this paper was to investigate the changing role of health care professionals in nursing homes, as well as the conditions that make this change possible. A systematic review of health care literature published in the last decade (2007-2017) was utilized to address these goals. Our findings suggest that although health care in nursing homes is shifting from task-oriented care to relation-oriented care (e.g., through an increased focus on patient dignity), various obstacles (e.g., negative self-image, work pressure, and a lack of developmental opportunities), needs (e.g., shared values, personal development, personal empowerment, team development, and demonstrating expertise), and competences (e.g., communication skills, attentiveness, negotiation skills, flexibility, teamwork, expertise, and coaching and leadership skills) still need to be addressed in order to successfully facilitate this change. As such, this paper provides various implications for health care research, health care institutions, practitioners, HR professionals and managers, and occupational health research.
Spaten, Ole Michael
Personal coaching and life-coaching psychology is for assisting individuals clarify values, visions and meaning of life, through a systematic process in which the coach facilitates improvement of satisfying and fruitful life experiences and achievement of personal life goals....
Jaime, Maria Catrina D; McCauley, Heather L; Tancredi, Daniel J; Nettiksimmons, Jasmine; Decker, Michele R; Silverman, Jay G; O'Connor, Brian; Stetkevich, Nicholas; Miller, Elizabeth
Adolescent relationship abuse (ARA) is a significant public health problem. Coaching Boys Into Men (CBIM) is an evidence-based ARA prevention program that trains coaches to deliver violence prevention messages to male athletes. Assessing acceptability and impact of CBIM on coaches may inform prevention efforts that involve these important adults in health promotion among youth. As part of a two-armed cluster-randomized controlled trial of CBIM in 16 high schools in Northern California, coaches completed baseline and postseason surveys (n = 176) to assess their attitudes and confidence delivering the program. Coaches in the intervention arm also participated in interviews (n = 36) that explored program acceptability, feasibility, and impact. Relative to controls, intervention coaches showed increases in confidence intervening when witnessing abusive behaviors among their athletes, greater bystander intervention, and greater frequency of violence-related discussions with athletes and other coaches. Coaches reported the program was easy to implement and valuable for their athletes. Findings illustrate the value of exploring attitudinal and behavioral changes among ARA prevention implementers, and suggest that coaches can gain confidence and enact behaviors to discourage ARA among male athletes. Coaches found the program to be feasible and valuable, which suggests potential for long-term uptake and sustainability. © The Author(s) 2014.
Sockolow, Paulina; Radhakrishnan, Kavita; Chou, Edgar Y; Wojciechowicz, Christine
Home care agencies are initiating "patient health goal elicitation" activities as part of home care admission planning. We categorized elicited goals and identified "clinically informative" goals at a home care agency. We examined patient goals that admitting clinicians documented in the point-of-care electronic health record; conducted content analysis on patient goal data to develop a coding scheme; grouped goal themes into codes; assigned codes to each goal; and identified goals that were in the patient voice. Of the 1,763 patient records, 16% lacked a goal; only 15 goals were in a patient's voice. Nurse and physician experts identified 12 of the 20 codes as clinically important accounting for 82% of goal occurrences. The most frequent goal documented was safety/falls (23%). Training and consistent communication of the intent and operationalization of patient goal elicitation may address the absence of patient voice and the less than universal recording of home care patients' goals.
The effectiveness of the use of a digital activity coaching system in addition to a two-week home-based exercise program in patients after total knee arthroplasty: study protocol for a randomized controlled trial.
Harmelink, Karen E M; Zeegers, A V C M; Tönis, Thijs M; Hullegie, Wim; Nijhuis-van der Sanden, Maria W G; Staal, J Bart
There is consistent evidence that supervised programs are not superior to home-based programs after total knee arthroplasty (TKA), especially in patients without complications. Home-based exercise programs are effective, but we hypothesize that their effectiveness can be improved by increasing the adherence to physical therapy advice to reach an adequate exercise level during the program and thereafter. Our hypothesis is that an activity coaching system (accelerometer-based activity sensor), alongside a home-based exercise program, will increase adherence to exercises and the activity level, thereby improving physical functioning and recovery. The objective of this study is to determine the effectiveness of an activity coaching system in addition to a home-based exercise program after a TKA compared to only the home-based exercise program with physical functioning as outcome. This study is a single-blind randomized controlled trial. Both the intervention (n = 55) and the control group (n = 55) receive a two-week home-based exercise program, and the intervention group receives an additional activity coaching system. This is a hand-held electronic device together with an app on a smartphone providing information and advice on exercise behavior during the day. The primary outcome is physical functioning, measured with the Timed Up and Go test (TUG) after two weeks, six weeks and three months. Secondary outcomes are 1) adherence to the activity level (activity diary); 2) physical functioning, measured with the 2-Minute Walk Test (2MWT) and the Knee Osteoarthritis Outcome Score; 3) quality of life (SF-36); 4) healthcare use up to one year postoperatively and 5) cost-effectiveness. Data are collected preoperatively, three days, two and six weeks, three months and one year postoperatively. The strengths of the study are the use of both performance-based tests and self-reported questionnaires and the personalized tailored program after TKA given by specialized physical
Heinmüller, M; Liel, K; Angerer, P; Gündel, H; Geldermann, B; Gottwald, M; Kimil, A; Limm, H
The aim of this study is to develop, implement and evaluate an education programme enabling the pedagogic staff of employment promotion agencies to integrate health promotion approaches und activities in vocational training programmes. The evaluation of the education programme is based on Kirkpatrick's 4 levels training evaluation model. Besides the participants' verbal end of session feedback, a standardised questionnaire was used at the end of the education programme and after 3 months practical experience. Process evaluation included the implementation level of the methods learned. From a total of 71 participants, 56 completed the first and 31 the second questionnaire (return rate 79% and 44%, respectively). The participants' mean age was 42 years, 80% were female. Only 22% of them integrated health topics systematically into their daily work. A 3-day basic training followed by case conferences during practical work was developed to transfer knowledge and practical competence in person-to-person talks and group activities (so called FIT-counselling and FIT-group). For 96% of participants, their expectations regarding the education programme were met completely or predominantly. 91% indicated a rise in motivation to work as health coach. When rating the training material, 96% judged it helpful for implementation/transfer. Many participants marked the education programme as being too short and wished more time for the topic of "mental health" and exchange of experiences. The follow-up after 3 months on-the-job training revealed that 84 and 97%, respectively, found FIT-counselling and FIT-groups helpful for their daily work. In all employment promotion agencies FIT-counselling and FIT-groups were implemented. Our results affirm the need for and prove the acceptance of education programmes enabling the pedagogic staff of job-training programmes to deliver health coaching. Periodic case conferences take into account the participants' request for more exchange of
Engberg, John; Castle, Nicholas G.; McCaffrey, Daniel
Purpose: It is widely believed that physical restraint use causes mental and physical health decline in nursing home residents. Yet few studies exist showing an association between restraint initiation and health decline. In this research, we examined whether physical restraint initiation is associated with subsequent lower physical or mental…
Stone, Robyn; Wilhelm, Jess; Bishop, Christine E; Bryant, Natasha S; Hermer, Linda; Squillace, Marie R
To identify agency policies and workplace characteristics that are associated with intent to leave the job among home health workers employed by certified agencies. Data are from the 2007 National Home and Hospice Care Survey/National Home Health Aide Survey, a nationally representative, linked data set of home health and hospice agencies and their workers. Logistic regression with survey weights was conducted to identify agency and workplace factors associated with intent to leave the job, controlling for worker, agency, and labor market characteristics. Job satisfaction, consistent patient assignment, and provision of health insurance were associated with lower intent to leave the job. By contrast, being assigned insufficient work hours and on-the-job injuries were associated with greater intent to leave the job after controlling for fixed worker, agency, and labor market characteristics. African American workers and workers with a higher household income also expressed greater intent to leave the job. This is the first analysis to use a weighted, nationally representative sample of home health workers linked with agency-level data. The findings suggest that intention to leave the job may be reduced through policies that prevent injuries, improve consistency of client assignment, improve experiences among African American workers, and offer sufficient hours to workers who want them. © The Author 2016. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: firstname.lastname@example.org.
Wise, Donald; Hammack, Marc
Leadership coaching is now seen as a valuable tool to assist school leaders. Through a survey of school principals, this study identified specific coaching competencies used by leadership coaches that were perceived by principals to influence key best practices for schools. These best practices have in turn been correlated to increased student…
Jaarsma, T.; Larsen, Torben; Stromberg, A.
in this population and specialised heart failure care can save costs and improve the quality of care. However, only a few European countries have implemented specialised home care and offered this to a larger number of patients with heart failure. Method: We developed a guide on Home Health in Heart Failure patients...... from a literature review, a survey of heart failure management programs, the opinion of researchers and practitioners, data from clinical trials and a reflection of an international expert meeting. Results: In integrated home care for heart failure patients, it is advised to consider the following...... components: integrated multidisciplinary care, patient and partner participation, care plans with clear goals of care, patient education, self-care management, appropriate access to care and optimised treatment. Discussion: We summarised the state of the art of home-based care for heart failure patients...
Cadet, Tamara J.; Berrett-Abebe, Julie; Burke, Shanna L.; Bakk, Louanne; Kalenderian, Elsbeth; Maramaldi, Peter
Nursing home residents over the age of 65 years are at high risk for poor oral health and related complications such as pneumonia and adverse diabetes outcomes. A preliminary study found that Massachusetts' nursing homes generally lack the training and resources needed to provide adequate oral health care to residents. In this study, an…
Molly, Asbjørn; Høeg, Bettina
Artiklen henvender sig til afdelingssygeplejersker med interesse for coaching. Hovedbudskabet er, at kollegial coaching tilbyder en ramme, hvor det er muligt at få udviklet et sprog for ledelse. I artiklen defineres coaching ind i en sygeplejekontekst, og to afdelingssygeplejersker fra Vejle...... Sygehus fortæller om deres erfaringer med kollegial coaching....
Keen, James P.
What does student coaching involve and what considerations make sense in deciding to engage an outside contractor to provide personal coaching? The author explores coaching in light of his own professional experience and uses this reflection as a platform from which to consider the pros and cons of student coaching when deciding whether to choose…
Murphy, Kevin; Ratey, Nancy; Maynard, Sandy; Sussman, Susan; Wright, Sarah D.
Despite limited scientific study on ADHD coaching as an intervention for adults with ADHD, the field of ADHD coaching has grown significantly and gained popularity in recent years. ADHD coaching is becoming a bona fide profession where one must advance through a rigorous training process, in order to be certified as a professional ADHD coach.…
This final rule will update Home Health Prospective Payment System (HH PPS) rates, including the national, standardized 60-day episode payment rates, the national per-visit rates, and the non-routine medical supply (NRS) conversion factor under the Medicare prospective payment system for home health agencies (HHAs), effective for episodes ending on or after January 1, 2016. As required by the Affordable Care Act, this rule implements the 3rd year of the 4-year phase-in of the rebasing adjustments to the HH PPS payment rates. This rule updates the HH PPS case-mix weights using the most current, complete data available at the time of rulemaking and provides a clarification regarding the use of the "initial encounter'' seventh character applicable to certain ICD-10-CM code categories. This final rule will also finalize reductions to the national, standardized 60-day episode payment rate in CY 2016, CY 2017, and CY 2018 of 0.97 percent in each year to account for estimated case-mix growth unrelated to increases in patient acuity (nominal case-mix growth) between CY 2012 and CY 2014. In addition, this rule implements a HH value-based purchasing (HHVBP) model, beginning January 1, 2016, in which all Medicare-certified HHAs in selected states will be required to participate. Finally, this rule finalizes minor changes to the home health quality reporting program and minor technical regulations text changes.
... Noncompetitive Supplements to Nursing Assistant and Home Health Aide Program Grantees AGENCY: Health Resources... expansion supplements of $100,000 to 10 Nursing Assistant and Home Health Aide (NAHHA) Program grantees to... Management; Care Coordination and Follow Up; and Behavioral Health and Social Support for Home Health Aides...
Phillips, Janet M; Riner, Mary E
Nurses and nurse educators need to be prepared to accelerate progress toward the United Nations' Sustainable Development Goals to improve local and global health in the face of continued poverty, hunger, and disease. This four-part Teaching Tips series will focus on developing nurse educators to prepare nurses for global engagement on the following topics: introduction to global health, systems thinking for global health, strategies for integrating global awareness and engagement into clinical practice, and leading and participating in service trips. The authors offer tips for increasing global awareness and using frameworks, strategies, and resources for both students and nurses to use in their own settings and practice. J Contin Educ Nurs. 2018;49(3):109-110. Copyright 2018, SLACK Incorporated.
Elsborg, Peter; Andersen, Vinnie; Stelter, Reinhard
). In both cases the participants were randomized into a group coaching group or a waiting control group. Effects of the intervention were tested with repeated measures mixed MANOVA. No effect on exercise continuation was observed. However the results of this study showed that group coaching (GC) over...... and participants experience relapse. The aim of this study was to investigate a group coaching interventions effects, as a standalone intervention and as an add-on to a physical activity intervention, on exercise maintenance, stress, anxiety and depression. Stress and recovery questionnaire, hospital anxiety...... depression scale and exercise participation was administered before, after a 3 months group coaching intervention as well as at 3 months follow-up. The participants were menopausal women coming from a physical activity intervention (n=56), and a group recruited via an advertisement in a newspaper (n=44...
Almeida, Osvaldo P; Marsh, Kylie; Murray, Karen; Hickey, Martha; Sim, Moira; Ford, Andrew; Flicker, Leon
To determine if health coaching (HC) decreases the incidence of depression, reduces the severity of symptoms, and increases quality of life during the menopausal transition (MT). Parallel, single-blinded, randomised controlled trial of 6 sessions of phone-delivered HC compared with usual care. Participants were 351 community-dwelling women free of major depression going through the MT, of whom 180 were assigned the intervention and 171 usual care. The primary outcome of interest was the incidence of clinically significant depressive symptoms over 52 weeks. Other study measures included the Hospital Anxiety and Depression Scale, quality of life (SF-12), the Menopause Rating Scale (MRS), diet, body mass index, alcohol use, smoking and physical activity. We considered that women with Patient Health Questionnaire (PHQ-9) scores between 5 and 14 (inclusive) had sub-threshold depressive symptoms. Nine women developed clinically significant symptoms of depression during the study-2 had been assigned HC (odds ratio, OR=0.26, 95%CI=0.05, 1.29; p=0.099). Intention-to-treat showed that, compared with usual care, the intervention led to a greater decline in depressive scores, most markedly for participants with sub-threshold depressive symptoms. Similar, but less pronounced, benefits were noticed for anxiety scores and the mental component summary of the SF-12. The intervention led to a decline in MRS scores by week 26 and subtle improvements in body mass, consumption of vegetables and smoking. HC addressing relevant risk factors for depression during the MT improves mental health measures. Our findings indicate that women with sub-threshold depressive symptoms may benefit the most from such interventions, and suggest that HC could play a useful role in minimizing mental health disturbance for women going through the MT. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.
Kneale, Laura; Choi, Yong; Demiris, George
Home health nurses and clients experience unmet information needs when transitioning from hospital to home health. Personal health records (PHRs) support consumer-centered information management activities. Previous work has assessed PHRs associated with healthcare providers, but these systems leave home health nurses unable to access necessary information. To evaluate the ability of publically available PHRs to accept, manage, and share information from a home health case study. Two researchers accessed the publically available PHRs on myPHR.com, and attempted to enter, manage, and share the case study data. We qualitatively described the PHR features, and identified gaps between the case study information and PHR functionality. Eighteen PHRs were identified in our initial search. Seven systems met our inclusion criteria, and are included in this review. The PHRs were able to accept basic medical information. Gaps occurred when entering, managing, and/or sharing data from the acute care and home health episodes. The PHRs that were reviewed were unable to effectively manage the case study information. Therefore, increasing consumer health literacy through these systems may be difficult. The PHRs that we reviewed were also unable to electronically share their data. The gap between the existing functionality and the information needs from the case study may make these PHRs difficult to use for home health environments. Additional work is needed to increase the functionality of the PHR systems to better fit the data needs of home health clients.
Des Moines Public Schools, IA. Teaching and Learning Div.
Home economics programs are offered to students in grades 6-12 in the Des Moines INdependent Community School District (Iowa). Programs at the middle school level are exploratory, leading to occupational training in family and consumer science, child care, food service, and textile and fashion arts at the high school level. Health education…
Jung, Kyoungrae; Polsky, Daniel
Market-based solutions are often proposed to improve health care quality; yet evidence on the role of competition in quality in non-hospital settings is sparse. We examine the relationship between competition and quality in home health care. This market is different from other markets in that service delivery takes place in patients' homes, which implies low costs of market entry and exit for agencies. We use 6 years of panel data for Medicare beneficiaries during the early 2000s. We identify the competition effect from within-market variation in competition over time. We analyze three quality measures: functional improvements, the number of home health visits, and discharges without hospitalization. We find that the relationship between competition and home health quality is nonlinear and its pattern differs by quality measure. Competition has positive effects on functional improvements and the number of visits in most ranges, but in the most competitive markets, functional outcomes and the number of visits slightly drop. Competition has a negative effect on discharges without hospitalization that is strongest in the most competitive markets. This finding is different from prior research on hospital markets and suggests that market-specific environments should be considered in developing polices to promote competition. Copyright © 2013 John Wiley & Sons, Ltd.
JUNG, KYOUNGRAE; POLSKY, DANIEL
SUMMARY Market-based solutions are often proposed to improve health care quality; yet evidence on the role of competition in quality in non-hospital settings is sparse. We examine the relationship between competition and quality in home health care. This market is different from other markets in that service delivery takes place in patients’ homes, which implies low costs of market entry and exit for agencies. We use 6 years of panel data for Medicare beneficiaries during the early 2000s. We identify the competition effect from within-market variation in competition over time. We analyze three quality measures: functional improvements, the number of home health visits, and discharges without hospitalization. We find that the relationship between competition and home health quality is nonlinear and its pattern differs by quality measure. Competition has positive effects on functional improvements and the number of visits in most ranges, but in the most competitive markets, functional outcomes and the number of visits slightly drop. Competition has a negative effect on discharges without hospitalization that is strongest in the most competitive markets. This finding is different from prior research on hospital markets and suggests that market-specific environments should be considered in developing polices to promote competition. PMID:23670849
Nielsen, Mette Strange; Jørgensen, Frances
The purpose of this study is to contribute to an understanding on how home health caregivers experience engagement in their work, and specifically, how aspects of home healthcare work create meaning associated with employee engagement. Although much research on engagement has been conducted, little has addressed how individual differences such as worker orientation influence engagement, or how engagement is experienced within a caregiving context. The study is based on a qualitative study in two home homecare organisations in Denmark using a think-aloud data technique, interviews and observations. The analysis suggests caregivers experience meaning in three relatively distinct ways, depending on their work orientation. Specifically, the nature of engagement varies across caregivers oriented towards being 'nurturers', 'professionals', or 'workers', and the sources of engagement differ for each of these types of caregivers. The article contributes by (i) advancing our theoretical understanding of employee engagement by emphasising meaning creation and (ii) identifying factors that influence meaning creation and engagement of home health caregivers, which should consequently affect the quality of services provided home healthcare patients. © 2015 Nordic College of Caring Science.
application for Tele-medicine (MAST). An introductory literature review identified stroke, heart failure (HF) and COPD as prototypes of IHC. Pre-existing evidence has been complemented by additional trials and surveys. Results: 1. Definition/organization of IHC: (1) Is carried out by a multidisciplinary team......-analysis of the effect on all-cause readmissions concludes OR=0.60 (CI95%: 0.40-0.92) COPD: 3 RCT (N=381) demonstrate each a significant reduction in readmissions. A meta-analysis of readmissions concludes (OR=0.5; CI: 0.25-0.80). 3. Health economic evaluation: For each selected condition the first year benefit...... satisfaction: Focus group interviews confirm literature findings of very good satisfaction by IHC both among patients/carers and health professionals. Discussion: The calculated net savings by IHC are not supposed to materialize in ‘cool’- cash but should enable local negotiation of adapted solutions...
Stratton, Chris [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Walker, Iain S. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)
This report is intended to provide home performance contractor trainers with a resource to keep both their workers and home residents safe and healthy. This document is an attempt to describe what we currently believe is safe, what we believe is unsafe, and what we’re unsure about. It is intended to identify health and safety issues and provide historical context and current understanding of both risks and mitigation strategies. In addition, it provides links to more in-depth resources for each issue. When we tighten the thermal envelope of a house to improve comfort and reduce energy use, we have to be sure that we are not compromising the indoor air quality of the home. This means identifying and mitigating or eliminating pollution sources before and after you make changes to the home. These sources can include materials and finishes in the home, exhaust gasses from combustion appliances, soil gasses such as radon, and moisture from a bathroom, kitchen, or unvented clothes dryer. Our first responsibility is to do no harm — this applies both to our clients and to our employees. Currently, there are many new products that are widely used but whose health effects are not well understood. Our in ability to have perfect information means the directive to do no harm can be difficult to obey. Each home is a little bit different, and in the face of a situation you’ve never encountered, it’s important to have a solid grasp of the fundamental concepts of building science when the hard and fast rules don’t apply . The home performance industry is gaining momentum, and has the potential to expand greatly as energy costs continue to rise. It is imperative that we remain vigilant about protecting the health and safety of our workers and our customers. It only takes a few news stories about a family that got sick after their home was tightened by a home performance contractor to scare off potential customers and taint the reputation of the entire industry. Good
Geber, Hilary; Bentley, Alison
Career development for full-time Health Sciences academics through to doctoral studies is a monumental task. Many academics have difficulty completing their studies in the minimum time as well as publishing after obtaining their degree. As this problem is particularly acute in the Health Sciences, the PhD Acceleration Programme in Health Sciences…
Swarbrick, Margaret; Gill, Kenneth J; Pratt, Carlos W
People receiving publicly funded behavioral health services for severe mental disorders have shorter lifespans and significantly impaired health-related quality of life compared to the general population. The aim of this article was to explore how peer wellness coaching (PWC), a manualized approach to pursue specific physical wellness goals, impacted goal attainment and overall health related quality of life. Deidentified archival program evaluation data were examined to explore whether peer delivered wellness coaching had an impact on 33 service recipients with regard to goal attainment and health-related quality of life. Participants were served by 1 of 12 wellness coach trainees from a transformation transfer initiative grant who had been trained in the manualized approach. Coaching participants and their coaches reported significant progress toward the attainment of individually chosen goals, 2 to 4 weeks after establishing their goals. After 8 to 10 weeks of peer delivered wellness coaching, improvements were evident in the self-report of physical health, general health, and perceived health. These improvements were sustained 90 days later. PWC is potentially a promising practice for helping people choose and pursue individual goals and facilitating positive health and wellness changes. Rigorous controlled research with larger samples is needed to evaluate the benefits of peer delivered wellness coaching. (PsycINFO Database Record (c) 2016 APA, all rights reserved).
Cronin, Colum; Armour, Kathleen M.
Coaching in the participation domain is the act of coaching participants that are less intensely engaged in sport than performance orientated athletes. This form of coaching is a popular activity occurring in community settings such as schools or sport clubs, and it is often undertaken with a broad range of social and health outcomes in mind. The…
Martin, Suzanne; Kelly, Greg; Kernohan, W George; McCreight, Bernadette; Nugent, Christopher
The integration of smart home technology to support health and social care is acquiring an increasing global significance. Provision is framed within the context of a rapidly changing population profile, which is impacting on the number of people requiring health and social care, workforce availability and the funding of healthcare systems. To explore the effectiveness of smart home technologies as an intervention for people with physical disability, cognitive impairment or learning disability, who are living at home, and to consider the impact on the individual's health status and on the financial resources of health care. We searched the following databases for primary studies: (a) the Cochrane Effective Practice and Organisation of Care (EPOC) Group Register, (b) the Cochrane Central Register of Controlled Trials (CENTRAL), (The Cochrane Library, issue 1, 2007), and (c) bibliographic databases, including MEDLINE (1966 to March 2007), EMBASE (1980 to March 2007) and CINAHL (1982 to March 2007). We also searched the Database of Abstracts of Reviews of Effectiveness (DARE). We searched the electronic databases using a strategy developed by the EPOC Trials Search Co-ordinator. We included randomised controlled trials (RCTs), quasi-experimental studies, controlled before and after studies (CBAs) and interrupted time series analyses (ITS). Participants included adults over the age of 18, living in their home in a community setting. Participants with a physical disability, dementia or a learning disability were included. The included interventions were social alarms, electronic assistive devices, telecare social alert platforms, environmental control systems, automated home environments and 'ubiquitous homes'. Outcome measures included any objective measure that records an impact on a participant's quality of life, healthcare professional workload, economic outcomes, costs to healthcare provider or costs to participant. We included measures of service satisfaction
Ziviani, Jenny; Poulsen, Anne; Hansen, Carla
Supporting children's participation in health-enhancing physical activities is an important occupational goal for therapists. Fundamental movement skills (FMS) are thought to underpin and enable many activity options. This study had two goals: first, to examine the relationship between fundamental movement skills (FMS) and physical activity, and second, to use this and existing evidence to inform strategies whereby children's motivation for and engagement in physical activity can be supported. A cross-sectional investigation of 124 children, aged 6-12 years, was undertaken. FMS were assessed using the Movement Assessment Battery for Children (M-ABC) and physical activity by pedometer step counts. A weak but significant association was found between weekend physical activity and balance skills for girls. Correlations between physical activity and ball skills or manual dexterity were not significant for either gender, however, having age appropriate ball skills did result in greater but not significant levels of physical activity for all children when grouped together. Findings from this study question the magnitude of the relationship between children's FMS and physical activity as measured by pedometers. If the goal of health enhancement through physical activity engagement is to be realised, it is proposed that community, occupation-based approaches may offer more potential than skills-based interventions at increasing activity participation. The concept of Engaging and Coaching for Health (EACH)-Child is introduced to this end. Occupational therapists are encouraged to work collaboratively with school and community organisations to assist children to find the physical activities that best accommodate their interests, abilities and offer opportunities for lifelong engagement.
Li, Qijuan; Keohane, Laura M; Thomas, Kali; Lee, Yoojin; Trivedi, Amal N
Several policy proposals advocate introducing copayments for home health care in the Medicare program. To our knowledge, no prior studies have assessed this cost-containment strategy. To determine the association of home health copayments with use of home health services. A difference-in-differences case-control study of 18 Medicare Advantage (MA) plans that introduced copayments for home health care between 2007 and 2011 and 18 concurrent control MA plans. The study included 135 302 enrollees in plans that introduced copayment and 155 892 enrollees in matched control plans. Introduction of copayments for home health care between 2007 and 2011. Proportion of enrollees receiving home health care, annual numbers of home health episodes, and days receiving home health care. Copayments for home health visits ranged from $5 to $20 per visit, which were estimated to be associated with $165 (interquartile range [IQR], $45-$180) to $660 (IQR, $180-$720) in out-of-pocket spending for the average user of home health care. The increased copayment for home health care was not associated with the proportion of enrollees receiving home health care (adjusted difference-in-differences, -0.15 percentage points; 95% CI, -0.38 to 0.09), the number of home health episodes per user (adjusted difference-in-differences, 0.01; 95% CI, -0.01 to 0.03), and home health days per user (adjusted difference-in-differences, -0.19; 95% CI, -3.02 to 2.64). In both intervention and control plans and across all levels of copayments, we observed higher disenrollment rates among enrollees with greater baseline use of home health care. We found no evidence that imposing copayments reduced the use of home health services among older adults. More intensive use of home health services was associated with increased rates of disenrollment in MA plans. The findings raise questions about the potential effectiveness of this cost-containment strategy.
Lau, Hunter Singh; Hollander, Matthew M; Cushman, Jeremy T; DuGoff, Eva H; Jones, Courtney M C; Kind, Amy J H; Lohmeier, Michael T; Coleman, Eric A; Shah, Manish N
The Care Transitions Intervention (CTI) has potential to improve the emergency department (ED)-to-home transition for older adults. Community paramedics may function as the CTI coaches; however, this requires the appropriate knowledge, skills, and attitudes, which they do not receive in traditional emergency medical services (EMS) education. This study aimed to define community paramedics' perceptions regarding their training needs to serve as CTI coaches supporting the ED-to-home transition. This study forms part of an ongoing randomized controlled trial evaluating a community paramedic-implemented CTI to enhance the ED-to-home transition. The community paramedics' training covered the following domains: the CTI program, geriatrics, effective coaching, ED discharge processes, and community paramedicine. Sixteen months after starting the study, we conducted audio-recorded semi-structured interviews with community paramedics at both study sites. After transcribing the interviews, team members independently coded the transcripts. Ensuing group analysis sessions led to the development of final codes and identifying common themes. Finally, we conducted member checking to confirm our interpretations of the interview data. We interviewed all 8 participating community paramedics. Participants consisted solely of non-Hispanic whites, included 5 women, and had a mean age of 43. Participants had extensive backgrounds in healthcare, primarily as EMS providers, but minimal experience with community paramedicine. All reported some prior geriatrics training. Four themes emerged from the interviews: (1) paramedics with positive attitudes and willingness to acquire the needed knowledge and skills will succeed as CTI coaches; (2) active rather than passive learning is preferred by paramedics; (3) the existing training could benefit from adjustments such as added content on mental health, dementia, and substance abuse issues, as well as content on coaching subjects with a range of
Xiao, Roy; Miller, Jacob A; Zafirau, William J; Gorodeski, Eiran Z; Young, James B
As healthcare costs rise, home health care represents an opportunity to reduce preventable adverse events and costs following hospital discharge. No studies have investigated the utility of home health care within the context of a large and diverse patient population. A retrospective cohort study was conducted between 1/1/2013 and 6/30/2015 at a single tertiary care institution to assess healthcare utilization after discharge with home health care. Control patients discharged with "self-care" were matched by propensity score to home health care patients. The primary outcome was total healthcare costs in the 365-day post-discharge period. Secondary outcomes included follow-up readmission and death. Multivariable linear and Cox proportional hazards regression were used to adjust for covariates. Among 64,541 total patients, 11,266 controls were matched to 6,363 home health care patients across 11 disease-based Institutes. During the 365-day post-discharge period, home health care was associated with a mean unadjusted savings of $15,233 per patient, or $6,433 after adjusting for covariates (p Home health care independently decreased the hazard of follow-up readmission (HR 0.82, p home health care most benefited patients discharged from the Digestive Disease (death HR 0.72, p home health care was associated with significant reduction in healthcare utilization and decreased hazard of readmission and death. These data inform development of value-based care plans. Copyright © 2018 Elsevier Inc. All rights reserved.
Bao, Yuhua; Shao, Huibo; Bruce, Martha L.; Press, Matthew J.
Objective Antidepressant management for older patients receiving home health care (HHC) may occur through two pathways: nurse-physician collaboration (without patient visits to the physician) and physician management through office visits. This study examines the relative contribution of the two pathways and how they interplay. Methods Retrospective analysis was conducted using Medicare claims of 7,389 depressed patients 65 or older who received HHC in 2006–7 and who possessed antidepressants at the start of HHC. A change in antidepressant therapy (vs. discontinuation or refill) was the main study outcome and could take the form of a change in dose, switch to a different antidepressant, or augmentation (addition of a new antidepressant). Logistic regressions were estimated to examine how use of home health nursing care, patient visits to physicians, and their interactions predict a change in antidepressant therapy. Results About 30% of patients experienced a change in antidepressants versus 51% who refilled and 18% who discontinued. Receipt of mental health specialty care was associated with a statistically significant, 10–20 percentage-point increase in the probability of antidepressant change; receipt of primary care was associated with a small and statistically significant increase in the probability of antidepressant change among patients with no mental health specialty care and above-average utilization of nursing care. Increased home health nursing care in absence of physician visits was not associated with increased antidepressant change. Conclusions Active antidepressant management resulting in a change in medication occurred on a limited scale among older patients receiving HHC. Addressing knowledge and practice gaps in antidepressant management by primary care providers and home health nurses and improving nurse-physician collaboration will be promising areas for future interventions. PMID:25158915
A recent survey of coaches ranks team cohesion as the most critical problem coaches face. Optimal interpersonal relationships among athletes and their coaches can maximize collective performance. Team dynamics are discussed and coaching tips are provided. (MT)
Nageswaran, Savithri; Golden, Shannon L
The objectives of this study are to describe the quality of home health care services for children with medical complexity, identify barriers to delivering optimal home health care, and discuss potential solutions to improve home health care delivery. In this qualitative study, we conducted 20 semistructured in-depth interviews with primary caregivers of children with medical complexity, and 4 focus groups with 18 home health nurses. During an iterative analysis process, we identified themes related to quality of home health care. There is substantial variability between home health nurses in the delivery of home health care to children. Lack of skills in nurses is common and has serious negative health consequences for children with medical complexity, including hospitalizations, emergency room visits, and need for medical procedures. Inadequate home health care also contributes to caregiver burden. A major barrier to delivering optimal home health care is the lack of training of home health nurses in pediatric care and technology use. Potential solutions for improving care include home health agencies training nurses in the care of children with medical complexity, support for nurses in clinical problem solving, and reimbursement for training nurses in pediatric home care. Caregiver-level interventions includes preparation of caregivers about: providing medical care for their children at home and addressing problems with home health care services. There are problems in the quality of home health care delivered to children with medical complexity. Training nurses in the care of children with medical complexity and preparing caregivers about home care could improve home health care quality. Copyright © 2017 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.
Härkönen, Niko; Klicznik, Roman
The Coach Assessment Tool was created to assist coaches of all sports for their own development. The starting point to develop the tool is the fact that coaching clinics solely focus on the technical and tactial skills of the sport. The education for coaches is lacking to teach the importance of the coach´s behavior towards their athletes. The question is how to teach properly the task in hand to increase the athlete´s performance considering the coach´s behavior. Nevertheless,...
Anne Marie Lunde Husebø
Full Text Available Background. This review identifies the content of virtual visits in community nursing services to older adults and explores the manner in which service users and the nurses use virtual visits. Design. An integrative literature review. Method. Data collection comprised a literature search in three databases: Cinahl, Medline, and PubMed. In addition, a manual search of reference lists and expert consultation were performed. A total of 12 articles met the inclusion criteria. The articles were reviewed in terms of study characteristics, service content and utilization, and patient and health care provider experience. Results. Our review shows that in most studies the service is delivered on a daily basis and in combination with in-person visits. The findings suggest that older home-dwelling patients can benefit from virtual visits in terms of enhanced social inclusion and medication compliance. Service users and their nurses found virtual visits satisfactory and suitable for care delivery in home care to the elderly. Evidence for cost-saving benefits of virtual visits was not found. Conclusions. The findings can inform the planning of virtual visits in home health care as a complementary service to in-person visits, in order to meet the increasingly complex needs of older adults living at home.
Curry, Raymond H.
New ways of thinking about medicine and health care demand new methods in medical education. Over the past two decades, as both the practice and the study of medicine have become increasingly concerned with demonstrable outcomes, medical schools have developed new curricula in health systems science and are increasingly emphasizing students’ development and demonstration of skills essential to a systems-based, outcomes-oriented practice environment. Polak and colleagues recently reported the ...
Nagatomo, I; Takigawa, M
One hundred and ninety elderly people receiving home health service were investigated. The intellectual levels, depressive state evaluated by the Cornell scale for depression in dementia (CSDD) scale, abnormal behaviors evaluated by the dementia behavior disturbance (DBD) scale, and activities of daily living (ADL) were examined. These assessments were performed by 72 skilled home helpers who also assessed the severity of their own level of stress using the Burnout scale. The intellectual level and mood-related signs, based on the CSDD scale, of the elderly living with families or with a spouse were diminished significantly as compared to the elderly living alone. The elderly living with families also performed worse on all ADL categories except for visual acuity as compared to the elderly living with a spouse or living alone. There was no significant correlation between the Burnout scale score and age or frequency of working as a home helper. These results suggest that elderly people living with families as compared to the elderly living with a spouse or living alone have greater mental health needs as well as more profound physical limitations.
Shaw, Deanna Lynn
The purpose of this study was to describe the experience of critical self-reflection by life coaches. Life coaching is expanding within many disciplines including education, health care, business, social work, and wellness. Life coaching involves a coach working with an individual or groups aimed at effecting change for professional and personal…
... concerning the billing methodology for non-VA providers of home health services and hospice care. The proposed rulemaking would include home health services and hospice care under the VA regulation governing... to ``RIN 2900-AN98--Payment for home health and services and hospice care by non-VA providers...
Redeker, N S; Brassard, A B
The purpose of this study was to examine the health patterns of cardiac surgical patients in the home health care population and their relationships to outcomes and duration of home health care using Gordon's Functional Health Pattern framework. Home health care records of 96 cardiac surgical clients were reviewed. Admission health pattern data, reasons for admission, duration and outcomes of home care services, characteristics of hospital experience, and demographic data were analyzed. Dysfunctional health patterns were primarily in the area of activity/exercise. The most common reasons for admission were monitoring of cardiopulmonary status, wound care, and instruction on diet, medications, and cardiac regimen. The mean duration of home care was 28.8 days. Thirty percent of the sample were readmitted to the hospital. Duration of home care was shorter for those who were married and for those who reported weakness, tiredness, or fatigue as a chief complaint. Readmission to the hospital was more likely for those who had complications during their initial hospital stay and those who required at least partial assistance with bathing, dressing, feeding, or toileting. Implications for practice and research are discussed.
Yeh, L; Wen, M J
The home health nursing movement is expanding rapidly. Home health nursing agencies (HHNAs) are expected to demonstrate that the care provided does make a difference for the client receiving the services. The purpose of this study was to explore client outcomes from home health nursing. Outcome indicators include: Services utilized (emergency services, re-hospitalization), physiological status (catheter indwelling status, consciousness level, wound severity-number and wound stages) and functional status (reflected by Barthel Index). A prospective research design was used to collect the results. Five hospital-based HHNAs were invited to participate in this research. Clients newly admitted to HHNAs and diagnosed as non-cancer patients were recruited, and the researchers gathered outcome indicators over a six-month period. Data were analyzed using SPSS 8.0 computer software. There were 75 clients in this study. Results showed that most of the clients (64.0%) received service for more than 180 days. The client characteristics were dominated by elderly (66.6% age above 70), female (53.3%) and married (74.7%). The three leading care needs were NG tubing service (84.0%), Foley tubing service (45.3%) and wound care (38.7%). The Kruscal Wallis Test revealed that there was no difference in emergency service frequency and re-hospitalization between clients who received service for more than 180 days and those who received service for less than 180 days. The Wilcoxon Sign rank test showed that within one half-year, catheter indwelling status, functional status, and wound severity were not significantly different, with the exception only of conscious level (p = .001). The results of this study can be viewed as preliminary data to assist in shaping home health nursing services in Taiwan.
Solenhill, Madeleine; Grotta, Alessandra; Pasquali, Elena; Bakkman, Linda; Bellocco, Rino; Trolle Lagerros, Ylva
Lifestyle-related health problems are an important health concern in the transport service industry. Web- and telephone-based interventions could be suitable for this target group requiring tailored approaches. To evaluate the effect of tailored Web-based health feedback and optional telephone coaching to improve lifestyle factors (body mass index-BMI, dietary intake, physical activity, stress, sleep, tobacco and alcohol consumption, disease history, self-perceived health, and motivation to change health habits), in comparison to no health feedback or telephone coaching. Overall, 3,876 employees in the Swedish transport services were emailed a Web-based questionnaire. They were randomized into: control group (group A, 498 of 1238 answered, 40.23%), or intervention Web (group B, 482 of 1305 answered, 36.93%), or intervention Web + telephone (group C, 493 of 1333 answered, 36.98%). All groups received an identical questionnaire, only the interventions differed. Group B received tailored Web-based health feedback, and group C received tailored Web-based health feedback + optional telephone coaching if the participants' reported health habits did not meet the national guidelines, or if they expressed motivation to change health habits. The Web-based feedback was fully automated. Telephone coaching was performed by trained health counselors. Nine months later, all participants received a follow-up questionnaire and intervention Web + telephone. Descriptive statistics, the chi-square test, analysis of variance, and generalized estimating equation (GEE) models were used. Overall, 981 of 1473 (66.60%) employees participated at baseline (men: 66.7%, mean age: 44 years, mean BMI: 26.4 kg/m(2)) and follow-up. No significant differences were found in reported health habits between the 3 groups over time. However, significant changes were found in motivation to change. The intervention groups reported higher motivation to improve dietary habits (144 of 301 participants, 47
...), the R&D issues involved in the design, development and implementation of a modular and configurable Home Care Platform that supports different health and social care domains, and the results of the clinical...
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McMahon, Samantha; Dyer, Mary; Barker, Catherine
This chapter considers the purpose of coaching, mentoring and supervision in early childhood eduaction and care. It examines a number of different approaches and considers the key skills required for effective coaching, mentoring and supervision.
Research information in sports physiology must be compiled in usable form, and coaches must incorporate the results into their coaching tactics and methods if American athletes are to be able to compete on equal terms in foreign competition. (MB)
Ritvo, Paul; Obadia, Maya; Santa Mina, Daniel; Alibhai, Shabbir; Sabiston, Catherine; Oh, Paul; Campbell, Kristin; McCready, David; Auger, Leslie; Jones, Jennifer Michelle
Although physical activity has been shown to contribute to long-term disease control and health in breast cancer survivors, a majority of breast cancer survivors do not meet physical activity guidelines. Past research has focused on promoting physical activity components for short-term breast cancer survivor benefits, but insufficient attention has been devoted to long-term outcomes and sustained exercise adherence. We are assessing a health coach intervention (iMOVE) that uses mobile technology to increase and sustain physical activity maintenance in initially inactive breast cancer survivors. This pilot randomized controlled trial (RCT) is an initial step in evaluating the iMOVE intervention and will inform development of a full-scale pragmatic RCT. We will enroll 107 physically inactive breast cancer survivors and randomly assign them to intervention or control groups at the University Health Network, a tertiary cancer care center in Toronto, Canada. Participants will be women (age 18 to 74 years) stratified by age (55 years and older/younger than 55 years) and adjuvant hormone therapy (AHT) exposure (AHT vs no AHT) following breast cancer treatment with no metastases or recurrence who report less than 60 minutes of preplanned physical activity per week. Both intervention and control groups receive the 12-week physical activity program with weekly group sessions and an individualized, progressive, home-based exercise program. The intervention group will additionally receive (1) 10 telephone-based health coaching sessions, (2) smartphone with data plan, if needed, (3) supportive health tracking software (Connected Wellness, NexJ Health Inc), and (4) a wearable step-counting device linked to a smartphone program. We will be assessing recruitment rates; acceptability reflected in selective, semistructured interviews; and enrollment, retention, and adherence quantitative intervention markers as pilot outcome measures. The primary clinical outcome will be directly
Ritvo, Paul; Obadia, Maya; Santa Mina, Daniel; Alibhai, Shabbir; Sabiston, Catherine; Oh, Paul; Campbell, Kristin; McCready, David; Auger, Leslie
Background Although physical activity has been shown to contribute to long-term disease control and health in breast cancer survivors, a majority of breast cancer survivors do not meet physical activity guidelines. Past research has focused on promoting physical activity components for short-term breast cancer survivor benefits, but insufficient attention has been devoted to long-term outcomes and sustained exercise adherence. We are assessing a health coach intervention (iMOVE) that uses mobile technology to increase and sustain physical activity maintenance in initially inactive breast cancer survivors. Objective This pilot randomized controlled trial (RCT) is an initial step in evaluating the iMOVE intervention and will inform development of a full-scale pragmatic RCT. Methods We will enroll 107 physically inactive breast cancer survivors and randomly assign them to intervention or control groups at the University Health Network, a tertiary cancer care center in Toronto, Canada. Participants will be women (age 18 to 74 years) stratified by age (55 years and older/younger than 55 years) and adjuvant hormone therapy (AHT) exposure (AHT vs no AHT) following breast cancer treatment with no metastases or recurrence who report less than 60 minutes of preplanned physical activity per week. Both intervention and control groups receive the 12-week physical activity program with weekly group sessions and an individualized, progressive, home-based exercise program. The intervention group will additionally receive (1) 10 telephone-based health coaching sessions, (2) smartphone with data plan, if needed, (3) supportive health tracking software (Connected Wellness, NexJ Health Inc), and (4) a wearable step-counting device linked to a smartphone program. Results We will be assessing recruitment rates; acceptability reflected in selective, semistructured interviews; and enrollment, retention, and adherence quantitative intervention markers as pilot outcome measures. The primary
Leading a school can be a lonely, challenging job, Elena Aguilar has found in her years coaching principals. Aguilar describes how coaching approach she's developed--transformational coaching--helps principals get three things most of them need: a neutral person they can talk with confidentially, job-embedded professional development, and a safe…
Jacobs, Frank; Claringbould, Inge; Knoppers, Annelies
The purpose of this paper was to gain insight into how coaches problematized their coaching practices and the process in which they engaged to become what they perceived to be better coaches using a course based on critical reflective practice. We assumed that constant critical self-reflection would
Spaten, Ole Michael; Løkken, Lillith Olesen; Kyndesen, Anna Imer
). Kvalitative interviews med fire deltagere før og efter coaching interventionen. Metode: Ni erfarne coaches gennemførte fire sessioner med 52 første semesters studerende fra Aalborg universitet. Deltagerne udfyldte DASS-21, Subjective Wellbeing Scale og Adult Hope Scale før og efter coaching interventionerne...
Shirasaki, O; Terada, H; Niwano, K; Nakanishi, T; Kanai, M; Miyawaki, Y; Souma, T; Tanaka, T; Kusunoki, T
The Japanese Home-health Apparatus Industrial Association is an official independent organization comprising ten departments. That concerned with home electronic sphygmomanometers, which has seven participants from different Japanese manufacturers, has already undertaken and is currently involved in various activities related to voluntary standards for performance validation and quality assurance. Because Japanese companies form a large proportion of manufacturers, these activities are important in terms of autonomic regulation. Although many improvements have been made to home electronic sphygmomanometers, some problems still remain unresolved, especially in terms of measurement reliability and easy operation by lay people. Another aspect of the department's work relates to making proposals on major validation standards, such as those of the Association for the Advancement of Medical Instrumentation, the British Hypertension Society and Comité Européen de Normalisation (CEN). Clinical validation should be discussed in order to define a more accurate standard method of measurement using auscultation and more appropriate criteria that are unaffected by primary blood pressure variation.
Carroll, Bob; Morbey, Hazel; Balogh, Ruth; Araoz, Gonzalo
In 2005, Carlisle suffered severe flooding and 1600 houses were affected. A qualitative research project to study the social and health impacts was undertaken. People whose homes had been flooded and workers who had supported them were interviewed. The findings showed that there was severe disruption to people's lives and severe damage to their homes, and many suffered from psychological health issues. Phenomenological and transactional perspectives are utilised to analyse the psychological processes (identity, attachment, alienation and dialectics) underlying the meaning of home and their impact on psychological health. Proposals for policy and practice are made.
Blackstone, Phyllis A.
In this article, the author posits that storytelling can be used as a method for developing positive interpersonal relationships between coaches and classroom teachers. The author argues that developing interpersonal relationships is a necessary but challenging aspect of successful coaching, and that storytelling offers a mechanism for greater…
Wayne, Noah; Perez, Daniel F; Kaplan, David M; Ritvo, Paul
Adoptions of health behaviors are crucial for maintaining good health after type 2 diabetes mellitus (T2DM) diagnoses. However, adherence to glucoregulating behaviors like regular exercise and balanced diet can be challenging, especially for people living in lower-socioeconomic status (SES) communities. Providing cost-effective interventions that improve self-management is important for improving quality of life and the sustainability of health care systems. To evaluate a health coach intervention with and without the use of mobile phones to support health behavior change in patients with type 2 diabetes. In this noninferiority, pragmatic randomized controlled trial (RCT), patients from two primary care health centers in Toronto, Canada, with type 2 diabetes and a glycated hemoglobin/hemoglobin A1c (HbA1c) level of ≥7.3% (56.3 mmol/mol) were randomized to receive 6 months of health coaching with or without mobile phone monitoring support. We hypothesized that both approaches would result in significant HbA1c reductions, although health coaching with mobile phone monitoring would result in significantly larger effects. Participants were evaluated at baseline, 3 months, and 6 months. The primary outcome was the change in HbA1c from baseline to 6 months (difference between and within groups). Other outcomes included weight, waist circumference, body mass index (BMI), satisfaction with life, depression and anxiety (Hospital Anxiety and Depression Scale [HADS]), positive and negative affect (Positive and Negative Affect Schedule [PANAS]), and quality of life (Short Form Health Survey-12 [SF-12]). A total of 138 patients were randomized and 7 were excluded for a substudy; of the remaining 131, 67 were allocated to the intervention group and 64 to the control group. Primary outcome data were available for 97 participants (74.0%). While both groups reduced their HbA1c levels, there were no significant between-group differences in change of HbA1c at 6 months using
Wayne, Noah; Perez, Daniel F; Kaplan, David M
Background Adoptions of health behaviors are crucial for maintaining good health after type 2 diabetes mellitus (T2DM) diagnoses. However, adherence to glucoregulating behaviors like regular exercise and balanced diet can be challenging, especially for people living in lower-socioeconomic status (SES) communities. Providing cost-effective interventions that improve self-management is important for improving quality of life and the sustainability of health care systems. Objective To evaluate a health coach intervention with and without the use of mobile phones to support health behavior change in patients with type 2 diabetes. Methods In this noninferiority, pragmatic randomized controlled trial (RCT), patients from two primary care health centers in Toronto, Canada, with type 2 diabetes and a glycated hemoglobin/hemoglobin A1c (HbA1c) level of ≥7.3% (56.3 mmol/mol) were randomized to receive 6 months of health coaching with or without mobile phone monitoring support. We hypothesized that both approaches would result in significant HbA1c reductions, although health coaching with mobile phone monitoring would result in significantly larger effects. Participants were evaluated at baseline, 3 months, and 6 months. The primary outcome was the change in HbA1c from baseline to 6 months (difference between and within groups). Other outcomes included weight, waist circumference, body mass index (BMI), satisfaction with life, depression and anxiety (Hospital Anxiety and Depression Scale [HADS]), positive and negative affect (Positive and Negative Affect Schedule [PANAS]), and quality of life (Short Form Health Survey-12 [SF-12]). Results A total of 138 patients were randomized and 7 were excluded for a substudy; of the remaining 131, 67 were allocated to the intervention group and 64 to the control group. Primary outcome data were available for 97 participants (74.0%). While both groups reduced their HbA1c levels, there were no significant between-group differences in
Grace Haeson Park
Full Text Available Background: A major effort is underway to integrate primary and community care in Canada's western province of British Columbia and in Fraser Health, its largest health authority. Integrated care is a critical component of Fraser Health's planning, to meet the challenges of caring for a growing, elderly population that is presenting more complex and chronic medical conditions. Description of integrated practice: An integrated care model partners family physicians with community-based home health case managers to support frail elderly patients who live at home. It is resulting in faster response times to patient needs, more informed assessments of a patient's state of health and pro-active identification of emerging patient issues. Early results: The model is intended to improve the quality of patient care and maintain the patients’ health status, to help them live at home confidently and safely, as long as possible. Preliminary pilot data measuring changes in home care services is showing positive trends when it comes to extending the length of a person's survival/tenure in the community (living in their home vs. admitted to residential care or deceased. Conclusion: Fraser Health's case manager–general practitioner partnership model is showing promising results including higher quality, appropriate, coordinated and efficient care; improved patient, caregiver and physician interactions with the system; improved health and prevention of acute care visits by senior adult patients.
Albrecht, Martina; Kupfer, Ramona; Reissmann, Daniel R; Mühlhauser, Ingrid; Köpke, Sascha
Associations between nursing home residents' oral health status and quality of life, respiratory tract infections, and nutritional status have been reported. Educational interventions for nurses or residents, or both, focusing on knowledge and skills related to oral health management may have the potential to improve residents' oral health. To assess the effects of oral health educational interventions for nursing home staff or residents, or both, to maintain or improve the oral health of nursing home residents. We searched the Cochrane Oral Health Trials Register (to 18 January 2016), the Cochrane Central Register of Controlled Trials (CENTRAL) (the Cochrane Library, 2015, Issue 12), MEDLINE Ovid (1946 to 18 January 2016), Embase Ovid (1980 to 18 January 2016), CINAHL EBSCO (1937 to 18 January 2016), and Web of Science Conference Proceedings (1990 to 18 January 2016). We searched ClinicalTrials.gov and the World Health Organization International Clinical Trials Registry Platform for ongoing trials to 18 January 2016. In addition, we searched reference lists of identified articles and contacted experts in the field. We placed no restrictions on language or date of publication when searching the electronic databases. Randomised controlled trials (RCTs) and cluster-RCTs comparing oral health educational programmes for nursing staff or residents, or both with usual care or any other oral healthcare intervention. Two review authors independently screened articles retrieved from the searches for relevance, extracted data from included studies, assessed risk of bias for each included study, and evaluated the overall quality of the evidence. We retrieved data about the development and evaluation processes of complex interventions on the basis of the Criteria for Reporting the Development and Evaluation of Complex Interventions in healthcare: revised guideline (CReDECI 2). We contacted authors of relevant studies for additional information. We included nine RCTs involving
Conclusion: This study showed that the overall perceived performance is higher than expectation for home health care service provided. The primary caregiver who was older than 30 years, who had lower education level, and other than siblings showed higher satisfaction. The four items that need improving included “home health care nurses will provide detailed description of services,” “home health care nurses will provide knowledge of illness,” “home health care nurses can complete the promised tasks,” and “home health care nurses will actively inquire patient’s conditions and needs.”
Gordon, Adam Lee; Franklin, Matthew; Bradshaw, Lucy; Logan, Pip; Elliott, Rachel; Gladman, John R F
UK care home residents are often poorly served by existing healthcare arrangements. Published descriptions of residents' health status have been limited by lack of detail and use of data derived from surveys drawn from social, rather than health, care records. to describe in detail the health status and healthcare resource use of UK care home residents a 180-day longitudinal cohort study of 227 residents across 11 UK care homes, 5 nursing and 6 residential, selected to be representative for nursing/residential status and dementia registration. Barthel index (BI), Mini-mental state examination (MMSE), Neuropsychiatric index (NPI), Mini-nutritional index (MNA), EuroQoL-5D (EQ-5D), 12-item General Health Questionnaire (GHQ-12), diagnoses and medications were recorded at baseline and BI, NPI, GHQ-12 and EQ-5D at follow-up after 180 days. National Health Service (NHS) resource use data were collected from databases of local healthcare providers. out of a total of 323, 227 residents were recruited. The median BI was 9 (IQR: 2.5-15.5), MMSE 13 (4-22) and number of medications 8 (5.5-10.5). The mean number of diagnoses per resident was 6.2 (SD: 4). Thirty per cent were malnourished, 66% had evidence of behavioural disturbance. Residents had contact with the NHS on average once per month. residents from both residential and nursing settings are dependent, cognitively impaired, have mild frequent behavioural symptoms, multimorbidity, polypharmacy and frequently use NHS resources. Effective care for such a cohort requires broad expertise from multiple disciplines delivered in a co-ordinated and managed way.
Everett, Estelle; Kane, Brian; Yoo, Ashley; Dobs, Adrian; Mathioudakis, Nestoras
Prediabetes is a high-risk state for the future development of type 2 diabetes, which may be prevented through physical activity (PA), adherence to a healthy diet, and weight loss. Mobile health (mHealth) technology is a practical and cost-effective method of delivering diabetes prevention programs in a real-world setting. Sweetch (Sweetch Health, Ltd) is a fully automated, personalized mHealth platform designed to promote adherence to PA and weight reduction in people with prediabetes. The objective of this pilot study was to calibrate the Sweetch app and determine the feasibility, acceptability, safety, and effectiveness of the Sweetch app in combination with a digital body weight scale (DBWS) in adults with prediabetes. This was a 3-month prospective, single-arm, observational study of adults with a diagnosis of prediabetes and body mass index (BMI) between 24 kg/m 2 and 40 kg/m 2 . Feasibility was assessed by study retention. Acceptability of the mobile platform and DBWS were evaluated using validated questionnaires. Effectiveness measures included change in PA, weight, BMI, glycated hemoglobin (HbA 1c ), and fasting blood glucose from baseline to 3-month visit. The significance of changes in outcome measures was evaluated using paired t test or Wilcoxon matched pairs test. The study retention rate was 47 out of 55 (86%) participants. There was a high degree of acceptability of the Sweetch app, with a median (interquartile range [IQR]) score of 78% (73%-80%) out of 100% on the validated System Usability Scale. Satisfaction regarding the DBWS was also high, with median (IQR) score of 93% (83%-100%). PA increased by 2.8 metabolic equivalent of task (MET)-hours per week (SD 6.8; P=.02), with mean weight loss of 1.6 kg (SD 2.5; P<.001) from baseline. The median change in A 1c was -0.1% (IQR -0.2% to 0.1%; P=.04), with no significant change in fasting blood glucose (-1 mg/dL; P=.59). There were no adverse events reported. The Sweetch mobile
Yun, Young Ho; Kim, Young Ae; Lee, Myung Kyung; Sim, Jin Ah; Nam, Byung-Ho; Kim, Sohee; Lee, Eun Sook; Noh, Dong-Young; Lim, Jae-Young; Kim, Sung; Kim, Si-Young; Cho, Chi-Heum; Jung, Kyung Hae; Chun, Mison; Lee, Soon Nam; Park, Kyong Hwa; Park, Sohee
We aimed to evaluate the potential benefits of the Leadership and Coaching for Health (LEACH) program on physical activity (PA), dietary habits, and distress management in cancer survivors. We randomly assigned 248 cancer survivors with an allocation ratio of two-to-one to the LEACH program (LP) group, coached by long-term survivors, or the usual care (UC) group. At baseline, 3, 6, and 12 months, we used PA scores, the intake of vegetables and fruits (VF), and the Post Traumatic Growth Inventory (PTGI) as primary outcomes and, for secondary outcomes, the Ten Rules for Highly Effective Health Behavior adhered to and quality of life (QOL), the Hospital Anxiety and Depression Scale (HADS), and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30). For primary outcomes, the two groups did not significantly differ in PA scores or VF intake but differed marginally in PTGI. For secondary outcomes, the LP group showed a significantly greater improvement in the HADS anxiety score, the social functioning score, and the appetite loss and financial difficulties scores of the EORTC QLQ-C30 scales from baseline to 3 months. From baseline to 12 months, the LP group showed a significantly greater decrease in the EORTC QLQ-C30 fatigue score and a significantly greater increase in the number of the Ten Rules for Highly Effective Health Behavior. Our findings indicate that the LEACH program, coached by long-term survivors, can provide effective management of the QOL of cancer survivors but not of their PA or dietary habits. Clinical trial information can be found for the following: NCT01527409 (the date when the trial was registered: February 2012).
Hosler, Akiko S; Solanki, Malini N; Savadatti, Sanghamitra
The purpose of this study is to explore barriers and needs related to diabetes care and the feasibility of diabetes self-management (DSM) "coaching" at faith-based organizations (FBOs) for the Indo-Guyanese community in Schenectady, New York. Participants were recruited though flyers and mass mailings, and in-depth interviews were conducted at their homes by a team of culturally matched interviewers using a semi-structured questionnaire. Characteristics of participants were compared with existing population-based data to confirm their representativeness. Responses were transcribed, coded, and summarized, and findings are presented along with selective quotations. Key dimensions of feasibility were scored and charted for visualization. Findings revealed barriers regarding diet-related knowledge and skills, access to structured DSM education, hyperglycemia control, and environmental support for physical activity. Participants responded positively to receiving free DSM coaching at their FBOs. All participants preferred a qualified health care professional such as certified diabetes educator as their coach and wanted coaching in all aspects of DSM; however, food preparation/diet was the most frequently requested specific topic. Participants uniformly disliked contact with the coach through e-mails and text messages but liked receiving periodic telephone calls at home by the coach. Overall, DSM coaching at FBOs rated high on the key dimensions of feasibility, namely, affordability, accessibility, acceptability, cultural relevance, and safety. This study sheds light on the feasibility of an FBO-based DSM intervention for the Indo-Guyanese. It offers insights into developing culturally appropriate DSM intervention format and strategy. © 2015 The Author(s).
Lentferink, Aniek J; Oldenhuis, Hilbrand Ke; de Groot, Martijn; Polstra, Louis; Velthuijsen, Hugo; van Gemert-Pijnen, Julia Ewc
The combination of self-tracking and persuasive eCoaching in automated interventions is a new and promising approach for healthy lifestyle management. The aim of this study was to identify key components of self-tracking and persuasive eCoaching in automated healthy lifestyle interventions that contribute to their effectiveness on health outcomes, usability, and adherence. A secondary aim was to identify the way in which these key components should be designed to contribute to improved health outcomes, usability, and adherence. The scoping review methodology proposed by Arskey and O'Malley was applied. Scopus, EMBASE, PsycINFO, and PubMed were searched for publications dated from January 1, 2013 to January 31, 2016 that included (1) self-tracking, (2) persuasive eCoaching, and (3) healthy lifestyle intervention. The search resulted in 32 publications, 17 of which provided results regarding the effect on health outcomes, 27 of which provided results regarding usability, and 13 of which provided results regarding adherence. Among the 32 publications, 27 described an intervention. The most commonly applied persuasive eCoaching components in the described interventions were personalization (n=24), suggestion (n=19), goal-setting (n=17), simulation (n=17), and reminders (n=15). As for self-tracking components, most interventions utilized an accelerometer to measure steps (n=11). Furthermore, the medium through which the user could access the intervention was usually a mobile phone (n=10). The following key components and their specific design seem to influence both health outcomes and usability in a positive way: reduction by setting short-term goals to eventually reach long-term goals, personalization of goals, praise messages, reminders to input self-tracking data into the technology, use of validity-tested devices, integration of self-tracking and persuasive eCoaching, and provision of face-to-face instructions during implementation. In addition, health outcomes or
Hatcher, Simon; Whittaker, Robyn; Patton, Murray; Miles, Wayne Sylvester; Ralph, Nicola; Kercher, Katharina; Sharon, Cynthia
The evidence for the effectiveness of Web-based therapies comes mainly from nonclinical populations, with a few studies in primary care. There is little evidence from patients referred to secondary mental health care with depression. Adherence to Web-based therapies is often poor. One way to increase this is to create a new health service role of a coach to guide people through the therapy. This study aimed to test in people referred to secondary care with depression if a Web-based therapy (The Journal) supported by a coach plus usual care would be more effective in reducing depression compared with usual care plus an information leaflet about Web-based resources after 12 weeks. We conducted a randomized controlled trial with two parallel arms and a process evaluation that included structured qualitative interviews analyzed using thematic analysis. The coach had a background in occupational therapy. Participants were recruited face-to-face at community mental health centers. We recruited 63 people into the trial (intervention 35, control 28). There were no statistically significant differences in the change from baseline in Patient Health Questionnaire-9 (PHQ-9) scores at 12 weeks comparing The Journal with usual care (mean change in PHQ-9 score 9.4 in the intervention group and 7.1 in the control group, t 41 =1.05, P=.30; mean difference=2.3, 95% CI -2.1 to 6.7). People who were offered The Journal attended on average about one less outpatient appointment compared with usual care, although this difference was not statistically significant (intervention mean number of visits 2.8 (SD 5.5) compared with 4.1 (SD 6.7) in the control group, t 45 =-0.80, P=.43; mean difference=1.3, 95% CI -4.5 to 2.0). The process evaluation found that the mean number of lessons completed in the intervention group was 2.5 (SD=1.9; range=0-6) and the number of contacts with the coach was a mean of 8.1 (SD=4.4; range=0-17). The qualitative interviews highlighted the problem of engaging
Burns, T; Knapp, M; Catty, J; Healey, A; Henderson, J; Watt, H; Wright, C
This review investigates the effectiveness of 'home treatment' for mental health problems in terms of hospitalisation and cost-effectiveness. For the purposes of this review, 'home treatment' is defined as a service that enables the patient to be treated outside hospital as far as possible and remain in their usual place of residence. METHODS - SYSTEMATIC LITERATURE SEARCH: 'Home treatment' excluded studies focused on day, residential and foster care. The review was based on Cochrane methodology, but non-randomised studies were included if they compared two services; these were only analysed if they provided evidence of the groups' baseline clinical comparability. METHODS - REVIEW OF ECONOMIC EVALUATIONS: Economic evaluations among the studies found were reviewed against established criteria. METHODS - IDENTIFICATION OF SERVICE COMPONENTS: A three-round Delphi exercise ascertained the degree of consensus among expert psychiatrists concerning the important components of community-based services that enable them to treat patients outside hospital. The identified components were used to construct the follow-up questionnaire. METHODS - FOLLOW-UP OF AUTHORS: As a supplement to the information available in the papers, authors of all the studies were followed up for data on service components, sustainability of programmes and service utilisation. METHODS - DATA ANALYSIS: The outcome measure was mean days in hospital per patient per month over the follow-up period. (1) Comparative analysis - compared experimental to control services. It analysed all studies with available data, divided into 'inpatient-control' and 'community-control' studies, and tested for associations between service components and difference in hospital days. (2) Experimental services analysis - analysed only experimental service data and tested for associations between service components and hospital days. RESULTS - SYSTEMATIC LITERATURE SEARCH: A total of 91 studies were found, conducted over a 30
De Vliegher, Kristel; Aertgeerts, Bert; Declercq, Anja; Moons, Philip
Are home nurses (also known as community nurses) ready for their changing role in primary care? A quantitative study was performed in home nursing in Flanders, Belgium, to explore the activity profile of home nurses and health care assistants, using the 24-hour recall instrument for home nursing. Seven dates were determined, covering each day of the week and the weekend, on which data collection would take place. All the home nurses and health care assistants from the participating organisations across Flanders were invited to participate in the study. All data were measured at nominal level. A total of 2478 home nurses and 277 health care assistants registered 336 128 (47 977 patients) and 36 905 (4558 patients) activities, respectively. Home nurses and health care assistants mainly perform 'self-care facilitation' activities in combination with 'psychosocial care' activities. Health care assistants also support home nurses in the 'selfcare facilitation' of patients who do not have a specific nursing indication.
Denton, Margaret A; Zeytinoğlu, Işk Urla; Davies, Sharon
The purpose of this paper is to examine the effects of working in clients' homes on the mental health and well-being of visiting home care workers. This paper reports the results of a survey of 674 visiting staff from three non-profit home care agencies in a medium-sized city in Ontario, Canada. Survey results are also complimented by data from 9 focus groups with 50 employees. For purposes of this study, home care workers include visiting therapists, nurses, and home support workers. Mental health and well-being is measured by three dependent variables: stress; job stress; and intrinsic job satisfaction. Multiple least squared regression analyses show several structural, emotional, physical, and organizational working conditions associated with the health and well-being of visiting home care workers. Overall, results show that workload, difficult clients, clients who take advantage of workers, sexual harassment, safety hazards, a repetitious job, and work-related injuries are associated with poorer health. Being fairly paid, having good benefits, emotional labour, organizational support, control over work, and peer support are associated with better health. Results suggest that policy change is needed to encourage healthier work environments for employees who work in clients' homes.
Heinrich, Katie M; Carlisle, Taran; Kehler, Ainslie; Cosgrove, Sarah J
Group-based training through CrossFit has recently exploded in popularity. Anecdotally, participants often make lifestyle changes and experience improved fitness. Participation factors were mapped to the Integrated Theory of Health Behavior Change and "sense of community" constructs. Key informant interviews were conducted with 6 CrossFit gym owners/coaches. Data were thematically coded with NVivo 10. Results revealed key factors that both facilitated and restricted participation in CrossFit. Findings provide implications for future theory application and highlight how to improve initiation and adherence by capitalizing on community building and taking steps to reduce intimidation and cost, facilitate realistic goals, and ensure social support.
De la Torre Muñoz, Gloria
El objetivo de este módulo es proporcionar al alumnado una introducción e idea del concepto de coaching, trabajar en el aula los principales recursos que pueden poner en práctica y desarrollar sus habilidades como coach. Existen multitudes de formas de hacer coaching de manera sistémica, ontológica pero modelo que trabajamos es el coaching co- activo. Este modelo define el coaching como una alianza entre dos personas para alcanzar las metas que el cliente se ha propuesto es una relación de...
Moraitou, Marina; Pateli, Adamantia; Fotiou, Sotiris
As access to health care is important to people's health especially for vulnerable groups that need nursing for a long period of time, new studies in the human sciences argue that the health of the population depend less on the quality of the health care, or on the amount of spending that goes into health care, and more heavily on the quality of everyday life. Smart home applications are designed to "sense" and monitor the health conditions of its residents through the use of a wide range of technological components (motion sensors, video cameras, wearable devices etc.), and web-based services that support their wish to stay at home. In this work, we provide a review of the main technological, psychosocial/ethical and economic challenges that the implementation of a Smart Health Caring Home raises.
... [CMS-1510-CN2] RIN 0938-AP88 Medicare Program; Home Health Prospective Payment System Rate Update for... ``Medicare Program; Home Health Prospective Payment System Rate Update for Calendar Year 2011; Changes in... Prospective Payment System Rate Update for Calendar Year 2011; Changes in Certification Requirements for Home...
Horowitz, Beverly P; Almonte, Tiffany; Vasil, Andrea
This exploratory research examined the benefits of a health education program utilizing the Home Safety Self-Assessment Tool (HSSAT) to increase perceived knowledge of home safety, recognition of unsafe activities, ability to safely perform activities, and develop home safety plans of 47 older adults. Focus groups in two senior centers explored social workers' perspectives on use of the HSSAT in community practice. Results for the health education program found significant differences between reported knowledge of home safety (p = .02), ability to recognize unsafe activities (p = .01), safely perform activities (p = .04), and develop a safety plan (p = .002). Social workers identified home safety as a major concern and the HSSAT a promising assessment tool. Research has implications for reducing environmental fall risks.
Health coaching and pedometers to enhance physical activity and prevent falls in community-dwelling people aged 60 years and over: study protocol for the Coaching for Healthy AGEing (CHAnGE) cluster randomised controlled trial.
Tiedemann, Anne; Rissel, Chris; Howard, Kirsten; Tong, Allison; Merom, Dafna; Smith, Stuart; Wickham, James; Bauman, Adrian; Lord, Stephen R; Vogler, Constance; Lindley, Richard I; Simpson, Judy M; Allman-Farinelli, Margaret; Sherrington, Catherine
Prevention of falls and promotion of physical activity are essential for maximising well-being in older age. However, there is evidence that promoting physical activity among older people without providing fall prevention advice may increase fall rates. This trial aims to establish the impact of a physical activity and fall prevention programme compared with a healthy eating programme on physical activity and falls among people aged 60+ years. This cluster randomised controlled trial will involve 60 groups of community-dwelling people aged 60+ years. Participating groups will be randomised to: (1) a physical activity and fall prevention intervention (30 groups), involving written information, fall risk assessment and prevention advice, a pedometer-based physical activity tracker and telephone-based health coaching; or (2) a healthy eating intervention (30 groups) involving written information and telephone-based dietary coaching. Primary outcomes will be objectively measured physical activity at 12 months post-randomisation and self-reported falls throughout the 12-month trial period. Secondary outcomes include: the proportion of fallers, the proportion of people meeting the Australian physical activity guidelines, body mass index, eating habits, mobility goal attainment, mobility-related confidence, quality of life, fear of falling, risk-taking behaviour, mood, well-being, self-reported physical activity, disability, and health and community service use. The between-group difference in the number of falls per person-year will be analysed using negative binomial regression models. For the continuously scored primary and secondary outcome measures, linear regression adjusted for corresponding baseline scores will assess the effect of group allocation. Analyses will be preplanned, conducted while masked to group allocation, will take into account cluster randomisation, and will use an intention-to-treat approach. Protocol has been approved by the Human Research
Jucelia Salgueiro Nascimento
Full Text Available Objective: To analyze the domiciliary visit performed by nurses in the Family Health Strategy as an activity to promote health. Methods: Exploratory/descriptive study with qualitative approach. The subjects were nine nurses of the Primary Health Units from Health Districts in Maceió-AL. Data was collected through semi-structured interviews in the months from April to August 2012 and were analyzed using content analysis and in light of the theoretical framework of Health Promotion. Results: The nurses recognize that the domiciliary visit can be a way to promote the health of individuals, families and community, but, in daily life, action maintains focus on disease, with curative actions of individual character, which do not take into account the social context where the user and his family are inserted. Conclusion: It is considered that the use of home visits by nurses in the family health strategy as a health promotion activity is still incipient because, although the nurses recognize the need for change in the model of care, in practice, it is observed that the focus of this action is directed to the biological model. doi:http://dx.doi.org/10.5020/18061230.2013.p513
McCaughey, Deirdre; McGhan, Gwen; Kim, Jungyoon; Brannon, Diane; Leroy, Hannes; Jablonski, Rita
Purpose of study: The direct care workforce continues to rank as one of the most frequently injured employee groups in North America. Occupational health and safety studies have shown that workplace injuries translate into negative outcomes for workers and their employers. The National Institute for Occupational Safety and Health (NIOSH)…
Vermont Agency of Education, 2016
To build collective capacity within organizations, schools and districts across the world have implemented coaching as an effective method for systemic reform. Vermont in particular has a wide variety of coaches, including instructional coaches and systems coaches, as well as a variety of interpretations of the coaching practice. Many schools…
Stewart, Craig; Owens, Lynn
The purpose of this paper was to use athletes' and former athletes' memories of their favorite coach to improve coach education curriculum. Player preferences of coaching behavior can affect both their attitudes toward their sport experiences and team performance. By identifying positive coaching behaviors as recalled by athletes, coach educators…
Demiris, George; Wouters, Eveline
Smart homes, home automation and ambient-assisted living are terms used to describe technological systems that enrich our living environment and provide means to support care, facilitate well-being and improve comfort. This handbook provides an overview of the domain from the perspective of health care and technology. In Part 1, we set out to describe the demographic changes in society, including ageing, and diseases and impairments which lead to the needs for technological solutions. In Part 2, we describe the technological solutions, ranging from sensor-based networks, components, to communication protocols that are used in the design of smart homes. We also deal will biomedical features which can be measured, and services that can be delivered to end-users as well as the use of social robots. In Part 3, we present best practices in the field. These best practices mainly focus on existing projects in Europe, the USA and Asia, in which people receive help through dedicated technological solutions being p...
Van Houtven, Courtney Harold; Jeffreys, Amy S.; Coffman, Cynthia J.
Purpose: The Veterans Affairs or VA health care system is in the process of significantly expanding home health care (HOC) nationwide. We describe VA HHC use in 2003 for all VA HHC users from 2002; we examine whether VA utilization across a broad spectrum of services differed for a sample of VA HHC users and their propensity-score-matched…
Primary prevention of stroke and cardiovascular disease in the community (PREVENTS): Methodology of a health wellness coaching intervention to reduce stroke and cardiovascular disease risk, a randomized clinical trial.
Mahon, Susan; Krishnamurthi, Rita; Vandal, Alain; Witt, Emma; Barker-Collo, Suzanne; Parmar, Priya; Theadom, Alice; Barber, Alan; Arroll, Bruce; Rush, Elaine; Elder, Hinemoa; Dyer, Jesse; Feigin, Valery
Rationale Stroke is a major cause of death and disability worldwide, yet 80% of strokes can be prevented through modifications of risk factors and lifestyle and by medication. While management strategies for primary stroke prevention in high cardiovascular disease risk individuals are well established, they are underutilized and existing practice of primary stroke prevention are inadequate. Behavioral interventions are emerging as highly promising strategies to improve cardiovascular disease risk factor management. Health Wellness Coaching is an innovative, patient-focused and cost-effective, multidimensional psychological intervention designed to motivate participants to adhere to recommended medication and lifestyle changes and has been shown to improve health and enhance well-being. Aims and/or hypothesis To determine the effectiveness of Health Wellness Coaching for primary stroke prevention in an ethnically diverse sample including Māori, Pacific Island, New Zealand European and Asian participants. Design A parallel, prospective, randomized, open-treatment, single-blinded end-point trial. Participants include 320 adults with absolute five-year cardiovascular disease risk ≥ 10%, calculated using the PREDICT web-based clinical tool. Randomization will be to Health Wellness Coaching or usual care groups. Participants randomized to Health Wellness Coaching will receive 15 coaching sessions over nine months. Study outcomes A substantial relative risk reduction of five-year cardiovascular disease risk at nine months post-randomization, which is defined as 10% relative risk reduction among those at moderate five-year cardiovascular disease risk (10-15%) and 25% among those at high risk (>15%). Discussion This clinical trial will determine whether Health Wellness Coaching is an effective intervention for reducing modifiable risk factors, and hence decrease the risk of stroke and cardiovascular disease.
Dorah U. Ramathuba
Full Text Available Background: The introduction of home-based care in rural communities in the 1980s contributed immensely toward the upliftment of the personal and environmental health of communities. Women’s groups provided health promotion skills and health education to communities and made a difference in health-related behaviour change. Objective: The purpose of the study was to explore and describe the home-based carers’ perception regarding health promotion concerning sexual health communication in Vhembe district, in the context of HIV, amongst communities still rooted in their culture. Method: A qualitative, explorative and descriptive design was used in order to understand home-based carers’ perceptions regarding health promotion on sexual health communication amongst rural communities which may adversely impact on health promotion practices. The population were home-based organisations in Vhembe. The sample was purposive and randomly selected and data were gathered through semi-structured face-to-face interviews and focus groups which determined data saturation. Open coding was used for analysis of data. Results: The results indicated that sexual communication was absent in most relationships and was not seen as necessary amongst married couples. Socioeconomic conditions, power inequity and emotional dependence had a negative impact on decision making and sexual communication. Conclusion: This study, therefore, recommends that educational and outreach efforts should focus on motivating change by improving the knowledge base of home-based carers. Since they are health promoters, they should be able to change the perceptions of the communities toward sexually-transmitted infections and HIV by promoting sexual health communication.
Ryvicker, Miriam; McDonald, Margaret V; Trachtenberg, Melissa; Peng, Timothy R; Sridharan, Sridevi; Feldman, Penny H
The Care Transitions Measure (CTM) was designed to assess the quality of patient transitions from the hospital. Many hospitals are using the measure to inform their efforts to improve transitional care. We sought to determine if the measure would have utility for home healthcare providers by predicting newly admitted patients at heightened risk for emergency department use, rehospitalization, or increased home health nursing visits. The CTM was administered to 495 home healthcare patients shortly after hospital discharge and home healthcare admission. Follow-up interviews were completed 30 and 60 days post hospital discharge. Interview data were supplemented with agency assessment and service use data. We did not find evidence that the CTM could predict home healthcare patients having an elevated risk for emergent care, rehospitalization, or higher home health nursing use. Because Medicare/Medicaid-certified home healthcare providers already use a comprehensive, mandated start of care assessment, the CTM may not provide them additional crucial information. Process and outcome measurement is increasingly becoming part of usual care. Selection of measures appropriate for each service setting requires thorough site-specific evaluation. In light of our findings, we cannot recommend the CTM as an additional measure in the home healthcare setting. © 2013 National Association for Healthcare Quality.
Knudsen, Karin Bæk; Pressler, Tacjana; Mortensen, Laust Hvas; Jarden, Mary; Boisen, Kirsten Arntz; Skov, Marianne; Quittner, Alexandra L; Katzenstein, Terese Lea
Over the last two decades, lifespan has increased significantly for people living with cystic fibrosis (CF). However, several studies have demonstrated that many young adults with CF report mental health problems and poor adherence to their prescribed treatments, challenging their long-term physical health. Treatment guidelines recommend interventions to improve adherence and self-management. The aim of this study was to test the feasibility of a life coaching intervention for young adults with CF. A randomized, controlled feasibility study was conducted at the CF Center at Copenhagen University Hospital, Rigshospitalet. Participants were young adults with CF, aged 18-30 years without severe intellectual impairments. Participants were randomized to either life coaching or standard care. The intervention consisted of up to 10 individual, face-to-face or telephone coaching sessions over a period of 1 year. Primary outcomes were recruitment success, acceptability, adherence to the intervention, and retention rates. Secondary outcome measures included health-related quality of life, adherence to treatment, self-efficacy, pulmonary function, body mass index, and blood glucose values. Among the 85 eligible patients approached, 40 (47%) were enrolled and randomized to the intervention or control group; two patients subsequently withdrew consent. Retention rates after 5 and 10 coaching sessions were 67% and 50%, respectively. Reasons for stopping the intervention included lack of time, poor health, perceiving coaching as not helpful, lack of motivation, and no need for further coaching. Coaching was primarily face-to-face (68%). No significant differences were found between the groups on any of the secondary outcomes. Both telephone and face-to-face coaching were convenient for participants, with 50% receiving the maximum offered coaching sessions. However, the dropout rate early in the intervention was a concern. In future studies, eligible participants should be screened
... Services of Residents § 415.204 Services of residents in skilled nursing facilities and home health... 42 Public Health 3 2010-10-01 2010-10-01 false Services of residents in skilled nursing facilities and home health agencies. 415.204 Section 415.204 Public Health CENTERS FOR MEDICARE & MEDICAID...
Porter, Jessie; Ntouva, Antiopi; Read, Andrew; Murdoch, Mandy; Ola, Dennis; Tsakos, Georgios
Background Good oral health in older residents of nursing homes is important for general health and quality of life. Very few studies have assessed how oral symptoms affect residents? quality of life. Objective To assess the clinical and subjective oral health, including oral health related quality of life (OHRQoL), and the association of oral symptoms with OHRQoL in older people residing in nursing homes in Islington, London. Method Overall, 325 residents from nine nursing homes were clinica...
: - Existential coaching - Protreptic coaching as a philosophically inspired coaching approach - Third-generation coaching as a narrative-collaborative practice The overall objective of this chapter is to present and discuss the state of knowledge about values as a central aspect of the coaching process...
Wang, Yun; Leifheit-Limson, Erica C; Fine, Jonathan; Pandolfi, Michelle M; Gao, Yan; Liu, Fanglin; Eckenrode, Sheila; Lichtman, Judith H
To evaluate national trends and geographic variation in the availability of home health care from 2002 to 2015 and identify county-specific characteristics associated with home health care. Observational study. All counties in the United States. All Medicare-certified home health agencies included in the Centers for Medicare & Medicaid Services Home Health Compare system. County-specific availability of home health care, defined as the number of available home health agencies that provided services to a given county per 100,000 population aged ≥18 years. The study included 15,184 Medicare-certified home health agencies that served 97% of U.S. ZIP codes. Between 2002-2003 and 2014-2015, the county-specific number of available home health agencies per 100,000 population aged ≥18 years increased from 14.7 to 21.8 and the median (inter-quartile range) population that was serviced by at least one home health agency increased from 403,605 (890,329) to 455,488 (1,039,328). Considerable geographic variation in the availability of home health care was observed. The West, North East, and South Atlantic regions had lower home health care availability than the Central regions, and this pattern persisted over the study period. Counties with higher median income, a larger senior population, higher rates of households without a car and low access to stores, more obesity, greater inactivity, and higher proportions of non-Hispanic white, non-Hispanic black, and Hispanic populations were more likely to have higher availability of home health care. The availability of home health care increased nationwide during the study period, but there was much geographic variation. © 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics Society.
Leff, E W; Hagenbach, G L; Marn, K K
Franklin County Home Health Agency (St Albans, Vermont) undertook a performance improvement project in 1996 to reduce employee injuries. A review of recent injuries led to the prevention of licensed nursing assistants' (LNAs') back and shoulder injuries as the first priority. Root causes of injuries were agency communication, employee training, patient home environment, nursing assistant body mechanics, and failure to use safety measures. Given that injury causality is complex and multifactorial, a variety of improvement strategies were implemented over the following two to three years. IMPLEMENTATION OF POTENTIAL SOLUTIONS: Short-term (a few months), mid-term (six months), and long-term (one year) potential solutions to the LNA back and shoulder injury problem were charted. Safety and health training was the major focus of the team's short-term plan. Risk management forms were to be used to identify and follow up on hazardous situations. Project plans that were successfully implemented included revision of LNA plans of care, standardization of the return-to-work process after injury, development of guidelines for identifying unsafe patient lifts and transfers, improved follow-up of employee reports of injury-risk situations in patient homes, improved body mechanics screening of new employees, and a stronger injury-prevention training program for current employees. A less successful initiative was aimed at collecting more data about injuries and causal factors. Employee injuries were gradually reduced from 4-10 per quarter to 0-3 per quarter. Injury prevention requires commitment, persistence, and patience--but not expensive improvements. Multiple interventions increase the chances of success when there are many root causes and lack of evidence regarding the effectiveness of various approaches.
Gorzelle, Gregg J; Kaiser, Kathy; Camp, Cameron J
Home care visits can last several hours. Home care workers are often at a loss on how to fill time spent in homes of clients. The challenge is how to use this time in ways that are productive and engaging for both clients and home health workers. The authors trained home health aides to implement Montessori-based activities while interacting with clients who have dementia. The results were amazing. Among other positive results, the authors found a statistically significant increase in the amount of pleasure displayed by clients after health workers received training.
Branch, L G; Goldberg, H B; Cheh, V A; Williams, J
The purpose of this study was to present descriptive information on the characteristics of 2,873 Medicare home health clients, to quantify systematically their patterns of service utilization and allowed charges during a total episode of care, and to clarify the bivariate associations between client characteristics and utilization. The model client was female, 75-84 years of age, living with a spouse, and frail based on a variety of indicators. The mean total episode was approximately 23 visits, with allowed charges of $1,238 (1986 dollars). Specific subgroups of clients, defined by their morbidities and frailties, used identifiable clusters of services. Implications for case-mix models and implications for capitation payments under health care reform are discussed.
German abstract: Auf der Grundlage aktueller Sozialforschung, neuer Lerntheorien und Diskurse der Personalführung entfaltet sich ein neues Verständnis von Coaching und Coaching-Psychologie. In der dritten Generation wird Coaching aus gesellschaftlicher Perspektive betrachtet. Wenn sich die...... Gesellschaft verändert, muss sich auch Coaching als spezifische Form der Interaktion weiterentwickeln: Die Mission des Third Generation Coaching ist die Entwicklung von Nachhaltigkeit in der Anwendung, indem sich der Dialog stärker auf Werte und Sinn-Schaffen ausrichtet, weg vom einengenden Zielfokus hin zur...... Betonung von Aspirationen, Leidenschaften und Werten. In diesem Sinne trägt Third Generation Coaching zur Entfaltung und Weiterentwicklung persönlicher Identität bei – ein entscheidender Faktor für die menschliche Entwicklung in unserer Zeit. Auf der Basis kollaborativer Zusammenarbeit dieses Ansatzes...
Neal, L J
A grounded-theory study of 30 home health nurses conducted in the Washington, DC, metropolitan area used unstructured audiotaped interviews to elicit data as to how home health nurses define their practice. The purpose of the study was to develop a beginning substantive research-based theory of home health nursing practice. The model that emerged consists of three stages by which nurses attain autonomy in their practice. Adaptation was found to be the core category, in that nurses cannot function effectively or successfully in the home health arena unless they are or learn to be adaptable. Data also revealed that home health nurses either knowingly or unknowingly use rehabilitation nursing principles in their practice, thereby lending credence to the supposition that home health nursing practice is congruent with rehabilitation nursing principles.
Rocchi, Meredith; Pelletier, Luc G
This study explored how the coaching context influences coaches' psychological needs, motivation, and reported interpersonal behaviors, using self-determination theory. In Study 1, 56 coaches identified how contextual factors influence their coaching experience. Coaches identified administration, athlete motivation, colleagues, parents, professional development, time, and work-life as having the largest impact on them. In Study 2, 424 coaches reported on their perceptions of the factors identified in Study 1 and their psychological needs, motivation, and interpersonal behaviors. Structural equation modeling analyses suggested perceptions of the coaching context supported or thwarted their psychological needs, which positively or negatively predicted their autonomous and controlled motivation. Coaches' autonomous motivation predicted their reported supportive interpersonal behaviors and controlled motivation predicted thwarting behaviors. Overall, the results provided additional support for understanding how the coaching context, coaches' psychological needs, and their motivation for coaching relate to their coaching behaviors.
Lucke-Wold, Brandon; Shawley, Samantha; Ingels, John Spencer; Stewart, Jonathan; Misra, Ranjita
The epidemic of obesity and diabetes in the United States poses major challenge to the prevention and management of chronic diseases. Furthermore, when this is viewed in other components of the metabolic syndrome (i.e., the burden of high cholesterol and hypertension), the prevalence of the metabolic syndrome continues to rise in the USA continued challenge is how to deal with this epidemic from a medical and public health standpoint. Community Based Participatory Research (CBPR) is a unique approach and offers a novel perspective for answering this challenge. A critical set of goals for CBPR is to address health disparities and social inequalities while getting community members engaged in all aspects of the research process. Utilizing the West Virginia Diabetes Prevention and Management Program and trained Health Coaches as a model, we discuss topics of consideration related to CBPR, involving trained health coaches, optimizing early adoption of healthy lifestyle behaviors, and enhancing participation. Through careful project planning and design, questions regarding disparities increasing susceptibility and preventive efforts within the community can be addressed successfully. These topics are part of a broader integration of theories such as participatory research, community engagement, and outcomes measurement. The understanding of the pathophysiology and epidemiology of the metabolic syndrome can help frame an appropriate strategy for establishing long-term community-wide changes that promote health. In order to continue to improve investigations for preventing the metabolic syndrome, it will be necessary to have aggressive efforts at the individual and population level for developing culturally sensitive programs that start early and are sustainable in practical environments such as the workplace. In this comprehensive review, we will discuss practical considerations related to project design, implementation, and how to measure effectiveness in regards to
Pimdee, Atipong; Nualnetr, Nomjit
Home health care is an essential service for home-bound patients in Thailand. In this action research study, we used the International Classification of Functioning, Disability and Health (ICF) framework to modify home health care services provided by a university hospital. Staff responsible for delivering the services (physical therapist, nurses, and Thai traditional medicine practitioners) participated in the development of an ICF-based assessment tool and home health care service procedure. After an 8-month trial of implementing these changes, professional satisfaction and empowerment were high among the home health care team members. Patients and their caregivers were also satisfied with the services. In conclusion, the ICF is an effective means of guiding home health care.
Guan, Kai; Shao, Minggang; Wu, Shuicai
This paper proposed a remote health monitoring system for the elderly based on smart home gateway. The proposed system consists of three parts: the smart clothing, the smart home gateway, and the health care server. The smart clothing collects the elderly's electrocardiogram (ECG) and motion signals. The home gateway is used for data transmission. The health care server provides services of data storage and user information management; it is constructed on the Windows-Apache-MySQL-PHP (WAMP) ...
Nakaishi, Lindsay; Moss, Helen; Weinstein, Marc; Perrin, Nancy; Rose, Linda; Anger, W Kent; Hanson, Ginger C; Christian, Mervyn; Glass, Nancy
Nominal research has examined sexual harassment and workplace violence against home care workers within consumer-driven home care models such as those offered in Oregon. This study examined home care workers' experiences of violence while providing care to consumer employers, the patients who hire and manage home care workers. Focus groups and interviews were conducted in Oregon with 83 home care workers, 99 Oregon Department of Human Services (DHS) employees, and 11 consumer employers. Home care workers reported incidents of workplace physical violence (44%), psychological abuse (65%), sexual harassment (41%), and sexual violence (14%). Further, three themes were identified that may increase the risk of workplace violence: (1) real and perceived barriers to reporting violence; (2) tolerance of violence; and (3) limited training to prevent violence. To ensure worker safety while maintaining quality care, safety policies and training for consumer employers, state DHS employees, and home care workers must be developed. Copyright 2013, SLACK Incorporated.
Bouman, A.; Rossum, E. van; Nelemans, P.; Kempen, G.I.J.M.; Knipschild, P.
BACKGROUND: Home visiting programs have been developed aimed at improving the health and independent functioning of older people. Also, they intend to reduce hospital and nursing home admission and associated cost. A substantial number of studies have examined the effects of preventive home visiting
... [CMS-1510-CN] RIN 0938-AP88 Medicare Program; Home Health Prospective Payment System Rate Update for... Health Prospective Payment System Rate Update for Calendar Year 2011; Changes in Certification... effective as if they had been included in the Medicare Program; Home Health Prospective Payment System Rate...
Aboalshamat, Khalid; Hou, Xiang-Yu; Strodl, Esben
Psychological distress is well-documented worldwide among medical and dental students. Few studies have assessed the impact of self-development coaching programs on the students' psychological health. The aim of the study was to evaluate the effect of a self-development coaching programme on the psychological health and academic performance of preclinical medical and dental students at Umm Al-Qura University, Saudi Arabia. Four-hundred and twenty-two participants (n = 422, 20-22 years) fulfilled the study requirements and were invited into a parallel-randomised controlled trial that was partially blinded. Participants were stratified by faculty, gender, and academic year, and then randomised. A total of 156 students participated in the intervention group (IG) and 163 students participated in the control group (CG). The IG received the selfdevelopment programme, involving skills and strategies aimed to improve students' psychological health and academic performance, through a two-day workshop. Meanwhile, the CG attended an active placebo programme focussing on theoretical information that was delivered through a five-hour workshop. Both programmes were conducted by the same presenter during Week 1 of the second semester of the 2012-2013 academic year. Data were gathered immediately before (T1), one week after (T2) and five weeks (T3) after the intervention. Psychological health was measured using the Depression Anxiety Stress Scale (DASS-21), the General Self-Efficacy (GSE), and the Satisfaction With Life Scale (SWLS). Academic performance was measured using students' academic weighted grades (WG). Student cognitive and emotional perceptions of the intervention were measured using the Credibility/Expectancy Questionnaire (CEQ). Data from 317 students, who completed the follow ups, were analysed across the three time periods (IG, n = 155; CG, n = 162). The baseline variables and demographic data of the IG and CG were not significantly different. The IG showed short
Francisco, P W; Jacobs, D E; Targos, L; Dixon, S L; Breysse, J; Rose, W; Cali, S
Ventilation standards, health, and indoor air quality have not been adequately examined for residential weatherization. This randomized trial showed how ASHRAE 62-1989 (n=39 houses) and ASHRAE 62.2-2010 (n=42 houses) influenced ventilation rates, moisture balance, indoor air quality, and self-reported physical and mental health outcomes. Average total airflow was nearly twice as high for ASHRAE 62.2-2010 (79 vs. 39 cfm). Volatile organic compounds, formaldehyde and carbon dioxide were all significantly reduced for the newer standard and first-floor radon was marginally lower, but for the older standard, only formaldehyde significantly decreased. Humidity in the ASHRAE 62.2-2010 group was only about half that of the ASHRAE 62-1989 group using the moisture balance metric. Radon was higher in the basement but lower on the first floor for ASHRAE 62.2-2010. Children in each group had fewer headaches, eczema, and skin allergies after weatherization and adults had improvements in psychological distress. Indoor air quality and health improve when weatherization is accompanied by an ASHRAE residential ventilation standard, and the 2010 ASHRAE standard has greater improvements in certain outcomes compared to the 1989 standard. Weatherization, home repair, and energy conservation projects should use the newer ASHRAE standard to improve indoor air quality and health. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Joynt Maddox, Karen E; Chen, Lena M; Zuckerman, Rachael; Epstein, Arnold M
More than 3 million Medicare beneficiaries use home health care annually, yet little is known about how vulnerable beneficiaries fare in the home health setting. This is particularly important given the recent launch of Medicare's Home Health Value-Based Purchasing model. The objective of this study was to determine odds of adverse clinical outcomes associated with dual enrollment in Medicaid and Medicare as a marker of individual poverty, residence in a low-income ZIP code tabulation area (ZCTA), and black race. Retrospective observational study using individuals-level logistic regression. Home health care. Fee-for-service Medicare beneficiaries from 2012 to 2014. Thirty- and 60-day clinical outcomes, including readmissions, admissions, and emergency department (ED) use. Home health agencies serving a high proportion of dually enrolled, low-income ZCTA, or black beneficiaries were less often high-quality. Dually-enrolled, low-income ZCTA, and Black beneficiaries receiving home health care after hospitalization had higher risk-adjusted odds of 30-day readmission (odds ratio [OR] = 1.08, P home health care without preceding hospitalization had higher 60-day admission (OR = 1.06, P home health services who are dually enrolled, live in a low-income neighborhood, or are black have higher rates of adverse clinical outcomes. These populations may be an important target for quality improvement under Home Health Value-Based Purchasing. © 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics Society.
Home care is different from other forms of health care. Clinicians are guests in patients' homes and may be the only healthcare providers patients see on a particular day or week, so they should feel comfortable working independently, but recognise they are part of a larger healthcare team.
Gayed, Aimée; Bryan, Bridget T; Petrie, Katherine; Deady, Mark; Milner, Allison; LaMontagne, Anthony D; Calvo, Rafael A; Mackinnon, Andrew; Christensen, Helen; Mykletun, Arnstein; Glozier, Nicholas; Harvey, Samuel B
Within high income countries, mental health is now the leading cause of long term sickness absence in the workplace. Managers are in a position to make changes and decisions that have a positive effect on the wellbeing of staff, the recovery of employees with mental ill health, and potentially prevent future mental health problems. However, managers report addressing workplace mental health issues as challenging. The aim of the HeadCoach trial is to evaluate the effectiveness of a newly developed online training intervention to determine whether it is able to build managers' confidence to better support individuals within their teams who are experiencing mental ill health, and the confidence to promote manager behaviour likely to result in a more mentally healthy workplace. We will conduct a cluster randomised control trial (RCT) to evaluate the effect of HeadCoach, an online training intervention for managers with a focus on the mental health of their employees, compared to a waitlist control. The target sample is 168 managers, and their direct employees. Managers and employees will be assessed at baseline and at 4-month follow up. Managers will have an additional, intermediate assessment 6-weeks post-baseline. The primary outcome is change from baseline in managers' self-reported confidence when dealing with mental health issues within their team and promoting a mentally healthy workplace. The difference between the intervention and waitlist control groups will be assessed using linear mixed effects repeated measures (MMRM) analysis of variance (ANOVA). Secondary managerial outcomes include mental health literacy, attitudes towards mental health issues in the workplace and managerial behaviour in dealing with mental health matters with their staff. Employee outcomes will be perceived level of manager support, engagement, psychological distress, and rates of sickness absence and presenteeism. To our knowledge this will be the first RCT of a purely online training
Alexander C Tsai
Full Text Available The U.S. foreclosure crisis intensified markedly during the Great Recession of 2007-09, and currently an estimated five percent of U.S. residential properties are more than 90 days past due or in the process of foreclosure. Yet there has been no systematic assessment of the effects of foreclosure on health and mental health.I applied systematic search terms to PubMed and PsycINFO to identify quantitative or qualitative studies about the relationship between home foreclosure and health or mental health. After screening the titles and abstracts of 930 publications and reviewing the full text of 76 articles, dissertations, and other reports, I identified 42 publications representing 35 unique studies about foreclosure, health, and mental health. The majority of studies (32 [91%] concluded that foreclosure had adverse effects on health or mental health, while three studies yielded null or mixed findings. Only two studies examined the extent to which foreclosure may have disproportionate impacts on ethnic or racial minority populations.Home foreclosure adversely affects health and mental health through channels operating at multiple levels: at the individual level, the stress of personally experiencing foreclosure was associated with worsened mental health and adverse health behaviors, which were in turn linked to poorer health status; at the community level, increasing degradation of the neighborhood environment had indirect, cross-level adverse effects on health and mental health. Early intervention may be able to prevent acute economic shocks from eventually developing into the chronic stress of foreclosure, with all of the attendant benefits this implies for health and mental health status. Programs designed to encourage early return of foreclosed properties back into productive use may have similar health and mental health benefits.
Ritchie, Christine S; Leff, Bruce
With the growth of value-based care, payers and health systems have begun to appreciate the need to provide enhanced services to homebound adults. Recent studies have shown that home-based medical services for this high-cost, high-need population reduce costs and improve outcomes. Home-based medical care services have two flavors that are related to historical context and specialty background-home-based primary care (HBPC) and home-based palliative care (HBPalC). Although the type of services provided by HBPC and HBPalC (together termed "home-based medical care") overlap, HBPC tends to encompass longitudinal and preventive care, while HBPalC often provides services for shorter durations focused more on distress management and goals of care clarification. Given workforce constraints and growing demand, both HBPC and HBPalC will benefit from working together within a population health framework-where HBPC provides care to all patients who have trouble accessing traditional office practices and where HBPalC offers adjunctive care to patients with high symptom burden and those who need assistance with goals clarification. Policy changes that support provision of medical care in the home, population health strategies that tailor home-based medical care to the specific needs of the patients and their caregivers, and educational initiatives to assure basic palliative care competence for all home-based medical providers will improve access and reduce illness burden to this important and underrecognized population. Copyright © 2017 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.
Samankasikorn, Wilaiporn; Pierce, Brittany; St Ivany, Amanda; Gwon, Seok Hyun; Schminkey, Donna; Bullock, Linda
Determine the extent that participation in Resource Mothers Program (RMP) home visiting improves maternal health at 3 months postpartum. A randomized controlled trial using RMPs in two urban and one rural location in a mid-Atlantic state. Community health workers from these RMPs enrolled teens into the study and the research team assigned participants to either the intervention group or telephone support control group using computerized randomization assignments. Data collection from baseline and 3 months postpartum using the Edinburgh Postnatal Depression Scale (EPDS) and the Prenatal Psychosocial Profile (PPP) is reported. The sample included 150 pregnant teens with a mean age of 17 years. Mean self-esteem scores between groups were not significantly different at baseline, but the RMP group self-esteem scores improved significantly at the 3 months postpartum interview (36.40 ± 5.63 for RMP vs. 34.10 ± 4.29 telephone control group, p = 0.049). Neither group was at risk for depression at baseline or 3 months postpartum. Because 60% of the total sample identified as Hispanic, post hoc analysis revealed significantly different baseline stress mean scores between Hispanic and non-Hispanic teens (p = 0.038); however, these differences were no longer significant by 3 months postpartum (p = 0.073). The EPDS scores by ethnicity were not different at baseline (p = 0.875) but were significantly different at 3 months (p = 0.007). The RMP home-visiting intervention can lead to improved self-esteem scores in teens, particularly in Hispanic teens. Improved self-esteem has been shown to lead to better parenting.
Bruce, Martha L; Lohman, Matthew C; Greenberg, Rebecca L; Bao, Yuhua; Raue, Patrick J
To determine whether a depression care management intervention in Medicare home health recipients decreases risk of hospitalization. Cluster-randomized trial. Nurse teams were randomized to intervention (12 teams) or enhanced usual care (EUC; 9 teams). Six home health agencies from distinct geographic regions. Home health recipients were interviewed at home and over the telephone. Individuals aged 65 and older who screened positive for depression on nurse assessments (N = 755) and a subset who consented to interviews (n = 306). The Depression CARE for PATients at Home (CAREPATH) guides nurses in managing depression during routine home visits. Clinical functions include weekly symptom assessment, medication management, care coordination, patient education, and goal setting. Researchers conducted telephone conferences with team supervisors every 2 weeks. Hospitalization while receiving home health services was assessed using data from the home health record. Hospitalization within 30 days of starting home health, regardless of how long recipients received home health services, was assessed using data from the home care record and research assessments. The relative hazard of being admitted to the hospital directly from home health was 35% lower within 30 days of starting home health care (hazard ratio (HR) = 0.65, P = .01) and 28% lower within 60 days (HR = 0.72, P = .03) for CAREPATH participants than for participants receiving EUC. In participants referred to home health directly from the hospital, the relative hazard of being rehospitalized was approximately 55% lower (HR = 0.45, P = .001) for CAREPATH participants. Integrating CAREPATH depression care management into routine nursing practice reduces hospitalization and rehospitalization risk in older adults receiving Medicare home health nursing services. © 2016, Copyright the Authors Journal compilation © 2016, The American Geriatrics Society.
Hermann, Ana Paula; Lacerda, Maria Ribeiro; Maftum, Mariluci Alves; Bernardino, Elizabeth; Mello, Ana Lúcia Schaefer Ferreira de
Home care, one of the services provided by the health system, requires health practitioners who are capable of understanding its specificities. This study aimed to build a substantive theory that describes experiences of home care teaching and learning during undergraduate degree courses in nursing, pharmacy, medicine, nutrition, dentistry and occupational therapy. A qualitative analysis was performed using the grounded theory approach based on the results of 63 semistructured interviews conducted with final year students, professors who taught subjects related to home care, and recent graduates working with home care, all participants in the above courses. The data was analyzed in three stages - open coding, axial coding and selective coding - resulting in the phenomenon Experiences of home care teaching and learning during the undergraduate health care degree courses. Its causes were described in the category Articulating knowledge of home care, strategies in the category Experiencing the unique nature of home care, intervening conditions in the category Understanding the multidimensional characteristics of home care, consequences in the category Changing thinking about home care training, and context in the category Understanding home care in the health system. Home care contributes towards the decentralization of hospital care.
Guzmán, Azucena; Wenborn, Jennifer; Ledgerd, Ritchard; Orrell, Martin
There is a recognised need to improve staff training in care homes. The aim of this study was to conduct a qualitative evaluation of the Ladder to the Moon Culture Change Studio Engagement Programme (CCSEP), a staff training programme aimed at enhancing staff-resident communication. Focus groups were conducted with residents able to provide consent; staff and relatives and managers were interviewed in two care homes. A theoretical framework was developed to interpret the impact of CCSEP using Framework Analysis. Residents noted that the programme appeared to result in staff interacting more with them, as well as enjoying working together as a team. Staff reported an improved sense of teamwork, developing more positive attitudes towards residents, as well as their concerns about using theatrical techniques in the care setting. Relatives identified care home organisational aspects as being barriers to implementation, and some regarded CCSEP simply as 'entertainment' rather than 'creative care'. This study provides an insight into the potential of this staff training programme to improve staff-resident interactions. However, participants' varying views of CCSEP highlight the need to brief staff, residents and relatives before implementation so as to enable full understanding of the aim. © 2016 John Wiley & Sons Ltd.
Conclusions: It is necessary to prepare guidelines for the establishment and management of waiting homes as well as set up admission and discharge criteria and to initiate quality control mechanisms. Keywords: Maternity waiting homes, waiting homes, prenatal care, intention to stay postpartum, postpartum care, Ethiopia, ...
Wittrock, Christian; Didriksen, Vibeke; Stelter, Reinhard
Coaching synes udbredt i danske organisationer og anvendes tilsyneladende i et utal af sammenhænge og på alle niveauer i organisationen. Blandt de adspurgte HR-ansvarlige er der generelt stor tilfredshed med coaching. Nærværende undersøgelse udgør et første overbliksbillede, som kan lede videre til...
Skytte Gørtz, Kim Erik
Bogen går i dybden med begrebet om coaching i en undersøgelse af, hvilken funktion og betydning filosofi kan have på og i coachprocessen......Bogen går i dybden med begrebet om coaching i en undersøgelse af, hvilken funktion og betydning filosofi kan have på og i coachprocessen...
Pedersen, Anita Monnerup
Coaching er ikke et neutralt værktøj, men producerer begrænsninger og muligheder for, hvad der kan tales om......Coaching er ikke et neutralt værktøj, men producerer begrænsninger og muligheder for, hvad der kan tales om...
Bogen er en grundbog, der sætter coaching ind i et større perspektiv og en bredere sammenhæng.......Bogen er en grundbog, der sætter coaching ind i et større perspektiv og en bredere sammenhæng....
Hansen, Rasmus Thorning
En generel beskrivelse af de problemer specialestuderende sidder med og hvorledes coaching kan hjælpe med at (gen)skabe motivation og fokus......En generel beskrivelse af de problemer specialestuderende sidder med og hvorledes coaching kan hjælpe med at (gen)skabe motivation og fokus...
In this essay a new model is presented as an attempt to operationalize the otherwise slightly abstract concept of ”suitable disturbances” (coined by Humberto Maturana), which is a central concept in systemic coaching. The argument stated is that the process of ’reading’ and ’recognizing’ a coache...
, Gruppen oder Teams neue Orientierung auf einer tieferen Sinnebene ermöglicht. Im Gegensatz zum Coaching der ersten Generation, bei dem das Erreichen bestimmter, festgeschriebener Ziele im Vordergrund steht, und im Gegensatz zum Coaching der zweiten Generation, in dem wünschenswerte zukünftige...
Godskesen, Mirjam Irene; Kobayashi, Sofie
In this paper we focus on individual coaching carried out by an external coach as a new pedagogical element that can impact doctoral students’ sense of progress in doctoral education. The study used a mixed methods approach in that we draw on quantitative and qualitative data from the evaluation...... impact the supervisor – student relationship in a positive way....
Nathanson, Stephen J.
This article describes a study conducted to identify the competencies appropriate for an athletic coach and to incorporate those competencies into a competency based coaching education program for the four-year colleges and universities within the New York state systems. (JMF)
Keizer, W.A.J.; Nandram, S.S.
In Chap. 12, Keizer and Nandram present the concept of Integral Transformational Coaching based on the concept of Flow and its effects on work performance. Integral Transformational Coaching is a method that prevents and cures unhealthy stress and burnout. They draw on some tried and tested
AF Branding & Trademark Licensing Join the Air Force Home About Us The Air Force Symbol Display Resources Document Library TM Connect Search AF Branding and Trademark Licensing Program: important links Legal Documents 10 U.S.C. Â§ 2260 15 U.S.C. Â§ 167;167; 1114-1125 DODI 5535.12, DoD Branding and
Irani, Elliane; Hirschman, Karen B; Cacchione, Pamela Z; Bowles, Kathryn H
To describe how home health nurses plan their daily work schedules and what challenges they face during the planning process. Home health nurses are viewed as independent providers and value the nature of their work because of the flexibility and autonomy they hold in developing their work schedules. However, there is limited empirical evidence about how home health nurses plan their work schedules, including the factors they consider during the process and the challenges they face within the dynamic home health setting. Qualitative descriptive design. Semi-structured interviews were conducted with 20 registered nurses who had greater than 2 years of experience in home health and were employed by one of the three participating home health agencies in the mid-Atlantic region of the United States. Data were analyzed using conventional content analysis. Four themes emerged about planning work schedules and daily itineraries: identifying patient needs to prioritize visits accordingly, partnering with patients to accommodate their preferences, coordinating visit timing with other providers to avoid overwhelming patients, and working within agency standards to meet productivity requirements. Scheduling challenges included readjusting the schedule based on patient needs and staffing availability, anticipating longer visits, and maintaining continuity of care with patients. Home health nurses make autonomous decisions regarding their work schedules while considering specific patient and agency factors, and overcome challenges related to the unpredictable nature of providing care in a home health setting. Future research is needed to further explore nurse productivity in home health and improve home health work environments. Home health nurses plan their work schedules to provide high quality care that is patient-centered and timely. The findings also highlight organizational priorities to facilitate continuity of care and support nurses while alleviating the burnout
Brown, Lisa M; Hyer, Kathryn; Schinka, John A; Mando, Ahed; Frazier, Darvis; Polivka-West, Lumarie
A growing body of research supports the value of mental health intervention to treat people affected by disasters. This study used a mixed-methods approach to evaluate pre- and posthurricane mental health service use in Florida nursing homes. A questionnaire was administered to 258 directors of nursing, administrators, and owners of nursing homes, representing two-thirds of Florida's counties, to identify residents' mental health needs and service use. In four subsequent focus group meetings with 22 nursing home administrators, underlying factors influencing residents' use of services were evaluated. Although most nursing homes provided some type of mental health care during normal operations, disaster-related mental health services were not routinely provided to residents. Receiving facilities were more likely than evacuating facilities to provide treatment to evacuated residents. Nursing home staff should be trained to deliver disaster-related mental health intervention and in procedures for making referrals for follow-up evaluation and formal intervention.
Full Text Available The necessity is emphasized to distinguish between the traditional model of data acquisition reported by a patient in doctor’s office and the more valuable and desired model to become acquainted with the core of the problem by going to a patient’s domicile. In the desired model it is possible to come across various determinants of health during home visits. Family members can be approached and there is a possibility to evaluate the relationships between the patient and his loved ones. One can visually assess one’s living conditions and predictable environmental hazard. For several years, the desired model has been put into practice by general practitioners and home health care nurses. Recently this model is also promoted by “health care therapists” who are members of “teams of home health care”. The authors, being convinced of the merits of “home and environmental model” of practical medicine, have developed a method of recording and illustrating data collected during visits in patient’s home. The elaborated tool helps to communicate and exchange information among general practitioners, home health care nurses, social workers of primary health care centers and specialists. The method improves the formulation of the plan of further therapeutic steps and remedial interventions in psycho-social relations and living conditions of patients.
Narayan, Mary; Farris, Cindy; Harris, Marilyn D; Hiong, Fong Yoke
Throughout the world, healthcare is increasingly being provided in home and community-based settings. There is a growing awareness that the most effective, least costly, patient-preferred setting is patients' home. Thus, home healthcare nursing is a growing nursing specialty, requiring a unique set of nursing knowledge and skills. Unlike many other nursing specialties, home healthcare nursing has few professional organizations to develop or support its practice. This article describes how an international network of home healthcare nurses developed international guidelines for home healthcare nurses throughout the world. It outlines how the guidelines for home healthcare nursing practice were developed, how an international panel of reviewers was recruited, and the process they used for reaching a consensus. It also describes the plan for nurses to contribute to future updates to the guidelines.
Reeder, Blaine; Meyer, Ellen; Lazar, Amanda; Chaudhuri, Shomir; Thompson, Hilaire J; Demiris, George
There is a critical need for public health interventions to support the independence of older adults as the world's population ages. Health smart homes (HSH) and home-based consumer health (HCH) technologies may play a role in these interventions. We conducted a systematic review of HSH and HCH literature from indexed repositories for health care and technology disciplines (e.g., MEDLINE, CINAHL, and IEEE Xplore) and classified included studies according to an evidence-based public health (EBPH) typology. One thousand, six hundred and thirty-nine candidate articles were identified. Thirty-one studies from the years 1998-2011 were included. Twenty-one included studies were classified as emerging, 10 as promising and 3 as effective (first tier). The majority of included studies were published in the period beginning in the year 2005. All 3 effective (first tier) studies and 9 of 10 of promising studies were published during this period. Almost all studies included an activity sensing component and most of them used passive infrared motion sensors. The three effective (first tier) studies all used a multicomponent technology approach that included activity sensing, reminders and other technologies tailored to individual preferences. Future research should explore the use of technology for self-management of health by older adults; social support; and self-reported health measures incorporated into personal health records, electronic medical records, and community health registries. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.
Full Text Available Objective: Individuals with serious mental illness (SMI have higher rates of preventable diseases such as diabetes in comparison to the general population. While multifaceted, these high rates of preventable diseases in the population with SMI may be partially attributed to limited access to primary care. A new program, the Behavioral Health Home (BHH, which allows for the delivery of somatic care coordination and population-based care, may provide this population with the much needed somatic coordination and education it requires. Methods: The impact of the population-based health management program of the BHH identification and severity rating of glucose metabolism disorders was assessed during the initial 10 months of the BHH. Results: Multiple patients were identified who either were not having hemoglobin A1c (HbA1c levels drawn per recommended guidelines for individuals prescribed antipsychotic medications or were within diabetic range but did not have a diagnosis of diabetes. Mixed results occurred in regard to patients’ HbA1c levels while engaging in the BHH. Conclusion: This case study provides some initial evidence for the utility of the BHH in regard to identifying patients who need preventive care.
Sengupta, Manisha; Ejaz, Farida K.; Harris-Kojetin, Lauren D.
Training and satisfaction with training were examined using data from nationally representative samples of 2,897 certified nursing assistants (CNAs) from the National Nursing Assistant Survey and 3,377 home health aides (HHAs) from the National Home Health Aide Survey conducted in 2004 and 2007, respectively. This article focuses on the…
... Prospective Payment System Rate Update for Calendar Year 2012; Final Rule #0;#0;Federal Register / Vol. 76, No... 0938-AQ30 Medicare Program; Home Health Prospective Payment System Rate Update for Calendar Year 2012... sets forth updates to the home health prospective payment system (HH PPS) rates, including: the...
... [CMS-1510-F2] RIN 0938-AP88 Medicare Program; Home Health Prospective Payment System Rate Update for... set forth an update to the Home Health Prospective Payment System (HH PPS) rates, including: The... the Medicare prospective payment system for HHAs. This correcting amendment corrects a technical error...
Wahlström, Lina; Bergström, Helena; Marttila, Anneli
Deinstitutionalisation has influenced the life situation for people with intellectual disabilities, whilst the experiences of health promotion in group homes now are limited. This study aimed to explore aspects important to consider when promoting health amongst persons with intellectual disabilities in group homes, from the perspective of…
Lindley, Lisa C; Mixer, Sandra J; Mack, Jennifer W
Families desire to bring their children home at end of life, and this creates a variety of unique care needs at home. This study analyzed the child and family factors associated with hospice versus home health care use in the last year of life among children with multiple complex chronic conditions. Using the Andersen Behavioral Healthcare Utilization Model, the predisposing, enabling, and need factors of the child and family were shown to be significant predictors of hospice and home health care use. Hospice and home health care have advantages, and families may wish to use the service that best fits their needs.
Hayashi, T; Kimura, M; Tamura, N; Hirata, S; Yabunaka, T; Kamimura, Y
Home patients have few chances for going out, so communication with their family means a lot. Talking and eating are particular pleasures. Therefore, oral and dental health and oral and dental support are very important for home patients. A dental hygienist from our clinic visits and offers oral and dental health (oral care) and oral and dental support (oral rehabilitation) to home patients as part of a care plan with home care nurses. Moreover, as general conditions are closely related with oral function, maintaining oral and dental health and regular oral and dental support are very important in order to improve the quality of life (QOL) of home patients.
Mackenzie, Lynette; Byles, Julie
Falls in older people are a major public health concern. To target falls prevention interventions, screening tools need to be able to identify older people at greater risk of falling. This study aimed to investigate the screening capacity of the Home Falls and Accidents Screening Tool for health professionals (HOME FAST-HP), and to identify the best cut-off score to identify older people at higher risk of falls using the HOME FAST-HP. The study used cross-sectional data from a random sample of 650 women from the 1921 to 1926 cohort of the Australian Longitudinal Study of Women's Health (ALSWH). Selected women were sent a postal survey including the HOME FAST-HP, falls history, and other health factors. Scores on the home fast were calculated and the cut-point for optimal sensitivity and specificity of the HOME FAST-HP in relation to falls was assessed using a Receiver Operating Characteristic curve. A total of 567 older women participated (response rate 87%). The mean age of participants was 77.5 yrs (95% CI 77.31-77.70). A total of 153 participants (27%) reported a fall in the previous six months. The mean number of hazards using the HOME FAST-HP was 9.74 (95% CI 9.48-10.01), range 2-22. Non-fallers had a mean of 9.6 hazards (95% CI 9.32-9.91) and fallers had a mean of 10.63 hazards (95% CI 10.08-11.19) which was a significant difference (t = 3.41, P = 0.001). The area under the receiver operator curve (AUC) was 0.58 (95% CI 0.53-0.64). A HOME FAST-HP cut-off score of 9 was associated with the optimal sensitivity for falls (73.9%), with specificity (37.9%), and positive predictive value was 30.6% and negative predictive value was 79.7%. The HOME FAST-HP can be used as a screening tool to identify fallers with a cut-off score of nine indicating a higher risk of falling. © 2018 Occupational Therapy Australia.
education trainers. However, viewing individual responses, worrying is the fact that one-third of respondents have very low levels of knowledge about protein supplements and believes that proteins are the main source of energy. If we take into account the fact that athletes are often used as a dietary supplement exactly as recommended by coaches, it would be expected that people advise taking these supplements know about any problems or negative occurrences that may endanger the health of athletes. References: Burns RD, Schiller R, Merrick MA, Wolf KN (2004. J Am Diet Assoc, 104, 246-9. Matkovic B, Knjaz D, Cigrovski V (2006. Croatian Sports Medicine Journal, 21, 3-7.
Medicare and Medicaid Programs; CY 2018 Home Health Prospective Payment System Rate Update and CY 2019 Case-Mix Adjustment Methodology Refinements; Home Health Value-Based Purchasing Model; and Home Health Quality Reporting Requirements. Final rule.
This final rule updates the home health prospective payment system (HH PPS) payment rates, including the national, standardized 60-day episode payment rates, the national per-visit rates, and the non-routine medical supply (NRS) conversion factor, effective for home health episodes of care ending on or after January 1, 2018. This rule also: Updates the HH PPS case-mix weights using the most current, complete data available at the time of rulemaking; implements the third year of a 3-year phase-in of a reduction to the national, standardized 60-day episode payment to account for estimated case-mix growth unrelated to increases in patient acuity (that is, nominal case-mix growth) between calendar year (CY) 2012 and CY 2014; and discusses our efforts to monitor the potential impacts of the rebasing adjustments that were implemented in CY 2014 through CY 2017. In addition, this rule finalizes changes to the Home Health Value-Based Purchasing (HHVBP) Model and to the Home Health Quality Reporting Program (HH QRP). We are not finalizing the implementation of the Home Health Groupings Model (HHGM) in this final rule.
Full Text Available Nowdays technologies are characterised by the expert specialists. In training technologies there are also coaches-experts for some sports. Aport from governing training technology, thus he performs manager’s work (planning, programing, accomplishing, controlling, correcting the coach also performs the work of an explorer, because the work of the coach is creative, creating, exploring and it is necessary to include innovation into training process, and innovations are nothing but rehearse of someting new, what is but scientific approach to the training. More the coach succeeds in controlling more factors which influence the sport achievement, he will be more successful. To be able to do all that, the coach must observe, follow, control and correct sportist’s reactions on exercises and loads all the time. The coach demonstrates his activity even through marketing, educational psychological, administrative- technical, nutritional and entire useful social role, so his work is interdisciplinary very complex, important, public, and thus it is a subject to critics. In order to be successful, a modern coach must be an exellent expert-specialist, but also an explorer and manager, and before all a creator of training technology
You, Sun-Ju; Chang, Hyun-Sook
The purpose of this study was to measure home health resource utilization using a Case-Mix Adjustor Model developed in the U.S. The subjects of this study were 484 patients who had received home health care more than 4 visits during a 60-day episode at 31 home health care institutions. Data on the 484 patients had to be merged onto a 60-day payment segment. Based on the results, the researcher classified home health resource groups (HHRG). The subjects were classified into 34 HHRGs in Korea. Home health resource utilization according to clinical severity was in order of Minimum (C0) service utilization moderate), and the lowest 97,000 won in group C2F3S1, so the former was 5.82 times higher than the latter. Resource utilization in home health care has become an issue of concern due to rising costs for home health care. The results suggest the need for more analytical attention on the utilization and expenditures for home care using a Case-Mix Adjustor Model.
Wang, Lan; He, Lin; Tao, Yanxia; Sun, Li; Zheng, Hong; Zheng, Yashu; Shen, Yuehao; Liu, Suyan; Zhao, Yue; Wang, Yaogang
Chronic obstructive pulmonary disease (COPD) is now the fourth leading cause of death in the world, and it continues to increase in developing countries. The World Health Organization expects COPD to be the third most common cause of death in the world by 2020. Effective and continuous postdischarge care can help patients to maintain good health. The use of electronic health records (EHRs) as an element of community health care is new technology in China. The aim of this study was to develop and evaluate a Web-based coaching program using EHRs for physical function and health-related quality of life for patients with COPD in China. A randomized controlled trial was conducted from 2008 to 2015 at two hospitals. The control group received routine care and the intervention group received routine care with the addition of the Web-based coaching program using EHRs. These were used to manage patients' demographic and clinical variables, publish relevant information, and have communication between patients and health care providers. Participants were not blinded to group assignment. The effects of the intervention were evaluated by lung function, including percent of forced expiratory volume in 1 second (FEV1%), percent of forced vital capacity (FVC%), peak expiratory flow (PEF), maximum midexpiratory flow; St George's Respiratory Questionnaire (SGRQ); Modified Medical Research Council Dyspnea Scale (MMRC); and 6-Minute Walk Test (6MWT). Data were collected before the program, and at 1, 3, 6, and 12 months after the program. Of the 130 participants, 120 (92.3%) completed the 12-month follow-up program. There were statistically significant differences in lung function (FEV1%: F1,4=5.47, P=.002; FVC%: F1,4=3.06, P=.02; PEF: F1,4=12.49, Pcoaching program using EHRs in China appears to be useful for patients with COPD when they are discharged from hospital into the community. It promotes the sharing of patients' medical information by hospital and community nurses, and
Coaching appears to be another modern counselling approach, practiced initially in the business world. It can to be analyzed through a comparison with social counselling. The roots of coaching go back to Ancient Greece.. Plato used to propagate the art of aksing questions by recording the Socratic dialogue. Today coaching is in substance related to mentoring, tutoring and coaching in sport. The core of the activity - according to different coaching definitions - is discovering the hidden pote...
Kovanen, Anne; Dunn, Katriina
The idea for this thesis was given by the founder and owner of PJHA – Piha ja Hyvinvointi Akseli, Tuula Rahkonen. This company is in the process of changing the business idea and structure, and the owner is hoping to gain some fresh ideas through coaching. The aim of this thesis was to research different coaching methods and further implement a case study on PJHA using an evolutionary coaching approach. The main focus in the thesis was on the case study and different ways to explore the evol...
Quinn, Margaret M; Markkanen, Pia K; Galligan, Catherine J; Sama, Susan R; Kriebel, David; Gore, Rebecca J; Brouillette, Natalie M; Okyere, Daniel; Sun, Chuan; Punnett, Laura; Laramie, Angela K; Davis, Letitia
Objectives In countries with ageing populations, home care (HC) aides are among the fastest growing jobs. There are few quantitative studies of HC occupational safety and health (OSH) conditions. The objectives of this study were to: (1) assess quantitatively the OSH hazards and benefits for a wide range of HC working conditions, and (2) compare OSH experiences of HC aides who are employed via different medical and social services systems in Massachusetts, USA. Methods HC aides were recruited for a survey via agencies that employ aides and schedule their visits with clients, and through a labour union of aides employed directly by clients or their families. The questionnaire included detailed questions about the most recent HC visits, as well as about individual aides’ OSH experiences. Results The study population included 1249 HC aides (634 agency-employed, 615 client-employed) contributing information on 3484 HC visits. Hazards occurring most frequently related to musculoskeletal strain, exposure to potentially infectious agents and cleaning chemicals for infection prevention and experience of violence. Client-hired and agency-hired aides had similar OSH experiences with a few exceptions, including use of sharps and experience of verbal violence. Conclusions The OSH experience of HC aides is similar to that of aides in institutional healthcare settings. Despite OSH challenges, HC aides enjoy caring for others and the benefits of HC work should be enhanced. Quantification of HC hazards and benefits is useful to prioritise resources for the development of preventive interventions and to provide an evidence base for policy-setting. PMID:26209318
Glatt, Kevin; Okunseri, Christopher; Flanagan, Diane; Simpson, Pippa; Cao, Yumei; Willis, Earnestine
Home visiting programs promote the education and health of Early Head Start (EHS) children and pregnant women. However, EHS's oral health component is unevenly implemented. We conducted an educational intervention to improve oral health knowledge and motivational interviewing techniques among Wisconsin EHS home visitors. A questionnaire assessing oral health-related knowledge and confidence was administered to home visitors before and after an educational session. Changes between pre/post-responses were analyzed with McNemar's test and Wilcoxon Signed Rank test. After the intervention there were increases in both knowledge and confidence related to oral health communication. Knowledge increases were observed in such topics as fluoridation, dental caries, and caregivers' role in assisting and supervising children's tooth brushing. A brief educational intervention was associated with increased home visitor knowledge and confidence in communicating oral health messages to EHS caregivers and pregnant women. © 2016 American Association of Public Health Dentistry.
African Journal for Physical Activity and Health Sciences ... review was conducted using the African Journals Online and Sabinet online databases to identify sport coaching studies published from 2006 to 2016, with 42 papers meeting the inclusion criteria. ... Keywords: Sport, review, coach education, research, profession ...
Adamakidou, T; Kalokerinou-Anagnostopoulou, A
The purpose of this review was to describe public home healthcare nursing services in Greece. The effectiveness and the efficiency of home healthcare nursing are well documented in the international literature. In Greece, during the current financial crisis, the development of home healthcare nursing services is the focus and interest of policymakers and academics because of its contribution to the viability of the healthcare system. A review was conducted of the existing legislation, the printed and electronic bibliography related to the legal framework, the structures that provide home health care, the funding of the services, the human resources and the services provided. The review of the literature revealed the strengths and weaknesses of the existing system of home health care and its opportunities and threats, which are summarized in a SWOT analysis. There is no Greek nursing literature on this topic. The development of home health nursing care requires multidimensional concurrent and combined changes and adjustments that would support and strengthen healthcare professionals in their practices. Academic and nursing professionals should provide guidelines and regulations and develop special competencies for the best nursing practice in home health care. At present, in Greece, which is in an economic crisis and undergoing reforms in public administration, there is an undeniable effort being made to give primary health care the position it deserves within the health system. There is an urgent need at central and academic levels to develop home healthcare services to improve the quality and efficiency of the services provided. © 2016 International Council of Nurses.
American Association for Health, Physical Education, and Recreation, Washington, DC.
This booklet is the product of a conference of the American Association of Health, Physical Education, and Recreation, the purpose of which was to revise professional preparation quidelines in dance, physical education, recreation education, and health and safety education. This report includes sections on physical education and coaching and on…
1 The Last Ten Kilometers Project, JSI Research & Training Institute, Inc., Addis ... The main aim of this study was to assess the situation of maternity waiting ... experiences and challenges of mothers using waiting homes. ..... education on MWHs were home visits by HEWs ... travel long distances to deliver food, which meant.
Lynch, Annette Rutt; Stillman, Stephen M.
An example of behavior modification used in athletic coaching is presented. The case study involves a member of a women's basketball team and details the use of behavior modification for both weight reduction and skill improvement. (JMF)
Wynn, Barbara O; Boustead, Anne
The California Department of Industrial Relations/Division of Worker's Compensation asked RAND to provide technical assistance in developing a fee schedule for home health services provided to injured workers. The fee schedule needs to address the full spectrum of home health services ranging from skilled nursing and therapy services to unskilled personal care or chore services that may be provided by family members. RAND researchers consulted with stakeholders in the California workers' compensation system to outline issues the fee schedule should address, reviewed home health fee schedules used by other payers, and conducted interviews with WC administrators from other jurisdictions to elicit their experiences. California stakeholders identified unskilled attendant services as most problematic in determining need and payment rates, particularly services furnished by family members. RAND researchers concentrated on fee schedule options that would result in a single fee schedule covering the full range of home health care services furnished to injured workers and made three sets of recommendations. The first set pertains to obtaining additional information that would highlight the policy issues likely to occur with the implementation of the fee schedule and alternatives for assessing an injured worker's home health care needs. Another approach conforms most closely with the Labor Code requirements. It would integrate the fee schedules used by Medicare, In-Home Health Supportive Services, and the federal Office of Workers' Compensation. The third approach would base the home health fee schedule on rules used by the federal Office of Workers' Compensation.
, vi dagligt skal forholde os til. Forfatterens forestilling om coaching tager udgangspunkt i en analyse af vort samfund – et samfund, der er kendetegnet af diversificering, identitetsudfordringer, ophævelse af vidensmonopolet, livslang uddannelse, nødvendighed til selvrefleksion mm. Bogen skal har...... dermed et særligt profil. Den skal markere (og skubbe til) en ny trend i coaching, som afgrænser sig fra pop coaching og GROW model o.l.. Coaching kan aldrig være ”the quick fix”. Vores tid tillader det bage ikke. Disse samfundsmæssige forandringer er grundlaget for coachingens eksistens og udbredelse......, men de skal også være fundament for den måde vi bedriver coaching. Derfor plæderer bogens forfatter for en 3. generations coaching i en form, hvor coachen og fokuspersonen mindre er fokuseret på løsninger, men i højere grad optaget af at skabe et rum til (selv)refleksion gennem en samskabende praksis....
”Tredje generations coaching” udfolder et nyt univers for coaching og coachingpsykologi gennem en bearbejdelse af aktuel samfundsforskning, nye læringsteorier og diskurser om det personlige lederskab. ”Tredje generations coaching” er funderet på en samfundsmæssig forståelse af coaching. Coaching er...... blevet så betydningsfuld, fordi samfundet opleves som uoverskueligt og hyperkomplekst. Viden skal nu udformes og anvendes i specifikke kontekster og situationer, og både i privatliv og i det offentlige rum skal vi lære at forhandle os til rette. Coaching kan hjælpe os til at skabe ny viden og mestre...... sociale forhandlinger. Coaching er dermed en slags fødselshjælp til nye refleksioner og perspektiver, en hjælp til selvhjælp og en støtte til ens egen selvdannelsesproces. ”Tredje generations coaching” fremhæver coach og coachee i deres narrativ-samskabende partnerskab. Til forskel fra første generations...
Radhakrishnan, Kavita; Topaz, Maxim; Masterson Creber, Ruth
Nurses provide most of home health services for patients with heart failure, and yet there are no evidence-based practice guidelines developed for home health nurses. The purpose of this article was to review the challenges and solutions for adapting generally available HF clinical practice guidelines to home health nursing. Appropriate HF guidelines were identified and home health nursing-relevant guidelines were extracted by the research team. In addition, a team of nursing academic and practice experts evaluated the extracted guidelines and reached consensus through Delphi rounds. We identified 172 recommendations relevant to home health nursing from the American Heart Association and Heart Failure Society of America guidelines. The recommendations were divided into 5 groups (generic, minority populations, normal ejection fraction, reduced ejection fraction, and comorbidities) and further subgroups. Experts agreed that 87% of the recommendations selected by the research team were relevant to home health nursing and rejected 6% of the selected recommendations. Experts' opinions were split on 7% of guideline recommendations. Experts mostly disagreed on recommendations related to HF medication and laboratory prescription as well as HF patient assessment. These disagreements were due to lack of patient information available to home health nurses as well as unclear understanding of scope of practice regulations for home health nursing. After 2 Delphi rounds over 8 months, we achieved 100% agreement on the recommendations. The finalized guideline included 153 recommendations. Guideline adaptation projects should include a broad scope of nursing practice recommendations from which home health agencies can customize relevant recommendations in accordance with available information and state and agency regulations.
Full Text Available Patients evaluate the quality of home health agencies (HHAs using the Health Consumer Assessment of Healthcare Providers and Systems (HCAHPS survey. This paper describes a prototype community health information system to help patients select appropriate and quality HHAs, according to the location, proprietary status, type of service, and year of HHA establishment. Five HCAHPS indicators were selected: “summary rating”, “quality of care”, “professional care”, “communication”, and “recommend agency”. Independent t-test analysis showed that agencies offering Speech Pathology, Medical-Social, or Home Health Aide services, receive significantly worse HCAHPS ratings, while mean ratings vary significantly across different US states. Multiple comparisons with post hoc ANOVA revealed differences between and within HHAs of different proprietary status (p < 0.001: governmental HHAs receiving higher ratings than private HHAs. Finally, there was observed a relationship between all five quality rating variables and the HHA year of establishment (Pearson, p < 0.001. The older the agency is, the better the HCAPS summary ratings. Findings provided the knowledge to design of a consumer health information system, to provide rankings filtered according to user criteria, comparing the quality rankings of eligible HHAs. Users can also see how a specific agency is ranked against eligible HHAs. Ultimately, the system aims to support the patient community with contextually realistic comparisons in an effort to choose optimal HH service.
... providers of home health services and hospice care. The preamble of that final rule stated the effective... 17.56, applicable to non-VA home health services and hospice care. Section 17.56 provides, among... DEPARTMENT OF VETERANS AFFAIRS 38 CFR Part 17 RIN 2900-AN98 Payment for Home Health Services and...
... Home › Aging & Health A to Z › Nursing Homes Font size A A A Print Share Glossary Basic ... Reason For Living in A Nursing Home Some type of disability with activities of daily living (ADLs) ...
Full Text Available There is some evidence that home safety assessment and modification (HSAM is effective in reducing falls in older people. But there are various knowledge gaps, including around cost-effectiveness and also the impacts at a health district-level.A previously established Markov macro-simulation model built for the whole New Zealand (NZ population (Pega et al 2016, Injury Prevention was enhanced and adapted to a health district level. This district was Counties Manukau District Health Board, which hosts 42,000 people aged 65+ years. A health system perspective was taken and a discount rate of 3% was used for both health gain and costs. Intervention effectiveness estimates came from a systematic review, and NZ-specific intervention costs were extracted from a randomized controlled trial. In the 65+ age-group in this health district, the HSAM program was estimated to achieve health gains of 2800 quality-adjusted life-years (QALYs; 95% uncertainty interval [UI]: 547 to 5280. The net health system cost was estimated at NZ$8.44 million (95% UI: $663 to $14.3 million. The incremental cost-effectiveness ratio (ICER was estimated at NZ$5480 suggesting HSAM is cost-effective (95%UI: cost saving to NZ$15,300 [equivalent to US$10,300]. Targeting HSAM only to people age 65+ or 75+ with previous injurious falls was estimated to be particularly cost-effective (ICERs: $700 and $832, respectively with the latter intervention being cost-saving. There was no evidence for differential cost-effectiveness by sex or by ethnicity: Māori (Indigenous population vs non-Māori.This modeling study suggests that a HSAM program could produce considerable health gain and be cost-effective for older people at a health district level. Nevertheless, comparisons may be desirable with other falls prevention interventions such as group exercise programs, which also provide social contact and may prevent various chronic diseases.
White, Andrew A; Brock, Douglas M; McCotter, Patricia I; Shannon, Sarah E; Gallagher, Thomas H
National guidelines call for health care organizations to provide around-the-clock coaching for medical error disclosure. However, frontline clinicians may not always seek risk managers for coaching. As part of a demonstration project designed to improve patient safety and reduce malpractice liability, we trained multidisciplinary disclosure coaches at 8 health care organizations in Washington State. The training was highly rated by participants, although not all emerged confident in their coaching skill. This multisite intervention can serve as a model for other organizations looking to enhance existing disclosure capabilities. Success likely requires cultural change and repeated practice opportunities for coaches. © 2017 American Society for Healthcare Risk Management of the American Hospital Association.
Dunyo, S K; Afari, E A; Koram, K A; Ahorlu, C K; Abubakar, I; Nkrumah, F K
A study was conducted in 1997 to compare the accuracy of presumptive diagnosis of malaria in children aged 1-9 years performed by caretakers of the children to that of health centre staff in 2 ecological zones in southern Ghana. Similar symptoms were reported in the children at home and at the health centre. In the home setting, symptoms were reported the same day that they occurred, 77.6% of the children with a report of fever were febrile (axillary temperature > or = 37.5 degrees C) and 64.7% of the reports of malaria were parasitologically confirmed. In the health centre, the median duration of symptoms before a child was seen was 3 days (range 1-14 days), 58.5% of the children with a report of fever were febrile and 62.6% of the clinically diagnosed cases were parasitologically confirmed. In the 2 settings almost all the infections were due to Plasmodium falciparum. Parasite density was 3 times higher in the health centre cases compared to the home-diagnosed cases. Early and appropriate treatment of malaria detected in children by caretakers may prevent complications that arise as a result of persistence of symptoms and attainment of high parasitaemic levels.
Full Text Available Home care aides (HCAs, predominantly women, constitute one of the fastest growing occupations in the United States. HCAs work in clients’ homes that lack typical workplace resources and benefits. This mixed-methods study examined how HCAs’ work environment was transformed by a pilot workplace health promotion program that targeted clients as well as workers. The intervention started with training HCAs to deliver a gentle physical activity program to their older clients in a Medicaid-funded home care program. Older HCAs aged 50+ reported increased time doing the types of physical activity that they delivered to their clients (stretching or strengthening exercise (p = 0.027. Almost all (98% HCAs were satisfied with the program. These quantitative results were corroborated by qualitative data from open-ended survey questions and focus groups. HCAs described how they exercised with clients and how the psychosocial work environment changed with the program. Building physical activity into HCAs’ job is feasible and can effectively promote HCAs’ health, especially among older HCAs.
Muramatsu, Naoko; Yin, Lijuan; Lin, Ting-Ti
Home care aides (HCAs), predominantly women, constitute one of the fastest growing occupations in the United States. HCAs work in clients' homes that lack typical workplace resources and benefits. This mixed-methods study examined how HCAs' work environment was transformed by a pilot workplace health promotion program that targeted clients as well as workers. The intervention started with training HCAs to deliver a gentle physical activity program to their older clients in a Medicaid-funded home care program. Older HCAs aged 50+ reported increased time doing the types of physical activity that they delivered to their clients (stretching or strengthening exercise) ( p = 0.027). Almost all (98%) HCAs were satisfied with the program. These quantitative results were corroborated by qualitative data from open-ended survey questions and focus groups. HCAs described how they exercised with clients and how the psychosocial work environment changed with the program. Building physical activity into HCAs' job is feasible and can effectively promote HCAs' health, especially among older HCAs.
... There is no such requirement for consumers who purchase home tests, even the ones prescribed or recommended ... device, contact the Manufacturer and User Facility Device Experience Database (MAUDE) . An online search is available. You ...
Vasquez, Monica S
To identify strategies to improve patient outcomes and prevent rehospitalizations in home healthcare. PRIMARY PRACTICE SETTINGS(S): Primarily for home healthcare but can also be a tool for all other fields in nursing. Through team collaboration and the proper resources, patient outcomes can improve and be cost-effective for home healthcare agencies despite the changes implemented after the Medicare change in payment for services, the prospective payment system. The main goal for home healthcare is to improve patient outcomes. Nurses experienced in case management can devise creative strategies to ensure patient outcomes are met in a cost-effective manner. With continuous changes in reimbursement and payment incentives, case managers in every level of care must know about, and be responsible for, fiscal initiatives.
Grubb, Paul Dallas
In 1990, Project CHERISH (Children in Home Environments: Regulation to Increase Safety and Health) enabled the Texas Department of Human Services to implement and evaluate several innovative strategies to strengthen regulation of family day care homes. This report contains descriptions of those strategies, an evaluation of their efficacy, and…
Veenvliet, C.; Eide, H.; Lange, M.A. de; Dulmen, S. van
Background. Living at home with a physical condition that requires assistance places high emotional burden on older persons that needs to be attended to by nurses. However, nurses in home health care have previously been found to communicate primarily in an instrumental way. This increases the risk
A community survey was carried out to determine the frequency and the methods of home deliveries in the Mosvold health ward in northern KwaZulu. Of a sample of 210 mothers interviewed 46% had given birth at home, and of these 48% were delivered by traditional birth attendants; 84% gave birth in a kneeling or sitting ...
Frahm, Kathryn; Gammonley, Denise; Zhang, Ning Jackie; Paek, Seung Chun
Using 2003 nursing home data from the Minimum Data Set (MDS) database, this study investigated the role of family support among nursing homes serving residents with a mental health history. Exploratory factor analysis was used to create and test a conceptual model of family support using indicators located within the MDS database. Families were…
Seniors and other hospital patients in the United States have traditionally had the option of being discharged to a skilled nursing facility (convalescent home) for post-acute services, or home with nursing and therapy services provided in the home setting. Traditionally, these home based services have been referred to as "home health." As more Americans have retired, home health services have expanded and are readily accessible. This growth put tremendous stress on the Medicare fund which pays for senior care services. However, "Home Care," which traditionally has been viewed as non-medical home based services, has also become a booming industry for the cost conscious in recent years as more Americans reach retirement age. With the passing of the Affordable Care Act in 2010, providers and payers are now finding themselves responsible for post-acute care and continuous patient health, so cost efficient solutions for post-acute care are thriving. For the first time in history, American hospitals and Insurers are recognizing Home Care as an effective model that achieves the Triple Aim of Health Care reform. Home Care, which is no longer completely non-medical services, has proven to be an integral part of the care continuum for seniors in recent years and is now becoming a viable solution for keeping patients well, while still honoring their desire to age and heal at home. This paper analyzes the benefits and risks of home care and provides a clear understanding as to why American hospitals are emphasizing SNF Avoidance and skipping home health, opting instead to refer patients directly to home care as the preferred discharge solution in a value based model.
represent about one-third of all visits provided under the program. Family and friends altio provide similar services to the elderly and consequently...example, that the individual is to be confined to his or her home but that this does not necessarily mean that the patient is bedridden . At the same...34feebleness" and "insecurity" cannot be considered home- bound. We believe that in many cases (particularly for the elderly ) it would be extremely
Kouanda, Seni; Bado, Aristide; Meda, Ivlabèhiré Bertrand; Yameogo, Gisèle S; Coulibaly, Abou; Haddad, Slim
To identify the factors associated with home births in the Kaya health district in Burkina Faso, where child delivery was free of charge between 2007 and 2011. Both qualitative and quantitative data were collected from the Kaya Health and Demographic Surveillance System (Kaya HDSS) among women who delivered at home or in a health facility between January 2008 and December 2010. Multilevel logistic regression was applied to quantitative data, while the qualitative data were analyzed thematically based on emerging themes, subthemes, and patterns across group and individual cases. The findings indicate that 12% (n=311) of childbirths occurred at home (n=2560). Key factors associated with home birth were age, distance from the household to the primary health center, and prenatal visits. The qualitative analysis showed that immediate child delivery, previous experience of giving birth at home, negative experiences with health centers, fear of cesarean delivery, and lack of transport are key predictors of home births. Though relevant, addressing the financial barrier to health care is not enough. Additional measures are necessary to further reduce the rate of home births. Copyright © 2016. Published by Elsevier Ireland Ltd.
Tielman, M.; Meggelen, M. van; Neerincx, M.A.; Brinkman, W.P.
Internet-based guided self-therapy systems provide a novel method for Post-Traumatic Stress Disorder patients to follow therapy at home with the assistance of a virtual coach. One of the main challenges for such a coach is assisting patients with recollecting their traumatic memories, a vital part
...-0210; Notice 2] Newell Coach Corporation, Grant of Petition for Decision of Inconsequential...: Newell Coach Corporation (Newell) has determined that certain motor homes that it manufactured between... action is warranted. NHTSA's Analysis and Decision: Section 5.3 of FMVSS 120 specifically states: S5.3...
Comeau, Amanda; Hutton, Eileen K; Simioni, Julia; Anvari, Ella; Bowen, Megan; Kruegar, Samantha; Darling, Elizabeth K
The purpose of this study was to develop assessment criteria that could be used to examine the level of integration of home birth within larger health care systems in developed countries across 11 international jurisdictions. An expert panel developed criteria and a definition to assess home birth integration within health care systems. We selected jurisdictions based on the publications that were eligible for inclusion in our systematic review and meta-analysis on planned place of birth. We sent the authors of the included publications a questionnaire about home birth practitioners and practices in their respective health care system at the time of their studies. We searched published peer-reviewed, non-peer-reviewed, and gray literature, and the websites of professional bodies to document information about home birth integration in each jurisdiction based on our criteria. Where information was lacking, we contacted experts in the field from the relevant jurisdiction. Home birth is well integrated into the health care system in British Columbia (Canada), England, Iceland, the Netherlands, New Zealand, Ontario (Canada), and Washington State (USA). Home birth is less well integrated into the health care system in Australia, Japan, Norway, and Sweden. This paper is the first to propose criteria for the evaluation of home birth integration within larger maternity care systems. Application of these criteria across 11 international jurisdictions indicates differences in the recognition and training of home birth practitioners, in access to hospital facilities, and in the supplies and equipment available at home births, which give rise to variation in the level of integration across different settings. Standardized criteria for the evaluation of systems integration are essential for interpreting planned home birth outcomes that emerge from contextual differences. © 2018 Wiley Periodicals, Inc.
Full Text Available Background: The understanding of the complex relationship between the home environment, well-being and daily functioning in the third age is currently weak. The aim of this paper is to present the methodological background of the Home and Health in the Third Age Study, and describe a sample of men and women in relation to their home and health situation. Methods and Design: The study sample included 371 people aged 67–70, living in ordinary housing in the south of Sweden. Structured interviews and observations were conducted to collect data about objective and perceived aspects of home and health. Results: The majority of the participants were in good health and had few functional limitations. Women had more functional limitations and reported more symptoms than men. Environmental barriers were found in every home investigated; the most were found in the kitchen and hygiene area. Environmental barriers were more common in multi-family than in one-family dwellings. Discussion: This study will increase our knowledge on home and health dynamics among people in the third age. The results have potential to contribute to societal planning related to housing provision, home care and social services for senior citizens.
The purpose of this study was to describe the current status of utilization and costs of home health nursing care by the levels of medical institutes in Korea. A secondary analysis of existing data was used from the national electronic data information(EDI) of 148 home health agencies for 6 months from May to Oct 2005 in total. The 148 agencies had multiple services in cerebral infaction, essential hypertension, sequela of cerebrovascular disease, type 2 diabetes mellitus, etc.. The highest 10 rankings of 76 categories of home health nursing services were composed of 96.4% of the total services, such as simple treatment, inflammatory treatment, urethra & bladder irrigation, inserting indwelling catheter etc., in that order. The highest 20 rankings of 226 categories of home examination services were composed of 77.0% of the total home examination services. In addition, the average cost of home health care per visit was 46,088 Won ( approximately 48 $, 1 $=960 Won). The costs ranged from 74,523 Won ( approximately 78 $, loss of chronic kidney function, N18) to 32,270 Won ( approximately 34 $, other cerebrovascular diseases, I67). Results suggest that client characteristics of hospital based HHNC are not different from community based HHNC or visiting nursing services for elderly. The national results will contribute to baseline data used to establish a policy for the home health nursing care system and education.
Kylén, Maya; Ekström, Henrik; Haak, Maria; Elmståhl, Sölve; Iwarsson, Susanne
Background: The understanding of the complex relationship between the home environment, well-being and daily functioning in the third age is currently weak. The aim of this paper is to present the methodological background of the Home and Health in the Third Age Study, and describe a sample of men and women in relation to their home and health situation. Methods and Design: The study sample included 371 people aged 67–70, living in ordinary housing in the south of Sweden. Structured interviews and observations were conducted to collect data about objective and perceived aspects of home and health. Results: The majority of the participants were in good health and had few functional limitations. Women had more functional limitations and reported more symptoms than men. Environmental barriers were found in every home investigated; the most were found in the kitchen and hygiene area. Environmental barriers were more common in multi-family than in one-family dwellings. Discussion: This study will increase our knowledge on home and health dynamics among people in the third age. The results have potential to contribute to societal planning related to housing provision, home care and social services for senior citizens. PMID:25019267
Kopechek, Jack; Bardales, Cheryl; Lash, A Todd; Walker, Curtis; Pfeil, Sheryl; Ledford, Cynthia H
Faculty coaching is recognized as an essential element for effective use of portfolios in undergraduate medical education, yet best practices for training these coaches are uncertain. New portfolio coaches participated in a multifaceted training program that included orienting modules, a 7.5-hr training workshop featuring analysis of reflective writing, an Observed Structured Teaching Exercise (OSTE), and subsequent longitudinal coaches' meetings for timely task training. Four desired coaching skills were emphasized in the initial training: creating a safe environment, explicitly using performance data, asking questions that elicit reflection, and guiding the student to develop future goals and plans. We collected and analyzed several outcomes: (a) coaches' self-assessment at key intervals, (b) open-ended written responses to three coaching vignettes, (c) video recordings of the OSTE, and (d) subsequent student evaluation of the coach. In an attempt to capture learning from the workshop, both the responses to written vignettes and the video-recorded encounters were coded for presence or absence of the four desired skills. Our portfolio and coaching program was instituted as part of a major undergraduate medical education reform. A new cohort of 25 coaches is enrolled with each matriculating student class, and each coach is assigned to work individually with 8-10 students, forming a coaching relationship that continues over 4 years. Coaches are compensated at 5% full-time equivalent. On coach self-assessment, the majority of coaches reported significant improvement in their perceived ability to assess a student's level of reflection, enhance reflection, use performance data, and guide a student to develop goals and plans. After two semesters, coach perception of improved abilities persisted. Students rated coaches as excellent (82%), reporting that coaches created safe environments (99%), promoted insight (92%), and aided in goal setting (97%). Written responses to
Ellenbecker, Carol Hall
Predicted severe nursing shortages and an increasing demand for home health care services have made the retention of experienced, qualified nursing staff a priority for health care organizations. The purpose of this paper is to describe a theoretical model of job retention for home health care nurses. The theoretical model is an integration of the findings of empirical research related to intent to stay and retention, components of Neal's theory of home health care nursing practice and findings from earlier work to develop an instrument to measure home health care nurses' job satisfaction. The theoretical model identifies antecedents to job satisfaction of home health care nurses. The antecedents are intrinsic and extrinsic job characteristics. The model also proposes that job satisfaction is directly related to retention and indirectly related to retention though intent to stay. Individual nurse characteristics are indirectly related to retention through intent to stay. The individual characteristic of tenure is indirectly related to retention through autonomy, as an intrinsic characteristic of job satisfaction, and intent to stay. The proposed model can be used to guide research that explores gaps in knowledge about intent to stay and retention among home health care nurses.
Vladutiu, Catherine J; Casteel, Carri; Nocera, Maryalice; Harrison, Robert; Peek-Asa, Corinne
In the rapidly growing home health and hospice industry, little is known about workplace violence prevention (WVP) training and violent events. We examined the characteristics of WVP training and estimated violent event rates among 191 home health and hospice care providers from six agencies in California. Training characteristics were identified from the Occupational Safety and Health Administration guidelines. Rates were estimated as the number of violent events divided by the total number of home visit hours. Between 2008 and 2009, 66.5% (n = 127) of providers reported receiving WVP training when newly hired or as recurrent training. On average, providers rated the quality of their training as 5.7 (1 = poor to 10 = excellent). Among all providers, there was an overall rate of 17.1 violent events per 1,000 visit-hours. Efforts to increase the number of home health care workers who receive WVP training and to improve training quality are needed. © 2015 Wiley Periodicals, Inc.
Phillips, Charles D
Case-mix classification and payment systems help assure that persons with similar needs receive similar amounts of care resources, which is a major equity concern for consumers, providers, and programs. Although health service programs for adults regularly use case-mix payment systems, programs providing health services to children and youth rarely use such models. This research utilized Medicaid home care expenditures and assessment data on 2,578 children receiving home care in one large state in the USA. Using classification and regression tree analyses, a case-mix model for long-term pediatric home care was developed. The Pediatric Home Care/Expenditure Classification Model (P/ECM) grouped children and youth in the study sample into 24 groups, explaining 41% of the variance in annual home care expenditures. The P/ECM creates the possibility of a more equitable, and potentially more effective, allocation of home care resources among children and youth facing serious health care challenges.
Wearing, Thomas; Dragoni, Nicola
Automated systems for monitoring elderly people in their home are becoming more and more common. Indeed, an increasing number of home sensor networks for healthcare can be found in the recent literature, indicating a clear research direction in smart homes for health-care. Although the huge amount...... of sensitive data these systems deal with and expose to the external world, security and privacy issues are surpris-ingly not taken into consideration. The aim of this paper is to raise some key security and privacy issues that home health monitor systems should face with. The analysis is based on a real world...... monitoring sensor network for healthcare built in the context of the eCare@Home project....
van der Heijden, Beatrice I J M; Demerouti, Evangelia; Bakker, Arnold B
This paper is a report of a study with three aims: (i) to investigate whether emotional, quantitative and physical demands have a causal, negative impact on nurses' health; (ii) to examine whether work-home interference can explain this effect, by playing a mediating role; and (iii) to test the so-called loss spiral hypothesis claiming that nurses' health problems lead to even higher job demands and more work-home interference over time. While many scholars have thought in terms of the stressor-->work-home interference-->strain model, the validity of a model that includes opposite pathways needs to be tested. A questionnaire was completed twice, with a 1-year time interval by 753 (63.4%) Registered Nurses working in hospitals, 183 (15.4%) working in nursing homes, and 251 (21.1%) working in home care institutions. The first measurement took place between October 2002 and June 2003. Our findings strongly support the idea of cross-lagged, reciprocal relationships between job demands and general health over time. The reciprocal model with work-home interference as an intervening variable (including reciprocal relationships between job demands, work-home interference and general health) showed a good fit to the data, and proved to be superior to both the causality and reversed causation models. The higher nurses' job demands, the higher is their level of work-home interference and the more likely is a general health deterioration over time, in turn giving rise to higher job demands and work-home interference, which may even aggravate the nurses' general health, and so on.
Ryu, Hosihn; An, Jiyoung; Koabyashi, Mia
Home health nursing care (HHNC) in Korea has taken on an important role under the mandate of the national health care system since 2000. This program was developed to verify the possibility of early discharge of hospitalized patients and cost containment through a research and development project that was conducted with the government from 1994 to 1999. The process of development of HHNC provided an opportunity to realize the advancement and changes in the system into a consumer-focused structure. This is an important turning point for the Korean health care system that suggests certain possibilities for building a foundation for further changes in the service delivery structure. The structure, which had been limited to a supplier-oriented model, is moving to a consumer-oriented structure. Accordingly, the major function and role of nursing policy makers in Korea is to develop an agenda and alternatives for policy-making in a systematic manner and to present implementation strategies clearly.
Göransson, Carina; Eriksson, Irene; Ziegert, Kristina; Wengström, Yvonne; Langius-Eklöf, Ann; Brovall, Maria; Kihlgren, Annica; Blomberg, Karin
To explore the experiences of using an app among older people with home-based health care and their nurses. Few information and communication technology innovations have been developed and tested for older people with chronic conditions living at home with home-based health care support. Innovative ways to support older people's health and self-care are needed. Explorative qualitative design. For 3 months to report health concerns, older people receiving home-based health care used an interactive app, which included direct access to self-care advice, graphs and a risk assessment model that sends alerts to nurses for rapid management. Interviews with older people (n = 17) and focus group discussions with home care nurses (n = 12) were conducted and analysed using thematic analysis. The findings reveal that a process occurs. Using the app, the older people participated in their care, and the app enabled learning and a new way of communication. The interaction gave a sense of security and increased self-confidence among older people. The home care nurses viewed the alerts as appropriate for the management of health concerns. However, all participants experienced challenges in using new technology and had suggestions for improvement. The use of an app appears to increase the older people's participation in their health care and offers them an opportunity to be an active partner in their care. The app as a new way to interact with home care nurses increased the feeling of security. The older people were motivated to learn to use the app and described potential use for it in the future. The use of an app should be considered as a useful information and communication technology innovation that can improve communication and accessibility for older people with home-based health care. © 2017 John Wiley & Sons Ltd.
Døhl, Øystein; Garåsen, Helge; Kalseth, Jorid; Magnussen, Jon
Within the setting of a public health service we analyse the distribution of resources between individuals in nursing homes funded by global budgets. Three questions are pursued. Firstly, whether there are systematic variations between nursing homes in the level of care given to patients. Secondly, whether such variations can be explained by nursing home characteristics. And thirdly, how individual need-related variables are associated with differences in the level of care given. The study included 1204 residents in 35 nursing homes and extra care sheltered housing facilities. Direct time spent with patients was recorded. In average each patient received 14.8 hours direct care each week. Multilevel regression analysis is used to analyse the relationship between individual characteristics, nursing home characteristics and time spent with patients in nursing homes. The study setting is the city of Trondheim, with a population of approximately 180 000. There are large variations between nursing homes in the total amount of individual care given to patients. As much as 24 percent of the variation of individual care between patients could be explained by variation between nursing homes. Adjusting for structural nursing home characteristics did not substantially reduce the variation between nursing homes. As expected a negative association was found between individual care and case-mix, implying that at nursing home level a more resource demanding case-mix is compensated by lowering the average amount of care. At individual level ADL-disability is the strongest predictor for use of resources in nursing homes. For the average user one point increase in ADL-disability increases the use of resources with 27 percent. In a financial reimbursement model for nursing homes with no adjustment for case-mix, the amount of care patients receive does not solely depend on the patients' own needs, but also on the needs of all the other residents.
McConnaughy, Rozalynd P; Wilson, Steven P
The goal of this content analysis was to identify commonly used content and design features of academic health sciences library home pages. After developing a checklist, data were collected from 135 academic health sciences library home pages. The core components of these library home pages included a contact phone number, a contact email address, an Ask-a-Librarian feature, the physical address listed, a feedback/suggestions link, subject guides, a discovery tool or database-specific search box, multimedia, social media, a site search option, a responsive web design, and a copyright year or update date.
Full Text Available This article describes and analyzes the improvisational and innovative process that takes place among professional musicians during the extraordinary concert. The aim is to draw parallels to the professional coaching conversation in order to examine what new angles this analogy can contribute in proportion to coaching as a practice. In other words, how can an analysis of the musician’s communication during a successful concert shed light on what is happening in a successful professional dialogue. The article contains both empirical data and theory. The empirical data comes to results from a qualitative study undertaken in connection with my thesis within the Master of Learning Processes Specializing in Organizational Coaching at Aalborg University, and is based on interviews with five professional orchestra musicians from the Royal Danish Orchestra, the Copenhagen Phil and the Danish National Symphony Orchestra
Bair, Mary Antony
This paper describes a faculty development project in which 12 teacher educators used the Cognitive Coaching model to engage in critical reflections about their teaching. Each identified an aspect of their teaching they wanted to improve and a colleague to serve as coach. Participants engaged in Cognitive Coaching cycles, consisting of planning…
... care institutions providing home service. 403.764 Section 403.764 Public Health CENTERS FOR MEDICARE... Basis and purpose of religious nonmedical health care institutions providing home service. (a) Basis... and 1878 of the Act regarding Medicare payment for items and services provided in the home setting...
Bergström, Anna; Skeen, Sarah; Duc, Duong M; Blandon, Elmer Zelaya; Estabrooks, Carole; Gustavsson, Petter; Hoa, Dinh Thi Phuong; Källestål, Carina; Målqvist, Mats; Nga, Nguyen Thu; Persson, Lars-Åke; Pervin, Jesmin; Peterson, Stefan; Rahman, Anisur; Selling, Katarina; Squires, Janet E; Tomlinson, Mark; Waiswa, Peter; Wallin, Lars
The gap between what is known and what is practiced results in health service users not benefitting from advances in healthcare, and in unnecessary costs. A supportive context is considered a key element for successful implementation of evidence-based practices (EBP). There were no tools available for the systematic mapping of aspects of organizational context influencing the implementation of EBPs in low- and middle-income countries (LMICs). Thus, this project aimed to develop and psychometrically validate a tool for this purpose. The development of the Context Assessment for Community Health (COACH) tool was premised on the context dimension in the Promoting Action on Research Implementation in Health Services framework, and is a derivative product of the Alberta Context Tool. Its development was undertaken in Bangladesh, Vietnam, Uganda, South Africa and Nicaragua in six phases: (1) defining dimensions and draft tool development, (2) content validity amongst in-country expert panels, (3) content validity amongst international experts, (4) response process validity, (5) translation and (6) evaluation of psychometric properties amongst 690 health workers in the five countries. The tool was validated for use amongst physicians, nurse/midwives and community health workers. The six phases of development resulted in a good fit between the theoretical dimensions of the COACH tool and its psychometric properties. The tool has 49 items measuring eight aspects of context: Resources, Community engagement, Commitment to work, Informal payment, Leadership, Work culture, Monitoring services for action and Sources of knowledge. Aspects of organizational context that were identified as influencing the implementation of EBPs in high-income settings were also found to be relevant in LMICs. However, there were additional aspects of context of relevance in LMICs specifically Resources, Community engagement, Commitment to work and Informal payment. Use of the COACH tool will allow
Farinha, Carolina Gomes
This study aims to shed some light into the debate of what is a suitable coaching training curricula, specifically in Portugal. We conducted a Delphi study with 5 coaching experts to analyse: i) what is the minimum academic training for a future coach, ii) what is the minimum of hours required for a coaching training program, iii) which competencies should it develop, iv) which contents should the training address, v) which are the requisites for one to be a coaching trainer and, vi) what ...
Full Text Available Background and context: A key role of the district’s Nursing Midwifery Practice and Workforce Unit is to build capability in the nursing and midwifery workforce. In this paper I reflect on the experience of my team following attendance at a two-day Coaching for Performance workshop and the impact this had on developing coaching skills for nurse managers and nurse unit managers in South Eastern Sydney Local Health District. Aims: To highlight how engaging in critical reflection enabled the unit team to identify gaps in the transfer of coaching skills learned from the two-day workshop to everyday management practices. The pilot project to embed coaching into management practices is the result of the team’s reflection. The method, findings and implications for coaching practices for nurse managers and nurse unit managers are described in detail. Findings: Using Gibbs’ model of reflection, the unit team reflected on its collective experiences following attendance at the workshop. This led to the development of a pilot coaching project called Embedding Coaching into Practice for nurse managers and nurse unit managers, which enabled the transfer of coaching skills learned to everyday management practices. The pilot project used a ‘coaching the coach’ approach, with structured follow-up at the managers’ places of work. This had a positive impact on the development of coaching skills and managers were able to use these skills with confidence to enable their staff to develop problem-solving skills. Conclusions: This paper highlights how using a validated tool for reflection can lead to positive change. ‘Coaching the coach’ can support transfer of coaching skills learned into everyday practices, which has a positive impact on work performance for nurse managers, nurse unit managers and their staff. It supports the practice development principle that lifelong learning can influence effective workplace cultures and have a positive impact on
Dawadi, Prafulla N; Cook, Diane J; Schmitter-Edgecombe, Maureen
One of the many services that intelligent systems can provide is the automated assessment of resident well-being. We hypothesize that the functional health of individuals, or ability of individuals to perform activities independently without assistance, can be estimated by tracking their activities using smart home technologies. In this paper, we introduce a machine learning-based method for assessing activity quality in smart homes. To validate our approach we quantify activity quality for 179 volunteer participants who performed a complex, interweaved set of activities in our smart home apartment. We observed a statistically significant correlation (r=0.79) between automated assessment of task quality and direct observation scores. Using machine learning techniques to predict the cognitive health of the participants based on task quality is accomplished with an AUC value of 0.64. We believe that this capability is an important step in understanding everyday functional health of individuals in their home environments.
Blondel, B; Bréart, G
This review of eight randomized controlled trials assessed two different types of home visits during pregnancy: (1) those offering social support to high-risk women; and (2) those providing medical care to women with complications. In both categories, pregnancy outcome was not improved when women received home visits. The summary odds ratio for preterm delivery (better integration of hospital and home services might allow a more rational use of health services for women with complications. In addition, we need to define more precisely the content of home visits providing social support. For this, further research is required on how emotional support, health education, and advice influence the health of women and infants and mother-child interactions.
Mills, Susanna; White, Martin; Brown, Heather; Wrieden, Wendy; Kwasnicka, Dominika; Halligan, Joel; Robalino, Shannon; Adams, Jean
Many dietary interventions assume a positive influence of home cooking on diet, health and social outcomes, but evidence remains inconsistent. We aimed to systematically review health and social determinants and outcomes of home cooking. Given the absence of a widely accepted, established definition, we defined home cooking as the actions required for preparing hot or cold foods at home, including combining, mixing and often heating ingredients. Nineteen electronic databases were searched for relevant literature. Peer-reviewed studies in English were included if they focussed mainly on home cooking, and presented post 19 th century observational or qualitative data on participants from high/very high human development index countries. Interventional study designs, which have previously been reviewed, were excluded. Themes were summarised using narrative synthesis. From 13,341 unique records, 38 studies - primarily cross-sectional in design - met the inclusion criteria. A conceptual model was developed, mapping determinants of home cooking to layers of influence including non-modifiable, individual, community and cultural factors. Key determinants included female gender, greater time availability and employment, close personal relationships, and culture and ethnic background. Putative outcomes were mostly at an individual level and focused on potential dietary benefits. Findings show that determinants of home cooking are more complex than simply possessing cooking skills, and that potential positive associations between cooking, diet and health require further confirmation. Current evidence is limited by reliance on cross-sectional studies and authors' conceptualisation of determinants and outcomes. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.
Ole Michael Spaten
Full Text Available 15 middle managers from a major Danish, nationwide company were trained to coach by two coaching psychologiststhrough theoretical presentations, individual coaching and peer coaching sessions with direct supervision(learning-by-doing, (see Spaten, 2011b. Until now there has been conducted rather limited empiricalresearch on managers who coach their employees. The aim was to investigate the managers challenging andsuccessful experiences when coaching their employees and how these coaching sessions were assessed by theiremployees. The qualitative analysis elicited three main themes: 1 coaching skills, 2 professional and personaldevelopment, and 3 the coaching relationship and power relations. Middle managers’ coaching skills were assessedvery positively by employees across all coaching sessions. One key finding of the study is that the manageras coach, should be very sensitive and empathetic in building the coaching relationship, be aware of the powerrelations and make clear boundaries between the role as leader and the role as coach.
Knaup, P; Schöpe, L
This editorial is part of the Focus Theme of Methods of Information in Medicine on "Using Data from Ambient Assisted Living and Smart Homes in Electronic Health Records". To increase efficiency in the health care of the future, data from innovative technology like it is used for ambient assisted living (AAL) or smart homes should be available for individual health decisions. Integrating and aggregating data from different medical devices and health records enables a comprehensive view on health data. The objective of this paper is to present examples of the state of the art in research on information management that leads to a sustainable use and long-term storage of health data provided by innovative assistive technologies in daily living. Current research deals with the perceived usefulness of sensor data, the participatory design of visual displays for presenting monitoring data, and communication architectures for integrating sensor data from home health care environments with health care providers either via a regional health record bank or via a telemedical center. Integrating data from AAL systems and smart homes with data from electronic patient or health records is still in an early stage. Several projects are in an advanced conceptual phase, some of them exploring feasibility with the help of prototypes. General comprehensive solutions are hardly available and should become a major issue of medical informatics research in the near future.
Chen, Chia-Ching; Yamada, Tetsuji; Nakashima, Taeko; Chiu, I-Ming
The purposes of this study are: (1) to empirically identify decision-making preferences of long-term health-care use, especially informal and formal home care (FHC) service use; (2) to evaluate outcomes vs. costs based on substitutability of informal and FHC service use; and (3) to investigate health outcome disparity based on substitutability. The methods of ordinary least squares, a logit model, and a bivariate probit model are used by controlling for socioeconomic, demographic, and physical/mental health factors to investigate outcomes and costs based substitutability of informal and formal health-care use. The data come from the 2013 Japanese Study of Aging and Retirement (JSTAR), which is designed by Keizai-Sangyo Kenkyu-jo, Hitotsubashi University, and the University of Tokyo. The JSTAR is a globally comparable data survey of the elderly. There exists a complement relationship between the informal home care (IHC) and community-based FHC services, and the elasticity's ranges from 0.18 to 0.22. These are reasonable results, which show that unobservable factors are positively related to IHC and community-based FHC, but negatively related to nursing home (NH) services based on our bivariate probit model. Regarding health-care outcome efficiency issue, the IHC is the best one among three types of elderly care: IHC, community-based FHC, and NH services. Health improvement/outcome of elderly with the IHC is heavier concentrated on IHC services than the elderly care services by community-based FHC and NH care services. Policy makers need to address a diversity of health outcomes and efficiency of services based on providing services to elderly through resource allocation to the different types of long-term care. A provision of partial or full compensation for elderly care at home is recommendable and a viable option to improve their quality of lives.
Full Text Available ObjectivesThe purposes of this study are: (1 to empirically identify decision-making preferences of long-term health-care use, especially informal and formal home care (FHC service use; (2 to evaluate outcomes vs. costs based on substitutability of informal and FHC service use; and (3 to investigate health outcome disparity based on substitutability.Methodology and dataThe methods of ordinary least squares, a logit model, and a bivariate probit model are used by controlling for socioeconomic, demographic, and physical/mental health factors to investigate outcomes and costs based substitutability of informal and formal health-care use. The data come from the 2013 Japanese Study of Aging and Retirement (JSTAR, which is designed by Keizai-Sangyo Kenkyu-jo, Hitotsubashi University, and the University of Tokyo. The JSTAR is a globally comparable data survey of the elderly.ResultsThere exists a complement relationship between the informal home care (IHC and community-based FHC services, and the elasticity’s ranges from 0.18 to 0.22. These are reasonable results, which show that unobservable factors are positively related to IHC and community-based FHC, but negatively related to nursing home (NH services based on our bivariate probit model. Regarding health-care outcome efficiency issue, the IHC is the best one among three types of elderly care: IHC, community-based FHC, and NH services. Health improvement/outcome of elderly with the IHC is heavier concentrated on IHC services than the elderly care services by community-based FHC and NH care services.ConclusionPolicy makers need to address a diversity of health outcomes and efficiency of services based on providing services to elderly through resource allocation to the different types of long-term care. A provision of partial or full compensation for elderly care at home is recommendable and a viable option to improve their quality of lives.
Zeytinoglu, Isik U; Denton, Margaret; Davies, Sharon; Plenderleith, Jennifer Millen
Office home care workers provide support to visiting staff, although their work tends to be invisible in many respects. This paper focuses on managers, supervisors, coor dinators, case managers and office administrative staff in home care. We examine the effects of workplace flexibility and worker insecurity on office home care workers' occupational health, particularly their self-reported stress and musculoskeletal disorders. Data come from our survey of 300 home care office staff in a mid-sized city in Ontario. Results show that workers' perceptions of insecurity are positively associated with musculoskeletal disorders but not workplace flexibility measures. We recommend that managers and other decision-makers in the home care field pay attention to the perceptions of workers' insecurity in initiating workplace flexibility measures.
Beck, Anne Marie
Objective: The purpose of this study was to evaluate the relationship between underweight status and weight loss events on the need for health care assistance among a sample of Danish nursing home residents over 12-months. Design: Longitudinal, repeated measures design with three data collection...... points at baseline (2004) and six and 12 months post baseline. Setting: 11 Danish nursing home facilities. Participants: 441 Danish nursing home residents over the age of 65. Measurements: Resident Assessment Instrument (RAI-NH) data were abstracted for each participant at each of three data collection...... of this study suggest that elderly nursing home residents with a low BMI or weight loss may add to the substantial and costly burden of nursing home care due to the associated need for higher levels of ADL assistance....
Leedahl, Skye N; Chapin, Rosemary K; Little, Todd D
Testing a model based on past research and theory, this study assessed relationships between facility characteristics (i.e., culture change efforts, social workers) and residents' social networks and social support across nursing homes; and examined relationships between multiple aspects of social integration (i.e., social networks, social capital, social engagement, social support) and mental and functional health for older adults in nursing homes. Data were collected at nursing homes using a planned missing data design with random sampling techniques. Data collection occurred at the individual-level through in-person structured interviews with older adult nursing home residents (N = 140) and at the facility-level (N = 30) with nursing home staff. The best fitting multilevel structural equation model indicated that the culture change subscale for relationships significantly predicted differences in residents' social networks. Additionally, social networks had a positive indirect relationship with mental and functional health among residents primarily via social engagement. Social capital had a positive direct relationship with both health outcomes. To predict better social integration and mental and functional health outcomes for nursing homes residents, study findings support prioritizing that close relationships exist among staff, residents, and the community as well as increased resident social engagement and social trust. © The Author 2014. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: email@example.com.
This paper proposed a remote health monitoring system for the elderly based on smart home gateway. The proposed system consists of three parts: the smart clothing, the smart home gateway, and the health care server. The smart clothing collects the elderly's electrocardiogram (ECG) and motion signals. The home gateway is used for data transmission. The health care server provides services of data storage and user information management; it is constructed on the Windows-Apache-MySQL-PHP (WAMP) platform and is tested on the Ali Cloud platform. To resolve the issues of data overload and network congestion of the home gateway, an ECG compression algorithm is applied. System demonstration shows that the ECG signals and motion signals of the elderly can be monitored. Evaluation of the compression algorithm shows that it has a high compression ratio and low distortion and consumes little time, which is suitable for home gateways. The proposed system has good scalability, and it is simple to operate. It has the potential to provide long-term and continuous home health monitoring services for the elderly. PMID:29204258
Full Text Available This paper proposed a remote health monitoring system for the elderly based on smart home gateway. The proposed system consists of three parts: the smart clothing, the smart home gateway, and the health care server. The smart clothing collects the elderly’s electrocardiogram (ECG and motion signals. The home gateway is used for data transmission. The health care server provides services of data storage and user information management; it is constructed on the Windows-Apache-MySQL-PHP (WAMP platform and is tested on the Ali Cloud platform. To resolve the issues of data overload and network congestion of the home gateway, an ECG compression algorithm is applied. System demonstration shows that the ECG signals and motion signals of the elderly can be monitored. Evaluation of the compression algorithm shows that it has a high compression ratio and low distortion and consumes little time, which is suitable for home gateways. The proposed system has good scalability, and it is simple to operate. It has the potential to provide long-term and continuous home health monitoring services for the elderly.
Guan, Kai; Shao, Minggang; Wu, Shuicai
This paper proposed a remote health monitoring system for the elderly based on smart home gateway. The proposed system consists of three parts: the smart clothing, the smart home gateway, and the health care server. The smart clothing collects the elderly's electrocardiogram (ECG) and motion signals. The home gateway is used for data transmission. The health care server provides services of data storage and user information management; it is constructed on the Windows-Apache-MySQL-PHP (WAMP) platform and is tested on the Ali Cloud platform. To resolve the issues of data overload and network congestion of the home gateway, an ECG compression algorithm is applied. System demonstration shows that the ECG signals and motion signals of the elderly can be monitored. Evaluation of the compression algorithm shows that it has a high compression ratio and low distortion and consumes little time, which is suitable for home gateways. The proposed system has good scalability, and it is simple to operate. It has the potential to provide long-term and continuous home health monitoring services for the elderly.
Coop Henriksen, Annemette
SFI gennemførte i foråret 2008 til foråret 2009 en pilotundersøgelse om coaching. Undersøgelsen var designet som et lodtrækningsforsøg og omfattede 42 kvindelige sygedagpengemodtagere fra Rødovre Jobcenter, der var sygemeldt med psykiske lidelser i form af stress, depression eller udbrændthed eller...... med lidelser i bevægeapparatet. Undersøgelsen er bestilt og finansieret af Rødovre Jobcenter. I rapporten undersøges, om coaching kan bidrage til at bringe sygedagpengemodtagere i arbejde eller tættere på arbejdsmarkedet målt ved, om deltagerne får fx øget motivation, mere selvtillid, øget afklaring...... og færre symptomer på sygdom. Undersøgelsen viser, at gruppen, der har modtaget coaching, oplever en positiv udvikling i forhold til stress, depression og udbrændthed. Gruppen, der modtog coaching, har den tydeligste positive udvikling, men begge grupper har oplevet en helbredsmæssig fremgang i...
Ruis, Carla; Huenges Wajer, Irene; Robe, Pierre; van Zandvoort, Martine
Background: The importance of monitoring cognition during awake craniotomy has been well described in previous studies. The relevance of being coached during such a procedure has received less attention and questions still remain unanswered about what factors are the most important herein.
An important task of a manager is to motivate her subordinates. One way in which a manager can give incentives to junior employees is through the assignment of tasks. How a manager allocates tasks in an organization, provides information to the junior employees about his ability. Without coaching
Mandali, Swarna L.
Good nutrition is important for optimal athletic performance. Adolescent athletes often depend on their coaches for nutritional information on weight management, dietary supplements, and dietary practices. Some dietary practices, such as vegetarianism, have the potential to be harmful to the adolescent athlete if not followed with careful…
Scales, Peter C.
One of the most powerful ways to boost the payoff from school sports lays in helping coaches build developmental relationships with student-athletes. Developmental relationships are close connections through which young people develop character skills to discover who they are, gain the ability to shape their own lives, and learn how to interact…
Lin, Chao-Hung; Young, Shuenn-Tsong; Kuo, Te-Son
With the aging of the population and the increasing patient preference for receiving care in their own homes, remote home care is one of the fastest growing areas of health care in Taiwan and many other countries. Many remote home-monitoring applications have been developed and implemented to enable both formal and informal caregivers to have remote access to patient data so that they can respond instantly to any abnormalities of in-home patients. The aim of this technology is to give both patients and relatives better control of the health care, reduce the burden on informal caregivers and reduce visits to hospitals and thus result in a better quality of life for both the patient and his/her family. To facilitate their widespread adoption, remote home-monitoring systems take advantage of the low-cost features and popularity of the Internet and PCs, but are inherently exposed to several security risks, such as virus and denial-of-service (DoS) attacks. These security threats exist as long as the in-home PC is directly accessible by remote-monitoring users over the Internet. The purpose of the study reported in this paper was to improve the security of such systems, with the proposed architecture aimed at increasing the system availability and confidentiality of patient information. A broker server is introduced between the remote-monitoring devices and the in-home PCs. This topology removes direct access to the in-home PC, and a firewall can be configured to deny all inbound connections while the remote home-monitoring application is operating. This architecture helps to transfer the security risks from the in-home PC to the managed broker server, on which more advanced security measures can be implemented. The pros and cons of this novel architecture design are also discussed and summarized.
Background In the UK there are almost three times as many beds in care homes as in National Health Service (NHS) hospitals. Care homes rely on primary health care for access to medical care and specialist services. Repeated policy documents and government reviews register concern about how health care works with independent providers, and the need to increase the equity, continuity and quality of medical care for care homes. Despite multiple initiatives, it is not known if some approaches to service delivery are more effective in promoting integrated working between the NHS and care homes. This study aims to evaluate the different integrated approaches to health care services supporting older people in care homes, and identify barriers and facilitators to integrated working. Methods A systematic review was conducted using Medline (PubMed), CINAHL, BNI, EMBASE, PsycInfo, DH Data, Kings Fund, Web of Science (WoS incl. SCI, SSCI, HCI) and the Cochrane Library incl. DARE. Studies were included if they evaluated the effectiveness of integrated working between primary health care professionals and care homes, or identified barriers and facilitators to integrated working. Studies were quality assessed; data was extracted on health, service use, cost and process related outcomes. A modified narrative synthesis approach was used to compare and contrast integration using the principles of framework analysis. Results Seventeen studies were included; 10 quantitative studies, two process evaluations, one mixed methods study and four qualitative. The majority were carried out in nursing homes. They were characterised by heterogeneity of topic, interventions, methodology and outcomes. Most quantitative studies reported limited effects of the intervention; there was insufficient information to evaluate cost. Facilitators to integrated working included care home managers' support and protected time for staff training. Studies with the potential for integrated working were longer in
Medicare and Medicaid programs; CY 2015 Home Health Prospective Payment System rate update; Home Health Quality Reporting Requirements; and survey and enforcement requirements for home health agencies. Final rule.
This final rule updates Home Health Prospective Payment System (HH PPS) rates, including the national, standardized 60-day episode payment rates, the national per-visit rates, and the non-routine medical supply (NRS) conversion factor under the Medicare prospective payment system for home health agencies (HHAs), effective for episodes ending on or after January 1, 2015. As required by the Affordable Care Act, this rule implements the second year of the four-year phase-in of the rebasing adjustments to the HH PPS payment rates. This rule provides information on our efforts to monitor the potential impacts of the rebasing adjustments and the Affordable Care Act mandated face-to-face encounter requirement. This rule also implements: Changes to simplify the face-to-face encounter regulatory requirements; changes to the HH PPS case-mix weights; changes to the home health quality reporting program requirements; changes to simplify the therapy reassessment timeframes; a revision to the Speech-Language Pathology (SLP) personnel qualifications; minor technical regulations text changes; and limitations on the reviewability of the civil monetary penalty provisions. Finally, this rule also discusses Medicare coverage of insulin injections under the HH PPS, the delay in the implementation of the International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM), and a HH value-based purchasing (HH VBP) model.
Loke, Alice Yuen; Mak, Y W
A community-wide school health project for the promotion of smoke-free homes was launched in June 2010 with the aim of promoting the benefits of smoke-free homes to all school-aged children (aged 6-18), and indirectly to their parents and family members. The 1-year project included health talks on a smoke-free life; the distribution of educational leaflets; slogan and visual art competitions; and a health fair held in June 2011. Two sets of questionnaires were developed to solicit a resolution and action from the participants regarding the establishment of a smoke-free home, and their decision to stay smoke-free. This is a paper to report on the activities of this project, the attempts to reach out to school-aged children, and their indications of agreement with, support for, and commitment to promoting smoke-free homes. The project reached an estimated 12,800 school-aged children in Hong Kong. A large proportion of those received educational leaflets (69.6-88.2 %). Of those who participated in the health fair, 69.7-87.6 % agreed to promote the concept of smoke-free homes to friends and family. More primary than secondary students pledged to not take up smoking (90.8 vs 85.8 %). About 82 % of those who had experimented with smoking pledged to stop. A small proportion of them reported already having established a smoke-free policy at home (14.9 %), placed a 'No Smoking' sign at home (16.4 %), informed visitors of their smoke-free policy at home (12.9 %), and asked visitors to dispose of lit cigarettes before entering their home (15.9 %). This community-wide school health project on the benefits of smoke-free homes reached a large number of students, and indirectly to family members, and home visitors. Public health efforts of this kind should be continued to reach younger generations and the general public.
Kan, Kristin; Choi, Hwajung; Davis, Matthew
Immigrant children in the United States historically experience lower-quality health care. Such disparities areconcerning for immigrant children with special health care needs (CSHCNs). Our study assesses the medical home presence for CSHCN by immigrant family type and evaluates which medical home components are associated with disparities. We used the 2011 National Survey of Children's Health, comparing the prevalence and odds of a parent-reported medical home and 5 specific medical home components by immigrant family types using bivariate and multivariate logistic regression. Foreign-born CSHCNs were less likely than CSHCNs with US-born parents to have a medical home (adjusted odds ratio = 0.40, 95% confidence interval 0.19-0.85). The adjusted prevalence of having a medical home was 28% among foreign-born CSHCNs (P special needs also had a lower odds of a medical home, compared with children with US-born parents (adjusted odds ratio = 0.62, 0.46-0.83). The medical home component most frequently absent for immigrant children without special needs and CSHCNs with a foreign-born parent was family-centered care. In contrast, foreign-born CSHCNs most often lacked care coordination (adjusted prevalence = 37% versus 56% for CSHCNs with US-born parents; P < .05). Disparities in medical home presence for CSHCNs appear to be exacerbated by immigrant family type. Efforts focused on improving family-centered care and care coordination may provide the greatest benefit for immigrant CSHCNs. Copyright © 2016 by the American Academy of Pediatrics.
Germeroth, Carrie; Sarama, Julie
Falling scores in math have prompted a renewed interest in math instruction at early ages. By their own admission, early childhood educators are generally underprepared and not always comfortable teaching math. Professional development (PD) in early mathematics is widely considered a main way to increase teachers' skills and efficacy (e.g., Guskey, 2000; Hyson & Woods, 2014; Munby, Russell, & Martin, 2001; Piasta, Logan, Pelatti, Capps, & Petrill, 2015; Richardson & Placier, 2001; Sarama, Clements, Wolfe, & Spitler, 2016; Sarama & DiBiase, 2004; Zaslow, 2014). However, it has been documented that stand-alone PD is not as effective in changing practice (e.g., Biancarosa & Bryk, 2011; Garet et al., 2008; Guskey, 2000; Hyson & Woods, 2014; Institute of Medicine and National Research Council, 2015; Joyce & Showers, 2002; Zaslow, 2014). Site-embedded ongoing support in the form of coaching or mentoring has been shown to be critical for successful implementation (Neuman & Cunningham, 2009; Powell, Diamond, Burchinal, & Koehler, 2010). In this chapter, we describe coaching models and abstract characteristics of effective coaching from the research. With this background, we provide an in-depth view of the coaching aspect of two large empirical studies in early mathematics. We introduce the theoretical framework from which the coaching models for these projects were developed and describe the research on which they were based. We then summarize how the planned models were instantiated and challenges to their implementation within each project. In the final section, we summarize what we have learned and described implications and challenges for the field. © 2017 Elsevier Inc. All rights reserved.
Smego, Raymond A; Khan, Mohammad Aslam; Khowaja, Khurshid; Rafique, Rozina; Datoo, Farida
This article describes a university-sponsored home health nursing program in a large urban center in Pakistan and details the essential elements needed in implementing such a program in a developing country. Compared to in-hospital treatment, home healthcare reduced hospital stay from 12.8 days to 3.9 days, and resulted in a net savings of Pakistani rupees (PRs) 5,374,135 (USD 89,569). A cost-effective home treatment program in a resource-limited country can be successfully implemented by using the hospital pharmacy as the central point for the preparation and distribution of medications and specialty nursing services.
Dixon, Sherry L.; Fowler, Cecile; Harris, Judy; Moffat, Sally; Martinez, Yolanda; Walton, Heather; Ruiz, Bernice; Jacobs, David E.
We evaluated whether combining asthma trigger reduction with housing structural repairs, device disbursement and education in low-income households with children would improve self-reported respiratory health and reduce housing-related respiratory health and injury hazards (convenience sample of n=67 homes with 63 asthmatic and 121 non-asthmatic children). At baseline, a visual assessment of the home environment and a structured occupant interview were used to examine 29 potential injury hazards and 7 potential respiratory health hazards. A home-specific intervention was designed to provide the children's parents or caretakers with the knowledge, skills, motivation, supplies, equipment, and minimum housing conditions necessary for a healthy and safe home. The enrolled households were primarily Hispanic and owned their homes. On average, 8 injury hazards were observed in the homes at baseline. Four months following intervention, the average declined to 2.2 hazards per home (p<0.001), with 97% of the parents reporting that their homes were safer following the interventions. An average of 3.3 respiratory health hazards were observed in the homes at baseline. Four months following intervention, the average declined to 0.9 hazards per home (p<0.001), with 96% of parents reporting that the respiratory health of their asthmatic children improved. A tailored healthy homes improvement package significantly improves self-reported respiratory health and safety, reduces respiratory health and injury hazards, and can be implemented in concert with a mobile clinical setting
In Part II of a three-part series, the financial, technological and legislative issues of a hospital-based home health-agency are discussed. Beginning a home healthcare service requires intensive research to answer key environmental and operational questions--need, competition, financial projections, initial start-up costs and the impact of delayed depreciation. Assessments involving technology, staffing, legislative and regulatory issues can help project service volume, productivity and cost-control.
Craft, R.L.; Warren, S.
This editorial paper presents a vision for intelligent health care in the home of the future, focusing on technologies with the highest potential payoff given targeted government funding over the next ten years. A secure, plug-and-play information framework provides the starting point for identifying technologies that must be developed before home-based devices can know their context and assimilate information to support care decisions.
Goodridge, Donna; Hawranik, Pamela; Duncan, Vicky; Turner, Hollie
Home health care services are expanding at a rapid pace in order to meet the needs of the growing population of older adults and those with chronic illnesses. Because of current restrictions on home health care as an insured service in some countries, individuals may be required to pay for some or all of their home care services out of pocket. These payments may potentially limit access to needed home care services for persons in the lowest socioeconomic strata. Previous research demonstrates a clear socioeconomic gradient in access to acute and primary care services, where those most in need of services are the most disadvantaged and under-serviced. There has been little attention paid thus far, however, to the way in which socioeconomic status may affect the receipt of home health care services. To determine what is known from existing literature about socioeconomic disparities in home health care access and utilization. A scoping review was used to map the extent and nature of the literature in this area. A search of the databases CINAHL, Medline, SocIndex and Sociological Abstracts as well as Dissertations International. A total of 206 potentially relevant articles were published between 2000 and April 2011. Two reviewers independently reviewed the articles, leaving 15 research articles to be included in the scoping review. The majority of articles reported secondary analyses of administrative datasets related to utilization of home health care. Several studies examined access and utilization using qualitative approaches. The distinction between professional and supportive home care services was not always clear in the articles. Individual and composite measures of socioeconomic status were reported, with the most frequently used indicator being income. Several studies used more complex composite ecological indicators of socieconomic status. There was general agreement that utilization of home health services favored persons with greater economic disadvantage
Fukuyama, Hajime; Ishida, Tadashi; Tachibana, Hiromasa; Iga, Chiya; Nakagawa, Hiroaki; Ito, Akihiro; Ubukata, Satoshi; Yoshioka, Hiroshige; Arita, Machiko; Hashimoto, Toru
Pneumonia which develops in patients while living in their own home is categorized as community-acquired pneumonia (CAP), even if these patients are bedridden and receiving home health care. However, because of the differences in patient backgrounds, we speculated that the clinical outcomes and pathogens of bedridden patients with pneumonia who are receiving home health care would be different from those of CAP. We conducted a prospective study of patients with CAP who were hospitalized at our hospital from April 2007 through September 2009. We compared home health care bedridden pneumonia (performance status 4, PS4-CAP) with non-PS4-CAP in a total of 505 enrolled patients in this study. Among these, 66 had PS4-CAP, mostly associated with aspiration. Severity scores, mortality rate, recurrence rate and length of hospital stay of those with PS4-CAP were significantly higher than those with non-PS4-CAP. Drug resistant pathogens were more frequently isolated from patients with PS4-CAP than from those of non-PS4-CAP. The results of patients with PS4-CAP were in agreement with those of previous health care-associated pneumonia (HCAP) reports. The present study suggested home health care bedridden pneumonia should be categorized as HCAP, not CAP.
Shahsavari, Hooman; Nasrabadi, Alireza Nikbakht; Almasian, Mohammad; Heydari, Heshmatolah; Hazini, Abdolrahim
Because of the variety of services and resources offered in the delivery of home health care, its management is a challenging and difficult task. The purpose of this study was to explore the administrative aspects of the delivery of home health care services. This qualitative study was conducted based on the traditional content analysis approach in 2015 in Iran. The participants were selected using the purposeful sampling method and data were collected through in-depth semi-structured personal interviews and from discussions in a focus group. The collected data were analyzed using the Lundman and Graneheim method. 23 individuals participated in individual interviews, and the collected data were categorized into the two main themes of policymaking and infrastructures, each of which consisted of some subcategories. Health policymakers could utilize the results of this study as baseline information in making decisions about the delivery of home health care services, taking into account the contextual dimensions of home care services, leading to improvements in home health care services.
Conrey, Elizabeth J; Seidu, Dazar; Ryan, Norma J; Chapman, Dj Sam
Medical homes deliver primary care that is accessible, continuous, comprehensive, family centered, coordinated, compassionate and culturally effective. Children with special health care needs (CSHCN) require a wide range of support to maintain health, making medical home access particularly important. We sought to understand independent risk factors for lacking access. We analyzed Ohio, USA data from the National Survey of Children with Special Health Care Needs (2005-2006). Among CSHCN, 55.6% had medical home access. The proportion achieving each medical home component was highest for having a personal doctor/nurse and lowest for receiving coordinated care, family-centered care and referrals. Specific subsets of CSHCN were significantly and independently more likely to lack medical home access: Hispanic (AOR=3.08), moderate/high severity of difficulty (AOR=2.84), and any public insurance (AOR=1.60). Efforts to advance medical home access must give special attention to these CSHCN populations and improvements must be made to referral access, family-centered care, and care coordination.
Moen, Phyllis; Fan, Wen; Kelly, Erin L
Drawing on two waves of survey data conducted six months apart in 2006, this study examined the impacts of a team-level flexibility initiative (ROWE--results only work environment) on changes in the work-home spillover and health behavior of employees at the Midwest headquarters of a large U.S. corporation. Using cluster analysis, we identified three distinct baseline spillover constellations: employees with high negative spillover, high positive spillover, and low overall spillover. Within-team spillover measures were highly intercorrelated, suggesting that work teams as well as individuals have identifiable patterns of spillover. Multilevel analyses showed ROWE reduced individual- and team-level negative work-home spillover but not positive work-home spillover or spillover from home-to-work. ROWE also promoted employees' health behaviors: increasing the odds of quitting smoking, decreasing smoking frequency, and promoting perceptions of adequate time for healthy meals. Trends suggest that ROWE also decreased the odds of excessive drinking and improved sleep adequacy and exercise frequency. Some health behavior effects were mediated via reduced individual-level negative work-home spillover (exercise frequency, adequate time for sleep) and reduced team-level negative work-home spillover (smoking frequency, exercise frequency, and adequate time for sleep). While we found no moderating effects of gender, ROWE especially improved the exercise frequency of singles and reduced the smoking frequency of employees with low overall spillover at baseline. Copyright © 2013. Published by Elsevier Ltd.
Moen, Phyllis; Fan, Wen; Kelly, Erin L.
Drawing on two waves of survey data conducted six months apart in 2006, this study examined the impacts of a team-level flexibility initiative (ROWE – Results Only Work Environment) on changes in the work-home spillover and health behavior of employees at the Midwest headquarters of a large US corporation. Using cluster analysis, we identified three distinct baseline spillover constellations: employees with high negative spillover, high positive spillover, and low overall spillover. Within-team spillover measures were highly intercorrelated, suggesting that work teams as well as individuals have identifiable patterns of spillover. Multilevel analyses showed ROWE reduced individual- and team-level negative work-home spillover but not positive work-home spillover or spillover from home-to-work. ROWE also promoted employees’ health behaviors: increasing the odds of quitting smoking, decreasing smoking frequency, and promoting perceptions of adequate time for healthy meals. Trends suggest that ROWE also decreased the odds of excessive drinking and improved sleep adequacy and exercise frequency. Some health behavior effects were mediated via reduced individual-level negative work-home spillover (exercise frequency, adequate time for sleep) and reduced team-level negative work-home spillover (smoking frequency, exercise frequency, and adequate time for sleep). While we found no moderating effects of gender, ROWE especially improved the exercise frequency of singles and reduced the smoking frequency of employees with low overall spillover at baseline. PMID:23517706
Michaels, D B
A rapidly growing caseload led this home healthcare agency in New England to develop and implement a new management structure built around the belief that 1) Professionals can manage their own practice and function as part of a self-directed work team; 2) Management's role is to foster an organizational culture which facilitates this; and 3) Total quality management is based on people-oriented service. A "flex-time" system, competitive compensation and empowerment stemming from responsible autonomy have begun to reduce turnover and enhance "word of mouth" advertising.
Stebbings, Juliette; Taylor, Ian M; Spray, Christopher M; Ntoumanis, Nikos
Embedded in the self-determination theory (Deci & Ryan, 2000) framework, we obtained self-report data from 418 paid and voluntary coaches from a variety of sports and competitive levels with the aim of exploring potential antecedents of coaches' perceived autonomy supportive and controlling behaviors. Controlling for socially desirable responses, structural equation modeling revealed that greater job security and opportunities for professional development, and lower work-life conflict were associated with psychological need satisfaction, which, in turn, was related to an adaptive process of psychological well-being and perceived autonomy support toward athletes. In contrast, higher work-life conflict and fewer opportunities for development were associated with a distinct maladaptive process of thwarted psychological needs, psychological ill-being, and perceived controlling interpersonal behavior. The results highlight how the coaching context may impact upon coaches' psychological health and their interpersonal behavior toward athletes. Moreover, evidence is provided for the independence of adaptive and maladaptive processes within the self-determination theory paradigm.
Mroz, Tracy M; Meadow, Ann; Colantuoni, Elizabeth; Leff, Bruce; Wolff, Jennifer L
To examine associations between organizational characteristics of home health agencies (eg, profit status, rehabilitation therapy staffing model, size, and rurality) and quality outcomes in Medicare beneficiaries with rehabilitation-sensitive conditions, conditions for which occupational, physical, and/or speech therapy have the potential to improve functioning, prevent or slow substantial decline in functioning, or increase ability to remain at home safely. Retrospective analysis. Home health agencies. Fee-for-service beneficiaries (N=1,006,562) admitted to 9250 Medicare-certified home health agencies in 2009. Not applicable. Institutional admission during home health care, community discharge, and institutional admission within 30 days of discharge. Nonprofit (vs for-profit) home health agencies were more likely to discharge beneficiaries to the community (odds ratio [OR], 1.23; 95% confidence interval [CI], 1.13-1.33) and less likely to have beneficiaries incur institutional admissions within 30 days of discharge (OR, .93; 95% CI, .88-.97). Agencies in rural (vs urban) counties were less likely to discharge patients to the community (OR, .83; 95% CI, .77-.90) and more likely to have beneficiaries incur institutional admissions during home health (OR, 1.24; 95% CI, 1.18-1.30) and within 30 days of discharge (OR, 1.15; 95% CI, 1.10-1.22). Agencies with contract (vs in-house) therapy staff were less likely to discharge beneficiaries to the community (OR, .79, 95% CI, .70-.91) and more likely to have beneficiaries incur institutional admissions during home health (OR, 1.09; 95% CI, 1.03-1.15) and within 30 days of discharge (OR, 1.17; 95% CI, 1.07-1.28). As payers continue to test and implement reimbursement mechanisms that seek to reward value over volume of services, greater attention should be paid to organizational factors that facilitate better coordinated, higher quality home health care for beneficiaries who may benefit from rehabilitation. Copyright © 2017
Heineke, Sally F.
Although coaching is used in many schools to facilitate teachers' professional learning, few studies look closely at coaching discourse. Exploring how coaching facilitates teachers' professional development, this study used tape-recorded coaching sessions and individual post-interviews to examine the one-on-one coaching interactions of 4…
The article is the introduce to coaching empirical research. There will be shown the coaching definition, perfect coaching process, all procedures and ways to deal coaching conversation. Moreover the paper will present the skills of asking questions in coaching. Joanna Żukowska
Bercovitz, Anita; Moss, Abigail J; Sengupta, Manisha; Harris-Kojetin, Lauren D; Squillace, Marie R; Emily, Rosenoff; Branden, Laura
This report provides an overview of the National Home Health Aide Survey (NHHAS), the first national probability survey of home health aides. NHHAS was designed to provide national estimates of home health aides who provided assistance in activities of daily living (ADLs) and were directly employed by agencies that provide home health and/or hospice care. This report discusses the need for and objectives of the survey, the design process, the survey methods, and data availability. METHODS NHHAS, a multistage probability sample survey, was conducted as a supplement to the 2007 National Home and Hospice Care Survey (NHHCS). Agencies providing home health and/or hospice care were sampled, and then aides employed by these agencies were sampled and interviewed by telephone. Survey topics included recruitment, training, job history, family life, client relations, work-related injuries, and demographics. NHHAS was virtually identical to the 2004 National Nursing Assistant Survey of certified nursing assistants employed in sampled nursing homes with minor changes to account for differences in workplace environment and responsibilities. RESULTS From September 2007 to April 2008, interviews were completed with 3,416 aides. A public-use data file that contains the interview responses, sampling weights, and design variables is available. The NHHAS overall response rate weighted by the inverse of the probability of selection was 41 percent. This rate is the product of the weighted first-stage agency response rate of 57 percent (i.e., weighted response rate of 59 percent for agency participation in NHHCS times the weighted response rate of 97 percent for agencies participating in NHHCS that also participated in NHHAS) and the weighted second-stage aide response rate of 72 percent to NHHAS.
Full Text Available Athletes obtain nutritional information from their coaches, yet their competency in this area is lacking. Currently, no research exists in the UK which has a different coach education system to many other countries. Therefore, the aim of this study was to evaluate the sports nutrition knowledge of UK coaching certificate (UKCC level 2 and 3, hockey and netball qualified coaches. All coaches (n = 163 completed a sports nutrition questionnaire to identify: (a if they provided nutritional advice; (b their level of sport nutrition knowledge; and (c factors that may have contributed to their level of knowledge. Over half the coaches provided advice to their athletes (n = 93, 57.1%, even though they were not competent to do so. Coaches responded correctly to 60.3 ± 10.5% of all knowledge questions with no differences between those providing advice and those who did not (p > 0.05. Those coaches who had undertaken formal nutrition training achieved higher scores than those who had not (p < 0.05. In conclusion, UK sports coaches would benefit from continued professional development in sports nutrition to enhance their coaching practice.
Cockburn, Emma; Fortune, Alistair; Briggs, Marc; Rumbold, Penny
Athletes obtain nutritional information from their coaches, yet their competency in this area is lacking. Currently, no research exists in the UK which has a different coach education system to many other countries. Therefore, the aim of this study was to evaluate the sports nutrition knowledge of UK coaching certificate (UKCC) level 2 and 3, hockey and netball qualified coaches. All coaches (n = 163) completed a sports nutrition questionnaire to identify: (a) if they provided nutritional advice; (b) their level of sport nutrition knowledge; and (c) factors that may have contributed to their level of knowledge. Over half the coaches provided advice to their athletes (n = 93, 57.1%), even though they were not competent to do so. Coaches responded correctly to 60.3 ± 10.5% of all knowledge questions with no differences between those providing advice and those who did not (p > 0.05). Those coaches who had undertaken formal nutrition training achieved higher scores than those who had not (p sports coaches would benefit from continued professional development in sports nutrition to enhance their coaching practice.
Neily, Julia; Mills, Peter D; Lee, Pamela; Carney, Brian; West, Priscilla; Percarpio, Katherine; Mazzia, Lisa; Paull, Douglas E; Bagian, James P
Communication is problematic in healthcare. The Veterans Health Administration is implementing Medical Team Training. The authors describe results of the first 32 of 130 sites to undergo the programme. This report is unique; it provides aggregate results of a crew resource-management programme for numerous facilities. Facilities were taught medical team training and implemented briefings, debriefings and other projects. The authors coached teams through consultative phone interviews over a year. Implementation teams self-reported implementation and rated programme impact: 1='no impact' and 5='significant impact.' We used logistic regression to examine implementation of briefing/debriefing. Ninety-seven per cent of facilities implemented briefings and debriefings, and all implemented an additional project. As of the final interview, 73% of OR and 67% of ICU implementation teams self-reported and rated staff impact 4-5. Eighty-six per cent of OR and 82% of ICU implementation teams self-reported and rated patient impact 4-5. Improved teamwork was reported by 84% of OR and 75% of ICU implementation teams. Efficiency improvements were reported by 94% of OR implementation teams. Almost all facilities (97%) reported a success story or avoiding an undesirable event. Sites with lower volume were more likely to conduct briefings/debriefings in all cases for all surgical services (p=0.03). Sites are implementing the programme with a positive impact on patients and staff, and improving teamwork, efficiency and safety. A unique feature of the programme is that implementation was facilitated through follow-up support. This may have contributed to the early success of the programme.
Boudjema, Sophia; Tarantini, Clément; Peretti-Watel, Patrick; Brouqui, Philippe
We used videorecordings of routine care to analyze health care providers' deviance from protocols and organized follow-up interviews that were conducted by an anthropologist and a nurse. After consent, health care workers were recorded during routine care by an automatic video remote control. Each participant was invited to watch her or his recorded behaviors on 2 different videos showing routine practices and her or his deviance from protocols, and to comment on them. After this step an in-depth interview based on preestablished guidelines was organized and explanations regarding the observed deviance was discussed. This design was intended to reveal the HCWs' subjectivity; that is, how they perceive hand hygiene issues in their daily routine, what concrete difficulties they face, and how they try to resolve them. We selected 43 of 250 videorecordings created during the study, which allowed us to study 15 out of 20 health care professionals. Twenty out of 43 videos showed 1 or more breaches in the hand hygiene protocol. The breaches were frequently linked to glove abuse. Deviance from protocols was explained by the health care workers as the result of an adaptive behavior; that is, facing work constraints that were disconnected from infection control protocols. Professional practices and protocols should be revisited to create simple messages that are adapted to the mandatory needs in a real life clinic environment. Copyright © 2017 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.
Rojanasarot, Sirikan; Carlson, Angeline M
The objective was to investigate the association between receiving care under the medical home model and parental assessment of the severity of asthma symptoms. It was hypothesized that parents of children who received care under the medical home model reported less severe asthma symptoms compared with their counterparts, whose care did not meet the medical home criteria. Secondary analyses were conducted using cross-sectional data from the 2011-2012 National Survey of Children's Health. Children with asthma aged 0-17 years were included and classified as receiving care from the medical home if their care contained 5 components: a personal doctor, a usual source of sick care, family-centered care, no problems getting referrals, and effective care coordination. Ordinal logistic regression was used to examine the relationship between parent-rated severity of asthma symptoms (mild, moderate, and severe symptoms) and the medical home. Approximately 52% of 8229 children who reported having asthma received care from the medical home. Only 30.8% of children with severe asthma symptoms received care that met the medical home criteria, compared to 55.7% of children with mild symptoms. After accounting for confounding factors, obtaining care under the medical home model decreased the odds of parent-reported severe asthma symptoms by 31% (adjusted odds ratio 0.69; 95% CI, 0.56-0.85). Study results suggest that the medical home model can reduce parent-rated severity of asthma symptoms. The findings highlight the importance of providing medical home care to children with asthma to improve the outcomes that matter most to children and their families.
Walter P. Wodchis
Full Text Available Health and social care systems across western developed nations are being challenged to meet the needs of an increasing number of people aging with multiple complex health and social needs. Community based primary health care (CBPHC has been associated with more equitable access to services, better population level outcomes and lower system level costs. Itmay be well suited to the increasingly complex needs of populations; however the implementation of CBPHC models of care faces many challenges. This paper describes a program of research by an international, multi-university, multidisciplinary research team who are seeking to understand how to scale up and spread models of Integrated CBPHC (ICBPHC. The key question being addressed is “What are the steps to implementing innovative integrated community-based primary health care models that address the health and social needs of older adults with complex care needs?” and will be answered in three phases. In the first phase we identify and describe exemplar models of ICBPHC and their context in relation to relevant policies and performance across the three jurisdictions (New Zealand, Ontario and Québec, Canada. The second phase involves a series of theory-informed, mixed methods case studies from which we shall develop a conceptual framework that captures not only the attributes of successful innovative ICBPHC models, but also how these models are being implemented. In the third phase, we aim to translate our research into practice by identifying emerging models of ICBPHC in advance, and working alongside policymakers to inform the development and implementation of these models in each jurisdiction. The final output of the program will be a comprehensive guide to the design, implementation and scaling-up of innovative models of ICBPHC.
Phillips, Charles D.
Case-mix classification and payment systems help assure that persons with similar needs receive similar amounts of care resources, which is a major equity concern for consumers, providers, and programs. Although health service programs for adults regularly use case-mix payment systems, programs providing health services to children and youth rarely use such models. This research utilized Medicaid home care expenditures and assessment data on 2,578 children receiving home care in one large sta...
... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services 42 CFR Parts 431 [CMS-1450-CN] RIN 0938-AR52 Medicare and Medicaid Programs; Home Health Prospective Payment System Rate... period titled ``Medicare and Medicaid Programs; Home Health Prospective Payment System Rate Update for CY...
Ajlouni, Musa T.; Dawani, Hania; Diab, Salah M.
Home care aims at supporting people with various degrees of dependency to remain at home rather than use residential, long-term, or institutional-based nursing care. Demographic, epidemiological, social, and cultural trends in Jordan as in other countries are changing the traditional patterns of care with growing emphasis on home care. The purpose of this study is to highlight the most common challenges related to home health care (HHC) services in Jordan as perceived by the managers of HHC agencies. Methods: a descriptive qualitative design that depends on focus group discussions has been used to collect data from a sample of 18 managers who met the selection criteria and who are willing to participate, the study found that, the main challenges of HHC services as perceived by managers were: shortage of female staff, lack of governance and regulation, poor management, unethical practices, lack of referral systems, and low accessibility of the poor and less privileged as HHC services are not included in health insurance schemes, it concludes also that the home health care industry in Jordan is facing many challenges and problems that may have negative effects on the effectiveness, efficiency, equity and quality of services and should be addressed by health policy makers. PMID:25946949
Huckfeldt, Peter J; Sood, Neeraj; Escarce, José J; Grabowski, David C; Newhouse, Joseph P
Medicare continues to implement payment reforms that shift reimbursement from fee-for-service toward episode-based payment, affecting average and marginal payment. We contrast the effects of two reforms for home health agencies. The home health interim payment system in 1997 lowered both types of payment; our conceptual model predicts a decline in the likelihood of use and costs, both of which we find. The home health prospective payment system in 2000 raised average but lowered marginal payment with theoretically ambiguous effects; we find a modest increase in use and costs. We find little substantive effect of either policy on readmissions or mortality. Copyright © 2014 Elsevier B.V. All rights reserved.
Kronborg, Hanne; Væth, Michael; Kristensen, Ingeborg
Objective: To assess if the absence of early home visits influenced the mothers’ breastfeeding duration and use of medical services. Design: Data from mothers who had given birth during a strike period were compared to data from a reference period with usual work practice. Sample: The study...... included 3834 newborn and 375 health visitors, 75 of whom worked during the strike period. Intervention: All families were offered non- standardized home visits after discharge in the reference period. During the strike, the service was based on individual risk assessment. Results: Overall, no difference....... The mothers’ needs for postnatal visits differed depending on parity: primiparae underlined uncertainty, multiparae underlined previous breastfeeding experience. Mothers had missed out on guidance on all areas of the health visitors’ service. Conclusion: Non-standardized home visits by health visitors were...
Chen, Ming-Chun; Kao, Chi-Wen; Chiu, Yu-Lung; Lin, Tzu-Ying; Tsai, Yu-Ting; Jian, Yi-Ting Zhang; Tzeng, Ya-Mei; Lin, Fu-Gong; Hwang, Shu-Ling; Li, Shan-Ru; Kao, Senyeong
Caregiver health is a crucial public health concern due to the increasing number of elderly people with disabilities. Elderly caregivers are more likely to have poorer health and be a care recipient than younger caregivers. The Taiwan government offers home-based long-term care (LTC) services to provide formal care and decrease the burden of caregivers. This study examined the effects of home-based LTC services on caregiver health according to caregiver age. This cross-sectional study included a simple random sample of care recipients and their caregivers. The care recipients had used LTC services under the Ten-Year Long-Term Care Project (TLTCP) in Taiwan. Data were collected through self-administered questionnaires from September 2012 to January 2013. The following variables were assessed for caregivers: health, sex, marital status, education level, relationship with care recipient, quality of relationship with care recipient, job, household monthly income, family income spent on caring for the care recipient (%) and caregiving period. Furthermore, the following factors were assessed for care recipients: age, sex, marital status, education level, living alone, number of family members living with the care recipient, quality of relationship with family and dependency level. The health of the caregivers and care recipients was measured using a self-rated question (self-rated health [SRH] was rated as very poor, poor, fair, good and very good). The study revealed that home nursing care was significantly associated with the health of caregivers aged 65 years or older; however, caregivers aged less than 65 who had used home nursing care, rehabilitation or respite care had poorer health than those who had not used these services. In addition, the following variables significantly improved the health of caregivers aged 65 years or older: caregiver employment, 20% or less of family income spent on caregiving than 81%-100% and higher care recipient health. The
Shah, P M; Shah, K P; Belsey, M A
The home-based maternal record offers an opportunity for family involvement in health care. Home-based records of maternal health have been used in several developing countries, and have led to increased detection and monitoring of women at high risk for complications during pregnancy. Home-based cards that include menstrual information remind health workers to educate and motivate women for family planning, and serve as a source of health statistics. Records that use pictures and symbols have been used by illiterate traditional birth attendants, and had an accurate completion rate of over 90%. The WHO has prepared a prototype record and guidelines for local adaptation. The objectives were to provide continuity of care throughout pregnancy, ensure recognition of at-risk women, encourage family participation in health care, an provide data on maternal health, breastfeeding, and family planning. The guidelines have been evaluated and results show that the records have improved the coverage, acceptability, and quality of MCH/FP care. The records have also led to an increase in diagnosis and referral of at-risk women and newborns, and the use of family planning and tetanus toxoid immunization has increased in the 13 centers where the reports are being used. Focus group discussions have shown that mothers, community members, primary health workers, and doctors and nurses liked the records. It is important to adapt criteria for high-risk conditions to the local areas where the records will be used to ensure the relevance of risk diagnosis. The evidence shows that home-based maternal and child records can be an important tool in the promotion of self-reliance and family participation in health care. In addition, home-based records can be used for the implementation of primary health care at the local level, and serve as a resource for data collection.
Janssens, B; Vanobbergen, J; Petrovic, M; Jacquet, W; Schols, J M G A; De Visschere, L
A study was conducted of nursing home residents with limited access to regular oral health care services to evaluate their oral health status, to perform an assessment of the need for oral treatment and to determine the possible predicting value of age, gender, care dependency and income level on their oral health status and treatment needs. Three experienced dentists collected clinical oral health data with a mobile dental unit in 23 nursing homes. Socio-demographic data were extracted from the residents' records in the nursing home. Besides the descriptive and bivariate analysis, a general linear mixed model analysis was also performed with the nursing home as random effect. The study sample consisted of 1,226 residents with a mean age of 83.9 years, of which 41.9% were edentulous. The mean D₃MFt in the dentate group was 24.5 and 77% needed extractions or fillings. In the group of residents wearing removable dentures, 36.9% needed repair, rebasing or renewal of the denture. The mixed model analysis demonstrated that with each year a resident gets older, the oral health outcomes get worse and that men have worse oral health and higher treatment needs than women. However, the level of income and care dependency had a less extensive role in predicting the oral health outcomes. The nursing home residents presented a poor overall oral health status and high dental and prosthetic treatment needs. Gender and age were important predicting variables for the oral health outcomes. Copyright© 2017 Dennis Barber Ltd.
Hooper, J I
The winds of change in health care make assessment of the family more important than ever as a tool for health care providers seeking to assist the family move themselves toward high-level wellness. Limited medical care and imposed self-responsibility for health promotion and illness prevention, which are natural consequences of these changes, move the locus of control for health management back to the family. The family's teachings, modeling, and interactions are greater influences than ever on the health of the patient. Gordon's functional health patterns provide a holistic model for assessment of the family because assessment data are classified under 11 headings: health perception and health management, nutritional-metabolic, elimination, activity and exercise, sleep and rest, cognition and perception, self-perception and self-concept, roles and relationships, sexuality and reproduction, coping and stress tolerance, and values and beliefs. Questions posed under each of the health patterns can be varied to reflect the uniqueness of the individual family as well as to inquire about family strengths and weaknesses in all patterns. Data using this model provide a comprehensive base for including the family in designing a plan of care.
Peters, Velibor P J M; de Rijk, Angelique E; Boumans, Nicolle P G
This paper is a report of a study conducted to determine if satisfaction with irregular working hours that are a form of shiftwork operates as a mediator between work and home characteristics and health problems. Shiftwork contributes to health problems, decreased well-being and poorer health habits. It also affects employees' decisions to leave the healthcare sector. Although many nurses voluntarily work shifts, there have been few studies of their satisfaction with irregular working hours when these are a form of shiftwork. A survey was carried out with 144 nurses working in three nursing homes and one care home in the Netherlands. Questionnaires were distributed in 2003 to 233 nurses who worked shifts (response rate 60%). The questionnaire contained items on work and home characteristics, satisfaction with irregular working hours that are a form of shiftwork and health. A new scale to measure satisfaction with irregular working hours was constructed. All work characteristics, but no home characteristics, were associated with satisfaction with irregular working hours. The work characteristics 'job demands' and the home characteristics 'autonomy at home' and 'home demands' were associated with health. Satisfaction with irregular working hours did not mediate between work/home characteristics and health. Those reporting more social support, lower job demands and more job autonomy were more satisfied with their irregular working times that were a form of shiftwork. Satisfaction with irregular working hours is a useful construct that requires further longitudinal study. The results also underline the importance of considering home characteristics when predicting health outcomes.
Dawadi, Prafulla Nath; Cook, Diane Joyce; Schmitter-Edgecombe, Maureen
Smart home technologies offer potential benefits for assisting clinicians by automating health monitoring and well-being assessment. In this paper, we examine the actual benefits of smart home-based analysis by monitoring daily behavior in the home and predicting clinical scores of the residents. To accomplish this goal, we propose a clinical assessment using activity behavior (CAAB) approach to model a smart home resident's daily behavior and predict the corresponding clinical scores. CAAB uses statistical features that describe characteristics of a resident's daily activity performance to train machine learning algorithms that predict the clinical scores. We evaluate the performance of CAAB utilizing smart home sensor data collected from 18 smart homes over two years. We obtain a statistically significant correlation ( r=0.72) between CAAB-predicted and clinician-provided cognitive scores and a statistically significant correlation ( r=0.45) between CAAB-predicted and clinician-provided mobility scores. These prediction results suggest that it is feasible to predict clinical scores using smart home sensor data and learning-based data analysis.
Clark, Matthew M; Bradley, Karleah L; Jenkins, Sarah M; Mettler, Emily A; Larson, Brent G; Preston, Heather R; Liesinger, Juliette T; Werneburg, Brooke L; Hagen, Philip T; Harris, Ann M; Riley, Beth A; Olsen, Kerry D; Vickers Douglas, Kristin S
To learn more about the potential psychosocial benefits of wellness coaching. Although wellness coaching is increasing in popularity, there are few published outcome studies. In a single-cohort study design, 100 employees who completed the 12-week wellness coaching program were of a mean age of 42 years, 90% were women, and most were overweight or obese. Three areas of psychosocial functioning were assessed: quality of life (QOL; 5 domains and overall), depressive symptoms (Patient Health Questionnaire-9), and perceived stress level (Perceived Stress Scale-10). Participants were recruited from January 1, 2011, through December 31, 2011; data were collected up to July 31, 2012, and were analyzed from August 1, 2012, through October 31, 2013. These 100 wellness coaching completers exhibited significant improvements in all 5 domains of QOL and overall QOL (Pcoaching, and they maintained these improvements at the 24-week follow-up. In this single-arm cohort study (level 2b evidence), participating in wellness coaching was associated with improvement in 3 key areas of psychosocial functioning: QOL, mood, and perceived stress level. The results from this single prospective cohort study suggest that these areas of functioning improve after participating in wellness coaching; however, randomized clinical trials involving large samples of diverse individuals are needed to establish level 1 evidence for wellness coaching. Copyright © 2014 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.
Polivka, Barbara J; Wills, Celia E; Darragh, Amy; Lavender, Steven; Sommerich, Carolyn; Stredney, Donald
The number of personnel providing in-home health care services is increasing substantially. The unique configuration of environmental hazards in individual client homes has a significant impact on the safety and health of home health care providers (HHPs). This mixed-methods study used data from a standardized questionnaire, focus groups, and individual interviews to explore environmental health and safety hazards encountered by HHPs in client homes. The participant sample (N = 68) included nurses, aides, therapists, and owners/managers from a variety of geographic locations. The most often-reported hazards were trip/slip/lift hazards, biohazards, and hazards from poor air quality, allergens, pests and rodents, and fire and burns. Frequency of identified key hazards varied by room, that is, kitchen (e.g., throw rugs, water on floor), bathroom (e.g., tight spaces for client handling), bedroom (e.g., bed too low), living room (e.g., animal waste), and hallway (e.g., clutter). Findings indicate the need for broader training to enable HHPs to identify and address hazards they encounter in client homes. © 2015 The Author(s).
Wang, Yun; Spatz, Erica S; Tariq, Maliha; Angraal, Suveen; Krumholz, Harlan M
To evaluate home health agency quality performance. Observational study. Home health agencies. All Medicare-certified agencies with at least 6 months of data from 2011 to 2015. Twenty-two quality indicators, five patient survey indicators, and their composite scores. The study included 11,462 Medicare-certified home health agencies that served 92.4% of all ZIP codes nationwide, accounting for 315.2 million people. The mean composite scores were 409.1 ± 22.7 out of 500 with the patient survey indicators and 492.3 ± 21.7 out of 600 without the patient survey indicators. Home health agency performance on 27 quality indicators varied, with the coefficients of dispersion ranging from 4.9 to 62.8. Categorization of agencies into performance quartiles revealed that 3,179 (27.7%) were in the low-performing group (below 25th percentile) at least one time during the period from 2011-12 to 2014-15 and that 493 were in the low-performing group throughout the study period. Geographic variation in agency performance was observed. Agencies with longer Medicare-certified years were more likely to have high-performing scores; agencies providing partial services, with proprietary ownership, and those with long travel distances to reach patients had lower performance. Agencies serving low-income counties and counties with lower proportions of women and senior residences and greater proportions of Hispanic residents were more likely to attain lower performance scores. Home health agency performance on several quality indicators varied, and many agencies were persistently in the lowest quartile of performance. Still, there is a need to improve the quality of care of all agencies. Many parts of the United States, particularly lower-income areas and areas with more Hispanic residents, are more likely to receive lower quality home health care. © 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics Society.
Warren, S.; Craft, R.L.; Bosma, J.T.
The US health care industry is experiencing a substantial paradigm shift with regard to home care due to the convergence of several technology areas. Increasingly-capable telehealth systems and the internet are not only moving the point of care closer to the patient, but the patient can now assume a more active role in his or her own care. These technologies, coupled with (1) the migration of the health care industry to electronic patient records and (2) the emergence of a growing number of enabling health care technologies (e.g., novel biosensors, wearable devices, and intelligent software agents), demonstrate unprecedented potential for delivering highly automated, intelligent health care in the home. This editorial paper presents a vision for the implementation of intelligent health care technology in the home of the future, focusing on areas of research that have the highest potential payoff given targeted government funding over the next ten years. Here, intelligent health care technology means smart devices and systems that are aware of their context and can therefore assimilate information to support care decisions. A systems perspective is used to describe a framework under which devices can interact with one another in a plug-and-play manner. Within this infrastructure, traditionally passive sensors and devices will have read/write access to appropriate portions of an individual's electronic medical record. Through intelligent software agents, plug-and-play mechanisms, messaging standards, and user authentication tools, these smart home-based medical devices will be aware of their own capabilities, their relationship to the other devices in the home system, and the identity of the individual(s) from whom they acquire data. Information surety technology will be essential to maintain the confidentiality of patient-identifiable medical information and to protect the integrity of geographically dispersed electronic medical records with which each home
Harwood, Lori; Clark, Alexander M
Understanding health decisions using critical realism: home-dialysis decision-making during chronic kidney disease This paper examines home-dialysis decision making in people with Chronic Kidney Disease (CKD) from the perspective of critical realism. CKD programmes focus on patient education for self-management to delay the progression of kidney disease and the preparation and support for renal replacement therapy e.g.) dialysis and transplantation. Home-dialysis has clear health, societal and economic benefits yet service usage is low despite efforts to realign resources and educate individuals. Current research on the determinants of modality selection is superficial and insufficient to capture the complexities embedded in the process of dialysis modality selection. Predictors of home-dialysis selection and the effect of chronic kidney disease educational programmes provide a limited explanation of this experience. A re-conceptualization of the problem is required in order to fully understand this process. The epistemology and ontology of critical realism guides our knowledge and methodology particularly suited for examination of these complexities. This approach examines the deeper mechanisms and wider determinants associated with modality decision making, specifically who chooses home dialysis and under what circumstances. Until more is known regarding dialysis modality decision making service usage of home dialysis will remain low as interventions will be based on inadequate epistemology. © 2011 Blackwell Publishing Ltd.
Full Text Available Karin Bæk Knudsen,1 Tacjana Pressler,2 Laust Hvas Mortensen,3 Mary Jarden,3,4 Kirsten Arntz Boisen,5 Marianne Skov,2 Alexandra L Quittner,6 Terese Lea Katzenstein1,7 1Department of Infectious Diseases, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark; 2Cystic Fibrosis Center Copenhagen, Department of Pediatric and Adolescent Medicine, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark; 3Department of Public Health, University of Copenhagen, Copenhagen, Denmark; 4University Hospital Center for Health Research (UCSF, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark; 5Center of Adolescent Medicine, Department of Pediatric and Adolescent Medicine, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark; 6Miami Children’s Research Institute, Miami, FL, USA; 7Department of Clinical Medicine, Faculty of Health and Social Sciences, University of Copenhagen, Copenhagen, Denmark Background: Over the last two decades, lifespan has increased significantly for people living with cystic fibrosis (CF. However, several studies have demonstrated that many young adults with CF report mental health problems and poor adherence to their prescribed treatments, challenging their long-term physical health. Treatment guidelines recommend interventions to improve adherence and self-management. The aim of this study was to test the feasibility of a life coaching intervention for young adults with CF. Methods: A randomized, controlled feasibility study was conducted at the CF Center at Copenhagen University Hospital, Rigshospitalet. Participants were young adults with CF, aged 18–30 years without severe intellectual impairments. Participants were randomized to either life coaching or standard care. The intervention consisted of up to 10 individual, face-to-face or telephone coaching sessions over a period of 1 year. Primary outcomes were recruitment success, acceptability, adherence to the
Choi, Sunha; Davitt, Joan K
The Balanced Budget Act of 1997 introduced 2 new reimbursement structures, the Interim Payment System (IPS, 1997-2000) and the Prospective Payment System (PPS, begun October 2000) for Medicare home health agencies (HHAs) under the fee-for-service program. This article describes and compares the impact of these changes on the Medicare home health market from a period before the BBA through the IPS and PPS in relation to agency characteristics. A secondary analysis of 1996, 1999, and 2002 Provider of Services data was conducted on all Medicare-certified HHAs. Frequencies and rates of change were calculated by agency characteristics to describe changes in the number of active agencies through those years. Logistic regression models were used to compare factors associated with market exits under different payment systems. The results indicate dramatic but disproportional changes in response to the IPS and the PPS among Medicare home health care agencies. Agency closures were greater and market entries fewer during the IPS, but more branch offices/subunits were closed during the PPS. Proprietary and freestanding agencies experienced greater volatility throughout, with the greatest number of closures seen in Region VI (Dallas). These results demonstrate the direct impact of policy changes on the home health care market and highlight the need to evaluate policy changes to understand both intended and unintended impacts on health markets. Future research should analyze the effect of these policy changes on other healthcare providers and systems and their impact on health outcomes for Medicare beneficiaries.
Woollard, R F
Seemingly intractable problems of overpopulation, ecologic degradation, diminishing resources and regional warfare are having a profound effect on global population health. Canadian physicians can assist in ameliorating these problems by helping to modify the overconsumption of natural resources at home and by participating in international health projects focused at the community level, where the health of individuals and that of their environment intersect. The author describes the work of ...
Petty, Gayle M; Lingham, Tony
The importance of health professionals working in teams was first acknowledged by the Institute of Medicine more than 15 years ago. Since then, teaching students to function in teams continues to present challenges in nursing education. This article presents an innovative process, using faculty as coaches in the classroom, to enhance student learning through experiential teamwork.
The overall aim of this thesis is to facilitate the development of evidence-based coaching through investigating a competency framework for Coaching Psychologists to enhance the coaching relationship towards a positive outcome. Coaching has been extensively applied to organisational and leadership development programmes in the past few decades. However, coaching is not an accredited profession because it is a cross-disciplinary methodology. There are still some gaps in the existing coaching r...
An important task of a manager is to motivate her subordinates. One way in which a manager can give incentives to junior employees is through the assignment of tasks. How a manager allocates tasks in an organization, provides information to the junior employees about his ability. Without coaching from a manager, the junior employee only has information about his past performance. Based on his past performance, a talented junior who has performed a difficult task sometimes decides to leave the...
Ludeman, Kate; Erlandson, Eddie
Highly intelligent, confident, and successful, alpha males represent about 70% of all senior executives. Natural leaders, they willingly take on levels of responsibility most rational people would find overwhelming. But many of their quintessential strengths can also make alphas difficult to work with. Their self-confidence can appear domineering. Their high expectations can make them excessively critical. Their unemotional style can keep them from inspiring their teams. That's why alphas need coaching to broaden their interpersonal tool kits while preserving their strengths. Drawing from their experience coaching more than 1,000 senior executives, the authors outline an approach tailored specifically for the alpha. Coaches get the alpha's attention by inundating him with data from 360-degree feedback presented in ways he will find compelling--both hard-boiled metrics and vivid verbatim comments from colleagues about his strengths and weaknesses. A 360-degree assessment is a wake-up call for most alphas, providing undeniable proof that their behavior doesn't work nearly as well as they think it does. That paves the way for a genuine commitment to change. In order to change, the alpha must venture into unfamiliar--and often uncomfortable--psychological territory. He must admit vulnerability, accept accountability not just for his own work for others', connect with his underlying emotions, learn to motivate through a balance of criticism and validation, and become aware of unproductive behavior patterns. The goal of executive coaching is not simply to treat the alpha as an individual problem but to improve the entire team dynamic. Initial success creates an incentive to persevere, and the virtuous cycle reverberates throughout the entire organization.
Full Text Available The growing population aging is a serious social problem in the world today. Accidental death at home is increasing because abnormal conditions can not be discovered in time, especially to the elderly who live alone. Besides, according to statistics, over 80 percent of the elderly need the service of home care in China. A health care information system for the elderly at home is developed to monitor the real–time state of the elderly remotely in this thesis. The system can show the current positions of the elderly in the house and judge whether they are in dangerous locations or have dangerous activities. In the case of emergency, the elderly can press the emergency button. The system also provides some help for the elderly’s daily life. The system offers the advantage for living at home more safely and more comfortably, and has better application prospect
Or, Calvin K.L.; Valdez, Rupa S.; Casper, Gail R.; Carayon, Pascale; Burke, Laura J.; Brennan, Patricia Flatley; Karsh, Ben-Tzion
Sicker patients with greater care needs are being discharged to their homes to assume responsibility for their own care with fewer nurses available to aid them. This situation brings with it a host of human factors and ergonomic (HFE) concerns, both for the home care nurse and the home dwelling patient, that can affect quality of care and patient safety. Many of these concerns are related to the critical home care tasks of information access, communication, and patient self-monitoring and self-management. Currently, a variety of health information technologies (HITs) are being promoted as possible solutions to those problems, but those same technologies bring with them a new set of HFE concerns. This paper reviews the HFE considerations for information access, communication, and patients self-monitoring and self-management, discusses how HIT can potentially mitigate current problems, and explains how the design and implementation of HIT itself requires careful HFE attention. PMID:19713630
Pillemer, Karl; Meador, Rhoda H; Teresi, Jeanne A; Chen, Emily K; Henderson, Charles R; Lachs, Mark S; Boratgis, Gabriel; Silver, Stephanie; Eimicke, Joseph P
To examine the effects of electronic health information technology (HIT) on nursing home residents. The study evaluated the impact of implementing a comprehensive HIT system on resident clinical, functional, and quality of care outcome indicators as well as measures of resident awareness of and satisfaction with the technology. The study used a prospective, quasi-experimental design, directly assessing 761 nursing home residents in 10 urban and suburban nursing homes in the greater New York City area. No statistically significant impact of the introduction of HIT on residents was found on any outcomes, with the exception of a significant negative effect on behavioral symptoms. Residents' subjective assessment of the HIT intervention were generally positive. The absence of effects on most indicators is encouraging for the future development of HIT in nursing homes. The single negative finding suggests that further investigation is needed on possible impact on resident behavior. © The Author(s) 2012
Bentayeb, Malek; Norback, Dan; Bednarek, Micha
cough. Elderly subjects aged ≥80 years were at higher risk. Pollutant effects were more pronounced in the case of poor ventilation. Even at low levels, indoor air quality affected respiratory health in elderly people permanently living in nursing homes, with frailty increasing with age. The effects were......Few data exist on respiratory effects of indoor air quality and comfort parameters in the elderly. In the context of the GERIE study, we investigated for the first time the relationships of these factors to respiratory morbidity among elderly people permanently living in nursing homes in seven...... European countries. 600 elderly people from 50 nursing homes underwent a medical examination and completed a standardised questionnaire. Air quality and comfort parameters were objectively assessed in situ in the nursing home. Mean concentrations of air pollutants did not exceed the existing standards...
Alhuwail, Dari; Koru, Güneş; Mills, Mary Etta
In the United States, home care clinicians often start the episode of care devoid of relevant fall-risk information. By collecting and analyzing qualitative data from 30 clinicians in one home health agency, this case study aimed to understand how the currently adopted information technology solutions supported the clinicians' fall-risk management (FRM) information domains, and explored opportunities to adopt other solutions to better support FRM. The currently adopted electronic health record system and fall-reporting application served only some information domains with a limited capacity. Substantial improvement in addressing the FRM information domains is possible by effectively modifying the existing solutions and purposefully adopting new solutions.
Lohman, Matthew C; Cotton, Brandi P; Zagaria, Alexandra B; Bao, Yuhua; Greenberg, Rebecca L; Fortuna, Karen L; Bruce, Martha L
Hospitalizations and potentially inappropriate medication (PIM) use are significant and costly issues among older home health patients, yet little is known about the prevalence of PIM use in home health or the relationship between PIM use and hospitalization risk in this population. To describe the prevalence of PIM use and association with hospitalization among Medicare home health patients. Cross-sectional analysis using data from 132 home health agencies in the US. Medicare beneficiaries starting home health nursing services between 2013 and 2014 (n = 87,780). Prevalence of individual and aggregate PIM use at start of care, measured using the 2012 Beers criteria. Relative risk (RR) of 30-day hospitalization or re-hospitalization associated with individual and aggregate PIM use, compared to no PIM use. In total, 30,168 (34.4%) patients were using at least one PIM, with 5969 (6.8%) taking at least two PIMs according to the Beers list. The most common types of PIMs were those affecting the brain or spinal cord, analgesics, and medications with anticholinergic properties. With the exception of nonsteroidal anti-inflammatory drugs (NSAIDs), PIM use across all classes was associated with elevated risk (10-33%) of hospitalization compared to non-use. Adjusting for demographic and clinical characteristics, patients using at least one PIM (excluding NSAIDs) had a 13% greater risk (RR = 1.13, 95% CI: 1.09, 1.17) of being hospitalized than patients using no PIMs, while patients using at least two PIMs had 21% greater risk (RR = 1.21, 95% CI: 1.12, 1.30). Similar associations were found between PIMs and re-hospitalization risk among patients referred to home health from a hospital. Given the high prevalence of PIM use and the association between PIMs and hospitalization risk, home health episodes represent opportunities to substantially reduce PIM use among older adults and prevent adverse outcomes. Efforts to address medication use during home health episodes
Nguyen, Ha Trong; Connelly, Luke Brian
We provide the first empirical evidence that better economic performances by immigrants' countries of origin, as measured by lower consumer price index (CPI) or higher gross domestic product, improve immigrants' mental health. We use an econometrically-robust approach that exploits exogenous changes in macroeconomic conditions across immigrants' home countries over time and controls for immigrants' observable and unobservable characteristics. The CPI effect is statistically significant and sizeable. Furthermore, the CPI effect diminishes as the time since emigrating increases. By contrast, home countries' unemployment rates and exchange rate fluctuations have no impact on immigrants' mental health. Copyright © 2017 John Wiley & Sons, Ltd.
Lines, Lisa M; Anderson, Wayne L; Blackmon, Brian D; Pronier, Cristalle R; Allen, Rachael W; Kenyon, Anne E
This study explored patient experiences in home health care through a literature review, focus groups, and interviews. Our goal was to develop a conceptual map of home health care patient experience domains. The conceptual map identifies technical and personal spheres of care, relating prior studies to new focus group and interview findings and identifying the most important domains of care. Study participants (n = 35) most frequently reported the most important domain as staff who are caring, supportive, patient, empathetic, respectful, and considerate (endorsed by 29% of participants). The conceptual map includes 114 discrete domains.
Theeboom, Tim; Van Vianen, Annelies E M; Beersma, Bianca
Economic pressures on companies, technological developments, and less stable career paths pose potential threats to the well-being of employees (e.g., stress, burn-out) and require constant adaptation. In the light of these challenges, it is not surprising that employees often seek the support of a coach. The role of a coach is to foster change by facilitating a coachees' movement through a self-regulatory cycle with the ultimate aim of stimulating sustained well-being and functioning. While meta-analytic research indicates that coaching interventions can be effectively applied to assist employees in dealing with change, the current literature on coaching lacks solid theoretical frameworks that are needed to build a cumulative knowledge-base and to inspire evidence-based practice. In this conceptual analysis, we examine the coaching process through a temporal lens. By doing so, we provide an integrated theoretical framework: a temporal map of coaching. In this framework, we link seminal concepts in psychology to the coaching process, and describe which competencies of coachees are crucial in the different stages of change that coaching aims to bring about. During the preparatory contemplation stage, targeting coachees' awareness by enhancing their mindfulness and environmental receptiveness is important. During the contemplation stage, coachees' willingness and perceived ability to change are central competencies. We propose that coaches should therefore foster intrinsic goal orientation and self-efficacy during this stage. During the planning stage, coaches should focus on goal-setting and implementation intentions. Finally, during the maintenance/termination stage, stimulating coachees' reflection is especially important in order to help them to integrate their learning experiences. The framework delineated in this paper contributes to the understanding of coaching as a tool to assist employees in dealing with the challenges of an increasingly dynamic work
Full Text Available Economic pressures on companies, technological developments, and less stable career paths pose potential threats to the well-being of employees (e.g., stress, burn-out and require constant adaptation. In the light of these challenges, it is not surprising that employees often seek the support of a coach. The role of a coach is to foster change by facilitating a coachees’ movement through a self-regulatory cycle with the ultimate aim of stimulating sustained well-being and functioning. While meta-analytic research indicates that coaching interventions can be effectively applied to assist employees in dealing with change, the current literature on coaching lacks solid theoretical frameworks that are needed to build a cumulative knowledge-base and to inspire evidence-based practice. In this conceptual analysis, we examine the coaching process through a temporal lens. By doing so, we provide an integrated theoretical framework: a temporal map of coaching. In this framework, we link seminal concepts in psychology to the coaching process, and describe which competencies of coachees are crucial in the different stages of change that coaching aims to bring about. During the preparatory contemplation stage, targeting coachees’ awareness by enhancing their mindfulness and environmental receptiveness is important. During the contemplation stage, coachees’ willingness and perceived ability to change are central competencies. We propose that coaches should therefore foster intrinsic goal orientation and self-efficacy during this stage. During the planning stage, coaches should focus on goal-setting and implementation intentions. Finally, during the maintenance/termination stage, stimulating coachees’ reflection is especially important in order to help them to integrate their learning experiences. The framework delineated in this paper contributes to the understanding of coaching as a tool to assist employees in dealing with the challenges of an
This chapter provides an overview of key principles and practices in executive coaching. Coaching is discussed as a reflective learning opportunity and offers the theoretical grounding, strategies, and case studies for each of four key elements of a coaching engagement.
Spaten, Ole Michael
rather limited empirical research on managers who coach their employees. The aim was to investigate the managers challenging and successful experiences when coaching their employees and how these coaching sessions were assessed by their employees. The qualitative analysis elicited three main themes: 1......15 middle managers from a major Danish, nationwide company were trained to coach by two coaching psychologists through theoretical presentations, individual coaching and peer coaching sessions with direct supervision (learning-by-doing, (see Spaten, 2011b)). Until now there has been conducted......) coaching skills, 2) professional and personal development, and 3) the coaching relationship and power relations. Middle managers’ coaching skills were assessed very positively by employees across all coaching sessions. One key finding of the study is that the manager as coach, should be very sensitive...
Batson, Vicki D; Yoder, Linda H
This article presents a report of a concept analysis of managerial coaching. Managerial coaching has been identified as a means for managers to give support to staff nurses, however, no clear delineation of what behaviours and attributes constitute managerial coaching or differentiate it from other career development relationships is provided in the current nursing literature. The CINAHL, ProQuest, Business Source Complete and PscyhIFNO databases were searched for articles published between 1980-2009 using the keywords coaching, managerial coaching, nurse manager support, nursing leadership, self-efficacy, work environment and empowerment. A hybrid approach was used, incorporating both Walker and Avant's method of concept analysis and King's conceptual system and Theory of Goal Attainment to explore the meaning of managerial coaching. Inclusive years of search ranged from 1980-2009. Managerial coaching is a specific dyadic relationship between the nurse manager and staff nurse intended to improve skills and knowledge as they relate to expected job performance. Antecedents and consequences are categorized at the individual and organizational level. Defining attributes, empirical referents and a model case are presented. The theoretical definition for this concept helps to differentiate it from other types of career development relationships and will give a basis for nurse managers to understand what skills and attributes are necessary to establish an effective managerial coaching relationship with staff nurses. Conceptualization will also assist in developing empirical studies examining managerial coaching behaviours in the work environment. © 2012 Blackwell Publishing Ltd.
Research purpose: The purpose of this article is to address the training and development needs of these consulting psychologists by presenting a competence executive coaching model for the planning, implementation and evaluation of executive coaching interventions. Research design, approach and method: The study was conducted while one of the authors was involved in teaching doctoral students in consulting psychology and executive coaching, specifically in the USA. The approach involved a literature review of executive coaching models and a qualitative study using focus groups to develop and evaluate the competence executive coaching model. Main findings: The literature review provided scant evidence of competence executive coaching models and there seems to be a specific need for this in the training of coaches in South Africa. Hence the model that was developed is an attempt to provide trainers with a structured model for the training of coaches. Contribution/value-add: The uniqueness of this competence model is not only described in terms of the six distinct coaching intervention phases, but also the competencies required in each.
Background and context: A key role of the district’s Nursing Midwifery Practice and Workforce Unit is to build capability in the nursing and midwifery workforce. In this paper I reflect on the experience of my team following attendance at a two-day Coaching for Performance workshop and the impact this had on developing coaching skills for nurse managers and nurse unit managers in South Eastern Sydney Local Health District. Aims: To highlight how engaging in critical reflection enabled the...
Margret Steixner plädiert in ihrem Beitrag für eine Integration des interkulturellen Coachings in andere Bereiche des Coachings. Basierend auf einer Coaching-Fallstudie entwickelt die Autorin einen hilfreichen Fragenkatalog für das interkulturelle Coaching. Intercultural Coaching identifies and develops intercultural competence as a key to success in the international and globalised work environment. Coaching in general has gained recognition as a very suitable method for competence develo...
Nurse coaches are responding to the mandate of Florence Nightingale (1820-1910)—the foundational philosopher of modern nursing—to advocate, identify, and focus on factors that promote health, healthy people, and healthy communities that are recognized today as environmental and social determinants of health.1,2 The Institute of Medicine report3 and other health initiatives suggest the need for increased education and leadership from nurses to address the healthcare needs of our nation and world. Nurse coaches are strategically pos-i tioned and equipped to implement health-promoting and evidence-based strategies with clients and support behavioral and lifestyle changes to enhance growth, overall health, and well-being. With possibilities not yet imagined, employment opportunities for nurses who incorporate coaching into professional practice are developing across the entire spectrum of health, well-ness, and healing. PMID:24416681
Dossey, Barbara M; Hess, Darlene
Nurse coaches are responding to the mandate of Florence Nightingale (1820-1910)-the foundational philosopher of modern nursing-to advocate, identify, and focus on factors that promote health, healthy people, and healthy communities that are recognized today as environmental and social determinants of health.(1) (,) (2) The Institute of Medicine report(3) and other health initiatives suggest the need for increased education and leadership from nurses to address the healthcare needs of our nation and world. Nurse coaches are strategically pos-i tioned and equipped to implement health-promoting and evidence-based strategies with clients and support behavioral and lifestyle changes to enhance growth, overall health, and well-being. With possibilities not yet imagined, employment opportunities for nurses who incorporate coaching into professional practice are developing across the entire spectrum of health, well-ness, and healing.
Ader, Jeremy; Stille, Christopher J; Keller, David; Miller, Benjamin F; Barr, Michael S; Perrin, James M
There has been a considerable expansion of the patient-centered medical home model of primary care delivery, in an effort to reduce health care costs and to improve patient experience and population health. To attain these goals, it is essential to integrate behavioral health services into the patient-centered medical home, because behavioral health problems often first present in the primary care setting, and they significantly affect physical health. At the 2013 Patient-Centered Medical Home Research Conference, an expert workgroup convened to determine policy recommendations to promote the integration of primary care and behavioral health. In this article we present these recommendations: Build demonstration projects to test existing approaches of integration, develop interdisciplinary training programs to support members of the integrated care team, implement population-based strategies to improve behavioral health, eliminate behavioral health carve-outs and test innovative payment models, and develop population-based measures to evaluate integration. Copyright © 2015 by the American Academy of Pediatrics.
Grundberg, Åke; Hansson, Anna; Religa, Dorota; Hillerås, Pernilla
Introduction Elderly people with multiple chronic conditions, or multimorbidity, are at risk of developing poor mental health. These seniors often remain in their homes with support from home care assistants (HCAs). Mental health promotion by HCAs needs to be studied further because they may be among the first to observe changes in clients’ mental health status. Aim To describe HCAs’ perspectives on detecting mental health problems and promoting mental health among homebound seniors with multimorbidity. Methods We applied a descriptive qualitative study design using semi-structured interviews. Content analyses were performed on five focus group interviews conducted in 2014 with 26 HCAs. Results Most HCAs stated that they were experienced in caring for clients with mental health problems such as anxiety, depression, sleep problems, and high alcohol consumption. The HCAs mentioned as causes, or risk factors, multiple chronic conditions, feelings of loneliness, and social isolation. The findings reveal that continuity of care and seniors’ own thoughts and perceptions were essential to detecting mental health problems. Observation, collaboration, and social support emerged as important means of detecting mental health problems and promoting mental health. Conclusion The HCAs had knowledge of risk factors, but they seemed insecure about which health professionals had the primary responsibility for mental health. They also seemed to have detected early signs of mental health problems, even though good personal knowledge of the client and continuity in home visits were crucial to do so. When it came to mental health promotion, the suggestions related to the aim of ending social isolation, decreasing feelings of loneliness, and increasing physical activity. The results indicate that the HCAs seemed dependent on supervision by district nurses and on care managers’ decisions to support the needed care, to schedule assignments related to the detection of mental health
Fielden, Sandra L; Davidson, Marilyn J; Sutherland, Valerie J
This longitudinal study sought to examine ways in which coaching and mentoring relationships impact on the professional development of nurses in terms of career and leadership behaviours, and evaluating the differences and similarities between those coaching and mentoring relationships. According to the UK government, leadership in nursing is essential to the improvement of service delivery, and the development and training of all nurses is vital in achieving effective change. A coaching and mentoring programme was used to explore the comparative advantages of these two approaches for the leadership development of nurses in acute, primary care and mental health settings. A longitudinal in-depth study was conducted to measure differences and similarities between the mentoring and coaching process as a result of a six-month coaching/mentoring programme. Five nurses from six UK Health Care Trusts were allocated to a coaching group (n = 15) or a mentoring group (n = 15), these were coached or mentored by a member of the senior directorate from their own Trust. Qualitative and quantitative data were collected at three time points (T1 = baseline, T2 = 4 months and T3 = 9 months) using semi-structured interviews and questionnaires. While mentoring was perceived to be 'support' and coaching was described as 'action', descriptions of the actual process and content were quite similar. However, while both groups reported significant development in terms of career development, leadership skills and capabilities, mentees reported the highest level of development with significantly higher scores in eight areas of leadership and management and in three areas of career impact. Implications for nurses and health services are discussed.