Little research has been done to document the value of using nursing diagnosis in home care and the impact that increased acuity levels have had in diagnostic selection. Nursing diagnosis documentation in home care was examined to see whether it had a relation to select client and visit pattern variables. This retrospective chart audit, which piloted a newly developed instrument called the Home Care Audit Tool, utilized a sample of 199 closed records of a large midwestern Visiting Nurse Association. The mean age of the client population was 76 years, with 64% female. There were 269 initial nursing diagnoses cited in the sample records, averaging 1.75 diagnoses per case. The number of recorded visits increased when select nursing diagnoses were cited together in a single case.
The purpose of this study was to continue research related to the identification of social support systems for an older adult homebound population of people who have diabetes compared to a control group of elder home care clients without diabetes, their knowledge level, and the significance of home health care intervention in these support networks. A sample of 11 older adult homebound people with diabetes and 11 older adult home care controls without diabetes from two home care agencies in Connecticut were used for this pilot study. A large sample was projected, but home-visiting scheduling difficulties arose. Eighty-two percent of both groups had adequate support systems. There was some difficulty with interpretation of the Homebound Diabetes Knowledge Level Questionnaire and further refinement is needed, especially in relationship to non-insulin-dependent diabetes mellitus client responses. Results from chart review, utilizing the Diabetes Clinical Indicator Tool, yielded a 59%-66% rate of the criteria met in the four categories outlined. It is evident that social support makes a significant contribution to the physical and psychological well-being of the home care elder, but further study is needed to examine the relationship between an individual's personal and professional network of support in this setting.
Collaborative project to examine social support in elder homebound diabetics Social support has a significant effect on the response to illness and treatment. The authors present some of the findings and practical applications originating from a collaborative study, including a clinical indicator tool for the diabetic patient. This information gives the home health care professional an expanded knowledgebase to use in developing individualized care plans for the elder home care diabetic.
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