Liaison nurses, employed by a home care organization, were introduced into two Dutch hospitals to improve discharge planning for stroke patients. The main aim of the study presented was to gain insight into the effects of liaison nursing on the quality of the discharge process and related outcomes. After the introduction of liaison nursing, hospital nurses completed a questionnaire on satisfaction with the liaison nurse. In addition, both before and after the introduction of liaison nursing, two groups of discharged stroke patients were interviewed by telephone. The records of these patients were also studied with respect to background characteristics and duration of hospital stays. The hospital nurses were, generally, positive about the liaison nurse and the job she did (e.g. they found that home care was better organized). Further, after the introduction of liaison nursing, more patients stated that their post-discharge needs had been discussed not later than 48 hours prior to discharge, and more patients said their aftercare had been discussed with community nurses. However, the number of patients whose medication had arrived at home on time had decreased. The results also indicated that there was no significant difference in the duration of stay between the before and after group. The overall conclusion is that the liaison nurses have been moderately successful in their jobs. However, since the study was conducted in only two Dutch hospitals, findings may not be representative of other settings. Future research on liaison nursing is therefore recommended.
Owing to many developments and changes in home care in the Netherlands, a national study on home help services was carried out. One of the aims was to examine the job content of the six new categories of home help, the differences in their work and the correspondence of daily practice with formal job descriptions. Six home help categories were examined: alpha helps; A home helps; B caring helps; C and D carers; and specialized E carers - self-registration forms and weekly reports were used for data-collection. For a period of 4 weeks, 458 home helps recorded on these forms all the activities they carried out during and outside home visits. The daily work of alpha helps, A home helps and B caring helps mainly involves housework and psycho-social/supportive activities, whilst B caring helps also carry out some personal care and C carers do some housework, personal care and psycho-social or supportive activities. The main work of D carers consists of personal care and psycho-social activities. Psycho-social activities are mainly carried out by specialized E carers, who also do housework, mostly together with the client. In daily practice, the four subordinate categories of home help carry out more psycho-social and reporting activities, and the three highest categories do more housework compared with their formal job descriptions. There also appears to be an overlap in the work of A home helps and B caring helps and in the work of C and D caters. An adjustment to formal job descriptions relating to the daily practice of home helpers is required, as well as more time for the extra activities home helps have to carry out. Finally, the overlap between various categories of home helps needs to be resolved whereby instead of six categories of home help, four new categories should be created.
In this literature review, several models for quality of working life and workload appropriate for home help servives are presented. The aim was to develop a model for assessing the psychological and physical outcomes of working in home help services: Although the models described in this review include many relevant aspects, such as job characteristics, working conditions, social support, stress, job satisfaction and burnout, they are not fully adequate for the specific situation in home help services. Accordingly, a new research model was developed based on the models presented and their research results. This integraated moddel has three main component: work‐load, psychological and physical outcomes and capacity for coping. Although a relationship among these tree components is assumed, its nature needs to be investigated.
Owing to many developments and changes in home care in the Netherlands, a national study was carried out. One of the aims was to examine the differences between the six categories of home help in the Netherlands regarding workload, pressure of work and capacity for coping. A total of 474 home helps from six categories participated in the study. A structured questionnaire, based on the components of the research model, was used, which consisted of existing scales regarding workload (organizational and job characteristics, working conditions), psychological and physical outcomes (job satisfaction, burnout, health) and capacity for coping (social support, leadership style, coping strategies). Workload, specifically organizational and job characteristics are scored low by alpha helps and, to a lesser degree, by A home helps. The higher categories of home help experienced relatively bad working conditions. Home helps, except for alpha helps, are, on the whole, quite satisfied with their work, which is one of the psychological and physical outcomes. The higher categories of home help (C, D and E carers) experienced high feelings of emotional exhaustion. Health, absenteeism and back problems did not differ significantly amongst home helps. When looking at capacity for coping, traditional home helps (A to E) received more social support. The subordinate categories of home help dealt less actively with their problems and sought less social support than the other categories. Alpha helps are not employed by the organization and this might cause low organizational and job characteristics, and little social support. Their satisfaction scores suggest that they would like to see their low organizational involvement changed. The higher categories of home help, who carry out many psychosocial tasks, have higher emotional and mental workload and high burnout scores. B, C and D carers, who perform personal care and have to adhere to strict planning, experience extreme time pressure and a high physical workload.
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