Challenges for Japanese rural home care workers in interprofessional collaboration: a qualitative study

Ohta, Ryuichi; Ryu, Yoshinori; Katsube, Takuji

doi:10.1080/01621424.2018.1525462

Cited by 26 publications

(18 citation statements)

References 21 publications

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“…Good cognitive function is important in older patients because it will enable them to effectively convey their symptoms. Some dependent older people with low cognitive function are isolated in rural areas; thus, home care professionals struggle to manage older people who cannot accurately report their symptoms [44][45][46]. Furthermore, rural areas lack healthcare resources; as such, a multidisciplinary education program is important for home care patients [47].…”

Section: Discussionmentioning

confidence: 99%

Risk of Hospital Readmission among Older Patients Discharged from the Rehabilitation Unit in a Rural Community Hospital: A Retrospective Cohort Study

Ohta¹,

Sano

2021

JCM

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Rehabilitation for hospitalized older people can improve their independence for performing activities of daily living (ADL), but determining its appropriateness can be challenging because of inherent limitations in their ADL and short life expectancy. Thus, we aimed to clarify the benefit of rehabilitation among older Japanese patients. We retrospectively evaluated consecutive older patients (age > 65 years) admitted to the rehabilitation unit of a rural community hospital between 1 April 2016 and 31 March 2020. The primary outcome measure was readmission for acute conditions. Of the 732 patients evaluated, 311 patients (42.5%) were readmitted. Readmission was significantly associated with body mass index (BMI) (p < 0.001), dependent condition (p < 0.001), higher cognitive domain scores in the functional independence measure (FIM) (p = 0.019), and polypharmacy (p = 0.026). The most frequent cause of readmission was pyelonephritis (11.9%), followed by pneumonia (10.9%), compression fracture (10.6%), heat stroke (8.4%), and cerebral stroke (8.0%). In conclusion, older Japanese patients discharged from rehabilitation units have lower readmission rates than those previously reported. Thus, better nutritional control, a multidisciplinary approach to the management of cognitive dysfunction, and a decrease in polypharmacy could be associated with improved outcomes among discharged older patients.

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Section: Discussionmentioning

confidence: 99%

Risk of Hospital Readmission among Older Patients Discharged from the Rehabilitation Unit in a Rural Community Hospital: A Retrospective Cohort Study

Ohta¹,

Sano

2021

JCM

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“…Home care professionals—especially home care workers and care managers—are often contacted by patients for healthcare services at home [ 26 ]. Thus, they can experience difficulties in dealing with the acute conditions of providing home care [ 27 , 28 ]. They also struggle with information-sharing among medical and home care professionals [ 27 , 28 ].…”

Section: Methodsmentioning

confidence: 99%

“…Thus, they can experience difficulties in dealing with the acute conditions of providing home care [ 27 , 28 ]. They also struggle with information-sharing among medical and home care professionals [ 27 , 28 ]. Home care workers have a process to convey the conditions of patients to other professionals, as well as patients’ families.…”

Section: Methodsmentioning

confidence: 99%

Comprehensive Care through Family Medicine: Improving the Sustainability of Aging Societies

Ohta¹,

Ueno²,

Kitayuguchi³

et al. 2021

Geriatrics

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Comprehensive care through family medicine can enhance the approach to multimorbidity, interprofessional collaboration, and community care, and make medical care more sustainable for older people. This study investigated the effect of implementing family medicine and the comprehensiveness of medical care in one of the most rural communities. This implementation research used medical care data from April 2015 to March 2020. Patients’ diagnoses were categorized according to the 10th revision of the International Statistical Classification of Disease and Related Health Problems (ICD-10). In 2016, family medicine was implemented in only one general hospital in Unnan. The comprehensiveness rate improved in all ICD-10 disease categories during the study period, especially in the following categories—infections; neoplasms; endocrine, nutritional, and metabolic diseases; mental disorders; nervous system; circulatory system; respiratory system; digestive system; skin and subcutaneous tissue; musculoskeletal system and connective tissue; and the genitourinary system. Implementing family medicine in rural Japanese communities can improve the comprehensiveness of medical care and resolve the issue of fragmentation of care by improving interprofessional collaboration and community care. It can be a solution for the aging of both patient and healthcare professionals. Future research can investigate the relationship between family medicine and patient health outcomes for improved healthcare sustainability.

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“…However, citizens in rural areas lack adequate resources for medical care, leading to inappropriate usage and inappropriate treatments such as medical care for mild symptoms [ 7 ]. Limited education among people living in rural areas may also affect HSB [ 8 – 10 ]. In addition, rural HSB needs to be improved by providing information and educational interventions of HSB from multiple perspectives as these people may also lack information about medical issues [ 7 , 11 ].…”

Section: Introductionmentioning

confidence: 99%

What resources do elderly people choose for managing their symptoms? Clarification of rural older people’s choices of help-seeking behaviors in Japan

Ohta

Ryu²,

Kitayuguchi³

et al. 2021

BMC Health Serv Res

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Background Appropriate help-seeking behavior (HSB) that involves lay and professional care may moderate the usage of medical resources and promote good health, especially among the rural elderly. However, there is little evidence regarding the rural elderly’s HSB choices for mild symptoms. Therefore, this study attempts to bridge this gap. Methods The participants were patients living in rural areas and over the age of 65, who attended Japanese clinics and general hospitals. In Phase 1, monthly diaries and one-on-one interviews about their mild symptoms and HSB were used to establish HSB items and assess its content validity. Content analysis helped determine the items. In Phase 2, participants were asked to complete the list to measure HSB. The answers to the list and HSB mentioned in the diaries were compared to evaluate concurrent validity. Retests were conducted to examine the content’s reliability and test-retest reliability. Results Phase 1 included 267 participants (average age = 75.1 years, standard deviation [SD] = 4.3; 50.1% male). The diary collection rate was 97.6%. Of the participants, 70.4% used lay care and 25.4% used professional care. Content analysis identified eight types of lay care and four types of professional care. Phase 2 included 315 participants (average age = 77.7 years, SD = 8.27; 46.0% male). In terms of validity, the results of the list and the diaries were correlated (Spearman r 0.704; p < 0.001). The most common behavior with mild symptoms was consulting with primary care physicians, followed by self-care and using home medicine. The test-retest reliability for mild symptoms found kappa values of 0.836 for lay care and 0.808 for professional care. Conclusions The choices of HSB for mild symptoms clarified identified in this study have high validity and reliability. Therefore, it can be used to assess the relationships between HSB and health conditions and the effectiveness of health promotion on rural older people’s HSB.

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Challenges for Japanese rural home care workers in interprofessional collaboration: a qualitative study

Cited by 26 publications

References 21 publications

Risk of Hospital Readmission among Older Patients Discharged from the Rehabilitation Unit in a Rural Community Hospital: A Retrospective Cohort Study

Risk of Hospital Readmission among Older Patients Discharged from the Rehabilitation Unit in a Rural Community Hospital: A Retrospective Cohort Study

Comprehensive Care through Family Medicine: Improving the Sustainability of Aging Societies

What resources do elderly people choose for managing their symptoms? Clarification of rural older people’s choices of help-seeking behaviors in Japan

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