Getting on With Living Life

Westra, Bonnie L.; Paitich, Nadine; Ekstrom, Dawn; Mehle, Susan; Kaeding, Maggie; Abdo, Sajeda; Monsen, Karen A.

doi:10.1097/nhh.0b013e3182a87654

Cited by 5 publications

(3 citation statements)

References 11 publications

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“…Category 4 was the only category that explicitly described how patients changed their physical environment and tools. Tasks in this category (eg, use and maintain assistive devices [ 16 , 20 , 42 , 50 , 56 , 58 , 59 , 62 , 67 , 69 , 72 , 74 , 89 , 90 , 95 , 97 , 98 ], do-it-yourself symptom management tools [ 18 , 19 , 47 , 59 , 62 , 66 , 74 , 77 , 95 ], and alter the physical environment [ 46 , 62 , 93 ]) had an immediate physical return in the form of better tools or a more comfortable physical environment, with the tools ranging from day-to-day items (eg, shoe insoles [ 97 ]) to specialized equipment (such as home oxygen tanks [ 59 ]). Patients are very aware of how this category is an investment to improve the quality of life as well as what kind of support (mainly financial) is available from health organizations.…”

Section: Resultsmentioning

confidence: 99%

“…This category included tasks where patients sought help from other people, including seek medical help [ 2 , 14 , 18 , 40 , 41 , 44 , 49 - 52 , 58 , 65 , 75 , 79 , 80 , 83 , 89 , 93 , 96 , 97 ], ask for help from family and friends [ 18 , 40 , 46 , 47 , 50 , 51 , 57 , 60 , 63 , 67 , 69 , 73 , 77 , 93 , 95 , 98 ], hire professional help [ 20 , 43 , 52 , 69 , 95 , 98 ], and consult complementary therapy [ 58 , 59 , 64 , 66 , 84 ]. This category also included unplanned interactions, such as visits to the emergency department [ 41 , 89 ].…”

Section: Resultsmentioning

confidence: 99%

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Patient Work and Their Contexts: Scoping Review

et al. 2020

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Background Having patients self-manage their health conditions is a widely promoted concept, but many patients struggle to practice it effectively. Moreover, few studies have analyzed the nature of work required from patients and how such work fits into the context of their daily life. Objective This study aimed to review the characteristics of patient work in adult patients. Patient work refers to tasks that health conditions impose on patients (eg, taking medications) within a system of contextual factors. Methods A systematic scoping review was conducted using narrative synthesis. Data were extracted from PubMed, Excerpta Medica database (EMBASE), Cumulative Index to Nursing and Allied Health Literature (CINAHL), and PsycINFO, including studies from August 2013 to August 2018. The included studies focused on adult patients and assessed one or more of the following: (1) physical health–related tasks, (2) cognitive health–related tasks, or (3) contextual factors affecting these tasks. Tasks were categorized according to the themes that emerged: (1) if the task is always visible to others or can be cognitive, (2) if the task must be conducted collaboratively or can be conducted alone, and (3) if the task was done with the purpose of creating resources. Contextual factors were grouped according to the level at which they exert influence (micro, meso, or macro) and where they fit in the patient work system (the macroergonomic layer of physical, social, and organizational factors; the mesoergonomic layer of household and community; and the microergonomic triad of person-task-tools). Results In total, 67 publications were included, with 58 original research articles and 9 review articles. A variety of patient work tasks were observed, ranging from physical and tangible tasks (such as taking medications and visiting health care professionals) to psychological and social tasks (such as creating coping strategies). Patient work was affected by a range of contextual factors on the micro, meso, or macro levels. Our results indicate that most patient work was done alone, in private, and often imposing cognitive burden with low amounts of support. Conclusions This review sought to provide insight into the work burden of health management from a patient perspective and how patient context influences such work. For many patients, health-related work is ever present, invisible, and overwhelming. When researchers and clinicians design and implement patient-facing interventions, it is important to understand how the extra work impacts one’s internal state and coping strategy, how such work fits into daily routines, and if these changes could be maintained in the long term.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Patient Work and Their Contexts: Scoping Review

et al. 2020

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“…Home health care (HHC) assists older adults to improve function and well-being, maintain their independence so as to remain at home safely, and avoid hospitalizations and institutionalization (Alliance for Home Health Quality and Innovation, 2014; Westra et al, 2013). Demand for HHC is expected to grow substantially as advances in health care and technology support adults living longer with chronic illnesses.…”

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confidence: 99%

Preparing Clinicians for Transitioning Patients Across Care Settings and Into the Home Through Simulation

Molloy

Cary

Brennan-Cook

et al. 2018

Home Healthcare Now

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Assuring home care staff competencies through simulation has the potential to improve care transitions and clinical outcomes. Recreating a home environment can be used for orientation of home care staff and to meet other learning needs. Lessons learned from the use of simulation in a geriatric nursing course in a prelicensure program can be used to prepare clinicians for transitioning patients across care settings. With simulation, learners can identify challenges in patient safety, pain management, and management of patients' cognitive decline as well as learn how to communicate with patients, family members, and the healthcare team. Simulation, as an interactive pedagogy, provides opportunities for learners to practice assessment, monitoring, and patient care in a controlled, safe, risk-free environment. Following participation in a simulation, learners are given the opportunity to reflect on ways to improve patient care when transitioning from acute to home care settings. Simulations described in this article can be used for orientation of staff to a home healthcare agency because they allow clinicians to hone the skills necessary for patient care in the home. Staff educators can also use simulation to validate staff competencies in caring for patients at home.

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A Call for Interfacing Measures of Instrumental Activities of Daily Living Across the Transition of Care

Koyfman

Finnell

2019

Home Healthcare Now

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The ability to maintain functional status is an essential aspect of self-care for older adults. Instrumental activities of daily living (IADLs) decline within hours of hospitalization and are often overlooked, underassessed, and underreported. The aim of this integrative review was to examine and compare methods used to assess IADLs to determine the best measure for use across the care continuum, especially during transitions of care. A literature search without date restrictions was conducted using PubMed, Cumulative Index of Nursing and Allied Health Literature (CINAHL), and Embase databases. Twelve studies of moderate quality were included in this review. More than half (58%) of the studies utilized the Lawton and Brody Scale to measure IADL among home-based and hospitalized patients. Implementation of this scale as standard practice and sharing the results with healthcare providers would encourage continuity of care with the goal of supporting older adults aging in place and preventing rehospitalization. In turn, this communication process may improve the transition from the inpatient to home setting, where, since 1999, the Outcome and Assessment Information Set has been mandated.

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Getting on With Living Life

Cited by 5 publications

References 11 publications

Patient Work and Their Contexts: Scoping Review

Patient Work and Their Contexts: Scoping Review

Preparing Clinicians for Transitioning Patients Across Care Settings and Into the Home Through Simulation

A Call for Interfacing Measures of Instrumental Activities of Daily Living Across the Transition of Care

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