The Role of a Multicomponent Home-Health Intervention in Reducing Caregiver Stress in Singapore: A Qualitative Study

Penkunas, Michael J.; Chan, Angelique; Wong, Chek Hooi; Korne, Dirk de; Tan, See Mieng; Wong, Sweet Fun

doi:10.1093/geronb/gbw008

Cited by 5 publications

(5 citation statements)

References 47 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…22,25 Live-in foreign domestic helpers are frequently employed in Asian communities especially in Singapore to provide caregiving support. 27 Domestic helpers were excluded as participants in this study, but this phenomenon presents potential opportunities for further exploration and identifies domestic helpers as additional stakeholders in HaH care that healthcare teams must be aware of and engage with.…”

Section: Discussionmentioning

confidence: 99%

Experiences of Patients and Their Caregivers Admitted to a Hospital-at-Home Program in Singapore: a Descriptive Qualitative Study

Chua

Koh

et al. 2022

J GEN INTERN MED

View full text Add to dashboard Cite

BACKGROUND: Hospital at Home (HaH) programs have been shown to improve clinical outcomes, quality of care, and patient satisfaction. However, how Asian patients experience HaH remained underexplored. OBJECTIVE: To explore the perceptions and experiences of patients and caregivers admitted to a hospital-at-home program in Singapore. DESIGN: Descriptive qualitative study design. PARTICIPANTS: Purposive sampling was used to conduct 36 interviews with 13 patients, nine Legally Acceptable Representatives (LARs), and 14 caregivers until data saturation was achieved. INTERVENTIONS: NUHS@Home is a HaH program providing care through a multi-disciplinary team, enabled by remote vital signs monitoring through a tablet and wireless blood pressure and oxygen meters. APPROACH: This study used in-depth semi-structured individual interviews. Interviews were transcribed and thematically analyzed using Braun and Clark's six-step inductive approach. KEY RESULTS: The overarching theme identified was "Enablers, difficulties, and improvements to the HaH experiences" which was supported by three key themes:(1) Perceived better care at home, (2) Importance of social support, and (3) Organizational structures required to support HaH. Participants described overall HaH experiences around factors contributing to their impeding engagement, overall satisfaction, and quality of care. CONCLUSIONS: Although HaH is unfamiliar to the Singapore population, most of the participants in this study had an overall positive experience. The key challenges found in this paper were the stress and inconvenience caused to caregivers. The enablers for positive HaH experiences were (1) consideration of patient's family members as key participants in the patients' therapeutic alliance;(2) the HaH care team must be accessible, approachable, and reassuring, and communicate frequently and timely with patients and their families; and (3) financing strategies to ensure HaH out-of-pockets costs remain affordable which are critical to keeping HaH as an option for patients and families.

show abstract

Section: Discussionmentioning

confidence: 99%

Experiences of Patients and Their Caregivers Admitted to a Hospital-at-Home Program in Singapore: a Descriptive Qualitative Study

Chua

Koh

et al. 2022

J GEN INTERN MED

View full text Add to dashboard Cite

show abstract

“…The Ageing In Place Programme (AIP) was initiated in 2011 in Singapore to tackle patient and caregivers’ social and nursing needs, which was able to successfully alleviate caregiver stressors [ 11 ]. It later merged with the transitional care service to form the AIP-Community Care Team (AIP-CCT) programme to reduce hospital readmission rates by addressing modifiable contributing factors, providing home visits and formulating individualised hospital care plans.…”

Section: Introductionmentioning

confidence: 99%

Community nurses’ perspectives on a novel blended training approach: a qualitative study

Low

2022

BMC Nurs

View full text Add to dashboard Cite

Background Transiting into the community setting often presents novel difficulties for nurses because the role demands skills that might not have been obtained through usual clinical experience or training. The Ageing-in-Place Community Care Team (AIP-CCT) Community Nurse Basic Training programme was developed to address this learning gap. This training programme prepares nurses to lead in a multi-disciplinary team in delivering patient-centred care to patients with progressive or life-limiting conditions in the community setting. This study evaluated the inaugural training programme provided to a group of nurses from an acute hospital in Singapore. Methods Qualitative in-depth interviews were carried out with 13 participants from the training programme three-months after completion of the AIP-CCT Community Nurse Basic Training programme provided by an acute hospital to understand the programme’s impact on their knowledge, skills and clinical practice, as well as barriers and facilitators to learning. Results Overall, perception towards the training course was mixed. Course content was found to be relevant, and participants reported that training led to improvement in their practice. However, experienced nurses felt that the content of some modules were lacking in depth. This could have explained why only junior nurses tended to hold favourable attitudes and felt that the training led to increase in their confidence level. Although medical content was assessed favourably, the course was not able to address some of the constraints faced by community nurses such as managing expectations and handling difficult patients in the home care setting. For some modules, face-to-face training was preferred and e-learning components can be improved to increase communication and interaction. Conclusion This study provided insights into how a community nurse training programme could be developed to meet the needs of community nurses. The training was able to reinforce skills and knowledge, address knowledge gaps and provide new clinical care approaches and communication strategies. These incremental effects on experienced community nurses could be extrapolated to have greater benefits for inexperienced community nurses. Based on findings of the study, potential changes to the training programme were discussed to improve training outcomes.

show abstract

“…As our aim is to present a template that can be modified to evaluate a diversity of programs, we chose to focus on describing our evaluation methodology and have not included the full results of our specific study here. For readers who are interested, portions of the study findings are presented elsewhere (see Penkunas et al, 2018).…”

Section: Introductionmentioning

confidence: 99%

Using Cost-Effectiveness Analysis in Mixed Methods Research: An Evaluation of an Integrated Care Program for Frequently Hospitalized Older Adults in Singapore

Penkunas

Matchar

Wong

et al. 2019

Journal of Mixed Methods Research

Self Cite

View full text Add to dashboard Cite

Traditional evaluation techniques are often not suitable for studying health interventions operating in real-world settings, particularly when interventions operate through complex causal pathways. We describe a mixed methods design for evaluating an integrated home care and social support service targeting mature and older adults (55+ years) in Singapore. Here, nurses and community health workers visit patients’ homes to address health and social needs while facilitating linkages to community-based services and providing caregiver support. Our mixed methods evaluation plan is composed of three components: quantitative comparison of hospital-based service utilization, cost-effectiveness analysis, and qualitative investigation into the experiences of patients, caregivers, and individuals who declined services. This article contributes a description of how cost-effectiveness analysis adds value when incorporated into mixed methods studies.

show abstract

The Role of a Multicomponent Home-Health Intervention in Reducing Caregiver Stress in Singapore: A Qualitative Study

Cited by 5 publications

References 47 publications

Experiences of Patients and Their Caregivers Admitted to a Hospital-at-Home Program in Singapore: a Descriptive Qualitative Study

Experiences of Patients and Their Caregivers Admitted to a Hospital-at-Home Program in Singapore: a Descriptive Qualitative Study

Community nurses’ perspectives on a novel blended training approach: a qualitative study

Using Cost-Effectiveness Analysis in Mixed Methods Research: An Evaluation of an Integrated Care Program for Frequently Hospitalized Older Adults in Singapore

Contact Info

Product

Resources

About