BACKGROUND AND OBJECTIVES

With the global population aging, there is an emerging need for access to quality longterm care (LTC) services. Many countries have developed LTC systems while others are at the infancy stage. This paper aimed to provide an overview of the country’s readiness for LTC based on the perspectives of relevant stakeholders. Specifically, it described the roles, initiatives, and challenges of relevant organizations and community leaders for LTC provision. It also described the older persons (OPs) and carers’ perspectives towards LTC including their awareness, capacity, and preferences.

The study utilized a descriptive design using qualitative methods of data collection namely key informant interviews (KIIs) and focus group discussions (FGDs). Participating institutions and their designated representatives were purposively sampled as key informants. OPs and carers from select barangays in NCR and Region IVA participated in the FGDs. Guided by the interpretivism approach, thematic analysis was performed. A trained research assistant coded the FGD and KII transcripts through the Nvivo PRO plus software and verified by the first author. Themes were reviewed and validated by the multidisciplinary team.

A total of 15 KIIs and two FGDs were conducted. The participating institutions and organizations were found to have varied roles and initiatives relevant to LTC; from strategic planning, development of policies and standards of care, training and capacity-building, and up to the actual implementation of LTC services. Identified challenges include implementation issues, financial issues, lack of political and stakeholder support, OPs and familial issues, and lack of knowledge on LTC.

Participants shared their description on what LTC is, an LTC facility, and the conditions of those in LTC facility. OPs expressed their willingness to utilize LTC services and identified several factors related to their preferred LTC arrangements. Carers identified various topics related to taking care of OPs that they would like to learn.

The roles, initiatives, and awareness of relevant stakeholders, older persons, and carers towards LTC were found to greatly vary. Policy makers, health workforce, families, communities, and the older persons themselves should have a better understanding of longterm care before they can provide or utilize the system. With the current landscape of LTC provision, the country still has a long way to go in achieving the integrated continuum of LTC appropriate to promote healthy aging. Promoting awareness, integrating LTC in the current programs and services for older persons in the country, capacitating the formal and non-formal caregivers, and strengthening collaborations are recommended.

Further research on quantitative measures of readiness for long-term care with focus on the health system and in-depth studies on the varieties or models of long-term care are recommended.

Background and Objectives With the global population aging, there is an emerging need for access to quality longterm care (LTC) services. Many countries have developed LTC systems while others are at the infancy stage. This paper aimed to provide an overview of the country’s readiness for LTC based on the perspectives of relevant stakeholders. Specifically, it described the roles, initiatives, and challenges of relevant organizations and community leaders for LTC provision. It also described the older persons (OPs) and carers’ perspectives towards LTC including their awareness, capacity, and preferences.
Home Care Services ; Long-Term Care ; Nursing Homes ; Philippines

PURPOSE: The purpose of this study was to develop a suicide prevention nursing competency program for visiting nurses, and to examine the effect of this program on suicide prevention-related knowledge, attitudes, and behaviors.METHODS: A total of 66 visiting nurses were recruited from 10 public health centers and divided equally into the experimental and control group. For the experimental group, the suicide prevention nursing competency program was provided twice a week for 120 minutes across 3 weeks. Participants were asked questions related to suicide prevention knowledge, attitudes, and behaviors at pre, post, and 1 month after the intervention. Data were analyzed using descriptive statistics, a t-test, repeated measure ANOVA, and Friedman test.RESULTS: There were significant differences in knowledge and behaviors at the measured time periods, and significant differences in attitudes and behaviors between the two groups. There were also significant interactions between groups and times in attitudes and behaviors. These results suggest that the effects of the program were persistent until the 1-month follow-up.CONCLUSION: The developed suicide prevention nursing competency program is effective in evidence-based education for visiting nurses to increase suicide prevention-related knowledge, attitudes, and behaviors.
Education ; Follow-Up Studies ; Home Health Nursing ; Nurses, Community Health ; Nursing ; Public Health ; Suicide

OBJECTIVES: Home-based nursing care services have increased over the past decade. However, accountability and privacy issues as well as security concerns become more challenging during care provider visits. Because of the heterogeneous combination of mobile and stationary assistive medical care devices, conventional systems lack architectural consistency, which leads to inherent time delays and inaccuracies in sharing information. The goal of our study is to develop an architecture that meets the competing goals of accountability and privacy and enhances security in distributed home-based care systems. METHODS: We realized this by using a context-aware approach to manage access to remote data. Our architecture uses a public certification service for individuals, the Japanese Public Key Infrastructure and Health Informatics-PKI to identify and validate the attributes of medical personnel. Both PKI mechanisms are provided by using separate smart cards issued by the government. RESULTS: Context-awareness enables users to have appropriate data access in home-based nursing environments. Our architecture ensures that healthcare providers perform the needed home care services by accessing patient data online and recording transactions. CONCLUSIONS: The proposed method aims to enhance healthcare data access and secure information delivery to preserve user's privacy. We implemented a prototype system and confirmed its feasibility by experimental evaluation. Our research can contribute to reducing patient neglect and wrongful treatment, and thus reduce health insurance costs by ensuring correct insurance claims. Our study can provide a baseline towards building distinctive intelligent treatment options to clinicians and serve as a model for home-based nursing care.
Asian Continental Ancestry Group ; Certification ; Computer Security ; Delivery of Health Care ; Electronic Health Records ; Health Information Exchange ; Health Personnel ; Health Smart Cards ; Home Care Services ; Home Health Nursing ; Humans ; Information Dissemination ; Insurance ; Insurance, Health ; Methods ; Nursing ; Nursing Care ; Privacy ; Social Responsibility

OBJECTIVES: We searched and reviewed the literature including the laws or acts, statistics, guidelines, papers and conference proceedings related to home visit nursing care in South Korea. METHOD: We searched and reviewed the literature including the laws or acts, statistics, guidelines, papers and conference proceedings related to home visit nursing care in Korea. RESULTS: There are three types of home care nursing in Korea. Public health center provides home visit nursing to vulnerable population by registered nurses for free, based on community health act in public health center. As of 2017, 1,261,208 people were enrolled in the visiting health program of public health center. Health behavior and disease management has been improved and showed having cost-benefit effect among the enrolled people in visiting health program. Visiting nursing care in long-term care services is provided by registered nurses or nurse aid, based on long-term care act. The cost is paid as the unit price according to service time. 1,095,764 older people used long-term care services in 2017, only 0.2% of total cost used for home visiting nursing. Even though the number of user of home visiting nursing, it was reported that users spent less medical cost and hospitalized shorter. Hospital-based home care nursing is provided to patients and their families under the prescription of a doctor by family nurse specialists who are employed by medical institute based on medical law. Four hundred sixty family nurse specialists worked for hospital-based home care nursing and hospital-based home care services accounted for 0.038% of total medical expenses in 2017. CONCLUSION: Even though home visit nursing care services are different in aspect of legal basis, personnel, running institutes, and cost basis, home visit nursing care showed cost-benefit effect and good health outcomes. In order to advance home visit nursing care, the integrated home visiting care, improvement of working condition, and revision of legal basis should be considered.
Academies and Institutes ; Disease Management ; Health Behavior ; Home Care Services ; Home Care Services, Hospital-Based ; House Calls ; Humans ; Jurisprudence ; Korea ; Long-Term Care ; Methods ; Nurses ; Nursing Care ; Nursing ; Prescriptions ; Public Health ; Running ; Specialization ; Vulnerable Populations

PURPOSE: In the nursing profession, it is imperative that students are able to transfer their undergraduate knowledge and skills into practice to become competent nurses. The aim of this study was to illuminate how infection prevention and control (IPC) education would be conducted in undergraduate nursing programs. METHODS: A qualitative design utilizing focus group interviews as its data collection method was employed. Twelve professors from twelve South Korean universities that have undergraduate nursing programs were recruited as research participants and divided into two focus groups. RESULTS: Focus group interview analysis showed that IPC education in undergraduate nursing programs for fostering IPC competency was composed of two categories: a pre-clinical course and a clinical course. Each included three subcategories-education contents, education strategies, and considerations of how infection control is taught to students as they continue from beginning to advanced-and the themes of each subcategory were derived. CONCLUSIONS: The findings of this study can provide an overview of how nursing professors should teach IPC education to undergraduates. As IPC education for nurses is very important, more in-depth discussions that include educators, clinical mentors, and nursing students regarding IPC education are needed to ensure patients' safety in clinical settings.
Data Collection ; Education ; Focus Groups ; Foster Home Care ; Humans ; Infection Control ; Korea ; Mentors ; Nursing ; Students, Nursing

PURPOSE: The purpose of this study is to identify factors influencing burnout in primary family caregivers of Home Health Care Patients. METHODS: Data were collected from 121 primary family caregivers of home health care patients in three different hospitals in ‘D’ metropolitan city and the study was conducted from August 10, 2016 to January 17, 2017. The data were analyzed using descriptive statistics, t-test, ANOVA, Pearson's Correlation Coefficient, Stepwise Multiple Linear Regression. RESULTS: Mean scores for the nursing needs of the participants were 3.54±0.79, the family functions were 1.24±0.58, the burnouts were 2.74±0.49. The burnouts were positively correlated with the nursing needs but inversely correlated with the family function. The factor that had the greatest influence on the burnouts of primary family caregivers of Home Health Care was family function (β=−.245, p=.001), followed by patients' daily activity (β=−.213, p=.014), age (β=.208, p=.032), monthly nursing services cost (β=−.196, p=.044) and nursing needs (β=.129, p=.014). The Explanatory Power of Models was 23%. CONCLUSION: Individually customized home care nursing intervention programs are required to be provided in accordance with patient's family function and daily activity, monthly home care nursing service cost, nursing needs and general characteristics of primary caregivers of Home Health Care Patients such as their age, the number of family members living together, sex and the name of disease.
Caregivers ; Delivery of Health Care ; Home Care Services ; Home Care Services, Hospital-Based ; Home Health Nursing ; Humans ; Linear Models ; Nursing ; Nursing Services

PURPOSE: This study was done to identify and prioritize educational needs for suicide prevention competencies among 212 visiting nurses from 33 public health centers. METHODS: Data were collected from August to October 2017 through self-administered questionnaires consisting of measures of suicide prevention competencies. Data were analyzed using descriptive statistics, paired t-test, and Borich's needs assessment model to determine the priority of educational needs. RESULTS: Visiting nurses reported that enhancing skills in suicide prevention were more significant than improving knowledge. The highest priority need was “utilizing counseling skills.” In addition, other educational needs were prioritized as followed by; “a strategic planning approach to suicide prevention”, “applying therapeutic communication”, “showing empathy”, and “using resources in the community.” CONCLUSION: The findings suggest that developing intervention programs to enhance counseling and strategic planning skills are needed to improve suicide prevention competencies among visiting nurses.
Counseling ; Educational Measurement ; Home Health Nursing ; Needs Assessment ; Nurses, Community Health ; Primary Prevention ; Public Health ; Suicide

With the motto ‘Equity from the Start for a Healthy Future’, the Seoul Healthy First Step Project (SHFSP) was launched in 2013 in an attempt to support women with young children, to improve the health and development of babies, and eventually to close the gap in child development. The SHFSP contains both universal components (universal risk assessment of mothers and universal home visitation after birth) and selective components (prenatal and postnatal sustained home visits, mothers' groups, and community service linkage), thereby taking a proportionate universality approach. For sustained home visits, the SHFSP introduced the Maternal and Early Childhood Sustained Home-visiting (MECSH) program from Australia, which has been proven to be effective in improving maternal and childhood outcomes. Between 2013~2017, the SHFSP has paid 58,327 visits to roughly 38 thousand families with babies. In 2017, the SHFSP covered 19.6% of families with newborn babies in Seoul. The SHFSP conducted internal satisfaction surveys of universal and sustained visitation service recipients, in which an overwhelming majority of mothers provided positive feedback. A performance assessment conducted in 2016 by an external organization showed that 93% of SHFSP service recipients were satisfied with the home visitations. Considering the popular support for the program from mothers and families in Seoul (the most affluent area in Korea) and the lack of a national home visiting program to promote early childhood health and development, this program should be expanded nationally in the near future.
Australia ; Child ; Child Development ; Female ; Home Health Nursing ; House Calls ; Humans ; Infant ; Infant, Newborn ; Korea ; Maternal-Child Health Services ; Mothers ; Risk Assessment ; Seoul ; Social Welfare

Singapore has an ageing population with a projected 53,000 people aged ≥ 60 years living with dementia by 2020. Primary care doctors have the opportunity to initiate early work-up for reversible causes of cognitive dysfunction, allowing identification of comorbidities and discussion of medical therapy options. Early diagnosis confers the sick role on the patient, which allays frustration and explains events and behaviour that may have strained relationships with family and friends. The patient can be encouraged to plan for future health and personal care options with a Lasting Power of Attorney and/or Advance Care Planning. Objective cognitive tests (e.g. abbreviated mental test and Mini-Mental State Examination) and brain imaging are adjuncts that help in formulating the diagnosis. Referral to a hospital memory clinic activates a multidisciplinary team approach to dementia, including clinical consultation, dementia counselling, physiotherapy sessions on gait/fall prevention, occupational therapy sessions on cognitive stimulation and caregiver training.
Advance Care Planning ; Aged ; Aged, 80 and over ; Brain ; physiopathology ; Caregivers ; Cognition ; Cognitive Dysfunction ; diagnosis ; epidemiology ; therapy ; Cognitive Therapy ; Dementia ; diagnosis ; epidemiology ; therapy ; Geriatrics ; methods ; Home Nursing ; Humans ; Interdisciplinary Communication ; Memory ; Middle Aged ; Neuropsychological Tests ; Referral and Consultation ; Singapore