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Background: Home care provides an excellent opportunity for personalizing treatment as nurses see patients in their natural environment. Along with its many advantages, the home care environment carries unique risks, as nurses are usually alone, without the protection and security provided by primary care clinics. There are no accurate data in Israel on the scope and characteristics of client violence against nurses during home visits. We conducted a qualitative study to investigate the nature of client violence faced by Israeli nurses during home visits, to gain insights into their perceptions and experiences, and to contribute to the development of effective policies and strategies to combat client violence in the healthcare sector. Methods: Twenty-seven female nurses from primary care clinics, who were exposed to client violence during a home visit, were interviewed using a semi-structured interview guide. The interviews were transcribed and analyzed, and categories and themes were extracted. Results: Most nurses interviewed experienced at least three incidents of client violence, the most common of which was verbal abuse. The nurses perceived that the location of the encounter between the nurse and the patient in the patient's natural surroundings, rather than within the controlled boundaries of a clinic, contributes to the risk of violence. Violence affected the nurses' professional decisions. The nurses reported that their organization had no established guidelines or instructions for safely conducting home visits, they were not provided with protective or security measures for emergencies, nor did they perceive that they had sufficient training to deal with client violence in clients' homes. Conclusions: Nurses encounter a range of challenges that make it difficult for them to deal with client violence during home visits, affecting their personal safety and professional decisions. Their ability to manage such situations is shaped by a complex interplay of personal and organizational factors and requires a range of strategies and resources to effectively address them. [ABSTRACT FROM AUTHOR]

Abstract Background Home care provides an excellent opportunity for personalizing treatment as nurses see patients in their natural environment. Along with its many advantages, the home care environment carries unique risks, as nurses are usually alone, without the protection and security provided by primary care clinics. There are no accurate data in Israel on the scope and characteristics of client violence against nurses during home visits. We conducted a qualitative study to investigate the nature of client violence faced by Israeli nurses during home visits, to gain insights into their perceptions and experiences, and to contribute to the development of effective policies and strategies to combat client violence in the healthcare sector. Methods Twenty-seven female nurses from primary care clinics, who were exposed to client violence during a home visit, were interviewed using a semi-structured interview guide. The interviews were transcribed and analyzed, and categories and themes were extracted. Results Most nurses interviewed experienced at least three incidents of client violence, the most common of which was verbal abuse. The nurses perceived that the location of the encounter between the nurse and the patient in the patient’s natural surroundings, rather than within the controlled boundaries of a clinic, contributes to the risk of violence. Violence affected the nurses’ professional decisions. The nurses reported that their organization had no established guidelines or instructions for safely conducting home visits, they were not provided with protective or security measures for emergencies, nor did they perceive that they had sufficient training to deal with client violence in clients’ homes. Conclusions Nurses encounter a range of challenges that make it difficult for them to deal with client violence during home visits, affecting their personal safety and professional decisions. Their ability to manage such situations is shaped by a complex interplay of personal and organizational factors and requires a range of strategies and resources to effectively address them.

Psychiatric rehabilitation is to assist disabled people in developing the emotional, social, and cognitive skills required to live, learn, and work in the community with the least amount of professional assistance. The goal of the current case study revealed that support from family, friends, community, treating mental health professionals, and drug compliance contributes to the recovery. Many persons with mental illness will experience disability which becomes a barrier to regular follow-up. The needs of severely disabled people are often neglected or not met adequately by mental health professionals, family, and the community. They do not understand what is happening in the community and the home environment. Therefore, the current case study made an effort to know the actual situation of mentally disabled people in their home environment and evaluated psychiatric rehabilitation needs. A case study was presented in detail with findings of the home visit and the strengths and weaknesses of the home visit from a social work perspective. The case study concludes that community attitude; the economic burden was one of the leading causes of barriers to psychiatric rehabilitation in India.

The COVID-19 pandemic dramatically changed health service delivery with vulnerable patients advised to isolate and appointments provided virtually. This change affected recruitment into an observational cohort study, undertaken at a single site, where participants with mitochondrial disorders were due to have specialist hospital-based audiovestibular tests. To ensure study viability, the study protocol was amended to allow home-based assessment for vulnerable participants. Here, we report outcomes of an online survey of participants who underwent home-based assessment, related to the experience, perceived benefits, and drawbacks of home audiovestibular assessments. Seventeen participants underwent home-based neuro-otological assessment, due to the need to isolate during COVID-19. Following the assessment, 16 out of 17 participants completed an anonymised online survey to share their experiences of the specialist home-based assessment. One hundred percent of participants rated the home-based assessment ‘very positively’ and would recommend it to others. Sixty-three percent rated it better than attending hospital outpatient testing settings. The benefits included no travel burden (27%) and reduced stress (13%). A majority reported no drawbacks in having the home visit. The patient-reported feedback suggests a person-centred approach where audiovestibular assessments are conducted in their homes is feasible for patients, acceptable and seen as beneficial to a vulnerable group of patients.

The COVID-19 pandemic dramatically changed health service delivery with vulnerable patients advised to isolate and appointments provided virtually. This change affected recruitment into an observational cohort study, undertaken at a single site, where participants with mitochondrial disorders were due to have specialist hospital-based audiovestibular tests. To ensure study viability, the study protocol was amended to allow home-based assessment for vulnerable participants. Here, we report outcomes of an online survey of participants who underwent home-based assessment, related to the experience, perceived benefits, and drawbacks of home audiovestibular assessments. Seventeen participants underwent home-based neuro-otological assessment, due to the need to isolate during COVID-19. Following the assessment, 16 out of 17 participants completed an anonymised online survey to share their experiences of the specialist home-based assessment. One hundred percent of participants rated the home-based assessment 'very positively' and would recommend it to others. Sixty-three percent rated it better than attending hospital outpatient testing settings. The benefits included no travel burden (27%) and reduced stress (13%). A majority reported no drawbacks in having the home visit. The patient-reported feedback suggests a person-centred approach where audiovestibular assessments are conducted in their homes is feasible for patients, acceptable and seen as beneficial to a vulnerable group of patients. [ABSTRACT FROM AUTHOR]

Background: Low–middle-income countries (LMICs) face increasing burdens from non-communicable disease (NCDs) requiring primary care task shifting to community health workers (CHWs). This study explored community members' perceptions of NCD-focused, CHW-led home visits in a historically disadvantaged township of South Africa. Methods: Trained CHWs visited community member homes, performing blood pressure and physical activity (PA) screenings, followed by brief counselling and a satisfaction survey. Semi-structured interviews were conducted within 3 days of the visit to learn about their experiences. Results: CHWs visited 173 households, with 153 adult community members consenting to participate (88.4%). Participants reported that it was easy to understand CHW-delivered information (97%), their questions were answered well (100%), and they would request home service again (93%). Twenty-eight follow-up interviews revealed four main themes: 1) acceptance of CHW visits, 2) openness to counselling, 3) satisfaction with screening and a basic understanding of the results, and 4) receptiveness to the PA advice. Conclusion: Community members viewed CHW-led home visits as an acceptable and feasible method for providing NCD-focused healthcare services in an under-resourced community. Expanding primary care reach through CHWs offers more accessible and individualized care, reducing barriers for individuals in under-resourced communities to access support for NCD risk reduction. [ABSTRACT FROM AUTHOR]

AbstractThis study examines the impact of menstrual management awareness training among beneficiaries of the Jalodari Project in Assam, India, covering three tea estates. Quantitative and qualitative data were gathered from 175 participants using various methods. The success of this project can be attributed to the successful implementation and monitoring of key performance indicators. The four-part training, covering menstrual basics and reproductive health, aims to empower participants to effectively manage their menstrual health. The study concludes that menstrual management training is a fundamental component of healthcare of women and that home visits can significantly enhance the effectiveness of awareness training. [ABSTRACT FROM AUTHOR]

ABSTRACT Objective: The objective is to describe the actions and activities carried out by the dentist during home visits. Methods: The experience took place during visits to users of the Basic Health Unit UBS Vila São Pedro in the Municipality of São Bernardo do Campo, a peripheral region with a lot of socioeconomic vulnerability, recording the periods from January to December 2022. The actions and activities described were cataloged as basic levels in health care: promotion, prevention, and diagnosis of soft tissue injuries and damage limitation. Dentists carried out 84 home visits with the purpose of offering oral health care to users restricted to bed, health promotion actions and activities were based on encouraging the practice of healthy habits, making caregivers of bedridden patients aware of the importance of oral hygiene, and how care should be carried out in the oral cavity of these patients where they no longer have the capacity for self-care. Results: The prevention actions were oral hygiene instruction mainly aimed at caring for patients who have restricted movements and who depend on a caregiver to perform oral hygiene, brushing or cleaning with gauze soaked with 0.12% chlorhexidine, and topical application of fluoride to the patients who still have dental elements. The other actions to limit pre-existing oral damage were tooth extractions with periodontal involvement. Conclusion: Therefore, dentist-in-home visits play a fundamental role in promoting quality of life and social life for patients who cannot go to a Basic Health Unit due to being temporarily restricted or permanently restricted to their home.

Tren perilaku penggunaan obat secara mandiri (swamedikasi) di kalangan masyarakat Indonesia, khususnya di Provinsi Sumatera Barat terus meningkat. Tanpa pengetahuan mengenai penggunaan obat yang tepat, masyarakat akan rentan terhadap masalah penggunaan obat. Oleh karena itu, edukasi penggunaan obat oleh perlu dilakukan untuk meningkatkan pengetahuan masyarakat mengenai penggunaan obat. Dengan meningkatkan pengetahuan, masyarakat akan memiliki perilaku penggunaan obat yang rasional. Tujuan kegiatan pengabdian ini adalah meningkatkan pengetahuan masyarakat terkait penggunaan obat bebas dan obat bebas terbatas dalam mengatasi gangguan kesehatan. Metode kegiatan yang dilakukan adalah edukasi melalui kunjungan rumah secara tatap muka. Kegiatan pengabdian ini dilakukan di Nagari Sikucur, Kecamatan V Koto Kampung Dalam, Kabupaten Padang Pariaman. Terdapat 30 anggota masyarakat/perwakilan keluarga yang menjadi sasaran edukasi penggunaan obat berbasis kunjungan rumah ini. Pelaksanaan kegiatan ini melibatkan lima tim pelaksana yang beranggotakan dosen berkualifikasi apoteker, mahasiswa S2 Farmasi dengan kualifikasi apoteker, dan mahasiswa S1 Farmasi. Kegiatan dimulai dengan perkenalan, dilanjutkan dengan pre-test, pemberian edukasi, post-test, dan penyerahan paket obat swamedikasi bagi masyarakat. Hasil edukasi berbasis kunjungan rumah ini menunjukkan skor pengetahuan masyarakat mengenai obat lebih tinggi dibandingkan sebelum edukasi. Dapat disimpulkan tujuan kegiatan ini tercapai dengan baik. Untuk mencapai hasil kegiatan yang lebih baik, diperlukan studi pendahuluan, kerja sama dengan pemangku kepentingan, alokasi waktu, serta persiapan teknis kegiatan yang memadai.

Abstract Background Low-and-middle income countries face a disproportionate burden of non-communicable diseases (NCDs) that threaten to overwhelm under-resourced health systems. Community health workers (CHWs) can promote NCD prevention, reach patients, and connect them to local community health resources; however, little has been done to examine how referrals to these resources are utilized by community members. The purpose of this study is to examine the use of referrals to community-based health resources and investigate the factors influencing patient utilization of referrals connecting them to appropriate health resources for elevated blood pressure (BP). Methods CHWs conducted home visits, which included BP screening and brief counseling, with community members in Soweto, South Africa. Participants with elevated (systolic BP: 121–139/ diastolic BP: 81–89 mmHg) or high (≥ 140/90 mmHg) BP were referred to either a local, community-based physical activity (PA) program managed by a non-governmental organization or local health clinics. The number of participants that received and utilized their referrals was tracked. Follow-up interviews were conducted with individuals given a referral who: (1) went to the PA program, (2) did not go to the PA program, (3) went to a clinic, and (4) did not go to a clinic. Interviews were transcribed and analyzed to identify common themes and differences between groups regarding their decisions to utilize the referrals. Results CHWs visited 1056 homes, with 1001 community members consenting to the screening; 29.2% (n = 292) of adults were classified as having optimal BP (≤120/80 mmHg), 35.8% (n = 359) had elevated BP, and 35.0% (n = 350) had high BP. One hundred and seventy-three participants accepted a referral to the PA program with 46 (26.6%) enrolling. Five themes emerged from the interviews: (1) prior knowledge and thoughts on BP, (2) psychosocial factors associated with BP control, (3) perception about receiving the referral, (4) contextual factors influencing referral utilization, and (5) perceived benefits of utilizing the referral. Conclusion CHWs can successfully increase community members’ access to health resources by providing appropriate referrals. However, greater attention needs to address community members’ barriers and hesitancy to utilize health resources.

Psychiatric rehabilitation is to assist disabled people in developing the emotional, social, and cognitive skills required to live, learn, and work in the community with the least amount of professional assistance. The goal of the current case study revealed that support from family, friends, community, treating mental health professionals, and drug compliance contributes to the recovery. Many persons with mental illness will experience disability which becomes a barrier to regular follow-up. The needs of severely disabled people are often neglected or not met adequately by mental health professionals, family, and the community. They do not understand what is happening in the community and the home environment. Therefore, the current case study made an effort to know the actual situation of mentally disabled people in their home environment and evaluated psychiatric rehabilitation needs. A case study was presented in detail with findings of the home visit and the strengths and weaknesses of the home visit from a social work perspective. The case study concludes that community attitude; the economic burden was one of the leading causes of barriers to psychiatric rehabilitation in India. [ABSTRACT FROM AUTHOR]

Metabolic diseases affect many people in Indonesia. Risk factors for metabolic diseases include age, lack of physical activity, poor diet, and heredity. To provide insight to the community, including youth cadres, is one of the most important efforts to prevent metabolic diseases. The method used in our program was to provide health education to youth cadres in Sagaracipta village, Ciparay subdistrict, Bandung district, regarding how to prevent metabolic disease through home visit, seminars, and counseling training. During the home visit activities, 16 residents' houses were visited to become learning media for youth cadres. The comparison of pre-test and post-test scores from 17 youth cadres in the seminar showed good improvement (39%) of their knowledge regarding metabolic diseases. At the end of the counseling training, 78.13% of youth cadres understood how to provide counseling about metabolic disease to the community. [ABSTRACT FROM AUTHOR]

Purpose: Little empirical data exists evaluating the feasibility of partnering with established home visiting programs to implement early childhood obesity prevention programs, despite the recommendation to do so. To inform this gap, we evaluated the feasibility of collecting anthropometric measurements of children by home visitors across multiple sites, and the alignment of these measurements with children in need, including with adverse family experiences (AFEs) given emerging evidence suggests an association with childhood obesity. Description: Our proof-of-concept study included primary data collection of child anthropometric measurements through an established home visiting program in four states. This sample included 248 children ages 6 months to 5 years. Assessment: In the sample, 37.1% of the children had overweight or obesity, 50% were female, 64.2% Hispanic/Latinx, 15.8% non-Hispanic Black, and 42.3% from rural/small towns. Households included substantial needs: 87.1% were low income, 73.8% low education, and 59.3% underemployment. Regarding AFEs, 38.3% of the children had at least one, with the most common being mothers who were treated violently. A multivariable model revealed community type, not AFEs, was significantly associated with overweight/obesity status, suggesting children in suburban and especially rural/small town residences (odds ratio 5.11; 95% CI [1.59, 16.39]) could be priority populations for childhood obesity prevention programs. Conclusion: Findings of this multi-site study inform the feasibility of partnering with home visiting programs to reach and measure a diverse sample of children and families in need of childhood obesity prevention. Significance: What is already known on this subject? Home visiting programs are a recommended gateway for early childhood obesity prevention efforts, but the feasibility of implementing this recommendation is understudied. What this study adds? This multi-site, multi-state study evaluated the feasibility of collecting anthropometric measurements through an established home visiting program, including the ability to reach children with overweight or obesity, from diverse backgrounds, and with adverse family experiences. This is an important step before implementing and scaling an early childhood obesity prevention program. Findings inform the development of childhood obesity prevention partnerships with home visiting programs. [ABSTRACT FROM AUTHOR]

Aims: The primary aim of this systematic review and meta‐analysis is to evaluate the effects of home nurse visiting on infant weight and breastfeeding; the secondary aim is to determine the duration, frequency and content of home visits. Methods: A systematic search of the PubMed, CINAHL, Embase (Ovid), Web of Science, Google Scholar and DergiPark databases for publications between September 2000 and January 2019 was conducted using established methods in compliance with the PRISMA‐P declaration guideline. Two authors independently evaluated the studies for inclusion and bias, extracted the data and checked their accuracy. Results: This meta‐analysis includes a total of 34 studies, 28 on breastfeeding and nine on infant weight. The average effect size of the 28 studies investigating the effect on breastfeeding was found to be OR: 2.24; 95% CI: 1.73–2.90; p < 0.001. The average effect size of the nine studies investigating the effect on infant weight was found to be ES: 0.197; 95% CI: 0.027–0.368; p < 0.05. Conclusion: There is an association between nurse home visits and breastfeeding and infant weight. Home visits by nurses should continue to remain within the nursing role and be analysed appropriately for mother and baby health. Summary statement: What is already known about this topic? Two of the most important factors affecting infant morbidity and mortality are infant weight and breastfeeding.Although breastfeeding has numerous benefits for the baby, breastfeeding rates are decreasing in the world and in Turkey. Breastfeeding improves infant health and supports development.One of the factors that negatively affects infant health is low or below expected body weight. Inadequate weight gain will in turn negatively affect the healthy growth of the baby.It has been found that care, education and support related to breastfeeding and infant weight improve outcomes for babies and their mothers but there is no evidence that home visitation is an effective way to deliver this care. What this paper adds? Review results indicate home visits have a significant effect on improving infant health. A positive effect was detected between nurse home visits and breastfeeding and infant weight. The implications of this paper: Home visits should be presented and analysed appropriately for the mother and baby's health.Education, care and support during home visits help mothers breastfeed. [ABSTRACT FROM AUTHOR]

The sustainability of breastfeeding remains a challenge for primiparous mothers. Empowering women through home visits by midwives needs to be enhanced to ensure the continuity of breastfeeding. This research aimed to compare the effectiveness of the SETIA (Self-Empowering Women, Empathy, Trust, Intimacy, and Affection) program with a standard program in assisting primiparous mothers to breastfeed their babies after one month. A total of 50 primiparous participants were divided into two groups through simple random sampling. The standard group received four home visits, while the SETIA group received five home visits within one month postpartum. The breastfeeding competency variable was evaluated after one month using the World Health Organization (WHO) instruments and interviews about exclusive breastfeeding. The variables were analyzed using comparative statistics. The results showed no significant difference between the standard and SETIA groups, with Mann-Whitney U values of 253.5 and Wilcoxon values of 578.5 (p-value=0.086, α

Abstract Background Asthma home-visit programs delivered by community health workers (CHWs) are an effective way to improve asthma outcomes and cost of care, through performing home environmental inspections, delivering education and hands-on demonstrations, and providing personalized behavior change support. During the COVID-19 pandemic, many in-person asthma CHW programs have been adapted to be delivered virtually, but it is unclear whether this is acceptable or feasible for clients with asthma. This qualitative study sought to identify perspectives of prior clients of the Public Health–Seattle & King County Asthma Program on acceptability and feasibility of a hypothetical virtual asthma program. Methods We performed semi-structured interviews with participants speaking English, Spanish, and Somali. An a priori codebook was developed based on the Theoretical Framework of Acceptability and was revised iteratively during coding. Intra-rater reliability was established, and thematic analysis was used to determine major themes. Results A total of 19 individuals participated (9 speaking English, 8 Spanish, and 2 Somali). Krippendorf’s alpha was 0.848, indicating high intra-rater reliability. Our results demonstrated that many participants felt positively about the prospect of completing the program virtually, but they also expected a variety of challenges, the most important of which were lack of engagement with the CHW and lack of confidence in the accuracy of a virtual home inspection. Participants also varied widely in their comfort level with videoconferencing platforms and their access to adequate internet connectivity. Conclusions Acceptability and feasibility of virtual programming varies widely between participants, indicating that there may be no “one-size-fits-all” approach. We present several recommendations for adapting in-person asthma home visit programs to a virtual format, including considering a hybrid approach to delivery, making concerted efforts to build rapport when using videoconferencing, and deliberately evaluating the effectiveness of new adaptations, especially if a virtual environmental assessment is attempted.

Abstract Background The transition to motherhood is characterized by physical, psychological, social, and relational changes. Quality of life (QoL) changes substantially during this transition. Higher QoL is associated with social support, essential for coping with the challenges and changes of becoming a mother. An early universal home visiting program (New Families) is developed to strengthen and support families. The study aims to evaluate the impact of New Families on first-time mothers’ QoL and to investigate the association between their QoL, social support, and selected possible predictive factors. Methods A prospective non-randomized controlled study with parallel group design. Child Health Services in five city districts of Oslo were matched in intervention and control groups. First-time mothers were allocated based on the residential area and assessed at pregnancy week 28 (N = 228), six weeks postpartum (N = 184), and three months postpartum (N = 167). Measures of the World Health Organization Quality of Life brief, Perinatal Infant Care Social Support Scale, and background variables were collected from October 2018 to June 2020. Multivariate linear regression models were applied to examine intervention impact and assess associations. Results Our data did not reveal a significant association between New Families intervention and the QoL levels of first-time mothers at three months postpartum. Thus, we analyzed the whole sample together. Emotional support was significantly associated with higher QoL levels in the physical health (B = 0.19, 95%CI [0.04 to 0.34]) and social relationships (B = 0.40, 95%CI [0.20 to 0.60]) domains. Appraisal support was significantly associated with higher QoL levels in the psychological (B = 0.34, 95%CI [0.18 to 0.50]) and environment (B = 0.33, 95%CI [0.19 to 0.48]) domains. QoL levels in pregnancy were significantly associated with QoL levels postpartum, showing small to medium effect size (ES = 0.30 to 0.55), depending on the domain. Conclusions Further research, including qualitative interviews, could provide more insights into the impact of New Families on QoL. A positive association between QoL levels in pregnancy and postpartum suggests that postnatal interventions targeting improved QoL could potentially improve postpartum QoL. Emotional and appraisal support seems beneficial for first-time mothers’ QoL and could be provided and facilitated by public health nurses. Trial registration clinicaltrial.gov NCT04162626.

Abstract Aim To investigate reflections of public health nurses (PHNs) on implementing the New Families programme, a supplement to the usual Norwegian child health centre programme. It involves user‐led decisions on the content and number of home visits offered by the family's PHN from pregnancy week 28 until the child is 2 years. Design An interpretive description approach. Methods Altogether 206 anonymized, undated reflection notes by PHNs becoming familiar with the programme were collected in 2017–2020. NVivo 12 and inductive content analysis were used to convert the data into manageable segments. Results Focusing on childhood experiences and parental role expectations among prospective parents during home visits was seen as a major shift in the nurses' counselling strategy. Providing relevant information to the parents‐to‐be ahead of a meeting was important. Given sufficient staff and guidance, the programme was considered a good basis for building a relationship with the family.

Home visits are an intervention instrument of the Unified Social Assistance System and the main link between teams and families. This qualitative research aimed to understand the experience of home visits, from the perspective of families monitored by the Unified Social Assistance System. So, 12 in-depth interviews were conducted with people from the families visited. The data were organized and analyzed from the perspective of Grounded Theory, with the aid of the software Atlas.Ti 8.4. The results showed families with histories of vulnerabilities and violence, the interviewees were unaware of the reason for the home visit and built ambivalent bonds with the professionals. The need to reflect on the proposal of the community bond and the objectives of home visits, between families and professionals, is highlighted. [ABSTRACT FROM AUTHOR]

Copyright of Saúde Coletiva is the property of MPM Comunicacao and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Foco (Interdisciplinary Studies Journal) is the property of Revista Foco and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Asthma home-visit programs delivered by community health workers (CHWs) are an effective way to improve asthma outcomes and cost of care, through performing home environmental inspections, delivering education and hands-on demonstrations, and providing personalized behavior change support. During the COVID-19 pandemic, many in-person asthma CHW programs have been adapted to be delivered virtually, but it is unclear whether this is acceptable or feasible for clients with asthma. This qualitative study sought to identify perspectives of prior clients of the Public Health–Seattle & King County Asthma Program on acceptability and feasibility of a hypothetical virtual asthma program. Methods: We performed semi-structured interviews with participants speaking English, Spanish, and Somali. An a priori codebook was developed based on the Theoretical Framework of Acceptability and was revised iteratively during coding. Intra-rater reliability was established, and thematic analysis was used to determine major themes. Results: A total of 19 individuals participated (9 speaking English, 8 Spanish, and 2 Somali). Krippendorf's alpha was 0.848, indicating high intra-rater reliability. Our results demonstrated that many participants felt positively about the prospect of completing the program virtually, but they also expected a variety of challenges, the most important of which were lack of engagement with the CHW and lack of confidence in the accuracy of a virtual home inspection. Participants also varied widely in their comfort level with videoconferencing platforms and their access to adequate internet connectivity. Conclusions: Acceptability and feasibility of virtual programming varies widely between participants, indicating that there may be no "one-size-fits-all" approach. We present several recommendations for adapting in-person asthma home visit programs to a virtual format, including considering a hybrid approach to delivery, making concerted efforts to build rapport when using videoconferencing, and deliberately evaluating the effectiveness of new adaptations, especially if a virtual environmental assessment is attempted. [ABSTRACT FROM AUTHOR]

Being a nurse, called kangofu ..., was a new occupation for women during the period of Taiwan under Japanese colonial rule, a profession which was only occupied by women until the 1980s. The promotion of public health work in Taiwan began during the Japanese colonial period, especially in the later part with the rise of health care workers, hokenfu ..., who can be viewed as the pioneers of Taiwan's public health nurses. After the retrocession of Taiwan to the Republic of China in 1945, under the support of U.S. aid and government resources, the public health centers established throughout the township level became the most basic public health institution in Taiwan. Operating from these centers, public health nurses became mainly responsible for publicizing various health affairs, promoting the knowledge of health policies, preventive health care, maternal and pediatric health, as well as infectious disease prevention and control. In addition to performing these public health duties, one of the most important tasks of public health nurses was home visits. They utilized their female roles to establish relationships with housewives, and during the visits, they not only observed the living conditions of the families in question, but also disseminated "correct" health knowledge. Through archives, health magazines, work reports, and newspapers, this article demonstrates that when considering the training of public health nurses at public health centers as well as their public health work and home visit practices from the 1950s to 1970s, one can apprehend the image of these nurses and how public health knowledge was circulated between them and women in post-war Taiwan. [ABSTRACT FROM AUTHOR]

This article explores a male first-time stroke patient who was a low-income single parent taking care of three minors. During interviews, the case's low moods were observed leading to motivation for further investigation. The nursing period was from September 3 to September 10, 2019. By providing care, conducting interviews, and using Gordon's 11 functional health patterns for assessment, a cross-disciplinary team collaborated on the care model and conducted a home visit on the day after discharge. Several health problems were confirmed: Ineffective health maintenance ability, physical activity impairment, and anxiety. Through a good nurse-patient relationship, care guidance was provided, and the patient was accompanied and listened to, which helped improve anxiety, encouraged rehabilitation, and achieved seamless home care and rehabilitation. During the home visit, the home environment was found to be dirty and disorganized. Through community resources, the environment was improved and more social resources were obtained. It is suggested that hospitals should establish care teams to deepen community involvement, provide assistance through home visits, ensure proper home care for the patient, reduce the chance of rehospitalization, enhance the quality of home care, and reduce the consumption of medical resources. [ABSTRACT FROM AUTHOR]

Copyright of Arquivos de Ciências da Saúde da UNIPAR is the property of Associacao Paranaense de Ensino e Cultura and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Aim: Phenylketonuria (PKU) is an inherited metabolic disorder in which accumulation of phenylalanine (Phe) leads to poor neurological outcomes without treatment. Dietary therapy is the main treatment and nonadherence is associated with elevated blood Phe levels and correspondingly poor neuropsychiatric outcomes. This study aimed to examine the effect of home visits on blood Phe levels in PKU patients. Methods: Sixty‐five paediatric PKU patients who were on low‐phenylalanine diet were visited monthly at home for 6 months. At each visit, dietary education was provided, patients' height and weight were measured and blood samples were collected. Results: Twenty‐eight (43.1%) patients had classic PKU and 37 (56.9%) had moderate PKU. Blood Phe levels decreased statistically significant at first, second, fifth, and sixth months compared with screening visit. Blood Phe levels in moderate PKU patients decreased significantly at the last visit unlike classic PKU patients. A significant decrease in blood Phe levels was observed in patients older than 10 years. Anthropometric parameters improved. Conclusions: Dietary nonadherence is the main treatment failure in PKU. Home visits for education are a promising way to improve treatment outcomes by providing quality education, better assessment, and correction of mistakes but they should be ongoing and supported by different interventions that address patients' special needs. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to determine the effect of a home visit program on the perceived care burden of family caregivers of adults with asthma. Design: A single‐blind randomized controlled trial. Sample: The study was conducted with 30 participants in both the intervention and control groups. Measurements: Care burden was measured via the Zarit Caregiver Burden Scale during the first interview at the pulmonology outpatient clinic and after the last home visit. Intervention: A nurse‐led home visit program with five visits over three months included education and health counseling with the intervention group. Control group received standard education given in the outpatient clinic. Results: The mean Zarit Caregiver Burden Scale scores of the intervention group in the post‐test were significantly lower than the control group. Conclusions: The current study revealed that the nurse‐led home visit program, including education and health counseling, was effective in reducing the care burden for family caregivers of adults with asthma. Nurses can play an active role in preventing the negative effects of caregivers' burden of care, protecting their sense of control, and improving their health. Home visits integrated into the health care system could be effective in reducing the care burden of family members. [ABSTRACT FROM AUTHOR]

Objective This study aimed to identify phenotypes of nutritional needs of home-visited clients with low income, and compare overall changes in knowledge, behavior, and status of nutritional needs before and after home visits by identified phenotypes. Materials and methods Omaha System data collected by public health nurses from 2013 to 2018 were used in this secondary data analysis study. A total of 900 low-income clients were included in the analysis. Latent class analysis (LCA) was used to identify phenotypes of nutrition symptoms or signs. Score changes in knowledge, behavior, and status were compared by phenotype. Results The five subgroups included Unbalanced Diet, Overweight, Underweight, Hyperglycemia with Adherence, and Hyperglycemia without Adherence. Only the Unbalanced Diet and Underweight groups showed an increase in knowledge. No other changes in behavior and status were observed in any of the phenotypes. Discussion and conclusions This LCA using standardized Omaha System Public Health Nursing data allowed us to identify phenotypes of nutritional needs among home-visited clients with low income and prioritize nutrition areas that public health nurses may focus on as part of public health nursing interventions. The sub-optimal changes in knowledge, behavior, and status suggest a need to re-examine the intervention details by phenotype and develop strategies to tailor public health nursing interventions to effectively meet the diverse nutritional needs of home-visited clients. [ABSTRACT FROM AUTHOR]

Aim: To investigate reflections of public health nurses (PHNs) on implementing the New Families programme, a supplement to the usual Norwegian child health centre programme. It involves user‐led decisions on the content and number of home visits offered by the family's PHN from pregnancy week 28 until the child is 2 years. Design: An interpretive description approach. Methods: Altogether 206 anonymized, undated reflection notes by PHNs becoming familiar with the programme were collected in 2017–2020. NVivo 12 and inductive content analysis were used to convert the data into manageable segments. Results: Focusing on childhood experiences and parental role expectations among prospective parents during home visits was seen as a major shift in the nurses' counselling strategy. Providing relevant information to the parents‐to‐be ahead of a meeting was important. Given sufficient staff and guidance, the programme was considered a good basis for building a relationship with the family. [ABSTRACT FROM AUTHOR]

Introduction: Postpartum home visits have yielded conflicting results. One of the challenges in this field is the implementation of effective training to support mothers after giving birth to investigate the problems of exclusive breastfeeding. The present study was performed with aim to investigate the impact of home visits by midwives on the amount of breastfeeding problems after delivery. Methods: This clinical trial study was conducted on 100 mothers who gave birth in Flowerjan Imam Khomeini Hospital in 2018. The subjects were randomly divided into two groups of intervention and control (n=50 in each group). The control group received routine postpartum care through health centers and the intervention group received training in 4 sessions (in the early postpartum period up to 42 days after birth) at home. The data collection tool was a demographic and breast problems questionnaire which was completed in mothers' homes. Data was analyzed by SPSS statistical software (version 22) and independent t-test and paired t-test. P0.05). The frequency of fissure on the third day was significantly lower in the intervention group than the control group (P0.05). There was no fissure in any of the two groups on the forty-second day. Conclusion: Practical advice and support on breastfeeding techniques by trained midwives may result in greater transfer of skills and reduced fissure and engorgement.

Home visits are an intervention instrument of the Unified Social Assistance System and the main link between teams and families. This qualitative research aimed to understand the experience of home visits, from the perspective of families monitored by the Unified Social Assistance System. So, 12 in-depth interviews were conducted with people from the families visited. The data were organized and analyzed from the perspective of Grounded Theory, with the aid of the software Atlas.Ti 8.4. The results showed families with histories of vulnerabilities and violence, the interviewees were unaware of the reason for the home visit and built ambivalent bonds with the professionals. The need to reflect on the proposal of the community bond and the objectives of home visits, between families and professionals, is highlighted.

Objective: The aim of this study was to investigate acceptance of preventive home visits (PHVs) for older adults in rural Germany. Design: Qualitative descriptive approach. Sample: We investigated the personal, individual perspective of adults aged 65 to 85, who were not yet eligible for benefits from the long‐term care insurance, were able to understand and speak German, and who lived in the municipality under study. Measurements: Fifteen semi‐structured interviews were conducted between 02/2019 and 08/2020. They were transcribed, coded using MAXQDA, and content analyzed. Ethical approval was obtained. Results: The acceptance of PHVs was extremely high and characterized by five main effects: very close relationship with the nurse, well‐being, empowerment, satisfaction, ambivalence. Participants wish to receive PHVs in the future and would recommend it to others. Even those with a healthy or health‐promoting lifestyle are thankful to be able to refer to the counselling sessions if life circumstances should deteriorate. Those who became care‐dependent wish to continue and perceive it as a valuable addition to their care. Conclusion: From the participants' point of view, this low‐threshold counselling‐and‐support approach should be maintained in the future. PHVs can support health and independence in older adults and therefore prevent them from becoming care‐dependent. [ABSTRACT FROM AUTHOR]

This study aims to define critical domains of salutogenic home visits conducted by public health nurses, and how thevisits can supplement a universal Child Health Clinic. A qualitative grounded theory study was conducted among three public health nurses in Stovner district, Oslo, Norway. The nurses were followed for 26 months offering home visits to all first-time parents. Data from focus group discussions, monthly reflection notes and bi-weekly meeting minutes were analysed using qualitative content analysis. Three critical themes emerged: building trust, prenatal visits and maintaining a salutogenic, strength-based approach. Extended public health nurse autonomy facilitated tailored support based on individual family needs. This promoted proportionate universalism to naturally be the gradient of the home visit intensity and kept actions at a universal level. The key component of family access and utilizing support was building and maintaining trust. Conducting prenatal visits was an important part of the nurse-family relationship, positively affecting later Child Health Clinic follow-up and continued care. Critical domains and benefits of practicing home visits emerged in this study and disclosed important aspects necessary for family access and utilizing support. By changing the point of entry from postnatal to prenatal, public health nurses-family relationship gets an important head start, positively affecting later follow-up and continued care. A tailored support to new families without using a predefined agenda and a salutogenic, strength-based philosophy can fit the public health nurses' professional beliefs and extend their autonomy. • When building a home visit program, the knowledge of practising health professionals needs to be recognized. • At the core of conducting home visits are building a trusting relationship between the public health nurse and the family. • Conducting home visits with a salutogenic theory and approach was a key factor of public health nurses job satisfaction. [ABSTRACT FROM AUTHOR]

A healthy family or not using several indicators or markers, in the framework of implementing the Healthy Indonesia Program it has been agreed that there are 12 indicators for family health status markers. With very low coverage, families with family members suffering from hypertension and not being treated regularly are certainly a problem for other family members and the patient himself. The flow of searching for articles uses the PRISMA (Preferred Reporting Items for Literature Reviews and Meta-Analyses) method which begins with collecting articles according to keywords from the various databases used. After that, a check is made for duplicate titles, and the same title is eliminated from the article search process. The search is continued by eliminating articles that have irrelevant titles to the topics to be reviewed. The results of the selection of selected articles were 7 articles. This condition becomes a reference for local governments at both the district and provincial levels to provide appropriate interventions as a solution to these health problems. The goal of achieving this health status is to become a benchmark for the central government to see the success of the health programs that have been implemented so far. public health services as the spearhead of PISPK implementation are required to be able to run the PISPK program thoroughly and cover all areas in the working area of the public health services. Community health center activities through home visits did not end with data collection but continued when carrying out interventions for residents who have health problems. PISPK's further intervention is very important to do in improving the Healthy Family Index. Research results should be disseminated at the Community Health Center to improve public health nursing services.

Background: Pediatric home-based palliative care and/or hospice provider (Physician, Advanced Practice Nurse, or Physician Assistant) home visits are an underexplored subject in the literature with little available descriptive data and limited evidence guiding how best to utilize them. Objectives: Describe the population receiving hospice and palliative medicine (HPM) provider home visits and characterize visit themes. Design: Retrospective chart review of electronic medical record (EMR) data Setting/Subjects: A total of 226 individuals 1 month to 21 years of age, who received an HPM provider home visit from January 1, 2013, to December 31, 2018; two large quaternary medical centers in the Midwest. Measurements: Demographic data, content, and details from home visit abstracted from the EMR. Results: The three most common diagnostic groups receiving HPM provider home visits were neurological (42%), congenital chromosomal (26%), and prematurity-related (14%) conditions. Goals of care (GOC) were discussed at 29% of visits; most commonly, goals related to code status (42%), technology dependence (20%), and nutrition/hydration (15%). A change in GOC occurred in 44% of visits. Forms of anticipatory guidance addressed were nutrition (68%), side effects of treatment (63%), pain assessment (59%), decline/death (32%), and allow natural death/do not resuscitate/advance directives (26%). Conclusion: HPM provider visits are diverse in content and changes in plan of care with potential for proactive identification of GOC and provision of important anticipatory guidance around patient decline and end of life. Further research is indicated to establish which populations benefit most and how to leverage this scarce resource strategically. [ABSTRACT FROM AUTHOR]

Objective:To evaluate the application of the Patient Health Questionnaire-9 (PHQ-9) in postpartum depression screening among postpartum women during home visit in the community. Methods:From December1,2020 to June 30,2021,all mothers who had postnatal home visits and were at least 18 years old in Changsha City were recruited. The mothers were asked to complete the general information form and PHQ-9 online. Within 7 days after screening,diagnostic interview was conducted through video meeting by 3 qualified mental health specialists. The Cronbach’s α coefficient,split-half reliability,area under the receiver operator characteristic curve (AUC),sensitivity,specificity,positive predictive value (PPV),negative predictive value (NPV) and cut-off value of PHQ-9 were evaluated. Results:Totally 1862 women completed the electronic questionnaire and the diagnostic interview,and 62 (3. 3%) mothers were diagnosed with a current depressive episode. The Cronbach’s a coefficient of PHQ-9 was 0. 85,the split-half reliability was 0. 81. AUC of PHQ-9 was 0. 87 (SE=0. 02,95% CI:0. 85-0. 93,P ＜0. 001) . The best cut-off for PHQ-9 was 4/5,with sensitivity of 73%,specificity of 77%,PPV of 10%,and NPV of 99%. Conclusion:It suggests that the Patient Health Questionnaire-9 (PHQ-9) may be an effective screening tool for postpartum depression during home visits in the community,but the positive predictive value is low. [ABSTRACT FROM AUTHOR]

Objective: Public health nurses in Norway provide a range of health promotion and primary prevention services to families in the postpartum period. The study objectives were to describe parents' experiences of: 1) being introduced to the Circle of Security Parenting program during a home visit and 2) participating in a parent group meeting. Design: Qualitative descriptive study. Sample: A purposeful sample of 24 caregivers (n = 15 mothers, n = 9 fathers) parenting an infant. Measures: In‐depth, semi‐structured interviews were conducted to document participants experiences. Content analysis was used to code and categorize the data. Findings: Three main categories with seven subcategories reflected the parents' experiences: 1) Confidence‐building home visit, 2) Awareness‐raising parental group, 3) Dissemination of knowledge. Conclusions: The parents experienced the home visit as being on their family's terms and reassuring. The parental group session started a reflection process which made them aware of the importance of being present for their child, how to modify their communication and have a common understanding of childrearing. The parents thought the group was a great way to introduce the Circle of Security Parenting program and experienced it as a continuation of the information presented at the home visit. The introduction provided them with new knowledge. [ABSTRACT FROM AUTHOR]

Abstract Background There is consensus that medical schools have a duty to educate students about social determinants of health (SDOH) and equip them with skills required to ameliorate health disparities. Although the National Academy of Medicine (NAM) urged the development of experiential long term programs, teaching is usually conducted in the pre-clinical years or as voluntary courses. ETGAR a required health disparities course, based on the social ecological model, was initiated to answer the NAM call. This study aimed to ascertain the course impact on students learning of SDOH and health disparities. Methods Students during their first clinical year cared for four patients in their transition from hospital back home, one patient in each internal medicine, surgery, pediatrics and obstetrics/gynecology rotation. The students home-visited their patients after meeting them in hospital and preparing a plain language discharge letter. Training session prior to the course, a tutorial in each rotation, and structured feedback gave the educational envelope. Mixed methodology was employed to evaluate the course impact. Quantitative data collected by students during the home-visit: patients’ characteristics and quality and safety of the transition back home using the Medication Discrepancy Tool and Care Transition Measure questionnaire. Stakeholders’ views were collected via interviews and focus groups with students representing all affiliated hospitals, and interviews with heads of departments most involved in the course. Results Three hundred six students in three academic years, between October 2016–July 2019, completed home visits for 485 disadvantaged patients with improvement in patients’ knowledge of their treatment (3.2 (0.96) vs 3.8 (0.57), Z = -7.12, p

Abstract Background Uncontrolled diabetes is an important public health problem that endangers the quality of life of patients. Promoting self-management through well-planned training is an essential strategy to control diabetes effectively. This study aimed to examine the effects of a training program based on social cognitive theory (SCT) on self-management behavior, glycemic index, and quality of life among patients with type 2 diabetes mellitus. Methods This is a quasi-experimental study with a pretest–posttest design. The statistical population included 106 adults with type 2 diabetes mellitus assigned to the intervention and control groups [n1 = n2 = 53], who received services from two urban health centers. A multi-method, SCT-based training program consisting of six 60–80-min sessions was run, followed by 2–3 follow-up home visits [once a month for each participant] for the intervention group. The data were collected before and three months after the intervention and were analyzed in SPSS 19. Results Before the intervention, there was no significant difference between the two groups regarding the main variables. After the intervention, there was a significant increase in the intervention group's mean scores of knowledge, self-efficacy, social support, outcome expectations, self-regulation, self-management behavior, glycemic index, and quality of life. There were no significant changes in these constructs in the control group after the intervention. The regression analysis results indicated that social cognitive theory and self-management could explain the variance in quality of life [adjusted R-squared = 0.476]. Conclusions The findings support the effectiveness of the multi-method, SCT-based educational intervention in improving self-management behaviors, glycemic index, and quality of life among patients with type 2 diabetes mellitus. It is suggested that the quality of type 2 diabetes care programs should be promoted. However, further research is needed to evaluate the long-term outcomes.

The uncertain health care situations, such as that created by the COVID-19 pandemic, has limited hospital access and facilitated a paradigm shift in health care toward an increased demand for standard home visits and community-based rehabilitation services, including by ambulatory individuals with spinal cord injury (SCI). This 6-month prospective study explored the validity and reliability of a single-time sit-to-stand (STSTS) test when used by primary health care (PHC) providers, including a village health volunteer, caregiver, individual with SCI, and health professional. Eighty-two participants were assessed for the STSTS using four arm placement conditions (arms on a walking device, arms on knees, arms free by the sides, and arms crossed over the chest) and standard measures, with prospective fall data follow-up over 6 months. Thirty participants involved in the reliability study were also assessed and reassessed for the ability to complete the STSTS conditions by PHC providers. Outcomes of the STSTS test, except the condition with arms on a walking device, could significantly discriminate lower extremity muscle strength (LEMS) and mobility of the participants (rpb = −0.58 to 0.69) with moderate concurrent validity. Outcomes of the tests without using the arms also showed moderate to almost-perfect reliability (kappa = 0.754–1.000) when assessed by PHC raters. The findings suggest the use of an STSTS with arms free by the sides as a standard practical measure by PHC providers to reflect LEMS and mobility of ambulatory individuals with SCI in various clinical, community, and home-based settings. [ABSTRACT FROM AUTHOR]

Madam M, a 54-year-old Malay lady with underlying bronchial asthma for the past 30 years, on fluticasone and salbutamol inhalers, was admitted to the hospital following the chief complaint of breathing difficulty one day before admission. The patient was diagnosed with Acute Exacerbation of Bronchial Asthma secondary to Community-Acquired Pneumonia related to obesity and a weak immune system which is evidenced by a history of chronic asthma, previous history of lung infection and the use of a corticosteroid inhaler. This is further contributed by a strong family history of asthma and a recent visit of relatives with flu-like symptoms. Furthermore, there is also continuous exposure to asthma triggers as evidenced by carpets in the living room of the patient's house, the presence of cats at the house and a nearby oil palm factory releasing fumes. Wellness intervention was identified and applied for this patient, who has self-consciousness about her health and receives good social and emotional support from family and friends. [ABSTRACT FROM AUTHOR]

No abstract available.