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Aim: This study aimed to discuss the role of home-visit nurses in managing continuous catecholamine infusion in patients with heart failure by investigating the outcome of patients and the home-visit nursing intervention., Methods: We conducted a retrospective, case series study of eight patients with heart failure who underwent home-based continuous catecholamine infusion between April 2016 and March 2024. Data including the patients' demographics, the duration of continuous catecholamine infusion, the frequency of nursing and emergency nursing visits, and patients' endpoints were collected., Results: The median age of the patients was 68.5 (interquartile range: 51.8-80.0) years and 75% were men. The most common diagnosis requiring home-based catecholamine infusion was dilated cardiomyopathy. The median duration of continuous catecholamine infusion in the patients was 58.0 days. The median frequency of nursing visits was 8.4 times each week. Forty-five emergency nursing visits occurred, and the most common reason for these visits was managing infusion device malfunctions. Among the patients, six died at home, one was hospitalized owing to fatal arrhythmia, and one withdrew from continuous catecholamine infusion., Conclusion: This study shows the complexities of providing home-based care for patients with heart failure requiring continuous catecholamine infusion. Most patients with heart failure were able to spend the rest of their lives at home, despite the challenges of managing such a treatment outside the hospital. Our findings indicate the need for early intervention, multidisciplinary collaboration, and the development of home care protocols to optimize treatment efficacy and the quality of life of these patients.

Abstract Background Japan has the largest population of older adults in the world; it is only growing as life expectancy increases worldwide. As such, solutions to potential obstacles must be studied to maintain healthy, productive lives for older adults. In 2011, the Japanese government has started a policy to increase “Elderly Housing with Care Services (EHCS)”, which is one of a private rental housing, as a place where safe and secure end-of-life care can be provided. The government expect for them to provide end-of-life care by collaborating with the Home-Visit Nursing Agencies (HVNA). The purpose of this study is to clarify the situation of the end-of-life care provision in EHCS in collaboration with HVNA and to examine the factors that associate with the provision of the end-of-life care in EHCS. Methods A two-stage nationwide survey (fax and mail surveys) were conducted. Of the 5,172 HVNA of the National Association for Visiting Nurse Services members, members from 359 agencies visited EHCS. Logistic regression analysis was conducted with the provision of end-of-life care to EHCS in 2017 as the dependent variable, and the following as independent variables: characteristics of HVNA and EHCS; characteristics of residents; collaborations between HVNA and EHCS; and the reasons for starting home-visit nursing. Results Of the 342 HVNA who responded to the collaborations with EHCS, 21.6% provided end-of-life care. The following factors were significantly associated with the provision of end-of-life care to inmates in elderly care facilities: being affiliated with a HVNA, admitting many residents using long-term care insurance, collaborating with each other for more than three years, and started visiting-nurse services after being requested by a resident’s physician. Conclusions This study clarified the situation of the provision of end-of-life care in EHCS in collaboration with HVNA and the related factors that help in providing end-of-life care in EHCS.

This study aims to examine the reliability and validity of Home-visit Nursing Quality Indicators for Children (HNQIC) with medical complexity in Japan that will enable measuring the quality of services provided by home-visit nursing agencies (HNA) for children with medical complexity (CMC) and their families. This study employed a model that measures medical quality as proposed by Donabedian in a conceptual framework. The HNQIC is comprised of a total of 42 items with responses in 5-point Likert scale: 8 items in "Structure", 24 items in "Process", and 10 items in "Outcome". A self-rating questionnaire survey was administered and responses from 57 home-visit nursing agencies were analyzed. An exploratory factor analysis was performed to examine the validity of the construct, and a covariance structure analysis was performed to examine the structural validity of the model that measures medical quality. The "Structure" and "Process" sections included 28 items in 5 factors, and the "Outcome" section included 7 items in 3 factors. The Cronbach's α coefficient for all of the items of "Structure" and "Process" was 0.93, and that of "Outcome" was 0.76. As a result of a covariance structure analysis, we obtained following goodness-of-fit indices: χ2 / df = 1.41, GFI =.897, AGFI =.794, CFI =.926, and for the coefficient of determination.14 ≤ R2 ≤.68. As the statistical validity of the HNQIC was confirmed, we determined the goodness-of-fit indices of the model to be acceptable. The findings suggested that the HNQIC can be used as a quality indicator to access care effects objectively to provide better support. • Home-visit nursing plays important roles to support increasing number of CMC. • Home-visit nursing quality indicator guidelines exclusive to CMC are needed. • Developed Home-visit Nursing Quality Indicators for Children with medical complexity. [ABSTRACT FROM AUTHOR]

Abstract Background The qualities required for new graduates to become visiting nurses remain unclear. The present study aimed to clarify the qualities required for new graduate visiting nurses. Methods Semi‐structured interviews were conducted with nine home‐visiting nurses. Content analysis was conducted by the transcribed data collected from visiting nurses. Results Years of nursing experience were ranged from 16 to 50. In total, 23 attributes were extracted and categorized. Conclusion Our findings indicated that the qualities required for new graduate visiting nurses were as follows: basic knowledge and skills required as professionals and appropriate attitudes as members of society.

Objectives: This study aims to clarify whether work engagement mediates the relationship between job resources (i.e., supervisor support, coworker support, and job control) and work-to-family positive spillover (WFPS) for home-visiting nursing staff. Methods: This cross-sectional study surveyed 15 male and 152 female participating home-visit nursing staff across 108 home-visit nursing stations in Fukuoka Prefecture, Japan. In February 2019, each participant provided informed consent and sociodemographic information, and answered three scales, including the short-form version of the Utrecht Work Engagement Scale in Japanese, the Japanese version of the Survey Work-Home Interaction – Nijmegen (J-SWING), and the Job Content Questionnaire (JCQ-22). We evaluated supervisor support, coworker support, and job control as job resources using the JCQ-22’s subscale. We then evaluated WFPS using the J-SWING’s subscale. The hypothesized model was then tested using structural equation modeling. Results: Job resources were positively related to work engagement among the home-visit nursing staff; in turn, work engagement was positively related to WFPS. Job resources had no significant relationship with WFPS. These results suggest that work engagement mediates the relationship between job resources and WFPS. Conclusions: This study found that job resources were not directly related to WFPS for home-visit nursing staff. However, work engagement mediated the relationship between job resources and WFPS.

Background: Japan has the largest population of older adults in the world; it is only growing as life expectancy increases worldwide. As such, solutions to potential obstacles must be studied to maintain healthy, productive lives for older adults. In 2011, the Japanese government has started a policy to increase "Elderly Housing with Care Services (EHCS)", which is one of a private rental housing, as a place where safe and secure end-of-life care can be provided. The government expect for them to provide end-of-life care by collaborating with the Home-Visit Nursing Agencies (HVNA). The purpose of this study is to clarify the situation of the end-of-life care provision in EHCS in collaboration with HVNA and to examine the factors that associate with the provision of the end-of-life care in EHCS. Methods: A two-stage nationwide survey (fax and mail surveys) were conducted. Of the 5,172 HVNA of the National Association for Visiting Nurse Services members, members from 359 agencies visited EHCS. Logistic regression analysis was conducted with the provision of end-of-life care to EHCS in 2017 as the dependent variable, and the following as independent variables: characteristics of HVNA and EHCS; characteristics of residents; collaborations between HVNA and EHCS; and the reasons for starting home-visit nursing. Results: Of the 342 HVNA who responded to the collaborations with EHCS, 21.6% provided end-of-life care. The following factors were significantly associated with the provision of end-of-life care to inmates in elderly care facilities: being affiliated with a HVNA, admitting many residents using long-term care insurance, collaborating with each other for more than three years, and started visiting-nurse services after being requested by a resident's physician. Conclusions: This study clarified the situation of the provision of end-of-life care in EHCS in collaboration with HVNA and the related factors that help in providing end-of-life care in EHCS. [ABSTRACT FROM AUTHOR]

Background: The qualities required for new graduates to become visiting nurses remain unclear. The present study aimed to clarify the qualities required for new graduate visiting nurses. Methods: Semi‐structured interviews were conducted with nine home‐visiting nurses. Content analysis was conducted by the transcribed data collected from visiting nurses. Results: Years of nursing experience were ranged from 16 to 50. In total, 23 attributes were extracted and categorized. Conclusion: Our findings indicated that the qualities required for new graduate visiting nurses were as follows: basic knowledge and skills required as professionals and appropriate attitudes as members of society. [ABSTRACT FROM AUTHOR]

Objectives　The primary aim of this study was to clarify the relationship between the number of public health nurses (PHNs) and the total number of people who received home-visit nursing services for mental health or intractable diseases. The secondary aim was to clarify the extent of regional differences in the number of PNHs and mental health or intractable diseases.Methods　This study used the total number of people who received home-visit nursing services for mental health or intractable diseases in 2019 from the Portal Site of Official Statistics of Japan (e-Stat) and population and area data in January 2020. Single and multiple regression analyses (covariates: population and area) were performed on the relationship between the number of PHNs per 100,000 population (abbreviated as "ratios of PHNs") and the total number of people who received home-visit nursing services for mental health or intractable diseases per 100,000 population (abbreviated as "mental health/intractable disease achievements"). Regional differences in ratios of PHNs and mental health/intractable disease achievement were examined using mean, standard deviation, maximum/minimum values, and Gini coefficients. Analyses were performed for each of the five units: the prefectures as a whole, prefectural public health centers, municipalities within the jurisdiction of prefectural public health centers, and cities in which public health centers are established (including or not including special wards).Results　Regression analyses indicated a positive relationship between the ratios of PHNs and mental health/intractable disease achievements. Multiple regression analysis indicated that both achievements were positively associated with population size and negatively associated with area size. The largest regression coefficients between the ratios of PHNs and achievements were 34.07 and 5.48 regarding mental health achievements and intractable disease achievements, respectively. For regional differences, the smallest Gini coefficient was the ratios of PHNs, and the largest was intractable disease achievements. The smallest and largest coefficient of the prefectures as a whole was 0.15 and 0.34, respectively. The maximum/minimum values of the prefectures as a whole also indicated that the smallest was 3.8 in the ratio of PHNs and the largest was 30.0 in intractable disease achievement.Conclusions　Increasing number of PHNs is needed to provide more home-visit nursing services for mental health and intractable diseases. It is particularly important to fill up the larger number of PHNs in smaller populations or larger area prefectures. Due to regional differences in the home-visit nursing service, it is important to promote the increase in the level of these activities.

The phenomenon of some patients with schizophrenia withdrawing and becoming hikikomori needs to be resolved. In some countries, outreach methods are being employed. In Japan, psychiatric home-visit nursing for patients with schizophrenia and hikikomori is being implemented. However, it is not based on sufficient evidence and relies on the experience and intuition of individual nurses. This study explored the underlying themes in the nursing practices of psychiatric home-visit nurses via semi-structured interviews with 10 nurses and a thematic analysis. Nine key themes emerged. Four themes-(i) understanding the patient's world, (ii) supporting the patients as they are, (iii) providing a sense of relief, and (iv) having equal relationships-highlighted the nurses' commitment to respecting patients' individuality while building and sustaining relationships. Two themes-(v) exploring the right timing and (vi) waiting for the appropriate timing-illustrated the nurses' anticipation of proactive patient engagement. Finally, three themes-(vii) working together on things, (viii) continuing care for expanding the patient's world, and (ix) nursing care for the patient's future-underscored the nurses' gradual and methodical approach to working alongside patients. Nursing practices based on these nine themes cultivated meaningful relationships and secured a sense of relief for the patients. Additionally, they awaited patients' proactive engagement and delivered timely support to facilitate positive daily life changes. These findings contribute to the establishment of evidence-based nursing practices for patients with schizophrenia and hikikomori.

This study examined the assessment criteria based on which care managers (CMs) decide to commence home-visit nursing to develop a common assessment scale to guide CMs in making sound decisions about whether to commence home-visit nursing. For this purpose, we conducted a postal survey of 200 CMs. After removing 17 items from the questionnaire based on item analysis, we analyzed the remaining factors to confirm construct validity. This factor analysis identified 96 items comprising the following four factors: (1) the daily life condition of users and the support required by them, (2) strengthening medical support, (3) scheduling medical treatment/management or recuperation, and (4) preparing for users' mental and physical changes and preventing the deterioration of the situation. The results of the study indicate the first step in the process of developing a common assessment scale; in this study, we clarified the general factors that underpin a decision to commence home-visit nursing and the relationships among the items for each factor. [ABSTRACT FROM AUTHOR]

Highlights: [•] Attached office nurses more recovered medical waste from patients’ homes. [•] Most nurses educated their patients on how to store home medical care waste in their homes and on how to separate them. [•] Around half of nurses educated their patients on where to dispose of their home medical care waste. [Copyright &y& Elsevier]

A questionnaire survey was conducted with the aim of examining the problems involved in the disposal of infectious waste at home-visit nursing stations and in its handling during home visits by nurses. From among the home-visit nursing stations registered with the National Association for Home-Visit Nursing Care, 1,965 offices were selected at random and questionnaires were sent to the selected offices. Nurses at 1,314 offices (66.9 %) responded to the survey and responses from 1,283 offices were identified as suitable for analysis after excluding 26 offices that closed and five offices whose main field of care was psychiatry. Offices were classified by management configuration. Offices attached to hospitals were classified as 'attached office' and all others were classified as 'independent office'. More attached office nurses recovered medical waste from patients' homes than did independent office nurses. They were also more likely to transport waste with them during the course of a day's visits. There was a significant difference between attached and independent offices in the burden of expense for waste disposal. Both offices have strong concern about waste treatment containers and handling in improvement in home medical care (HMC) waste disposal. Thus, in order to alleviate these concerns, it is necessary to provide nurses with containers for medical waste suited to home-visit nursing care and tools for preventing injuries. Japanese government should address HMC waste disposal more comprehensively through necessary legislation, subsidization and standardization. [ABSTRACT FROM AUTHOR]

Background: Japan is presently experiencing a growth in the number of male caregivers and this situation has given rise to some concerns over gender differences. Previous studies have suggested that there are gender differences in caregiver burden in home care, however, it is still unclear whether or not gender differences exist. We therefore conducted this study to attain a better understanding of the Japanese male caregiver burden in home care, using data from the Nagoya Longitudinal Study of Frail Elderly (NLS-FE). Methods: NLS-FE is a large prospective study of community-dwelling elderly persons eligible for public long-term care insurance who live in Nagoya city and use the services of the Nagoya City Health Care Service Foundation for Older People, which comprises 17 visiting nursing stations and corresponding care-managing centers, from November to December 2003. Data used in this study included the Japanese version of the Zarit Caregiver Burden Interview, caregivers’ and dependents’ characteristics, and the caregiving situation. The differences in dependent and caregiver characteristics between male and female caregiver groups were assessed using the χ2-test for categorical variables or the unpaired t-test for continuous variables. Multiple logistic regression was used to examine the association between dependent and caregiver characteristics and caregiver burden. Results: A total of 399 male caregivers and 1193 female caregivers were included in our analysis. Before and after controlling baseline variables, we did not detect a difference between male and female caregivers with respect to caregiver burden. Conclusion: Our study suggests that differences in caregiver burden may not necessarily exist between male and female caregivers in Japan. [ABSTRACT FROM AUTHOR]

Despite the 2012 fee revision raising fees for home-visit nursing services to increase their supply in Japan, 300 to 500 home-visit nursing agencies (VNA) are still being closed annually. This study aims to identify the regional and organizational characteristics of the VNAs that closed after the 2012 fee revision. A longitudinal observational study was conducted using nationwide panel data of VNAs from 2014 to 2017 (N = 6496). Multiple logistic regression models stratified by years of operation were used for the analysis. We identified 821 closed agencies (12.6%). In this study, many important factors related to VNA closures were found. In the less than three years group, there were regional factors (lower aging rate and larger number of clinics) and an organizational factor (higher proportion of users under 40 years of age). In the 3-14 years group, there was a regional factor (larger number of clinics) and organizational factors (smaller number of FTE nurses, smaller number of users per FTE nurse, and smaller number of medical care types that can be provided). In the over 15 years group, there was an organizational factor (smaller number of FTE nurses). The findings provide valuable insights for policymakers in avoiding VNA closures.

This study aimed to identify educational needs and determine priorities in nursing care for home visit nurses providing services within the national long-term care insurance system in South Korea. This cross-sectional descriptive study assessed the educational needs of 92 home visit nurses. Participants' characteristics were analyzed using percentages, averages, and standard deviations. Educational needs were calculated for participants' current and required competency levels, utilizing the paired t-test, Borich's educational needs formula, and the locus for focus model. Four main categories were identified as top priorities: (1) health assessment, (2) cognitive function care, (3) disease management, and (4) medication management. The study's findings could support the development of appropriate and responsive education and training programs for home-visit nurses-as it reflects the actual needs of this group., Competing Interests: The authors declare no conflict of interest.

The primary purpose of this study was to clarify the path by which high job demands on home-visit nursing staff affect their mental health through work-family negative spillover (WFNS, FWNS). The secondary purpose was to clarify the path by which high job control and high social support in the workplace positively affect the mental health of nursing home-visit staff through work-family positive spillover (WFPS, FWPS). A cross-sectional survey using a self-administered questionnaire was conducted on 1,022 visiting nursing staff working at 108 visiting nursing stations in Fukuoka Prefecture in February, 2019. The measurement tools comprised sociodemographic factors, the Japanese version of the Survey Work-Home Interaction - NijmeGen (SWING-J), Job Content Questionnaire (JCQ-22), the Work-Family Culture Scale, and the K6 scale. Six models were determined in an analysis of the model: (1) working time load → WFNS → FWNS → psychological distress, (2) job demands → WFNS → FWNS → psychological distress, (3) job demands → psychological distress, (4) workplace support → job control → WFPS → psychological distress, (5) workplace support → WFPS → psychological distress, and (6) workplace support → psychological distress. This study clarified that job demands and working time load may adversely affect the mental health of home-visit nursing staff through the mediation of WFNS. It was also clarified that high job control and workplace support may have a positive effect on mental health through the mediation of WFPS.

Inscriptions on 291 nursing diagnosis items regarding 100 home convalescents were subjected to analysis. The 291-item nursing diagnosis was found to be consistent with a previously reported nursing diagnosis developed by the authors from Henderson's 14 items covering basic nursing practice. Additionally, the analysis indicated a need for nursing diagnosis items for family members, as caregivers for the patients recuperating at home. [ABSTRACT FROM AUTHOR]