The Application of Multimedia Messaging Services via Mobile Phones to Support Outpatients:Home Nursing Guidance for Pediatric Intestinal Colostomy Complications

Objective: To present a model of extended home nursing support provided through WeChat for pediatric colostomy patients between the first and second surgery to support parents and to assist them in nursing possible complications at home, to reduce colostomy complications caused by improper care, to improve the quality of life of patients at home and to ensure the success of the recovery and second surgery. Methods: A combination of relevant clinical information, health care guidelines, and training as well as the establishment of a specific monitoring protocol was provided to the parents during the patient’ s first hospitalization. A support system for nursing the colostomy was established with regular follow-up via WeChat after the patient’ s first discharge from the hospital using a predetermined protocol. During the 3 to 6 months of home care in-between the colostomy operations, the charge nurse initiated the phone follow-up and provided specific, individual guidance and feedback. If necessary, extended serv-ice at predetermined intervals was provided in the 1st week, the 1st month, the 2nd month and the 3rd month. Results: Extended assistance for the home care of patients with pediatric colostomy complications im-proved the quality of life of the patients and caregivers and was accepted by all parties involved upon in-troduction. The assistance provided support for the parents at all hours, efficiently reduced the level of complications for this type of patient and facilitated fast referrals to hospital care in cases of emergen-cies. Furthermore it paved the way to successful second stage surgeries, provided direct feedback to the charge nurse and improved the work satisfaction and sense of achievement of the nurses involved. Conclusions: All 80 cases supported by WeChat successfully underwent two-stage pediatric colostomy operations. The response of the parents and the medical staff involved was very positive. This method is easy to use, economical to operate and could be applied generally to support home care.

Neuroarchitecture Analysis in the Mis Abuelitos Nursing Home in Cochachinche, Huanuco, Peru - A Secondary Publication

Neuroarchitecture is a set of characteristics grouped into principles that seek to generate a certain behavior when applied.These principles will vary according to the type of user for whom the design is intended.In this research,these neuroarchitectural principles are identified in the nursing home Mis Abuelitos in Cochachinche,Huánuco.The home was designed and built with notions of nature and the Andean while emphasizing the occupants are the elderly.With this purpose,qualitative research was carried out using two sequential criteria,the first was to identify what these principles are and the second was to recognize the principles within the area.The principles that are assertively used for the elderly occupants were selected.The study observation was performed with observation and photographic sheets and was analyzed with ATLAS.ti processing software.It was obtained that the three neuroarchitectural principles are present in the nursing home which are 67%of the recommended characteristics for the elderly.

Application of horticulture therapy as a health intervention for elderly people in nursing homes:a scoping review

Objective:To review the scope of interventional studies on horticultural therapy(HT)applied to elderly people in nursing institutions to support the efficient implementation of HT among this target group.Methods:In accordance with the scoping review framework proposed by the Joanna Briggs Institute(JBI),the Pub Med,JSTOR,Web of Science,CNKI,and Wanfang databases were searched.Data from the retrieved literature were summarized and analyzed.Results:In all,18 studies were included in this review.The target population groups of interventions included self-supporting elderly people,cognitively impaired elderly people,elderly people with negative emotions,and elderly people with frailty living in nursing institutions.HT interventions,including planting,craft activities,derivative activities,and outdoor viewing activities,are implemented indoors,outdoors,or in mixed settings.The most common duration of the intervention was 8 weeks,the most common frequency was once per week,and the most common session duration was 60 min.Conclusions:The measurements used in HT interventions included assessments of physical,psycho-mental,and social health;quality of life;and activity effects.Future studies should include partially dependent groups and completely dependent groups of elderly individuals,interventions that last at least 6 months,scientifically designed activity intensity and safety-guarantee plans,and outcomeevaluation indicators such as compliance and intervention benefits.

Reducing Hospital Stays for Patients Discharged to Nursing Homes

This study described programs that support length of stay reduction in the metropolitan area of Syracuse, New York. It demonstrated that these initiatives could improve hospital efficiency by expediting the movement of patients from inpatient hospitals to nursing homes at the community level. The Subacute and Complex Care Programs have focused on hospital patients with some of the longest lengths of stay. The inpatient days associated with these patients have the greatest potential for moving from acute care to long-term care providers. The use of these programs has the potential for saving staff time in hospitals associated with nurses, as well as pharmaceuticals and testing. All of these resources have contributed to the high costs of inpatient acute care.

Application of Home Health Nursing Abroad:A Literature Review

Currently, with advancesin medical science, the average lifespan of citizens is gradually in- creasing worldwide, resulting in the emergence of an aging society. Aged patients are especially prone to suffering from various chronic diseases, and many elderly patients select to receive home-based care. Thus, professional care in elderly patients＇ homes is needed, which also represents a mark of social development. Today, home health nursing is widely applied, including nursing of post labor mothers and their infants, and osteoporosis patients, among others. The aim of the present study was to explore the home health nursing model and its applicable range, as well as existing problems and the impact of the model in the domestic settings.

Staff characteristics and care in Chinese nursing homes: A systematic literature review

The need for institutional long-term care(LTC)services,including nursing homes(NHs),is increasing in China's Mainland in part due to the aging population and changing family structures.In developing NH staff training programs,a review is needed to synthesize knowledge about staff and resident characteristics,and care provided in NHs.This systematic review aims to describe,in Chinese NHs,(1)NH staff characteristics and the care they provide,(2)resident characteristics and care needs,and (3)the role of family members.The 45 articles included in this review covered both urban and rural areas of China's Mainland.We found that staff in Chinese NHs were older and had lower education levels in comparison with those in western countries.Most direct caregivers in urban areas were migratory workers from rural area.Chinese NHs had few qualification standards for staff preparation for their roles in NHs.Also,functional levels of residents in Chinese NHs were higher compared to NH residents in western countries.In addition,family members played important roles in caring for NH residents.These findings suggest a need for staff development programs that tailor for lower educated NH staff and care needs of residents with widely varying levels in function from independent to bedbound in China's Mainland.The findings also suggest that staff qualification standards require critically policy development to improve the capacity of Chinese NHs to provide competent and safe care.

Working experiences of nursing aides in nursing homes:A qualitative study

Objective:To examine how nursing aides in nursing homes perceived their caring work.Methods:Twenty-four nursing aides from one public and one private nursing home in Fuzhou,Fujian Province,China were selected and interviewed in focus groups.Phenomenological analysis was performed.Results:Two themes(positive and negative working experiences)and six sub-themes were drawn:companionship,happiness,trust,achievement,hard work,and grievance.Conclusion:A reasonable work arrangement,positive psychological intervention,and the strengthening of professional,medical and social supports are recommended to improve the work quality and satisfaction of nursing aides in elderly homes.

Predictors of Falls Efficacy Scale responses among nursing home residents in China

Objectives:The objective of this study was to examine the falls efficacy of older adults in nursing homes and the related predictors of falling.Methods:A sample of 317 older adults was recruited from 18 nursing homes in the Fujian province of China.The Modified Falls Efficacy Scale(MFES)and Kessler Psychological Distress Scale(K10)were employed to collect data.Results:The falls efficacy of older adults was moderate(7.80±1.17).The falls efficacy questionnaire item“Get dressed and undressed”scored the highest(9.12±1.440),while“Crossing roads”scored the lowest(5.77±3.371).Multiple regression analysis demonstrated that mental health status,degree of self-care,age and gender were each predictors of the falls efficacy of older adults.Conclusions:Falls efficacy enhancing programs for nursing home residents should take mental health status,degree of self-care,age and gender into account.

Prevalence of frailty among nursing home residents in China:a systematic review and meta-analysis

Background:The prevalence of frailty among nursing home residents is high.However,in China,prevalence of frailty keeps unknown in this population.The purpose of this meta-analysis is to assess the prevalence of frailty and prefrailty and find out the factors related to the prevalence of frailty among nursing home residents in China.Methods:We searched both English(PubMed,Cochrane Library,Embase,Web of Science and Scopus)and Chinese(CNKI,WanFang,SinoMed,and VIP)databases from their inception date until 15 September 2020.Two reviewers independently screened literature,extracted data,and evaluated the risk of bias included studies.Stata12.0 software was used to conduct meta-analysis.Results:A total of 16 studies were included in this review,involving 7,777 nursing home residents.The prevalence of frailty ranged from 29.2% to 66.6% in the included studies.The pooled prevalence of frailty and prefrailty were 49%(95%CI:43-55%)and 42%(95%CI:34–50%),respectively.The assessment tool(P<0.001),gender(P<0.001),self-rated health(P<0.001)and type of institution(P<0.001)were significantly associated with the prevalence of frailty among nursing home residents in China.Conclusions:The prevalence of frailty among nursing home residents in China was relatively high.Considering the adverse health outcomes of frailty,nursing home administrators should screen frailty regularly,identify the risk factors of frailty,take actions accordingly and improve the frailty status for older adults.

Home‑based treatment and nursing plan of a patient diagnosed with mild‑to‑common coronavirus disease 2019

To date,there are no known specific antiviral medicines recommended for coronavirus disease 2019(COVID‑19).The treatment mainly focuses on the improvement of the immunity of the individual and the application of palliative treatment.A case of a patient diagnosed with mild COVID‑19 and then later developed common COVID‑19 which was treated and closely monitored at home will be presented.The patient was advised for self‑quarantine with several prescribed medications.Nursing home and self‑care advice were given to the patient,including a change of lifestyle for the duration of the isolation,medication advice,symptomatic care,change of diet,how to monitor the progress of the disease,psychological care,and follow‑up instructions.During the course of the nursing plan,the patient showed significant improvements,and normal life functions were restored.On February 05,2020,novel coronavirus nucleic acid test showed negative after re‑examination;the patient was cured.Therefore,providing adequate nursing plan for home‑based self‑care treatment can effectively cure mild and common cases of COVID‑19.

Treatment of heart failure in nursing home residents

BackgroundFor the treatment of chronic heart failure （HF）, both pharmacological and non-pharmacological treatment should be em-ployed in HF patients. Although HF is highly prevalent in nursing home residents, it is not clear whether the recommendations in the guide-lines for pharmacological therapy also are followed in nursing home residents. The aim of this study is to investigate how HF is treated in nursing home residents and to determine to what extent the current treatment corresponds to the guidelines.MethodsNursing home resi-dents of five large nursing home care organizations in the southern part of the Netherlands with a previous diagnosis of HF based on medical records irrespective of the left ventricle ejection fraction （LVEF） were included in this cross-sectional design study. Data were gathered on the （medical） records, which included clinical characteristics and pharmacological- and non-pharmacological treatment. Echocardiography was used as part of the study to determine the LVEF.ResultsOut of 501 residents, 112 had a diagnosis of HF at inclusion. One-third of them received an ACE-inhibitor and 40% used aβ-blocker. In 66%, there was a prescription of diuretics with a preference of a loop diuretic. Focusing on the residents with a LVEF￡ 40%, only 46% of the 22 residents used an ACE-inhibitor and 64% aβ-blocker. The median daily doses of prescribed medication were lower than those that were recommended by the guidelines. Non-pharmacological interventions were recorded in almost none of the residents with HF.ConclusionsThe recommended medical therapy of HF was often not prescribed; if pre-scribed, the dosage was usually far below what was recommended. In addition, non-pharmacological interventions were mostly not used at all.

Nursing homes’social responsibility and competitive edge:a cross‐sectional study on elderly choices about care service and price levels in Zhejiang Province,China

Background In the context of China's aging population,meeting consumer demand is an essential way for nursing homes to fulfill social responsibilities and improve competitive advantages.However,since little is known about the elderly's service level and price choices for nursing home care,this study aims to explore the non-disabled elderly's nursing home admission intention,service level,and price choices.Methods A cross-sectional survey of 402 non-disabled respondents was conducted in three different income level cities of Zhejiang Province,in July and August 2018.Multinomial logistic regression and multiple linear regression were used to identify the determinants of admission intention,service level choice,and price choice.Results Education,residence,and number of children were significantly associated with nursing home admission intention.Compared to those with no intention,the elderly with higher income and household wealth were less likely to have conditional intentions,and those living with the family were less likely to have unconditional intentions.Compared to medium-level services,the elderly with higher monthly income(relative risk ratio[RRR]3.07,95%confidence interval[CI]:1.801 to 5.233),household wealth(RRR 5.451,95%CI:2.249 to 13.216),and age(RRR 1.528,95%CI:1.004 to 2.326)were more likely to prefer high-level services,while older adults with higher monthly income(RRR 0.516,95%CI:0.344 to 0.774),and those with pensions(RRR 0.267,95%CI:0.076 to 0.931)were less likely to prefer low-level services.The elderly's price preference increased by 398 CNY as monthly income increased by 1000 CNY,and by 270 CNY as the housing number increased by one.Having pensions increased price preference(468 CNY),whereas having health insurance decreased price preference(–690 CNY).Conclusion The elderly's intention of nursing home admission was primarily affected by sociodemographic factors,while price and service level choices were primarily affected by financial factors.Nursing homes should use the market segmentation method to provide precision nursing home care for different groups of non-disabled elderly.

Effects of Band Therapy Using Music on Grasping Power, Depression, and Personal Relationships in Nursing-Home-Dwelling Elderly Individuals

The current study examined the effects of band therapy using music on grasping power, depression, and personal relationships among residents of a nursing home. Thirty subjects participated in the study. The band therapy included greetings, warm-up exercises with music, singing with dance, playing instruments, closing speech, and stretching with background music. Band therapy was held for 40 minutes once per week, for a total of four sessions, in the activity room of the nursing home. Findings showed that grasping power, depression, and personal relationships were improved at posttest, but the differences were not statistically significant. A better study design to compare the effects of band therapy with the other group, and a more simple and repeated intervention for the elderly to follow without stress might be necessary.

The impact of mindfulness therapy on life happiness of the elderly in nursing homes

Background:Nursing homes have been developed as an important way to solve the old-age care problem.While,nursing homes in China pay attention to the life care of the elderly,but lack of promoting the life happiness of the elderly.Mindfulness therapy is an emerging approach to improve the individual's ability to regulate emotions and maintain the stability of emotions.Purpose:To explore the effect of mindfulness therapy on improving life happiness of elderly in nursing homes.Methods:The study was performed in 2019 in Tianjin,in China.Seventy-six participants eventually were included in the study to receive either daily life care or daily life care and mindfulness therapy.The treatment lasted for eight weeks.The Campbell Index of Well-being and Satisfaction With Life Scale were mainly adopted.The paired sample t-test was conducted for comparing between two groups,using SPSS 17.0.Results:Subjective well-being was shown to be a significant correlation with life satisfaction.Compared with before treatment,the well-being(9.57±3.00 vs 11.69±2.32)and life satisfaction scores(20.43±8.08 vs 26.70±5.61)were increased significantly in mindfulness therapy group(P<0.05).The means of the subjective well-being and life satisfaction scores in mindfulness therapy group were 11.69±2.32 and 26.70±5.61 after the intervention,respectively,whereas the means of the subjective well-being and life satisfaction scores in the control group were 10.27±2.16 and 23.03±5.59,respectively.A significant change was found between two groups(t=2.141,P<0.05;t=2.395,P<0.05).Conclusion:Mindfulness therapy may be an effective therapy to improve life happiness of elderly in nursing homes.

The influence of professional identity and ageism on turnover intention in nursing homes: a cross-sectional study from suzhou, China

Purpose:The aim of this study is to evaluate the influence of professional identity and ageism on turnover intention of nurses employed in nursing homes.Methods:From April to May 2019,a cross-sectional study was designed to investigate 410 nurses in nursing homes by random cluster sampling using a questionnaire.Descriptive analyses,t-tests,one-way ANOVA,Pearson’s correlation and multiple regression were performed for data analyses.Results:The scores of ageism,professional identity and turnover intention were57.91±11.06,106.93±16.22 and 15.98±3.47.Ageism was a positive predictor with turnover intention and professional identity was a negative predictor of turnover intention.Female,monthly income and the love for working in nursing homes impacted the turnover intention.Conclusions:Cultivating nurses’professional identity and reduce the ageism of nurses towards the elderly can reduce turnover intention.

Perceptions and barriers that influence the ability to provide appropriate incontinence care in nursing home residents: Statements from nursing staff

Urinary incontinence is a common medical condition among nursing home residents. Urinary incontinence in older people has a multifactorial etiology and is therefore more difficult to assess and treat than urinary incontinence in younger people. Previous research has shown that incontinence care in nursing home residents often is inadequate and little systematized. The aim of this study was to identify perceptions and barriers that influence the ability of the nursing staff to provide appropriate incontinence care. This was a qualitative study using focus-group methodology. Data were collected from three focus-group interviews with 15 members of the nursing staff from six different units in a nursing home. The focus-group interviews were recorded on tape, transcribed verbatim and analyzed according to qualitative content analysis. Three topics and eight categories were identified. The first topic, Perceptions and barriers associated with residents, consisted of one category: “physical and cognitive problems”. The second topic, Perceptions and barriers associated with nursing staff, consisted of three categories: “lack of knowledge”, “attitudes and beliefs” and “lack of accessibility”. The third topic, Perceptions and barriers associated with organizational culture, consisted of four categories: “rigid routines”, “lack of resource”, “lack of documentation” and “lack of leadership”. The findings from this study show that there are many barriers that might influence the possibilities of nursing staff to provide appropriate incontinence care to residents in nursing homes. However, it can nevertheless seem like opinions and the attitude of nursing staff, together with a lack of knowledge about UI, are the most important barriers to provide appropriate incontinence care.

Nursing Staff’s Experiences of Providing Toilet Assistance to Elderly Nursing Home Residents with Urinary Incontinence

Introduction: Urinary incontinence is a common condition among elderly. It affects their daily life and quality of life. Toilet assistance may decrease urinary incontinence episodes among elderly. Many nursing home residents do not receive the available evidence-based toilet assistance they need. Aim: The aim of the present study was to describe nursing staff members’ experiences of providing toilet assistance to elderly nursing home residents with urinary incontinence. Design: A descriptive design with a qualitative content analysis method was used. Method: Four nurses and seven auxiliary nurses were interviewed in three homogenous focus groups. Data were collected during spring 2015. Results: The most essential opportunity factor for good toilet assistance was the nursing staff’s attitude and behavior regarding the elderly’s need to visit the lavatory. This resulted in individual toilet assistance in which the elderly’s integrity and needs were cared for. Functioning routines and sufficient staff availability were crucial in determining whether the elderly could visit the lavatory. Other enabling factors for good toilet assistance were information and education of staff. The main obstructing factors for good toilet assistance were the elderly’s decreased cognitive ability, negative attitudes toward receiving toilet assistance and lack of communication and co-operation between professionals with regard to prescribing and fastening individual incontinence aids. Conclusion: Providing toilet assistance is a considerable nursing intervention for elderly to help them regain continence or contain incontinence, whenever possible. Person-centered incontinence care is important for developing and adjusting toilet assistance based on each older person’s individual needs.

Norwegian Nursing Home——A Care Facility or a Home?

This article focuses on the function of Norwegian nursing homes. A brief history of institutionalisation of older people in Norway is presented. An expressed task for Norwegian nursing homes is active treatment, and even though the “Guarantee of dignity” was implemented from January 2011, there are proofs that the rights of the residents are constantly violated. Another task for Norwegian nursing homes is to be home for the residents. This double function of the nursing home, being both a care facility and a home is discussed, and whether the nursing homes succeed in fulfilling these tasks or not is questioned. It is also questioned if Goffman’s descriptions of total institutions are applicable on nursing homes of today.

Nursing Students’Clinical Learning Environment in Norwegian Nursing Homes:Lack of Innovative Teaching and Learning Strategies

Background: Nursing students hesitate to choose aged care as a career, and the aged care sectors are on an edge regarding nursing positions. Clinical learning environments may influence nursing students’ career choices. Few studies have explored learning environments in nursing homes, although students increasingly have placements there. Objectives: The aim was to produce information for developing nursing students’ learning opportunities in nursing homes. Design: A cross-sectional survey design was used. Settings: The study was conducted at a university college in southeast Norway. Participants: Students in two cohorts of a bachelor degree program in nursing participated, N = 499. Methods: Data were collected on nursing students’ perceptions of clinical learning environments during placements in five nursing homes. A 42-item validated questionnaire with the subscales personalization, individualization, involvement, task orientation, innovation, and satisfaction was used. Data analysis used descriptive statistics, t-tests, and linear regression analysis. Results: Total scores showed overall satisfaction with clinical learning environments in nursing homes. However, innovation subscale scores were very low. First year students had significantly higher scores than third year students on the total scale, and most subscales. Age was significantly associated with total scale scores and subscale satisfaction scores. Higher education and work experience before entering nursing education were significantly associated with involvement subscale scores. Conclusions: Students are more positive than negative about their clinical learning environments. Low valuation of innovation seems to be a consistent finding in studies in both nursing homes and hospitals internationally. For innovative learning strategies to function they must be anchored at the organizational level. Future research should develop and test more innovative learning strategies for nursing students.

Objective and Subjective Dental Treatment Needs among Nursing Home Residents

Objective: The aim of the study was to analyze oral, dental and denture hygiene, and the current treatment needs in nursing home residents. Design: Cross-sectional design. Setting: Nursing homes in Saxony, Germany. Participants and Intervention: Participating dentists recorded the frequency of oral, dental and denture care, dental treatment needs, and the request for treatment in 11,144 nursing home residents by using standardized checklists. Results: Mean age of the residents was 82.5 years, and 74.6% were females. For 54.0% of those examined, nursing staff did care for oral, dental, and denture hygiene. 77.5% of the residents performed oral hygiene more frequently than once daily, 19.8% only once a day, and 2.6% performed oral hygiene less frequent. A need for dental treatment was identified in 64.1% of the residents, of which 34.5% were missing dentures, and 29.7% suffered from dental diseases. 58.3% of the residents not requesting treatment had a clinical need for dental therapy. Objective and subjective need for treatment correlated positively (p < 0.001). Conclusion: Nursing home staff should be aware of the poor oral hygiene and health care conditions in residents. In addition to regular dental check-ups, nursing home residents should be given advice on dental care. Furthermore, dentists and health insurances should develop an action plan to improve oral health of nursing home residents, and to reduce additional costs due to lack of dental care.