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Home Care Workers in Heart Failure: ...

Sterling, Madeline R.

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Home Care Workers in Heart Failure: Overlooked and Undervalued.

紀錄類型:	書目-電子資源 : Monograph/item
正題名/作者:	Home Care Workers in Heart Failure: Overlooked and Undervalued./
作者:	Sterling, Madeline R.
出版者:	Ann Arbor : ProQuest Dissertations & Theses, : 2018,
面頁冊數:	56 p.
附註:	Source: Masters Abstracts International, Volume: 58-01.
Contained By:	Masters Abstracts International58-01(E).
標題:	Epidemiology. -
電子資源:	http://pqdd.sinica.edu.tw/twdaoapp/servlet/advanced?query=10822247
ISBN:	9780438203242

Home Care Workers in Heart Failure: Overlooked and Undervalued.
Sterling, Madeline R.

Home Care Workers in Heart Failure: Overlooked and Undervalued. - Ann Arbor : ProQuest Dissertations & Theses, 2018 - 56 p.

Source: Masters Abstracts International, Volume: 58-01.

Thesis (M.S.)--Weill Medical College of Cornell University, 2018.

Background: Home care workers (HCWs), which include home health aides and personal care aides, are increasingly being used by community-dwelling adults with heart failure (HF) for post-hospitalization care and long-term assistance. Yet despite their growing presence, little is known about their role in the management of HF or their effect on health outcomes among adults with HF. To address this gap, we first conducted a systematic review of the literature in order to (1) describe utilization patterns of HCWs by adults with HF (2) examine the effect of HCWs on HF outcomes (3) review HF interventions that involve HCWs (Chapter 1). Next, we sought to understand the perspectives of HCWs who care for adults with HF, specifically the challenges they face, as the foundation for the development of future interventions (Chapter 2).

ISBN: 9780438203242Subjects--Topical Terms:

568544
Epidemiology.

Home Care Workers in Heart Failure: Overlooked and Undervalued.
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245 1 0 $a Home Care Workers in Heart Failure: Overlooked and Undervalued.
260 1 $a Ann Arbor : $b ProQuest Dissertations & Theses, $c 2018
300 $a 56 p.
500 $a Source: Masters Abstracts International, Volume: 58-01.
500 $a Advisers: Mary Charlson; Carol Mancuso.
502 $a Thesis (M.S.)--Weill Medical College of Cornell University, 2018.
520 $a Background: Home care workers (HCWs), which include home health aides and personal care aides, are increasingly being used by community-dwelling adults with heart failure (HF) for post-hospitalization care and long-term assistance. Yet despite their growing presence, little is known about their role in the management of HF or their effect on health outcomes among adults with HF. To address this gap, we first conducted a systematic review of the literature in order to (1) describe utilization patterns of HCWs by adults with HF (2) examine the effect of HCWs on HF outcomes (3) review HF interventions that involve HCWs (Chapter 1). Next, we sought to understand the perspectives of HCWs who care for adults with HF, specifically the challenges they face, as the foundation for the development of future interventions (Chapter 2).
520 $a Methods: For the systematic review, five electronic databases (Ovid MEDLINE, Ovid EMBASE, Cochrane Library [Wiley], CINAHL [EBSCO], and AgeLine [EBSCO]) were searched from inception through August 4, 2017. The yield was screened using pre-specified inclusion and exclusion criteria. Two authors independently reviewed references and a third reviewer acted as an arbitrator when needed. Data were extracted from articles that met the inclusion criteria and the Downs and Black (DB) checklist was used for quality assessment.
520 $a In order to understand the perspectives of HCWs who care for adults with HF, we conducted eight focus groups in collaboration with the Home Care Industry Education Fund, a benefit fund within the 1199 Service Employees International Union-United Healthcare Worker's East, the largest healthcare union in the US. HCWs who cared for a client with HF within the last year and were HCWs for ? 2 years were eligible to participate. Focus groups were recorded and professionally transcribed, and data were analyzed thematically.
520 $a Results: For the systematic review, a total of six studies met the inclusion criteria. Two were descriptive, three were retrospective cohort studies, and one was a quasi-experimental study. Results of these studies suggest that adults with HF who live alone and have functional and cognitive deficits, tend to utilize HCWs, however the effect of having a HCW on post-HF hospitalization outcomes is unclear. One study found that a HCW-delivered educational intervention improved HF patients' self-care abilities. Overall, despite some significant findings, the studies assessed were of poor-to-fair quality.
520 $a For the qualitative study, the 46 participants had mean age of 49 years (SD 10), 98% were female, 17 37% were Black, 54% were Hispanic, and 91% had ≥ high school education. General and disease-specific themes emerged. Five general themes were: 1) the work is hard; 2) HCWs do not feel valued; 3) communication is fragmented; 4) HCWs are dedicated to clients and families, but often "caught in the middle"; 5) HCWs love their job. Three HF-specific themes were: 1) HF is frightening; 2) HCWs manage HF without HF training; 3) the care plan is problematic.
520 $a Conclusions: Although HCWs are quite common, the findings from our systematic review suggest that the literature on these paraprofessionals in HF is limited and of low quality, suggesting that additional rigorous research is warranted. The results of our community-partnered qualitative study suggest that HCWs are dedicated professionals who feel marginalized in the healthcare system. Although frequently involved in aspects of HF management, most HCW have not received HF training. While they can be the eyes and ears of their HF clients, HCWs are largely ignored by other healthcare providers. HF-specific training as well as interventions that aim to better integrate HCWs into the healthcare team may improve their ability to care for adults with HF.
590 $a School code: 0967.
650 4 $a Epidemiology. $3 568544
650 4 $a Medicine. $3 641104
650 4 $a Public health. $3 534748
690 $a 0766
690 $a 0564
690 $a 0573
710 2 $a Weill Medical College of Cornell University. $b Clinical Epidemiology & Health Services Research. $3 3179347
773 0 $t Masters Abstracts International $g 58-01(E).
790 $a 0967
791 $a M.S.
792 $a 2018
793 $a English
856 4 0 $u http://pqdd.sinica.edu.tw/twdaoapp/servlet/advanced?query=10822247