基于社区的家庭健康项目与慢性病：文献综述

Community-Based Home Health Programs and Chronic Disease: Synthesis of the Literature.

作者信息

Vandiver Tonya, Anderson Tracy, Boston Brittani, Bowers Cynthia, Hall Norma

机构信息

Tonya Vandiver, MSN, is a Registered Nurse at Indiana University Health. She has worked in a variety of areas, including critical care, interventional radiology, and ambulatory/post anesthesia care. She is a member of American Society of Perianesthesia Nurses and Sigma Theta Tau International Honor Society of Nursing. She recently completed 360 practicum hours in case management for completion of her MSN degree. Tracy Anderson, MSN, is a Case Manager at Indiana University Hospital. She has over 20 years of health care experience and has worked in a variety of positions including bedside nursing, cardiologist rounding nurse, utilization review management, and case management. Her passion for case management inspired her research in community-based home health programs. She is a member of Sigma Theta Tau International Honor Society of Nursing. Brittani Boston, MSN, is a Pediatric Registered Nurse at Indiana University Hospital. She currently works in the Neonatal Intensive Care Unit, and has over 6 years of experience working with newborns and children in a critical care setting. Recently, she has worked on projects within her hospital that have focused on employee engagement and retention. Her interest in community health has inspired her research in community-based health programs and case management. Cynthia Bowers, DNP, RN, CNE, is an Assistant Professor of Nursing at University of Indianapolis, Indiana. She has over 26 years' health care experience including acute care nursing, new hospital development, operational management, and nursing education. Her research in health care and various published articles has provided experiences to prepare for writing this article. Norma Hall, DNP, RN-BC, CNE, is an Assistant Professor and Dean at the University of Indianapolis in Indianapolis, Indiana. She has over 25 years of experience as a nurse administrator, nurse educator, and consultant. She has published numerous articles on various aspects of nurse management and leadership; presented widely on a variety of subjects, including clinical, leadership, and education topics; and has held offices in professional nursing organizations.

出版信息

Prof Case Manag. 2018 Jan/Feb;23(1):25-31. doi: 10.1097/NCM.0000000000000242.

DOI:10.1097/NCM.0000000000000242

PMID:29176341

Abstract

PURPOSE OF STUDY

This article reviewed and evaluated literature on the various community-based home health programs and their effectiveness at preventing hospital admissions in adults. The research question addressed is as follows: Do community-based home health programs decrease hospital admissions in adult patients with chronic disease?

PRIMARY PRACTICE SETTING

The primary practice setting evaluated in this review of the literature was community-based home health programs.

METHODOLOGY AND SAMPLE

In this literature review, a seven-step review method was utilized to assess the evidence. Three electronic databases were used to conduct the initial search inquiry: CINAHL (Cumulative Index to Nursing and Allied Health Literature) Plus with Full Text, Medline, and PsycINFO. The search parameters include research from 2006 through 2016, English-language studies, and research published in peer-reviewed journals. The following search terms were used in multiple combinations: community-based health programs, chronic disease, and home. The primary sample population assessed was older adults with chronic disease.

RESULTS

The research identified three common themes that influenced quality-of-life outcomes and health care utilization in participants of a community-based home health program. These themes were encouragement and emotional support, home visits, and multidisciplinary coordination of care. Additional concepts of depression and educational reinforcement were also noted.

IMPLICATIONS FOR CASE MANAGEMENT PRACTICE

This literature review indicates that community-based home health programs are a viable solution to providing cost-effective health care to the adult population with chronic diseases. Community-based home health programs have been shown to have a positive impact on the quality of life and a decrease in health care utilization, including emergency department and primary care practitioner visits and hospital admissions, for adults with chronic disease.

摘要

研究目的

本文回顾并评估了有关各种基于社区的家庭健康项目及其在预防成人住院方面有效性的文献。所探讨的研究问题如下：基于社区的家庭健康项目能否降低成年慢性病患者的住院率？

主要实践环境

本次文献综述所评估的主要实践环境是基于社区的家庭健康项目。

方法与样本

在本次文献综述中，采用了七步综述法来评估证据。使用了三个电子数据库进行初步检索：CINAHL（护理学与健康相关学科累积索引）全文版、Medline和PsycINFO。检索参数包括2006年至2016年的研究、英文研究以及发表在同行评审期刊上的研究。以下检索词以多种组合方式使用：基于社区的健康项目、慢性病和家庭。所评估的主要样本群体是患有慢性病的老年人。