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      Balancing between extremes—Work in hospital‐at‐home

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          Abstract

          Aim

          To describe HAH staff's perceptions about HAH care, including work structures, processes and outcomes.

          Design

          Cross‐sectional descriptive study of three HAH units in Finland.

          Methods

          Three focus group interviews of interprofessional staff members ( N = 24) were analysed through thematic content analysis (COREQ). In addition, an audit visit was conducted at Guy's and St Thomas' @home service, the United Kingdom.

          Results

          The Finnish HAH staff perceived they were balancing between different extremes: the patient's and his/her near‐one's opinions and wishes, well‐being and integrity, the promotion of person‐centred care and own work safety, a deeper meaning for work and the need for further support. Both in Finland and the UK, patients were perceived to be satisfied with care and HAH was perceived to save hospital bed places.

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          Most cited references17

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          Home care in Europe: a systematic literature review

          Background Health and social services provided at home are becoming increasingly important. Hence, there is a need for information on home care in Europe. The objective of this literature review was to respond to this need by systematically describing what has been reported on home care in Europe in the scientific literature over the past decade. Methods A systematic literature search was performed for papers on home care published in English, using the following data bases: Cinahl, the Cochrane Library, Embase, Medline, PsycINFO, Sociological Abstracts, Social Services Abstracts, and Social Care Online. Studies were only included if they complied with the definition of home care, were published between January 1998 and October 2009, and dealt with at least one of the 31 specified countries. Clinical interventions, instrument developments, local projects and reviews were excluded. The data extracted included: the characteristics of the study and aspects of home care 'policy & regulation', 'financing', 'organisation & service delivery', and 'clients & informal carers'. Results Seventy-four out of 5,133 potentially relevant studies met the inclusion criteria, providing information on 18 countries. Many focused on the characteristics of home care recipients and on the organisation of home care. Geographical inequalities, market forces, quality and integration of services were also among the issues frequently discussed. Conclusions Home care systems appeared to differ both between and within countries. The papers included, however, provided only a limited picture of home care. Many studies only focused on one aspect of the home care system and international comparative studies were rare. Furthermore, little information emerged on home care financing and on home care in general in Eastern Europe. This review clearly shows the need for more scientific publications on home care, especially studies comparing countries. A comprehensive and more complete insight into the state of home care in Europe requires the gathering of information using a uniform framework and methodology.
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            The Future of Home Health Care

            The Future of Home Health project sought to support transformation of home health and home-based care to meet the needs of patients in the evolving U.S. health care system. Interviews with key thought leaders and stakeholders resulted in key themes about the future of home health care. By synthesizing this qualitative research, a literature review, case studies, and the themes from a 2014 Institute of Medicine and National Research Council workshop on “The Future of Home Health Care,” the authors articulate a vision for home-based care and recommend a bold framework for the Medicare-certified home health agency of the future. The authors also identify challenges and recommendations for achievement of this framework.
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              Developing a person-centred approach to carer assessment and support.

              Community nurses play an important role in providing palliative care and support for patients and carers at home. The Carer Support Needs Assessment Tool (CSNAT) provides practitioners with an evidence-based comprehensive tool to use with carers in palliative home care. As a practice tool, the CSNAT uses a person-centred approach-that is, the process of carer assessment and support is facilitated by practitioners but is carerled. In this paper, the CSNAT research team provides an overview of the development of the tool and the benefits for both carers and practitioners arising from using the CSNAT as a person-centred approach in practice. The authors outline the five stages of the CSNAT approach to assist practitioners wishing to implement the CSNAT in practice.
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                Author and article information

                Contributors
                hevaarti@abo.fi
                Journal
                Nurs Open
                Nurs Open
                10.1002/(ISSN)2054-1058
                NOP2
                Nursing Open
                John Wiley and Sons Inc. (Hoboken )
                2054-1058
                22 October 2019
                January 2020
                : 7
                : 1 ( doiID: 10.1002/nop2.v7.1 )
                : 398-410
                Affiliations
                [ 1 ] Faculty of Education and Welfare Studies Åbo Akademi University Vasa Finland
                [ 2 ] Bachelor of Healthcare Nursing Novia University of Applied Sciences Åbo Finland
                [ 3 ] Nursing@Home & Pal@Home Guy's and St Thomas' NHS Foundation Trust Elmcourt Health Centre London UK
                [ 4 ] Faculty of Health and Social Sciences University of South‐Eastern Norway Kongsberg Norway
                Author notes
                [*] [* ] Correspondence

                Heli Vaartio‐Rajalin, Department of Caring science, Åbo Akademi University, Strandgatan 2, 65100 Vasa, Finland.

                Email: hevaarti@ 123456abo.fi

                Author information
                https://orcid.org/0000-0002-5957-0038
                https://orcid.org/0000-0001-9934-2788
                Article
                NOP2402
                10.1002/nop2.402
                6917957
                31871725
                f8d4d5c3-ecef-4a43-a519-fe108ade13ea
                © 2019 The Authors. Nursing Open published by John Wiley & Sons Ltd.

                This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

                History
                : 26 August 2019
                : 25 September 2019
                Page count
                Figures: 0, Tables: 3, Pages: 13, Words: 9628
                Categories
                Research Article
                Research Articles
                Custom metadata
                2.0
                January 2020
                Converter:WILEY_ML3GV2_TO_JATSPMC version:5.7.3 mode:remove_FC converted:18.12.2019

                experiences,hospital‐at‐home,interprofessional,nurses,nursing,nursing practice

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