Work - Volume 41, issue 3

Article Type: Other

DOI: 10.3233/WOR-2012-1301

Citation: Work, vol. 41, no. 3, pp. 313-314, 2012

Authors: Zayas-Cabán, Teresa

Article Type: Research Article

Abstract: Objective: Achieving optimal health outcomes requires that consumers maintain myriad health data and understand how to utilize appropriate health information management applications. This case study investigated four families' health information management tasks in their homes. Participants: Four different families participated in the study: a single parent household; two nuclear family households; and an extended family household. Methods: A work system model known as the balance model was used as a guiding framework for data collection. Data …collection consisted of three stages: (1) primary health information manager interviews; (2) family interviews; and (3) task observations. Results: Overall, families reported 69 unique health information management tasks that took place in nine different locations, using 22 different information storage artifacts. Frequently occurring tasks related to health management or health coordination were conducted in public spaces. Less frequent or more time-consuming tasks, such as researching a health concern or storing medical history, were performed in private spaces such as bedrooms or studies. Conclusions: Similarities across households suggest potential foundational design elements that consumer health information technology application designers need to balance with tailored interventions to successfully support variations in individuals' health information management needs. Show more

Keywords: Case study, balance model, interviews, observations, household

DOI: 10.3233/WOR-2012-1306

Citation: Work, vol. 41, no. 3, pp. 315-328, 2012

Authors: Moen, Anne | Smørdal, Ole

Article Type: Research Article

Abstract: Objective: Everyday challenges to "live well" with a rare disorder, anorectal anomaly, was the starting point to design a social-software environment, called RareICT, to help patients and family members in their everyday, additional un-paid work. Participants: Persons with the rare disorder, family members and health providers were recruited to elaborate challenges to daily living given this condition. Methods: An exploratory study was designed, and we set up a series of participatory design …workshops to explore challenges to everyday living with a rare medical condition. Results: Anorectal anomaly has few visible outward signs, and is often surrounded with secrecies. Findings shed light on efforts to maintain physical functioning, psychosocial and emotional wellbeing. For an affected person to "live well" modifications to everyday routines, along with management work, support work and planning work are required. Accumulating practical strategies, everyday experiences and knowledge, along with virtual access to peers may augment such health maintenance work if integrity, accountability and trust, confidentiality and privacy are maintained. Conclusion: A social-software environment was set up to offer co-evolving content and augment health-related decision-making at home. To evaluate the project will focus on interest in maintaining participation determined and how users benefit from services such as RareICT. Show more

Keywords: Self-care, health maintenance in the home, Web 2.0, wiki, social software, rare diagnoses

DOI: 10.3233/WOR-2012-1303

Citation: Work, vol. 41, no. 3, pp. 329-337, 2012

Authors: Stolee, Paul | Zaza, Christine | Schuehlein, Sheila

Article Type: Research Article

Abstract: Objective: Exercise programs have been found to have substantial benefits for older persons, but implementing these programs with frail homebound seniors is challenging. The project team aimed to evaluate an in-home exercise program for older adults – the Victorian Order of Nurses' for Canada's SMART (Seniors Maintaining Active Roles Together)® (VON SMART®) In-Home Exercise Program– in which the exercises are led by trained volunteers. The majority of volunteers were females who exercise …regularly. Over half of the volunteers were 60 years of age or older, and over half had had prior health or fitness training. Volunteers reported receiving multiple benefits from performing their role as an exercise leader. Participants: From January to August, 2009, a total of 59 volunteers, seven Site Coordinators, and 33 home-bound older (mean age: 80 years; SD: 8.8) clients from eight VON sites and one partner organization participated in the evaluation. Methods: Data collection included pre-post quantitative measures of participants' physical function, satisfaction surveys of participants, follow up semi-structured interviews of participants, feedback surveys of volunteers and site coordinators, and a focus group interview of site coordinators. Results: The Chair Stand test (p< 0.001), the Reaching Forward test (p=0.028), the Activities Balance Confidence Scale (p=0.02), as well as measures of activities of daily living (ADL) inside the home (p=0.001) and outside the home (p=0.009) showed significant improvement. Conclusions: This evaluation showed that the exercises improved participants' strength, flexibility, balance, and ability to perform ADL. This study provides additional evidence of the benefits of in-home exercise for frail seniors, and supports a role for volunteers in delivering these programs. The volunteers reported receiving social benefits of meeting new people, being able to see the difference they helped make in others, as well as personal physical benefits from exercising more. Show more

Keywords: Home exercise, volunteers, frail seniors, physical function

DOI: 10.3233/WOR-2012-1304

Citation: Work, vol. 41, no. 3, pp. 339-354, 2012

Authors: Laszlo, Aniko | Henry, Alexis | Goldsberry, Jean | Lapine, Kimberly

Article Type: Research Article

Abstract: Unemployment is a significant problem among working-age adults with disabilities. The Bristol Employment Collaborative (BEC), one of five Regional Employment Collaboratives in Massachusetts, brings together State agencies, community employment service providers, educational institutions, local businesses, economic development organizations, and people with disabilities to design and implement regional strategies to enhance employment opportunities and outcomes for people with disabilities. Launched in 2009, BEC has developed an innovative model to train people with disabilities …to become personal assistance services workers, a healthcare occupation with high demand. The case study describes the strategic planning process undertaken by BEC partners to develop a certificate program to be offered by the local community college. The first class enrolled in September 2010 and graduated ten weeks later. Innovative approaches such as the one being pursued and developed by the BEC could help address both unemployment for people with disabilities and the labor shortages in the healthcare sector. Show more

Keywords: Personal assistance services (PAS), strategic planning, collaboration, supported education, supported employment

DOI: 10.3233/WOR-2012-1302

Citation: Work, vol. 41, no. 3, pp. 355-360, 2012

Authors: Fu, Maggie | Weick-Brady, Mary | Tanno, Eleanor

Article Type: Research Article

Abstract: Objective: With the rising numbers of elderly populations and those with chronic diseases, the Home Healthcare field has inevitable expanded within the United States. Patients, more specifically home-bound patients, are becoming increasingly dependent on medical technology to help sustain and improve their quality if life. Often times, home care patients, or care recipients, depend on a properly functioning medical device for recovery. As efficient as this method may be, home healthcare also comes along with many …challenges involving use and management of medical devices. Difficulties regarding device function, use, the environment, and human factors can all serve as factors to jeopardize patient safety. FDA recognizes that devices need to be safe and capable of meeting needs in an uncontrolled home environment. Participants: Major stakeholders such as manufacturers, distributors, human factor specialists, professional health organizations, healthcare professionals, patient/caregivers, and other government agencies. Result: FDA would assure that manufacturers are designing and testing devices for the home, that proper training and education to use the device are available and completed, and the public knows how to report problems with their devices. Methods: FDA launched the Medical Device Home Use Initiative in April 2010 which proposed different methods that can support safety and safe use of medical devices in the home environment. Conclusion: FDA faces many challenges in assuring safe usage of medical devices in the home. FDA hopes that stakeholders can also become actively involved in working with us to address a total life cycle approach on device safety. Show more

Keywords: Caregiver, care recipient, manufacturer, human factors, policy

DOI: 10.3233/WOR-2012-1305

Citation: Work, vol. 41, no. 3, pp. 361-365, 2012