The Experts below are selected from a list of 360 Experts worldwide ranked by ideXlab platform
Werner B F Brouwer - One of the best experts on this subject based on the ideXlab platform.
-
give me a break informal Caregiver attitudes towards Respite Care
Health Policy, 2008Co-Authors: Job Van Exel, Gjalt De Graaf, Werner B F BrouwerAbstract:Abstract Background/objective Because informal health Care is now recognized to be indispensable to health Care systems, different forms of Respite Care have been developed and publicly funded that supposedly alleviate Caregivers’ perceived burdens and help prolong the Care giving task. Nonetheless, the use of Respite Care services is low even among substantially strained Caregivers. To throw light on this low usage, this paper explores the associations between attitudes towards Respite Care, characteristics of the Care giving situation, and the need and use of Respite Care. Method The survey, administered to a sample of 273 informal Caregivers, addressed Caregiver, Care recipient, and Care giving situation characteristics, as well as the familiarity and use of Respite Care services. It also included a sub-set of 12 statements eliciting attitudes towards Respite Care from an earlier study [Van Exel NJA, De Graaf G, Brouwer WBF. Care for a break? An investigation of informal Caregivers’ attitudes toward Respite Care using Q-methodology. Health Policy 2007;83(2/3):332–42]. Associations between variables were measured using univariate statistics and multinomial logistic regression. Results We found three Caregiver attitudes, distributed fairly equally in the sample, that are apparently associated with Caregiver educational level, employment status, health and happiness, as well as Care recipient gender, duration and intensity of Care giving, relationship, co-residence, need for surveillance, and subjective burden and process utility of Care giving. However, the relation between attitude and familiarity with and use of Respite Care services is ambiguous. Conclusions Although further exploration is needed of the mix of Q-methodology and survey analysis, the overall results indicate that a considerable portion of the Caregiver population needs but does not readily ask for support or Respite Care. This finding has important policy implications in the context of an ageing population.
-
Care for a break an investigation of informal Caregivers attitudes toward Respite Care using q methodology
Health Policy, 2007Co-Authors: Job Van Exel, Gjalt De Graaf, Werner B F BrouwerAbstract:Abstract Objective To investigate informal Caregivers' attitudes toward Respite Care. Method Interviews with informal Caregivers during open-house support groups (three) for informal Caregivers, conducted late 2004 at Informal Care Support Centres in the city of Rotterdam, The Netherlands. A Q-methodological study was conducted. Informal Caregivers were asked to rank-order 39 statements regarding motivation for providing informal Care; supporting capacity; physical, psychological, practical, financial, relational and social obstacles; subjective burden; need for support; experienced support; and propensity and impediments to make use of Respite Care. In addition, respondents explained their Q-sort in writing and completed a questionnaire regarding characteristics of the Caregiver, the Care recipient, and the objective and subjective burden of their Care giving situation. Individual Q-sorts were analysed using PQMethod 2.11 (statistical method factor analysis with a varimax rotation). Objective of Q-analysis was to reveal a limited number of corresponding ways the statements were sorted. For the factors identified, composite sorts were determined. Factors were interpreted and described using the composite sorts, differences and similarities in rank value of statements between factors and the explanations by respondents. Results We found three distinct groups of Caregivers: informal Caregivers who need and ask for Respite Care , those who need but won ' t ask for Respite Care , and those that do not need Respite Care . Caregivers in the first two groups experience substantial burden, while those in the third group enjoy sufficient support and appear to manage pretty well. Caregivers in the second and third group derive considerable satisfaction from Care giving. On balance, Caregivers in the first two groups would sometimes rather have someone else take over their task. The first group feels misunderstood and undervalued by health and welfare organisations and has problems obtaining Respite. The desire for Respite of Caregivers in the second group is not unambiguous, affected by Care recipient resistance against Respite. Conclusions Respite Care programmes should target Caregivers in the first two groups. Regarding the second group, effort should be directed to both Caregiver and Care recipient. They need to be convinced that it is in their mutual interest to make the Care giving task manageable in the long run, because they report serious burden from Care giving coupled with a resistance to Respite Care.
-
Respite Care an explorative study of demand and use in dutch informal Caregivers
Health Policy, 2006Co-Authors: Job Van Exel, Marjolein Moree, Marc A Koopmanschap, Trudy Schreuder Goedheijt, Werner B F BrouwerAbstract:Recently, there has been increasing concern for the well-being of informal Caregivers. Attention is directed at the development of Respite Care programs that provide support and relief by (temporarily) easing the burden for the Caregiver. Yet, little is known about Caregivers' needs, desires and use of Respite Care facilities. A survey was conducted among a population of informal Caregivers, to investigate demand for and use of the four most common types of Respite Care, namely in-home Respite Care, day-Care, short-stay and special holiday arrangements. The 273 Caregivers that participated in this study were reasonably well informed about existing services, especially out-of-home services; least informed was a subgroup that needs but currently does not make use of Respite. About one-third of Caregivers made use of Respite Care. These Caregivers experienced substantial burden and expected burden (60.7 on a 0-100 scale) to increase substantially in case Respite Care would no longer be available (+31 on a 0-100 scale). Caregivers and Care recipients were generally satisfied with the Respite Care they receive. About half of the non-users indicated to need or desire Respite Care, in general those non-users experiencing a relatively high burden. The main impeding factor for use of Respite Care was Care recipient resistance against Respite (38%). A majority of Carers (62%) anticipated that Respite Care could substantially decrease their subjective burden (-29 on a 0-100 scale). Mostly Respite Care facilities reach the Caregivers most in need of support, but not all Caregivers in need make use of Respite. Improvements are possible in terms of information provision and focus on combined Caregiver-Care recipient needs and desires. More research is needed into the (cost-)effectiveness of Respite Care.
-
the desire for support and Respite Care preferences of dutch informal Caregivers
Health Policy, 2004Co-Authors: Marc A Koopmanschap, N J A Van Exel, G A M Van Den Bos, B Van Den Berg, Werner B F BrouwerAbstract:Informal Care is an indispensable element in the Care for many patients. In order to maintain a sustainable input of informal Care, it seems important to identify measures to alleviate the burden of Care giving for Caregivers at risk of burn out or other serious health problems, such as support and Respite Care. Thus, far research has focused on the burden of Caregiving and on the supply of Respite Care. The demand side: what type of Care is preferred by informal Caregivers and what determines their preferences, is virtually unknown. We analysed the preferences and the underlying determinants for several types of support and Respite Care in a sample of 950 Dutch informal Caregivers. Almost 80% of the respondents desire support or Respite Care in general, 42-47% would prefer more communication with other informal Caregivers or more information of professional Caregivers. Some time off is preferred by 40% of the respondents. The results show that Caregiver characteristics, Care recipient characteristics, elements of the Caregiving situation and institutional variables determine the desire for support and Respite Care. Especially, the subjective burden of Caregiving is important, whereas the number of Caregiving tasks and the time invested (objective burden) hardly affect the desire for support and Respite Care.
Gerard J Byrne - One of the best experts on this subject based on the ideXlab platform.
-
prevalence of disruptive behaviour displayed by older people in community and residential Respite Care settings
International Journal of Mental Health Nursing, 2007Co-Authors: Christine Neville, Gerard J ByrneAbstract:The aim of this study was to determine the prevalence of disruptive behaviour displayed by older people in community and residential Respite Care settings. The specific objectives were to (i) obtain an estimate of the frequency of disruptive behaviour displayed by older people in the community setting before residential Respite Care; (ii) characterize older people being admitted for residential Respite Care; and (iii) obtain an estimate of the frequency of disruptive behaviour displayed by older people in residential Respite Care. A quantitative approach using a cross-sectional survey was employed in the community and in the residential aged Care facilities. The older people (n = 100) had a mean age of 81.8 years (range 66-96 years). The older people were being admitted from their homes for booked Respite Care at residential aged Care facilities in a regional Australian city. Home Caregivers and nurses rated disruptive behaviour using the Dementia Behaviour Disturbance Scale (DBDS). Reliability data for the DBDS are provided. As expected, in both community and residential Respite settings, older people with dementia (29%) scored significantly higher on the DBDS than people without dementia. In addition, DBDS scores were unexpectedly higher in the community setting than in the Respite setting. These findings should be taken into consideration by primary health-Care professionals when offering treatment options to the home Caregivers and by staff in the residential aged Care facilities that offer Respite.
-
the impact of residential Respite Care on the behavior of older people
International Psychogeriatrics, 2005Co-Authors: Christine Neville, Gerard J ByrneAbstract:Background: The aim of this study was to examine the impact of residential Respite Care on disruptive behavior displayed by older people, particularly those with dementia. Methods: A quasi-experimental, repeated-measures, single-group design was used. The participants were a consecutive series of 100 older people with a mean age of 81.8 years (range 66-96 years) who had been booked for a Respite admission to one of several residential aged Care facilities in a provincial Australian city. A diagnosis of dementia was reported for 29% of the sample. Disruptive behaviors were rated before and after the period of Respite by home Caregivers (N = 100) and during the period of Respite by nurses (N= 25) using the Dementia Behavior Disturbance Scale (DBDS). Results: Age, male gender and the presence of dementia were all significantly related to the frequency of reported disruptive behaviors. Residential Respite Care was associated with a significant reduction in the frequency of reported disruptive behaviors in older people (Wald chi(2) = 28.28, P < 0.0001). However, this improvement in behavior did not persist into the post-Respite period. The deteriorating behavioral trajectory that was evident prior to Respite Care continued following the period of Respite Care. Conclusions: Residential Respite Care was associated with a temporary diminution in the frequency of reported disruptive behaviors in older people. This finding should be reassuring both for family Carets considering placing a relative in residential Respite Care and for health workers considering whether to recommend such a course of action.
Janne Petersen - One of the best experts on this subject based on the ideXlab platform.
-
post hospital medical Respite Care for homeless people in denmark a randomized controlled trial and cost utility analysis
BMC Health Services Research, 2020Co-Authors: Camilla Nygaard Bring, Maja Pedersen, Nina Brunes, Janne Petersen, Marie Kruse, Mikkel Zollner AnkarfeldtAbstract:Being homeless entails higher mortality, morbidity, and prevalence of psychiatric diseases. This leads to more frequent and expensive use of health Care services. Medical Respite Care enables an opportunity to recuperate after a hospitalization and has shown a positive effect on readmissions, but little is known about the cost-effectiveness of medical Respite Care for homeless people discharged from acute hospitalization. Therefore, the aim of the present study was to investigate the cost-effectiveness of a 2-week stay in post-hospital medical Respite Care. A randomized controlled trial and cost-utility analysis, from a societal perspective, was conducted between April 2014 and March 2016. Homeless people aged > 18 years with an acute admission were included from 10 different hospitals in the Capital Region of Denmark. The intervention group (n = 53) was offered a 2-week medical Respite Care stay at a Red Cross facility and the control group (n = 43) was discharged without any extra help (usual Care), but with the opportunity to seek help in shelters and from street nurses and doctors in the municipalities. The primary outcome was the difference in health Care costs 3 months following inclusion in the study. Secondary outcomes were change in health-related quality of life and health Care costs 6 months following inclusion in the study. Data were collected through Danish registries, financial management systems in the municipalities and at the Red Cross, and by using the EQ-5D questionnaire. After 3 and 6 months, the intervention group had €4761 (p = 0.10) and €8515 (p = 0.04) lower costs than the control group, respectively. Crude costs at 3 months were €8448 and €13,553 for the intervention and control group respectively. The higher costs in the control group were mainly related to acute admissions. Both groups had minor quality-adjusted life year gains. This is the first randomized controlled trial to investigate the cost-effectiveness of a 2-week medical Respite Care stay for homeless people after hospitalization. The study showed that the intervention is cost-effective. Furthermore, this study illustrates that it is possible to perform research with satisfying follow-up with a target group that is hard to reach. ClinicalTrials.gov Identifier: NCT02649595.
-
homeless people s experiences of medical Respite Care following acute hospitalisation in denmark
Health & Social Care in The Community, 2018Co-Authors: Maja Pedersen, Camilla Nygaard Bring, Nina Brunes, Ove Andersen, Janne Petersen, Mary JardenAbstract:The aim of this study was to explore homeless people's health perspectives and experiences of a 2-week medical Respite Care programme following acute hospitalisation. There is a high level of health inequality when comparing the health status of homeless people to the general population, including increased mortality and morbidity. Homelessness predisposes an increased risk of infectious disease, cancer and chronic illness, such as diabetes and cardiovascular disease. Moreover, homeless people have a higher frequency of acute hospitalisation than general population estimates. In order to facilitate the transition from hospitalisation back to life on the streets, homeless people who were acutely hospitalised in the Capital Region of Denmark were offered 2 weeks of medical Respite Care from the day of discharge by a non-governmental organisation. This is a qualitative study with a phenomenological hermeneutical approach based on narrative interviews of 12 homeless people who received medical Respite Care from 1 March 2016 to 30 September 2016. Data were collected through individual semi-structured interviews and analysed according to Lindseth and Norberg's presentation of Paul Ricoeur's theory of interpretation. The analysis identified four themes: (i) basic needs are of highest priority; (ii) a safe environment provides security and comfort; (ii) social support is just as important as healthCare; and (iv) restitution facilitates reflection. The findings indicated that the medical Respite Care centre provided a place of rest and restitution following hospitalisation, which made room for self-reflection among the homeless people regarding their past and present life, and also their wishes for a better future. This study also indicates that a medical Respite Care stay can contribute to the creation of a temporary condition in which the basic needs of the homeless people are met, enabling them to be more hopeful and to think more positively about the future.
Mary Jarden - One of the best experts on this subject based on the ideXlab platform.
-
homeless people s experiences of medical Respite Care following acute hospitalisation in denmark
Health & Social Care in The Community, 2018Co-Authors: Maja Pedersen, Camilla Nygaard Bring, Nina Brunes, Ove Andersen, Janne Petersen, Mary JardenAbstract:The aim of this study was to explore homeless people's health perspectives and experiences of a 2-week medical Respite Care programme following acute hospitalisation. There is a high level of health inequality when comparing the health status of homeless people to the general population, including increased mortality and morbidity. Homelessness predisposes an increased risk of infectious disease, cancer and chronic illness, such as diabetes and cardiovascular disease. Moreover, homeless people have a higher frequency of acute hospitalisation than general population estimates. In order to facilitate the transition from hospitalisation back to life on the streets, homeless people who were acutely hospitalised in the Capital Region of Denmark were offered 2 weeks of medical Respite Care from the day of discharge by a non-governmental organisation. This is a qualitative study with a phenomenological hermeneutical approach based on narrative interviews of 12 homeless people who received medical Respite Care from 1 March 2016 to 30 September 2016. Data were collected through individual semi-structured interviews and analysed according to Lindseth and Norberg's presentation of Paul Ricoeur's theory of interpretation. The analysis identified four themes: (i) basic needs are of highest priority; (ii) a safe environment provides security and comfort; (ii) social support is just as important as healthCare; and (iv) restitution facilitates reflection. The findings indicated that the medical Respite Care centre provided a place of rest and restitution following hospitalisation, which made room for self-reflection among the homeless people regarding their past and present life, and also their wishes for a better future. This study also indicates that a medical Respite Care stay can contribute to the creation of a temporary condition in which the basic needs of the homeless people are met, enabling them to be more hopeful and to think more positively about the future.
Maja Pedersen - One of the best experts on this subject based on the ideXlab platform.
-
post hospital medical Respite Care for homeless people in denmark a randomized controlled trial and cost utility analysis
BMC Health Services Research, 2020Co-Authors: Camilla Nygaard Bring, Maja Pedersen, Nina Brunes, Janne Petersen, Marie Kruse, Mikkel Zollner AnkarfeldtAbstract:Being homeless entails higher mortality, morbidity, and prevalence of psychiatric diseases. This leads to more frequent and expensive use of health Care services. Medical Respite Care enables an opportunity to recuperate after a hospitalization and has shown a positive effect on readmissions, but little is known about the cost-effectiveness of medical Respite Care for homeless people discharged from acute hospitalization. Therefore, the aim of the present study was to investigate the cost-effectiveness of a 2-week stay in post-hospital medical Respite Care. A randomized controlled trial and cost-utility analysis, from a societal perspective, was conducted between April 2014 and March 2016. Homeless people aged > 18 years with an acute admission were included from 10 different hospitals in the Capital Region of Denmark. The intervention group (n = 53) was offered a 2-week medical Respite Care stay at a Red Cross facility and the control group (n = 43) was discharged without any extra help (usual Care), but with the opportunity to seek help in shelters and from street nurses and doctors in the municipalities. The primary outcome was the difference in health Care costs 3 months following inclusion in the study. Secondary outcomes were change in health-related quality of life and health Care costs 6 months following inclusion in the study. Data were collected through Danish registries, financial management systems in the municipalities and at the Red Cross, and by using the EQ-5D questionnaire. After 3 and 6 months, the intervention group had €4761 (p = 0.10) and €8515 (p = 0.04) lower costs than the control group, respectively. Crude costs at 3 months were €8448 and €13,553 for the intervention and control group respectively. The higher costs in the control group were mainly related to acute admissions. Both groups had minor quality-adjusted life year gains. This is the first randomized controlled trial to investigate the cost-effectiveness of a 2-week medical Respite Care stay for homeless people after hospitalization. The study showed that the intervention is cost-effective. Furthermore, this study illustrates that it is possible to perform research with satisfying follow-up with a target group that is hard to reach. ClinicalTrials.gov Identifier: NCT02649595.
-
homeless people s experiences of medical Respite Care following acute hospitalisation in denmark
Health & Social Care in The Community, 2018Co-Authors: Maja Pedersen, Camilla Nygaard Bring, Nina Brunes, Ove Andersen, Janne Petersen, Mary JardenAbstract:The aim of this study was to explore homeless people's health perspectives and experiences of a 2-week medical Respite Care programme following acute hospitalisation. There is a high level of health inequality when comparing the health status of homeless people to the general population, including increased mortality and morbidity. Homelessness predisposes an increased risk of infectious disease, cancer and chronic illness, such as diabetes and cardiovascular disease. Moreover, homeless people have a higher frequency of acute hospitalisation than general population estimates. In order to facilitate the transition from hospitalisation back to life on the streets, homeless people who were acutely hospitalised in the Capital Region of Denmark were offered 2 weeks of medical Respite Care from the day of discharge by a non-governmental organisation. This is a qualitative study with a phenomenological hermeneutical approach based on narrative interviews of 12 homeless people who received medical Respite Care from 1 March 2016 to 30 September 2016. Data were collected through individual semi-structured interviews and analysed according to Lindseth and Norberg's presentation of Paul Ricoeur's theory of interpretation. The analysis identified four themes: (i) basic needs are of highest priority; (ii) a safe environment provides security and comfort; (ii) social support is just as important as healthCare; and (iv) restitution facilitates reflection. The findings indicated that the medical Respite Care centre provided a place of rest and restitution following hospitalisation, which made room for self-reflection among the homeless people regarding their past and present life, and also their wishes for a better future. This study also indicates that a medical Respite Care stay can contribute to the creation of a temporary condition in which the basic needs of the homeless people are met, enabling them to be more hopeful and to think more positively about the future.
