Edith Roth Gjevjon

Measuring interpersonal continuity in high‐frequency home healthcare services

AIM To provide a method for assessing the degree of interpersonal continuity adapted to context and to measure and assess the degree of interpersonal continuity for long-term recipients dependent on daily home health care. BACKGROUND Interpersonal continuity is important to the quality of care for long-term dependents. In high-frequency home healthcare services where patients receive daily care from many nurses or other health personnel over time, interpersonal continuity may be difficult to attain. DESIGN A cross-sectional study with a descriptive design. METHODS Information concerning 79 patients receiving long-term frequent care was collected during four weeks in a maximum variation sample of Norwegian municipalities, from January 2009-May 2010. We measured interpersonal continuity objectively using indices of dispersion and the next-day sequence of health personnel. For each measure, we computed the highest feasible level of continuity that could be attained in this home healthcare context given a standard shift plan. This level was then used as benchmark against which the actual level of continuity was assessed. RESULTS Patients received on average 51 visits from a mean of 17 different carers during four weeks. The results revealed a low degree of interpersonal continuity in practice, far below what was feasible according to the benchmarks. CONCLUSION High-frequency home health care was characterized by interpersonal discontinuity, but with potential for improvement. Objective measures of interpersonal continuity, when the benchmark is adapted to the context, are useful tools for planning and surveying continuity of care.

Being old in an always-on culture: Older people's perceptions and experiences of online communication

ABSTRACT Research on the digital divide has moved beyond connectivity to skills and usage disparities. Yet for many older people lack of connectivity remains a challenge, and for those who do have access, skills and usage remain an issue. We report findings of an in-depth qualitative study of older peoples perceptions of online communications and also their actual experiences. Findings indicate that older people who are already socially well connected benefit from online communication more than those who are not.

Older Patients’ and Next of Kin’s Perspectives on Continuity in Long-Term Home Health Care

The study explored how 125 older patients and 92 next of kin experienced and assessed continuity in long-term home health care. Data were collected by means of structured interviews. A majority of the patients indicated that having a high number of health care personnel involved in their care was not problematic. For patients, informed and skilled health personnel along with knowing the visiting personnel may compensate for a high number of personnel. For next of kin, accepting a high number of personnel was related to the carers being informed about the patient’s situation. This study indicates that, in terms of patient satisfaction, the overall quality of care is more important than the number of people providing the care.