Differences in Home Health Nursing Care for Patients with Parkinson’s Disease by Stage of Progress: Patients in Hoehn and Yahr Stages III, IV, and V

As societal aging progresses globally, the number of people with Parkinson’s disease (PD) is expected to increase worldwide. Accordingly, the need for home health nursing care for homebound patients with PD will continue to expand. We aimed to clarify the clinical care provided by nurses to homebound patients in each Hoehn and Yahr (HY) stage of the disease. We analyzed the visiting nursing records of patients and observed the clinical care provided by nurses in patients’ homes and nursing homes to compare the attributes of patients and differences in nursing care by HY stage. All 21 patients surveyed were at or above HY stage III. The nurses visited each patient nine times per month, on average. The number of visits was positively correlated with HY stage. All stage III patients were homebound, and medication dosage and dispensation assistance were quite common. Several stage IV patients were admitted into nursing homes. In stage V, assistance with hygiene, bedsore management, urine withdrawal/bladder catheters, and other excretory aids were among the most common forms of nursing care provided. As patients’ stages progressed, guidance/educational care meant to encourage self-care decreased and direct physical care increased. Clear differences in nursing care were observed between HY stages, suggesting that stage-based protocols regarding the nature and frequency of nursing visits may be useful for ensuring consistent, effective care of patients with PD.

Perceived Risk and Hazards Associated With Home Health Care Among Home Health Nurses of India

The objective of this study is to categorize the home health nursing care activities and hazards applicable to Indian settings, into high, medium, and low priority levels with the help of risk assessment table and risk matrix. The research design is exploratory and the study is cross-sectional, A self-administered questionnaire is prepared for Indian settings based on the literature review; the content validity and the internal consistency were ensured; the mean scores and the frequencies for the activities were calculated. The severity scores for the identified 14 perceived high-risk activities were assigned with the help of the brainstorming session. The hazard of slippery floors and exposure to blood fell into high priority area (denoted by red area) with high severity and high occurrence score, similarly overloaded and unsafe electrical outlets, rushing with clients, time pressure for reaching the client’s home, and contact with chemicals fell into medium priority category (denoted by yellow area). Finally, hazards such as uncontrolled pets and verbal abuse from patients fell into low priority levels. The providers should take measures for hazards such as slippery floors, overloaded and unsafe electrical outlets, rushing with clients, time pressure for reaching the client’s home, exposure to blood, and contact with chemicals, as these hazards fell into high-medium severity rating with high-medium probability.

Understanding Replication: Trust But Verify

Replication as a pillar of science is described in the context of the replication crisis that first struck psychology but spread quickly to other science-based fields. Empirical evidence suggests that the crisis is real but not well understood. We explain why replication often fails in science and how research in home health can be strengthened by a greater understanding of the value of replication and current thinking about replication success or failure decisions. We conclude with a call for replication in home health nursing that couples original research and replication in the same report.