Leadership and quality of working life in home health care

Home health care has undergone startling changes in the past decade and, in the process, become a strategically important ingredient of health care delivery. However, the question remains whether home health care organizations can deliver the benefits anticipated for integrated care delivery systems. The answer to this question depends to a great extent on whether home health care organizations build vibrant, visionary leadership capable of transforming organizations and motivating staff to deliver high quality and low cost services. This paper examines a case study of transformational leadership as it relates to the quality of working life for nurses, homemakers, and staff. The findings indicate that leader behaviour is strongly associated with homemakers', and to a lesser extent staff members', job satisfaction, job involvement, and propensity to remain with the organization. These job attitudes have been shown to be related to higher job performance. The implications for leadership in home health agencies are discussed.     

The significance of long-term care in health reform

The American Association of Homes and Services for the Aging, long-term care institutions, and housing providers applaud the proposed state entitlement program in the President's plan, because it is consistent with the belief that individuals should have autonomy and should be able to live as independently as possible for as long as possible. The author presents a convincing argument that elderly and disabled people prefer home and community-based care delivered at home or in home-like settings (aging in place) over the far more expensive nursing facility care, which is now perceived as care of the "last resort."     

The importance of quality of life research for health care reform in the USA and the future of public health

Quality of life research data have significant implications for the social and public policy in the USA as it can be used to evaluate the cost-effectiveness of various permutations of treatment as well as the human effectiveness of health care system restructuring. The USA spends more on health care per capita than any other industralized nation, yet on major health indicators, such as infant mortality rate, this expenditure is not related to beneficial effects on the community. When epidemiological and quality of life data drive national health care planning, improved approaches to the management of health service delivery may become apparent. Ultimately only the patient or consumer can determine if a particular treatment is successful; the same may be true for health care reform.     

Patients' rights, quality of life, and health care system performance

The purpose of this paper is to promote the development of a social contract between patient and clinician that permits patients to state how they want to live as they survive rather than what they are willing to lose to extend their survival. To do this, patients must have sufficient leverage to affect the nature of the care they receive. This leverage, it is proposed, can be achieved by first making a Declaration of Patients Rights Relative to Their Quality of Life' and then evaluating the extent to which the patient's providers comply with this rights statement. The paper also reviews The World Health Report 2000 [Health Systems: Improving Performance Geneva: WHO, 2000] as an example of an alternative approach to defining a health care social contract and evaluating a health system's performance. Also discussed, were steps that could be taken to facilitate the integration of the patients' rights statement into medical practice and health care systems performance.     

Musculoskeletal disorders and quality of life in health care providers working in patient transportation

The aim of this study was to evaluate musculoskeletal symptoms, quality of life and tasks perceived as most tiring by health care workers performing a patient transfer service for a city hall administration in the countryside of S?o Paulo state. A questionnaire was used for collecting demographic and occupational data; an instrument derived from the "Nordic Questionnaire"; a questionnaire to evaluate quality of life (SF 36) and the BORG scale. In this study, 82% workers reported at least one musculoskeletal symptom over the twelve previous months. Quality of life was affected in the following aspects: pain, social aspects, and vitality. Workers felt that all tasks related to patient transfer required intense physical effort which compromised their musculoskeletal system.     

Specifying quality in health care

Quality should be a central issue in the commissioning and provision of health care. This requires a systematic approach to defining and monitoring quality. Such an approach should address: quality characteristics such as efficiency, accessibility, effectiveness (which may conflict with each other); the several levels at which quality may be specified, from general (across all health care) to specific (particular conditions or patient groups); and the methods of quality monitoring which include documented policies, clinical audit, inspection visits/patient surveys, and routine information returns. Shows how a matrix for quality surveillance can be devised which provides a framework for purchasers and providers to work together in developing quality in health care.     

Adolescent distinctions between quality of life and self-rated health in quality of life research

Background  

In adult quality of life (QOL) research, the QOL construct appears to differ from self-rated health status. Although increased QOL continues to be recognized as an important outcome in health promotion and medical intervention, little research has attempted to explore adolescent perceptual differences between self-rated health and QOL.     

Health-related quality of life predicted subsequent health care resource utilization in patients with active cancer

Quality of Life Research - The objective of this study was to estimate the association between SF-12v2® Health Survey (SF-12v2) scores and subsequent health care resource utilization (HCRU)...