Assumptions of good practices in home care for the elderly: a systematic review

A systematic review, based on the Joanna Briggs Institute’s proposal: without restriction of dates; in the English, Portuguese and Spanish languages; conducted in PubMed, CINAHL, LILACS, Embase and Scopus databases.

Results:

Among 453 articles identified, 16 were included in the review: seven qualitative and nine quantitative, published between 1996 and 2015. The synthesis of the data identified as best practices identifies a premise of care centered on the elderly and the inclusion of the elderly, family and nurses as agents of this care.

Conclusion:

According to evidence, good practices in gerontological and nursing home care fundamentally depend on constant planning and reorganization, so that they are indeed comprehensive and contextualized. Thus, providing care will be reasoned by and driven to the elderly, based on their specific and global needs, favoring a process of healthy and active aging.

Descriptors:
Health Services for the Aged; Home Care Services; Home Health Nursing; Geriatric Nursing; Review

Question	Yes*	Partially
1. Was there a clear statement of the aims of the research?	16	00
2. Is the methodology appropriate?	14	02
3. Was the research design appropriate to address the aims of the research?	16	00
4. Was the recruitment strategy appropriate to the aims of the research?	16	00
5. Was the data collected in a way that addressed the research issue?	16	00
6. Has the relationship between researcher and the participants been adequately considered?	16	00
7. Have ethical issues been taken into consideration?	16	00
8. Was the data analysis sufficiently rigorous?	15	01
9. Is there a clear statement of findings?	16	00
10. How valuable is the research?	16	00

Author/ Year	Periodical/country	Objective	Method/Study
Author/ Year	Periodical/country	Objective	Type	Variables	Intervention	Sample
Griffiths⁽²⁰20 Griffiths R, Johnson M, Piper M, Langdon R. A nursing intervention for the quality use of medicines by elderly community clients. Int J Nurs Pract[Internet]. 2004[cited 2018 May 12]. 10(4):166-76. Available from: https://onlinelibrary.wiley.com/doi/epdf/10.1111/j.1440-172X.2004.00476.x https://onlinelibrary.wiley.com/doi/epdf... ⁾ et al., 2004	International Journal of Nursing Practice/ Australia	To analyze the effectiveness of "community nurses" in improving knowledge and self-management of medications in a group of elderly people.	Quasi- experimental study	Medication self-management	Health education	Initial: 184Final: 24
Marek⁽²¹21 Marek KD, Popejoy L, Petroski G, Rantz M. Nurse care coordination in community-based long-term care. J Nurs Scholars[Internet]. 2006[cited 2018 May 12];38(1):80-6. Available from: https://sigmapubs.onlinelibrary.wiley.com/doi/epdf/10.1111/j.1547-5069.2006.00081.x https://sigmapubs.onlinelibrary.wiley.co... ⁾ et al., 2006	Journal of Nursing Scholarship/ USA	To determine and compare the impact of nursing care on patients in a program.	Quasi-experimental study	General cognition, medication self-administration,dyspnea, and pain	Caring program	Initial: 55Final: 30
Park, Kim⁽²²22 Park E, Kim J. The impact of a nurse-led home visitation program on hypertension self-management among older community-dwelling Koreans. Public Health Nurs[Internet]. 2016[cited 2018 May 12];33(1):42-52. Available from: https://onlinelibrary.wiley.com/doi/pdf/10.1111/phn.12220 https://onlinelibrary.wiley.com/doi/pdf/... ⁾, 2015	Public Health Nursing/ South Korea	To evaluate the impact of a program of home visits for hypertensive elderly Koreans.	A quasi-experimental study, with a random sample, without a control group	Knowledge about arterial hypertension, adherence to medication, and general self-confidence in treatment	Health education	Sample: 13,452
Badia⁽²³23 Badia JG, Santos BA, Segura JCC, Casellas MDC, Lombardo FC, Tebar AH, et al. Nursing workload predictors in Catalonia (Spain): a home care cohort study. Gac Sanit[Internet]. 2011[cited 2018 May 12];25(4):308-13. Available from: http://scielo.isciii.es/pdf/gs/v25n4/original7.pdf http://scielo.isciii.es/pdf/gs/v25n4/ori... ⁾ et al., 2011	Gaceta Sanitaria/ Spain	To identify the characteristics of chronic patients, to predict the nursing workload.	Cross-sectional study	Home visit (dependent) and chronic characteristic (independent)	Health education	Initial: 1068Final: 1002
Villas Boas⁽²⁴24 Vilas Boas PJF, Souza ML, Augusto MC, Floripes TM. Acompanhamento domiciliar de idoso de Unidade da Saúde da Família de Botucatu. Rev Bras Educ Med[Internet]. 2012[cited 2018 May 12];36(1):161-5. Available from: http://www.scielo.br/pdf/rbem/v36n1s1/v36n1s1a22.pdf http://www.scielo.br/pdf/rbem/v36n1s1/v3... ⁾ et al., 2012	Revista Brasileira de Educação Médica/ Brazil	To perform the home follow-up on the elderly in the Family health unit	Cross-sectional study, with a convenience sample	Activities of daily living and instrumental activities of daily living	Health education	Initial: 15Final: 12
Karlsson ⁽²⁵25 Karlsson S, Edberg AK, Jakobsson ULF, Hallberg IR. Care satisfaction among older people receiving public care and service at home or in special accommodation. J Clin Nurs[Internet]. 2013[cited 2018 May 12];318-30. Available from: https://onlinelibrary.wiley.com/doi/epdf/10.1111/jocn.12115 https://onlinelibrary.wiley.com/doi/epdf... ⁾ et al., 2013	Journal of Clinical Nursing/ Sweden	To explore the satisfaction of home care in relation to the place of residence, functional dependence, and health complaints among people 65 years of age or older	Cross-sectional study	Functional dependence, health complaints, and quality of life	Health education	Sample: 166
Markle-Reid⁽²⁶26 Markle-Reid M, Weir R, Browne G, Roberts J, Gafni A, Henderson S. Health promotion for frail older home care clientes. J Adv Nurs[Internet]. 2006[cited 2018 May 12];54(3):381-39. Available from: https://onlinelibrary.wiley.com/doi/epdf/10.1111/j.1365-2648.2006.03817.x https://onlinelibrary.wiley.com/doi/epdf... ⁾et al., 2006	Journal of Advanced Nursing/ Canada	To evaluate the comparative effects and costs of a nursing promotion intervention conducted by nurses, together with the home care team.	Randomized, controlled, single blind trial	Cognition, depression and social support	Health education	Initial: 288Final: 288
Moraes⁽²⁷27 Moraes GLA, Borges CL, Oliveira ET, Sarmento LR, Araújo PR, Silva MJ. Aplicação de protocolo de prevenção de úlcera por pressão no contexto domiciliar: uma trajetória percorrida. Cogitare Enferm[Internet]. 2013[cited 2018 May 12];18(2):387-91. Available from: https://revistas.ufpr.br/cogitare/article/view/32590 https://revistas.ufpr.br/cogitare/articl... ⁾ et al., 2013	Cogitare Enfermagem/Brazil	To verify the influence of the application of a nursing protocol on the prevention of pressure ulcers in the elderly in home care.	Experimental randomized trial	Pressure ulcer	Pressure Ulcer Prevention Protocol (UPP)	Initial: 520Final: 40
Cooper⁽²⁸28 Cooper J, McCarter KA. The development of a community and home-based chronic care management program for older adults. Public Health Nurs[Internet]. 2013[cited 2018 May 12];31:36-43. Available from: https://onlinelibrary.wiley.com/doi/pdf/10.1111/phn.12049 https://onlinelibrary.wiley.com/doi/pdf/... ⁾ et al., 2011	Public Health Nursing/USA	To evaluate the impact of a program on the care of individuals with chronic disease	Longitudinal study with a convenience sample	Knowledge about chronic diseases	Health education	Initial: 55Final: 55

Author/ Year	Periodic/ Country	Method			Assumptions of good practices
Author/ Year	Periodic/ Country	Referential	Data collection	Data analysis	Categories identified
Rodrigues⁽²⁹29 Rodrigues RAP, Casagrande, LDR. Atividade educativa com as idosas que tiveram queda e seus cuidadores: atuação da enfermeira geriátrica no domicílio. Acta Paul Enferm. 1996;9(1):80-91.⁾ et al, 1996	Acta Paulista de Enfermagem/ Brazil	Action Research	Participant observation and semi-structured interview	Thematic content analysis	Education; Bonding
Martins⁽³⁰30 Martins JJ, Nascimento ERP, Erdmann AL, Candemil MC, Belaver GM. Cuidado no contexto domiciliar: o discurso de idosos/familiares e profissionais. Rev Enferm[Internet]. 2009[cited 2018 May 12];17(4):556-62. Available from: http://www.facenf.uerj.br/v17n4/v17n4a18.pdf http://www.facenf.uerj.br/v17n4/v17n4a18... ⁾ et al, 2009	Revista de Enfermagem da UERJ/ Brazil	Case study	Semi-structured interview based on previously formulated script	Discourse of the collective subject	Self-care; family; social support network; bonding
SilvaI⁽³¹31 Silva KL, Sena RR, Seixas CT, Feuerwerker LCM, Merhy EE. Atenção domiciliar como mudança do modelo tecnoassistencial. Rev Saúde Pública [Internet]. 2010[cited 2018 May 12];44(1):166-76. Available from: http://www.scielo.br/pdf/rsp/v44n1/18.pdf http://www.scielo.br/pdf/rsp/v44n1/18.pd... ⁾et al., 2010	Revista de Saúde Pública/ Brazil	Case study	Documental analysis and interviews	Analysis of medical records and interviews	Self-care; bonding; environment; specific needs
Ribeiro⁽³²32 Ribeiro AP. Atuação do enfermeiro da estratégia saúde da família na atenção à saúde do idoso. Rev Enferm Integrada, Minas Gerais[Internet]. 2011[cited 2018 May 12];4(2):779-92. Available from: https://www.unileste.edu.br/enfermagemintegrada/artigo/v4_2/01-ATUACAO-DO-ENFERMEIRO-DA-ESTRATEGIA-SAUDE-DA-FAMILIA-NA-ATENCAO-A-SAUDE-DO-IDOSO(RIBEIRO;PIRES).pdf https://www.unileste.edu.br/enfermagemin... ⁾et al., 2014	Revista Enfermagem Integrada/ Brazil	Descriptive study	Interview script with recording	Readings of reports, analysis, and data categorization	Self-care; education; bonding; specific needs
Cardoso⁽³³33 Cardoso CMC, Marion D, Wichmann FMA, Luzzi G, Benitez LB, Franco M, et al. Atendimento à Unidade Familiar do Idoso: experiência multidisciplinar. Est Interdisc Envelhecimento[Internet]. 2011[cited 2018 May 12];16:385-394. Available from: https://seer.ufrgs.br/RevEnvelhecer/article/view/9933/0 https://seer.ufrgs.br/RevEnvelhecer/arti... ⁾, 2011	Estudos interdisciplinares de envelhecimento/ Brazil	Experience report	Data recording and evaluation of actions	Descriptive summary	Self-care; education; health promotion
Gago⁽³⁴34 Gago EA, Lopes MJ. Cuidados domiciliares: interação do enfermeiro com a pessoa idosa/família. Acta Paul Enferm[Internet]. 2012[cited 2018 May 12];25(1):74-80. Available from: http://www.scielo.br/pdf/ape/v25nspe1/pt_12.pdf http://www.scielo.br/pdf/ape/v25nspe1/pt... ⁾, Lopes., 2012	Acta Paulista de Enfermagem/ Brazil	Grounded Theory	Non-participant observation and semi-structured interview	Constant comparative analysis method and use of NVivo8® Software	Home environment; bonding; health education; family; visit type
Carvalhais, Sousa⁽³⁵35 Carvalhais M, Sousa L. Qualidade dos cuidados domiciliares em enfermagem a idosos dependentes. Saude Soc[Internet]. 2013[cited 2018 May 12];22(1):160-72. Available from: http://www.scielo.br/pdf/sausoc/v22n1/15.pdf http://www.scielo.br/pdf/sausoc/v22n1/15... ⁾, 2013	Saúde Sociedade de São Paulo/ Portugal	Exploratory study	Photovoice	Content analysis by three independent experts	Healthy aging; bonding; family; self-care

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[1] Corresponding Author: Rosalina Aparecida Partezani Rodrigues. E-mail: rosalina@eerp.usp.br