Geriatric nursing (New York, N.Y.) · 2026
Association between integrative novel home-based long-term care service, hospitalization, and challenging behaviors in dementia: A secondary analysis of nationwide cross-sectional study.
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Hirooka Kayo, Takahashi Kunihiko, Anzai Tatsuhiko, Iwasawa Yuko, Hakuno Kaori, Tamogami Yumi, Fukui Sakiko
Аннотация
PURPOSE/AIMS: To identify the factors associated with hospitalization of community-dwelling users of nursing small-scale multifunctional home care (NSMHC), a long-term care insurance service grounded in a person-centered, integrated approach.
METHODS: Data collected between October and November 2022 in Japan were analyzed. A structured questionnaire about NSMHC was used to collect data. The administrator of each NSMHC agency completed the questionnaire.
RESULTS: Of 1936 users included in the analysis, 257 reported a reduction in hospitalizations. Of 440 users with dementia, 112 reported improvements in challenging behaviors. Binary logistic regression analysis revealed that care related to medical procedures, including oxygen therapy (odds ratio [OR], 2.45; 95 % confidence interval [CI], 1.11-5.25) and wound care (OR, 1.99; 95 % CI, 1.17-3.38), was associated with a reduction in hospitalizations. Additionally, service agencies that received support from specialized nurses in the care of elimination disorders (OR, 1.86; 95 % CI, 1.01-3.42) and respiratory care (OR, 2.41; 95 % CI, 1.07-9.43) were significant predictors of reduction in hospitalizations. Among users with dementia, standard nursing care, such as providing education and support for family members (OR, 3.90; 95 % CI, 1.30-11.6), was associated with improvements in challenging behaviors. Service agencies receiving support from specialized nurses for the care of challenging behaviors or delirium (OR, 2.20; 95 % CI, 1.15-4.18) were also associated with improvements in challenging behaviors in dementia.
CONCLUSIONS: Policymakers should consider increasing the availability of NSMHC services, as they effectively address the needs of older individuals, enabling them to continue living in their communities.
METHODS: Data collected between October and November 2022 in Japan were analyzed. A structured questionnaire about NSMHC was used to collect data. The administrator of each NSMHC agency completed the questionnaire.
RESULTS: Of 1936 users included in the analysis, 257 reported a reduction in hospitalizations. Of 440 users with dementia, 112 reported improvements in challenging behaviors. Binary logistic regression analysis revealed that care related to medical procedures, including oxygen therapy (odds ratio [OR], 2.45; 95 % confidence interval [CI], 1.11-5.25) and wound care (OR, 1.99; 95 % CI, 1.17-3.38), was associated with a reduction in hospitalizations. Additionally, service agencies that received support from specialized nurses in the care of elimination disorders (OR, 1.86; 95 % CI, 1.01-3.42) and respiratory care (OR, 2.41; 95 % CI, 1.07-9.43) were significant predictors of reduction in hospitalizations. Among users with dementia, standard nursing care, such as providing education and support for family members (OR, 3.90; 95 % CI, 1.30-11.6), was associated with improvements in challenging behaviors. Service agencies receiving support from specialized nurses for the care of challenging behaviors or delirium (OR, 2.20; 95 % CI, 1.15-4.18) were also associated with improvements in challenging behaviors in dementia.
CONCLUSIONS: Policymakers should consider increasing the availability of NSMHC services, as they effectively address the needs of older individuals, enabling them to continue living in their communities.