The expansion of home-based cancer care aims to reduce hospital burden while supporting patient-centered treatment. For patients with multiple myeloma who require long-term therapy and frequent hospital visits, community-based treatment may improve flexibility and quality of life. This prospective mixed-methods study explored the feasibility of community nurses administering subcutaneous daratumumab in patients’ homes or local healthcare clinics. Nineteen patients, nine community nurses, and four hospital healthcare professionals participated in interviews or focus groups. Patient-reported quality of life was assessed using the EORTC QLQ-C30. Most patients preferred home- or local-based administration, citing greater comfort, reduced travel, and a greater sense of normalcy. Community nurses and hospital professionals considered the model feasible and safe when supported by structured training, clear guidelines, and effective communication. However, medication delivery and care coordination created logistical challenges that reduced flexibility for some patients. Quality-of-life scores showed no consistent differences between home- and hospital-based treatment. Home administration should consider clinical stability, cognitive function, patient preferences, and daily routines. Successful implementation requires standardized training, clear roles, reliable communication, and efficient workflows. Home-based daratumumab should be offered as an individualized option within integrated cancer care rather than as a universal replacement for hospital-based treatment.
Dementia is characterized by progressive cognitive decline and behavioral symptoms that significantly impair quality of life for both people living with dementia and their paid and unpaid caregivers. Music-based interventions offer unique therapeutic benefits because musical memory often remains intact in dementia, enabling emotional connection and reminiscence. This article provides a practical framework for home care nurses to implement music interventions across all stages of dementia (early, middle, and late) in the home setting. The evidence suggests that music can reduce agitation, anxiety, depression, and sleep disturbances while promoting social engagement and enhancing mood. Strategies include assessing musical preferences, creating personalized playlists, and integrating music into daily care activities such as bathing or dressing. Nurses should monitor responses and collaborate with family caregivers, while considering the ethical implications of providing music. By tailoring music interventions to individual needs and behavioral symptoms, nurses can improve quality of life for people living with dementia and potentially alleviate family caregiver burden. Current research is synthesized to provide actionable strategies for nursing practice, emphasizing the role of culturally meaningful music and individualized delivery methods.
In home health practice, clinicians may utilize set-pace or self-pace exercise to assess cardiorespiratory health. This study investigated cardiorespiratory responses between two self-paced and two set-paced submaximal activities. A prospective, observational, cross-sectional study included a convenience sample of 40 community-dwelling older adults (18 males and 22 females). Participants completed four submaximal endurance activities during a single session: 3-minute self-paced seated marching, 3-minute self-paced standing marching, 3-minute set-paced seated marching, and 3-minute set-paced standing marching. Heart rate (HR), blood pressure (BP), rate of perceived exertion (RPE), and oxygen consumption (VO2) were measured before and after each activity. Differences were analyzed using within-subjects repeated-measures analysis of variance with Bonferroni adjustments. Significant differences were observed between the four activities for post-exercise HR, SBP, RPE, and VO2 (all p < .001). The mean cadence during self-paced standing marching and self-paced seated marching were 130.39 and 109.50 steps per minute respectively, compared with a standardized cadence of 88 steps per minute for set-paced activities. Cardiorespiratory responses are influenced by pacing strategy. Self-paced activities elicited greater cardiorespiratory responses than set-paced activities due to faster movement cadences. Clinicians must appreciate that when given autonomy, older adults may self-select higher movement cadences, that result in increased physiological stress.
The transition into the postpartum period brings deep physical, emotional, and relational shifts, placing individuals at a significant risk for both pelvic floor dysfunction (PFD) and perinatal mood and anxiety disorders (PMADs). Despite their prevalence, symptoms of both PFD and PMADs are frequently overlooked during routine postpartum follow-up visits, ultimately compromising maternal role performance, daily functioning, and family well-being. Home-based health practitioners (HHPs) can address these gaps during home visits by applying trauma-informed assessment strategies, using brief validated screening tools, and establishing a safe environment for open discussion. This article defines the intersection of PFD and PMADs, describes a methodology for evidence-based home intervention, and provides practical strategies to enhance functional postpartum recovery in the home setting.
Hypertension is a major modifiable risk factor for recurrent stroke in Thailand. This study examined whether home blood pressure monitoring (HBPM) improved short-term blood pressure (BP) control after ischemic stroke. A non-equivalent control group quasi-experimental study was conducted at Phrachomklao Hospital, Thailand. Sequential allocation assigned 130 older adults to standard care and 130 to standard care plus HBPM. The primary outcome was BP control 1 week after discharge based on national guidelines. Multiple logistic regression adjusted for demographic and clinical factors. Of 260 participants, 215 completed the study (HBPM, n = 114; control, n = 101). After adjustment, the HBPM group had significantly greater odds of achieving BP control than the control group (OR = 22.656, 95% CI [9.494-54.066], p < .001). Smoking, diabetes, and lower discharge systolic BP were also associated with BP control, although these findings should be interpreted cautiously. HBPM was associated with improved short-term BP control in older adults following ischemic stroke. HBPM may be a useful addition to post-discharge care, but the single-center design and short follow-up limit generalizability. Further research should examine long-term effects and stroke recurrence.
