Abstract |
Background: The "Help at Home" program provides care and support services to people who, due to
disability, age or other needs, have difficulties in taking care of themselves. Usual services are multifaceted
and incorporate help with things like domestic help, health care, accompanying to doctor's
visits, shopping, cooking, cleaning, and general support in daily activities. Home help programs are
supervised and organized from all municipalities in Greece while similar programs exist in almost all
European countries.
Methodology: This is a single-centered cross-sectional study that concerns the population of
beneficiaries of the "Help at Home" program in the Municipality of Mylopotamos. After obtaining the
necessary permits (Municipality of Mylopotamos, University of Crete) and written consents from the
users, interviews were conducted with a closed questionnaire. These questions are structured to
concern the health scientists who provide services within the framework of the program, the offered
and desired services as well as the satisfaction with the program.Specifically, the questionnaire
sections included demographic data, their medical history, the Katz Competency Scale, service
frequency and desired service frequencies, service workers, provided and desired services, and
satisfaction with the program and with each type of employee separately.
Results: The number of users who participated in the study was 390 people (96.8%), 13 people less
than the total of 403 potential participants. Their characteristics were: Married (49.2%), female (64.1%), graduates or illiterate (90.3%), with children (90.1%) or grandchildren (87.4%), moderate
economic condition (49.4%) and an average age of 81.7 ± 10.4 years summarize the profile of users
from the program. Other characteristics concerning the study sample are related to the elderly (>80
years) (44.3%) or to some pathological disease (45.6%) or psychiatric disease (16.5%), while the
ability measured by the scale Katz showed that over 3/4 of users do not face any problem in his/her
daily life. Cardiac and musculoskeletal problems were the most frequent problems with percentages of
72.1% and 49.7% respectively, while regarding his habits, watching TV programs (69.4%) and
visiting friends/relatives ( 66.6%) were the most frequent choices. The services they consider
receiving mainly from the program were nursing (89.7%), family helper (55.4%), social assistance
(20.3%) and social scientist services (13.4%) considering that the specialties are not fully understood.
Among the desired medical services were that of the general practitioner (68.4%) and the pathologist
(37.6%), while other specializations did not exceed 25.0%. Regarding the services provided in the
home, paying bills (24.1%) and shopping (16.4%) were provided by the program, while the desire for
the same services exceeded 40%. Monitoring the administration of treatment (45.9%) and
companionship (39.2%) were the most frequently provided as well as among the most desired along
with assistance in the bathroom (28.2%). Nursing services such as blood drawing and injection
therapy were almost at rates above 94%, while the most desired service was accompanying services
(74.9%). In general, users recorded the highest percentages >98% regarding their information,on
issues related to their problems, from the professionals of the program. Also users wanted more
frequent service provision on average 11.3 ± 9.9 days/month. The satisfaction with the program was
characterized as very good in more than 3 / 4 of the users, while the overall satisfaction was
influenced by education (p=0.04), marital status (p=0.008), the existence of children (p=0.010) or
grandchildren (p=0.032), financial status (p=0.026) and type of user (p=0.043). The individual
satisfactions of the social worker were affected by habits such as travel and membership in a club,
while the work of the social scientist was not significantly affected by any variable. The nurse's
judgment was influenced by education (p=0.020), marital status (p=0.030), presence of children
(p=0.015), type of patient (p=0.021) and habits (association p<0.001, travel p<0.001). Finally,
satisfaction with the family helper showed an effect from education (p=0.010), family status
(p=0.026), the existence of children (p=0.012) and grandchildren (p=0.022), watching television
(p=0.009 ) gardening (p=0.035) and club membership (p=0.001)
Discussion. The Help at Home program as implemented in the Municipality of Mylopotamos covers a
wide range of needs of the users of the area. Users seem to want more from the program while the
services provided, possibly due to understaffing and regulation, do not fully meet the needs. Despite
the fact that satisfaction was high, it was observed that it was influenced by several factors with the
older, those with a better financial situation and those with a stable family environment showing
greater satisfaction, showing that the overall satisfaction is also influenced by the general situation of
the user.
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