title: Measuring the need for nursing care in older adults living at home.
abstract: The Community Health Intensity Rating Scale (CHIRS) has been found to significantly explain variation in resources consumed by both home health care clients and high-risk public health nurse clients. Secondary analysis of CHIRS scores from two earlier retrospective studies provided insights into basic similarities and differences between older adults served by a home care program (n = 208) and those served by a public health nursing program for frail elderly (n = 47). CHIRS scores for both client groups demonstrated a substantial need for care, with a greater range of CHIRS global scores for home health care clients but significantly higher (CHIRS total scores for the public health nurse clients (t = -5.24, p < .001). These findings suggest that the public health nurse clients experienced needs across multiple areas whereas the home health care clients' needs were more narrowly focused and episodic. Representation of needs by an intensity rating such as CHIRS can foster more focused visit planning and more specific outcome assessment, assist in planning staffing and in-service education, and focus nursing education regarding care of older adults.
authors.affiliation: University of Nebraska Medical Center, College of Nursing, Omaha, USA.
authors.forename: B J
authors.initials: BJ
authors.lastname: Hays
authors.forename: E H
authors.initials: EH
authors.lastname: Willborn
authors.forename: P
authors.initials: P
authors.lastname: Lopez
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D015577:Geriatric Assessment; D006301:Health Services Needs and Demand; D006699:Home Care Services; D006801:Humans; D008297:Male; D008875:Middle Aged; D009730:Nursing Assessment / Q000592:standards*; D011637:Public Health Nursing; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity