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Sadarangani TR, Gaugler JE, Dabelko-Schoeny H, Marx KA. Adult Day Services, Health Equity for Older Adults With Complex Needs, and the COVID-19 Pandemic. Am J Public Health 2022; 112:1421-1428. [PMID: 36103694 PMCID: PMC9480461 DOI: 10.2105/ajph.2022.306968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/31/2022] [Indexed: 11/04/2022]
Abstract
Morbidity and mortality from COVID-19 have unduly affected older adults from racial and ethnic minority groups. In this article, we highlight the experiences and vulnerabilities of diverse older adults with complex health and social needs when their access to vital, but overlooked, community-based adult day service centers (ADSCs) was abruptly cut off during a pandemic. Pandemic-related ADSC closures left vulnerable older adults and their care partners without essential daily support and services, such as health monitoring and socialization. However, the magnitude of the impact of ADSC closures on well-being, particularly among members of racial/ethnic minority groups, has yet to be measured with any form of "big data" because large-scale, nationally representative data sets consisting of participant-level information and outcomes associated with ADSC participation do not yet exist. Unmet needs of older adults resulting from pandemic-related ADSC closures are underrecognized because of a lack of systematic data collection, undermining efforts to achieve health equity. We call on ADSCs to link rigorous collection of racial and ethnic data to quality measures of access to equitable "age-friendly" care as a means of better supporting diverse community-dwelling older adults beyond the COVID-19 pandemic. (Am J Public Health. 2022;112(10):1421-1428. https://doi.org/10.2105/AJPH.2022.306968).
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Affiliation(s)
- Tina R Sadarangani
- Tina R. Sadarangani is with the Rory Meyers College of Nursing, New York University, New York. Joseph E. Gaugler is with the School of Public Health, Division of Health Policy and Management, University of Minnesota, Minneapolis. Holly Dabelko-Schoeny is with the College of Social Work, Age-Friendly Innovation Center, Ohio State University, Columbus. Katherine A. Marx is with the School of Nursing, Center for Innovative Care in Aging, Johns Hopkins University, Baltimore, MD
| | - Joseph E Gaugler
- Tina R. Sadarangani is with the Rory Meyers College of Nursing, New York University, New York. Joseph E. Gaugler is with the School of Public Health, Division of Health Policy and Management, University of Minnesota, Minneapolis. Holly Dabelko-Schoeny is with the College of Social Work, Age-Friendly Innovation Center, Ohio State University, Columbus. Katherine A. Marx is with the School of Nursing, Center for Innovative Care in Aging, Johns Hopkins University, Baltimore, MD
| | - Holly Dabelko-Schoeny
- Tina R. Sadarangani is with the Rory Meyers College of Nursing, New York University, New York. Joseph E. Gaugler is with the School of Public Health, Division of Health Policy and Management, University of Minnesota, Minneapolis. Holly Dabelko-Schoeny is with the College of Social Work, Age-Friendly Innovation Center, Ohio State University, Columbus. Katherine A. Marx is with the School of Nursing, Center for Innovative Care in Aging, Johns Hopkins University, Baltimore, MD
| | - Katherine A Marx
- Tina R. Sadarangani is with the Rory Meyers College of Nursing, New York University, New York. Joseph E. Gaugler is with the School of Public Health, Division of Health Policy and Management, University of Minnesota, Minneapolis. Holly Dabelko-Schoeny is with the College of Social Work, Age-Friendly Innovation Center, Ohio State University, Columbus. Katherine A. Marx is with the School of Nursing, Center for Innovative Care in Aging, Johns Hopkins University, Baltimore, MD
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Martin K, Bickle K, Lok J. Investigating the impact of cognitive bias in nursing documentation on decision-making and judgement. Int J Ment Health Nurs 2022; 31:897-907. [PMID: 35355387 DOI: 10.1111/inm.12997] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 02/15/2022] [Accepted: 03/09/2022] [Indexed: 11/30/2022]
Abstract
The clinical documentation of patients' mental status, behaviour and functioning is a fundamental aspect of inpatient mental health care. It is an important source of information-sharing with the interprofessional team and used by other clinicians within the circle of care to guide their decision-making process. Given the body of evidence highlighting concerns about the quality of nursing documentation and the growing literature demonstrating the presence of bias in healthcare, it is critically important that we examine the impact of this bias in nursing practice. The primary objective of this study was to determine whether clinical decisions and judgements change when nurses read documentation that is either biased or neutral. Using a quantitative, observational study that used surveys to collect data, participants were exposed to two patient vignettes and six clinical notes associated with each patient (notes were written with either biased or neutral language) and asked to make clinical decisions and judgements. Results from 199 nurse participants from a tertiary mental health hospital revealed a notable relationship between the type of notes read (biased vs. neutral) and clinical practice, namely, participants reading biased notes were less likely to offer health teaching when administering pro re nata (PRN) medication for sleep. We also found differences in decision-making and judgements based on the type of note read depending on years of experience and type of education. The results indicate that biased language in nursing documentation can influence other clinicians' decisions and judgements about patients, thereby indicating a cascade of bias.
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Affiliation(s)
- Krystle Martin
- Ontario Shores Centre for Mental Health Services, Whitby, Ontario, Canada.,University of Ontario Institute of Technology, Oshawa, Ontario, Canada
| | - Korri Bickle
- Ontario Shores Centre for Mental Health Services, Whitby, Ontario, Canada
| | - Jessica Lok
- Ontario Shores Centre for Mental Health Services, Whitby, Ontario, Canada
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Jones DD. Examining the Unconscious Racial Biases and Attitudes of Physicians, Nurses, and the Public: Implications for Future Health Care Education and Practice. Health Equity 2022; 6:375-381. [PMID: 35651358 PMCID: PMC9148656 DOI: 10.1089/heq.2021.0141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/14/2022] [Indexed: 11/12/2022] Open
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