Instruments for assessing the preferences for everyday living of older people with various care needs across different care settings: an evidence map

How Do We Achieve Person-Centered Care across Health Care Settings? Expanding Ideological Perspectives into Practice to Advance Person-Centered Care

Person or patient-centered care (PCC) is touted as the gold standard in geriatric medical care across care settings. However, despite more than 3 decades of research and practice initiatives, it remains a challenge to consistently implement PCC that fully places the individual at the center of care planning and the delivery process. The lack of universal implementation of PCC, we argue, may be in large part due to the use of multiple terms and ideologies leading to an inability to coordinate efforts across medical settings. This article reviews recent ideological PCC movements ("What Matters to You," the Age Friendly Health Systems 4 Ms/5 Ms, "Whole Health," Patient Priorities Care, and Medicare/Medicaid person-centered care initiatives), provides a discussion of how these ideologies are implemented in a nursing home setting through preference-based care and provides implications for coordinated integration of PCC across all care settings now and into the future. We argue for the need to draw on known information and validated methodologies for assessing and implementing PCC to collectively move beyond an ideological representation of the concept into an integrated model of PCC for all older adults receiving care.

The PELI-D II Study: Development and Preliminary Validation of the Preferences for Leisure Activities Inventory (P-LAI) for Adult Day Services

OBJECTIVES

The current study aimed to develop and preliminarily validate an initial version of an instrument to assess the leisure activity preferences of people receiving adult day services (ADS).

METHODS

Based on previously conducted concept mapping steps, we identified 12 clusters of preferences for leisure activities. We adopted the structure of the Preferences for Everyday Living Inventory and phrased our cluster labels as questions to develop a first draft of the Preferences for Leisure Activities Inventory (P-LAI). We conducted cognitive interviews (n = 8) to revise, preliminarily validate, and preliminarily finalize the P-LAI.

RESULTS

The draft of the P-LAI included 25 questions. Based on the results of the cognitive interviews, the number of questions was reduced to 21, three questions were rephrased, and evidence to support the preliminary validity of the P-LAI based on the response processes was provided.

CONCLUSIONS

The P-LAI is the first instrument to assess preferences for leisure activities in the ADS environment.

CLINICAL IMPLICATIONS

The preliminary results of the P-LAI allow ADS providers and healthcare professionals to assess the preferences for leisure activities of people who receive ADS in a structured way. Based on these results, preference-based services can be designed and planned, and the person-centered philosophy of care can be further operationalized in the ADS environment.

"This is Slowly Becoming my Interest…": The Understanding of Leisure and Preferences for Leisure Activities of People Receiving Adult Day Services

Currently it is unknown what people receiving adult day services (ADS) understand as leisure and the activities they prefer remain unknown. To address these gaps, we investigated the understanding of leisure of people receiving ADS. We conducted semistructured interviews with 15 people receiving ADS in Germany. Interviews were analyzed using reflexive thematic analysis. The sweet bitter symphony emphasizes the sensations that shape participant's understanding of leisure. Young, wild & free! describes the types of preferred activities. Is this our last tango? refers to the barriers. Anchors aweigh! the [ongoing] voyage describes the process by which leisure is transferred from private domain to the ADS environment. The beginning is the end is the beginning illustrates the paradox of understanding the ADS as offering a form of leisure and the adaptation to engage in nonpreference-based activities. Our findings indicate the importance in offering leisure activities that enable preference-based engagement in the ADS.

Mapping implementation strategies of evidence-based interventions for three preselected phenomena in people with dementia-a scoping review

BACKGROUND

Caring for people with dementia is complex, and there are various evidence-based interventions. However, a gap exists between the available interventions and how to implement them. The objectives of our review are to identify implementation strategies, implementation outcomes, and influencing factors for the implementation of evidence-based interventions that focus on three preselected phenomena in people with dementia: (A) behavior that challenges supporting a person with dementia in long-term care, (B) delirium in acute care, and (C) postacute care needs.

METHODS

We conducted a scoping review according to the description of the Joanna Briggs Institute. We searched MEDLINE, CINAHL, and PsycINFO. For the data analysis, we conducted deductive content analysis. For this analysis, we used the Expert Recommendations for Implementation Change (ERIC), implementation outcomes according to Proctor and colleagues, and the Consolidated Framework for Implementation Research (CFIR).

RESULTS

We identified 362 (A), 544 (B), and 714 records (C) on the three phenomena and included 7 (A), 3 (B), and 3 (C) studies. Among the studies, nine reported on the implementation strategies they used. Clusters with the most reported strategies were adapt and tailor to context and train and educate stakeholders. We identified one study that tested the effectiveness of the applied implementation strategy, while ten studies reported implementation outcomes (mostly fidelity). Regarding factors that influence implementation, all identified studies reported between 1 and 19 factors. The most reported factors were available resources and the adaptability of the intervention. To address dementia-specific influencing factors, we enhanced the CFIR construct of patient needs and resources to include family needs and resources.

CONCLUSIONS

We found a high degree of homogeneity across the different dementia phenomena, the evidence-based interventions, and the care settings in terms of the implementation strategies used, implementation outcomes measured, and influencing factors identified. However, it remains unclear to what extent implementation strategies themselves are evidence-based and which intervention strategy can be used by practitioners when either the implementation outcomes are not adjusted to the implementation strategy and/or the effects of implementation strategies are mostly unknown. Future research needs to focus on investigating the effectiveness of implementation strategies for evidence-based interventions for dementia care.

TRIAL REGISTRATION

The review protocol was prospectively published (Manietta et al., BMJ Open 11:e051611, 2021).

Counseling regarding the care of people with dementia with a focus on §7a SGB XI in Germany: a "gray-shaded" scoping review

BACKGROUND

Care counseling is an important psychosocial intervention for people with care needs and their relatives and can contribute to maintaining and/or improving a patient's quality of life and reducing the burden of caregivers. This is especially the case for people with dementia and their relatives, in which the methods of care counseling need to be different than those for individuals with non-dementia related care needs. Furthermore, the counseling content needs to be adjusted to the specific form and stage of dementia. In Germany, every person who receives support per the German Social Law Book XI (SBG XI) can take advantage of care counseling according to §7a SGB XI. To date, there is no systematic overview of counseling services for people with dementia and their relatives related to this specific provision in Germany.

METHODS

We conducted a gray-shaded scoping review with a focus on the evaluation of care counseling according to §7a SGB XI for people with dementia and their relatives. For this purpose, we applied five search strategies. We researched (1) national electronic databases, (2) Google, (3) targeted websites, (4) experts, and (5) academic electronic databases. Additionally, for the included gray literature, we conducted backward citation tracking via reference lists and forward citation tracking via Google Scholar for scientific articles. Screening of the identified potentially relevant records was performed independently by two reviewers.

RESULTS

We identified 985 records and included 6 studies in our review. We divided the identified studies into three themes: understanding conceptual dimensions, digitalization of counseling, and understanding the perspective of those being counseled. No studies investigated the perspective and experience of people with dementia and their relatives regarding the counseling service according to §7a SGB XI.

CONCLUSIONS

Our results show that further research is needed, especially regarding the experience of people with dementia and their relatives who participated in counseling according to §7a SGB XI. It seems essential to understand the perspective of people with dementia and their relatives to improve and tailor counseling services in Germany.

REGISTRATION

The review protocol was prospectively published (BMJ Open 12:e059771, 2022).

Consulting concepts and structures for people with dementia in Germany: a protocol for a 'grey-shaded' scoping review

INTRODUCTION

Literature reviews represent an important type of study for the various professions in healthcare. The consideration and inclusion of grey literature is gaining importance in all types of reviews. However, searching for grey literature is challenging for different reasons and the search is often insufficiently transparently reported in reviews. The aim of this protocol is to describe our planned methodical approach for a scoping review with a specific focus on grey literature related to the topic of consulting according to §7a of the German Social Law, Book XI (SGB XI) for people with dementia and their relatives in Germany.

METHODS AND ANALYSIS

We will use the following search strategies: (1) search in the German electronic databases, for example, Livivo and GeroLit (via GBV), (2) google search engines, (3) targeted websites, for example, Alzheimer's association and (4) contact experts, for example, stakeholders of private care insurance companies who provide consulting according to §7a SGB XI. Additionally, we will conduct a search in the academic electronic databases MEDLINE (via PubMed) and CINAHL (via EBSCO). For included grey literature, we will conduct a backward citation tracking via reference lists. For included scientific articles, we will conduct a backward (via reference lists) and forward (via Google scholar) citation tracking. Each strategy will be conducted by one reviewer. Screening of the identified potentially relevant records will be conducted in Covidence by two reviewers independently. Results will be charted in a table and illustrated descriptively.

ETHICS AND DISSEMINATION

There are no ethical concerns with conducting a scoping review. We will discuss our results regarding consulting according to §7a SGB XI for people with dementia and their relatives with a variety of stakeholders in Germany. We will disseminate the thematic results and the methodological reflection of our search approach in the form of articles in peer-reviewed and non-peer-reviewed journals.