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McGilton KS, Haslam-Larmer L, Wills A, Krassikova A, Babineau J, Robert B, Heer C, McAiney C, Dobell G, Bethell J, Kay K, Keatings M, Kaasalainen S, Feldman S, Sidani S, Martin-Misener R. Nurse practitioner/physician collaborative models of care: a scoping review protocol. BMC Geriatr 2023; 23:98. [PMID: 36797669 PMCID: PMC9934505 DOI: 10.1186/s12877-023-03798-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Accepted: 02/03/2023] [Indexed: 02/18/2023] Open
Abstract
BACKGROUND Before the COVID-19 pandemic, many long-term care (LTC) homes experienced difficulties in providing residents with access to primary care, typically delivered by community-based family physicians or nurse practitioners (NPs). During the pandemic, legislative changes in Ontario, Canada enabled NPs to act in the role of Medical Directors thereby empowering NPs to work to their full scope of practice. Emerging from this new context, it remains unclear how NPs and physicians will best work together as primary care providers. NP/physician collaborative models appear key to achieving optimal resident outcomes. This scoping review aims to map available evidence on existing collaborative models of care between NPs and physicians within LTC homes. METHODS The review will be guided by the research question, "What are the structures, processes and outcomes of collaborative models of care involving NPs and Physicians in LTC homes?" This scoping review will be conducted according to the methods framework for scoping reviews outlined by Arksey and O'Malley and refined by Levac et al., Colquhoun et al., and Daudt et al., as well as the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) Statement. Electronic databases (MEDLINE, Embase + Embase Classic, APA PsycInfo, Cochrane Central Register of Controlled Trials, AMED, CINAHL, Ageline, and Scopus), grey literature, and reference lists of included articles will be searched. English language studies that describe NP and physician collaborative models within the LTC setting will be included. DISCUSSION This scoping review will consolidate what is known about existing NP/physician collaborative models of care in LTC homes. Results will be used to inform the development of a collaborative practice framework for long-term care clinical leadership.
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Affiliation(s)
- Katherine S. McGilton
- grid.231844.80000 0004 0474 0428KITE Research Institute, Toronto Rehabilitation Institute – University Health Network, 550 University Avenue, Toronto, ON M5G 2A2 Canada ,grid.17063.330000 0001 2157 2938Lawrence S. Bloomberg, Faculty of Nursing, University of Toronto, 155 College Street, Toronto, ON M5T 1P8 Canada
| | - Lynn Haslam-Larmer
- grid.231844.80000 0004 0474 0428KITE Research Institute, Toronto Rehabilitation Institute – University Health Network, 550 University Avenue, Toronto, ON M5G 2A2 Canada ,grid.17063.330000 0001 2157 2938Lawrence S. Bloomberg, Faculty of Nursing, University of Toronto, 155 College Street, Toronto, ON M5T 1P8 Canada
| | - Aria Wills
- grid.231844.80000 0004 0474 0428KITE Research Institute, Toronto Rehabilitation Institute – University Health Network, 550 University Avenue, Toronto, ON M5G 2A2 Canada ,grid.17063.330000 0001 2157 2938Lawrence S. Bloomberg, Faculty of Nursing, University of Toronto, 155 College Street, Toronto, ON M5T 1P8 Canada
| | - Alexandra Krassikova
- grid.231844.80000 0004 0474 0428KITE Research Institute, Toronto Rehabilitation Institute – University Health Network, 550 University Avenue, Toronto, ON M5G 2A2 Canada
| | - Jessica Babineau
- grid.231844.80000 0004 0474 0428Library & Information Services, University Health Network, 550 University Avenue, Toronto, ON M5G 2A2 Canada ,grid.231844.80000 0004 0474 0428The Institute for Education Research, University Health Network, Toronto, Canada
| | - Ben Robert
- Perley Health, 1750 Russell Road, Ottawa, ON K1G 5Z6 Canada ,grid.28046.380000 0001 2182 2255Faculty of Medicine, University of Ottawa, 451 Smyth Road #2044, Ottawa, ON K1H 8M5 Canada
| | - Carrie Heer
- Brant Community Healthcare System, 200 Terrace Hill Street, Brantford, ON N3R 1G9 Canada ,grid.418792.10000 0000 9064 3333Bruyère Research Institute, 85 Primrose Ave, Ottawa, ON K1R 6M1 Canada
| | - Carrie McAiney
- grid.498777.2Schlegel-UW Research Institute for Aging, Waterloo, ON N2J 0E2 Canada ,grid.46078.3d0000 0000 8644 1405School of Public Health Sciences, University of Waterloo, 200 University Avenue West, Waterloo, ON N2L 3G1 Canada
| | - Gail Dobell
- Ontario Health, 130 Bloor Street West, Toronto, ON M5S 1N5 Canada
| | - Jennifer Bethell
- grid.231844.80000 0004 0474 0428KITE Research Institute, Toronto Rehabilitation Institute – University Health Network, 550 University Avenue, Toronto, ON M5G 2A2 Canada ,grid.17063.330000 0001 2157 2938Institute of Health Policy, Management and Evaluation, University of Toronto, 155 College Street, Toronto, ON M5T 3M7 Canada
| | - Kelly Kay
- Provincial Geriatrics Leadership Ontario, Toronto, Canada ,grid.17063.330000 0001 2157 2938Ontario Institute for Studies in Education and the Institute for Life Course and Aging, University of Toronto, 246 Bloor Street West, Toronto, ON M5S 1V4 Canada
| | - Margaret Keatings
- grid.42327.300000 0004 0473 9646The Hospital for Sick Children, 555 University Ave, Toronto, ON M5G 1X8 Canada
| | - Sharon Kaasalainen
- grid.25073.330000 0004 1936 8227School of Nursing, McMaster University, 1280 Main Street West, Hamilton, ON L8S 4K1 Canada
| | - Sid Feldman
- Baycrest Health Sciences, 3560 Bathurst Street, Toronto, ON M6A2E1 Canada ,grid.17063.330000 0001 2157 2938Department of Family and Community Medicine, Temerty Medicine, University of Toronto, 1 King’s College Circle, Toronto, ON M5S 1A8 Canada
| | - Souraya Sidani
- Daphne Cockwell School of Nursing, Toronto Metropolitan University, 250 Victoria Street, Toronto, ON M5B 2K9 Canada
| | - Ruth Martin-Misener
- grid.55602.340000 0004 1936 8200School of Nursing, Dalhousie University, Room G26, Forrest Bldg., 5869 University Avenue, Halifax, NS B3H 4R2 Canada
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Measuring relatives' perceptions of end-of-life communication with physicians in five countries: a psychometric analysis. Eur J Ageing 2022; 19:1561-1570. [PMID: 36692786 PMCID: PMC9729495 DOI: 10.1007/s10433-022-00742-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/26/2022] [Indexed: 11/15/2022] Open
Abstract
The Family Perceptions of Physician-Family Caregiver Communication scale (FPPFC) was developed to assess quality of physician-family end-of-life communication in nursing homes. However, its validity has been tested only in the USA and the Netherlands. The aim of this paper is to evaluate the FPPFC construct validity and its reliability, as well as the psychometric characteristics of the items comprising the scale. Data were collected in cross-sectional study in Belgium, Finland, Italy, the Netherlands and Poland. The factorial structure was tested in confirmatory factor analysis. Item parameters were obtained using an item response theory model. Participants were 737 relatives of nursing home residents who died up to 3 months prior to the study. In general, the FPPFC scale proved to be a unidimensional and reliable measure of the perceived quality of physician-family communication in nursing home settings in all five countries. Nevertheless, we found unsatisfactory fit to the data with a confirmatory model. An item that referred to advance care planning performed less well in Poland and Italy than in the Northern European countries. In the item analysis, we found that with no loss of reliability and with increased coherency of the item content across countries, the full 7-item version can be shortened to a 4-item version, which may be more appropriate for international studies. Therefore, we recommend use of the brief 4-item FPPFC version by nursing home managers and professionals as an evaluation tool, and by researchers for their studies as these four items confer the same meaning across countries.
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