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Larsson K, Wallroth V, Schröder A. Efforts of a Mobile Geriatric Team from a Next-of-Kin Perspective: A Phenomenographic Study. Healthcare (Basel) 2023; 11:healthcare11071038. [PMID: 37046965 PMCID: PMC10094527 DOI: 10.3390/healthcare11071038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Revised: 03/15/2023] [Accepted: 03/27/2023] [Indexed: 04/08/2023] Open
Abstract
Many older adults with complex illnesses are today cared for by their next of kin in their own homes and are often sent between different caregivers in public healthcare. Mobile Geriatric Teams (MGTs) are a healthcare initiative for older adults with extensive care needs living at home, coordinated between hospital, primary, and municipal care. The study aims to describe how next of kin experience care efforts from an MGT for their older adult family members. The study has a descriptive qualitative design and uses a phenomenographic approach. Fourteen next of kin to older adult family members who receive efforts from an MGT were interviewed. Two descriptive categories reflecting their experiences emerged: Professional care and No longer having the main responsibility. The study shows that the participants valued that the staff was very competent, that the physician made home visits and could make quick decisions, and that treatments were given at home. They feel that they receive support and experience security and that a burden is lifted from them. Our study shows that through the MGT, next of kin become involved in the care and are relieved of the burden of responsibility of caring for their older family member.
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Affiliation(s)
- Kjerstin Larsson
- University Health Care Research Center, Faculty of Medicine and Health, Örebro University, 702 81 Örebro, Sweden
| | - Veronika Wallroth
- Division of Social Work (SOCARB), Department of Culture and Society (IKOS), Linköping University, 581 83 Linköping, Sweden
| | - Agneta Schröder
- University Health Care Research Center, Faculty of Medicine and Health, Örebro University, 702 81 Örebro, Sweden
- Department of Nursing, Faculty of Health, Care and Nursing, Norwegian University of Science and Technology (NTNU), 2815 Gjövik, Norway
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2
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Smith S, Martin‐Khan M, Travers C. What constitutes a quality community aged care service-client perspectives: An international scoping study. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e3593-e3628. [PMID: 36083293 PMCID: PMC10087212 DOI: 10.1111/hsc.13998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 06/25/2022] [Accepted: 08/20/2022] [Indexed: 06/15/2023]
Abstract
Overwhelmingly, older Australians (people aged 65 years and older or 50 years and older for Aboriginal and Torres Strait Islander people) prefer to remain living in their own home rather than moving into residential care. To enable older Australians who require assistance to remain living at home, the Federal Government provides a wide range of community care services, the provision of which has increased substantially over the last 15 years. The importance of client preferences, prefaced by the introduction of consumer directed care across community aged care services, has gathered momentum in Australia following legislation in 2015. Older peoples' preferences differ in comparison to younger people with disability and those with mental health concerns. Older people focus more on the provision of services rather than the notion of independent living itself. This scoping review aimed to explore what aspects people aged 65 years and older consider to be important qualities of aged care services delivered in the community. A computerised search in MEDLINE, CINAHL, PubMed and PsychINFO and hand searches of the Cochrane database and Google Scholar were completed in May 2022. Sixty-two articles met the selection criteria and were included in the review. Data were extracted using a fit-for-purpose protocol and analysed using the Miles and Huberman Model for thematic analysis. Results identified five themes representing quality domains that describe features that are important to clients: staff knowledge, respect for clients, a person-centred approach, a collaborative partnership with clients and clear communication. When providers of community aged care services are planning to assess the quality of their services, these findings could be used to guide their evaluation. This will ensure that future services delivered accommodate the needs and preferences of clients who receive them.
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Affiliation(s)
- Sandra Smith
- Centre for Health Services ResearchThe University of QueenslandBrisbaneQueenslandAustralia
| | - Melinda Martin‐Khan
- Centre for Health Services ResearchThe University of QueenslandBrisbaneQueenslandAustralia
| | - Catherine Travers
- School of Health and Rehabilitation SciencesThe University of QueenslandBrisbaneQueenslandAustralia
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3
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Hsieh CM, Kenagy GP. Exploring the association between quality of homecare services and older adults' well-being. Home Health Care Serv Q 2020; 39:65-79. [PMID: 32036771 DOI: 10.1080/01621424.2020.1726849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Homecare services play an important role in enabling older adults with chronic illness or functional impairment to continue living in their homes and communities. Previous research on homecare services has not fully explored the potential psychological benefits of homecare services. This study investigates the association between quality of homecare services and psychological well-being by analyzing two surveys. The results showed that the association between well-being and the quality of homecare services was mediated by satisfaction with health (z = 4.36, p = .000), satisfaction with family life (z = 4.96, p = .000) and satisfaction with friendship (z = 3.56, p = .000). The top three most important life domains, health, family life, and friendships, combined fully mediated the association between well-being and the quality of homecare services. These findings suggest that quality homecare services could enhance clients' well-being in the areas of family life and friendships beyond health.
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Affiliation(s)
- Chang-Ming Hsieh
- Jane Addams College of Social Work, University of Illinois at Chicago, Chicago, Illinois, USA
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4
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Age-friendly communities for older persons with intellectual disabilities. QUALITY IN AGEING AND OLDER ADULTS 2019. [DOI: 10.1108/qaoa-11-2018-0058] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
The life expectancy for persons with intellectual disabilities (ID) has increased significantly, resulting in an increasing number of aging persons with ID. To promote healthy and active aging of persons with ID, discussions on new initiatives to design age-friendly communities have begun at local and international levels. The purpose of this paper, a qualitative research study, is to identify features of an age-friendly community, and facilitators and barriers from the perspectives of older adults with mild ID and their caregivers who live in the city of Winnipeg in Canada.
Design/methodology/approach
Seven older persons with mild ID were interviewed, and 15 caregivers participated in focus group discussions. All participants were asked questions about features of community living and their experiences in eight broad topic areas (i.e. transportation, housing, social participation, respect and social inclusion, opportunities for community involvement, communication and information, community support and healthcare services, and outdoor spaces and buildings).
Findings
The results indicated that many of the current features of the city of Winnipeg do not adequately address the needs of aging persons with ID; specifically, participants revealed that issues related to accessibility, social participation, social disrespect and inclusion, and lack of resources were important barriers to independence.
Originality/value
The findings will increase awareness of the needs of aging persons with ID and inform programme planning, service delivery, coordination of community-based services and policies to support healthy and active aging for this vulnerable population.
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Chase JAD, Russell D, Rice M, Abbott C, Bowles KH, Mehr DR. Caregivers' Experiences Regarding Training and Support in the Post-Acute Home Health-Care Setting. J Patient Exp 2019; 7:561-569. [PMID: 33062879 PMCID: PMC7534114 DOI: 10.1177/2374373519869156] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Background: Post-acute home health-care (HHC) services provide a unique opportunity to train and support family caregivers of older adults returning home after a hospitalization. To enhance family-focused training and support strategies, we must first understand caregivers’ experiences. Objective: To explore caregivers’ experiences regarding training and support for managing older adults’ physical functioning (PF) needs in the post-acute HHC setting. Method: We conducted a qualitative descriptive study using semi-structured telephone interviews of 20 family caregivers. Interviews were recorded, transcribed, and analyzed using conventional content analysis. Results: We identified the following primary categories: facilitators to learning (eg, past experience, learning methods), barriers to learning (eg, learning on their own, communication, timing/logistics, preferred information and timing of information delivery), and interactions with HHC providers (eg, positive/negative interactions, provider training and knowledge). Conclusion: Caregivers were responsive to learning strategies to manage older adults’ PF needs and, importantly, voiced ideas to improve family-focused training and support. HHC providers can use these findings to tailor training and support of family caregivers in the post-acute HHC setting.
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Affiliation(s)
- Jo-Ana D Chase
- Sinclair School of Nursing, University of Missouri, Columbia, MO, USA
| | - David Russell
- Department of Sociology, Appalachian State University, Boone, NC, USA.,Center for Home Care Policy & Research, Visiting Nurse Service of New York, New York, NY, USA
| | - Meridith Rice
- Sinclair School of Nursing, University of Missouri, Columbia, MO, USA
| | - Carmen Abbott
- Department of Physical Therapy, University of Missouri, Columbia, MO, USA
| | - Kathryn H Bowles
- School of Nursing, University of Pennsylvania, Philadelphia, PA, USA
| | - David R Mehr
- Department of Family and Community Medicine, University of Missouri School of Medicine, Columbia, MO, USA
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6
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Rivas C, Tkacz D, Antao L, Mentzakis E, Gordon M, Anstee S, Giordano R. Automated analysis of free-text comments and dashboard representations in patient experience surveys: a multimethod co-design study. HEALTH SERVICES AND DELIVERY RESEARCH 2019. [DOI: 10.3310/hsdr07230] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BackgroundPatient experience surveys (PESs) often include informative free-text comments, but with no way of systematically, efficiently and usefully analysing and reporting these. The National Cancer Patient Experience Survey (CPES), used to model the approach reported here, generates > 70,000 free-text comments annually.Main aimTo improve the use and usefulness of PES free-text comments in driving health service changes that improve the patient experience.Secondary aims(1) To structure CPES free-text comments using rule-based information retrieval (IR) (‘text engineering’), drawing on health-care domain-specific gazetteers of terms, with in-built transferability to other surveys and conditions; (2) to display the results usefully for health-care professionals, in a digital toolkit dashboard display that drills down to the original free text; (3) to explore the usefulness of interdisciplinary mixed stakeholder co-design and consensus-forming approaches in technology development, ensuring that outputs have meaning for all; and (4) to explore the usefulness of Normalisation Process Theory (NPT) in structuring outputs for implementation and sustainability.DesignA scoping review, rapid review and surveys with stakeholders in health care (patients, carers, health-care providers, commissioners, policy-makers and charities) explored clinical dashboard design/patient experience themes. The findings informed the rules for the draft rule-based IR [developed using half of the 2013 Wales CPES (WCPES) data set] and prototype toolkit dashboards summarising PES data. These were refined following mixed stakeholder, concept-mapping workshops and interviews, which were structured to enable consensus-forming ‘co-design’ work. IR validation used the second half of the WCPES, with comparison against its manual analysis; transferability was tested using further health-care data sets. A discrete choice experiment (DCE) explored which toolkit features were preferred by health-care professionals, with a simple cost–benefit analysis. Structured walk-throughs with NHS managers in Wessex, London and Leeds explored usability and general implementation into practice.Key outcomesA taxonomy of ranked PES themes, a checklist of key features recommended for digital clinical toolkits, rule-based IR validation and transferability scores, usability, and goal-oriented, cost–benefit and marketability results. The secondary outputs were a survey, scoping and rapid review findings, and concordance and discordance between stakeholders and methods.Results(1) The surveys, rapid review and workshops showed that stakeholders differed in their understandings of the patient experience and priorities for change, but that they reached consensus on a shortlist of 19 themes; six were considered to be core; (2) the scoping review and one survey explored the clinical toolkit design, emphasising that such toolkits should be quick and easy to use, and embedded in workflows; the workshop discussions, the DCE and the walk-throughs confirmed this and foregrounded other features to form the toolkit design checklist; and (3) the rule-based IR, developed using noun and verb phrases and lookup gazetteers, was 86% accurate on the WCPES, but needs modification to improve this and to be accurate with other data sets. The DCE and the walk-through suggest that the toolkit would be well accepted, with a favourable cost–benefit ratio, if implemented into practice with appropriate infrastructure support.LimitationsSmall participant numbers and sampling bias across component studies. The scoping review studies mostly used top-down approaches and focused on professional dashboards. The rapid review of themes had limited scope, with no second reviewer. The IR needs further refinement, especially for transferability. New governance restrictions further limit immediate use.ConclusionsUsing a multidisciplinary, mixed stakeholder, use of co-design, proof of concept was shown for an automated display of patient experience free-text comments in a way that could drive health-care improvements in real time. The approach is easily modified for transferable application.Future workFurther exploration is needed of implementation into practice, transferable uses and technology development co-design approaches.FundingThe National Institute for Health Research Health Services and Delivery Research programme.
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Affiliation(s)
- Carol Rivas
- Faculty of Health Sciences, University of Southampton, Southampton, UK
- Department of Social Science Research Unit, University College London, London, UK
| | - Daria Tkacz
- Faculty of Health Sciences, University of Southampton, Southampton, UK
| | - Laurence Antao
- Faculty of Health Sciences, University of Southampton, Southampton, UK
| | - Emmanouil Mentzakis
- Economics within Social Sciences, University of Southampton, Southampton, UK
| | | | - Sydney Anstee
- Faculty of Health Sciences, University of Southampton, Southampton, UK
| | - Richard Giordano
- Faculty of Health Sciences, University of Southampton, Southampton, UK
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7
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Irani E, Hirschman KB, Cacchione PZ, Bowles KH. How home health nurses plan their work schedules: A qualitative descriptive study. J Clin Nurs 2018; 27:4066-4076. [PMID: 29893442 DOI: 10.1111/jocn.14548] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/03/2018] [Indexed: 11/29/2022]
Abstract
AIMS AND OBJECTIVES To describe how home health nurses plan their daily work schedules and what challenges they face during the planning process. BACKGROUND Home health nurses are viewed as independent providers and value the nature of their work because of the flexibility and autonomy they hold in developing their work schedules. However, there is limited empirical evidence about how home health nurses plan their work schedules, including the factors they consider during the process and the challenges they face within the dynamic home health setting. DESIGN Qualitative descriptive design. METHODS Semi-structured interviews were conducted with 20 registered nurses who had >2 years of experience in home health and were employed by one of the three participating home health agencies in the mid-Atlantic region of the United States. Data were analysed using conventional content analysis. RESULTS Four themes emerged about planning work schedules and daily itineraries: identifying patient needs to prioritise visits accordingly, partnering with patients to accommodate their preferences, coordinating visit timing with other providers to avoid overwhelming patients, and working within agency standards to meet productivity requirements. Scheduling challenges included readjusting the schedule based on patient needs and staffing availability, anticipating longer visits, and maintaining continuity of care with patients. CONCLUSION Home health nurses make autonomous decisions regarding their work schedules while considering specific patient and agency factors, and overcome challenges related to the unpredictable nature of providing care in a home health setting. Future research is needed to further explore nurse productivity in home health and improve home health work environments. RELEVANCE TO CLINICAL PRACTICE Home health nurses plan their work schedules to provide high quality care that is patient-centered and timely. The findings also highlight organisational priorities to facilitate continuity of care and support nurses while alleviating the burnout associated with high productivity requirements.
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Affiliation(s)
- Elliane Irani
- Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, Ohio
| | - Karen B Hirschman
- School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Pamela Z Cacchione
- School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Kathryn H Bowles
- School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania.,Center for Home Care Policy and Research, Visiting Nurse Service of New York, New York City, New York
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8
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Lines LM, Anderson WL, Blackmon BD, Pronier CR, Allen RW, Kenyon AE. Qualitative analysis and conceptual mapping of patient experiences in home health care. Home Health Care Serv Q 2018; 37:25-40. [PMID: 29338664 DOI: 10.1080/01621424.2017.1421490] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
This study explored patient experiences in home health care through a literature review, focus groups, and interviews. Our goal was to develop a conceptual map of home health care patient experience domains. The conceptual map identifies technical and personal spheres of care, relating prior studies to new focus group and interview findings and identifying the most important domains of care. Study participants (n = 35) most frequently reported the most important domain as staff who are caring, supportive, patient, empathetic, respectful, and considerate (endorsed by 29% of participants). The conceptual map includes 114 discrete domains.
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Affiliation(s)
- Lisa M Lines
- a Center for Advanced Methods Development , RTI International , Waltham , Massachusetts , USA.,b Quantitative Health Sciences , University of Massachusetts Medical School, Worcester, Massachusetts, USA
| | - Wayne L Anderson
- c Aging, Disability, & Long-Term Care Program , RTI International , Durham , North Carolina , USA
| | - Brian D Blackmon
- d Survey Research Division , RTI International , Durham , North Carolina , USA
| | - Cristalle R Pronier
- d Survey Research Division , RTI International , Durham , North Carolina , USA
| | - Rachael W Allen
- d Survey Research Division , RTI International , Durham , North Carolina , USA
| | - Anne E Kenyon
- d Survey Research Division , RTI International , Durham , North Carolina , USA
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9
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Bendixen BE, Kirkevold M, Graue M, Haltbakk J. Experiences of being a family member to an older person with diabetes receiving home care services. Scand J Caring Sci 2017; 32:805-814. [PMID: 28833315 DOI: 10.1111/scs.12511] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2017] [Accepted: 06/28/2017] [Indexed: 11/29/2022]
Abstract
AIM To describe family members' experiences of attending to an old person with diabetes receiving home care services, including their interaction with the formal caregivers. METHODS AND RESULTS The study has a qualitative descriptive design. From May to August 2015, eight family members were interviewed. Interviews were analysed using qualitative content analysis. To describe family members' experiences, the following four themes were identified: Security through patients' self-management skills and diabetes knowledge; Perceived burden due to the old persons' deteriorated health; Security through competent home care services; and Doubt due to personnel's inadequate approach and interaction. CONCLUSION It is important for personnel in home care services to consider patients' self-management skills and the family members' diabetes knowledge as key aspects in order to limit experiences of burden when the older person with diabetes has deteriorating health. The findings underscore that interaction with home care personnel skilled in managing diabetes helps family members feel secure.
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Affiliation(s)
- Bente E Bendixen
- Department of Nursing, Faculty of Health- and Social Sciences, Western Norway University of Applied Sciences, Bergen, Norway
| | - Marit Kirkevold
- Centre for Evidence-Based Practice, Faculty of Health- and Social Sciences, Western Norway University of Applied Sciences, Bergen, Norway.,Department of Nursing Science, Faculty of Medicine, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Marit Graue
- Department of Nursing, Faculty of Health- and Social Sciences, Western Norway University of Applied Sciences, Bergen, Norway.,Centre for Evidence-Based Practice, Faculty of Health- and Social Sciences, Western Norway University of Applied Sciences, Bergen, Norway
| | - Johannes Haltbakk
- Department of Nursing, Faculty of Health- and Social Sciences, Western Norway University of Applied Sciences, Bergen, Norway
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10
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Job Satisfaction: Insights from Home Support Care Workers in Three Canadian Jurisdictions. Can J Aging 2017; 36:1-14. [DOI: 10.1017/s0714980816000726] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
RÉSUMÉCette étude, utilisant des méthodes mixtes, a permis de déterminer les caractéristiques personnelles et professionnelles qui déterminent la satisfaction au travail des travailleurs de soutien à domicile (TSD) qui offrent de l’aide aux personnes âgées. Les données étaient fondées sur une mesure normalisée de la satisfaction au travail ainsi que sur des entretiens qualitatifs et approfondis avec 176 travailleurs de soutien à domicile de trois administrations provinciales canadiennes (Colombie-Britannique, n = 108; Ontario, n = 28; Nouvelle-Écosse, n = 40). Nous nous attendions à ce que la variabilité des profils démographiques parmi les trois groupes de travailleurs et des différentes fiches de poste soit associées à des différences dans la perception de satisfaction professionnelle. Ce n’était pas le cas. Les résultats de l’analyse qualitative mettent en lumière les principaux domaines qui ont contribué à la satisfaction au travail. Ces domaines concernent le travail (horaires, voyages d’affaires et sécurité), les questions économiques (sécurité de revenu) ou organisationnelles (communication, soutien et respect). Compte tenu de ces constatations, nous recommandons des améliorations en ce qui concerne la communication au lieu de travail, une plus grande marge de temps de déplacement entre les clients et la parité salariale avec des postes équivalents dans les établissements de soins de longue durée.
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11
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van Wieringen M, Broese van Groenou MI, Groenewegen P. Impact of home care management on the involvement of informal caregivers by formal caregivers. Home Health Care Serv Q 2015; 34:67-84. [PMID: 25894592 DOI: 10.1080/01621424.2015.1029185] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
This study explores the link between management characteristics of home care agencies and the involvement of informal caregivers in caregiving. Based on a study of policy documents of two agencies and semi-structured interviews with five team managers and 31 formal caregivers, we conclude that, although the importance of involving informal caregivers is emphasized in official documentation, actual contact with informal caregivers is often lacking. Comparison of the work processes of the two agencies shows that contact with informal caregivers and their potential involvement are enhanced by smaller teams, less task division, and clarity about the responsibilities of formal caregivers.
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Affiliation(s)
- Marieke van Wieringen
- a Department of Organization Sciences , VU University Amsterdam , Amsterdam , The Netherlands
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12
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Abstract
The need for home care is increasing in Canada, yet little is known about the home care experience of clients and their families. Uncovering the meaning of the home care experience is an important step towards developing understanding and public awareness. We explored the experiences of home care using arts-based methods and individual interviews with 11 participants (one client and 10 family caregivers). Participants discussed the numerous ways formal home care and family caregiving affected their lives, how they coped with these effects, their experiences in hospitals or assisted living facilities, and aspects of the home care experience they liked or disliked. Participants agreed that home care facilitated a better quality of life for families and clients, although they acknowledged some challenges with it. The artistic outputs produced by participants facilitated interview dialogue and fostered understanding of key themes within the research team.
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13
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Beattie M, Lauder W, Atherton I, Murphy DJ. Instruments to measure patient experience of health care quality in hospitals: a systematic review protocol. Syst Rev 2014; 3:4. [PMID: 24387141 PMCID: PMC3892022 DOI: 10.1186/2046-4053-3-4] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2013] [Accepted: 12/13/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Improving and sustaining the quality of care in hospitals is an intractable and persistent challenge. The patients' experience of the quality of hospital care can provide insightful feedback to enable clinical teams to direct quality improvement efforts in areas where they are most needed. Yet, patient experience is often marginalised in favour of aspects of care that are easier to quantify (for example, waiting time). Attempts to measure patient experience have been hindered by a proliferation of instruments using various outcome measures with varying degrees of psychometric development and testing. METHODS/DESIGN We will conduct a systematic review and utility critique of instruments used to measure patient experience of health care quality in hospitals. The databases Medical Literature Analysis and Retrieval System Online (MEDLINE), Cumulative Index to Nursing and Allied Health Literature (CINAHL), Psychological Information (Psych Info) and Web of Knowledge will be searched from inception until end November 2013. Search strategies will include the key words; patient, adult, hospital, secondary care, questionnaires, instruments, health care surveys, experience, satisfaction and patient opinion in various combinations. We will contact experts in the field of measuring patient experience and scrutinise all secondary references. A reviewer will apply an inclusion criteria scale to all titles and abstracts. A second reviewer will apply the inclusion criteria scale to a random 10% selection. Two reviewers will independently evaluate the methodological rigour of the testing of the instruments using the Consensus-based Standards for the Selection of Health Measurement Instruments (COSMIN) checklist. Disagreements will be resolved through consensus. Instruments will be critiqued and grouped using van der Vleuten's utility index. We will present a narrative synthesis on the utility of all instruments and make recommendations for instrument selection in practice. DISCUSSION This systematic review of the utility of instruments to measure patient experience of hospital quality care will aid clinicians, managers and policy makers to select an instrument fit for purpose. Importantly, appropriate instrument selection will provide a mechanism for patients' voices to be heard on the quality of care they receive in hospitals. PROSPERO registration CRD42013006754.
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Affiliation(s)
- Michelle Beattie
- School of Nursing, Midwifery and Health, University of Stirling, Highland Campus, Centre for Health Science, Old Perth Rd, Inverness IV2 3JH, UK.
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14
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Lang A, Macdonald MT, Storch J, Stevenson L, Mitchell L, Barber T, Roach S, Toon L, Griffin M, Easty A, Curry CG, LaCroix H, Donaldson S, Doran D, Blais R. Researching Triads in Home Care. HOME HEALTH CARE MANAGEMENT AND PRACTICE 2013. [DOI: 10.1177/1084822313501077] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Home care demand in Canada has more than doubled in recent years. While research related to safety in home care is growing, it lags behind that of patient safety in institutional settings. One of the gaps in the literature is the study of the perceptions of home care triads (clients, their unpaid caregivers, and paid providers). Thus, the objectives of this qualitative study were to describe the safety challenges of home care triads and to further understand the multiple dimensions of safety that contribute to or reduce safety concerns for these triads. Findings indicate that clients, unpaid caregivers, and providers struggle in the home care system. Home care models that are client centered need to be considered to provide seamless, quality, sustainable home care.
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Affiliation(s)
| | | | - Jan Storch
- University of Victoria, British Columbia, Canada
| | - Lynn Stevenson
- Vancouver Island Health Authority, Victoria, British Columbia, Canada
| | | | - Tanya Barber
- Dalhousie University, Halifax, Nova Scotia, Canada
| | - Sheri Roach
- Capital District Health Authority, Halifax, Nova Scotia, Canada
| | | | - Melissa Griffin
- Centre for Global Health Innovation, Toronto, Ontario, Canada
| | - Anthony Easty
- Centre for Global Health Innovation, Toronto, Ontario, Canada
| | | | | | - Susan Donaldson
- Canadian Home Care Association, Mississauga, Ontario, Canada
| | | | - Régis Blais
- Université de Montréal (DASUM), Montréal, Quebec, Canada
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