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Stolee P, Mallinson S, Kernoghan A, Brierley M, Tong C, Elliott J, Abdallah L. Feasibility of Goal Attainment Scaling as a patient-reported outcome measure for older patients in primary care. J Patient Rep Outcomes 2023; 7:78. [PMID: 37486530 PMCID: PMC10366064 DOI: 10.1186/s41687-023-00615-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 07/07/2023] [Indexed: 07/25/2023] Open
Abstract
BACKGROUND Goal Attainment Scaling (GAS) is an outcome measure that reflects the perspectives and experiences of patients, consistent with patient-centred care approaches and with the aims of patient-reported outcome measures (PROMs). GAS has been used in a variety of clinical settings, including in geriatric care, but research on its feasibility in primary care practice has been limited. The time required to complete GAS is a barrier to its use by busy primary care clinicians. In this study, we explored the feasibility of lay interviewers completing GAS with older primary care patients. METHODS Older adults were recruited from participants of a larger study in five primary care clinics in Alberta and Ontario, Canada. GAS guides were developed based on semi-structured telephone interviews completed by a non-clinician lay interviewer; goals were reviewed in a follow-up interview after six months. RESULTS Goal-setting interviews were conducted with 41 participants. GAS follow-up guides could be developed for 40 patients (mean of two goals/patient); follow-up interviews were completed with 29 patients. Mobility-focused goals were the most common goal areas identified. CONCLUSIONS Study results suggest that it is feasible for lay interviewers to conduct GAS over the telephone with older primary care patients. This study yielded an inventory of patient goal areas that could be used as a starting point for future goal-setting interviews in primary care. Recommendations are made for use of GAS and for future research in the primary care context.
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Affiliation(s)
- Paul Stolee
- School of Public Health Sciences, University of Waterloo, 200 University Avenue West, Waterloo, ON, N2L 3G1, Canada.
| | - Sara Mallinson
- Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada
- Health Systems Evaluation and Evidence, Alberta Health Services, Calgary, AB, Canada
| | - Alison Kernoghan
- School of Public Health Sciences, University of Waterloo, 200 University Avenue West, Waterloo, ON, N2L 3G1, Canada
| | - Meaghan Brierley
- Health Systems Evaluation and Evidence, Alberta Health Services, Calgary, AB, Canada
| | - Catherine Tong
- School of Public Health Sciences, University of Waterloo, 200 University Avenue West, Waterloo, ON, N2L 3G1, Canada
| | - Jacobi Elliott
- School of Public Health Sciences, University of Waterloo, 200 University Avenue West, Waterloo, ON, N2L 3G1, Canada
- Lawson Health Research Institute, London, ON, Canada
| | - Lama Abdallah
- School of Public Health Sciences, University of Waterloo, 200 University Avenue West, Waterloo, ON, N2L 3G1, Canada
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Yoshimura M, Kawamura M, Hasegawa S, Ito YM, Takahashi K, Sumi N. Development and validation of the Care Transitions Scale for Patients with Heart Failure: A tool for nurses to assess patients' readiness for hospital discharge. Jpn J Nurs Sci 2023; 20:e12522. [PMID: 36755473 DOI: 10.1111/jjns.12522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 11/06/2022] [Accepted: 12/22/2022] [Indexed: 02/10/2023]
Abstract
AIM This study aimed to develop and assess the validity and reliability of the Care Transitions Scale for Patients with Heart Failure (CTS-HF) as a nurse-reported measure for evaluating patients' readiness for hospital discharge. METHODS We conducted a cross-sectional study of cardiovascular ward nurses from 163 hospitals across Japan. Structural validity was assessed using exploratory factor analysis with development participants and confirmatory factor analysis with validation participants. Convergent validity was assessed by correlation with the Discharge Planning of Ward Nurses scale (DPWN). Hypotheses testing for construct validity was performed as comparisons between subgroups of transitional care practice. RESULTS Valid responses were obtained from 704 nurses (development participants, n = 352; validation participants, n = 352). The final scale comprised 21 items divided into six factors: "Clear preparation for how to manage health at home," "Adjusting to home care/support system," "Transitions of medication management from hospital to home," "Dealing with patients' concerns and questions," "Transitions of disease management from hospital to home," and "Family support." Indices of fit supported these results (comparative fit index = 0.944, root mean square error of approximation = 0.057). The CTS-HF was significantly correlated with the DPWN. The nurses' subgroup with higher transitional care practice had higher CTS-HF scores. Cronbach's alpha was .93 for the CTS-HF. CONCLUSIONS The CTS-HF showed sufficient reliability and validity for use in evaluating discharge care. Further studies are needed regarding the usefulness of this scale in nursing practice.
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Affiliation(s)
- Mai Yoshimura
- Graduate School of Health Sciences, Hokkaido University, Sapporo, Japan
| | - Masumi Kawamura
- Department of Nursing, Sapporo-Kosei General Hospital, Sapporo, Japan
| | - Satoko Hasegawa
- Department of Nursing, Hokkaido University Hospital, Sapporo, Japan
| | - Yoichi M Ito
- Data Science Center, Promotion Unit, Institute of Health Science Innovation for Medical Care, Hokkaido University Hospital, Sapporo, Japan
| | - Keita Takahashi
- Data Science Center, Promotion Unit, Institute of Health Science Innovation for Medical Care, Hokkaido University Hospital, Sapporo, Japan
| | - Naomi Sumi
- Department of Fundamental Nursing, Faculty of Health Sciences, Hokkaido University, Sapporo, Japan
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Schick-Makaroff K, Wozniak LA, Short H, Davison SN, Klarenbach S, Buzinski R, Walsh M, Johnson JA. How the Routine Use of Patient-Reported Outcome Measures for Hemodialysis Care Influences Patient-Clinician Communication: A Mixed-Methods Study. Clin J Am Soc Nephrol 2022; 17:1631-1645. [PMID: 36283760 PMCID: PMC9718041 DOI: 10.2215/cjn.05940522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Accepted: 09/21/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND AND OBJECTIVES Patient-reported outcome measures invite patients to self-report aspects of their quality of life and have been reported to enhance communication with clinicians. We aimed to examine how routine use of patient-reported outcome measures in in-center hemodialysis units influenced patient-clinician communication. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS A concurrent, longitudinal, mixed-methods approach was used. We used data from a cluster randomized controlled trial of 17 hemodialysis units in northern Alberta that introduced a patient-reported outcome measures intervention. Patient-clinician communication was assessed using a modified Communication Assessment Tool. Using interpretive description, we explored patients' and nurses' perceptions of communication pertaining to routine patient-reported outcome measure use. Through purposeful sampling, we interviewed ten patients and eight nurses and conducted six observations in the dialysis units, which were documented in field notes. We reviewed 779 patient responses to open-ended survey questions from randomized controlled trial data. Qualitative data were thematically analyzed. RESULTS Overall, patient-reported outcome measure use did not substantively improve patient-clinician communication. There was a small positive change in mean total Communication Assessment Tool scores (range, 1-5) from baseline to 12 months in patient-reported outcome measure use units (0.25) but little difference from control group units that did not use patient-reported outcome measures (0.21). The qualitative findings provide in-depth insights into why patient-reported outcome measure use did not improve patient-clinician communication. The purpose of patient-reported outcome measure use was not always understood by patients and clinicians; patient-reported outcome measures were not implemented as originally intended in the trial, despite clinician training; there were challenges using patient-reported outcome measures as a means to communicate; and patient-reported outcome measure use was perceived to have limited value. CONCLUSIONS While patient-reported outcome measures use did not improve patient-clinician communication, qualitative data suggest implementation challenges, including limited clarity of purpose and perceived limited value, that may have limited the effectiveness of the intervention.
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Affiliation(s)
- Kara Schick-Makaroff
- Edmonton Clinic Health Academy, Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
| | - Lisa A. Wozniak
- Li Ka Shing Centre for Health Research Innovation, School of Public Health, University of Alberta, Edmonton, Alberta, Canada
| | - Hilary Short
- Li Ka Shing Centre for Health Research Innovation, School of Public Health, University of Alberta, Edmonton, Alberta, Canada
| | - Sara N. Davison
- Division of Nephrology and Immunology, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Scott Klarenbach
- Division of Nephrology and Immunology, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
| | | | - Michael Walsh
- Division of Nephrology, Department of Medicine, McMaster University, St. Joseph’s Healthcare, Hamilton, Ontario, Canada
| | - Jeffrey A. Johnson
- Li Ka Shing Centre for Health Research Innovation, School of Public Health, University of Alberta, Edmonton, Alberta, Canada
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4
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Belmin J, Villani P, Gay M, Fabries S, Havreng-Théry C, Malvoisin S, Denis F, Veyron JH. Real-world implementation of an eHealth system based on an artificial intelligence designed to predict and reduce emergency department visits by older adults: pragmatic trial. J Med Internet Res 2022; 24:e40387. [PMID: 35921685 PMCID: PMC9501682 DOI: 10.2196/40387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2022] [Revised: 07/28/2022] [Accepted: 07/30/2022] [Indexed: 11/25/2022] Open
Abstract
Background Frail older people use emergency services extensively, and digital systems that monitor health remotely could be useful in reducing these visits by earlier detection of worsening health conditions. Objective We aimed to implement a system that produces alerts when the machine learning algorithm identifies a short-term risk for an emergency department (ED) visit and examine health interventions delivered after these alerts and users’ experience. This study highlights the feasibility of the general system and its performance in reducing ED visits. It also evaluates the accuracy of alerts’ prediction. Methods An uncontrolled multicenter trial was conducted in community-dwelling older adults receiving assistance from home aides (HAs). We implemented an eHealth system that produces an alert for a high risk of ED visits. After each home visit, the HAs completed a questionnaire on participants’ functional status, using a smartphone app, and the information was processed in real time by a previously developed machine learning algorithm that identifies patients at risk of an ED visit within 14 days. In case of risk, the eHealth system alerted a coordinating nurse who could then inform the family carer and the patient’s nurses or general practitioner. The primary outcomes were the rate of ED visits and the number of deaths after alert-triggered health interventions (ATHIs) and users’ experience with the eHealth system; the secondary outcome was the accuracy of the eHealth system in predicting ED visits. Results We included 206 patients (mean age 85, SD 8 years; 161/206, 78% women) who received aid from 109 HAs, and the mean follow-up period was 10 months. The HAs monitored 2656 visits, which resulted in 405 alerts. Two ED visits were recorded following 131 alerts with an ATHI (2/131, 1.5%), whereas 36 ED visits were recorded following 274 alerts that did not result in an ATHI (36/274, 13.4%), corresponding to an odds ratio of 0.10 (95% IC 0.02-0.43; P<.001). Five patients died during the study. All had alerts, 4 did not have an ATHI and were hospitalized, and 1 had an ATHI (P=.04). In terms of overall usability, the digital system was easy to use for 90% (98/109) of HAs, and response time was acceptable for 89% (98/109) of them. Conclusions The eHealth system has been successfully implemented, was appreciated by users, and produced relevant alerts. ATHIs were associated with a lower rate of ED visits, suggesting that the eHealth system might be effective in lowering the number of ED visits in this population. Trial Registration clinicaltrials.gov NCT05221697; https://clinicaltrials.gov/ct2/show/NCT05221697.
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Affiliation(s)
- Joël Belmin
- Hôpital Charles Foix, Assistance Publique-Hôpitaux de Paris, Ivry-sur-Seine, FR.,Laboratoire Informatique Médicale et Ingénierie des Connaissances en eSanté (UMRS 1142), Institut National de la Santé et de la Recherche Médicale and Sorbonne Université, Paris, France, Paris, FR
| | - Patrick Villani
- Unité de médecine interne, gériatrie et thérapeutique, Assistance Publique-Hôpitaux de Marseille, Marseille, FR.,Université Aix-Marseille, Centre National de la Recherche Scientifique, Etablissement Français du Sang, Anthropologie bio-culturelle, Droit, Ethique et Santé, Marseille, FR
| | - Mathias Gay
- Communauté professionnelle de santé Itinéraire Santé, Marseille, FR
| | - Stéphane Fabries
- Intervenants Libéraux et Hospitaliers Unis pour le Patient, Marseille, FR
| | - Charlotte Havreng-Théry
- Laboratoire Informatique Médicale et Ingénierie des Connaissances en eSanté (UMRS 1142), Institut National de la Santé et de la Recherche Médicale and Sorbonne Université, Paris, France, Paris, FR.,PRESAGE, 72 boulevard de Sébastopol, Paris, FR
| | | | - Fabrice Denis
- Institut Inter-Régional de Cancérologie Jean Bernard, Le Mans, FR
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Mao H, Xie Y, Shen Y, Wang M, Luo Y. Effectiveness of nurse-led discharge service on adult surgical inpatients: A meta-analysis of randomized controlled trials. Nurs Open 2022; 9:2250-2262. [PMID: 35661429 PMCID: PMC9374412 DOI: 10.1002/nop2.1268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Revised: 03/01/2022] [Accepted: 05/10/2022] [Indexed: 11/07/2022] Open
Abstract
Aim To determine the effectiveness of nurse‐led discharge service for adult surgical inpatients. Design The report of this review was conducted by the preferred reporting items for systematic reviews and meta‐analyses (PRISMA) statement checklist. Methods The PubMed, Web of Science, ScienceDirect, Cochrane Library (CENTRAL), MEDLINE and Embase as well as four Chinese databases including CNKI, Wanfang database, VIP database and CBM were searched for randomized controlled trials. Two reviewers independently extracted data and assessed risk of bias. And meta‐analyses were conducted for the eligible studies by Review manager 5.4.1. Results A total of 1,649 participants were enrolled in 12 randomized controlled trials. The result of readmission rate and emergency visit of intervention group were lower than those of the control group; activities of daily living and quality of life in the intervention group were higher than that of the control group. There was no statistical difference in the length of stay between the two groups.
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Affiliation(s)
- Huina Mao
- Nursing Department, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Yarui Xie
- Nursing Department, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Ying Shen
- Nursing Department, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Mei Wang
- Department of Oncology, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Yingxia Luo
- Department of Urology, Zhujiang Hospital, Southern Medical University, Guangzhou, China
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6
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Andersson V, Sawatzky R, Öhlén J. Relating person-centredness to quality-of-life assessments and patient-reported outcomes in healthcare: A critical theoretical discussion. Nurs Philos 2022; 23:e12391. [PMID: 35502530 PMCID: PMC9285740 DOI: 10.1111/nup.12391] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 03/22/2022] [Accepted: 04/05/2022] [Indexed: 12/24/2022]
Abstract
Engagement with the historical and theoretical underpinnings of measuring quality of life (QoL) and patient‐reported outcomes (PROs) in healthcare is important. Ideas and values that shape such practices—and in the endgame, people's lives—might otherwise remain unexamined, be taken for granted or even essentialized. Our aim is to explicate and theoretically discuss the philosophical tenets underlying the practices of QoL assessment and PRO measurement in relation to the notion of person‐centredness. First, we engage with the late‐modern history of the concept of QoL and the act of assessing and measuring it. Working with the historical method of genealogy, we describe the development of both QoL assessments and PRO measures (PROMs) within healthcare by accounting for the contextual conditions for their possibility. In this way, the historical and philosophical underpinnings of these measurement practices are highlighted. We move on to analyse theoretical and philosophical underpinnings regarding the use of PROMs and QoL assessments in clinical practice, as demonstrated in review studies thereof. Finally, we offer a critical analysis regarding the state of theory in the literature and conclude that, although improved person‐centredness is an implied driver of QoL assessments and PROMs in clinical practice, enhanced theoretical underpinning of the development of QoL assessments is called for.
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Affiliation(s)
- Viktor Andersson
- Institute of Health and Care Sciences and Centre for Person-Centred Care, and Palliative Centre, University of Gothenburg, Sahlgrenska University Hospital Region Västra Götaland, Goteborg, Sweden
| | - Richard Sawatzky
- School of Nursing, Trinity Western University, Langley, British Columbia, Canada.,Centre for Health Evaluation and Outcome Sciences, University of British Columbia, Vancouver, British Columbia, Canada.,Institute of Health and Care Sciences and Centre for Person-Centred Care, University of Gothenburg Sahlgrenska Academy, Goteborg, Sweden
| | - Joakim Öhlén
- Institute of Health and Care Sciences and Centre for Person-Centred Care, and Palliative Centre, University of Gothenburg, Sahlgrenska University Hospital Region Västra Götaland, Goteborg, Sweden
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Kokorelias KM, Nelson MLA, Tang T, Steele Gray C, Ellen M, Plett D, Jarach CM, Xin Nie J, Thavorn K, Singh H. Who is Included in Digital Health Technologies to Support Hospital to Home Transitions for Older Adults?: Secondary analysis of a rapid review and equity-informed recommendations (Preprint). JMIR Aging 2021; 5:e35925. [PMID: 35475971 PMCID: PMC9096639 DOI: 10.2196/35925] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 03/08/2022] [Accepted: 03/14/2022] [Indexed: 12/25/2022] Open
Affiliation(s)
- Kristina Marie Kokorelias
- St John's Rehab Research Program, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
- Department of Medicine, Sinai Health System/University Health Network, Toronto, ON, Canada
| | - Michelle LA Nelson
- Lunenfeld-Tanenbaum Research Institute, Sinai Health, Toronto, ON, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
- March of Dimes Canada, Toronto, ON, Canada
| | - Terence Tang
- Institute for Better Health, Trillium Health Partners, Toronto, ON, Canada
- Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Carolyn Steele Gray
- Lunenfeld-Tanenbaum Research Institute, Sinai Health, Toronto, ON, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
| | - Moriah Ellen
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
- Department of Health Policy and Management, Ben-Gurion University of the Negev, Eilat, Israel
- Guilford Glazer Faculty of Business and Management, Ben-Gurion University of the Negev, Eilat, Israel
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Eilat, Israel
| | - Donna Plett
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
| | - Carlotta Micaela Jarach
- Department of Environmental Health Sciences, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Jason Xin Nie
- Institute for Better Health, Trillium Health Partners, Toronto, ON, Canada
| | - Kednapa Thavorn
- Ottawa Hospital Research Institute, School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
| | - Hardeep Singh
- March of Dimes Canada, Toronto, ON, Canada
- Department of Occupational Science & Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
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8
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Schick-Makaroff K, Sawatzky R, Cuthbertson L, Öhlén J, Beemer A, Duquette D, Karimi-Dehkordi M, Stajduhar KI, Suryaprakash N, Terblanche L, Wolff AC, Cohen SR. Knowledge translation resources to support the use of quality of life assessment tools for the care of older adults living at home and their family caregivers. Qual Life Res 2021; 31:1727-1747. [PMID: 34664161 PMCID: PMC9098582 DOI: 10.1007/s11136-021-03011-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/04/2021] [Indexed: 11/29/2022]
Abstract
Purpose To support the use of quality of life (QOL) assessment tools for older adults, we developed knowledge translation (KT) resources tailored for four audiences: (1) older adults and their family caregivers (micro), (2) healthcare providers (micro), (3) healthcare managers and leaders (meso), and (4) government leaders and decision-makers (macro). Our objectives were to (1) describe knowledge gaps and resources and (2) develop corresponding tailored KT resources to support use of QOL assessment tools by each of the micro-, meso-, and macro-audiences. Methods Data were collected in two phases through semi-structured interviews/focus groups with the four audiences in Canada. Data were analyzed using qualitative description analysis. KT resources were iteratively refined through formative evaluation. Results Older adults and family caregivers (N = 12) wanted basic knowledge about what “QOL assessment” meant and how it could improve their care. Healthcare providers (N = 13) needed practical solutions on how to integrate QOL assessment tools in their practice. Healthcare managers and leaders (N = 14) desired information about using patient-reported outcome measures (PROMs) and patient-reported experience measures (PREMs) in healthcare programs and quality improvement. Government leaders and decision-makers (N = 11) needed to know how to access, use, and interpret PROM and PREM information for decision-making purposes. Based on these insights and evidence-based sources, we developed KT resources to introduce QOL assessment through 8 infographic brochures, 1 whiteboard animation, 1 live-action video, and a webpage. Conclusion Our study affirms the need to tailor KT resources on QOL assessment for different audiences. Our KT resources are available: www.healthyqol.com/older-adults.
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Affiliation(s)
- Kara Schick-Makaroff
- Faculty of Nursing, University of Alberta, 4-116 Edmonton Clinic Health Academy, 11405-87 Ave, Edmonton, AB, T6G 1C9, Canada
| | - Richard Sawatzky
- School of Nursing, Trinity Western University, 22500 University Drive, Langley, BC, V2Y 1Y1, Canada. .,Centre for Health Evaluation & Outcome Sciences, St. Paul's Hospital, 588- 1081 Burrard Street, Vancouver, V6Z 1Y6, Canada. .,Sahlgrenska Academy, University of Gothenburg, Medicinaregatan 3, Box 400, 405 30, Gothenburg, Sweden.
| | - Lena Cuthbertson
- Office of Patient Centred Measurement, British Columbia, Ministry of Health, 1190 Hornby Street, 341F, Vancouver, BC, V6Z 2K5, Canada
| | - Joakim Öhlén
- Institute of Health and Care Sciences, and Centre for Person-Centred Care (GPCC), Sahlgrenska Academy, University of Gothenburg, Box 400, 405 30, Gothenburg, Sweden.,Palliative Centre, Sahlgrenska University Hospital, Västra Götaland Region, Gothenburg, Sweden
| | - Autumn Beemer
- Faculty of Nursing, University of Alberta, Level 3, Edmonton Clinic Health Academy, 11405-87 Ave, Edmonton, AB, T6G 1C9, Canada
| | - Dominique Duquette
- Faculty of Nursing, University of Alberta, Level 3, Edmonton Clinic Health Academy, 11405-87 Ave, Edmonton, AB, T6G 1C9, Canada
| | - Mehri Karimi-Dehkordi
- Division of Geriatric Medicine, Department of Medicine, University of Alberta, 1-198 Clinical Sciences Building, 11350 - 83Avenue, Edmonton, AB, T6G 2P4, Canada
| | - Kelli I Stajduhar
- School of Nursing, Institute on Aging and Lifelong Health, University of Victoria, STN CSC, PO Box 1700, Victoria, BC, V8W 2Y2, Canada
| | - Nitya Suryaprakash
- Center for Clinical Epidemiology and Evaluation, University of British Columbia, 7th Floor, 828 West 10th Avenue, Research Pavilion, Vancouver, BC, V5Z 1M9, Canada
| | - Landa Terblanche
- School of Nursing, Trinity Western University, 22500 University Drive, Langley, BC, V2Y 1Y1, Canada
| | - Angela C Wolff
- School of Nursing, Trinity Western University, 22500 University Drive, Langley, BC, V2Y 1Y1, Canada
| | - S Robin Cohen
- Departments of Oncology and Medicine, McGill University, Montreal, QC, H4A 3T2, Canada.,Lady Davis Research Institute of the Jewish General Hospital, Montreal, QC, H3T 1E2, Canada
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Hughes SE, Aiyegbusi OL, Lasserson DS, Collis P, Cruz Rivera S, McMullan C, Turner GM, Glasby J, Calvert M. Protocol for a scoping review exploring the use of patient-reported outcomes in adult social care. BMJ Open 2021; 11:e045206. [PMID: 33849854 PMCID: PMC8051391 DOI: 10.1136/bmjopen-2020-045206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION Patient-reported outcomes (PROs) are measures of a person's own views of their health, functioning and quality of life. They are typically assessed using validated, self-completed questionnaires known as patient-reported outcome measures (PROMs). PROMs are used in healthcare settings to support care planning, clinical decision-making, patient-practitioner communication and quality improvement. PROMs have a potential role in the delivery of social care where people often have multiple and complex long-term health conditions. However, the use of PROMs in this context is currently unclear. The objective of this scoping review is to explore the evidence relating to the use of PROMs in adult social care. METHODS AND ANALYSES The electronic databases Medline (Ovid), PsychInfo (Ovid), ASSIA (ProQuest), Social Care Online (SCIE), Web of Science and EMBASE (Ovid) were searched on 29 September 2020 to identify eligible studies and other publically available documents published since 2010. A grey literature search and hand searching of citations and reference lists of the included studies will also be undertaken. No restrictions on study design or language of publication will be applied. Screening and data extraction will be completed independently by two reviewers. Quality appraisal of the included documents will use the Critical Appraisal Skills Programme and AACODS (Authority, Accuracy, Coverage, Objectivity, Date, Significance) checklists. A customised data charting table will be used for data extraction, with analysis of qualitative data using the framework method. The review findings will be presented as tables and in a narrative summary. ETHICS AND DISSEMINATION Ethical review is not required as scoping reviews are a form of secondary data analysis that synthesise data from publically available sources. Review findings will be shared with service users and other relevant stakeholders and disseminated through a peer-reviewed publication and conference presentations. This protocol is registered on the Open Science Framework (www.osf.io).
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Affiliation(s)
- Sarah E Hughes
- Centre for Patient Reported Outcomes Research (CPROR), University of Birmingham, Birmingham, UK
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
- National Institute for Health Research Applied Research Centre West Midlands, University of Birmingham, Birmingham, UK
| | - Olalekan Lee Aiyegbusi
- Centre for Patient Reported Outcomes Research (CPROR), University of Birmingham, Birmingham, UK
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
- National Institute for Health Research Applied Research Centre West Midlands, University of Birmingham, Birmingham, UK
- NIHR Birmingham Biomedical Research Centre, University of Birmingham, University of Birmingham, Birmingham, UK
- University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | | | - Philip Collis
- Centre for Patient Reported Outcomes Research (CPROR), University of Birmingham, Birmingham, UK
| | - Samantha Cruz Rivera
- Centre for Patient Reported Outcomes Research (CPROR), University of Birmingham, Birmingham, UK
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
- Birmingham Health Partners Centre for Regulatory Science and Innovation, Birmingham, UK
| | - Christel McMullan
- Centre for Patient Reported Outcomes Research (CPROR), University of Birmingham, Birmingham, UK
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Grace M Turner
- Centre for Patient Reported Outcomes Research (CPROR), University of Birmingham, Birmingham, UK
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Jon Glasby
- Department of Social Work and Social Care, University of Birmingham, Birmingham, UK
| | - Melanie Calvert
- Centre for Patient Reported Outcomes Research (CPROR), University of Birmingham, Birmingham, UK
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
- National Institute for Health Research Applied Research Centre West Midlands, University of Birmingham, Birmingham, UK
- NIHR Birmingham Biomedical Research Centre, University of Birmingham, University of Birmingham, Birmingham, UK
- Birmingham Health Partners Centre for Regulatory Science and Innovation, Birmingham, UK
- National Institute for Health Research Surgical Reconstruction and Microbiology Research Centre, Birmingham, UK
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McDonald AP, Rizzotti R, Rivera JM, D'Arcy RCN, Park G, Song X. Toward improved homecare of frail older adults: A focus group study synthesizing patient and caregiver perspectives. Aging Med (Milton) 2021; 4:4-11. [PMID: 33738374 PMCID: PMC7954833 DOI: 10.1002/agm2.12144] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 12/09/2020] [Accepted: 12/09/2020] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Adopting a better understanding of how both older adults and health care providers view the community management of frailty is necessary for improving home health, especially facing the coronavirus disease 2019 (COVID-19) pandemic. We conducted a qualitative focus group study to assess how both older adults and health care providers view frailty and virtual health care in home health. METHODS Two focus groups enrolled home-living older adults and health care professionals, respectively (n = 15). Questions targeting the use of virtual / telehealth technologies in-home care for frail older adults were administered at audio-recorded group interviews. Transcribed discussions were coded and analyzed using NVivo software. RESULTS The older adult group emphasized the autonomy related to increasing frailty and social isolation and the need for transparent dissemination of health care planning. They were optimistic about remote technology-based supports and suggested that telehealth / health-monitoring/tracking were in high demand. Health care professionals emphasized the importance of a holistic biopsychosocial approach to frailty management. They highlighted the need for standardized early assessment and management of frailty. CONCLUSIONS The integrated perspectives provided an updated understanding of what older adults and practitioners value in home-living supports. This knowledge is helpful to advancing virtual home care, providing better care for frail individuals with complex health care needs.
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Affiliation(s)
- Andrew P. McDonald
- Health Sciences and InnovationSurrey Memorial HospitalFraser HealthSurreyBritish ColumbiaCanada
- Faculty of MedicineUniversity of British ColumbiaVancouverBritish ColumbiaCanada
| | | | - Joanna M. Rivera
- Health Sciences and InnovationSurrey Memorial HospitalFraser HealthSurreyBritish ColumbiaCanada
- Faculty of Health SciencesSimon Fraser UniversityBurnabyBritish ColumbiaCanada
| | - Ryan C. N. D'Arcy
- Health Sciences and InnovationSurrey Memorial HospitalFraser HealthSurreyBritish ColumbiaCanada
- Faculty of Applied SciencesSimon Fraser UniversityBurnabyBritish ColumbiaCanada
| | - Grace Park
- Community Actions and Resources Empowering Seniors (CARES)Fraser HealthSurreyBritish ColumbiaCanada
- Home and Community Care MedicineFraser HealthSurreyBritish ColumbiaCanada
| | - Xiaowei Song
- Health Sciences and InnovationSurrey Memorial HospitalFraser HealthSurreyBritish ColumbiaCanada
- Faculty of ScienceSimon Fraser UniversityBurnabyBritish ColumbiaCanada
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van Oppen JD, Valderas JM, Mackintosh NJ, Conroy SP. Patient-reported outcome and experience measures in geriatric emergency medicine. Z Gerontol Geriatr 2020; 54:122-124. [PMID: 32939573 DOI: 10.1007/s00391-020-01777-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Accepted: 08/13/2020] [Indexed: 11/30/2022]
Abstract
Older people with frailty and health crises have complex physical and social needs. Modern emergency care systems are fast-flowing, using protocols optimised for single-problem presentations. Systems must incorporate individualised care to best serve people with multiple problems. Healthcare quality is typically appraised with service metrics, such as department length of stay and mortality. Worldwide, patient-reported outcome measures (PROM) and patient-reported experience measures (PREM) are increasingly used in research, service development and performance evaluation, paving the ground for their use to support individual clinical decision-making. The PROMs and PREMs are person-centred metrics, which inform healthcare decisions at the individual level and which at the strategic level drive improvement through comparison of interprovider effectiveness. To date, there is no PROM or PREM specifically developed for older people with frailty and emergency care needs.
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Affiliation(s)
- James D van Oppen
- Department of Health Sciences, University of Leicester, LE1 7RH, Leicester, UK. .,Emergency and Specialist Medicine, University Hospitals Leicester NHS Trust, LE1 5WW, Leicester, UK.
| | - Jose M Valderas
- Health Services and Policy Research Group, University of Exeter, EX1 2LU, Exeter, UK
| | - Nicola J Mackintosh
- Department of Health Sciences, University of Leicester, LE1 7RH, Leicester, UK
| | - Simon P Conroy
- Department of Health Sciences, University of Leicester, LE1 7RH, Leicester, UK.,Emergency and Specialist Medicine, University Hospitals Leicester NHS Trust, LE1 5WW, Leicester, UK
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