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Bergeot J, Tenand M. Does informal care delay nursing home entry? Evidence from Dutch linked survey and administrative data. JOURNAL OF HEALTH ECONOMICS 2023; 92:102831. [PMID: 37913647 DOI: 10.1016/j.jhealeco.2023.102831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 05/31/2023] [Accepted: 10/14/2023] [Indexed: 11/03/2023]
Abstract
We assess whether informal care receipt affects the probability of transitioning to a nursing home. Available evidence derives from the US, where nursing home stays are often temporary. Exploiting linked survey and administrative data from the Netherlands, we use the gender mix of children to retrieve exogenous variation in informal care receipt. We find that informal care increases the chance of an admission within a three-year period for individuals with severe functional limitations, and increases the costs incurred on formal home care. For individuals with mild limitations, informal care substantially decreases total care costs, whereas its effect on nursing home admission is unclear. Further, informal care results in lower post-acute care use and hospital care costs, and does not increase mortality. Promoting informal care cannot be expected to systematically result in lower institutionalization rate and care costs, but it may nonetheless induce health benefits for its recipients.
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Affiliation(s)
- Julien Bergeot
- Department of Economics, Ca'Foscari University of Venice, Italy.
| | - Marianne Tenand
- Erasmus School of Health Policy & Management (ESHPM), Erasmus University Rotterdam, Erasmus Center for Health Economics Rotterdam (EsCHER), The Netherlands; CPB Netherlands Bureau for Economic Policy Analysis, The Netherlands
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Patel V, Lindenmeyer A, Gao F, Yeung J. A qualitative study exploring the lived experiences of patients living with mild, moderate and severe frailty, following hip fracture surgery and hospitalisation. PLoS One 2023; 18:e0285980. [PMID: 37200345 DOI: 10.1371/journal.pone.0285980] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 05/07/2023] [Indexed: 05/20/2023] Open
Abstract
It is well recognised that hip fracture surgery is associated with a negative impact on short and long-term post-operative physical health and emotional well-being for patients. Furthermore, these patients are known to be frail with multiple co-morbidities. This study explores how frailty shapes the lived experiences of rehabilitation and recovery for patients who have undergone hip fracture surgery. Semi-structured interviews were conducted with sixteen participants, recently discharged from hospital following hip fracture surgery. Interpretative phenomenological analysis was applied to explore the lived experiences of frail patients and ascertain important themes. Patient experiences were captured in seven overarching themes: 1) the hospital as a place of "safety", 2) placing trust in others, 3) the slow recovery journey impeded by attitude and support, 4) maintaining autonomy and dignity whilst feeling vulnerable, 5) seeking a new normal, 6) loneliness and social isolation and 7) the ageing body. Based on our study findings, we have been able to suggest a number of opportunities to improve support for frailer patients in finding a new routine to their everyday lives, these include on-going physical and psychological support, information and education and a robust pathway for transition of care into the community. A conceptual thematic diagram is presented which helps to understand the experience and the complex needs of frail older people undergoing hip fracture surgery.
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Affiliation(s)
- Vanisha Patel
- Department of Anaesthetics, University Hospital Birmingham NHS Foundation Trust, Birmingham, United Kingdom
| | - Antje Lindenmeyer
- Institute of Clinical Sciences, University of Birmingham, Birmingham, United Kingdom
| | - Fang Gao
- Birmingham Acute Care Research Centre, Institute of Inflammation and Ageing, University of Birmingham Research Laboratories, Birmingham, United Kingdom
| | - Joyce Yeung
- Warwick Medical School, Warwick Clinical Trials Unit, University of Warwick, Warwick, United Kingdom
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Bradley G, Baker K, Bailey C. The meaning of rehabilitation: a qualitative study exploring perspectives of occupational therapists and physiotherapists working with older people in acute care. Disabil Rehabil 2021; 43:2295-2303. [PMID: 31800328 DOI: 10.1080/09638288.2019.1697762] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Revised: 11/22/2019] [Accepted: 11/22/2019] [Indexed: 10/25/2022]
Abstract
OBJECTIVE To explore how occupational therapists and physiotherapists constructed and interpreted the meaning of rehabilitation in relation to older people in acute care. DESIGN A focussed ethnographic study was undertaken, primarily using observation, interviewing and review of clinical records within one acute medical ward in a general hospital in the UK. Five patient participants gave consent for their episode of care to be studied, with observations and interviews primarily involving the identified patients and five occupational therapy and physiotherapy professionals. RESULTS Four themes were identified: rehabilitation as a process to facilitate physical improvement; rehabilitation as physiotherapy-led; rehabilitation as a place…but not here; and rehabilitation as a process which prioritises safety over function. Such conceptualisations of rehabilitation were recognised as rooted in social and historical perceptions and challenged the ideals of rehabilitation professionals. CONCLUSIONS The meaning of rehabilitation in acute care is shaped by a range of cultural, contextual and systemic influences. Recognising these influences, and subsequent challenges to rehabilitation ideals, can encourage professionals to work towards meaningful change.Implications for RehabilitationA reductionist version of rehabilitation was evident within this context which placed value on physical improvement, achieving optimum safety and led by physiotherapy.This version of rehabilitation was unsatisfactory to occupational therapists and physiotherapists in this setting and different to their ideals.Where rehabilitation may be associated with another place, practitioners should reflect on whether this is influencing patients becoming a lower priority for interventions whilst waiting and address this, if required, within their own reasoning, prioritisation and delegation.Those who recognise similarities with their own practice context could individually, and within teams, revisit definitions of rehabilitation to notice, document and have conversations about the ideals of their professions versus the reality of practice.Occupational therapists and physiotherapists can be champions for organisational and cultural change to promote rehabilitation as a multi-disciplinary phase of care working towards optimising improvements in wellbeing, function and safety, irrespective of location.
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Affiliation(s)
- Gemma Bradley
- Faculty of Health and Life Sciences, Northumbria University, Newcastle-Upon-Tyne, UK
| | - Katherine Baker
- Faculty of Health and Life Sciences, Northumbria University, Newcastle-Upon-Tyne, UK
| | - Catherine Bailey
- Faculty of Health and Life Sciences, Northumbria University, Newcastle-Upon-Tyne, UK
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A Study on Supply-Demand Satisfaction of Community-Based Senior Care Combined with the Psychological Perception of the Elderly. Healthcare (Basel) 2021; 9:healthcare9060643. [PMID: 34072401 PMCID: PMC8229548 DOI: 10.3390/healthcare9060643] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 05/25/2021] [Accepted: 05/25/2021] [Indexed: 11/29/2022] Open
Abstract
Based on Maslow’s hierarchy of needs theory and customer satisfaction theory, we constructed a satisfaction model for supply–demand satisfaction for community-based senior care (SSCSC) combined with the psychological perspective of the elderly, and four dimensions of basic living needs (BLNs), living environment (LE), personal traits (PTs), and livability for the aged (LA) were selected to construct the model. The data were obtained from 296 questionnaires from seniors over 50 years old (or completed by relatives on their behalf, according to their actual situation). Twenty-two observed variables were selected for the five latent variables, and their interactions were explored using structural equation modeling. The results showed that LA was the most significant factor influencing SSCSC, and it was followed by BLNs and LE. PTs did not show a direct effect on LA, but they could have an indirect effect on SSCSC through influencing BLNs and LE. Based on the current state of community aging satisfaction, we propose to establish a community elderly care service system based on the basic needs of the elderly population, providing differentiated and refined elderly care services and improving the level of aging-friendly communities. This study provides references for the government to formulate relevant policies and other supply entities to make strategic decisions and has important implications for further enhancing community elderly services to become an important part of the social security system for the elderly.
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Kalánková D, Stolt M, Scott PA, Papastavrou E, Suhonen R. Unmet care needs of older people: A scoping review. Nurs Ethics 2020; 28:149-178. [PMID: 33000674 DOI: 10.1177/0969733020948112] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
The aim was to synthesize the findings of empirical research about the unmet nursing care needs of older people, mainly from their point of view, from all settings, focusing on (1) methodological approaches, (2) relevant concepts and terminology and (3) type, nature and ethical issues raised in the investigations. A scoping review after Arksey and O'Malley. Two electronic databases, MEDLINE/PubMed and CINAHL (from earliest to December 2019) were used. Systematic search protocol was developed using several terms for unmet care needs and missed care. Using a three-step retrieval process, peer-reviewed, empirical studies concerning the unmet care needs of older people in care settings, published in English were included. An inductive content analysis was used to analyse the results of the included studies (n = 53). The most frequently used investigation method was the questionnaire survey seeking the opinions of older people, informal caregivers or healthcare professionals. The unmet care needs identified using the World Health Organization classification were categorized as physical, psychosocial and spiritual, and mostly described individuals' experiences, though some discussed unmet care needs at an organizational level. The ethical issues raised related to the clinical prioritization of tasks associated with failing to carry out nursing care activities needed. The unmet care needs highlighted in this review are related to poor patient outcomes. The needs of institutionalized older patients remain under-diagnosed and thus, untreated. Negative care outcomes generate a range of serious practical issues for older people in care institutions, which, in turn, raises ethical issues that need to be addressed. Unmet care needs may lead to marginalization, discrimination and inequality in care and service delivery. Further studies are required about patients' expectations when they are admitted to hospital settings, or training of nurses in terms of understanding the complex needs of older persons.
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Affiliation(s)
| | | | - P Anne Scott
- 8799National University of Ireland Galway, Ireland
| | | | - Riitta Suhonen
- 8058University of Turku, Finland; Turku University Hospital, Finland; City of Turku Welfare Division, Finland
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Gabay G. From the crisis in acute care to postdischarge resilience - The communication experience of Geriatric patients: A qualitative study. Scand J Caring Sci 2020; 35:123-133. [PMID: 32068292 DOI: 10.1111/scs.12826] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Accepted: 01/19/2020] [Indexed: 01/22/2023]
Abstract
BACKGROUND Hospital readmissions due to illness among geriatric patients result in human suffering and psychological trauma. Resilience in chronic illness protects geriatric patients from outcomes of trauma leads to psychological and physical well-being and enables bouncing back to life. While communication has been linked to improved health outcomes, little is known about communication pathways in the context of postdischarge resilience. AIM AND OBJECTIVE To explore the role of communication pathways that acute-care clinicians used with geriatric patients in postdischarge resilience. METHODOLOGICAL DESIGN AND JUSTIFICATION Participants were ten geriatric patients who were readmitted several times in the past year. Twenty narrative interviews were conducted, one upon discharge and the other a month thereafter. Data for each phase of interviews were analysed using methods of selection mechanisms and Bricolage. ETHICAL ISSUES The ethics committee approved the study. Participants signed an informed-consent form for participation and publication. FINDINGS Communication in acute care that enhanced health literacy, perceived control and reflection, contributed to higher comprehensibility and manageability during the hospitalisation and postdischarge meaningfulness postdischarge, contributing resilience. Participants who experienced other forms of communication demonstrated anxiety and helplessness with lingering psychological trauma postdischarge. CONCLUSIONS Acute care may provide clinicians with opportunities to alleviate the suffering of geriatric patients and contribute to their postdischarge resilience. The suggested T.E.R model delineates communication pathways to fuel the trajectory from psychological trauma to postdischarge resilience in practice.
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Affiliation(s)
- Gillie Gabay
- School of Behavioural Sciences and Psychology, Health Psychology Research, College of Management Academic Studies, Rishon Letzion, Israel
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Herold-Majumdar A, Alex C, Gerber H, Penz M, Röder M, Mittelstaedt GV, Behrens J. [Autonomy and Participation As Common Goals of Nursing, Therapy and Social Medicine: Proposal for an Organizational Configuration Model on the Basis of Service Blueprinting]. DAS GESUNDHEITSWESEN 2019; 82:163-171. [PMID: 31113006 DOI: 10.1055/a-0887-4502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
BACKGROUND Every person who is in the need of long-term care (according to German Social Code SGB XI §14) fulfills the requirements of disability according to German Social Code SGB IX, § 2. The right of participation and autonomy must be specially protected and realized for persons with long-term care needs because these persons have a limited capacity to advance their interests. The rights of people in the need of long-term care or assistance are protected not only by the national constitution but also by the UN Disability Rights Convention. Participation is an important principle of these extra-statutory regulations and has an extraordinary significance and individual meaning for quality of life. For concretizing the aim of participation and for realizing participation in daily practice, the following question arises: How must organizations be configured to achieve individual aims of participation for persons with long-term care need, complex health care needs and with potential for rehabilitation across sectoral, disciplinary and professional borders? This analysis focuses on people older than 70 years with geriatric-relevant multimorbidity and with potential for rehabilitation. AIM The aim of this study was to create a configuration model for the organization of interdisciplinary cooperation in rehabilitation out of a case study and on the basis of the service blueprinting method [1]. In a next step this configuration model can be evaluated concerning its effectiveness for achieving individual participation goals and quality of life of persons with long-term care need and with potential for rehabilitation. METHOD For creating the configuration model, the service blueprinting method [1] on the basis of Dervin's sense making theory [11] was applied to a case vignette of geriatric rehabilitation against a background of organization theories and nursing science concepts. With the case study the configuration model can be applied exemplarily at the setting of restorative care, therapy and rehabilitation. With the service blueprinting method, the rehabilitation process is aligned onto the geriatric patient's individual health care needs, perceptions of participation and quality of life. RESULTS As a result of the sequencing and service blueprinting process we offer a dynamic model for the coordination of responsibility of interdisciplinary rehabilitation teams with a user-centered alignment. Its effectiveness (and side-effects) for interdisciplinary cooperation and for patient's individual goals of participation and quality of life must be evaluated in further studies. A mixed-method design should be used to evaluate objective outcome parameters such as dependency on nursing care, hospital admission rates and subjective outcome parameters such as patient's perception of participation, autonomy and quality of life. IMPLICATIONS FOR HEALTHCARE PRACTICE The configuration model can be used for evaluating already implemented geriatric rehabilitation processes and organizations. The configuration model can be used in health care research or organizational research. After more evidence for desirable effects, it can be implemented into the health care system. Side effects should be monitored.This paper was written in cooperation with the working group "Nursing", department "Practical Social Medicine and Rehabilitation" of the German Society of Social Medicine and Prevention (Deutsche Gesellschaft für Sozialmedizin und Prävention DGSMP e.V.).
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Affiliation(s)
- Astrid Herold-Majumdar
- Fakultät für angewandte Sozialwissenschaften, Hochschule für angewandte Wissenschaften München, München
| | | | | | | | | | | | - Johann Behrens
- Institut für Gesundheits- und Pflegewissenschaft, Martin-Luther-Universität Halle-Wittenberg, Halle (Saale)
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Gustafsson LK, Östlund G, Zander V, Elfström ML, Anbäcken EM. 'Best fit' caring skills of an interprofessional team in short-term goal-directed reablement: older adults' perceptions. Scand J Caring Sci 2019; 33:498-506. [PMID: 30653689 DOI: 10.1111/scs.12650] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2018] [Accepted: 12/11/2018] [Indexed: 11/27/2022]
Abstract
This paper reports a study conducted to illuminate older adults' perceptions of multiproffesional team's caring skills as success factors for health support in short-term goal-directed reablement. The fact that older adults are given perquisites to live in their own homes puts great demands on the professional care given them at home. An option offered could be short-term goal-directed reablement delivered by an interprofessional team. This means after periods in hospitals to strengthen their multidimensional health, older adults' reablement processes are supported to return to their daily life as soon as possible. Crucial in making these intentions a reality seems to be identifying the professional's approach that works as success factors for health support in the reablement process. A descriptive qualitative design with a phenomenographic approach based on interviews with 23 older persons who had received short-term goal-directed reablement at home after a period at hospital was used. The study was approved by an ethical board. The analysis revealed four major referential aspects of multiproffesional team's caring skills as success factors for health-support in short-term goal-directed reablement: a motivating caregiver, a positive atmosphere-creating caregiver, a human fellowship-oriented caregiver and a caregiver that goes beyond the expected. In this study, all caring skills in the continuum are perceived as positively loaded necessities in different situations during the reablement process. Caring skills as success factors are initially shown at a practical level, such as how the professional caregivers encourage and motivate the older persons in different training situations. At a deeper level, the caregivers open their hearts and have the capacity to go beyond the expected in the professional caregiver-patient relationship. The multiproffesional team's best fit caring skills during the home reablement process need to be addressed as evidence base in the area of elderly home care.
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Affiliation(s)
- Lena-Karin Gustafsson
- Division of Caring Science, School of Health, Care and Social Welfare, Mälardalens University, Eskilstuna, Sweden
| | - Gunnel Östlund
- Division of Social work, School of Health, Care and Social Welfare, Mälardalens University, Eskilstuna, Sweden
| | - Viktoria Zander
- Division of Psychology, School of Health, Care and Social Welfare, Mälardalens University, Eskilstuna, Sweden
| | - Magnus L Elfström
- Division of Physiotherapy, School of Health, Care and Social Welfare, Mälardalens University, Eskilstuna, Sweden
| | - Els-Marie Anbäcken
- Division of Social work, School of Health, Care and Social Welfare, Mälardalens University, Eskilstuna, Sweden
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Digby R, Lee S, Williams A. The experience of people with dementia and nurses in hospital: an integrative review. J Clin Nurs 2017; 26:1152-1171. [PMID: 27322590 DOI: 10.1111/jocn.13429] [Citation(s) in RCA: 86] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/11/2016] [Indexed: 11/28/2022]
Abstract
AIMS AND OBJECTIVES To identify and examine existing research exploring how people with dementia and nurses view acute hospital care. BACKGROUND Admission to hospital can be traumatic for a person with dementia due to an inability to cope with unfamiliar environments, faces and routines. Adverse behavioural and health outcomes can result. Dementia adds complexity to patient care. Inability to deliver appropriate care is a source of stress and frustration for nurses. METHODS Integrative review of the literature 2005-2015 reporting the experience of people with dementia and nurses caring for them in an acute hospital setting (n = 24). RESULTS Hospitals focus on acute medical care; consequently people with dementia are considered low priority and a disruption to normal routine. Risk management often takes priority over patient dignity. People with dementia are stigmatised. Families have significant roles to play in the care of a person with dementia in hospital but are often excluded. Nurses struggle to complete even basic patient care, and focus on tasks often at the expense of specific patient needs. Support for nurses is lacking. The job satisfaction of nurses caring for people with dementia is poor. CONCLUSIONS Nurses require improved education and support to care for patients with dementia. Hospitals must focus on genuine caring concurrently with rapid discharge requirements, risk mitigation and fiscal restraint. More research is needed to inform the development of appropriate care for people with dementia in hospitals. RELEVANCE TO CLINICAL PRACTICE Nurses must understand the complex needs of people with dementia in hospital. Nurse education about dementia, practical support, strong clinical leadership and role-modelling is needed. Empathy for patients regardless of diagnosis must remain a core attribute of nurses. Current hospital culture requires wider system review to mitigate against stigmatisation of patients with dementia.
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Affiliation(s)
- Robin Digby
- Monash University, Frankston, Vic., Australia
| | - Susan Lee
- Nursing and Midwifery, Peninsula Campus, Monash University, Frankston, Vic., Australia
| | - Allison Williams
- Monash Nursing Academy, Clayton Campus, Monash University, Clayton, Vic., Australia
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Bamm EL, Rosenbaum P, Wilkins S, Stratford P. Performance of the measures of processes of care for adults and service providers in rehabilitation settings. PATIENT-RELATED OUTCOME MEASURES 2015; 6:157-65. [PMID: 26089710 PMCID: PMC4467744 DOI: 10.2147/prom.s81361] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Introduction In recent years, client-centered care has been embraced as a new philosophy of care by many organizations around the world. Clinicians and researchers have identified the need for valid and reliable outcome measures that are easy to use to evaluate success of implementation of new concepts. Objective The current study was developed to complete adaptation and field testing of the companion patient-reported measures of processes of care for adults (MPOC-A) and the service provider self-reflection measure of processes of care for service providers working with adult clients (MPOC-SP(A)). Design A validation study Settings In-patient rehabilitation facilities. Main outcome measures MPOC-A and measure of processes of care for service providers working with adult clients (MPOC-SP(A)). Results Three hundred and eighty-four health care providers, 61 patients, and 16 family members completed the questionnaires. Good to excellent internal consistency (0.71–0.88 for health care professionals, 0.82–0.90 for patients, and 0.87–0.94 for family members), as well as moderate to good correlations between domains (0.40–0.78 for health care professionals and 0.52–0.84 for clients) supported internal reliability of the tools. Exploratory factor analysis of the MPOC-SP(A) responses supported the multidimensionality of the questionnaire. Conclusion MPOC-A and MPOC-SP(A) are valid and reliable tools to assess patient and service-provider accounts, respectively, of the extent to which they experience, or are able to provide, client-centered service. Research should now be undertaken to explore in more detail the relationships between client experience and provider reports of their own behavior.
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Affiliation(s)
- Elena L Bamm
- School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada
| | - Peter Rosenbaum
- School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada ; CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, ON, Canada
| | - Seanne Wilkins
- School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada
| | - Paul Stratford
- School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada
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Posters. Br J Occup Ther 2014. [DOI: 10.1177/03080226140770s804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Gill SD, Dunning T, McKinnon F, Cook D, Bourke J. Understanding the experience of inpatient rehabilitation: insights into patient-centred care from patients and family members. Scand J Caring Sci 2013; 28:264-72. [DOI: 10.1111/scs.12055] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2013] [Accepted: 05/03/2013] [Indexed: 11/29/2022]
Affiliation(s)
- Stephen D. Gill
- Safety and Quality Unit; Barwon Health; Geelong Geelong, VIC Australia
| | - Trisha Dunning
- Centre for Nursing and Allied Health Research Deakin University and Barwon Health; Geelong VIC Australia
| | | | - Desma Cook
- Safety and Quality Unit; Barwon Health; Geelong Geelong, VIC Australia
| | - Jo Bourke
- Safety and Quality Unit; Barwon Health; Geelong Geelong, VIC Australia
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Digby R, Bloomer MJ. People with dementia and the hospital environment: the view of patients and family carers. Int J Older People Nurs 2013; 9:34-43. [PMID: 23320624 DOI: 10.1111/opn.12014] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2012] [Accepted: 10/07/2012] [Indexed: 11/29/2022]
Abstract
BACKGROUND A metropolitan geriatric evaluation and management (GEM) facility in Australia was undergoing expansion, and consideration for the needs of individuals with dementia and their family carers was identified as important in planning the new facility. Existing literature revealed that people in hospital value privacy, minimal noise, family amenities and homeliness, but these findings did not consider the perspectives of the person with dementia specifically. AIM The aim was to elicit the perspectives of current inpatients with dementia, and their family carers, about the environment/design features that they believe are necessary for people with dementia, and their family carers. METHOD AND DESIGN This qualitative study utilised in-depth semi-structured interviews to obtain information from current inpatients with dementia and their family carers. RESULTS Participants described how the care received was more important than the physical environment; however, participants also valued homeliness, privacy for the patient and for conversations, a shared space without a television and a connection to the outside. Participants described how accommodating carers, providing quiet spaces and appropriate amenities were also important. CONCLUSIONS While participants valued care over the physical surroundings, they also offered valuable information about their experience in the ward environment. Despite cognitive difficulties, people with dementia were able to provide useful information about the environment within which they were being cared. IMPLICATIONS FOR PRACTICE Consumer opinions about hospital design/environment should be considered as an important source of data. Privacy and personal space for people with dementia and their family carers, a connection with the outside environment , and the needs of carers and visitors are all important considerations when designing healthcare environments.
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Affiliation(s)
- Robin Digby
- The Mornington Centre, Peninsula Health, Mornington, Vic., Australia
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Couzner L, Crotty M, Walker R, Ratcliffe J. Examining older patient preferences for quality of care in postacute transition care and day rehabilitation programs. Health (London) 2013. [DOI: 10.4236/health.2013.56a2019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Brown S, Craddock D, Greenyer CH. Medical Patients' Experiences of Inreach Occupational Therapy: Continuity between Hospital and Home. Br J Occup Ther 2012. [DOI: 10.4276/030802212x13418284515875] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Introduction: Reforms in the National Health Service have encouraged a whole system approach. However, coordinated care may be difficult at the interface between acute hospital and community services. Inreach services are community based and the same member of staff provides intervention in hospital and after discharge. This qualitative study aimed to understand medical patients' experiences of inreach occupational therapy. Method: Semi-structured interviews were conducted with a convenience sample of seven older people, following their discharge from a medical inreach occupational therapy service. Thematic analysis was used to explore findings. Findings: Uncertainty was expressed about the role of occupational therapy and about participants not feeling involved in their hospital discharge. There was an appreciation that inreach occupational therapy could aid continuity of care. Some participants considered regular contact with a known health professional to be reassuring on return home, whereas for other participants the principle of accurate information sharing between staff was particularly important at discharge. Conclusion: All participants valued a seamless service between occupational therapy in hospital and at home. The importance of services working across organisational boundaries is emphasised, tailoring the timing of interventions to meet individuals' needs.
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Affiliation(s)
- Sarah Brown
- Team Leader Occupational Therapist, Southern Health NHS Foundation Trust, Occupational Therapy Service, Queen Alexandra Hospital, Portsmouth
| | - Deborah Craddock
- Director of Programmes for Researcher Development, Faculty of Health Sciences, University of Southampton, Southampton
| | - Corinne Hutt Greenyer
- Lecturer in Occupational Therapy, Faculty of Health Sciences, University of Southampton, Southampton
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Bamm EL, Rosenbaum P, Stratford P. Validation of the measure of processes of care for adults: a measure of client-centred care. Int J Qual Health Care 2010; 22:302-9. [DOI: 10.1093/intqhc/mzq031] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
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