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Dragosits A, Martinsen B, Hemingway A, Norlyk A. Coming home: older patients' and their relatives' experiences of well-being in the transition from hospital to home after early discharge. Int J Qual Stud Health Well-being 2024; 19:2300154. [PMID: 38166522 PMCID: PMC10769116 DOI: 10.1080/17482631.2023.2300154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 12/25/2023] [Indexed: 01/04/2024] Open
Abstract
BACKGROUND This study aims to investigate the lived experience of well-being among older patients and their relatives in the transition from hospital to home after early discharge. Research has shown that the transition brings severe challenges to their everyday lives. However, to date, there has been a lack of research focusing on the lived experiences of well-being during this process. METHODS The data collection and analysis followed the phenomenological approach of Reflective Lifeworld Research. Ten in-depth interviews with older patients and their relatives were conducted in Austria up to 2-5 days after hospital discharge. RESULTS The essential meaning of the phenomenon of well-being in the transition from hospital to home is marked by security and confidence to face the challenges following the discharge. Four constituents emerged: being calm and in alignment with the homecoming, being in familiar surroundings at home-a sense of belonging, striving towards independence-continuity of life and having faith in the future. CONCLUSION Our findings point to the importance of recognizing the vulnerability associated with the transition from hospital to home, as it impacts the existential aspects of space and time. Facilitating a sense of continuity and belonging can foster well-being during this critical period.
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Affiliation(s)
- Aline Dragosits
- Department of Public Health, Faculty of Health, Aarhus University, Aarhus C, Denmark
| | - Bente Martinsen
- Department of People and Technology, Roskilde University, Roskilde, Denmark
| | - Ann Hemingway
- Department of Medical Science & Public Health, Bournemouth University, Bournemouth, Dorset, UK
| | - Annelise Norlyk
- Department of Public Health, Faculty of Health, Aarhus University, Aarhus C, Denmark
- Department of Health and Nursing Science, Faculty of Health and Sport Sciences, Agder University, Grimstad, Norway
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Li Y, Luo L, Dong H. Delivering Integrated Community Care for the Elderly: A Qualitative Case Study in Southern China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:680. [PMID: 38928927 PMCID: PMC11203458 DOI: 10.3390/ijerph21060680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2024] [Revised: 05/15/2024] [Accepted: 05/22/2024] [Indexed: 06/28/2024]
Abstract
The rapid aging and increasing care demands among the elderly population present challenges to China's health and social care system. The concept of aging in place has prompted the implementation of integrated community care (ICC) in the country. This study aims to provide empirical insights into the practices of integrated care policies and approaches at the community level. Data for this study were collected through six months of participatory observations at a local community health service center in a southern Chinese city. Semi-structured interviews were conducted with the multidisciplinary community care team to gather frontline formal caregiver perceptions of ICC, thereby facilitating a better understanding of the obstacles and opportunities. Qualitative analysis revealed four themes: the ICC delivery model and development strategies within the community care scheme, the person-centered guiding principle, and the challenges and struggles encountered by formal caregivers within China's current ICC system. The case study presented herein serves as a notable example of the pivotal role of primary care in the successful implementation of elderly care within a community setting. The adoption of a private organization-led approach to medico-social integration care in the community holds significant potential as a service delivery model for effectively addressing a wide range of elderly care issues.
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Affiliation(s)
- Yiqiao Li
- School of Marxism, South China Normal University, Guangzhou 510631, China;
| | - Lan Luo
- Huangpu Hongshanjie Community Health Service Center, Guangzhou 510725, China
| | - Hongying Dong
- School of Marxism, South China Normal University, Guangzhou 510631, China;
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Ingvarsson E, Schildmeijer K, Hagerman H, Lindberg C. "Being the main character but not always involved in one's own care transition" - a qualitative descriptive study of older adults' experiences of being discharged from in-patient care to home. BMC Health Serv Res 2024; 24:571. [PMID: 38698451 PMCID: PMC11067295 DOI: 10.1186/s12913-024-11039-3] [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: 12/20/2023] [Accepted: 04/24/2024] [Indexed: 05/05/2024] Open
Abstract
BACKGROUND The growing number of older adults with chronic diseases challenges already strained healthcare systems. Fragmented systems make transitions between healthcare settings demanding, posing risks during transitions from in-patient care to home. Despite efforts to make healthcare person-centered during care transitions, previous research indicates that these ambitions are not yet achieved. Therefore, there is a need to examine whether recent initiatives have positively influenced older adults' experiences of transitions from in-patient care to home. This study aimed to describe older adults' experiences of being discharged from in-patient care to home. METHODS This study had a qualitative descriptive design. Individual interviews were conducted in January-June 2022 with 17 older Swedish adults with chronic diseases and needing coordinated care transitions from in-patient care to home. Data were analyzed using inductive qualitative content analysis. RESULTS The findings indicate that despite being the supposed main character, the older adult is not always involved in the planning and decision-making of their own care transition, often having poor insight and involvement in, and impact on, these aspects. This leads to an experience of mismatch between actual needs and the expectations of planned support after discharge. CONCLUSIONS The study reveals a notable disparity between the assumed central role of older adults in care transitions and their insight and involvement in planning and decision-making.
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Affiliation(s)
- Emelie Ingvarsson
- Department of Health and Caring Sciences, Linnaeus University, Universitetsplatsen 1 392 31, Kalmar, Växjö, Sweden.
| | - Kristina Schildmeijer
- Department of Health and Caring Sciences, Linnaeus University, Universitetsplatsen 1 392 31, Kalmar, Växjö, Sweden
| | - Heidi Hagerman
- Department of Health and Caring Sciences, Linnaeus University, Universitetsplatsen 1 392 31, Kalmar, Växjö, Sweden
| | - Catharina Lindberg
- Department of Health and Caring Sciences, Linnaeus University, Universitetsplatsen 1 392 31, Kalmar, Växjö, Sweden
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Beck SH, Eilertsen G, Andersen-Ranberg K, Janssens A, Nielsen DS. In the footstep of the old patient from hospital to home: A qualitative field observation study. Scand J Caring Sci 2024. [PMID: 38610099 DOI: 10.1111/scs.13257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 01/25/2024] [Accepted: 03/09/2024] [Indexed: 04/14/2024]
Abstract
BACKGROUND Older people often have multiple health conditions and therefore extended care needs. The transition from the hospital back to their home requires careful planning. The fragmented healthcare system and rapid discharge from the hospital can result in limited involvement of the older patient in the discharge planning process. We aimed to explore how older hospitalised patients experienced the transition from hospital to home and how possibilities and constraints in interactions with relevant parties in the transition affected their everyday lives. METHOD An ethnographic participant observation study including interviews was conducted with 10 older hospitalised patients. The theoretical perspective in the study is critical psychology and data were analysed using the condition-, meaning- and reasoning analysis. RESULTS Three themes were identified: (1) Lost in transition - the person's ability to act is limited, (2) In transition - the relatives become important, (3) At home - the home transforms into a workplace. CONCLUSION Lack of involvement becomes a condition for older patients as some struggle to create meaning in their transition, affecting their everyday lives. The patients experienced their relatives as important as they ensured that the HCPs got to know their values and wishes. This knowledge is important for HCPs working closely with older people both at the hospital and at home ensuring active involvement of the older person with respect and acknowledgement of the older person's wishes, needs, resources and vulnerability.
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Affiliation(s)
- Sanne Have Beck
- Geriatric Research Unit, Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Department of Geriatric Medicine, Odense University Hospital, Odense, Denmark
| | - Grethe Eilertsen
- USN Research Group of Older Peoples' Health, Faculty of Health and Social Sciences, Universitetet I Sørøst-Norge, Drammen, Norway
| | - Karen Andersen-Ranberg
- Geriatric Research Unit, Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Department of Geriatric Medicine, Odense University Hospital, Odense, Denmark
| | - Astrid Janssens
- Bioethics and Health Humanities, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
- Department of Public Health, User Perspective and Community-Based Interventions, University of Southern Denmark, Odense, Denmark
- Centre for Research with Patients and Relatives, Odense University Hospital, Odense, Denmark
- University of Exeter Medical School, Exeter, UK
| | - Dorthe Susanne Nielsen
- Geriatric Research Unit, Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Department of Geriatric Medicine, Odense University Hospital, Odense, Denmark
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Hodge O, Rasekaba T, Blackberry I, Steer CB. Age-friendly healthcare: integrating the 4Ms to enable age-friendly cancer care. Curr Opin Support Palliat Care 2024; 18:9-15. [PMID: 38252057 DOI: 10.1097/spc.0000000000000687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2024]
Abstract
PURPOSE OF REVIEW There is a growing movement towards person-centred, age-friendly healthcare in the care of older adults, including those with cancer. The Age-Friendly Health Systems (AFHS) initiative uses the 4Ms framework to enable this change. This review documents the utility and implications of 4Ms implementation across different settings, with a particular focus on cancer care. RECENT FINDINGS The AFHS initiative 4Ms framework uses a set of core, evidence-based guidelines (focussing on What Matters, Medication, Mentation and Mobility) to improve person-centred care. The successful implementation of the 4Ms has been documented in many different healthcare settings including orthopaedics primary care, and cancer care. Implementation of the 4Ms framework into existing workflows complements the use of geriatric assessment to improve care of older adults with cancer. Models for implementation of the 4Ms within a cancer centre are described. Active engagement and education of healthcare providers is integral to success. Solutions to implementing the What Matters component are addressed. SUMMARY Cancer centres can successfully implement the 4Ms framework into existing workflows through a complex change management process and development of infrastructure that engages healthcare providers, facilitating cultural change whilst employing quality improvement methodology to gradually adapt the status quo to age-friendly processes.
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Affiliation(s)
- Oliver Hodge
- UNSW School of Clinical Medicine, Rural Clinical Campus, Albury Campus, NSW
| | | | - Irene Blackberry
- John Richards Centre for Rural Ageing Research
- Care Economy Research Institute, La Trobe University, Wodonga, VIC
| | - Christopher B Steer
- UNSW School of Clinical Medicine, Rural Clinical Campus, Albury Campus, NSW
- John Richards Centre for Rural Ageing Research
- Border Medical Oncology and Haematology, Albury Wodonga Regional Cancer Centre, Albury, NSW, Australia
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Ding K, Makanjee C. Radiographers' perspectives on interactional processes during older persons diagnostic medical imaging encounters: a qualitative study. BMC Geriatr 2024; 24:205. [PMID: 38418965 PMCID: PMC10900639 DOI: 10.1186/s12877-024-04792-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 02/07/2024] [Indexed: 03/02/2024] Open
Abstract
BACKGROUND Within a diagnostic medical imaging context, an interaction encompasses communication, physical contact and emotional support. These intricacies are an integral part in achieving a successful medical imaging outcome. An increasing ageing population presents unique challenges and leads to a higher demand for medical imaging services. There is a paucity of literature exploring the specialised knowledge and skills required by radiographers to service optimal person-centred care for elderly patients. The purpose of the study was to explore radiographers' perspectives on interactional processes during older persons diagnostic medical imaging encounters. METHODS The study used a qualitative exploratory research design with a descriptive approach to gain insights from 12 purposively sampled Australian radiographers, through open-ended interviews conducted online or by telephone. Verbatim transcripts were produced, and a thematic analysis employed until data saturation had been reached. RESULTS The three themes that emerged from the data analysis were: (1) optimising care and communication, (2) expectations and preconceptions and (3) physical and emotional comfort and safety. Generally, the approach to undertaking older persons examinations entailed more adaptive and flexible competencies and skills in comparison to the familiarised routine diagnostic medical imaging encounters with the younger cohort. Radiographers shared aspects on striking a balance between efficiency and proficiency with the elderly patient needs, preferences, values, safety and well-being considerations. This required swift, complex decision-making and judgement calls due to the unpredictable nature of the context in which the elderly person was situated. The result was the adaptation of examination protocols through equipment manipulation, with minimal disruptions to emotional and physical comfort, achieved through interventions and support strategies. CONCLUSION The results highlight the many considerations for radiographers during a short clinical interaction. There is optimism in adding value to the elderly persons experience through a complex interactional process. It is anticipated that the identified skills will inform on best practice principles to achieve an elderly person-centred care medical imaging outcome.
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Affiliation(s)
- Kevin Ding
- Department of Medical Radiation Science, University of Canberra, University Drive, 2617, Bruce, ACT, Australia
| | - Chandra Makanjee
- Department of Medical Radiation Science, University of Canberra, University Drive, 2617, Bruce, ACT, Australia.
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Östlund AS, Högnelid J, Olsson A. Being an older hospitalized patient during the COVID-19 pandemic - A qualitative interview study. BMC Geriatr 2023; 23:810. [PMID: 38053062 PMCID: PMC10698926 DOI: 10.1186/s12877-023-04562-1] [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: 04/21/2023] [Accepted: 12/04/2023] [Indexed: 12/07/2023] Open
Abstract
BACKGROUND Older people hospitalized for COVID-19 are a vulnerable group due to the disease itself, aging and often loss of hearing and vision. Person-centered care, where patients have opportunities to communicate and participate in their own care, is important. However, because healthcare staff needed to wear personal protective equipment during the pandemic, to protect the patients and themselves, providing person-centered care was often difficult. This study aims to describe older hospitalized patients' experiences both of being cared for, while having COVID-19, and of the care provided by healthcare staff wearing PPE. METHODS Fourteen older patients, over 65 years of age, were interviewed, and the data were analyzed using qualitative content analysis. The study adhered to Consolidated criteria for reporting qualitative research guidelines. RESULTS Three subthemes and one overall theme, "The desire for survival overshadows difficulties", emerged in the analysis. The main findings revealed that the older hospitalized patients experienced the care they received from the healthcare staff as satisfactory. The older patients reported understanding and accepting that the pandemic situation meant that their ability to participate in their own care and communicate with healthcare staff were given lower priority. CONCLUSIONS Older hospitalized patients need to be provided person-centered care, and situations such as a pandemic are no exception. Care tasks that are not acute in nature, e.g., planning for patients' return home, could be conducted by healthcare staff not required to wear PPE.
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Affiliation(s)
- Ann-Sofi Östlund
- Faculty of Health and Occupational Studies, Department of Caring Sciences, University of Gävle, Gävle, S-801 76, Sweden
| | - Julia Högnelid
- Faculty of Health and Occupational Studies, Department of Caring Sciences, University of Gävle, Gävle, S-801 76, Sweden
| | - Annakarin Olsson
- Faculty of Health and Occupational Studies, Department of Caring Sciences, University of Gävle, Gävle, S-801 76, Sweden.
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Hunsbedt Fjellså HM, Husebø AML, Braut H, Mikkelsen A, Storm M. Older Adults' Experiences With Participation and eHealth in Care Coordination: Qualitative Interview Study in a Primary Care Setting. J Particip Med 2023; 15:e47550. [PMID: 37782538 PMCID: PMC10580142 DOI: 10.2196/47550] [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: 03/24/2023] [Revised: 07/06/2023] [Accepted: 07/27/2023] [Indexed: 10/03/2023] Open
Abstract
BACKGROUND Owing to the demographic changes in the elderly population worldwide, delivering coordinated care at home to multimorbid older adults is of great importance. Older adults living with multiple chronic conditions need information to manage and coordinate their care. eHealth can be effective for gaining sufficient information, communicating, and self-managing chronic conditions. However, incorporating older adults' health preferences and ensuring active involvement remain challenging. More knowledge is needed to ensure successful participation and eHealth use in care coordination. OBJECTIVE This study aimed to explore multimorbid older adults' experiences with participation and eHealth in care coordination with general practitioners (GPs) and district nurses (DNs). METHODS The study had a qualitative explorative approach. Data collection included semistructured interviews with 20 older adults with multimorbidity receiving primary care services from their GPs and DNs. The participants were included by their GPs or nurses at a local intermunicipal acute inpatient care unit. The data analysis was guided by systematic text condensation. RESULTS We identified 2 categories: (1) older adults in charge of and using eHealth in care coordination, and (2) older adults with a loss of control in care coordination. The first category describes how communication with GPs and DNs can facilitate participation, the importance of managing own medication, and how eHealth can support older adults' information needs. The second category focuses on older adults who depend on guidance and help from their GPs and DNs to manage their health, describing how a lack of capacity and system support to be involved makes these adults lose control of their care coordination. CONCLUSIONS Being in charge of care coordination is important for older multimorbid adults. The results show that older adults are willing to use eHealth to be informed and to seek information, which ensures high levels of participation in care coordination. Future research should investigate how older adults can be involved in electronic information sharing with health care providers.
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Affiliation(s)
| | - Anne Marie Lunde Husebø
- Department of Public Health, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
- Research Group of Nursing and Health Sciences, Stavanger University Hospital, Stavanger, Norway
| | - Harald Braut
- Department of Innovation, Leadership, and Marketing, Business School, University of Stavanger, Stavanger, Norway
| | - Aslaug Mikkelsen
- Department of Innovation, Leadership, and Marketing, Business School, University of Stavanger, Stavanger, Norway
- Stavanger University Hospital, Stavanger, Norway
| | - Marianne Storm
- Department of Public Health, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
- Faculty of Health Sciences and Social Care, Molde University College, Molde, Norway
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Dadich A, Kearns R, Harris-Roxas B, Ni Chroinin D, Boydell K, Ní Shé É, Lim D, Gonski P, Kohler F. What constitutes brilliant aged care? A qualitative study of practices that exceed expectation. J Clin Nurs 2023; 32:7425-7441. [PMID: 37314051 DOI: 10.1111/jocn.16789] [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: 01/10/2023] [Revised: 05/17/2023] [Accepted: 05/29/2023] [Indexed: 06/15/2023]
Abstract
AIM This study aimed to explore what constitutes brilliant aged care. BACKGROUND Although many aged care services do not offer the care that older people and carers need and want, some perform better. Rather than focus on problems with aged care, this study examined brilliant aged care-practices that exceeded expectation. DESIGN The methodology for this study was informed by grounded theory, underpinned by constructionism to socially construct meaning. METHODS This study invited nominations for a Brilliant Award via a survey, and interviews with the nominees via web conference. After receiving survey responses from 10 nominators, interviews were conducted with 12 nominees. Data were analysed using reflexive thematic analysis and documented according to COREQ guidelines to optimise rigour and transparency. RESULTS According to participants, brilliant aged care involved being relationally attuned to older people, a deep understanding of the older person, recognition of aged care as more than a job, innovative practices and permission to reprioritise. CONCLUSIONS This study suggests that, in aged care, brilliance happens. It emphasises the importance of meaningful connections and relationships in aged care, where thoughtful acts acknowledge an older person's value and humanity as well as creativity and innovation. RELEVANCE TO CLINICAL PRACTICE For those who manage and deliver aged care, the findings suggest that small practice changes can make a positive difference to older people. Brilliant aged care can involve acts of empathy; enthusiasm for aged care; innovative practices, even those that are small scale; and reprioritising workplace tasks to spend time with older people. For policymakers, this study highlights the need to recognise and raise the profile of the pockets of brilliance within the aged care sector. This might be achieved via awards and other initiatives that serve to celebrate and learn from brilliance in its myriad forms. PATIENT OR PUBLIC CONTRIBUTION The nominees, who included carers, were invited to participate in workshops with other carers and older people to co-design a model of brilliant aged care, during which workshop participants discussed and critiqued the findings constructed from the data.
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Affiliation(s)
- Ann Dadich
- School of Business, Western Sydney University, Parramatta, New South Wales, Australia
| | - Rachael Kearns
- Institute for Culture and Society, Western Sydney University, Penrith, New South Wales, Australia
| | - Ben Harris-Roxas
- School of Population Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Danielle Ni Chroinin
- South Western Sydney Local Health District, University of New South Wales, Liverpool, New South Wales, Australia
| | | | - Éidín Ní Shé
- Royal College of Surgeons in Ireland, Dublin, Ireland
| | - David Lim
- School of Health Sciences, Western Sydney University, Penrith, New South Wales, Australia
| | - Peter Gonski
- South Eastern Sydney Local Health District & University of New South Wales, Sydney, New South Wales, Australia
| | - Friedbert Kohler
- HammondCare Health, South Western Sydney Local Health District & University of New South Wales, Prairiewood, New South Wales, Australia
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Kattouw CE, Aase K, Viksveen P. Stakeholder perspectives on the preferred service ecosystem for senior citizens living at home: a qualitative interview study. BMC Geriatr 2023; 23:576. [PMID: 37726648 PMCID: PMC10508029 DOI: 10.1186/s12877-023-04303-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 09/09/2023] [Indexed: 09/21/2023] Open
Abstract
BACKGROUND Most senior citizens want to live independently at home as long as possible. The World Health Organization recommends an age-friendly community approach by transforming the service ecosystem for senior citizens and basing it on the question "What matters to you?". However, there is limited research-based knowledge to determine the characteristics of the preferred service ecosystem from the perspectives of multiple stakeholders. Therefore, the aim of the study was to gain a deeper understanding of multiple stakeholder perspectives on the preferred service ecosystem for senior citizens living at home. METHODS Four stakeholder groups (n = 57) from a Norwegian municipality participated in an interview study in 2019 and 2020: senior citizens, carers, healthcare professionals, and managers. Data were analysed according to qualitative content analysis. RESULTS Overall, there was considerable correspondence between the four stakeholder groups' perspectives on the preferred service ecosystem for senior citizens. Six themes were developed: (1) "self-reliance - living independently at home as long as possible"; (2) "remaining active and social within the community"; (3) "support for living at home as long as possible"; (4) "accessible information and services"; (5) "continuity of services"; and (6) "compassionate and competent healthcare professionals". CONCLUSIONS In order to adapt and meet changing needs, the preferred service ecosystem should support senior citizens' autonomy through interpersonal relationships and involvement. Healthcare managers and decision makers should consider a broader range of practical and social support services. Municipalities should plan for and develop age-friendly infrastructures, while healthcare professionals should rely on their compassion and competence to meet senior citizens' needs.
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Affiliation(s)
- Christophe Eward Kattouw
- Department of Quality and Health Technology, Faculty of Health Sciences, SHARE - Centre for Resilience in Healthcare, University of Stavanger, Post Box 8600, Forus, Stavanger, 4036, Norway.
| | - Karina Aase
- Department of Quality and Health Technology, Faculty of Health Sciences, SHARE - Centre for Resilience in Healthcare, University of Stavanger, Post Box 8600, Forus, Stavanger, 4036, Norway
| | - Petter Viksveen
- Department of Quality and Health Technology, Faculty of Health Sciences, SHARE - Centre for Resilience in Healthcare, University of Stavanger, Post Box 8600, Forus, Stavanger, 4036, Norway
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Martínez-Angulo P, Rich-Ruiz M, Ventura-Puertos PE, López-Quero S. Integrating shared decision-making, expressing preferences and active participation of older adults in primary care nursing: a systematic review of qualitative studies and qualitative meta-synthesis. BMJ Open 2023; 13:e071549. [PMID: 37344120 DOI: 10.1136/bmjopen-2022-071549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/23/2023] Open
Abstract
OBJECTIVES To systematically synthesise the results of primary qualitative studies on how community-dwelling older adults experience shared decision-making processes, express preferences and actively participate in care. DESIGN Systematic review of qualitative studies and qualitative meta-synthesis. METHODS We focused on studies about community-dwelling participants aged ≥65 undergoing a health-disease process circumscribed to a primary healthcare setting, and the central theme should focus on either shared decision-making, expressing preferences or patient participation. We searched the following databases: MEDLINE, CINAHL, Web of Science, Scopus and PsycINFO (time publication frame 2012-2022). We excluded studies in those cases where the qualitative results were not analysed or unrelated to the phenomenon addressed, phenomena were not clear enough to be included or the setting did not occur in the community. RESULTS A total of 12 studies were included in this meta-synthesis. We appraised the quality of the selected studies through Critical Appraisal Skills Programme (CASP) Checklist. The metasummary comprised the frequency and intensity of qualitative patterns across the included studies. The meta-synthesis revealed four influential elements in their interaction: recognising personal qualities, facing professional characteristics, experiences of discrimination and a double-edged context. CONCLUSIONS The phenomena studied were influenced by how older people approached their role in their binomial relationship with healthcare professionals. Those with a reinforced self-concept were better aware of health-disease-related situations regarding shared decision-making and the importance of being communicatively assertive. Professional characteristics were also crucial in how older people modulated their acting ability through their personality, communication skills and the approach healthcare professionals used towards older adults. Situations of discrimination generated through an imbalance of power inhibited the expression of preferences and hindered the active participation of older people. The context surrounding the participants influenced all these situations, key in tipping the balance between a therapeutic and a harmful side. PROSPERO REGISTRATION NUMBER CRD42022363515.
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Affiliation(s)
- Pablo Martínez-Angulo
- Department of Nursing, Pharmacology and Physiotherapy, Faculty of Medicine and Nursing, University of Córdoba (UCO), Córdoba, Andalucía, Spain
- Interdisciplinary Research Group in Discourse Analysis (HUM380), University of Córdoba (UCO), Córdoba, Andalucía, Spain
| | - Manuel Rich-Ruiz
- Department of Nursing, Pharmacology and Physiotherapy, Faculty of Medicine and Nursing, University of Córdoba (UCO), Córdoba, Andalucía, Spain
- Nursing and Healthcare Research Unit (Investén-isciii), Instituto de Salud Carlos III, Madrid, Spain
- Ciber Fragility and Healthy Aging (CIBERFES), Madrid, Spain
| | - Pedro E Ventura-Puertos
- Department of Nursing, Pharmacology and Physiotherapy, Faculty of Medicine and Nursing, University of Córdoba (UCO), Córdoba, Andalucía, Spain
- Interdisciplinary Research Group in Discourse Analysis (HUM380), University of Córdoba (UCO), Córdoba, Andalucía, Spain
| | - Salvador López-Quero
- Interdisciplinary Research Group in Discourse Analysis (HUM380), University of Córdoba (UCO), Córdoba, Andalucía, Spain
- Department of Language Sciences, Faculty of Philosophy and Letters, University of Córdoba (UCO), Córdoba, Andalucía, Spain
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12
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Liao L, Feng M, You Y, Chen Y, Guan C, Liu Y. Experiences of older people, healthcare providers and caregivers on implementing person-centered care for community-dwelling older people: a systematic review and qualitative meta-synthesis. BMC Geriatr 2023; 23:207. [PMID: 37003992 PMCID: PMC10067217 DOI: 10.1186/s12877-023-03915-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 03/21/2023] [Indexed: 04/03/2023] Open
Abstract
BACKGROUND Person-centered care (PCC) is a critical approach to improving the quality of care for community-dwelling older people. Old-age care services could be provided according to older peoples' choices, needs, and preferences. The purpose of this study was to synthesize research evidence on the experiences of older people, healthcare providers, and caregivers with PCC and to identify the enablers and barriers to implementing PCC for community-dwelling older people. METHODS A meta-synthesis of qualitative research design was adopted. Data searches were performed using CINAHL (EBSCOhost), PubMed (OvidSP), Embase (Ovid), Cochrane Database, and PsycINFO (Ovid) in published articles and were reviewed from the earliest date to February 2023. The Qualitative Method Appraisal Tool was used to conduct a quality appraisal on selected articles. Data were extracted based on the capacity, opportunity, and motivation-behavior model (COM-B model), and the findings were synthesized using the meta-aggregative approach. RESULTS Twelve included articles were analyzed to identify 122 findings that were organized into 11 categories and combined into three synthesized findings-capacities of older people, healthcare providers, and caregivers; opportunities in the implementation of PCC; motivation in implementing PCC. Capacities consisted of a lack of person-centered knowledge and skills, negative attitudes toward shared decision-making, and a lack of formal training to enhance capabilities among HCPs. Opportunities included a lack of coordination in resource allocation, strengthening multidisciplinary teamwork, establishing a desirable environment, and time constraints. Motivation in implementing PCC included encouraging self-reflection and regulation, respecting the autonomy of older people, lack of clear reward and empowerment mechanisms, and being resilient and optimistic. CONCLUSIONS The findings of this research provide a reference for implementing successful PCC in the community. The researchers identified barriers and facilitators of implementing PCC, facilitating through stakeholder's person-centered knowledge and skills being valued and respecting the autonomy of older people. Establishing a positive environment and strengthening multidisciplinary team members also promotes the implementation of PCC. However, additional studies are required to explore the influencing factors and address the barriers.
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Affiliation(s)
- Lulu Liao
- Department of Nursing, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Mingjiao Feng
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Yanjie You
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Yuqin Chen
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Chunyan Guan
- Department of Otolaryngology Head and Neck Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
| | - Yilan Liu
- Department of Nursing, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
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13
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Kraun L, van Achterberg T, Vlaeyen E, Fret B, Briké SM, Ellen M, De Vliegher K. Transitional care decision-making through the eyes of older people and informal caregivers: An in-depth interview-based study. Health Expect 2023; 26:1266-1275. [PMID: 36919194 PMCID: PMC10154836 DOI: 10.1111/hex.13743] [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: 12/30/2022] [Revised: 02/17/2023] [Accepted: 02/21/2023] [Indexed: 03/16/2023] Open
Abstract
BACKGROUND Older people with multifaceted care needs often require treatment and complex care across different settings. However, transitional care is often inadequately managed, and older people and their informal caregivers are not always sufficiently heard and/or supported in transitional care decision-making. OBJECTIVE To explore older people's and informal caregivers' experiences with, views on, and needs concerning empowerment in transitional care decision-making. METHODS A qualitative descriptive study was conducted in the TRANS-SENIOR consortium's collaborative research using semistructured in-depth interviews between October 2020 and June 2021 in Flanders, Belgium. A total of 29 people were interviewed, including 14 older people and 15 informal caregivers who faced a transition from home to another care setting or vice versa. Data were analysed according to the Qualitative Analysis Guide of Leuven. FINDINGS Five themes were identified in relation to the participant's experiences, views and needs: involvement in the decision-making process; informal caregivers' burden of responsibility; the importance of information and support; reflections on the decision and influencing factors. CONCLUSIONS Overall, older people and informal caregivers wished to be more seen, recognised, informed and proactively supported in transitional care decision-making. However, their preferences for greater involvement in decision-making vary and are affected by several factors that are both intrinsic and extrinsic. Therefore, healthcare systems might seek out age-tuned and person-centred empowerment approaches focusing on older people's and informal caregivers' empowerment. For future studies, we recommend developing specific strategies for such empowerment. PATIENT OR PUBLIC CONTRIBUTION Older persons' representatives were involved in designing the TRANS-SENIOR programme of research, including the current study. Healthcare professionals and nursing care directors were involved in the study design and the selection and recruitment of participants.
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Affiliation(s)
- Lotan Kraun
- Nursing Department, Wit-Gele Kruis van Vlaanderen, Brussels, Belgium.,Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, KU Leuven, Leuven, Belgium.,Department of Health Policy and Management, Guilford Glazer Faculty of Business and Management and Faculty of Health Sciences, Ben-Gurion University of the Negev, Beersheba, Israel
| | - Theo van Achterberg
- Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, KU Leuven, Leuven, Belgium
| | - Ellen Vlaeyen
- Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, KU Leuven, Leuven, Belgium.,Department of Public Health and Primary Care, Faculty of Medicine and Life Sciences, Hasselt University, Hasselt, Belgium
| | - Bram Fret
- Nursing Department, Wit-Gele Kruis van Vlaanderen, Brussels, Belgium
| | - Sarah Marie Briké
- Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, KU Leuven, Leuven, Belgium
| | - Moriah Ellen
- Department of Health Policy and Management, Guilford Glazer Faculty of Business and Management and Faculty of Health Sciences, Ben-Gurion University of the Negev, Beersheba, Israel.,Institute of Health Policy Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Kristel De Vliegher
- Nursing Department, Wit-Gele Kruis van Vlaanderen, Brussels, Belgium.,Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, KU Leuven, Leuven, Belgium
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14
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Williams S, O’Riordan C, Steed F, Leahy A, Shanahan E, Peters C, O’Connor M, Galvin R, Morrissey AM. Early Supported Discharge for Older Adults Admitted to Hospital with Medical Complaints: A Qualitative Study Exploring the Views of Stakeholders. J Multidiscip Healthc 2022; 15:2861-2870. [PMID: 36561433 PMCID: PMC9766477 DOI: 10.2147/jmdh.s380572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 10/07/2022] [Indexed: 12/23/2022] Open
Abstract
Introduction Early supported discharge (ESD) is well established as a model of health service delivery for people with stroke. Emerging evidence indicates that ESD also reduces the length of stay for older medical inpatients. There is a dearth of evidence exploring the views of stakeholders on ESD as a model of care for older medical inpatients. The overall aim of this study is to explore the views and perceptions of older adults, family carers and healthcare professionals on the potential role of ESD for older adults admitted to hospital with medical complaints. Methods Purposeful sampling was used to recruit older adults and family carers for interview. For Healthcare Professionals (HCPs), snowball purposeful sampling was used. Phone interviews took place following a semi-structured interview guide. Focus groups were moderated by A-MM. Braun and Clarke's approach to thematic analysis was used. Ethical approval was granted by the HSE Mid-Western Area Regional Ethics Committee in November 2021 (REC Ref. 096/2021). Results Fifteen HCPs took part across three focus groups, with six older adults and two family members participating in one-to-one interviews. Three themes were identified: 1. Pre-ESD experiences of providing and receiving older adult inpatient care, 2. Navigating discharge procedures from acute hospital services, 3. A vision for more integrated model of care and a medical ESD team. Discussion This study provided insight into the current discharge experiences of older adult care in the acute setting, the potential role for ESD in this population and the key factors that would need to be considered for the running of an ESD service for older adults admitted to hospital with medical complaints. Conclusion This research highlights the barriers and facilitators to ESD for older medical inpatients from the perspectives of key stakeholders. Given the adverse outcomes associated with prolonged hospital stay, these findings will help inform the development of a feasibility trial, examining patient and process outcomes for older adults admitted to hospital with medical complaints who receive an ESD intervention.
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Affiliation(s)
- Susan Williams
- School of Allied Health, University of Limerick, Limerick, Ireland,Correspondence: Susan Williams, School of Allied Health, Faculty of Education and Health Sciences, Ageing Research Centre, Health Research Institute, University of Limerick, Limerick, Ireland, Email
| | - Clíona O’Riordan
- School of Allied Health, University of Limerick, Limerick, Ireland
| | - Fiona Steed
- Department of Medicine, University Hospital Limerick, Limerick, Ireland
| | - Aoife Leahy
- School of Allied Health, University of Limerick, Limerick, Ireland,Department of Ageing and Therapeutics, University Hospital Limerick, Limerick, Ireland
| | - Elaine Shanahan
- Department of Ageing and Therapeutics, University Hospital Limerick, Limerick, Ireland
| | - Catherine Peters
- Department of Ageing and Therapeutics, University Hospital Limerick, Limerick, Ireland
| | - Margaret O’Connor
- Department of Ageing and Therapeutics, University Hospital Limerick, Limerick, Ireland,School of Medicine, University of Limerick, Limerick, Ireland
| | - Rose Galvin
- School of Allied Health, University of Limerick, Limerick, Ireland
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15
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Puustinen J, Kangasniemi M, Pasanen M, Turjamaa R. Recognising older people's individual resources and home‐care‐specific tasks in home care in Finland: A document analysis of care and service plans. Scand J Caring Sci 2022; 37:507-523. [PMID: 36464860 DOI: 10.1111/scs.13135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 10/27/2022] [Accepted: 11/06/2022] [Indexed: 12/07/2022]
Abstract
BACKGROUND AND RATIONALE Comprehensive care and service planning in home care is tailored to older people's individual needs and resources in order to support them living at home. However, little is known about how these individual resources and home-care-specific tasks are recognised in older people's care and service plans. AIMS To describe the content of care and service plans in older people's home care with special attention to their individual resources and home-care-specific tasks. DESIGN This was a document-based cross-sectional study with mixed-methods analysis, carried out in Eastern Finland during Spring 2018. METHODS A document analysis using the deductive Finnish Care Classification (FinCC), and an inductively developed framework of older people's care and service plans (n = 71). The data were analysed with descriptive statistical methods. RESULTS Altogether, 1718 notes were relevant to the FinCC main categories: 707 (41%) focused on older people's needs and 1011 (59%) on nursing interventions. We identified 1104 notes based on the 26 inductively developed main categories: the majority (n = 628, 57%) focused on individual resources and the remainder (n = 476, 43%) on home-care-specific tasks. Increasing age resulted in fewer notes on safety and sensory functions. There were fewer notes on resources related to sleeping and wakefulness after longer care and service periods. An increased number of home visits resulted in more documentation on tasks related to pharmaceutical issues, including repeat prescriptions. DISCUSSION Individual resources for older people were documented, to some extent, in their care and service plans. It is necessary to review these alongside home-care-specific tasks that support older people's independence and safety at home. CONCLUSION Individual resources need to be recognised in order to enable home-care professionals to provide tailored, high-quality home care services. Home-care-specific tasks should be supported by documentation with updated, sensitive home care classifications.
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Affiliation(s)
- Jonna Puustinen
- Department of Nursing Science, Faculty of Medicine University of Turku Turku Finland
| | - Mari Kangasniemi
- Department of Nursing Science, Faculty of Medicine University of Turku Turku Finland
| | - Miko Pasanen
- Department of Nursing Science, Faculty of Medicine University of Turku Turku Finland
| | - Riitta Turjamaa
- Unit of Continuous Learning Savonia University of Applied Sciences Kuopio Finland
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16
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Saunders R, Crookes K, Gullick K, Gallagher O, Seaman K, Scaini D, Ang SGM, Bulsara C, Ewens B, Hughes J, O'Connell B, Etherton-Beer C. Nurses leading volunteer support for older adults in hospital: A discussion paper. Collegian 2022. [DOI: 10.1016/j.colegn.2022.08.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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17
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Kvael LAH, Olsen CF. Assuring patient participation and care continuity in intermediate care: Getting the most out of family meetings using the four habits model. Health Expect 2022; 25:2582-2592. [PMID: 35999673 PMCID: PMC9615078 DOI: 10.1111/hex.13591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 07/27/2022] [Accepted: 08/12/2022] [Indexed: 11/30/2022] Open
Abstract
Introduction As a transitional care intervention, intermediate care (IC) bridges the pathway for older patients from hospital to home. Within family meetings in IC, the older patient, his or her relatives, the interdisciplinary team and the municipal case manager come together to discuss goals and interventions during the IC stay, including follow‐up services after discharge. Although family meetings are a common aspect of teamwork in IC, it is unclear how the voices of older people and their relatives are coming across. The aim of this study is to explore how patient participation is framed and negotiated within family meetings in IC. Methods This study is based on qualitative data from the observation of 14 interdisciplinary family meetings in Norwegian IC services. As a theoretical framework, the authors have used the four habits model developed by Frankel and Stein as a lens to understand the interrelated sequence of events that typically takes place during a family meeting and the importance of communication skills to promote patient participation. Results The thematic analysis resulted in 16 categories and 4 main themes related to the 4 habits model: (i) grounding the family meetings, (ii) what matters to you?, (iii) being empathically present and (iv) the power of a final closure. Conclusion There was considerable variation in the way current family meetings were conducted. It seemed crucial to start the meeting with a proper introduction and explanation of the purpose of the meeting to establish trust and to be able to successfully move to the next stage of eliciting the patients' preferences, views and goals via the ‘what matters to you?’ question. There were examples of empathetic communication among meeting participants perceived to facilitate patient participation. Finally, to successfully end the meeting and agree on a shared plan, it seemed crucial for case managers who held the decision‐making power to attend the meetings. Framing family meetings in line with the four habits sequential approach may have the potential to assure patient participation and care continuity in IC services. Patient or Public Contribution This article is part of a larger project based on a James Lind Alliance process that brings patients, relatives, health care professionals and researchers together in priority setting partnerships to identify and prioritize evidence uncertainties that they agree are the most important. Accordingly, the design and content of this article have been initiated and discussed in the project's stakeholder group consisting of one patient representative, one relative representative, two health care professionals from IC settings, two representatives from the Norwegian Health Association and two representatives from the Agency of Health in Norway.
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Affiliation(s)
- Linda A H Kvael
- Department of Rehabilitation Science and Health Technology, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway.,Department of Ageing Research and Housing Studies, Norwegian Social Research-NOVA, Oslo Metropolitan University, Oslo, Norway
| | - Cecilie F Olsen
- Department of Rehabilitation Science and Health Technology, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
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18
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Bowden A, Wilson V, Traynor V, Chang HCR. The impact of ageing simulation education on qualified acute care nurses' empathy towards older people: A mixed-methods study. J Clin Nurs 2022. [PMID: 35915585 DOI: 10.1111/jocn.16474] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Revised: 06/06/2022] [Accepted: 07/01/2022] [Indexed: 11/29/2022]
Abstract
AIMS AND OBJECTIVES To evaluate the influence of an ageing simulation intervention on qualified acute care nurses' empathy towards older people. BACKGROUND Life expectancy is increasing globally with an increased incidence of older people accessing healthcare services. As such, it is essential for qualified nurses within hospital settings to connect with older people by establishing healthful relationships. Empathy is an essential component of healthful nurse-patient relationships. Fortunately, empathy can be taught through education. DESIGN A convergent mixed-methods design was utilised. METHODS Nurses (N = 95) undertook an 8-hour ageing simulation intervention. Data were collected from April 2019 to May 2020 across three time points: before the intervention (T0); immediately after (T1) and at three months follow-up (T2). A mix of convenience (intervention) and purposeful (follow-up) sampling techniques were utilised. Quantitative data were collected via the Interpersonal Reactivity Index survey (n = 86) and analysed using repeat measures ANOVA to compare mean scores across time points. Qualitative data were collected via debriefing discussions (N = 95) and focus groups (n = 38), and analysed using a systematic thematic analysis method. Data convergence occurred during the interpretation phase. Study reported with the TREND checklist. RESULTS Primarily, when quantitative and qualitative findings were merged they confirmed each others' empathy outcomes. Quantitative results showed a statistically significant increase in affective and cognitive empathy levels among nurses post-intervention. Qualitative findings expanded on quantitative results and revealed an increase in nurses' affective, cognitive and behavioural empathy represented in themes 'enhancing my empathy', 'impact of ageing', 'from self to others' and 'person-centred moments'. CONCLUSIONS This study adds empirical evidence how a mixed-methods design can be used to evaluate the influence of an ageing simulation intervention on nurses' empathy levels. RELEVANCE TO CLINICAL PRACTICE Ageing simulation interventions are a suitable experiential educational approach to improve acute care nurses' affective, cognitive and behavioural empathy towards older people.
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Affiliation(s)
- Alera Bowden
- Faculty of Science, Medicine and Health, School of Nursing, University of Wollongong, Wollongong, New South Wales, Australia.,Illawarra Shoalhaven Local Health District, Wollongong, New South Wales, Australia.,Illawarra Health and Medical Research Institute (IHMRI), Wollongong, New South Wales, Australia
| | - Valerie Wilson
- Faculty of Science, Medicine and Health, School of Nursing, University of Wollongong, Wollongong, New South Wales, Australia.,Illawarra Shoalhaven Local Health District, Wollongong, New South Wales, Australia.,Illawarra Health and Medical Research Institute (IHMRI), Wollongong, New South Wales, Australia
| | - Victoria Traynor
- Faculty of Science, Medicine and Health, School of Nursing, University of Wollongong, Wollongong, New South Wales, Australia.,Illawarra Health and Medical Research Institute (IHMRI), Wollongong, New South Wales, Australia
| | - Hui-Chen Rita Chang
- Faculty of Science, Medicine and Health, School of Nursing, University of Wollongong, Wollongong, New South Wales, Australia.,Illawarra Health and Medical Research Institute (IHMRI), Wollongong, New South Wales, Australia
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19
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Singh S, Patra S, Khan AM. Health care services: Utilization and perception among elderly in an urban resettlement colony of Delhi. J Family Med Prim Care 2022; 11:1468-1473. [PMID: 35516719 PMCID: PMC9067175 DOI: 10.4103/jfmpc.jfmpc_1584_21] [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: 08/07/2021] [Revised: 12/09/2021] [Accepted: 12/16/2021] [Indexed: 11/18/2022] Open
Abstract
Context: Health care utilization informs us about the utility of services which are available. We have a paucity of studies related to health care utilization among elderly in India. Aims: The aim of this study is to find out utilization of health care services by elderly (≥60 years), pattern, factors associated with, and perception of the elderly population regarding facilitators and barriers for the same. Settings and Design: A community based cross-sectional, observational study was conducted in a resettlement colony of East Delhi. Materials and Methods: A pretested, semi-structured, and interviewer-administered questionnaire was used. Duration of data collection was November 2018 to January 2020. Statistical Analysis Used: For quantitative variables, mean, median, proportion, Chi-square test, binary logistic regression using Statistical Package for the Social Sciences (SPSS), and for qualitative variables thematic analysis were done. Results: The study included 288 study participants. Although utilization of health care services in last 15 days among elderly is 90%, it was also found that 69% of the elderly consulted a licensed medical practitioner. A private facility was visited by 58% of the study participants. Female gender (OR: 1.97; P = 0.02), religion as Hindu (OR, 2.09; P = 0.04), and marital status “single” (OR, 1.8; P = 0.04) were observed to be significant predictors of health care utilization. The participants expressed less waiting time, cashless facility for visits, availability of an accompanying person, behavior of staffs work as facilitators for utilization of services. Conclusions: Considering the unique characteristics of this age group, a shift from facility to community-based approach may be considered. Efforts may be made to create elderly friendly health facilities.
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Affiliation(s)
- Shivani Singh
- Department of Community Medicine, University College of Medical Sciences, Delhi, India
| | - Somdatta Patra
- Department of Community Medicine, University College of Medical Sciences, Delhi, India
| | - Amir M Khan
- Department of Community Medicine, University College of Medical Sciences, Delhi, India
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