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Scott MM, Ménard A, Sun AH, Murmann M, Ramzy A, Rasaputra P, Fleming M, Orosz Z, Huynh C, Welch V, Cooper-Reed A, Hsu AT. Building evidence to advance health equity: a systematic review on care-related outcomes for older, minoritised populations in long-term care homes. Age Ageing 2024; 53:afae059. [PMID: 38557665 PMCID: PMC10982852 DOI: 10.1093/ageing/afae059] [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: 04/14/2023] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND Advancing health equity requires more contextualised evidence. OBJECTIVES To synthesise published evidence using an existing framework on the origins of health disparities and determine care-related outcome disparities for residents of long-term care, comparing minoritised populations to the context-specific dominant population. DESIGN Systematic review. SUBJECTS Residents of 24-hour long-term care homes. METHODS The protocol was registered a priori with PROSPERO (CRD42021269489). Literature published between 1 January 2000 and 26 September 2021, was searched, including studies comparing baseline characteristics and outcomes in minoritised versus dominant populations. Dual screening, two-reviewer verification for extraction, and risk of bias assessments were conducted to ensure rigour. Studies were synthesized using a conceptual framework to contextualise evidence according to multi-level factors contributing to the development of care disparities. RESULTS Twenty-one of 34 included studies demonstrated disparities in care outcomes for minoritised groups compared to majority groups. Thirty-one studies observed differences in individual-level characteristics (e.g. age, education, underlying conditions) upon entry to homes, with several outcome disparities (e.g. restraint use, number of medications) present at baseline and remaining or worsening over time. Significant gaps in evidence were identified, particularly an absence of literature on provider information and evidence on the experience of intersecting minority identities that contribute to care-related outcome disparities in long-term care. CONCLUSION This review found differences in minoritised populations' care-related outcomes. The findings provide guidance for future health equity policy and research-supporting diverse and intersectional capacity building in long-term care.
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Affiliation(s)
- Mary M Scott
- The Public Health Agency of Canada, Ottawa, ON, Canada
- The Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Alixe Ménard
- The Ottawa Hospital Research Institute, Ottawa, ON, Canada
- Department of Health Sciences, University of Ottawa, Ottawa, ON, Canada
| | - Annie H Sun
- Bruyere Research Institute, Ottawa, ON, Canada
| | - Maya Murmann
- The Ottawa Hospital Research Institute, Ottawa, ON, Canada
- Bruyere Research Institute, Ottawa, ON, Canada
| | - Amy Ramzy
- Bruyere Research Institute, Ottawa, ON, Canada
| | | | - Michelle Fleming
- Bruyere Research Institute, Ottawa, ON, Canada
- Ontario Centres for Learning, Research and Innovation in Long-Term Care, Ottawa, ON, Canada
| | - Zsófia Orosz
- Bruyere Research Institute, Ottawa, ON, Canada
- Ontario Centres for Learning, Research and Innovation in Long-Term Care, Ottawa, ON, Canada
| | - Chau Huynh
- Bruyere Research Institute, Ottawa, ON, Canada
| | - Vivian Welch
- Bruyere Research Institute, Ottawa, ON, Canada
- The Campbell Collaboration, Philadelphia, PA, USA
| | | | - Amy T Hsu
- The Ottawa Hospital Research Institute, Ottawa, ON, Canada
- Bruyere Research Institute, Ottawa, ON, Canada
- Ontario Centres for Learning, Research and Innovation in Long-Term Care, Ottawa, ON, Canada
- Department of Family Medicine, University of Ottawa, Ottawa, ON, Canada
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Salomé GM. A Booklet on the Assessment, Prevention, and Treatment of Incontinence-Associated Dermatitis. Adv Skin Wound Care 2023; 36:355-360. [PMID: 37212588 DOI: 10.1097/01.asw.0000926624.17117.0f] [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: 05/23/2023]
Abstract
OBJECTIVE Printed materials have been used as educational resources to assist healthcare professionals in evidence-based clinical practice by providing guidelines for treatment, prevention, and self-care. The aim of this study was to develop and validate a booklet on the risk assessment, prevention, and treatment of incontinence-associated dermatitis. METHODS This was a descriptive, analytic, and quantitative study. The booklet was developed in six steps: situational diagnosis, development of the research question, integrative review of the literature, synthesis of knowledge, structuring and design, and validation of the content. An expert panel composed of 27 experienced nurses carried out content validation using the Delphi technique. The content validity index (CVI) and Cronbach α coefficient were calculated. RESULTS The mean Cronbach α for the evaluation questionnaire was .91, indicating excellent internal consistency. The evaluators classified the content of the booklet from "inadequate" to "totally adequate" (overall CVI, 0.91) in the first round of consultation and from "adequate" and "totally adequate" (overall CVI, 1.0) in a second round of consultation. The booklet was therefore considered validated. CONCLUSIONS A booklet on risk assessment, prevention, and treatment of incontinence-associated dermatitis was created and validated by an expert panel, obtaining 100% consensus among the evaluators in the second round of consultation.
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Affiliation(s)
- Geraldo Magela Salomé
- Geraldo Magela Salomé, PhD, RN, is Associate Professor, Professional Master's Program in Applied Health Sciences, Universidade do Vale do Sapucai (UNIVAS), Pouso Alegre, Minas Gerais, Brazil
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Jiang Q, Chen K, Liu Y, Zhou J, Bai Y, Zhao J, Weng Y, Zhu Y, Feng H, Wang J, Cai Y, Ou Y. Relationship between dry skin and pressure injury in older patients: A multicentre cross‐sectional survey in China. Int Wound J 2022; 20:1402-1417. [PMID: 36307094 PMCID: PMC10088826 DOI: 10.1111/iwj.13993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Accepted: 10/09/2022] [Indexed: 11/27/2022] Open
Abstract
Dry skin and pressure injuries in older persons have become global health care problems. This was a multicentre, prospective cross-sectional study in 44 hospitals and 8 long term care institutions from 20 provinces, autonomous regions and municipalities in China and aimed to explore the relationship between the two skin problems in older patients. We mainly found 11 602 cases with dry skin and 1076 cases with pressure injuries in a total of 33 769 valid participants. The overall prevalence of dry skin and pressure injuries was 34.4% (95% confidence interval [CI] 33.9-34.9) and 3.1% (95% CI 2.9-3.3). Stage 2+ pressure injuries were the most (32.9%), followed by stage 1 (32.4%). The patients with dry skin had more pressure injuries than ones without dry skin (50.0% vs 33.9%). The patients with very severe and severe dry skin had more pressure injury risk (OR 2.22 and 1.90) and more stage 2+ pressure injury risk (OR 2.83 and 1.63). Other nine predictors associated with overall pressure injuries and stage 2+ pressure injuries. The area under receiver operating characteristic (ROC) curve of the predictive models of overall pressure injuries and stage 2+ pressure injuries were 0.89 (95% CI 0.88-0.90) and 0.91 (95% CI 0.90-0.92), respectively.
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Affiliation(s)
- Qixia Jiang
- Department of Burn and Plastic Surgery Jinling Hospital, Medical School of Nanjing University Nanjing China
| | - Kesu Chen
- Medical School Nanjing University Nanjing China
| | - Yuxiu Liu
- Data and Statistics Division of Department of Critical Care Medicine Jinling Hospital, Nanjing Medical University Nanjing China
- Department of Biostatistics School of Public Health, Nanjing Medical University Nanjing China
| | - Jihong Zhou
- Department of Cosmetology Nanjing Hospital of Traditional Chinese Medicine Nanjing China
| | - Yuxuan Bai
- Clinical Academic Department Zhejiang Top‐Medical Dressing Co., Ltd. Wenzhou China
| | - Jing Zhao
- Department of Outpatient Treatment the First Affiliated Hospital of Nanjing Medical University Nanjing China
| | - Yajuan Weng
- Nursing Department the First People's Hospital of Changzhou Changzhou China
| | - Yuling Zhu
- Department of Burn and Plastic Surgery Jinling Hospital, Medical School of Nanjing University Nanjing China
| | - Haixia Feng
- Nursing Department Zhongda Hospital Affiliated Southeast University Nanjing China
| | - Jing Wang
- Nursing Department Yangpu Hospital, School of Medicine, Tongji University Shanghai China
| | - Yunmin Cai
- Wound Diagnosis and Treatment Center JinShan Hospital Affiliated to Fudan University Shanghai China
| | - Yulan Ou
- Nursing Department the First Affiliated Hospital of University of South China Hengyang China
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Salomé GM, Rocha CAD, Miranda FD, Alves JR, Dutra RAA, Tenório AG. Algorithms for prevention and treatment of incontinence-associated dermatitis. ESTIMA 2020. [DOI: 10.30886/estima.v18.837_in] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Objective: To build and validate algorithms for prevention and treatment of incontinence-associated dermatitis. Method: A methodological study. An integrative review of articles published from 2009 to 2019 was carried out after a literature search in the main Health Sciences databases for the construction of the algorithms. The algorithms were evaluated by 27 nurses using the Delphi technique. The content validity index was used for data analysis. Results: The judges evaluated the algorithms from inadequate to adequate in the first round of consultation, and from adequate to totally adequate in the second round of consultation. The global content validity index was 0.923 in the first consultation and 1.0 in the second consultation. Conclusion: After reviewing the literature, the algorithms were constructed and validated by professionals with experience in the area, reaching agreement among the judges in the second round of consultation.
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Affiliation(s)
- Geraldo Magela Salomé
- Universidade do Vale do Sapucaí – Faculdade de Ciências Médicas Dr. José Antônio Garcia Coutinho – Pouso Alegre (MG), Brazil
| | - Cleber Aparecido da Rocha
- Universidade do Vale do Sapucaí – Faculdade de Ciências Médicas Dr. José Antônio Garcia Coutinho – Pouso Alegre (MG), Brazil
| | - Flávio Dutra Miranda
- Universidade do Vale do Sapucaí – Faculdade de Ciências Médicas Dr. José Antônio Garcia Coutinho – Pouso Alegre (MG), Brazil
| | - José Ronaldo Alves
- Universidade do Vale do Sapucaí – Faculdade de Ciências Médicas Dr. José Antônio Garcia Coutinho – Pouso Alegre (MG), Brazil
| | - Rosimar Aparecida Alves Dutra
- Universidade do Vale do Sapucaí – Faculdade de Ciências Médicas Dr. José Antônio Garcia Coutinho – Pouso Alegre (MG), Brazil
| | - Amanda Gabriele Tenório
- Universidade do Vale do Sapucaí – Faculdade de Ciências Médicas Dr. José Antônio Garcia Coutinho – Escola de Enfermagem – Pouso Alegre (MG), Brazil
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Salomé GM, Rocha CAD, Miranda FD, Alves JR, Dutra RAA, Tenório AG. Algoritmos para prevenção e tratamento de dermatite associada à incontinência. ESTIMA 2020. [DOI: 10.30886/estima.v18.837_pt] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Objetivo: Construir e validar algoritmos para a prevenção e o tratamento da dermatite associada à incontinência. Método: Estudo metodológico. Para o desenvolvimento dos algoritmos, foi realizada revisão integrativa de artigos publicados de 2009 a 2019 encontrados nas principais bases de dados em ciências da saúde. A avaliação dos algoritmos foi realizada com 27 enfermeiros, utilizando a técnica de Delphi. Para a análise de dados, foi adotado o índice de validade de conteúdo. Resultados: Os juízes consideraram os algoritmos entre inadequados e adequados na primeira avaliação e entre adequados e totalmente adequados na segunda avaliação. O índice de validade de conteúdo geral foi de 0,923 na primeira avaliação e 1,0 na segunda avaliação. Conclusão: Após revisão da literatura, os algoritmos foram construídos e validados por profissionais com experiência na área, obtendo concordância entre os juízes na segunda avaliação.
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Affiliation(s)
- Geraldo Magela Salomé
- Universidade do Vale do Sapucaí – Faculdade de Ciências Médicas Dr. José Antônio Garcia Coutinho – Pouso Alegre (MG), Brazil
| | - Cleber Aparecido da Rocha
- Universidade do Vale do Sapucaí – Faculdade de Ciências Médicas Dr. José Antônio Garcia Coutinho – Pouso Alegre (MG), Brazil
| | - Flávio Dutra Miranda
- Universidade do Vale do Sapucaí – Faculdade de Ciências Médicas Dr. José Antônio Garcia Coutinho – Pouso Alegre (MG), Brazil
| | - José Ronaldo Alves
- Universidade do Vale do Sapucaí – Faculdade de Ciências Médicas Dr. José Antônio Garcia Coutinho – Pouso Alegre (MG), Brazil
| | - Rosimar Aparecida Alves Dutra
- Universidade do Vale do Sapucaí – Faculdade de Ciências Médicas Dr. José Antônio Garcia Coutinho – Pouso Alegre (MG), Brazil
| | - Amanda Gabriele Tenório
- Universidade do Vale do Sapucaí – Faculdade de Ciências Médicas Dr. José Antônio Garcia Coutinho – Escola de Enfermagem – Pouso Alegre (MG), Brazil
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