The association between patient engagement and quality of care interactions among acute care patients with dementia

Effective staff-patient communication is critical in acute care settings, particularly for patients with dementia. Limited work has examined the impact of quality of staff-patient care interactions on patient engagement. The purpose of this study was to determine whether the quality of staff-patient care interactions were associated with active patient engagement during the interaction after controlling for relevant covariates. The study was a secondary data analysis using baseline data from the Function Focused Care for Acute Care intervention study, with a total sample of 286 patients. Descriptive statistics and a generalized linear mixed model were used. The findings indicated that there was a significant relationship between the quality of care interactions and patient engagement such that receiving positive care interactions resulted in higher odds of active patient engagement. These findings can inform future interventions and training for acute care staff to improve quality of care interactions and patient engagement.

Building evidence to advance health equity: a systematic review on care-related outcomes for older, minoritised populations in long-term care homes

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.

Subjective memory complaints and social participation among older adults: results from the health and retirement study

Objectives:This study aims to examine whether subjective memory complaints (SMC) contribute to social participation among older adults.Method:The study sample was 4,713 community-dwelling older adults aged 65 years and older from four waves (2010, 2012, 2014, 2016) of the Health and Retirement Study. Hierarchical linear modeling analysis was used to examine the association of SMC with social participation after controlling for factors influencing social participation. Demographic factors (i.e. age, gender, and perceived socioeconomic status) were entered in block 1, health-related factors (i.e. health conditions, perceived health, instrumental activities of daily living, memory-immediate and delayed, and depressive symptoms) were entered in block 2, environmental factors (i.e. perceived social support and strain from spouse, child, family, and friend) were entered in block 3, and SMC was entered in block 4.Results:The result showed that factors significantly contributing to social participation are age (standardized β = -0.08, p < 0.01), perceived socioeconomic status (β = 0.16, p < 0.001), perceived health (β = 0.15, p < 0.001), instrumental activities of daily living (β = 0.12, p < 0.001), memory-immediate and delayed (β = 0.09, p < 0.001; β = 0.08, p < 0.001, respectively), social support from spouse and friend (β = 0.04, p < 0.05; β = 0.13, p < 0.001, respectively), social strain from friend (β = 0.07, p < 0.001), and SMC (β = -0.05, p < 0.001). The demographic factors explained 9.5%, health-related factors explained 8.5%, environmental factors explained 2.4%, and SMC explained 0.1% of the variance in social participation.Conclusion: This finding suggests that SMC may contribute to social participation in older adults.Supplemental data for this article can be accessed online at https://doi.org/10.1080/13607863.2021.1961123 .

Home‐ and community‐level predictors of social connection in nursing home residents: A scoping review

Background and Aims

Methods

Results

Conclusion

Adaptation, validity and reliability of geriatric self-efficacy index for urinary incontinence (GSE-UI) in geriatric incontinents

PURPOSE

The purpose of this study was to translate and culturally adapt the GSE-UI for use with a Turkish population and to determine its validity and reliability.

METHODS

120 elderly with UI aged 60 and over years (mean 72.89 ± 9.59 years) participated in this study. An interview was held to determine the type, severity and frequency if any, incontinence. Then, the Mini-Mental State Examination, IIQ-7, UDI-6 and I-QOL questionnaires were administered to the participants. After translating the tool to Turkish, test and retest was performed with an interval of 7-14 days.

RESULTS

The internal consistency of the first test of the GSE-UI-Turkish was excellent, with a Cronbach α of 0.95. The test-retest reliability of the GSE-UI-Turkish was found to be excellent (ICC = 0.94, 95% CI 0.92-0.96). The correlation coefficient between the GSE-UI-Turkish and the UDI-6, IIQ-7, I-QOL were found to be good to excellent (r = 0.68, r = 0.67, r = 0.81, r = 0.45, respectively; p < 0.0001).

CONCLUSION

Results of our study GSE-UI of Turkish version, self-efficacy evaluation in geriatric incontinence was a valid and reliable survey that can be used in clinical practice.

Characteristics of Socially Isolated Residents in Long-Term Care: A Retrospective Cohort Study

Objectives: To identify socially isolated long-term care residents and to compare their demographic characteristics, functional status, and health conditions to residents who are not isolated. Methods: We conducted a retrospective cohort study using the Resident Assessment Instrument, Minimum Data Set, 2.0 (RAI-MDS) data, from residents in 34 long-term care homes in Alberta, Canada (2008–2018). Using logistic regression, we compared the characteristics, conditions, and functional status of residents who were socially isolated (no contact with family/friends) and non-socially isolated residents. Results: Socially isolated residents were male, younger, and had a longer length of stay in the home, than non-socially isolated residents. Socially isolated residents lacked social engagement and exhibited signs of depression. Discussion: Socially isolated residents had unique care concerns, including psychiatric disorders, and co-morbid conditions. Our approach, using a single item in an existing data source, has the potential to assist clinicians in screening for socially isolated long-term care residents.

Impaired Mobility and Urinary Incontinence in Nursing Home Residents: A Multicenter Study

PURPOSE

The purpose of this study was to evaluate associations among use of walking aids, mobility status, and occurrence of urinary incontinence (UI) in geriatric patients residing in nursing homes, and to examine associations between UI severity (frequency and amount) and its impact on health-related quality of life (QoL).

DESIGN

Multicenter descriptive cross-sectional prevalence study.

SUBJECTS AND SETTING

A total of 2044 patients from nursing homes were included in the study. A majority were female (72.0%), the mean age of participants was 82.1 years (SD 11.2), their mean body mass index was 26.1 (SD 5.4), and their mean Care Dependency Scale score was 46.0 (SD 18.2), indicating a medium to high care dependency. The study setting was 30 nursing homes throughout Germany from 2014 to 2015.

METHODS

Data were collected by trained nurses using a standardized data collection form to collect information about demographic characteristics, health conditions, mobility status measured according to the Elderly Mobility Scale (EMS), UI, and QoL measured using the International Consultation of Incontinence Questionnaire Short Form (ICIQ-SF).

RESULTS

The prevalence of UI was 69.7% (n = 1804). Analysis of variance showed that, in 1659 nursing home residents with information on UI, 572 reported a medium amount of leakage with a mean impact on health-related QoL of 2.2 (SD 2.2, P < .001) on a scale from 0 (no impact) to 10 (very high impact). The mean of the impact on QoL in 235 residents who reported a large amount of leakage was 2.4 (SD 3.0, P < .001). In 1741 residents with information on the frequency of UI, 637 reported being urinary incontinent more than once a day with a mean impact on QoL of 2.2 (SD 2.1, P < .001) and 359 residents with permanent UI stated a mean impact on QoL of 2.1 (SD 2.8, P < .001). According to the bivariate association of UI with use of walking aids, the highest prevalence of UI (61.2%) was in patients who did not use any walking aids. The Chi-square Automatic Interaction Detector (CHAID) of the relationship between mobility according to the EMS and UI indicated that 71.1% of all patients with UI did not use any walking aids, although their mobility status had been reduced.

CONCLUSIONS

Findings indicate a significant association between impaired mobility and UI in nursing home residents. Chronic, severe urinary incontinence exerted the greatest impact on health-related QoL. Therefore, we recommend measures to preserve or regain mobility to minimize or prevent UI in geriatric residents and patients and, thus, increase their health-related QoL.