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Garattini L, Nobili A, Mannucci PM. A European National Health and Social Service model: the S of social. Intern Emerg Med 2024; 19:233-235. [PMID: 38091229 DOI: 10.1007/s11739-023-03483-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 11/07/2023] [Indexed: 01/31/2024]
Affiliation(s)
- Livio Garattini
- Istituto Di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | | | - Pier Mannuccio Mannucci
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Angelo Bianchi Bonomi Hemophilia and Thrombosis Center and University of Milan, Milan, Italy.
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Nordin S, Elf M, McKee K. Development and initial validation of the staff perception of residential care environments (SPORE) instrument. Int J Older People Nurs 2024; 19:e12596. [PMID: 38073273 DOI: 10.1111/opn.12596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 11/05/2023] [Accepted: 11/30/2023] [Indexed: 01/26/2024]
Abstract
BACKGROUND The impact of the physical environment on healthcare staff well-being and work performance is well recognised, yet there is a lack of instruments assessing environmental features from the perspective of staff working in residential care facilities (RCFs) for older people. OBJECTIVES To develop and provide initial validation of the instrument Staff Perceptions Of Residential care facility Environments (SPORE). DESIGN An instrument development and psychometric evaluation study. METHODS Based on material from a British project, items were translated and adapted for Swedish residential care facilities as SPORE. Care staff (N = 200), recruited from 20 Swedish RCFs, completed a questionnaire-based survey containing the SPORE instrument and two other instruments selected as suitable for use in the validation. In addition, an environmental assessment instrument was used for further validation. Analyses were performed at individual (staff) level and home (RCF) level. RESULTS The SPORE subscales demonstrated good internal consistency reliability and were moderately to strongly correlated at the individual level with the subscales of measures of person-centred care, and strongly correlated with the same measures at the home level. The SPORE subscales were also highly correlated with the total score of the instrument used to assess the quality of the physical environment. CONCLUSION The initial validation indicates that the SPORE instrument is promising for measuring care staff perceptions of environmental features in care facilities for older people. SPORE can be a valuable instrument for use in research and in practice to evaluate the environment as part of working towards high-quality care. IMPLICATIONS FOR PRACTICE The design of the physical environment within RCFs can affect the staff's health and work performance. The instrument is useful for evaluating the environment and informing decisions about design solutions that support staff in their important work.
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Affiliation(s)
- Susanna Nordin
- School of Health and Welfare, Dalarna University, Falun, Sweden
| | - Marie Elf
- School of Health and Welfare, Dalarna University, Falun, Sweden
| | - Kevin McKee
- School of Health and Welfare, Dalarna University, Falun, Sweden
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Vrettos I, Anagnostopoulos F, Voukelatou P, Panayiotou S, Kyvetos A, Nikas A, Kollia D, Niakas D. Factors associated with health-related quality of life of informal caregivers of older patients and the mediating role of subjective caregivers' burden. Psychogeriatrics 2023; 23:286-297. [PMID: 36597270 DOI: 10.1111/psyg.12930] [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] [Received: 10/07/2022] [Revised: 12/19/2022] [Accepted: 12/21/2022] [Indexed: 01/05/2023]
Abstract
BACKGROUND Caregiving has been associated with increased subjective burden and decreased health-related quality of life (HRQOL) for caregivers. The aim of the study was to clarify the precise relationship between caregivers' burden, caregivers' HRQOL, and other risk factors, considering that subjective burden was a risk factor for poor HRQOL, which may also mediate the effects of some known risk factors. METHODS In this cross-sectional study, patients' and their informal caregivers' characteristics were recorded for 311 patient-caregiver dyads. Subjective caregiver burden and caregivers' HRQOL were assessed using the Zarit Burden Interview and the 12-item Short-Form Health Survey (SF-12), respectively. Mediation analysis was used to examine the relationships between variables. Caregivers' mental component summary (MCS) and physical component summary (PCS) scores were regarded as outcome variables, caregivers' subjective burden was considered the mediator, and patients' and caregivers' characteristics were treated as predictors. RESULTS Caregivers' subjective burden was negatively related to both PCS and MCS of caregivers' HRQOL, after controlling for the effects of demographic and clinical variables. Moreover, significant associations, mostly indirect via caregivers' subjective burden, existed between caregivers' socio-demographic characteristics, duration of caregiving, patients' frailty status, patients' co-morbidity, and caregivers' HRQOL. CONCLUSION Caregivers' subjective burden plays a major and mediating role on influencing caregivers' HRQOL. Our findings may direct future research and promote the implementation of interventions to reduce caregivers' burden and improve caregivers' HRQOL.
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Affiliation(s)
- Ioannis Vrettos
- 2nd Department of Internal Medicine, General and Oncology Hospital of Kifissia "Agioi Anargyroi", Athens, Greece
| | - Fotios Anagnostopoulos
- Department of Psychology, Panteion University of Social and Political Sciences, Athens, Greece
| | - Panagiota Voukelatou
- 2nd Department of Internal Medicine, General and Oncology Hospital of Kifissia "Agioi Anargyroi", Athens, Greece
| | - Stefani Panayiotou
- 2nd Department of Internal Medicine, General and Oncology Hospital of Kifissia "Agioi Anargyroi", Athens, Greece
| | - Andreas Kyvetos
- 2nd Department of Internal Medicine, General and Oncology Hospital of Kifissia "Agioi Anargyroi", Athens, Greece
| | - Anastasios Nikas
- 2nd Department of Internal Medicine, General and Oncology Hospital of Kifissia "Agioi Anargyroi", Athens, Greece
| | - Dafni Kollia
- 2nd Department of Internal Medicine, General and Oncology Hospital of Kifissia "Agioi Anargyroi", Athens, Greece
| | - Dimitris Niakas
- Department of Health Economics, School of Health Sciences, National and Kapodistrian University of Athens, Athens, Greece
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Health care services and costs after hip fracture, comparing conventional versus standardised care: A retrospective study with 12-month follow-up. Injury 2021; 52:3434-3439. [PMID: 33551261 DOI: 10.1016/j.injury.2021.01.034] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Revised: 01/22/2021] [Accepted: 01/23/2021] [Indexed: 02/02/2023]
Abstract
AIMS To compare costs related to a standardised versus conventional hospital care for older patients after fragility hip fracture and determine whether a shift in hospital care led to cost-shifts between specialists and primary health care. METHODS We retrospectively collected and calculated volumes of care and accompanying costs from fracture time until 12 months after hospital discharge for 979 patients. All patients aged ≥ 65 years had fragility hip fractures. The data set had few missing data points because of the patient registry, administrative databases, and a low migration rate. RESULTS Total costs per patient at 12 months were EUR 78 164 (standard deviation [SD] 58 056) and EUR 78 068 (SD 60 131) for conventional and standardised care, respectively (p = 0.480). Total specialist care costs were significantly lower for the standardised care group (p < 0.001). Total primary care costs were higher for the standardised care group (p = 0.424). Total costs per day of life for the conventional and standardised care groups were EUR 434 and EUR 371, respectively (p = 0.003). Patients in the standardised care group had 17 more days of life. CONCLUSIONS Implementation of a standardised care to improve outcomes for patients with hip fracture caused lower specialist care costs and higher primary care costs, indicating care- and cost-shifts from specialist to primary health care.
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Kavandi H, Jaana M. Factors that affect health information technology adoption by seniors: A systematic review. HEALTH & SOCIAL CARE IN THE COMMUNITY 2020; 28:1827-1842. [PMID: 32378769 DOI: 10.1111/hsc.13011] [Citation(s) in RCA: 45] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Revised: 03/06/2020] [Accepted: 04/01/2020] [Indexed: 05/05/2023]
Abstract
The number of seniors and prevalence of chronic conditions are increasing worldwide, resulting in more pressure on health systems. Health Information Technologies (HIT) present opportunities to support the healthcare needs of seniors. Although prior studies have investigated HIT and seniors, it remains unclear what factors significantly affect the adoption of different HIT by elderly people in the community. A Systematic Review (SR) was conducted between December 2017 and February 2018 (with a search update in 2018-2019) to critically appraise and synthesise existing evidence on HIT adoption factors among seniors. Following the PRISMA guidelines, five major databases were consulted (PubMed, Medline, CINAHL, Scopus and Web of Science). The inclusion criteria consisted of empirical studies, published in English, and reporting impacts of specific factors on HIT adoption among seniors in the community. A total of 41 studies were included in this review, mostly published between 2014 and 2017 in Europe and the US; the level of evidence in these studies was low to moderate. The factors that affect HIT adoption did not differ across types of technologies or age groups. The findings reveal that seniors adopt HIT that are perceived as useful and requiring low effort commitment; price/cost value were reported as adoption barriers. Social influence, facilitating conditions, senior-friendly product design, self-efficacy, Intrinsic Technology Quality, experience/training and technology anxiety may affect HIT adoption by seniors, although the evidence on these impacts remains weak and limited. Mixed and inconclusive evidence was observed on the impacts of socio-demographic variables, health condition, habit and privacy/security. Given the reported low level of HIT adoption among seniors, we call for more rigorous research in this area using a 'senior-centred' approach, which takes into account the discourse/interaction between seniors and their collective environment to better understand the factors that affect their technology adoption and address their needs.
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Affiliation(s)
- Hamidreza Kavandi
- Electronic Business Technologies, Telfer School of Management, University of Ottawa, Ottawa, ON, Canada
| | - Mirou Jaana
- Health Systems Management, Telfer School of Management, Ottawa, ON, Canada
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Busquet-Duran X, Jiménez-Zafra EM, Manresa-Domínguez JM, Tura-Poma M, Bosch-delaRosa O, Moragas-Roca A, Galera Padilla MC, Martin Moreno S, Martínez-Losada E, Crespo-Ramírez S, López-Garcia AI, Torán-Monserrat P. Describing Complexity in Palliative Home Care Through HexCom: A Cross-Sectional, Multicenter Study. J Multidiscip Healthc 2020; 13:297-308. [PMID: 32256078 PMCID: PMC7090197 DOI: 10.2147/jmdh.s240835] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Accepted: 02/18/2020] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Complexity has become a core issue in caring for patients with advanced disease and/or at the end-of-life. The Hexagon of Complexity (HexCom) is a complexity assessment model in the process of validation in health-care settings. Our objective is to use the instrument to describe differences in complexity across disease groups in specific home care for advanced disease and/or at the end-of-life patients, both in general and as relates to each domain and subdomain. METHODS Cross-sectional study of home care was conducted in Catalonia. The instrument includes 6 domains of needs (clinical, psychological/emotional, social/family, spiritual, ethical, and death-related), 4 domains of resources (intrapersonal, interpersonal, transpersonal, and practical), and 3 levels of complexity (High (H), Moderate (M), and Low (L)). Interdisciplinary home care teams assessed and agreed on the level of complexity for each patient. RESULTS Forty-three teams participated (74.1% of those invited). A total of 832 patients were assessed, 61.4% of which were cancer patients. Moderate complexity was observed in 385 (47.0%) cases and high complexity in 347 (42.4%). The median complexity score was 51 for cancer patients and 23 for patients with dementia (p<0.001). We observed the highest level of complexity in the social/family domain. Patients/families most frequently used interpersonal resources (80.5%). CONCLUSIONS This study sheds light on the high-intensity work of support teams, the importance of the social/family domain and planning the place of death, substantial differences in needs and resources across disease groups, and the importance of relationship wellbeing at the end-of-life.
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Affiliation(s)
- Xavier Busquet-Duran
- Home Care Program, Support Team, PADES Granollers, Vallès Oriental Primary Health Care Services, Catalan Institute of Health, Barcelona, Spain
- Multidisciplinary Research Group on Health and Society (GREMSAS), Barcelona, Spain
- Department of Nursing, University Foundation of Bages (FUB), University of Vic. Central University of Catalunya, Barcelona, Spain
| | - Eva Maria Jiménez-Zafra
- Home Care Program, Support Team, PADES Granollers, Vallès Oriental Primary Health Care Services, Catalan Institute of Health, Barcelona, Spain
| | - Josep Maria Manresa-Domínguez
- Multidisciplinary Research Group on Health and Society (GREMSAS), Barcelona, Spain
- Metropolitan Nord Unit of Research Support, University Institute of Research in Primary Care (IDIAP) Jordi Gol, Barcelona, Spain
- Department of Nursing, Autonomous University of Barcelona, Barcelona, Spain
| | - Magda Tura-Poma
- Home Care Program, Support Team, PADES Granollers, Vallès Oriental Primary Health Care Services, Catalan Institute of Health, Barcelona, Spain
| | | | - Anna Moragas-Roca
- Home Care Program, Support Team, PADES Granollers, Vallès Oriental Primary Health Care Services, Catalan Institute of Health, Barcelona, Spain
| | - Maria Concepción Galera Padilla
- Home Care Program, Support Team, PADES Granollers, Vallès Oriental Primary Health Care Services, Catalan Institute of Health, Barcelona, Spain
| | - Susana Martin Moreno
- Home Care Program, Support Team, PADES Granollers, Vallès Oriental Primary Health Care Services, Catalan Institute of Health, Barcelona, Spain
| | - Emilio Martínez-Losada
- Home Care Program, Support Team, PADES Granollers, Vallès Oriental Primary Health Care Services, Catalan Institute of Health, Barcelona, Spain
| | | | - Ana Isabel López-Garcia
- Home Care Program, Support Team, PADES Granollers, Vallès Oriental Primary Health Care Services, Catalan Institute of Health, Barcelona, Spain
| | - Pere Torán-Monserrat
- Multidisciplinary Research Group on Health and Society (GREMSAS), Barcelona, Spain
- Metropolitan Nord Unit of Research Support, University Institute of Research in Primary Care (IDIAP) Jordi Gol, Barcelona, Spain
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Jakobsen FA, Vik K, Ytterhus B. The art of maintaining everyday life: collaboration among older parents, their adult children, and health care professionals in reablement. J Multidiscip Healthc 2019; 12:269-280. [PMID: 31118653 PMCID: PMC6499486 DOI: 10.2147/jmdh.s195833] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2018] [Accepted: 02/18/2019] [Indexed: 01/13/2023] Open
Abstract
Background: A shift in the work-divide among generations and an ageing population have altered the balance of care and support between families and welfare states. Although state policy has increasingly acknowledged that older adults ageing in place receive support from family members, how adult children perceive their collaboration with their parents and health care professionals in reablement services remains unclear. The aim of this study is to identify how adult children perceive the collaboration between older parents, family members, and health care professionals in reablement services. Methods: This study has a qualitative research design with a constructivist grounded theory approach. In total, 15 adult children – 6 sons, 8 daughters, and a daughter-in-law, aged 47–64 years – whose parents had received reablement services, participated in in-depth interviews. Results: Our findings clarify how children and their older parents’ reablement services can collaborate to support how the adult children manage and maintain both their own and their parents’ everyday lives. The core category derived from our data analysis was the art of maintaining everyday life, with four subcategories indicating the different dimensions of that process: doing what is best for one’s parents, negotiating the dilemmas of everyday life, managing parents’ reablement, and ensuring the flow of everyday life. Conclusion: To promote collaboration among older adults, their children, and health care professionals in reablement, health care professionals need to proactively involve older adults’ family members in the reablement processes, particularly because older adults and their children do not always express all of their care-related needs to reablement services.
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Affiliation(s)
- Fanny Alexandra Jakobsen
- Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Kjersti Vik
- Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Borgunn Ytterhus
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
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