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Sánchez-Valdeón L, Bello-Corral L, Mayo-Iscar A, Fernández-Lázaro D, Seco-Calvo J. Impact of discontinuing non-pharmacological interventions on cognitive impairment in dementia patients by COVID-19 lockdown. A pilot observational, longitudinal, retrospective study carried out in an adult day center in Spain during the COVID-19 pandemic. Front Med (Lausanne) 2023; 10:1204151. [PMID: 37575999 PMCID: PMC10416240 DOI: 10.3389/fmed.2023.1204151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Accepted: 07/17/2023] [Indexed: 08/15/2023] Open
Abstract
Background The lockdown imposed during the COVID-19 pandemic led to social isolation and prevented patients with dementia from receiving a suite of non-pharmacological interventions (NPIs) that prevent cognitive decline. This discontinuation of NPIs could substantially affect the mental health status of people with dementia in social care settings, such as adult day care centers (ADCs). Propose The study aimed to evaluate the effects of the COVID-19 lockdown on mental health and cognitive impairment in patients with dementia who could not attend their usual ADCs and did not receive our NPIs, based on World Health Organization (WHO) Guidelines. Methods Observational, longitudinal, retrospective study carried out in an adult day center in Spain and reported it in accordance with the Strengthening Reporting of Observational Studies in Epidemiology (STROBE) statement. Cognitive status was assessed using the Mini-Mental State Examination (MMSE) in 80 patients attending the ADC of the "Leonese Association of Dementia Patients" (León, Spain), who had been evaluated with this instrument before the COVID-19 lockdown. Results We observed a 0.4-point decrease in MMSE score/month (IQR = 1.4) during lockdown versus a 0.1-point decrease/month (IQR = 0.3) before this period (p = 0.038). Notably, this translated to >10-point decreases in MMSE score/year in 33.8% of participants during lockdown versus 5.5% earlier (p < 0.001). No statistically significant associations (p < 0.05) were found between the individual characteristics of the caregivers and the occurrence of the event. Conclusion The reported declines in MMSE scores reveal a significant acceleration of cognitive decline during the period of inactivity. This could suggest that our NPIs, focused on slowing cognitive decline, are beneficial and, therefore, necessary in patients with dementia.
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Affiliation(s)
| | - Laura Bello-Corral
- Department of Nursing and Physical Therapy, University of León, León, Spain
| | - Agustín Mayo-Iscar
- Department of Statistics and Operations Research and IMUVA, University of Valladolid, Valladolid, Spain
| | - Diego Fernández-Lázaro
- Department of Cellular Biology, Genetics, Histology and Pharmacology, Faculty of Health Sciences, University of Valladolid, Campus of Soria, Soria, Spain
- Neurobiology Research Group, Faculty of Medicine, University of Valladolid, Valladolid, Spain
| | - Jesús Seco-Calvo
- Institute of Biomedicine (IBIOMED), Universidad de León, León, Spain
- Department of Physiology, University of the Basque Country, Leioa, Spain
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Kirvalidze M, Abbadi A, Dahlberg L, Sacco LB, Morin L, Calderón-Larrañaga A. Effectiveness of interventions designed to mitigate the negative health outcomes of informal caregiving to older adults: an umbrella review of systematic reviews and meta-analyses. BMJ Open 2023; 13:e068646. [PMID: 37085312 PMCID: PMC10124259 DOI: 10.1136/bmjopen-2022-068646] [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: 04/23/2023] Open
Abstract
OBJECTIVES This umbrella review aimed to evaluate whether certain interventions can mitigate the negative health consequences of caregiving, which interventions are more effective than others depending on the circumstances, and how these interventions are experienced by caregivers themselves. DESIGN An umbrella review of systematic reviews was conducted. DATA SOURCES Quantitative (with or without meta-analyses), qualitative and mixed-methods systematic reviews were included. ELIGIBILITY CRITERIA Reviews were considered eligible if they met the following criteria: included primary studies targeting informal (ie, unpaid) caregivers of older people or persons presenting with ageing-related diseases; focused on support interventions and assessed their effectiveness (quantitative reviews) or their implementation and/or lived experience of the target population (qualitative reviews); included physical or mental health-related outcomes of informal caregivers. DATA EXTRACTION AND SYNTHESIS A total of 47 reviews were included, covering 619 distinct primary studies. Each potentially eligible review underwent critical appraisal and citation overlap assessment. Data were extracted independently by two reviewers and cross-checked. Quantitative review results were synthesised narratively and presented in tabular format, while qualitative findings were compiled using the mega-aggregation framework synthesis method. RESULTS The evidence regarding the effectiveness of interventions on physical and mental health outcomes was inconclusive. Quantitative reviews were highly discordant, whereas qualitative reviews only reported practical, emotional and relational benefits. Multicomponent and person-centred interventions seemed to yield highest effectiveness and acceptability. Heterogeneity among caregivers, care receivers and care contexts was often overlooked. Important issues related to the low quality of evidence and futile overproduction of similar reviews were identified. CONCLUSIONS Lack of robust evidence calls for better intervention research and evaluation practices. It may be warranted to avoid one-size-fits-all approaches to intervention design. Primary care and other existing resources should be leveraged to support interventions, possibly with increasing contributions from the non-profit sector. PROSPERO REGISTRATION NUMBER CRD42021252841; BMJ Open: doi:10.1136/bmjopen-2021-053117.
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Affiliation(s)
- Mariam Kirvalidze
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Solna, Sweden
| | - Ahmad Abbadi
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Solna, Sweden
| | - Lena Dahlberg
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Solna, Sweden
- School of Health and Welfare, Dalarna University, Falun, Sweden
| | - Lawrence B Sacco
- Stress Research Institute, Department of Psychology, Stockholm University, Stockholm, Sweden
| | - Lucas Morin
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Solna, Sweden
- Inserm CIC 1431, University Hospital of Besançon, Besançon, France
| | - Amaia Calderón-Larrañaga
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Solna, Sweden
- Stockholm Gerontology Research Center, Stockholm, Sweden
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Strandenaes MG, Lund A, Engedal K, Kirkevold Ø, Selbaek G, Benth JŠ, Rokstad AMM. Self-reported quality of life in people with dementia attending a day-care programme in Norway: A 24-month quasi-experimental study. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:1315-1324. [PMID: 34032347 DOI: 10.1111/hsc.13455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 04/14/2021] [Accepted: 05/04/2021] [Indexed: 06/12/2023]
Abstract
The objectives of the study were (a) to compare self-reported Quality of Life (QoL) in a 24-month follow-up of people with dementia attending day care designed for people with dementia (day-care group, DC) with people with dementia who did not attend day care (control group, CG) and (b) to explore factors associated with QoL. A quasi-experimental design with a 24-month follow-up period was used. The DC group included 181 participants recruited from 53 day-care services. The CG included 76 participants recruited from 19 municipalities with no available day care designed for people with dementia. The sample covered the four health regions of Norway and inclusion period lasted from December 2013 to July 2015. The Quality of Life in Alzheimer's Disease (QoL-AD) scale was used as the outcome measure. The differences in QoL between groups and the associations between participant characteristics and QoL, such as depressive symptoms and functional dependency, were examined using a linear mixed model. In the multiple model, the overall trend in QoL did not differ significantly between the DC and CG. However, the DC group exhibited significantly higher self-reported QoL than the CG at all time points (p < 0.001 at T0, p = 0.018 at T12, and p = 0.006 at T24). Participants with shallow or no awareness who attended day care had significantly higher scores on QoL-AD than persons with full awareness (p = 0.017). More depressive symptoms (p < 0.001) and higher functional dependency (p < 0.001) were associated with lower self-reported QoL. The study revealed higher scores of self-reported QoL among people attending day care compared with those who did not attend, showing that day care might have positive impact on the lives of people with dementia.
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Affiliation(s)
- Margit Gausdal Strandenaes
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
- Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway
- Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway
| | - Anne Lund
- Faculty of Health Sciences, Department of Occupational Therapy, Prosthetics and Orthotics, OsloMet - Oslo Metropolitan University, Oslo, Norway
| | - Knut Engedal
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
- Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway
| | - Øyvind Kirkevold
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
- Department of Health Sciences, Norwegian University of Science and Technology (NTNU), Gjøvik, Norway
- Research Centre for Age Related Functional decline and Disease, Innlandet Hospital Trust, Ottestad, Norway
| | - Geir Selbaek
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
- Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Jūratė Šaltytė Benth
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Health Services Research Unit, Research Centre, Akershus University Hospital, Lørenskog, Norway
| | - Anne Marie Mork Rokstad
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
- Faculty of Health Sciences and Social Care, Molde University College, Molde, Norway
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Hamilton M, Crawford T, Thomson C, Jeon YH, Bassett K. New directions in centre-based aged care in Australia: Responding to changing funding models and the COVID-19 pandemic. Australas J Ageing 2022; 41:457-465. [PMID: 35607866 PMCID: PMC9348156 DOI: 10.1111/ajag.13081] [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: 09/08/2021] [Revised: 03/06/2022] [Accepted: 04/03/2022] [Indexed: 11/28/2022]
Abstract
Objectives Centre‐based aged care services are a key site of early intervention and support for people with dementia and their carers. This paper examines the impact of new aged care funding structures on centre‐based aged care service accessibility and delivery. It also examines the challenges and opportunities for change facing the sector in the light of the COVID‐19 pandemic. Methods Semi‐structured interviews were conducted online with 29 managers or supervisors of centre‐based aged care services in Greater Sydney. Results The analysis reinforced the essential role of centre‐based aged care services in improving the cognitive, physical and psychological health of older people with dementia and their carers. However, the changing funding context and the COVID‐19 pandemic have created challenges in access to centre‐based services, particularly for the most vulnerable. The challenges created by the COVID‐19 pandemic also opened opportunities for the introduction of new models of service practice to meet the individual needs of older people and their carers. Conclusions Greater investment in, and flexibility in the funding for, centre‐based aged care services is needed to facilitate access for people with dementia and their carers and improve their health and well‐being.
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Affiliation(s)
- Myra Hamilton
- Centre of Excellence on Population Ageing Research, University of Sydney, Sydney, New South Wales, Australia
| | - Tonia Crawford
- Sydney Nursing School, University of Sydney, Sydney, New South Wales, Australia
| | - Cathy Thomson
- Social Policy Research Centre, University of New South Wales, Sydney, New South Wales, Australia
| | - Yun-Hee Jeon
- Sydney Nursing School, University of Sydney, Sydney, New South Wales, Australia
| | - Kimberley Bassett
- Sydney Nursing School, University of Sydney, Sydney, New South Wales, Australia
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5
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Michelet M, Selbaek G, Strand BH, Lund A, Engedal K, Bieber A, Gonçalves-Pereira M, Hopper L, Irving K, Jelley H, Marques MJ, Orrell M, Portolani DM, Sjölund BM, Sköldunger A, Stephan A, Verhey F, de Vugt M, Wolfs C, Woods B, Zanetti O, Bergh S. Associations between unmet needs for daytime activities and company and scores on the Neuropsychiatric Inventory-Questionnaire in people with dementia: a longitudinal study. Aging Ment Health 2022; 26:725-734. [PMID: 33860718 DOI: 10.1080/13607863.2021.1910792] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVES To examine prospectively the association between unmet needs for daytime activities and company and behavioural and psychological symptoms of dementia. METHODS We included 451 people with mild or moderate dementia, from eight European countries, who were assessed three times over 12 months. Unmet needs were measured with the Camberwell Assessment of Need for the Elderly. Three sub-syndromes of the Neuropsychiatric Inventory-Questionnaire were regressed, one-by-one, against unmet needs for daytime activities and company, adjusting for demographic and clinical-functional covariates. RESULTS Unmet needs for daytime activities were associated with more affective symptoms at baseline, six and twelve months, mean 0.74 (p < 0.001), 0.76 (p < 0.001) and 0.78 (p = 0.001) points higher score respectively, and with more psychotic symptoms at baseline (mean 0.39 points, p = 0.007) and at six months follow-up (mean 0.31 points, p = 0.006). Unmet needs for company were associated with more affective symptoms at baseline, six and twelve months, mean 0.44 (p = 0.033), 0.67 (p < 0.001) and 0.91 (p < 0.001) points higher score respectively, and with more psychotic symptoms at baseline (mean 0.40 points, p = 0.005) and at six months (mean 0.35 points, p = 0.002) follow-up. CONCLUSION Interventions to reduce unmet needs for daytime activities and company could reduce affective and psychotic symptoms in people with dementia.
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Affiliation(s)
- Mona Michelet
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway.,Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway.,Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Geir Selbaek
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway.,Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway.,Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Bjørn Heine Strand
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway.,Department of Chronic Diseases and Ageing, Norwegian Institute of Public Health, Oslo, Norway
| | - Anne Lund
- Faculty of Health Sciences, Department of Occupational Therapy, Prosthetics and Orthotics, OsloMet - Oslo Metropolitan University, Oslo, Norway
| | - Knut Engedal
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway.,Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway
| | - Anja Bieber
- Medical Faculty, Institute of Health and Nursing Sciences, Martin Luther University Halle-Wittenberg, Halle, Germany
| | - Manuel Gonçalves-Pereira
- Comprehensive Health Research Centre (CHRC), CEDOC, Nova Medical School/Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisbon, Portugal
| | - Louise Hopper
- School of Psychology, Dublin City University, Dublin, Ireland
| | - Kate Irving
- School of Nursing, Psychotherapy and Community Health, Dublin City University, Dublin, Ireland
| | - Hannah Jelley
- Dementia Services Development Centre, Bangor University, Bangor, UK
| | - Maria J Marques
- Comprehensive Health Research Centre (CHRC), CEDOC, Nova Medical School/Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisbon, Portugal
| | - Martin Orrell
- Institute of Mental Health, Nottingham University, Nottingham, UK
| | - Daniel M Portolani
- IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Britt-Marie Sjölund
- Aging Research Center (ARC), Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet and Stockholm University, Stockholm, Sweden.,Faculty of Health and Occupational Studies, Department Caring Sciences, University of Gävle, Gävle, Sweden
| | - Anders Sköldunger
- Division of Neurogeriatrics, Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet, Stockholm, Sweden
| | - Astrid Stephan
- Medical Faculty, Institute of Health and Nursing Sciences, Martin Luther University Halle-Wittenberg, Halle, Germany
| | - Frans Verhey
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Alzheimer Center Limburg, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Marjolein de Vugt
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Alzheimer Center Limburg, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Claire Wolfs
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Alzheimer Center Limburg, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Bob Woods
- Dementia Services Development Centre, Bangor University, Bangor, UK
| | - Orazio Zanetti
- IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Sverre Bergh
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway.,Research Centre for Age-Related Functional Decline and Disease, Innlandet Hospital Trust, Ottestad, Norway
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Taranrød LB, Pedersen I, Kirkevold Ø, Eriksen S. Being sheltered from a demanding everyday life: experiences of the next of kin to people with dementia attending farm-based daycare. Int J Qual Stud Health Well-being 2021; 16:1959497. [PMID: 34338623 PMCID: PMC8330702 DOI: 10.1080/17482631.2021.1959497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/20/2021] [Indexed: 11/21/2022] Open
Abstract
PURPOSE Farm-based daycare (FDC) is a type of daycare service for people with dementia. The aim of the present study was to explore the next of kin's experiences with FDC and how the service may affect their daily life. METHODS The study has a qualitative, descriptive design. Eight semi-structured interviews with next of kin were conducted. The data were analysed in accordance with content analysis. RESULTS We identified three main categories: (1) I am fine when you are fine, (2) Significant aspects of the service at the farm, and (3) FDC as a part of the dementia trajectory. The findings were summarized in one overarching, latent theme: "Being sheltered from a demanding everyday life". CONCLUSIONS The findings indicate that next of kin's experience of respite is closely connected to the well-being of their relatives at the FDC and the quality of the service. FDC provides significant support through a part of the trajectory of dementia. Despite experiencing respite and support, next of kin continue to struggle with ethical and moral decisions about the futures of their relatives with dementia.
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Affiliation(s)
- Liv Bjerknes Taranrød
- Vestfold Hospital Trust, Norwegian National Advisory Unit on Ageing and Health, Tønsberg, Norway
- Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Ingeborg Pedersen
- Department of Public Health Science, Norwegian University of Life Sciences, Ås, Ås, Norway
| | - Øyvind Kirkevold
- Vestfold Hospital Trust, Norwegian National Advisory Unit on Ageing and Health, Tønsberg, Norway
- Innlandet Hospital Trust, Centre for Age Related Functional Decline and Diseases (AFS), Hamar, Norway
- Department of Health Sciences, Norwegian University of Science and Technology (NTNU), Gjøvik, Norway
| | - Siren Eriksen
- Vestfold Hospital Trust, Norwegian National Advisory Unit on Ageing and Health, Tønsberg, Norway
- Department of Bachelor in Nursing, Lovisenberg Diaconal University College, Oslo, Norway
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Esquer Rochin MA, Gutierrez-Garcia JO, Rosales JH, Rodriguez LF. Design and evaluation of a dashboard to support the comprehension of the progression of patients with dementia in day centers. Int J Med Inform 2021; 156:104617. [PMID: 34710725 DOI: 10.1016/j.ijmedinf.2021.104617] [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: 06/16/2021] [Revised: 09/17/2021] [Accepted: 10/09/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND AND OBJECTIVE In day centers, people with dementia are assigned to specific groups to receive care according to the progression of the disease. This article presents the design and evaluation of a dashboard aimed at facilitating the comprehension of the progression of people with dementia to support decision-making of healthcare professionals (HCPs) when determining patient-group assignment. MATERIALS AND METHOD A participatory design methodology was followed to build the dashboard. The grounded theory methodology was utilized to identify requirements. A total of 8 HCPs participated in the design and evaluation of a low-fidelity prototype. The perceived usefulness and perceived ease of use of the high-fidelity prototype was evaluated by 15 HCPs (from several day centers) and 38 psychology students utilizing a questionnaire based on the technology acceptance model. RESULTS HCPs perceived the dashboard as extremely likely to be useful (Mdn=6.5 out of 7) and quite likely to be usable (Mdn=6 out of 7). Psychology students perceived the dashboard as quite likely to be useful and usable (both with Mdn=6). CONCLUSIONS Making use of a participatory design helped foster in HCPs a sense of ownership of the dashboard, thus facilitating its acceptance. The creation of low-fidelity and high-fidelity prototypes led to identifying valuable, timely, and specific feedback at different stages of the development process as well as to establishing a set of lessons learned for the development of dashboards in the healthcare domain.
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8
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Resiak D, Mpofu E, Rothwell R. Organic Collaborative Research Partnership Building: Researchers, Needle and Syringe Program Providers, and People Who Inject Drugs. Healthcare (Basel) 2021; 9:healthcare9111417. [PMID: 34828463 PMCID: PMC8620050 DOI: 10.3390/healthcare9111417] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 10/01/2021] [Accepted: 10/18/2021] [Indexed: 11/18/2022] Open
Abstract
(1) Background: People who inject drugs (PWID) and needle and syringe program (NSP) providers increasingly partner with researchers to explore harm reduction best practice. However, a paucity of research exists regarding how best to engage PWID and community NSP providers to generate the evidence for sustainable harm reduction services. (2) Aim: This study reports on our use of an organic community research partnership-building approach between researchers, NSP providers, and PWID in Canberra ACT, Australia. (3) Method: Survey participants included both PWID (n = 70) and NSP providers (n = 26) across primary (n = 2), secondary (n = 7), and outreach (n = 1) services in Canberra ACT. Applying an organic partnership-building strategy, we engaged with partners and adapted approaches according to information gained in the process of implementation. (4) Results: We found engaging in relationship building around partner priority activities created mutual understanding and trust premised in authenticity of the evolving partnership. Our organic approach, which included a partner audit of the research tools for relevance, resulted in high acceptance and enrolment into the research by NSP providers and PWID. Finally, we observed strong social capital building utilizing an organic approach for the sustainability of the partnership. (5) Conclusions: The results of this study provide evidence for the benefits of organic collaborative research partnership building with NSP providers and PWID for authentic service program implementation. Our approach to research partnership building resulted in strong relationships built on shared goals and objectives, mutual gains, and complementary expertise. We propose the wider use of organic approaches to developing collaborative research partnerships with NSP providers and PWID to enhance consumer responsiveness towards service provision.
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Affiliation(s)
- Danielle Resiak
- School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia;
- Correspondence: (D.R.); (E.M.)
| | - Elias Mpofu
- School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia;
- Rehabilitation and Health Services Department, University of North Texas, Denton, TX 76203, USA
- School of Human and Community Development, The University of the Witwatersrand, Johannesburg 2000, South Africa
- Family and Community Medicine, Meharry Medical College, Nashville, TN 37208, USA
- Correspondence: (D.R.); (E.M.)
| | - Roderick Rothwell
- School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia;
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Siette J, Jorgensen M, Nguyen A, Knaggs G, Miller S, Westbrook JI. A mixed-methods study evaluating the impact of an excursion-based social group on quality of life of older adults. BMC Geriatr 2021; 21:356. [PMID: 34112098 PMCID: PMC8194178 DOI: 10.1186/s12877-021-02295-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Accepted: 05/24/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Social isolation is an increasing concern for older adults who live in the community. Despite some availability of social support programs to address social isolation, their effectiveness is not routinely measured. This study aimed to evaluate an innovative excursion-based program offering unique social experiences to older adults receiving aged care services. METHODS This six-month before and after mixed-methods study evaluated the outcomes of an Australian excursion-based program which offered social and physical outings to bring older adults receiving aged care services into the wider community. The study combined two parts: Part 1 was a pre-post survey assessing the quality of life of older adults who received the excursion-based program for 6 months (n = 56; two time-points, analysed using signed rank test) and Part 2 involved qualitative in-depth, semi-structured interviews (n = 24 aged care staff, older adults and carers; analysed using thematic analysis). RESULTS Older adults experienced a significant increase in quality of life scores (p < 0.001) between baseline and 6 months. Interviews confirmed these observations and suggested that benefits of participation included increased opportunities for social participation, psychological wellbeing, physical function, and carer respite. Interviews also revealed being in a group setting, having tailored, convenient and accessible activities, alongside supportive staff were key drivers in improving the wellbeing of participants. CONCLUSIONS Participating in an excursion-based community program may improve wellbeing in older adults. Aging policy should focus on prioritizing initiatives that promote social connectivity with the wider community and assist in improving outcomes for older adults.
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Affiliation(s)
- Joyce Siette
- Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, Macquarie, New South Wales, 2109, Australia.
| | - Mikaela Jorgensen
- Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, Macquarie, New South Wales, 2109, Australia
| | - Amy Nguyen
- Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, Macquarie, New South Wales, 2109, Australia.,St Vincent's Clinical School, University of New South Wales, Sydney, Australia
| | - Gilbert Knaggs
- Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, Macquarie, New South Wales, 2109, Australia
| | | | - Johanna I Westbrook
- Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, Macquarie, New South Wales, 2109, Australia
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10
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Duan-Porter W, Ullman K, Rosebush C, McKenzie L, Ensrud KE, Ratner E, Greer N, Shippee T, Gaugler JE, Wilt TJ. Interventions to Prevent or Delay Long-Term Nursing Home Placement for Adults with Impairments-a Systematic Review of Reviews. J Gen Intern Med 2020; 35:2118-2129. [PMID: 31898134 PMCID: PMC7352002 DOI: 10.1007/s11606-019-05568-5] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Revised: 11/05/2019] [Accepted: 11/20/2019] [Indexed: 12/14/2022]
Abstract
BACKGROUND With continued growth in the older adult population, US federal and state costs for long-term care services are projected to increase. Recent policy changes have shifted funding to home and community-based services (HCBS), but it remains unclear whether HCBS can prevent or delay long-term nursing home placement (NHP). METHODS We searched MEDLINE (OVID), Sociological Abstracts, PsycINFO, CINAHL, and Embase (from inception through September 2018); and Cochrane Database of Systematic Reviews, Joanna Briggs Institute Database, AHRQ Evidence-based Practice Center, and VA Evidence Synthesis Program reports (from inception through November 2018) for English-language systematic reviews. We also sought expert referrals. Eligible reviews addressed HCBS for community-dwelling adults with, or at risk of developing, physical and/or cognitive impairments. Two individuals rated quality (using modified AMSTAR 2) and abstracted review characteristics, including definition of NHP and interventions. From a prioritized subset of the highest-quality and most recent reviews, we abstracted intervention effects and strength of evidence (as reported by review authors). RESULTS Of 47 eligible reviews, most focused on caregiver support (n = 10), respite care and adult day programs (n = 9), case management (n = 8), and preventive home visits (n = 6). Among 20 prioritized reviews, 12 exclusively included randomized controlled trials, while the rest also included observational studies. Prioritized reviews found no overall benefit or inconsistent effects for caregiver support (n = 2), respite care and adult day programs (n = 3), case management (n = 4), and preventive home visits (n = 2). For caregiver support, case management, and preventive home visits, some reviews highlighted that a few studies of higher-intensity models reduced NHP. Reviews on other interventions (n = 9) generally found a lack of evidence examining NHP. DISCUSSION Evidence indicated no benefit or inconsistent effects of HCBS in preventing or delaying NHP. Demonstration of substantial impacts on NHP may require longer-term studies of higher-intensity interventions that can be adapted for a variety of settings. Registration PROSPERO # CRD42018116198.
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Affiliation(s)
- Wei Duan-Porter
- Center for Care Delivery and Outcomes Research, VAHSRD Minneapolis VA Health Care System, Minneapolis, MN, USA.
- University of Minnesota Medical School, Minneapolis, MN, USA.
| | - Kristen Ullman
- Center for Care Delivery and Outcomes Research, VAHSRD Minneapolis VA Health Care System, Minneapolis, MN, USA
| | - Christina Rosebush
- Center for Care Delivery and Outcomes Research, VAHSRD Minneapolis VA Health Care System, Minneapolis, MN, USA
- School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - Lauren McKenzie
- Center for Care Delivery and Outcomes Research, VAHSRD Minneapolis VA Health Care System, Minneapolis, MN, USA
| | - Kristine E Ensrud
- Center for Care Delivery and Outcomes Research, VAHSRD Minneapolis VA Health Care System, Minneapolis, MN, USA
- University of Minnesota Medical School, Minneapolis, MN, USA
- School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - Edward Ratner
- University of Minnesota Medical School, Minneapolis, MN, USA
- Geriatric Research Education & Clinical Center, Minneapolis VA Health Care System, Minneapolis, MN, USA
| | - Nancy Greer
- Center for Care Delivery and Outcomes Research, VAHSRD Minneapolis VA Health Care System, Minneapolis, MN, USA
| | - Tetyana Shippee
- School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - Joseph E Gaugler
- School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - Timothy J Wilt
- Center for Care Delivery and Outcomes Research, VAHSRD Minneapolis VA Health Care System, Minneapolis, MN, USA
- University of Minnesota Medical School, Minneapolis, MN, USA
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11
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Rokstad AMM, Engedal K, Kirkevold Ø, Benth JŠ, Selbæk G. The impact of attending day care designed for home-dwelling people with dementia on nursing home admission: a 24-month controlled study. BMC Health Serv Res 2018; 18:864. [PMID: 30445937 PMCID: PMC6240251 DOI: 10.1186/s12913-018-3686-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Accepted: 11/05/2018] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Day care services offer meaningful activities, a safe environment for attendees and respite for family caregivers while being expected to delay the need for nursing home (NH) admission. However, previous research has shown inconsistent results regarding postponement of NH admission. The objective of the study was to explore the influence of a day care programme designed for home-dwelling people with dementia on NH admission. METHOD A quasi-experimental trial explored the proportion of patients permanently admitted to nursing homes after 24 months as the main outcome by comparing a group of day care attendees (DG) and a group of participants without day care (CG). In all, 257 participants were included (181 in DG and 76 in CG). A logistic regression model was developed with NH admission as the outcome. Participant group (DG or CG) was the main predictor, baseline patient and family caregiver characteristics and interactions were used as covariates. RESULTS The mean age of participants was 81.5 (SD 6.4), 65% were women and 53% lived alone. The mean MMSE score was 20.4 (SD 3.5). In all, 128 (50%) of the participants were admitted to a nursing home by the 24-month follow-up, 63 participants (25%) completed the follow-up assessment and 66 (26%) dropped out due to death (8%) and other reasons (18%). In the logistic unadjusted regression model for NH admission after 24 months, participant group (DG or CG) was not found to be a significant predictor of NH admission. The results from the adjusted model revealed that the participant group was associated with NH admission through the interactions with age, living conditions, affective symptoms, sleep symptoms and practical functioning, showing a higher probability for NH admission in DG compared to CG. CONCLUSION The study reveals no evidence to confirm that day care services designed for people with dementia postpone the need for NH admission. Admission to nursing homes seems to be based on a complex mix of personal and functional characteristics both in the person with dementia and the family caregivers. The findings should be considered in accordance with the limitation of inadequate power and the high drop-out rate. TRIAL REGISTRATION The study is registered in Clinical Trials ( NCT01943071 ).
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Affiliation(s)
- Anne Marie Mork Rokstad
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Postbox 2136, 3103 Tønsberg, Norway
- Faculty of Health Sciences and Social care, Molde University College, Molde, Norway
| | - Knut Engedal
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Postbox 2136, 3103 Tønsberg, Norway
| | - Øyvind Kirkevold
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Postbox 2136, 3103 Tønsberg, Norway
- Department of Care and Nursing, Faculty of Health, Norwegian University of Science and Technology (NTNU), Gjøvik, Norway
- The Research Centre for Age-Related Functional Decline and Disease, Innlandet Hospital Trust, Ottestad, Norway
| | - Jūratė Šaltytė Benth
- Institute of Clinical Medicine, Campus Ahus, University of Oslo, Oslo, Norway
- Health Services Research Unit, Research Centre, Akershus University Hospital, Postbox 1000, Lørenskog, 1478 Oslo, Norway
| | - Geir Selbæk
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Postbox 2136, 3103 Tønsberg, Norway
- The Research Centre for Age-Related Functional Decline and Disease, Innlandet Hospital Trust, Ottestad, Norway
- Department of Nursing Science, Faculty of Medicine, University of Oslo, Oslo, Norway
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