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Boucaud-Maitre D, Villeneuve R, Rambhojan C, Simo-Tabué N, Thibault N, Rinaldo L, Dartigues JF, Dramé M, Amieva H, Tabué-Teguo M. Clinical Characteristics of Older Adults Living in Foster Families in the French West Indies: Baseline Screening of the KArukera Study of Aging in Foster Families (KASAF) Cohort. Innov Aging 2024; 8:igae063. [PMID: 39087204 PMCID: PMC11290254 DOI: 10.1093/geroni/igae063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Indexed: 08/02/2024] Open
Abstract
Background and Objectives Foster families for older adults could represent a transitional or alternative model to nursing homes. The aim of this study was to describe the clinical characteristics of older adults in foster families and to compare them with those of residents in nursing homes in French West Indies. Research Design and Methods This study is a cross-sectional analysis of the KArukera Study of Aging in Foster Families (KASAF) cohort. Sociodemographic and clinical characteristics were extracted. Dependency was assessed using the Activities of Daily Living (ADL) scale and cognition using the Mini-Mental State Examination (MMSE) scale. Age, gender, ADL, and MMSE scores were compared with nursing home residents from a twin study of KASAF (n = 332). Results A total of 107 older adults (mean age 81.8 years; 61.7% women) were recruited in 56 foster families between September 2020 and May 2021. In all, 25.5% had diabetes mellitus and 45.8% suffered from hypertension. The mean MMSE score was 9.3 ± 10.1 and 76.0% had major cognitive impairment (MMSE score <18); 12.5% were diagnosed with Parkinson's disease, and 42.0% of the residents were confined to bed or in a wheelchair, with a mean ADL score of 1.5 ± 1.8. Almost all the residents (96.3%) benefited from a medical follow-up by a nurse who visited once or twice a day. Compared to older adults living in nursing homes, those in foster families were more frequently women (61.7% vs 49.4%) and had lower ADL score (1.5 vs 2.4) and lower MMSE score (9.3 vs 11.3). Discussion and Implications The clinical profile of foster families' residents was quite similar to that of nursing home residents in terms of demographics, dementia, and dependency. Foster families might represent an interesting strategy to address the unmet clinical and social needs of dependent older adults, especially in countries where nursing homes are not sufficiently developed. Clinical Trials Registration Number NCT04545775.
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Affiliation(s)
- Denis Boucaud-Maitre
- DRCI, Centre Hospitalier Le Vinatier, Bron, France
- Equipe EPICLIV, Université des Antilles, Fort-de-France, Martinique, France
| | - Roxane Villeneuve
- Inserm U1219 Bordeaux Population Health Center, University of Bordeaux, Bordeaux, France
| | - Christine Rambhojan
- DRCI, Centre Hospitalo-Universitaire de Guadeloupe, Pointe-à-Pitre, Guadeloupe, France
| | - Nadine Simo-Tabué
- Service de Gériatrie, Centre Hospitalo-Universitaire de Martinique, Fort-de-France, Martinique, France
| | - Nathalie Thibault
- DRCI, Centre Hospitalo-Universitaire de Guadeloupe, Pointe-à-Pitre, Guadeloupe, France
| | - Leila Rinaldo
- DRCI, Centre Hospitalo-Universitaire de Guadeloupe, Pointe-à-Pitre, Guadeloupe, France
| | | | - Moustapha Dramé
- Service de Gériatrie, Centre Hospitalo-Universitaire de Martinique, Fort-de-France, Martinique, France
| | - Hélène Amieva
- Inserm U1219 Bordeaux Population Health Center, University of Bordeaux, Bordeaux, France
| | - Maturin Tabué-Teguo
- Equipe EPICLIV, Université des Antilles, Fort-de-France, Martinique, France
- Service de Gériatrie, Centre Hospitalo-Universitaire de Martinique, Fort-de-France, Martinique, France
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Wachholz PA, Morsch P, Villalobos Dintrans P, Barrientos-Calvo I, Browne J, Bello-Chavolla OY, Vega E. Institutional care in four Latin American countries: the importance of fostering public information and evaluation strategies. Rev Panam Salud Publica 2024; 48:e14. [PMID: 38464879 PMCID: PMC10921907 DOI: 10.26633/rpsp.2024.14] [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: 07/02/2023] [Accepted: 12/15/2023] [Indexed: 03/12/2024] Open
Abstract
More than 8 million older people in Latin America depend on long-term care (LTC), accounting for 12% of people aged ≥ 60 years and almost 27% of those aged ≥ 80. It is crucial to develop sustainable strategies for providing LTC in the area, including institutional care. This special report aims to characterize institutional LTC in four countries (Brazil, Chile, Costa Rica and Mexico), using available information systems, and to identify the strategies adopted to support institutional care in these countries. This narrative review used nationwide, open-access, public data sources to gather demographic estimates and information about institutional LTC coverage and the availability of open-access data for the proportion of people with LTC needs, the number of LTC facilities and the number of residents living in them. These countries have a larger share of older people than the average in Latin America but fewer LTC facilities than required by the demand. National surveys lack standardization in defining disability, LTC and dependency on care. Information about institutional care is mainly fragmented and does not regularly include LTC facilities, their residents and workers. Data are crucial to inform evidence-based decisions to favor prioritization and to support advances in promoting policies around institutional LTC in Latin America. Although information about institutional care in the region is fragmented and insufficient, this paper profiles the four selected countries. It highlights the need for a better structure for data-driven LTC information systems. The lack of information emphasizes the urgency of the need to focus on and encourage research into this topic.
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Affiliation(s)
- Patrick Alexander Wachholz
- Faculdade de Medicina de Botucatu Universidade Estadual Paulista (Unesp) Botucatu Brazil Faculdade de Medicina de Botucatu, Universidade Estadual Paulista (Unesp), Botucatu, Brazil
| | - Patricia Morsch
- Health Systems and Services Life Course Unit Pan American Health Organization Washington, D.C. United States Health Systems and Services, Life Course Unit, Pan American Health Organization, Washington, D.C., United States
| | - Pablo Villalobos Dintrans
- Programa Centro Salud Pública Facultad de Ciencias Médicas Universidad de Santiago Santiago Chile Programa Centro Salud Pública, Facultad de Ciencias Médicas, Universidad de Santiago, Santiago, Chile
| | - Isabel Barrientos-Calvo
- Facultad de Medicina Universidad de Costa Rica San José Costa Rica Facultad de Medicina, Universidad de Costa Rica San José, Costa Rica
| | - Jorge Browne
- Sección de Geriatría Facultad de Medicina Pontificia Universidad Católica de Chile Santiago Chile Sección de Geriatría, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Omar Yaxmehen Bello-Chavolla
- Dirección de Investigación Instituto Nacional de Geriatría Ciudad de México México Dirección de Investigación, Instituto Nacional de Geriatría, Ciudad de México, México
| | - Enrique Vega
- Health Systems and Services Life Course Unit Pan American Health Organization Washington, D.C. United States Health Systems and Services, Life Course Unit, Pan American Health Organization, Washington, D.C., United States
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Fares MOA, Perracini MR, Rosa MABMV, Cunha AIL, de Souza MA, Ricci NA. Research utilisation in older people care: Translation, cross-cultural adaptation and validation of instruments into Brazilian Portuguese. Int J Older People Nurs 2023; 18:e12494. [PMID: 35842923 DOI: 10.1111/opn.12494] [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: 06/02/2021] [Revised: 06/17/2022] [Accepted: 06/24/2022] [Indexed: 01/13/2023]
Abstract
AIMS To translate and culturally validate the Estabrooks' Kinds of Research Utilization (RU) and the Conceptual Research Utilization Scale (CRU) into Brazilian Portuguese; and to describe the research use by health professionals working on Long Term Care Institutions (LTCI) for older people. BACKGROUND Research utilisation ensures greater quality and effectiveness in the care provided by health professionals. However, there are no instruments to evaluate research utilisation in Latin America countries, like Brazil. MATERIALS & METHODS A methodological cross-sectional questionnaire validity and descriptive study. The translation and adaptation of the instruments was performed in seven steps following psychometric guidelines. The instruments evaluate research utilisation by health professionals in clinical practice. The RU is composed of single-items of instrumental, persuasive, conceptual and overall forms; and the CRU the conceptual form through a 5-item scale. Professionals of technical level and graduated working in nine LTCI were evaluated from August to December 2018. Descriptive and inferential (reliability, correlation, internal consistency and structure of CRU) analyses were conducted. RESULTS Sample composed of 117 professionals, 67.5% of healthcare aides and 32.5% of graduated health professionals. All forms of research utilisation showed high implementation in practice (about 75% of the time, or frequently). CRU internal consistency (α = 0.885) and structure were adequate. There were significant correlations between RU and CRU (from very low r = 0.187 to high r = 0.712). Intra-rater, inter-rater and alternate forms reliability ranged from moderate to substantial. CONCLUSIONS The Brazilian versions of the RU and the CRU are valid, reliable and acceptable for evaluating research utilisation by professionals working on LTCI. It is of great relevance to introduce these instruments in low- and middle-income countries to have future data on how much older people care is influenced by the best evidence available. These instruments can be adapted to different healthcare settings and populations.
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Affiliation(s)
- Mainá Osório Akel Fares
- Master's and Doctoral Programs in Physical Therapy, Universidade Cidade de São Paulo (UNICID), São Paulo, Brazil
| | - Monica Rodrigues Perracini
- Master's and Doctoral Programs in Physical Therapy, Universidade Cidade de São Paulo (UNICID), São Paulo, Brazil
| | | | - Ana Izabel Lopes Cunha
- Master's and Doctoral Programs in Physical Therapy, Universidade Cidade de São Paulo (UNICID), São Paulo, Brazil
| | - Mariana Abacherly de Souza
- Master's and Doctoral Programs in Physical Therapy, Universidade Cidade de São Paulo (UNICID), São Paulo, Brazil
| | - Natalia Aquaroni Ricci
- Master's and Doctoral Programs in Physical Therapy, Universidade Cidade de São Paulo (UNICID), São Paulo, Brazil
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Peryer G, Kelly S, Blake J, Burton JK, Irvine L, Cowan A, Akdur G, Killett A, Brand SL, Musa MK, Meyer J, Gordon AL, Goodman C. Contextual factors influencing complex intervention research processes in care homes: a systematic review and framework synthesis. Age Ageing 2022; 51:6540144. [PMID: 35231097 PMCID: PMC8887840 DOI: 10.1093/ageing/afac014] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Indexed: 12/20/2022] Open
Abstract
Background Care homes are complex settings to undertake intervention research. Barriers to research implementation processes can threaten studies’ validity, reducing the value to residents, staff, researchers and funders. We aimed to (i) identify and categorise contextual factors that may mediate outcomes of complex intervention studies in care homes and (ii) provide recommendations to minimise the risk of expensive research implementation failures. Methods We conducted a systematic review using a framework synthesis approach viewed through a complex adaptive systems lens. We searched: MEDLINE, Embase, CINAHL, ASSIA databases and grey literature. We sought process evaluations of care home complex interventions published in English. Narrative data were indexed under 28 context domains. We performed an inductive thematic analysis across the context domains. Results We included 33 process evaluations conducted in high-income countries, published between 2005 and 2019. Framework synthesis identified barriers to implementation that were more common at the task and organisational level. Inductive thematic analysis identified (i) avoiding procedural drift and (ii) participatory action and learning as key priorities for research teams. Research team recommendations include advice for protocol design and care home engagement. Care home team recommendations focus on internal resources and team dynamics. Collaborative recommendations apply to care homes’ individual context and the importance of maintaining positive working relationships. Discussion Researchers planning and undertaking research with care homes need a sensitive appreciation of the complex care home context. Study implementation is most effective where an intervention is co-produced, with agreed purpose and adequate resources to incorporate within existing routines and care practices.
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Affiliation(s)
- Guy Peryer
- School of Health Sciences, University of East Anglia, Norwich Research Park, Norwich NR4 7TJ, UK
- NIHR Applied Research Collaboration, East of England, England, UK
| | - Sarah Kelly
- Cambridge Public Health, University of Cambridge, East Forvie Site, Cambridge CB2 0SZ, UK
- THIS Institute (The Healthcare Improvement Studies Institute), University of Cambridge, Cambridge Biomedical Campus, Cambridge CB2 0AH, UK
| | - Jessica Blake
- Centre for Research in Public Health and Community Care, University of Hertfordshire, Hatfield, UK
| | - Jennifer K Burton
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, New Lister Building, Glasgow Royal Infirmary, Glasgow G31 2ER, UK
| | - Lisa Irvine
- Centre for Research in Public Health and Community Care, University of Hertfordshire, Hatfield, UK
| | - Andy Cowan
- Cambridge Public Health, University of Cambridge, East Forvie Site, Cambridge CB2 0SZ, UK
| | - Gizdem Akdur
- Centre for Research in Public Health and Community Care, University of Hertfordshire, Hatfield, UK
| | - Anne Killett
- School of Health Sciences, University of East Anglia, Norwich Research Park, Norwich NR4 7TJ, UK
- NIHR Applied Research Collaboration, East of England, England, UK
| | - Sarah L Brand
- St Luke's Campus, Heavitree Road, University of Exeter, Exeter EX1 2LU, UK
- NIHR Applied Research Collaboration, South West Peninsula, England, UK
| | - Massirfufulay Kpehe Musa
- Centre for Research in Public Health and Community Care, University of Hertfordshire, Hatfield, UK
| | - Julienne Meyer
- National Care Forum/Care for Older People, School of Health Sciences, Division of Nursing, City, University of London, London, UK
| | - Adam L Gordon
- School of Medicine, University of Nottingham, Nottingham, UK
- NIHR Applied Research Collaboration East Midlands (ARC-EM), Nottingham, UK
| | - Claire Goodman
- Centre for Research in Public Health and Community Care, University of Hertfordshire, Hatfield, UK
- NIHR Applied Research Collaboration, East of England, England, UK
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Devi R, Gordon A, Dening T. Enhancing the Quality of Care in Long-Term Care Settings. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031409. [PMID: 35162431 PMCID: PMC8834779 DOI: 10.3390/ijerph19031409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 01/24/2022] [Indexed: 12/03/2022]
Affiliation(s)
- Reena Devi
- School of Healthcare, University of Leeds, Leeds LS2 9JT, UK
- Nurturing Innovation in Care Home Excellence in Leeds (NICHE-Leeds), Leeds, UK
- Correspondence:
| | - Adam Gordon
- School of Medicine, University of Nottingham, Nottingham NG7 2RD, UK; (A.G.); (T.D.)
- National Institute of Health Research (NIHR) Applied Research Collaboration-East Midlands (ARC-EM), Nottingham, UK
| | - Tom Dening
- School of Medicine, University of Nottingham, Nottingham NG7 2RD, UK; (A.G.); (T.D.)
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Domingues MARDC, Wachholz PA, Silva CBD, Peres LCS, Chacon PF, Bezerra PCDL, Lohmann S, Moreira VG, Duarte YADO, Giacomin KC. Methodological description of the mapping of Brazilian long-term care facilities for older adults. GERIATRICS, GERONTOLOGY AND AGING 2021. [DOI: 10.53886/gga.e0210049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVE: To describe the methodological approach adopted to build a database of long-term care facilities (LCTFs) in Brazil. METHODS: This exploratory research was conducted for 12 months, between August 2020 and July 2021, based on primarily publicly accessible data. First, the Unified Social Assistance System (Sistema Único de Assistência Social [SUAS]) database from 2019 was adopted as the primary source of information. In addition, public agencies and managers were consulted and invited to share their databases, while researchers and private entities collaborated by making their spreadsheets available. Data were organized in spreadsheets for each Brazilian state. LTCFs not catering to older adults (aged 60 years and over) were excluded. Duplicate data were excluded when overlaps were identified. RESULTS: This brief communication describes the methodology adopted for mapping the current status of Brazilian LTCFs. Despite its caveats, this study represents an important advance in the identification, characterization, and monitoring of these services nationwide. A total of 5769 facilities were found in the 2019 SUAS census. After excluding facilities not caring for residents aged 60 years or over, this number decreased to 2381 LTCFs. The consolidation and filtering of information from multiple data sources led to the identification of 7029 LTCFs throughout the country. CONCLUSION: Building a solid database was paramount to devising a national policy on long-term care. By including multiple sources, the scope of this survey was wider than all previous efforts and constituted an unprecedented collaborative experience in the country, including the potential to become the first national dataset for the Brazilian LTC sector.
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Affiliation(s)
| | | | | | | | | | | | - Sandra Lohmann
- National Front to Strengthen Long-term Care Facilities for Older Adults
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