System Redesign: The Value of a Primary Care Liaison Model to Address Unmet Social Needs among Older Primary Care Patients

Factors associated with the perceived need for assistance from voluntary services in home-based older adults in Chinese urban areas: a cross-sectional study

BACKGROUND

With China's rapidly aging population, meeting the diverse care needs of senior citizens is becoming more challenging. Although voluntary social services have numerous advantages and are popular among older adults, there is little information on the need for assistance from volunteer-based social services, particularly those with a medical background, and influencing factors among urban home-based older adults. This study aimed to assess the need for assistance from voluntary services and related factors among urban home-based older adults in China.

METHODS

A cross-sectional study was conducted in 2022 on communities in four cities in China. The 27-item Home-Based Older Adults Assistance Need Scale was used to measure the assistance needs of 498 participants aged 60 and above. Multiple linear regression models were conducted to identify salient variables associated with the need for assistance from voluntary services.

RESULTS

The mean score of the need for assistance from voluntary services was 88.60 ± 24.37. The mean scores of the items examining four dimensions, namely, health maintenance, visiting communication, social intercourse, and daily life, were 3.64 ± 1.08, 3.49 ± 1.04, 3.33 ± 1.08, and 2.78 ± 1.08, respectively. The level of depression, willingness to assist older adults, attaching importance to health preservation, ability to self-comfort, desire to accept assistance from others, and the presence of more children or none at all were all positively correlated with the perceived need for assistance from voluntary services. In contrast, social care obtained from visiting medical institutions was negatively correlated. These seven factors explained 28.5% of the total variance.

CONCLUSIONS

Urban home-based older adults in China were found to have significant requirements for assistance from volunteer services, and several complex factors were associated with more significant assistance needs. These findings may encourage the extremely limited numbers of social volunteers, particularly those with a medical background, to identify priorities in providing assistance services to the large numbers of urban home-based older adults and thus improve service delivery.

Using the Age-Friendly Health Systems Framework to Track Wellness and Health Promotion Priorities of Older Adults in the Global Community

The promotion of health and wellness interventions for older adults is important in controlling the onset and progression of disabilities as well as disease in these individuals [...].

Evidence, expertise, and patient/family preferences to maximize health for older adults with implications for evidence-based practice

BACKGROUND

As Americans live longer and with chronic conditions, the healthcare system, researchers, faculty, practicing providers, patients, and families must adapt to changing societal needs and goals.

AIMS

The aim of this commentary was to offer recommendations that align with the six vital directions to improve the health care and quality of life for older Americans.

METHODS

This article expands upon the six vital directions from an evidence-based practice (EBP) perspective that values the three legs of the EBP stool: (1) research evidence, (2) clinician expertise, and (3) patient preferences, values, and circumstances.

RESULTS

The recommendations reflect the scientific literature, our expertise in EBP and research, our nursing roles and expertise, and our experiences in the care of our older parents. By sharing our experiences as nurse scientists and daughters, we offer insight to raise the healthcare bar for older adults through EBP and meaningful, person-centered care.

LINKING ACTION TO EVIDENCE

Vital directions for improving the health care and quality of life for older Americans include promoting interprofessional education to create an adequately prepared workforce; researching and implementing pathways to minimize the social determinants of health for older adults; disseminating findings that remediate older adult health disparities; innovating approaches for managing chronic health conditions at home; and studying and implementing approaches for allocating resources for end-of-life care that are satisfying for the patients, their family, and clinicians.

Factors Related to Family Caregivers’ Readiness for the Hospital Discharge of Advanced Cancer Patients

Background: Many family caregivers of advanced cancer patients worry about being unable to provide in-home care and delay the discharge. Little is known about the influencing factors of discharge readiness. Methods: This study aimed to investigate the influencing factors of family caregivers’ readiness, used a cross-sectional survey, and enrolled 123 sets of advanced cancer patients and family caregivers using convenience sampling from four oncology wards in a medical centre in northern Taiwan. A self-developed five-point Likert questionnaire, the “Discharge Care Assessment Scale”, surveyed the family caregivers’ difficulties with providing in-home care. Results: The study showed that the discharge readiness of family caregivers affects whether patients can be discharged home. Moreover, the influencing factors of family caregivers’ discharge readiness were the patient’s physical activity performance status and expressed discharge willingness; the presence of someone to assist family caregivers with in-home care; and the difficulties of in-home care. The best prediction model accuracy was78.0%, and the Nagelkerke R² was 0.52. Conclusion: Discharge planning should start at the point of admission data collection, with the influencing factors of family caregivers’ discharge readiness. It is essential to help patients increase the likelihood of being discharged home.