Search results for ‘Subject term:"long term care"’ Sort:
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Impact of interprofessional collaboration on chronic disease management: findings from a systematic review of clinical trial and meta-analysis
- Authors:
- PASCUCCI Domenico, et al
- Journal article citation:
- Health Policy, 125(2), 2021, pp.191-202.
- Publisher:
- Elsevier
Improvement of chronic disease management demands effective collaborative relationships between health and social-care which is achieved through teamwork. Interprofessional Education (IPE) and Interprofessional Collaboration (IPC) are recognized as essential for the delivery of effective and efficient healthcare. Although IPC and IPE are key components of primary care, evidence of studies evaluating how an IPE intervention prior to IPC improved chronic patient outcomes remains scarce. The aim of this study was to assess the impact of IPC interventions on the management of chronic patients compared to usual care. A systematic review and meta-analysis of Randomized Controlled Trials (RCTs) on IPC interventions on chronicity management and their impact on clinical and process outcomes was conducted. Of the 11,128 papers initially retrieved, 23 met the inclusion criteria. Meta-analyses results showed the reduction of systolic blood pressure (Mean Difference (MD) -3.70; 95 % CI -7.39, -0.01), glycosylated hemoglobin (MD -0.20; 95 % CI -0.47, -0.07), LDL cholesterol (MD -5.74; 95 % CI -9.34, -2.14), diastolic blood pressure (MD -1.95; 95 % CI -3.18, -0.72), days of hospitalization (MD -2.22; 95 % CI -4.30, -0.140). A number of positive findings for outcomes related to IPC were found reflecting an improvement of quality of care and an enhancement in the delivery of patient-centered and coordinated care. Moreover, the need for a purposeful systemic approach linking interprofessional education with interprofessional collaboration and patient health and wellbeing is necessary. (Edited publisher abstract)
Factors affecting the implementation, use, and adoption of real-time location system technology for persons living with cognitive disabilities in long-term care homes: systematic review
- Authors:
- GRIGOROVICH Alisa, et al
- Journal article citation:
- Journal of Medical Internet Research, 23(1), 2021, p.e22831. Online only
- Publisher:
- JMIR Publications
Background: As the aging population continues to grow, the number of adults living with dementia or other cognitive disabilities in residential long-term care homes is expected to increase. Technologies such as real-time locating systems (RTLS) are being investigated for their potential to improve the health and safety of residents and the quality of care and efficiency of long-term care facilities. Objective: The aim of this study is to identify factors that affect the implementation, adoption, and use of RTLS for use with persons living with dementia or other cognitive disabilities in long-term care homes. Methods: We conducted a systematic review of the peer-reviewed English language literature indexed in MEDLINE, Embase, PsycINFO, and CINAHL from inception up to and including May 5, 2020. Search strategies included keywords and subject headings related to cognitive disability, residential long-term care settings, and RTLS. Study characteristics, methodologies, and data were extracted and analyzed using constant comparative techniques. Results: A total of 12 publications were included in the review. Most studies were conducted in the Netherlands (7/12, 58%) and used a descriptive qualitative study design. We identified 3 themes from our analysis of the studies: barriers to implementation, enablers of implementation, and agency and context. Barriers to implementation included lack of motivation for engagement; technology ecosystem and infrastructure challenges; and myths, stories, and shared understanding. Enablers of implementation included understanding local workflows, policies, and technologies; usability and user-centered design; communication with providers; and establishing policies, frameworks, governance, and evaluation. Agency and context were examined from the perspective of residents, family members, care providers, and the long-term care organizations. Conclusions: There is a striking lack of evidence to justify the use of RTLS to improve the lives of residents and care providers in long-term care settings. More research related to RTLS use with cognitively impaired residents is required; this research should include longitudinal evaluation of end-to-end implementations that are developed using scientific theory and rigorous analysis of the functionality, efficiency, and effectiveness of these systems. Future research is required on the ethics of monitoring residents using RTLS and its impact on the privacy of residents and health care workers. (Edited publisher abstract)
The impact of cash-for-care schemes on the uptake of community-based and residential care: a systematic review
- Authors:
- PATTYN Eva, et al
- Journal article citation:
- Health Policy, 125(3), 2021, pp.363-374.
- Publisher:
- Elsevier
Background: Internationally, deinstitutionalization and the provision of community-based care are growing policy aims. Several developed countries have thus introduced cash-for-care schemes, which turn the traditional funding stream from the perspective of the care provider around, giving purchasing power to care users. This review explores whether cash-for-care schemes encourage the shift towards deinstitutionalization. Methods: Ten databases covering medical, nursing and social science journals were systematically screened up to July 10, 2020. Only peer-reviewed articles written in English or French and containing empirical evidence on the uptake of care services in a cash-for-care scheme were included. Results: The search resulted in 6,865 hits of which 27 articles were retained. Most studies took place in the United Kingdom or the United States. Overall, the search showed mixed results concerning the uptake of the different types of community-based care. Conclusion: Evidence demonstrating a higher uptake of informal, respite or home care individually, is scarce and inconclusive. A reduction in residential care and an uptake of services in the community can, with caution, be noted. However, contextual and individual factors can affect the way deinstitutionalization takes place and which community-based services are chosen. Future research should therefore focus on the underlying processes and influencing factors, in order to obtain a clear view of the shift towards deinstitutionalization. (Edited publisher abstract)
Nursing staff time and care quality in long-term care facilities: a systematic review
- Authors:
- ARMIJO-OLIVO Susan, et al
- Journal article citation:
- Gerontologist, 60(3), 2020, pp.e200-e217.
- Publisher:
- Oxford University Press
In long-term care (LTC) facilities, nursing staff are important contributors to resident care and well-being. Despite this, the relationships between nursing staff coverage, care hours, and quality of resident care in LTC facilities are not well understood and have implications for policy-makers. This systematic review summarizes current evidence on the relationship between nursing staff coverage, care hours, and quality of resident care in LTC facilities. Research Design and Methods: A structured literature search was conducted using four bibliographic databases and gray literature sources. Abstracts were screened by two independent reviewers using Covidence software. Data from the included studies were summarized using a pretested extraction form. The studies were critically appraised, and their results were synthesized narratively. Results: The systematic searched yielded 15,842 citations, of which 54 studies (all observational) were included for synthesis. Most studies (n = 53, 98%) investigated the effect of nursing staff time on resident care. Eleven studies addressed minimum care hours and quality of care. One study examined the association between different nursing staff coverage models and resident outcomes. Overall, the quality of the included studies was poor. Discussion and Implications: Because the evidence was inconsistent and of low quality, there is uncertainty about the direction and magnitude of the association between nursing staff time and type of coverage on quality of care. More rigorously designed studies are needed to test the effects of different cutoffs of care hours and different nursing coverage models on the quality of resident care in LTC facilities. (Publisher abstract)
Factors associated with the willingness of older people to engage with long-term care services: a systematic review
- Authors:
- ZHANG Yuanyuan, et al
- Journal article citation:
- Health and Social Care in the Community, early cite May 2022,
- Publisher:
- Wiley
The ageing of the population has resulted in an increase in the demand for long-term care services for older people, but with limited resources, its challenges have also been highlighted. Although factors affecting the willingness of older people to engage with long-term care services have been widely reported, however, systematic review has not synthesised the evidence, and its associated factors remain unclear. This systematic review aims to study and synthesise the best available evidence on the potential factors related to the willingness of older people to engage with long-term care services. Eight electronic databases were comprehensively searched from inception to January 2021: the Cochrane Library, PubMed, Web of Science, CINAHL, Wanfang Database, China Knowledge Resource Integrated Database (CNKI), Weipu Database (VIP), and Chinese Biomedical Literature Database (CBM). The original literatures were screened according to selection criteria. Two researchers used 11-item checklist recommended by the Agency for Healthcare Research and Quality to evaluate the quality of the included literatures. And the review used narrative synthesis to integrate factors related to the willingness of older people to engage with long-term care services. In total, 7794 studies were screened and 35 studies were included in this review. Among them, 23 studies were rated as moderate quality and 12 was high quality. Data synthesis identified that age, education, number of children, living arrangements, the relationship with children, primary caregivers, place of residence, social support, household income, medical insurance, activities of daily living ability and spiritual comfort should all be taken into account when establishing the appropriate long-term care service model or formulating relevant policies. However, many factors remain undetermined and require more rigorous original literature support. And multiple areas can be also considered in the future studies, especially psychological factors. (Edited publisher abstract)
Perceptions and experiences of person-centered care among nurses and nurse aides in long term residential care facilities: a systematic review of qualitative studies
- Authors:
- GUNEY Seda, KARADAG Ayise, EL-MASRI Maher
- Journal article citation:
- Geriatric Nursing, 42(4), 2021, pp.816-824.
- Publisher:
- Elsevier
Objective: The aim of this study is to report the findings of meta-synthesis of the experiences and perceptions of person-centered care among nurses and nurse aides in long term care facilities to help managers and policy makers in providing and improving health services. Methods: This is a meta-synthesis of qualitative studies guided by seven steps process of meta-ethnography developed by Noblit and Hare. Systematic literature searching was conducted in CINAHL, MEDLINE, Web of Science, PubMed, PsycINFO, Scopus, Cochrane library and ProQuest dissertations databases. We assessed quality of the studies using Critical Appraisal Skills Program tool. Results: Eleven studies and one dissertation were identified as relevant for the review. The analysis of this systematic review was resulted in three categories: Recognizing resident's emotional needs and preferences under the task-based workload; holistic understanding to build relationship and participation; teamwork, being recognized and ongoing training to overcome the challenges. Conclusion: The concept of PCC in direct care level is perceived well with majority of the study participants but the reality between perceived and practicing PCC is different which indicates mostly lack of organizational rearrangements and support. (Edited publisher abstract)
Oral status of older people in medium to long-stay health and social care setting: a systematic review
- Authors:
- RUIZ-ROCA Juan Antonio, et al
- Journal article citation:
- BMC Geriatrics, 21(363), 2021, Online only
- Publisher:
- BioMed Central Ltd
Background: Older patients who spend long periods hospitalized or those who are in a situation of institutionalization represent a risk group in this regard, as many of them suffer a degree of dependence and need help to perform the basic tasks of personal care. It is therefore important to learn more of the oral health status of this group of patients in order to make a proper assessment of the situation and to develop protocols for its management. The purpose of the study was to conduct a systematic review to ascertain the oral health status of older people patients admitted to institutions or hospitalized for a long period of time. Methods: a systematic review of the literature published in two different databases (PubMed, Embase and Cochrane Library) was carried out, with 12 different combinations of keywords based on the following selection criteria: studies published in the last 5 years, in English and/or Spanish and/or Portuguese, with samples of ≥30 patients, performed in patients older than 65 years, admitted to any type of institution and/or hospital center for at least 7 days and in which the state of hard and/or soft tissues of the oral cavity were evaluated in some way. The selected articles were subjected to a thorough analysis. Results: The search strategy covered 1.014 articles: 689 from Pubmed and 325 from Cochrane Library. After applying the eligibility criteria, five articles were selected for our review. The level of evidence of the articles was, a sample of 773 patients most of them were women with an average age older than 70 years old. Conclusions: The oral health of patients aged more than 65 is worse than that of the rest population. Long hospital stays or being institutionalized in a residence makes this group susceptible to a worsening of their oral health status. It is necessary to develop protocols for the oral health care of these patients, accompanied by training programs for the personnel responsible. (Edited publisher abstract)
Deeply discrediting: a systematic review examining the conceptualizations and consequences of the stigma of working in aged care
- Authors:
- MANCHHA Asmita V., et al
- Journal article citation:
- Gerontologist, 61(4), 2021, pp.e129-e146.
- Publisher:
- Oxford University Press
Background and Objectives: The stigma of working in aged care can discredit and devalue those working in gerontology. This overlooked workforce issue may underpin complex staffing challenges like chronic worker shortages and inadequate care delivery. Our review synthesizes the existing literature and introduces a conceptual framework based on linguistics to reconcile disparate conceptualizations and negative consequences of this stigma. Research Design and Methods: We conducted a systematic review and assessed peer-reviewed articles published from 1973 to 2019 across 5 databases. Fifty-nine articles were selected based on criteria grounded in stigma theory. Results: Only 10 articles explicitly used the term “stigma” when conceptualizing the stigma of working in aged care. An additional 49 articles conceptualized this stigma in terms of stigma processes (e.g., status loss). Findings from a deeper examination using a linguistic analysis revealed societal groups predominantly conceptualized stigma in 3 distinct ways based on (a) unfavorable character judgment of aged care workers, (b) lower value placed on aged care work, and (c) negative emotional reactions towards working in aged care. Last, stigma was associated with adverse psychological and job-related consequences. Discussion and Implications: Reconceptualizing this workforce issue and recognizing it as a societal challenge will enable policymakers to design evidence-based interventions at industry and societal levels. We propose workforce challenges in the aged care sector such as attraction, retention, and well-being may lessen with interventions aimed at mitigating the stigma of working in aged care. (Edited publisher abstract)
Social interactions of persons with dementia living in special care units in long-term care: a mixed-methods systematic review
- Authors:
- ADLBRECHT Laura, et al
- Journal article citation:
- Dementia: the International Journal of Social Research and Practice, 20(3), 2021, pp.967-984.
- Publisher:
- Sage
Background: Special care units are a well-utilized approach in the long-term care for persons with dementia. A therapeutic goal of such settings is to provide meaningful engagement and a sense of community that is crucial for the overall quality of life. In recent years, several studies followed this notion by investigating residents’ social interactions and the influence of the environment on these interactions. Aims: This review aims to synthesize the literature on the social interactions of persons with dementia living in special care units. Design: A mixed-methods systematic review was conducted. Methods: Literature was searched in PubMed, CINAHL, PsycINFO, the Cochrane Library and Web of Science databases. Additionally, reference lists of relevant articles were searched. Studies were screened, data were extracted and the quality was appraised. Separate syntheses were conducted for qualitative and quantitative studies, which were subsequently merged in the final mixed-methods synthesis. Results: In total, 18 articles were included, investigating large-scale, small-scale and homelike special care units and green care farms. Residents in special care units experience few social interactions but more than those in the comparative groups. Opportunities to interact are only marginally seized. Interactions typically occur in small groups and are facilitated by familiarity and the organizational environment. Residents mainly rely on staff members to create social interaction, for example initiating or facilitating resident-to-resident interaction. Conclusion: Although the evidence base is increasing, it is still fragmented and built on different concepts, interventions, control groups and measurements. Nevertheless, the first conclusions suggest a positive impact of special care units on residents’ social interactions. Although the review yielded a more comprehensive picture of residents’ social life, further high-quality research built on a sound theoretical background is needed. (Edited publisher abstract)
The association between quality of life and nursing home facility for the elderly population: a systematic review and meta-analysis
- Authors:
- LI Yang-Tzu, et al
- Journal article citation:
- International Journal of Gerontology, 15(1), 2021, pp.16-24.
- Publisher:
- Airiti Library
- Place of publication:
- Taiwan
Background: To investigate the association between quality of life and nursing home facility for the elderly population. Methods: The researchers searched the PubMed, Medline, and Cochrane Library for relevant perspective studies without language limitations from inception to 17^(th) June 2020 for relevant publications with a priori defined inclusion and exclusion criteria. Two authors independently selected studies, assessed risk of bias, and extracted data. The disagreement was resolved by discussion with a third author. Results: There are 18 articles involved in the final meta-analysis. The disparities were found of accessing the quality of life (World Health Organization Quality-of-Life, Quality of Life in Last-Stage Dementia, Nottingham Health Profile-Turkish Version, EUROPE Health Interview Survey-QoL , Visual analogue Scales, Flanagan Quality of Life Scale) and the level of independence (Barthel Index, Kahoku Aging Longitudinal Study Scale, Visual Analogue Scales, Activities of Daily Living Scales, Instrumental Activities of Daily Living Scales). Conclusion: The available limited, very low-quality evidence does not support a significant association between quality of life and nursing home facility for the elderly population. Further rigorous and long-term follow-up studies should be conducted with more objective measures. (Edited publisher abstract)