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Older adults’ demand for integrated care and its influencing factors: a scoping review
- Authors:
- WANG Zhenyu, LIU Zhihan
- Journal article citation:
- International Journal of Integrated Care, 21(4), 2021, p.28. Online only
- Publisher:
- International Foundation for Integrated Care
Introduction: Integration has become a major concern for governments, healthcare and aged care systems in many countries. However, the research on and implementation of integrated care in China started relatively late, and there is no review on the needs of older adults with regard to integrated care and the influencing factors. Therefore, this paper aims to provide a scoping review by searching, evaluating, and summarizing the Chinese and international literature on the need for and the factors influencing integrated care for older people. In addition, this review highlights evidence of the gap between China and the world in integrated care. Methods: Using a framework proposed by Arksey and O’Malley, a systematic search of 12 domestic and international databases was conducted. Of the 890 original studies retrieved, those that met the established inclusion criteria were screened and scored using the Ekman quality assessment tool. The qualitative description method was used to summarize the demand for integrated care for older adults and the influencing factors. Results: A total of 49 papers were included. These studies were from eleven countries on five continents (most commonly China and the US) and were mostly cross-sectional quantitative studies that surveyed the integrated care needs of older people living in homes/communities or long-term care facilities. The analysis shows that existing research on the integrated care needs of older people in China adopts a single perspective and is inadequate and unsystematic in its assessment; the integrated care needs of older adults and the factors influencing them are multifaceted; and both in China and internationally, the community-home care scenario most consistently meets the needs and expectations of older adults. Conclusion: Although there is no uniform definition of integrated care in China or abroad and each country has its own national definition and system of integrated care, there are certain commonalities regarding the needs of older adults and the factors that influence them across countries. Our research reveals a gap between China and the international community in terms of integrated care. (Edited publisher abstract)
Inclusion/exclusion criteria in late life depression antidepressant efficacy trials
- Authors:
- ZIMMERMAN Mark, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 32(9), 2017, pp.1009-1016.
- Publisher:
- Wiley
Objective: The generalisability of antidepressant efficacy trials (AETs) has been questioned. No studies have examined the inclusion/exclusion criteria used in placebo-controlled studies of late life depression and compared them to the criteria used in non-late life AETs. Method: The authors conducted a comprehensive literature review of placebo-controlled AETs published from January, 1995 through December, 2014. They compared the inclusion/exclusion criteria used in the 18 studies of late life depression to those used in non-late life depression. Results: There were nine inclusion/exclusion criteria that were used in more than half of the late life depression AETs: minimum severity on a symptom severity scale (100.0%), significant suicidal ideation (77.8%), psychotic features during the current episode of depression or history of a psychotic disorder (94.4%), history of bipolar disorder (77.8%), diagnosis of alcohol or drug abuse or dependence (83.3%), presence of a comorbid nondepressive, nonsubstance use Axis I disorder (55.6%), episode duration too short (66.7%), and an insufficient score on a cognitive screen (88.3%) or the presence of a cognitive disorder (55.6%). There were some differences between the late life and non-late life depression studies—use of a screening measure of cognitive functioning, presence of a cognitive disorder such as dementia, and the minimum depression severity cutoff score required at baseline. Conclusions: The inclusion/exclusion criteria in AETs of late life depression were generally similar to the criteria used in non-late life depression (Edited publisher abstract)
Towards a new conceptualization of depression in older adult cancer patients: a review of the literature
- Authors:
- SARACINO Rebecca M., ROSENFELD Barry, NELSON Christian J.
- Journal article citation:
- Aging and Mental Health, 20(12), 2016, pp.1230-1242.
- Publisher:
- Taylor and Francis
Objectives: This paper reviews the phenomenology of depression in older adults, and individuals diagnosed with cancer. Method: PsychInfo, PubMed, Web of Science, and Google Scholar databases were searched for English-language studies addressing the phenomenology, symptoms, or assessment of depression in older adults and those with cancer. Results: The Diagnostic and Statistical Manual for Mental Disorders (DSM) criteria that appear to be relevant to both older adults and cancer patients are anhedonia, concentration difficulties, sleep disturbances, psychomotor retardation/agitation, and loss of energy. Possible alternative criteria that may be important considerations included constructs such as loss of purpose, loneliness, and irritability in older adults. Among cancer patients, tearfulness, social withdrawal, and not participating in treatment despite ability to do so were identified as potentially important symptoms. Conclusions: Current DSM criteria may not adequately assess depression in older cancer patients and alternative criteria may be important to inform the understanding and identification of depression in this population. Enhancing diagnostic accuracy of depression is important as both the over-diagnosis and under-diagnosis is accompanied with significant costs. Thus, continued research exploring the phenomenology and identifying effective indicators of depression in older cancer patients is needed. (Edited publisher abstract)
Life story resources in dementia care: a review
- Authors:
- KINDELL Jacqueline, et al
- Journal article citation:
- Quality in Ageing and Older Adults, 15(3), 2014, pp.151-161.
- Publisher:
- Emerald
Purpose: Life story work has a relatively long tradition in the caring sciences and is recognised as an important component of dementia care and practice. However, to date, there has not been a review of accessible life story resources. The paper aims to discuss these issues. Design/methodology/approach: Following a systematic approach to identification and inclusion, 11 life story resources were reviewed to ascertain areas of commonality and divergence between the materials. Findings: The authors were able to group the analysis under eight areas and at the end of this process, it was uncertain if life story work is a formal staff intervention or an informal activity that people with dementia and their families could engage in. Resources also varied in terms of whether the life story information was organised in a chronological way, or with topics of interest/discussion or with a combination of both. Life story evaluation and its impact on the life of the person with dementia is in need of development. Practical implications: Across the resources the authors identified four reasons to do life story work which the authors have named as: emotional connections; interactional connections; building new connections and practical care connections. Social implications: There was limited guidance aimed at helping people with dementia to develop and compile their own life story. Originality/value: This paper provides new insights into the usefulness, future directions and content of life story resources in dementia care. It will be of interest to those in health and social care as well as people living with dementia. (Publisher abstract)
Prescribing safely in elderly psychiatric wards: survey of possible drug interactions
- Authors:
- VASUDEV Akshaya, HARRISON Richard
- Journal article citation:
- Psychiatric Bulletin, 33(11), November 2008, pp.417-418.
- Publisher:
- Royal College of Psychiatrists
A cross-sectional survey of patient drug prescriptions on two elderly psychiatric wards was carried out to estimate the potential of drug-drug interactions. Two standardised databases, British National Formulary (BNF; British Medical Association & Royal Pharmaceutical Society of Great Britain, 2007) and UptoDate (www.uptodate.com/), were employed. A majority (96%) of drug prescriptions in our study could potentially cause drug-drug interactions. Most patients were on multiple drugs (on average eight drugs per patient). There was poor concordance between the two databases: BNF picked up fewer cases of potential drug-drug interactions than Upto Date (43 v.152 instances) and they also estimated the potential for hazardousness differently. Polypharmacy is common in elderly psychiatric patients and this increases the possibility of a drug-drug interaction. Estimating the risk of interactions depends on a sound knowledge in therapeutics and/or referring to a standardised source of information. The results of this study question the concordance of two well-referenced databases.
A commentary on the emerging literature on advocacy for older people
- Author:
- SCOURFIELD Peter
- Journal article citation:
- Quality in Ageing, 8(4), December 2007, pp.18-27.
- Publisher:
- Pier Professional
- Place of publication:
- Brighton
This article comments on emerging themes derived from recent official publications on older people's advocacy in the UK. There is an examination of relevant policy documents and the responses from service user groups. Discussion includes clarity in defining advocacy; the nature of the advocacy relationship; sustained and reliable financing of advocacy services; the uneven nature of provision; lack of inter-agency connectivity; the need to establish national standards for advocacy; problems of mental capacity; and advocacy for care home residents and for minority groups. The need for and direction of further research is proposed.
Extra care housing
- Author:
- HENWOOD Melanie
- Journal article citation:
- Community Care, 19.07.07, 2007, pp.34-35.
- Publisher:
- Reed Business Information
The author reviews the results of a literature review on how a new approach to housing can benefit people needing high levels of support. It also looks at a toolkit produced by the Care Services Improvement Partnership, which is designed to assist the development of extra care housing in the context of the wider accommodation and support needs of older people.
Lifting the depression
- Author:
- MANTHORPE Jill
- Journal article citation:
- Community Care, 11.05.07, 2007, pp.42-43,45.
- Publisher:
- Reed Business Information
The author examines a review of studies on suicide and older people, and draws out the implications for practitioners.
Is there a process of spiritual change or development associated with ageing? A critical review of research
- Author:
- DALBY P.
- Journal article citation:
- Aging and Mental Health, 10(1), January 2006, pp.4-12.
- Publisher:
- Taylor and Francis
This review considers whether research shows a process of spiritual change or development associated with ageing. Spirituality was understood as that which is central to a sense of meaning and purpose in an individual's life and pertains to the sacred or transcendent. Electronic literature searches were conducted to find research published 1985–2003 aimed at understanding spiritual change, themes and tasks in later life. A total of 13 studies were reviewed that looked at changes in spirituality over time, spiritual themes and tasks in a lifespan development context. The research reviewed suggested that some aspects of spirituality remain stable into old age but that there are identifiable spiritual tasks, needs and changes associated with ageing. Some common spiritual themes identified across the research were integrity, humanistic concern, changing relationships with others and concern for younger generations, relationship with a transcendent being or power, self transcendence, and coming to terms with death. These were not related to age per se, but to some of the challenges that age presents, and were mediated by cultural factors and individual differences. The findings and their limitations were discussed.
Dementia care mapping: a review of the research literature
- Author:
- BROOKER Dawn
- Journal article citation:
- Gerontologist, 45(Supplement), October 2005, pp.11-18.
- Publisher:
- Oxford University Press
The published literature on dementia care mapping (DCM) in improving quality of life and quality of care through practice development and research dates back to 1993. The purpose of this review of the research literature is to answer some key questions about the nature of the tool and its efficacy, to inform the ongoing revision of the tool, and to set an agenda for future research. The DCM bibliographic database at the University of Bradford in the United Kingdom contains all publications known on DCM This formed the basis of the review. Texts that specifically examined the efficacy of DCM or in which DCM was used as a main measure in the evaluation or research were reviewed. Thirty-four papers were categorized into five main types: (a) cross-sectional surveys, (b) evaluations of interventions, (c) practice development evaluations, (d) multimethod evaluations, and (e) papers investigating the psychometric properties of DCM. These publications provide some evidence regarding the efficacy of DCM, issues of validity and reliability, and its use in practice and research. The need for further development and research in a number of key areas is highlighted.