Dataset Information

The Resident VIEW in Community-Based Care Residential Settings.

ABSTRACT: The Resident VIEW is a measure of person-centered care (PCC) from residents' perspectives and was previously studied in nursing homes. The current study presents descriptive data for the Resident VIEW in community-based care settings including assisted living, residential care (AL/RC), and adult foster homes (AFH). Using a two-stage sampling design, we recruited 31 AL/RC and 119 AFH in Oregon and completed face-to-face structured interviews with 227 and 195 residents, respectively. Residents provided ratings for both the importance of and their experience with 66 items that tapped into PCC practices in eight domains. Results are provided for each item, many of which are significantly associated with greater quality of life, better resident satisfaction, and fewer depressive symptoms, especially in the domains of personalized care and being treated like a person. Incongruence between importance and experience ratings indicate many residents experience unmet needs across multiple domains. The Resident VIEW performed well in different types of settings, providing an important tool for researchers and providers who wish to learn about the PCC experience from residents' points of view.

SUBMITTER: White DL

PROVIDER: S-EPMC9742690 | biostudies-literature | 2022 Jan-Dec

REPOSITORIES: biostudies-literature

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The Resident VIEW in Community-Based Care Residential Settings.

White Diana L DL Tunalilar Ozcan O Hasworth Serena S Winfree Jaclyn J

Gerontology & geriatric medicine 20220101

The Resident VIEW is a measure of person-centered care (PCC) from residents' perspectives and was previously studied in nursing homes. The current study presents descriptive data for the Resident VIEW in community-based care settings including assisted living, residential care (AL/RC), and adult foster homes (AFH). Using a two-stage sampling design, we recruited 31 AL/RC and 119 AFH in Oregon and completed face-to-face structured interviews with 227 and 195 residents, respectively. Residents pro ...[more]

PMID: 36518807

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Project description:IntroductionPreventing falls is a priority for aged care providers. Research to date has focused on fall prevention strategies in single settings (e.g., residential aged care (RAC) or community settings). However, some aged care providers deliver care, including fall prevention interventions, across RAC and community settings. We conducted an umbrella review to identify what type of fall prevention interventions had the greatest impact on falls outcomes in RAC and community settings.MethodsFive databases were searched for systematic reviews of falls prevention randomised control trials in older adults living in the community or RAC. Data extracted included systematic review methods, population characteristics, intervention characteristics, setting details (RAC or community), and fall-related outcomes (falls, people who have had a fall, fall-related hospitalisations, and fall-related fractures). Review quality was appraised using the Assessment of Multiple Systematic Reviews-2 tool.ResultsOne-hundred and six systematic reviews were included; 63 and 19 of these stratified results by community and RAC settings respectively, the remainder looked at both settings. The most common intervention types discussed in reviews included 'exercise' (61%, n = 65), 'multifactorial' (two or more intervention types delivered together) (26%, n = 28), and 'vitamin D' (18%, n = 19). In RAC and community settings, 'exercise' interventions demonstrated the most consistent reduction in falls and people who have had a fall compared to other intervention types. 'Multifactorial' interventions were also beneficial in both settings however demonstrated more consistent reduction in falls and people who fall in RAC settings compared to community settings. 'Vitamin D' interventions may be beneficial in community-dwelling populations but not in RAC settings. It was not possible to stratify fall-related hospitalisation and fall-related fracture outcomes by setting due to limited number of RAC-specific reviews (n = 3 and 0 respectively).Conclusion'Exercise' interventions may be the most appropriate falls prevention intervention for older adults in RAC and community settings as it is beneficial for multiple fall-related outcomes (falls, fall-related fractures, and people who have had a fall). Augmenting 'exercise' interventions to become 'multifactorial' interventions may also improve the incidence of falls in both settings.

Project description:BackgroundEvidence-based quality improvement models for depression have not been fully implemented in routine primary care settings. To date, few studies have examined the organizational factors associated with depression management in real-world primary care practice. To successfully implement quality improvement models for depression, there must be a better understanding of the relevant organizational structure and processes of the primary care setting. The objective of this study is to describe these organizational features of routine primary care practice, and the organization of depression care, using survey questions derived from an evidence-based framework.MethodsWe used this framework to implement a survey of 27 practices comprised of 49 unique offices within a large primary care practice network in western Pennsylvania. Survey questions addressed practice structure (e.g., human resources, leadership, information technology (IT) infrastructure, and external incentives) and process features (e.g., staff performance, degree of integrated depression care, and IT performance).ResultsThe results of our survey demonstrated substantial variation across the practice network of organizational factors pertinent to implementation of evidence-based depression management. Notably, quality improvement capability and IT infrastructure were widespread, but specific application to depression care differed between practices, as did coordination and communication tasks surrounding depression treatment.ConclusionsThe primary care practices in the network that we surveyed are at differing stages in their organization and implementation of evidence-based depression management. Practical surveys such as this may serve to better direct implementation of these quality improvement strategies for depression by improving understanding of the organizational barriers and facilitators that exist within both practices and practice networks. In addition, survey information can inform efforts of individual primary care practices in customizing intervention strategies to improve depression management.

Project description:BackgroundThe precautions and restrictions imposed by the recent Covid-19 pandemic drew attention to the criticality of quality of care in long-term care facilities internationally, and in Canada. They also underscored the importance of residents' quality of life. In deference to the risk mitigation measures in Canadian long-term care settings during Covid-19, some person-centred, quality of life policies were paused, unused, or under-utilised. This study aimed to interrogate these existing but latent policies, to capture their potentiality in terms of positively influencing the quality of life of residents in long-term care in Canada.MethodsThe study analysed policies related to quality of life of long-term care residents in four Canadian provinces (British Columbia, Alberta, Ontario, and Nova Scotia). Three policy orientations were framed utilising a comparative approach: situational (environmental conditions), structural (organisational content), and temporal (developmental trajectories). 84 long term care policies were reviewed, relating to different policy jurisdictions, policy types, and quality of life domains.ResultsOverall, the intersection of jurisdiction, policy types, and quality of life domains confirms that some policies, particularly safety, security and order, may be prioritised in different types of policy documents, and over other quality of life domains. Alternatively, the presence of a resident focused quality of life in many policies affirms the cultural shift towards greater person-centredness. These findings are both explicit and implicit, and mediated through the expression of individual policy excerpts.ConclusionThe analysis provides substantive evidence of three key policy levers: situations-providing specific examples of resident focused quality of life policy overshadowing in each jurisdiction; structures-identifying which types of policy and quality of life expressions are more vulnerable to dominance by others; and trajectories-confirming the cultural shift towards more person-centredness in Canadian long-term care related policies over time. It also demonstrates and contextualises examples of policy slippage, differential policy weights, and cultural shifts across existing policies. When applied within a resident focused, quality of life lens, these policies can be leveraged to improve extant resource utilisation. Consequently, the study provides a timely, positive, forward-facing roadmap upon which to enhance and build policies that capitalise and enable person-centredness in the provision of long-term care in Canada.

Project description:This study explored measures of subjective and objective sleep health and the association with fall occurrence and falls risk for older adults. A longitudinal observational study was conducted with participants in residential aged care (n = 36) and community dwelling (n = 35) settings. At baseline, objective sleep data involved wearing wrist worn accelerometers and measuring falls risk by walking using the Quantitative timed up and go (QTUG) of a simple, cognitive, and motor task. Subjective sleep data was collected by completing sleep diaries using the Karolinska Sleepiness Scale and sleep quality scale, respectively. Longitudinal falls data were collected at baseline, 3, 6, and 9 months. Falls risk was calculated via QTUG. Responses to a fall questionnaire were used to quantify fall occurrence. Independent samples t-test examined differences in objective and subjective sleep variables between settings. Logistic regression explored whether objective or subjective sleep variables could predict an overall fall occurrence. Linear regression determined if a particular sleep variable could predict an overall falls risk. Multiple regression determined if sleep variables could predict falls risk. No significant differences were found between residential and community-dwelling adults in subjective or objective sleep measures. Logistic regression showed no significant associations between most sleep variables and falls risk, except for average awakening length, where each additional minute was associated with a 1.8% increase in fall likelihood (OR = 1.02, 95% CI [1.00-1.03], P = .037). Conversely, higher awakening frequency was associated with reduced falls risk in the simple timed up-and-go task (R² = .21, β = -.69, P = .009, 95% CI [-1.20 to -0.18]). Findings suggest no significant differences in sleep health or falls risk between residential and community-dwelling older adults, though specific sleep disruptions showed minor associations with falls risk.

Project description:BackgroundFrailty is a known risk factor for an array of adverse outcomes including more frequent and prolonged health services use and high health care costs. Aging of the population has implications for care provision across the care continuum, particularly for people living with frailty. Despite known risks associated with frailty, there has been limited research on care pathways that address the needs of persons living with frailty. Our study aims to review and examine, in a rigorous way, the quality of evidence for multi-component interventions and care pathways focused on frailty.MethodsA comprehensive electronic search strategy will be used to identify studies that evaluate multi-component interventions or care pathways for persons living with frailty. The search strategy will include terms for frailty, multi-component interventions, effectiveness, and cost effectiveness applied to the following databases: MEDLINE (OVID), EMBASE (OVID), CINAHL (EBSCO), Cochrane Central Register of Controlled Trials (CENTRAL), and Cochrane Database of Systematic Reviews. An adapted search for Google Scholar and gray literature databases will also be used. References of included studies will be hand-searched for additional citations of frailty-inclusive care. Known experts and corresponding authors of identified articles will be contacted by email to identify further eligible studies. Risk of bias will be assessed using the Effective Public Health Practice Project Quality Assessment tool. Data will be extracted from eligible studies and it is anticipated that narrative analysis will be used. If studies with sufficient homogeneity are found, then pooled effects will be reported using meta-analysis.DiscussionThis review will appraise the evidence currently available on multi-component frailty interventions. Results will inform on clinical pathway development for people living with frailty across the care continuum and will guide future research to address gaps in the literature and areas in need of further development.Systematic review registrationPROSPERO CRD42020166733.

Dataset Information

The Resident VIEW in Community-Based Care Residential Settings.

Publications

The Resident VIEW in Community-Based Care Residential Settings.

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