Integrating community participation in the transition of older adults from hospital to home: a scoping review

Gough, Claire; Baker, Nicky; Weber, Heather; Lewis, Lucy; Barr, Christopher; Maeder, Anthony; George, Stacey

doi:10.1080/09638288.2021.1912197

Cited by 7 publications

(13 citation statements)

References 39 publications

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“…A recent scoping review on community participation found only barriers reposted in the literature. 12 Therefore, the potential facilitators, such as information and systems to match suitability, flexibility and expectations, identified in the current study are…”

Section: Discussionmentioning

confidence: 99%

“…Indeed, the outpatient nurses expressed concern about the potential misuse of volunteering in the health system. Nevertheless, community participation is recommended in the transition process from hospital to home for people with chronic illness, 12 and it is recommended that agencies fund voluntary services and educate stakeholders about the benefits 28 . It has previously been found that pwNC were treated unequally during the volunteering process 10 .…”

Section: Discussionmentioning

confidence: 99%

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Exploring the barriers and facilitators to volunteering as an intervention for those with long‐term neurological conditions: How make therapeutic volunteering possible?

Eisenhut,

Collett,

Yazdani

2023

Health Expectations

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BackgroundVolunteering may have therapeutic benefits, but little is known about its requirements and potential for people with neurological conditions (pwNC).DesignTwo separate focus groups were conducted in Darmstadt, Germany: one group consisting of six pwNC and another group consisting of four health care professionals and three volunteering service providers. The focus groups were audio‐recorded, transcribed and data were managed using NVivo12. The thematic analysis was applied.ResultsFour main themes were identified: (1) Impact of volunteering, (2) Individualisation, (3) Developmental space and (4) Funded supported volunteering.ConclusionAccording to the findings, volunteering can be used as a strategy to enhance physical, mental and social well‐being in disease management for people with long‐term neurological conditions.Patients or Public ContributionFacilitators for accessibility of therapeutic volunteering; involvement of pwNC.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Exploring the barriers and facilitators to volunteering as an intervention for those with long‐term neurological conditions: How make therapeutic volunteering possible?

Eisenhut,

Collett,

Yazdani

2023

Health Expectations

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“…Being dependent on others and being unable to plan and manage your own time and activities has previously emerged as a restricting condition on participation in social and leisure activity [ 15 ] and social isolation is often exacerbated by not being able to drive and get to places [ 24 ]. Other barriers identified elsewhere include psychological difficulties such as anxiety and lack/loss of confidence in social settings or the public sphere [ 21 , 22 , 24 , 25 ], hidden disability such as loss of confidence in one’s body and appearance [ 22 ] and feeling ‘cut off’ from healthcare support post-discharge or experiencing unmet rehabilitation needs leading to activity avoidance and social withdrawal [ 15 , 24 ].…”

Section: Discussionmentioning

confidence: 99%

“…Upon discharge from hospital, transition of care for all older adults could also include a focus on maintaining patients’ previous activities [ 25 ]. Once in the community setting, social prescribing may also offer practical support, including engagement in activities such as hobby clubs.…”

Section: Discussionmentioning

confidence: 99%

Returning to Leisure Activity Post-Stroke: Barriers and Facilitators to Engagement

Harrison

Thetford

Reeves

et al. 2022

IJERPH

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Objectives: To identify barriers and facilitators to engagement when returning to, or participating in, leisure activity post-stroke or Transient Ischemic Attack (TIA). Design: Sequential explanatory, mixed methods study. Setting: 21 hospital sites across England, Wales and Northern Ireland. Participants: Adults with a clinical diagnosis of first/recurrent stroke or TIA. Patients approaching end of life were excluded. Participants were recruited as in-patients or at first clinic appointment and a baseline questionnaire was completed. A 6-month follow-up questionnaire was sent to participants for self-completion. Open-text questions were asked about barriers and facilitators when returning to, or participating in, leisure activity. Responses were thematically analysed and explored by participant characteristics, including type of leisure activity undertaken. Characteristics also included measures of socioeconomic deprivation, mood, fatigue and disability. Results: 2000 participants returned a 6-month follow-up questionnaire (78% stroke, 22% TIA); 1045 participants responded to a question on barriers and 820 on facilitators. Twelve themes were identified and the proportion of responses were reported (%). Barriers: physical difficulties (69%), lower energy levels (17%), loss of independence (11%), psychological difficulties (10%), hidden disabilities (7%), and delay or lack of healthcare provision (3%). Facilitators: family support (35%), healthcare support (27%), well-being and fitness (22%), friendship support (20%), self-management (19%), and returning to normality (9%). ‘Physical difficulties’ was the most reported barrier across all participant characteristics and activity types. Family support was the most reported facilitator except for those with greater disability, where it was healthcare support and those without fatigue where it was well-being and exercise. Conclusions: Physical difficulties and lack of energy are problematic for stroke and TIA survivors who want to return to or participate in leisure activity. Healthcare support alone cannot overcome all practical and emotional issues related to leisure activity engagement. Family support and improving well-being are important facilitators and future research should explore these mechanisms further.

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“…However, most studies conducted during and after acute hospitalization examined predictors of decline in Basic Activities of Daily Living (BADL) such as personal hygiene and dressing [3,4] while overlooking other domains of participation relevant to high-functioning older adults such as outdoor recreational, social and leisure-physical activities. In light of this trend, recent studies have emphasized the importance of using a comprehensive assessment of participation that can capture even small incremental changes in function after acute hospitalization in older adults [5][6][7].…”

Section: Introductionmentioning

confidence: 99%

The contribution of functional cognition screening during acute illness hospitalization of older adults in predicting participation in daily life after discharge

et al. 2022

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Background Cognitive assessment in acutely hospitalized older adults is mainly limited to neuropsychological screening measures of global cognition. Performance-based assessments of functional cognition better indicate functioning in real-life situations. However, their predictive validity has been less studied in acute hospital settings. The aim of this study was to explore the unique contribution of functional cognition screening during acute illness hospitalization in predicting participation of older adults one and three months after discharge beyond traditional neuropsychological measures. Methods This prospective longitudinal study included 84 older adults ≥ 65 years hospitalized in internal medicine wards due to acute illness, followed by home visits at one month and telephone interviews at three months (n = 77). Participation in instrumental activities of daily living, social and leisure activities was measured by the Activity Card Sort. In-hospital factors included cognitive status (telephone version of the Mini-Mental State Examination, Color Trails Test), functional cognition screening (medication sorting task from the alternative Executive Function Performance Test), emotional status (Hospital Anxiety and Depression scale), functional decline during hospitalization (modified Barthel index), length of hospital stay, the severity of the acute illness, symptoms severity and comorbidities. Results Functional cognition outperformed the neuropsychological measures in predicting participation declines in a sample of relatively high-functioning older adults. According to a hierarchical multiple linear regression analysis, the overall model explained 28.4% of the variance in participation after one month and 19.5% after three months. Age and gender explained 18.6% of the variance after one month and 13.5% after three months. The medication sorting task explained an additional 5.5% of the variance of participation after one month and 5.1% after three months, beyond age and gender. Length of stay and the Color Trails Test were not significant contributors to the change in participation. Conclusions By incorporating functional cognition into acute settings, healthcare professionals would be able to better detect older adults with mild executive dysfunctions who are at risk for participation declines. Early identification of executive dysfunctions can improve continuity of care and planning of tailored post-discharge rehabilitation services, especially for high-functioning older adults, a mostly overlooked population in acute settings. The results support the use of functional cognition screening measure of medication management ability in acute settings.

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Integrating community participation in the transition of older adults from hospital to home: a scoping review

Cited by 7 publications

References 39 publications

Exploring the barriers and facilitators to volunteering as an intervention for those with long‐term neurological conditions: How make therapeutic volunteering possible?

Exploring the barriers and facilitators to volunteering as an intervention for those with long‐term neurological conditions: How make therapeutic volunteering possible?

Returning to Leisure Activity Post-Stroke: Barriers and Facilitators to Engagement

The contribution of functional cognition screening during acute illness hospitalization of older adults in predicting participation in daily life after discharge

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