Older people's views of quality of care: a randomised controlled study of continuum of care

Berglund, Heléne; Wilhelmson, Katarina; Blomberg, Staffan; Dunér, Anna; Kjellgren, Karin; Hasson, Henna

doi:10.1111/jocn.12276

Cited by 39 publications

(35 citation statements)

References 42 publications

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“…Thus, patients with complex, comprehensive care needs within primary care should be managed using collaborative care models involving inter-professional competencies (Stans et al 2013). In addition, a comprehensive continuum of care intervention may be successful if it includes care planning in the patients' homes and with case managers and a multi-professional team (Berglund et al 2013). Finally, the DNs in this study also lacked a structured forum for collaboration with physicians, such as GPs, regarding matters of the mental health care of these patients.…”

Section: Discussionmentioning

confidence: 99%

District nurses' perspectives on detecting mental health problems and promoting mental health among community‐dwelling seniors with multimorbidity

Grundberg

Hansson

Hillerås

et al. 2016

Journal of Clinical Nursing

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Aims and objectivesTo describe district nurses' perspectives on detecting mental health problems and promoting mental health among homebound older people with multimorbidity.BackgroundMental health problems among older people with multiple chronic conditions, that is, multimorbidity, are challenging issues. These patients' homes often serve as arenas in which district nurses can promote health. Mental health promotion must be studied in greater depth within primary care because older people with multimorbidity are particularly prone to developing poor mental health, which can go undetected and untreated.DesignA descriptive, qualitative study using semi‐structured interviews and content analysis.MethodsTwenty‐five district nurses completed individual or focus group interviews. Data were analysed using qualitative content analysis.ResultsMost district nurses stated that detecting mental health problems and promoting mental health were important tasks but that they typically focused on more practical home health care tasks. The findings revealed that district nurses focused on assessment, collaboration and social support as means of detecting mental health problems and promoting mental health.ConclusionsThe district nurses described various factors and actions that appeared to be important prerequisites for their involvement in primary mental health care. Nevertheless, there were no established goals for mental health promotion, and district nurses often seemed to depend on their collaboration with other actors. Our findings indicated that district nurses cannot bear the primary responsibility for the early detection of mental health problems and early interventions to promote mental health within this population.Relevance to clinical practiceThe findings of this study indicated that workforce training and collaboration between different care providers are important elements in the future development of this field. Early detection and early treatment of mental health‐related issues should also be stated as explicit objectives in the provision of care to community‐dwelling older people with multimorbidity.

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Section: Discussionmentioning

confidence: 99%

District nurses' perspectives on detecting mental health problems and promoting mental health among community‐dwelling seniors with multimorbidity

Grundberg

Hansson

Hillerås

et al. 2016

Journal of Clinical Nursing

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“…When receiving a comprehensive continuum of care intervention, frail older people perceived quality of care significantly higher [35]. More specially the items about care planning in the intervention group were rated higher than the control group at three- and 12 months follow-ups.…”

Section: Resultsmentioning

confidence: 99%

Outcome Indicators on Interprofessional Collaboration Interventions for Elderly

Tsakitzidis

Timmermans

Callewaert³

et al. 2016

International Journal of Integrated Care

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Background:Geriatric care increasingly needs more multidisciplinary health care services to deliver the necessary complex and continuous care. The aim of this study is to summarize indicators of effective interprofessional outcomes for this population.Method:A systematic review is performed in the Cochrane Library, Pubmed (Medline), Embase, Cinahl and Psychinfo with a search until June 2014.Results:Overall, 689 references were identified of which 29 studies met the inclusion criteria. All outcome indicators were summarized in three categories: collaboration, patient level outcome and costs. Seventeen out of 24 outcome indicators within the category of ‘collaboration’ reached significant difference in advantage of the intervention group. On ‘patient outcome level’ only 15 out of 32 outcome parameters met statistical significance. In the category of ‘costs’ only one study reached statistical significance.Discussion and conclusion:The overall effects of interprofessional interventions for elderly are positive, but based on heterogeneous outcomes. Outcome indicators of interprofessional collaboration for elderly with a significant effect can be summarized in three main categories: ‘collaboration’, patient level’ and ‘costs’. For ‘collaboration’ the outcome indicators are key elements of collaboration, involved disciplines, professional and patient satisfaction and quality of care. On ‘patient level’ the outcome indicators are pain, fall incidence, quality of life, independence for daily life activities, depression and agitated behaviour, transitions, length of stay in hospital, mortality and period of rehabilitation. ‘Costs’ of interprofessional interventions on short- and long-term for elderly need further investigation. When organizing interprofessional collaboration or interprofessional education these outcome indicators can be considered as important topics to be addressed. Overall more research is needed to gain insight in the process of interprofessional collaboration and so to learn to work interprofessionally.

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“…[21,22] Also, lack of communicational systems across the health care sectors negatively affects the older patient's transition between the sectors. It indicates the importance of proper information not only between health care professionals, but also between the health care professional and the older patient.…”

Section: Domainsmentioning

confidence: 99%

“…[23] Insufficient information seems to limit the older patient's understanding and feeling of being properly taken care of. [21,22] Several studies report a lack of information continuity between health care sectors, and the lack of information exchange has proven to compromise patient safety. [24,25] The patients who are well-informed about the transferral process express satisfaction, feel safe, and are in control of their situation.…”

Section: Domainsmentioning

confidence: 99%

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Patient satisfaction and early geriatric follow-up after discharge in older acute medical patients

Gregersen

Haahr

Pedersen

et al. 2016

Clinical Nursing Studies

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Objective: "Early geriatric follow-up after discharge" is a care model designed to create a safe transition from hospital to home by adding a follow-up visit in the patient's home within 24 hours after discharge. Patient satisfaction is of major importance to evaluate health care services. Therefore, the aim of this study was to compare patient satisfaction after early geriatric follow-up with that of usual follow-up after discharge. Materials and methods: The study is a cross-sectorial quantitative questionnaire survey. The target population was 75+ years' medical patients acutely admitted to an emergency department (ED) and enrolled in a quasi-randomized controlled trial. A 14-item satisfaction questionnaire, based on semi-structured interviews, was mailed to all cognitively well-functioning patients in both groups 2-4 weeks after discharge during three defined time periods. The themes of importance were: feeling safe, receiving sufficient information, experiencing good communication between health care professionals, involvement in care decisions, and relatives' involvement. Each question was evaluated by a 5-point Likert scale. The patients, who did not respond within 14 days, were reminded by phone and offered assistance to fill out the questionnaire. Results: In total, 173 out of 272 patients (64%) returned their questionnaire. Baseline characteristics of the groups were similar. More patients in the intervention group (receiving early geriatric follow-up after discharge) were "satisfied with treatment and care after discharge" and were "satisfied with the continuity of care at home" compared to the patients in the control group (receiving usual follow-up). More women were non-responders than men. Conclusions: Older medical patients acutely admitted to hospital were more satisfied with early geriatric follow-up than usual follow-up after discharge.

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Older people's views of quality of care: a randomised controlled study of continuum of care

Abstract: The results have implications for policymakers, managers and professionals in the area of health and social care for older people to meet individual needs of frail older people.

Cited by 39 publications

References 42 publications

District nurses' perspectives on detecting mental health problems and promoting mental health among community‐dwelling seniors with multimorbidity

District nurses' perspectives on detecting mental health problems and promoting mental health among community‐dwelling seniors with multimorbidity

Outcome Indicators on Interprofessional Collaboration Interventions for Elderly

Patient satisfaction and early geriatric follow-up after discharge in older acute medical patients

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