Research Priorities in Post-acute and Long-term Care: Results of a Stakeholder Needs Assessment

Drake, Cynthia; Wald, Heidi L.; Eber, Leslie Beth; Trojanowski, Joanna I; Nearing, Kathryn; Boxer, Rebecca S.

doi:10.1016/j.jamda.2019.02.018

Cited by 18 publications

(12 citation statements)

References 14 publications

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“…Families are keen to participate in research ( Drake et al 2019 ). There are increasing calls for relationship-centred models of care ( Allison et al 2019 ).…”

Section: Discussionmentioning

confidence: 99%

Interventions promoting family involvement with care homes following placement of a relative with dementia: A systematic review

et al. 2021

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There is a wealth of literature investigating the role of family involvement within care homes following placement of a relative with dementia. This review summarises how family involvement is measured and aims to address two questions: (1) which interventions concerning family involvement have been evaluated? And (2) does family involvement within care homes have a positive effect on a resident’s quality of life and behavioural and psychological symptoms of dementia? After searching and screening on the three major databases PsycINFO, MEDLINE and CINAHL Plus for papers published between January 2005 and May 2021, 22 papers were included for synthesis and appraisal due to their relevance to family involvement interventions and or family involvement with resident outcomes. Results show that in 11 interventions designed to enhance at least one type of family involvement, most found positive changes in communication and family–staff relationships. Improvement in resident behavioural and psychological symptoms of dementia was reported in two randomised controlled trials promoting partnership. Visit frequency was associated with a reduction of behavioural and psychological symptoms of dementia for residents with moderate dementia. Family involvement was related to positive quality of life benefits for residents. Contrasting results and methodological weaknesses in some studies made definitive conclusions difficult. Few interventions to specifically promote family involvement within care homes following placement of a relative with dementia have been evaluated. Many proposals for further research made over a decade ago by Gaugler (2005) have yet to be extensively pursued. Uncertainty remains about how best to facilitate an optimum level and type of family involvement to ensure significant quality of life and behavioural and psychological symptoms of dementia benefits for residents with dementia.

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“…Families are keen to participate in research ( Drake et al 2019 ). There are increasing calls for relationship-centred models of care ( Allison et al 2019 ).…”

Section: Discussionmentioning

confidence: 99%

Interventions promoting family involvement with care homes following placement of a relative with dementia: A systematic review

et al. 2021

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“…Recently Backhaus et al, (2020) Families are keen to participate in research (Drake et al, 2019). There are increasing calls for relationship centred models of care (Allison, Balbino, & Covinsky, 2019).…”

Section: Strengths and Limitationsmentioning

confidence: 99%

Family involvement with care homes following placement of a relative living with dementia: a review

et al. 2021

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This review updated a previous review [Gaugler JE (2005) Family involvement in residential long-term care: a synthesis and critical review. Aging and Mental Health9, 105–118] and focused on dementia. Fourteen years of development in family involvement with care homes following placement of a relative was explored. The review aimed to investigate two questions: (1) What types of involvement do families have with care homes following placement of people living with dementia? (2) Which factors influence family involvement with care homes? PsycINFO, MEDLINE and CINAHL Plus were searched for publications between January 2005 and December 2018. Thirty-three papers representing 30 studies were included. Papers were appraised using a quality rating tool designed for use with mixed study designs. Studies were of a reasonable quality though some weaknesses included single-site samples, high attrition rates and poor reporting. Twenty-eight papers highlighted types of involvement including collaboration, family–staff relationship development, decision making and visiting. Twenty-five papers pertained to factors influencing involvement, which included outcome of care quality evaluation, wish for recognition and sense of integration into the care team. Type of family involvement has changed over time with increased emphasis on families’ desire for partnership, to be active rather than passive advocates, and to focus on care monitoring and evaluation. Seven themes of family involvement activities are featured and a non-linear process is proposed. When compared to patient and family-centred care principles, an analysis of family involvement types found good fit overall and potential for framework improvements. Over 30 diverse factors influence inter-family variation in the level and nature of family involvement. Consideration of these factors and resolution of the gaps in evidence, including intergenerational and cultural concerns, can improve care home facilitation of family participation. This dementia-specific review is a comprehensive timely complement to Gaugler's seminal work about older adults in care.

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“…Due to the steady improvement of acute mortality and increased awareness of the prolonged impact of critical illness on surgical patients, the long-term outcome is currently an essential issue in critically ill surgical patients [ 2 , 3 , 22 ]. Wunsch et al, analysing 3 year outcome among 35,308 patients who were discharged from ICU and two control groups, including 12,173 hospital controls 5266 general controls in Medicare claim, reported that patients discharged from ICU had a consistent higher 3-year mortality compared with those in hospital controls (39.5% vs. 34.5%; aHR 1.07, 95% CI 1.01–1.10) and general controls (39.5% vs. 14.9%; aHR 2.39, 95% CI 2.31–2.48) after adjustment of relevant covariates [ 4 ].…”

Section: Discussionmentioning

confidence: 99%

The association between culture positivity and long-term mortality in critically ill surgical patients

Wong

et al. 2021

j intensive care

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Background The long-term outcome is an essential issue in critically ill patients, and the identification of early determinant is needed for risk stratification of the long-term outcome. In the present study, we investigate the association between culture positivity during admission and long-term outcome in critically ill surgical patients. Methods We linked the 2015–2019 critical care database at Taichung Veterans General Hospital with the nationwide death registration files in Taiwan. We described the long-term mortality and proportion of culture positivity among enrolled subjects. We used a log-rank test to estimate survival curves between patients with and without positive cultures and a multivariable Cox proportional hazards regression model to determine hazard ratio (HR) and 95% confidence interval (CI). Results A total of 6748 critically ill patients were enrolled, and 32.5% (2196/6749) of them died during the follow-up period, with the overall follow-up duration was 1.8 ± 1.4 years. We found that 31.4% (2122/6748) of critically ill patients had at least one positive culture during the index admission, and the number of patients with positive culture in the blood, respiratory tract, urinary tract, skin and soft tissue and abdomen were 417, 1702, 554, 194 and 139, respectively. We found that a positive culture from any sites was independently associated with high long-term mortality (aHR 1.579, 95% CI 1.422–1.754) after adjusting relevant covariates, including age, sex, body-mass index, comorbidities, severity score, shock, early fluid overload, receiving mechanical ventilation and the need of renal replacement therapy for critical illness. Conclusions We linked two databases to identify that a positive culture during admission was independently correlated with increased long-term mortality in critically ill surgical patients. Our findings highlight the need for vigilance among patients with a positive culture during admission, and more studies are warranted to validate our findings and to clarify underlying mechanisms.

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Research Priorities in Post-acute and Long-term Care: Results of a Stakeholder Needs Assessment

Cited by 18 publications

References 14 publications

Interventions promoting family involvement with care homes following placement of a relative with dementia: A systematic review

Interventions promoting family involvement with care homes following placement of a relative with dementia: A systematic review

Family involvement with care homes following placement of a relative living with dementia: a review

The association between culture positivity and long-term mortality in critically ill surgical patients

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