‘Who's actually gonna read this?’ An evaluation of staff experiences of the value of information contained in written care plans in supporting care in three different dementia care settings

Drummond, Corinne; Simpson, Alan

doi:10.1111/jpm.12380

Cited by 11 publications

(15 citation statements)

References 30 publications

(41 reference statements)

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“…There was a considerable focus on the impact of valuing decisions for the future (Brazil et al, 2015;Dening et al, 2013;Dening et al, 2017;Drummond and Simpson, 2017;O'Kelly et al, 2015;Poole et al, 2018;Poppe et al, 2013;Robinson et al, 2013). By valuing decision-making for the future, people with dementia and their family saw it as an opportunity and catalyst to make the preferences of the person with dementia known, which brought them relief and reassurance (O'Kelly et al, 2015).…”

Section: Resultsmentioning

confidence: 99%

“…From HCP perspectives, making decisions about the future was seen to be a good idea, but one that was difficult to implement (Brazil et al, 2015;Drummond and Simpson, 2017;Robinson et al, 2013). A postal survey of general practitioners in Table 2.…”

Section: Resultsmentioning

confidence: 99%

“…They discussed the future early as they valued the input of the person with dementia and wanted to avoid leaving the discussion too late for the person with dementia to participate in as their condition worsened (De Vleminck et al, 2014). However, some HCPs viewed end-of-life discussions to be time-consuming and not part of their responsibility (Beernaert et al, 2014;Drummond and Simpson, 2017;Poppe et al, 2013). Some people with dementia doubted whether their documented wishes would be respected or fulfilled and thus, did not value the process of formally planning for the future.…”

Section: Resultsmentioning

confidence: 99%

“…Some family members did not value making formal plans for the future as they believed it would be open to misinterpretation by the HCP, or the plan would nullify their authority to make decisions on behalf of the person with dementia once they lose their decision-making capacity (Dening et al, 2013). Some HCPs also held reservations about the value of formally planning for the future as they believed that it could become a tick-box procedure to reach service provision targets or duplicated existing processes (Drummond and Simpson, 2017;Robinson et al, 2013).…”

Section: Resultsmentioning

confidence: 99%

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The key factors for the engagement of primary stakeholders in decision-making for the future care of people with dementia living in the community: a systematic integrative review

Lai

Jeon

McKenzie

2019

Int. Psychogeriatr.

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Background:Engagement of people with dementia who are living in the community, their family or carers, and healthcare professionals in decision-making related to their future care is an area yet to be explored in the literature. In particular, little is known about the factors most likely to underpin their engagement.Objectives:To identify key factors for the engagement of the person with dementia living in the community, as well as their family or carer and their healthcare professionals in decision-making processes related to future care.Design:This is an integrative review guided by the PRISMA guidelines; the Mixed Methods Appraisal Tool was used to assess study quality. MEDLINE, PubMed, CINAHL, PsycINFO and Embase databases were searched for articles published from 2012 to 2018 that focused on people with dementia who live in the community, their family or carers, and community-based healthcare professionals.Results:Twenty articles were included in the review, and six key factors were identified through thematic analysis: knowledge and understanding of dementia and decision-making for the future, valuing decision-making for the future, healthcare professionals’ communication skills, timing of initiating conversations, relationship quality, and orientation to the future.Conclusion:This review identifies the six key factors required for the engagement of the three primary key stakeholders in decision-making about the future care of people with dementia. It also situates the factors within the complex context in which people with dementia, their family or carers, and healthcare professionals typically find themselves.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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The key factors for the engagement of primary stakeholders in decision-making for the future care of people with dementia living in the community: a systematic integrative review

Lai

Jeon

McKenzie

2019

Int. Psychogeriatr.

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“…If meaningful service user and carer involvement in care planning is to be achieved, then there is a pressing need to agree and foster a system-wide, user-centred model of collaboration and involvement. 21,22 Our research programme aimed to address the gap between policy and practice by addressing this need.…”

Section: Recommendations For Researchmentioning

confidence: 99%

Training to enhance user and carer involvement in mental health-care planning: the EQUIP research programme including a cluster RCT

Lovell

Bee

Bower

et al. 2019

Programme Grants Appl Res

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Background Service users and carers using mental health services want more involvement in their care and the aim of this research programme was to enhance service user and carer involvement in care planning in mental health services. Objectives Co-develop and co-deliver a training intervention for health professionals in community mental health teams, which aimed to enhance service user and carer involvement in care planning. Develop a patient-reported outcome measure of service user involvement in care planning, design an audit tool and assess individual preferences for key aspects of care planning involvement. Evaluate the clinical effectiveness and the cost-effectiveness of the training. Understand the barriers to and facilitators of implementing service user- and carer-involved care planning. Disseminate resources to stakeholders. Methods A systematic review, focus groups and interviews with service users/carers/health professionals informed the training and determined the priorities underpinning involvement in care planning. Data from focus groups and interviews were combined and analysed using framework analysis. The results of the systematic review, focus groups/interviews and a review of the training interventions were synthesised to develop the final training intervention. To develop and validate the patient-reported outcome measure, items were generated from focus groups and interviews, and a psychometric analysis was conducted. Patient-reported outcome measure items and a three-round consensus exercise were used to develop an audit tool, and a stated preference survey was undertaken to assess individual preferences for key aspects of care planning. The clinical effectiveness and cost-effectiveness of the training were evaluated using a pragmatic cluster trial with cohort and cross-sectional samples. A nested longitudinal qualitative process evaluation using multiple methods, including semistructured interviews with key informants involved locally and nationally in mental health policy, practice and research, was undertaken. A mapping exercise was used to determine current practice, and semistructured interviews were undertaken with service users and mental health professionals from both the usual-care and the intervention arms of the trial at three time points (i.e. baseline and 6 months and 12 months post intervention). Results The results from focus groups (n = 56) and interviews (n = 74) highlighted a need to deliver training to increase the quality of care planning and a training intervention was developed. We recruited 402 participants to develop the final 14-item patient-reported outcome measure and a six-item audit tool. We recruited 232 participants for the stated preference survey and found that preferences were strongest for the attribute ‘my preferences for care are included in the care plan’. The training was delivered to 304 care co-ordinators working in community mental health teams across 10 NHS trusts. The cluster trial and cross-sectional survey recruited 1286 service users and 90 carers, and the primary outcome was the Health Care Climate Questionnaire. Training was positively evaluated. The results showed no statistically significant difference on the primary outcome (the Health Care Climate Questionnaire) (adjusted mean difference –0.064, 95% confidence interval –0.343 to 0.215; p = 0.654) or secondary outcomes at the 6-month follow-up. Overall, the training intervention was associated with a net saving of –£54.00 (95% confidence interval –£193.00 to £84.00), with a net quality-adjusted life-year loss of –0.014 (95% confidence interval –0.034 to 0.005). The longitudinal process evaluation recruited 54 service users, professionals and carers, finding a failure of training to become embedded in routine care. Limitations Our pragmatic study was designed to improve service user and care involvement in care planning among routine community mental health services. We intervened in 18 sites with > 300 care co-ordinators. However, our volunteer sites may not be fully representative of the wider population, and we lacked data with which to compare our participants with the eligible population. Conclusions We co-developed and co-delivered a training intervention and developed a unidimensional measure of service user and carer involvement in care planning and an audit tool. Despite a high level of satisfaction with the training, no significant effect was found; therefore, the intervention was ineffective. There was a failure of training to become embedded and normalised because of a lack of organisational readiness to accept change. Working with NHS trusts in our ‘Willing Adopters’ programme with enhanced organisational buy-in yielded some promising results. Future work Research should focus on developing and evaluating new organisational initiatives in addition to training health-care professionals to address contextual barriers to service and carer involvement in care planning, and explore co-designing and delivering new ways of enhancing service users’ and carers’ capabilities to engage in care planning. Trial registration Current Controlled Trials ISRCTN16488358. Funding This project was funded by the National Institute for Health Research (NIHR) Programme Grants for Applied Research programme and will be published in full in Programme Grants for Applied Research; Vol. 7, No. 9. See the NIHR Journals Library website for further project information.

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Utilizing nursing standards in electronic health records: A descriptive qualitative study

Laukvik,

Lyngstad,

Rotegård

et al. 2024

International Journal of Medical Informatics

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‘Who's actually gonna read this?’ An evaluation of staff experiences of the value of information contained in written care plans in supporting care in three different dementia care settings

Cited by 11 publications

References 30 publications

The key factors for the engagement of primary stakeholders in decision-making for the future care of people with dementia living in the community: a systematic integrative review

The key factors for the engagement of primary stakeholders in decision-making for the future care of people with dementia living in the community: a systematic integrative review

Training to enhance user and carer involvement in mental health-care planning: the EQUIP research programme including a cluster RCT

Utilizing nursing standards in electronic health records: A descriptive qualitative study

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