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Rees J, Burton A, Walters K, Cooper C. Exploring the provision and support of care for long-term conditions in dementia: A qualitative study combining interviews and document analysis. DEMENTIA 2023; 22:820-837. [PMID: 36883009 PMCID: PMC9996169 DOI: 10.1177/14713012231161854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/09/2023]
Abstract
BACKGROUND The challenge of managing multiple long-term conditions is a prevalent issue for people with dementia and those who support their care. The presence of dementia complicates healthcare delivery and the development of personalised care plans, as health systems and clinical guidelines are often designed around single condition services. OBJECTIVE This study aimed to explore how care for long-term conditions is provided and supported for people with dementia in the community. METHODS In a qualitative, case study design, consecutive telephone or video-call interviews were conducted with people with dementia, their family carers and healthcare providers over a four-month period. Participant accounts were triangulated with documentary analysis of primary care medical records and event-based diaries kept by participants with dementia. Thematic analysis was used to develop across-group themes. FINDINGS Six main themes were identified from eight case studies: 1) Balancing support and independence, 2) Implementing and adapting advice for dementia contexts, 3) Prioritising physical, cognitive and mental health needs, 4) Competing and entwined needs and priorities, 5) Curating supportive professional networks, 6) Family carer support and coping. DISCUSSION These findings reflect the dynamic nature of dementia care which requires the adaptation of support in response to changing need. We witnessed the daily realities for families of implementing care recommendations in the community, which were often adapted for the contexts of family carers' priorities for care of the person living with dementia and what they were able to provide. Realistic self-management plans which are deliverable in practice must consider the intersection of physical, cognitive and mental health needs and priorities, and family carers needs and resources.
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Affiliation(s)
- Jessica Rees
- Division of Psychiatry, 4919University College London, London, UK
| | - Alexandra Burton
- Department of Behavioural Science and Health4919, University College London, London, UK
| | - Kate Walters
- Primary Care and Population Health, 4919University College London, London, UK
| | - Claudia Cooper
- Centre for Psychiatry and Mental health, Wolfson Institute of Population Health, 4617Queen Mary University of London, London, UK
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Km SUR, Hirano Y, Hirakawa Y, Yatsuya H. Diabetes management in people living with dementia in Japan: a qualitative exploration. Psychogeriatrics 2022; 22:728-735. [PMID: 35811502 DOI: 10.1111/psyg.12876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 05/23/2022] [Accepted: 06/21/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND Dementia and diabetes are highly prevalent among the older society in Japan. People living with dementia (PLWD) often face hurdles in managing diabetes. This study explored the perspectives of healthcare providers in Japan regarding diabetes management in PLWD. METHODS We conducted a qualitative study using in-depth interviews as a data collection method. A total of 15 physicians and nurses were interviewed. A qualitative content analysis of the codes was performed to generate the themes. RESULTS The major themes focused on the management of medications/therapeutic regimen, difficulties of continuing health care, emotional aspects of PLWD for adherence to lifestyle modification, and varying direction and degree of family support for diabetes care. CONCLUSION PLWD in Japan face challenges in medication management, food restriction, and lifestyle modification. Policies to engage home visit care workers in medication management, consideration of the emotional aspect of PLWD, and utilisation of social support might help in the proper management of diabetes in PLWD.
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Affiliation(s)
- Saif-Ur-Rahman Km
- Department of Public Health and Health Systems, Graduate School of Medicine, Nagoya University, Nagoya, Japan.,Health Systems and Population Studies Division, icddr,b, Dhaka, Bangladesh.,College of Medicine, Nursing and Health Sciences, University of Galway, Galway, Ireland.,Evidence Synthesis Ireland and Cochrane Ireland, Galway, Ireland
| | - Yukiko Hirano
- Department of Public Health and Health Systems, Graduate School of Medicine, Nagoya University, Nagoya, Japan
| | - Yoshihisa Hirakawa
- Department of Public Health and Health Systems, Graduate School of Medicine, Nagoya University, Nagoya, Japan
| | - Hiroshi Yatsuya
- Department of Public Health and Health Systems, Graduate School of Medicine, Nagoya University, Nagoya, Japan
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3
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Developing New Methods for Person-Centred Approaches to Adjudicate Context-Mechanism-Outcome Configurations in Realist Evaluation. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19042370. [PMID: 35206560 PMCID: PMC8871803 DOI: 10.3390/ijerph19042370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 02/14/2022] [Accepted: 02/15/2022] [Indexed: 01/25/2023]
Abstract
Realist evaluation provides a general method of evaluating the application of interventions including policy, legislation, projects, and new processes in social settings such as law enforcement, healthcare and education. Realist evaluation focuses on what about interventions works, for whom, and in what circumstances, and there is a growing body of work using realist evaluation to analyse interventions in healthcare organizations, including those using Lean Six Sigma improvement methodologies. Whilst realist evaluation facilitates the analysis of interventions using both qualitative and quantitative research, there is little guidance given on methods of data collection and analysis. The purpose of this study is to address this lack of guidance through detailing the use of innovative person-centred methods of data collection and analysis in a realist evaluation that enabled us to understand the contribution of Lean Six Sigma to person-centred care and cultures. This use of person-centred principles in the adjudication of identified program theories has informed novel methods of collecting and analysing data in realist evaluation that facilitate a person-centred approach to working with research participants and a way of making the implicit explicit when adjudicating program theory.
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Keen J, Abdulwahid MA, King N, Wright JM, Randell R, Gardner P, Waring J, Longo R, Nikolova S, Sloan C, Greenhalgh J. Effects of interorganisational information technology networks on patient safety: a realist synthesis. BMJ Open 2020; 10:e036608. [PMID: 33039991 PMCID: PMC7552839 DOI: 10.1136/bmjopen-2019-036608] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
OBJECTIVE Health services in many countries are investing in interorganisational networks, linking patients' records held in different organisations across a city or region. The aim of the systematic review was to establish how, why and in what circumstances these networks improve patient safety, fail to do so, or increase safety risks, for people living at home. DESIGN Realist synthesis, drawing on both quantitative and qualitative evidence, and including consultation with stakeholders in nominal groups and semistructured interviews. ELIGIBILITY CRITERIA The coordination of services for older people living at home, and medicine reconciliation for older patients returning home from hospital. INFORMATION SOURCES 17 sources including Medline, Embase, CINAHL, Cochrane Library, Web of Science, ACM Digital Library, and Applied Social Sciences Index and Abstracts. OUTCOMES Changes in patients' clinical risks. RESULTS We did not find any detailed accounts of the sequences of events that policymakers and others believe will lead from the deployment of interoperable networks to improved patient safety. We were, though, able to identify a substantial number of theory fragments, and these were used to develop programme theories.There is good evidence that there are problems with the coordination of services in general, and the reconciliation of medication lists in particular, and it indicates that most problems are social and organisational in nature. There is also good evidence that doctors and other professionals find interoperable networks difficult to use. There was limited high-quality evidence about safety-related outcomes associated with the deployment of interoperable networks. CONCLUSIONS Empirical evidence does not currently justify claims about the beneficial effects of interoperable networks on patient safety. There appears to be a mismatch between technology-driven assumptions about the effects of networks and the sociotechnical nature of coordination problems. PROSPERO REGISTRATION NUMBER CRD42017073004.
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Affiliation(s)
- Justin Keen
- Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | | | - Natalie King
- Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | - Judy M Wright
- Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | - Rebecca Randell
- Faculty of Health Studies, University of Bradford, Bradford, West Yorkshire, UK
| | - Peter Gardner
- School of Pharmacy and Medical Sciences, University of Bradford, Bradford, UK
| | - Justin Waring
- Health Services Management Centre, University of Birmingham, Birmingham, UK
| | - Roberta Longo
- Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | - Silviya Nikolova
- Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | - Claire Sloan
- Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
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5
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Abrams R, Park S, Wong G, Rastogi J, Boylan AM, Tierney S, Petrova M, Dawson S, Roberts N. Lost in reviews: Looking for the involvement of stakeholders, patients, public and other non-researcher contributors in realist reviews. Res Synth Methods 2020; 12:239-247. [PMID: 32985074 DOI: 10.1002/jrsm.1459] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 09/07/2020] [Accepted: 09/24/2020] [Indexed: 12/31/2022]
Abstract
The involvement of non-researcher contributors (eg, stakeholders, patients and the public, decision and policy makers, experts, lay contributors) has taken a variety of forms within evidence syntheses. Realist reviews are a form of evidence synthesis that involves non-researcher contributors yet this practice has received little attention. In particular, the role of patient and public involvement (PPI) has not been clearly documented. This review of reviews describes the ways in which contributor involvement, including PPI, is documented within healthcare realist reviews published over the last five years. A total of 448 papers published between 2014 and 2019 were screened, yielding 71 full-text papers included in this review. Statements about contributor involvement were synthesized across each review using framework analysis. Three themes are described in this article including nomenclature, nature of involvement, and reporting impact. Papers indicate that contributor involvement in realist reviews refers to stakeholders, experts, or advisory groups (ie, professionals, clinicians, or academics). Patients and the public are occasionally subsumed into these groups and in doing so, the nature and impact of their involvement become challenging to identify and at times, is lost completely. Our review findings indicate a need for the realist review community to develop guidance to support researchers in their future collaboration with contributors, including patients and the public.
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Affiliation(s)
- Ruth Abrams
- School of Health Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford, England
| | - Sophie Park
- Department of Primary care and population health, UCL, London, UK
| | - Geoff Wong
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Juhi Rastogi
- Department of Primary care and population health, UCL, London, UK
| | - Anne-Marie Boylan
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Stephanie Tierney
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Mila Petrova
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Shoba Dawson
- Centre for Academic Primary Care, Bristol Medical School, Population Health Sciences, University of Bristol, Bristol, UK
| | - Nia Roberts
- Bodleian Health Care Libraries, University of Oxford, Oxford, UK
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6
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Rees JL, Burton A, Walters KR, Leverton M, Rapaport P, Herat Gunaratne R, Beresford-Dent J, Cooper C. Exploring how people with dementia can be best supported to manage long-term conditions: a qualitative study of stakeholder perspectives. BMJ Open 2020; 10:e041873. [PMID: 33033103 PMCID: PMC7545621 DOI: 10.1136/bmjopen-2020-041873] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 07/29/2020] [Accepted: 09/09/2020] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES To explore how the self-management of comorbid long-term conditions is experienced and negotiated by people with dementia and their carers. DESIGN Secondary thematic analysis of 82 semi-structured interviews. SETTING Community settings across the United Kingdom. PARTICIPANTS 11 people with dementia, 22 family carers, 19 health professionals and 30 homecare staff. RESULTS We identified three overarching themes: (1) The process of substituting self-management: stakeholders balanced the wishes of people with dementia to retain autonomy with the risks of lower adherence to medical treatments. The task of helping a person with dementia to take medication was perceived as intermediate between a personal care and a medical activity; rules about which professionals could perform this activity sometimes caused conflict. (2) Communication in the care network: family carers often communicated with services and made decisions about how to implement medical advice. In situations where family carers or homecare workers were not substituting self-management, it could be challenging for general practitioners to identify changes in self-management and decide when to intervene. (3) Impact of physical health on and from dementia: healthcare professionals acknowledged the inter-relatedness of physical health and cognition to adapt care accordingly. Some treatments prescribed for long-term conditions were perceived as unhelpful when not adapted to the context of dementia. Healthcare professionals and homecare workers sometimes felt that family carers were unable to accept that available treatments may not be helpful to people with dementia and that this sometimes led to the continuation of treatments of questionable benefit. CONCLUSION The process of substituting self-management evolves with advancement of dementia symptoms and relies on communication in the care network, while considering the impact on and from dementia to achieve holistic physical health management. Care decisions must consider people with dementia as a whole, and be based on realistic outcomes and best interests.
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Affiliation(s)
| | | | - Kate R Walters
- Primary Care and Population Health, University College London, London, UK
| | - Monica Leverton
- Division of Psychiatry, University College London, London, UK
| | - Penny Rapaport
- Division of Psychiatry, University College London, London, UK
| | | | | | - Claudia Cooper
- Division of Psychiatry, University College London, London, UK
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Du Y, Paiva K, Cebula A, Kim S, Lopez K, Li C, White C, Myneni S, Seshadri S, Wang J. Diabetes-Related Topics in an Online Forum for Caregivers of Individuals Living With Alzheimer Disease and Related Dementias: Qualitative Inquiry. J Med Internet Res 2020; 22:e17851. [PMID: 32628119 PMCID: PMC7381255 DOI: 10.2196/17851] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Revised: 04/07/2020] [Accepted: 06/03/2020] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Diabetes and Alzheimer disease and related dementias (ADRD) are the seventh and sixth leading causes of death in the United States, respectively, and they coexist in many older adults. Caring for a loved one with both ADRD and diabetes is challenging and burdensome. OBJECTIVE This study aims to explore diabetes-related topics in the Alzheimer's Association ALZConnected caregiver forum by family caregivers of persons living with ADRD. METHODS User posts on the Alzheimer's Association ALZConnected caregiver forum were extracted. A total of 528 posts related to diabetes were included in the analysis. Of the users who generated the 528 posts, approximately 96.1% (275/286) were relatives of the care recipient with ADRD (eg, child, grandchild, spouse, sibling, or unspecified relative). Two researchers analyzed the data independently using thematic analysis. Any divergence was discussed among the research team, and an agreement was reached with a senior researcher's input as deemed necessary. RESULTS Thematic analysis revealed 7 key themes. The results showed that comorbidities of ADRD were common topics of discussions among family caregivers. Diabetes management in ADRD challenged family caregivers. Family caregivers might neglect their own health care because of the caring burden, and they reported poor health outcomes and reduced quality of life. The online forum provided a platform for family caregivers to seek support in their attempts to learn more about how to manage the ADRD of their care recipients and seek support for managing their own lives as caregivers. CONCLUSIONS The ALZConnected forum provided a platform for caregivers to seek informational and emotional support for caring for persons living with ADRD and diabetes. The overwhelming burdens with these two health conditions were apparent for both caregivers and care recipients based on discussions from the online forum. Studies are urgently needed to provide practical guidelines and interventions for diabetes management in individuals with diabetes and ADRD. Future studies to explore delivering diabetes management interventions through online communities in caregivers and their care recipients with ADRD and diabetes are warranted.
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Affiliation(s)
- Yan Du
- Center on Smart and Connected Health Technologies, School of Nursing, The University of Texas Health Science Center at San Antonio, San Antonio, TX, United States
| | - Kristi Paiva
- Center on Smart and Connected Health Technologies, School of Nursing, The University of Texas Health Science Center at San Antonio, San Antonio, TX, United States
| | - Adrian Cebula
- Center on Smart and Connected Health Technologies, School of Nursing, The University of Texas Health Science Center at San Antonio, San Antonio, TX, United States
| | - Seon Kim
- Center on Smart and Connected Health Technologies, School of Nursing, The University of Texas Health Science Center at San Antonio, San Antonio, TX, United States
| | - Katrina Lopez
- Center on Smart and Connected Health Technologies, School of Nursing, The University of Texas Health Science Center at San Antonio, San Antonio, TX, United States
| | - Chengdong Li
- Center on Smart and Connected Health Technologies, School of Nursing, The University of Texas Health Science Center at San Antonio, San Antonio, TX, United States
| | - Carole White
- School of Nursing, The University of Texas Health Science Center at San Antonio, San Antonio, TX, United States
| | - Sahiti Myneni
- School of Biomedical Informatics, The University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Sudha Seshadri
- Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases, The University of Texas Health Science Center at San Antonio, San Antonio, TX, United States
| | - Jing Wang
- Center on Smart and Connected Health Technologies, School of Nursing, The University of Texas Health Science Center at San Antonio, San Antonio, TX, United States
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Srikanth V, Sinclair AJ, Hill-Briggs F, Moran C, Biessels GJ. Type 2 diabetes and cognitive dysfunction-towards effective management of both comorbidities. Lancet Diabetes Endocrinol 2020; 8:535-545. [PMID: 32445740 DOI: 10.1016/s2213-8587(20)30118-2] [Citation(s) in RCA: 180] [Impact Index Per Article: 45.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Revised: 03/03/2020] [Accepted: 03/25/2020] [Indexed: 12/25/2022]
Abstract
Type 2 diabetes and cognitive dysfunction are highly prevalent disorders worldwide. Although type 2 diabetes is associated with an increased risk of dementia, awareness of the link between the two conditions is poor, and few recommendations are available to guide clinicians about how to approach cognitive dysfunction in people with diabetes. Clinical guidelines in diabetes have only recently begun to emphasise the importance of cognitive impairment in diabetes and its management. This Series paper aims to synthesise knowledge about the link between diabetes and cognitive dysfunction, issues pertaining to screening and diagnosis of cognitive impairment and dementia in those with type 2 diabetes, management of diabetes in people with cognitive dysfunction (accounting for age and frailty), and emerging therapies for prevention. A conceptual framework for approaching screening and diagnosis is included, and future research directions to guide the field forward are suggested.
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Affiliation(s)
- Velandai Srikanth
- Department of Geriatric Medicine, Peninsula Health, Peninsula Clinical School, Monash University, Melbourne, VIC, Australia.
| | - Alan J Sinclair
- Faculty of Life Sciences and Medicine, King's College London, London, UK
| | - Felicia Hill-Briggs
- Johns Hopkins School of Medicine, Welch Center for Prevention, Epidemiology, and Clinical Research, Baltimore, MD, USA
| | - Chris Moran
- Department of Geriatric Medicine, Peninsula Health, Peninsula Clinical School, Monash University, Melbourne, VIC, Australia
| | - Geert Jan Biessels
- Department of Neurology, UMC Utrecht Brain Center, University Medical Center, Utrecht, Netherlands
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Rees J, Tuijt R, Burton A, Walters K, Cooper C. Supporting self-care of long-term conditions in people with dementia: A systematic review. Int J Nurs Stud 2019; 116:103432. [PMID: 32197788 DOI: 10.1016/j.ijnurstu.2019.103432] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Revised: 09/09/2019] [Accepted: 09/13/2019] [Indexed: 11/18/2022]
Abstract
BACKGROUND Long-term conditions are common in people living with dementia; their self-management is an important determinant of wellbeing. Family carers often support or substitute self-care activities, and act as proxies for self-management, as dementia progresses. OBJECTIVES To conduct the first systematic review of how management of long-term conditions in people with dementia is best enabled and supported, including factors that facilitate or inhibit self-management and management by a proxy. DESIGN Systematic review. DATA SOURCES We systematically searched MEDLINE, PsychINFO, Embase and Allied and Complementary Medicine databases up to November 2018. REVIEW METHODS We identified the long-term conditions most prevalent in people with dementia that require an element of self-management. We then developed our inclusion criteria to identify qualitative and quantitative studies describing the self-management (or self-management assisted by family carers) of long-term conditions in people with dementia. Two authors independently rated study validity using a standardised checklist. We synthesised qualitative and quantitative findings using a data driven convergent synthesis approach. RESULTS We included 12 articles meeting predetermined inclusion criteria: seven qualitative, two case studies, two quantitative and one mixed methods study. We identified four main themes across these studies: (1) dementia symptoms impeding treatment regimens (forgetfulness, decreased understanding, ability to communicate symptoms and behavioural and psychological symptoms); (2) adapting routines to be simpler, (using memory aids and accommodating physical limitations); (3) negotiating self-management support (carer availability and knowledge; balancing needs for safety and empowerment); and (4) interface with professionals, (Routine simplification, condition specific education, and acknowledging carer role). CONCLUSIONS People living with dementia can be supported to manage their own health for as long as possible, through simplifying routines and reminding, but where this can no longer be negotiated, carers take over responsibility for self-management, often due to safety concerns. Empowerment of people with dementia to remain involved in their care reduces the loss experienced by this transition. Communication and partnership between clinicians and carers is critical when supporting people living with a long-term condition and dementia. Care planning for people living with dementia and a long-term condition should include explicit discussion of how these partnerships will work and guidance on strategies carers can use to support people to self-manage long-term conditions.
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Affiliation(s)
- Jessica Rees
- Division of Psychiatry, University College London, London, UK.
| | - Remco Tuijt
- Division of Psychiatry, University College London, London, UK
| | | | - Kate Walters
- Division of Psychiatry, University College London, London, UK
| | - Claudia Cooper
- Division of Psychiatry, University College London, London, UK
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Bethell J, Commisso E, Rostad HM, Puts M, Babineau J, Grinbergs-Saull A, Wighton MB, Hammel J, Doyle E, Nadeau S, McGilton KS. Patient engagement in research related to dementia: A scoping review. DEMENTIA 2018; 17:944-975. [PMID: 30373460 DOI: 10.1177/1471301218789292] [Citation(s) in RCA: 72] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Patient 'engagement' or 'involvement' in health research broadly refers to including people with lived experience (i.e. individuals with personal experience of a health issue and their friends, family and caregivers or carers) in the research process. Although previous reviews have systematically summarized approaches to patient engagement in research, it is unclear whether and how engagement activities have been implemented or adapted for research related to dementia. We conducted a scoping review to describe the extent and nature of patient engagement approaches that have been used to involve persons with dementia and their care partners in research. We then summarized the reported barriers, enablers, and impacts of this engagement. Fifty-four research articles were included in the review and almost all were published after 2010. Persons with dementia and their care partners have been engaged in diverse phases of the research process. The majority of engagement involved both persons with dementia and care partners. Barriers and enablers to engagement included those identified for general patient engagement in research, but some more specific to engaging persons with dementia and their care partners were also reported. Very few studies assessed the impact of patient engagement. While the arguments for patient engagement in research are compelling, research to demonstrate the impact - on the research process and outcomes as well as on persons with dementia, care partners, researchers, research institutions and society - is still needed.
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Affiliation(s)
- Jennifer Bethell
- Toronto Rehabilitation Institute - University Health Network, Toronto, Canada
| | - Elana Commisso
- Toronto Rehabilitation Institute - University Health Network, Toronto, Canada
| | | | - Martine Puts
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Canada
| | - Jessica Babineau
- Toronto Rehabilitation Institute - University Health Network, Toronto, Canada
| | - Anna Grinbergs-Saull
- Alzheimer's Society, UK; NIHR Clinical Research Network South London, Guy's Hospital, London, UK
| | | | - John Hammel
- Ontario Dementia Advisory Group, London, Canada
| | - Elizabeth Doyle
- Geriatric Medicine, Nova Scotia Health Authority / Dalhousie University, Halifax, Canada; Canadian Consortium on Neurodegeneration in Aging
| | - Sacha Nadeau
- Geriatric Medicine, Nova Scotia Health Authority / Dalhousie University, Halifax, Canada; Canadian Consortium on Neurodegeneration in Aging
| | - Katherine S McGilton
- Toronto Rehabilitation Institute - University Health Network, Toronto, Canada; Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Canada; Canadian Consortium on Neurodegeneration in Aging
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