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Graham L, Brundle C, Harrison N, Andre D, Clegg A, Forster A, Spilsbury K. What are the priorities for research of older people living in their own home, including those living with frailty? A systematic review and content analysis of studies reporting older people's priorities and unmet needs. Age Ageing 2024; 53:afad232. [PMID: 38243402 PMCID: PMC10798941 DOI: 10.1093/ageing/afad232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Indexed: 01/21/2024] Open
Abstract
BACKGROUND There is limited evidence regarding the needs of older people, including those living with frailty, to inform research priority setting. OBJECTIVES This systematic review aimed to identify the range of research priorities of community-dwelling older people living in their own home, including those living with frailty. METHODS Included studies were from economically developed countries and designed to identify the priorities for research or unmet needs of community-dwelling older people. Studies were excluded if they described priorities relating to specific health conditions. Medline, Embase, PsycInfo and CINAHL were searched (January 2010-June 2022), alongside grey literature. Study quality was assessed, but studies were not excluded on the basis of quality. A bespoke data extraction form was used and content analysis undertaken to synthesise findings. RESULTS Seventy-five reports were included. Seven explicitly aimed to identify the priorities or unmet needs of frail older people; 68 did not specify frailty as a characteristic. Study designs varied, including priority setting exercises, surveys, interviews, focus groups and literature reviews. Identified priorities and unmet needs were organised into themes: prevention and management, improving health and care service provision, improving daily life, meeting carers' needs and planning ahead. DISCUSSION Many priority areas were raised by older people, carers and health/care professionals, but few were identified explicitly by/for frail older people. An overarching need was identified for tailored, collaborative provision of care and support. CONCLUSION Review findings provide a valuable resource for researchers and health/care staff wishing to focus their research or service provision on areas of importance for older people.
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Affiliation(s)
- Liz Graham
- Academic Unit for Ageing and Stroke Research, Bradford Teaching Hospitals NHS Foundation Trust/University of Leeds, Bradford, UK
| | - Caroline Brundle
- Academic Unit for Ageing and Stroke Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
| | - Nicola Harrison
- Academic Unit for Ageing and Stroke Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
| | | | - Andrew Clegg
- Academic Unit for Ageing and Stroke Research, Bradford Teaching Hospitals NHS Foundation Trust/University of Leeds, Bradford, UK
| | - Anne Forster
- Academic Unit for Ageing and Stroke Research, Bradford Teaching Hospitals NHS Foundation Trust/University of Leeds, Bradford, UK
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Barnes K, Hladkowicz E, Dorrance K, Bryson GL, Forster AJ, Gagné S, Huang A, Lalu MM, Lavallée LT, Saunders C, Moloo H, Nantel J, Power B, Scheede-Bergdahl C, Taljaard M, van Walraven C, McCartney CJL, McIsaac DI. Barriers and facilitators to participation in exercise prehabilitation before cancer surgery for older adults with frailty: a qualitative study. BMC Geriatr 2023; 23:356. [PMID: 37280523 DOI: 10.1186/s12877-023-03990-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 04/22/2023] [Indexed: 06/08/2023] Open
Abstract
BACKGROUND Older adults with frailty are at an increased risk of adverse outcomes after surgery. Exercise before surgery (exercise prehabilitation) may reduce adverse events and improve recovery after surgery. However, adherence with exercise therapy is often low, especially in older populations. The purpose of this study was to qualitatively assess the barriers and facilitators to participating in exercise prehabilitation from the perspective of older people with frailty participating in the intervention arm of a randomized trial. METHODS This was a research ethics approved, nested descriptive qualitative study within a randomized controlled trial of home-based exercise prehabilitation vs. standard care with older patients (≥ 60 years) having elective cancer surgery, and who were living with frailty (Clinical Frailty Scale ≥ 4). The intervention was a home-based prehabilitation program for at least 3 weeks before surgery that involved aerobic activity, strength and stretching, and nutritional advice. After completing the prehabilitation program, participants were asked to partake in a semi-structured interview informed by the Theoretical Domains Framework (TDF). Qualitative analysis was guided by the TDF. RESULTS Fifteen qualitative interviews were completed. Facilitators included: 1) the program being manageable and suitable to older adults with frailty, 2) adequate resources to support engagement, 3) support from others, 4) a sense of control, intrinsic value, noticing progress and improving health outcomes and 5) the program was enjoyable and facilitated by previous experience. Barriers included: 1) pre-existing conditions, fatigue and baseline fitness, 2) weather, and 3) guilt and frustration when unable to exercise. A need for individualization and variety was offered as a suggestion by participants and was therefore described as both a barrier and facilitator. CONCLUSIONS Home-based exercise prehabilitation is feasible and acceptable to older people with frailty preparing for cancer surgery. Participants identified that a home-based program was manageable, easy to follow with helpful resources, included valuable support from the research team, and they reported self-perceived health benefits and a sense of control over their health. Future studies and implementation should consider increased personalization based on health and fitness, psychosocial support and modifications to aerobic exercises in response to adverse weather conditions.
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Affiliation(s)
- Keely Barnes
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada
| | - Emily Hladkowicz
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada
| | - Kristin Dorrance
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada
| | - Gregory L Bryson
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada
- Department of Anesthesiology and Pain Medicine, University of Ottawa and The Ottawa Hospital, The Ottawa Hospital Civic Campus, Room B311, 1053 Carling Ave, Ottawa, ON, K1Y 4E9, Canada
| | - Alan J Forster
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada
- Division of General Internal Medicine, University of Ottawa and The Ottawa Hospital, Ottawa, Canada
| | - Sylvain Gagné
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada
- Department of Anesthesiology and Pain Medicine, University of Ottawa and The Ottawa Hospital, The Ottawa Hospital Civic Campus, Room B311, 1053 Carling Ave, Ottawa, ON, K1Y 4E9, Canada
| | - Allen Huang
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada
- Division of Geriatric Medicine, University of Ottawa and The Ottawa Hospital, Ottawa, Canada
| | - Manoj M Lalu
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada
- Department of Anesthesiology and Pain Medicine, University of Ottawa and The Ottawa Hospital, The Ottawa Hospital Civic Campus, Room B311, 1053 Carling Ave, Ottawa, ON, K1Y 4E9, Canada
| | - Luke T Lavallée
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada
- Division of Urology, University of Ottawa and The Ottawa Hospital, Ottawa, Canada
| | - Chelsey Saunders
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada
- Department of Anesthesiology and Pain Medicine, University of Ottawa and The Ottawa Hospital, The Ottawa Hospital Civic Campus, Room B311, 1053 Carling Ave, Ottawa, ON, K1Y 4E9, Canada
| | - Hussein Moloo
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada
- Division of General Surgery, University of Ottawa and The Ottawa Hospital, Ottawa, Canada
| | - Julie Nantel
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada
- School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, Canada
| | - Barbara Power
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada
- Division of Geriatric Medicine, University of Ottawa and The Ottawa Hospital, Ottawa, Canada
| | | | - Monica Taljaard
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada
- School of Epidemiology & Public Health, University of Ottawa, Ottawa, Canada
| | - Carl van Walraven
- Department of Anesthesiology and Pain Medicine, University of Ottawa and The Ottawa Hospital, The Ottawa Hospital Civic Campus, Room B311, 1053 Carling Ave, Ottawa, ON, K1Y 4E9, Canada
- Department of Medicine, University of Ottawa and The Ottawa Hospital, Ottawa, Canada
| | - Colin J L McCartney
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada
- Department of Anesthesiology and Pain Medicine, University of Ottawa and The Ottawa Hospital, The Ottawa Hospital Civic Campus, Room B311, 1053 Carling Ave, Ottawa, ON, K1Y 4E9, Canada
| | - Daniel I McIsaac
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada.
- Department of Anesthesiology and Pain Medicine, University of Ottawa and The Ottawa Hospital, The Ottawa Hospital Civic Campus, Room B311, 1053 Carling Ave, Ottawa, ON, K1Y 4E9, Canada.
- School of Epidemiology & Public Health, University of Ottawa, Ottawa, Canada.
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Barbeau VI, Madani L, Al Ameer A, Tanjong Ghogomu E, Beecher D, Conde M, Howe TE, Marcus S, Morley R, Nasser M, Smith M, Thompson Coon J, Welch VA. Research priority setting related to older adults: a scoping review to inform the Cochrane-Campbell Global Ageing Partnership work programme. BMJ Open 2022; 12:e063485. [PMID: 36123060 PMCID: PMC9486333 DOI: 10.1136/bmjopen-2022-063485] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 08/10/2022] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVE To explore and map the findings of prior research priority-setting initiatives related to improving the health and well-being of older adults. DESIGN Scoping review. DATA SOURCES Searched MEDLINE, EMBASE, AgeLine, CINAHL and PsycINFO databases from January 2014 to 26 April 2021, and the James Lind Alliance top 10 priorities. ELIGIBILITY CRITERIA We included primary studies reporting research priorities gathered from stakeholders that focused on ageing or the health of older adults (≥60 years). There were no restrictions by setting, but language was limited to English and French. DATA EXTRACTION AND SYNTHESIS We used a modified Reporting Guideline for Priority Setting of Health Research (REPRISE) guideline to assess the transparency of the reported methods. Population-intervention-control-outcome (PICO) priorities were categorised according to their associated International Classification of Health Interventions (ICHI) and International Classification of Functioning (ICF) outcomes. Broad research topics were categorised thematically. RESULTS Sixty-four studies met our inclusion criteria. The studies gathered opinions from various stakeholder groups, including clinicians (n=56 studies) and older adults (n=35), and caregivers (n=24), with 75% of the initiatives involving multiple groups. None of the included priority-setting initiatives reported gathering opinions from stakeholders located in low-income or middle-income countries. Of the priorities extracted, 272 were identified as broad research topics, while 217 were identified as PICO priorities. PICO priorities that involved clinical outcomes (n=165 priorities) and interventions concerning health-related behaviours (n=59) were identified most often. Broad research topics on health services and systems were identified most often (n=60). Across all these included studies, the reporting of six REPRISE elements was deemed to be critically low. CONCLUSION Future priority setting initiatives should focus on documenting a more detailed methodology with all initiatives eliciting opinions from caregivers and older adults to ensure priorities reflect the opinions of all key stakeholder groups.
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Affiliation(s)
| | - Leen Madani
- Bruyere Research Institute, Ottawa, Ontario, Canada
| | | | | | | | - Monserrat Conde
- Cochrane Campbell Global Ageing Partnership, Portimao, Portugal
- University of Oxford Centre for Evidence-Based Medicine, Oxford, UK
| | - Tracey E Howe
- Cochrane Campbell Global Ageing Partnership, Glasgow, UK
| | - Sue Marcus
- Radcliffe Department of Medicine, University of Oxford, Oxford, UK
| | | | | | | | - Jo Thompson Coon
- NIHR CLAHRC South West Peninsula, University of Exeter Medical School, Exeter, UK
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Developing a Regional Strategy for Older Adults Living With Frailty: Recommendations From Patients, Family Caregivers and Health Care Providers. Int J Integr Care 2022; 22:13. [PMID: 36117872 PMCID: PMC9438459 DOI: 10.5334/ijic.6438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Accepted: 08/23/2022] [Indexed: 12/02/2022] Open
Abstract
Introduction: Health care organizations are increasingly recognizing the need to integrate the health care system to better care for older adults. We partnered with a local health centre to inform the development of a Regional Frail Senior Strategy for Southwestern Ontario, Canada. Methodology: Interviews were conducted with 12 older adults (65+, with chronic conditions) and family caregivers. 44 interviews were also completed with health care providers from across the region. To engage with a range of stakeholders on the strategy, four feedback fairs were hosted. Interviewees emphasized the importance of person and family-centred care, integration of health care services, issues of access, and further training and education for health care professionals. Findings and stakeholder feedback were synthesized into 14 recommendations. Discussion: The data and recommendations outlined in this paper informed the development of the frailty strategy for a region in Ontario. Participatory methods and stakeholder engagement identified pertinent themes related to enhancing care for older adults with frailty. Conclusion: The creation of a frailty strategy is imperative in recognizing and responding to the needs of older adults with complex conditions. Our approach may be relevant to other organizations and health systems interested in developing their own regional frailty strategies.
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McIsaac DI, Fergusson DA, Khadaroo R, Meliambro A, Muscedere J, Gillis C, Hladkowicz E, Taljaard M. PREPARE trial: a protocol for a multicentre randomised trial of frailty-focused preoperative exercise to decrease postoperative complication rates and disability scores. BMJ Open 2022; 12:e064165. [PMID: 35940835 PMCID: PMC9364396 DOI: 10.1136/bmjopen-2022-064165] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 05/30/2022] [Indexed: 12/14/2022] Open
Abstract
INTRODUCTION Frailty is a strong predictor of adverse postoperative outcomes. Prehabilitation may improve outcomes after surgery for older people with frailty by addressing physical and physiologic deficits. The objective of this trial is to evaluate the efficacy of home-based multimodal prehabilitation in decreasing patient-reported disability and postoperative complications in older people with frailty having major surgery. METHODS AND ANALYSIS We will conduct a multicentre, randomised controlled trial of home-based prehabilitation versus standard care among consenting patients >60 years with frailty (Clinical Frailty Scale>4) having elective inpatient major non-cardiac, non-neurologic or non-orthopaedic surgery. Patients will be partially blinded; clinicians and outcome assessors will be fully blinded. The intervention consists of >3 weeks of prehabilitation (exercise (strength, aerobic and stretching) and nutrition (advice and protein supplementation)). The study has two primary outcomes: in-hospital complications and patient-reported disability 30 days after surgery. Secondary outcomes include survival, lower limb function, quality of life and resource utilisation. A sample size of 750 participants (375 per arm) provides >90% power to detect a minimally important absolute difference of 8 on the 100-point patient-reported disability scale and a 25% relative risk reduction in complications, using a two-sided alpha value of 0.025 to account for the two primary outcomes. Analyses will follow intention to treat principles for all randomised participants. All participants will be followed to either death or up to 1 year. ETHICS AND DISSEMINATION Ethical approval has been granted by Clinical Trials Ontario (Project ID: 1785) and our ethics review board (Protocol Approval #20190409-01T). Results will be disseminated through presentation at scientific conferences, through peer-reviewed publication, stakeholder organisations and engagement of social and traditional media. TRIAL REGISTRATION NUMBER NCT04221295.
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Affiliation(s)
- Daniel I McIsaac
- Anesthesiology and Pain Medicine, Ottawa Hospital Research Institute Clinical Epidemiology Program, Ottawa, Ontario, Canada
| | - Dean A Fergusson
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Rachel Khadaroo
- Department of Surgery, University of Alberta, Edmonton, Alberta, Canada
| | - Amanda Meliambro
- Patient Engagement, Ottawa Hospital General Campus, Ottawa, Ontario, Canada
| | | | - Chelsia Gillis
- School of Human Nutrition, McGill University, Montreal, Quebec, Canada
| | - Emily Hladkowicz
- Anesthesiology and Pain Medicine, Ottawa Hospital Research Institute Clinical Epidemiology Program, Ottawa, Ontario, Canada
| | - Monica Taljaard
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
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Cole L, Easley J, Grightmire L, Lakshmanan EM, Matthias SJ, McBoyle K, Piercell E, Purdy A, Schneider N, Wassersug RJ, Martino R, Fitch MI. Every Story Is Different: Experiences With Body Changes Related to Cancer. Front Psychol 2022; 13:831811. [PMID: 35677121 PMCID: PMC9169964 DOI: 10.3389/fpsyg.2022.831811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Accepted: 04/05/2022] [Indexed: 11/16/2022] Open
Abstract
One of the important aspects of stakeholder engagement in cancer care and system planning is hearing from individuals who have been diagnosed with cancer about the impact of the diagnosis and treatment on their lives. Hearing stories from the perspectives of cancer survivors offers opportunity to gain new insight and understanding about experiences of being diagnosed and treated for cancer. This article presents ten short narratives about survivors' perspectives on body image and cancer. Each story is unique but, taken together, the picture they create is one of facing challenges, discovering personal resilience, and moving forward to engage in living. The stories emphasize the importance of communication and support from healthcare providers and understanding needs for a person-centered cancer care system.
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Affiliation(s)
- Linda Cole
- Independent Scholar, Toronto, ON, Canada
| | | | | | | | - Sharon J. Matthias
- Matthias Inc: Connecting for Innovation and Advancing Societies, Edmonton, AB, Canada
| | | | | | | | | | | | - Rosemary Martino
- Department of Speech Language Pathology, Rehabilitation Science Institute, University of Toronto, Toronto, ON, Canada
| | - Margaret I. Fitch
- Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada
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McIsaac DI, Hladkowicz E, Bryson GL, Forster AJ, Gagne S, Huang A, Lalu M, Lavallée LT, Moloo H, Nantel J, Power B, Scheede-Bergdahl C, van Walraven C, McCartney CJL, Taljaard M. Home-based prehabilitation with exercise to improve postoperative recovery for older adults with frailty having cancer surgery: the PREHAB randomised clinical trial. Br J Anaesth 2022; 129:41-48. [PMID: 35589429 DOI: 10.1016/j.bja.2022.04.006] [Citation(s) in RCA: 32] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 03/23/2022] [Accepted: 04/11/2022] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Frailty is a state of vulnerability as a result of decreased reserves. Prehabilitation may increase reserve and improve postoperative outcomes. Our objective was to determine if home-based prehabilitation improves postoperative functional recovery in older adults with frailty having cancer surgery. METHODS This double blind randomised trial enrolled people ≥60 yr having elective cancer surgery and ≥3 weeks from enrolment to surgery as eligible. Participation in a remotely supported, home-based exercise prehabilitation program plus nutritional guidance was compared with standard care plus written advice on age-appropriate activity and nutrition. The primary outcome was 6-min walk test (6MWT) distance at the first postoperative clinic visit. Secondary outcomes included physical performance, quality of life, disability, length of stay, non-home discharge, and 30-day readmission. RESULTS Of 543 patients assessed, 254 were eligible and 204 (80%) were randomised (102 per arm); 182 (94 intervention and 88 control) had surgery and were analysed. Mean age was 74 yr and 57% were female. Mean duration of participation was 5 weeks, mean adherence was 61% (range 0%-100%). We found no significant difference in 6MWT at follow-up (+14 m, 95% confidence interval -26-55 m, P=0.486), or for secondary outcomes. Analyses using a prespecified adherence definition of ≥80% supported improvements in 6MWT distance, complication count, and disability. CONCLUSIONS A home-based prehabilitation program did not significantly improve postoperative recovery or other outcomes in older adults with frailty having cancer surgery. Program adherence may be a key mediator of prehabilitation efficacy. CLINICAL TRIAL REGISTRATION NCT02934230.
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Affiliation(s)
- Daniel I McIsaac
- Department of Anesthesiology & Pain Medicine, The Ottawa Hospital, University of Ottawa, Ottawa, ON, Canada; Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada; School of Epidemiology & Public Health, University of Ottawa, Ottawa, ON, Canada.
| | - Emily Hladkowicz
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada; School of Rehabilitation Therapy, Queen's University, Kingston, ON, Canada
| | - Gregory L Bryson
- Department of Anesthesiology & Pain Medicine, The Ottawa Hospital, University of Ottawa, Ottawa, ON, Canada; Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Alan J Forster
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada; Division of General Internal Medicine, University of Ottawa and the Ottawa Hospital, Ottawa, ON, Canada
| | - Sylvain Gagne
- Department of Anesthesiology & Pain Medicine, The Ottawa Hospital, University of Ottawa, Ottawa, ON, Canada; Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Allen Huang
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada; Division of Geriatric Medicine, University of Ottawa and the Ottawa Hospital, Ottawa, ON, Canada
| | - Manoj Lalu
- Department of Anesthesiology & Pain Medicine, The Ottawa Hospital, University of Ottawa, Ottawa, ON, Canada; Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Luke T Lavallée
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada; Division of Urology and University of Ottawa and the Ottawa Hospital, Ottawa, ON, Canada
| | - Husein Moloo
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada; Division of General Surgery, University of Ottawa and the Ottawa Hospital, Ottawa, ON, Canada
| | - Julie Nantel
- School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada
| | - Barbara Power
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada; Division of Geriatric Medicine, University of Ottawa and the Ottawa Hospital, Ottawa, ON, Canada
| | | | - Carl van Walraven
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada; Department of Medicine, University of Ottawa and the Ottawa Hospital, Ottawa, ON, Canada; Institute for Clinical Evaluative Sciences, University of Ottawa, Ottawa, ON, Canada
| | - Colin J L McCartney
- Department of Anesthesiology & Pain Medicine, The Ottawa Hospital, University of Ottawa, Ottawa, ON, Canada; Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Monica Taljaard
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada; School of Epidemiology & Public Health, University of Ottawa, Ottawa, ON, Canada
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Braun T, Bahns C, Elsner B, Kopkow C. Forschungsprioritäten in der physiotherapeutischen Forschung in Deutschland – Eine systematische Analyse von Publikationen der physioscience der letzten 10 Jahre. PHYSIOSCIENCE 2022. [DOI: 10.1055/a-1549-5166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Zusammenfassung
Hintergrund Forschungsprioritäten können dazu beitragen, Evidenz in den Bereichen zu entwickeln, die für Patient*innen und Kliniker*innen am wichtigsten sind. Forschungsprioritäten werden jedoch in der biomedizinischen Forschung nur unzureichend berücksichtigt.
Ziel Beschreibung der Berücksichtigung von Forschungsprioritäten in der physiotherapeutischen Forschung in Deutschland.
Methode Analyse von physiotherapeutischen Berichten aus Deutschland, die zwischen 2011 und 2020 in der Fachzeitschrift physioscience publiziert wurden. Für jeden eingeschlossenen Bericht wurde die primäre Forschungsfrage und/oder der Hauptgegenstandsbereich identifiziert und, falls möglich, einem spezifischen Gesundheitszustand zugeordnet. Danach wurde für jeden Bericht geprüft, ob eine gesundheitszustandsspezifische Forschungspriorität (von der James Lind Alliance oder aus wissenschaftlichen Datenbanken) bzw. eine der Top 26 der physiotherapiespezifischen Forschungsprioritäten des britischen Berufsverbandes „The Chartered Society of Physiotherapy (CSP)“ aus 2018 adressiert wurde. Die Datenanalyse erfolgte deskriptiv.
Ergebnisse Es konnten 78 Berichte in die Analyse eingeschlossen werden. Die häufigsten Studientypen waren Übersichtsarbeiten (17/78, 22 %), Beobachtungsstudien (16/78, 21 %) und Umfragen (13/78, 17 %). Für die Analyse der gesundheitszustandsspezifischen Forschungsprioritäten konnten 51 Berichte berücksichtigt werden. In 51 % dieser Berichte (26/51) wurde eine der 10 wichtigsten Forschungsprioritäten des jeweiligen Themengebiets adressiert. In den übrigen Berichten wurde keine gesundheitszustandsspezifische Forschungspriorität berücksichtigt (13/51, 25 %) oder die Priorität gehörte nicht zu den Top Ten (12/51, 24 %).Für die Analyse der physiotherapeutischen Forschungsprioritäten wurden alle 78 Berichte berücksichtigt. In 21 % dieser Berichte (16/78) wurde eine Top-Ten-Priorität adressiert. In den übrigen Berichten wurde eine weniger wichtige Priorität adressiert (Listenplatz 11–26; 25/78, 32 %) oder das Forschungsthema des Berichts gehörte nicht zu den Top 26 (37/78, 47 %).
Schlussfolgerung Die vorliegende Studie liefert erste Hinweise darauf, dass Forschungsprioritäten in der physiotherapeutischen Forschung in Deutschland nur unzureichend berücksichtigt werden. Ein erheblicher Teil der Forschung scheint somit an den Bedürfnissen von Patient*innen und Kliniker*innen vorbeizugehen. Die Berücksichtigung existierender Forschungsprioritäten und die Entwicklung nationaler Forschungsprioritäten für die Physiotherapie in Deutschland könnten dazu beitragen, den Nutzen der physiotherapeutischen Forschung für die öffentliche Gesundheit zu vergrößern.
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Affiliation(s)
- Tobias Braun
- Hochschule für Gesundheit, Department für Angewandte Gesundheitswissenschaften, Studienbereich Physiotherapie, Bochum, Deutschland
- HSD Hochschule Döpfer, Fachbereich Gesundheit, Köln, Deutschland
| | - Carolin Bahns
- Brandenburgische Technische Universität Cottbus-Senftenberg, Fachgebiet Therapiewissenschaften, Senftenberg, Deutschland
| | - Bernhard Elsner
- SRH Hochschule für Gesundheit, Department Therapiewissenschaften, Campus Gera, Gera, Deutschland
- Technische Universität Dresden, Gesundheitswissenschaften/Public Health, Dresden, Deutschland
| | - Christian Kopkow
- Brandenburgische Technische Universität Cottbus-Senftenberg, Fachgebiet Therapiewissenschaften, Senftenberg, Deutschland
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Aguayo GA, Goetzinger C, Scibilia R, Fischer A, Seuring T, Tran VT, Ravaud P, Bereczky T, Huiart L, Fagherazzi G. Methods to Generate Innovative Research Ideas and Improve Patient and Public Involvement in Modern Epidemiological Research: Review, Patient Viewpoint, and Guidelines for Implementation of a Digital Cohort Study. J Med Internet Res 2021; 23:e25743. [PMID: 34941554 PMCID: PMC8738987 DOI: 10.2196/25743] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Revised: 01/16/2021] [Accepted: 10/08/2021] [Indexed: 01/20/2023] Open
Abstract
Background Patient and public involvement (PPI) in research aims to increase the quality and relevance of research by incorporating the perspective of those ultimately affected by the research. Despite these potential benefits, PPI is rarely included in epidemiology protocols. Objective The aim of this study is to provide an overview of methods used for PPI and offer practical recommendations for its efficient implementation in epidemiological research. Methods We conducted a review on PPI methods. We mirrored it with a patient advocate’s viewpoint about PPI. We then identified key steps to optimize PPI in epidemiological research based on our review and the viewpoint of the patient advocate, taking into account the identification of barriers to, and facilitators of, PPI. From these, we provided practical recommendations to launch a patient-centered cohort study. We used the implementation of a new digital cohort study as an exemplary use case. Results We analyzed data from 97 studies, of which 58 (60%) were performed in the United Kingdom. The most common methods were workshops (47/97, 48%); surveys (33/97, 34%); meetings, events, or conferences (28/97, 29%); focus groups (25/97, 26%); interviews (23/97, 24%); consensus techniques (8/97, 8%); James Lind Alliance consensus technique (7/97, 7%); social media analysis (6/97, 6%); and experience-based co-design (3/97, 3%). The viewpoint of a patient advocate showed a strong interest in participating in research. The most usual PPI modalities were research ideas (60/97, 62%), co-design (42/97, 43%), defining priorities (31/97, 32%), and participation in data analysis (25/97, 26%). We identified 9 general recommendations and 32 key PPI-related steps that can serve as guidelines to increase the relevance of epidemiological studies. Conclusions PPI is a project within a project that contributes to improving knowledge and increasing the relevance of research. PPI methods are mainly used for idea generation. On the basis of our review and case study, we recommend that PPI be included at an early stage and throughout the research cycle and that methods be combined for generation of new ideas. For e-cohorts, the use of digital tools is essential to scale up PPI. We encourage investigators to rely on our practical recommendations to extend PPI in future epidemiological studies.
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Affiliation(s)
- Gloria A Aguayo
- Deep Digital Phenotyping Research Unit, Department of Population Health, Luxembourg Institute of Health, Strassen, Luxembourg
| | - Catherine Goetzinger
- Deep Digital Phenotyping Research Unit, Department of Population Health, Luxembourg Institute of Health, Strassen, Luxembourg
| | - Renza Scibilia
- Diabetes Australia, Melbourne, Australia.,Diabetogenic, Melbourne, Australia
| | - Aurélie Fischer
- Deep Digital Phenotyping Research Unit, Department of Population Health, Luxembourg Institute of Health, Strassen, Luxembourg
| | - Till Seuring
- Luxembourg Institute of Socio-Economic Research, Esch/Alzette, Luxembourg
| | - Viet-Thi Tran
- Centre of Research in Epidemiology and Statistic Sorbonne Paris Cité, National Institute of Health and Medical Research (INSERM), French National Institute for Agricultural Research (INRA), Université de Paris, Paris, France.,Centre d'Epidémiologie Clinique, Hôpital Hôtel-Dieu, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Philippe Ravaud
- Centre of Research in Epidemiology and Statistic Sorbonne Paris Cité, National Institute of Health and Medical Research (INSERM), French National Institute for Agricultural Research (INRA), Université de Paris, Paris, France.,Centre d'Epidémiologie Clinique, Hôpital Hôtel-Dieu, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Tamás Bereczky
- European Patients' Academy on Therapeutic Innovation, Brussels, Belgium
| | - Laetitia Huiart
- Deep Digital Phenotyping Research Unit, Department of Population Health, Luxembourg Institute of Health, Strassen, Luxembourg
| | - Guy Fagherazzi
- Deep Digital Phenotyping Research Unit, Department of Population Health, Luxembourg Institute of Health, Strassen, Luxembourg
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Madsen K, Wibe T, Bye A, Debesay J, Bergland A. Top 10 research priorities to improve the everyday life of older patients with multimorbidity: A James Lind Alliance (JLA) inspired Priority Setting Partnership (PSP). TIDSSKRIFT FOR OMSORGSFORSKNING 2021. [DOI: 10.18261/issn.2387-5984-2021-02-05] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Abstract
There is growing interest in conceptualizing and diagnosing frailty. Less is understood, however, about older adults' perceptions of the term "frail", and the implications of being classified as "frail". The purpose of this scoping review was to map the breadth of primary studies; and describe the meaning, perceptions, and perceived implications of frailty language amongst community-dwelling older adults. Eight studies were included in the review and three core themes were identified: (1) understanding frailty as inevitable age-related decline in multiple domains, (2) perceiving frailty as a generalizing label, and (3) perceiving impacts of language on health and health care utilization. Clinical practice recommendations for health care professionals working with individuals with frailty include: (1) maintaining a holistic view of frailty that extends beyond physical function to include psychosocial and environmental constructs, (2) using person-first language, and (3) using a strengths-based approach to discuss aspects of frailty.
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12
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Digital Health Interventions among People Living with Frailty: A Scoping Review. J Am Med Dir Assoc 2021; 22:1802-1812.e21. [PMID: 34000266 DOI: 10.1016/j.jamda.2021.04.012] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 04/08/2021] [Accepted: 04/11/2021] [Indexed: 11/20/2022]
Abstract
OBJECTIVES Digital health interventions (DHIs) are interesting resources to improve various health conditions. However, their use in the older and frail population is still sparse. We aimed to give an overview of DHI used in the frail older population. DESIGN Scoping review with PRISMA guidelines based on Population, Concept, and Context. SETTING AND PARTICIPANTS We included original studies in English with DHI (concept) on people described as frail (population) in the clinical or community setting (context) and no limitation on date of publication. We searched 3 online databases (PubMed, Scopus, and Web of Science). MEASURES We described DHI in terms of purpose, delivering, content and assessment. We also described frailty assessment and study design. RESULTS We included 105 studies that fulfilled our eligibility criteria. The most frequently reported DHIs were with the purpose of monitoring (45; 43%), with a delivery method of sensor-based technologies (59; 56%), with a content of feedback to users (34; 32%), and for assessment of feasibility (57; 54%). Efficacy was reported in 31 (30%) studies and usability/feasibility in 57 (55%) studies. The most common study design was descriptive exploratory for new methodology or technology (24; 23%). There were 14 (13%) randomized controlled trials, with only 4 of 14 studies (29%) showing a low or moderate risk of bias. Frailty assessment using validated scales was reported in only 47 (45%) studies. CONCLUSIONS AND IMPLICATIONS There was much heterogeneity among frailty assessments, study designs, and evaluations of DHIs. There is now a strong need for more standardized approaches to assess frailty, well-structured randomized controlled trials, and proper evaluation and report. This work will contribute to the development of better DHIs in this vulnerable population.
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13
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Søvde BE, Sandvoll AM, Natvik E, Drageset J. In the borderland of the body: How home-dwelling older people experience frailty. Scand J Caring Sci 2021; 36:255-264. [PMID: 33939195 DOI: 10.1111/scs.12984] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Accepted: 03/14/2021] [Indexed: 01/10/2023]
Abstract
RATIONALE The increasing number of frail home-dwelling older people has sharpened the focus on discovering and implementing suitable treatment and care in clinical practice, aiming to prevent loss of physical functioning and preserve their autonomy and well-being. People's embodied experiences may yield rich descriptions to help to understand frailty. Thoroughly understanding older people's individual perceptions is especially relevant because the numbers of home-dwelling older people are increasing, and people tend to develop more health problems and become frailer as they age. Their perspectives are important to develop knowledge and high-quality care. AIM To explore the lived experiences of frail home-dwelling older people. METHODS We conducted a phenomenological study to obtain in-depth descriptions of the phenomenon. We interviewed 10 home-dwelling older adults (seven women and three men, 72-90 years old) in depth about their lived experience of frailty. We analysed the data using a hermeneutic phenomenological approach described by van Manen. FINDINGS The lived experience of frailty is described in one essential theme: frailty as being in the borderland of the body, including three interrelated subthemes: (1) the body shuts down; (2) living on the edge; and (3) not giving up. CONCLUSIONS Our study gives insight into lived experiences with frailty among home-dwelling older people related to their own body. Older people's experience of meaningful activities strengthened their feeling of being themselves, despite their frail and deteriorating body. Healthcare providers must consider the strategies of frail older people to consider both their vulnerabilities and self-perceived strengths. The resources and deficits of frail older people present in the state of being frail need to be recognised.
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Affiliation(s)
- Bente Egge Søvde
- Department of Health and Caring Sciences, Western Norway University of Applied Sciences, Førde, Norway.,Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Anne Marie Sandvoll
- Department of Health and Caring Sciences, Western Norway University of Applied Sciences, Førde, Norway
| | - Eli Natvik
- Department of Health and Caring Sciences, Western Norway University of Applied Sciences, Førde, Norway
| | - Jorunn Drageset
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.,Department of Health and Social Sciences, Western Norway University of Applied Sciences, Bergen, Norway
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14
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Hanson HM, Cowan K, Wagg A. Identifying what matters most for the health of older adults in Alberta: results from a James Lind Alliance Research Priority Setting Partnership. CMAJ Open 2021; 9:E522-E528. [PMID: 34021009 PMCID: PMC8177950 DOI: 10.9778/cmajo.20190225] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND As the number of older adults continues to increase, addressing their health becomes increasingly important for both the population and the health care system. The aim of this priority setting partnership was to use direct engagement with older adults, caregivers and health care providers to identify and prioritize the most important topics on the health of older adults that should be addressed by future research. METHODS We followed the James Lind Alliance method. We conducted an initial online and paper survey from Jan. 22 to May 2, 2018, with older adults in Alberta aged 65 years and older to identify what respondents saw as being most important for the health of older adults. We formed responses into summary questions and checked them against existing evidence. We administered a second survey (July 3 to Aug. 2, 2018) to shortlist summary questions and held an in-person workshop (Aug. 30, 2018) to rank the list through discussion and shared decision-making. RESULTS We recruited 670 participants (32.7% older adults, 19.7% caregivers, 46.9% health and social care workers) in the initial survey to tell us what topics on the health of older adults mattered most to them. Over 3000 responses generated 101 summary questions, of which only 4 were completely answered by existing evidence. The second prioritization survey was completed by 232 participants (28.4% older adults, 24.6% care partners, 47.0% health and social care workers) to produce a shortlist of 22 high priority questions. Twenty-two attendees participated in the summary workshop to create a prioritized list of 10 questions for future research that address aspects of the health system, provision of care and living well in older adulthood. INTERPRETATION Older adults, caregivers and clinicians collectively produced a prioritized list of questions that matter most to older adults' health in Alberta. Provincial researchers and research funders should consider these unmet knowledge needs of end-users in future endeavours.
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Affiliation(s)
- Heather M Hanson
- Seniors Health Strategic Clinical Network (Hanson, Wagg), Alberta Health Services; Department of Community Health Sciences (Hanson), Cumming School of Medicine, University of Calgary, Calgary, Alta.; James Lind Alliance (Cowan), National Institute for Health Research Evaluation, Trials and Studies Coordinating Centre, University of Southampton, Southampton, UK; Division of Geriatric Medicine (Wagg), Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Alta
| | - Katherine Cowan
- Seniors Health Strategic Clinical Network (Hanson, Wagg), Alberta Health Services; Department of Community Health Sciences (Hanson), Cumming School of Medicine, University of Calgary, Calgary, Alta.; James Lind Alliance (Cowan), National Institute for Health Research Evaluation, Trials and Studies Coordinating Centre, University of Southampton, Southampton, UK; Division of Geriatric Medicine (Wagg), Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Alta
| | - Adrian Wagg
- Seniors Health Strategic Clinical Network (Hanson, Wagg), Alberta Health Services; Department of Community Health Sciences (Hanson), Cumming School of Medicine, University of Calgary, Calgary, Alta.; James Lind Alliance (Cowan), National Institute for Health Research Evaluation, Trials and Studies Coordinating Centre, University of Southampton, Southampton, UK; Division of Geriatric Medicine (Wagg), Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Alta.
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15
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Ludwig C, Graham ID, Lavoie J, Gifford W, Stacey D. Ethical considerations for engaging frail and seriously ill patients as partners in research: sub-analysis of a systematic review. RESEARCH INVOLVEMENT AND ENGAGEMENT 2021; 7:8. [PMID: 33517912 PMCID: PMC7849091 DOI: 10.1186/s40900-021-00254-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Accepted: 01/21/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND The commitment to engage patients as partners in research has been described as a political, moral and ethical imperative. Researchers feel ill-equipped to deal with potential ethical implications of engaging patients as partners. The aim of this study is to identify the ethical considerations related to engaging frail and seriously ill (FSI) patients as partners in research. METHODS We conducted a sub-analysis of a prior systematic review of 30 studies that engaged FSI patients as partners in research. Studies were included if they reported ethical considerations associated with partnering. We performed deductive content analysis, data were categorized according to Beauchamp and Childress' Principles of Biomedical Ethics (2019): autonomy, non-maleficence, beneficence, and justice. RESULTS Twenty-five studies were included. Common ethical considerations reported in relation to the principles were: autonomy - promoting desired level of involvement, addressing relational and intellectual power, facilitating knowledge and understanding of research; non-maleficence - protection from financial burden, physical and emotional suffering; beneficence - putting things right for others, showing value-added, and supporting patient-partners; and, justice - achieving appropriate representation, mutual respect for contributions, and distributing risks and benefits. CONCLUSIONS When partnering with FSI patients, research teams need to establish shared values and ensure processes are in place to identify and address ethical issues. Researchers and patients should work together to clarify the intent and outcomes of the partnership, actively address power differentials, recognize and minimize the potential for unintended harm, and strive to maximize the benefits of partnership. SYSTEMATIC REVIEW REGISTRATION The protocol for the original systematic review has been registered with the International Prospective Register of Systematic Reviews PROSPERO (CRD42019127994).
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Affiliation(s)
- Claire Ludwig
- University of Ottawa, Faculty of Health Sciences, School of Nursing, Roger Guindon Hall, 451 Smyth Road, Ottawa, Ontario K1H 8M5 Canada
| | - Ian D. Graham
- University of Ottawa, Faculty of Health Sciences, School of Nursing, Roger Guindon Hall, 451 Smyth Road, Ottawa, Ontario K1H 8M5 Canada
- University of Ottawa, Faculty of Medicine, School of Epidemiology and Public Health, 600 Peter Morand Crescent, Ottawa, K1G 5Z3 Ontario Canada
- Ottawa Hospital Research Institute, Clinical Epidemiology Program, 501 Smyth Road, Ottawa, Ontario K1H 8L6 Canada
| | - Josee Lavoie
- Geriatric Psychiatry Program, Royal Ottawa Mental Health Centre, 1145 Carling Avenue, Ottawa, Ontario K1Z 7K4 Canada
| | - Wendy Gifford
- University of Ottawa, Faculty of Health Sciences, School of Nursing, Roger Guindon Hall, 451 Smyth Road, Ottawa, Ontario K1H 8M5 Canada
| | - Dawn Stacey
- University of Ottawa, Faculty of Health Sciences, School of Nursing, Roger Guindon Hall, 451 Smyth Road, Ottawa, Ontario K1H 8M5 Canada
- Ottawa Hospital Research Institute, Clinical Epidemiology Program, 501 Smyth Road, Ottawa, Ontario K1H 8L6 Canada
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16
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Rodríguez-Mañas L, Rodriguez-Sánchez I. Research on Frailty: Where We Stand and Where We Need to Go. J Am Med Dir Assoc 2021; 22:520-523. [PMID: 33493466 DOI: 10.1016/j.jamda.2021.01.061] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Accepted: 01/12/2021] [Indexed: 11/29/2022]
Affiliation(s)
- Leocadio Rodríguez-Mañas
- Servicio de Geriatría. Hospital Universitario de Getafe, Getafe (Madrid), Spain; Centro de Investigación Biomédica en Red "Fragilidad y Envejecimiento Saludable" (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain.
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17
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Chamberlain SA, Estabrooks CA, Keefe JM, Hoben M, Berendonk C, Corbett K, Gruneir A. Citizen and stakeholder led priority setting for long-term care research: identifying research priorities within the Translating Research in Elder Care (TREC) Program. RESEARCH INVOLVEMENT AND ENGAGEMENT 2020; 6:24. [PMID: 32467774 PMCID: PMC7229578 DOI: 10.1186/s40900-020-00199-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Accepted: 04/23/2020] [Indexed: 05/21/2023]
Abstract
BACKGROUND The Translating Research in Elder Care (TREC) program is a longitudinal partnered program of research in Western Canada that aims to improve the quality of care and quality of life for residents and quality of worklife for staff in long-term care settings. This program of research includes researchers, citizens (persons living with dementia and caregivers of persons living in long-term care), and stakeholders (representatives from provincial and regional health authorities, owner-operators of long-term care homes). The aim of this paper is to describe how we used priority setting methods with citizens and stakeholders to identify ten priorities for research using the TREC data. METHODS We adapted the James Lind Alliance Priority Setting Partnership method to ensure our citizens and stakeholders could identify priorities within the existing TREC data. We administered an online survey to our citizen and stakeholder partners. An in-person priority setting workshop was held in March 2019 in Alberta, Canada to establish consensus on ten research priorities. The in-person workshop used a nominal group technique and involved two rounds of small group prioritization and one final full group ranking. RESULTS We received 72 online survey respondents and 19 persons (citizens, stakeholders) attended the in-person priority setting workshop. The workshop resulted in an unranked list of their ten research priorities for the TREC program. These priorities encompassed a range of non-clinical topics, including: influence of staffing (ratios, type of care provider) on residents and staff work life, influence of the work environment on resident outcomes, and the impact of quality improvement activities on residents and staff. CONCLUSIONS This modified priority setting approach provided citizens and stakeholders with an opportunity to identify their own research priorities within the TREC program, without the external pressures of researchers. These priorities will inform the secondary analyses of the TREC data and the development of new projects. This modified priority setting may be a useful approach for research teams trying to engage their non-academic partners and to identify areas for future research.
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Affiliation(s)
- Stephanie A. Chamberlain
- Department of Family Medicine, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Alberta T6G 2T4 Canada
| | | | - Janice M. Keefe
- Department of Family Studies and Gerontology, Mount Saint Vincent University, Halifax, Nova Scotia B3M 2J6 Canada
| | - Matthias Hoben
- Faculty of Nursing, University of Alberta, Edmonton, Alberta T6G 1C9 Canada
| | - Charlotte Berendonk
- Translating Research in Elder Care (TREC) program, University of Alberta, Edmonton, Alberta T6G 1C9 Canada
| | - Kyle Corbett
- Translating Research in Elder Care (TREC) program, University of Alberta, Edmonton, Alberta T6G 1C9 Canada
| | - Andrea Gruneir
- Department of Family Medicine, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Alberta T6G 2T4 Canada
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Ludwig C, Graham ID, Gifford W, Lavoie J, Stacey D. Partnering with frail or seriously ill patients in research: a systematic review. RESEARCH INVOLVEMENT AND ENGAGEMENT 2020; 6:52. [PMID: 32944284 PMCID: PMC7488581 DOI: 10.1186/s40900-020-00225-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Accepted: 07/27/2020] [Indexed: 05/15/2023]
Abstract
BACKGROUND The expectation to include patients as partners in research has steadily gained momentum. The vulnerability of frail and/or seriously ill patients provides additional complexity and may deter researchers from welcoming individuals from this patient population onto their teams. The aim was to synthesize the evidence on the engagement of frail and/or seriously ill patients as research partners across the research cycle. METHODS A systematic review was conducted using PRISMA guidelines. A search strategy included MEDLINE®, EMBASE®, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and PsycINFO from database inception to April, 2019. Eligible studies were peer-reviewed qualitative, quantitative, and mixed methods research reporting on the engagement of frail and/or seriously ill patients as partners on research teams. The Mixed Methods Appraisal Tool was used to appraise study quality. Narrative analysis was conducted. RESULTS Of 8763 citations, 30 were included. Most studies included individuals with cancer on the research team (60%). Barriers included: lack of time and resources (50%), discontinuity in contribution (37%), and concerns for well-being (33%). Facilitators included: trust and mutual respect (60%), structural accessibility (57%), flexibility in timing and methods of engagement (43%), and attention to care and comfort, (33%). Perceived impacts for patients included: renewed personal sense of agency (37%) and emotional/peer support (37%). Impacts for researchers included sensitization to the lived experience of disease (57%) and an increased appreciation of the benefits of patient engagement (23%). Research design, execution, and outcomes, developed with patients, were deemed more suitable, relevant and reflective of patients' priorities. CONCLUSIONS There is emerging evidence to suggest that research partnerships with frail and/or seriously ill patients can be achieved successfully. Patients mostly report benefit from partnering with research teams. Frailty and/or serious illness do present legitimate concerns for their well-being but appear to be successfully mitigated when researchers ensure that the purpose of engagement is well-defined, the timing and methods of engagement are flexible, and the practical and emotional needs of patient partners are addressed throughout the process. SYSTEMATIC REVIEW REGISTRATION The systematic review protocol was registered with the International Prospective Register of Systematic Reviews PROSPERO (CRD42019127994).
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Affiliation(s)
- Claire Ludwig
- University of Ottawa, Faculty of Health Sciences, School of Nursing, Roger Guindon Hall, 451 Smyth Road, Ottawa, Ontario K1H 8M5 Canada
| | - Ian D. Graham
- University of Ottawa, Faculty of Medicine, School of Epidemiology and Public Health, Ottawa, Ontario, Canada and Ottawa Hospital Research Institute, Clinical Epidemiology Program, 501 Smyth Road, Ottawa, Ontario K1H 8L6 Canada
| | - Wendy Gifford
- University of Ottawa, Faculty of Health Sciences, School of Nursing, Roger Guindon Hall, 451 Smyth Road, Ottawa, Ontario K1H 8M5 Canada
| | - Josee Lavoie
- Geriatric Psychiatry Program, Royal Ottawa Mental Health Centre, 1145 Carling Avenue, Ottawa, Ontario K1Z 7K4 Canada
| | - Dawn Stacey
- University of Ottawa, Faculty of Health Sciences, School of Nursing, Roger Guindon Hall, 451 Smyth Road, Ottawa, Ontario K1H 8M5 Canada
- Ottawa Hospital Research Institute, Clinical Epidemiology Program, 501 Smyth Road, Ottawa, Ontario K1H 8L6 Canada
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