scholarly journals How could discourse theories of identity formation critically engage patient-centered care in older adults?

2018 ◽  
Vol 19 (3) ◽  
pp. 205-216
Author(s):  
Anna Horton ◽  
Simon Horton
Keyword(s):  
Older Adults ◽  
Older People ◽  
Identity Formation ◽  
Design Methodology ◽  
Patient Centered ◽  
Content Type ◽  
Clinical Encounters ◽  
Centered Care ◽  
Conceptual Paper

Purpose The purpose of this paper is to explore how discourse theories can contribute to the concept of identity formation within a patient- or person-centered care (PCC) orientation, to enable more critical engagement with PCC in older people. Design/methodology/approach This is a conceptual paper. Findings This paper concludes that the discourse literature has important insights for understanding identity formation in older people as operationalized in the context of PCC in three particular ways: accounting for multiplicity in patients’ identity; exploring “the devolution of responsibility” to address shifts in performing identities in clinical encounters; and attending to a “crisis of positioning” to engage empowerment discourse within a PCC philosophy. Originality/value Whilst a notion of patient identity is at the heart of PCC, the concept remains inconsistent and underdeveloped. This is particularly problematic for the quality of care in older adults, as PCC has become increasingly synonymous with care of older people. Discourse theories of identity formation can be used to critically engage with identity within the context of PCC, so as to develop more nuanced understandings of “the person” or “the patient,” with the potential to improve research into care for aging and older adults.

scholarly journals Accounting for the messiness of the research process: the fieldpath approach

2018 ◽  
Vol 13 (4) ◽  
pp. 315-332 ◽  
Author(s):  
Perttu Salovaara
Keyword(s):  
Qualitative Research ◽  
Design Methodology ◽  
Research Process ◽  
Content Type ◽  
Environmental Consequences ◽  
Human Ethics ◽  
Conceptual Paper ◽  
The Common ◽  
Practical Implications

Purpose It has recently become more acknowledged that there is a quality of “messiness” to the qualitative research process. The purpose of this paper is to introduce the fieldpath approach—a hermeneutically inspired framework—to account for the non-linearity, uncertainty and ambiguity of the research process. Design/methodology/approach This conceptual paper reviews how the scope of hermeneutics has been partly misunderstood. The paper discusses how the scope of hermeneutics has lately been expanded by works such as Günter Figal’s (2010) Objectivity: The Hermeneutical and Philosophy. Findings The fieldpath approach proposes that a heightened relation to materiality enables the messiness of the process to be preserved, while at the same time offering a way to find one’s footing in the midst of ontologically incomplete phenomena that are still—in a processual fashion—forming and becoming. Research limitations/implications This is a conceptual paper. In addition to the research mentioned here, more studies would be needed to legitimise, test and refine the approach. Practical implications Objectivity provides an additional criterion for researchers to lean on when facing the non-linearity and unexpected turns inherent in the qualitative research process. Social implications The stress on materiality involves an ethical dimension. Post-human ethics are concerned with the future environmental consequences and sustainability of the material world. The way that matter matters in our methodologies is of primary importance. Originality/value First, the paper emphasises that hermeneutics, contrary to the common perception, does offer criteria for evaluating between interpretations. Second, it introduces the notion of hermeneutic objectivity, which stresses the importance of materiality for interpretations. Third, it introduces the fieldpath approach, which, based on the previous criterion of hermeneutic objectivity, allows for the messiness of the research process, while also preserving a tight grip on the hermeneutic imperative of “understanding in a new way”.

scholarly journals Ready for prime time: role for geriatric assessment to improve quality of care in hematology practice

Hematology ◽  
2019 ◽  
Vol 2019 (1) ◽  
pp. 53-58 ◽  
Author(s):  
Heidi D. Klepin
Keyword(s):  
Older Adults ◽  
Quality Of Care ◽  
Geriatric Assessment ◽  
Hematologic Malignancies ◽  
Patient Centered ◽  
Functional Reserve ◽  
Centered Care ◽  
Assessment Measures

Abstract Older adults represent the growing majority of patients diagnosed with hematologic disorders, yet they remain underrepresented on clinical trials. Older patients of the same chronologic age differ from one another with varying comorbidity and functional reserve. The concepts of frailty and resilience are important to patient-centered care and are patient and setting specific. The use of geriatric assessment to inform tailored decision making and management can personalize care for older adults with hematologic malignancies. This article will highlight available evidence to support the role of geriatric assessment measures to enhance quality of care for older adults diagnosed with hematologic malignancies.

scholarly journals Should dehydration in older people be a marker of lack of quality in long term care provision?

2014 ◽  
Vol 15 (4) ◽  
pp. 232-236 ◽  
Author(s):  
Lee Hooper ◽  
Diane K Bunn
Keyword(s):  
Older People ◽  
Residential Care ◽  
Design Methodology ◽  
Long Term Care ◽  
Care Provision ◽  
Good Care ◽  
Term Care ◽  
Content Type

Purpose – The purpose of this paper is to consider whether dehydration in older people should be used as a marker of lack of quality in long-term care provision. Design/methodology/approach – The piece examines the assumed relationship between dehydration and the quality of care, and then considers the factors that can lead to dehydration in older people. Findings – Even with the best care, older people, in the absence of a sense of thirst, and for fear of urinary accidents, difficulties getting to the toilet or choking, may choose to drink less than would be ideal for their health. While good care supports older people to minimise these problems, it also respects older people making their own decisions around when, what and how much to drink. It appears that dehydration may sometimes be a sign of good care, as well as arising from poor care. Social implications – Residential care homes should not be stigmatised on the basis of their residents being dehydrated, but rather helped to explore whether they are achieving an appropriate balance between care and quality of life for their residents. Originality/value – This discussion may be of use to those living in, working in, managing or assessing residential care.

Misunderstandings about older people fuel corona virus complacency

2020 ◽  
Vol 24 (4) ◽  
pp. 269-272
Author(s):  
Ellery Altshuler
Keyword(s):  
Quality Of Life ◽  
Data Collection ◽  
Older People ◽  
Economic Impact ◽  
Design Methodology ◽  
Content Type ◽  
Public Response ◽  
The Public ◽  
Personal Experiences

Purpose The purpose of this paper is to explore public assumptions underlying the apparent disregard for the lives of older people during the coronavirus outbreak. It attempts to dispel myths about quality of life among older people. Design/methodology/approach This paper integrates the author’s personal experiences as a doctor with data collection, which involved general PubMed searches for articles relating to the public response to the effect of coronavirus on older people; beliefs about the lives of older people; and issues of happiness, contentedness and quality of life in older people. Findings Some people have concluded that the lives of older people – which they believe to be of low quality – are worth risking to lessen the economic impact of coronavirus. This morbid calculation is based in part on the assumption that older people are less happy than younger people. In fact, the evidence shows that as people get older, they become significantly happier. Originality/value This paper asks readers to explore their assumptions about ageing and reaffirms the importance of protecting older people in the midst of the coronavirus pandemic.

Perceptions of healthy eating in transitional phases of life

2014 ◽  
Vol 116 (4) ◽  
pp. 570-584 ◽  
Author(s):  
Tino Bech-Larsen ◽  
Laura Kazbare
Keyword(s):  
Older Adults ◽  
Social Cognition ◽  
Older People ◽  
Focus Groups ◽  
Study Design ◽  
Healthy Eating ◽  
Design Methodology ◽  
Approach And Avoidance ◽  
Content Type ◽  
Older Adulthood

Purpose – Although adolescents and older adults are often targets for nutritional change interventions, little has been done to explore how people in these transitional life phases perceive the matter themselves. The aim of this paper is to explore and compare adolescents' and older adults' own perceptions of the barriers and facilitators of a change towards healthier eating. Design/methodology/approach – This study design consisted of four focus groups that were conducted with adolescents and older adults to identify their health orientations, and their expected and experienced outcomes and self-efficacies in implementing approach and avoidance behaviours in relation to healthy eating, i.e. increasing consumption of fruit and vegetables and decreasing consumption of soft drinks and red meat. Findings – The study resulted in a number of interesting insights, e.g. that older and younger participants alike: were keen not to seem “overly healthy” to their important others, had a demonstratively detached orientation towards healthy eating and felt that their diets were generally healthy (although this was generally disproved by their self-reported intake data). Originality/value – The study and findings reported in this article contribute by providing the first steps towards a better understanding of how social cognition and self-efficacy perceptions related to healthy eating develop in the transitional phases of adolescence and older adulthood. In order to complement and validate the findings of the study; and with the aim of facilitating efficient nutritional change interventions directed at adolescents and older people, further studies should be conducted.

scholarly journals Patient-Centered Outcomes Research and Patient-Centered Care for Older Adults

2017 ◽  
Vol 3 ◽  
pp. 233372141770075 ◽  
Author(s):  
Ravishankar Jayadevappa
Keyword(s):  
Older Adults ◽  
Outcomes Research ◽  
Well Being ◽  
Clinical Decision ◽  
Patient Centered Care ◽  
Patient Centered ◽  
Health Decision ◽  
Centered Care ◽  
Value Based Care

Patient-centered care that reflects consumer-driven health care decision of an individual as opposed to collective or social choice–based health decision has many implications for clinical decision and resource allocation. With possession of required information and faced with appropriate assessment of preferences, older adults make better choices for their own health. However, one must acknowledge that patient-centered approach for older adults should effectively integrate tenets of value-based care to improve overall quality of care and societal well-being. In this perspective, I present the importance and challenges of patient-centered care and patient-centered outcomes research among older adults.

Leveraging collective intelligence: from univocal to multivocal representation of cultural heritage

2018 ◽  
Vol 74 (6) ◽  
pp. 1190-1203 ◽  
Author(s):  
Lala Hajibayova
Keyword(s):  
Cultural Heritage ◽  
Design Methodology ◽  
Collective Intelligence ◽  
Top Down ◽  
Traditional Role ◽  
Theoretical Understanding ◽  
Content Type ◽  
Conceptual Paper

Purpose After reviewing cultural heritage institutions; crowdsourcing initiatives and tension between univocal and multivocal views of those who interact with cultural expressions, this paper argues that to support vibrant and effective crowdsourcing communities while ensuring the quality of the work of crowdsourcing project volunteers it is essential to reevaluate and transform the traditional univocal, top-down approach to representation and organization. The paper aims to discuss these issues. Design/methodology/approach This conceptual paper applies Foucault’s power–knowledge construct and theories of representation to the processes and practices employed in cultural heritage crowdsourcing projects. Findings Viewed through the Foucauldian lens, cultural heritage professionals are regarded as active parts of the power–knowledge relationship due to their direct engagement in the representation, organization and dissemination of knowledge, exercised not only through the traditional role of cultural heritage institutions as gatekeepers of knowledge but, more importantly, through the power of representation and organization of the cultural heritage. Originality/value This paper provides a theoretical understanding of cultural heritage crowdsourcing initiatives and proposes a framework for multivocal representation of cultural heritage expressions in which the voices of volunteers have the same validity as the voices of cultural heritage professionals.

A value-based taxonomy of improvement approaches in healthcare

2017 ◽  
Vol 31 (4) ◽  
pp. 445-458 ◽  
Author(s):  
Christian Colldén ◽  
Ida Gremyr ◽  
Andreas Hellström ◽  
Daniella Sporraeus
Keyword(s):  
Design Methodology ◽  
Healthcare Professionals ◽  
Management Practice ◽  
Healthcare Management ◽  
Patient Centered ◽  
Content Type ◽  
A Value ◽  
Centered Care ◽  
Organizational Focus

Purpose The concept of value is becoming increasingly fashionable in healthcare and various improvement approaches (IAs) have been introduced with the aim of increasing value. The purpose of this paper is to construct a taxonomy that supports the management of parallel IAs in healthcare. Design/methodology/approach Based on previous research, this paper proposes a taxonomy that includes the dimensions of view on value and organizational focus; three contemporary IAs – lean, value-based healthcare, and patient-centered care – are related to the taxonomy. An illustrative qualitative case study in the context of psychiatric (psychosis) care is then presented that contains data from 23 interviews and focuses on the value concept, IAs, and the proposed taxonomy. Findings Respondents recognized the dimensions of the proposed taxonomy and indicated its usefulness as support for choosing and combining different IAs into a coherent management model, and for facilitating dialog about IAs. The findings also suggested that the view of value as “health outcomes” is widespread, but healthcare professionals are less likely than managers to also view value as a process. Originality/value The conceptual contribution of this paper is to delineate some important characteristics of IAs in relation to the emerging “value era”. It also highlights the coexistence of different IAs in healthcare management practice. A taxonomy is proposed that can help managers choose, adapt, and combine IAs in local management models.

Public health and prevention: acting to make longer lives healthier

2016 ◽  
Vol 20 (2) ◽  
pp. 110-120 ◽  
Author(s):  
Charles Alessi ◽  
Elaine Rashbrook
Keyword(s):  
Public Health ◽  
Older Adults ◽  
Older People ◽  
Health Risks ◽  
Design Methodology ◽  
Clinical Excellence ◽  
Good Health ◽  
Comprehensive Review ◽  
Content Type ◽  
Practical Implications

Purpose – The purpose of this paper is to outline the action that can be taken to ensure longer and healthier lives. Design/methodology/approach – The paper draws on the relevant recommendations set out by the National Institute for Clinical Excellence to delay or prevent the onset of ill health in later years, followed by a number of recommended approaches to promote healthy behaviours in older adults as well as those in midlife. Findings – There is a clear need for public health and the prevention agenda to help ensure that later years are not just longer, but healthier. Practical implications – The paper identifies how, when and where the health risks associated with the majority of years lost to ill health can be addressed, and advocates the importance of taking an asset-based approach to promoting good health in older people. Originality/value – The paper is a comprehensive review of the key public health actions that can be taken to ensure longer and healthier lives.

Grey Pride: priorities for a minister for older people

2015 ◽  
Vol 16 (1) ◽  
pp. 62-64
Author(s):  
Jane Ashcroft
Keyword(s):  
Older People ◽  
Social Service ◽  
Service Provision ◽  
Design Methodology ◽  
Content Type ◽  
Government Administration ◽  
Use Of Resources ◽  
The Uk ◽  
Practical Implications

Purpose – The purpose of this paper is to argue the case for there to be a UK Minister for Older People supported by the work of a Commissioner for Older People. Design/methodology/approach – Draws on the work of the UK Grey Pride campaign to compare trends in demography and expectations with health and social service provision. Findings – With hospital “bed blocking” reportedly costing £20 million per month and limited responses to older peoples’ needs for appropriate housing, care and resources, the Grey Pride campaign has received widespread support with 30 organisations backing their campaign for a Minister for Older People. Practical implications – A Minister could help prioritise coordinated use of resources to make them more efficient and to help manage older peoples’ expectations. A Commissioner for Older People could investigate the accessibility and quality of care for older people. Originality/value – Identifies how no government administration to date has demonstrated its explicit commitment to prioritising older peoples’ needs.

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