scholarly journals What are the consequences of caring for older people and what interventions are effective for supporting unpaid carers? A rapid review of systematic reviews

BMJ Open ◽  
2021 ◽  
Vol 11 (9) ◽  
pp. e046187
Author(s):  
Gemma F Spiers ◽  
Jennifer Liddle ◽  
Tafadzwa Patience Kunonga ◽  
Ishbel Orla Whitehead ◽  
Fiona Beyer ◽  
...  
Keyword(s):  
Older People ◽  
Systematic Reviews ◽  
Well Being ◽  
Social Determinant ◽  
Rapid Review ◽  
Current Evidence ◽  
Effective Interventions ◽  
Summary Data ◽  
Social Determinant Of Health

ObjectivesTo identify and map evidence about the consequences of unpaid caring for all carers of older people, and effective interventions to support this carer population.DesignA rapid review of systematic reviews, focused on the consequences for carers of unpaid caring for older people, and interventions to support this heterogeneous group of carers. Reviews of carers of all ages were eligible, with any outcome measures relating to carers’ health, and social and financial well-being. Searches were conducted in MEDLINE, PsycInfo and Epistemonikos (January 2000 to January 2020). Records were screened, and included systematic reviews were quality appraised. Summary data were extracted and a narrative synthesis produced.ResultsTwelve systematic reviews reporting evidence about the consequences of caring for carers (n=6) and assessing the effectiveness of carer interventions (n=6) were included. The review evidence typically focused on mental health outcomes, with little information identified about carers’ physical, social and financial well-being. Clear estimates of the prevalence and severity of carer outcomes, and how these differ between carers and non-carers, were absent. A range of interventions were identified, but there was no strong evidence of effectiveness. In some studies, the choice of outcome measure may underestimate the full impact of an intervention.ConclusionsCurrent evidence fails to fully quantify the impacts that caring for older people has on carers’ health and well-being. Information on social patterning of the consequences of caring is absent. Systematic measurement of a broad range of outcomes, with comparison to the general population, is needed to better understand the true consequences of caring. Classification of unpaid caring as a social determinant of health could be an effective lever to bring greater focus and support to this population. Further work is needed to develop and identify suitable interventions in order to support evidence-based policymaking and practice.

scholarly journals Mechanisms linking teenage mothers’ educational attainment with self-reported health at age 50

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Julie Maslowsky ◽  
C. Emily Hendrick ◽  
Haley Stritzel
Keyword(s):  
Educational Attainment ◽  
Well Being ◽  
The United States ◽  
Social Determinant ◽  
Early Childbearing ◽  
Partner Characteristics ◽  
Higher Educational Attainment ◽  
The Life Course ◽  
Social Determinant Of Health

Abstract Background Early childbearing is associated with adverse health and well-being throughout the life course for women in the United States. As education continues to be a modifiable social determinant of health after a young woman gives birth, the association of increased educational attainment with long-term health for women who begin childbearing as teenagers is worthy of investigation. Methods Data are from 301 mothers in the National Longitudinal Survey of Youth 1979 who gave birth prior to age 19. We estimated path models to assess women’s incomes, partner characteristics, and health behaviors at age 40 as mediators of the relationship between their educational attainment and self-rated general health at age 50. Results After accounting for observed background factors that select women into early childbearing and lower educational attainment, higher levels of education (high school diploma and GED attainment vs. no degree) were indirectly associated with higher self-rated health at age 50 via higher participant income at age 40. Conclusions As education is a social determinant of health that is amenable to intervention after a teen gives birth, our results are supportive of higher educational attainment as a potential pathway to improving long-term health outcomes of women who begin childbearing early.

scholarly journals Evidence of Workplace Interventions—A Systematic Review of Systematic Reviews

2019 ◽  
Vol 16 (19) ◽  
pp. 3553 ◽  
Author(s):  
Claudia Pieper ◽  
Sarah Schröer ◽  
Anna-Lisa Eilerts
Keyword(s):  
Health Promotion ◽  
Systematic Reviews ◽  
Search Strategy ◽  
Workplace Health Promotion ◽  
Well Being ◽  
Current Evidence ◽  
Economic Evaluations ◽  
High Quality ◽  
Older Employees ◽  
Health Promotion Interventions

Work environment factors are highly correlated with employees’ health and well-being. Our aim was to sum up current evidence of health promotion interventions in the workplace, focusing on interventions for the prevention of musculoskeletal disorders, psychological and behavioral disorders as well as interventions for older employees and economic evaluations. We conducted a comprehensive literature search including systematic reviews published from April 2012 to October 2017 in electronic databases and search engines, websites of relevant organizations and institutions. It consisted of simple and specific terms and word combinations related to workplace health promotion based on the search strategy of a previous review. After full-text screening, 74 references met the eligibility criteria. Using the same search strategy, there was a higher proportion of relevant high-quality studies as compared with the earlier review. The heterogeneity of health promotion interventions regarding intervention components, settings and study populations still limits the comparability of studies. Future studies should also address the societal and insurer perspective, including costs to the worker such as lost income and lost time at work of family members due to caregiving activities. To this end, more high-quality evidence is needed.

Exercise, physical activity and mental well-being in later life

2014 ◽  
Vol 24 (4) ◽  
pp. 319-325 ◽  
Author(s):  
Gill Windle
Keyword(s):  
Physical Activity ◽  
Systematic Reviews ◽  
Psychological Functioning ◽  
Later Life ◽  
Well Being ◽  
Moderate Intensity ◽  
Current Evidence ◽  
Research Attention ◽  
Time Activity ◽  
Mental Well Being

SummaryExercise and physical activity are thought to be among the most important lifestyle factors for the maintenance of health and prevention of premature disease and mortality. Yet sedentary lifestyles are common. Many people avoid exercise, and have done so across their lifespan. Exercise and physical activity are also considered important for positive psychological functioning; however, this has received limited research attention. This mini-review discusses the effects of exercise and physical activity on mental health and well-being in later life. It draws on international peer reviewed research, summarized in systematic reviews and/or meta-anlaysis, and presents the key findings. Systematic reviews and meta-analyses generally confirm the importance of exercise for mental well-being; however, there is a lack of good quality research. The review discusses some of the barriers to exercise, and identifies strategies that may facilitate uptake and adherence in later life. Limitations in the current evidence are discussed. Based on the current evidence, it is recommended that health practitioners should encourage exercise or physical activity of low to moderate intensity, and leisure time activity such as walking, especially at retirement. Future intervention research would benefit by focusing on people who have not self-selected into studies so as to understand the causal direction, and include theory driven approaches to behaviour change.

‘I can speak on this here’: empowerment within an Aboriginal adult literacy campaign

2020 ◽  
pp. 1-8
Author(s):  
Frances Williamson ◽  
Bob Boughton
Keyword(s):  
Adult Literacy ◽  
Well Being ◽  
Social Determinant ◽  
Self Control ◽  
Literacy Campaign ◽  
Learning To Read ◽  
Australian Aboriginal ◽  
The Relationship ◽  
Social Determinant Of Health

Abstract This case study details the impacts of an Aboriginal-led adult literacy campaign in Brewarrina between 2015 and 2017. Forming part of a wider investigation into literacy as a social determinant of health, the study explores the relationship between involvement in the literacy campaign and the capacity of graduates to take greater control of the conditions affecting their lives. Empowerment is used here as the central explanatory construct despite robust criticism of theoretical slippage. We argue that empowerment remains relevant particularly in the context of ongoing and entrenched disenfranchisement of the low-literate in Australian Aboriginal communities. Drawing on in-depth ‘yarning’ interviews, we find strong evidence of individual empowerment among graduates of the adult literacy campaign, particularly in terms of increased self-control and confidence. However, collective change such as increased participation and organisation at the community level is less apparent. This finding underscores two important aspects of empowerment. Firstly, like learning to read and write, the task of regaining personal and collective power can be a slow and difficult undertaking. Secondly, achieving empowerment is intimately linked to addressing the causes of disempowerment. This ultimately means tackling those power relations which impact choices, opportunities and well-being beyond the borders of individual's lives and communities.

Reflections From the Other Side: The Refugee Journey to Health and Well-Being

2016 ◽  
Vol 22 (4) ◽  
pp. 283-288
Author(s):  
Raney Linck ◽  
Munira Osman
Keyword(s):  
Well Being ◽  
Social Determinant ◽  
Somali Refugees ◽  
Somali Woman ◽  
Health Care Barriers ◽  
Person Perspective ◽  
Global Health Issue ◽  
Displaced People ◽  
Health And Well Being ◽  
Social Determinant Of Health

The refugee crisis is an urgent global health issue; the number of displaced people has escalated to its worst point in recorded history. To explore the refugee phenomenon as a social determinant of health, this article examines the experience of Somali refugees in Minnesota. Health care barriers unique to refugees are explored through the first-person perspective of one Somali woman who ultimately became a nurse.

scholarly journals Promotion of Physical Activity in Older People Using mHealth and eHealth Technologies: Rapid Review of Reviews

10.2196/22201 ◽  
2020 ◽  
Vol 22 (12) ◽  
pp. e22201
Author(s):  
Lisa McGarrigle ◽  
Chris Todd
Keyword(s):  
Physical Activity ◽  
Older People ◽  
Systematic Reviews ◽  
English Language ◽  
Rapid Review ◽  
Activity Levels ◽  
Increased Risk ◽  
Reduced Physical Activity ◽  
Promotion Of Physical Activity ◽  
Review Of Reviews

Background Older people are at increased risk of adverse health events because of reduced physical activity. There is concern that activity levels are further reduced in the context of the COVID-19 pandemic, as many older people are practicing physical and social distancing to minimize transmission. Mobile health (mHealth) and eHealth technologies may offer a means by which older people can engage in physical activity while physically distancing. Objective The objective of this study was to assess the evidence for mHealth or eHealth technology in the promotion of physical activity among older people aged 50 years or older. Methods We conducted a rapid review of reviews using PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. We searched for systematic reviews published in the English language in 3 electronic databases: MEDLINE, CINAHL Plus, and Scopus. Two reviewers used predefined inclusion criteria to select relevant reviews and extracted data on review characteristics and intervention effectiveness. Two independent raters assessed review quality using the AMSTAR-2 tool. Results Titles and abstracts (n=472) were screened, and 14 full-text reviews were assessed for eligibility. Initially, we included 5 reviews but excluded 1 from the narrative as it was judged to be of critically low quality. Three reviews concluded that mHealth or eHealth interventions were effective in increasing physical activity. One review found that the evidence was inconclusive. Conclusions There is low to moderate evidence that interventions delivered via mHealth or eHealth approaches may be effective in increasing physical activity in older adults in the short term. Components of successful interventions include self-monitoring, incorporation of theory and behavior change techniques, and social and professional support.

scholarly journals Prevalence of mental disorders among people who are homeless: An umbrella review

2020 ◽  
Vol 66 (6) ◽  
pp. 528-541 ◽  
Author(s):  
Md Mahbub Hossain ◽  
Abida Sultana ◽  
Samia Tasnim ◽  
Qiping Fan ◽  
Ping Ma ◽  
...  
Keyword(s):  
Mental Disorders ◽  
Systematic Reviews ◽  
Psychotic Disorders ◽  
Age Groups ◽  
Homeless People ◽  
Well Being ◽  
Current Evidence ◽  
Umbrella Review ◽  
Physical Health Problems ◽  
Meta Analyses

Background: Homelessness is a major problem that critically impacts the mental health and well-being of the affected individuals. This umbrella review aimed to evaluate the current evidence on the prevalence of mental disorders among homeless people from evidence-based systematic reviews and meta-analyses. Methods: We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and Joanna Briggs Institute (JBI) methodology for umbrella reviews. We searched 12 major databases and additional sources to identify systematically conducted reviews and meta-analyses reporting the prevalence of mental disorders among homeless populations. Results: We evaluated 1,277 citations and found 15 reviews meeting our criteria. Most studies were conducted among high-income countries with samples from different age groups. Studies reported high prevalence rates of depressive and anxiety disorders, schizophrenia spectrum and psychotic disorders, substance use disorders, suicidal behavior, bipolar and mood disorders, neurocognitive disorders and other mental disorders among homeless people. Moreover, studies also reported a high burden of co-occurring mental and physical health problems among the homeless experiencing mental disorders. Conclusion: This umbrella review synthesized the current evidence on the epidemiological burden of mental disorders in homelessness. This evidence necessitates advanced research to explore psychosocial and epidemiological correlates and adopt multipronged interventions to prevent, identify and treat mental disorders among homeless populations.

scholarly journals Rapid review of decision-making for place of care and death in older people: lessons for COVID-19

2020 ◽  
Author(s):  
Emily West ◽  
Kirsten Moore ◽  
Nuriye Kupeli ◽  
Elizabeth L Sampson ◽  
Pushpa Nair ◽  
...  
Keyword(s):  
Older Adults ◽  
Decision Making ◽  
Older People ◽  
Data Extraction ◽  
Rapid Review ◽  
Current Evidence ◽  
Key Factors ◽  
Full Data ◽  
Review Of Reviews ◽  
Experience Of Illness

Abstract Introduction The coronavirus pandemic (COVID-19) has affected the functioning and capacity of healthcare systems worldwide. COVID-19 has also disproportionately affected older adults. In the context of COVID-19, decision-making surrounding place of care (PoC) and place of death (PoD) in older adults involves significant new challenges. Aims To explore key factors that influence PoC and PoD decisions in older adults. A secondary aim was to investigate key factors that influence the process and outcome of these decisions in older adults. To apply findings from current evidence to the context of COVID-19. Methods Rapid review of reviews, undertaken using WHO guidance for rapid reviews for the production of actionable evidence. Data extracted was synthesised using narrative synthesis, with thematic analysis and tabulation. Results 10 papers were included for full data extraction. These papers were published between 2005 and 2020. Papers included discussed actual PoD, as well as preferred. Results were divided into papers that explored the process of decision-making, and those that explored decision-making outcomes. Conclusions The process and outcomes of decision-making for older people are affected by many factors—all of which have the potential to influence both patients and caregivers experience of illness and dying. Within the context of COVID-19, such decisions may have to be made rapidly and be reflexive to changing needs of systems and of families and patients.

scholarly journals What evidence is there on the effectiveness of different models of delivering urgent care? A rapid review

2015 ◽  
Vol 3 (43) ◽  
pp. 1-134 ◽  
Author(s):  
Janette Turner ◽  
Joanne Coster ◽  
Duncan Chambers ◽  
Anna Cantrell ◽  
Viet-Hai Phung ◽  
...  
Keyword(s):  
Empirical Evidence ◽  
Systematic Reviews ◽  
Evidence Synthesis ◽  
Evidence Base ◽  
Service Planning ◽  
Urgent Care ◽  
Rapid Review ◽  
Current Evidence ◽  
Primary Research ◽  
Current Evidence Base

BackgroundIn 2013 NHS England set out its strategy for the development of an emergency and urgent care system that is more responsive to patients’ needs, improves outcomes and delivers clinically excellent and safe care. Knowledge about the current evidence base on models for provision of safe and effective urgent care, and the gaps in evidence that need to be addressed, can support this process.ObjectiveThe purpose of the evidence synthesis is to assess the nature and quality of the existing evidence base on delivery of emergency and urgent care services and identify gaps that require further primary research or evidence synthesis.Data sourcesMEDLINE, EMBASE, The Cochrane Library, the Cumulative Index to Nursing and Allied Health Literature (CINAHL) and the Web of Science.MethodsWe have conducted a rapid, framework-based, evidence synthesis approach. Five separate reviews linked to themes in the NHS England review were conducted. One general and five theme-specific database searches were conducted for the years 1995–2014. Relevant systematic reviews and additional primary research papers were included and narrative assessment of evidence quality was conducted for each review.ResultsThe review was completed in 6 months. In total, 45 systematic reviews and 102 primary research studies have been included across all five reviews. The key findings for each review are as follows: (1) demand – there is little empirical evidence to explain increases in demand for urgent care; (2) telephone triage – overall, these services provide appropriate and safe decision-making with high patient satisfaction, but the required clinical skill mix and effectiveness in a system is unclear; (3) extended paramedic roles have been implemented in various health settings and appear to be successful at reducing the number of transports to hospital, making safe decisions about the need for transport and delivering acceptable, cost-effective care out of hospital; (4) emergency department (ED) – the evidence on co-location of general practitioner services with EDs indicates that there is potential to improve care. The attempt to summarise the evidence about wider ED operations proved to be too complex and further focused reviews are needed; and (5) there is no empirical evidence to support the design and development of urgent care networks.LimitationsAlthough there is a large body of evidence on relevant interventions, much of it is weak, with only very small numbers of randomised controlled trials identified. Evidence is dominated by single-site studies, many of which were uncontrolled.ConclusionsThe evidence gaps of most relevance to the delivery of services are (1) a requirement for more detailed understanding and mapping of the characteristics of demand to inform service planning; (2) assessment of the current state of urgent care network development and evaluation of the effectiveness of different models; and (3) expanding the current evidence base on existing interventions that are viewed as central to delivery of the NHS England plan by assessing the implications of increasing interventions at scale and measuring costs and system impact. It would be prudent to develop a national picture of existing pilot projects or interventions in development to support decisions about research commissioning.FundingThe National Institute for Health Research Health Services and Delivery Research Programme.

Sign in / Sign up

Export Citation Format

Share Document