scholarly journals Unmet care needs of older people: A scoping review

2020 ◽  
pp. 096973302094811
Author(s):  
Dominika Kalánková ◽  
Minna Stolt ◽  
P Anne Scott ◽  
Evridiki Papastavrou ◽  
Riitta Suhonen
Keyword(s):  
Older People ◽  
Nursing Care ◽  
Scoping Review ◽  
Ethical Issues ◽  
Empirical Studies ◽  
Point Of View ◽  
World Health ◽  
Organizational Level ◽  
Care Needs ◽  
Complex Needs

The aim was to synthesize the findings of empirical research about the unmet nursing care needs of older people, mainly from their point of view, from all settings, focusing on (1) methodological approaches, (2) relevant concepts and terminology and (3) type, nature and ethical issues raised in the investigations. A scoping review after Arksey and O’Malley. Two electronic databases, MEDLINE/PubMed and CINAHL (from earliest to December 2019) were used. Systematic search protocol was developed using several terms for unmet care needs and missed care. Using a three-step retrieval process, peer-reviewed, empirical studies concerning the unmet care needs of older people in care settings, published in English were included. An inductive content analysis was used to analyse the results of the included studies (n = 53). The most frequently used investigation method was the questionnaire survey seeking the opinions of older people, informal caregivers or healthcare professionals. The unmet care needs identified using the World Health Organization classification were categorized as physical, psychosocial and spiritual, and mostly described individuals’ experiences, though some discussed unmet care needs at an organizational level. The ethical issues raised related to the clinical prioritization of tasks associated with failing to carry out nursing care activities needed. The unmet care needs highlighted in this review are related to poor patient outcomes. The needs of institutionalized older patients remain under-diagnosed and thus, untreated. Negative care outcomes generate a range of serious practical issues for older people in care institutions, which, in turn, raises ethical issues that need to be addressed. Unmet care needs may lead to marginalization, discrimination and inequality in care and service delivery. Further studies are required about patients’ expectations when they are admitted to hospital settings, or training of nurses in terms of understanding the complex needs of older persons.

Ethical issues related to the use of gerontechnology in older people care: A scoping review

2019 ◽  
Vol 27 (1) ◽  
pp. 88-103 ◽  
Author(s):  
Suvi Sundgren ◽  
Minna Stolt ◽  
Riitta Suhonen
Keyword(s):  
Older People ◽  
Scoping Review ◽  
Ethical Issues ◽  
Scientific Practice ◽  
Empirical Studies ◽  
Quality Care ◽  
Healthcare Services ◽  
Community Dwelling ◽  
Main Theme ◽  
Community Dwelling Older People

Background: Demographic trends indicate growth of population aged 65 and older in Western countries. One of the greatest challenges is to provide high-quality care for all. Technological solutions designed for older people, gerontechnology, can somewhat balance the gap between resources and the increasing demand of healthcare services. However, there are also ethical issues in the use of gerontechnology that need to be pointed out. Purpose: To describe what ethical issues are related to the use of gerontechnology in the care of community-dwelling older people. Methods: A scoping review was performed to identify and analyse studies concerning ethical issues when using gerontechnology in the home care of older people. The literature search was limited to studies published after 1990 and addressed to the electronic databases CINAHL, PubMed, Cochrane, Medic, IEEE Explore and Web of Science. The search was performed in July−August 2018. Data from empirical studies were analysed using thematic analysis. Ethical considerations: This scoping review was conducted in accordance with good scientific practice. The work of other researchers was respected and cited appropriately. Results: A total of 17 studies were identified. Two main themes were found. ‘Balancing between the benefits of using gerontechnology and the basic rights of older people’, consisted of the subthemes safety, privacy and autonomy. The other main theme, ‘Gerontechnology as a risk of insecurity for older people’, included the subthemes fear of losing human contact and concern and fear. Surveillance and monitoring technologies were mainly studied. Conclusion: These results suggest that there may be ethical issues related to the use of gerontechnology and they must therefore be taken into consideration when implementing technology in the care of community-dwelling older people.

scholarly journals Urban health nexus with coronavirus disease 2019 (COVID-19) preparedness and response in Africa: Rapid scoping review of the early evidence

2021 ◽  
Vol 9 ◽  
pp. 205031212199436
Author(s):  
Robert Kaba Alhassan ◽  
Jerry John Nutor ◽  
Aaron Asibi Abuosi ◽  
Agani Afaya ◽  
Solomon Salia Mohammed ◽  
...  
Keyword(s):  
Urban Health ◽  
Scoping Review ◽  
Empirical Studies ◽  
Grey Literature ◽  
Spillover Effects ◽  
Health Systems Strengthening ◽  
World Health ◽  
African Countries ◽  
Response Strategies ◽  
Early Evidence

Introduction: Severe acute respiratory syndrome coronavirus 2 also called coronavirus disease 2019 was first reported in the African continent on 14 February 2020 in Egypt. As at 18 December 2020, the continent reported 2,449,754 confirmed cases, 57,817 deaths and 2,073,214 recoveries. Urban cities in Africa have particularly suffered the brunt of coronavirus disease 2019 coupled with criticisms that the response strategies have largely been a ‘one-size-fits-all’ approach. This article reviewed early evidence on urban health nexus with coronavirus disease 2019 preparedness and response in Africa. Methods: A rapid scoping review of empirical and grey literature was done using data sources such as ScienceDirect, GoogleScholar, PubMed, HINARI and official websites of World Health Organization and Africa Centres for Disease Control and Prevention. A total of 26 full articles (empirical studies, reviews and commentaries) were synthesised and analysed qualitatively based on predefined inclusion criteria on publication relevance and quality. Results: Over 70% of the 26 articles reported on coronavirus disease 2019 response strategies across Africa; 27% of the articles reported on preparedness towards coronavirus disease 2019, while 38% reported on urbanisation nexus with coronavirus disease 2019; 40% of the publications were full-text empirical studies, while the remaining 60% were either commentaries, reviews or editorials. It was found that urban cities remain epicentres of coronavirus disease 2019 in Africa. Even though some successes have been recorded in Africa regarding coronavirus disease 2019 fight, the continent’s response strategies were largely found to be a ‘one-size-fits-all’ approach. Consequently, adoption of ‘Western elitist’ mitigating measures for coronavirus disease 2019 containment resulted in excesses and spillover effects on individuals, families and economies in Africa. Conclusion: Africa needs to increase commitment to health systems strengthening through context-specific interventions and prioritisation of pandemic preparedness over response. Likewise, improved economic resilience and proper urban planning will help African countries to respond better to future public health emergencies, as coronavirus disease 2019 cases continue to surge on the continent.

scholarly journals Supporting shared decision-making for older people with multiple health and social care needs: a realist synthesis

2018 ◽  
Vol 6 (28) ◽  
pp. 1-84
Author(s):  
Frances Bunn ◽  
Claire Goodman ◽  
Bridget Russell ◽  
Patricia Wilson ◽  
Jill Manthorpe ◽  
...  
Keyword(s):  
Decision Making ◽  
Older People ◽  
Shared Decision Making ◽  
Shared Decision ◽  
Family Carers ◽  
Care Needs ◽  
Programme Theory ◽  
Complex Needs ◽  
Need Support ◽  
Multiple Health

BackgroundHealth-care systems are increasingly moving towards more integrated approaches. Shared decision-making (SDM) is central to these models but may be complicated by the need to negotiate and communicate decisions between multiple providers, as well as patients and their family carers; this is particularly the case for older people with complex needs.ObjectivesTo provide a context-relevant understanding of how models to facilitate SDM might work for older people with multiple health and care needs and how they might be applied to integrated care models.DesignRealist synthesis following Realist and Meta-narrative Evidence Syntheses: Evolving Standards (RAMESES) publication standards.ParticipantsTwenty-four stakeholders took part in interviews.Data sourcesElectronic databases including MEDLINE (via PubMed), The Cochrane Library, Scopus, Google and Google Scholar (Google Inc., Mountain View, CA, USA). Lateral searches were also carried out. All types of evidence were included.Review methodsIterative stakeholder-driven, three-stage approach, involving (1) scoping of the literature and stakeholder interviews (n = 13) to develop initial programme theory/ies, (2) systematic searches for evidence to test and develop the theories and (3) validation of programme theory/ies with stakeholders (n = 11).ResultsWe included 88 papers, of which 29 focused on older people or people with complex needs. We identified four theories (context–mechanism–outcome configurations) that together provide an account of what needs to be in place for SDM to work for older people with complex needs: understanding and assessing patient and carer values and capacity to access and use care; organising systems to support and prioritise SDM; supporting and preparing patients and family carers to engage in SDM; and a person-centred culture of which SDM is a part. Programmes likely to be successful in promoting SDM are those that create trust between those involved, allow service users to feel that they are respected and understood, and engender confidence to engage in SDM.LimitationsThere is a lack of evidence on interventions to promote SDM in older people with complex needs or on interprofessional approaches to SDM.ConclusionsModels of SDM for older people with complex health and care needs should be conceptualised as a series of conversations that patients, and their family carers, may have with a variety of different health and care professionals. To embed SDM in practice requires a shift from a biomedical focus to a more person-centred ethos. Service providers are likely to need support, both in terms of the way services are organised and delivered and in terms of their own continuing professional development. Older people with complex needs may need support to engage in SDM. How this support is best provided needs further exploration, although face-to-face interactions and ongoing patient–professional relationships are key.Future workThere is a need for further work to establish how organisational structures can be better aligned to meet the requirements of older people with complex needs. This includes a need to define and evaluate the contribution that different members of health and care teams can make to SDM for older people with complex health and care needs.Study registrationThis study is registered as PROSPERO CRD42016039013.FundingThe National Institute for Health Research Health Services and Delivery Research programme.

scholarly journals Nursing Care Coordination for Patients with Complex Needs in Primary Healthcare: A Scoping Review

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Marlène Karam ◽  
Maud-Christine Chouinard ◽  
Marie-Eve Poitras ◽  
Yves Couturier ◽  
Isabelle Vedel ◽  
...  
Keyword(s):  
Nursing Care ◽  
Scoping Review ◽  
Care Coordination ◽  
Primary Healthcare ◽  
Complex Needs

scholarly journals Zdravstvena nega obolelih od karcinoma dojke sa metastatskim promenama na endokranijumu

2021 ◽  
Vol 5 (9) ◽  
pp. 14-21
Author(s):  
Gora Miljanović ◽  
Vida Čolaković ◽  
Dragana Terzić-Marković ◽  
Vesna Jovanović ◽  
Mirjana Smuđa ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Quality Of Life ◽  
Patient Care ◽  
Nursing Care ◽  
Direct Method ◽  
Care Process ◽  
Care Needs ◽  
Optimal Care ◽  
Complex Needs

Introduction: Breast cancer is the transformation of healthy breast cells into malignant cells. The disease is characterized by metastases that can range from limited bone metastases to wide-spread and life-threatening metastases. The main goal of caring for these patients is to successfully control the symptoms of the disease, the side effects of the tumor while preserving the quality of life and surviving as long as possible. Objective was to show the specifics of interventions in the health care of a patient with breast cancer with metastatic changes in the endocranium Methods: We used a descriptive method and a conservative direct method: case study of a patient with breast cancer and metastatic changes in the brain according to the method of the Nursing Care Process (NCP). Discussion: Modern nursing care implies patient care according to a scientifically based method, universal in the nursing practice NCP, according to which care is focused on the patient/family, re-specting their preferences. NCP includes: continuous assessment of the patient's condition and defining problems and care needs, setting goals and selecting optimal care strategies. The most COM-mon collaborative problems for our patient were: pain, fatigue, anemia, insomnia. The problems that the nurses solved through independent interventions were: deficit in self-care, prevention of falls and injuries, lack of knowledge regarding the radiation pro-cedure, risk of infection, and the possibility of excess fluid volume. Conclusion: Patients with advanced breast cancer and their families have complex needs, the failure of which can result in impaired quality of life. An individual approach is needed in as-sessing the patient's condition, identifying needs, and planning interventions based on scientific evidence, available health re-sources, and preferences of patient/family. Patient care according to the NCP method promises a more comprehensive approach, improved patient experience as well as improved medical out-comes.

Domestic violence and multi-agency risk assessment conferences (MARACs): a scoping review

2014 ◽  
Vol 16 (6) ◽  
pp. 389-398 ◽  
Author(s):  
Rachel Robbins ◽  
Hugh McLaughlin ◽  
Concetta Banks ◽  
Claire Bellamy ◽  
Debbie Thackray
Keyword(s):  
Risk Assessment ◽  
Domestic Violence ◽  
Scoping Review ◽  
Social Care ◽  
Care Practice ◽  
Academic Press ◽  
Care Needs ◽  
Content Type ◽  
Complex Needs ◽  
Agency Risk

Purpose – The purpose of this paper is to draw attention to the potential and limits of the Multi-Agency Risk Assessment Conferences (MARACs) in supporting adults with social care needs who also experience domestic violence. Design/methodology/approach – The paper reports on a scoping review as part of a wider research project entitled: to identify and assess the effectiveness of social care's contribution to the development of MARAC and the protection of adults facing domestic violence. Findings – An understanding of the workings of MARAC could support social care practice with high-risk victims of domestic violence. However, the conception of risk assessment and management central to the process also poses ethical dilemmas for practitioners. Practical implications – Social care is ideally placed to support, in an holistic manner, a group of vulnerable service-users with complex needs. However, the current climate of austerity could jeopardise this work. Originality/value – There is little in the professional and academic press on the MARAC process and particularly in relation to adults and older people. This paper alerts the practice community to the process, its historical development and characteristics and implications for practice.

Situating Ethics in Online Mourning Research: A Scoping Review of Empirical Studies

2019 ◽  
Vol 25 (3) ◽  
pp. 289-299
Author(s):  
David Myles ◽  
Maria Cherba ◽  
Florence Millerand
Keyword(s):  
Scoping Review ◽  
Ethical Issues ◽  
Empirical Studies ◽  
Public Disclosure ◽  
The Public ◽  
The Past ◽  
Ethical Decisions ◽  
Emerging Trends ◽  
Data Sensitivity

In the past decade, social media have put mourning practices at the forefront of daily life in ways that challenge assumptions made about the public disclosure of information often construed as being highly intimate. This article examines how researchers conceive online mourning in empirical studies and how such conceptions inform (or not) methodological and ethical decisions. Through a scoping review, we identified 40 empirical papers addressing online mourning. Our analysis shows that, while online mourning practices have overwhelmingly been problematized in terms of privacy and publicness within the current literature, ethical issues relating to their analysis have been scarcely addressed in empirical research. In line with Foucault’s work on the dispositif, we then examine the performative role of privacy and data sensitivity in the context of online mourning research (notably in relation to consent procurement) and discuss our findings in light of emerging trends in context-based ethics.

scholarly journals Instruments for assessing the preferences for everyday living of older people with various care needs: protocol for an evidence map

BMJ Open ◽  
2021 ◽  
Vol 11 (9) ◽  
pp. e048921
Author(s):  
Mike Rommerskirch-Manietta ◽  
Daniel Purwins ◽  
Kimberly Van Haitsma ◽  
Katherine Abbott ◽  
Martina Roes
Keyword(s):  
Older People ◽  
Nursing Care ◽  
Care Needs ◽  
Evidence Map ◽  
The Public ◽  
Time Period ◽  
Ethical Approval ◽  
Care Outcomes ◽  
Study Designs ◽  
Everyday Living

IntroductionConsideration of the preferences for everyday living of older people with various care needs is a prerequisite for person-centred and evidence-based nursing care. Knowledge of and respect for these preferences by nursing staff are associated with better care outcomes for older people with various care needs. To assess preferences in a structured way, instruments focusing on different topics of everyday living appear to be useful. It is unclear which instruments exist for assessing preferences for everyday living. The aim of this planned review is to identify relevant instruments for assessing the preferences for everyday living of older people with various care needs in the form of an evidence map. Additionally, gaps requiring further research will be presented.Methods and analysisTo identify the different instruments, we will conduct a systematic search in the electronic databases MEDLINE (via PubMed), CINAHL and PsycINFO (via EBSCO). In addition, we will perform backward and forward citation tracking via reference lists and Google Scholar. The identified records will be independently screened (title/abstract and full text) by two reviewers. Data from the included studies will be extracted independently by the same two reviewers. In all three steps, the results will be checked for deviations, and if there are any deviations, they will be discussed. If no consensus can be achieved through discussion, a third reviewer will be engaged. All study designs will be included, and there will be no limitations regarding the publication status or time period. We will include all studies published in English and German that use instruments focusing on the assessment of preferences for everyday living in people older than 60 years of age with various care needs. For data charting, we will extract the number, categories and types of preferences, the care setting for which the instrument was developed and, if available, psychometric properties. Finally, the various extracted results will be presented in the form of tables and a bubble plot.Ethics and disseminationThere are no ethical concerns related to the construction of an evidence map, and ethical approval was given by the Witten/Herdecke University (application number 226/2020). We will discuss our results with practitioners in the field of nursing care and persons with various care needs. We will also make our results available to practitioners in an upcoming Project (PELI-D II) and to the public at (inter)national conferences and in the form of practice and peer-reviewed articles.

scholarly journals The Increasing Centrality of Robotic Technology in the Context of Nursing Care: Bioethical Implications Analyzed through a Scoping Review Approach

2021 ◽  
Vol 2021 ◽  
pp. 1-28
Author(s):  
Filippo Gibelli ◽  
Giovanna Ricci ◽  
Ascanio Sirignano ◽  
Stefania Turrina ◽  
Domenico De Leo
Keyword(s):  
Nursing Care ◽  
Scoping Review ◽  
Ethical Issues ◽  
Research Question ◽  
Healthcare Services ◽  
Social Robots ◽  
Service Robots ◽  
Design System ◽  
Main Research ◽  
Ethical Frameworks

At the dawn of the fourth industrial revolution, the healthcare industry is experiencing a momentous shift in the direction of increasingly pervasive technologization of care. If, up until the 2000s, imagining healthcare provided by robots was a purely futuristic fantasy, today, such a scenario is in fact a concrete reality, especially in some countries, such as Japan, where nursing care is largely delivered by assistive and social robots in both public and private healthcare settings, as well as in home care. This revolution in the context of care, already underway in many countries and destined to take place soon on a global scale, raises obvious ethical issues, related primarily to the progressive dehumanization of healthcare, a process which, moreover, has undergone an important acceleration following the outbreak of the COVID-19 pandemic, which has made it necessary to devise new systems to deliver healthcare services while minimizing interhuman contact. According to leading industry experts, nurses will be the primary users of healthcare robots in the short term. The aim of this study is to provide a general overview, through a scoping review approach, of the most relevant ethical issues that have emerged in the nursing care field in relation to the increasingly decisive role that service robots play in the provision of care. Specifically, through the adoption of the population-concept-context framework, we formulated this broad question: what are the most relevant ethical issues directly impacting clinical practice that arise in nursing care delivered by assistive and social robots? We conducted the review according to the five-step methodology outlined by Arksey and O’Malley. The first two steps, formulating the main research question and carrying out the literature search, were performed based on the population-context-concept (PCC) framework suggested by the Joanna Briggs Institute. Starting from an initial quota of 2,328 scientific papers, we performed an initial screening through a computer system by eliminating duplicated and non-English language articles. The next step consisted of selection based on a reading of the titles and abstracts, adopting four precise exclusion criteria: articles related to a nonnursing environment, articles dealing with bioethical aspects in a marginal way, articles related to technological devices other than robots, and articles that did not treat the dynamics of human-robot relationships in depth. Of the 2,328 titles and abstracts screened, we included 14. The results of the 14 papers revealed the existence of nonnegligible difficulties in the integration of robotic systems within nursing, leading to a lively search for new theoretical ethical frameworks, in which robots can find a place; concurrent with this exploration are the frantic attempts to identify the best ethical design system applicable to robots who work alongside nurses in hospital wards. In the final part of the paper, we also proposed considerations about the Italian nursing context and the legal implications of nursing care provided by robots in light of the Italian legislative panorama. Regarding future perspectives, this paper offers insights regarding robot engagement strategies within nursing.

scholarly journals Knowledge of Ghanaian Graduating Undergraduate Nurses About Ageing

2021 ◽  
Vol 7 ◽  
pp. 237796082110209
Author(s):  
Confidence Alorse Atakro
Keyword(s):  
Nursing Students ◽  
Older People ◽  
Nursing Care ◽  
Age Groups ◽  
Nursing Schools ◽  
Care Needs ◽  
Quality Healthcare ◽  
Undergraduate Nursing ◽  
Gerontological Nursing ◽  
Nursing Courses

Introduction Knowledge on ageing has an impact on the quality of care provided to older people. Although older Ghanaians provide various forms of support to family and communities, many of them experience poor nursing care in the Ghanaian health system. There is, however, dearth of evidence regarding knowledge of ageing among Ghanaian nurses. Objective This study therefore used a descriptive survey approach to investigate knowledge of graduating undergraduate nurses on physiological, and psychosocial changes in ageing. Methods Seventy graduating undergraduate nurses were surveyed to identify their knowledge on physiological and psychosocial changes leading to care needs of older people in Ghana. Three undergraduate nursing programs with gerontological nursing courses were purposively selected for the study. Descriptive statistics were used to analyze the data in order to present quantitative descriptions of variables in this study. Results The response rate in the study was 42%. Findings of the study show graduating undergraduate nursing students have inadequate knowledge on ageing. Several gaps in knowledge regarding ageing were identified. Although undergraduate nursing schools had gerontological nursing courses in their programs, over 90% of participating graduating nursing students indicated pain, anxiety and depression are normal aspects in the ageing process. Conclusion It is imperative to improve the current curricula content on gerontological nursing in Ghanaian nursing schools to equip nurses with knowledge and skills needed to provide quality healthcare to older people in Ghana. Improving knowledge on ageing through evidence-informed gerontological nursing curricula content will lead to better nursing care of older Ghanaians. Providing educational opportunities for improved quality nursing care of older Ghanaians is in line with the United Nations (UN) Sustainable Development Goal 3, which aims at providing equal and quality healthcare to all age groups by 2030.

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