scholarly journals The SAFEST review: a mixed methods systematic review of shock-absorbing flooring for fall-related injury prevention

2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Amy Drahota ◽  
Lambert M. Felix ◽  
James Raftery ◽  
Bethany E. Keenan ◽  
Chantelle C. Lachance ◽  
...  
Keyword(s):  
Systematic Review ◽  
Mixed Methods ◽  
Care Home ◽  
Core Outcome Set ◽  
Dominant Strategy ◽  
Care Homes ◽  
Injurious Falls ◽  
Home Based ◽  
Randomised Controlled ◽  
Quality Evidence

Abstract Background Shock-absorbing flooring may minimise impact forces incurred from falls to reduce fall-related injuries; however, synthesized evidence is required to inform decision-making in hospitals and care homes. Methods This is a Health Technology Assessment mixed methods systematic review of flooring interventions targeting older adults and staff in care settings. Our search incorporated the findings from a previous scoping review, MEDLINE, AgeLine, and Scopus (to September 2019) and other sources. Two independent reviewers selected, assessed, and extracted data from studies. We assessed risk of bias using Cochrane and Joanna Briggs Institute tools, undertook meta-analyses, and meta-aggregation. Results 20 of 22 included studies assessed our outcomes (3 Randomised Controlled Trials (RCTs); 7 observational; 5 qualitative; 5 economic), on novel floors (N = 12), sports floors (N = 5), carpet (N = 5), and wooden sub-floors (N = 1). Quantitative data related to 11,857 patient falls (9 studies), and 163 staff injuries (1 study). One care home-based RCT found a novel underlay produced similar injurious falls rates (high-quality evidence) and falls rates (moderate-quality evidence) to a plywood underlay with vinyl overlay and concrete sub-floors. Very low-quality evidence suggested that shock-absorbing flooring may reduce injuries in hospitals (Rate Ratio 0.55, 95% CI 0.36 to 0.84, 2 studies; 27.1% vs. 42.4%; Risk Ratio (RR) = 0.64, 95% CI 0.44 to 0.93, 2 studies) and care homes (26.4% vs. 33.0%; RR 0.80, 95% CI 0.70 to 0.91, 3 studies), without increasing falls. Economic evidence indicated that if injuries are fewer and falls not increased, then shock-absorbing flooring would be a dominant strategy. Fracture outcomes were imprecise; however, hip fractures reduced from 30 in 1000 falls on concrete to 18 in 1000 falls on wooden sub-floors (OR 0.59, 95% CI 0.45 to 0.78; one study; very low-quality evidence). Staff found moving wheeled equipment harder on shock-absorbing floors leading to workplace adaptations. Very low-quality evidence suggests staff injuries were no less frequent on rigid floors. Conclusion Evidence favouring shock-absorbing flooring is uncertain and of very low quality. Robust research following a core outcome set is required, with attention to wider staff workplace implications. Trial registration PROSPERO CRD42019118834.

scholarly journals Psychometric properties and feasibility of use of dementia specific quality of life instruments for use in care settings: a systematic review

2019 ◽  
pp. 1-15 ◽  
Author(s):  
Laura J. Hughes ◽  
Nicolas Farina ◽  
Thomas E. Page ◽  
Naji Tabet ◽  
Sube Banerjee
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Psychometric Properties ◽  
Care Home ◽  
Care Homes ◽  
Cosmin Checklist ◽  
Many Instruments ◽  
The Uk ◽  
Quality Instruments

ABSTRACTBackground:Over 400,000 people live in care home settings in the UK. One way of understanding and improving the quality of care provided is by measuring and understanding the quality of life (QoL) of those living in care homes. This review aimed to identify and examine the psychometric properties including feasibility of use of dementia-specific QoL measures developed or validated for use in care settings.Design:Systematic review.Methods:Instruments were identified using four electronic databases (PubMed, PsycINFO, Web of Science, and CINAHL) and lateral search techniques. Searches were conducted in January 2017. Studies which reported on the development and/or validation of dementia specific QoL instruments for use in care settings written in English were eligible for inclusion. The methodological quality of the studies was assessed using the COSMIN checklist. Feasibility was assessed using a checklist developed specifically for the review.Results:Six hundred and sixteen articles were identified in the initial search. After de-duplication, screening and further lateral searches were performed, 25 studies reporting on 9 dementia-specific QoL instruments for use in care home settings were included in the review. Limited evidence was available on the psychometric properties of many instruments identified. Higher-quality instruments were not easily accessible or had low feasibility of use.Conclusions:Few high-quality instruments of QoL validated for use in care home settings are readily or freely available. This review highlights the need to develop a well-validated measure of QoL for use within care homes that is also feasible and accessible.

scholarly journals Remote Health Care Provision in Care Homes in England: An Exploratory Mixed Methods Study of Yorkshire and the Humber

Technologies ◽  
2019 ◽  
Vol 7 (1) ◽  
pp. 24 ◽  
Author(s):  
Louise Newbould ◽  
Gail Mountain ◽  
Steven Ariss ◽  
Mark Hawley
Keyword(s):  
Health Care ◽  
Mixed Methods ◽  
Urban Areas ◽  
Health Care Services ◽  
Qualitative Interviews ◽  
Care Home ◽  
Mixed Methods Study ◽  
Care Homes ◽  
Health Care Provision ◽  
Care Provision

An increasing demand for care homes in the UK, has necessitated the evaluation of innovative methods for delivering more effective health care. Videoconferencing may be one way to meet this demand. However, there is a lack of literature on the provision of videoconferencing in England. This mixed-methods study aimed to map current attitudes, knowledge and provision of videoconferencing in the Yorkshire and Humber region of England. Qualitative interviews with care home managers, a scoping review and field notes from a Special Interest Group (SIG) informed the development of a descriptive convenience survey which was sent out to care home managers in the Yorkshire and Humber region of England. The survey had a 14% (n = 124) response rate. Of those who responded, 10% (n = 12) reported using videoconferencing for health care; with over 78% (n = 97) of respondents’ care homes being based in urban areas. Approximately 62% (n = 77) of the 124 respondents had heard of videoconferencing for health care provision. Of those who reported not using videoconferencing (n = 112), 39% (n = 48) said they would consider it but would need to know more. The top ranked reason for not introducing videoconferencing was the belief that residents would not be comfortable using videoconferencing to consult with a healthcare professional. The main reason for implementation was the need for speedier access to services. Those already using videoconferencing rated videoconferencing overall as being very good (50%) (n = 6) or good (42%) (n = 5). Those who were not using it in practice appeared sceptical before implementing videoconferencing. The main driver of uptake was the home’s current access to and satisfaction with traditionally delivered health care services.

scholarly journals Adopt a Care Home: An intergenerational initiative bringing children into care homes

Dementia ◽  
2017 ◽  
Vol 18 (5) ◽  
pp. 1679-1694 ◽  
Author(s):  
Laura Di Bona ◽  
Sheila Kennedy ◽  
Gail Mountain
Keyword(s):  
Mixed Methods ◽  
Focus Groups ◽  
Social Inclusion ◽  
Care Home ◽  
Care Homes ◽  
Care Home Staff ◽  
Impact Data ◽  
School Care

Dementia friendly communities, in which people living with dementia actively participate and those around them are educated about dementia, may improve the wellbeing of those living with dementia and reduce the associated stigma. The Adopt a Care Home scheme aims to contribute towards this by teaching schoolchildren about dementia and linking them with people living with dementia in a local care home. Forty-one children, 10 people living with dementia and 8 school/care home staff participated in a mixed methods (questionnaires, observations, interviews and focus groups) evaluation to assess the scheme’s feasibility and impact. Data were analysed statistically and thematically. The scheme was successfully implemented, increased children’s dementia awareness and appeared enjoyable for most participants. Findings, therefore, demonstrate the scheme’s potential to contribute towards dementia friendly communities by increasing children’s knowledge and understanding of dementia and engaging people living with dementia in an enjoyable activity, increasing their social inclusion.

scholarly journals Study of Physical, Psychological, and Spiritual Impact of Family Caregiver In Home-Based Stroke Treatment: A Systematic Review

2021 ◽  
Vol 9 (T4) ◽  
pp. 236-239
Author(s):  
Anggi Stiexs ◽  
Nur Chayati
Keyword(s):  
Systematic Review ◽  
Home Care ◽  
Family Caregiver ◽  
Care Home ◽  
Stroke Patients ◽  
Term Care ◽  
Stroke Treatment ◽  
Home Based ◽  
The Family ◽  
Home Based Care

BACKGROUND: Family support during stroke treatment at home is crucial. However, post-stroke patients’ long-term care will be a problem for families, reducing the level of life satisfaction and physical burden for caregivers. Furthermore, families may experience depression. AIM: Analyzing family conditions related to physical, psychological, and spiritual conditions that receive home-based health worker interventions. METHODS: Study implemented systematic review design with Prisma guidelines, initially with the identification of article sources, following by article screening, checking the eligibility of studies then appraised the selected articles. Three databases were used, Ebsco, PubMed, and PROQUEST. Only studies using quasi-experimental, pre-experimental, and RCT designs were included in this study. Furthermore, those articles were published between 2014 until 2019, full type article and conducted anykind of home intervention for stroke patients and/or family member. Keywords that were employed “Stroke, Apoplexy, Cerebrovascular Accident, Vascular Accident, Home Care Services, home care, Home Health Care, Domiciliary Care, Physical, Physics, Psychological Factors, Psychological Side Effects, Psychosocial Factors, Spirituality.” Totally, 19,528 articles were obtained. Finally, only six eligible articles met review requirements. RESULTS: Implementation of home-based care lowered the physical fatigue of the family. In psychological responses showed that home-based care could reduce the incidence of depression and anxiety levels. Another impact was that the family felt helped because patients could more independently do their activities. Furthermore, the family always supported to motivate the patients to do their daily tasks. CONCLUSION: Home-based interventions for stroke patients can reduce depression, anxiety, and fatigue for the family caregiver.

scholarly journals Embedding qualitative research in randomised controlled trials to improve recruitment: findings from two recruitment optimisation studies of orthopaedic surgical trials.

2021 ◽  
Author(s):  
Arabella Scantlebury ◽  
Catriona McDaid ◽  
Stephen Brealey ◽  
Elizabeth Cook ◽  
Arun Ranganathan ◽  
...  
Keyword(s):  
Systematic Review ◽  
United Kingdom ◽  
Mixed Methods ◽  
Randomised Controlled Trials ◽  
Controlled Trials ◽  
Surgical Trials ◽  
Patient Pathways ◽  
Study Results ◽  
Randomised Controlled ◽  
The Impact

Abstract Background: Recruitment of patients is one of the main challenges when designing and conducting randomised controlled trials (RCTs). Trials of rare injuries, or those that include surgical interventions pose added challenges due to the small number of potentially eligible patients and issues with patient preferences and surgeon equipoise. We explore key issues to consider when recruiting to orthopaedic surgical trials from the perspective of staff and patients with the aim of informing the development of strategies to improve recruitment in future research. Design: Two qualitative process evaluations of a United Kingdom-wide orthopaedic surgical RCT (ACTIVE) and mixed methods randomised feasibility study (PRESTO). Qualitative semi-structured interviews were conducted and data was analysed thematically. Setting: NHS secondary care organisations throughout the United Kingdom. Interviews were undertaken via telephone. Participants: 37 trial recruiters (surgeons, physiotherapists, research nurses) and 22 patients were interviewed. Patients included those who agreed to participate in the ACTIVE and PRESTO studies and patients that declined participation in the ACTIVE study. Results: We used a mixed methods systematic review of recruiting patients to randomised controlled trials as a framework for reporting and analysing our findings. Our findings mapped onto those identified in the systematic review and highlighted the importance of equipoise, randomisation, communication, patient’s circumstances, altruism and trust in clinical and research teams. Our findings also emphasised the importance of considering how eligibility criteria are operationalised and the impact of complex patient pathways when recruiting to surgical trials. In particular, the influence of health professionals, who are not involved in trial recruitment, on patients’ treatment preferences by suggesting they would receive a certain treatment ahead of recruitment consultations should not be underestimated. Conclusions: A wealth of evidence exploring factors affecting recruitment to randomised controlled trials exists. A methodological shift is now required to ensure that this evidence is used by all those involved in recruitment and to ensure that existing knowledge is translated into methods for optimising recruitment to future trials. Trial registries: ACTIVE: (ISRCTN98152560) PRESTO: (ISRCTN12094890)

scholarly journals Clinical outcomes and outcome measurement tools reported in randomised controlled trials of treatment for snakebite envenoming: A systematic review

2021 ◽  
Vol 15 (8) ◽  
pp. e0009589
Author(s):  
Michael Abouyannis ◽  
Dinesh Aggarwal ◽  
David G. Lalloo ◽  
Nicholas R. Casewell ◽  
Mainga Hamaluba ◽  
...  
Keyword(s):  
Systematic Review ◽  
Clinical Trials ◽  
Outcome Measures ◽  
Randomised Controlled Trials ◽  
Core Outcome Set ◽  
Controlled Trials ◽  
Study Protocols ◽  
Outcome Set ◽  
Secondary Analyses ◽  
Randomised Controlled

Background Snakebite is a priority neglected tropical disease and causes a range of complications that vary depending on the snake species. Randomised clinical trials have used varied outcome measures that do not allow results to be compared or combined. In accordance with the Core Outcomes Measurements in Effectiveness Trials (COMET) initiative, this systematic review aims to support the development of a globally relevant core outcome set for snakebite. Methods All randomised controlled trials, secondary analyses of randomised controlled trials and study protocols investigating the efficacy of therapeutics for human snakebite envenoming were eligible for inclusion. Study screening and data extraction were conducted in duplicate by two independent reviewers. All primary and secondary outcome measures were extracted and compiled, as were adverse event outcome measures. Similar outcome measures were grouped into domains. The study was prospectively registered with PROSPERO: CRD42020196160. Results This systematic review included 43 randomised controlled trials, two secondary analyses and 13 study protocols. A total of 382 outcome measures were extracted and, after duplicates were merged, there were 153 unique outcomes. The most frequently used outcome domain (‘venom antigenaemia’) was included in less than one third of the studies. The unique outcomes were classified into 60 outcome domains. Patient-centred outcomes were used in only three of the studies. Discussion Significant heterogeneity in outcome measures exists in snakebite clinical trials. Consensus is needed to select outcome measures that are valid, reliable, patient-centred and feasible. The results of this systematic review strongly support the development of a core outcome set for use in snakebite clinical trials.

scholarly journals Ownership and COVID-19 in care homes for older people: A living systematic review of outbreaks, infections, and mortalities

2021 ◽  
Author(s):  
Anders Malthe Bach-Mortensen ◽  
Ben Verboom ◽  
Ani Movsisyan ◽  
Michelle Degli Esposti
Keyword(s):  
Systematic Review ◽  
Older People ◽  
Care Home ◽  
Academic Research ◽  
Developed Countries ◽  
Care Homes ◽  
For Profit ◽  
News Reports ◽  
Increased Risk ◽  
New Research

AbstractBackgroundThe adult social care sector is increasingly outsourced to for-profit providers, who constitute the largest provider of care homes in many developed countries. During the COVID-19 pandemic, for-profit providers have been accused of failing their residents by prioritising profits over care, prevention, and caution, which has been reported to result in a higher prevalence of COVID-19 infections and deaths in for-profit care homes. Although many of these reports are anecdotal or based on news reports, there is a growing body of academic research investigating ownership variation across COVID-19 outcomes, which has not been systematically appraised and synthesised.ObjectivesTo identify, appraise, and synthesise the available research on ownership variation in COVID-19 outcomes (outbreaks, infections, deaths, shortage of personal protective equipment (PPE) and staff) across for-profit, public, and non-profit care homes for older people, and to update our findings as new research becomes available.DesignLiving systematic review.MethodsThis review was prospectively registered with Prospero (CRD42020218673). We searched 17 databases and performed forward and backward citation tracking of all included studies. Search results were screened and reviewed in duplicate. Risk of bias (RoB) was assessed in duplicate according to the COSMOS-E guidance. Data was extracted by ABM and independently validated. The results were synthesised by country, RoB, and model adjustments, and visualised using harvest plots.ResultsTwenty-nine studies across five countries were included, with 75% of included studies conducted in the Unites States. For-profit ownership was not consistently associated with a higher probability of a COVID-19 outbreak. However, there was compelling evidence of worse COVID-19 outcomes following an outbreak, with for-profit care homes having higher rates of accumulative infections and deaths. For-profit providers were also associated with shortages in PPE, which may have contributed to the higher incidence of infections and deaths in the early stages of the pandemic. Chain affiliation was often correlated with an increased risk of outbreak but was usually not reported to be associated with higher rates of deaths and infections.ConclusionFor-profit ownership was a consistent risk factor for higher cumulative COVID-19 infections and deaths in the first wave of the pandemic. Thus, ownership and the characteristics associated with FP care home providers may present key regulatable factors that can be addressed to improve health outcomes in vulnerable populations and reduce health disparities. This review will be updated as new research becomes published, which may change the conclusion of our synthesis.

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