scholarly journals A Scoping Review and Thematic Classification of Patient Complexity: Offering a Unifying Framework

2012 ◽  
Vol 2 (1) ◽  
pp. 1-9 ◽  
Author(s):  
Alexis K. Schaink ◽  
Kerry Kuluski ◽  
Renée F. Lyons ◽  
Martin Fortin ◽  
Alejandro R. Jadad ◽  
...  
Keyword(s):  
Scoping Review ◽  
Chronic Conditions ◽  
Modern Medicine ◽  
Complex Chronic Conditions ◽  
Health And Social Care ◽  
Payment Schemes ◽  
Important Health ◽  
The Face ◽  
Patient Complexity ◽  
Important Health Issue

The path to improving healthcare quality for individuals with complex health conditions is complicated by a lack of common understanding of complexity. Modern medicine, together with social and environmental factors, has extended life, leading to a growing population of patients with chronic conditions. In many cases, there are social and psychological factors that impact treatment, health outcomes, and quality of life. This is the face of complexity. Care challenges, burden, and cost have positioned complexity as an important health issue. Complex chronic conditions are now being discussed by clinicians, researchers, and policy-makers around such issues as quantification, payment schemes, transitions, management models, clinical practice, and improved patient experience. We conducted a scoping review of the literature for definitions and descriptions of complexity. We provide an overview of complex chronic conditions, and what is known about complexity, and describe variations in how it is understood. We developed a Complexity Framework from these findings to guide our approach to understanding patient complexity. It is critical to use common vernacular and conceptualization of complexity to improve service and outcomes for patients with complex chronic conditions. Many questions still persist about how to develop this work with a health and social care lens; our framework offers a foundation to structure thinking about complex patients. Further insight into patient complexity can inform treatment models and goals of care, and identify required services and barriers to the management of complexity.

scholarly journals Identifying and understanding the health and social care needs of older adults with multiple chronic conditions and their caregivers: a protocol for a scoping review

BMJ Open ◽  
2017 ◽  
Vol 7 (12) ◽  
pp. e018247 ◽  
Author(s):  
Elana Commisso ◽  
Katherine S McGilton ◽  
Ana Patricia Ayala ◽  
Melissa, K Andrew ◽  
Howard Bergman ◽  
...  
Keyword(s):  
Older Adults ◽  
Family Caregivers ◽  
Scoping Review ◽  
Chronic Conditions ◽  
Social Care ◽  
Grey Literature ◽  
Well Being ◽  
Multiple Chronic Conditions ◽  
Care Needs ◽  
Health And Social Care

IntroductionPeople are living longer; however, they are not necessarily experiencing good health and well-being as they age. Many older adults live with multiple chronic conditions (MCC), and complex health issues, which adversely affect their day-to-day functioning and overall quality of life. As a result, they frequently rely on the support of friend and/or family caregivers. Caregivers of older adults with MCC often face challenges to their own well-being and also require support. Currently, not enough is known about the health and social care needs of older adults with MCC and the needs of their caregivers or how best to identify and meet these needs. This study will examine and synthesise the literature on the needs of older adults with MCC and those of their caregivers, and identify gaps in evidence and directions for further research.Methods and analysisWe will conduct a scoping review of the peer-reviewed and grey literature using the updated Arksey and O’Malley framework. The literature will be identified using a multidatabase and grey literature search strategy developed by a health sciences librarian. Papers, reports and other materials addressing the health and social care needs of older adults and their friend/family caregivers will be included. Search results will be screened, independently, by two reviewers, and data will be abstracted from included literature and charted in duplicate.Ethics and disseminationThis scoping review does not require ethics approval. We anticipate that study findings will inform novel strategies for identifying and ascertaining the health and social care needs of older adults living with MCC and those of their caregivers. Working with knowledge-user members of our team, we will prepare materials and presentations to disseminate findings to relevant stakeholder and end-user groups at local, national and international levels. We will also publish our findings in a peer-reviewed journal.

scholarly journals Translation, adaptation and pilot testing of the Pictorial Fit-Frail Scale (PFFS) for use in Malaysia – The PFFS-Malay version (PFFS-M)

2021 ◽  
Vol 16 (2) ◽  
pp. 27-36
Author(s):  
Sally Suriani Ahip ◽  
Sazlina Shariff-Ghazali ◽  
Sabrina Lukas ◽  
Azah Abdul Samad ◽  
Ummu Kalsum Mustapha ◽  
...  
Keyword(s):  
The Elderly ◽  
Face Validity ◽  
Clinical Settings ◽  
Term Care ◽  
Targeted Interventions ◽  
Adverse Health Outcomes ◽  
Health Domains ◽  
Important Health ◽  
The Face ◽  
Important Health Issue

Background: Frailty is an important health issue in an aging population; it is a state of vulnerability that renders the elderly susceptible to adverse health outcomes, including disability, hospitalization, long-term care admission and death. Early frailty stages are recognizable through screening and are reversible with targeted interventions. To date, however, there is no screening tool for use in Malaysia. The English Pictorial Fit-Frail Scale (PFFS) is a visual tool that assesses a person’s fitness-frailty level in 14 health domains, with higher scores indicating higher frailty. Objective: The aim was to translate and adapt the English PFFS for use in Malaysian clinical settings. Methods: The original English PFFS underwent forward and backward-translation by two bilingual translators to and from the Malay language. A finalized version, the PFFS-Malay (PFFS-M), was formed after expert reviewers’ consensus and was pilot tested with 20 patients, 20 caregivers, 16 healthcare assistants, 17 nurses and 22 doctors. Score agreement between patients and their caregivers and among healthcare professionals were assessed. All participants rated their understanding of the scale using the feasibility survey forms. Results: A total of 95 participants were included. There were high percentages of scoring agreements among all participants on the scale (66.7% to 98.9%). Overall feedback from all respondents were positive and supported the face validity of the PFFS-M. Conclusion: The PFFS-M reflects an accurate translation for the Malaysian population. The scale is usable and feasible and has face validity. Reliability and predictive validity assessments of the PFFS-M are currently underway.

Nurse-Led Models of Care for Patients with Complex Chronic Conditions: A Scoping Review

2019 ◽  
Vol 32 (3) ◽  
pp. 57-56
Author(s):  
Kayleigh Gordon ◽  
Carolyn Gray ◽  
Katie Dainty ◽  
Jane deLacy ◽  
Emily Seto
Keyword(s):  
Scoping Review ◽  
Chronic Conditions ◽  
Models Of Care ◽  
Complex Chronic Conditions

scholarly journals Identifying and understanding the health and social care needs of Indigenous older adults with multiple chronic conditions and their caregivers: a scoping review

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Sharlene Webkamigad ◽  
Robyn Rowe ◽  
Shanna Peltier ◽  
Amanda Froehlich Chow ◽  
Katherine S. McGilton ◽  
...  
Keyword(s):  
Older Adults ◽  
Scoping Review ◽  
Chronic Conditions ◽  
Social Care ◽  
Multiple Chronic Conditions ◽  
Care Needs ◽  
Health And Social Care

scholarly journals Challenging collaboration of general practitioners and specialists for patients with complex chronic conditions: A scoping review to identify improvement strategies

2021 ◽  
Author(s):  
Rebecca Tomaschek ◽  
Patricia Lampart ◽  
Anke Scheel-Sailer ◽  
Armin Gemperli ◽  
Christoph Merlo ◽  
...  
Keyword(s):  
General Practitioners ◽  
Scoping Review ◽  
Chronic Conditions ◽  
Knowledge Exchange ◽  
Daily Practice ◽  
Medical Specialists ◽  
Complex Chronic Conditions ◽  
Pubmed Database ◽  
Communication And Coordination ◽  
Definition Of

Abstract BackgroundCollaboration between medical specialists and general practitioners (GPs) is well known from daily practice, but research on the topic is rather scarce. This scoping review summarizes role distributions and components of this collaboration that have potential for improvement for the care of patients with complex chronic conditions. Methods Scoping review as a knowledge synthesis for components of collaboration and role distributions between medical specialists and GPs in intervention studies. The PubMed database was searched for literature from 2010-2020.ResultsLiterature search and reference screening generated 2,174 articles. Of these, 30 articles originating from 22 unique projects were included in our synthesis. These projects focus on different patient populations and take diverse approaches to improve collaboration within an intervention. The GP is most commonly in charge of patient management and extends the scope of practice. The specialist provides support when needed. Clear definition of roles and responsibilities, resources for knowledge exchange and raising awareness through education from specialists for specific health conditions are commonly utilized interventions. Typically, combinations of process and system changes that address communication and coordination issues are applied. Most interventions improve provider and patient satisfaction, health outcomes, and reduce fragmentation of patient care.ConclusionInterventions to improve collaboration between GPs and medical specialists seem promising. Further efforts should be made to test and apply the findings in broad clinical practice.

scholarly journals Medicinal Plants, Phytochemicals, and Herbs to Combat Viral Pathogens Including SARS-CoV-2

Molecules ◽  
2021 ◽  
Vol 26 (6) ◽  
pp. 1775
Author(s):  
Arumugam Vijaya Anand ◽  
Balasubramanian Balamuralikrishnan ◽  
Mohandass Kaviya ◽  
Kathirvel Bharathi ◽  
Aluru Parithathvi ◽  
...  
Keyword(s):  
Medicinal Plants ◽  
Severe Acute Respiratory Syndrome ◽  
Viral Entry ◽  
Antiviral Agents ◽  
Special Focus ◽  
Direct Inhibition ◽  
Viral Pathogens ◽  
Important Health ◽  
Antiviral Activities ◽  
Important Health Issue

The coronavirus disease 2019 (COVID-19) pandemic, caused by severe acute respiratory syndrome corona virus-2 (SARS-CoV-2), is the most important health issue, internationally. With no specific and effective antiviral therapy for COVID-19, new or repurposed antiviral are urgently needed. Phytochemicals pose a ray of hope for human health during this pandemic, and a great deal of research is concentrated on it. Phytochemicals have been used as antiviral agents against several viruses since they could inhibit several viruses via different mechanisms of direct inhibition either at the viral entry point or the replication stages and via immunomodulation potentials. Recent evidence also suggests that some plants and its components have shown promising antiviral properties against SARS-CoV-2. This review summarizes certain phytochemical agents along with their mode of actions and potential antiviral activities against important viral pathogens. A special focus has been given on medicinal plants and their extracts as well as herbs which have shown promising results to combat SARS-CoV-2 infection and can be useful in treating patients with COVID-19 as alternatives for treatment under phytotherapy approaches during this devastating pandemic situation.

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