Living with Frailty - What Healthcare Issues Matter to an Older Person? A Focus Group Study

2020 ◽  
Author(s):  
Kathryn Tipping(Former Corresponding Author) ◽  
Asangaedem Akpan New
Keyword(s):  
Focus Group ◽  
Older People ◽  
Health Care Professionals ◽  
Quantitative Research ◽  
Discharge Planning ◽  
Health Issues ◽  
Older Person ◽  
Focus Group Study ◽  
Clinical Frailty Scale ◽  
Small Project

Abstract Background The study set out to interview older people with frailty and find out what healthcare issues matter to them. Older people with frailty are an important population subgroup. In the United Kingdom, over 65s already outnumber under 16s, and this is expected to increase. Research into health issues has been undertaken by the International Consortium for Health Outcomes Measurement (ICHOM) and this study builds on that. Recent research has been undertaken in America into health issues. However, these studies were not specifically focused on older people. Methods A scoping review of the literature was undertaken to highlight any gaps in this area of research. Thereafter a focus group interview was carried out with six older people with frailty. Qualitative research often uses smaller samples than quantitative research 7 . Braun and Clarke recommend that for a small project, such as this one, 6-10 interviews should be held. Braun and Clarke state that smaller groups (three to eight participants) work best in terms of generating a rich discussion and have the added benefit of being easier to manage 7 . The six participants were aged 65 years and over and had mild to moderate frailty using the Rockwood Clinical Frailty Scale. 8 The interview was recorded and transcribed, analysed and themes identified. Results The eight themes identified were trust in medical professionals, vulnerability of being an older person in hospital, polypharmacy and wastage of medication, discharge planning and co-ordination of care at home, taking responsibility for your own health, nomenclature, autonomy and falls. Conclusion This study has identified themes to raise awareness among health care professionals about what health issues matter to older people with frailty. The study findings will provide an opportunity for meaningful discussions around what is needed to meet these preferred health issues.

69 What Health Outcomes Matter to Frail Older People?

2020 ◽  
Vol 49 (Supplement_1) ◽  
pp. i21-i21
Author(s):  
K S Tipping
Keyword(s):  
Health Care ◽  
Focus Group ◽  
Older People ◽  
Health Outcomes ◽  
Health Care Professionals ◽  
Focus Group Interview ◽  
Group Interview ◽  
Health Priorities ◽  
Frail Older People ◽  
Clinical Frailty Scale

Abstract Introduction The purpose of this project was to explore what health outcomes matter to frail older people. This would provide information that would be of use to both providers and payers of health care services to align their priorities in line with these. Frailty is an important and relevant topic in healthcare. In England 5% of people aged 60-69 have frailty. This rises to 65% in people aged over 90. There are 1.8 million people aged over 60 and 0.8 million people aged over 80 living with frailty. (English Longitudinal Study of Ageing (2016)). This number is due to increase. The aims of this research were: To review the literature on health outcomes in older people including frail older people.To conduct a focus group interview with frail older people to ascertain their views on health outcomes.To disseminate and share the reviews and study findings via presentations and publications. Ethics Ethical approval was granted by the University of Liverpool’s Health and Life Sciences Research Ethics Committee (application number 4163). Methods A systematic review of the literature was undertaken. Thereafter a focus group interview was held with six frail older people. The participants were aged 65 years and over and had mild to moderate frailty using the Clinical Frailty Scale. The interview recording was transcribed, and common themes identified and analysed. Results Eight themes were identified from the focus group: - Trust in medical professionalsVulnerability of being an older person in hospitalPolypharmacy and wastage of medicationDischarge Planning & Co-Ordination of Care at HomeTaking responsibility for your own healthNomenclatureAutonomyFalls Conclusion This study has identified themes that can be utilised to raise awareness among health care professionals on what matters to frail older people. The study findings will hopefully provide an opportunity for meaningful discussions around what is needed to better meet these desired health outcomes. References 1. Akpan A, Roberts C, Bandeen-Roche K, Batty B, Bausewein C, Bell D, et al. Standard set of health outcome measures for older persons. BMC Geriatr 2018;18(1):36. 2. Naik AD, Dindo LN, Van Liew JR, Hundt NE, Vo L, Hernandez-Bigos K, et al. Development of a Clinically Feasible Process for Identifying Individual Health Priorities. Journal of the American Geriatrics Society 2018;66(10):1872–9.

scholarly journals Developing a recovery-focused therapy for older people with bipolar disorder: a qualitative focus group study

BMJ Open ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. e049829
Author(s):  
Elizabeth Tyler ◽  
Fiona Lobban ◽  
Rita Long ◽  
Steven H Jones
Keyword(s):  
Older Adults ◽  
Bipolar Disorder ◽  
Focus Group ◽  
Older People ◽  
Focus Groups ◽  
Later Life ◽  
Focus Group Study ◽  
Age Related ◽  
Health Related ◽  
Age Related Changes

ObjectivesAs awareness of bipolar disorder (BD) increases and the world experiences a rapid ageing of the population, the number of people living with BD in later life is expected to rise substantially. There is no current evidence base for the effectiveness of psychological interventions for older adults with BD. This focus group study explored a number of topics to inform the development and delivery of a recovery-focused therapy (RfT) for older adults with BD.DesignA qualitative focus group study.SettingThree focus groups were conducted at a university in the North West of England.ParticipantsEight people took part in the focus groups; six older adults with BD, one carer and one friend.ResultsParticipant’s responses clustered into six themes: (1) health-related and age-related changes in later life, (2) the experience of BD in later life, (3) managing and coping with BD in later life, (4) recovery in later life, (5) seeking helping in the future and (6) adapting RfT for older people.ConclusionsParticipants reported a range of health-related and age-related changes and strategies to manage their BD. Participants held mixed views about using the term ‘recovery’ in later life. Participants were in agreement that certain adaptations were needed for delivering RfT for older adults, based on their experience of living with BD in later life. The data collected as part of the focus groups have led to a number of recommendations for delivering RfT for older adults with BD in a randomised controlled trial (Clinical Trial Registration: ISRCTN13875321).

Medication review for the older person

2007 ◽  
Vol 17 (1) ◽  
pp. 25-32 ◽  
Author(s):  
Maggi Banning
Keyword(s):  
Older People ◽  
Health Care Professionals ◽  
Drug Dose ◽  
Inappropriate Drug ◽  
Older Person ◽  
Duration Of Treatment ◽  
Chronic Morbidity ◽  
Effects Of Aging ◽  
The Impact ◽  
Repeat Prescriptions

People of 65 years and older accounted for 21% of the population of England and Wales in 2001, and their proportion is increasing. It is forecast that the number of people over the age 75 years will double within the next 50 years, and that of those over the age of 90 will increase fivefold. The older patient with declining health poses significant challenges for health care professionals, in particular those of managing chronic morbidity and the effects of aging. Many older people require pharmacological treatment for multiple, co-existing pathologies. Those of 65 years and over receive 56% of all prescriptions in England, of which 78% are repeat prescriptions, and people in residential care, on average, receive five different medicines concurrently. The impact of repeat prescriptions means that, due to inadequate monitoring, many older people continue to administer medicines they no longer require, and thereby risk receiving an inappropriate drug, dose or duration of treatment. In addition to this, there is the propensity for older people to mismanage medicines, increasing their risk of unplanned drug-related admission to hospital and drug-related morbidity.

Investigating the Attitudes of Health-Care Professionals towards the Use of Integrated Care Pathways in a District General Hospital: A Thematic Analysis of Focus Group Discussion

2005 ◽  
Vol 9 (2) ◽  
pp. 57-66 ◽  
Author(s):  
Tanya Claridge ◽  
Dianne Parker ◽  
Gary Cook
Keyword(s):  
Health Care ◽  
Focus Group ◽  
Focus Group Discussion ◽  
Thematic Analysis ◽  
Health Care Professionals ◽  
Group Discussion ◽  
District General Hospital ◽  
Survey Questionnaire ◽  
Focus Group Study ◽  
Integrated Care Pathways

Context: Integrated care pathways (ICPs) are an increasingly common approach to the standardization and integration of health-care practice in the NHS. They delineate interdisciplinary critical decision points and evidence-based daily treatment regimens for patients in specific disease groups. ICP champions assert that they have the potential to decrease medical errors, increase the accuracy of data capture, increase the efficiency of personnel and ultimately improve the quality of patient care. Despite the theoretical benefits of ICP use, there was anecdotal evidence of staff unease and audit evidence of variable compliance with ICPs at a district general hospital (DGH). Objective: This focus group study was one of the three interdependent methodologies used to investigate the attitudes of health-care professionals towards ICPs in a DGH. It was anticipated that thematic analysis of the focus group discussion would facilitate further the interpretation of qualitative data already analysed in a previous phase of the project, and inform the development of a survey questionnaire investigating the attitudes of the health-care professionals towards ICPs. Design: Ten focus groups comprising on average, six health-care professionals were conducted. The staff involved included doctors, nurses, professions allied to medicine, a member of the Community Health Council and non-clinical managers. The focus groups included staff with a range of seniority and speciality. Results: Analysis of the data achieved facilitated the confirmation and identification of themes underpinning the focus group discussion. These are reported here and illustrated by representative quotations. Conclusion: The focus group study provided a valuable insight into the attitudes regarding ICPs of over 60 health-care professionals. The themes identified were used to facilitate the development of a survey questionnaire to explore them in a quantifiable way. Focus group methodology proved to be a useful way to explore emerging issues in depth, and to observe areas of disagreement among staff.

Limitations in Health-Care System Resources Affecting Adherence of Patient With Psoriasis to Topical Drugs: A Focus Group Study

2020 ◽  
Vol 5 (2) ◽  
pp. 54-60
Author(s):  
Mathias Tiedemann Svendsen ◽  
Steven R. Feldman ◽  
Sylvia Naiga Tiedemann ◽  
Anne Sofie Stochholm Sørensen ◽  
Cecilie Marie Ringgaard Rivas ◽  
...  
Keyword(s):  
Health Care ◽  
Focus Group ◽  
Health Care System ◽  
Continuity Of Care ◽  
Health Care Professionals ◽  
Topical Therapy ◽  
Focus Group Study ◽  
Topical Drugs ◽  
System Resources ◽  
Care System

Background: Topical therapy is first-line treatment for patients with mild-to-moderate psoriasis, but low adherence to topical drugs is a barrier to treatment success. Health-care system resources are considered to have an impact on adherence of patient with psoriasis to topical drugs. Objective: To investigate dermatology nurses’ perception of the impact of health-care system resources on topical therapy adherence in patients with psoriasis. Methods: A semistructured focus group study was performed with 6 dermatology nurses and 2 student nurses. Participants were recruited from a dermatology outpatient hospital clinic. The study focused on the dermatology nurses’ perception of the effect health-care system resources (including health-care services provided to patients, how clinics are organized, and how the health-care personnel communicate) have on adherence of patients with psoriasis to topical treatment. The focus group discussion was divided into 3 areas: communication with patients and intercollegial communication, follow-up visits and admissions to consultations by other health-care professions, and how to establish consultations to support adherence of patients with psoriasis to topical drugs. Data were analyzed by a systematic text condensation method based on a phenomenological–hermeneutic approach. Results: Nurses identified a number of health-care system resources that may affect adherence of patients with psoriasis, primarily professional collaboration and communication, continuity of care, and the establishment of nurse consultations. Conclusion: Adherence may by negatively affected by contradictory information about topical drugs due to inadequate interprofessional collaboration among health-care professionals. Improving communication between health-care professionals and patients, ensuring continuity of care, and establishing nurse consultations may improve topical therapy outcomes.

scholarly journals The Living Environment and Thermal Behaviours of Older South Australians: A Multi-Focus Group Study

2019 ◽  
Vol 16 (6) ◽  
pp. 935 ◽  
Author(s):  
Joost van Hoof ◽  
Helen Bennetts ◽  
Alana Hansen ◽  
Jan Kazak ◽  
Veronica Soebarto
Keyword(s):  
Focus Group ◽  
Older People ◽  
Thermal Sensitivity ◽  
South Australia ◽  
Living Environment ◽  
Cold Weather ◽  
Personal Factors ◽  
Focus Group Study ◽  
Heating And Cooling ◽  
House Design

Ageing brings about physiological changes that affect people’s thermal sensitivity and thermoregulation. The majority of older Australians prefer to age in place and modifications to the home environment are often required to accommodate the occupants as they age and possibly become frail. However, modifications to aid thermal comfort are not always considered. Using a qualitative approach this study aims to understand the thermal qualities of the existing living environment of older South Australians, their strategies for keeping cool in hot weather and warm in cold weather and to identify existing problems related to planning and house design, and the use of heating and cooling. Data were gathered via seven focus group sessions with 49 older people living in three climate zones in South Australia. The sessions yielded four main themes, namely ‘personal factors’, ‘feeling’, ‘knowing’ and ‘doing’. These themes can be used as a basis to develop information and guidelines for older people in dealing with hot and cold weather.

scholarly journals Aesthetically Designing Video-Call Technology With Care Home Residents: A Focus Group Study

2021 ◽  
Vol 12 ◽  
Author(s):  
Sonam Zamir ◽  
Felicity Allman ◽  
Catherine Hagan Hennessy ◽  
Adrian Haffner Taylor ◽  
Ray Brian Jones
Keyword(s):  
Focus Group ◽  
Older People ◽  
Focus Groups ◽  
New Technologies ◽  
Low Cost ◽  
Care Home ◽  
Framework Analysis ◽  
Focus Group Study ◽  
People With Dementia ◽  
Technological Intervention

BackgroundVideo-calls have proven to be useful for older care home residents in improving socialization and reducing loneliness. Nonetheless, to facilitate the acceptability and usability of a new technological intervention, especially among people with dementia, there is a need for user-led design improvements. The current study conducted focus groups with an embedded activity with older people to allow for a person-centered design of a video-call intervention.MethodsTwenty-eight residents across four care homes in the South West of England participated in focus groups to aesthetically personalize and ‘dress-up’ the equipment used in a video-call intervention. Each care home was provided with a ‘Skype on Wheels’ (SoW) device, a wheelable ‘chassis’ comprising an iPad or tablet for access to Skype, and a telephone handset. During the focus group, residents were encouraged to participate in an activity using colorful materials to ‘dress-up’ SoW. Comments before, during and after the ‘dress up’ activity were audio recorded. Framework analysis was used to analyze the focus group data.ResultsOlder people, including seven with dementia were able to interact with and implement design changes to SoW through aesthetic personalization. Themes arising from the data included estrangement, anthropomorphism, reminiscence, personalization, need for socialization versus fear of socialization and attitudes toward technology. After this brief exposure to SoW, residents expressed the likelihood of using video-calls for socialization in the future.ConclusionCare home residents enjoy engaging with new technologies when given the opportunity to interact with it, to personalize it and to understand its purpose. Low cost aesthetic personalization of technologies can improve their acceptability, usability, and implementation within complex care environments.

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