Prioritization of Indicators of the Quality of Care Provided to Older Adults with Frailty by Key Stakeholders from Five Canadian Provinces

Abstract Background: To meet the needs of older adults with frailty better, it is essential to understand which aspects of care are important from their perspective. We therefore sought to assess the importance of a set of quality indicators (QI) for monitoring outcomes in this population. Methods: In this mixed-method study, key stakeholders completed a survey on the importance of 36 QIs, and then explained their ratings in a semi-structured interview. Stakeholders included older adults with frailty and their caregivers, healthcare providers (HCPs), and healthcare administrators or policy/decision makers (DMs). We conducted descriptive statistical analyses of quantitative variables, and deductive thematic qualitative analyses of interview transcripts. Results: The 42 participants (8 older adults, 18 HCPs, and 16 DMs) rated six QIs as more important: increasing the patients’ quality of life; increasing healthcare staff skills; decreasing patients’ symptoms; decreasing family caregiver burden; increasing patients’ satisfaction with care; and increasing family doctor continuity of care.Conclusions: Key stakeholders prioritized QIs that focus on outcomes targeted to patients and caregivers, whereas the current healthcare systems generally focus on processes of care. Quality improvement initiatives should therefore take better account of aspects of care that are important for older adults with frailty, such as having a chance to express their individual goals of care, receiving quality communications from HCPs, or monitoring symptoms that they might not spontaneously describe. Our results point to the need for patient-centred care that is oriented toward quality of life for older adults with frailty.

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Subjective well-being and quality of life of rural-to-urban migrant and local older adults in Dongguan, China

Social Behavior and Personality An International Journal ◽

10.2224/sbp.10959 ◽

2021 ◽

Vol 49 (12) ◽

pp. 1-11

Author(s):

Yuxi Liu ◽

Thammasin Ingviya ◽

Rassamee Sangthong ◽

Chonghua Wan

Keyword(s):

Quality Of Life ◽

Older Adults ◽

Policy Decision ◽

Well Being ◽

Subjective Well Being ◽

Community Based ◽

Chinese Policy ◽

Local Residents ◽

Urban Migrant

We conducted a community-based survey to compare the subjective well-being (SWB) and quality of life (QoL) of 470 rural-to-urban migrant and 422 local older adults living in Dongguan, China. Ordinal logistic regression was used to assess the dose-response relationships of SWB, QoL, and individual and environmental factors. Results show that migrant (vs. local) residents had greater SWB and better QoL. Positive self-rated health, lack of chronic diseases, not being depressed, taking regular exercise, living close to recreation facilities, and having good social cohesion were positive determinants for SWB and QoL of both local and migrant respondents. Our results provide useful information for Chinese policy decision making to promote the health of older adults.

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Knowing yourself: women opinions about menopause and climacteric

Revista de Enfermagem UFPE on line ◽

10.5205/reuol.980-7143-1-le.0402201043 ◽

2010 ◽

Vol 4 (2) ◽

pp. 792

Author(s):

Cecília Nogueira Valença ◽

Lorena Mara Nóbrega de Azevêdo ◽

Fernanda Aparecida Soares Malveira ◽

Raimunda Medeiros Germano

Keyword(s):

Quality Of Life ◽

Self Care ◽

Rio Grande ◽

Structured Interview ◽

Care Quality ◽

Calidad De Vida ◽

Health Aging ◽

Las Mujeres ◽

Del Rio

ABSTRACTObjective: to know women’s opinion about climacteric and menopause attended at a Reproductive Health Center. Methodology: this is a descriptive-exploratory study, from qualitative approach, performed by 50 women from 45 to 59 years-old who answered a semi-structured interview, after the project has been approval by the Ethics Committee of the Federal University of Rio Grande do Norte under protocol number 031/2008. A technique of analysis of content was used on data collected. Results: 84% of women had heard about what the climateric is and 94% about menopause, but they were confused about climateric and menopause, elderly and illness. The climateric was revealed as anxiety, artralgias/mialgias and hot waves. Important ways to reach the quality of life were considered: physical activity, healthy intake and to avoid smoking. Conclusion: it is essential that women have access to health information for understanding changes of climateric/menopause, avoiding/easing the climateric syndrome and exercising self-care. Descriptors: climateric; menopause; nursing; women’s health; aging; self care; quality of life. RESUMOObjetivo: conhecer a visão de mulheres de um centro de saúde reprodutiva sobre climatério e menopausa. Metodologia: estudo descritivo-exploratório, de abordagem qualitativa. Participaram 50 mulheres, de 45 a 59 anos, de um centro de saúde reprodutiva em Natal/ RN que responderam a uma entrevista semiestruturada, após aprovação pelo parecer 031/2008 do Comitê de Ética em Pesquisa da Universidade Federal do Rio Grande do Norte. Foi utilizada a técnica de análise de conteúdo nos dados coletados. Resultados: 84% já ouviram falar o que é o climatério e 94% sobre menopausa, mas confundiam climatério com menopausa, terceira idade e doença. O climatério revelou-se como ansiedade, artralgias/mialgias e fogachos. Consideraram medidas importantes para a qualidade de vida: atividade física, alimentação saudável e evitar o tabagismo. Conclusão: é essencial que as mulheres tenham acesso à informação em saúde para compreender as mudanças do climatério/menopausa, prevenindo/amenizando a síndrome climatérica e exercendo o autocuidado. Descritores: climatério; menopausa; enfermagem; saúde da mulher; envelhecimento; autocuidado; qualidade de vida. RESUMENObjetivo: conocer la opinión de las mujeres sobre climaterio y menopausia atendidos en un Centro de Salud Reprodutiva. Metodologia: estudio exploratorio y descriptivo, de abordaje cualitativo. Participarán 50 mujeres, de 45 a 59 años, después que responderán a una entrevista semiestructurada, y de obtener la aprovacion de la Comisión de Ética de la Universidad Federal del Rio Grande del Norte con el numero de protocolo 031/2008. La interpretación y el análisis se basaran en el análisis de contenido en los datos recolectados. Resultados: 84% han oído hablar lo que es el climaterio y 94% sobre menopausia, pero confundían climaterio con menopausia, tercera edad y enfermedad. El climaterio se reveló como ansiedad, artralgias/mialgias y olas de calor. Consideraran medidas importantes para la cualidade de vida: la actividad física, alimentación saludable y evitar fumar. Conclusión: es esencial que las mujeres tengan acceso a La información en salud para comprender las mudanzas del climaterio/menopausia, para la prevención y la disminución del síndrome del climaterio y ejerciendo lo autocuidado. Descriptores: climaterio; menopausia; enfermería; salud de la mujer; envejecimiento; autocuidado; calidad de vida.

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Linking people and activities through community mobility: an international comparison of the mobility patterns of older drivers and non-drivers

Ageing and Society ◽

10.1017/s0144686x20001968 ◽

2021 ◽

pp. 1-26

Author(s):

Carolyn Unsworth ◽

Anne Dickerson ◽

Isabelle Gélinas ◽

Priscilla Harries ◽

Isabel Margot-Cattin ◽

...

Keyword(s):

Quality Of Life ◽

Older Adults ◽

Community Participation ◽

Public Transportation ◽

Later Life ◽

Structured Interview ◽

Mobility Patterns ◽

Community Mobility ◽

Transport Mobility

Abstract Community mobility using private and public transportation is important for maintaining health, social participation and living well in later life. This international cross-sectional cohort study (N = 246) reported on the health and driving status of older adults from seven countries where the mobility patterns of drivers and non-drivers were compared in terms of city and rural areas, weather, as well as their respective differences in the number of out-of-home places accessed and quality of life. Older adults participated in a semi-structured interview and completed four standardised instruments: the EQ-5D-5L, modified PULSES health profile, modified Transportation Questionnaire, and the Transport – Participation in Activities and Places Outside the Home. Results suggested inclement weather and place of residence negatively impacted out-of-home activities but did not increase use of public transportation. Drivers accessed more out-of-home activities than non-drivers, suggesting higher community participation among this group, and quality of life was generally high among all participants, but slightly higher for drivers. Findings indicate that a complex myriad of factors can influence community mobility in older adults and further investigations are needed to understand patterns of transport in later life, particularly with regard to those factors that promote and maintain transport mobility, and relationships between transport mobility, community participation and quality of life.

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Systematic review of 29 self-report instruments for assessing quality of life in older adults receiving aged care services

BMJ Open ◽

10.1136/bmjopen-2021-050892 ◽

2021 ◽

Vol 11 (11) ◽

pp. e050892

Author(s):

Joyce Siette ◽

Gilbert Thomas Knaggs ◽

Yvonne Zurynski ◽

Julie Ratcliffe ◽

Laura Dodds ◽

...

Keyword(s):

Quality Of Life ◽

Systematic Review ◽

Older Adults ◽

Social Care ◽

Aged Care ◽

Care Quality ◽

Cochrane Library ◽

Term Care ◽

Care Services

BackgroundQuality of life (QoL) outcomes are used to monitor quality of care for older adults accessing aged care services, yet it remains unclear which QoL instruments best meet older adults’, providers’ and policymakers’ needs. This review aimed to (1) identify QoL instruments used in aged care and describe them in terms of QoL domains measured and logistical details; (2) summarise in which aged care settings the instruments have been used and (3) discuss factors to consider in deciding on the suitability of QoL instruments for use in aged care services.DesignSystematic review.Data sourcesMEDLINE, EMBASE, PsycINFO, Cochrane Library and CINAHL from inception to 2021.Eligibility criteriaInstruments were included if they were designed for adults (>18 years), available in English, been applied in a peer-reviewed research study examining QoL outcomes in adults >65 years accessing aged care (including home/social care, residential/long-term care) and had reported psychometrics.Data extraction and synthesisTwo researchers independently reviewed the measures and extracted the data. Data synthesis was performed via narrative review of eligible instruments.Results292 articles reporting on 29 QoL instruments were included. Eight domains of QoL were addressed: physical health, mental health, emotional state, social connection, environment, autonomy and overall QoL. The period between 1990 and 2000 produced the greatest number of newly developed instruments. The EuroQoL-5 Dimensions (EQ-5D) and Short Form-series were used across multiple aged care contexts including home and residential care. More recent instruments (eg, ICEpop CAPability measure for Older people (ICECAP-O) and Adult Social Care Outcomes Toolkit (ASCOT)) tend to capture emotional sentiment towards personal circumstances and higher order care needs, in comparison with more established instruments (eg, EQ-5D) which are largely focused on health status.ConclusionsA comprehensive list of QoL instruments and their characteristics is provided to inform instrument choice for use in research or for care quality assurance in aged care settings, depending on needs and interests of users.

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Discrepancy between food offered and consumed during hospitalization in older adult patients

Proceedings of The Nutrition Society ◽

10.1017/s0029665120004267 ◽

2020 ◽

Vol 79 (OCE2) ◽

Author(s):

Ligia J. Dominguez ◽

Francesco Milazzo ◽

Angela Parisi ◽

Mario Barbagallo

Keyword(s):

Quality Of Life ◽

Older Adults ◽

Cognitive Performance ◽

Physical Performance ◽

Early Recognition ◽

Depression Scale ◽

Care Quality ◽

Hospitalized Patients ◽

Hospitalized Older Adults

AbstractMalnutrition is one of the most frequent geriatric syndromes and a key contributor to frailty. Ageing is commonly associated with modifications in eating habits with changes in appetite and food intake. Malnutrition is not only a sign of illness, but its presence increases morbidity, hospital stay, institutionalization, poor quality of life, in-hospital complications, expenses, and mortality. Hospitalized patients have increased calorie requirements to overcome the increased energy expenditure due to acute disease. We aimed to evaluate the actual consumption of the food offered to a sample of hospitalized older adults. Sixty hospitalized patients (women/men = 23/37) were recruited sequentially. After participants signed an informed consent, we evaluated their mean actual intake of macronutrients (carbohydrates, proteins, and fats) at lunch during three consecutive days, calculated with a nutrition analysis software from the weighted food (first course, second course, side dishes) measured before and after consumption. Other parameters assessed included self-sufficiency by the capacity to perform basic and instrumental activities of daily living (ADL, IADL), cognitive performance with Mini Mental State Evaluation (MMSE), Geriatric Depression Scale (GDS), physical performance with the Short Physical Performance Battery (SPPB) and handgrip dynamometry, EAT-10 test for the assessment of swallowing capacity, and anthropometric parameters. Mean ± SD of the main parameters assessed were as follows: age 77.8 ± 9.3 years, BMI 27.1 ± 8.7 Kg/m2, ADL 3.8 ± 2.0, IADL 4.1 ± 2.8 (indicative of compromise self-efficacy), MMSE 21.8 ± 5.9, SSPB 5.3 ± 3.1, handgrip dynamometry 16.5 ± 7.8 Kg (indicative of mild to moderate cognitive and physical impairment). The mean intake of macronutrients for the 3-day assessment was 65.7 ± 20.6% of carbohydrates, 74.3 ± 30.4% of proteins, and 47.4 ± 38.1% of fats of the total amount offered at lunch. Older patients tended to have lower intakes of carbohydrates, proteins, and fats, while participants with higher SPPB had higher intakes of carbohydrates and proteins. The results of the present study show that hospitalized older adults, with compromised autonomy, physical and cognitive performance, had lower consumption compared to what is offered to them in the hospital despite their elevated nutritional needs due to the acute illness leading to hospitalization. Undernutrition and weight-loss are key factors associated with increased mortality and morbidity. Therefore, it is crucial to set appropriate nutritional interventions in hospitalized patients, particularly those with disability and cognitive decline. Early recognition and treatment of malnutrition are essential preventive measures to improve the quality of care, quality of life, and decrease mortality risk in hospitalized older adults.

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Knowledge translation resources to support the use of quality of life assessment tools for the care of older adults living at home and their family caregivers

Quality of Life Research ◽

10.1007/s11136-021-03011-z ◽

2021 ◽

Author(s):

Kara Schick-Makaroff ◽

Richard Sawatzky ◽

Lena Cuthbertson ◽

Joakim Öhlén ◽

Autumn Beemer ◽

...

Keyword(s):

Quality Of Life ◽

Older Adults ◽

Knowledge Translation ◽

Family Caregivers ◽

Healthcare Providers ◽

Decision Makers ◽

Assessment Tools ◽

Life Assessment ◽

Patient Reported

Abstract Purpose To support the use of quality of life (QOL) assessment tools for older adults, we developed knowledge translation (KT) resources tailored for four audiences: (1) older adults and their family caregivers (micro), (2) healthcare providers (micro), (3) healthcare managers and leaders (meso), and (4) government leaders and decision-makers (macro). Our objectives were to (1) describe knowledge gaps and resources and (2) develop corresponding tailored KT resources to support use of QOL assessment tools by each of the micro-, meso-, and macro-audiences. Methods Data were collected in two phases through semi-structured interviews/focus groups with the four audiences in Canada. Data were analyzed using qualitative description analysis. KT resources were iteratively refined through formative evaluation. Results Older adults and family caregivers (N = 12) wanted basic knowledge about what “QOL assessment” meant and how it could improve their care. Healthcare providers (N = 13) needed practical solutions on how to integrate QOL assessment tools in their practice. Healthcare managers and leaders (N = 14) desired information about using patient-reported outcome measures (PROMs) and patient-reported experience measures (PREMs) in healthcare programs and quality improvement. Government leaders and decision-makers (N = 11) needed to know how to access, use, and interpret PROM and PREM information for decision-making purposes. Based on these insights and evidence-based sources, we developed KT resources to introduce QOL assessment through 8 infographic brochures, 1 whiteboard animation, 1 live-action video, and a webpage. Conclusion Our study affirms the need to tailor KT resources on QOL assessment for different audiences. Our KT resources are available: www.healthyqol.com/older-adults.

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