scholarly journals Innovation to enhance health in care homes and evaluation of tools for measuring outcomes of care: rapid evidence synthesis

2019 ◽  
Vol 7 (27) ◽  
pp. 1-178 ◽  
Author(s):  
Barbara Hanratty ◽  
Dawn Craig ◽  
Katie Brittain ◽  
Karen Spilsbury ◽  
John Vines ◽  
...  

BackgroundFlexible, integrated models of service delivery are being developed to meet the changing demands of an ageing population. To underpin the spread of innovative models of care across the NHS, summaries of the current research evidence are needed. This report focuses exclusively on care homes and reviews work in four specific areas, identified as key enablers for the NHS England vanguard programme.AimTo conduct a rapid synthesis of evidence relating to enhancing health in care homes across four key areas: technology, communication and engagement, workforce and evaluation.Objectives(1) To map the published literature on the uses, benefits and challenges of technology in care homes; flexible and innovative uses of the nursing and support workforce to benefit resident care; communication and engagement between care homes, communities and health-related organisations; and approaches to the evaluation of new models of care in care homes. (2) To conduct rapid, systematic syntheses of evidence to answer the following questions. Which technologies have a positive impact on resident health and well-being? How should care homes and the NHS communicate to enhance resident, family and staff outcomes and experiences? Which measurement tools have been validated for use in UK care homes? What is the evidence that staffing levels (i.e. ratio of registered nurses and support staff to residents or different levels of support staff) influence resident outcomes?Data sourcesSearches of MEDLINE, CINAHL, Science Citation Index, Cochrane Database of Systematic Reviews, DARE (Database of Abstracts of Reviews of Effects) and Index to Theses. Grey literature was sought via Google™ (Mountain View, CA, USA) and websites relevant to each individual search.DesignMapping review and rapid, systematic evidence syntheses.SettingCare homes with and without nursing in high-income countries.Review methodsPublished literature was mapped to a bespoke framework, and four linked rapid critical reviews of the available evidence were undertaken using systematic methods. Data were not suitable for meta-analysis, and are presented in narrative syntheses.ResultsSeven hundred and sixty-one studies were mapped across the four topic areas, and 65 studies were included in systematic rapid reviews. This work identified a paucity of large, high-quality research studies, particularly from the UK. The key findings include the following. (1) Technology: some of the most promising interventions appear to be games that promote physical activity and enhance mental health and well-being. (2) Communication and engagement: structured communication tools have been shown to enhance communication with health services and resident outcomes in US studies. No robust evidence was identified on care home engagement with communities. (3) Evaluation: 6 of the 65 measurement tools identified had been validated for use in UK care homes, two of which provide general assessments of care. The methodological quality of all six tools was assessed as poor. (4) Workforce: joint working within and beyond the care home and initiatives that focus on staff taking on new but specific care tasks appear to be associated with enhanced outcomes. Evidence for staff taking on traditional nursing tasks without qualification is limited, but promising.LimitationsThis review was restricted to English-language publications after the year 2000. The rapid methodology has facilitated a broad review in a short time period, but the possibility of omissions and errors cannot be excluded.ConclusionsThis review provides limited evidential support for some of the innovations in the NHS vanguard programme, and identifies key issues and gaps for future research and evaluation.Future workFuture work should provide high-quality evidence, in particular experimental studies, economic evaluations and research sensitive to the UK context.Study registrationThis study is registered as PROSPERO CRD42016052933, CRD42016052933, CRD42016052937 and CRD42016052938.FundingThe National Institute for Health Research Health Services and Delivery Research programme.

2017 ◽  
Author(s):  
Gabriel Marais ◽  
Rebecca Shankland ◽  
Pascale Haag ◽  
Robin Fiault ◽  
Bridget Juniper

In France, little data are available on mental health and well-being in academia, and nothing has been published about PhD students. From studies abroad, we know that doing a PhD is a difficult experience resulting in high attrition rates with significant financial and human costs. Here we focused on PhD students in biology at university Lyon 1. A first study aimed at measuring the mental health and well-being of PhD students using several generalist and PhD-specific tools. Our results on 136 participants showed that a large fraction of the PhD students experience abnormal levels of stress, depression and anxiety, and their mean well-being score is significantly lower than that of a British reference sample. French PhD student well-being is specifically affected by career uncertainty, perceived lack of progress in the PhD and perceived lack of competence, which points towards possible cultural differences of experiencing a PhD in France and the UK. In a second study, we carried out a positive psychology intervention. Comparing the scores of the test and control groups showed a clear effect of the intervention on reducing anxiety. We discuss our results and the possible future steps to improve French PhD students’ well-being.


2019 ◽  
pp. 1-15 ◽  
Author(s):  
Laura J. Hughes ◽  
Nicolas Farina ◽  
Thomas E. Page ◽  
Naji Tabet ◽  
Sube Banerjee

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.


Dementia ◽  
2017 ◽  
Vol 19 (4) ◽  
pp. 1316-1324
Author(s):  
Claire Royston ◽  
Gary Mitchell ◽  
Colin Sheeran ◽  
Joanne Strain ◽  
Sue Goldsmith

There are an increasing number of people living with dementia in care home settings. Recent reports suggest that people who deliver care to residents living with dementia in care homes require specialist support to provide optimum care. To address this need Four Seasons Health Care, the largest provider of care homes within the UK today, sought to design a dementia care framework that enhanced the quality of life for people living with dementia in their care homes. The framework was designed using a robust evidence base, engagement with people living with dementia, their care partners, policy-writers, multidisciplinary professionals and people within the organisation. This paper describes the methodology behind the dementia care framework and outcomes data from the first phase (of 20 care homes that included the care of 451 people living with dementia). The main outcome was a significant improvement in the quality of the lives of residents across biological, psychological, social and spiritual needs.


2013 ◽  
Vol 21 (1) ◽  
pp. 26-33 ◽  
Author(s):  
Sian Lockwood

PurposeThis paper seeks to explore the potential of micro‐enterprises to assist local health and well‐being boards in delivering their strategies, especially in relation to tackling health inequalities, prevention and community support.Design/methodology/approachThis paper draws on experience gained by Community Catalysts from its work supporting social care and health micro‐enterprise across the UK. There has been little formal research into social care and health micro‐enterprise and so the paper relies heavily on data gathered by Community Catalysts in the course of its work and uses local case studies to illustrate points.FindingsThe paper explains the importance of social care and health micro‐enterprise to the work of health and well being boards, emphasising its potential to help tackle health inequalities and contribute to effective health and well‐being strategies.Originality/valueThere are no examples as yet of imaginative health and well‐being boards engaging effectively with micro‐providers, but boards can draw on learning from local authorities actively stimulating and supporting local micro‐enterprise.


2021 ◽  
Vol 13 (21) ◽  
pp. 12207
Author(s):  
Rokhshid Ghaziani ◽  
Mark Lemon ◽  
Paramita Atmodiwirjo

Existing frameworks for biophilic design have similar strategies and attributes as useful checklists for designers; however, the focus has been on adults rather than children, and there remains the need for more guidance related to school design by extension. The application of biophilia would be a design resolution in schools because of its impact on children’s health and well-being, which has been more important since the pandemic started; however, it remains quite unexplored in school design in many countries, including the UK. Biophilic design patterns can be used in school buildings and grounds for greater connectivity between spaces and nature in order to promote children’s well-being. This paper focuses on ten biophilic design patterns under two categories of ‘nature in the space’ and ‘natural analogues.’ This study presents the findings of case studies in various countries. The analysis focuses on the manifestations of biophilia to inform the application of biophilic design patterns for primary schools. Finally, this paper suggests how primary school children could be involved in a co-design process in order to evaluate biophilic design patterns.


2021 ◽  
pp. 1-10
Author(s):  
Rebecca J. Syed Sheriff ◽  
Helen Adams ◽  
Evgenia Riga ◽  
Andrew K. Przybylski ◽  
Laura Bonsaver ◽  
...  

Aims and method To gain a deeper understanding of the use of online culture and its potential benefits to mental health and well-being, sociodemographic characteristics and self-reported data on usage, perceived mental health benefits and health status were collected in an online cross-sectional survey during COVID-19 restrictions in the UK in June–July 2020. Results In total, 1056 people completed the survey. A high proportion of participants reported finding online culture helpful for mental health; all but one of the benefits were associated with regular use and some with age. Reported benefits were wide-ranging and interconnected. Those aged under 25 years were less likely to be regular users of online culture or to have increased their use during lockdown. Clinical implications There may be benefits in targeting cultural resources for mental health to vulnerable groups such as young adults.


2010 ◽  
Vol 69 (4) ◽  
pp. 465-469 ◽  
Author(s):  
C. A. Russell ◽  
M. Elia

More than 3 million individuals are estimated to be at risk of malnutrition in the UK, of whom about 93% live in the community. BAPEN's Nutrition Screening Week surveys using criteria based on the ‘Malnutrition Universal Screening Tool’ (‘MUST’) revealed that 28% of individuals on admission to hospital and 30–40% of those admitted to care homes in the previous 6 months were malnourished (medium+high risk using ‘MUST’). About three quarters of hospital admissions and about a third of care home admissions came from their own homes with a malnutrition prevalence of 24% in each case. Outpatient studies using ‘MUST’ showed that 16–20% patients were malnourished and these were associated with more hospital admissions and longer length of stay. In sheltered housing, 10–14% of the tenants were found to be malnourished, with an overall estimated absolute prevalence of malnutrition which exceeded that in hospitals. In all cases, the majority of subjects were at high risk of malnutrition. These studies have helped establish the magnitude of the malnutrition problem in the UK and identified the need for integrated strategies between and within care settings. While hospitals provide a good opportunity to identify malnourished patients among more than 10 million patients admitted there annually and the five- to six-fold greater number attending outpatient departments, commissioners and providers of healthcare services should be aware that much of the malnutrition present in the UK originates in the community before admission to hospitals or care homes or attendance at outpatient clinics.


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