Everyday Lives of Middle-Aged Persons with Multimorbidity: A Mixed Methods Systematic Review

The healthcare burden of patients with multimorbidity may negatively affect their family lives, leisure time and professional activities. This mixed methods systematic review synthesizes studies to assess how multimorbidity affects the everyday lives of middle-aged persons, and identifies skills and resources that may help them overcome that burden. Two independent reviewers screened title/abstracts/full texts in seven databases, extracted data and used the Mixed Methods Appraisal Tool (MMAT) to assess risk of bias (RoB). We synthesized findings from 44 studies (49,519 patients) narratively and, where possible, quantitatively. Over half the studies provided insufficient information to assess representativeness or response bias. Two studies assessed global functioning, 15 examined physical functioning, 18 psychosocial functioning and 28 work functioning. Nineteen studies explored skills and resources that help people cope with multimorbidity. Middle-aged persons with multimorbidity have greater impairment in global, physical and psychosocial functioning, as well as lower employment rates and work productivity, than those without. Certain skills and resources help them cope with their everyday lives. To provide holistic and dynamic health care plans that meet the needs of middle-aged persons, health professionals need greater understanding of the experience of coping with multimorbidity and the associated healthcare burden.

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Everyday lives of middle-aged persons living with multimorbidity: protocol of a mixed-methods systematic review

BMJ Open ◽

10.1136/bmjopen-2021-050990 ◽

2021 ◽

Vol 11 (12) ◽

pp. e050990

Author(s):

Ana Isabel Gonzalez-Gonzalez ◽

Robin Brünn ◽

Julia Nothacker ◽

Truc Sophia Dinh ◽

Maria-Sophie Brueckle ◽

...

Keyword(s):

Social Sciences ◽

Systematic Review ◽

Mixed Methods ◽

Everyday Life ◽

Citation Index ◽

Life Experiences ◽

Middle Aged ◽

Everyday Lives ◽

The Everyday ◽

Social Sciences Citation Index

IntroductionMultimorbidity is the simultaneous occurrence of several (chronic) diseases. Persons living with multimorbidity not only have complex care needs, but the burden of care often has a negative impact on their family lives, leisure time and professional activities. The aim of this project is to systematically review the literature to assess how multimorbidity affects the everyday lives of middle-aged persons, and to find out what abilities and resources help in the development of coping strategies to overcome the challenges of living with it.Methods and analysisWe will systematically search for studies reporting on the everyday life experiences of middle-aged persons (30–60 years) with multimorbidity (≥2 chronic conditions) in MEDLINE, CINAHL, PsycINFO, Social Sciences Citation Index, Social Sciences Citation Index Expanded, PSYNDEX and The Cochrane Library from inception. We will include all primary studies that use quantitative, qualitative and mixed methodologies, irrespective of publication date/study setting.Two independent reviewers will screen titles/abstracts/full texts, extract data from the selected studies and present evidence in terms of study/population characteristics, data collection method and the phenomenon of interest, that is, everyday life experiences of middle-aged persons with multimorbidity. Risk of bias will be independently assessed by two reviewers using the Mixed Methods Appraisal Tool. We will use a convergent integrated approach on qualitative/quantitative studies, whereby information will be synthesised narratively and, if possible, quantitatively.Ethics and disseminationEthical approval is not required due to the nature of the proposed systematic review. Results from this research will be disseminated at relevant (inter)national conferences and via publication in peer-reviewed journals.PROSPERO registration numberCRD42021226699.

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Understanding how to facilitate continence for people with dementia in acute hospital settings: a mixed methods systematic review and thematic synthesis

Systematic Reviews ◽

10.1186/s13643-021-01743-0 ◽

2021 ◽

Vol 10 (1) ◽

Author(s):

Deborah Edwards ◽

Jane Harden ◽

Aled Jones ◽

Katie Featherstone

Keyword(s):

Systematic Review ◽

Mixed Methods ◽

Phase 1 ◽

Significant Risk ◽

Hospital Setting ◽

Acute Hospital ◽

Phase 2 ◽

Thematic Synthesis ◽

Care Plans ◽

People With Dementia

Abstract Background People living with dementia (PLWD) are at significant risk of developing urinary and/or faecal incontinence and are also at risk of functional incontinence or being labelled as being incontinent. Despite the growing population of PLWD and importance of continence care, little is known about the appropriate management, organisation, and interactional strategies for PLWD admitted to acute hospitals. This mixed methods systematic review and thematic synthesis sought to identify successful strategies across all care settings that could then be used to inform innovations in continence care for PLWD in the acute hospital setting. Methods In phase 1, a scoping search of two electronic databases (MEDLINE and PsycINFO) and a consultation with stakeholders was undertaken. Findings were presented to the project steering group and two priority areas for phase 2 were identified which were communication and individualised care plans. In phase 2, eight databases and relevant UK government and other organisational websites were searched for English language citations from inception to August 2020. Critical appraisal was conducted using the Mixed Methods Appraisal Tool (MMAT Version 11). Thematic synthesis was employed and the strength of synthesised findings for the intervention studies was assessed using the GRADE approach and the confidence in synthesised qualitative and survey findings was assessed using the CERQual approach. Results In phase 1, 1348 citations were found and 75 included. In phase 2, 6247 citations were found, 14 research studies and 14 policy and guidance documents were included. The quality of studies varied. Material was synthesised into three overarching syntheses which were: communication this is dignified, person-centred and respectful; communication during outpatients apointments and delivering individualised continence care. Conclusions Recognising that PLWD are not always able to communicate their continence needs verbally is important. Incorporating interpersonal and communication skills into the context of continence care within training for those working with this patient group is crucial for continence to be maintained during an acute admission. Continence care in the acute setting should be tailored to the individual and be developed in partnership with staff and caregivers. Trial registration PROSPERO: CRD42018119495.

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Strategies to Inform Innovations in Continence Care for People Living with Dementia in the Acute Hospital Setting: A Mixed Methods Narrative Synthesis Review

10.21203/rs.3.rs-78042/v1 ◽

2020 ◽

Author(s):

Deborah Edwards ◽

Jane Harden ◽

Aled Jones ◽

Katie Featherstone

Keyword(s):

Systematic Review ◽

Mixed Methods ◽

English Language ◽

Phase 1 ◽

Significant Risk ◽

Hospital Setting ◽

Acute Hospital ◽

Phase 2 ◽

Care Plans ◽

Acute Hospital Setting

Abstract Background: People living with dementia are at significant risk of developing urinary and/or faecal incontinence but are also at risk of functional incontinence or being labelled as being incontinent. Despite the growing population of PLWD and importance of continence care little is known about the appropriate management, organisation, and interactional, strategies for PLWD admitted to acute hospitals. This mixed methods narrative systematic review sought to identify successful strategies across all care settings that could then be used to inform innovations in continence care for PLWD in the acute hospital setting.Methods: In phase 1 a scoping search of two electronic databases (MEDLINE and PSYCinfo) and a consultation with stakeholders was undertaken. Findings from were presented to the project steering and two priority areas for phase 2 were identified which were communication and individualised care plans. In phase 2 eight databases and relevant UK government and other organisational websites were searched for English language citations from inception to August 2020. Critical appraisal was conducted using the Mixed Methods Appraisal Tool (MMA Version 11). Thematic synthesis was employed and the strength of synthesised findings for the intervention studies was assessed using the GRADE approach and the and confidence in synthesised qualitative and survey findings was assessed using the CERQual tool. Results: In phase 1, 1348 citations were found and 75 included. In phase 2, 6247 citations were found 14 research studies and 14 policy and guidance documents were included. The quality of studies varied. Material was synthesized in order to identify the facilitators and barriers around developing communication strategies and individualised management plans in response to the continence needs of PLWD.Conclusions: Recognising that PLWD are not always able to communicate their continence needs verbally is important. Incorporating interpersonal and communication skills into the context of continence care within training for those working with this patient group is crucial for continence to be maintained during an acute admission. Continence care in the acute setting should be tailored to the individual and be developed in partnership with staff and caregivers.Systematic review registration: PROSPERO: CRD42018119495

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