Decisions and Decisional Needs of Canadians From all Provinces and Territories During the COVID-19 Pandemic: Population-Based Cross-sectional Surveys

Stacey, Dawn; Ludwig, Claire; Archambault, Patrick; Smith, Maureen; Taljaard, Monica; Carley, Meg; Plourde, Karine V.; Boland, Laura; Gogovor, Amédé; Graham, Ian D.; Kobewka, Daniel; McLean, Robert K.D.; Nelson, Michelle; Vanderspank‐Wright, Brandi; Légaré, France

doi:10.2196/43652

Cited by 8 publications

(4 citation statements)

References 55 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Future pandemic mitigation strategies will have to focus on improving communication throughout the care continuum (referrals, communications between clinics or specialties, patient and caregiver empowerment), and the preservation of homecare services. Among potential patient-oriented solutions that need further investigation would be better patient-centered communication skills among health professionals [ 58 ], addressing new patient decisional needs earlier [ 59 , 60 ], decreasing loneliness and social isolation [ 61 ], having a single electronic medical record shared across different care settings [ 62 ] and accessible to patients themselves [ 63 ], better virtual care services and tools [ 14 ], and more efficient knowledge mobilization and management [ 64 ].…”

Section: Discussionmentioning

confidence: 99%

Transitions of care for older adults discharged home from the emergency department: an inductive thematic content analysis of patient comments

Couture,

Germain,

Côté

et al. 2024

BMC Geriatr

Self Cite

View full text Add to dashboard Cite

Objective Improving care transitions for older adults can reduce emergency department (ED) visits, adverse events, and empower community autonomy. We conducted an inductive qualitative content analysis to identify themes emerging from comments to better understand ED care transitions. Methods The LEARNING WISDOM prospective longitudinal observational cohort includes older adults (≥ 65 years) who experienced a care transition after an ED visit from both before and during COVID-19. Their comments on this transition were collected via phone interview and transcribed. We conducted an inductive qualitative content analysis with randomly selected comments until saturation. Themes that arose from comments were coded and organized into frequencies and proportions. We followed the Standards for Reporting Qualitative Research (SRQR). Results Comments from 690 patients (339 pre-COVID, 351 during COVID) composed of 351 women (50.9%) and 339 men (49.1%) were analyzed. Patients were satisfied with acute emergency care, and the proportion of patients with positive acute care experiences increased with the COVID-19 pandemic. Negative patient comments were most often related to communication between health providers across the care continuum and the professionalism of personnel in the ED. Comments concerning home care became more neutral with the COVID-19 pandemic. Conclusion Patients were satisfied overall with acute care but reported gaps in professionalism and follow-up communication between providers. Comments may have changed in tone from positive to neutral regarding home care over the COVID-19 pandemic due to service slowdowns. Addressing these concerns may improve the quality of care transitions and provide future pandemic mitigation strategies.

show abstract

Section: Discussionmentioning

confidence: 99%

Transitions of care for older adults discharged home from the emergency department: an inductive thematic content analysis of patient comments

Couture,

Germain,

Côté

et al. 2024

BMC Geriatr

Self Cite

View full text Add to dashboard Cite

show abstract

“…It is therefore possible that these PtDAs do not represent all the current or emerging difficult decisions faced by older adults, their families, and stakeholders. During the COVID-19 pandemic, different decisional needs emerged among older adults that affected their care, such as “should I delay my surgery?” [ 66 , 67 ]. To address this limitation, if participants express a desire for new PtDAs that do not yet exist, we will use the generic Ottawa decision aid to create one that is culturally adapted to the Quebec context [ 68 ].…”

Section: Discussionmentioning

confidence: 99%

Engagement of Older Adults Receiving Home Care Services and Their Caregivers in Health Decisions in Partnership With Clinical Teams: Protocol for a Multimethod Study to Prioritize and Culturally Adapt Decision Aids for Home Care

Guay-Bélanger,

Aubin,

Cimon

et al. 2023

JMIR Res Protoc

Self Cite

View full text Add to dashboard Cite

Background Older adults (people aged 65 years and older) face many difficult decisions. Patient decision aids (PtDAs) can help them and their families make informed value-congruent decisions. Some PtDAs have been developed for the home care context, but little is known about scaling them for use with older adults in a different culture. Objective This study aims to (1) assess the scalability of existing PtDAs for older adults in the home care context; (2) prioritize those that best match the decisional needs of older adults in home care; and (3) culturally adapt the prioritized PtDAs so they can be scaled successfully to the Quebec health care system. Methods This multimethod study includes 3 phases. All phases will be overseen by a steering committee of older adults, caregivers, health professionals, decision makers, community organization representatives, and researchers with the needed expertise. In phase 1, we will use the Innovation Scalability Self-administered Questionnaire, a validated scalability self-assessment tool, to assess the scalability of 33 PtDAs previously identified in a systematic review. Based on their scalability, their quality (based on the International Patient Decision Aids Standards), and the importance of the decision point, we will retain approximately a third of these. In phase 2, we will conduct a 2-round web-based Delphi to prioritize the PtDAs selected in phase 1. Using a snowball recruitment strategy, we aim to recruit 60 Delphi participants in the province of Quebec, including older adults, caregivers, health professionals, decision makers involved in home care services, and PtDA experts. In the first round, we will ask participants to rate the importance of several PtDA decision points according to various criteria such as prevalence and difficulty on a 5-point Likert scale (1=not important to 5=very important). Approximately 6 of the highest-rated PtDAs will be retained for presentation in the second round, and we will select up to 3 PtDAs judged as having the highest priority for cultural adaptation. In phase 3, using the Chenel framework and user-centered design methods, we will update and adapt the PtDAs to the Quebec health care system and integrate these PtDAs into an interprofessional shared decision-making training program for home care teams. The adapted PtDAs will respect the International Patient Decision Aids Standards criteria. Results This study was funded in March 2022 by the Canadian Institutes of Health Research. Data collection for the web-based Delphi began in October 2023. Results are expected to be published in May 2024. Conclusions This project will provide relevant and culturally appropriate decision support tools for older adults making difficult decisions and their home care teams that will be ready for scaling across the province of Quebec. International Registered Report Identifier (IRRID) PRR1-10.2196/53150

show abstract

“…With over 13 billion doses of vaccines administered worldwide [ 2 ], public health policy makers around the world have been relying on evidence from clinical trials to guide decision-making and develop vaccination strategies to prevent the spread and consequences of this pandemic [ 3 ]. In addition to evidence from controlled clinical trials, real-world evidence regarding vaccine effectiveness is important to guide policy making [ 4 , 5 ] and patient decision-making [ 6 ]. In particular, real-world evidence can help understand vaccine effectiveness against different disease severities in different susceptible populations often excluded from clinical trials [ 7 ], inform policy makers about the length of vaccine protection over time [ 8 ], and document rarer side effects [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

Accuracy of Self-Reported COVID-19 Vaccination Status Compared With a Public Health Vaccination Registry in Québec: Observational Diagnostic Study

Archambault,

Rosychuk,

Audet

et al. 2023

JMIR Public Health Surveill

Self Cite

View full text Add to dashboard Cite

Background The accuracy of self-reported vaccination status is important to guide real-world vaccine effectiveness studies and policy making in jurisdictions where access to electronic vaccine registries is restricted. Objective This study aimed to determine the accuracy of self-reported vaccination status and reliability of the self-reported number of doses, brand, and time of vaccine administration. Methods This diagnostic accuracy study was completed by the Canadian COVID-19 Emergency Department Rapid Response Network. We enrolled consecutive patients presenting to 4 emergency departments (EDs) in Québec between March 24, 2020, and December 25, 2021. We included adult patients who were able to consent, could speak English or French, and had a proven COVID-19 infection. We compared the self-reported vaccination status of the patients with their vaccination status in the electronic Québec Vaccination Registry. Our primary outcome was the accuracy of the self-reported vaccination status (index test) ascertained during telephone follow-up compared with the Québec Vaccination Registry (reference standard). The accuracy was calculated by dividing all correctly self-reported vaccinated and unvaccinated participants by the sum of all correctly and incorrectly self-reported vaccinated and unvaccinated participants. We also reported interrater agreement with the reference standard as measured by unweighted Cohen κ for self-reported vaccination status at telephone follow-up and at the time of their index ED visit, number of vaccine doses, and brand. Results During the study period, we included 1361 participants. At the time of the follow-up interview, 932 participants reported at least 1 dose of a COVID-19 vaccine. The accuracy of the self-reported vaccination status was 96% (95% CI 95%-97%). Cohen κ for self-reported vaccination status at phone follow-up was 0.91 (95% CI 0.89-0.93) and 0.85 (95% CI 0.77-0.92) at the time of their index ED visit. Cohen κ was 0.89 (95% CI 0.87-0.91) for the number of doses, 0.80 (95% CI 0.75-0.84) for the brand of the first dose, 0.76 (95% CI 0.70-0.83) for the brand of the second dose, and 0.59 (95% CI 0.34-0.83) for the brand of the third dose. Conclusions We reported a high accuracy of self-reported vaccination status for adult patients without cognitive disorders who can express themselves in English or French. Researchers can use self-reported COVID-19 vaccination data on the number of doses received, vaccine brand name, and timing of vaccination to guide future research with patients who are capable of self-reporting their vaccination data. However, access to official electronic vaccine registries is still needed to determine the vaccination status in certain susceptible populations where self-reported vaccination data remain missing or impossible to obtain. Trial Registration Clinicaltrials.gov NCT04702945; https://clinicaltrials.gov/ct2/show/NCT04702945

show abstract

Decisions and Decisional Needs of Canadians From all Provinces and Territories During the COVID-19 Pandemic: Population-Based Cross-sectional Surveys

Cited by 8 publications

References 55 publications

Transitions of care for older adults discharged home from the emergency department: an inductive thematic content analysis of patient comments

Transitions of care for older adults discharged home from the emergency department: an inductive thematic content analysis of patient comments

Engagement of Older Adults Receiving Home Care Services and Their Caregivers in Health Decisions in Partnership With Clinical Teams: Protocol for a Multimethod Study to Prioritize and Culturally Adapt Decision Aids for Home Care

Accuracy of Self-Reported COVID-19 Vaccination Status Compared With a Public Health Vaccination Registry in Québec: Observational Diagnostic Study

Contact Info

Product

Resources

About