In This Issue: Clinical Decision Support

Stange, Kurt C.

doi:10.1370/afm.1215

Cited by 2 publications

(2 citation statements)

References 11 publications

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“…The RE-AIM conceptual framework guided the evaluation of the ACP intervention [ 19 , 31 ]. Under the ‘Adoption’ component within this framework thematic analysis [ 32 ] was employed to explore the acceptability of the nurse-led ACP intervention for older adults at risk of functional decline.…”

Section: Methodsmentioning

confidence: 99%

“…Person-centred care has been shown to improve patient experience, care quality, and health outcomes, including for those with long-term conditions [ 16 – 19 ], and to be more cost-effective [ 20 ]. Patients are less likely to use emergency hospital services, and more likely to adhere to their treatment and medication regimes when playing a collaborative role in their health and care [ 16 ].…”

Section: Introductionmentioning

confidence: 99%

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Acceptability of a nurse-led, person-centred, anticipatory care planning intervention for older people at risk of functional decline: A qualitative study

et al. 2021

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Background As the population of older adults increases, the complexity of care required to support those who choose to remain in the community amplifies. Anticipatory Care Planning (ACP), through earlier identification of healthcare needs, is evidenced to improve quality of life, decrease aggressive interventions, and prolong life. With patient acceptability of growing importance in the design, implementation, and evaluation of healthcare interventions, this study reports on the acceptability of a primary care based ACP intervention on the island of Ireland. Methods As part of the evaluation of a feasibility cluster randomized controlled trial (cRCT) testing an ACP intervention for older people at risk of functional decline, intervention participants [n = 34] were interviewed in their homes at 10-week follow-up to determine acceptability. The intervention consisted of home visits by specifically trained registered nurses who assessed participants’ health, discussed their health goals and plans, and devised an anticipatory care plan in collaboration with participants’ GPs and adjunct clinical pharmacist. Thematic analysis was employed to analyze interview data. The feasibility cRCT involved eight general practitioner (GP) practices as cluster sites, stratified by jurisdiction, four in Northern Ireland (NI) (two intervention, two control), and four in the Republic of Ireland (ROI) (two intervention, two control). Participants were assessed for risk of functional decline. A total of 34 patients received the intervention and 31 received usual care. Findings Thematic analysis resulted in five main themes: timing of intervention, understanding of ACP, personality & individual differences, loneliness & social isolation, and views on healthcare provision. These map across the Four Factor Model of Acceptability (‘4FMA’), a newly developed conceptual framework comprising four components: intervention factors, personal factors, social support factors, and healthcare provision factors. Conclusion Acceptability of this primary care based ACP intervention was high, with nurses’ home visits, GP anchorage, multidisciplinary working, personalized approach, and active listening regarded as beneficial. Appropriate timing, and patient health education emerged as vital.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%