Older Patients’ Involvement in Shared  Decision-Making—A Systematic Review

Holm, Anne Lise; Berland, Astrid; Severinsson, Elisabeth

doi:10.4236/ojn.2016.63018

Cited by 20 publications

(14 citation statements)

References 43 publications

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“…This can be compared to a study by Foss, in which older adults were found to practice participation in a discrete way and not assume user-involvement as a right (Foss, 2011). It may also be understood as that users are accustomed to traditions that support a passive patient role (Holm, Berland, & Severinsson, 2016).…”

Section: Discussionmentioning

confidence: 97%

Ideal and reality; Community healthcare professionals’ experiences of user‐involvement in reablement

Jokstad

Skovdahl

Landmark

et al. 2018

Health Soc Care Community

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Many welfare states offer reablement, also known as restorative care, as an intervention to promote healthy ageing and support older adults in regaining or maintaining their independence in daily life. Reablement is a time‐limited, intensive, multidisciplinary, person‐centred and goal‐directed rehabilitative intervention. Reablement emanates from the user’s goals, thus user‐involvement is a key factor. The aim of our study was to explore healthcare professionals’ experiences of user‐involvement in reablement. The context for the study was an urban municipality in south‐eastern Norway where reablement had been implemented into home‐care services 1.5 years prior to the study. Eighteen healthcare professionals recruited from home‐care services participated in focus groups. The material was analysed using qualitative content analysis. The findings resulted in one main theme: Transforming user‐involvement from ideal to reality—a demanding process, and four sub‐themes: (a) An ideal of self‐determination and co‐operation; (b) Diverse ability to commit to what user‐involvement requires; (c) Continuous co‐creation processes; and (d) Challenged by old traditions. User‐involvement is a valued ideal that professionals strive towards when providing healthcare. Two main strategies that professionals use to enable user‐involvement were identified here: spending sufficient time and having patience with users during the initial stage of an intervention, and starting an intervention by introducing small tasks that users can master. It was also seen that if the time and arenas for interdisciplinary meetings were lacking, professionals could demonstrate traditional attitudes and practice when faced with limited user‐involvement in the intervention. There is a need for follow‐up over time at the structural, personal, and cultural levels to develop reablement as an intervention with a strong person‐centred approach. The findings of this study have relevance for practice development in several reablement settings.

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Section: Discussionmentioning

confidence: 97%

Ideal and reality; Community healthcare professionals’ experiences of user‐involvement in reablement

Jokstad

Skovdahl

Landmark

et al. 2018

Health Soc Care Community

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“…Similar evaluations have been done of in earlier systematic reviews [20] [21]. In this study the PRISMA checklist was employed [22], Table 2.…”

Section: Evaluation Of the Included Studiesmentioning

confidence: 97%

“…Older patients require better support to cope with the emotional consequences of multimorbidity. Healthcare professionals need to change their traditional authoritative role to one that allows them to form partnerships with their patients within a shared decision-making perspective [21]. However, self-management does not always fulfil the aim of autonomy or empowerment.…”

Section: Discussionmentioning

confidence: 99%

“…The healthcare system has a traditional view of the patient-doctor relationship, where the nurse is viewed as an assistant to the doctor [5]. Changing the roles of the healthcare professional and the patient to one that involves shared decision-making has been outlined in several studies [21]. Shared decision-making can enhance the care relationship as it involves a better balance of power between the patient and the healthcare professional [21].…”

Section: Discussionmentioning

confidence: 99%

“…An important aspect of systematic reviews is examination of the methodologies of the primary studies [19] [21]. The PRISMA checklist was used to review methodological aspects of the design, sample size, response rate, causality, measurements, generalization and ethical approval [20], in addition to other methodological literature [19] [23]- [25].…”

Section: Evaluation Of the Included Studiesmentioning

confidence: 99%

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Managing the Needs of Older Patients with Multimorbidity—A Systematic Review of the Challenges Faced by the Healthcare Services

Holm¹,

Berland²,

Severinsson³

2016

OJN

Self Cite

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Research fails to provide an overview of the challenges involved in caring for older patients with multimorbidity. Multimorbidity is defined as the presence of two or more chronic conditions in the same person, leading to a high risk of care dependency. The aim of this review was to illuminate the challenges faced by the healthcare services in managing the needs of older patients with multimorbidity. A systematic review was performed, a total of 1,965 abstracts were read and nine quantitative studies included. Data were analysed by thematic synthesis, revealing six themes: A frequent problem in older female patients; High healthcare expenditure and costs, Medication management problems, Social inequities, Complex healthcare and consultation needs and High mortality. The study highlights that healthcare professionals struggle to obtain suitable guidelines for the care of patients with multimorbidity while trying to respond to their needs. Patient-centred integration across settings and coordination in clinical practice are necessary. The healthcare system today does not seem to focus on patient safety and preventing harm. Older patients should be reviewed by a healthcare professional responsible for coordinating their care. To ensure safe and effective care for elderly persons with multimorbidity, the healthcare services should abandon the current focus on managing innumerable individual diseases and conditions.

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Doctor-Patient Relations

Barr

2021

Encyclopedia of Gerontology and Population Aging

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Older Patients’ Involvement in Shared Decision-Making—A Systematic Review

Cited by 20 publications

References 43 publications

Ideal and reality; Community healthcare professionals’ experiences of user‐involvement in reablement

Ideal and reality; Community healthcare professionals’ experiences of user‐involvement in reablement

Managing the Needs of Older Patients with Multimorbidity—A Systematic Review of the Challenges Faced by the Healthcare Services

Doctor-Patient Relations

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