Perspectives of older adults, caregivers, and healthcare providers on frailty screening: a qualitative study

Damme, Jill Van; Neiterman, Elena; Oremus, Mark; Lemmon, Kassandra; Stolee, Paul

doi:10.1186/s12877-020-1459-6

Cited by 21 publications

(29 citation statements)

References 44 publications

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“…Stakeholders' level of understanding on frailty seen in our study was in line with results from previous studies in Canada (17,29), especially from the perspective of aging as well as physical, cognitive and social factors. Similar to our ndings, these two studies, conducted on participants from health clinics, found that healthcare providers possessed various levels of understanding regarding frailty, and recognized aging and physical factors to be the most important aspects of frailty.…”

Section: Comparison With Existing Literaturesupporting

confidence: 91%

“…The need to better de ne frailty and the use of a standardized tool to ensure consistent and transferable results as suggested by the participants was also shown by several studies (29,33). A study in the Netherlands (29) found that the lack of guidelines for care after frailty screening prevented frailty screening programs from being implemented. In the A&E setting speci cally, due to patients' reduced function and increased vulnerability, it would be challenging to obtain accurate frailty screening results (29).…”

Section: Comparison With Existing Literaturementioning

confidence: 99%

“…However, our study recognized an additional barrier, which is the lack of agreement about the importance of frailty screening and, therefore management, among different specialties in the acute setting. The need to better de ne frailty and the use of a standardized tool to ensure consistent and transferable results as suggested by the participants was also shown by several studies (29,33). A study in the Netherlands (29) found that the lack of guidelines for care after frailty screening prevented frailty screening programs from being implemented.…”

Section: Comparison With Existing Literaturementioning

confidence: 99%

“…A study in the Netherlands (29) found that the lack of guidelines for care after frailty screening prevented frailty screening programs from being implemented. In the A&E setting speci cally, due to patients' reduced function and increased vulnerability, it would be challenging to obtain accurate frailty screening results (29). In addition, an integrative review of 14 screening tools in acute care settings suggested that overwhelming workloads, uncooperativeness among members of the multidisciplinary team and insu cient follow-up management support could hamper the implementation of frailty screening (36).…”

Section: Comparison With Existing Literaturementioning

confidence: 99%

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Perspectives on Frailty Screening, Management and Its Implementation Among Acute Care Providers in Singapore: A Qualitative Study

Xiao¹,

Le²,

Chen³

et al. 2020

Preprint

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Background Frailty has emerged to be a public health concern among aging populations. COVID-19 pandemic has reminded how the frailest individuals are particularly exposed to adverse outcomes. It is important to identify and manage frailty to delay functional decline and reduce unnecessary health utilizations. Our study explored understanding on frailty and practice of frailty screening among different acute care professionals in Singapore, (2) identify barriers and facilitators concerning frailty screening, management and its implementation.Methods A qualitative study using focus group discussion among nurses and individual interviews among physicians from four departments (Accident & Emergency, Anaethesia, General Surgery, Orthopedics) in three acute hospitals from the three public health clusters in Singapore. Participants were recruited through a combination of purposive, convenience and snowball approach with a directed approach by using NVIVO 12.0 to analyse the data. Result Frailty was mainly but inadequately understood as a physical and age-related concept. Screening for frailty in acute care was considered necessary to reduce adverse health outcomes. Specific issues related to screening, management and implementation identified were: cooperation from patient/caregivers, acceptance from healthcare workers/hospital managers, need for dedicated resources, guidelines for follow-up management and consensus on the scope of measurement for different specialties. Conclusion Our findings indicated the need for 1) education program for patients/care givers and stakeholders 2) hospital wide push to adopt and develop a uniform frailty screening tool and process and 3) applying relevant guidelines, developing whole of hospital approach and process for the management of frail patients.

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Section: Comparison With Existing Literaturesupporting

confidence: 91%

Section: Comparison With Existing Literaturementioning

confidence: 99%

Section: Comparison With Existing Literaturementioning

confidence: 99%

Section: Comparison With Existing Literaturementioning

confidence: 99%

See 2 more Smart Citations

Perspectives on Frailty Screening, Management and Its Implementation Among Acute Care Providers in Singapore: A Qualitative Study

Xiao¹,

Le²,

Chen³

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

“…Furthermore, participants described the importance of a holistic approach to unravel the older patient as a whole beyond just the medical complaints. The need of older people to receive holistic care and to be involved in decision-making has been described previously for the ED setting [ 25 ], and is corresponding to literature in community-dwelling older people and older patients in regular health care [ 26 – 29 ]. Our findings suggest that screening could aid in reaching this goal and additionally could help to comfort patients by means of attention for them as a person.…”

Section: Discussionmentioning

confidence: 99%

Experiences with and attitudes towards geriatric screening among older emergency department patients: a qualitative study

et al. 2021

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Background The patient perspective on the use of screening for high risks of adverse health outcomes in Emergency Department (ED) care is underexposed, although it is an important perspective influencing implementation in routine care. This study explores the experiences with, and attitudes towards geriatric screening in routine ED care among older people who visited the ED. Methods This was a qualitative study using individual face-to-face semi-structured interviews. Interviews were conducted in older patients (≥70 years) who completed the ‘Acutely Presenting Older Patient’ screener while visiting the ED of a Dutch academic hospital. Purposive convenience sampling was used to select a heterogeneous sample of participants regarding age, disease severity and the result from screening. Transcripts were analyzed inductively using thematic analysis. Results After 13 interviews (7 women, median age 82 years), data saturation was reached. The participants had noticed little of the screening administration during triage and screening was considered as a normal part of ED care. Most participants believed that geriatric screening contributes to assessing older patients holistically, recognizing geriatric problems early and comforting patients with communication and attention. None of the participants had a negative attitude towards screening or thought that screening is discrimination on age. Care providers should communicate respectfully with frail older patients and involve them in decision-making. Conclusions Older patients experienced geriatric screening as a normal part of ED care and had predominantly positive attitudes towards its use in the ED. This qualitative study advocates for continuing the implementation of geriatric screening in routine ED practice.

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Clinical Frailty Scale at presentation to the emergency department: interrater reliability and use of algorithm-assisted assessment

Albrecht,

Espejo,

Riedel

et al. 2023

Eur Geriatr Med

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Purpose The Clinical Frailty Scale (CFS) allows health care providers to quickly stratify older patients, to support clinical decision-making. However, few studies have evaluated the CFS interrater reliability (IRR) in Emergency Departments (EDs), and the freely available smartphone application for CFS assessment was never tested for reliability. This study aimed to evaluate the interrater reliability of the Clinical Frailty Scale (CFS) ratings between experienced and unexperienced staff (ED clinicians and a study team (ST) of medical students supported by a smartphone application to assess the CFS), and to determine the feasibility of CFS assignment in patients aged 65 or older at triage. Methods Cross-sectional study using consecutive sampling of ED patients aged 65 or older. We compared assessments by ED clinicians (Triage Clinicians (TC) and geriatric ED trained nurses (geriED-TN)) and a study team (ST) of medical students using a smartphone application for CFS scoring. The study is registered on Clinicaltrials.gov (NCT05400707). Results We included 1349 patients aged 65 and older. Quadratic-weighted kappa values for ordinal CFS levels showed a good IRR between TC and ST (ϰ = 0.73, 95% CI 0.69–0.76), similarly to that between TC and geriED-TN (ϰ = 0.75, 95% CI 0.66–0.82) and between the ST and geriED-TN (ϰ = 0.74, 95% CI 0.63–0.81). A CFS rating was assigned to 972 (70.2%) patients at triage. Conclusion We found good IRR in the assessment of frailty with the CFS in different ED providers and a team using a smartphone application to support rating. A CFS assessment occurred in more than two-thirds (70.2%) of patients at triage.

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Perspectives of older adults, caregivers, and healthcare providers on frailty screening: a qualitative study

Cited by 21 publications

References 44 publications

Perspectives on Frailty Screening, Management and Its Implementation Among Acute Care Providers in Singapore: A Qualitative Study

Perspectives on Frailty Screening, Management and Its Implementation Among Acute Care Providers in Singapore: A Qualitative Study

Experiences with and attitudes towards geriatric screening among older emergency department patients: a qualitative study

Clinical Frailty Scale at presentation to the emergency department: interrater reliability and use of algorithm-assisted assessment

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