Survey on the attitudes of hospital doctors towards the terms ‘acopia’ and ‘social admission’ in clinical practice

Curran, David; Chattopadhyay, Indrajit

doi:10.7861/clinmedicine.15-3-312

Cited by 4 publications

(6 citation statements)

References 5 publications

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“…This latter finding contrasts with a survey of physicians in Wales in which two-thirds (62.7%) considered patients labelled as “social admissions/acopia” were a burden on national health resources, with 44.8% of physicians admitted to feeling that these patients were a burden on their time. 15 …”

Section: Discussionmentioning

confidence: 99%

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Managing “socially admitted” patients in hospital: a qualitative study of health care providers’ perceptions

Mah,

Stilwell,

Kubiseski

et al. 2024

CMAJ

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Background: Emergency departments are a last resort for some socially vulnerable patients without an acute medical illness (colloquially known as “socially admitted” patients), resulting in their occupation of hospital beds typically designated for patients requiring acute medical care. In this study, we aimed to explore the perceptions of health care providers regarding patients admitted as “social admissions.” Methods: This qualitative study was informed by grounded theory and involved semistructured interviews at a Nova Scotia tertiary care centre. From October 2022 to July 2023, we interviewed eligible participants, including any health care clinician or administrator who worked directly with “socially admitted” patients. Virtual or in-person individual interviews were audio-recorded and transcribed, then independently and iteratively coded. We mapped themes on the 5 domains of the Quintuple Aim conceptual framework. Results: We interviewed 20 nurses, physicians, administrators, and social workers. Most identified as female ( n = 11) and White ( n = 13), and were in their mid to late career ( n = 13). We categorized 9 themes into 5 domains: patient experience (patient description, provision of care); care team well-being (moral distress, hierarchy of care); health equity (stigma and missed opportunities, prejudices); cost of care (wait-lists and scarcity of alternatives); and population health (factors leading to vulnerability, system changes). Participants described experiences caring for “socially admitted” patients, perceptions and assumptions underlying “social” presentations, system barriers to care delivery, and suggestions of potential solutions. Interpretation: Health care providers viewed “socially admitted” patients as needing enhanced care but identified individual, institutional, and system challenges that impeded its realization. Examining perceptions of the people who care for “socially admitted” patients offers insights to guide clinicians and policy-makers in caring for socially vulnerable patients.

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Section: Discussionmentioning

confidence: 99%

“…14 A survey from Wales showed that 51.8% of hospital physicians consider that they frequently care for these patients, encountering them several times per week. 15 …”

mentioning

confidence: 99%

Managing “socially admitted” patients in hospital: a qualitative study of health care providers’ perceptions

Mah,

Stilwell,

Kubiseski

et al. 2024

CMAJ

View full text Add to dashboard Cite

show abstract

“…“Acopia” is a term that has emerged in medicine and multi-disciplinary professions in the past few decades. It is a term that means “unable to cope” and while commonly used (Curran and Chattopadhyay, 2015), there is no common understanding of what the term means. Kee and Rippengale (2008) suggest that individuals described as “problematic” or “not coping at home with daily life” – are likely to be identified as acopic.…”

Section: Understanding “Acopia” – a Disputed Diagnosismentioning

confidence: 99%

“…If as Kee and Rippengale (2008) and Curran and Chattopadhyay (2015) identify, “acopia” is solely or crudely an inability to cope with daily activities at home – the condition should disappear in hospital. As a hospital in-patient, support is available 24 h a day – and as the individual is not in the home environment they could reasonably be expected to have no signs of “acopia”.…”

Section: Understanding “Acopia” – a Disputed Diagnosismentioning

confidence: 99%

“…Amongst the new terms that have entered into health and social care language – the word or diagnosis “acopia” has appeared. The use of the term “acopia” a pseudo – medical term for the inability to cope has become common place in clinical practice (Curran and Chattopadhyay, 2015). This widespread use or acknowledgement of the term is despite it having no recognised or universal formulation or characteristics.…”

Section: Introductionmentioning

confidence: 99%

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Diagnosis of “acopia”: prescription for neglect?

Hodges¹

2021

JAP

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Purpose This paper aims to reflect upon the usefulness of the word “acopia” as a diagnosis in relation to individuals in hospital. Design/methodology/approach A response to existing literature and consideration of application to practice with adults who may be vulnerable. Findings The term “acopia” is derived from medicine but has gained popularity throughout health and social care. It is a term that has no diagnostic tool or agreed characteristics. Practical implications Practitioners across a number of professional disciplines need to be aware of the individual circumstances, preferences and priorities of individuals to secure the most appropriate care and support for each person. Failure to acknowledge complexity of an individual’s presenting condition at hospital admission may have fatal consequences. Originality/value The importance of language used to refer to adults who are likely to be vulnerable may influence the quality of the care and treatment that they receive.

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Navigating the choppy waters to Nirvana: A critical reflective account of caring for ageing parents in the fourth age

McInnes

2021

Ageing and Society

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This article revisits a paper and from an autoethnographic/critical reflective biographical approach re-examines seven cultural notions or myths, which may encourage ageism. It is framed within my experiential knowledge of caring for my ageing parents, with the tensions and challenges around problematising the value of expertise based on experience, communication, grief, and autonomy and freedom versus safety. The commentary emphasises that by analysing the impact of our personal life experiences, we can start to understand both the intended and unintended consequences of policy and practice affecting those in the fourth age. As a social work educator, I wanted to reflect upon how my tacit experiential knowledge, if made explicit, could impact upon my own and others’ learning. The recent death of my father has allowed for a period of reflection on my own caring and indeed my professional social work experience, knowledge, skills and practice. It is argued that the ageing process is unequal as class and socio-economic factors, i.e. geography, age, gender, religion and ethnicity, all play parts in determining how someone ages, and indeed upon the care an individual older person receives. A fuller understanding of negotiating the role of one stakeholder, that of a family carer in the ageing process, is elicited in this paper.

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Survey on the attitudes of hospital doctors towards the terms ‘acopia’ and ‘social admission’ in clinical practice

Abstract: Letters not directly related to articles published in Clinical Medicine and presenting unpublished original data should be submitted for publication in this section. Clinical and scientifi c letters should not exceed 500 words and may include one table and up to fi ve references.

Cited by 4 publications

References 5 publications

Managing “socially admitted” patients in hospital: a qualitative study of health care providers’ perceptions

Managing “socially admitted” patients in hospital: a qualitative study of health care providers’ perceptions

Diagnosis of “acopia”: prescription for neglect?

Navigating the choppy waters to Nirvana: A critical reflective account of caring for ageing parents in the fourth age

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