The utilization of a nurse‐led clinic by older people with cognitive complaints: Do they follow our advice?

Abstract

Aim: Cognitive assessment services were found to be beneficial to older people with cognitive complaints but information is limited on adherence to the recommendations provided. This study aimed to identify predictors of clients' adherence to nursing recommendations after attending a community-based nurse-led cognitive assessment service in Hong Kong.Methods: A cross-sectional design was adopted. We analysed a dataset routinely collected from clients attending the services between January 2012 and January 2018.Multiple regression analyses were conducted to identify predictors (demographics, functional health status and cognitive performance) of the clients' adherence. Their satisfaction with the services was also examined.Results: Two hundred and twenty-three clients attended the clinic. Of the 133 who completed the telephone follow-up at the 6 months postconsultation, 44.1% did not adhere to the recommendations. Clients with a higher Clinical Dementia Rating (OR = 4.17), lower Clock Drawing Test score (OR = 1.13) and lower education level (OR = 0.91) were found to be less likely to adhere to the nursing recommendations. were satisfied with the overall services. Conclusion:Cognitive assessment services in nurse-led clinics could provide a selfreferred service for older people with cognitive complaints. However, low adherence to nursing recommendations was found among clients with poorer cognitive functions and lower education levels.

Nurse‐led clinics in primary health care: A scoping review of contemporary definitions, implementation enablers and barriers and their health impact

“…A total of 36 studies were agreed upon for inclusion in the literature review (Figure 1). Overall, the final group of publications included nine Randomised Control Trials (Bleijenberg et al., 2016; Harrison et al., 2008; Houweling et al., 2011; Imhof et al., 2012; Jacobs et al., 2007; Murchie et al., 2003; Salisbury et al., 2002; Sande et al., 2020; Williams et al., 2005), nine qualitative studies (Clendon & White, 2001; Lindsay, 2001; Marshall et al., 2011; McNeal, 2019; Mills et al., 2012; Minstrell et al., 2015; Nymberg & Drevenhorn, 2016; Pritchard‐Jones et al., 2015; Sullivan et al., 2022), three evaluation studies (Coddington et al., 2011; Dalton et al., 2023; Fernandez, 2007), four cross sectional studies (Fuller et al., 2020; Kor et al., 2022; Krothe & Clendon, 2006; Miles et al., 2003). In addition, four mixed methods studies were included (Frasso et al., 2017; Hammersley et al., 2022; Hegney et al., 2013; Wong & Chung, 2006), along with two cohort studies (Barello et al., 2022; Harvey et al., 2018), two multi‐methods studies (Hegarty et al., 2013), a needs analysis (Clendon & White, 2001), a case study (Callaghan et al., 2012), a secondary analysis (Bleijenberg et al., 2017) and an action research study (Mills & Fitzgerald, 2008).…”

“…In addition, it was noted that, within the PHC setting, the interaction and provision of service must be accessible and flexible in referral and delivery. It must be centred on evidence‐based practice and treatment, encompassing the use of practice guidelines, protocols, and data to inform practice and patient outcomes (Coddington et al., 2011; Harvey et al., 2018; Houweling et al., 2011; Imhof et al., 2012; Kor et al., 2022; Mills et al., 2012; Mills & Fitzgerald, 2008; Nymberg & Drevenhorn, 2016).…”

“…The partnership must employ a holistic patient‐centred approach to address the health care needs of individuals and their families (Coddington et al., 2011; Frasso et al., 2017; Harvey et al., 2018; Imhof et al., 2012; Marshall et al., 2011;Miles et al., 2003; Mills et al., 2012; Wong & Chung, 2006). Further, it was suggested that nurse‐led interventions need to move beyond task‐oriented practice to be innovatively based on critical thinking and evidence integrating preventative care and maintaining wellbeing (Clendon & White, 2001; Frasso et al., 2017; Kor et al., 2022; Lindsay, 2001). Further, it should also encompass ‘assessment and evaluation, health teaching/counselling, treatment and procedures, and case management’ (Wong & Chung, 2006, p. 366).…”

“…In line with working and functioning independently, nurses within the PHC setting should be appropriately qualified with core skills and knowledge (Coddington et al., 2011). Completing accredited specialised training skills, where knowledge is developed relevant to a specific health care area in which care is then provided was also considered vital (Harvey et al., 2018; Kor et al., 2022; Mills et al., 2012; Minstrell et al., 2015; Wong & Chung, 2006). It was suggested that training may include, but not be limited to, Masters level and Nurse Practitioner training to provide highly competent nurses for specialised nurse‐led clinics (Kor et al., 2022; Mills et al., 2012).…”

“…An examination of the quality of relationships between the nurse and health consumer is required to understand what impact the care has on the whole person rather than determining impact by a number of biomedical markers (Bleijenberg et al, 2017;Kor et al, 2022).…”