Catherine M Milte1,2, Julie Ratcliffe2, Owen Davies1,2, Craig Whitehead1,2, Stacey Masters3, Maria Crotty1,2. 1. Department of Rehabilitation and Aged Care, Repatriation General Hospital, Flinders University, Adelaide, SA, Australia. 2. Clinical Effectiveness Cluster, Flinders University, Adelaide, SA, Australia. 3. Discipline of General Practice, Flinders University, Adelaide, SA, Australia.
Abstract
BACKGROUND: Clinicians, older adults and caregivers frequently meet to make decisions around treatment and lifestyle during an acute hospital admission. Patient age, psychological status and health locus of control (HLC) influence patient preference for consultation involvement and information but overall, a shared-decision-making (SDM) approach is favoured. However, it is not known whether these characteristics and the presence of cognitive impairment influence SDM competency during family meetings. OBJECTIVE: To describe meetings between older adults, caregivers and geriatricians in intermediate care and explore patient and meeting characteristics associated with a SDM communication style. METHODS: Fifty-nine family meetings involving geriatricians, patients in an intermediate care setting following an acute hospital admission and their caregivers were rated using the OPTION system for measuring clinician SDM behaviour. The geriatric depression scale and multidimensional HLC scale were completed by patients. The mini-mental state exam (MMSE) assessed patient's level of cognitive impairment. RESULTS: Meetings lasted 38 min (SD 13) and scored 41 (SD 17) of 100 on the OPTION scale. Nine (SD 2.2) topics were discussed during each meeting, and most were initiated by the geriatrician. Meeting length was an important determinant of OPTION score, with higher SDM competency displayed in longer meetings. Patient characteristics, including MMSE, HLC and depression did not explain SDM competency. CONCLUSION: Whilst SDM can be achieved during consultations frail older patients and their caregivers, an increased consultation time is a consequence of this approach.
BACKGROUND: Clinicians, older adults and caregivers frequently meet to make decisions around treatment and lifestyle during an acute hospital admission. Patient age, psychological status and health locus of control (HLC) influence patient preference for consultation involvement and information but overall, a shared-decision-making (SDM) approach is favoured. However, it is not known whether these characteristics and the presence of cognitive impairment influence SDM competency during family meetings. OBJECTIVE: To describe meetings between older adults, caregivers and geriatricians in intermediate care and explore patient and meeting characteristics associated with a SDM communication style. METHODS: Fifty-nine family meetings involving geriatricians, patients in an intermediate care setting following an acute hospital admission and their caregivers were rated using the OPTION system for measuring clinician SDM behaviour. The geriatric depression scale and multidimensional HLC scale were completed by patients. The mini-mental state exam (MMSE) assessed patient's level of cognitive impairment. RESULTS: Meetings lasted 38 min (SD 13) and scored 41 (SD 17) of 100 on the OPTION scale. Nine (SD 2.2) topics were discussed during each meeting, and most were initiated by the geriatrician. Meeting length was an important determinant of OPTION score, with higher SDM competency displayed in longer meetings. Patient characteristics, including MMSE, HLC and depression did not explain SDM competency. CONCLUSION: Whilst SDM can be achieved during consultations frail older patients and their caregivers, an increased consultation time is a consequence of this approach.
Authors: Jordy Mehawej; Jane Saczynski; Hawa O Abu; Marc Gagnier; Benita A Bamgbade; Darleen Lessard; Katherine Trymbulak; Connor Saleeba; Catarina I Kiefe; Robert J Goldberg; David D McManus Journal: Can Geriatr J Date: 2021-09-01
Authors: Ruth E Pel-Littel; Marjolein Snaterse; Nelly Marela Teppich; Bianca M Buurman; Faridi S van Etten-Jamaludin; Julia C M van Weert; Mirella M Minkman; Wilma J M Scholte Op Reimer Journal: BMC Geriatr Date: 2021-02-06 Impact factor: 3.921
Authors: Billingsley Kaambwa; Julie Ratcliffe; Sandra L Bradley; Stacey Masters; Owen Davies; Craig Whitehead; Catherine Milte; Ian D Cameron; Tracey Young; Jason Gordon; Maria Crotty Journal: BMC Health Serv Res Date: 2015-12-09 Impact factor: 2.655