Laura C Blomaard1, Mareline Olthof2,3, Yvette Meuleman4, Bas de Groot5, Jacobijn Gussekloo2,3, Simon P Mooijaart2,6. 1. Department of Internal Medicine, section Geriatrics, Leiden University Medical Center, PO Box 9600, 2300, RC, Leiden, The Netherlands. l.c.blomaard@lumc.nl. 2. Department of Internal Medicine, section Geriatrics, Leiden University Medical Center, PO Box 9600, 2300, RC, Leiden, The Netherlands. 3. Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands. 4. Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands. 5. Department of Emergency Medicine, Leiden University Medical Center, Leiden, The Netherlands. 6. Institute of Evidence-Based Medicine in Old Age | IEMO, Leiden, The Netherlands.
Abstract
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.
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.
Entities:
Keywords:
Emergency medicine; Frailty; Frailty screening; Older adults; Qualitative research
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