Mary T Fox1, Souraya Sidani2, Jeffrey I Butler3, Mark W Skinner4, Marilyn Macdonald5, Evelyne Durocher6, Kathleen F Hunter7, Adrian Wagg8, Lori E Weeks9, Ann MacLeod10, Sherry Dahlke11. 1. School of Nursing, Faculty of Health, York University Centre for Aging Research and Education, York University, HNES suite 343, 4700 Keele St, Toronto, Ontario, M3J 1P3, Canada. maryfox@yorku.ca. 2. School of Nursing, Faculty of Community Services, Ryerson University, 350 Victoria Street, Toronto, Ontario, M5B 2K3, Canada. 3. School of Nursing, York University Centre for Aging Research and Education, Faculty of Health, York University, HNES suite 343, 4700 Keele Street, Toronto, Ontario, M3J 1P3, Canada. 4. Trent School of the Environment, Trent University, 1600 West Bank Drive, Peterborough, Ontario, K9L 0G2, Canada. 5. School of Nursing, Dalhousie University, Room 130, Forrest Bldg., PO Box 15000, 5869 University Avenue, Halifax, Nova Scotia, B3H 4R2, Canada. 6. School of Rehabilitation Science, Institute of Applied Health Sciences, Faculty of Health Sciences, McMaster University, Room 428, 1400 Main St. W, Hamilton, Ontario, L8S 1C7, Canada. 7. Faculty of Nursing, University of Alberta, 5-293 Edmonton Clinic Health Academy 11405-87 Ave NW, Edmonton, Alberta, T6G 1C9, Canada. 8. Department of Geriatric Medicine, University of Alberta, 1-198 Clinical Sciences Building, Edmonton, Canada. 9. School of Nursing, Dalhousie University, Room G30, Forrest Bldg. PO Box 15000, Halifax, Nova Scotia, B3H 4R2, Canada. 10. Trent/Fleming School of Nursing, Trent University, 1600 West Bank Drive, Peterborough, Ontario, K9L 0G2, Canada. 11. Faculty of Nursing, University of Alberta, Edmonton Clinic Health Academy 11405-87 Ave NW, Edmonton, Alberta, T6G 1C9, Canada.
Abstract
BACKGROUND: Transitional care involves time-limited interventions focusing on the continuity of care from hospital to home, to optimize patient functioning and management. Providing interventions, as part of transitional care, that optimize the functioning of older people with dementia is critical due to the small window of opportunity in which they can return to their baseline levels of functioning. Yet prior research on transitional care has not included interventions focused on functioning and did not target older people with dementia in rural communities, limiting the applicability of transitional care to this population. Accordingly, the goal of this study is to align hospital-to-home transitional care with the function-related needs of older people with dementia and their family-caregivers in rural communities. METHODS: In this multimethod study, two phases of activities are planned in rural Ontario and Nova Scotia. In phase I, a purposive sample of 15-20 people with dementia and 15-20 family-caregivers in each province will rate the acceptability of six evidence-based interventions and participate in semi-structured interviews to explore the interventions' acceptability and, where relevant, how to improve their acceptability. Acceptable interventions will be further examined in phase II, in which a purposive sample of healthcare providers, stratified by employment location (hospital vs. homecare) and role (clinician vs. decision-maker), will (1) rate the acceptability of the interventions and (2) participate in semi-structured focus group discussions on the facilitators and barriers to delivering the interventions, and suggestions to enable their incorporation into rural transitional care. Two to three focus groups per stratum (8-10 healthcare providers per focus group) will be held for a total of 8-12 focus groups per province. Data analysis will involve qualitative content analysis of interview and focus group discussions and descriptive statistics of intervention acceptability ratings. DISCUSSION: Findings will (1) include a set of acceptable interventions for rural transitional care that promote older patients' functioning and family-caregivers' ability to support patients' functioning, (2) identify resources needed to incorporate the interventions into rural transitional care, and (3) provide high-quality evidence to inform new transitional care practices and policies and guide future research.
BACKGROUND: Transitional care involves time-limited interventions focusing on the continuity of care from hospital to home, to optimize patient functioning and management. Providing interventions, as part of transitional care, that optimize the functioning of older people with dementia is critical due to the small window of opportunity in which they can return to their baseline levels of functioning. Yet prior research on transitional care has not included interventions focused on functioning and did not target older people with dementia in rural communities, limiting the applicability of transitional care to this population. Accordingly, the goal of this study is to align hospital-to-home transitional care with the function-related needs of older people with dementia and their family-caregivers in rural communities. METHODS: In this multimethod study, two phases of activities are planned in rural Ontario and Nova Scotia. In phase I, a purposive sample of 15-20 people with dementia and 15-20 family-caregivers in each province will rate the acceptability of six evidence-based interventions and participate in semi-structured interviews to explore the interventions' acceptability and, where relevant, how to improve their acceptability. Acceptable interventions will be further examined in phase II, in which a purposive sample of healthcare providers, stratified by employment location (hospital vs. homecare) and role (clinician vs. decision-maker), will (1) rate the acceptability of the interventions and (2) participate in semi-structured focus group discussions on the facilitators and barriers to delivering the interventions, and suggestions to enable their incorporation into rural transitional care. Two to three focus groups per stratum (8-10 healthcare providers per focus group) will be held for a total of 8-12 focus groups per province. Data analysis will involve qualitative content analysis of interview and focus group discussions and descriptive statistics of intervention acceptability ratings. DISCUSSION: Findings will (1) include a set of acceptable interventions for rural transitional care that promote older patients' functioning and family-caregivers' ability to support patients' functioning, (2) identify resources needed to incorporate the interventions into rural transitional care, and (3) provide high-quality evidence to inform new transitional care practices and policies and guide future research.
Authors: Cynthia M Boyd; C Seth Landefeld; Steven R Counsell; Robert M Palmer; Richard H Fortinsky; Denise Kresevic; Christopher Burant; Kenneth E Covinsky Journal: J Am Geriatr Soc Date: 2008-12 Impact factor: 5.562
Authors: Hardeep Singh; Carolyn Steele Gray; Michelle L A Nelson; Jason X Nie; Rachel Thombs; Alana Armas; Christian Fortin; Hedieh Molla Ghanbari; Terence Tang Journal: PLoS One Date: 2022-08-18 Impact factor: 3.752