Dataset Information

Social integration and loneliness among long-term care home residents: protocol for a scoping review.

ABSTRACT:

Introduction

Social well-being is associated with better physical and mental health. It is also important for quality of life, including from the perspectives of those living in long-term care (LTC) homes. However, given the characteristics of the LTC home environment and the people who live there, the nature and influence of social integration and loneliness, and strategies to address them, may differ in this population compared with those living in the community. The objective of this scoping review is to provide an overview of the nature and extent of research on social integration and loneliness among LTC home residents, including a summary of how these concepts have been operationalised and any evidence from specific groups.

Methods and analysis

This study protocol describes the methods of a scoping review of peer-reviewed literature related to social integration and loneliness among LTC home residents. A literature search was developed by an Information Specialist and will be conducted in MEDLINE(R) ALL (in Ovid, including Epub Ahead of Print, In-Process & Other Non-Indexed Citations, Ovid MEDLINE(R) Daily) and then translated into CINAHL (EBSCO), PsycINFO (Ovid), Scopus, Sociological Abstracts (Proquest), Embase and Embase Classic (Ovid), Emcare Nursing (Ovid) and AgeLine (EBSCO). Two reviewers will independently screen titles and abstracts of articles identified in the search. Two reviewers will then independently review full text articles for inclusion. Data extraction will also be carried out in duplicate. We will engage LTC home community members, including residents, family and staff, to refine the review questions, assist in interpreting the results and participate in knowledge translation.

Ethics and dissemination

Ethics approval is not required. We will present findings at conferences and publish in a peer-reviewed journal. Ultimately, we hope to inform future observational and interventional research aimed at improving the health and quality of life of LTC home residents.

SUBMITTER: Bethell J

PROVIDER: S-EPMC6924697 | biostudies-literature | 2019 Dec

REPOSITORIES: biostudies-literature

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Publications

Social integration and loneliness among long-term care home residents: protocol for a scoping review.

Bethell Jennifer J Babineau Jessica J Iaboni Andrea A Green Robin R Cuaresma-Canlas Rachelle R Karunananthan Roobika R Schon Barbara B Schon Denise D McGilton Katherine S KS

BMJ open 20191209 12

<h4>Introduction</h4>Social well-being is associated with better physical and mental health. It is also important for quality of life, including from the perspectives of those living in long-term care (LTC) homes. However, given the characteristics of the LTC home environment and the people who live there, the nature and influence of social integration and loneliness, and strategies to address them, may differ in this population compared with those living in the community. The objective of this ...[more]

PMID: 31822544

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Project description:IntroductionPrior to the COVID-19 pandemic, social isolation and loneliness (SIL) affected at least one-third of the older people. The pandemic has prompted governments around the world to implement some extreme measures such as banning public gatherings, imposing social distancing, mobility restrictions and quarantine to control the spread and impact of the novel coronavirus. Though these unprecedented measures may be crucial from a public health perspective, they also have the potential to further exacerbate the problems of SIL among residents in long-term care homes (LTCHs). However, some LTCHs have developed promising best practices (PBPs) to respond to the current situation and prepare for future pandemics. Key aspects of such practices revolve around maintaining and strengthening social connections between residents and their families which helps to reduce SIL. This scoping review looks at existing PBPs that have been implemented to reduce SIL among LTCH residents during the most recent pandemics.Methods and analysisWe will follow Arksey and O'Malley's framework of scoping review, further developed by Levac et al. In addition, we will also apply the Joanna Briggs Institute Reviewers' 'Methodology for Scoping Reviews'. Ten electronic databases and grey literature will be searched for articles published from January 2003 to March 2021 in either English or French. Two reviewers will independently screen titles and abstracts and then full texts for final inclusion. Data will be extracted using a standardised form from 'Evidence for Policy and Practice Information'. The results will be presented in a tabular form and will be summarised and interpreted using a narrative synthesis.Ethics and disseminationFormal ethical approval is not required as no primary data are collected. Findings will be used to develop a solid knowledge corpus to address the challenges of SIL in LTCHs. Our findings will help to identify cutting edge practices, including technological interventions that could support health services in addressing SIL in the context of LTCHs and our ageing society.

Project description:IntroductionEvidence concerning the effectiveness of non-pharmacological interventions that are applied to people with dementia living in long-term care facilities is inconsistent. The purpose of this protocol is to describe the methodological considerations that will guide the completion of a scoping review that will inventorise and assess the effectiveness of the various non-pharmacological interventions that are documented in literature for improving quality of life of people with dementia living in long-term care.Methods and analysisThis scoping review will combine the methodology outlined in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews and Guidance for conducting systematic scoping reviews by Peters et al. PubMed; MEDLINE; CINAHL; Embase; Cochrane Database of Systematic Reviews; Cochrane Central Register of Controlled Trials; Emcare; Sociological Abstracts and PsycINFO databases will be searched. Grey literature databases will also be explored. A two-stage screening process consisting of a title and abstract scan and a full-text review will be used to determine the eligibility of studies. Studies, irrespective of design, will be included that quantitatively assess quality of life of long-term care residents who receive non-pharmacological interventions for dementia. A pair of reviewers will independently assess all articles for eligibility, and all eligible articles will be abstracted and charted using a standardised form. The extracted data will undergo a 'narrative review' or a descriptive analysis of the contextual or process-oriented data and quantitative analysis reflecting the objectives of this scoping review.Ethics and disseminationResearch ethics approval is not required for this scoping review. This review started off in October 2018, anticipated end date is June 2020. We plan to disseminate this research through publications, presentations at relevant national and international conferences and meetings with relevant stakeholders. This scoping review protocol has been registered at Open Science Framework (https://osf.io/tupbv).

Project description:IntroductionPatient engagement is important when developing health guidelines to ensure high-quality and patient-centred recommendations. However, patient engagement in research and guideline development remains suboptimal, particularly for vulnerable populations, including residents with dementia living in long-term care (LTC) who are often not included in research and guideline development because of perceived and actual challenges with their health, memory, concentration and communication. Optimal strategies and methods for engaging LTC residents with dementia in research and guideline development remain unknown.Methods and analysisWe will conduct a scoping review in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) extension to answer the research questions: (1) What methods have been used to engage LTC residents with dementia in research and guideline development? (2) What are the outcomes of resident engagement? (3) What are the barriers and facilitators to resident engagement? Systematic searches for peer-reviewed articles will be conducted in: Academic Search Premier (EBSCO), APA PsycINFO (EBSCO), CINAHL (EBSCO), Medline (OVID), Embase (Elsevier), Web of Science, and Cochrane Database and in grey literature. Two team members will screen articles and extract data. Results will be presented according to the research question they address. We will engage stakeholders including residents, family members, healthcare providers and representatives from relevant organisations throughout the study.Ethics and disseminationThe scoping review will synthesise what is known about resident engagement in research and guideline development. It may identify gaps in the literature about the optimal methods to engage residents in performing research and developing guidelines and reveal opportunities for new methods. The results will be helpful for researchers and policy-makers seeking to develop guidelines and researchers engaging in topics that reflect the priorities and experiences of people with dementia. Results of the scoping review will be disseminated via publication in a peer-reviewed journal and conference presentations, and a one-page lay summary will be shared with our engaged stakeholders.

Project description:ObjectiveCurrent information on opioid use in nursing home residents, particularly those with dementia, is unknown. We examined the temporal trends in opioid use by dementia severity and the association of dementia severity with opioid use in long-term care nursing home residents.DesignRepeated measures cross-sectional study.SettingLong-term care nursing homes.ParticipantsUsing 20% Minimum Data Set (MDS) and Medicare claims from 2011-2017, we included long-term care residents (n = 734,739) from each year who had 120 days of consecutive stay. In a secondary analysis, we included residents who had an emergency department visit for a fracture (n = 12,927).MeasurementsDementia was classified as no, mild, moderate, and severe based on the first MDS assessment each year. In the 120 days of nursing home stay, opioid use was measured as any, prolonged (>90 days), and high-dose (≥90 morphine milligram equivalent dose/day). For residents with a fracture, opioid use was measured within 7 days after emergency department discharge. Association of dementia severity with opioid use was evaluated using logistic regression.ResultsOverall, any opioid use declined by 8.5% (35.2% to 32.2%, P < .001), prolonged use by 5.0% (14.1% to 13.4%, P < .001), and high-dose by 21.4% (1.4% to 1.1%, P < .001) from 2011 to 2017. Opioid use declined across 4 dementia severity groups. Among residents with fracture, opioid use declined by 9% in mild, 9.5% in moderate, and 12.3% in severe dementia. The odds of receiving any, prolonged, and high-dose opioids decreased with increasing severity of dementia. For example, severe dementia reduced the odds of any [23.5% vs 47.6%; odds ratio (OR) 0.56, 95% confidence interval (CI) 0.55-0.57], prolonged (9.8% vs 20.7%; OR 0.69, 95% CI 0.67-0.71), and high-dose (1.0% vs 2.3%; OR 0.69, 95% CI 0.63-0.74) opioids.Conclusions and implicationsUse of opioids declined in nursing home residents from 2011 to 2017, and the use was lower in residents with dementia, possibly reflecting suboptimal pain management in this population.

Project description:IntroductionThere is a growing demand for long-term care services for older adults that embrace a model of care centred on individual recipients of care. In long-term care, models of person, resident and relationship-centred care have been developed and implemented to promote independence, decision making and choices of residents. Although the concepts of centredness have been readily adopted in these environments, what constitutes centredness is often vague and lacks conceptual clarity and definition. The research questions guiding this scoping review are: (1) What are the defining attributes, conceptual boundaries and theoretical underpinnings of each centredness term in long-term care? (2) For what purposes have centredness directed models of care been used in this context? (3) What types of study designs have been used to examine centredness in this context? (4) What outcomes related to centredness have been reported or evaluated and how were they measured in long-term care?Methods and analysisThis review uses the methodological framework for conducting a scoping review by Arksey and O'Malley. The search strategy will be applied to nine bibliographic and citation databases, Google Scholar and the grey literature. Study selection will occur in a two-step process. First, the titles and abstracts of all search results will be screened by individual reviewers. Second, a full-text review will be conducted by a pair of reviewers. To be included articles must (1) define centredness in the context of long-term care; (2) describe the defining features of centredness; (3) explore the theoretical underpinnings of centredness; (4) outline outcomes of centredness or (5) use outcome measures related to centredness. Data will be extracted from included studies and analysed using thematic analysis as described by Braun and Clark.Ethics and disseminationResearch ethics approval is not required for this scoping review. Dissemination strategies will follow a targeted and tailored approach based on study findings.

Dataset Information

Social integration and loneliness among long-term care home residents: protocol for a scoping review.

Introduction

Methods and analysis

Ethics and dissemination

Publications

Social integration and loneliness among long-term care home residents: protocol for a scoping review.

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