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Home-modification interventions addressing falls and participation in activities of daily living among older adults: a scoping review protocol.

ABSTRACT: INTRODUCTION:Falls are the second leading reason for incidental or unexpected deaths worldwide. Many older adults who fall, regardless of whether they are injured or not, tend to experience fear of fall and this can lead to decreased participation in activities of daily living (ADLs). Subsequent falls lead to weakness, a decline in physical functioning, increased chances of falling and a negative impact on the instrumental ADLs. Here, we present our scoping review protocol to appraise the literature to describe and explain the home-modification interventions used by occupational therapists to address falls and participation in ADLs among community-dwelling older adults. We are aiming to review the available home-modification intervention protocols, facilitators and barriers to such interventions, and the experiences of occupational therapists and clients after receiving these interventions. METHODS AND ANALYSIS:This scoping review protocol follows existing guidelines for scoping reviews with a particular attention on Arksey and O'Malley (2005) and Colquhoun et al (2014). We will include the following databases: Scopus, Web of Science, PubMed, ProQuest, Cumulative Index to Nursing and Allied Health Literature and Google Scholar. We plan to conduct the literature search from August 16, 2020 to September 15, 2020. Two reviewers will independently screen eligible studies for inclusion. We will extract the bibliographic data, study design, details of the intervention provided, outcomes and experiences of occupational therapists and clients, and further organise them for better understanding. ETHICS AND DISSEMINATION:As secondary data analysis, this scoping review does not require ethics approval. Results will summarise and disseminate the existing literature related to home-modification interventions provided by occupational therapists addressing falls and participation in ADLs among community-dwelling older adults. We plan to disseminate the results through peer-reviewed journals and conferences, targeting occupational therapists, other rehabilitation workers, researchers and policy makers.

SUBMITTER: Georlee GM

PROVIDER: S-EPMC7485230 | biostudies-literature | 2020 Sep

REPOSITORIES: biostudies-literature

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Home-modification interventions addressing falls and participation in activities of daily living among older adults: a scoping review protocol.

Georlee Gifty M GM U Abiram A Dat Pham Ngoc PN Tuan Nguyen Khac NK Mehrotra Shashank S

BMJ open 20200910 9

<h4>Introduction</h4>Falls are the second leading reason for incidental or unexpected deaths worldwide. Many older adults who fall, regardless of whether they are injured or not, tend to experience fear of fall and this can lead to decreased participation in activities of daily living (ADLs). Subsequent falls lead to weakness, a decline in physical functioning, increased chances of falling and a negative impact on the instrumental ADLs. Here, we present our scoping review protocol to appraise th ...[more]

PMID: 32912995

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Project description:IntroductionCancer screening is an integral component of primary care, and providers can play a key role in facilitating screening. While much work has focused on patient interventions, there has been less attention on primary care provider (PCP) interventions. In addition, marginalised patients experience disparities in cancer screening which are likely to worsen if not addressed. The objective of this scoping review is to report on the range, extent and nature of PCP interventions that maximise cancer screening participation among marginalised patients. Our review will target cancers where there is strong evidence to support screening, including lung, cervical, breast and colorectal cancers.Methods and analysisThis is a scoping review conducted in accordance with the framework by Levac et al. Comprehensive searches will be conducted by a health sciences librarian using Ovid MEDLINE, Ovid Embase, Scopus, CINAHL Complete and the Cochrane Central Register of Controlled Trials. We will include peer-reviewed English language literature published from 1 January 2000 to 31 March 2022 that describes PCP interventions to maximise cancer screening participation for breast, cervical, lung and colorectal cancers. Two independent reviewers will screen all articles and identify eligible studies for inclusion in two stages: title and abstract, then full text. A third reviewer will resolve any discrepancies. Charted data will be synthesised through a narrative synthesis using a piloted data extraction form informed by the Template for Intervention Description and Replication checklist.Ethics and disseminationSince this is a synthesis of digitally published literature, no ethics approval is needed for this work. We will target appropriate primary care or cancer screening journals and conference presentations to publish and disseminate the results of this scoping review. The results will also be used to inform an ongoing research study developing PCP interventions for addressing cancer screening with marginalised patients.

Project description:BACKGROUND:Many older people live at home, often with complex and chronic health and social care needs. Integrated care programs are increasingly being implemented as a way to better address these needs. To support older people living at home, it is also essential to maintain their safety. Integrated care programs have the potential to address a wide range of risks and problems that could undermine older people's ability to live independently at home. The aim of this scoping review is to provide insight into how integrated care programs address safety risks faced by older people living at home - an area that is rather underexplored. METHODS:Safety was conceptualised as preventing or reducing the risk of problems, associated with individual functioning and behaviour, social and physical environments, and health and social care management, which could undermine older people's ability to live independently at home. For this scoping review a systematic literature search was performed to identify papers describing integrated care programs where at least one intervention component addressed safety risks. Data were extracted on the programs' characteristics, safety risks addressed, and the activities and interventions used to address them. RESULTS:None of the 11 programs included in this review explicitly mentioned safety in their goals. Nevertheless, following the principles of our conceptual framework, the programs appeared to address risks in multiple domains. Most attention was paid to risks related to older people's functioning, behaviour, and the health and social care they receive. Risks related to people's physical and social environments received less attention. CONCLUSION:Even though prevention of safety risks is not an explicit goal of integrated care programs, the programs address a wide range of risks on multiple domains. The need to address social and environmental risks is becoming increasingly important given the growing number of people receiving care and support at home. Prioritising a multidimensional approach to safety in integrated care programs could enhance the ability of health and social care systems to support older people to live safely at home.

Project description:ObjectivesRecent research has indicated seemingly increased propensity for falls and accelerated bone demineralisation in people living with HIV (PLWH). We aim to map out the extent and nature of existing research relating to falls in PLWH and describe the relationship between bone demineralisation and falls in PLWH.MethodsA scoping review was done following Arksey & O'Malley's methodological framework and recommendations from Joanna Briggs Institute. Four databases were searched until October 2019 for peer-reviewed studies available in English reporting on the definition, prevalence, assessment, risk factors and interventions for falls in PLWH as well as information on bone demineralisation linked to falls in PLWH. Narrative reviews were excluded. Two reviewers independently performed the extraction using a predesigned Excel sheet. A descriptive analysis of extracted information was done.ResultsFourteen studies on falls in older PLWH were identified, with all but one study conducted in high-income countries. Prevalence of falls in PLWH ranged from 12% to 41%. Variable assessment tools/tests were used to assess potential risk factors, but it remains to be determined which are more predictive and appropriate for use among PLWH. Considerable agreement existed for risk factors regarding use of medications while evidence regarding functional and cognitive impairments were variable. Few studies compared risk factors for falls in PLWH with those in age-matched and sex-matched seronegative population. There is currently no evidence for interventions to prevent or reduce falls risk in PLWH.ConclusionMore research is needed on falls in younger cohorts of PLWH and in sub-Saharan Africa where HIV is most prevalent and more robust clades exist. More studies need to report on data in seronegative controls to determine risk factors unique to PLWH. More intervention studies targeted at falls prevention and promotion of bone health are required. Quality clinical practice guidelines highlighting validated assessment tools and outcome measures need to be developed.

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Home-modification interventions addressing falls and participation in activities of daily living among older adults: a scoping review protocol.

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Home-modification interventions addressing falls and participation in activities of daily living among older adults: a scoping review protocol.

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