Mihyun Lee

Patient- and family-centered care interventions for improving the quality of health care: A review of systematic reviews

BACKGROUND Patient- and family-centered care interventions are increasingly being implemented in various settings for improving the quality of health care. However, the huge amounts of information coming from both primary studies and reviews on patient- and family-centered care interventions have made it difficult to identify and use the available evidence effectively. OBJECTIVES This review aimed to synthesize and evaluate the evidence from published systematic reviews on the effects of patient- and family-centered care interventions. It also aimed to assess the quality of the systematic reviews in order to formulate recommendations for improving the quality of future systematic reviews. DESIGN Review of systematic reviews. DATA SOURCES Six databases were searched for relevant published reviews that assessed patient- and family-centered care interventions and were reported on in English in peer-reviewed journals up to September 18, 2017. The reference lists of all selected publications were also used to identify additional eligible studies. REVIEW METHODS Reviewers independently selected reviews, extracted data, and assessed the methodological quality of the included reviews using A MeaSurement Tool to Assess Systematic Reviews (AMSTAR) checklist. These results were presented and discussed among researchers to resolve disagreements and reach a consensus. A narrative approach was adopted to pool the constituent elements of interventions. The review protocol was registered with PROSPERO (registration number CRD42017080427). RESULTS Twenty-eight reviews published between 2011 and 2017 met the inclusion criteria. The interventions targeted the patients, their family members, and the health-care. The interventions involved the following core outcomes: Regarding patients, they were improving knowledge about their health, increasing skills to manage self-care behaviors, enhancing satisfaction, increasing quality of life, and reducing admissions, readmissions, and length of the hospital stay. Regarding family members, they were reducing the intensity of stress, anxiety, depression, and increasing the satisfaction and relationship with health-care providers. Regarding health-care providers, the interventions could improve job satisfaction and confidence, quality of care, and reduce stress and burnout. The overall methodological quality of the 28 reviews was moderate, with a mean AMSTAR score of 6.79 (SD 1.45). CONCLUSION This review has provided evidence for the effects of patient- and family-centered care interventions applied to diverse patients, family members, and health-care providers. The evidence indicates that patient- and family-centered care could be a critical approach for improving the quality of health care. Additionally, the quality of future reviews needs to be improved in order to produce reliable evidence in the current era of evidence-based practice.

Patient and Caregiver Interplay in Behavioral and Psychological Symptoms of Dementia Family Caregiver’s Experience

The purpose of this study was to identify family caregivers’ experiences in managing the behavioral and psychological symptoms of dementia (BPSD) with particular focus on their interpersonal interactions with patient with dementia. Data were collected through focus-group interviews with 15 family caregivers from three local dementia-support centers located in Seoul. Data were analyzed using content analysis. Three main themes were identified through data analysis: triggers of BPSD, family caregiver’s actions in response to BPSD and patient’s reactions, and the effect of BPSD on family caregivers. Findings demonstrated that BPSD depended on the complex interplay of family caregivers and patients, including their interaction style. This information could help nurses when counseling and educating family caregivers to improve or modify their attitudes and approaches to behavioral symptoms of patients.

DEVELOPING A COMMUNITY OUTREACH IN-HOME DEMENTIA CAREGIVER PROGRAM IN KOREA

was used to gain a more in-depth understanding of caring for older adults in an Asian American community in the South. Interviews were conducted with leaders to understand the phenomenon from a community perspective. The study was approved by a university review board. Results: Areas of concerns identified include intergenerational dynamics, physical and mental health concerns, and the need for a community center and living facility. Conclusions: The poster provides some awareness of the unique concerns in caring for the older adult Asian American population in the South from a community perspective. The rise of the Asian American older adult population and the large percentage of immigrants makes the challenges to care for older adults unavailable for many families. Service providers must be knowledgeable about aging concerns in their communities and they must work with local Area Agencies on Aging to advocate for the increasingly diverse older adult population.

Web-Based Individualized Interactive Education for the Elderly Using Age Friendly Interface

Individually tailored interactive education using computer science is increasing in the area of health education. Safe medication is one of major health issues in the elderly population who has chronic multiple diseases. The purpose of this study was to describe a research which purpose is to develop a tailored interactive education program using age friendly interface to improve safe medication of the elderly in the community. The system is being developed using the following five processes: 1) Analysis stage 2) Designing stage 3) Content Framing and development stage 4) Program application stage 5) Evaluation stage. Interactive learning activities consisted of animation, games, online quiz and medication diary to facilitate the cognitive and emotional interactional learning of the elderly. The completed program was applied to the elderly in the community and tailored interactive education was an effective teaching media of safe medication for the elderly in the information age.