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Family meetings for older adults in intermediate care settings: the impact of patient cognitive impairment and other characteristics on shared decision making

Milte, Catherine M., Ratcliffe, Julie, Davies, Owen, Whitehead, Craig, Masters, Stacey and Crotty, Maria 2015, Family meetings for older adults in intermediate care settings: the impact of patient cognitive impairment and other characteristics on shared decision making, Health expectations, vol. 18, no. 5, pp. 1030-1040, doi: 10.1111/hex.12076.

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Title Family meetings for older adults in intermediate care settings: the impact of patient cognitive impairment and other characteristics on shared decision making
Author(s) Milte, Catherine M.ORCID iD for Milte, Catherine M. orcid.org/0000-0003-0035-6405
Ratcliffe, Julie
Davies, Owen
Whitehead, Craig
Masters, Stacey
Crotty, Maria
Journal name Health expectations
Volume number 18
Issue number 5
Start page 1030
End page 1040
Total pages 11
Publisher Wiley
Place of publication London, Eng.
Publication date 2015-10
ISSN 1369-7625
Keyword(s) decision making
frail elderly
health services for aged
physician-patient relations
Aged
Aged, 80 and over
Caregivers
Cognition Disorders
Family
Female
Geriatrics
Humans
Intermediate Care Facilities
Internal-External Control
Male
Patient Participation
Science & Technology
Life Sciences & Biomedicine
Health Care Sciences & Services
Health Policy & Services
Public, Environmental & Occupational Health
Summary BACKGROUND: Clinicians, older adults and caregivers frequently meet to make decisions around treatment and lifestyle during an acute hospital admission. Patient age, psychological status and health locus of control (HLC) influence patient preference for consultation involvement and information but overall, a shared-decision-making (SDM) approach is favoured. However, it is not known whether these characteristics and the presence of cognitive impairment influence SDM competency during family meetings.
OBJECTIVE: To describe meetings between older adults, caregivers and geriatricians in intermediate care and explore patient and meeting characteristics associated with a SDM communication style.
METHODS: Fifty-nine family meetings involving geriatricians, patients in an intermediate care setting following an acute hospital admission and their caregivers were rated using the OPTION system for measuring clinician SDM behaviour. The geriatric depression scale and multidimensional HLC scale were completed by patients. The mini-mental state exam (MMSE) assessed patient's level of cognitive impairment.
RESULTS: Meetings lasted 38 min (SD 13) and scored 41 (SD 17) of 100 on the OPTION scale. Nine (SD 2.2) topics were discussed during each meeting, and most were initiated by the geriatrician. Meeting length was an important determinant of OPTION score, with higher SDM competency displayed in longer meetings. Patient characteristics, including MMSE, HLC and depression did not explain SDM competency.
CONCLUSION: Whilst SDM can be achieved during consultations frail older patients and their caregivers, an increased consultation time is a consequence of this approach.
Language eng
DOI 10.1111/hex.12076
Field of Research 111702 Aged Health Care
1117 Public Health And Health Services
1110 Nursing
1701 Psychology
Socio Economic Objective 920502 Health Related to Ageing
HERDC Research category C1.1 Refereed article in a scholarly journal
ERA Research output type C Journal article
Copyright notice ©2013, John Wiley & Sons Ltd
Persistent URL http://hdl.handle.net/10536/DRO/DU:30070214

Document type: Journal Article
Collection: School of Exercise and Nutrition Sciences
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