The role of regulation in the care of older people with depression living in long-term care: a systematic scoping review.

BACKGROUND: This aim of this study was to explore the role of regulation on the quality of care of older people living with depression in LTC, which in this paper is a domestic environment providing 24-h care for people with complex health needs and increased vulnerability. METHODS: We conducted a systematic scoping review. A peer reviewed search strategy was developed in consultation with a specialist librarian. Several databases were searched to identify relevant studies including: Embase (using the OVID platform); MEDLINE (using the OVID platform); Psych info (using the OVID platform); Ageline (using the EBSCO platform); and CINHAL (using the EBSCO platform). Articles were screened by three reviewers with conflicts resolved in consultation with authors. Data charting was completed by one reviewer, with a quality check performed by a second reviewer. Key themes were then derived from the included studies. RESULTS: The search yielded 778 unique articles, of which 20 were included. Articles were grouped by themes: regulatory requirements, funding issues, and organizational issues. CONCLUSION: The highly regulated environment of LTC poses significant challenges which can influence the quality of care of residents with depression. Despite existing evidence around prevalence and improved treatment regimens, regulation appears to have failed to capture the best practice and contemporary knowledge available. This scoping review has identified a need for further empirical research to explore these issues.

Impact of a Geriatric Day Hospital Program on Older Adults' Functional Independence and Caregiver Stress: A Non-Experimental, Single Group Pre-/Posttest Study.

Objective: To evaluate the impact of a geriatric day hospital program on older adults' functional independence and on caregiver stress. Methods: We used a single group pre- and posttest design. The data were collected through chart reviews and follow-up phone calls. Outcomes included fear of falling, balance, functional exercise capacity (walking distance), and caregiver stress. Descriptive statistics were used for sociodemographic data, dependent t test for paired samples of normally distributed data, and the Wilcoxon signed-rank test for determining differences between nonnormally distributed data sets. Results: We found a statistically significant difference in pre (33.54) and post (27.47) mean rank scores for fear of falling (Z = -3.895, P < .001), pre (49.5) and post (59.42) scores for balance (Z = -8.725, P < .001), and pre (250.07 m) and post (291.20 m) for functional exercise capacity (P < .001). No statistically significant difference was found with respect to caregiver stress pre (22.05) and post (19.90) scores (Z = -0.422, P = .673). Discussion: Future research may consider approaching evaluative studies of a similar type using not only quantitative but also qualitative methods to obtain a more comprehensive understanding of older adults' functional ability and caregiver stress before and after participating in a geriatric day hospital program.

Exploring the role of regulation and the care of older people with depression living in long-term care? A systematic scoping review protocol.

INTRODUCTION: This systematic scoping review will explore the role of regulation on the care of older people living with depression in long-term care. Depression presents a significant burden to older people living in long-term care. Regulation in the long-term care sector has increased, but there are still concerns about quality of care in the sector. METHODS AND ANALYSIS: Using Arksey and O'Malley's scoping review methodology as a guide, our scoping review will search several databases: Embase; MEDLINE (using the OVID platform); Psych info; Ageline; and CINAHL, alongside the grey literature. An expert librarian has assisted the research team, using the Peer Review of Electronic Search Strategies, to assess the search strategy. The research team has formulated search strategies and two reviewers will independently screen studies for final study selection. We will summarise extracted data in tabular format; use a narrative format to describe their relevance; and finally, identify knowledge gaps and topics for future research. ETHICS AND DISSEMINATION: This scoping review will outline the scope of the existing literature related to the influence of regulation on the care of older people living with depression in long-term care. The scoping review findings will be disseminated through publication in a peer-reviewed journal. The findings will be useful to policy-makers, managers and clinicians working in the long-term care sector.

Managerial leadership for research use in nursing and allied health care professions: a systematic review.

BACKGROUND: Leadership by point-of-care and senior managers is increasingly recognized as critical to the acceptance and use of research evidence in practice. The purpose of this systematic review was to identify the leadership behaviours of managers that are associated with research use by clinical staff in nursing and allied health professionals. METHODS: A mixed methods systematic review was performed. Eight electronic bibliographic databases were searched. Studies examining the association between leadership behaviours and nurses and allied health professionals' use of research were eligible for inclusion. Studies were excluded if leadership could not be clearly attributed to someone in a management position. Two reviewers independently screened abstracts, reviewed full-text articles, extracted data and performed quality assessments. Narrative synthesis was conducted. RESULTS: The search yielded 7019 unique titles and abstracts after duplicates were removed. Three hundred five full-text articles were reviewed, and 31 studies reported in 34 articles were included. Methods used were qualitative (n = 19), cross-sectional survey (n = 9), and mixed methods (n = 3). All studies included nurses, and six also included allied health professionals. Twelve leadership behaviours were extracted from the data for point-of-care managers and ten for senior managers. Findings indicated that managers performed a diverse range of leadership behaviours that encompassed change-oriented, relation-oriented and task-oriented behaviours. The most commonly described behavior was support for the change, which involved demonstrating conceptual and operational commitment to research-based practices. CONCLUSIONS: This systematic review adds to the growing body of evidence that indicates that manager-staff dyads are influential in translating research evidence into action. Findings also reveal that leadership for research use involves change and task-oriented behaviours that influence the environmental milieu and the organisational infrastructure that supports clinical care. While findings explain how managers enact leadership for research use, we now require robust methodological studies to determine which behaviours are effective in enabling research use with nurses and allied health professionals for high-quality evidence-based care. TRIAL REGISTRATION: PROSPERO CRD42014007660.

Parents' preferences for services for children with hearing loss: a conjoint analysis study.

OBJECTIVE: Early identification of permanent childhood hearing loss through universal newborn hearing screening is rapidly becoming a standard of care. However, it is well recognized that hearing screening must be embedded within a comprehensive system of rehabilitation and parent support services. This study was undertaken with parents of young children with permanent hearing loss to examine their preferences for characteristics associated with intervention services. A secondary goal was to explore whether preferences may differ according to patient subgroups. DESIGN: Conjoint analysis, a preference-based economic technique, was used to investigate parents' strength of preferences. A cross-sectional survey that consisted of hypothetical clinic scenarios was developed based on information from qualitative interviews with parents. The questionnaire was administered to parents receiving intervention services in the province of Ontario, Canada, shortly after the implementation of a universal hearing screening program. The sample was recruited from three different clinical programs. RESULTS: A total of 48 of 75 respondents completed the questionnaire, a response rate of 64%. The participants varied by screening status of the child (25 screened, 23 not screened), type of device (23 hearing aids, 25 cochlear implants), and region. All five characteristics of care that were selected for inclusion in the survey were found to be statistically significant attributes of services: coordinated services, access to parent support, access to information, frequency of services, and location of services. Parents showed a preference for clinic-based rather than home-based services. Preferences toward once a week therapy services rather than services two to three times weekly were also found. In particular, parents valued service models that consisted of well-coordinated care with access to support from other parents. Differences in respondents according to hearing screening status (screened or unscreened), type of hearing device (hearing aid or cochlear implant), or region (Ottawa or Toronto) did not seem to affect parents' preferences for attributes of care. CONCLUSIONS: Conjoint analysis is a useful technique for quantifying parents' preferences for care. The values expressed by parents provide insights into the aspects of a service model that should receive consideration in the development of programs for young children with hearing loss and their families.

¿Es el mejoramiento de la calidad un punto de confluencia para la educación en salud pública en las Américas? / Is quality enhancement a focal point for the public health education in the Americas ?

Este documento presenta un panorama general sobre el mejoramiento de la calidad y se ocupa de temas vinculados con la educación universitaria que podrían ser instructivos para sus programas de salud pública. Para beneficio de los lectores, primero intentamos ubicar el tema del mejoramiento de la calidad en el contexto apropiado y demostrar su pertinencia. A continuación, se describe su alcance y principales características, así como los valores asociados con ella. Luego se analizan las principales dificultades que surgen al intentar establecer una estrategia para este fin, y se exponen las posibles maneras de superarlas. Finalmente, tratamos de extraer las principales consecuencias que el mejoramiento de la calidad tiene para las instituciones de educación en salud pública (IESP) de las Américas, en especial la necesidad de una colaboración más estrecha entre los distintos programas de salud pública