Understanding the role of financial health literacy in midlife and old age: A scoping review.

As global population ageing persists, understanding older adults' capacity to navigate the financial and healthcare system is essential. This scoping review examines how the concept of financial health literacy (FHL) is described and measured in the existing literature, the factors that may affect it, and its potential outcomes in middle-aged and older adults. The review follows the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) extension guidelines to synthesise the available evidence on this topic. We utilised electronic databases and hand searching to identify relevant literature published between 2010 and 2022. A total of 29 articles were included in this review. The results showed that FHL involved accessing, understanding and utilising financial information for planning/management of healthcare expenses and selecting appropriate health services. However, FHL is not particularly depicted as a concept in the current literature, as most studies investigated health literacy, financial literacy and health insurance literacy as separate domains that were interrelated to one another. No validated measurement tool was developed for FHL. We propose five domains to indicate the concept and measurement of FHL in middle-aged/older adults: money management, management of medical bills, understanding health insurance, deciding on appropriate health services, and planning for long-term care needs. Demographic variables, such as sex (females), advanced age, cognitive impairment, low education and income and racial and ethnic minorities, were found to be related to low FHL. The reviewed studies also showed that FHL was related to several outcomes, including healthcare decision-making, physical health and psychological well-being. Hence, future studies to develop and validate assessment tools of FHL, together with the involvement of vulnerable groups, are imperative to understanding the concept of FHL. This could also facilitate the development of appropriate interventions that could enhance this capacity in the ageing population.

Exploring the challenges and needs of home caregivers of hemodialysis patients in the Philippines: A mixed methods study.

OBJECTIVES: Although the importance of home caregivers of chronic kidney disease patients has been increasingly recognized, their perceived caregiving difficulties and requisites remain underexplored. This study investigated the challenges and needs of home caregivers of hemodialysis patients in the Philippines. METHODS: We utilized a mixed-method (QUAN + qual), explanatory sequential design. Data were collected from July 2017 to May 2018 from 46 home caregivers of hemodialysis patients. A three-part researcher-made survey were developed from literature search, personal values and cultural context, while some items were generated from a standardized tool that measures caregiver infrastructure and needs of those caring from frail US veterans. The tool developed gathered the participants' profile, caregiving characteristics, and related needs. The tool was validated and pretested for reliability. Fifteen participants were also interviewed to explore caregiving challenges and needs. Descriptive and χ2 statistics were used for quantitative outcomes, while thematic analysis was employed for qualitative data. RESULTS: Participants provided moderate assistance to patients, spending an average of 10.65 h/day and 5.08 days/week in caregiving. The most difficult caregiving circumstances were having costly expenses (78.26%); missing work (50.00%); and experiencing negative feelings (47.83%), stress (43.48%), and physical difficulties (34.78%). They also had the lowest confidence in deciding when to contact health providers (x̅ = 3.31, SD = 0.94) and finding patient care services (x̅ = 2.93, SD = 1.08). Qualitative findings further revealed caregiving needs and challenges in cost management, physical and psychological health, assumption of multiple roles, lifestyle adjustment, and reinforcement of carer knowledge, skills, and attitudes. CONCLUSION: Supportive strategies are needed to address the challenges encountered by home caregivers of hemodialysis patients. Findings can be utilized in developing appropriate interventions for home caregivers in low-resource settings where home caregiving and healthcare system issues, such as lack of access to resources and social support, are prevalent.

A conjoint analysis of the communication preferences of registered nurses towards mechanically ventilated patients.

BACKGROUND: The nurse-patient communication is a dyadic process involving the transmission and recognition of information and feelings. However, communication difficulty is a common phenomenon among mechanically ventilated patients which causes distress among patients and may compromise the quality of patient care that nurses provide. AIM: To explicate the communication preferences of registered nurses towards mechanically ventilated patients. DESIGN: Cross-sectional, choice-based conjoint analysis METHODS: From August to November 2017, 201 purposively selected registered nurses with prior experience in caring for mechanically ventilated patients were surveyed and ranked 12 choice bundles with four selected attributes of the communication process. RESULTS: Family participation was the most important attribute (40.40%) while communication initiator was the least important attribute (15.44%). Registered nurses prefer to communicate with mechanically ventilated patients if family members are involved (utility = 1.03), if conventional communication equipment are used (utility = 0.24), if open-ended questions are asked (utility = 0.13), and if nurses are the communication initiator (utility = 0.22). CONCLUSION: The model of communication preferences highlights the importance of involving the family in the communication process and can inform family-centered policies for mechanically ventilated patients. Unit policies on the use of conventional communication equipment should be considered to maximize the nurse-patient communication and potentially improve patient care.

Family Presence During Resuscitation Benefits-Risks Scale (FPDR-BRS): Instrument Development and Psychometric Validation.

UNLABELLED: Family presence during resuscitation (FPDR) is a growing health care practice; nevertheless, countless controversies surround this medical principle. Several studies have investigated the perceptions of health care professionals toward FPDR, yet psychometrically sound instruments assessing family members' perceptions of FPDR are scarce. Hence we aimed to develop and psychometrically validate the Family Presence During Resuscitation Benefits-Risks Scale (FPDR-BRS). METHODS: Using a methodological design, an initial 27-item questionnaire was developed after extensive literature and theoretical review. Psychometric validation assessed content validity through a 2-step process involving expert nurses and doctors, basic item analysis, internal consistency using Cronbach's α, and construct validity via exploratory factor analysis. After acquiring Ethics Review Board approval, the FPDR-BRS was tested on 130 randomly selected eligible family members from a tertiary government hospital in the Philippines. RESULTS: The initial 27-item questionnaire was reduced to 23 items after content validation, yielding an item content validity index and scale content validity index/Ave rage of 1.00. Basic item analysis revealed acceptable inter-item and item-scale correlations. Exploratory factor analysis extracted 4 factors, namely, personnel risks, personal risks, insight-building benefits, and connection-forming benefits. Cronbach's α for the entire scale was 0.90, with high subscale reliability coefficients. DISCUSSION: The 23-item FPDR-BRS exhibited satisfactory psychometric properties and may be used to quantitatively measure a family member's perception towards witnessing the resuscitation of his or her significant other. Further comprehensive psychometric evaluations are warranted to ensure robust cross-cultural comparisons.