Measurement Properties of the Multiple Errands Test: A Systematic Review.

OBJECTIVE: To systematically review, summarize, and evaluate published evidence on measurement properties of real-world versions of the Multiple Errands Test (MET) following Consensus-based Standards for the Selection of Health Measurement Instruments guidelines. DATA SOURCES: Four databases were searched in May 2019 using multiple variants of the name of the MET from 1991 onward following the publication of the original MET. STUDY SELECTION: We included peer-reviewed original research articles in English that provided data on measurement properties (reliability, validity, and responsiveness to change) on real-world versions of the MET in any clinical population. DATA EXTRACTION: Data on the MET characteristics, study population, and evidence for each measurement property were extracted using predefined criteria. The review team critically appraised the methodological quality and rated the results from each study as sufficient (+), insufficient (-), or indeterminate (?). DATA SUMMARY: Data on each measurement property were pooled. Pooled results were rated as sufficient (+), insufficient (-), mixed (±), or indeterminate (?). The overall quality of evidence per measurement property was graded based on risk of bias, sample size, and consistency of results. The overall evidence for each measurement property was determined as high, moderate, low, or very low. RESULTS: We found 33 studies that provided data on measurement properties of real-world versions of the MET. Pooled results revealed high-quality evidence for interrater reliability and moderate-quality evidence for known-group validity. Limited support for other kinds of reliability and validity was found. CONCLUSIONS: This review suggests the MET should be used cautiously. Reasons for the limited psychometric support are discussed, the value of generic forms of the MET that do not require site specific adaptations is noted, and areas for further psychometric work are highlighted.

A Narrative Inquiry Into the Lived Experiences of the Oldest-Old Caregivers and How These Are Shaped by Age and Aging.

BACKGROUND AND OBJECTIVES: Oldest-old (80+) spousal caregivers of people with dementia are a fast-growing, highly vulnerable, and poorly understood population. As oldest-old individuals, these caregivers have a high likelihood of experiencing aging-related changes (e.g., frailty and multimorbidity) that result in unique caregiving experiences and support needs. Specialized interventions, sensitive to caregivers' age- and aging-related experiences and needs, may be required to provide adequate support to this group. To date, this group has received limited attention in the literature. Thus, the purpose of this study was to elucidate how age and aging shape the experiences of oldest-old spousal caregivers of people with dementia. RESEARCH DESIGN AND METHODS: We used a narrative gerontology approach, with 2-3 semistructured interviews with 11 caregivers ages 80-89 (25 interviews in total). We analyzed narrative data thematically. RESULTS: We identified 4 main themes representing caregivers' perceptions of age or aging: aging as decline, aging as life experience, doings in older age, and older age as perceived by others. Our results illustrate a breadth of age- and aging-related caregiving experiences stemming from each perception. DISCUSSION AND IMPLICATIONS: This study provides insight into the particular experiences of oldest-old spousal caregivers of people with dementia and provides a foundation for critical future research that will continue to explore the experiences of this unique and fast-growing caregiving group. A more nuanced understanding of this caregiving subgroup is needed to develop age-sensitive health and social care services to meet their needs and, ultimately, improve their well-being and that of their spouses.

Stroke Patients' Experiences in an Adaptive Healing Room in a Stroke Rehabilitation Unit.

OBJECTIVES: This study evaluated the user experiences (UX) of stroke patients residing in the adaptive healing room (AHR) and compared them to the UX of patients residing in standard private rooms (SPRs). BACKGROUND: Healing environments in healthcare settings can promote patients' healing processes, outcomes, and psychological well-being. The AHR was designed as a healing environment for stroke patients and has been previously evaluated in laboratory settings. This study was the first to evaluate it in its intended context-a stroke rehabilitation unit. METHODS: The UX of 10 patients residing in the AHR and 15 patients residing in SPRs were collected via structured interviews with a set of open-ended questions and analyzed using quantitative and qualitative methods. RESULTS: The AHR design features (orientation screen, skylight, and nature view) were rated positively by most patients. The skylight emerged as the least favorable. Responses to open-ended questions revealed that UX may be further improved if patients have more control over some of the settings (e.g., light intensity and nature views), and if the system allowed for more stimulation for patients at later stages of their recovery. Additionally, the results suggest that patients in the AHR have better UX than patients in the SPRs. CONCLUSION: The AHR has the potential to improve UX in the stroke rehabilitation unit. Patient feedback can be used to refine the AHR before carrying out clinical trials to assess the effect of the AHR on patient outcomes (e.g., sleep, mood, and length of stay) and stroke recovery.

A Scoping Review of Literature on Sex and Gender Differences Among Dementia Spousal Caregivers.

BACKGROUND AND OBJECTIVES: Sex and gender differences among dementia spousal caregivers have been investigated, but never systematically reviewed or synthesized. A synthesis of findings can help facilitate specificity in practice and in health policy development. As a first step towards such a synthesis, this scoping review reports the available evidence, identifies research gaps, and suggests possible directions for future research. RESEARCH DESIGN AND METHODS: A scoping review methodology was used to identify articles, and to chart and analyze data. Systematic searches for published, empirical studies, with an explicit goal or hypothesis related to sex or gender differences were conducted in seven databases. RESULTS: Sixty-one studies met inclusion criteria. Most (n = 45) were quantitative, cross-sectional studies. Caregivers included in the studies were generally 61-70 years old, Caucasian, middle-class, and highly educated. The most extensively investigated differences are: depression, burden, objective physical health, and informal supports. DISCUSSION AND IMPLICATIONS: This scoping review is the first to summarize and critique the research on sex and gender differences that are specific to dementia spousal caregivers. The review can be used by researchers to make decisions regarding future systematic reviews and primary studies. To further strengthen the evidence base, future studies may benefit from including more caregivers of ethnic minorities, using more qualitative, longitudinal, or experimental designs, and focusing on variables needed to inform caregiving models and theories. Overall, this scoping review contributes to furthering gender-sensitive practices and policies that are better tailored to the specific needs of this population.