The needs of older patients in hospital care: a scoping review

Abstract

Background

Research into care for older patients in the hospital environment has become an increasingly valuable source of information, as it gives feedback on the quality of hospital care provided. The aim of this study is to provide a comprehensive overview of the self-reported needs of older people in hospital care.

Methods

The scoping review was conducted by searching the following databases: Medline, Web of Science, ProQuest Central, Scopus, Cinahl, PsycINFO and Summon.

Results

The search identified articles focusing on older people in hospital care. The majority of these articles address the system and quality of care for seniors at a somewhat general and theoretical level. Met and unmet needs were assessed by a variety of test methods focusing mainly on medical issues (e.g., Mini-Nutritional Assessment, ADLs—activities of daily living, Abbey Pain Scale) and mostly from the perspective of hospital staff, carers and relatives. Only 15 articles used assessments based on information and opinions obtained from the seniors themseAbstract_Paralves (self-reported needs). A thematic analysis revealed seven main themes: conduct and care in emergency departments, dignity, nutritional care, satisfaction of patients’ needs, pain, caring with respect, decision-making and spiritual needs.

Conclusion/discussion

The results of this scoping review suggest that more attention should be focused on information acquired from the patients themselves, as it is only the patient, however, old or frail, who can offer an accurate perspective on met or unmet needs and the quality of care provided.

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References

  1. 1.

    Nicholson C, Morrow EM, Hicks A et al (2017) Supportive care for older people with frailty in hospital: an integrative review. Int J Nurs Stud 66:60–71. https://doi.org/10.1016/j.ijnurstu.2016.11.015

    Article  PubMed  Google Scholar 

  2. 2.

    Edvardsson D, Nay R (2010) Acute care and older people: challenges and ways forward. Austr J Adv Nurs 27:63–69

    Google Scholar 

  3. 3.

    Heckman GA, Molnar FJ, Lee L (2013) Geriatric medicine leadership of healthcare transformation: to be or not to be? Can Geriatrics J 16:192–195. https://doi.org/10.5770/cgj.16.89

    Article  Google Scholar 

  4. 4.

    Ekdahl A, Anderson L, Friedrichsen M (2010) They do what they think is the best for me: frail elderly patients’ preference for participation in their care during hospitalization. Patient Educ Counsel 80:233–240. https://doi.org/10.1016/j.pec.2009.10.026

    Article  Google Scholar 

  5. 5.

    Moher D, Liberati A, Tetzlaff J et al (2009) Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med 6:e1000097. https://doi.org/10.1371/journal.pmed.1000097

    Article  PubMed  PubMed Central  Google Scholar 

  6. 6.

    Shamseer L, Moher D, Clarke M et al (2015) Preferred reporting items for systematic review and meta-analysis protocols PRISMA-P: elaboration and explanation. Syst Rev 349:g7647. https://doi.org/10.1136/bmj.g7647

    Article  Google Scholar 

  7. 7.

    Kelley ML, Parke B, Jokinen N et al (2011) Senior-friendly emergency department care: an environmental assessment. J Health Serv Res Policy 16:6–12. https://doi.org/10.1258/jhsrp.2010.009132

    Article  PubMed  Google Scholar 

  8. 8.

    Tauber-Gilmore M, Addis G, Zahran Z et al (2017) The views of older people and health professionals about dignity in acute hospital care. J Clin Nurs 27:223–234. https://doi.org/10.1111/jocn.13877

    Article  PubMed  Google Scholar 

  9. 9.

    Calnan M, Tadd W, Calnan S et al (2013) “I often worry about the older person being in that system”: exploring the key influences on the provision of dignified care for older people in acute hospitals. Ageing Soc 33:465–485. https://doi.org/10.1017/s0144686x12000025

    Article  Google Scholar 

  10. 10.

    Bonetti L, Terzoni S, Lusignani M et al (2017) Prevalence of malnutrition among older people in medical and surgical wards in hospital and quality of nutritional care: a multicenter, cross-sectional study. J Clin Nurs 26:5082–5092. https://doi.org/10.1111/jocn.14051

    Article  PubMed  Google Scholar 

  11. 11.

    Kalfoss M (2010) Quality of life among Norwegian older adults: focus group results. Gerontol Nurs 3:100–112. https://doi.org/10.3928/19404921-20091207-99

    Article  Google Scholar 

  12. 12.

    Lambert S, Cheung WY, Davies S et al (2009) Comparison of two tools developed to assess the needs of older people with complex care needs. J Res Nurs 14:421–436. https://doi.org/10.1177/1744987108096972

    Article  Google Scholar 

  13. 13.

    Munch L, Tvistholm N, Trosborg I et al (2016) Living with constipation—older people’s experiences and strategies with constipation before and during hospitalization. Int J Qual Stud Health Well-Being 11:1–8. https://doi.org/10.3402/qhw.v11.30732

    Article  Google Scholar 

  14. 14.

    Green B, Raymond G, Peardon J et al (2012) “Not just grapes and flowers”: older people’s perspectives on the role and importance of hospital visiting. Qual Ageing Older Adults 13:82–88. https://doi.org/10.1108/14717791211231166

    Article  Google Scholar 

  15. 15.

    McLiesh P, Mungall D, Wiechula R (2009) Are we providing the best possible pain management for our elderly patients in the acute-care setting? Int J Evid Based Healthcare 7:173–180. https://doi.org/10.1111/j.1744-1609.2009.00138.x

    Article  Google Scholar 

  16. 16.

    Koskenniemi J, Leino-Kilpi H, Suhonen R (2012) Respect in the care of older patients in acute hospitals. Nurs Ethics 20:5–17. https://doi.org/10.1177/0969733012454449

    Article  PubMed  Google Scholar 

  17. 17.

    Kluit MJ, Dijkstra GJ, Rooij SE (2018) The decision-making process for unplanned admission to hospital unveiled in hospitalised older adults: a qualitative study. BMC Geriatrics 18:318. https://doi.org/10.1186/s12877-018-1013-y

    Article  PubMed  PubMed Central  Google Scholar 

  18. 18.

    Meide H, Olthuis G, Leget C (2014) Feeling an outsider left in uncertainty—a phenomenological study on the experiences of older hospital patients. Scand J Caring Sci 29:528–536. https://doi.org/10.1111/scs.12187

    Article  PubMed  Google Scholar 

  19. 19.

    Macmillan TH (2016) Hospital discharge: lost opportunities to promote or maintain older people’s mental health. Qual Ageing Older Adults 17:189–197. https://doi.org/10.1108/qaoa-06-2015-0029

    Article  Google Scholar 

  20. 20.

    Hodge DR, Wolosin RJ (2012) Addressing older adults’ spiritual needs in health care settings: an analysis of inpatient hospital satisfaction data. J Soc Serv Res 38:187–198. https://doi.org/10.1080/01488376.2011.640242

    Article  Google Scholar 

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Funding

This study was supported by the Charles University Grant Agency, project no. 760219.

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Correspondence to Hana Bláhová.

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On behalf of all of the authors, the corresponding author states that there is no conflict of interest.

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Not conducted, as this is a scoping review.

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Not conducted, as this is a scoping review.

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Bláhová, H., Bártová, A., Dostálová, V. et al. The needs of older patients in hospital care: a scoping review. Aging Clin Exp Res (2020). https://doi.org/10.1007/s40520-020-01734-6

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Keywords

  • Needs
  • Hospital
  • Acute care
  • Senior