Aging, Community and Health Research Group (ACHRU)

McMaster University

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Our latest publications are listed below. Read the highlights or click on the link to read more.

Healthcare providers’ experiences in supporting community-living older adults to manage multiple chronic conditions: a qualitative study by Jenny Ploeg, Marie-Lee Yous, Kimberly Fraser, Sinead Dufour, Lisa Garland Baird, Sharon Kaasalainen, Carrie McAiney, Maureen Markle-Reid. (BMC Geriatrics)

Living with multiple chronic conditions (MCC), the coexistence of two or more chronic conditions, is becoming more prevalent as the population ages. Primary care and home care providers play key roles in caring for older adults with MCC such as facilitating complex care decisions, shared decision-making, and access to community health and support services. While there is some research on the perceptions and experiences of these providers in caring for this population, much of this literature is focused specifically on family physicians. Little is known about the experiences of other primary care and home care providers from multiple disciplines who care for this vulnerable group. The purpose of this study was to explore the experiences of primary and home care healthcare providers in supporting the care of older adults with MCC living in the community, and identify ways of improving care delivery and outcomes for this group.

Capacity development amongst academic trainees in community-based primary health care research: The Aging, Community and Health Research Unit Experience by Rebecca Ganann, Shelley Peacock, Anna Garnett, Melissa Northwood, Ashley Hyde, Sue Bookey-Bassett, Laurie Kennedy, Maureen Markle-Reid, Jenny Ploeg, Ruta Valaitis R. (Primary Health Care Research and Development) 

Health care system capacity and sustainability to address the needs of an aging population are a challenge worldwide. An aging population has brought attention to the limitations associated with existing health systems, specifically the heavy emphasis on costly acute care and insufficient investments in comprehensive primary health care (PHC). Health system reform demands capacity building of academic trainees in PHC research to meet this challenge. The Aging, Community and Health Research Unit at McMaster University has purposefully employed a capacity building model for interdisciplinary trainee development. This paper describes the processes and outcomes of the model, outlining how the provision of funding, mentorship, and a unique learning environment enables capacity building in networking, collaboration, leadership development, and knowledge mobilization among its trainees. The reciprocal advancement of the research unit through the knowledge and productivity of trainees will also be detailed.

Comparison of users and non-users of a Web-based Intervention for Carers of Older Persons with Alzheimer’s Disease and Related Dementias: A mixed method secondary analysis by Wendy Duggleby, Jenny Ploeg, Carrie McAiney, Kathryn Fisher, Kathya Jovel Ruiz, Sunita Ghosh, Shelley Peacock, Maureen Markle-Reid, Allison Williams, Jean Triscott, Jennifer Swindle. (Journal of Medical Internet Research)

A self-administered Web-based intervention was developed to help carers of persons with Alzheimer disease and related dementias (ADRD) and multiple chronic conditions (MCC) deal with the significant transitions they experience. The intervention, My Tools 4 Care (MT4C), was evaluated during a pragmatic mixed methods randomized controlled trial with 199 carers. Those in the intervention group received free, password-protected access to MT4C for three months. MT4C was found to increase hope in participants at three months compared with the control group. However, in the intervention group, 22% (20/92) did not use MT4C at all during the three-month period.

Contextual factors influencing the implementation of innovations in community-based primary health care: the experience of 12 Canadian research teams by Jenny Ploeg, Sabrina T. Wong, Kasra Hassani, Marie-Lee Yous, Martin Fortin, Claire Kendall, Clare Liddy, Maureen Markle-Reid, Bojana Petrovic, Emilie Dionne, Cathie M. Scott, Walter Wodchis. (Primary Health Care Research & Development)

The objectives of this paper are to: (1) identify contextual factors such as policy that impacted the implementation of community-based primary health care (CBPHC) innovations among 12 Canadian research teams and (2) describe strategies used by the teams to address contextual factors influencing implementation of CBPHC innovations. In primary care settings, consideration of contextual factors when implementing change has been recognized as critically important to success. However, contextual factors are rarely recorded, analyzed or considered when implementing change. The lack of consideration of contextual factors has negative implications not only for successfully implementing primary health care (PHC) innovations, but also for their sustainability and scalability.

Insights on multimorbidity and associated health service use and costs from three population-based studies of older adults in Ontario with diabetes, dementia and stroke by Lauren Griffith, Amanda Gruneir, Kathy Fisher, Dilkhush Panjwani, Amiram Gafni, C Patterson, Maureen Markle-Reid, Jenny Ploeg. (BMC Health Services Research)

Most studies that examine comorbidity and its impact on health service utilization focus on a single index-condition and are published in disease-specific journals, which limit opportunities to identify patterns across conditions/disciplines. These comparisons are further complicated by the impact of using different study designs, multimorbidity definitions and data sources. The aim of this paper is to share insights on multimorbidity and associated health services use and costs by reflecting on the common patterns across 3 parallel studies in distinct disease cohorts (diabetes, dementia, and stroke) that used the same study design and were conducted in the same health jurisdiction over the same time period.

ACHRU Trainee Publications

Understanding the complexity of diabetes and urinary incontinence in older adults receiving home care services: Protocol for a mixed methods study by Melissa Northwood, Jenny Ploeg, Maureen Markle-Reid, Diana Sherifali. (International Journal of Qualitative Methods)

Urinary incontinence (UI) is a very prevalent problem for older adults with type 2 diabetes mellitus (T2DM) receiving home care services. However, the complexities of living with UI and T2DM and providing nursing care for older adults in the home care context have received very little research attention. This article describes a protocol for a convergent, mixed methods research design study to address this knowledge and practice gap. The objectives of the proposed study are to (a) determine the prevalence and correlates of UI in older adults living with T2DM receiving home care services, (b) explore the experiences of older adults living with T2DM and UI receiving home care services, (c) explore the experiences of home care nurses caring for this population, and (d) converge the multiple data sources to provide a deeper understanding of the problem and implications for provision of home care services to this population.

Self-report tools for assessing physical activity in community-living older adults with multiple chronic conditions: A systematic review of psychometric properties and feasibility by Anna Garnett, Jenny Ploeg, Maureen Markle-Reid, Patricia Strachan. (Canadian Journal on Aging)

The purpose of this study was to identify the self-report physical activity (PA) tool best suited for assessment of PA in community-dwelling older adults with multiple chronic conditions (MCC). PA can positively influence physical and psychological health in this population. Although self-report PA tools exist, little is known about the psychometric properties and feasibility of using these tools in older adults with MCC. A systematic literature review from 2000 to 2018 was conducted of studies reporting on the psychometric properties and feasibility of 18 self-report PA tools for community-dwelling older adults (≥ 65 years) to determine the suitability of these tools for use in older adults with MCC. Based on an assessment of the available evidence for the psychometric properties and feasibility of 18 different self-report PA tools, the Physical Activity Assessment Scale for the Elderly (PASE) is recommended as the best-suited self-report PA tool for older adults with MCC.

Nurses' experiences in caring for older adults with responsive behaviors of dementia in acute care by Marie-Lee Yous, Jenny Ploeg, Sharon Kaasalainen, Lori Schindel Martin. (SAGE Open Nursing)

Approximately 56,000 individuals with dementia were admitted to Canadian hospitals in 2016, and 75% of them experience responsive behaviors. Responsive behaviors are words or actions used to express one's needs (e.g., wandering, yelling, hitting, and restlessness). Health-care professionals perceive these behaviors to be a challenging aspect in providing care for persons with dementia.

 

Published on: November 22, 2019

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