Evidence map›Paper›PMID 32428202›Full record

ArticleAge and ageing2020

The work of older people and their informal caregivers in managing an acute health event in a hospital at home or hospital inpatient setting.

Petra Mäkelä, David Stott, Mary Godfrey, Graham Ellis, Rebekah Schiff, Sasha Shepperd

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In one paragraph

Article in Age and ageing, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 papers, 10 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
29citing papers in PubMed, 10 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

29 citing papers in PubMed, 10 syntheses or guidelines pooled it.

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  4. Admission avoidance hospital at home.The Cochrane database of systematic reviews · 2024
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  9. Discharge planning from hospital.The Cochrane database of systematic reviews · 2022
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Petra MäkeläLondon School of Hygiene & Tropical Medicine, London, UK.
David StottInstitute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK.
Mary GodfreyInstitute of Health Sciences, University of Leeds, Leeds, UK.
Graham EllisMonklands Hospital, NHS Lanarkshire, Glasgow, UK.
Rebekah SchiffDepartment of Ageing and Health, Guy's & St Thomas' NHS Foundation Trust, London, UK.
Sasha ShepperdNuffield Department of Population Health, University of Oxford, Oxford, UK.

Funding

Department of Health 12/209/66
6 · The paper itself

Abstract

backgroundThere is limited understanding of the contribution made by older people and their caregivers to acute healthcare in the home and how this compares to hospital inpatient healthcare.

objectivesTo explore the work of older people and caregivers at the time of an acute health event, the interface with professionals in a hospital and hospital at home (HAH) and how their experiences relate to the principles underpinning comprehensive geriatric assessment (CGA).

designA qualitative interview study within a UK multi-site participant randomised trial of geriatrician-led admission avoidance HAH, compared with hospital inpatient care.

methodsWe conducted semi-structured interviews with 34 older people (15 had received HAH and 19 hospital care) alone or alongside caregivers (29 caregivers; 12 HAH, 17 hospital care), in three sites that recruited participants to a randomised trial, during 2017-2018. We used normalisation process theory to guide our analysis and interpretation of the data.

resultsPatients and caregivers described efforts to understand changes in health, interpret assessments and mitigate a lack of involvement in decisions. Practical work included managing risks, mobilising resources to meet health-related needs, and integrating the acute episode into longer-term strategies. Personal, relational and environmental factors facilitated or challenged adaptive capacity and ability to manage.

conclusionsPatients and caregivers contributed to acute healthcare in both locations, often in parallel to healthcare providers. Our findings highlight an opportunity for CGA-guided services at the interface of acute and chronic condition management to facilitate personal, social and service strategies extending beyond an acute episode of healthcare.

Indexed as

CaregiversInpatientsAgedGeriatriciansHospitalsHumansQualitative ResearchAdmission avoidance hospital at homeInformal caregiversInpatient hospitalOlder peopleQualitative research

Identifiers

PMID32428202
PMCPMC7444665

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.