Evidence map›Paper›PMID 37520079›Full record

ArticleJournal of the American College of Emergency Physicians open2023

Older adults' goals of care in the emergency department setting: A qualitative study guided by the 4Ms framework.

Melissa Sheber, Mackenzie McKnight, Daniel Liebzeit, Aaron Seaman, Erica K Husser, Harleah Buck, Heather S Reisinger, Sangil Lee

Open access · goldAbstract read
In one paragraph

Article in Journal of the American College of Emergency Physicians open, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
1.4field-weighted citation impact, top 19% of its field
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

3 citing papers in PubMed, 4 citations in OpenAlex.

  1. Observational
  2. Enhancing healthcare access for an older population: The age-friendly emergency department.Journal of the American College of Emergency Physicians open · 2024
    Review
  3. Article
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

8 authors at 2 institutions in 1 country.

Melissa SheberDepartment of Emergency Medicine University of Iowa Carver College of Medicine Iowa City Iowa USA.
Mackenzie McKnightDepartment of Emergency Medicine University of Iowa Carver College of Medicine Iowa City Iowa USA.
Daniel LiebzeitUniversity of Iowa College of Nursing Iowa City Iowa USA.
Aaron SeamanDepartment of Internal Medicine University of Iowa Carver College of Medicine Iowa City Iowa USA.
Erica K HusserRoss and Carol Nese College of Nursing Pennsylvania State University, University Park Pennsylvania USA.
Harleah BuckUniversity of Iowa College of Nursing Iowa City Iowa USA.
Heather S ReisingerDepartment of Internal Medicine University of Iowa Carver College of Medicine Iowa City Iowa USA.
Sangil LeeDepartment of Emergency Medicine University of Iowa Carver College of Medicine Department of Epidemiology University of Iowa College of Public Health Iowa City Iowa USA.
University of Iowa · USPennsylvania State University · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: We sought to identify what matters to older adults (60 years and older) presenting to the emergency department (ED) and the challenges or concerns they identify related to medication, mobility, and mentation to inform how the 4Ms framework could improve care of older adults in the ED setting. Methods: A qualitative study was conducted using the 4Ms to identify what matters to older adults (≥60 years old) presenting to the ED and what challenges or concerns they identify related to medication, mobility, and mentation. We conducted semi-structured interviews with a convenience sample of patients in a single ED. Interview guide responses and interviewer field notes were entered into REDCap. Interviews were reviewed by the research team (2 coders per interview) who inductively assigned codes. A codebook was created through an iterative process and was used to group codes into themes and sub-themes within the 4Ms framework. Results: A total of 20 ED patients participated in the interviews lasting 30-60 minutes. Codes identified for "what matters" included problem-oriented expectation, coordination and continuity, staying engaged, being with family, and getting back home. Codes related to the other 4Ms (medication, mobility, and mentation) described challenges. Medication challenges included: non-adherence, side effects, polypharmacy, and knowledge. Mobility challenges included physical activity and independence. Last, mentation challenges included memory concerns, depressed mood, and stress and worry. Conclusions: Our study used the 4Ms to identify "what matters" to older adults presenting to the ED and the challenges they face regarding medication, mobility, and mentation. Understanding what matters to patients and the specific challenges they face can help shape and individualize a patient-centered approach to care to facilitate the goals of care discussion and handoff to the next care team.

Identifiers

PMID37520079
PMCPMC10375261
OpenAlexW4385348574

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
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.