Evidence map›Paper›PMID 39642361›Full record

ArticleJMIR research protocols2024

Characterizing Emergency Department Disposition Conversations for Persons Living With Dementia: Protocol for an Ethnographic Study.

Justine Seidenfeld, Matthew Tucker, Melissa Harris-Gersten, Gemmae M Fix, Ivonne Guzman, Nina R Sperber, Susan N Hastings

Abstract read
In one paragraph

Article in JMIR research protocols, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–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

1 citing paper in PubMed.

  1. 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

7 authors.

Justine SeidenfeldCenter of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham VA Health Care System, Durham, NC, United States.ORCID 0000-0001-6912-7315
Matthew TuckerCenter of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham VA Health Care System, Durham, NC, United States.ORCID 0000-0002-9724-6765
Melissa Harris-GerstenCenter of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham VA Health Care System, Durham, NC, United States.ORCID 0000-0001-5430-7890
Gemmae M FixCenter for Health Optimization and Implementation Research, VA Bedford Healthcare System, Bedford, MA, United States.ORCID 0000-0001-6055-4177
Ivonne GuzmanCenter of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham VA Health Care System, Durham, NC, United States.ORCID 0009-0005-7379-212X
Nina R SperberCenter of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham VA Health Care System, Durham, NC, United States.ORCID 0000-0001-6640-2510
Susan N HastingsCenter of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham VA Health Care System, Durham, NC, United States.ORCID 0000-0002-5750-8820

Funding

Research Education Component CoreP30AG072958 · NIA · DUKE UNIVERSITY · PI Maria Marquine · 2021 to 2026
$24.1M
Geriatrics Emergency care Applied Research Network 2.1 - AdvanCing and Expanding Dementia care (GEAR 2.1 - ACED)R33AG069822 · NIA · YALE UNIVERSITY · PI Ula Y Hwang, MANISH N SHAH · 2023 to 2026
$5.3M
HSRD VA CIN 13-410NIA NIH HHS P30 AG072958NIA NIH HHS R33 AG069822
6 · The paper itself

Abstract

backgroundAlmost 40% of persons living with dementia make an emergency department (ED) visit each year. One of the most impactful and costly elements of their ED care is the decision to discharge or admit them to the hospital-the "disposition" decision. When more than one reasonable option exists regarding a health care decision, such as the decision to admit or not, it often requires a complex conversation between patients, care partners, and ED providers, ideally involving shared decision-making. However, little is known about how these conversations are conducted and the real-world context in which they take place. Best practices in ED communication and shared decision-making for persons living with dementia and their care partners are limited.

objectiveThis study aims to characterize current practices in ED disposition conversations for persons living with dementia and their care partners, informed by perspectives from patient and care partner participants.

methodsThis study will use an ethnographic design, including direct observation methods with a semistructured data collection tool to capture the ED encounter for up to 20 patient and care partner dyads, including all discussions about dispositions. Follow-up qualitative, semistructured interviews will be conducted with persons living with dementia and their care partners to explore specific observations made during their ED encounter, and to gain insight into their perspective on their role and elements of decision support used during that conversation.

resultsData collection was initiated in October 2023, with 13 dyads recruited and observed as of July 2024. This study is expected to be completed by December 2024.

conclusionsNovel methods can offer novel insights. By combining direct observation and follow-up interviews about an ED visit, our study design will provide insights into how ED disposition occurs in real-world settings for persons living with dementia. Findings can inform more patient-centered interventions for disposition decision-making. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/65043.

Indexed as

Anthropology, CulturalDementiaEmergency Service, HospitalAgedCommunicationDecision MakingFemaleHumansMalePatient DischargeQualitative Researchcaregiversdementiadirect observationsemergency medicineethnography

Identifiers

PMID39642361
PMCPMC11662188

What OpenQuestion holds

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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.