Managing care for older people in community hospitals.
Research type
Research Study
Full title
Managing clinical uncertainty for older people in community hospitals to increase comfort and reduce distress; development and feasibility evaluation of a new tool, Symptom and Psychosocial Assessment and Communication Evaluation (SPACEtoolkit)
IRAS ID
241166
Contact name
Catherine Evans
Contact email
Sponsor organisation
King's College London
Duration of Study in the UK
0 years, 6 months, 3 days
Research summary
People are living longer. There is therefore a growing population of people living with multiple long-term illnesses associated with ageing, including frailty or dementia. Acute events such as infections are common in this population and characterised by clinical uncertainty with regards to recovery. Clinical uncertainty is complex to manage, making assessment and communication challenging, and leading to increased distress and anxiety for patients and their carers. Community hospitals frequently care for older people during times of decline and clinical uncertainty as to recovery or deterioration.
We want to find ways to improve assessment and communication for older people admitted to community hospitals to reduce anxiety and distress for them and their carers. There are already tools that have been developed for these purposes but developed and evaluated in acute hospitals. We do not know how well they may work for community hospitals where nurses provide the majority of care with limited support from a medical doctor. We therefore aim to develop and evaluate the feasibility of the new toolkit - the Symptom and Psychosocial Assessment and Communication Evaluation (SPACEtoolkit) to reduce distress and anxiety for patients and carers.
This is third stage of the study. In this stage, we aim to identify the components of the SPACEtoolkit, gain an understanding of how it may work to improve the care of people experiencing uncertainty, and identify what resources are required to support its implementation. To do this, we conduct two stakeholder consultations with 60 health and social care staff, senior NHS staff, care home staff, commissioners, and family members to generate recommendations for SPACEtoolkit. We then use these findings to conduct a feasibility discrete choice experiment with 33 older patients in community hospitals and 10-13 carers to measure preferences in managing clinical uncertainty and understand how the
SPACEtoolkit may work and its intended benefits.REC name
London - Camberwell St Giles Research Ethics Committee
REC reference
18/LO/1343
Date of REC Opinion
4 Oct 2018
REC opinion
Further Information Favourable Opinion