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Engaging Older Adults in Health Care Decision-Making: A Realist Synthesis

Author

Listed:
  • Jacobi Elliott

    (University of Waterloo)

  • Heather McNeil

    (University of Waterloo)

  • Jessica Ashbourne

    (University of Waterloo)

  • Kelsey Huson

    (Conestoga College)

  • Veronique Boscart

    (University of Waterloo
    Conestoga College
    Schlegel-UW Research Institute for Aging)

  • Paul Stolee

    (University of Waterloo
    Schlegel-UW Research Institute for Aging)

Abstract

Background Engagement in healthcare decision making has been recognized as an important, and often lacking, aspect of care, especially in the care of older adults who are major users of the healthcare system. Objective We aimed to conduct a review of available knowledge on engagement in healthcare decision making with a focus on older patients and their caregivers. Methods We conducted a realist synthesis focusing on strategies for engagement of older patients and their caregivers in healthcare decision making. The synthesis encompassed theoretical frameworks and both peer-reviewed and grey literature. Expert consultations included interviews (n = 2) with academics and group consultations (n = 3) with older adults and their caregivers. Abstracts that reported description, assessment, or evaluation of strategies for engagement of adult patients, families, or caregivers (i.e., that report on actual experiences of engagement) were included. Results The search generated 15,683 articles, 663 of which were pertinent to healthcare decision making. Theoretical and empirical work identified a range of strategies and levels of engagement of older patients and their families in healthcare decision making. The importance of communication emerged as a key recommendation for meaningful engagement among providers and patients and their caregivers. The principles developed in this study should be implemented with consideration of the context in which care is being provided. Conclusions We have developed a framework that promotes the engagement of patients and their caregivers as equal partners in healthcare decision making. Future research should implement and test the framework in various clinical settings.

Suggested Citation

  • Jacobi Elliott & Heather McNeil & Jessica Ashbourne & Kelsey Huson & Veronique Boscart & Paul Stolee, 2016. "Engaging Older Adults in Health Care Decision-Making: A Realist Synthesis," The Patient: Patient-Centered Outcomes Research, Springer;International Academy of Health Preference Research, vol. 9(5), pages 383-393, October.
    • Handle: RePEc:spr:patien:v:9:y:2016:i:5:d:10.1007_s40271-016-0168-x
    DOI: 10.1007/s40271-016-0168-x
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    References listed on IDEAS

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    1. Mead, Nicola & Bower, Peter & Hann, Mark, 2002. "The impact of general practitioners' patient-centredness on patients' post-consultation satisfaction and enablement," Social Science & Medicine, Elsevier, vol. 55(2), pages 283-299, July.
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    Cited by:

    1. Marta Rzadkiewicz & Mariusz Jaworski & Dorota Włodarczyk, 2022. "The Brave Patient after 80—Satisfaction with Visit and Individual Determinants of Proactive Patient Attitude among the Oldest General Practice Users," IJERPH, MDPI, vol. 19(10), pages 1-10, May.
    2. Susanna Nordin & Jodi Sturge & Maria Ayoub & Allyson Jones & Kevin McKee & Lena Dahlberg & Louise Meijering & Marie Elf, 2021. "The Role of Information and Communication Technology (ICT) for Older Adults’ Decision-Making Related to Health, and Health and Social Care Services in Daily Life—A Scoping Review," IJERPH, MDPI, vol. 19(1), pages 1-18, December.

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