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Measurement Instruments for Quantifying Physical Resilience in Aging: A Scoping Review Protocol

Peer reviewed: 
Yes, item is peer reviewed.
Date created: 
2019-01-14
Abstract: 

Background:  Physical resilience is the ability to optimize or recover motor function in the face of disease, injury, or aging-related decline. Greater knowledge of how some individuals regain or maintain function despite pathology may help identify protective factors and approaches that promote healthy aging. To date, a scoping review on physical resilience has not been conducted. The aims are to (1) identify measurement instruments for physical resilience, (2) synthesize and map the key concepts of physical resilience, and (3) identify gaps and make recommendations for future research.

Methods:  A scoping review of Scopus, Web of Science, Cumulative Index to Nursing and Allied Health Literature, Medline Ovid, PsycINFO, and AgeLine databases will take place using the search strategy “resilience” AND (aging OR elderly OR older adult). The initial electronic search will be supplemented by hand searching the reference lists and review articles to identify any missing studies. Two parallel independent assessments of study eligibility will be conducted for the title, abstract, and full-text screens. To meet study inclusion criteria, the term “resilience” must be applied in relation to the physical health of older adults. Any disagreement will be resolved by consensus and a third reviewer consulted to make a decision if consensus is not achieved initially. Physical resilience information to be extracted are measurement instruments that describe the core domains of (1) body function or structure (signs or symptoms, etc.), (2) activity and participation (quality of life, etc.), and (3) societal impact. Tables and/or charts will map the data with distribution of studies by core domains. Finally, the amalgamation of results will be an iterative process whereby reviewers will refine the plan for presenting results after data extraction is completed so that all of the contents of the extraction may be included in the results.

Discussion:  The information gleaned in this scoping review will be essential to understand how physical resilience is currently measured and identify gaps for further research.

Document type: 
Article
File(s): 

Conceptualising and Operationalising Resilience in Older Adults

Peer reviewed: 
Yes, item is peer reviewed.
Date created: 
2019-03-28
Abstract: 

Context: As a result of increases in life expectancy and decreases in fertility, the proportion of the population entering later life has increased dramatically in recent decades. When faced with age-related challenges, some older adults respond more positively to adversity than would be expected given the level of adversity that they have experienced, demonstrating ‘resilience’.

Objectives: Having a clear conceptual framework for resilience is a prerequisite to operationalising resilience in a research context.

Methods: Here we compare and contrast several approaches to the operationalisation of resilience: psychometric-driven and data-driven (variable-centred and individual-centred) methods.

Results: Psychometric-driven methods involve the administration of established questionnaires aimed at quantifying resilience. Data-driven techniques use statistical procedures to examine and/or operationalise resilience and can be broadly categorised into variable-centred methods, i.e. interaction and residuals, and individual-centred methods, i.e. categorical and latent class.

Conclusions: The specific question(s) driving the research and the nature of the variables a researcher intends to use in their adversity-outcome dyad will largely dictate which methods are more (or less) appropriate in that circumstance. A measured approach to the ways in which resilience is investigated is warranted in order to facilitate the most useful application of this burgeoning field of research.

Document type: 
Article
File(s): 

Performance Comparison of Linear and Nonlinear Feature Selection Methods for the Analysis of Large Survey Datasets

Peer reviewed: 
Yes, item is peer reviewed.
Date created: 
2019-03-21
Abstract: 

Large survey databases for aging-related analysis are often examined to discover key factors that affect a dependent variable of interest. Typically, this analysis is performed with methods assuming linear dependencies between variables. Such assumptions however do not hold in many cases, wherein data are linked by way of non-linear dependencies. This in turn requires applications of analytic methods, which are more accurate in identifying potentially non-linear dependencies. Here, we objectively compared the feature selection performance of several frequently-used linear selection methods and three non-linear selection methods in the context of large survey data. These methods were assessed using both synthetic and real-world datasets, wherein relationships between the features and dependent variables were known in advance. In contrast to linear methods, we found that the non-linear methods offered better overall feature selection performance than linear methods in all usage conditions. Moreover, the performance of the non-linear methods was more stable, being unaffected by the inclusion or exclusion of variables from the datasets. These properties make non-linear feature selection methods a potentially preferable tool for both hypothesis-driven and exploratory analyses for aging-related datasets.

Document type: 
Article
File(s): 

Appreciative Inquiry: Bridging Research and Practice in a Hospital Setting

Peer reviewed: 
Yes, item is peer reviewed.
Date created: 
2018-04-18
Abstract: 

Purpose:  In this action study, researchers worked with a team of interdisciplinary practitioners to co-develop knowledge and practice in a medical unit of a large urban hospital in Canada. An appreciative inquiry approach was utilized to guide the project. This article specifically focuses on examining the research experiences of practitioners and their accounts on how the research influenced their practice development to enact person-centered care.

Method:  The project took place in the hospital’s medical unit. A total of 50 staff participants attended focus groups including nursing staff, allied health practitioners, unit leaders, and physicians. One senior hospital administrator was interviewed individually. In total, 36 focus groups were conducted to bring participants together to co-vision and co-develop person-centered care.

Results:  Analysis of the data produced three themes: (a) appreciating the power of co-inquiry, (b) building team capacity, and (c) continuous development. Furthermore, 10 key enablers for engaging staff in the research process were developed from the data. A conceptual tool, “team Engagement Action Making” (TEAM) has been created to support others to do similar work in practice development.

Conclusion:  An appreciative inquiry approach has the potential to address gaps in knowledge by revealing ways to take action. Future research should further investigate how the appreciative inquiry approach may be used to support bridging research and practice.

Document type: 
Article
File(s): 

Using Video-Reflexive Ethnography to Engage Hospital Staff to Improve Dementia Care

Peer reviewed: 
Yes, item is peer reviewed.
Date created: 
2018-07-11
Abstract: 

In this article, we discuss how video-reflexive ethnography may be useful in engaging staff to improve dementia care in a hospital medical unit. Seven patients with dementia were involved in the production of patient-story videos, and fifty members of staff (nurses, physicians, and allied health practitioners) participated in video-reflexive groups. We identified five substantial themes to describe how video-reflexive groups might contribute to enacting person-centered care for improving dementia care: (a) seeing through patients’ eyes, (b) seeing normal strange and surprised, (c) seeing inside and between, (d) seeing with others inspires actions, and (e) seeing with the team builds a culture of learning. Our findings suggest that video reflexivity is not only useful for staff engagement but also effective in enhancing team capacity to enact person-centered care in the hospital setting.

Document type: 
Article
File(s): 

‘I am Busy Independent Woman Who has Sense of Humor, Caring about Others’: Older Adults’ Self- representations in Online Dating Profiles

Peer reviewed: 
Yes, item is peer reviewed.
Date created: 
2017-12
Abstract: 

Similar to their younger counterparts, older adults (age +) are increasingly turning to online dating sites to find potential romantic and sexual partners. In this paper, we draw upon qualitative data from a thematic analysis of  randomly selected online dating profiles posted by Canadian heterosexual older adults who self-identified as Asian, Black, Caucasian or Native American. In particular, we exam-ined how the older adults’ self-presentations varied according to race/ethnicity, age and gender, and how the language they used to describe themselves and their preferred potential partners reflected and reinforced idealised images of ageing. Our analysis identified five primary ways in which the older adults portrayed them-selves. They depicted themselves as active and busy with cultural/artistic, social and adventurous activities; and also as physically healthy and intellectually engaged. Third, they emphasised the ways in which they were productive through work and vol-unteer activities. Fourth, they accentuated their positive approach to life, identifying themselves as happy, fun-loving and humorous individuals. Finally, they highlighted their personable characteristics, portraying themselves as trustworthy and caring. We discuss our findings with a particular focus on gender differences, drawing on lit-erature on masculinity and femininity, and also look at capital and power relations by considering the online dating setting as a field in the Bourdieusian sense.

Document type: 
Article
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Gerontology Graduate Training in North America: Shifting Landscapes, Innovation and Future Directions

Peer reviewed: 
No, item is not peer reviewed.
Date created: 
2016-07-29
Abstract: 

As the Canadian population ages it is anticipated there will be an increased demand for students with advanced training in gerontology. In today's highly fluid and competitive environment, the challenge for gerontology graduate programs will be how to attract the best and brightest students and provide them with the knowledge base and skillsets that they will need in order to be successful. Yet, very little research has been conducted on the state of gerontology graduate education in North America with a focus on Canadian programs. Given this gap, the purpose of this report is to: a) report on current trends in gerontology graduate education and b) highlight innovations and potential future directions for the discipline in general, and the Simon Fraser University (SFU) graduate programs in gerontology, more specifically. This report was funded by the SFU, Dean of Graduate Studies SCORE program: Strengthening the Core Fund for Innovation in Graduate Education.

 

For this project a total of 40 eligible English language gerontology graduate programs (doctoral or master's level) offered by Canadian or American universities were identified. Interviews were conducted with 23/40 universities and data were collected on a number of topics such as target students, marketing and publicity methods, and program requirements. Some supplementary data were also collected from online information sources. Of the universities in the sample, 10 offer doctoral level programs (total of 12 programs) and 20 offer master's level programs (total of 24 programs). Eight of the universities are Canadian and fifteen are American.

Document type: 
Report
File(s): 

Experiencing ‘Pathologized Presence and Normalized Absence’; Understanding Health Related Experiences and Access to Health Care Among Iraqi and Somali Asylum Seekers, Refugees and Persons Without Legal Status

Peer reviewed: 
Yes, item is peer reviewed.
Date created: 
2015
Abstract: 

Background

Asylum seekers, refugees and persons without legal status have been reported to experience a range of difficulties when accessing public services and supports in the UK. While research has identified health care barriers to equitable access such as language difficulties, it has not considered the broader social contexts of marginalization experienced through the dynamics of ‘othering’. The current study explores health and health care experiences of Somali and Iraqi asylum seekers, refugees and persons without legal status, highlighting ‘minoritization’ processes and the ‘pathologization’ of difference as analytical lenses to understand the multiple layers of oppression that contribute to health inequities.

Methods

For the study, qualitative methods were used to document the lived experiences of asylum seekers, refugees and persons without legal status. Thirty-five in-depth interviews and five focus groups were used to explore personal accounts, reveal shared understandings and enable social, cognitive and emotional understandings of on-going health problems and challenges when seeking treatment and care. A participatory framework was undertaken which inspired collaborative workings with local organizations that worked directly with asylum seekers, refugees and persons without legal status.

Results

The analysis revealed four key themes: 1) pre-departure histories and post-arrival challenges; 2) legal status; 3) health knowledges and procedural barriers as well as 4) language and cultural competence. Confidentiality, trust, wait times and short doctor-patient consultations were emphasized as being insufficient for culturally specific communications and often translating into inadequate treatment and care. Barriers to accessing health care was associated with social disadvantage and restrictions of the broader welfare system suggesting that a re-evaluation of the asylum seeking process is required to improve the situation.

Discussions

Macro- and micro-level intersections of accustomed societal beliefs, practices and norms, broad-levellegislation and policy decisions, and health care and social services delivery methods have affected the health and health care experiences of forced migrants that reside in the UK. Research highlights how ‘minoritization processes,’ influencing the intersections between social identities, can hinder access to and delivery of health and social services to vulnerable groups. Similar findings were reported here; and the most influential mechanism directly impacting health and access to health and social services was legal status.

Conclusions

Equitable health care provision requires systemic change that incorporate understandings of marginalization, ‘othering’ processes and the intersections between the past histories and everyday realities of asylum seekers, refugees and persons without legal status.

Document type: 
Article
File(s): 

Development of a Comprehensive Hospital-Based Elder Abuse Intervention: An Initial Systematic Scoping Review

Peer reviewed: 
Yes, item is peer reviewed.
Date created: 
2015
Abstract: 

Introduction

Elder abuse, a universal human rights problem, is associated with many negative consequences. In most jurisdictions, however, there are no comprehensive hospital-based interventions for elder abuse that address the totality of needs of abused older adults: psychological, physical, legal, and social. As the first step towards the development of such an intervention, we undertook a systematic scoping review.

Objectives

Our primary objective was to systematically extract and synthesize actionable and applicable recommendations for components of a multidisciplinary intersectoral hospital-based elder abuse intervention. A secondary objective was to summarize the characteristics of the responses reviewed, including methods of development and validation.

Methods

The grey and scholarly literatures were systematically searched, with two independent reviewers conducting the title, abstract and full text screening. Documents were considered eligible for inclusion if they: 1) addressed a response (e.g., an intervention) to elder abuse, 2) contained recommendations for responding to abused older adults with potential relevance to a multidisciplinary and intersectoral hospital-based elder abuse intervention; and 3) were available in English.

Analysis

The extracted recommendations for care were collated, coded, categorized into themes, and further reviewed for relevancy to a comprehensive hospital-based response. Characteristics of the responses were summarized using descriptive statistics.

Results

649 recommendations were extracted from 68 distinct elder abuse responses, 149 of which were deemed relevant and were categorized into 5 themes: Initial contact; Capacity and consent; Interview with older adult, caregiver, collateral contacts, and/or suspected abuser; Assessment: physical/forensic, mental, psychosocial, and environmental/functional; and care plan. Only 6 responses had been evaluated, suggesting a significant gap between development and implementation of recommendations.

Discussion

To address the lack of evidence to support the recommendations extracted in this review, in a future study, a group of experts will formally evaluate each recommendation for its inclusion in a comprehensive hospital-based response.

Document type: 
Article
File(s): 

An Educational Video to Promote Multi-Factorial Approaches For Fall and Injury Prevention in Long-Term Care Facilities

Peer reviewed: 
Yes, item is peer reviewed.
Date created: 
2014
Abstract: 

Background

Older adults living in long term care (LTC) settings are vulnerable to fall-related injuries. There is a need to develop and implement evidence-based approaches to address fall injury prevention in LTC. Knowledge translation (KT) interventions to support the uptake of evidence-based approaches to fall injury prevention in LTC need to be responsive to the learning needs of LTC staff and use mediums, such as videos, that are accessible and easy-to-use. This article describes the development of two unique educational videos to promote fall injury prevention in long-term care (LTC) settings. These videos are unique from other fall prevention videos in that they include video footage of real life falls captured in the LTC setting.

Methods

Two educational videos were developed (2012–2013) to support the uptake of findings from a study exploring the causes of falls based on video footage captured in LTC facilities. The videos were developed by: (1) conducting learning needs assessment in LTC settings via six focus groups (2) liaising with LTC settings to identify learning priorities through unstructured conversations; and (3) aligning the content with principles of adult learning theory.

Results

The videos included footage of falls, interviews with older adults and fall injury prevention experts. The videos present evidence-based fall injury prevention recommendations aligned to the needs of LTC staff and: (1) highlight recommendations deemed by LTC staff as most urgent (learner-centered learning); (2) highlight negative impacts of falls on older adults (encourage meaning-making); and, (3) prompt LTC staff to reflect on fall injury prevention practices (encourage critical reflection).

Conclusions

Educational videos are an important tool available to researchers seeking to translate evidence-based recommendations into LTC settings. Additional research is needed to determine their impact on practice.

Document type: 
Article
File(s):