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Evaluating the Quality of Patient Decision-Making Regarding Post-Acute Care

Overview of attention for article published in JGIM: Journal of General Internal Medicine, February 2018
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About this Attention Score

  • In the top 25% of all research outputs scored by Altmetric
  • High Attention Score compared to outputs of the same age (81st percentile)
  • Good Attention Score compared to outputs of the same age and source (65th percentile)

Mentioned by

twitter
16 tweeters

Citations

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2 Dimensions

Readers on

mendeley
11 Mendeley
Title
Evaluating the Quality of Patient Decision-Making Regarding Post-Acute Care
Published in
JGIM: Journal of General Internal Medicine, February 2018
DOI 10.1007/s11606-017-4298-1
Pubmed ID
Authors

Robert E. Burke, Jacqueline Jones, Emily Lawrence, Amy Ladebue, Roman Ayele, Chelsea Leonard, Brandi Lippmann, Daniel D. Matlock, Rebecca Allyn, Ethan Cumbler

Abstract

Despite a national focus on post-acute care brought about by recent payment reforms, relatively little is known about how hospitalized older adults and their caregivers decide whether to go to a skilled nursing facility (SNF) after hospitalization. We sought to understand to what extent hospitalized older adults and their caregivers are empowered to make a high-quality decision about utilizing an SNF for post-acute care and what contextual or process elements led to satisfaction with the outcome of their decision once in SNF. Qualitative inquiry using the Ottawa Decision Support Framework (ODSF), a conceptual framework that describes key components of high-quality decision-making. Thirty-two previously community-dwelling older adults (≥ 65 years old) and 22 caregivers interviewed at three different hospitals and three skilled nursing facilities. We used key components of the ODSF to identify elements of context and process that affected decision-making and to what extent the outcome was characteristic of a high-quality decision: informed, values based, and not associated with regret or blame. The most important contextual themes were the presence of active medical conditions in the hospital that made decision-making difficult, prior experiences with hospital readmission or SNF, relative level of caregiver support, and pressure to make a decision quickly for which participants felt unprepared. Patients described playing a passive role in the decision-making process and largely relying on recommendations from the medical team. Patients commonly expressed resignation and a perceived lack of choice or autonomy, leading to dissatisfaction with the outcome. Understanding and intervening to improve the quality of decision-making regarding post-acute care supports is essential for improving outcomes of hospitalized older adults. Our results suggest that simply providing information is not sufficient; rather, incorporating key contextual factors and improving the decision-making process for both patients and clinicians are also essential.

Twitter Demographics

The data shown below were collected from the profiles of 16 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 11 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 11 100%

Demographic breakdown

Readers by professional status Count As %
Student > Ph. D. Student 2 18%
Unspecified 2 18%
Professor 1 9%
Lecturer > Senior Lecturer 1 9%
Student > Bachelor 1 9%
Other 4 36%
Readers by discipline Count As %
Unspecified 5 45%
Medicine and Dentistry 3 27%
Social Sciences 2 18%
Agricultural and Biological Sciences 1 9%

Attention Score in Context

This research output has an Altmetric Attention Score of 10. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 13 June 2018.
All research outputs
#1,229,746
of 11,465,445 outputs
Outputs from JGIM: Journal of General Internal Medicine
#924
of 4,043 outputs
Outputs of similar age
#52,438
of 289,437 outputs
Outputs of similar age from JGIM: Journal of General Internal Medicine
#46
of 134 outputs
Altmetric has tracked 11,465,445 research outputs across all sources so far. Compared to these this one has done well and is in the 89th percentile: it's in the top 25% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 4,043 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 13.6. This one has done well, scoring higher than 77% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 289,437 tracked outputs that were published within six weeks on either side of this one in any source. This one has done well, scoring higher than 81% of its contemporaries.
We're also able to compare this research output to 134 others from the same source and published within six weeks on either side of this one. This one has gotten more attention than average, scoring higher than 65% of its contemporaries.