Stakeholders' experiences of comprehensive geriatric assessment in an inpatient hospital setting: a qualitative systematic review and meta-ethnography

Íde O'Shaughnessy; Christine Fitzgerald; Christina Hayes; Aoife Leahy; Margaret O'Connor; Damien Ryan; Denys Shchetkovsky; Fiona Steed; Leonora Carey; Colin Quinn; Elaine Shanahan; Rose Galvin; Katie Robinson

doi:10.1186/s12877-023-04505-w

Stakeholders' experiences of comprehensive geriatric assessment in an inpatient hospital setting: a qualitative systematic review and meta-ethnography

BMC Geriatr. 2023 Dec 8;23(1):821. doi: 10.1186/s12877-023-04505-w.

Authors

Íde O'Shaughnessy¹, Christine Fitzgerald², Christina Hayes², Aoife Leahy^{2

3}, Margaret O'Connor^{3

4}, Damien Ryan^{4

5}, Denys Shchetkovsky⁵, Fiona Steed⁶, Leonora Carey⁷, Colin Quinn³, Elaine Shanahan³, Rose Galvin², Katie Robinson²

Affiliations

¹ School of Allied Health, Faculty of Education and Health Sciences, Ageing Research Centre, Health Research Institute, University of Limerick, Limerick, Ireland. Ide.OShaughnessy@ul.ie.
² School of Allied Health, Faculty of Education and Health Sciences, Ageing Research Centre, Health Research Institute, University of Limerick, Limerick, Ireland.
³ Department of Ageing and Therapeutics, University Hospital Limerick, Dooradoyle, Limerick, Ireland.
⁴ School of Medicine, Faculty of Education and Health Sciences, University of Limerick, Limerick, Ireland.
⁵ Emergency Department, Limerick EM Education Research Training (ALERT), University Hospital Limerick, Dooradoyle, Limerick, Ireland.
⁶ Department of Health, Baggot Street, Dublin, Ireland.
⁷ Department of Occupational Therapy, University Hospital Limerick, Dooradoyle, Limerick, Ireland.

Abstract

Background: Comprehensive geriatric assessment (CGA) is considered the gold standard approach to improving a range of outcomes for older adults living with frailty admitted to hospital. To date, research has predominantly focused on quantitative syntheses of the international evidence with limited focus on qualitative synthesis of stakeholder perspectives. This review aims to resolve this research gap by identifying and synthesising qualitative studies reporting multiple stakeholders' experiences of inpatient CGA.

Methods: A systematic search of five electronic databases was conducted. Qualitative or mixed methods studies that included qualitative findings on the experiences of CGA in an inpatient hospital setting from the perspective of healthcare professionals (HCP), older adults, and those important to them were included. The protocol was registered on PROSPERO (Registration: CRD42021283167) and the 10-item Critical Appraisal Skills Programme checklist was used to appraise the methodological quality of included studies. Results were synthesised as a meta-ethnography.

Results: Eleven studies, which reported on the experiences of 153 HCPs, 91 older adults and 57 caregivers were included. The studies dated from 2011 to 2021 and three key themes were identified: (1) HCPs, older adults and caregivers report conflicting views on CGA as a holistic process, (2) most HCPs, but only some older adults and caregivers view CGA goalsetting and care planning as collaborative, and (3) all stakeholders value care continuity during the transition from hospital to home but often fail to achieve it.

Conclusion: While HCPs, older adults, and caregivers' values and ambitions related to CGA broadly align, their experiences often differ. The identified themes highlight organisational and relational factors, which positively and negatively influence CGA practices and processes in an inpatient hospital setting.

Keywords: Comprehensive geriatric assessment; Inpatient; Meta-ethnography; Older adults; Qualitative evidence synthesis.

Publication types

Systematic Review
Research Support, Non-U.S. Gov't

MeSH terms

Aged
Anthropology, Cultural
Geriatric Assessment* / methods
Hospitals
Humans
Inpatients*
Qualitative Research