ACCeptability of Elderly PaTients’ self-assessment in the Emergency Department – (ACCEPTED)
Principal Investigator: Marcel Émond, MD, MSc, Centre de Recherche du CHU de Québec- Université Laval
Co-investigator : Marie-Eve Lamontagne, erg., Ph.D., Researcher, Centre interdisciplinaire de recherche en réadaptation et en intégration sociale, Université Laval
Collaborator: Jacques Lee, MSc, FRCP. Sunnybrook Health Science center, Toronto
Local research coordinator: Alexandra Nadeau
Student: Valérie Boucher, master in Clinical and Biomedical Sciences, Université Laval
Granting agency: Fondation du CHU de Québec
The project “Frailty assessment of Older Canadians Using Emergency Services with Tablet Technology (FOCUS–TT)”, funded by the Canadian Frailty Network, tested a software allowing seniors to self-assess, providing data to help the emergency health professionals better screen elderly patients and identify those who would actually benefit from a more comprehensive assessment. The tablet and software were tested in the ED environment. However, the acceptability of self-evaluation remains unknown, as the opinions of targeted users have yet to be explored. This is critical since acceptability influences adherence and uptake of an innovation.
Assessing acceptability is a fundamental step in the evaluation of a new intervention, tool or technology. Targeted users of a new technology or intervention all have different views, beliefs, knowledge and understanding of a problem. The literature is clear on the fact that if patients are provided with a treatment they find acceptable, its effect will be greater and more beneficial because the patients’ adherence and enthusiasm will also be greater. Acceptability for patients is therefore very important. A detailed understanding of the acceptability of self-evaluation, how users are responding to this new practice, and how it meets their needs will promote better implementation and uptake and optimize its impacts. More specifically, we want a better understanding of the overall perception of older patients’ self-assessment using this new technology. This project will allow for the in-depth evaluation of the acceptability of patient self-assessment to elderly patients and their caregivers.
Objectives: The goal of this study is to evaluate the acceptability of patients’ self-assessment of their frailty, cognitive and functional status in the ED. This project has three main objectives: 1) to evaluate the acceptability of patients’ self-assessment of their frailty, cognitive and functional status in the ED according to elderly patients and their caregivers. 2) to evaluate the acceptability of usual evaluations elderly patients have received by ED health professionals according to elderly patients and their caregivers. 3) to compare the acceptability scores of the two forms of evaluations.
Elderly patients: Inclusion criteria: 1) Patients aged 65 years and older consulting to the ED of the Hôpital de l’Enfant-Jésus for any medical reason. Patients will be excluded if they: 1) have an acute medical condition that could lead to their admission to the intensive care unit; 2) are unable to speak French; 3) are unable to consent (i.e. known severe dementia).
Caregivers: Inclusion criteria: 1) Caregiver / relative of a study participant who is present at the time of elderly patient enrollment.
Study relevance:The results of this study will provide researchers, clinicians, knowledge users, health leaders and administrators with valuable information regarding the acceptability of older patients’ self-assessment according to older Canadians and their caregivers compared to the acceptability of usual evaluation by ED health professionals. The success or failure of any new tool is decided by the people who are “on the front lines” and we believe that involving and better understanding them will promote better implementation and uptake of this innovative self-assessment technology, as well as optimizing its impact.
Positive results to this study and successful implementation of the tool could be the first step towards developing innovative tools or products for elders/caregivers to self-assess either in the ED or in any other hospital ward/speciality or even from home. This could lead to a better use of limited resources, faster and better management of elderly patients’ care, as well as better referrals during ED stay and after their discharge. All of this will help ensure that older Canadians maintain their independence, health and quality of life after an acute health situation.