Publications by authors named "Deirdre O Donnell"

Article Synopsis
  • Healthy ageing is important for older people and can be helped by how society supports them, but this support can sometimes be lacking.
  • The TILDA project studies how to promote healthy ageing and finds out what older people and their support groups think about its efforts.
  • Interviews with 15 organizations showed some limitations of TILDA, like not being inclusive enough, but also highlighted its benefits, like providing useful information to help plan for the needs of older people in the future.
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Decision-making for patients with stroke in neurocritical care is uniquely challenging because of the gravity and high preference sensitivity of these decisions. Shared decision-making (SDM) is recommended to align decisions with patient values. However, limited evidence exists on the experiences and perceptions of key stakeholders involved in SDM for neurocritical patients with stroke.

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Background: All healthcare professional education programmes must adopt a systematic approach towards ensuring graduates achieve the competencies required to be an evidence-based practitioner. While a list of competencies for evidence-based practice exist, health care educators continue to struggle with effectively integrating the necessary competencies into existing curricula. The purpose of this project was to develop an open access cross-discipline, learning outcomes framework to support educators in integrating the teaching, learning and assessment required to ensure all graduates of health care professional programmes can achieve the necessary evidence-based practice competencies.

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Established in 2006, the Irish Longitudinal Study on Ageing (TILDA) investigates the health, economic and social circumstances of a nationally-representative sample of people aged fifty years and older in a series of biennial data collection waves. Irish newspapers have been reporting the results of TILDA for over a decade and a half, and their texts represent reports of scientific research distilled through the pen of journalists. In their totality, their texts constitute a public discourse on ageing and health.

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Article Synopsis
  • International policy emphasizes interdisciplinary teamwork as essential for integrating health and social care for older individuals, moving care from hospitals to community settings.
  • The National Clinical Programme for Older People in Ireland is crucial in designing the National Older Person's Service Model, which includes specialized Community Specialist Teams (CST-OPs) focused on this new care delivery approach.
  • A realist evaluation will assess and enhance interprofessional collaboration competencies in CST-OPs, informing curriculum development and providing insights for healthcare leaders on necessary resources for effective care integration.
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Article Synopsis
  • - Supported decision-making (ADM) focuses on helping people with disabilities, especially older individuals with cognitive impairments, make health and social care choices equitably, challenging existing power dynamics in healthcare settings.
  • - The study uses a critical hermeneutic approach, gathering qualitative insights from health and social care professionals, older patients, and family carers to understand their experiences with ADM.
  • - Results highlight three themes: the concentration of power within medical teams, biases towards those with cognitive competence, and the struggle to balance patient autonomy with a risk-averse care culture in acute settings, indicating the need for cultural changes in decision-making practices.
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Meaningful and inclusive involvement of all people affected by research in the design, management and dissemination of that research requires skills, time, flexibility and resources. There continue to be research practices that create implicit and explicit exclusion of some members of the public who may be 'seldom heard' or 'frequently ignored'. Our focus is particularly on the involvement of people living with cognitive impairment, including people with one of the many forms of dementia and people with learning disabilities.

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Current evidence offers little guidance as to how interprofessional collaboration can be fostered within the context of integrated care and older people. This research describes the co-design of core competencies for interprofessional collaboration within integrated care teams for older people and the development of practical guidance to support teams in building proficiency. Using a co-design approach, we conducted three studies (co-design workshops, qualitative interviews, and an online validation forum), the combined output of which is a Core Competency Framework, that includes three domains describing six competencies for proficiency in interprofessional collaboration within integrated care of older people.

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Problem: Sexual and gender minority (SGM) people face multiple health disparities. Clinicians often lack adequate training to address health needs of SGM people. In this setting, some health care organizations have sought to develop system-wide curricula to build clinician knowledge and capacity around SGM health.

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Formal assessments of cognition that rely on language may conceal the non-linguistic cognitive function of people with aphasia. This may have detrimental consequences for how people with aphasia are supported to reveal communicative and decision-making competence. This case report demonstrates a multidisciplinary team approach to supporting the health and social care decision-making of people with aphasia.

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Shared decision-making (SDM) is a dialogical relationship where the physician and the patient define the problem, discuss the available options according to the patient's values and preferences, and co-construct the treatment plan. Undertaking SDM in a clinical setting with patients who have limited, impaired or fluctuating cognitive capacity may prove challenging. Supported (defined "Assisted" in the Irish context) decision-making describes how people with impaired or fluctuating capacity remain in control of their healthcare-related choices through mechanisms which build and maximise capacity.

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Background: Global health care policy and regulatory requirements indicate that nursing students must be prepared for person-centred practice. Despite this, there is no evidence of a theoretically derived instrument to measure students' perceptions of person-centred practice.

Objectives: To adapt the Person-centred Practice Inventory-Staff instrument for use with healthcare students and to test the adapted instrument.

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Article Synopsis
  • There is a growing emphasis on a human rights-based approach to assisted decision-making (ADM) for older people in Ireland, supported by legislative changes that empower their participation in care planning.
  • The study explored the experiences of Health and Social Care Professionals (HSCPs) regarding ADM in acute hospitals, identifying key barriers and enablers through 26 interviews.
  • Findings revealed a gap between policy and practice in ADM, highlighting the need for better education and training for HSCPs to effectively implement ADM principles.
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Health and social care staff have had to quickly adapt, respond and improve teamwork, as a response to the COVID-19 pandemic. Our objective was to rapidly summarize the emerging evidence of new ways of working in the care of older people during this period. We conducted an exploration of the emerging evidence within the timeframe of 1 March 2020 to 11 May 2020.

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Article Synopsis
  • - The National Integrated Care Programme for Older People (NICPOP) aims to help older adults live independently by improving healthcare services tailored to their complex needs through integrated care between hospital and community settings.
  • - The ECLECTIC project, in partnership with NICPOP, will create a framework to support interprofessional collaboration among healthcare teams that serve older people, focusing on necessary skills and teamwork across care settings.
  • - The project's three phases involve defining collaboration competencies, implementing a leadership intervention for multidisciplinary teams, and analyzing data to refine the framework for future collaboration in elderly care.
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Article Synopsis
  • The UCD PPI Ignite program aims to integrate public and patient involvement in health-related research and education, focusing on challenges faced during the early stages of research projects.
  • A full-day workshop was held with diverse participants to establish a values-based approach for PPI projects, leading to the agreement on a set of core values.
  • Four key values were identified—respect, openness, reciprocity, and flexibility—highlighting the importance of authentic partnership and transparency, especially regarding funding uncertainties.
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Objective: The Assisted Decision-Making (ADM) (Capacity) Act was enacted in 2015 in Ireland and will be commenced in 2021. This paper is focused on this pre-implementation stage within the acute setting and uses a health systems responsiveness framework.

Methods: We conducted face-to-face interviews using a critical incident technique.

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Article Synopsis
  • The United Nations Convention on the Rights of Persons with Disabilities affirms the legal right to decision-making support for individuals with disabilities, which is ratified in Ireland by the Assisted Decision-Making (Capacity) Act (2015), although its main provisions are not yet in effect.
  • A Rapid Realist Review was conducted to identify the mechanisms facilitating the incorporation of Assisted Decision Making (ADM) by healthcare professionals, involving collaboration with stakeholders and iterative refinement of Programme Theory through discussions and literature analysis.
  • The study identified four key domains essential for successful ADM implementation: Personalisation of Health & ADM Service Provision, Culture & Leadership, Environmental & Social Re-structuring, and Education, Training & Enablement.
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Background: Although not an inevitable part of ageing, frailty is an increasingly common condition in older people. Frail older patients are particularly vulnerable to the adverse effects of hospitalisation, including deconditioning, immobility and loss of independence (Chong et al, J Am Med Dir Assoc 18:638.e7-638.

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: Frailty is the age-accelerated decline across multiple organ systems which leads to vulnerability to poor resolution of homeostasis after a stressor event. This loss of reserve means that a minor illness can result in a disproportionate loss of functional ability. Improving acute care for frail older patients is now a national priority and an important aspect of the National Programme for Older People in Ireland.

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Older adults have reduced sleep quality compared with younger adults when sleeping at habitual times and greater sleep disruption when their sleep is at adverse times. The purpose of this analysis was to investigate how subjective measures of sleep relate to objectively recorded sleep in older subjects scheduled to sleep at all times of day. We analyzed data from 24 healthy older (55-74 years) subjects who took part in a 32-day inpatient study where polysomnography was recorded each night and subjective sleep was assessed after each scheduled wake time.

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Several studies have implicated the dopamine transporter gene (DAT1) as conferring susceptibility to attention deficit hyperactivity disorder (ADHD), in particular, a VNTR situated at the 3' end of the gene. In addition, the 10-repeat VNTR allele associated with ADHD has been reported to be associated with an over-active transporter protein (DAT). Thus children possessing this variant might be particularly responsive to methylphenidate, a drug known to act by blocking DAT.

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