Understanding old age and victimisation: a critical exploration

Editorial: Welcome to the <i>International Journal of Older People Nursing</i>

This paper is a report of a study of the experiences of older people living with a long-term urinary catheter and the development of a substantive theory grounded in their realities. Understanding the user perspective is a prerequisite for involving older people in a collaborative relationship with healthcare professionals which is built around their needs and wishes. Older people's views and experiences of the complexity of living with a long-term catheter have not been widely researched. An enhanced understanding of catheter users' perspectives and an awareness of their needs can be used to improve care. A grounded theory approach was adopted and 20 in-depth interviews were carried out in England in 2005 and 2006 with 13 older people living at home with long-term urinary catheters. The core category 'all about acceptance' described older people's adjustment to living with a long-term urinary catheter; the two categories 'at ease' and 'uneasy' reflect the extremes of contentment experienced. Three interlinking categories of 'trying to understand', 'judging catheter performance' and 'being aware of the catheter' shaped older people's relationships with their catheters and this was mediated by their 'interaction with others'. The consequences for older people fluctuated along a continuum from 'engaging actively' to experiencing 'downbeat sentiments'. To assist older people to adjust to living with a catheter, healthcare professionals must be sensitive to their life situations and individual needs rather than focusing predominantly on catheter performance and complications.

Aim To report on the experiences of using software (Qualitative Assessment and Review Instrument (QARI)) specifically designed to synthesise qualitative research studies. Background The synthesis of qualitative research using a systematic review process is somewhat contentious and at present a variety of approaches exists. One approach is the QARI tool from the Joanna Briggs Institute (JBI) which provides a structured process to qualitative synthesis for appraising, extracting and synthesizing qualitative research that is considered more aggregative than interpretative. The process shares similarities with the methods of quantitative systematic review although the analysis stage is grounded in qualitative methodology. QARI provides a means for accumulating and synthesizing qualitative-based knowledge on the view and experiences of healthcare users and staff that can be used alongside systematic reviews of effectiveness to supply information on barriers and facilitators to adopting an intervention. The synthesis of qualitative research on older people's experiences of falls is used as the focus in this paper. Conclusions In common with other qualitative synthesis methodologies, there remain important areas for debate. These relate to the process and outcomes of: quality assessment, extracting findings from primary studies, the creation of categories (themes, metaphors), the expression of the synthesis and the credibility of an iterative review process.

To explore older people's initial experience of household isolation, social distancing and shielding, and the plans they constructed to support them through the COVID-19 pandemic. Public health guidance for those aged 70 or older was predominantly to undertake stringent social distancing within their household. Little is known about older people's experience of these measures. This paper explores changes experienced by those over the age of 70 during the first two weeks of household isolation, social distancing and shielding in the UK and the Republic of Ireland, and their early perceptions and plans to support them through the pandemic. An inductive phenomenological study. University staff posted the study invitation flyer on social media, such as WhatsApp neighbourhood groups, the Nextdoor App and Twitter. Qualitative semi-structured interviews were undertaken with 19 participants and repeated at 2-week intervals for 10weeks; further data collection is still in progress. This paper presents the findings from the baseline interviews, which showed older peoples' early responses. The COREQ (COnsolidated criteria for REporting Qualitative research) checklist was adhered to in the reporting of this study. Three themes emerged from older people's early experiences of social distancing: protective measures; current and future plans; and acceptance of a good life, but still a life to live. People over 70 adapted to household isolation, social distancing and shielding, by using social media and neighbourhood resources. Nurses and other professionals can develop holistic care for older people by listening to their experiences of what works for them, helping them link to local and distant supports. Understanding the holistic life view of older people, including death anxiety, is an important element of care planning; to help older people access the protective resources, they need to reduce the serious risks associated with coronavirus. Older people engage with social media, and during the current pandemic and beyond nurses can engage with this medium to communicate with older people. The importance of nurses to understand some older people consider quality of life to be more important than longevity, which may impact on their adherence to health advice.

Older people's views of prioritization in health care. The applicability of an interview study. Old age has been stated as a criterion for prioritization in health care, although older people are seldom asked for their opinions. The aim of this pilot study was to investigate the applicability of a questionnaire as a base for an interview study to explore older people's experiences and views of prioritization in health care. Descriptive, with a qualitative and quantitative approach. Fifty-four persons, 32 women and 22 men (aged 60-93 years), were asked to participate in a structured, tape-recorded interview covering their experience and views of the priorities applied in health care. The questions in the interview manual appeared to be applicable for collecting data concerning views of prioritization, but the analysis revealed that certain questions, particularly on economic matters, were missing. The procedure, a personal structured interview had advantages, for example, in capturing the respondents' reflections on the questions. The respondents emphasized the equal value of all human beings and that age is not a basis for prioritization within health care. The respondents also showed an unwillingness to precede anyone in rank. The questions used proved to be adequate but to be really complete further questions need to be added. This pilot study indicates that older people's views on priorities in health care differ from those expressed by the younger population. The study therefore needs to be replicated in a larger sample to be fully able to understand older people's views of prioritization, which will require exploring gender and age differences as well as other aspects that may explain variations.

Resilience from the point of view of older people: ‘There's still life beyond a funny knee’

To explore older people's experiences of registered nurses' leadership close to them in community home care. In Sweden and throughout the world, the number of people 65years and older is increasing. While older people are living for more years, living longer can bring more diseases and disabilities, which might lead to the need for home care. Registered nurses are responsible for older people's care needs in their leadership in community home care; this is a part of their professional role as registered nurses, and it implies that they must be multi-artists. An explorative and inductive design was used in two communities in western Sweden. Individual interviews were conducted with older people (n=12) with at least one year of experience with community home care. Data were analysed using qualitative content analysis. The results are presented in the theme 'my registered nurse', including five categories - relationship, professional competence, nursing interventions, coordination and collaboration and organisation - and 15sub-categories. These findings are based on older people's own experiences. This is specific, as the phenomenon of the RNs leadership is rarely explored from the perspective of older people. There is a need for organisations to create more opportunities for older people to have their own registered nurses leading close to them. This is because registered nurses have specific competences for meeting older people's individual needs and involving them as competent partners in satisfying their care needs.

This article explores the temporalities experienced by persons aged 70 years and over during the first months of the COVID-19 pandemic in Finland. Although the temporalities of the pandemic have been analysed from multiple perspectives, we contribute to this line of research in two ways. First, we show how deeply the pandemic affected older people's experiences of temporality. Second, we further develop the concept of forced present to highlight the consequences that the restriction measures had on older persons’ situations and perceptions of temporality. More specifically, we asked the following question: How did older people perceive time (past, present and future) during the pandemic? We used thematic analysis to examine a dataset consisting of written letters (N = 77) collected between April and June 2020. The findings showed that social isolation forced older people to live in the present without being able to plan their near future because they had no knowledge of when they would be ‘free’ again, which made some participants feel anxious and depressed. Furthermore, we found that the present became intertwined with the personal past as well as with the collective past, as evidenced by participants’ descriptions of war, previous pandemics and hardships. This article deepens our understanding of older people's everyday lives during the pandemic and highlights the problematic nature of social isolation of older people as a safety measure. Overall, this article reveals the particularity of older people's experiences in unequal pandemic times and the ageism inherent in the restriction measures.

A systematic review was undertaken of qualitative and quantitative studies and reviews that focus on older people's views and experiences of falls prevention. The review was undertaken to provide an additional dimension to the clinical effectiveness evidence provided by a Cochrane review on falls prevention (Gillespie et al. 2003) to inform the development of a national guideline on falls prevention in older people. As guideline recommendations or policies relating to preventive strategies have the potential to increase health care costs, it is important that all sources of evidence are reviewed by guideline development groups so that an understanding is achieved of the acceptability and sustainability of interventions in relation to different groups and settings. Accordingly, this review examined the literature on the views, preferences, and experiences of older people in relation to falls prevention strategies. Twenty-four studies meeting the inclusion criteria were critically reviewed and were then summarized into evidence tables. The key facilitators and barriers to participation in falls prevention programs were derived from the commonly occurring and consistent themes arising from the reviewed studies. The implications of these findings for the clinical effectiveness review conclusions were then taken into account. Several important findings emerged. These included preferences for falls prevention strategies not involving behaviour change among some groups, the need to promote the social value of falls prevention programs, and the importance of identifying and addressing factors associated with activity avoidance. In terms of the impact of these findings on the Cochrane review, the most important implication is that although trials of multifactorial falls prevention packages have reported beneficial results, in clinical practice it is important to consult with individual potential participants and find out what characteristics they are willing to modify, and what changes they are prepared to make to reduce their risk of falling. Otherwise, there is the risk that expensive programs are not properly targeted or fail to achieve maximum participation rates. Further work on the most robust and pragmatic methods of synthesizing disparate studies on patients' views and preferences to inform evidence-based guideline recommendations is needed.

Information about health is gained from various sources but little is known about the health information-seeking behaviours of older people and what factors affect this. This pilot study aimed to explore older people's experiences and views on their health information-seeking behaviours and to gain a better understanding of these. A qualitative study with nine older people was undertaken, using diaries and semi-structured interviews to gather data. Three key themes emerged relating to why they sought information, what shaped this and where health information was accessed. This study is generating new knowledge of older people's experiences and views on their health information-seeking behaviour. By understanding these, community nurses will be better placed to promote strategies that improve older people's access to appropriate health information and support its effective use.

Information about health is gained from various sources, but little is known about the health information-seeking behaviours of older people and what factors affect this. This pilot study aimed to explore older people's experiences and views on their health information-seeking behaviours and to gain a better understanding of these. A qualitative study with 9 older people was undertaken, using diaries and semi-structured interviews to gather data. Three key themes emerged relating to why they sought information, what shaped this and where health information was accessed. This study is generating fresh knowledge of older people's experiences and views on health information-seeking behaviour. By understanding these, health professionals will be better placed to promote strategies that improve older people's access to appropriate health information and support its effective use.

Information about health is gained from various sources but little is known about the health information-seeking behaviours of older people and what factors affect this. This pilot study aimed to explore older people's experiences and views on their health information-seeking behaviours and to gain a better understanding of these. A qualitative study with nine older people was undertaken, using diaries and semi-structured interviews to gather data. Three key themes emerged relating to why they sought information, what shaped this and where health information was accessed. This study is generating new knowledge of older people's experiences and views on their health information-seeking behaviour. By understanding these, community nurses will be better placed to promote strategies that improve older people's access to appropriate health information and support its effective use.

Older people's experiences in acute care settings: Systematic review and synthesis of qualitative studies

Commentary on Tse MMY, Pun SPY &amp; Benzie IFF (2005) Pain relief strategies used by the older people with chronic pain: an exploratory survey for planning patient‐centred intervention. <i>Journal of Clinical Nursing</i> 14, 315–320

PurposeThis study aims to explore the experiences of older people “ageing in place”, focussing on the implementation of “Circles of Support”, a pilot intervention aimed at mitigating the risk of hospitalisation amongst socially-isolated older people.Design/methodology/approachThe study draws on qualitative research, taking in semi-structured interviews with participants in the intervention and with community networkers involved in delivering the programme.FindingsThe research provides indicative findings supporting the idea that social isolation is linked to health issues amongst older people. It also suggests that targeted interventions can go some way to mitigating this problem. The findings presented here also indicate the importance of a deeper understanding of the lived experiences of socially-isolated older people in designing and delivering interventions.Originality/valueThe study contribution is in three areas. It presents findings based on the pilot programme relating to the experiences of older people at risk of social isolation and provides an indication of the value of interventions aimed at tackling social isolation, connecting these to the risk of hospitalisation.