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How to achieve the desired outcomes of advance care planning in nursing homes: a theory of change

Overview of attention for article published in BMC Geriatrics, February 2018
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About this Attention Score

  • In the top 5% of all research outputs scored by Altmetric
  • High Attention Score compared to outputs of the same age (91st percentile)

Mentioned by

blogs
2 blogs
twitter
28 tweeters
facebook
1 Facebook page

Citations

dimensions_citation
35 Dimensions

Readers on

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189 Mendeley
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Title
How to achieve the desired outcomes of advance care planning in nursing homes: a theory of change
Published in
BMC Geriatrics, February 2018
DOI 10.1186/s12877-018-0723-5
Pubmed ID
Authors

J. Gilissen, L. Pivodic, C. Gastmans, R. Vander Stichele, L. Deliens, E. Breuer, L. Van den Block

Abstract

Advance care planning (ACP) has been identified as particularly relevant for nursing home residents, but it remains unclear how or under what circumstances ACP works and can best be implemented in such settings. We aimed to develop a theory that outlines the hypothetical causal pathway of ACP in nursing homes, i.e. what changes are expected, by means of which processes and under what circumstances. The Theory of Change approach is a participatory method of programme design and evaluation whose underlying intention is to improve understanding of how and why a programme works. It results in a Theory of Change map that visually represents how, why and under what circumstances ACP is expected to work in nursing home settings in Belgium. Using this approach, we integrated the results of two workshops with stakeholders (n = 27) with the results of a contextual analysis and a systematic literature review. We identified two long-term outcomes that ACP can achieve: to improve the correspondence between residents’ wishes and the care/treatment they receive and to make sure residents and their family feel involved in planning their future care and are confident their care will be according to their wishes. Besides willingness on the part of nursing home management to implement ACP and act accordingly, other necessary preconditions are identified and put in chronological order. These preconditions serve as precursors to, or requirements for, accomplishing successful ACP. Nine original key intervention components with specific rationales are identified at several levels (resident/family, staff or nursing home) to target the preconditions: selection of a trainer, ensuring engagement by management, training ACP reference persons, in-service education for healthcare staff, information for staff, general practitioners, residents and their family, ACP conversations and documentation, regular reflection sessions, multidisciplinary meetings, and formal monitoring. The Theory of Change map presented here illustrates a theory of how ACP is expected to work in order to achieve its desired long-term outcomes while highlighting organisational factors that potentially facilitate the implementation and sustainability of ACP. We provide the first comprehensive rationale of how ACP is expected to work in nursing homes, something that has been called for repeatedly.

Twitter Demographics

The data shown below were collected from the profiles of 28 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 189 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 189 100%

Demographic breakdown

Readers by professional status Count As %
Student > Master 29 15%
Researcher 24 13%
Student > Ph. D. Student 23 12%
Student > Bachelor 17 9%
Student > Doctoral Student 16 8%
Other 48 25%
Unknown 32 17%
Readers by discipline Count As %
Nursing and Health Professions 51 27%
Medicine and Dentistry 34 18%
Social Sciences 25 13%
Psychology 6 3%
Business, Management and Accounting 4 2%
Other 24 13%
Unknown 45 24%

Attention Score in Context

This research output has an Altmetric Attention Score of 30. 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 10 March 2019.
All research outputs
#901,880
of 18,920,065 outputs
Outputs from BMC Geriatrics
#139
of 2,292 outputs
Outputs of similar age
#24,224
of 289,717 outputs
Outputs of similar age from BMC Geriatrics
#1
of 1 outputs
Altmetric has tracked 18,920,065 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 95th percentile: it's in the top 5% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 2,292 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 10.1. This one has done particularly well, scoring higher than 93% 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 289,717 tracked outputs that were published within six weeks on either side of this one in any source. This one has done particularly well, scoring higher than 91% of its contemporaries.
We're also able to compare this research output to 1 others from the same source and published within six weeks on either side of this one. This one has scored higher than all of them