Mapping Research Conducted on Long-Term Care Facilities for Older People in Brazil: A Scoping Review
Abstract
:1. Introduction
- Describe the type and quality of empirical research conducted in Brazilian LTCFs for those aged over 60 years;
- Identify the topic areas of published research;
- Map the regions in Brazil where this research was conducted;
- Identify current knowledge gaps.
2. Methods
Eligibility Criteria
- Were empirical original research published in scientific journals;
- Investigated LTCF residents (older people aged 60 years and above as per/in line with the Brazilian definition of older people), their families, the LTCF workforce (e.g., healthcare professionals, care staff, and management-level staff), or LTCF organizations.
3. Results
3.1. Study Inclusion
3.2. Features of Included Studies
3.3. Characteristics of Included LTCFs
3.4. Research Topic Areas
3.5. Methodological Appraisal
4. Discussion
5. Conclusions and Implications
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Qualitative (n = 67) | Descriptive (n = 82) | Non-Randomized (n = 159) | RCT (n = 6) | Mixed Methods (n = 11) | |
---|---|---|---|---|---|
Publication Date | |||||
1999–2009 | 11 (16.4%) | 19 (23.1%) | 24 (15.1%) | 1 (16.6%) | 5 (45.5%) |
2010–2015 | 42 (62.6%) | 45 (54.9%) | 83 (52.2%) | 1 (16.6%) | 5 (45.5%) |
≥2016 | 14 (20.9%) | 18 (21.9%) | 52 (32.7%) | 4 (66.8%) | 1 (9.0%) |
Language | |||||
English | 6 (8.9%) | 15 (18.3%) | 47 (29.5%) | 1 (16.6%) | 2 (18.2%) |
Portuguese | 46 (68.7%) | 51 (62.2%) | 73 (45.9%) | 3 (50.0%) | 7 (63.6%) |
At least Portuguese/English | 15 (22.4%) | 16 (19.5%) | 39 (24.6%) | 2 (33.4%) | 2 (18.2%) |
Geographic area * | |||||
North | 1 (1.5%) | 0 | 4 (2.5%) | 0 | 0 |
Northeast | 13 (19.4%) | 21 (25.6%) | 32 (20.1%) | 1 (16.6%) | 0 |
South | 29 (43.2%) | 17 (20.7%) | 35 (22.0%) | 3 (50.0%) | 7 (63.6%) |
Southeast | 14 (20.9%) | 34 (41.5%) | 65 (40.9%) | 0 | 4 (36.4%) |
Midwest | 4 (5.9%) | 6 (7.3%) | 16 (10.0%) | 1 (16.6%) | 0 |
≥2 geographic area | 3 (4.5%) | 2 (2.4%) | 3 (1.9%) | 0 | 0 |
NR | 3 (4.5%) | 2 (2.4%) | 4 (2.5%) | 1 (16.6%) | 0 |
1st Author Institution | |||||
Public University | 44 (65.7%) | 59 (71.9%) | 106 (66.7%) | 4 (66.8%) | 6 (54.5%) |
Private University | 19 (28.3%) | 17 (20.7%) | 33 (20.7%) | 2 (33.2%) | 5 (45.5%) |
Health Service | 2 (3.0%) | 2 (2.4%) | 6 (3.8%) | 0 | 0 |
Governmental Agency | 0 | 1 (1.2%) | 1 (0.6%) | 0 | 0 |
Others | 2 (3.0%) | 2 (2.4%) | 1 (0.6%) | 0 | 0 |
NR | 0 | 1 (1.2%) | 2 (1.2%) | 0 | 0 |
Ethical approval † | |||||
Yes | 59 (88.0%) | 64 (78.0%) | 132 (83.0%) | 5 (83.4%) | 8 (72.7%) |
NR | 8 (12.0%) | 18 (22.0%) | 27 (17.0%) | 1 (16.6%) | 3 (27.3%) |
Qualitative (n = 67) | Descriptive (n = 82) | Non-Randomized (n = 159) | RCT (n = 6) | Mixed Methods (n = 11) | |
---|---|---|---|---|---|
Type of setting | |||||
Profit | 2 (3.0%) | 0 | 1 (0.6%) | 0 | 0 |
Non-profit | 32 (47.7%) | 31 (37.8%) | 59 (37.1%) | 3 (50.0%) | 1 (9.0%) |
Both | 12 (17.9%) | 17 (20.7%) | 36 (22.6%) | 0 | 5 (45.5%) |
NR | 21 (31.4%) | 34 (41.5%) | 63 (39.6%) | 3 (50.0%) | 5 (45.5%) |
Setting Location | |||||
Rural | 1 (1.5%) | 0 | 1 (0.6%) | 0 | 0 |
Urban | 43 (64.2%) | 42 (51.2%) | 94 (59.1%) | 2 (33.2%) | 8 (72.7%) |
Both | 0 | 5 (6.1%) | 8 (5.0%) | 0 | 0 |
NR | 23 (34.3%) | 35 (42.7%) | 56 (35.3%) | 4 (66.8%) | 3 (27.2%) |
Number of LTCF | |||||
1 | 46 (68.7%) | 35 (42.1%) | 60 (37.7%) | 3 (50.0%) | 5 (45.5%) |
2–5 | 9 (13.4%) | 19 (22.9%) | 37 (23.2%) | 3 (50.0%) | 1 (9.0%) |
6–10 | 8 (11.9%) | 12 (15.6%) | 25 (15.7%) | 0 | 0 |
≥11 | 3 (4.5%) | 08 (9.7%) | 22 (13.8%) | 0 | 4 (36.5%) |
NR/NA | 1 (1.5%) | 08 (9.7%) | 15 (9.4%) | 0 | 1 (9.0%) |
(Min–Max, mean, median) | (0–52, 3.7, 1) | (1–156, 10.1, 2) | (1–125,6.4, 2) | (1–5, 2.0, 1.5) | (1–52, 14.4, 1) |
Sample composition | |||||
Older adults | 33 (49.2%) | 64 (78.0%) | 133 (83.6%) | 6 (100%) | 5 (45.5%) |
Total (Min–Max, mean, median) | Total = 428 (2–59, 12.9, 10) | Total = 11,358 (1–2184, 177.4, 76) | Total = 22.747 (4–3903, 171.0, 81.0) | Total = 164 (13–37, 27.3, 30) | Total = 204 (8–55, 40.8, 43) |
Family | 1 (1.5%) | 0 | 0 | 0 | 0 |
Total (Min–Max, mean, median) | Total = 6 | ||||
Staff | 19 (28.3%) | 7 (8.5%) | 7 (4.4%) | 0 | 3 (27.2%) |
Total (Min–Max, mean, median) | Total = 337 (7–40, 17.7, 16) | Total = 411 (12–181, 58.7, 38.5) | Total = 459 (22–181, 65.5, 45) | Total = 281 (38–181, 93.6, 62) | |
LTCF characteristics | 3 (4.4%) | 7 (8.5%) | 2 (1.3%) | 0 | 0 |
Total (Min–Max, mean, median) | Total = 59 (1–52, 19.6, 6) | 199 (4–156, 28.4, 7.5) | Total = 80 (29–51, 40.0, 40) | ||
Managers and stakeholders | 3 (4.4%) | 1 (1.2%) | 0 | 0 | |
Total (Min–Max, mean, median) | Total = 18 (5–7, 6.0, 6) | Total = 67 | |||
Older adults × Non-institutionalized older adults | 0 | 2 (2.4%) | 15 (9.4%) | 0 | 1 (9.0%) |
Total (Min–Max, mean, median) | Total = 192 (15–177, 96.0, 96) × Total = 273 (30–243, 136.5, 136.5) | Total = 1180 (14–393, 78.7, 42) × Total = 16,839 (14–598, 112.6, 76) | Total = 30 × Total = 30 | ||
Older adults × Staff | 2 (3.0%) | 1 (1.2%) | 2 (1.3%) | 0 | 2 (18.3%) |
Total (Min–Max, mean, median) | Total = 13 (3–10, 6.5, 6.5) × Total = 25 (9–16, 12.5, 12.5) | Total = 62 × Total = 33 | Total = 57 (11–46, 28.5,28.5) × Total = 40 (15–25, 20.0, 20) | Total = 314 (6–308,157.0, 157) × Total = 50 (7–43, 25.0, 25.0) | |
Older adults × Family | 1 (1.5%) | ||||
Total (Min–Max, mean, median) | Total = 3 × Total = 3 | ||||
Older adults × Managers | 3 (4.4%) | ||||
Total (Min–Max, mean, median) | Total = 27 (8–11, 13.5, 8) × Total = 17 (3–7, 8.5, 7) | ||||
Family × Staff | 1 (1.5%) | ||||
Total (Min–Max, mean, median) | Total = 13 × Total = 19 | ||||
Managers × Staff | 1 (1.5%) | ||||
Total (Min–Max, mean, median) | Total = 20 × Total = 36 |
Screening Questions (for All Types) | Qualitative (n = 67) | |||||||||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Are there clear research questions? | Do the collected data allow to address the research questions? | Is the qualitative approach appropriate to answer the research question? | Are the qualitative data collection methods adequate to address the research question? | Are the findings adequately derived from the data? | Is the interpretation of results sufficiently substantiated by data? | Is there coherence between qualitative data sources, collection, analysis, and interpretation? | ||||||||||||||
Y | N | C | Y | N | C | Y | N | C | Y | N | C | Y | N | C | Y | N | C | Y | N | C |
62 | 5 | - | 53 | 9 | 5 | 56 | 6 | 5 | 38 | 7 | 22 | 40 | 3 | 24 | 37 | 6 | 24 | 37 | 11 | 19 |
Quantitative randomized controlled trials (n = 6) | ||||||||||||||||||||
Is randomization appropriately performed? | Are the groups comparable at baseline? | Are there complete outcome data? | Are outcome assessors blinded to the intervention provided? | Did the participants adhere to the assigned intervention? | ||||||||||||||||
Y | N | C | Y | N | C | Y | N | C | Y | N | C | Y | N | C | Y | N | C | Y | N | C |
6 | - | - | 5 | - | 1 | 1 | 1 | 4 | 4 | - | 2 | 3 | 2 | 1 | 2 | 3 | 1 | 2 | 1 | 3 |
Quantitative non- randomized (n = 159) | ||||||||||||||||||||
Are the participants representative of the target population? | Are measurements appropriate regarding both the outcome and intervention (or exposure)? | Are there complete outcome data? | Are the confounders accounted for in the design and analysis? | During the study period, is the intervention administered (or exposure occurred) as intended? | ||||||||||||||||
Y | N | C | Y | N | C | Y | N | C | Y | N | C | Y | N | C | Y | N | C | Y | N | C |
156 | 3 | - | 140 | 6 | 13 | 57 | 47 | 55 | 120 | 19 | 20 | 126 | 7 | 26 | 56 | 58 | 45 | 120 | 15 | 24 |
Quantitative descriptive (n = 82) | ||||||||||||||||||||
Is the sampling strategy relevant to address the research question? | Is the sample representative of the target population? | Are the measurements appropriate? | Is the risk of nonresponse bias low? | Is the statistical analysis appropriate to answer the research question? | ||||||||||||||||
Y | N | C | Y | N | C | Y | N | C | Y | N | C | Y | N | C | Y | N | C | Y | N | C |
78 | 3 | 1 | 64 | 11 | 7 | 37 | 21 | 24 | 32 | 31 | 19 | 61 | 9 | 12 | 29 | 12 | 41 | 58 | 8 | 16 |
Mixed methods (n = 11) | ||||||||||||||||||||
Is there an adequate rationale for using a mixed methods design to address the research question? | Are the different components of the study effectively integrated to answer the research question? | Are the outputs of the integration of qualitative and quantitative components adequately interpreted? | Are divergences and inconsistencies between quantitative and qualitative results adequately addressed? | Do the different components of the study adhere to the quality criteria of each tradition of the methods involved? | ||||||||||||||||
Y | N | C | Y | N | C | Y | N | C | Y | N | C | Y | N | C | Y | N | C | Y | N | C |
11 | - | - | 7 | 1 | 3 | 7 | 1 | 3 | 6 | 4 | 1 | 6 | 4 | 1 | 3 | 2 | 6 | 6 | 4 | 1 |
Category with most of the studies with YES | ||||||||||||||||||||
Category with most of the studies with NO | ||||||||||||||||||||
Category with most of the studies with CANNOT DETERMINE |
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Wachholz, P.A.; De Oliveira, D.C.; Hinsliff-Smith, K.; Devi, R.; Villas Boas, P.J.F.; Shepherd, V.; Jacinto, A.F.; Watanabe, H.A.W.; Gordon, A.L.; Ricci, N.A. Mapping Research Conducted on Long-Term Care Facilities for Older People in Brazil: A Scoping Review. Int. J. Environ. Res. Public Health 2021, 18, 1522. https://doi.org/10.3390/ijerph18041522
Wachholz PA, De Oliveira DC, Hinsliff-Smith K, Devi R, Villas Boas PJF, Shepherd V, Jacinto AF, Watanabe HAW, Gordon AL, Ricci NA. Mapping Research Conducted on Long-Term Care Facilities for Older People in Brazil: A Scoping Review. International Journal of Environmental Research and Public Health. 2021; 18(4):1522. https://doi.org/10.3390/ijerph18041522
Chicago/Turabian StyleWachholz, Patrick Alexander, Deborah Cristina De Oliveira, Kathryn Hinsliff-Smith, Reena Devi, Paulo José Fortes Villas Boas, Victoria Shepherd, Alessandro Ferrari Jacinto, Helena Akemi Wada Watanabe, Adam Lee Gordon, and Natalia Aquaroni Ricci. 2021. "Mapping Research Conducted on Long-Term Care Facilities for Older People in Brazil: A Scoping Review" International Journal of Environmental Research and Public Health 18, no. 4: 1522. https://doi.org/10.3390/ijerph18041522
APA StyleWachholz, P. A., De Oliveira, D. C., Hinsliff-Smith, K., Devi, R., Villas Boas, P. J. F., Shepherd, V., Jacinto, A. F., Watanabe, H. A. W., Gordon, A. L., & Ricci, N. A. (2021). Mapping Research Conducted on Long-Term Care Facilities for Older People in Brazil: A Scoping Review. International Journal of Environmental Research and Public Health, 18(4), 1522. https://doi.org/10.3390/ijerph18041522