PMID- 30709345
OWN - NLM
STAT- MEDLINE
DCOM- 20190325
LR  - 20231005
IS  - 1472-6963 (Electronic)
IS  - 1472-6963 (Linking)
VI  - 19
IP  - 1
DP  - 2019 Feb 1
TI  - Influences on the access to and use of formal community care by people with 
      dementia and their informal caregivers: a scoping review.
PG  - 88
LID - 10.1186/s12913-018-3825-z [doi]
LID - 88
AB  - BACKGROUND: The literature describes the obstacles to sufficient care faced by 
      people with dementia and their informal caregivers. Although factors influencing 
      access and utilisation are frequently studied, the body of knowledge lacks an 
      overview of aspects related to influence. The frequently used Behavioural Model 
      of Health Care Use (BM) could be used to structure and explain these aspects. An 
      adaptation of the BM emphasises psychosocial influences and appears to enrich the 
      understanding of the use of long-term care for dementia. METHODS: We conducted a 
      scoping review with the aim of providing an overview of the aspects influencing 
      the access to and utilisation of formal community care in dementia. Our search 
      covered the PubMed, CINAHL, Social Science Citation Index and PsychInfo 
      databases, as well as grey literature. Two researchers assessed the full texts 
      for eligibility. A data extraction form was developed and tested. We analysed the 
      main topics investigated by the studies and mapped and described the investigated 
      psychosocial aspects according to the BM after narratively summarising the 
      findings. We used the Mixed Method Appraisal Tool (MMAT) to critically appraise 
      the included studies. RESULTS: A total of 94 studies were included: n = 55 with 
      quantitative designs, 35 with qualitative designs and four with mixed methods. 
      The studies investigated different services, mainly focusing on health care 
      services. One third of the studies provided information regarding the severity of 
      dementia. The most frequently investigated main topics were ethnicity and 
      attitudes towards services. Psychosocial aspects were frequently investigated, 
      although few studies considered the perspectives of people with dementia. 
      Approximately half of the studies reported a theoretical framework. The adapted 
      BM facilitated the structuring and description of psychosocial aspects. However, 
      this instrument did not address topics beyond the scope of psychosocial aspects, 
      such as sociodemographic characteristics. CONCLUSIONS: The access to and 
      utilisation of formal community care for dementia can only be partly explained by 
      individual influencing aspects. Therefore, a theoretical framework would likely 
      help to describe this complex subject. Our findings indicate that the 
      psychosocial categories of the adapted BM enriched the original BM, and that 
      people with dementia should more often be included in healthcare service research 
      to ensure a better understanding of the barriers to accessing formal community 
      care.
FAU - Bieber, Anja
AU  - Bieber A
AUID- ORCID: 0000-0002-9506-2532
AD  - Institute of Health and Nursing Sciences, Martin Luther University 
      Halle-Wittenberg, Halle (Saale), Germany. anja.bieber@medizin.uni-halle.de.
FAU - Nguyen, Natalie
AU  - Nguyen N
AD  - Institute of Health and Nursing Sciences, Martin Luther University 
      Halle-Wittenberg, Halle (Saale), Germany.
FAU - Meyer, Gabriele
AU  - Meyer G
AD  - Institute of Health and Nursing Sciences, Martin Luther University 
      Halle-Wittenberg, Halle (Saale), Germany.
FAU - Stephan, Astrid
AU  - Stephan A
AD  - Institute of Health and Nursing Sciences, Martin Luther University 
      Halle-Wittenberg, Halle (Saale), Germany.
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20190201
PL  - England
TA  - BMC Health Serv Res
JT  - BMC health services research
JID - 101088677
SB  - IM
MH  - Attitude to Health
MH  - Caregivers/psychology/*statistics & numerical data
MH  - Community Health Services/*statistics & numerical data
MH  - Dementia/ethnology/*therapy
MH  - Facilities and Services Utilization
MH  - Female
MH  - Health Services Accessibility/*statistics & numerical data
MH  - Humans
MH  - Male
MH  - Research Design
PMC - PMC6359781
OTO - NOTNLM
OT  - Access
OT  - Community care
OT  - Dementia
OT  - Influencing aspects
OT  - Utilisation
COIS- ETHICS APPROVAL AND CONSENT TO PARTICIPATE: Not applicable (review). CONSENT FOR 
      PUBLICATION: Not applicable. COMPETING INTERESTS: The authors declare that they 
      have no competing interests. PUBLISHER'S NOTE: Springer Nature remains neutral 
      with regard to jurisdictional claims in published maps and institutional 
      affiliations.
EDAT- 2019/02/03 06:00
MHDA- 2019/03/26 06:00
PMCR- 2019/02/01
CRDT- 2019/02/03 06:00
PHST- 2017/12/30 00:00 [received]
PHST- 2018/12/17 00:00 [accepted]
PHST- 2019/02/03 06:00 [entrez]
PHST- 2019/02/03 06:00 [pubmed]
PHST- 2019/03/26 06:00 [medline]
PHST- 2019/02/01 00:00 [pmc-release]
AID - 10.1186/s12913-018-3825-z [pii]
AID - 3825 [pii]
AID - 10.1186/s12913-018-3825-z [doi]
PST - epublish
SO  - BMC Health Serv Res. 2019 Feb 1;19(1):88. doi: 10.1186/s12913-018-3825-z.