Assessing What Matters Most in Older Adults With Multicomplexity
Abstract Background and Objectives Abilities and activities that are often simultaneously valued may not be simultaneously achievable for older adults with multicomplexity. Because of this, the Geriatrics 5Ms framework prioritizes care on “what matters most.” This study aimed to evaluate and refine...
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| Veröffentlicht in: | The Gerontologist 2022-04, Vol.62 (4), p.e224-e234 |
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| container_title | The Gerontologist |
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| creator | Moye, Jennifer Driver, Jane A Owsiany, Montgomery T Chen, Li Qing Whitley, Jessica Cruz Auguste, Elizabeth J Paik, Julie M |
| description | Abstract
Background and Objectives
Abilities and activities that are often simultaneously valued may not be simultaneously achievable for older adults with multicomplexity. Because of this, the Geriatrics 5Ms framework prioritizes care on “what matters most.” This study aimed to evaluate and refine the What Matters Most—Structured Tool (WMM-ST).
Research Design and Methods
About 105 older adults with an average of 4 chronic conditions completed the WMM-ST along with open-ended questions from the Serious Illness Conversation Guide. Participants also provided demographic and social information, completed cognitive screening with the Telephone-Montreal Cognitive Assessment-Short and frailty screening with the Frail scale. Quantitative and qualitative analyses aimed to (a) describe values; (b) evaluate the association of patient characteristics with values; and (c) assess validity via the tool’s acceptability, educational bias, and content accuracy.
Results
Older adults varied in what matters most. Ratings demonstrated modest associations with social support, religiosity, cognition, and frailty, but not with age or education. The WMM-ST was rated as understandable (86%) and applicable to their current situation (61%) independent of education. Qualitative analyses supported the content validity of WMM-ST, while revealing additional content.
Discussion and Implications
It is possible to assess what matters most to older adults with multicomplexity using a structured tool. Such tools may be useful in making an abstract process clearer but require further validation in diverse samples. |
| doi_str_mv | 10.1093/geront/gnab071 |
| format | Article |
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Background and Objectives
Abilities and activities that are often simultaneously valued may not be simultaneously achievable for older adults with multicomplexity. Because of this, the Geriatrics 5Ms framework prioritizes care on “what matters most.” This study aimed to evaluate and refine the What Matters Most—Structured Tool (WMM-ST).
Research Design and Methods
About 105 older adults with an average of 4 chronic conditions completed the WMM-ST along with open-ended questions from the Serious Illness Conversation Guide. Participants also provided demographic and social information, completed cognitive screening with the Telephone-Montreal Cognitive Assessment-Short and frailty screening with the Frail scale. Quantitative and qualitative analyses aimed to (a) describe values; (b) evaluate the association of patient characteristics with values; and (c) assess validity via the tool’s acceptability, educational bias, and content accuracy.
Results
Older adults varied in what matters most. Ratings demonstrated modest associations with social support, religiosity, cognition, and frailty, but not with age or education. The WMM-ST was rated as understandable (86%) and applicable to their current situation (61%) independent of education. Qualitative analyses supported the content validity of WMM-ST, while revealing additional content.
Discussion and Implications
It is possible to assess what matters most to older adults with multicomplexity using a structured tool. Such tools may be useful in making an abstract process clearer but require further validation in diverse samples.</description><identifier>ISSN: 0016-9013</identifier><identifier>EISSN: 1758-5341</identifier><identifier>DOI: 10.1093/geront/gnab071</identifier><identifier>PMID: 34043004</identifier><language>eng</language><publisher>US: Oxford University Press</publisher><subject>Aged ; Cognition ; Comorbidity ; Evaluation ; Frail Elderly ; Frailty ; Frailty - diagnosis ; Geriatric Assessment ; Geriatrics ; Geriatrics - education ; Humans ; Mental Status and Dementia Tests ; Older people ; Qualitative research ; Religiosity ; Social learning ; Social support ; Tests</subject><ispartof>The Gerontologist, 2022-04, Vol.62 (4), p.e224-e234</ispartof><rights>Published by Oxford University Press on behalf of The Gerontological Society of America 2021. 2021</rights><rights>Published by Oxford University Press on behalf of The Gerontological Society of America 2021.</rights><rights>Copyright Oxford University Press May 2022</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c452t-d721c63c294f56d26c925d6a75ef33425737b04c9ad68b506f6b045847a632d33</citedby><cites>FETCH-LOGICAL-c452t-d721c63c294f56d26c925d6a75ef33425737b04c9ad68b506f6b045847a632d33</cites><orcidid>0000-0002-3434-347X</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,780,784,885,1584,27924,27925,33774</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34043004$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Meeks, Suzanne</contributor><creatorcontrib>Moye, Jennifer</creatorcontrib><creatorcontrib>Driver, Jane A</creatorcontrib><creatorcontrib>Owsiany, Montgomery T</creatorcontrib><creatorcontrib>Chen, Li Qing</creatorcontrib><creatorcontrib>Whitley, Jessica Cruz</creatorcontrib><creatorcontrib>Auguste, Elizabeth J</creatorcontrib><creatorcontrib>Paik, Julie M</creatorcontrib><title>Assessing What Matters Most in Older Adults With Multicomplexity</title><title>The Gerontologist</title><addtitle>Gerontologist</addtitle><description>Abstract
Background and Objectives
Abilities and activities that are often simultaneously valued may not be simultaneously achievable for older adults with multicomplexity. Because of this, the Geriatrics 5Ms framework prioritizes care on “what matters most.” This study aimed to evaluate and refine the What Matters Most—Structured Tool (WMM-ST).
Research Design and Methods
About 105 older adults with an average of 4 chronic conditions completed the WMM-ST along with open-ended questions from the Serious Illness Conversation Guide. Participants also provided demographic and social information, completed cognitive screening with the Telephone-Montreal Cognitive Assessment-Short and frailty screening with the Frail scale. Quantitative and qualitative analyses aimed to (a) describe values; (b) evaluate the association of patient characteristics with values; and (c) assess validity via the tool’s acceptability, educational bias, and content accuracy.
Results
Older adults varied in what matters most. Ratings demonstrated modest associations with social support, religiosity, cognition, and frailty, but not with age or education. The WMM-ST was rated as understandable (86%) and applicable to their current situation (61%) independent of education. Qualitative analyses supported the content validity of WMM-ST, while revealing additional content.
Discussion and Implications
It is possible to assess what matters most to older adults with multicomplexity using a structured tool. Such tools may be useful in making an abstract process clearer but require further validation in diverse samples.</description><subject>Aged</subject><subject>Cognition</subject><subject>Comorbidity</subject><subject>Evaluation</subject><subject>Frail Elderly</subject><subject>Frailty</subject><subject>Frailty - diagnosis</subject><subject>Geriatric Assessment</subject><subject>Geriatrics</subject><subject>Geriatrics - education</subject><subject>Humans</subject><subject>Mental Status and Dementia Tests</subject><subject>Older people</subject><subject>Qualitative research</subject><subject>Religiosity</subject><subject>Social learning</subject><subject>Social support</subject><subject>Tests</subject><issn>0016-9013</issn><issn>1758-5341</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BHHNA</sourceid><recordid>eNqFkctLAzEQxoMoWh9Xj7LgRQ-rSSaP3YtYxBdYelE8hjSbbSPbTU2yov-9K61FvXiaGeY3H_PxIXRI8BnBJZxPbfBtOp-2eoIl2UADInmRc2BkEw0wJiIvMYEdtBvjC-5nSuU22gGGGWDMBuhyGKON0bXT7HmmUzbSKdkQs5GPKXNtNm4qG7Jh1TUpZs8uzbJR3zrj54vGvrv0sY-2at1Ee7Cqe-jp5vrx6i5_GN_eXw0fcsM4TXklKTECDC1ZzUVFhSkpr4SW3NYAjHIJcoKZKXUlignHohb9yAsmtQBaAeyhi6XuopvMbWVsm4Ju1CK4uQ4fymunfm9aN1NT_6aKsqAAuBc4WQkE_9rZmNTcRWObRrfWd1FRDgAECP1Cj_-gL74LbW9PUcFLUUomip46W1Im-BiDrdfPEKy-wlHLcNQqnP7g6KeFNf6dRg-cLgHfLf4T-wSG5pp3</recordid><startdate>20220420</startdate><enddate>20220420</enddate><creator>Moye, Jennifer</creator><creator>Driver, Jane A</creator><creator>Owsiany, Montgomery T</creator><creator>Chen, Li Qing</creator><creator>Whitley, Jessica Cruz</creator><creator>Auguste, Elizabeth J</creator><creator>Paik, Julie M</creator><general>Oxford University Press</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7U3</scope><scope>7U4</scope><scope>ASE</scope><scope>BHHNA</scope><scope>DWI</scope><scope>FPQ</scope><scope>K6X</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>WZK</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-3434-347X</orcidid></search><sort><creationdate>20220420</creationdate><title>Assessing What Matters Most in Older Adults With Multicomplexity</title><author>Moye, Jennifer ; Driver, Jane A ; Owsiany, Montgomery T ; Chen, Li Qing ; Whitley, Jessica Cruz ; Auguste, Elizabeth J ; Paik, Julie M</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c452t-d721c63c294f56d26c925d6a75ef33425737b04c9ad68b506f6b045847a632d33</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Aged</topic><topic>Cognition</topic><topic>Comorbidity</topic><topic>Evaluation</topic><topic>Frail Elderly</topic><topic>Frailty</topic><topic>Frailty - diagnosis</topic><topic>Geriatric Assessment</topic><topic>Geriatrics</topic><topic>Geriatrics - education</topic><topic>Humans</topic><topic>Mental Status and Dementia Tests</topic><topic>Older people</topic><topic>Qualitative research</topic><topic>Religiosity</topic><topic>Social learning</topic><topic>Social support</topic><topic>Tests</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Moye, Jennifer</creatorcontrib><creatorcontrib>Driver, Jane A</creatorcontrib><creatorcontrib>Owsiany, Montgomery T</creatorcontrib><creatorcontrib>Chen, Li Qing</creatorcontrib><creatorcontrib>Whitley, Jessica Cruz</creatorcontrib><creatorcontrib>Auguste, Elizabeth J</creatorcontrib><creatorcontrib>Paik, Julie M</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Social Services Abstracts</collection><collection>Sociological Abstracts (pre-2017)</collection><collection>British Nursing Index</collection><collection>Sociological Abstracts</collection><collection>Sociological Abstracts</collection><collection>British Nursing Index (BNI) (1985 to Present)</collection><collection>British Nursing Index</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>Sociological Abstracts (Ovid)</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>The Gerontologist</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Moye, Jennifer</au><au>Driver, Jane A</au><au>Owsiany, Montgomery T</au><au>Chen, Li Qing</au><au>Whitley, Jessica Cruz</au><au>Auguste, Elizabeth J</au><au>Paik, Julie M</au><au>Meeks, Suzanne</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Assessing What Matters Most in Older Adults With Multicomplexity</atitle><jtitle>The Gerontologist</jtitle><addtitle>Gerontologist</addtitle><date>2022-04-20</date><risdate>2022</risdate><volume>62</volume><issue>4</issue><spage>e224</spage><epage>e234</epage><pages>e224-e234</pages><issn>0016-9013</issn><eissn>1758-5341</eissn><abstract>Abstract
Background and Objectives
Abilities and activities that are often simultaneously valued may not be simultaneously achievable for older adults with multicomplexity. Because of this, the Geriatrics 5Ms framework prioritizes care on “what matters most.” This study aimed to evaluate and refine the What Matters Most—Structured Tool (WMM-ST).
Research Design and Methods
About 105 older adults with an average of 4 chronic conditions completed the WMM-ST along with open-ended questions from the Serious Illness Conversation Guide. Participants also provided demographic and social information, completed cognitive screening with the Telephone-Montreal Cognitive Assessment-Short and frailty screening with the Frail scale. Quantitative and qualitative analyses aimed to (a) describe values; (b) evaluate the association of patient characteristics with values; and (c) assess validity via the tool’s acceptability, educational bias, and content accuracy.
Results
Older adults varied in what matters most. Ratings demonstrated modest associations with social support, religiosity, cognition, and frailty, but not with age or education. The WMM-ST was rated as understandable (86%) and applicable to their current situation (61%) independent of education. Qualitative analyses supported the content validity of WMM-ST, while revealing additional content.
Discussion and Implications
It is possible to assess what matters most to older adults with multicomplexity using a structured tool. Such tools may be useful in making an abstract process clearer but require further validation in diverse samples.</abstract><cop>US</cop><pub>Oxford University Press</pub><pmid>34043004</pmid><doi>10.1093/geront/gnab071</doi><orcidid>https://orcid.org/0000-0002-3434-347X</orcidid><oa>free_for_read</oa></addata></record> |
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| ispartof | The Gerontologist, 2022-04, Vol.62 (4), p.e224-e234 |
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| source | MEDLINE; Sociological Abstracts; Oxford University Press Journals All Titles (1996-Current); Alma/SFX Local Collection |
| subjects | Aged Cognition Comorbidity Evaluation Frail Elderly Frailty Frailty - diagnosis Geriatric Assessment Geriatrics Geriatrics - education Humans Mental Status and Dementia Tests Older people Qualitative research Religiosity Social learning Social support Tests |
| title | Assessing What Matters Most in Older Adults With Multicomplexity |
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