Table 2 Summary of qualitative findings and CERQual assessments of confidence
Summary of review finding | Contributing studies | Example for data support (original citations from the qualitative studies’ participants) | CERQual assessment of confidence | Explanation of CERQual assessment |
|---|---|---|---|---|
Features of healthcare structures | ||||
1. Older people wish to receive care that fits their individual needs | “It is what they do – they who are the right persons… they do something extra. They have learned to treat us as we want” ([42], p.742) | High | Seventeen studies with no or very minor concerns regarding methodological limitations and adequacy contributed to this review finding. Although there were minor concerns about coherence and relevance, this was only due to a limited number of studies/extent of data | |
2. Older people value being looked after regularly | “The most important is the safety – you know, that someone cares and looks after you and checks that the head is still functioning; that is very reassuring. And knowing you are within the municipality’s system” ([48], p. 704) | High | Ten studies with no or very minor concerns regarding adequacy and relevance contributed to this review finding. Although there were minor concerns about methodological limitations and coherence, this was only due to a limited number of studies/extent of data | |
3. Older people accept delegation | “Or he’ll send the head nurse… to see what’s the matter. One of them would be here and see exactly what’s the matter and she would confer with him [the GP] what was to be done” ([37], p. 4) | Low | Five studies contributed to this review finding. While there were no or very minor concerns regarding methodological limitations, there were moderate concerns regarding coherence and adequacy because of the small number of studies and partially contradictory data. Moreover, there were minor concerns about relevance | |
4. Older people value home visits, but not all think they are necessary | “The GP can go through his patient records to see which patients need a home visit, which patients really need it” ([51], p. e557) | Low | Four studies contributed to this review finding. While there were no or very minor concerns regarding methodological limitations and relevance, there were moderate concerns regarding coherence and adequacy because of the small number of studies and partially contradictory data | |
5. Older people want fast contact to care | “I know who to call, and I am certain that I will get help the day I need. It cannot be any better” ([48], p. 704) | High | Eight studies contributed to this review finding. There were no or very minor concerns regarding methodological limitations, coherence, adequacy and relevance | |
6. Older people want easy access to care | “It goes through so many different levels before you actually get any help […]. If you need them, they’re not there” ([46], p. 9) | High | Ten studies contributed to this review finding. There were no or very minor concerns regarding methodological limitations, coherence and adequacy. Although there were moderate concerns regarding relevance, the review finding still is a valid representation of the data | |
7. Older people reject waiting times | “I come here for an appointment and wait for three hours. There is no single time I have come here when my blood pressure hasn’t gotten higher, I guess I get angry. Where is the priority on old age? At least above 80 years old. I’m 87” ([40] p. 346) | Moderate | Four studies contributed to this review finding. There were no or very minor concerns regarding methodological limitations and coherence. However, there were minor concerns regarding adequacy and relevance and due to the quite small number of studies, we found that this weakened the review finding | |
8. Older people want reliable and continuous care | “Never the same [nurse]. Do not know how many different persons they are? I do not know who is coming you know” ([42], p. 740) | High | Fourteen studies contributed to this review finding. There were no or very minor concerns regarding methodological limitations, coherence and adequacy. Although there were minor concerns regarding relevance, there was in sum no negative impact on the review finding | |
9. Older people value care coordination | “She was wonderful, she was a wonderful help… she sorted my doctor out, and sorted my nurse out” ([53], p. 811) | Moderate | Ten studies contributed to this review finding. There were no or very minor concerns regarding coherence and adequacy. However, there were moderate concerns regarding methodological limitations and relevance that weakened the review finding in total | |
10. Older people prefer home care | “You feel best at home, this is your home, where your things are. The home is part of you. Being at home means that everything is friendly and free” ([35], p. 3) | High | Nine studies contributed to this review finding. There were no or very minor concerns regarding methodological limitations and adequacy. Although there were minor concerns regarding coherence and relevance, this did not significantly affect the review finding, which was still a valid representation of the data | |
11. Older people prefer personal information | “Well, I think you absorb better, you understand it better, what’s available. Otherwise I think that we would just have thrown away the brochures and thought that we would wait to deal with it until something happens. Now we know about this, we have received a visit, it remains in our memory” ([33], p. 5) | Low | Five studies contributed to this review finding. While there were no or very minor concerns regarding methodological limitations, there were moderate concerns regarding relevance. Moreover, there were minor concerns regarding coherence and adequacy. Since the number of contributing studies was small, we found that this significantly impacted the strength of the review finding | |
12. Older people value advice to help with daily life | “And I find it very difficult to keep my balance. And they [name, physiotherapist in the project] asked me how would it be if you stood with your legs further apart… then your balance will be a bit better… And I’ve been doing it, and it’s absolutely true, because now I can stand and wash up” ([43], p. 9) | High | Seven studies contributed to this review finding. There were no or very minor concerns regarding coherence, adequacy and relevance. However, there were moderate concerns regarding methodological limitations. Since this is mostly due to one study, there was no significant impact on the review finding in total | |
13. Older people want information on care options and services | “She understands my problems and has suggested a number of assistive devices that I neither knew existed nor knew that I could get. I could not have managed without those helping aids. Thanks to them, I can now live close to normal” ([48], p. 705) | Moderate | Six studies contributed to this review finding. While there were no or very minor concerns regarding methodological limitations, there were minor concerns regarding coherence and adequacy. Moreover, there were moderate concerns regarding relevance that weakened the review finding | |
14. Older people want to be informed comprehensively | “When I get a new pill, she usually goes through it with me; she usually says what it is good for and how it works and such things. And I should watch if I have something more than what is written in the leaflet. If something else happens” ([41], p. 5) | Low | Eight studies contributed to this review finding. There were no or very minor concerns regarding methodological limitations. However, there were moderate concerns regarding coherence, adequacy and relevance. Since there was one study with limitations that provided a large part of data and moreover, there were partially contradictory data, there was a strong weakening of the review finding | |
15. Older people want more time for their care | “I just wish the GP would listen to me for a while. Just sit there and listen to me and give me my say…. I think just let me try and explain things to you. But he’s a very busy man” ([53], p. 812) | High | Thirteen studies contributed to this review finding. There were no or very minor concerns regarding methodological limitations, coherence, adequacy and relevance. Although there were minor concerns regarding relevance, this did not impact the strength of the review finding | |
Features of care relationships | ||||
16. Older people expect healthcare professionals to be knowledgeable | “I also expect him to keep his level of knowledge up to par with his skills. By which I mean, that he takes refresher courses regularly” ([34], p. 4) | High | Twelve studies contributed to this review finding. There were no or very minor concerns regarding methodological limitations, coherence and adequacy. Although there were moderate concerns regarding relevance, the review finding was still a valid representation of the data | |
17. Older people value healthcare professionals' communication skills | “She explained everything so well… that made a difference” ([53], p. 810) | Moderate | Seven studies contributed to this review finding. There were no or very minor concerns regarding coherence and relevance. However, there were minor concerns regarding adequacy and moderate concerns regarding methodological limitations. Altogether, we found that this weakened the review finding, but to a limited extent | |
18. Older people wish to receive personal attention | “Just that they think about us, it's nice, they think of older people” ([33], p. 4) | High | Sixteen studies contributed to this review finding. There were no or very minor concerns regarding methodological limitations, coherence, adequacy and relevance | |
19. Older people value close, long-term relationships | “They have become my friends, and I can rely on them” ([35], p. 5) | High | Twelve studies contributed to this review finding. There were no or very minor concerns regarding coherence, adequacy and relevance. Although there were minor concerns regarding methodological limitations, this was only due to a small number of studies and there was no impact on the review finding in total | |
20. Older people want to be treated in a friendly way | “I want them to be honest and also I want them to be friendly” ([45], p. 1249) | High | Eleven studies contributed to this review finding. There were no or very minor concerns regarding methodological limitations, coherence and adequacy. Although there were minor concerns regarding relevance, this was only due to a small number of studies and there was no impact on the review finding in total | |
21. Older people value open and confidential communication | “And you could talk to her… about everything. About things I do not want to mention to you. But I developed very good trust to her” ([43], p. 9) | High | Thirteen studies contributed to this review finding. There were no or very minor concerns regarding methodological limitations, coherence, adequacy and relevance | |
22. Older people want to be involved in decisions and care | “Once I had an infection in my wrist and that was solved—but he’s never asked about it again. That’s a little bit of response you would like to receive, that you feel that we’ve solved the problem together” ([50], p. 9) | Moderate | Sixteen studies contributed to this review finding. There were no or minor concerns regarding adequacy, but minor concerns regarding methodological limitations, coherence and relevance. In total, we found that the review finding lost strength, in particular due to contradictory data | |
23. Older people value activity | “Now you are old, but look how much you can do, and it’s me who will do it. It’s not them, it’s me who will do all the things they talked about. I need to engage in all these activities, I cannot just sit. … I have an insight, an insight into everything that I can do now and that feels very important” ([33], p. 5) | High | Twelve studies contributed to this review finding. There were no or very minor concerns regarding methodological limitations, coherence, adequacy and relevance | |