Development of a periodic health examination form for the frail elderly in long-term care.

abstract

OBJECTIVE: To create an evidence-based periodic health examination (PHE) form geared to long-term care (LTC) residents. DESIGN: Two-phase study: literature review to develop a quantitative, cross-sectional, self-administered survey, and administration of the survey followed by a focus group. A PHE form for LTC residents was developed based on participants' recommendations. SETTING: Hamilton, Ont. PARTICIPANTS: A total of 106 health care professionals completed the survey; 10 LTC physicians participated in the focus group. MAIN OUTCOME MEASURES: The items deemed most important and most likely to be performed during a PHE; themes from focus group discussions. RESULTS: Respondents' top 4 most important PHE items were also the top 4 items they thought were most likely to be performed during a PHE in LTC: reviewing active health status, reviewing pain control, reviewing medications, and screening for falls. Thematic analysis from the focus group discussion generated 3 main themes: current physician perspectives on the existing annual health examination in LTC, conceptual ideas for the new PHE form, and physician perspectives on the optimization of care in LTC settings. The findings from the survey, along with the themes from the focus group, were incorporated to create a PHE form for LTC residents. CONCLUSION: The proposed PHE form emphasizes tracking a patient's functional course over time and combines evidence-based preventive health interventions and health assessments with what is clinically important for LTC.