Self Assessment of Health and Social Care Needs by …

1 NCCSDO 2005 1 Self Assessment of Health and Social care Needs by Older People: A multi-method systematic review of practices, accuracy, effectiveness and experience Report for the National Co-ordinating Centre for NHS Service Delivery and Organisation R & D (NCCSDO) April 2005, revised August 2005 Prepared by Peter Griffiths Roz Ullman Ruth Harris King s College London Address for correspondence Peter Griffiths King s College London Florence Nightingale School of Nursing & Midwifery 57 Waterloo Road SE1 8WA Email: Telephone: 020 7848 3012 Fax.

2 020 7848 3219 NCCSDO 2005 2 Acknowledgements This report was prepared on behalf of the project team. In addition to the authors, the team comprised Sally Brearley, Helen Bowers, Mike Nolan, Ian Norman and Gill Ritchie. The team would like to acknowledge the contributions made by the Tower Hamlets Older Person s Reference group, who generously allowed us to meet with them and provided us with valuable insights into the perspective of older people, and all those who identified possible examples of self Assessment or acted as informants for our case studies.

3 We offer particular thanks to Mrs Peggy Ullman and the late Mr Len Ullman who acted as informal sounding boards for many of our ideas in the early stages of this project and gave valuable insights into the nature of self- Assessment .NCCSDO 2005 3 Contents Executive Scope ..7 Experience of Recommendations for further Recommendations for Recommendations for Section 1 The self in Scope of the Self report and Health Self rated Health and Self rated Health and Older people and Review Section 2 Review Search Identification of self- Assessment practice and unpublished Selection of items for Section 3 The Scope of Self Focussed Health Acting on the

4 Issues/topics Internal vs. External Predictive vs. Section summary focussed Health General Health Acting on the Self- Assessment of Health and Social care Needs by older people NCCSDO 2005 4 Issues/topics Internal vs. external Predictive vs. Section summary general Health Social care and life Initiation of the Interpretation of completed Acting on the Issues/topics Internal vs. external Predictive vs. Section summary Social care and life Comprehensive Acting on the Structure/format of the Issues/topics Internal vs.

5 External Predictive vs. diagnostic Section summary comprehensive Implications and recommendations for research, practice and Section 4 Accuracy of Inclusion Data Focused Health Nutrition & oral Endocrine Hearing and Section General Health Social care and life Comprehensive Implications and recommendations for research, practice and Self- Assessment of Health and Social care Needs by older people NCCSDO 2005 5 Section 5 Effectiveness of self- Assessment methods95 Focussed General Health and Medication Life Health checks.

6 102 Self care Dartmouth COOP clinical improvement Comprehensive Implications and recommendations for research, practice and Section 6 The experience of Inclusion Focussed Health Section summary focussed Health General Health Section summary general Health Social care and life Content of the Section summary Social care and life Comprehensive Section summary comprehensive Implications and recommendations for research, practice and Section 7 Implications and recommendations for research.

7 Practice and Section 8 Section 9 Tables for studies of Self- Assessment of Health and Social care Needs by older people NCCSDO 2005 6 Studies considered for the effectiveness Studies considered for the experience of Data extraction NCCSDO 2005 6 Executive summary Background This review considers the evidence base for self- Assessment by older people in managing and identifying Health and Social care Needs . Self- Assessment is widely advocated in policy and practice developments for older people.

8 The National Service Framework for Older People specifically emphasises person centred care , the key themes of which are proper Assessment of potentially complex Needs , integration of Assessment , sharing of information between services and with clients and active involvement of older people in both Health promotion and assessments. The single- Assessment process is a key tool to achieve these goals and self- Assessment is identified as having an important role. Despite the widespread discussion there is little agreement on the precise meaning of the term.

9 Although occasionally used to simply refer to self-report self- Assessment is defined here as comprising at least self-report, self-completion or direction of the process and self as the potential beneficiary of the Assessment . In addition to these three elements, self- Assessment can be self-initiated, self-interpreted and prompt self- care actions. Self- Assessment raises complex questions about accuracy, effectiveness and the experience for users. This review addresses these complex issues through a number of approaches.

10 These are; - a survey of the scope of approaches toward self- Assessment based upon a comprehensive review of literature and a survey of practice - a systematic review of studies of accuracy comparing the results of self-assessments with appropriate gold standard assessments - a systematic review of controlled trials of effectiveness of self- Assessment - a review of qualitative evidence of self- Assessment focussing on the experience and acceptability of self- Assessment from the perspective of both the