Making the Move: A Mixed Research Integrative Review
Abstract
:1. Introduction
1.1. Background
1.2. Theoretical Framework and Definitions
2. Experimental Section
2.1. Design
2.2. Method/Inclusion/Exclusion Criteria
2.3. Synthesis of the Literature
Review Criteria | Good | Fair | Poor | Very Poor |
---|---|---|---|---|
Introduction and aims: Was there good background and clear statement of the aims of the research? | Full but concise background to discussion/study containing up-to-date literature review and highlighting gaps in the literature; clear statement of aim AND objectives including research questions | Some background and literature review/research questions outlined | Some background but no aim/objective/questions, OR Aims/objectives but inadequate background | No mention of aims/objectives |
Method and data: Is the method appropriate and clearly explained? | Method is appropriate and described clearly. Clear details of the data collection and recording | Method appropriate, description could be better; data described | Questionable whether method is appropriate; method described inadequately; little description of data | No mention of method AND/OR method inappropriate AND/OR no details of data |
Sampling: Was the sampling strategy appropriate to address aims? | Details (demographics) of who was studied and how they were recruited; why was this group targeted; the sample size was justified by the study; response rates shown and explained | Sample size justified; most information given but some missing | Sampling mentioned but few descriptive details | No details of the sample |
Data analysis: Was the description of the data analysis sufficiently rigorous? | Clear description of how analysis was done: Qual. studiesdescription of how themes derived/respondent validation or triangulation; Quant. studies-Reasons for tests selected hypothesis driven/numbers add up/statistical significance discussed | Qual. studies-Descriptive discussion of analysis | Minimum details about analysis | No discussion about analysis |
Ethics and bias: Have ethical issues been addressed and what has necessary ethical approval gained? Has the relationship between researchers and participants been adequately considered? | Ethics-Where necessary issues of confidentiality, sensitivity, and consent were addressed Bias-Researcher was reflexive and/or aware of own bias | Lip service was paid to (previous column) | Brief mention of issues | No mention of issues |
Results: Is there a clear statement of findings? | Findings explicit, easy to understand, and in logical progression; tables, if present, are explained in text; results relate directly to aims; sufficient data are presented to support findings | Findings mentioned but more explanation could be given; data presented relate directly to results | Findings presented but haphazardly, not explained, and do not progress logically from results | Findings not mentioned or do not relate to aims |
Transferability or generalizability: Are the findings of this study transferable (generalizable) to a wider population? | Context and setting of the study is described sufficiently to allow comparison with other contexts and settings, plus high score in (Sampling) | Some context and setting described, but more needed to replicate or compare the study with others, PLUS “fair” score or higher in (Sampling) | Minimal description of context/setting | No description of context/setting |
Implications and usefulness: How important are these findings to policy and practice? | Contributes something new and/or different in terms of understanding/insight or perspective; suggests ideas for further research; suggests implications for policy and/or practice | Two of the (previous column) included | Only one of the (previous column) included | None of the above |
3. Results
Synthesis Summary
Author | Aim/Purpose | Sample | Method | Key Findings/Themes |
---|---|---|---|---|
Bekhet, A., Zauszniewski, J. & Nakhla, W. (2009) [18] | To understand the reasons why elders move to retirement communities and what living in retirement communities is like from the perspective of relocated elders | Cognitively intact, relocated elders (n = 104) from a parent study | Qualitative interviews | Pushing factors; Pulling factors; Overlapping factors |
Lee, V., Simpson, J., Froggatt, K. (2013) [14] | To explore qualitatively older people’s experiences after an initial adjustment phase in order to illuminate ongoing processes of transition and related psychological factors; to explore how transitions were internalized and reflected upon within residents’ life stories | Purposive sample; British older adults (n = 8) | Qualitative; interviews | Transition may be influenced by key plots of ‘uncertainty’, ‘identity’ and ‘power/control’, which are interwoven within individual’s daily and more long-term existence. |
Walker, E., & McNamara, B. (2013) [20] | To identify key factors over different stages of relocation; to determine the range of strategies employed by older adults in relocating and maintaining a sense of home; to explore the scope for preventative occupational therapy in promoting health and well-being | Purposive/snowball sample; Australian older adults (n = 16) | Qualitative; semistructured interviews | Two main findings: successful transitions were made by researching and gathering information prior to the move and maintaining the ability to exercise agency across the relocation process |
Johnson, R., Schwiebert, V., Rosenmann, P. (1994) [39] | To identify factors influencing placement of older adults in nursing homes; to delineate the process by which this decision occurred | Cognitively intact older adults (n = 18), >60 years, at least one year in nursing home, English speaking | Qualitative descriptive design; semistructured interviews; open ended questions | Factors Influencing placement: health issues, caregiver issues, fear of living alone; placement decision makers: “powerful other”/self; advice to others making placement decisions |
Lee, D. (1997) [37] | To explore and investigate Chinese elder people’s perceptions of residential care placement | Convenience sample (n = 20); older adults >60 years from adult day centers | Quasi-qualitative; semi-structured taped interviews | Likelihood of residential care placement: Most (40%) believed a move would be necessary beliefs about residential care: Positive and negative perceptions Knowledge/experience of residential care homes: most information garnered from friends/acquaintances or volunteering in a care center |
Lee, D. (1999) [36] | To achieve understanding of how Chinese elders in Hong Kong experience the changes associated with admission to residential care homes | Purposive sampling; older adults (n = 10) newly admitted to residential care homes; no hearing or speech deficits | Descriptive qualitative; audiotaped interviews within one week of admission | Positive and negative feelings about the move; Chinese culture encourages modifying expectations and adaptation; Communal living; Establishing new relationships |
Shippee, T. (2009) [40] | To investigate how residents perceive transitions across levels of care and how residents manage social relations while moving within the CCRC | Purposive sample (n = 35) | Qualitative: observation and interviews | Autonomy; Threats to privacy/personal space; Fatalism; Social |
Sviden, G., Wikstrom, B., Hjortsjo-Norberg, M. (2002) [27] | To describe the qualitatively different ways in which the participants said they experienced relocating to sheltered housing and adjusting to new living arrangements | Swedish older adults (n = 59) who resided in sheltered housing at least one year | Qualitative, exploratory, phenomenological approach; semistructured interviews | Reasons for moving to sheltered housing; Experiences related to reception at the sheltered housing; Adjustment to living in sheltered housing |
Walker, C. , Curry, L., & Hogstel, M. (2007) [23] | To verify the nature and kind of distress associated with relocation stress syndrome (RSS); to validate diagnostic criteria for RSS among older adults residing in nursing homes and assisted living facilities; to determine whether RSS manifests differently among residents of one kind of facility versus another | Convenience sample (n = 16); nursing home (n = 8) and assisted living (n = 8) residents; >65 years, no greater than mild cognitive impairment | Qualitative; structured interviews | Moving from independent residence to LTC; Relocation differences between AL and LTC placement; Stressful relocation? |
Wilson, S. (1997) [34] | To identify variance in the initial responses of older adults whose move into a nursing home is expected to be a permanent move and is either planned or unplanned | Older adults (n = 15) who had recently relocated | Exploratory, descriptive, qualitative interviews | Overwhelmed phase; Adjustment phase; Initial acceptance phase |
Armer, J.(1993) [35] | To examine the relationship of perceived choice, perceived social support, cognitive appraisal, coping strategies, self-related health with adjustment to relocation of community based rural elderly | Residents (n = 50)of two congregate residential facilities; >60 years, without cognitive impairment or debilitating health conditions | Mixed methods: Cross-sectional, descriptive correlational; semi-structured interviews; Questionnaire with instruments | Instrument scores correlated significantly with perceived choice in relocation and current environment, social support (family/neighbors), predictability, threat appraisal, challenge appraisal. |
Qualitative themes: Most reported positive feelings toward relocation; Perceived choice in relocation/environment improved adjustment | ||||
Johnson, R., Popejoy, L., Radina, E. (2010) [33] | To identify extent of older adults’ participation in relocation decision making and extent of SOC (sense of coherence), function, physical ability as related to decision making. | Random selection of nursing home residents (n = 16) | Mixed methods: qualitative interviews and four instruments: | Qualitative: Two themes: “They put me here” & “I made the decision.” |
Quantitative: Significance was not attained | ||||
Leggett, S., Davies, S., Hiskey, S., & Erskine, J. (2011) [38] | To explore the application of the Time, Environment, Motivation, Personality, and Outcome (TEMPO) model and establish whether an increase in frequency of prefactuals/counterfactuals might emerge as people move along the TEMPO timeline | Opportunistic sampling (n = 66) divided into two groups: Age 18-64 (n = 33) and age >65 (n = 33) | Mixed methods; cross-sectional; Interviews using two fictitious scenarios about relocation | Qualitative-multiple themes focused on preplanning for a move due to poor health |
Quantitative-Older adults tended to view scenarios as opportunities to plan ahead | ||||
Bekhet, A., Fouad, R., & Zauszniewski, J. (2010) [41] | To determine whether the effects of risk factors (relocation) on elders’ resilience (adjustment) are influenced by protective factors such as positive cognitions | Convenience sample of Egyptian older adults (n = 94) who had relocated to retirement communities | Cross-sectional; quantitative; three instruments | Mediation: Relocation controllability had a direct negative effect on relocation adjustment (B = −0.36, p < 0.001) |
Relocation controllability had a direct negative effect on positive cognitions (B = −0.41, p < 0.001) | ||||
Effect of relocation controllability and positive cognitions on relocation adjustment (B = −0.20, p < 0.05) |
4. Discussion
Limitations
5. Conclusions
Author Contributions
Conflicts of Interest
References
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Gilbert, S.; Amella, E.; Edlund, B.; Nemeth, L. Making the Move: A Mixed Research Integrative Review. Healthcare 2015, 3, 757-774. https://doi.org/10.3390/healthcare3030757
Gilbert S, Amella E, Edlund B, Nemeth L. Making the Move: A Mixed Research Integrative Review. Healthcare. 2015; 3(3):757-774. https://doi.org/10.3390/healthcare3030757
Chicago/Turabian StyleGilbert, Sarah, Elaine Amella, Barbara Edlund, and Lynne Nemeth. 2015. "Making the Move: A Mixed Research Integrative Review" Healthcare 3, no. 3: 757-774. https://doi.org/10.3390/healthcare3030757