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. 2023 Oct 4;23(1):622.
doi: 10.1186/s12877-023-04318-x.

Systematic review of research barriers, facilitators, and stakeholders in long-term care and geriatric settings, and a conceptual mapping framework to build research capacity

Quoc Dinh Nguyen  1   2   3 , Marie-France Forget  4   5 , Xi Sophie Zhang  6   7 , Catherine Richer  6   7 , Renata Podbielski  8 , Pierrette Gaudreau  9   5 , Philippe Desmarais  4   9   5
Affiliations

Systematic review of research barriers, facilitators, and stakeholders in long-term care and geriatric settings, and a conceptual mapping framework to build research capacity

Quoc Dinh Nguyen et al. BMC Geriatr. .

Abstract

Background: Older adults are underrepresented in research. Heterogeneity of research processes in this population, specifically in long-term care (LTC) and geriatric acute care (GAC), is not well described and may impede the design, planning, and conduct of research. In this study, we identified, quantified, and mapped stakeholders, research stages, and transversal themes of research processes, to develop a mapping framework to improve research capacity by better characterizing this heterogeneity.

Methods: Multicomponent mixed methods study. An environmental scan was used to initiate a preliminary framework. We conducted a systematic literature search on processes, barriers, and methods for clinical research in GAC and LTC to extract and update stakeholders, research stages, and themes. Importance and interactions of elements were synthesized via heatmaps by number of articles, mentions, and content intersections.

Results: For our initial framework and environmental scan, we surveyed 24 stakeholders. Of 9277 records, 68 articles were included in our systematic review and allowed us to identify 12 stakeholders, 13 research stages, 17 transversal themes (either barriers, facilitators, general themes, or recommendations), and 1868 intersections. Differences in relative importance between LTC and GAC emerged for stakeholders (staff, managers vs. caregivers, ethics committees), and for research stages (funding, facility recruitment vs. ethics, individual recruitment). Crucial themes according to specific stakeholders were collaboration for the research team; communication, trust, and human resources for managers; heterogeneity for patients and residents. A heatmap framework synthesizing vital stakeholders and themes per research stage was generated.

Conclusions: We identified and quantified the interactions between stakeholders, stages, and themes to characterize heterogeneity in LTC and GAC research. Our framework may serve as a blueprint to co-construct and improve each stage of the research process.

Keywords: Barriers and facilitators; Geriatric acute care; Long-term care; Nursing home; Research methods; Underrepresentation.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Distribution and importance of stakeholders, research stages, and themes. Notes. (A) Stakeholders. (B) Research stages. (C) Themes. Articles are the basic unit of analysis. Themes include content coded as barriers, facilitators, themes, or recommendations
Fig. 2
Fig. 2
Interaction heatmaps for stakeholders by importance of research stages and transversal themes. The numbers in the heatmap cells indicate the order of importance for each stakeholder by the number of articles published. Duplicate cell ranks are due to ties. (A) Stakeholders by research stages. (B) Stakeholders by themes
Fig. 3
Fig. 3
Final conceptual framework: interaction heatmap of primary stakeholders, research stages, and transversal themes, with steps to build and mobilize research capacity. AL = alignment; AP = appropriation; CT = communication and trust; CO = collaboration; ET = ethical committees; FD = funding; FR = fragmentation; HR = human resources; HT = heterogeneity; LR = legal and regulations; MR = material resources; SD = standardization; TR = training. Ties alter the exact number of themes displayed
See this image and copyright information in PMC

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