Risk Instrument for Screening in the Community (RISC): Cross Cultural Perspectives

Abstract

Older people are at an increased risk of developing multiple co-morbidities causing subsequent cognitive, functional decline and frailty and increasing the risk of adverse healthcare outcomes. Public Health Nurses (PHNs), geriatricians and researchers developed the Risk Instrument for Screening in the Community (RISC) to record the presence of problems, severity (mild, moderate, severe) of concerns and caregiver networks' ability to manage the patient across three domains: mental state, activities of daily living and medical state. The aim of this study was to explore the experiences of healthcare professionals who had used the RISC with community-dwelling older adults, between countries. Five focus groups (n = 28) were conducted in five countries (Australia, Northern Ireland, Portugal, Republic of Ireland and Spain). Four main themes were identified from participants' experiences using the RISC: 'Tool Usability'; 'Benefits for Patients and Carers'; 'Operational Challenges'; and 'Recommendations for Improvement'. Some cultural differences were found between participants with regards to terminologies such as 'caregiver network' and 'insight' and expectation in relation to caring. Disciplinary differences were identified related to different conceptualisations of health. The RISC offers an innovative approach to identify and score risk in community dwelling older adults. However, further research is necessary to reflect cultural and disciplinary norms.