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Bergmann S, Peper J, Bieber A. The use of formal care for dementia from a professional perspective: a scoping review. BMC Health Serv Res 2022; 22:825. [PMID: 35752801 PMCID: PMC9233851 DOI: 10.1186/s12913-022-08229-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Accepted: 06/16/2022] [Indexed: 01/10/2023] Open
Abstract
Background and objectives The progressive character of dementia usually leads to a continuously increasing need for support. There is some evidence of late use of professional support during the disease course. We aim to provide an overview of aspects influencing access and use of formal care in dementia from the perspective of health and social care professionals. Additionally, the perspectives of professionals and people with dementia/informal carers will be compared. Methods We conducted a scoping review with a systematic literature search in Medline via Ovid in January 2019 and updated this in April 2020 and in May 2021. Publications were considered eligible when focusing on influencing aspects of the use of formal care or support for people with dementia in an outpatient setting from the perspective of health professionals. Included publications were critically appraised using the Mixed Method Appraisal Tool. We identified aspects of access to and use of formal care and support services. A consultation exercise with three specialised trained dementia care nurses was conducted to validate our results. Results We included 29 studies: n = 20 qualitative, n = 6 quantitative-descriptive, n = 3 mixed-methods. Various support services were identified, but a focus was on services for diagnostic and treatment of dementia. A wide range of influencing aspects (n = 15) describe the access to and use of formal care services. Aspects related to the complexity and structure of the healthcare system and the competence of professionals were frequently addressed. Second, attitudes and expectations of professionals, and experiences with people with dementia and their informal carers were identified. The dementia care nurses highlighted the importance of coordinated care to enhance dementia-specific competencies. Conclusions Health and social care professionals still describe barriers in accessing and using formal care due to various influences. Ways to improve access to and use of professional support in dementia should consider individual and system-level activities, as well as overarching aspects. Important topics are therefore education and training of professionals and coordinated dementia-specific care to provide adequate support for people with dementia and their relatives. Several professions may be involved in this increasingly important field, e.g., nurses with a dementia-specific training like dementia care nurses.
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Affiliation(s)
- Stefanie Bergmann
- Institute of Health and Nursing Sciences, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Julia Peper
- Institute of Health and Nursing Sciences, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Anja Bieber
- Institute of Health and Nursing Sciences, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany.
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Qin HC, He Z, Luo ZW, Zhu YL. Management of hip fracture in COVID-19 infected patients. World J Orthop 2022; 13:544-554. [PMID: 35949705 PMCID: PMC9244961 DOI: 10.5312/wjo.v13.i6.544] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 02/07/2022] [Accepted: 04/26/2022] [Indexed: 02/06/2023] Open
Abstract
Given that the global population of elderly individuals is expanding and the difficulty of recovery, hip fractures will be a huge challenge and a critical health issue for all of humanity. Although people have spent more time at home during the coronavirus disease 2019 (COVID-19) pandemic, hip fractures show no sign of abating. Extensive studies have shown that patients with hip fracture and COVID-19 have a multifold increase in mortality compared to those uninfected and a more complex clinical condition. At present, no detailed research has systematically analyzed the relationship between these two conditions and proposed a comprehensive solution. This article aims to systematically review the impact of COVID-19 on hip fracture and provide practical suggestions. We found that hip fracture patients with COVID-19 have higher mortality rates and more complicated clinical outcomes. Indirectly, COVID-19 prevents hip fracture patients from receiving regular medical treatment. With regard to the problems we encounter, we provide clinical recommendations based on existing research evidence and a clinical flowchart for the management of hip fracture patients who are COVID-19 positive. Our study will help clinicians adequately prepare in advance when dealing with such patients and optimize treatment decisions.
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Affiliation(s)
- Hao-Cheng Qin
- Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, Shanghai 200040, China
| | - Zhong He
- Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, Shanghai 200040, China
| | - Zhi-Wen Luo
- Department of Sports Medicine, Huashan Hospital, Fudan University, Shanghai 200040, China
| | - Yu-Lian Zhu
- Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, Shanghai 200040, China
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Telemedicine application in patients with chronic disease: a systematic review and meta-analysis. BMC Med Inform Decis Mak 2022; 22:105. [PMID: 35440082 PMCID: PMC9017076 DOI: 10.1186/s12911-022-01845-2] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Accepted: 04/11/2022] [Indexed: 01/12/2023] Open
Abstract
Background Telemedicine has been widely used for long-term care and self-management in patients with chronic disease, but there is no consensus regarding the effect of telemedicine on chronic disease management. The aim of this study is to review and analyse the effect of telemedicine on the management of chronic diseases such as hypertension, diabetes, and rheumatoid arthritis using a systematic review and meta-analysis. Methods We performed a comprehensive literature search of the Web of Science, PubMed, MEDLINE, EMBASE, CNKI (Chinese database), VIP (Chinese database), WanFang (Chinese database), and SinoMed (Chinese database) databases from their inception until December 31, 2021. The retrieved literature was screened and assessed independently by two authors. We used the risk-of-bias assessment tool recommended by the Cochrane Handbook for Systematic Reviews of Interventions 5.0.2 for assessing literature quality and Revman 5.3 software to conduct the meta-analysis. Results Fifteen articles were included in this study. The results of the systematic review indicated that telemedicine consultation and telemonitoring are the most commonly used intervention methods. Telemedicine is helpful for improving self-management in patients with rheumatoid arthritis. The results of the meta-analysis showed patients’ index of glycosylated hemoglobin (HbA1c) improved after 12 months of intervention (MD = − 0.84; 95% CI = − 1.53, − 0.16; Z = 2.42; P = 0.02), and no significant differences in fasting blood glucose (FBG) levels were observed after 6 months of intervention (MD = − 0.35; 95% CI = − 0.75,0.06; Z = 1.69; P = 0.09). The results also showed that systolic blood pressure (MD = − 6.71; 95% CI = − 11.40, − 2.02; Z = 2.81; P = 0.005) was reduced after 6 months of intervention. Conclusion Telemedicine had a positive effect on the management of diabetes, hypertension, and rheumatoid arthritis, especially when telemedicine consultation and telemonitoring method were used. When telemedicine was used as a disease management tool for patients with diabetes, the optimal intervention time is 12 months. Telemedicine improved the systolic blood pressure in hypertensive patients while also reducing negative emotions and enhancing medication adherence in rheumatoid arthritis patients.
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Daemen M, Bruinsma J, Bakker C, Zwaaftink RG, Koopmans R, Oostijen A, Loose B, Verhey F, de Vugt M, Peetoom K. A cross-sectional evaluation of the Dutch RHAPSODY program: online information and support for caregivers of persons with young-onset dementia. Internet Interv 2022; 28:100530. [PMID: 35433278 PMCID: PMC9005959 DOI: 10.1016/j.invent.2022.100530] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 03/18/2022] [Accepted: 03/23/2022] [Indexed: 12/04/2022] Open
Abstract
UNLABELLED Caregivers of persons with young-onset dementia (YOD) have an explicit need for tailored information and support about YOD. Therefore, during the European RHAPSODY project a web-based information and support program for YOD caregivers was developed. The program was recently tailored to the Dutch context. This study evaluates the Dutch version on user acceptability, usability, user satisfaction, and user behavior. METHODS A cross-sectional study was conducted to evaluate the publicly available Dutch RHAPSODY program. A pop-up survey, extensive survey, and a semi-structured interview were used to evaluate how visitors perceived the program in terms of acceptability, usability, and their satisfaction. Web metrics registered user behavior. Quantitative data were analyzed using descriptive statistics and a deductive content analysis was used to analyze qualitative data. RESULTS A total of 26 participants completed the pop-up survey, 19 completed the extensive survey, and 10 participated in the semi-structured interviews. Most participants were caregivers and healthcare professionals. They perceived the program as acceptable and usable in daily life and were satisfied with the quality of the content. The majority would use the program again and recommend it to others. Participants emphasized the necessity and desirability of a central platform incorporating educational and practical information about YOD. The page with an explanation about what YOD entails was most viewed (360 unique page views). Most time was spent on the page about the diagnostic process (6.5 min). CONCLUSIONS The Dutch RHAPSODY program showed good user acceptability, usability, and user satisfaction. The program met the need for tailored information and support regarding YOD and adds value to existing available support for YOD caregivers. Raising awareness about the program's existence among healthcare professionals may help caregivers to find appropriate post-diagnostic information. The program also provides educational opportunities for healthcare professionals.
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Affiliation(s)
- Maud Daemen
- Department of Psychiatry and Neuropsychology/Alzheimer Center Limburg, School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands,Corresponding author.
| | - Jeroen Bruinsma
- Department of Psychiatry and Neuropsychology/Alzheimer Center Limburg, School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands
| | - Christian Bakker
- Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, the Netherlands,Radboudumc Alzheimer Center, Nijmegen, the Netherlands,Groenhuysen, Center for Specialized Geriatric Care, Roosendaal, the Netherlands
| | | | - Raymond Koopmans
- Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, the Netherlands,Radboudumc Alzheimer Center, Nijmegen, the Netherlands,Joachim and Anna, Center for Specialized Geriatric Care, Nijmegen, the Netherlands
| | | | - Bernard Loose
- Dutch Alzheimer's Society, Amersfoort, the Netherlands
| | - Frans Verhey
- Department of Psychiatry and Neuropsychology/Alzheimer Center Limburg, School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands
| | - Marjolein de Vugt
- Department of Psychiatry and Neuropsychology/Alzheimer Center Limburg, School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands
| | - Kirsten Peetoom
- Department of Psychiatry and Neuropsychology/Alzheimer Center Limburg, School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands
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Abstract
COVID-19 pandemic and subsequent lockdowns created a global public health crisis generating mental health problems including social isolation, stress, and anxiety especially for persons with dementia and their carers. This article reports on the use of digital technology to maintain social connectivity via a virtual group session that focused on the topic of "what is home." Participants in this session included 16 day-care center clients representing an immigrant community identified with mild to moderate cognitive impairment. A trained psychodrama therapist conducted the virtual group meeting based on five key techniques: spectrogram, role reversal, doubling, mirroring, and soliloquy. The NVivo software was used for the qualitative analysis of the transcribed video recording to identify key themes based on grounded theory methodology. Zooming from home, clients engaged in significant social interaction. Findings of the NVivo analysis identified the following themes of "what is home": Emotions and home, Home is family, Home is community, and Reminiscence (with objects and traditions). Findings suggest that digital interactive technologies, like Zoom, enhance social connectivity thus mitigating the negative impact of social isolation for persons with dementia especially during pandemic lockdowns. Our pilot findings based on virtual group meetings from home demonstrate that participants can express significant emotive capacity and enhanced connectivity with one another despite a diagnosis of mild to moderate dementia. While larger studies are needed to confirm these findings, we suggest that this methodology may be used to support persons with dementia not only in times of pandemics but also as an addition to other community and home care services. Changes in reimbursement policies to include these innovative home services may be helpful in building more resilient communities for the more highly vulnerable populations.
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Affiliation(s)
- Nancy Brown
- Talpiot English-speaking Center, 151027MELABEV-Community Clubs for Eldercare, Jerusalem, Israel.,PhD Candidate, University of Edinburgh, Edinburgh, Scotland, UK
| | - Tzippi Cedar
- Talpiot English-speaking Center, MELABEV-Community Clubs for Eldercare, Jerusalem, Israel
| | - Chariklia Tziraki
- Talpiot English-speaking Center, MELABEV-Community Clubs for Eldercare, Jerusalem, Israel.,Hebrew University, Jerusalem, Israel
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56
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Hernandez HHC, Ong PL, Anthony P, Ang SL, Salim NBM, Yew PYS, Ali NB, Lim JP, Lim WS, Chew J. Cognitive assessment by telemedicine: reliability and agreement between face-to-face and remote videoconference-based cognitive tests in older adults attending a memory clinic. Ann Geriatr Med Res 2022; 26:42-48. [PMID: 35236016 PMCID: PMC8984169 DOI: 10.4235/agmr.22.0005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Accepted: 02/26/2022] [Indexed: 11/04/2022] Open
Abstract
Background The coronavirus disease 2019 (COVID-19) pandemic has spurred the rapid adoption of telemedicine. However, the reproducibility of face-to-face (F2F) versus remote videoconference-based cognitive testing remains to be established. We assessed the reliability and agreement between F2F and remote administrations of the Abbreviated Mental Test (AMT), modified version of the Chinese Mini-Mental State Examination (mCMMSE), and Chinese Frontal Assessment Battery (CFAB) in older adults attending a memory clinic. Methods The participants underwent F2F followed by remote videoconference-based assessment by the same assessor within 3 weeks. Reliability was evaluated using intraclass correlation coefficients (ICC; two-way mixed, absolute agreement), the mean difference between remote and F2F-based assessments using paired-sample t-tests, and agreement using Bland-Altman plots. Results Fifty-six subjects (mean age, 76±5.4 years; 74% mild; 19% moderate dementia) completed the AMT and mCMMSE, of which 30 completed the CFAB. Good reliability was noted based on the ICC values—AMT: ICC=0.80, 95% confidence interval [CI] 0.68–0.88; mCMMSE: ICC=0.80, 95% CI 0.63–0.88; CFAB: ICC=0.82, 95% CI 0.66–0.91. However, remote AMT and mCMMSE scores were higher compared to F2F—mean difference (i.e., remote minus F2F): AMT 0.3±1.1, p=0.03; mCMMSE 1.3±2.9, p=0.001. Significant differences were observed in the orientation and recall items of the mCMMSE and the similarities and conflicting instructions of CFAB. Bland–Altman plots indicated wide 95% limits of agreement (AMT -1.9 to 2.6; mCMMSE -4.3 to 6.9; CFAB -3.0 to 3.8), exceeding the a priori-defined levels of error. Conclusion While the remote and F2F cognitive assessments demonstrated good overall reliability, the test scores were higher when performed remotely compared to F2F. The discrepancies in agreement warrant attention to patient selection and environment optimization for the successful adaptation of telemedicine for cognitive assessment.
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Affiliation(s)
| | - Poh Ling Ong
- Dementia Care, Nursing Specialty, Tan Tock Seng Hospital, Singapore
| | | | - Siew Ling Ang
- Dementia Care, Nursing Specialty, Tan Tock Seng Hospital, Singapore
| | | | | | | | - Jun Pei Lim
- Department of Geriatric Medicine, Tan Tock Seng Hospital, Singapore.,Institute of Geriatrics and Active Ageing, Tan Tock Seng Hospital, Singapore
| | - Wee Shiong Lim
- Department of Geriatric Medicine, Tan Tock Seng Hospital, Singapore.,Institute of Geriatrics and Active Ageing, Tan Tock Seng Hospital, Singapore
| | - Justin Chew
- Department of Geriatric Medicine, Tan Tock Seng Hospital, Singapore.,Institute of Geriatrics and Active Ageing, Tan Tock Seng Hospital, Singapore
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Geschke K, Palm S, Fellgiebel A, Wuttke-Linnemann A. Resilience in Informal Caregivers of People Living with Dementia in the Face of COVID-19 Pandemic-Related Changes to Daily Life. GEROPSYCH 2022. [DOI: 10.1024/1662-9647/a000273] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Abstract. Informal caregivers of people living with dementia (PwD) are at increased risk for the development of stress-related physical and mental illness. Nevertheless, because of differing resilience, they show interindividual differences in their ability to cope. Particularly during the COVID-19 pandemic, with the associated pandemic control measures and pandemic-related changes to daily life, resilience might be further challenged, and stress might consequently increase. Therefore, we review the evidence on informal caregivers’ experience during the COVID-19 pandemic regarding effects of the pandemic control measures on (a) the caregiver’s health, (b) the care recipient’s health, (c) the stability of the care situation, and (d) coping in daily life. We conclude with implications on how to strengthen resilience and reduce stress in terms of environmental, social, and individual resources.
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Affiliation(s)
- Katharina Geschke
- Department of Psychiatry and Psychotherapy, University Medical Center Mainz, Mainz, Germany
- Center for Mental Health in Old Age, Landeskrankenhaus (AöR), Mainz, Germany
| | - Svenja Palm
- Department of Psychiatry and Psychotherapy, University Medical Center Mainz, Mainz, Germany
| | - Andreas Fellgiebel
- Department of Psychiatry and Psychotherapy, University Medical Center Mainz, Mainz, Germany
- Center for Mental Health in Old Age, Landeskrankenhaus (AöR), Mainz, Germany
| | - Alexandra Wuttke-Linnemann
- Department of Psychiatry and Psychotherapy, University Medical Center Mainz, Mainz, Germany
- Center for Mental Health in Old Age, Landeskrankenhaus (AöR), Mainz, Germany
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Gutiérrez Á, Cain R, Nadine Diaz, Aranda MP. The Digital Divide Exacerbates Disparities in Latinx Recruitment for Alzheimer’s Disease and Related Dementias Online Education During COVID-19. Gerontol Geriatr Med 2022; 8:23337214221081372. [PMID: 35252476 PMCID: PMC8891594 DOI: 10.1177/23337214221081372] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 01/14/2022] [Accepted: 02/01/2022] [Indexed: 12/24/2022] Open
Abstract
Latinx adults experience a high burden of dementia. Given that modifiable factors
drive dementia disparities, engaging Latinxs in Alzheimer’s disease and related
dementias (ADRD) education is critical to address dementia burden among this
aging population. Yet, no studies have documented the role of the COVID-19
pandemic on dementia education among Latinxs. This study: (1) elucidates the
recruitment and retention processes targeting Latinxs for online educational
events during the pandemic; (2) describes facilitators/barriers to
participation; and (3) offers lessons learned. We developed online
dementia-focused workshops (English and Spanish) and employed a cold-calling
approach to invite Latinx participants enrolled in clinical studies
(N = 209). Bivariate tests assessed demographic and
cognitive differences between those who recruiters did (n = 60)
and did not (n = 149) successfully engage. Frequency counts
assessed participants’ technological access. Only 8/209 attended the online
events; all held university degrees, most reported English as their primary
language, and none experienced cognitive impairment. Results underscore how
educational attainment, cognitive impairment, language preference, and age
intersect to shape recruitment in dementia-focused online education. To promote
healthy aging and to ameliorate dementia disparities, barriers to online
engagement among older Spanish-speaking Latinxs with cognitive impairment and
low educational attainment must be addressed.
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Affiliation(s)
| | - Rosalba Cain
- University of Southern California, Los Angeles, CA, USA
- USC Alzheimer’s Disease Research Center, Los Angeles, CA, USA
| | - Nadine Diaz
- University of Southern California, Los Angeles, CA, USA
- USC Alzheimer’s Disease Research Center, Los Angeles, CA, USA
| | - María P. Aranda
- University of Southern California, Los Angeles, CA, USA
- USC Alzheimer’s Disease Research Center, Los Angeles, CA, USA
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59
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Equity in Changes to Dementia Care in the Community during the First Wave of the COVID-19 Pandemic in High Income Countries: A Scoping Review. SOCIETIES 2022. [DOI: 10.3390/soc12020030] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
During COVID-19, emergency measures, such as physical distancing and program restrictions, have reduced community-based supports for PLWD and their caregivers. Consequently, reductions in dementia services and resources have contributed to existing health inequities in this population. Academic databases were searched in July 2020. Grey literature was retrieved using the CADTH Grey Matters tool. Articles from 2000 to 2020 in English and from high-income countries were included. Literature that discussed any changes to community support and services for PLWD and/or their caregivers during any infectious respiratory outbreak was included. Findings were extracted using a template adapted from the Health Equity Impact Assessment (HEIA) tool. A total of 15 articles were identified; all focused on the COVID-19 pandemic. Evidence was primarily based on expert opinion, with only three primary research studies meeting inclusion criteria. Most alterations to dementia services described switching to telehealth platforms. There was limited information on social determinants of health and how these intersected to influence the experience of service changes among different populations. More research is needed to better understand how services for PLWD can continue or be transitioned online during infectious disease outbreaks and address issues of health (in)equities for PLWD and/or their caregivers.
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60
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Malmgren Fänge A, Christensen J, Backhouse T, Kenkmann A, Killett A, Fisher O, Chiatti C, Lethin C. Care Home and Home Care Staff's Learning during the COVID-19 Pandemic and Beliefs about Subsequent Changes in the Future: A Survey Study in Sweden, Italy, Germany and the United Kingdom. Healthcare (Basel) 2022; 10:306. [PMID: 35206920 PMCID: PMC8872186 DOI: 10.3390/healthcare10020306] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 01/27/2022] [Accepted: 02/02/2022] [Indexed: 02/04/2023] Open
Abstract
The aim of this study was to compare perceptions of learning from the COVID-19 pandemic and beliefs in subsequent changes for the future, among care home and home care staff, in four European countries. A 29-item on-line questionnaire was designed in English and later translated into Swedish, Italian, and German on the impact of the pandemic on stress and anxiety. Anonymous data from care staff respondents was collected in four countries between 7 October 2020 and 17 December 2010: Sweden (n = 212), Italy (n = 103), Germany (n = 120), and the United Kingdom (n = 167). While care staff in all countries reported learning in multiple areas of care practice, Italy reported the highest levels of learning and the most agreement that changes will occur in the future due to the pandemic. Conversely, care staff in Germany reported low levels of learning and reported the least agreement for change in the future. While the pandemic has strained care home and home care staff practices, our study indicates that much learning of new skills and knowledge has taken place within the workforce. Our study has demonstrated the potential of cross-border collaborations and experiences for enhancing knowledge acquisition in relation to societal challenges and needs. The results could be built upon to improve future health care and care service practices.
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Affiliation(s)
- Agneta Malmgren Fänge
- Department of Health Sciences, Lund University, 221 00 Lund, Sweden; (A.M.F.); (C.L.)
| | - Jonas Christensen
- Department of Social Work, Faculty of Health and Society, Malmö University, 205 06 Malmö, Sweden
| | - Tamara Backhouse
- School of Health Sciences, University of East Anglia, Norwich NR4 7TJ, UK; (T.B.); (A.K.)
| | - Andrea Kenkmann
- Center for Aging, Catholic University of Applied Sciences Munich, 836 71 Benediktbeuern, Germany;
| | - Anne Killett
- School of Health Sciences, University of East Anglia, Norwich NR4 7TJ, UK; (T.B.); (A.K.)
| | - Oliver Fisher
- Department of Economics and Social Sciences, Università Politecnica delle Marche, 60121 Ancona, Italy;
- Centre for Socio-Economic Research on Ageing, IRCCS INRCA—National Institute of Health and Science on Ageing, 60124 Ancona, Italy
| | | | - Connie Lethin
- Department of Health Sciences, Lund University, 221 00 Lund, Sweden; (A.M.F.); (C.L.)
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61
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Perkins L, Fisher E, Felstead C, Rooney C, Wong GHY, Dai R, Vaitheswaran S, Natarajan N, Mograbi DC, Ferri CP, Stott J, Spector A. Delivering Cognitive Stimulation Therapy (CST) Virtually: Developing and Field-Testing a New Framework. Clin Interv Aging 2022; 17:97-116. [PMID: 35173425 PMCID: PMC8841739 DOI: 10.2147/cia.s348906] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Accepted: 12/28/2021] [Indexed: 12/21/2022] Open
Abstract
Purpose This feasibility and pilot study aimed to develop and field-test a 14-session virtual Cognitive Stimulation Therapy (vCST) programme for people living with dementia, developed as a result of services moving online during the COVID-19 pandemic. Methods The vCST protocol was developed using the existing group CST manual, through stakeholder consultation with people living with dementia, caregivers, CST group facilitators and dementia service managers. This protocol was then field-tested with 10 groups of people living with dementia in the Brazil, China (Hong Kong), India, Ireland and the UK, and feedback on the protocol was gathered from 14 facilitators. Results Field testing in five countries indicated acceptability to group facilitators and participants. Feedback from these groups was used to refine the developed protocol. The final vCST protocol is proposed, including session materials for delivery of CST over videoconferencing and a framework for offering CST virtually in global settings. Conclusion vCST is a feasible online intervention for many people living with dementia. We recommend that it is offered to those unable to access traditional in-person CST for health reasons, lack of transport or COVID-19 restrictions. Further research is needed to explore if participant outcomes are comparable to in-person CST groups.
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Affiliation(s)
- Luke Perkins
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Emily Fisher
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
- Correspondence: Emily Fisher, Research Department of Clinical, Educational and Health Psychology, University College London, Gower Street, London, WC1E 6BT, UK, Tel +44 20 7679 5770, Email
| | - Cerne Felstead
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Claire Rooney
- Occupational Therapy Department, Older Persons Services, Our Lady’s Hospice and Care Services, Harold’s Cross, Dublin, Ireland
| | - Gloria H Y Wong
- Department of Social Work and Social Administration, University of Hong Kong, Hong Kong, Hong Kong
| | - Ruizhi Dai
- Faculty of Social Sciences, University of Hong Kong, Hong Kong, Hong Kong
| | - Sridhar Vaitheswaran
- Dementia Care in Schizophrenia Research Foundation (DEMCARES), Chennai, Tamil Nadu, India
| | - Nirupama Natarajan
- Dementia Care in Schizophrenia Research Foundation (DEMCARES), Chennai, Tamil Nadu, India
| | - Daniel C Mograbi
- Department of Psychology, Pontifícia Universidade Católica do Rio de Janeiro, Rio de Janeiro, Brazil
- Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Cleusa P Ferri
- Department of Psychiatry, Universidade Federal de São Paulo, São Paulo, Brazil
- Health Technology Assessment Unit, Hospital Alemão Oswaldo Cruz, São Paulo, Brazil
| | - Joshua Stott
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Aimee Spector
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
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Paplikar A, Rajagopalan J, Alladi S. Care for dementia patients and caregivers amid COVID-19 pandemic. CEREBRAL CIRCULATION - COGNITION AND BEHAVIOR 2022; 3:100040. [PMID: 35072119 PMCID: PMC8763414 DOI: 10.1016/j.cccb.2022.100040] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 11/13/2021] [Accepted: 01/16/2022] [Indexed: 01/10/2023]
Abstract
BACKGROUND Multiple efforts have been taken across the world to bridge gaps in evidence and provide recommendations for dementia care and caregiver support during the COVID-19 pandemic. We aimed to review the available literature on measures used to alleviate the negative impacts of the pandemic on dementia care. METHODS We searched three databases: PubMed, CINAHL and PsycINFO to identify studies that described strategies that were recommended or taken to provide care and support to persons with dementia and their caregivers during the COVID-19 pandemic. RESULTS We included a total of 37 papers, originating from high, middle and low-income countries. We also included 6 papers exploring safety of COVID-19 vaccinations. Infection prevention recommendations predominantly involved providing consistent reminders to persons with dementia to engage in infection prevention measures and included measures to restrict wandering in long-term care settings to reduce spread of infection. Medical care included tele and video consultations to maintain and monitor clinical stability. Guidance for continuing rehabilitation activities for persons with dementia through remotely conducted cognitive stimulating activities, physical exercises and environmental modifications were further highlighted by multiple studies/articles. In addition, strategies to support caregivers were also advised and included teleconsultations and psycho-educational programs. CONCLUSION The COVID-19 pandemic has exposed gaps in health and social care systems across the world, but has also revealed the enduring dedication of clinicians, expert groups and dementia support organizations to modify and adapt existing dementia care services to meet the needs of persons with dementia and their caregivers during periods of emergency.
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Affiliation(s)
- Avanthi Paplikar
- Dr. S.R.Chandrasekhar Institute of Speech and Hearing, Bengaluru, India, 560084
- Department of Neurology, National Institute of Mental Health and Neurosciences [NIMHANS], Bengaluru, India, 560029
| | - Jayeeta Rajagopalan
- Department of Neurology, National Institute of Mental Health and Neurosciences [NIMHANS], Bengaluru, India, 560029
| | - Suvarna Alladi
- Department of Neurology, National Institute of Mental Health and Neurosciences [NIMHANS], Bengaluru, India, 560029
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Hu Y, Yang H, Hou C, Chen W, Zhang H, Ying Z, Hu Y, Sun Y, Qu Y, Feychting M, Valdimarsdottir U, Song H, Fang F. COVID-19 related outcomes among individuals with neurodegenerative diseases: a cohort analysis in the UK biobank. BMC Neurol 2022; 22:15. [PMID: 34996388 PMCID: PMC8739517 DOI: 10.1186/s12883-021-02536-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Accepted: 12/26/2021] [Indexed: 02/08/2023] Open
Abstract
Background An increased susceptibility to COVID-19 has been suggested for individuals with neurodegenerative diseases, but data are scarce from longitudinal studies. Methods In this community-based cohort study, we included 96,275 participants of the UK Biobank who had available SARS-CoV-2 test results in Public Health England. Of these, 2617 had a clinical diagnosis of neurodegenerative diseases in the UK Biobank inpatient hospital data before the outbreak of COVID-19 (defined as January 31st, 2020), while the remaining participants constituted the reference group. We then followed both groups from January 31st, 2020 to June 14th, 2021 for ascertainment of COVID-19 outcomes, including any COVID-19, inpatient care for COVID-19, and COVID-19 related death. Logistic regression was applied to estimate the association between neurogenerative disease and risks of COVID-19 outcomes, adjusted for multiple confounders and somatic comorbidities. Results We observed an elevated risk of COVID-19 outcomes among individuals with a neurodegenerative disease compared with the reference group, corresponding to a fully adjusted odds ratio of 2.47 (95%CI 2.25–2.71) for any COVID-19, 2.18 (95%CI 1.94–2.45) for inpatient COVID-19, and 3.67 (95%CI 3.11–4.34) for COVID-19 related death. Among individuals with a positive test result for SARS-CoV-2, individuals with neurodegenerative diseases had also a higher risk of COVID-19 related death than others (fully adjusted odds ratio 2.08; 95%CI 1.71–2.53). Conclusion Among UK Biobank participants who received at least one test for SARS-CoV-2, a pre-existing diagnosis of neurodegenerative disease was associated with a subsequently increased risk of COVID-19, especially COVID-19 related death. Supplementary Information The online version contains supplementary material available at 10.1186/s12883-021-02536-7.
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Affiliation(s)
- Yihan Hu
- West China Biomedical Big Data Center and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Guo Xue Lane 37, Chengdu, 610041, China.,Medical Big Data Center, Sichuan University, Chengdu, 610041, China.,Institute of Environmental Medicine, Karolinska Institutet, 171 77, Stockholm, Sweden
| | - Huazhen Yang
- West China Biomedical Big Data Center and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Guo Xue Lane 37, Chengdu, 610041, China.,Medical Big Data Center, Sichuan University, Chengdu, 610041, China
| | - Can Hou
- West China Biomedical Big Data Center and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Guo Xue Lane 37, Chengdu, 610041, China.,Medical Big Data Center, Sichuan University, Chengdu, 610041, China
| | - Wenwen Chen
- Division of Nephrology, Kidney Research Institute, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Hanyue Zhang
- West China Biomedical Big Data Center and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Guo Xue Lane 37, Chengdu, 610041, China.,Medical Big Data Center, Sichuan University, Chengdu, 610041, China
| | - Zhiye Ying
- West China Biomedical Big Data Center and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Guo Xue Lane 37, Chengdu, 610041, China.,Medical Big Data Center, Sichuan University, Chengdu, 610041, China
| | - Yao Hu
- West China Biomedical Big Data Center and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Guo Xue Lane 37, Chengdu, 610041, China.,Medical Big Data Center, Sichuan University, Chengdu, 610041, China
| | - Yajing Sun
- West China Biomedical Big Data Center and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Guo Xue Lane 37, Chengdu, 610041, China.,Medical Big Data Center, Sichuan University, Chengdu, 610041, China
| | - Yuanyuan Qu
- West China Biomedical Big Data Center and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Guo Xue Lane 37, Chengdu, 610041, China.,Medical Big Data Center, Sichuan University, Chengdu, 610041, China
| | - Maria Feychting
- Institute of Environmental Medicine, Karolinska Institutet, 171 77, Stockholm, Sweden
| | - Unnur Valdimarsdottir
- Center of Public Health Sciences, Faculty of Medicine, University of Iceland, 101, Reykjavík, Iceland.,Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, 171 77, Stockholm, Sweden
| | - Huan Song
- West China Biomedical Big Data Center and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Guo Xue Lane 37, Chengdu, 610041, China. .,Medical Big Data Center, Sichuan University, Chengdu, 610041, China. .,Center of Public Health Sciences, Faculty of Medicine, University of Iceland, 101, Reykjavík, Iceland.
| | - Fang Fang
- Institute of Environmental Medicine, Karolinska Institutet, 171 77, Stockholm, Sweden
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Losada A, Vara-García C, Romero-Moreno R, Barrera-Caballero S, Pedroso-Chaparro MDS, Jiménez-Gonzalo L, Fernandes-Pires J, Cabrera I, Gallego-Alberto L, Huertas-Domingo C, Mérida-Herrera L, Olazarán-Rodríguez J, Márquez-González M. Caring for Relatives with Dementia in Times of COVID-19: Impact on Caregivers and Care-recipients. Clin Gerontol 2022; 45:71-85. [PMID: 34096470 DOI: 10.1080/07317115.2021.1928356] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
OBJECTIVES To analyze caregivers' perceived impact of the pandemic in their mental health and the well-being of the care-recipients. METHODS Caregivers (N = 88) were asked if they had COVID-19 and about their perceptions of change of care-recipients' health conditions as well as whether their own mental health, conflicts with care-recipients and other relatives, thoughts of giving up caregiving, and feelings of coping well with the situation. RESULTS A large percentage of caregivers perceived a worsening of care-recipients' symptoms and of their own negative emotions, an increase in the number of conflicts and thoughts of needing to give up caregiving. Having had COVID-19 and reporting higher levels of distress as well as giving up caregiving were related to perceived worsening in care-recipients well-being. Perceived increases were mainly reported by younger caregivers, those who perceived to have not coped well, and those reporting an increase in conflicts. Some caregivers perceived an increase in positive emotions. CONCLUSIONS The pandemic has a negative impact on caregivers' perceptions about the course of their own emotions and care-recipients' well-being. CLINICAL IMPLICATIONS Interventions are needed to train caregivers in strategies to cope with the sources of stress caused by the pandemic and to promote social support.
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Affiliation(s)
- Andrés Losada
- Facultad de Ciencias de la Salud, Universidad Rey Juan Carlos, Madrid, Spain
| | - Carlos Vara-García
- Facultad de Ciencias de la Salud, Universidad Rey Juan Carlos, Madrid, Spain
| | - Rosa Romero-Moreno
- Facultad de Ciencias de la Salud, Universidad Rey Juan Carlos, Madrid, Spain
| | | | | | | | | | - Isabel Cabrera
- Facultad de Psicología, Universidad Autónoma de Madrid, Madrid, Spain
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Kokorelias KM, Nelson MLA, Tang T, Steele Gray C, Ellen M, Plett D, Jarach CM, Xin Nie J, Thavorn K, Singh H. Who is Included in Digital Health Technologies to Support Hospital to Home Transitions for Older Adults?: Secondary analysis of a rapid review and equity-informed recommendations (Preprint). JMIR Aging 2021; 5:e35925. [PMID: 35475971 PMCID: PMC9096639 DOI: 10.2196/35925] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 03/08/2022] [Accepted: 03/14/2022] [Indexed: 12/25/2022] Open
Affiliation(s)
- Kristina Marie Kokorelias
- St John's Rehab Research Program, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
- Department of Medicine, Sinai Health System/University Health Network, Toronto, ON, Canada
| | - Michelle LA Nelson
- Lunenfeld-Tanenbaum Research Institute, Sinai Health, Toronto, ON, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
- March of Dimes Canada, Toronto, ON, Canada
| | - Terence Tang
- Institute for Better Health, Trillium Health Partners, Toronto, ON, Canada
- Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Carolyn Steele Gray
- Lunenfeld-Tanenbaum Research Institute, Sinai Health, Toronto, ON, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
| | - Moriah Ellen
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
- Department of Health Policy and Management, Ben-Gurion University of the Negev, Eilat, Israel
- Guilford Glazer Faculty of Business and Management, Ben-Gurion University of the Negev, Eilat, Israel
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Eilat, Israel
| | - Donna Plett
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
| | - Carlotta Micaela Jarach
- Department of Environmental Health Sciences, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Jason Xin Nie
- Institute for Better Health, Trillium Health Partners, Toronto, ON, Canada
| | - Kednapa Thavorn
- Ottawa Hospital Research Institute, School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
| | - Hardeep Singh
- March of Dimes Canada, Toronto, ON, Canada
- Department of Occupational Science & Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
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Maggio MG, La Rosa G, Calatozzo P, Andaloro A, Foti Cuzzola M, Cannavò A, Militi D, Manuli A, Oddo V, Pioggia G, Calabrò RS. How COVID-19 Has Affected Caregivers' Burden of Patients with Dementia: An Exploratory Study Focusing on Coping Strategies and Quality of Life during the Lockdown. J Clin Med 2021; 10:jcm10245953. [PMID: 34945251 PMCID: PMC8704515 DOI: 10.3390/jcm10245953] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2021] [Revised: 12/11/2021] [Accepted: 12/16/2021] [Indexed: 12/14/2022] Open
Abstract
COVID-19 has caused a public and international health emergency, leading to isolation and social distancing. These restrictions have had a significant impact on the caregivers of people with dementia, increasing the burden of patient management. The purpose of this study was to investigate the stress perceived by caregivers of patients with Alzheimer’s disease (AD) during the pandemic. We used a cross-sectional survey design to evaluate the caregivers’ psychological responses and coping strategies. Eighty-four caregivers of patients with a diagnosis of AD were involved in this study by completing an online questionnaire. They presented a high perception of stress (the Perceived Stress Scale mean ± DS: 33.5 ± 4.5), and their high burden in caring was mainly related to physical difficulties (Caregiver Burden Inventory–Physical Burden mean ± DS: 15.0 ± 2.1) and perception of loss of time (Caregiver Burden Inventory–Time-dependence Burden mean ± DS: 16.5 ± 1.4). Moreover, caregivers perceived their quality of life as very low (Short Form-12 Health Survey Physical mean ± DS: 13.5 ± 2.7; Short Form-12 Health Survey Mental Health mean ± DS: 16.4 ± 4.2). Finally, we found that participants mostly used dysfunctional coping strategies, such as avoidance strategies (Coping Orientation to Problem Experiences–Avoidance Strategies mean ± DS: 39.5 ± 7.1), but these strategies did not affect the stress level of caregivers. Given that caregivers present a high burden and stress, innovative tools could be a valuable solution to investigate and support their emotional and behavioral status during difficult periods, such as the COVID-19 pandemic.
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Affiliation(s)
- Maria Grazia Maggio
- Department of Biomedical and Biotechnological Science, The University of Catania, 95123 Catania, Italy;
| | - Gianluca La Rosa
- AOU Policlinico Gaetano Martino, 98125 Messina, Italy; (G.L.R.); (A.C.); (A.M.)
| | - Patrizia Calatozzo
- Studio di Psicoterapia Relazionale e Riabilitazione Cognitiva, 98124 Messina, Italy; (P.C.); (A.A.); (M.F.C.)
| | - Adriana Andaloro
- Studio di Psicoterapia Relazionale e Riabilitazione Cognitiva, 98124 Messina, Italy; (P.C.); (A.A.); (M.F.C.)
| | - Marilena Foti Cuzzola
- Studio di Psicoterapia Relazionale e Riabilitazione Cognitiva, 98124 Messina, Italy; (P.C.); (A.A.); (M.F.C.)
| | - Antonino Cannavò
- AOU Policlinico Gaetano Martino, 98125 Messina, Italy; (G.L.R.); (A.C.); (A.M.)
| | - David Militi
- Odontostomatology and Dental Surgery Study, 98124 Messina, Italy;
| | - Alfredo Manuli
- AOU Policlinico Gaetano Martino, 98125 Messina, Italy; (G.L.R.); (A.C.); (A.M.)
| | - Valentina Oddo
- Università degli Studi di Messina-Piazza Pugliatti, 1, 98122 Messina, Italy;
| | - Giovanni Pioggia
- Institute for Biomedical Research and Innovation, National Research Council of Italy (IRIB-CNR), 98164 Messina, Italy;
| | - Rocco Salvatore Calabrò
- IRCCS Centro Neurolesi Bonino Pulejo, 98121 Messina, Italy
- Correspondence: ; Tel.: +39-09-0601-2380
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Pastells-Peiró R, Fernández-Lago H, Rubinat Arnaldo E, Bellon F, Martínez-Soldevila J, Gea-Sánchez M. Information and communication technologies for the improvement of cognitive function in healthy older adults: a systematic review protocol. BMJ Open 2021; 11:e046544. [PMID: 34916307 PMCID: PMC8679132 DOI: 10.1136/bmjopen-2020-046544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION Mild cognitive impairment is one of the consequences of ageing, causing functional disability, a poor quality of life and an increased socioeconomic expenditure. Evidence shows that patients go through a long preclinical stage in which cognitive deficits appear subtly until they reach the threshold of dementia. Non-pharmacological interventions have been gaining ground as prevention of modifiable factors of cognitive decline such as obesity, diabetes, physical inactivity or social isolation. Along these lines, Information and Communication Technologies (ICTs) can be a tool for cognitive stimulation, cognitive training and cognitive rehabilitation. The main objective of the systematic review will be to review and analyse the use of ICTs for the improvement of cognitive functions in healthy older adult population aged 50 and over, for the prevention of cognitive impairment METHODS: A systematic review will be conducted including randomised clinical trials in adults without diseases or accidents associated with cognitive impairment, and whom have used ICTs for the improvement of cognitive functions between 2010 and 2020 in English or Spanish. The articles that report data on cognitive function by domain, for example, memory or executive functions, or by test will be included. The databases Medline (PubMed), CinahlPlus, Scopus, ISI WoS, CENTRAL and IEEE Xplore will be searched. Studies that meet the inclusion criteria will be analysed according to the Cochrane RoB2 tool for risk of bias assessment. ETHICS AND DISSEMINATION Ethical approval is not necessary as this is a systematic review. The results will be published in scientific journals, as well as in specialised congresses on the subject of study.
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Affiliation(s)
- Roland Pastells-Peiró
- Department of Nursing and Physiotherapy, University of Lleida, Lleida, Spain
- Grup de Recerca de Cures en Salut, Lleida Institute for Biomedical Research Dr. Pifarré Foundation (IRBLleida), Lleida, Spain
- Society, Health, Education and Culture Research Group (GESEC), University of Lleida, Lleida, Spain
| | - Helena Fernández-Lago
- Department of Nursing and Physiotherapy, University of Lleida, Lleida, Spain
- Grup de Recerca de Cures en Salut, Lleida Institute for Biomedical Research Dr. Pifarré Foundation (IRBLleida), Lleida, Spain
- Society, Health, Education and Culture Research Group (GESEC), University of Lleida, Lleida, Spain
| | - Esther Rubinat Arnaldo
- Department of Nursing and Physiotherapy, University of Lleida, Lleida, Spain
- Grup de Recerca de Cures en Salut, Lleida Institute for Biomedical Research Dr. Pifarré Foundation (IRBLleida), Lleida, Spain
- Society, Health, Education and Culture Research Group (GESEC), University of Lleida, Lleida, Spain
- CIBER of Diabetes and Associated Metabolic Diseases (CIBERDEM), Instituto de Salud Carlos III, Madrid, Spain
| | - Filip Bellon
- Department of Nursing and Physiotherapy, University of Lleida, Lleida, Spain
- Grup de Recerca de Cures en Salut, Lleida Institute for Biomedical Research Dr. Pifarré Foundation (IRBLleida), Lleida, Spain
| | - Jordi Martínez-Soldevila
- Department of Nursing and Physiotherapy, University of Lleida, Lleida, Spain
- Grup de Recerca de Cures en Salut, Lleida Institute for Biomedical Research Dr. Pifarré Foundation (IRBLleida), Lleida, Spain
- Society, Health, Education and Culture Research Group (GESEC), University of Lleida, Lleida, Spain
| | - Montserrat Gea-Sánchez
- Department of Nursing and Physiotherapy, University of Lleida, Lleida, Spain
- Grup de Recerca de Cures en Salut, Lleida Institute for Biomedical Research Dr. Pifarré Foundation (IRBLleida), Lleida, Spain
- Society, Health, Education and Culture Research Group (GESEC), University of Lleida, Lleida, Spain
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The Experiences of People with Dementia and Informal Carers Related to the Closure of Social and Medical Services in Poland during the COVID-19 Pandemic-A Qualitative Study. Healthcare (Basel) 2021; 9:healthcare9121677. [PMID: 34946403 PMCID: PMC8702134 DOI: 10.3390/healthcare9121677] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 11/27/2021] [Accepted: 11/30/2021] [Indexed: 02/07/2023] Open
Abstract
Older people with dementia are particularly at risk of COVID-19; however, relatively little is known about the indirect impact of the pandemic on the lives of those living with, and/or caring for someone with, dementia. The aim of this study was to investigate the experiences of people with dementia and informal carers during the closure of available social and medical services in Poland during the COVID-19 pandemic. A qualitative thematic analysis of semi-structured interviews with people with dementia (n = 5) and informal carers (n = 21) was performed between June and August 2020 after the first wave of COVID-19 in Poland. Three overarching themes were identified: (1) care re-organization; (2) psychological responses; (3) emerging needs. The factor underlying all these elements was reliance on other people. Social support and engagement are vital to the ongoing health and well-being of people living with dementia and their informal carers. Services need to be strengthened to provide ongoing provision to those living with dementia to reach pre-pandemic levels, if not better. Within the post-pandemic environment, people with dementia and their informal carers need reassurance that they can rely on external institutional and social support able to meet their needs.
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Elsayed W. Covid-19 pandemic and its impact on increasing the risks of children's addiction to electronic games from a social work perspective. Heliyon 2021; 7:e08503. [PMID: 34869925 PMCID: PMC8632740 DOI: 10.1016/j.heliyon.2021.e08503] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Revised: 09/20/2021] [Accepted: 11/26/2021] [Indexed: 02/03/2023] Open
Abstract
Children are among the social groups most affected by the COVID-19 pandemic because they have found themselves forced to stay at home, far from their schoolmates, their friends, and far from all the activities they used to do before the pandemic. so, it was their only refuge for recreation during their stay in Home is staying in front of the screens of tablets, smartphones, and computers to play electronic games for long hours, and there is no doubt that the sudden shift in the lifestyle of children during the Covid-19 pandemic had serious consequences and risks threatening their stability at all levels. In light of that, the current study aimed to determine the impact of the Covid-19 pandemic on increasing the social, psychological, behavioral, and health risks of children's addiction to electronic games from a social work perspective. This study falls under the type of descriptive-analytical studies that are based on describing the reality of the problem under study. The study sample included 289 children in the age group 6-17 years in the first grade to the twelfth grade at school. The researcher designed a questionnaire that reflects the four risks facing children to assess these risks. The results showed is that the value of all impacts of the Covid-19 pandemic on the increasing risks of children's addiction to electronic games came to a total weight of (27907), weighted relative weight of (80.47%). This indication is High, indicating that the level of impact is High for the Covid-19 pandemic on the increase in all types of risks of children's addiction to electronic games. It ranked first " Behavioral Risks " at 91.15%, It is followed by the ranked second "Social risks " at 85.5%, Then came third place " Psychological Risks" at 80.91%, and in finally in fourth place " Health Risks" at 64.28%, which necessitates the need to take a set of serious measures by educating parents to monitor the content of electronic games that their children play, especially violent games, in addition to, reduce the number of hours the child spends practicing these games, and to encourage parents to form a bridge of communication and constructive dialogue between them and their children, and that parents put controls and restrictions on their children's practice of electronic games to confront abnormal behavioral, psychological and social patterns such as aggression, violence, deception, lying, imitation, vigilance, physical stress, poor eyesight, distance from practicing religious rituals, academic delay, introversion, depression, intolerance, selfishness, sadness, isolation from society, social withdrawal and lack of forming social relationships and lack of communication with others. The researcher took care that the results of the current study are very accurate and representative of the reality of the research problem, in light of the researcher's emphasis on the commitment to observe ethical rules to ensure the confidentiality of data. finally, the current study will greatly benefit researchers interested in the field of childhood and its problems and they will rely on its results and recommendations in how to protect children from the dangers of electronic game addiction in light of the Covid-19 crisis in particular.
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Affiliation(s)
- Walaa Elsayed
- College of Humanities and Science, Ajman University, Ajman, United Arab Emirates
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Okuno T, Itoshima H, Shin JH, Morishita T, Kunisawa S, Imanaka Y. Physical restraint of dementia patients in acute care hospitals during the COVID-19 pandemic: A cohort analysis in Japan. PLoS One 2021; 16:e0260446. [PMID: 34807945 PMCID: PMC8608313 DOI: 10.1371/journal.pone.0260446] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2021] [Accepted: 11/09/2021] [Indexed: 01/10/2023] Open
Abstract
Introduction The coronavirus disease (COVID-19) pandemic has caused unprecedented challenges for the medical staff worldwide, especially for those in hospitals where COVID-19-positive patients are hospitalized. The announcement of COVID-19 hospital restrictions by the Japanese government has led to several limitations in hospital care, including an increased use of physical restraints, which could affect the care of elderly dementia patients. However, few studies have empirically validated the impact of physical restraint use during the COVID-19 pandemic. We aimed to evaluate the impact of regulatory changes, consequent to the pandemic, on physical restraint use among elderly dementia patients in acute care hospitals. Methods In this retrospective study, we extracted the data of elderly patients (aged > 64 years) who received dementia care in acute care hospitals between January 6, 2019, and July 4, 2020. We divided patients into two groups depending on whether they were admitted to hospitals that received COVID-19-positive patients. We calculated descriptive statistics to compare the trend in 2-week intervals and conducted an interrupted time-series analysis to validate the changes in the use of physical restraint. Results In hospitals that received COVID-19-positive patients, the number of patients who were physically restrained per 1,000 hospital admissions increased after the government’s announcement, with a maximum incidence of 501.4 per 1,000 hospital admissions between the 73rd and 74th week after the announcement. Additionally, a significant increase in the use of physical restraints for elderly dementia patients was noted (p = 0.004) in hospitals that received COVID-19-positive patients. Elderly dementia patients who required personal care experienced a significant increase in the use of physical restraints during the COVID-19 pandemic. Conclusion Understanding the causes and mechanisms underlying an increased use of physical restraints for dementia patients can help design more effective care protocols for similar future situations.
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Affiliation(s)
- Takuya Okuno
- Department of Healthcare Economics and Quality Management, Graduate School of Medicine, Kyoto University, Kyoto City, Kyoto, Japan
| | - Hisashi Itoshima
- Department of Healthcare Economics and Quality Management, Graduate School of Medicine, Kyoto University, Kyoto City, Kyoto, Japan
| | - Jung-ho Shin
- Department of Healthcare Economics and Quality Management, Graduate School of Medicine, Kyoto University, Kyoto City, Kyoto, Japan
| | - Tetsuji Morishita
- Department of Healthcare Economics and Quality Management, Graduate School of Medicine, Kyoto University, Kyoto City, Kyoto, Japan
| | - Susumu Kunisawa
- Department of Healthcare Economics and Quality Management, Graduate School of Medicine, Kyoto University, Kyoto City, Kyoto, Japan
| | - Yuichi Imanaka
- Department of Healthcare Economics and Quality Management, Graduate School of Medicine, Kyoto University, Kyoto City, Kyoto, Japan
- * E-mail:
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Digitization in gynecology and obstetrics in times of COVID-19: Results of a national survey. Internet Interv 2021; 26:100478. [PMID: 34786351 PMCID: PMC8580852 DOI: 10.1016/j.invent.2021.100478] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2021] [Revised: 10/26/2021] [Accepted: 11/01/2021] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION In the COVID-19 pandemic, many consultations had to be cancelled, postponed, or converted to a virtual format. The use of telemedicine in the management of Women's Health Care could support doctors (tele-gynecology). This study analyses the use and perception of telemedicine applications among gynecologists in Germany. MATERIALS AND METHODS This prospective cross-sectional study was based on a survey of gynecologists in Germany during the COVID-19 pandemic. Descriptive statistics were calculated, and regression analyses were performed to show correlations. RESULTS The gynecologists expect telemedicine to be used in gynecology and obstetrics. 76.4% (365/478) of the respondents rated their knowledge of telemedicine as insufficient. The majority of respondents (437/478, 91.6%) said they did not currently use telemedicine, although 67.3% (321/478) would like to do so. Obstacles to the introduction of telemedicine include the purchase of technical equipment (325/478, 68.1%), administration (305/478, 64.0%) and poor reimbursement (233/478, 48.9%). Gynecologists surveyed would prefer telemedicine to communicate directly with other doctors (388/478, 81.2%) rather than to communicate with patients (228/478, 47.8%). In the treatment phases, 73.2% (349/478) of the respondents would use telemedicine during follow-up. Half of the respondents would choose tele counseling as a specific approach to improving care (246/478, 51.5%). CONCLUSION Telemedicine in gynecology finds little use but high acceptance. The absence of a structured framework is an obstacle to effective implementation. Training courses should be introduced to improve the limited knowledge in the use of telemedicine. More research in tele-gynecology is needed. These include large-scale randomized controlled trials, economic analyses and the exploration of user preferences.
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Zanin E, Aiello EN, Diana L, Fusi G, Bonato M, Niang A, Ognibene F, Corvaglia A, De Caro C, Cintoli S, Marchetti G, Vestri A. Tele-neuropsychological assessment tools in Italy: a systematic review on psychometric properties and usability. Neurol Sci 2021; 43:125-138. [PMID: 34751849 PMCID: PMC8576086 DOI: 10.1007/s10072-021-05719-9] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2021] [Accepted: 10/30/2021] [Indexed: 02/06/2023]
Abstract
Background The current COVID-19 pandemic has abruptly catalysed a shift towards remote assessment in neuropsychological practice (tele-neuropsychology, t-NPs). Although the validity of t-NPs diagnostics is gaining recognition worldwide, little is known about its implementation in Italy. The present review by the Italian working group on tele-neuropsychology (TELA) aims at describing the availability, psychometric properties, and feasibility of t-NPs tools currently available in Italy. Methods Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. This work was pre-registered on the Prospective Register of Systematic Reviews (PROSPERO; CRD42021239687). Observational studies reporting telephone-, videoconference- or web-based assessment of cognition/behaviour in Italian both healthy participants (HPs) and patients were included. Bias assessment was performed through ad hoc scales. Results Fourteen studies were included from an initial N = 895 (4 databases searched). Studies were subdivided into those focused on psychometric properties and those characterized by a predominant applied nature. The majority of studies addressed either adult/elderly HPs or neurological/internal patients. Multi-domain screening tools for cognition, behaviour, mood/anxiety and quality of life were the most represented. Findings regarding validity, reliability, sensitivity, specificity and clinical usability were reported for cognitive screenings — the telephone- and videoconference-based Mini-Mental State Examination and the Telephone Interview for Cognitive Status. Discussion Positive albeit preliminary evidence regarding psychometric properties and feasibility in both clinical and non-clinical populations of Italian t-NPs brief screening tools are herewith provided. Further studies exploring clinical usability of t-NPs and psychometric properties/feasibility of tests for the in-depth assessment of specific cognitive domains are necessary. Supplementary Information The online version contains supplementary material available at 10.1007/s10072-021-05719-9.
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Affiliation(s)
- Elia Zanin
- Ospedale Riabilitativo di Alta Specializzazione (ORAS)-ULSS 2 TV, Motta di Livenza, Italy
| | - Edoardo Nicolò Aiello
- School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy. .,PhD Program in Neuroscience, University of Milano-Bicocca, Monza, Italy.
| | - Lorenzo Diana
- School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy.,PhD Program in Neuroscience, University of Milano-Bicocca, Monza, Italy
| | - Giulia Fusi
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Mario Bonato
- Department of General Psychology, University of Padua, Padova, Italy
| | - Aida Niang
- Department of Psychology, University of Milano-Bicocca, Milan, Italy
| | | | - Alessia Corvaglia
- Department of Biomedical and Clinical Science "Luigi Sacco", University of Milan, Milan, Italy
| | | | - Simona Cintoli
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Giulia Marchetti
- Department of General Psychology, University of Padua, Padova, Italy
| | - Alec Vestri
- Unit for the Rehabilitation of Acquired Neuropsychological Disorders, IRCCS E. Medea, Pieve di Soligo, Italy
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73
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Kazawa K, Akishita M, Ikeda M, Iwatsubo T, Ishii S. Experts' perception of support for people with dementia and their families during the COVID-19 pandemic. Geriatr Gerontol Int 2021; 22:26-31. [PMID: 34755439 PMCID: PMC8653314 DOI: 10.1111/ggi.14307] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Revised: 10/21/2021] [Accepted: 10/25/2021] [Indexed: 01/03/2023]
Abstract
Aim This study aimed to explore the perceptions of dementia experts on support for people with dementia (PWD) and their families, considering PWD's vulnerability regarding COVID‐19 prevention. Methods A collaborative qualitative study was conducted, involving Hiroshima University, the Japan Geriatrics Society, the Japan Society for Dementia Research, and the Japanese Psychogeriatric Society. An anonymous, self‐reported questionnaire survey was sent to dementia experts from 456 medical centers for dementia in Japan. The responses were categorized in a qualitative inductive manner. Results A total of 214 experts from 119 centers responded (facility recovery rate: 26.1%). Four core themes emerged from the data analysis. Of these themes, three were related to support for infection prevention and related issues and response to infection: (i) support for continuation of daily life while preventing infection; (ii) support to mitigate the unfavorable effects of infection prevention measures; and (iii) decision‐making support and treatment for infected PWD. The remaining theme, (iv) community building for PWD living together, was extracted as a basis for facilitating themes (i) to (iii). Furthermore, in each theme, the roles of medical and long‐term care facilities, administration, and the need for community collaboration were identified. Conclusions Dementia experts strongly felt the need not only for short‐term support to prevent the spread of infection to PWD and their families during the pandemic, but also for long‐term support to enable them to maintain their daily lives and mitigate the impact of infection prevention measures. Geriatr Gerontol Int 2022; 22: 26–31.
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Affiliation(s)
- Kana Kazawa
- Department of Medicine for Integrated Approach to Social Inclusion, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Masahiro Akishita
- Department of Geriatric Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Manabu Ikeda
- Department of Psychiatry, Osaka University Graduate School of Medicine, Suita, Japan
| | - Takeshi Iwatsubo
- Department of Neuropathology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Shinya Ishii
- Department of Medicine for Integrated Approach to Social Inclusion, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
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Bannon S, Wang K, Grunberg VA, Dickerson BC, Vranceanu AM. Couples' experiences managing young-onset dementia early in the COVID-19 pandemic. THE GERONTOLOGIST 2021; 62:1173-1184. [PMID: 34739072 DOI: 10.1093/geront/gnab162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND AND OBJECTIVES The COVID-19 pandemic created unexpected stressors for society, and could disproportionately impact more vulnerable groups. One such group is couples facing young-onset dementia (YOD), who experience pandemic-induced stressors alongside ongoing YOD-related stressors (e.g., progressive symptoms, increased caregiving needs). Using a qualitative design, our objective was to characterize the experiences of couples living with YOD early in the COVID-19 pandemic and the impact on couples' relationship and wellbeing. RESEARCH DESIGN AND METHODS Couples (N = 23) of persons with YOD and their spousal caregivers participated in a one-hour live video, joint interview during the early COVID-19 pandemic. We used a hybrid inductive-deductive coding approach to thematic analysis to extract findings within two a-priori domains: (1) psychosocial stressors experienced during the early pandemic and (2) the impact of early pandemic stressors on couples' relationships and wellbeing. RESULTS Thematic analyses revealed 6 main themes: (1) increased caregiving responsibilities, (2) increased uncertainty, (3) increased social isolation and disruptions in social support and medical care, (4) loss of meaningful activities and routines, (5) changes to the couple's relationship, and (6) heightened emotional distress. DISCUSSION AND IMPLICATIONS The COVID-19 pandemic exacerbated relationship strain and distress among couples managing This population may face negative outcomes due to the dual-impact of YOD- and pandemic-related stressors. It is imperative to provide timely resources and psychosocial support to couples facing YOD to mitigate the negative impact of such stressors on individual health and wellbeing and the couples' relationship together.
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Affiliation(s)
- Sarah Bannon
- Integrated Brain Health Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Katherine Wang
- Integrated Brain Health Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Victoria A Grunberg
- Integrated Brain Health Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Bradford C Dickerson
- Frontotemporal Disorders Unit, Department of Neurology, Massachusetts Genral Hospital, Harvard Medical School, Boston, MA, USA
| | - Ana Maria Vranceanu
- Integrated Brain Health Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
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Brandão L, Bauer MA, Haas AN, Silveira RDS, Alves CP, de Souza DN, Beber BC, de Oliveira WF. Playing remotely in times of crisis: A program to overcome social isolation. Int J Geriatr Psychiatry 2021; 37:10.1002/gps.5638. [PMID: 34628669 PMCID: PMC8646309 DOI: 10.1002/gps.5638] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 10/03/2021] [Indexed: 11/08/2022]
Abstract
OBJECTIVES This study aims to examine the feasibility of an intergenerational remote intervention program designed to promote the wellbeing and social connection of vulnerable older adults, mainly people with aphasia and dementia during the COVID-19 pandemic in the south of Brazil. Undergraduate students were guided to lead weekly sessions of clowning, storytelling, dancing, and cooking-related activities for 3 months (from November/2020 to February/2021). METHOD The mixed-method design of the study addresses the implementation and feasibility of the program. Data analysis considered both quantitative-number of individuals who accepted the invitation to participate, voluntary dropouts, attendance-and qualitative data-participative observation and thematic analysis of evaluative conversations. An inclusive group of 34 older adults with stroke-induced cognitive impairments, dementia and individuals without any neurological conditions enrolled in the program based on social and racial equity principles. Feasibility and acceptability were addressed in terms of recruitment, implementation, remote evaluation, delivery of remote intervention, adherence, and attendance. Activities and participants' perceptions are described. RESULTS The initial period of the program achieved 83.7% of adherence and sustainability for additional 3 months. Preliminary results suggest feasibility and acceptability, considering formal and informal support in digital inclusion. Participatory observations describe that the structure of sessions and activities were well received. The analysis of participants' perceptions detects the thematic saliency of feelings of social connection and a sense of having learned with the group. CONCLUSIONS Preliminary results of this study demonstrate the feasibility and acceptability of the program, pointing to its potential mental health benefits.
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Affiliation(s)
- Lenisa Brandão
- Department of Health and Human CommunicationInstitute of PsychologyUniversidade Federal do Rio Grande do SulPorto AlegreBrazil
| | - Magda Aline Bauer
- Faculty of DentistryUniversidade Federal do Rio Grande do SulPorto AlegreBrazil
| | - Aline Nogueira Haas
- Department of Physical Education, Physiotherapy and Dance, School of Physical Education, Physiotherapy and DanceUniversidade Federal do Rio Grande do SulPorto AlegreBrazil
| | - Raquel da Silva Silveira
- Department of Social PsychologyInstitute of PsychologyUniversidade Federal do Rio Grande do SulPorto AlegreBrazil
| | - Camila Pereira Alves
- Department of Informatics EducationFederal University of Rio Grande do SulPorto AlegreBrazil
| | | | - Bárbara Costa Beber
- Department of Speech TherapyUniversidade Federal de Ciências da Saúde de Porto AlegrePorto AlegreBrazil
| | - Walter Ferreira de Oliveira
- Department of Public HealthPost Graduate Program in Mental Health and Psychosocial CareUniversidade Federal de Santa CatarinaFlorianópolisBrazil
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Di Lorito C, Masud T, Gladman J, Godfrey M, Dunlop M, Bosco A, Harwood RH. Deconditioning in people living with dementia during the COVID-19 pandemic: qualitative study from the Promoting Activity, Independence and Stability in Early Dementia (PrAISED) process evaluation. BMC Geriatr 2021; 21:529. [PMID: 34620129 PMCID: PMC8495442 DOI: 10.1186/s12877-021-02451-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Accepted: 09/02/2021] [Indexed: 01/10/2023] Open
Abstract
Background Restrictions introduced in response to the COVID-19 pandemic led to increased risk of deconditioning in the general population. No empirical evidence of this effect however has been gathered in people living with dementia. This study aims to identify the causes and effects of COVID-19-related deconditioning in people living with dementia. Methods This is a longitudinal phenomenological qualitative study. Participants living with dementia, their caregivers and therapists involved in the Promoting Activity, Independence and Stability in Early Dementia (PrAISED) process evaluation during the COVID-19 pandemic were qualitatively interviewed at two time points: the baseline 2 months after the national lockdown was imposed in England (i.e., May 2020), the follow up 2 months after the first set (i.e. July 2020). The data were analysed through deductive thematic analysis. Results Twenty-four participants living with dementia, 19 caregivers and 15 therapists took part in the study. Two themes were identified: Causes of deconditioning in people living with dementia during the COVID-19 pandemic and effects of deconditioning in people living with dementia during the COVID-19 pandemic. A self-reinforcing pattern was common, whereby lockdown made the person apathetic, demotivated, socially disengaged, and frailer. This reduced activity levels, which in turn reinforced the effects of deconditioning over time. Without external supporters, most participants lacked the motivation / cognitive abilities to keep active. Provided the proper infrastructure and support, some participants could use tele-rehabilitation to combat deconditioning. Conclusion The added risks and effects of deconditioning on people with dementia require considerable efforts from policy makers and clinicians to ensure that they initiate and maintain physical activity in prolonged periods of social distancing. Delivering rehabilitation in the same way as before the pandemic might not be feasible or sustainable and innovative approaches must be found. Digital support for this population has shown promising results but remains a challenge. Trial registration The PrAISED trial and process evaluation have received ethical approval number 18/YH/0059 from the Bradford/Leeds Ethics Committee. The ISRCTN Registration Number for PrAISED is 15320670.
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Affiliation(s)
- Claudio Di Lorito
- Division of Rehabilitation, Ageing and Wellbeing, University of Nottingham, Nottingham, NG7 2TU, UK.
| | - Tahir Masud
- Nottingham University Hospitals NHS Trust, Hucknall Rd, Nottingham, NG5 1PB, UK
| | - John Gladman
- Division of Rehabilitation, Ageing and Wellbeing, University of Nottingham, Nottingham, NG7 2TU, UK
| | - Maureen Godfrey
- Division of Rehabilitation, Ageing and Wellbeing, University of Nottingham, Nottingham, NG7 2TU, UK
| | - Marianne Dunlop
- Division of Rehabilitation, Ageing and Wellbeing, University of Nottingham, Nottingham, NG7 2TU, UK
| | - Alessandro Bosco
- School of Health Sciences, University of Manchester, Manchester, M13 9PL, UK
| | - Rowan H Harwood
- Division of Health Sciences, University of Nottingham, Nottingham, NG7 2TU, UK
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77
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Aker N, West E, Davies N, Moore KJ, Sampson EL, Nair P, Kupeli N. Challenges faced during the COVID-19 pandemic by family carers of people living with dementia towards the end of life. BMC Health Serv Res 2021; 21:996. [PMID: 34548067 PMCID: PMC8454696 DOI: 10.1186/s12913-021-07019-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Accepted: 08/31/2021] [Indexed: 01/10/2023] Open
Abstract
Background People living with dementia account for a large proportion of deaths due to COVID-19. Family carers are faced with making significant and emotive decisions during the pandemic, including decisions about end of life. We aimed to explore the challenges faced by family carers of people living with dementia during the first wave of the COVID-19 pandemic in England, as reported by charity telephone support line staff, who were able to objectively discuss a range of different experiences of many different carers who call the helpline. In particular, we focussed on key concerns and areas of decision making at the end of life. Methods We conducted a qualitative study using semi-structured interviews with eight telephone support line staff from two UK based charities who support carers of people living with dementia and those at the end of life. Interviews were conducted in the first wave of the pandemic in England in May–June 2020. Results An overarching theme of uncertainty and reactivity during a crisis was identified, and within this, five main themes were identified: concerns about care transitions, uncertainty in engaging support and help, pandemic-motivated care planning, maintaining the wellbeing of the person living with dementia, and trust, loss of agency and confusion. Conclusions Family carers may be reluctant to seek support because of fear of what may happen to their relative, which may include hospitalisation and becoming ill with COVID-19, care home placement, or not being able to be with a relative at the end of life. In some cases, a lack of trust has developed, and instead carers are seeking support from alternative services they trust such as nationally known charities.This study was used to inform the development of a decision aid to support family carers making decisions about care for their relative with dementia during the pandemic, who the lack the capacity to make their own decisions.
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Affiliation(s)
- Narin Aker
- Centre for Ageing Population Studies, Research Department of Primary Care and Population Health, University College London, London, UK
| | - Emily West
- Marie Curie Palliative Care Research Department, Division of Psychiatry, University College London, 6th Floor, Maple House, 149 Tottenham Court Road, London, W1T 7NF, UK
| | - Nathan Davies
- Centre for Ageing Population Studies, Research Department of Primary Care and Population Health, University College London, London, UK.,Marie Curie Palliative Care Research Department, Division of Psychiatry, University College London, 6th Floor, Maple House, 149 Tottenham Court Road, London, W1T 7NF, UK
| | - Kirsten J Moore
- Marie Curie Palliative Care Research Department, Division of Psychiatry, University College London, 6th Floor, Maple House, 149 Tottenham Court Road, London, W1T 7NF, UK.,National Ageing Research Institute, Parkville, Victoria, Australia
| | - Elizabeth L Sampson
- Marie Curie Palliative Care Research Department, Division of Psychiatry, University College London, 6th Floor, Maple House, 149 Tottenham Court Road, London, W1T 7NF, UK.,Barnet, Enfield and Haringey Mental Health Liaison Service, North Middlesex University Hospital NHS Trust, London, UK
| | - Pushpa Nair
- Centre for Ageing Population Studies, Research Department of Primary Care and Population Health, University College London, London, UK
| | - Nuriye Kupeli
- Marie Curie Palliative Care Research Department, Division of Psychiatry, University College London, 6th Floor, Maple House, 149 Tottenham Court Road, London, W1T 7NF, UK.
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Hertling S, Hertling D, Martin D, Graul I. Acceptance, Use and Barriers of Telemedicine in times of SARS-CoV-2 in Transgender Health Care: Results of a nationwide cross-sectional survey. JMIR Public Health Surveill 2021; 7:e30278. [PMID: 34591783 PMCID: PMC8647970 DOI: 10.2196/30278] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Revised: 07/02/2021] [Accepted: 09/19/2021] [Indexed: 11/13/2022] Open
Abstract
Background The global incidence in the treatment of transgender people is increasing. During the COVID-19 pandemic, many consultations had to be cancelled, postponed, or converted to a virtual format. Telemedicine in the management of transgender health care could support physicians. Objective The aim of this study was to analyze the acceptance, use, and barriers of telemedicine in transgender health care in times of SARS-CoV-2 in Germany. Methods This prospective cross-sectional study was based on a survey of gynecological endocrinologists and transgender patients undergoing gender-affirming hormone treatment in Germany during the COVID-19 pandemic. Descriptive statistics were calculated, and regression analyses were performed to show correlations. Results We analyzed responses of 269 transgender patients and 202 gynecological endocrinologists treating transgender patients. Most believed that telemedicine was useful. Physicians and patients rated their knowledge of telemedicine as unsatisfactory. The majority of respondents said they did not currently use telemedicine, although they would like to do so. Patients and physicians reported that their attitudes toward telemedicine had changed positively and that their use of telemedicine had increased due to COVID-19. The majority in both groups agreed on the implementation of virtual visits in the context of stable disease conditions. In the treatment phases, 74.3% (150/202) of the physicians said they would use telemedicine during follow-ups. Half of the physicians said they would choose tele-counseling as a specific approach to improving care (128/202, 63.4%). Obstacles to the introduction of telemedicine among physicians included the purchase of technical equipment (132/202, 65.3%), administration (124/202, 61.4%), and poor reimbursement (106/202, 52.5%). Conclusions Telemedicine in transgender health care found limited use but high acceptance among doctors and patients alike. The absence of a structured framework is an obstacle for effective implementation. Training courses should be introduced to improve the limited knowledge of physicians in the use of telemedicine. More research in tele-endogynecology is needed. Future studies should include large-scale randomized controlled trials, economic analyses, and the exploration of user preferences.
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Affiliation(s)
- Stefan Hertling
- Department of Obstetrics and Gynaecology, University Hospital Jena, Am Klinikum 1, Jena, DE.,Orthopaedic Department, Campus Eisenberg, University Hospital Jena, Eisenberg, Germany, Eisenberg, DE.,Fakultät für Gesundheit (Department für Humanmedizin), Lehrstuhl für Medizintheorie, Integrative und Anthroposophische Medizin, Witten/Herdecke, DE
| | - Doreen Hertling
- Department of Gynaecology, Hospital Rummelsberg, University Hospital Erlangen, Rummelsberg, DE
| | - David Martin
- Fakultät für Gesundheit (Department für Humanmedizin), Lehrstuhl für Medizintheorie, Integrative und Anthroposophische Medizin, Witten/Herdecke, DE
| | - Isabel Graul
- Department of trauma, hand and reconstructive surgery, University hospital Jena, Jena, Germany, Jena, DE.,Orthopaedic Department, Campus Eisenberg, University Hospital Jena, Eisenberg, Germany, Eisenberg, DE.,Department für Orthopädie, Unfall - Universitätsklinikum Halle, Halle, DE
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79
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Sriram V, Jenkinson C, Peters M. Carers' experiences of assistive technology use in dementia care: a cross sectional survey. BMC Geriatr 2021; 21:471. [PMID: 34433416 PMCID: PMC8385483 DOI: 10.1186/s12877-021-02417-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Accepted: 08/09/2021] [Indexed: 11/10/2022] Open
Abstract
Background Assistive Technology (AT) supports persons with dementia and their carers (family, friends and neighbours), yet little is known about experiences and the impact of AT on carers. We report on an exploratory survey that examined the types, uses, costs and impact of AT on carers as well as their quality of life. Methods A cross-sectional survey using the Carers Assistive Technology Experience Questionnaire collected data from carers in the UK, who used at least one AT in the previous year and provided more than 10 h of care for a person with dementia, living at home. Carers completed the questionnaire online or on paper and information on AT, socio-demographic details, and Short-Form Health Survey (SF-12) data were collected. Descriptive and inferential statistics were used to report results and draw conclusions. Results Data from 201 carers was analysed. Smartphones and tablet computers were the most frequently used AT. AT were used predominantly for safety, communication, and reminders. Carers usually make decisions on buying and continued use of AT. Multiple AT devices were used in the care of persons with dementia and number of AT used was associated with perceived satisfaction. Satisfaction with AT was not related to age, living arrangements and relationship of carers. From the SF-12, Mean Physical Component Score was 49.19 (95%CI- 47.75 to 50.63) and Mental Component Score was 45.37 (95%CI- 43.93 to 46.80). Women, carers in the 46–65 age group and carers who were not extremely satisfied with AT had lower MCS scores. Carers who lived with the person with dementia and older carers had lower PCS scores. Conclusions Carers report that AT has a beneficial impact. Carers use multiple ATs, perceive AT to be satisfactory and recommend AT use to others. To support carers, we recommend establishment of centrally funded information sources and a loan store for AT. Further research on incremental addition of AT and changes to formal/paid care because of using AT should be undertaken. Practitioners, academics, manufactures and policy makers should consider the experiences of carers in research, development and use of AT to facilitate improved community living of people with dementia. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-021-02417-1.
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Affiliation(s)
- Vimal Sriram
- Health Services Research Unit, Nuffield Department of Population Health, University of Oxford, Richard Doll Building, Old Road Campus, Oxford, OX3 7LF, UK.
| | - Crispin Jenkinson
- Health Services Research Unit, Nuffield Department of Population Health, University of Oxford, Richard Doll Building, Old Road Campus, Oxford, OX3 7LF, UK
| | - Michele Peters
- Health Services Research Unit, Nuffield Department of Population Health, University of Oxford, Richard Doll Building, Old Road Campus, Oxford, OX3 7LF, UK
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Toniolo S, Scarioni M, Di Lorenzo F, Hort J, Georges J, Tomic S, Nobili F, Frederiksen KS. Dementia and COVID-19, a Bidirectional Liaison: Risk Factors, Biomarkers, and Optimal Health Care. J Alzheimers Dis 2021; 82:883-898. [PMID: 34092646 DOI: 10.3233/jad-210335] [Citation(s) in RCA: 46] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Cognitive impairment following SARS-CoV-2 infection is being increasingly recognized as an acute and possibly also long-term sequela of the disease. Direct viral entry as well as systemic mechanisms such as cytokine storm are thought to contribute to neuroinflammation in these patients. Biomarkers of COVID-19-induced cognitive impairment are currently lacking, but there is some limited evidence that SARS-CoV-2 could preferentially target the frontal lobes, as suggested by behavioral and dysexecutive symptoms, fronto-temporal hypoperfusion on MRI, EEG slowing in frontal regions, and frontal hypometabolism on 18F-FDG-PET. Possible confounders include cognitive impairment due to hypoxia and mechanical ventilation and post-traumatic stress disorder. Conversely, patients already suffering from dementia, as well as their caregivers, have been greatly impacted by the disruption of their care caused by COVID-19. Patients with dementia have experienced worsening of cognitive, behavioral, and psychological symptoms, and the rate of COVID-19-related deaths is disproportionately high among cognitively impaired people. Multiple factors, such as difficulties in remembering and executing safeguarding procedures, age, comorbidities, residing in care homes, and poorer access to hospital standard of care play a role in the increased morbidity and mortality. Non-pharmacological interventions and new technologies have shown a potential for the management of patients with dementia, and for the support of their caregivers.
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Affiliation(s)
- Sofia Toniolo
- Cognitive Neurology Group, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Marta Scarioni
- Department of Neurology, Amsterdam University Medical Centers, Location VUmc, Alzheimer Center, Amsterdam, The Netherlands.,Department of Pathology, Amsterdam University Medical Centers, Location VUmc, Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - Francesco Di Lorenzo
- Clinical Imaging Sciences Centre, Brighton and Sussex Medical School, Brighton, UK.,Non-invasive Brain Stimulation Unit, IRCCS Fondazione Santa Lucia, Rome, Italy
| | - Jakub Hort
- International Clinical Research Center, St. Anne's University Hospital Brno, Brno, Czech Republic
| | | | - Svetlana Tomic
- Department of Neurology, Osijek University Hospital Center, Osijek, Croatia.,Faculty of Medicine, University Josip Juraj Strossmayer of Osijek, Osijek, Croatia
| | - Flavio Nobili
- Neurology Clinic, IRCCS Ospedale Policlinico San Martino, Genoa, Italy.,Department of Neuroscience (DINOGMI), University of Genoa, Genoa, Italy
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Hanna K, Giebel C, Butchard S, Tetlow H, Ward K, Shenton J, Cannon J, Komuravelli A, Gaughan A, Eley R, Rogers C, Rajagopal M, Limbert S, Callaghan S, Whittington R, Shaw L, Donnellan W, Gabbay M. Resilience and supporting people living with dementia during the time of COVID-19; A qualitative study. DEMENTIA 2021; 21:250-269. [PMID: 34346231 PMCID: PMC8721689 DOI: 10.1177/14713012211036601] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES To explore the different factors of resilience for people living with dementia and unpaid carers, in response to sudden changes in care and lifestyle during the COVID-19 pandemic. METHODS Unpaid carers and people living with dementia were offered telephone interviews in April 2020 to discuss their experiences since the COVID-19 pandemic. Participants were asked about the benefits and challenges of accessing dementia support, as well as coping, symptoms, strategies and impacts. Each transcript was analysed using inductive and deductive thematic analysis by two researchers. FINDINGS Semi-structured interviews from 50 participants (n = 42 unpaid carers and n = 8 people living with dementia) reported protective and risk factors of resilience concerning (1) communication, (2) adaptations, (3) support networks and (4) lifestyle factors and coping mechanisms. CONCLUSIONS Resilience factors considered both organisational factors for external support, along with individual coping mechanisms. Organisations and social support services should consider resilience factors in future service planning, to better support people living with dementia, or caring someone living with dementia, during times of great stress. The ecological model of resilience established from this research refers to resilience during times of unexpected change in the COVID-19 pandemic; however, it could be considered relevant in other periods of high stress within this cohort.
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Affiliation(s)
- Kerry Hanna
- Department of Primary Care & Mental Health, 4591University of Liverpool, Liverpool, UK
| | - Clarissa Giebel
- Department of Primary Care & Mental Health, 4591University of Liverpool, UK; NIHR ARC NWC, Liverpool, UK
| | - Sarah Butchard
- Department of Primary Care & Mental Health, 4591University of Liverpool, UK; NIHR ARC NWC, Liverpool, UK
| | - Hilary Tetlow
- SURF Liverpool, 4591University of Liverpool, Liverpool, UK
| | - Kym Ward
- The Brain Charity, Liverpool, UK
| | | | | | | | - Anna Gaughan
- Together In Dementia Everyday (TIDE), Liverpool, UK
| | - Ruth Eley
- Liverpool Dementia Action Alliance, Liverpool, UK
| | | | | | | | | | | | - Lisa Shaw
- Department of Modern Languages and Cultures, 4591University of Liverpool, Liverpool, UK
| | - Warren Donnellan
- Department of Psychology, 4591University of Liverpool, Liverpool, UK
| | - Mark Gabbay
- Department of Primary Care & Mental Health, 4591University of Liverpool, Liverpool, UK; NIHR ARC NWC, Liverpool, UK
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82
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Dellazizzo L, Léveillé N, Landry C, Dumais A. Systematic Review on the Mental Health and Treatment Impacts of COVID-19 on Neurocognitive Disorders. J Pers Med 2021; 11:jpm11080746. [PMID: 34442390 PMCID: PMC8401453 DOI: 10.3390/jpm11080746] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 07/27/2021] [Accepted: 07/28/2021] [Indexed: 01/10/2023] Open
Abstract
Objectives. The COVID-19 pandemic has had many public health impacts, especially on vulnerable individuals including adults with neurocognitive disorders (NCD). With increasing literature, this systematic literature review aimed to address the mental health effects of COVID-19 on people with NCD in addition to examine the impact of the pandemic on treatments/resources for NCD. Methods. A literature search was conducted in the electronic databases of PubMed, PsycINFO, Web of Science and Google Scholar. Studies were included so long as they assessed the mental health or therapeutic effects of COVID-19 on NCD. Results. Among the retrieved articles, 59 met eligibility criteria. First, the pandemic and resulting self-isolation led to many detrimental effects on psychological well-being. Exacerbation and relapses of neurocognitive and behavioral symptoms were observed, as well as emergences of new psychological symptoms (i.e., depression, anxiety). Second, therapeutic and community services for individuals suffering from NCD, such as social support services and outpatient clinics, were disrupted or reduced leading to postponed appointments and evaluations, as well as reduced access to medications. These issues were somewhat palliated with the growth of telemedicine. Conclusions. This systematic review highlights the extent of the effects of the pandemic, and the topics addressed should be taken into consideration by healthcare practitioners, institutions, and policymakers to ensure that proper measures are employed to protect this population from additional harm.
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Affiliation(s)
- Laura Dellazizzo
- Research Center of the Institut Universitaire en Santé Mentale de Montréal, 7331 Hochelaga, Montreal, QC H1N 3V2, Canada; (L.D.); (N.L.); (C.L.)
- Faculty of Medicine, Université de Montréal, 2900 Edouard Montpetit Blvd, Montreal, QC H3T 1J4, Canada
| | - Nayla Léveillé
- Research Center of the Institut Universitaire en Santé Mentale de Montréal, 7331 Hochelaga, Montreal, QC H1N 3V2, Canada; (L.D.); (N.L.); (C.L.)
- Faculty of Medicine, Université de Montréal, 2900 Edouard Montpetit Blvd, Montreal, QC H3T 1J4, Canada
| | - Clara Landry
- Research Center of the Institut Universitaire en Santé Mentale de Montréal, 7331 Hochelaga, Montreal, QC H1N 3V2, Canada; (L.D.); (N.L.); (C.L.)
- Faculty of Medicine, Université de Montréal, 2900 Edouard Montpetit Blvd, Montreal, QC H3T 1J4, Canada
| | - Alexandre Dumais
- Research Center of the Institut Universitaire en Santé Mentale de Montréal, 7331 Hochelaga, Montreal, QC H1N 3V2, Canada; (L.D.); (N.L.); (C.L.)
- Faculty of Medicine, Université de Montréal, 2900 Edouard Montpetit Blvd, Montreal, QC H3T 1J4, Canada
- Institut National de Psychiatrie Légale Philippe-Pinel, 10905 Blvd Henri-Bourassa E, Montreal, QC H1C 1H1, Canada
- Correspondence:
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Scheibe M, Lang C, Druschke D, Arnold K, Luntz E, Schmitt J, Holthoff-Detto V. Independent Use of a Home-Based Telemonitoring App by Older Patients With Multimorbidity and Mild Cognitive Impairment: Qualitative Study. JMIR Hum Factors 2021; 8:e27156. [PMID: 34255664 PMCID: PMC8314150 DOI: 10.2196/27156] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 04/16/2021] [Accepted: 05/03/2021] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND The management of multimorbidity is complex and patients have a high burden of disease. When symptoms of dementia also appear, it becomes even more difficult for patients to cope with their everyday lives and manage their diseases. Home-based telemonitoring may support older patients with multimorbidity and mild cognitive impairment (MCI) in their regular monitoring and self-management. However, to date, there has been no investigation into whether patients with MCI are able to operate a telemonitoring app independently to manage their own diseases. This question has become even more important during the current COVID-19 pandemic to maintain high-quality medical care for this patient group. OBJECTIVE We examined the following research questions: (1) How do patients with MCI assess the usability of the telemonitoring app? (2) How do patients with MCI assess the range of functions offered by the telemonitoring app? (3) Was there an additional benefit for the patients with MCI in using the telemonitoring app? (4) Were patients with MCI able to use the telemonitoring app independently and without restrictions? (5) To what extent does previous experience with smartphones, tablets, or computers influence the perceived ease of use of the telemonitoring app? METHODS We performed a formative evaluation of a telemonitoring app. Therefore, we carried out a qualitative study and conducted guided interviews. All interviews were audio-recorded, transcribed verbatim, and analyzed using the Mayring method of structured content analysis. RESULTS Twelve patients (8 women, 4 men) were interviewed; they had an average age of 78.7 years (SD 5.6) and an average Mini-Mental State Examination score of 24.5 (SD 1.6). The interviews lasted between 17 and 75 minutes (mean 41.8 minutes, SD 19.4). Nine patients reported that the telemonitoring app was easy to use. All respondents assessed the range of functions as good or adequate. Desired functionalities mainly included more innovative and varied educational material, better fit of the telemonitoring app for specific needs of patients with MCI, and a more individually tailored content. Ten of the 12 patients stated that the telemonitoring app had an additional benefit for them. Most frequently reported benefits included increased feeling of security, appreciation of regular monitoring of vital parameters, and increased independence due to telemonitoring. Eight patients were able to operate the app independently. Participants found the app easy to use regardless of whether they had prior experience with smartphones, tablets, or computers. CONCLUSIONS The majority of examined patients with MCI were capable of operating the telemonitoring app independently. Crucial components in attaining independent use were comprehensive personal support from the start of use and appropriate design features. This study provides initial evidence that patients with MCI could increasingly be considered as a relevant user group of telemonitoring apps.
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Affiliation(s)
- Madlen Scheibe
- Center for Evidence-Based Healthcare, University Hospital Carl Gustav Carus and Carl Gustav Carus Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Caroline Lang
- Center for Evidence-Based Healthcare, University Hospital Carl Gustav Carus and Carl Gustav Carus Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Diana Druschke
- Center for Evidence-Based Healthcare, University Hospital Carl Gustav Carus and Carl Gustav Carus Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Katrin Arnold
- Center for Evidence-Based Healthcare, University Hospital Carl Gustav Carus and Carl Gustav Carus Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Edwin Luntz
- Center for Evidence-Based Healthcare, University Hospital Carl Gustav Carus and Carl Gustav Carus Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Jochen Schmitt
- Center for Evidence-Based Healthcare, University Hospital Carl Gustav Carus and Carl Gustav Carus Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Vjera Holthoff-Detto
- Department of Psychiatry, Psychotherapy and Psychosomatics, Alexianer Hospital Hedwigshöhe, St Hedwig Hospital Berlin, Berlin, Germany
- Carl Gustav Carus Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
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Telemedicine as a Therapeutic Option in Sports Medicine: Results of a Nationwide Cross-Sectional Study among Physicians and Patients in Germany. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18137110. [PMID: 34281045 PMCID: PMC8297228 DOI: 10.3390/ijerph18137110] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 06/30/2021] [Accepted: 07/01/2021] [Indexed: 12/05/2022]
Abstract
Background: Worldwide, the number of treatments in the field of sports medicine is increasing. However, the COVID-19 pandemic has changed everyday life. Many consultations had to be cancelled, postponed, or converted to a virtual format. Telemedicine in sports medicine could support physicians. This study analyzes the use and perception of telemedicine applications among physicians and patients in the field of sports medicine in Germany. Methods: This prospective cross-sectional study was based on a survey of sports medicine physicians and patients in Germany during the COVID-19 pandemic. Descriptive statistics were calculated. Results: We analyzed the responses of 729 patients and 702 sports medicine physicians. Most believed that telemedicine is useful. Both physicians and patients rated their knowledge of telemedicine as unsatisfactory. The majority of respondents said they do not currently use telemedicine but would like to do so. Patients and physicians reported that their attitude had changed positively towards telemedicine and that their usage had increased due to COVID-19. The majority in both groups agreed on implementing virtual visits in stable disease conditions. Telemedicine was considered helpful for follow-up monitoring and prevention by both groups. Conclusion: Telemedicine in sports medicine has seen limited use but is highly accepted among physicians and patients alike. The absence of a structured framework is an obstacle to effective implementation. Training courses should be introduced to improve the limited knowledge regarding the use of telemedicine. More research in telemedicine in sports medicine is needed. This includes large-scale randomized controlled trials, economic analyses and explorations of user preferences.
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85
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Impact of the COVID-19 Pandemic on Family Carers of Older People Living with Dementia in Italy and Hungary. SUSTAINABILITY 2021. [DOI: 10.3390/su13137107] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The COVID-19 pandemic has had a major effect on both older people with dementia and families caring for them. This paper presents the results of an online survey carried out among Italian and Hungarian family carers of people with dementia during the first pandemic wave (May–July 2020, n = 370). The research questions were the following: (1) How has the pandemic changed the lives of family carers? (2) How did government restriction measures change the availability of care-related help? (3) What other changes did families experience? Results show that about one-quarter of both subsamples experienced a deterioration in their financial status. A decline in both general and mental health was also reported. Due to “lockdown”, family carers’ burden increased substantially. Utilization of care-related help decreased, and the share of those left with no help increased in both countries. Cross-country differences emerged in terms of dementia care system, severity of the first pandemic wave, and measures put in place by governments. Findings outline the weaknesses of support structures and their country-specific vulnerabilities to a worldwide pandemic. To better protect people with dementia in the future, it is essential to strengthen their family carers, and support structures need to be re-evaluated and re-designed.
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86
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Freiesleben SD, Megges H, Herrmann C, Wessel L, Peters O. Overcoming barriers to the adoption of locating technologies in dementia care: a multi-stakeholder focus group study. BMC Geriatr 2021; 21:378. [PMID: 34154542 PMCID: PMC8218472 DOI: 10.1186/s12877-021-02323-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Accepted: 05/13/2021] [Indexed: 11/19/2022] Open
Abstract
Background Locating technologies are a subtype of assistive technology that aim to support persons with dementia by helping manage spatial orientation impairments and provide aid to care partners by intervening when necessary. Although a variety of locating devices are commercially available, their adoption has remained low in the past years. Several studies have explored barriers to the adoption of assistive technologies from the perspective of professional stakeholders, but in-depth explorations for locating technologies are sparse. Additionally, the inputs of business professionals are lacking. The aim of this study was to expand knowledge on barriers to the adoption of locating technologies from a multi-stakeholder professional perspective, and to explore strategies to optimize adoption. Methods In total, 22 professionals working in business (n = 7), healthcare (n = 6) and research (n = 9) fields related to gerontology and gerontechnology participated in our focus group study. Perceptions on the value of using locating technologies for dementia care, barriers to their adoption, as well as salient services and information dissemination strategies were explored. After verbatim transcription, transcripts were analysed following an inductive data-driven content analysis approach in MAXQDA. Results Six key adoption barriers centering on: (1) awareness-, (2) technological-, (3) product characteristic- and (4) capital investment-based limitations, (5) unclear benefits, as well as (6) ethical concerns emerged. The interplay between barriers was high. Five core themes on services and information dissemination strategies centering on: (1) digital autonomy support, (2) emergency support, (3) information dissemination actors, (4) product acquisition, and (5) product advertising were extracted. Conclusions Our study with interdisciplinary stakeholders expands knowledge on barriers to the adoption of locating technologies for dementia care, and reinforces recommendations that an interdisciplinary strategy is needed to optimize adoption. Also, our findings show that focusing on services to increase digital autonomy and on information dissemination strategies has been largely overlooked and may be particularly effective. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-021-02323-6.
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Affiliation(s)
- Silka Dawn Freiesleben
- Department of Psychiatry, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health (BIH), Lindenberger Weg 80, 13125, Berlin, Germany. .,German Center for Neurodegenerative Diseases (DZNE), Berlin, Germany. .,Memory Clinic and Dementia Prevention Center, Experimental and Clinical Research Center (ECRC), Lindenberger Weg 80, 13125, Berlin, Germany.
| | - Herlind Megges
- Department of Psychiatry, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health (BIH), Lindenberger Weg 80, 13125, Berlin, Germany.,German Center for Neurodegenerative Diseases (DZNE), Berlin, Germany.,Memory Clinic and Dementia Prevention Center, Experimental and Clinical Research Center (ECRC), Lindenberger Weg 80, 13125, Berlin, Germany.,Present address: Federal Ministry for Family Affairs, Senior Citizens, Women and Youth (BMFSFJ), Berlin, Germany
| | - Christina Herrmann
- Department of Psychiatry, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health (BIH), Lindenberger Weg 80, 13125, Berlin, Germany.,Memory Clinic and Dementia Prevention Center, Experimental and Clinical Research Center (ECRC), Lindenberger Weg 80, 13125, Berlin, Germany
| | - Lauri Wessel
- European New School of Digital Studies, European University Viadrina, Große Scharrnstraße 59, 15230, Frankfurt (Oder), Germany
| | - Oliver Peters
- Department of Psychiatry, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health (BIH), Lindenberger Weg 80, 13125, Berlin, Germany.,German Center for Neurodegenerative Diseases (DZNE), Berlin, Germany.,Memory Clinic and Dementia Prevention Center, Experimental and Clinical Research Center (ECRC), Lindenberger Weg 80, 13125, Berlin, Germany
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Reichold M, Dietzel N, Chmelirsch C, Kolominsky-Rabas PL, Graessel E, Prokosch HU. Designing and Implementing an IT Architecture for a Digital Multicenter Dementia Registry: digiDEM Bayern. Appl Clin Inform 2021; 12:551-563. [PMID: 34134149 PMCID: PMC8208839 DOI: 10.1055/s-0041-1731286] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
Background
Registries are an essential research tool to investigate the long-term course of diseases and their impact on the affected. The project digiDEM Bayern will set up a prospective dementia registry to collect long-term data of people with dementia and their caregivers in Bavaria (Germany) supported by more than 300 research partners.
Objective
The objective of this article is to outline an information technology (IT) architecture for the integration of a registry and comprehensive participant management in a dementia study. Measures to ensure high data quality, study governance, along with data privacy, and security are to be included in the architecture.
Methods
The architecture was developed based on an iterative, stakeholder-oriented process. The development was inspired by the Twin Peaks Model that focuses on the codevelopment of requirements and architecture. We gradually moved from a general to a detailed understanding of both the requirements and design through a series of iterations. The experience learned from the pilot phase was integrated into a further iterative process of continuous improvement of the architecture.
Results
The infrastructure provides a standardized workflow to support the electronic data collection and trace each participant's study process. Therefore, the implementation consists of three systems: (1) electronic data capture system for Web-based or offline app-based data collection; (2) participant management system for the administration of the identity data of participants and research partners as well as of the overall study governance process; and (3) videoconferencing software for conducting interviews online. First experiences in the pilot phase have proven the feasibility of the framework.
Conclusion
This article outlines an IT architecture to integrate a registry and participant management in a dementia research project. The framework was discussed and developed with the involvement of numerous stakeholders. Due to its adaptability of used software systems, a transfer to other projects should be easily possible.
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Affiliation(s)
- Michael Reichold
- Department of Medical Informatics, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Nikolas Dietzel
- Interdisciplinary Center for Health Technology Assessment (HTA) and Public Health (IZPH), Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Christina Chmelirsch
- Interdisciplinary Center for Health Technology Assessment (HTA) and Public Health (IZPH), Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Peter L Kolominsky-Rabas
- Interdisciplinary Center for Health Technology Assessment (HTA) and Public Health (IZPH), Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Elmar Graessel
- Center for Health Services Research in Medicine, Department of Psychiatry and Psychotherapy, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Hans-Ulrich Prokosch
- Department of Medical Informatics, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Erlangen, Germany
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Scerpella DL, Bouranis NG, Webster MJ, Dellapina M, Koeuth S, Parker LJ, Kales HC, Gitlin LN. Using Geographic Information Systems (GIS) for Targeted National Recruitment of Community-Dwelling Caregivers Managing Dementia-Related Behavioral and Psychological Symptoms: A Recruitment Approach for a Randomized Clinical Trial. JOURNAL OF GEOGRAPHIC INFORMATION SYSTEM 2021; 13:302-317. [PMID: 34484851 PMCID: PMC8415725 DOI: 10.4236/jgis.2021.133017] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Over 16 million caregivers of people living with dementia require support in a range of issues, including self-care, disease education, and guidance for how to manage behavioral and psychological symptoms of dementia (BPSD). Non-pharmacological interventions are needed to address these areas, and online applications have been shown to be safe and effective. To ensure the efficacy of such interventions, racially, ethnically, geographically, and socioeconomically diverse participants must be recruited to increase the generalizability of study outcomes. This protocol paper describes a recruitment plan using Geographic Information Systems (GIS) to reach a representative sample of caregivers across the United States for a national Phase III clinical study. Using publicly available census data from the American Community Survey (ACS), combined with location data for local aging resources such as Area Agencies on Aging (AAA), recruitment will be derived from data analysis conducted in ESRI ArcGIS v10.7.1. Datasets including age, gender, income, and education will be assessed nationally at the county and census tract spatial scale in a nine-step process to develop recruitment priority areas containing high concentrations of eligible participants living in the community. Overall, the current protocol will demonstrate the value of GIS in tailoring targeted outreach strategies to recruit community-dwelling populations through local resource institutions. This novel approach may have far-reaching implications in future recruitment initiatives and help to secure racially/ethnically diverse samples.
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Affiliation(s)
| | - Nicole G Bouranis
- College of Nursing and Health Professions, Drexel University, Philadelphia, USA
| | - Melinda J Webster
- College of Nursing and Health Professions, Drexel University, Philadelphia, USA
| | - Maria Dellapina
- College of Nursing and Health Professions, Drexel University, Philadelphia, USA
| | - Sokha Koeuth
- College of Nursing and Health Professions, Drexel University, Philadelphia, USA
| | - Lauren J Parker
- School of Public Health, Johns Hopkins University, Baltimore, USA
| | - Helen C Kales
- Department of Psychiatry, University of California-Davis, Sacramento, USA
| | - Laura N Gitlin
- College of Nursing and Health Professions, Drexel University, Philadelphia, USA
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Goodman-Casanova JM, Dura-Perez E, Guerrero-Pertiñez G, Barnestein-Fonseca P, Guzman-Parra J, Vega-Nuñez A, Varela-Moreno E, Cuesta-Vargas A, Mayoral-Cleries F. Cognitive Outcomes During COVID-19 Confinement Among Older People and Their Caregivers Using Technologies for Dementia: Protocol for an Observational Cohort Study. JMIR Res Protoc 2021; 10:e26431. [PMID: 33909588 PMCID: PMC8133176 DOI: 10.2196/26431] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Revised: 02/02/2021] [Accepted: 04/12/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic has led to worldwide implementation of unprecedented restrictions to control its rapid spread and mitigate its impact. The Spanish government has enforced social distancing, quarantine, and home confinement measures. Such restrictions on activities of daily life and separation from loved ones may lead to social isolation and loneliness with health-related consequences among community-dwelling older adults with mild cognitive impairment or mild dementia and their caregivers. Additionally, inadequate access to health care and social support services may aggravate chronic conditions. Home-based technological interventions have emerged for combating social isolation and loneliness, while simultaneously preventing the risk of virus exposure. OBJECTIVE The aim of this cohort study is to explore, analyze, and determine the impact of social isolation on (1) cognition, quality of life, mood, technophilia, and perceived stress among community-dwelling older adults with mild cognitive impairment or mild dementia and on the caregiver burden; (2) access to and utilization of health and social care services; and (3) cognitive, social, and entertainment-related uses of information and communication technologies. METHODS This study will be conducted in Málaga (Andalucía, Spain). In total 200 dyads, consisting of a person with mild cognitive impairment or mild dementia and his/her informal caregiver, will be contacted by telephone. Potential respondents will be participants of the following clinical trials: support, monitoring, and reminder technology for mild dementia (n=100) and television-based assistive integrated service to support European adults living with mild dementia or mild cognitive impairment (n=100). RESULTS As of May 2021, a total of 153 participants have been enrolled and assessed during COVID-19 confinement, of whom 67 have been assessed at 6 months of enrollment. Changes in the mean values of the variables will be analyzed relative to baseline findings of previous studies with those during and after confinement, using repeated-measures analysis of variance or the nonparametric Friedman test, as appropriate. The performance of multivariate analysis of covariance (ANCOVA) to introduce potential covariates will also be considered. Values of 95% CI will be used. CONCLUSIONS If our hypothesis is accepted, these findings will demonstrate the negative impact of social isolation owing to COVID-19 confinement on cognition, quality of life, mood, and perceived stress among community-dwelling older adults with mild cognitive impairment and mild dementia, the impact on technophilia, caregiver burden, the access to and utilization of health and social care services, and the cognitive, social, and entertainment-related use of information and communication technologies during and after COVID-19 confinement. TRIAL REGISTRATION ClinicalTrials.gov NCT04385797; https://clinicaltrials.gov/ct2/show/NCT04385797. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/26431.
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Affiliation(s)
- Jessica Marian Goodman-Casanova
- Department of Mental Health, Regional University Hospital of Málaga, Biomedical Research Institute of Malaga (IBIMA), Málaga, Spain
| | - Elena Dura-Perez
- Department of Mental Health, Regional University Hospital of Málaga, Biomedical Research Institute of Malaga (IBIMA), Málaga, Spain
- Faculty of Psychology, University of Málaga, Málaga, Spain
| | - Gloria Guerrero-Pertiñez
- Department of Mental Health, Regional University Hospital of Málaga, Biomedical Research Institute of Malaga (IBIMA), Málaga, Spain
| | - Pilar Barnestein-Fonseca
- Department of Mental Health, Regional University Hospital of Málaga, Biomedical Research Institute of Malaga (IBIMA), Málaga, Spain
| | - Jose Guzman-Parra
- Department of Mental Health, Regional University Hospital of Málaga, Biomedical Research Institute of Malaga (IBIMA), Málaga, Spain
| | - Amanda Vega-Nuñez
- Department of Mental Health, Regional University Hospital of Málaga, Biomedical Research Institute of Malaga (IBIMA), Málaga, Spain
| | - Esperanza Varela-Moreno
- Department of Mental Health, Regional University Hospital of Málaga, Biomedical Research Institute of Malaga (IBIMA), Málaga, Spain
| | - Antonio Cuesta-Vargas
- Department of Physiotherapy, University of Málaga, Biomedical Research Institute of Malaga (IBIMA), Málaga, Spain
| | - Fermin Mayoral-Cleries
- Department of Mental Health, Regional University Hospital of Málaga, Biomedical Research Institute of Malaga (IBIMA), Málaga, Spain
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Trevisan C, Del Signore S, Fumagalli S, Gareri P, Malara A, Mossello E, Volpato S, Monzani F, Coin A, Bellelli G, Zia G, Ranhoff AH, Antonelli Incalzi R. Assessing the impact of COVID-19 on the health of geriatric patients: The European GeroCovid Observational Study. Eur J Intern Med 2021; 87:29-35. [PMID: 33573885 PMCID: PMC7847394 DOI: 10.1016/j.ejim.2021.01.017] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 12/02/2020] [Accepted: 01/18/2021] [Indexed: 12/18/2022]
Abstract
BACKGROUND Despite the growing evidence on COVID-19, there are still many gaps in the understanding of this disease, especially in individuals in advanced age. We describe the study protocol of GeroCovid Observational, a multi-purpose, multi-setting and multicenter initiative that aims at investigating: risk factors, clinical presentation and outcomes of individuals affected by COVID-19 in acute and residential care settings; best strategies to prevent infection in long-term care facilities; and, impact of the pandemic on neuropsychologic, functional and physical health, and on medical management in outpatients and home care patients at risk of COVID-19, with a special focus on individuals with dementia. METHODS GeroCovid involves individuals aged ≥60 years, at risk of or affected by COVID-19, prospectively or retrospectively observed since March 1st, 2020. Data are collected in multiple investigational sites across Italy, Spain and Norway, and recorded in a de-identified clinical e-Registry. A common framework was adapted to different care settings: acute wards, long-term care facilities, geriatric outpatient and home care, and outpatient memory clinics. RESULTS At September 16th, 2020, 66 investigational sites obtained their Ethical Committee approval and 1618 cases (mean age 80.6 [SD=9.0] years; 45% men) have been recorded in the e-Registry. The average inclusion rate since the study start on April 25th, 2020, is 11.2 patients/day. New cases enrollment will ended on December 31st , 2020, and the clinical follow-up will end on June 30th, 2021. CONCLUSION GeroCovid will explore relevant aspects of COVID-19 in adults aged ≥60 years with high-quality and comprehensive data, which will help to optimize COVID-19 prevention and management, with practical implications for ongoing and possible future pandemics. TRIAL REGISTRATION NCT04379440 (clinicaltrial.gov).
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Affiliation(s)
- Caterina Trevisan
- Geriatrics Unit and the GeroCovid Working Group, Department of Medicine (DIMED), University of Padua, Italy.
| | | | - Stefano Fumagalli
- Geriatric Intensive Care Unit, Department of Experimental and Clinical Medicine, University of Florence, Italy
| | - Pietro Gareri
- Center for Cognitive Disorders and Dementia - Catanzaro Lido, ASP Catanzaro, Italy
| | - Alba Malara
- Scientific Committee of National Association of Third Age Residences (ANASTE) Calabria, Lamezia Terme (Catanzaro), Italy
| | - Enrico Mossello
- Geriatric Intensive Care Unit, Department of Experimental and Clinical Medicine, University of Florence, Italy
| | - Stefano Volpato
- Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - Fabio Monzani
- Geriatrics Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Alessandra Coin
- Geriatrics Unit and the GeroCovid Working Group, Department of Medicine (DIMED), University of Padua, Italy
| | - Giuseppe Bellelli
- School of Medicine and Surgery, Acute Geriatric Unit, University of Milano-Bicocca, San Gerardo Hospital, Monza, Italy
| | | | - Anette Hylen Ranhoff
- Department of Clinical Science, University of Bergen, Norway and Diakonhjemmet Hospital, Oslo, Norway
| | - Raffaele Antonelli Incalzi
- Geriatrics Unit, Department of Medicine, Campus Bio-Medico University and Teaching Hospital, Rome, Italy
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91
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Pareyson D, Pantaleoni C, Eleopra R, De Filippis G, Moroni I, Freri E, Zibordi F, Bulgheroni S, Pagliano E, Sarti D, Silvani A, Grazzi L, Tiraboschi P, Didato G, Anghileri E, Bersano A, Valentini L, Piacentini S, Muscio C, Leonardi M, Mariotti C, Eoli M, Nuzzo S, Tagliavini F, Confalonieri P, De Giorgi F. Neuro-telehealth for fragile patients in a tertiary referral neurological institute during the COVID-19 pandemic in Milan, Lombardy. Neurol Sci 2021; 42:2637-2644. [PMID: 33929645 PMCID: PMC8086222 DOI: 10.1007/s10072-021-05252-9] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Accepted: 04/10/2021] [Indexed: 12/20/2022]
Abstract
Background Lombardy was severely hit by the COVID-19 pandemic since February 2020 and the Health System underwent rapid reorganization. Outpatient clinics were stopped for non-urgent patients: it became a priority to manage hundreds of fragile neurological patients who suddenly had less reference points. In Italy, before the pandemic, Televisits were neither recognized nor priced. Methods At the Fondazione IRCCS Istituto Neurologico C. Besta, we reorganized outpatient clinics to deliver Neuro-telemedicine services, including Televisits and Teleneurorehabilitation, since March 2020. A dedicated Working Group prepared the procedure, tested the system, and designed satisfaction questionnaires for adults and children. Results After a pilot phase, we prepared a procedure for Telemedicine outpatient clinics which was approved by hospital directions. It included prescription, booking, consenting, privacy and data protection, secure connection with patients (Teams Microsoft 365), electronic report preparation and delivery, reporting, and accountability of the services. During the March–September 2020 period, we delivered 3167 Telemedicine services, including 1618 Televisits, to 1694 patients (972 adults, 722 children) with a wide range of chronic neurological disorders. We successfully administered different clinical assessment and scales. Satisfaction among patients and caregivers was very high. Conclusions During the dramatic emergency, we were able to take care of more than 1600 patients by organizing Neuro-telehealth in a few weeks, lessening the impact of the pandemic on fragile patients with chronic neurological disorders; this strategy is now stably embedded in our care pathways. In Italy, Telehealth is at present recognized and priced and is becoming a stable pillar of the health system.
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Affiliation(s)
- Davide Pareyson
- Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy. .,Rare Neurodegenerative and Neurometabolic Diseases Unit, Clinical Neurosciences Department, Fondazione IRCCS Istituto Neurologico Carlo Besta, Via Celoria 11, 20133, Milan, Italy.
| | | | - Roberto Eleopra
- Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | | | - Isabella Moroni
- Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Elena Freri
- Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | | | - Sara Bulgheroni
- Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | | | - Daniela Sarti
- Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Antonio Silvani
- Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Licia Grazzi
- Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | | | - Giuseppe Didato
- Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Elena Anghileri
- Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Anna Bersano
- Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Laura Valentini
- Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | | | - Cristina Muscio
- Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | | | | | - Marica Eoli
- Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Sara Nuzzo
- Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
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92
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Dowson B, Atkinson R, Barnes J, Barone C, Cutts N, Donnebaum E, Hung Hsu M, Lo Coco I, John G, Meadows G, O'Neill A, Noble D, Norman G, Pfende F, Quinn P, Warren A, Watkins C, Schneider J. Digital Approaches to Music-Making for People With Dementia in Response to the COVID-19 Pandemic: Current Practice and Recommendations. Front Psychol 2021; 12:625258. [PMID: 33967893 PMCID: PMC8103026 DOI: 10.3389/fpsyg.2021.625258] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Accepted: 03/22/2021] [Indexed: 11/25/2022] Open
Abstract
Before COVID-19, dementia singing groups and choirs flourished, providing activity, cognitive stimulation, and social support for thousands of people with dementia in the UK. Interactive music provides one of the most effective psychosocial interventions for people with dementia; it can allay agitation and promote wellbeing. Since COVID-19 has halted the delivery of in-person musical activities, it is important for the welfare of people with dementia and their carers to investigate what alternatives to live music making exist, how these alternatives are delivered and how their accessibility can be expanded. This community case study examines recent practice in online music-making in response to COVID-19 restrictions for people with dementia and their supporters, focusing on a UK context. It documents current opportunities for digital music making, and assesses the barriers and facilitators to their delivery and accessibility. Online searches of video streaming sites and social media documented what music activities were available. Expert practitioners and providers collaborated on this study and supplied input about the sessions they had been delivering, the technological challenges and solutions they had found, and the responses of the participants. Recommendations for best practice were developed and refined in consultation with these collaborators. Over 50 examples of online music activities were identified. In addition to the challenges of digital inclusion and accessibility for some older people, delivering live music online has unique challenges due to audio latency and sound quality. It is necessary to adapt the session to the technology's limitations rather than expect to overcome these challenges. The recommendations highlight the importance of accessibility, digital safety and wellbeing of participants. They also suggest ways to optimize the quality of their musical experience. The pandemic has prompted innovative approaches to deliver activities and interventions in a digital format, and people with dementia and their carers have adapted rapidly. While online music is meeting a clear current need for social connection and cognitive stimulation, it also offers some advantages which remain relevant after COVID-19 restrictions are relaxed. The recommendations of this study are intended to be useful to musicians, dementia care practitioners, and researchers during the pandemic and beyond.
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Affiliation(s)
- Becky Dowson
- Institute of Mental Health, University of Nottingham, Nottingham, United Kingdom.,Blue Skies Singing Group Facilitator, Nottingham, United Kingdom
| | | | - Julie Barnes
- Blue Skies Singing Group Facilitator, Nottingham, United Kingdom
| | | | - Nick Cutts
- OPUS Music CIC, Alfreton, United Kingdom
| | | | - Ming Hung Hsu
- MHA, Derby, United Kingdom.,Cambridge Institute for Music Therapy Research, Anglia Ruskin University, Cambridge, United Kingdom
| | | | - Gareth John
- Chiltern Music Therapy, Chesham, United Kingdom
| | | | - Angela O'Neill
- Our Dementia Choir/Alzheimer's Society, Nottingham, United Kingdom
| | | | | | - Farai Pfende
- JoCo Learning and Development, Nottingham, United Kingdom
| | - Paul Quinn
- SongTime CIC, Nottingham, United Kingdom
| | | | | | - Justine Schneider
- Institute of Mental Health, University of Nottingham, Nottingham, United Kingdom
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93
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Werner P, Tur-Sinai A, AboJabel H. Examining Dementia Family Caregivers' Forgone Care for General Practitioners and Medical Specialists during a COVID-19 Lockdown. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:3688. [PMID: 33916152 PMCID: PMC8036927 DOI: 10.3390/ijerph18073688] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 03/30/2021] [Accepted: 03/31/2021] [Indexed: 12/16/2022]
Abstract
The present study aimed to assess dementia caregivers' reports of the prevalence and correlates of forgone care regarding visits to a general practitioner (GP) and to a specialist during the COVID-19 lockdown in Israel, using Andersen's Behavioral Model of Healthcare Utilization. A cross-sectional study using an online survey was conducted with 73 Israeli family caregivers of persons with dementia residing in the community (81% Jews, 86% female, mean age = 54). Overall, one out of two participants reported having to delay seeking needed help from a GP or a specialist for themselves, as well as for their relatives with dementia, during the COVID-19 lockdown period. Among the predisposing factor, education was associated with caregivers' reports regarding forgone care for themselves as well as for their loved ones. Living with the care-receiver and income level were the enabling factors associated with forgone care for caregivers. Finally, feelings of burden were associated with caregivers' forgone care and feelings of loneliness and perceptions of the care-receiver's cognitive functioning were associated with care-receivers' forgone care. Our findings show that it is essential that this population receive appropriate practical and emotional support at times of distress and crisis to enable them to continue with their caregiving role.
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Affiliation(s)
- Perla Werner
- Department of Community Mental Health, University of Haifa, Mt. Carmel, Haifa 3498838, Israel;
| | - Aviad Tur-Sinai
- Department of Health Systems Management, The Max Stern Yezreel Valley College, Yezreel Valley 1930600, Israel;
- School of Nursing, University of Rochester Medical Center, Rochester, NY 14627-0446, USA
| | - Hanan AboJabel
- Department of Community Mental Health, University of Haifa, Mt. Carmel, Haifa 3498838, Israel;
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94
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Virtual visits for chronic neurologic disorders during COVID-19 pandemic. Neurol Sci 2021; 42:2607-2610. [PMID: 33774762 PMCID: PMC8003890 DOI: 10.1007/s10072-021-05212-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Accepted: 03/20/2021] [Indexed: 12/26/2022]
Abstract
Background COVID-19 pandemic has boosted telemedicine in medical clinical practice. Experiences in the management of chronic neurological disorders are limited and scattered. The aim of the study was to evaluate feasibility and efficacy of virtual visit for chronic neurological disorders during COVID-19 pandemic. Methods All patients scheduled for a visit during the lockdown period were contacted. The patients fell into four categories: (1) long-term follow-up, the patient was re-scheduled; (2) visit was necessary, teleconsultation was accepted; (3) problem was solved by phone call; and (4) visit was necessary and teleconsultation was not feasible, then visit was maintained. Google Meet was used. During the virtual visit, neurological examination was performed, and demographic and clinical characteristics were recorded. Results At the end of May 2020, 184 virtual visits for 178 patients were performed for the following diseases: myasthenia gravis (47 patients), multiple sclerosis (79), epilepsy (12), headache (6), and parkinsonism (34). The patients were 70 males and 108 females with a mean age of 53.5 years (range 13–90). During virtual visit, we were able to obtain a satisfactory neurological examination. Conclusions We demonstrated feasibility and effectiveness of virtual visit in the management of a large group of patients with common chronic neurological disorders.
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95
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Gitlin LN, Bouranis N, Kern V, Koeuth S, Marx KA, McClure LA, Lyketsos CG, Kales HC. WeCareAdvisor, an Online Platform to Help Family Caregivers Manage Dementia-Related Behavioral Symptoms: an Efficacy Trial in the Time of COVID-19. JOURNAL OF TECHNOLOGY IN BEHAVIORAL SCIENCE 2021; 7:33-44. [PMID: 33786370 PMCID: PMC7994055 DOI: 10.1007/s41347-021-00204-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Revised: 02/11/2021] [Accepted: 03/19/2021] [Indexed: 11/13/2022]
Abstract
Dementia-related behavioral and psychology symptoms (BPSD) are undertreated and have negative consequences. However, families do not have access to disease information, tailored problem-solving and effective management strategies, and with COVID-19, are more socially isolated and distressed. To address this dementia care gap, we describe a Phase III efficacy trial testing an online platform, WeCareAdvisor, and design modifications necessitated by COVID-19. WeCareAdvisor provides caregivers with disease information, daily tips, and a systematic approach for describing behaviors, investigating underlying causes, creating tailored strategies, and evaluating their effectiveness (DICE). The trial will enroll 326 caregivers nationwide, randomly assign them to immediately receive WeCareAdvisor (treatment), or a 3-month waitlist (control) and evaluate short (1- and 3-month) and long-term (6-month) outcomes for caregiver distress with and confidence managing BPSD, and BPSD occurrences. We will also evaluate utilization patterns with different prompting conditions: high-intensity (telephone and email reminders), low-intensity (email reminders), or no reminders to use WeCareAdvisor. COVID-19 necessitated design modifications resulting in greater inclusivity of caregivers from diverse races, ethnicities, and geographic areas. Key modifications include shifting from in-home, in-person interviewing to telephone; adjusting tool functionality from operating on a grant-funded iPad to caregivers' personal internet-capable devices; and expanding recruitment from one metropolitan area to nationwide. Study modifications necessitated by COVID-19 facilitate national outreach, easier tool adoption, and enable more diverse caregivers to participate. This study addresses a critical dementia care need, and design modifications may shorten timeline from efficacy testing to commercialization.
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96
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Pappadà A, Chattat R, Chirico I, Valente M, Ottoboni G. Assistive Technologies in Dementia Care: An Updated Analysis of the Literature. Front Psychol 2021; 12:644587. [PMID: 33841281 PMCID: PMC8024695 DOI: 10.3389/fpsyg.2021.644587] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Accepted: 02/25/2021] [Indexed: 12/17/2022] Open
Abstract
Objectives: Technology can assist and support both people with dementia (PWD) and caregivers. Recently, technology has begun to embed remote components. Timely with respect to the pandemic, the present work reviews the most recent literature on technology in dementia contexts together with the newest studies about technological support published until October 2020. The final aim is to provide a synthesis of the timeliest evidence upon which clinical and non-clinical decision-makers can rely to make choices about technology in the case of further pandemic waves. Methods: A review of reviews was performed alongside a review of the studies run during the first pandemic wave. PsycInfo, CINAHL, and PubMed-online were the databases inspected for relevant papers published from January 2010. Results: The search identified 420 articles, 30 of which were reviews and nine of which were new studies meeting the inclusion criteria. Studies were first sorted according to the target population, then summarized thematically in a narrative synthesis. The studies targeting technologies for PWD were categorized as follows: monitoring and security purposes, sustaining daily life, and therapeutic interventions. Each category showed potential benefits. Differently, the interventions for caregivers were classified as informative, psycho-education programs, psychosocial-supportive, therapeutic, and cognitive/physical training. Benefits to mental health, skills learning, and social aspects emerged. Conclusions: The evidence shows that technology is well-accepted and can support PWD and caregivers to bypass physical and environmental problems both during regular times and during future pandemic waves. Nevertheless, the lack of a common methodological background is revealed by this analysis. Further and more standardized research is necessary to improve the implementation of technologies in everyday life while respecting the necessary personalization.
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Affiliation(s)
| | - Rabih Chattat
- Department of Psychology, University of Bologna, Bologna, Italy
| | - Ilaria Chirico
- Department of Psychology, University of Bologna, Bologna, Italy
| | - Marco Valente
- Department of Psychology, University of Bologna, Bologna, Italy
| | - Giovanni Ottoboni
- Department of Psychology, University of Bologna, Bologna, Italy.,"G. Prodi" Interdipartimental Center for Cancer Research, Bologna, Italy
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97
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Wójcik D, Szczechowiak K, Konopka P, Owczarek M, Kuzia A, Rydlewska-Liszkowska I, Pikala M. Informal Dementia Caregivers: Current Technology Use and Acceptance of Technology in Care. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18063167. [PMID: 33808644 PMCID: PMC8003488 DOI: 10.3390/ijerph18063167] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 03/10/2021] [Accepted: 03/16/2021] [Indexed: 01/10/2023]
Abstract
(1) Background: Given the increased social isolation caused by the COVID-19 pandemic, the challenges faced by informal dementia caregivers have increased. An increasing use of technology, both in care and dementia clinical trials, depends upon caregivers' abilities as a user. Accordingly, the aim of our study was to verify the current technology (smartphone and computer) use and acceptance in care, regarding socio-demographic variables; (2) Methods: Questionnaires were distributed to 102 dementia caregivers, mostly of patients with moderate dementia; (3) Results: The majority of participants were women (63%), and large number of them used technological devices such as a smartphone (91%) or computer (81%). Results revealed differences between age, gender, and education level on technology acceptance. Interestingly, smartphone use and acceptance seemed to be feasible, regardless of age, whereas computer use was negatively correlated with age. Technology was perceived by respondents as most useful for patients' activities including locomotion, toileting, and meals; (4) Conclusions: The future of technology use in dementia care should indicate solutions tailored to individual characteristics such as new technology solutions (GPS trackers, smartphone apps, dietary intervention, and meal planning apps).
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Affiliation(s)
- Daniel Wójcik
- Department of Management and Logistics in Health Care, Medical University of Lodz, Poland InterDoktorMen Medical University of Lodz, 90-419 Lodz, Poland;
- Wroclaw’s Alzheimer Center, 53-659 Wroclaw, Poland;
- Department of Epidemiology and Biostatistics, Social and Preventive Medicine of the Medical University of Lodz, 90-752 Lodz, Poland;
- Correspondence: ; Tel.: +48-505134649
| | | | - Patrycja Konopka
- Institute of Psychology, Polish Academy of Sciences, 00-378 Warsaw, Poland;
| | - Mateusz Owczarek
- Institute of Psychology, University of Wroclaw, 50-527 Wroclaw, Poland; (M.O.); (A.K.)
| | - Agata Kuzia
- Institute of Psychology, University of Wroclaw, 50-527 Wroclaw, Poland; (M.O.); (A.K.)
| | - Izabela Rydlewska-Liszkowska
- Department of Management and Logistics in Health Care, Medical University of Lodz, Poland InterDoktorMen Medical University of Lodz, 90-419 Lodz, Poland;
| | - Małgorzata Pikala
- Department of Epidemiology and Biostatistics, Social and Preventive Medicine of the Medical University of Lodz, 90-752 Lodz, Poland;
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98
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Josephsen SR, Fritz RL. Smart moves for an aging population. J Am Geriatr Soc 2021; 69:1695-1697. [PMID: 33713420 DOI: 10.1111/jgs.17100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Accepted: 02/13/2021] [Indexed: 12/01/2022]
Affiliation(s)
- Samuel R Josephsen
- Elson S. Floyd College of Medicine, Washington State University Spokane, Washington, USA
| | - Roschelle L Fritz
- College of Nursing, Washington State University Vancouver, Washington, USA
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Sharma S, Batra S, Gupta S, Sharma VK, Rahman MH, Kamal MA. Persons with co-existing neurological disorders: Risk analysis, considerations and management in COVID-19 pandemic. CNS & NEUROLOGICAL DISORDERS-DRUG TARGETS 2021; 21:228-234. [PMID: 33687889 DOI: 10.2174/1871527320666210308113457] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Revised: 11/17/2020] [Accepted: 11/30/2020] [Indexed: 01/08/2023]
Abstract
Increasing reports of neurological symptoms in COVID-19 patient's warrant clinicians to adopt and define the standardized diagnostic and managing protocols in order to investigate the linkage of neurological symptoms in COVID-19. Encephalitis, anosmia, acute cerebrovascular disease and ageusia are some of the emerging neurological manifestations which are reported in several cohort studies on hospitalized patients with COVID-19. Although the COVID-19 pandemic is primarily associated with respiratory tract system but measures like lockdown and restricted physical movements to control the spread of this infection will certainly have neurobehavioural implications. Additionally, some of the patients with pre-existing neurological manifestations like epilepsy, Parkinson's and Alzheimer's disease are more prone to infection and demands extra as well as improvisation in their treatment therapy. In this review we have focused on the neurovirological clinical manifestations associated with COVID-19 pandemic. Although the prevalence of neurovirological manifestations is rare but increasing reports cannot be ignored and needs to be discussed thoroughly with respect to risk analysis and considerations for developing management strategy. This also helps in defining the burden of neurological disorders associated with COVID-19 patients.
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Affiliation(s)
- Sumit Sharma
- Chitkara College of Pharmacy, Chitkara University, Punjab. India
| | - Sonali Batra
- Department of Pharmaceutical Sciences, Guru Jambheshwar University of Science and Technology, Hisar, Haryana. India
| | - Saurabh Gupta
- Chitkara College of Pharmacy, Chitkara University, Punjab. India
| | | | - Md Habibur Rahman
- Department of Pharmacy, South East University, Banani, Dhaka-1213. Bangladesh
| | - Mohammad Amjad Kamal
- Enzymoics, 7 Peterlee place, Hebersham, NSW 2770, Novel Global Community Educational Foundation. Australia
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100
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Doraiswamy S, Jithesh A, Mamtani R, Abraham A, Cheema S. Telehealth Use in Geriatrics Care during the COVID-19 Pandemic-A Scoping Review and Evidence Synthesis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:1755. [PMID: 33670270 PMCID: PMC7918552 DOI: 10.3390/ijerph18041755] [Citation(s) in RCA: 68] [Impact Index Per Article: 22.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 01/31/2021] [Accepted: 02/08/2021] [Indexed: 12/12/2022]
Abstract
Introduction: Globally, the COVID-19 pandemic has affected older people disproportionately. Prior to the pandemic, some studies reported that telehealth was an efficient and effective form of health care delivery, particularly for older people. There has been increased use of telehealth and publication of new literature on this topic during the pandemic, so we conducted a scoping review and evidence synthesis for telehealth use in geriatric care to summarize learning from these new data. Methods: We searched PubMed, Embase, and the World Health Organization's COVID-19 global research database for articles published between 1 January and 20 August 2020. We included 79 articles that met our inclusion criteria. The information collected has been synthesized and presented as descriptive statistics. Strengths, weaknesses, opportunities, and threats (SWOT) have also been discussed. Results: The articles included in our review provide some evidence of effective provision of preventive, curative, and rehabilitative telehealth services for older people, but they highlight a greater focus on curative services and are mostly concentrated in high-income countries. We identified convenience and affordability as the strengths of telehealth use in geriatric care. Weaknesses identified include the inability of telehealth to cater to the needs of older people with specific physical and cognitive limitations. While the threats of increasing inequity and the lack of standardization in the provision of age-friendly telehealth services remain, we identified opportunities for technologic advancements driven by simplicity and user-friendliness for older people. Conclusion: Telehealth offers futuristic promise for the provision of essential health care services for older people worldwide. However, the extent of these services via telehealth appears to be currently limited in low and low-middle income countries. Optimizing telehealth services that can be accessed by older people requires greater government investments and active engagement by broader participation of older people, their caregivers, physicians and other health care providers, technology experts, and health managers.
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Affiliation(s)
- Sathyanarayanan Doraiswamy
- Institute for Population Health, Weill Cornell Medicine-Qatar, P.O. Box 24144, Doha, Qatar; (A.J.); (R.M.); (A.A.); (S.C.)
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