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Warr R, Ruggiano N, Daquin J, Anderson Herzog M, Jiang Z, Gray J. Health Information Seeking Using Tech and Non-Tech Sources Among a Diverse Sample of Caregivers in the Deep South. JOURNAL OF GERONTOLOGICAL SOCIAL WORK 2024; 67:605-620. [PMID: 38662939 DOI: 10.1080/01634372.2024.2339960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Accepted: 04/03/2024] [Indexed: 05/24/2024]
Abstract
Caregivers of people living with dementia (PLWD) are often tasked with making decisions about their loved one's daily care and healthcare treatment, causing stress and decision-making fatigue. Many caregivers engage in health information seeking to improve their health literacy for optimal decision-making, though there is limited knowledge about the strategies used to increase their health literacy. This study involved a survey of caregivers in Alabama, most of whom were African American and/or living in rural communities that have historically underserved. The findings shed light on caregivers' experiences in seeking out health-related information and their perceptions of various sources of information.
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Affiliation(s)
- Retisha Warr
- School of Social Work, University of Alabama, Tuscaloosa, Alabama, USA
| | - Nicole Ruggiano
- School of Social Work, University of Alabama, Tuscaloosa, Alabama, USA
| | - Jane Daquin
- Department of Criminology and Criminal Justice, University of Alabama, Tuscaloosa, Alabama, USA
| | - Monica Anderson Herzog
- Department of Computer Science, College of Engineering, University of Alabama, Tuscaloosa, Alabama, USA
| | - Zhe Jiang
- Computer & Information Science & Engineering, University of Florida, Gainesville, Florida, USA
| | - Jeff Gray
- Department of Computer Science, College of Engineering, University of Alabama, Tuscaloosa, Alabama, USA
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Rosell J, Araya AX, Miranda-Castillo C. Internet use by informal caregivers in Chile: An analysis including age and gender perspectives. Clin Gerontol 2024; 47:26-38. [PMID: 36773058 DOI: 10.1080/07317115.2023.2173692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Abstract
OBJECTIVES This study explored the relationship between Internet use and informal caregivers' characteristics. METHODS We used the Chilean Sociodemographic Characterization Survey. A total of 86,172 informal caregivers were identified. We conducted a weighted χ2 to test differences in 10 types of Internet use and weighted logistic regressions with caregivers' characteristics as predictors of Internet use. RESULTS Younger caregivers engaged in more types of use than the older ones. Education level was positively associated with all types of use, such as searching for information (OR = 3.52, CI 95% [2.34, 5.29]). Age was negatively related to Internet use. Women used the Internet more to communicate via social networks. Being single reduced the likelihood of performing certain types of use, such as information seeking. The number of people living in households has increased entertainment. CONCLUSIONS Older caregivers with lower education levels are at greater risk of digital exclusion. The same occurred in some types of use with single caregivers, where fewer people lived in the household. CLINICAL IMPLICATIONS The Internet can be a tool for coping with caregiving tasks and their negative consequences. Interventions should consider these characteristics when promoting online tools and performing online interventions to reach the broadest possible audience.
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Affiliation(s)
- Javiera Rosell
- Millennium Institute for Care Research (MICARE), Chile
- Escuela de Psicología, Facultad de Ciencias Sociales, Pontificia Universidad Católica de Chile, Chile
- Oxford Institute of Population Ageing, University of Oxford Oxford, UK
| | - Alejandra-Ximena Araya
- Millennium Institute for Care Research (MICARE), Chile
- Facultad de Enfermería, Universidad Andres Bello, Chile
| | - Claudia Miranda-Castillo
- Millennium Institute for Care Research (MICARE), Chile
- Facultad de Enfermería, Universidad Andres Bello, Chile
- Instituto Milenio para la Investigación en Depresión y Personalidad (MIDAP), Chile
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Newmark RL, Allison TA, Smith AK, Perissinotto CM, Tha SH, Kotwal AA. The Role of Digital Technologies in Facilitating Psychosocial Resilience to Sudden Social Isolation Among Older Adults: Lessons Learned from the COVID-19 Pandemic. J Appl Gerontol 2023; 42:2348-2359. [PMID: 37536316 PMCID: PMC11056268 DOI: 10.1177/07334648231190228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/05/2023] Open
Abstract
This study investigated how older adults adopted new technologies in response to sudden social isolation caused by the COVID-19 pandemic and how this adoption was related to their long-term psychosocial well-being. The study involved a 6-month longitudinal survey of 151 older adults and two phone-based focus groups, which informed a semi-structured interview guide and purposive sampling of diverse community-dwelling older adults. We then conducted twenty qualitative interviews and thematic analysis and mapped themes to 6-month quantitative trajectories of psychosocial health. Three themes emerged: first, most participants adopted multiple technologies to maintain social connection and psychosocial well-being. Second, participants felt left behind by certain technologies due to complicated systems or ageist societal norms. Third, pandemic-related community resources promoted technology independence among isolated older adults and those wanting to avoid "burdening" family. Results challenge ageist stereotypes and provide a framework for encouraging access and comfort with multiple technologies to adapt to sudden health crises or disruptive events.
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Affiliation(s)
- Rebecca L Newmark
- Division of Geriatrics, Department of Medicine, University of California, San Francisco, CA, USA
- Department of Humanities and Social Sciences, University of California, San Francisco, CA, USA
- School of Medicine, University of California, San Francisco, CA, USA
| | - Theresa A Allison
- Division of Geriatrics, Department of Medicine, University of California, San Francisco, CA, USA
- Geriatrics, Palliative, and Extended Care Service Line, San Francisco Veterans Affairs Medical Center, San Francisco, CA, USA
| | - Alexander K Smith
- Division of Geriatrics, Department of Medicine, University of California, San Francisco, CA, USA
- Geriatrics, Palliative, and Extended Care Service Line, San Francisco Veterans Affairs Medical Center, San Francisco, CA, USA
| | - Carla M Perissinotto
- Division of Geriatrics, Department of Medicine, University of California, San Francisco, CA, USA
| | - Soe Han Tha
- Division of Geriatrics, Department of Medicine, University of California, San Francisco, CA, USA
| | - Ashwin A Kotwal
- Division of Geriatrics, Department of Medicine, University of California, San Francisco, CA, USA
- Geriatrics, Palliative, and Extended Care Service Line, San Francisco Veterans Affairs Medical Center, San Francisco, CA, USA
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Rush KL, Singh S, Seaton CL, Burton L, Li E, Jones C, Davis JC, Hasan K, Kern B, Janke R. Telehealth Use for Enhancing the Health of Rural Older Adults: A Systematic Mixed Studies Review. THE GERONTOLOGIST 2022; 62:e564-e577. [PMID: 34661675 DOI: 10.1093/geront/gnab141] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Telehealth holds potential for inclusive and cost-saving health care; however, a better understanding of the use and acceptance of telehealth for health promotion among rural older adults is needed. This systematic review aimed to synthesize evidence for telehealth use among rural-living older adults and to explore cost-effectiveness for health systems and patients. RESEARCH DESIGN AND METHODS This systematic review was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Study designs reporting health promotion telehealth interventions with rural-living adults aged 55 and older were eligible for review. Following screening and inclusion, articles were quality-rated and ranked by level of evidence. Data extraction was guided by the Technology Acceptance Model and organized into outcomes related to ease of use, usefulness, intention to use, and usage behavior along with cost-effectiveness. RESULTS Of 2,247 articles screened, 42 were included. Positive findings for the usefulness of telehealth for promoting rural older adults' health were reported in 37 studies. Evidence for ease of use and usage behavior was mixed. Five studies examined intention to continue to use telehealth and in 4 of these, patients preferred telehealth. Telehealth was cost-effective for health care delivery (as a process) compared to face to face. However, findings were mixed for cost-effectiveness with both reports of savings (e.g., reduced travel) and increased costs (e.g., insurance). DISCUSSION AND IMPLICATIONS Telehealth was useful for promoting health among rural-living older adults. Technological supports are needed to improve telehealth ease of use and adherence. Cost-effectiveness of telehealth needs more study, particularly targeting older adults.
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Affiliation(s)
- Kathy L Rush
- School of Nursing, University of British Columbia, Okanagan Campus, Kelowna, British Columbia, Canada
| | - Sarah Singh
- School of Nursing, University of British Columbia, Okanagan Campus, Kelowna, British Columbia, Canada
| | - Cherisse L Seaton
- School of Nursing, University of British Columbia, Okanagan Campus, Kelowna, British Columbia, Canada
| | - Lindsay Burton
- School of Nursing, University of British Columbia, Okanagan Campus, Kelowna, British Columbia, Canada
| | - Eric Li
- Faculty of Management, University of British Columbia, Okanagan Campus, Kelowna, British Columbia, Canada
| | - Charlotte Jones
- Faculty of Medicine, University of British Columbia, Okanagan Campus, Kelowna, British Columbia, Canada
| | - Jennifer C Davis
- Faculty of Management, University of British Columbia, Okanagan Campus, Kelowna, British Columbia, Canada
| | - Khalad Hasan
- Department of Computer Science, Mathematics, Physics and Statistics, University of British Columbia, Okanagan Campus, Kelowna, British Columbia, Canada
| | - Brodie Kern
- School of Nursing, University of British Columbia, Okanagan Campus, Kelowna, British Columbia, Canada
| | - Robert Janke
- Research and Administration, Library Administration, University of British Columbia, Okanagan Campus, Kelowna, British Columbia, Canada
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How Can the Modern Chinese Family Retirement Function Be Separated and Sustainable? SUSTAINABILITY 2022. [DOI: 10.3390/su14159443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
In the context of hybrid changes taking place in population and family structures, it is widely perceived that the function of the family as a place where older people retire has weakened. Family support has lost its vitality and has been replaced by public support. However, since the elderly are inseparably connected to their family, it is relevant to rethink and analyze how modern families’ pension functions can be sustainable. Based on structural functionalism and the family modernization theory, we construct an analytical framework to understand how the family ageing function operates separately. Fieldwork was carried out in Nantong, a place where the population has drastically aged. We documented different types of households to explain the changes and differences in modern family ageing. The results show that it is not simply a general weakening, but that a differentiated development pattern has separated the family functions and that there is a functional alternative path to compensate for sustainable development. That is, the economic function is strengthened and compensates for the weakened service function. Based on our research, we argue that families and the government should share the responsibility of meeting the diversified and specialized needs of older people in families where economic functions have strengthened and service functions have weakened. In families where both sets of functions have weakened, the government needs to overtake those functions. Today, family retirement function has been revitalized and redeveloped.
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Lee S, Ory MG, Dahlke DV, Smith ML. Social Support, Sense of Belonging, and Communication Technology Use Among Paid and Unpaid Caregivers of Middle-Aged and Older Adults. Front Public Health 2022; 10:898042. [PMID: 35712314 PMCID: PMC9196896 DOI: 10.3389/fpubh.2022.898042] [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: 03/16/2022] [Accepted: 05/06/2022] [Indexed: 11/13/2022] Open
Abstract
Objectives The objectives of this study are to: (1) describe communication technology use among paid and unpaid middle-aged and older caregivers of adults 50 and older in a natural (non-experimental) setting; and (2) examine the association between communication technology use, perceived social support, and sense of belonging in this population. Methods Means and standard deviations, or frequencies and percentages, were used to describe study participants. Chi-square tests or independent sample t-tests were used to compare sociodemographic characteristics, communication technology use, perceived social support, and sense of belonging to the local community between paid and unpaid caregivers. Multivariable regression analysis was performed to predict each outcome (i.e., sense of belonging and social support) based on the use of texting or communication applications. Results The average age of participants was age 64.2 years, and the majority was female (74.8%) and non-Hispanic White (66.9%). Compared to paid caregivers, unpaid caregivers were older (64.5 vs. 62.2 years, p = 0.022) and a larger proportion were non-Hispanic White (70.8% vs. 47.7%, p < 0.001). Nearly 83% of the study participants reported using texting or communication applications (81.5% among paid caregivers and 83.1% among unpaid caregivers, p = 0.718). After adjusting for caregivers' age, sex, race/ethnicity, and education, a significantly higher sense of belonging was observed among paid caregivers than unpaid caregivers (b = 9.40, p = 0.009). After adjusting for caregivers' age, sex, race/ethnicity, and education, the use of texting or other communication applications significantly increased caregivers' perceived availability of social support (b = 0.35, p = 001). Conclusions These study results showed a greater sense of belonging to the local community among paid caregivers compared to unpaid caregivers. The use of communication technology was associated with an increased sense of belonging to their local community among paid caregivers, yet the use of communication technology did not contribute to feelings of belonging among unpaid caregivers. In an aging society, both paid and unpaid caregivers are essential elements of the care system. Research is needed to understand the social support needs of paid and unpaid caregivers and the types of interventions to promote social support and community engagement for both groups.
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Affiliation(s)
- Shinduk Lee
- Division of Health Systems and Community-Based Care, College of Nursing, University of Utah, Salt Lake City, UT, United States.,Department of Environmental and Occupational Health, School of Public Health, Texas A&M University, College Station, TX, United States.,Center for Population Health and Aging, Texas A&M University, College Station, TX, United States
| | - Marcia G Ory
- Department of Environmental and Occupational Health, School of Public Health, Texas A&M University, College Station, TX, United States.,Center for Population Health and Aging, Texas A&M University, College Station, TX, United States
| | - Deborah Vollmer Dahlke
- Department of Environmental and Occupational Health, School of Public Health, Texas A&M University, College Station, TX, United States.,DVD Associates LLC, Austin, TX, United States
| | - Matthew Lee Smith
- Department of Environmental and Occupational Health, School of Public Health, Texas A&M University, College Station, TX, United States.,Center for Population Health and Aging, Texas A&M University, College Station, TX, United States
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Lyu M, Zhao Q, Yang Y, Hao X, Qin Y, Li K. Benefits of and barriers to telehealth for the informal caregivers of elderly individuals in rural areas: A scoping review. Aust J Rural Health 2022; 30:442-457. [PMID: 35460580 DOI: 10.1111/ajr.12869] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 01/25/2022] [Accepted: 03/07/2022] [Indexed: 12/19/2022] Open
Abstract
INTRODUCTION Maintaining care for elderly individuals in rural areas is heavily dependent on support from informal caregivers. Many informal caregivers of the elderly in rural areas feel burdened and urgently require professional support. Interests in telehealth that can provide support irrespective of geographical location have been increasing. OBJECTIVE To identify the benefits of and barriers in telehealth engagement for rural caregivers to provide evidence for service improvement. DESIGN A scoping review method was used following PRISMA-ScR guidelines and Arksey and O'Malley's five-stage framework. Five databases were searched. The search terms were chosen based on the target intervention (i.e. telehealth), target population (caregivers of elderly individuals) and target context (rural areas). Two authors independently assessed the eligibility of studies and extracted data from eligible studies. FINDINGS Of 4220 retrieved studies, 19 articles met the inclusion criteria. This study identified four benefits of and two barriers to telehealth for rural caregivers. Four subthemes were identified as the key benefits in using telehealth for caregivers: decrease in psychological distress, increase in care efficiency, increase in social support and increase in access to resources, while inadequate telehealth infrastructures and caregivers' own reasons were the primary barriers in using telehealth for those populations. CONCLUSIONS Telehealth was shown to significantly benefit rural caregivers. Future research can be designed and conducted for overcoming the barriers to telehealth. Additionally, the benefits identified by this review need to be translated from research into practice for rural caregivers' care.
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Affiliation(s)
- Miaohua Lyu
- School of Nursing, Jilin University, Changchun, China
| | - Qiheng Zhao
- Orthopaedics Department, China-Japan Union Hospital of Jilin University, Changchun, China
| | - Yuhang Yang
- School of Nursing, Jilin University, Changchun, China
| | - Xiaonan Hao
- School of Nursing, Jilin University, Changchun, China
| | - Yuan Qin
- School of Nursing, Jilin University, Changchun, China
| | - Kun Li
- School of Nursing, Jilin University, Changchun, China
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Malmir S, Navipour H, Negarandeh R. Exploring challenges among Iranian family caregivers of seniors with multiple chronic conditions: a qualitative research study. BMC Geriatr 2022; 22:270. [PMID: 35365077 PMCID: PMC8973877 DOI: 10.1186/s12877-022-02881-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Accepted: 03/02/2022] [Indexed: 11/28/2022] Open
Abstract
Background It is believed that seniors with multiple chronic diseases are in dire need of support from their family caregivers; however, it can impose a significant burden on these caregivers. Therefore, it is imperative to take into account caregivers’ needs, as covert patients, along with the needs of patients; besides, it is necessary to develop supportive and health promotion programs for them. There is a critical gap in the knowledge about health problems related to family caregivers of the growing population of these senior citizens. The present study aimed to explain the challenges imposed on family caregivers of seniors with several chronic diseases in Iran. Methods This study was conducted based on the conventional qualitative content analysis method. For this purpose, 13 family caregivers of seniors with several chronic diseases were selected using the purposive sampling method. The study population included those referred to two health centers and outpatient clinics of two public hospitals in Khorramabad, Iran. Data were collected through semi-structured interviews. Data analysis was performed along with data collection using inductive thematic analysis proposed by Elo and Kyngäs. Besides, Guba and Lincoln’s criteria were used to ensure the trustworthiness of the data. Results The analysis of the obtained data led to the identification of challenges of family caregivers of the older patients with multiple chronic diseases; these challenges were classified into six main categories, including the impact of caregiving on family relationships, disruption of social relationships, disruption of personal and occupational plans, physical health-related issues, negative emotions, and dealing with the high costs of care. Conclusions Given that family caregivers may face several challenges while taking care of seniors with multiple chronic diseases, healthcare providers should design and plan various interventions based on such challenges using a caregiver-centered approach.
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Affiliation(s)
- Sahar Malmir
- Nursing Department, Faculty of Medical Science, Tarbiat Modares University, Tehran, Iran
| | - Hassan Navipour
- Department of Nursing, School of Medical Sciences, Tarbiat Modares University, Tehran, Iran.
| | - Reza Negarandeh
- Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran.
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Borchard J, Bindoff A, Farrow M, Kim S, McInerney F, Doherty K. Family carers of people living with dementia and discussion board engagement in the Understanding Dementia Massive Open Online Course. Aging Ment Health 2022; 27:887-895. [PMID: 35195059 DOI: 10.1080/13607863.2022.2042188] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
OBJECTIVES This study compared discussion board involvement between family carers and non-carers in the Understanding Dementia Massive Open Online Course (UD-MOOC). METHODS A mixed methods observational cohort study of family carers and non-carers was undertaken over the February-April 2020 UD-MOOC. Discussion board engagement was measured as number of posts and replies and examined longitudinally using mixed models. Discussion topics were explored through structural topic models (STM). Subsequently, thematic analysis of STM derived-topic exemplars was conducted to contextualise these discussions. RESULTS Family carers were (n = 2320) found to post (p < 0.001) and reply (p = 0.029) significantly more often than non-carers (n = 2392). Of the 32-STM derived-topics, meaningful activities (mean Δ = 0.007, 95% CrI [0.005-0.100]), personal stories of diagnosis (mean Δ = 0.007, 95% CrI [0.005-0.009]), and family history of dementia (mean Δ = 0.006, 95% CrI [0.004-0.008]) were discussed significantly more frequently by family carers compared to non-carers. CONCLUSION These results may reflect underlying motivational differences and circumstantial relevance. Perhaps the greater engagement by family carers is related to a sense of having inadequate relevant offline social resources, where engagement in the UD-MOOC discussion boards may serve as means to share experiences with others.
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Affiliation(s)
- Jay Borchard
- Wicking Dementia Research & Education Centre, College of Health and Medicine, University of Tasmania, Hobart, TAS, Australia
| | - Aidan Bindoff
- Wicking Dementia Research & Education Centre, College of Health and Medicine, University of Tasmania, Hobart, TAS, Australia
| | - Maree Farrow
- Wicking Dementia Research & Education Centre, College of Health and Medicine, University of Tasmania, Hobart, TAS, Australia
| | - Sarang Kim
- Wicking Dementia Research & Education Centre, College of Health and Medicine, University of Tasmania, Hobart, TAS, Australia
| | - Fran McInerney
- Wicking Dementia Research & Education Centre, College of Health and Medicine, University of Tasmania, Hobart, TAS, Australia
| | - Kathleen Doherty
- Wicking Dementia Research & Education Centre, College of Health and Medicine, University of Tasmania, Hobart, TAS, Australia
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Ageing Perception as a Key Predictor of Self-Rated Health by Rural Older People—A Study with Gender and Inclusive Perspectives. LAND 2022. [DOI: 10.3390/land11030323] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
This paper investigates positive perceptions of ageing in rural people aged 65 and over as a key predictor of the self-assessment of one’s health. Method: The sample covers a total of 3389 people from the ‘Survey of Health, Ageing and Retirement’ (SHARE), wave 6 (W6, 2015). This research analyses men and women who live in a rural environment. A linear regression model is proposed to consider the dependent variable ‘self-rated health’ and independent variables based on measures of quality of life in older adults. This study confirms that rural women perceive their health on the basis of factors different to those of their male contemporaries. The variable ‘How often do you feel/think that you can do the things that you want to do?’ is associated with women’s self-perceived health. In men, a high relationship (with p < 0.001) is obtained for the variables ‘How often do you feel/think look back on your life with a sense of happiness?’ and ‘How often do you feel/think that family responsibilities prevent you from doing what you want to do?’ Certain daily activities (e.g., leisure or care), along with a positive perception of life, influence one’s perceptions of one’s own health, especially in the case of women. In sum, rural older women make a positive evaluation of their own health and ageing, while rural older men relate self-rated health to passivity and reminiscing. There is a need for further research on psycho-social and socio-spatial issues from an intergenerational, technological and gender perspective for rural and territorial influences to attain better health and quality of life for rural older people in comparison to urban people.
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Airola E. Learning and Use of eHealth Among Older Adults Living at Home in Rural and Nonrural Settings: Systematic Review. J Med Internet Res 2021; 23:e23804. [PMID: 34860664 PMCID: PMC8686468 DOI: 10.2196/23804] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Revised: 11/23/2020] [Accepted: 10/14/2021] [Indexed: 02/06/2023] Open
Abstract
Background Care policies emphasize deinstitutionalization and aging in place in response to demographic changes. Different eHealth technologies are one way to achieve this aim. However, there is a need to better understand older adults’ needs for eHealth services, and thus, these health solutions require further exploration. Objective The purpose of this systematic literature review is to appraise, synthesize, and summarize the literature on older adults’ (aged ≥60 years) eHealth learning and use in real home settings, particularly in rural and remote areas, with a focus on the social and cultural context. Methods A systematic search was conducted in January 2020 using 4 academic databases. The studies by means of qualitative thematic analysis to identify the barriers, enablers, and support practices involved in the domestication process were examined. In addition, we identified the various meanings attached to eHealth technologies for older adults living in rural and remote areas. Results In total, 31 empirical studies published between 2010 and 2020 were included in this review. A total of 17 articles included participants from rural and remote areas. The most regularly reported barriers related to older adults’ learning to use and use of eHealth were health-related difficulties, such as cognitive impairment or impaired hearing. The most reported enabler was the support provided for older adults in learning and use of eHealth. Support mainly comprised older adults’ own digital competences, which were distributed with their social network. It was found that eHealth technology is needed for rural and remote areas to facilitate access and reduce logistical barriers to health care services. Conclusions The literature review provided information and practical implications for designers, health care providers, and policy makers. On the basis of these findings, eHealth technologies should be easy to use, and adequate support should be provided to older adults for use.
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Affiliation(s)
- Ella Airola
- Media Education Hub, Faculty of Education, University of Lapland, Rovaniemi, Finland
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12
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Shah SGS, Nogueras D, van Woerden HC, Kiparoglou V. Evaluation of the Effectiveness of Digital Technology Interventions to Reduce Loneliness in Older Adults: Systematic Review and Meta-analysis. J Med Internet Res 2021; 23:e24712. [PMID: 34085942 PMCID: PMC8214187 DOI: 10.2196/24712] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Revised: 11/09/2020] [Accepted: 04/19/2021] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Loneliness is a serious public health issue, and its burden is increasing in many countries. Loneliness affects social, physical, and mental health, and it is associated with multimorbidity and premature mortality. In addition to social interventions, a range of digital technology interventions (DTIs) are being used to tackle loneliness. However, there is limited evidence on the effectiveness of DTIs in reducing loneliness, especially in adults. The effectiveness of DTIs in reducing loneliness needs to be systematically assessed. OBJECTIVE The objective of this study is to assess the effectiveness of DTIs in reducing loneliness in older adults. METHODS We conducted electronic searches in PubMed, MEDLINE, CINAHL, Embase, and Web of Science for empirical studies published in English from January 1, 2010, to July 31, 2019. The study selection criteria included interventional studies that used any type of DTIs to reduce loneliness in adults (aged ≥18 years) with a minimum intervention duration of 3 months and follow-up measurements at least 3 months after the intervention. Two researchers independently screened articles and extracted data using the PICO (participant, intervention, comparator, and outcome) framework. The primary outcome measure was loneliness. Loneliness scores in both the intervention and control groups at baseline and at follow-up at 3, 4, 6, and 12 months after the intervention were extracted. Data were analyzed via narrative synthesis and meta-analysis using RevMan (The Cochrane Collaboration) software. RESULTS A total of 6 studies were selected from 4939 screened articles. These studies included 1 before and after study and 5 clinical trials (4 randomized clinical trials and 1 quasi-experimental study). All of these studies enrolled a total of 646 participants (men: n=154, 23.8%; women: n=427, 66.1%; no gender information: n=65, 10.1%) with an average age of 73-78 years (SD 6-11). Five clinical trials were included in the meta-analysis, and by using the random effects model, standardized mean differences (SMDs) were calculated for each trial and pooled across studies at the 3-, 4-, and 6-month follow-ups. The overall effect estimates showed no statistically significant difference in the effectiveness of DTIs compared with that of usual care or non-DTIs at follow-up at 3 months (SMD 0.02; 95% CI -0.36 to 0.40; P=.92), 4 months (SMD -1.11; 95% CI -2.60 to 0.38; P=.14), and 6 months (SMD -0.11; 95% CI -0.54 to 0.32; P=.61). The quality of evidence was very low to moderate in these trials. CONCLUSIONS Our meta-analysis shows no evidence supporting the effectiveness of DTIs in reducing loneliness in older adults. Future research may consider randomized controlled trials with larger sample sizes and longer durations for both the interventions and follow-ups. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.1136/bmjopen-2019-032455.
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Affiliation(s)
- Syed Ghulam Sarwar Shah
- NIHR Oxford Biomedical Research Centre, Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom
- Radcliffe Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - David Nogueras
- EvZein Limited, Holley Crescent, Headington, Oxford, United Kingdom
| | - Hugo Cornelis van Woerden
- Public Health Agency Northern Ireland, Belfast, United Kingdom
- Division of Rural Health and Wellbeing, University of the Highlands and Islands, Inverness, United Kingdom
- Institute of Nursing and Health Research, Ulster University, Belfast, United Kingdom
| | - Vasiliki Kiparoglou
- NIHR Oxford Biomedical Research Centre, Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
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13
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Abstract
As the number of older adults is expected to increase exponentially within the next few decades, loneliness, social isolation, and depression among seniors are growing public health concerns. Although formal treatment options, such as therapy and medication, can be helpful for depression, they can also be expensive and sometimes ineffective. It is therefore important to consider other potential treatment options and social interventions. Alternative methods for addressing mental health issues are especially important for older adults, as they may encounter barriers associated with aging such as limited mobility and decreased social networks. In these circumstances, online social networking may offer a potential "social cure" to alleviate loneliness, social isolation, and depression. The purpose of this scoping review was to gather and summarize the current literature on associations between online social networking and mental health outcomes (e.g., depression, life satisfaction, loneliness) among older adults. An initial search of 3,699 articles resulted in 52 articles that met criteria for inclusion. Five common themes were identified: (1) enhanced communication with family and friends, (2) greater independence and self-efficacy, (3) creation of online communities, (4) positive associations with well-being and life satisfaction, and (5) decreased depressive symptoms. Implications for older adults' mental health, social connectedness, programs and policies are discussed.
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14
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Hwang B, Pelter MM, Moser DK, Dracup K. Effects of an educational intervention on heart failure knowledge, self-care behaviors, and health-related quality of life of patients with heart failure: Exploring the role of depression. PATIENT EDUCATION AND COUNSELING 2020; 103:1201-1208. [PMID: 31964579 PMCID: PMC7253326 DOI: 10.1016/j.pec.2020.01.007] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Revised: 12/20/2019] [Accepted: 01/13/2020] [Indexed: 05/15/2023]
Abstract
OBJECTIVES To test effects of an educational intervention on patient-reported outcomes among rural heart failure (HF) patients and to examine whether effects differed between patients with and without depression. METHODS Patients (N = 614) were randomized to usual care (UC) or 1 of 2 intervention groups. Both intervention groups received face-to-face education, followed by either 2 phone calls (LITE) or biweekly calls until they demonstrated content competency (PLUS). Follow-up lasted 24 months. Statistical analyses included linear mixed models and subgroup analyses by depression status. RESULTS Both intervention groups showed improvement in HF knowledge at 3 months (LITE-UC, p = 0.003; PLUS-UC, p < 0.001). Improvement lasted 24 months only in the PLUS group. Compared to UC, both intervention groups exhibited better self-care at 3 months (LITE-UC, p < 0.001; PLUS-UC, p < 0.001) and 12 months (LITE-UC, p = 0.001; PLUS-UC, p = 0.002). There were no differences in health-related quality of life (HRQOL) among groups. In subgroup analyses, similar effects were found among non-depressed, but not among depressed patients. CONCLUSION The educational intervention improved HF knowledge and self-care, but not HRQOL. No intervention effects were observed in patients with depressive symptoms. PRACTICE IMPLICATIONS The simple educational intervention is promising to improve HF knowledge and self-care. Additional strategies are needed for depressed patients.
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Affiliation(s)
- Boyoung Hwang
- College of Nursing & Research Institute of Nursing Science, Seoul National University, Seoul, Republic of Korea.
| | | | - Debra K Moser
- College of Nursing, University of Kentucky, Lexington, USA
| | - Kathleen Dracup
- School of Nursing, University of California, San Francisco, USA
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15
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Yong ASL, Price L, Napier F, Matthews K. Supporting sustainable occupational lives for partner caregivers of people with dementia. Br J Occup Ther 2020. [DOI: 10.1177/0308022619898080] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Introduction This qualitative research explores the experience of partner caregivers and how their partner’s dementia impacts on their daily living and occupational lives, with the aim of informing the sustainability of homecare and decreasing the likelihood of formal care. Method Ten participants were recruited through Alzheimer’s Society groups. They were interviewed using the same semi-structured interview process and asked questions about their daily activities and caregiving role. The data was analysed using Braun and Clarke’s thematic analysis process and themes generated using inductive coding and reasoning. Findings Three main themes were identified: (1) losing occupational activities and roles; (2) adapting to a new occupational life and (3) adjusting to a new relationship in the trajectory of their partner’s illness. Conclusion This study highlights the complex occupational challenges experienced by partner caregivers of people with dementia. It suggests that there is a role for occupational therapists in sustaining homecare by working with partner caregivers as ‘expert service users’. Involvement should be provided at critical points of the caregiving journey and include co-creating technology solutions for social inclusion, sustaining adaptive engagement in personal occupations, creating opportunities for restoration and supporting caregivers to preserve their partner’s personhood.
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Affiliation(s)
| | - Lee Price
- School of Health Sciences, University of Brighton, Brighton, UK
| | - Fiona Napier
- Brighton General Hospital, Sussex Community NHS Foundation Trust, Sussex, UK
| | - Kate Matthews
- Worthing Responsive Service, Sussex Community NHS Foundation Trust, Sussex, UK
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16
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Newman K, Wang AH, Wang AZY, Hanna D. The role of internet-based digital tools in reducing social isolation and addressing support needs among informal caregivers: a scoping review. BMC Public Health 2019; 19:1495. [PMID: 31706294 PMCID: PMC6842183 DOI: 10.1186/s12889-019-7837-3] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2018] [Accepted: 10/23/2019] [Indexed: 11/22/2022] Open
Abstract
Background In Canada, 8.1 million people informally provide care without payment, primarily to family members; 6.1 million of them are employed at a full-time or part-time job. Digital technologies, such as internet-based tools, can provide informal caregivers’ access to information and support. This scoping review aimed to explore the role of internet-based digital tools in reducing social isolation and addressing support needs among informal caregivers. Methods A systematic search for relevant peer-reviewed literature was conducted of four electronic databases, guided by Arksey and O’Malley’s framework. An extensive search for relevant grey literature was also conducted. Results The screening process yielded twenty-three papers. The following themes were generated from the reviewed studies: searching for and receiving support; gaining a sense of social inclusion and belonging; and benefits and challenges of web-based support. The studies noted that, to connect with peers and obtain social support, informal caregivers often turn to online platforms. By engaging with peers in online communities, these caregivers reported regaining a sense of social inclusion and belonging. Conclusions The findings suggest that internet-based digital tools can be a cost-effective and convenient way to develop programs that help unpaid caregivers form communities, gain support, and access resources. Service providers can leverage digital tools to deliver support to caregivers within online communities.
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Affiliation(s)
- Kristine Newman
- Ryerson University, 350 Victoria Street, Toronto, Ontario, M5B 2K3, Canada.
| | - Angel He Wang
- Ryerson University, 350 Victoria Street, Toronto, Ontario, M5B 2K3, Canada
| | - Arthur Ze Yu Wang
- Ryerson University, 350 Victoria Street, Toronto, Ontario, M5B 2K3, Canada
| | - Dalia Hanna
- Ryerson University, 350 Victoria Street, Toronto, Ontario, M5B 2K3, Canada
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17
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Morelli N, Barello S, Mayan M, Graffigna G. Supporting family caregiver engagement in the care of old persons living in hard to reach communities: A scoping review. HEALTH & SOCIAL CARE IN THE COMMUNITY 2019; 27:1363-1374. [PMID: 31441179 DOI: 10.1111/hsc.12826] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/07/2019] [Revised: 07/18/2019] [Accepted: 07/22/2019] [Indexed: 06/10/2023]
Abstract
Today, 8.5% of the world's population is 65 and over, and this statistic will reach 17% by 2050 (He et al., U.S. Census Bureau, international population reports, P95/16-1, An ageing world: 2015, U.S., 2016). They are the people who, with increasing age, will find themselves more closely interfacing with the national health system, which in many countries shows strong imbalances between rural and urban areas. In this context, a fundamental role is played by the relatives who find themselves becoming informal caregivers to compensate for lack of services. To date, however, little has been done to help these people. In this article, we want to identify the nature and extent of research evidence that had its objective to help informal caregivers in rural, hard to reach areas (Grant & Booth, Health Information & Libraries Journal, 2009, 26, 91). Following the approach set out by Arksey and O'Malley (International Journal of Social Research Methodology, 2005, 8, 19), we conducted a scoping review in May 2018 and closed the review with an update in September 2018. We identified 14 studies published from 2012, the European Year of Active Ageing, promoted by the European Commission, which had three domains of implementation: emotional support to decrease the emotional burden of caregivers, educational support to increase their skills, and organisational support to improve the mobility of caregivers and carereceivers. Although informal caregivers play a fundamental role in many countries, the studies that have been involved in alleviating their caring burden are few; nevertheless, they provide interesting indications. This lack of attention confirms how this portion of the population is still neglected by scientific research and risks having unequal access to health and social care. Future research is needed, not only to create and improve services to caregivers in rural, hard to reach areas, but also to evaluate and focus on the participation and the engagement of caregivers in the co-design of these services.
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Affiliation(s)
- Niccolò Morelli
- Department of Sociology and Business Law, Engage Minds Hub Consumer & Health Research Center, Università di Bologna, Bologna, Italy
| | - Serena Barello
- Department of Psychology, EngageMinds Hub Consumer & Health Research Center, Università Cattolica del Sacro Cuore (Milano), Milano, Italy
| | - Maria Mayan
- Faculty of Extension, University of Alberta, Edmonton, AB, Canada
| | - Guendalina Graffigna
- Department of Psychology, EngageMinds Hub Consumer & Health Research Center, Università Cattolica del Sacro Cuore (Milano), Milano, Italy
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18
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Cherba M, Thoër C, Turbide O, Denault V, Renaud L, Valderrama A, Courcy I, Cordelier B, Laquerre ME, Cyr C, Hovington J, Muloin C. [Online social support as a mode of psychosocial intervention: A review of scientific literature, avenues for future research, and recommendations for practitioners]. SANTE PUBLIQUE 2019; Vol. 31:83-92. [PMID: 31210521 DOI: 10.3917/spub.191.0083] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
OBJECTIVE The goal of this review is to present online social support interventions described in recent scientific literature, in order to (i) guide organizations wishing to develop such an intervention or to improve an existing program, and (ii) to identify future research directions and recommendations for practitioners. METHODS AND RESULTS 59 peer-reviewed articles presenting online social support interventions (2006-2016) were analyzed by using a thematic grid focusing on theoretical perspectives on social support, the online platforms used and their functionalities, the process of intervention development and evaluation, the modalities of participation and the facilitation methods, the documented impacts of interventions, and finally future research directions and recommendations for practitioners. A narrative methodology was used to identify challenges in intervention development and implementation, in order to provide guidance to organizations who want to develop or improve their online social support services. CONCLUSIONS Several research directions and recommendations for the development of online social support interventions are suggested, including the need to develop theoretical models of online social support and enrich traditional models of social support, the need to understand the benefits associated with different levels of participation, the importance of needs assessment in the development of interventions, and the contribution of qualitative methods to the evaluation of interventions.
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Xie B, Champion JD, Kwak J, Fleischmann KR. Mobile Health, Information Preferences, and Surrogate Decision-Making Preferences of Family Caregivers of People With Dementia in Rural Hispanic Communities: Cross-Sectional Questionnaire Study. J Med Internet Res 2018; 20:e11682. [PMID: 30530450 PMCID: PMC6305885 DOI: 10.2196/11682] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Revised: 09/11/2018] [Accepted: 09/12/2018] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Mobile health (mHealth) technology holds promise for promoting health education and reducing health disparities and inequalities in underserved populations. However, little research has been done to develop mHealth interventions for family caregivers of people with dementia, particularly those in rural Hispanic communities, who often serve as surrogate decision makers for their relatives with dementia. OBJECTIVE As part of a larger project to develop and test a novel, affordable, and easy-to-use mHealth intervention to deliver individually tailored materials in rural Hispanic communities, in this pilot study, we aimed to examine (1) characteristics of people with dementia and their family caregivers in rural Hispanic communities, (2) caregivers' preferences for types and amounts of health information and participation in surrogate decision making, and (3) caregivers' mobile device usage and their desire for receiving information via mobile devices. METHODS This was a cross-sectional survey. A convenience sample of 50 caregivers of people with dementia was recruited from rural health care facilities in Southwest Texas during 3 weeks of April 2017 to May 2017 via word-of-mouth and flyers posted at the facilities. RESULTS More women than men were in the patient group (χ21=17.2, P<.001) and in the caregiver group (χ21=22.2, P<.001). More patients were on Medicare and Medicaid; more caregivers had private insurance (P<.001 in all cases). Overall, 42% of patients did not have a power of attorney for their health care; 40% did not have a living will or advance directive. Caregivers were interested in receiving all types of information and participating in all types of decisions, although on subscales for diagnosis, treatment, laboratory tests, self-care, and complementary and alternative medicine, their levels of interest for decision-making participation were significantly lower than those for receiving information. On the psychosocial subscale, caregivers' desire was greater for surrogate decision-making participation than for information. Caregivers did not differ in their interests in information and participation in decision making on the health care provider subscale. All but 1 caregiver (98%) owned a mobile phone and 84% had a smartphone. Two-thirds wanted to receive at least a little dementia-related information via a smartphone or tablet. The amount of dementia-related information caregivers wanted to receive via a mobile device was significantly greater for women than for men (U=84.50, P=.029). Caregivers who owned a tablet were more likely to want to receive dementia-related information via a mobile device than those who did not own a tablet (U=152.0, P=.006). CONCLUSIONS Caregivers in rural Hispanic communities were interested in receiving a wide range of information as well as participating in making decisions for their relatives with dementia. There is much need for effective mHealth interventions that can provide information tailored to the needs and preferences of these caregivers.
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Affiliation(s)
- Bo Xie
- School of Nursing, The University of Texas at Austin, Austin, TX, United States
- School of Information, The University of Texas at Austin, Austin, TX, United States
| | | | - Jung Kwak
- School of Nursing, The University of Texas at Austin, Austin, TX, United States
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20
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Lemetyinen H, Onwumere J, Drake RJ, Abel K, Haigh C, Moulton G, Edge D. Co-production and evaluation of an e-learning resource to improve African-Caribbean families' knowledge about schizophrenia and engagement with services: a pilot randomised controlled trial protocol. Pilot Feasibility Stud 2018; 4:174. [PMID: 30479829 PMCID: PMC6245541 DOI: 10.1186/s40814-018-0368-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2018] [Accepted: 11/07/2018] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND A higher proportion of African-Caribbean people in the UK are diagnosed with schizophrenia spectrum disorders than other ethnic groups. High levels of shame and stigma at individual and community levels contribute to delayed access to care, potentially increasing the duration of untreated psychosis and so worsening outcomes. Inferior access, more coercive care, and worse outcomes have created a 'circle of fear' of mental health services within African-Caribbean communities. This further discourages early engagement with statutory services and increases the burden of care for families living with schizophrenia.Providing tailored and relevant information about psychosis (psychoeducation) has the potential for improving outcomes for patients and families. However, there are no culturally appropriate psychoeducation programmes for African-Caribbeans in the UK. We aim to determine whether an e-learning resource, co-produced with African-Caribbean stakeholders to improve knowledge about psychoses, would be culturally acceptable and accessible to members of this population. METHODS A pilot randomised controlled trial of the feasibility of co-producing and testing a novel e-learning resource to improve knowledge about and attitudes towards schizophrenia in African-Caribbean families. We will seek to recruit 40 participants, aged ≥ 16 years, either to receive the intervention or as controls. They will self-refer or be referred via inpatient and wellbeing services, family and carers' forums, statutory community mental health teams, and voluntary sector/non-governmental agencies (NGOs). Participants will complete the Ca-KAP, ASMI, and SF-12. Acceptability will be explored qualitatively via focus groups and individual semi-structured interviews. DISCUSSION The proposed trial will demonstrate the feasibility of conducting a fully powered RCT to evaluate the efficacy of an e-learning resource about schizophrenia with African-Caribbean families. Qualitative work will explore the intervention's accessibility and barriers/facilitators to participation, including attitudes to randomisation. These data will facilitate further refinement of the intervention. TRIAL REGISTRATION ISRCTN11394005, retrospectively registered 20/03/2018.
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Affiliation(s)
- Henna Lemetyinen
- Division of Psychology & Mental Health, Faculty of Biology, Medicine and Health, School of Health Sciences, The University of Manchester, Manchester, UK
| | - Juliana Onwumere
- King’s College London, Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, London, UK
- South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Monks Orchard Road, Beckenham, Kent BR3 3BX UK
| | - Richard James Drake
- Division of Psychology & Mental Health, Faculty of Biology, Medicine and Health, School of Health Sciences, The University of Manchester, Manchester, UK
- Greater Manchester Mental Health NHS Foundation Trust, Bury New Road, Prestwich, Manchester, UK
| | - Kathryn Abel
- Division of Psychology & Mental Health, Faculty of Biology, Medicine and Health, School of Health Sciences, The University of Manchester, Manchester, UK
- Greater Manchester Mental Health NHS Foundation Trust, Bury New Road, Prestwich, Manchester, UK
| | - Carol Haigh
- Manchester Metropolitan University, Brook Building, Bonsall Street, Manchester, UK
| | - Georgina Moulton
- Division of Informatics, Imaging and Data Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - Dawn Edge
- Division of Psychology & Mental Health, Faculty of Biology, Medicine and Health, School of Health Sciences, The University of Manchester, Manchester, UK
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21
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Xie B, Berkley AS, Kwak J, Fleischmann KR, Champion JD, Koltai KS. End-of-life decision making by family caregivers of persons with advanced dementia: A literature review of decision aids. SAGE Open Med 2018; 6:2050312118777517. [PMID: 29844911 PMCID: PMC5966844 DOI: 10.1177/2050312118777517] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2017] [Accepted: 04/25/2018] [Indexed: 12/27/2022] Open
Abstract
Objectives: To investigate existing knowledge in the literature about end-of-life decision making by family caregivers of persons with dementia, focusing on decision aids for caregivers of persons with advanced dementia, and to identify gaps in the literature that can guide future research. Methods: A literature review through systematic searches in PubMed, CINAHL Plus with Full Text, and PsycINFO was conducted in February 2018; publications with full text in English and published in the past 10 years were selected in multiple steps. Results: The final sample included five decision aids with predominantly Caucasian participants; three of them had control groups, and three used audiovisual technology in presenting the intervention materials. No other technology was used in any intervention. Existing interventions lacked tailoring of information to caregivers’ preferences for different types and amounts of information necessary to make decisions consistent with patients’ values. Conclusion: Research is needed in exploring the use of technology in decision aids that could provide tailored information to facilitate caregivers’ decision making. More diverse samples are needed.
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Affiliation(s)
- Bo Xie
- School of Nursing, The University of Texas at Austin, Austin, TX, USA.,School of Information, The University of Texas at Austin, Austin, TX, USA
| | - Amy S Berkley
- School of Nursing, The University of Texas at Austin, Austin, TX, USA
| | - Jung Kwak
- School of Nursing, The University of Texas at Austin, Austin, TX, USA
| | | | | | - Kolina S Koltai
- School of Information, The University of Texas at Austin, Austin, TX, USA
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22
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Bergström AL, Hanson E. An integrative review of information and communication technology based support interventions for carers of home dwelling older people. ACTA ACUST UNITED AC 2018. [PMID: 29527109 PMCID: PMC5814658 DOI: 10.3233/tad-160158] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND A growing number of studies of informal carers of older people reveal positive results concerning support via Information and Communication Technologies (ICT). Systematic examination of factors that have a potential impact on carer outcomes are needed to inform future research. OBJECTIVE To explore studies concerning ICT support of adult carers of older people and to identify study characteristics that have a potential impact on carer outcomes. METHODS This integrative review includes 123 studies published since 2005. Fundamental questions for designing sensitive support interventions; 'who, what, and how' were applied to a synthesis of the results. RESULTS Identified characteristics from the studies responding to the who question included variables of the carers, such as their relationship with the care recipient or their ethnicity. Characteristics related to the what question related to the types of interventions, and the how question concerned the different services or programs offered, the idiosyncratic needs of the carers, and the types of technologies used. CONCLUSION Results are discussed according to micro, meso and macro levels of analysis. This extensive review can inform future studies and highlight the evidence in the area for decision makers, practitioners and/or NGOs working with innovative forms of support for carers of older people.
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Affiliation(s)
| | - Elizabeth Hanson
- Swedish Family Care Competence Centre, Professor Health Care Sciences, Linnaeus University, Kalmar, Sweden
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23
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Sin J, Henderson C, Spain D, Cornelius V, Chen T, Gillard S. eHealth interventions for family carers of people with long term illness: A promising approach? Clin Psychol Rev 2018; 60:109-125. [PMID: 29429856 DOI: 10.1016/j.cpr.2018.01.008] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2017] [Revised: 11/29/2017] [Accepted: 01/31/2018] [Indexed: 12/22/2022]
Abstract
Family carers of people who have long term illness often experience physical and mental health morbidities, and burden. While there is good evidence to suggest that carers benefit from psychosocial interventions, these have primarily been delivered via face-to-face individual or group-formats. eHealth interventions offer a novel, accessible and self-paced approach to care delivery. Whether these are effective for carers' wellbeing has been little explored. This paper reports the first comprehensive systematic review in this area. A total of 78 studies, describing 62 discrete interventions, were identified. Interventions commonly aimed to promote carers' knowledge, self-efficacy, caregiving appraisal, and reduce global health morbidities. Interventions were offered to carers of people with a wide range of long term illness; dementia has been the most researched area, as reported in 40% of studies. Clinical and methodological heterogeneity in interventions precluded meta-analyses, and so data were analysed narratively. The most popular approach has comprised psychoeducational interventions delivered via an enriched online environment with supplementary modes of communication, such as network support with professionals and peers. Overall, carers appreciate the flexibility and self-paced nature of eHealth interventions, with high rates of satisfaction and acceptability. More studies using robust designs are needed to extend the evidence base.
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Affiliation(s)
- Jacqueline Sin
- Population Health Research Institute, St George's, University of London, Cranmer Terrace, London SW17 0RE, England, UK; School of Psychology & Clinical Language Sciences, University of Reading, Earley Gate, Reading RG6 6AL, England, UK.
| | - Claire Henderson
- Health Service & Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park, London SE5 8AF, England, UK.
| | - Debbie Spain
- MRC Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park, London SE5 8AF, England, UK.
| | - Victoria Cornelius
- Imperial Clinical Trials Unit, School of Public Health, Imperial College London, Stadium House, 68 Wood Lane, London W12 7RH, England, UK.
| | - Tao Chen
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool L3 5QA, England, UK.
| | - Steve Gillard
- Population Health Research Institute, St George's, University of London, Cranmer Terrace, London SW17 0RE, England, UK.
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Reinwand DA, Crutzen R, Zank S. Online activities among elder informal caregivers: Results from a cross-sectional study. Digit Health 2018; 4:2055207618779715. [PMID: 31463072 PMCID: PMC6034351 DOI: 10.1177/2055207618779715] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2017] [Accepted: 05/06/2018] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVES The internet can be used as a source to gain information or support during highly demanding circumstances, e.g. providing informal care. While internet use has been studied among older people, less is known about informal caregivers' online behaviour. This study aims to explore differences in internet use regarding online activities between informal caregivers and non-caregivers. METHODS We used data of the Dutch Longitudinal Internet Studies for the Social Sciences panel (2014), including people aged 65 and older (N = 1413). To test differences with regard to 15 common internet activities; descriptive statistics and χ 2 tests were conducted. RESULTS The sample included 1197 participants aged 65 and older, and 325 (27.2%) were identified as informal caregivers. It was found that informal caregivers played more online games (χ 2 (1, 1198) = 6.20, p = 0.01), while non-caregivers more often read online news (χ 2 (1, 1198) = 4.44, p = 0.04) and were more active on social network websites (χ 2 (1, 1198) = 5.07, p = 0.02) compared to their counterparts. CONCLUSION Based on a representative sample, the results show that informal caregivers do not use the internet more for information seeking, but more often for playing online games, which may indicate that the internet is used to compensate for stress. Further research is needed to identify how informal caregivers can be supported by online services.
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Affiliation(s)
- Dominique A Reinwand
- Rehabilitative Gerontology, Faculty of Human Sciences, University of Cologne, Germany
| | - Rik Crutzen
- Care and Public Health Research Institute (CAPHRI), Department of Health Promotion, Maastricht University, The Netherlands
| | - Susanne Zank
- Rehabilitative Gerontology, Faculty of Human Sciences, University of Cologne, Germany
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Åkerlind C, Martin L, Gustafsson C. eHomecare and safety: The experiences of older patients and their relatives. Geriatr Nurs 2017; 39:178-185. [PMID: 28988833 DOI: 10.1016/j.gerinurse.2017.08.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2017] [Revised: 08/14/2017] [Accepted: 08/21/2017] [Indexed: 11/27/2022]
Abstract
The study's aim was to extend descriptions of how older patients with granted eHomecare and their relatives understand safety, and further to describe how they experience safety in everyday life. The study was conducted in Sweden. The participants were 12 older patients who had been provided with eHomecare and 8 relatives. Data were collected by semi-structured individual interviews. A conceptual framework of safety was used and a qualitative content analysis was conducted in a deductive and an inductive phase. The deductive results are presented in predefined categories: perceived sense of safety, disturbance and threats, re-establishing safety, and new safety. The inductive analysis resulted in two main categories: safety as part of everyday life and eHomecare as safety. The results show that eHomecare can promote safety for older patients and their relatives. Existing doubts and ethical concerns about the service can be minimized by providing adequate information.
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Affiliation(s)
- Charlotta Åkerlind
- School of Health, Care and Social Welfare, Mälardalen University, Sweden.
| | - Lene Martin
- School of Health, Care and Social Welfare, Mälardalen University, Sweden; School of Health Sciences, City University London, UK
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Akzeptanz von Informations- und Kommunikationstechnologien bei Senioren. PRÄVENTION UND GESUNDHEITSFÖRDERUNG 2017. [DOI: 10.1007/s11553-017-0610-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Older People Using e-Health Services—Exploring Frequency of Use and Associations with Perceived Benefits for Spouse Caregivers. INFORMATICS 2016. [DOI: 10.3390/informatics3030015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Blusi M, Kristiansen L, Jong M. Exploring the influence of Internet-based caregiver support on experiences of isolation for older spouse caregivers in rural areas: a qualitative interview study. Int J Older People Nurs 2014; 10:211-20. [DOI: 10.1111/opn.12074] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2014] [Accepted: 09/29/2014] [Indexed: 11/27/2022]
Affiliation(s)
- Madeleine Blusi
- Department of Research & Development; Association of Local Authorities in Västernorrland County; Härnösand Sweden
- Department of Nursing; Mid-Sweden University; Campus Sundsvall; Sundsvall Sweden
| | - Lisbeth Kristiansen
- Department of Nursing; Mid-Sweden University; Campus Sundsvall; Sundsvall Sweden
| | - Mats Jong
- Department of Nursing; Mid-Sweden University; Campus Sundsvall; Sundsvall Sweden
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Blusi M, Dalin R, Jong M. The benefits of e-health support for older family caregivers in rural areas. J Telemed Telecare 2014; 20:63-9. [PMID: 24446251 DOI: 10.1177/1357633x13519901] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
We conducted a pragmatic, mixed methods study comparing rural family caregivers receiving e-health caregiver support (n = 35) with a control group (n = 21) receiving conventional, non-e-health, caregiver support. After 18 months, the benefits of support were evaluated using the Care Effectiveness Scale (40-items exploring the domains of preparedness, enrichment and predictability). In all domains the e-health group scored significantly higher than the control group. The adjusted difference for overall benefits was 3.0 (P = 0.02) on the scale 0-10. In addition, semi structured interviews were conducted with a sub-sample of the caregivers. For the e-health group flexibility, availability and being able to individualise the support were essential factors. All caregivers in the control group found conventional support to be beneficial, but also stressed unmet needs related to the conventional support being standardised and non-flexible. The study suggests that providers of caregiver support should offer e-health support as an alternative to conventional caregiver support, as it can be more beneficial to family caregivers.
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Affiliation(s)
- Madeleine Blusi
- Department of Research and Development, Association of Local Authorities in Västernorrland County, Härnösand, Sweden
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