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Flakk Nordang E, Halvorsen K. Service users' experiences with mobile safety alarms in home care: A qualitative study. Nurs Open 2022; 9:2063-2072. [PMID: 35437942 PMCID: PMC9190702 DOI: 10.1002/nop2.1217] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 02/26/2022] [Accepted: 03/08/2022] [Indexed: 11/09/2022] Open
Abstract
Aim To investigate service users of home‐based care experiences of using mobile safety alarm and how the alarm affects their ability to cope with everyday life. Design A qualitative study with semi‐structured interviews. Methods The data were collected through semi‐structured interviews and analysed according to systematic text condensation. Four men and six women, between 47 and 85 years of age, were included in the study. Results Three main themes emerged in the analysis: dimensions of safety, the functionality of the alarm and variation in user guidance. The greatest benefit of having a mobile safety alarm was the feeling of safety. Moreover, the certainty of obtaining contact with the health professionals in any situation was highly valued. However, regarding implementation of the mobile safety alarm, the findings revealed a varying understanding among the service users. Nevertheless, the need for social interaction in their everyday lives is an important factor to recognize.
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Affiliation(s)
- Elise Flakk Nordang
- Department of Digital Health Research, Division of Medicine, Oslo University Hospital, Oslo, Norway.,Institute of Nursing and Health promotion, Oslo Metropolitan University, Oslo, Norway
| | - Kristin Halvorsen
- Institute of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway.,Faculty of Medicine and Health Sciences, The Norwegian University of Science and Technology, NTNU, Trondheim, Norway
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Mooses K, Camacho M, Cavallo F, Burnard MD, Dantas C, D’Onofrio G, Fernandes A, Fiorini L, Gama A, Perandrés Gómez A, Gonzalez L, Guardado D, Iqbal T, Sanchez Melero M, Melero Muñoz FJ, Moreno Muro FJ, Nijboer F, Ortet S, Rovini E, Toccafondi L, Tunc S, Taveter K. Involving Older Adults During COVID-19 Restrictions in Developing an Ecosystem Supporting Active Aging: Overview of Alternative Elicitation Methods and Common Requirements From Five European Countries. Front Psychol 2022; 13:818706. [PMID: 35295401 PMCID: PMC8918691 DOI: 10.3389/fpsyg.2022.818706] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Accepted: 02/07/2022] [Indexed: 01/26/2023] Open
Abstract
Background Information and communication technology solutions have the potential to support active and healthy aging and improve monitoring and treatment outcomes. To make such solutions acceptable, all stakeholders must be involved in the requirements elicitation process. Due to the COVID-19 situation, alternative approaches to commonly used face-to-face methods must often be used. One aim of the current article is to share a unique experience from the Pharaon project where due to the COVID-19 outbreak alternative elicitation methods were used. In addition, an overview of common functional, quality, and emotional goals identified by six pilot sites is presented to complement the knowledge about the needs of older adults. Methods Originally planned face-to-face co-creation seminars were impossible to carry out, and all pilot sites chose alternative requirements elicitation methods that were most suitable in their situation. The elicited requirements were presented in the form of goal models. In one summary goal model, we provide an overview of common functional, quality, and emotional goals. Results Different elicitation methods were combined based on the digital literacy of the target group and their access to digital tools. Methods applied without digital technologies were phone interviews, reviews of literature and previous projects, while by means of digital technologies online interviews, online questionnaires, and (semi-)virtual co-creation seminars were conducted. The combination of the methods allowed to involve all planned stakeholders. Virtual and semi-virtual co-creation seminars created collaborative environment comparable to face-to-face situations, while online participation helped to save the time of the participants. The most prevalent functional goals elicited were “Monitor health,” “Receive advice,” “Receive information.” “Easy to use/comfortable,” “personalized/tailored,” “automatic/smart” were identified as most prevalent quality goals. Most frequently occurring emotional goals were “involved,” “empowered,” and “informed.” Conclusion There are alternative methods to face-to-face co-creation seminars, which effectively involve older adults and other stakeholders in the requirements elicitation process. Despite the used elicitation method, the requirements can be easily transformed into goal models to present the results in a uniform way. The common requirements across different pilots provided a strong foundation for representing detailed requirements and input for further software development processes.
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Affiliation(s)
- Kerli Mooses
- Institute of Computer Science, Faculty of Science and Technology, University of Tartu, Tartu, Estonia
- *Correspondence: Kerli Mooses,
| | - Mariana Camacho
- Department of Innovation, Santa Casa da Misericórdia da Amadora (SCMA), Amadora, Portugal
| | - Filippo Cavallo
- Department of Industrial Engineering, University of Florence, Florence, Italy
| | - Michael David Burnard
- InnoRenew CoE, Izola, Slovenia
- Andrej Marušič Institute, University of Primorska, Koper, Slovenia
| | - Carina Dantas
- Cáritas Diocesana de Coimbra (CDC), Coimbra, Portugal
| | - Grazia D’Onofrio
- Complex Unit of Geriatrics, Department of Medical Sciences, Fondazione “Casa Sollievo della Sofferenza”—IRCCS, Foggia, Italy
| | - Adriano Fernandes
- Department of Innovation, Santa Casa da Misericórdia da Amadora (SCMA), Amadora, Portugal
| | - Laura Fiorini
- Department of Industrial Engineering, University of Florence, Florence, Italy
| | - Ana Gama
- Department of Innovation, Santa Casa da Misericórdia da Amadora (SCMA), Amadora, Portugal
| | | | | | | | - Tahira Iqbal
- Institute of Computer Science, Faculty of Science and Technology, University of Tartu, Tartu, Estonia
| | - María Sanchez Melero
- Technical Research Centre of Furniture and Wood of the Region of Murcia, Yecla, Spain
| | - Francisco José Melero Muñoz
- Technical Research Centre of Furniture and Wood of the Region of Murcia, Yecla, Spain
- Telecommunication Networks Engineering Group, Technical University of Cartagena, Cartagena, Spain
| | | | - Femke Nijboer
- Biomedical Signals and Systems, University of Twente, Enschede, Netherlands
| | - Sofia Ortet
- Cáritas Diocesana de Coimbra (CDC), Coimbra, Portugal
| | - Erika Rovini
- Department of Industrial Engineering, University of Florence, Florence, Italy
| | | | - Sefora Tunc
- Biomedical Signals and Systems, University of Twente, Enschede, Netherlands
| | - Kuldar Taveter
- Institute of Computer Science, Faculty of Science and Technology, University of Tartu, Tartu, Estonia
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Effectiveness and feasibility of home-based telerehabilitation for community-dwelling elderly people in Southeast Asian countries and regions: a systematic review. Aging Clin Exp Res 2021; 33:2657-2669. [PMID: 33765258 PMCID: PMC7993072 DOI: 10.1007/s40520-021-01820-3] [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] [Received: 02/03/2021] [Accepted: 02/17/2021] [Indexed: 02/03/2023]
Abstract
This systematic review aimed to evaluate the impact of home-based telerehabilitation on physical function among community-dwelling elderly people in Southeast Asian countries and regions, and to investigate its feasibility. A systematic electronic literature search was conducted in PubMed/MEDLINE and PEDro according to PRISMA guidelines. Randomized controlled trials conducted in the area that involved elderly people and any physical function indexes were included. Home-based telerehabilitation was defined as a specific remote rehabilitation intervention that used any kind of technological device allowing healthcare professional/patient interaction. Information regarding the effect and feasibility (intervention completion rate) of home-based telerehabilitation was extracted from eligible articles. We used the Revised Cochrane risk-of-bias tool for randomized trials to assess methodological quality of the included articles. Eventually, six studies were included as eligible articles. The overall risk of bias judgement was assessed as “High” in five studies. All studies were conducted in either China or South Korea, and heterogeneity in terms of participants’ health condition and intervention regimen was observed across the studies. Our narrative-based analysis showed that compared with conventional rehabilitation, either equal or better effects on physical function were reported across the six studies. The intervention completion rates were 81% ± 11 on average (range 59–96%). Although we could not obtain conclusive evidence due to limited relevant information with heterogeneity across the studies, our findings suggest that home-based telerehabilitation can be a strategy for rehabilitation service delivery with acceptable feasibility comparable to conventional rehabilitation for elderly people in the area.
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Landgren S, Cajander Å. Non-use of Digital Health Consultations Among Swedish Elderly Living in the Countryside. Front Public Health 2021; 9:588583. [PMID: 34568247 PMCID: PMC8460856 DOI: 10.3389/fpubh.2021.588583] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Accepted: 08/16/2021] [Indexed: 11/13/2022] Open
Abstract
Digital health consultations in primary care have the advantage of offering equal healthcare for people residing in the countryside. While it is gaining acceptance among young- and middle-aged people, the elderly are reluctant to use it. The aim of this study was hence to identify reasons for non-use among elderly in the countryside and describe perceived possible challenges and opportunities with digital health consultations. Semi-structured interviews were conducted with 13 persons over 65 years old residing in the Swedish countryside. There was a mistrust for services offered by private companies and their public funding, a lack of knowledge of available services, and a lack of perceived usefulness. Personal interaction and continuity was more important than time or travel conveniences, although these advantages were recognized. To prevent digital exclusion, caregivers need to offer information, encouragement, or tools for the elderly. Digital primary care also needs to offer familiarity, with continuity and personal connections.
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Affiliation(s)
- Sara Landgren
- Department of Informatics and Media, Uppsala University, Uppsala, Sweden
| | - Åsa Cajander
- Department of Informatics and Media, Uppsala University, Uppsala, Sweden.,Department of Information Technology, Uppsala University, Uppsala, Sweden
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Piera-Jiménez J, Daugbjerg S, Stafylas P, Meyer I, Müller S, Lewis L, da Col P, Folkvord F, Lupiáñez-Villanueva F. BeyondSilos, a Telehealth-Enhanced Integrated Care Model in the Domiciliary Setting for Older Patients: Observational Prospective Cohort Study for Effectiveness and Cost-Effectiveness Assessments. JMIR Med Inform 2020; 8:e20938. [PMID: 33021490 PMCID: PMC7576466 DOI: 10.2196/20938] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 08/12/2020] [Accepted: 09/06/2020] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Information and communication technology may provide domiciliary care programs with continuity of care. However, evidence about the effectiveness and cost-effectiveness of information and communication technology in the context of integrated care models is relatively scarce. OBJECTIVE The objective of our study was to provide evidence on the clinical effectiveness and cost-effectiveness of the BeyondSilos project for patients enrolled in the Badalona city pilot site in Spain. METHODS A quasi-experimental study was used to assess the cost-effectiveness of information and communication technology-enhanced integration of health and social care, including the third sector (intervention), compared to basic health and social care coordination (comparator). The study was conducted in Badalona between 2015 and 2016. Participants were followed for 8 months. RESULTS The study included 198 patients: 98 in the intervention group and 100 in the comparator group. The mean Barthel index remained unchanged in the intervention group (mean change 0.14, 95% CI -4.51 to 4.78; P=.95) but decreased in the comparator group (mean change -3.23, 95% CI -5.34 to -1.11; P=.003). Instrumental Activities of Daily Living significantly decreased in both groups: mean changes of -0.23 (95% CI -0.44 to -0.02; P=.03) and -0.33 (95% CI -0.46 to -0.20; P<.001) in the intervention and comparator groups, respectively. No differences were found in the Geriatric Depression Scale (intervention: mean change 0.28, 95% CI -0.44 to 1.01, P=.44; comparator: mean change -0.29, 95% CI -0.59 to 0.01, P=.06). The intervention showed cost-effectiveness (incremental cost-effectiveness ratio €6505.52, approximately US $7582). CONCLUSIONS The information and communication technology-enhanced integrated domiciliary care program was cost-effective. The beneficial effects of this approach strongly rely upon the commitment of the professional staff involved. TRIAL REGISTRATION ClinicalTrials.gov NCT03111004; http://clinicaltrials.gov/ct2/show/ NCT03111004.
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Affiliation(s)
- Jordi Piera-Jiménez
- Open Evidence Research Group, Universitat Oberta de Catalunya, Barcelona, Spain.,Department of Research & Development, Badalona Serveis Assistencials, Badalona, Spain
| | - Signe Daugbjerg
- Graduate School of Health Economics and Management, Università Cattolica del Sacro Cuore, Roma, Italy
| | | | - Ingo Meyer
- PMV Research Group, Universität zu Köln, Köln, Germany
| | - Sonja Müller
- Empirica Gesellschaft für Kommunikations und Technologieforschung GmbH, Bonn, Germany
| | - Leo Lewis
- International Foundation for Integrated Care, Oxford, United Kingdom
| | | | - Frans Folkvord
- Open Evidence Research Group, Universitat Oberta de Catalunya, Barcelona, Spain.,Tilburg School of Humanities and Digital Sciences, Tilburg University, Tilburg, Netherlands
| | - Francisco Lupiáñez-Villanueva
- Open Evidence Research Group, Universitat Oberta de Catalunya, Barcelona, Spain.,Department of Information and Communication Sciences, Universitat Oberta de Catalunya, Barcelona, Spain
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Mois G, Beer JM. The Role of Healthcare Robotics in Providing Support to Older Adults: a Socio-ecological Perspective. CURRENT GERIATRICS REPORTS 2020; 9:82-89. [PMID: 32435576 PMCID: PMC7223616 DOI: 10.1007/s13670-020-00314-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
PURPOSE OF REVIEW In this review, we provide an overview of how healthcare robotics can facilitate healthy aging, with an emphasis on physical, cognitive, and social supports. We next provide a synthesis of future challenges and considerations in the development and application of healthcare robots. We organize these considerations using a socio-ecological perspective and discuss considerations at the individual, care partner, community healthcare, and healthcare policy levels. RECENT FINDINGS Older adults are the fastest growing segment of the US population. Age-related changes and challenges can present difficulties, for older adults want to age healthily and maintain independence. Technology, specifically healthcare robots, has potential to provide health supports to older adults. These supports span widely across the physical, cognitive, and social aspects of healthy aging. SUMMARY Our review suggests that while healthcare robotics has potential to revolutionize the way in which older adults manage their health, there are many challenges such as clinical effectiveness, technology acceptance, health informatics, and healthcare policy and ethics. Addressing these challenges at all levels of the healthcare system will help ensure that healthcare robotics promote healthy aging and are applied safely, effectively, and reliably.
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Affiliation(s)
- George Mois
- School of Social Work, University of Georgia, 279 Williams St, Athens, GA 30602 USA
| | - Jenay M. Beer
- School of Social Work, University of Georgia, 279 Williams St, Athens, GA 30602 USA
- Institute of Gerontology, University of Georgia, 102 Spear Road, Athens, GA 30606 USA
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Gjestsen MT, Wiig S, Testad I. Health Care Personnel's Perspective on Potential Electronic Health Interventions to Prevent Hospitalizations for Older Persons Receiving Community Care: Qualitative Study. J Med Internet Res 2020; 22:e12797. [PMID: 31895045 PMCID: PMC6966552 DOI: 10.2196/12797] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Revised: 04/30/2019] [Accepted: 06/03/2019] [Indexed: 11/13/2022] Open
Abstract
Background The use of electronic health (eHealth) interventions is suggested to help monitor and treat degenerative and chronic diseases through the use of sensors, alarms, and reminders and can potentially prevent hospitalizations for home-dwelling older persons receiving community care. It is increasingly recognized that the health care personnel’s acceptance of a technological application remains a key challenge in adopting an intervention, thus interventions must be perceived to be useful and fit for purpose by the actual users. Objective The aim of this study was to identify and explore the perspectives of managers and health care personnel in community care regarding the use of eHealth interventions in terms of prevention of hospitalizations for home-dwelling older persons receiving community care. Methods A case study with a qualitative approach was carried out in community care in a Norwegian municipality, comprising individual interviews and focus group interviews. A total of 5 individual interviews and 2 focus group interviews (n=12) were undertaken to provide the health care personnel’s and managers’ perspective regarding the use of eHealth interventions, which could potentially prevent hospitalizations for home-dwelling older persons receiving community care. Data were analyzed by way of systematic text condensation, as described by Malterud. Results The data analysis of focus group interviews and individual interviews resulted in 2 categories: potential technological applications and potential patient groups. Discussions in the focus groups generated several suggestions and wishes related to technical applications that they could make use of in their day-to-day practice. The health care personnel warranted tools and measures to enhance and document their clinical observations in contact with patients. They also identified patient groups, such as patients with chronic obstructive pulmonary disease or dehydration or urinary tract infections, for whom hospitalizations could potentially have been prevented. Conclusions We have shown that the health care personnel in community care warrant various technological applications that have the potential to improve quality of care and resource utilization in the studied municipality. We have identified needs and important matters in practice, which are paramount for acceptance and adoption of an intervention in community care.
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Affiliation(s)
| | - Siri Wiig
- Centre for Resilience in Healthcare, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
| | - Ingelin Testad
- Centre for Age-related Medicine, Stavanger University Hospital, Stavanger, Norway.,Exeter University Medical School, Exeter University, Exeter, United Kingdom
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Marsch LA, Hegel MT, Greene MA. Leveraging digital technology to intervene on personality processes to promote healthy aging. Personal Disord 2019; 10:33-45. [PMID: 30604982 PMCID: PMC6322418 DOI: 10.1037/per0000275] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The scientific evidence is clear that personality processes (particularly conscientiousness and neuroticism) play an important role in healthy aging. Assuming it would be desirable to assist individuals to change their personality in directions that would promote healthy aging, the next step is designing interventions for the task. During the past decade, technological advances have made it possible to develop and evaluate interventions delivered via web and mobile digital technologies. The purpose of this article is to discuss the possibilities for leveraging technology to intervene on personality processes to promote healthy aging, with a specific emphasis on applications for older adults. We begin by reviewing interventions that target personality change to treat mental health problems and physical health, followed by the scant research leveraging digital technologies in targeting personality processes. We present a rationale for adopting a transdiagnostic model to guide intervention development and review the brief literature supporting transdiagnostic interventions when adapted for digital delivery (transdiagnostic Internet-based cognitive-behavioral therapy). We then summarize the literature on designing technology interventions to meet the specific needs of older adults and some of the impressive results from digital technology (Internet-based cognitive-behavioral therapy) intervention studies. We conclude with suggestions for addressing gaps in this important but understudied area of research, with a focus on research targeted to older adults. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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Affiliation(s)
- Lisa A Marsch
- Center for Technology and Behavioral Health, Geisel School of Medicine, Department of Psychiatry, Dartmouth College
| | - Mark T Hegel
- Center for Technology and Behavioral Health, Geisel School of Medicine, Department of Psychiatry, Dartmouth College
| | - Mary Ann Greene
- Center for Technology and Behavioral Health, Geisel School of Medicine, Department of Psychiatry, Dartmouth College
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Shiells K, Holmerova I, Steffl M, Stepankova O. Electronic patient records as a tool to facilitate care provision in nursing homes: an integrative review. Inform Health Soc Care 2018; 44:262-277. [PMID: 30125140 DOI: 10.1080/17538157.2018.1496091] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Objective: The electronic patient record (EPR) has been introduced into nursing homes with the aim of reducing time spent on documentation, improving documentation quality and increasing transferability of information, all of which should facilitate care provision. However, previous research has shown that EPR may be creating new burdens for staff. The purpose of this literature review is to explore how EPR is facilitating or hindering care provision in nursing homes. Methods: An integrative literature review was carried out using four electronic databases to search for relevant articles. After screening, 22 articles were included for thematic synthesis. Results: Thematic synthesis resulted in six analytical themes linked to care provision: time for direct care; accountability; assessment and care planning; exchange of information; risk awareness; and person-centered care. Conclusion: For EPR to facilitate care provision in nursing homes, consideration should be given to the type of device used for documentation, as well as the types of applications, the functionality, content, and structure of EPR. Further research exploring the experiences of end users is required to identify the optimal characteristics of an EPR system specifically for use in nursing homes.
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Affiliation(s)
- Kate Shiells
- a Centre of Expertise in Longevity and Long-Term Care, Faculty of Humanities, Charles University , Prague , Czech Republic
| | - Iva Holmerova
- a Centre of Expertise in Longevity and Long-Term Care, Faculty of Humanities, Charles University , Prague , Czech Republic
| | - Michal Steffl
- b Department of Physiology and Biochemistry, Faculty of Physical Education and Sport, Charles University , Prague , Czech Republic
| | - Olga Stepankova
- c Department of Cybernetics, Faculty of Electrical Engineering, Czech Technical University in Prague , Prague , Czech Republic
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Abstract
Most developing countries are generally characterized by some problems such as limited resources and professional isolation in the health area. Information and Communication Technology (ICT) is supposed to give solutions through the use of e-Healthcare technologies. Information and communication technologies are valuable tools used to establish and maintain connections within and between healthcare providers, and between healthcare providers and Patients. Telehomecare evolves constantly. It can aid disabled persons, increase patient compliance, enhance caregivers' effectiveness, and connect socially isolated individuals to their care providers. Various research works have investigated different aspects of ICT in the context of telehomecare in some developed and developing countries. This paper describes an architectural framework for the development of telehomecare in Algeria for diabetes measurement and remote monitoring.
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Affiliation(s)
- Karim Zarour
- LIRE Laboratory, Department of Software Technologies and Information Systems, Faculty of New Technologies of Information and Communication, University Constantine 2, Constantine, Algeria
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12
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Davis J, Morgans A, Burgess S. Information management in the Australian aged care setting. HEALTH INF MANAG J 2016; 46:3-14. [DOI: 10.1177/1833358316639434] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: Information management systems and processes have an impact on quality and safety of care in any setting and particularly in the complex care setting of aged care. Few studies have comprehensively examined information management in the Australian aged care setting. Objective: To (i) critically analyse and synthesize evidence related to information management in aged care, (ii) identify aged care data collection frameworks and (iii) identify factors impacting information management. Methods: An integrative review of Australian literature published between March 2008 and August 2014 and data collection frameworks concerning information management in aged care were carried out. Results: There is limited research investigating the information-rich setting of aged care in Australia. Electronic systems featured strongly in the review. Existing research focuses on residential settings with community aged care largely absent. Information systems and processes in the setting of aged care in Australia are underdeveloped and poorly integrated. Conclusions: Data quality and access are more problematic within community aged care than residential care settings. The results of this review represent an argument for a national approach to information management in aged care to address multiple stakeholder information needs and more effectively support client care.
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Affiliation(s)
- Jenny Davis
- Benetas, Victoria, Australia
- Monash University, Australia
| | - Amee Morgans
- Monash University, Australia
- Royal District Nursing Service, Victoria, Australia
| | - Stephen Burgess
- Benetas, Victoria, Australia
- Monash University, Australia
- Royal District Nursing Service, Victoria, Australia
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13
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Kaambwa B, Ratcliffe J, Shulver W, Killington M, Taylor A, Crotty M, Carati C, Tieman J, Wade V, Kidd MR. Investigating the preferences of older people for telehealth as a new model of health care service delivery: A discrete choice experiment. J Telemed Telecare 2016; 23:301-313. [PMID: 26985004 DOI: 10.1177/1357633x16637725] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Introduction Telehealth approaches to health care delivery can potentially improve quality of care and clinical outcomes, reduce mortality and hospital utilisation, and complement conventional treatments. However, substantial research into the potential for integrating telehealth within health care in Australia, particularly in the provision of services relevant to older people, including palliative care, aged care and rehabilitation, is lacking. Furthermore, to date, no discrete choice experiment (DCE) studies internationally have sought the views and preferences of older people about the basic features that should make up a telehealth approach to these services. Methods Using a DCE, we investigated the relative importance of six salient features of telehealth (what aspects of care are to be pursued during telehealth sessions, distance to the nearest hospital or clinic, clinicians' attitude to telehealth, patients' experience of using technology, what types of assessments should be conducted face-to-face versus via telehealth sessions and the costs associated with receiving telehealth). Data were obtained from an online panel of older people aged 65 years and above, drawn from the Australian general population. Results The mean age for 330 study participants was 69 years. In general, individuals expressed strong preferences for telehealth services that offered all aspects of care, were relatively inexpensive and targeted specifically at individuals living in remote regions without easy access to a hospital or clinic. Participants also preferred telehealth services to be offered to individuals with some prior experience of using technology, provided by clinicians who were positive about telehealth but wanted all or some pre-telehealth health assessments to take place in a hospital or clinic. Preferences only differed by gender. Additionally, respondents did not feel that telehealth led to loss of privacy and confidentiality. Discussion Our findings indicate a preference amongst respondents for face-to-face pre-telehealth health assessments and, thereafter, a comprehensive telehealth model (in terms of services offered) targeted at those with some technological know-how as a substitute for attendance at hospitals and clinics, especially where these health facilities were far away from older people's homes. The findings may be usefully incorporated into the design of future telehealth models of service delivery for older people.
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Affiliation(s)
- Billingsley Kaambwa
- 1 Flinders Health Economics Group, Flinders University, Repatriation General Hospital, Adelaide, Australia
| | - Julie Ratcliffe
- 1 Flinders Health Economics Group, Flinders University, Repatriation General Hospital, Adelaide, Australia
| | - Wendy Shulver
- 2 Department of Rehabilitation and Aged Care, Flinders University, Repatriation General Hospital, Adelaide, Australia
| | - Maggie Killington
- 2 Department of Rehabilitation and Aged Care, Flinders University, Repatriation General Hospital, Adelaide, Australia
| | - Alan Taylor
- 3 Faculty of Medicine, Nursing and Health Sciences, Flinders University, Adelaide, Australia
| | - Maria Crotty
- 2 Department of Rehabilitation and Aged Care, Flinders University, Repatriation General Hospital, Adelaide, Australia
| | - Colin Carati
- 3 Faculty of Medicine, Nursing and Health Sciences, Flinders University, Adelaide, Australia.,4 NH&MRC Centre for Research Excellence in TeleHealth, University of Queensland, Brisbane, Australia
| | - Jennifer Tieman
- 5 Discipline of Palliative and Supportive Services, School of Health Sciences, Flinders University, Adelaide, Australia
| | - Victoria Wade
- 6 Discipline of General Practice, The University of Adelaide, Adelaide, Australia
| | - Michael R Kidd
- 3 Faculty of Medicine, Nursing and Health Sciences, Flinders University, Adelaide, Australia
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14
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Wu D, Li Y. Online health information seeking behaviors among Chinese elderly. LIBRARY & INFORMATION SCIENCE RESEARCH 2016. [DOI: 10.1016/j.lisr.2016.08.011] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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15
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Shulver W, Killington M, Morris C, Crotty M. 'Well, if the kids can do it, I can do it': older rehabilitation patients' experiences of telerehabilitation. Health Expect 2016; 20:120-129. [PMID: 26890025 PMCID: PMC5217918 DOI: 10.1111/hex.12443] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/01/2016] [Indexed: 01/19/2023] Open
Abstract
Background and objective Although trials continue to emerge supporting the role of telerehabilitation, implementation has been slow. Key users include older people living with disabilities who are frequent users of hospital rehabilitation services but whose voices are rarely heard. It is unclear whether the use of technologies and reduced face‐to‐face contact is acceptable to these people. We report on a qualitative study of community dwelling participants who had received a home telerehabilitation programme as an alternative to conventional rehabilitation. Design Thirteen older participants, three spouses and one carer were interviewed. All had participated in an individualized therapy programme, using a combination of face‐to‐face and video consults with therapists. The programme used ‘off‐the‐shelf’ technologies including iPads for videoconferencing and electronic FitBitR devices. Interviews were recorded, transcribed verbatim and analysed using NVivo software. Results Thematic analysis resulted in five emergent themes: (i) telerehabilitation is convenient; (ii) telerehabilitation promotes motivation and self‐awareness; (iii) telerehabilitation fosters positive therapeutic relationships; (iv) mastering technologies used by younger relatives is a valued aspect of telerehabilitation; and (v) Telerehabilitation does not replace traditional face‐to‐face rehabilitation therapies. Conclusions Participants found telerehabilitation convenient and motivating, coped well with the technology and developed positive therapeutic relationships. The learning and practice aspects sat well in the context of a rehabilitation programme. The use of commercially available technologies may have contributed to respondents' high levels of acceptability. The perception of telerehabilitation as complementary to in‐person care and the expectation of technological support have implications for the implementation and delivery of telerehabilitation services to older people.
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Affiliation(s)
- Wendy Shulver
- Rehabilitation, Aged and Extended Care, Flinders University, Daw Park, SA, Australia
| | - Maggie Killington
- Rehabilitation, Aged and Extended Care, Flinders University, Daw Park, SA, Australia.,Rehabilitation and Aged Care, Repatriation General Hospital, Daw Park, SA, Australia
| | - Claire Morris
- Rehabilitation and Aged Care, Repatriation General Hospital, Daw Park, SA, Australia
| | - Maria Crotty
- Rehabilitation, Aged and Extended Care, Flinders University, Daw Park, SA, Australia.,Rehabilitation and Aged Care, Repatriation General Hospital, Daw Park, SA, Australia
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Vancea M, Solé-Casals J. Population Aging in the European Information Societies: Towards a Comprehensive Research Agenda in eHealth Innovations for Elderly. Aging Dis 2015; 7:526-39. [PMID: 27493837 DOI: 10.14336/ad.2015.1214] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2015] [Accepted: 12/14/2015] [Indexed: 11/01/2022] Open
Abstract
Population ageing is one of the major social and economic challenges of our contemporary societies. With the advent of the information society, new research and technological developments have been promoted in the field of assistive technologies and information and communication technologies of benefit to elderly people. This article examines the potentialities of new informatics developments in generating solutions to better address elderly people's daily-life, especially those with chronic illness and/or low autonomy. The authours attempt to propose a research agenda, by exposing various strengts and weaknesses of eHealth innovations for elderly, mainly grounded in secondary sources analysis.
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Affiliation(s)
- Mihaela Vancea
- 1Núcleo de Investigación Científica y Desarrollo Tecnológico en Ciencias Sociales y las Humanidades Universidad de la Frontera, Chile
| | - Jordi Solé-Casals
- 2Data and Signal Processing Research Group, U Sciences Tech, University of Vic - Central University of Catalonia, Spain
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Wiig S, Guise V, Anderson J, Storm M, Lunde Husebø AM, Testad I, Søyland E, Moltu KL. Safer@home-Simulation and training: the study protocol of a qualitative action research design. BMJ Open 2014; 4:e004995. [PMID: 25079924 PMCID: PMC4120417 DOI: 10.1136/bmjopen-2014-004995] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION While it is predicted that telecare and other information and communication technology (ICT)-assisted services will have an increasingly important role in future healthcare services, their implementation in practice is complex. For implementation of telecare to be successful and ensure quality of care, sufficient training for staff (healthcare professionals) and service users (patients) is fundamental. Telecare training has been found to have positive effects on attitudes to, sustained use of, and outcomes associated with telecare. However, the potential contribution of training in the adoption, quality and safety of telecare services is an under-investigated research field. The overall aim of this study is to develop and evaluate simulation-based telecare training programmes to aid the use of videophone technology in elderly home care. Research-based training programmes will be designed for healthcare professionals, service users and next of kin, and the study will explore the impact of training on adoption, quality and safety of new telecare services. METHODS AND ANALYSIS The study has a qualitative action research design. The research will be undertaken in close collaboration with a multidisciplinary team consisting of researchers and managers and clinical representatives from healthcare services in two Norwegian municipalities, alongside experts in clinical education and simulation, as well as service user (patient) representatives. The qualitative methods used involve focus group interviews, semistructured interviews, observation and document analysis. To ensure trustworthiness in the data analysis, we will apply member checks and analyst triangulation; in addition to providing contextual and sample description to allow for evaluation of transferability of our results to other contexts and groups. ETHICS AND DISSEMINATION The study is approved by the Norwegian Social Science Data Services. The study is based on voluntary participation and informed written consent. Informants can withdraw at any point in time. The results will be disseminated at research conferences, peer review journals, one PhD thesis and through public presentations to people outside the scientific community.
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Affiliation(s)
- Siri Wiig
- Department of Health Studies, University of Stavanger, Stavanger, Norway
| | - Veslemøy Guise
- Department of Health Studies, University of Stavanger, Stavanger, Norway
| | - Janet Anderson
- Department of Health Studies, University of Stavanger, Stavanger, Norway
- Florence Nightingale School of Nursing and Midwifery, King's College, London, UK
| | - Marianne Storm
- Department of Health Studies, University of Stavanger, Stavanger, Norway
| | | | - Ingelin Testad
- Department of Health Studies, University of Stavanger, Stavanger, Norway
- Regional Centre for Age-related Medicine, SESAM, Stavanger University Hospital, Stavanger, Norway
| | - Elsa Søyland
- Stavanger Acute Medicine Foundation for Education and Research, Stavanger, Norway
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Fischer SH, David D, Crotty BH, Dierks M, Safran C. Acceptance and use of health information technology by community-dwelling elders. Int J Med Inform 2014; 83:624-35. [PMID: 24996581 DOI: 10.1016/j.ijmedinf.2014.06.005] [Citation(s) in RCA: 195] [Impact Index Per Article: 19.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2013] [Revised: 05/16/2014] [Accepted: 06/09/2014] [Indexed: 10/25/2022]
Abstract
OBJECTIVES With the worldwide population growing in age, information technology may help meet important needs to prepare and support patients and families for aging. We sought to explore the use and acceptance of information technology for health among the elderly by reviewing the existing literature. METHODS Review of literature using PubMed and Google Scholar, references from relevant papers, and consultation with experts. RESULTS Elderly people approach the Internet and health information technology differently than younger people, but have growing rates of adoption. Assistive technology, such as sensors or home monitors, may help 'aging in place', but these have not been thoroughly evaluated. Elders face many barriers in using technology for healthcare decision-making, including issues with familiarity, willingness to ask for help, trust of the technology, privacy, and design challenges. CONCLUSIONS Barriers must be addressed for these tools to be available to this growing population. Design, education, research, and policy all play roles in addressing these barriers to acceptance and use.
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Affiliation(s)
- Shira H Fischer
- Division of Clinical Informatics, Beth Israel Deaconess Medical Center, 1330 Beacon St., Suite 400, Brookline, MA 02446, United States; RAND Corporation, 20 Park Plaza, Suite 920, Boston, MA 02116, United States.
| | - Daniel David
- Division of Clinical Informatics, Beth Israel Deaconess Medical Center, 1330 Beacon St., Suite 400, Brookline, MA 02446, United States; Jonas Foundation Scholar, School of Nursing, Bouvé College of Health Sciences, Northeastern University, 360 Huntington Ave., Boston, MA 02115, United States
| | - Bradley H Crotty
- Division of Clinical Informatics, Beth Israel Deaconess Medical Center, 1330 Beacon St., Suite 400, Brookline, MA 02446, United States
| | - Meghan Dierks
- Division of Clinical Informatics, Beth Israel Deaconess Medical Center, 1330 Beacon St., Suite 400, Brookline, MA 02446, United States
| | - Charles Safran
- Division of Clinical Informatics, Beth Israel Deaconess Medical Center, 1330 Beacon St., Suite 400, Brookline, MA 02446, United States
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Vermeulen J, Verwey R, Hochstenbach LMJ, van der Weegen S, Man YP, de Witte LP. Experiences of multidisciplinary development team members during user-centered design of telecare products and services: a qualitative study. J Med Internet Res 2014; 16:e124. [PMID: 24840245 PMCID: PMC4051739 DOI: 10.2196/jmir.3195] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2013] [Revised: 03/17/2014] [Accepted: 04/28/2014] [Indexed: 11/13/2022] Open
Abstract
Background User-centered design (UCD) methodologies can help take the needs and requirements of potential end-users into account during the development of innovative telecare products and services. Understanding how members of multidisciplinary development teams experience the UCD process might help to gain insight into factors that members with different backgrounds consider critical during the development of telecare products and services. Objective The primary objective of this study was to explore how members of multidisciplinary development teams experienced the UCD process of telecare products and services. The secondary objective was to identify differences and similarities in the barriers and facilitators they experienced. Methods Twenty-five members of multidisciplinary development teams of four Research and Development (R&D) projects participated in this study. The R&D projects aimed to develop telecare products and services that can support self-management in elderly people or patients with chronic conditions. Seven participants were representatives of end-users (elderly persons or patients with chronic conditions), three were professional end-users (geriatrician and nurses), five were engineers, four were managers (of R&D companies or engineering teams), and six were researchers. All participants were interviewed by a researcher who was not part of their own development team. The following topics were discussed during the interviews: (1) aim of the project, (2) role of the participant, (3) experiences during the development process, (4) points of improvement, and (5) what the project meant to the participant. Results Experiences of participants related to the following themes: (1) creating a development team, (2) expectations regarding responsibilities and roles, (3) translating user requirements into technical requirements, (4) technical challenges, (5) evaluation of developed products and services, and (6) valorization. Multidisciplinary team members from different backgrounds often reported similar experienced barriers (eg, different members of the development team speak a “different language”) and facilitators (eg, team members should voice expectations at the start of the project to prevent miscommunication at a later stage). However, some experienced barriers and facilitators were reported only by certain groups of participants. For example, only managers reported the experience that having different ideas about what a good business case is within one development team was a barrier, whereas only end-users emphasized the facilitating role of project management in end-user participation and the importance of continuous feedback from researchers on input of end-users. Conclusions Many similarities seem to exist between the experienced barriers and facilitators of members of multidisciplinary development teams during UCD of telecare products and services. However, differences in experiences between team members from various backgrounds exist as well. Insights into these similarities and differences can improve understanding between team members from different backgrounds, which can optimize collaboration during the development of telecare products and services.
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Affiliation(s)
- Joan Vermeulen
- CAPHRI, Department of Health Services Research, Maastricht University, Maastricht, Netherlands.
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Reeder B, Demiris G, Marek KD. Older adults' satisfaction with a medication dispensing device in home care. Inform Health Soc Care 2013; 38:211-22. [PMID: 23323721 PMCID: PMC4122419 DOI: 10.3109/17538157.2012.741084] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
INTRODUCTION Older adults with multiple chronic conditions face the complex task of medication management involving multiple medications of varying doses at different times. Advances in telehealth technologies have resulted in home-based devices for medication management and health monitoring of older adults. We examined older adults' perceptions of a telehealth medication dispensing device as part of a clinical trial involving home healthcare clients, nurse coordination and use of the medication dispensing device. METHODS Ninety-six frail older adult participants who used the medication dispensing device for 12 months completed a satisfaction survey related to perceived usefulness and reliability. Results were analyzed and grouped by themes in the following areas: Ease of Use, Reliability, Medication Management Assistance, Routine Task Performance and Acceptability. RESULTS Nearly all participants perceived the medication dispensing device as very easy to use, very reliable and helpful in the management of their medications. Eighty-four percent of participants expressed a desire to use the machine in the future. CONCLUSION The technology-enhanced medication management device in this study is an acceptable tool for older adults to manage medication in collaboration with home care nurses. Improved usability and cost models for medication dispensers are areas for future research.
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Affiliation(s)
- Blaine Reeder
- Biobehavioral Nursing and Health Systems, University of Washington, Seattle, WA 98195, USA.
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Reeder B, Meyer E, Lazar A, Chaudhuri S, Thompson HJ, Demiris G. Framing the evidence for health smart homes and home-based consumer health technologies as a public health intervention for independent aging: a systematic review. Int J Med Inform 2013; 82:565-79. [PMID: 23639263 DOI: 10.1016/j.ijmedinf.2013.03.007] [Citation(s) in RCA: 78] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2012] [Revised: 03/08/2013] [Accepted: 03/31/2013] [Indexed: 11/25/2022]
Abstract
INTRODUCTION There is a critical need for public health interventions to support the independence of older adults as the world's population ages. Health smart homes (HSH) and home-based consumer health (HCH) technologies may play a role in these interventions. METHODS We conducted a systematic review of HSH and HCH literature from indexed repositories for health care and technology disciplines (e.g., MEDLINE, CINAHL, and IEEE Xplore) and classified included studies according to an evidence-based public health (EBPH) typology. RESULTS One thousand, six hundred and thirty-nine candidate articles were identified. Thirty-one studies from the years 1998-2011 were included. Twenty-one included studies were classified as emerging, 10 as promising and 3 as effective (first tier). CONCLUSION The majority of included studies were published in the period beginning in the year 2005. All 3 effective (first tier) studies and 9 of 10 of promising studies were published during this period. Almost all studies included an activity sensing component and most of them used passive infrared motion sensors. The three effective (first tier) studies all used a multicomponent technology approach that included activity sensing, reminders and other technologies tailored to individual preferences. Future research should explore the use of technology for self-management of health by older adults; social support; and self-reported health measures incorporated into personal health records, electronic medical records, and community health registries.
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Affiliation(s)
- Blaine Reeder
- Biobehavioral Nursing and Health Systems, School of Nursing, Box 357266, University of Washington, Seattle, WA 98195, USA.
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Using Information and Communication Technology in Home Care for Communication between Patients, Family Members, and Healthcare Professionals: A Systematic Review. Int J Telemed Appl 2013; 2013:461829. [PMID: 23690763 PMCID: PMC3649237 DOI: 10.1155/2013/461829] [Citation(s) in RCA: 137] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2012] [Revised: 01/17/2013] [Accepted: 02/03/2013] [Indexed: 12/02/2022] Open
Abstract
Introduction. Information and communication technology (ICT) are becoming a natural part in healthcare both for delivering and giving accessibility to healthcare for people with chronic illness living at home. Aim. The aim was to review existing studies describing the use of ICT in home care for communication between patients, family members, and healthcare professionals. Methods. A review of studies was conducted that identified 1,276 studies. A selection process and quality appraisal were conducted, which finally resulted in 107 studies. Results. The general results offer an overview of characteristics of studies describing the use of ICT applications in home care and are summarized in areas including study approach, quality appraisal, publications data, terminology used for defining the technology, and disease diagnosis. The specific results describe how communication with ICT was performed in home care and the benefits and drawbacks with the use of ICT. Results were predominated by positive responses in the use of ICT. Conclusion. The use of ICT applications in home care is an expanding research area, with a variety of ICT tools used that could increase accessibility to home care. Using ICT can lead to people living with chronic illnesses gaining control of their illness that promotes self-care.
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Damant J, Knapp M, Watters S, Freddolino P, Ellis M, King D. The impact of ICT services on perceptions of the quality of life of older people. ACTA ACUST UNITED AC 2013. [DOI: 10.1108/17549451311313183] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Huang JC. Innovative health care delivery system--a questionnaire survey to evaluate the influence of behavioral factors on individuals' acceptance of telecare. Comput Biol Med 2013; 43:281-6. [PMID: 23375377 DOI: 10.1016/j.compbiomed.2012.12.011] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2011] [Revised: 11/20/2012] [Accepted: 12/27/2012] [Indexed: 11/17/2022]
Abstract
The purpose of this research is to explore people's intention to use telecare and evaluate the degree of influence that behavioral factors on individuals' acceptance of telecare. The subjects are residents of Taiwan. The Structural Equation Modeling (SEM) technique was used to analyze the forecasting model applied to telecare. The results show that this model has good explanatory power for the behavioral intentions of using telecare. Among factors influencing the behavioral intentions of using telecare, the strongest factor is attitude, followed by the perceived usefulness, the perceived ease of use, subjective norms, and personal innovativeness, respectively. The findings of this study may serve as a reference to future studies.
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Affiliation(s)
- Jui-Chen Huang
- Department of Health Business Administration, Hungkuang University, No.1018, Sec.6, Taiwan Blvd., Shalu Dist., Taichung City 43302, Taiwan, R.O.C.
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Vermeulen J, Neyens JCL, Spreeuwenberg MD, van Rossum E, Sipers W, Habets H, Hewson DJ, de Witte LP. User-centered development and testing of a monitoring system that provides feedback regarding physical functioning to elderly people. Patient Prefer Adherence 2013; 7:843-54. [PMID: 24039407 PMCID: PMC3770345 DOI: 10.2147/ppa.s45897] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
PURPOSE To involve elderly people during the development of a mobile interface of a monitoring system that provides feedback to them regarding changes in physical functioning and to test the system in a pilot study. METHODS AND PARTICIPANTS The iterative user-centered development process consisted of the following phases: (1) selection of user representatives; (2) analysis of users and their context; (3) identification of user requirements; (4) development of the interface; and (5) evaluation of the interface in the lab. Subsequently, the monitoring and feedback system was tested in a pilot study by five patients who were recruited via a geriatric outpatient clinic. Participants used a bathroom scale to monitor weight and balance, and a mobile phone to monitor physical activity on a daily basis for six weeks. Personalized feedback was provided via the interface of the mobile phone. Usability was evaluated on a scale from 1 to 7 using a modified version of the Post-Study System Usability Questionnaire (PSSUQ); higher scores indicated better usability. Interviews were conducted to gain insight into the experiences of the participants with the system. RESULTS The developed interface uses colors, emoticons, and written and/or spoken text messages to provide daily feedback regarding (changes in) weight, balance, and physical activity. The participants rated the usability of the monitoring and feedback system with a mean score of 5.2 (standard deviation 0.90) on the modified PSSUQ. The interviews revealed that most participants liked using the system and appreciated that it signaled changes in their physical functioning. However, usability was negatively influenced by a few technical errors. CONCLUSION Involvement of elderly users during the development process resulted in an interface with good usability. However, the technical functioning of the monitoring system needs to be optimized before it can be used to support elderly people in their self-management.
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Affiliation(s)
- Joan Vermeulen
- School for Public Health and Primary Care (CAPHRI), Maastricht University, Maastricht, The Netherlands
- Correspondence: Joan Vermeulen, School for Public Health and Primary Care (CAPHRI), Maastricht University, Duboisdomein 30, PO Box 616, 6200 MD, Maastricht, The Netherlands, Tel +31 433 882 199, Fax +31 433 884 162, Email
| | - Jacques CL Neyens
- School for Public Health and Primary Care (CAPHRI), Maastricht University, Maastricht, The Netherlands
| | - Marieke D Spreeuwenberg
- School for Public Health and Primary Care (CAPHRI), Maastricht University, Maastricht, The Netherlands
| | - Erik van Rossum
- School for Public Health and Primary Care (CAPHRI), Maastricht University, Maastricht, The Netherlands
- Research Center for Technology in Care, Zuyd University of Applied Sciences, Heerlen, The Netherlands
| | - Walther Sipers
- Expertise Center for Elderly Care, Orbis Medical Center, Sittard, The Netherlands
| | - Herbert Habets
- Expertise Center for Elderly Care, Orbis Medical Center, Sittard, The Netherlands
| | - David J Hewson
- Institute Charles Delaunay, Université de Technologie de Troyes, Troyes, France
| | - Luc P de Witte
- School for Public Health and Primary Care (CAPHRI), Maastricht University, Maastricht, The Netherlands
- Research Center for Technology in Care, Zuyd University of Applied Sciences, Heerlen, The Netherlands
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Eghdam A, Scholl J, Bartfai A, Koch S. Information and communication technology to support self-management of patients with mild acquired cognitive impairments: systematic review. J Med Internet Res 2012; 14:e159. [PMID: 23165152 PMCID: PMC3510771 DOI: 10.2196/jmir.2275] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2012] [Revised: 09/14/2012] [Accepted: 10/24/2012] [Indexed: 11/18/2022] Open
Abstract
Background Mild acquired cognitive impairment (MACI) is a new term used to describe a subgroup of patients with mild cognitive impairment (MCI) who are expected to reach a stable cognitive level over time. This patient group is generally young and have acquired MCI from a head injury or mild stroke. Although the past decade has seen a large amount of research on how to use information and communication technology (ICT) to support self-management of patients with chronic diseases, MACI has not received much attention. Therefore, there is a lack of information about what tools have been created and evaluated that are suitable for self-management of MACI patients, and a lack of clear direction on how best to proceed with ICT tools to support self-management of MACI patients. Objective This paper aims to provide direction for further research and development of tools that can support health care professionals in assisting MACI patients with self-management. An overview of studies reporting on the design and/or evaluation of ICT tools for assisting MACI patients in self-management is presented. We also analyze the evidence of benefit provided by these tools, and how their functionality matches MACI patients’ needs to determine areas of interest for further research and development. Methods A review of the existing literature about available assistive ICT tools for MACI patients was conducted using 8 different medical, scientific, engineering, and physiotherapy library databases. The functionality of tools was analyzed using an analytical framework based on the International Classification of Functioning, Disability and Health (ICF) and a subset of common and important problems for patients with MACI created by MACI experts in Sweden. Results A total of 55 search phrases applied in the 8 databases returned 5969 articles. After review, 7 articles met the inclusion criteria. Most articles reported case reports and exploratory research. Out of the 7 articles, 4 (57%) studies had less than 10 participants, 5 (71%) technologies were memory aids, and 6 studies were mobile technologies. All 7 studies fit the profile for patients with MACI as described by our analytical framework. However, several areas in the framework important for meeting patient needs were not covered by the functionality in any of the ICT tools. Conclusions This study shows a lack of ICT tools developed and evaluated for supporting self-management of MACI patients. Our analytical framework was a valuable tool for providing an overview of how the functionality of these tools matched patient needs. There are a number of important areas for MACI patients that are not covered by the functionality of existing tools, such as support for interpersonal interactions and relationships. Further research on ICT tools to support self-management for patients with MACI is needed.
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Affiliation(s)
- Aboozar Eghdam
- Health Informatics Centre-HIC, Department of Learning, Informatics, Management and Ethics-LIME, Karolinska Institutet, Stockholm, Sweden.
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Zhang Y, Yu P, Shen J. The benefits of introducing electronic health records in residential aged care facilities: A multiple case study. Int J Med Inform 2012; 81:690-704. [DOI: 10.1016/j.ijmedinf.2012.05.013] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2011] [Revised: 05/21/2012] [Accepted: 05/28/2012] [Indexed: 11/17/2022]
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Marschollek M. Decision support at home (DS@HOME)--system architectures and requirements. BMC Med Inform Decis Mak 2012; 12:43. [PMID: 22640470 PMCID: PMC3464181 DOI: 10.1186/1472-6947-12-43] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2011] [Accepted: 05/28/2012] [Indexed: 12/02/2022] Open
Abstract
Background Demographic change with its consequences of an aging society and an increase in the demand for care in the home environment has triggered intensive research activities in sensor devices and smart home technologies. While many advanced technologies are already available, there is still a lack of decision support systems (DSS) for the interpretation of data generated in home environments. The aim of the research for this paper is to present the state-of-the-art in DSS for these data, to define characteristic properties of such systems, and to define the requirements for successful home care DSS implementations. Methods A literature review was performed along with the analysis of cross-references. Characteristic properties are proposed and requirements are derived from the available body of literature. Results 79 papers were identified and analyzed, of which 20 describe implementations of decision components. Most authors mention server-based decision support components, but only few papers provide details about the system architecture or the knowledge base. A list of requirements derived from the analysis is presented. Among the primary drawbacks of current systems are the missing integration of DSS in current health information system architectures including interfaces, the missing agreement among developers with regard to the formalization and customization of medical knowledge and a lack of intelligent algorithms to interpret data from multiple sources including clinical application systems. Conclusions Future research needs to address these issues in order to provide useful information – and not only large amounts of data – for both the patient and the caregiver. Furthermore, there is a need for outcome studies allowing for identifying successful implementation concepts.
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Affiliation(s)
- Michael Marschollek
- Hanover Medical School, Peter L, Reichertz Institute for Medical Informatics, Carl-Neuberg-Str 1, Hanover 30625, Germany.
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Kumar P, Lee SG, Lee HJ. E-SAP: efficient-strong authentication protocol for healthcare applications using wireless medical sensor networks. SENSORS 2012; 12:1625-47. [PMID: 22438729 PMCID: PMC3304131 DOI: 10.3390/s120201625] [Citation(s) in RCA: 102] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/29/2011] [Revised: 01/13/2012] [Accepted: 02/02/2012] [Indexed: 11/14/2022]
Abstract
A wireless medical sensor network (WMSN) can sense humans’ physiological signs without sacrificing patient comfort and transmit patient vital signs to health professionals’ hand-held devices. The patient physiological data are highly sensitive and WMSNs are extremely vulnerable to many attacks. Therefore, it must be ensured that patients’ medical signs are not exposed to unauthorized users. Consequently, strong user authentication is the main concern for the success and large scale deployment of WMSNs. In this regard, this paper presents an efficient, strong authentication protocol, named E-SAP, for healthcare application using WMSNs. The proposed E-SAP includes: (1) a two-factor (i.e., password and smartcard) professional authentication; (2) mutual authentication between the professional and the medical sensor; (3) symmetric encryption/decryption for providing message confidentiality; (4) establishment of a secure session key at the end of authentication; and (5) professionals can change their password. Further, the proposed protocol requires three message exchanges between the professional, medical sensor node and gateway node, and achieves efficiency (i.e., low computation and communication cost). Through the formal analysis, security analysis and performance analysis, we demonstrate that E-SAP is more secure against many practical attacks, and allows a tradeoff between the security and the performance cost for healthcare application using WMSNs.
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Affiliation(s)
- Pardeep Kumar
- Department of Ubiquitous-IT, Graduate School of Design & IT, Dongseo University, Sasang-Gu, Busan 617-716, Korea; E-Mail:
| | - Sang-Gon Lee
- Division of Computer & Information Engineering, Dongseo University, San 69-1, Jurye-2-Dong, Sasang-Gu, Busan 617-716, Korea; E-Mail: (S.-G.L.)
| | - Hoon-Jae Lee
- Division of Computer & Information Engineering, Dongseo University, San 69-1, Jurye-2-Dong, Sasang-Gu, Busan 617-716, Korea; E-Mail: (S.-G.L.)
- Author to whom correspondence should be addressed; E-Mail: ; Tel.: +82-51-320-1730; Fax: +82-51-327-8955
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Kumar P, Lee HJ. Security issues in healthcare applications using wireless medical sensor networks: a survey. SENSORS (BASEL, SWITZERLAND) 2011; 12:55-91. [PMID: 22368458 PMCID: PMC3279202 DOI: 10.3390/s120100055] [Citation(s) in RCA: 237] [Impact Index Per Article: 18.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/21/2011] [Revised: 12/07/2011] [Accepted: 12/15/2011] [Indexed: 11/16/2022]
Abstract
Healthcare applications are considered as promising fields for wireless sensor networks, where patients can be monitored using wireless medical sensor networks (WMSNs). Current WMSN healthcare research trends focus on patient reliable communication, patient mobility, and energy-efficient routing, as a few examples. However, deploying new technologies in healthcare applications without considering security makes patient privacy vulnerable. Moreover, the physiological data of an individual are highly sensitive. Therefore, security is a paramount requirement of healthcare applications, especially in the case of patient privacy, if the patient has an embarrassing disease. This paper discusses the security and privacy issues in healthcare application using WMSNs. We highlight some popular healthcare projects using wireless medical sensor networks, and discuss their security. Our aim is to instigate discussion on these critical issues since the success of healthcare application depends directly on patient security and privacy, for ethic as well as legal reasons. In addition, we discuss the issues with existing security mechanisms, and sketch out the important security requirements for such applications. In addition, the paper reviews existing schemes that have been recently proposed to provide security solutions in wireless healthcare scenarios. Finally, the paper ends up with a summary of open security research issues that need to be explored for future healthcare applications using WMSNs.
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Affiliation(s)
- Pardeep Kumar
- Department of Ubiquitous-IT, Graduate School of Design & IT, Dongseo University, San 69-1, Jurye-2-Dong, Sasang-Gu, Busan 617-716, Korea; E-Mail:
| | - Hoon-Jae Lee
- Department of Ubiquitous-IT, Graduate School of Design & IT, Dongseo University, San 69-1, Jurye-2-Dong, Sasang-Gu, Busan 617-716, Korea; E-Mail:
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Fossum M, Ehnfors M, Fruhling A, Ehrenberg A. An evaluation of the usability of a computerized decision support system for nursing homes. Appl Clin Inform 2011; 2:420-36. [PMID: 23616886 DOI: 10.4338/aci-2011-07-ra-0043] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2011] [Accepted: 09/09/2011] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Computerized decision support systems (CDSSs) have the potential to significantly improve the quality of nursing care of older people by enhancing the decision making of nursing personnel. Despite this potential, health care organizations have been slow to incorporate CDSSs into nursing home practices. OBJECTIVE This study describes facilitators and barriers that impact the ability of nursing personnel to effectively use a clinical CDSS for planning and treating pressure ulcers (PUs) and malnutrition and for following the suggested risk assessment guidelines for the care of nursing home residents. METHODS We employed a qualitative descriptive design using varied methods, including structured group interviews, cognitive walkthrough observations and a graphical user interface (GUI) usability evaluation. Group interviews were conducted with 25 nursing personnel from four nursing homes in southern Norway. Five nursing personnel participated in cognitive walkthrough observations and the GUI usability evaluation. Text transcripts were analyzed using qualitative content analysis. RESULTS Group interview participants reported that ease of use, usefulness and a supportive work environment were key facilitators of CDSS use. The barriers identified were lack of training, resistance to using computers and limited integration of the CDSS with the facility's electronic health record (EHR) system. Key findings from the usability evaluation also identified the difficulty of using the CDSS within the EHR and the poorly designed GUI integration as barriers. CONCLUSION Overall, we found disconnect between two types of nursing personnel. Those who were comfortable with computer technology reported positive feedback about the CDSS, while others expressed resistance to using the CDSS for various reasons. This study revealed that organizations must invest more resources in educating nursing personnel on the seriousness of PUs and poor nutrition in the elderly, providing specialized CDSS training and ensuring that nursing personnel have time in the workday to use the CDSS.
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Huang JC. Exploring the Acceptance of Telecare Among Senior Citizens: An Application of Back-Propagation Network. Telemed J E Health 2011; 17:111-7. [DOI: 10.1089/tmj.2010.0118] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Jui-Chen Huang
- Department of Health Business Administration, Hungkuang University, Hsinchu County, Taiwan, ROC
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Abstract
During the last decade, the challenges of an ageing society became focus for extensive scientific, public and political discussions. From discussions in scientific fora within each discipline, there is now a shift towards cross-disciplinary scientific approaches. The aim of this article is therefore, to collect and describe different scientific viewpoints in this regard and to point out research gaps to be addressed in the future. The article is based on a number of review articles and keynote lectures given by the author, and complemented with informal interviews of experts from different scientific fields engaged in the field of technology and ageing. Results show that research has emerged from being technology-focussed to scenario-based taking different scientific perspectives into account. However, the biggest challenge still is to accommodate the need for a holistic integrated service which means to provide personalised services and adapt technology and content to individual needs of different stakeholders. Further, cross-disciplinary research is needed that relates informatics and technology to different stages of the aging process and that evaluates the effects of proposed technical solutions.
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Affiliation(s)
- Sabine Koch
- Health Informatics Centre, LIME, Karolinska Institutet, Stockholm, Sweden.
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Serrano JA. Fostering User Participation in Ambient Assisted Living Projects. INTERNATIONAL JOURNAL OF E-HEALTH AND MEDICAL COMMUNICATIONS 2010. [DOI: 10.4018/jehmc.2010040104] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Participatory design has been widely accepted as an effective strategy for understanding and including users’ needs in technology development. But the successful integration of user participation depends on the way it is carried out, that is, when and how are the users involved in the process, how are the users’ needs and requirements transferred to the technologists, and how is it verified that these requirements have been satisfied in the developed prototypes? These questions can be summarized as, how can one make the users’ voice heard across the development of complex ubiquitous healthcare services? Finding adequate answers to these questions normally is complex due to the challenges that arise when using new and untested technology, as is the case of ubiquitous healthcare services. This paper will present answers to such questions from experience gathered during European projects in the AAL (Ambient Assisted Living) area, in which qualified specialists collaborate to provide a pool of competences that are vital in guaranteeing the success of ubiquitous healthcare services.
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