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Omotunde M, Hunter K, Wagg A. Examining attitudes to uptake and sustainment of technology among care aides in the delivery of care: a scoping review protocol. BMJ Open 2024; 14:e079475. [PMID: 39260847 PMCID: PMC11409386 DOI: 10.1136/bmjopen-2023-079475] [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] [Received: 09/01/2023] [Accepted: 08/21/2024] [Indexed: 09/13/2024] Open
Abstract
INTRODUCTION Care aides are health workers who deliver hands-on care to patients across the healthcare continuum. The use of technology in healthcare delivery is increasing, and evidence regarding how care aides' attitudes may either facilitate or hinder the adoption of healthcare technologies is lacking.The aim of the proposed scoping review is to examine available evidence regarding care aides' attitudes towards the adoption of innovation and factors that may influence the sustainable use of technology in healthcare delivery. Published studies, grey literature and review articles that identify a method for the review, conference abstracts and website publications regarding the attitude, uptake and sustainable use of technology in care delivery by care aides will be included. For abstracts that have resulted in publications, the full publications will be included. The search for evidence commenced in June 2023 and will end in March 2024. METHODS AND ANALYSIS The Joanna Briggs Institute (JBI) method will be used to conduct the review. The CINAHL, Cochrane Library, EMBASE, MEDLINE, ProQuest, PubMed, SCOPUS, PROSPERO, Web of Science and JBI Evidence Synthesis databases will be searched using keywords for publications within the last 20 years to examine trends in health technology and attitudes of care aides towards innovation over the last two decades. A search of grey literature and websites will be conducted. The reference list of the retrieved articles will be used to identify additional literature. The search results will be exported into a literature management tool for screening and analysis. Article screening will be performed by two authors and if a third is needed to resolve any differences. Data analysis will be guided by two theoretical frameworks. ETHICS AND DISSEMINATION No ethics approval is required. The findings will be disseminated in a peer-reviewed journal and presented in conferences. REGISTRATION DETAILS https://doi.org/10.17605/OSF.IO/CZQUP.
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Affiliation(s)
- Muyibat Omotunde
- Department of Medicine, University of Alberta Faculty of Medicine & Dentistry, Edmonton, Alberta, Canada
| | | | - Adrian Wagg
- Department of Medicine, University of Alberta Faculty of Medicine & Dentistry, Edmonton, Alberta, Canada
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Tremoulet PD, Lobo AF, Simmons CA, Baliga G, Brady M. Assessing the Usability and Feasibility of Digital Assistant Tools for Direct Support Professionals: Participatory Design and Pilot-Testing. JMIR Hum Factors 2024; 11:e51612. [PMID: 38662420 PMCID: PMC11082739 DOI: 10.2196/51612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Revised: 03/07/2024] [Accepted: 03/16/2024] [Indexed: 04/26/2024] Open
Abstract
BACKGROUND The United States is experiencing a direct support professional (DSP) crisis, with demand far exceeding supply. Although generating documentation is a critical responsibility, it is one of the most wearisome aspects of DSPs' jobs. Technology that enables DSPs to log informal time-stamped notes throughout their shift could help reduce the burden of end-of-shift documentation and increase job satisfaction, which in turn could improve the quality of life of the individuals with intellectual and developmental disabilities (IDDs) whom DSPs support. However, DSPs, with varied ages, levels of education, and comfort using technology, are not likely to adopt tools that detract from caregiving responsibilities or increase workload; therefore, technological tools for them must be relatively simple, extremely intuitive, and provide highly valued capabilities. OBJECTIVE This paper describes the development and pilot-testing of a digital assistant tool (DAT) that enables DSPs to create informal notes throughout their shifts and use these notes to facilitate end-of-shift documentation. The purpose of the pilot study was to assess the usability and feasibility of the DAT. METHODS The research team applied an established user-centered participatory design process to design, develop, and test the DAT prototypes between May 2020 and April 2023. Pilot-testing entailed having 14 DSPs who support adults with IDDs use the first full implementation of the DAT prototypes during 2 or 3 successive work shifts and fill out demographic and usability questionnaires. RESULTS Participants used the DAT prototypes to create notes and help generate end-of-shift reports. The System Usability Scale score of 81.79 indicates that they found the prototypes easy to use. Survey responses imply that using the DAT made it easier for participants to produce required documentation and suggest that they would adopt the DAT if this tool were available for daily use. CONCLUSIONS Simple technologies such as the DAT prototypes, which enable DSPs to use mobile devices to log time-stamped notes throughout their shift with minimal effort and use the notes to help write reports, have the potential to both reduce the burden associated with producing documentation and enhance the quality (level of detail and accuracy) of this documentation. This could help to increase job satisfaction and reduce turnover in DSPs, both of which would help improve the quality of life of the individuals with IDDs whom they support. The pilot test results indicate that DSPs found the DAT easy to use. Next steps include (1) producing more robust versions of the DAT with additional capabilities, such as storing data locally on mobile devices when Wi-Fi is not available; and (2) eliciting input from agency directors, families, and others who use data about adults with IDDs to help care for them to ensure that data produced by DSPs are relevant and useful.
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Affiliation(s)
| | - Andrea F Lobo
- Department of Computer Science, Rowan University, Glassboro, NJ, United States
| | | | - Ganesh Baliga
- Department of Computer Science, Rowan University, Glassboro, NJ, United States
| | - Matthew Brady
- Department of Computer Science, Rowan University, Glassboro, NJ, United States
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Bults M, van Leersum CM, Olthuis TJJ, Siebrand E, Malik Z, Liu L, Miguel-Cruz A, Jukema JS, den Ouden MEM. Acceptance of a Digital Assistant (Anne4Care) for Older Adult Immigrants Living With Dementia: Qualitative Descriptive Study. JMIR Aging 2024; 7:e50219. [PMID: 38639994 PMCID: PMC11069095 DOI: 10.2196/50219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 01/15/2024] [Accepted: 02/21/2024] [Indexed: 04/20/2024] Open
Abstract
BACKGROUND There is a need to develop and coordinate dementia care plans that use assistive technology for vulnerable groups such as immigrant populations. However, immigrant populations are seldom included in various stages of the development and implementation of assistive technology, which does not optimize technology acceptance. OBJECTIVE This study aims to gain an in-depth understanding of the acceptance of a digital personal assistant, called Anne4Care, by older adult immigrants living with dementia in their own homes. METHODS This study used a qualitative descriptive research design with naturalistic inquiry. A total of 13 older adults participated in this study. The participants were invited for 2 interviews. After an introduction of Anne4Care, the first interview examined the lives and needs of participants, their expectations, and previous experiences with assistive technology in daily life. Four months later, the second interview sought to understand facilitators and barriers, suggestions for modifications, and the role of health care professionals. Three semistructured interviews were conducted with health care professionals to examine the roles and challenges they experienced in the use and implementation of Anne4Care. Content analysis, using NVivo11, was performed on all transcripts. RESULTS All 13 participants had an immigration background. There were 10 male and 3 female participants, with ages ranging from 52 to 83 years. Participants were diagnosed with an early-stage form of dementia or acquired brain injury. None of the older adult participants knew or used digital assistive technology at the beginning. They obtained assistance from health care professionals and family caregivers who explained and set up the technology. Four themes were found to be critical aspects of the acceptance of the digital personal assistant Anne4Care: (1) use of Anne4Care, (2) positive aspects of Anne4Care, (3) challenges with Anne4Care, and (4) expectations. Assistance at first increased the burden on health care professionals and families. After the initial effort, most health care professionals and families experienced that Anne4Care reduced their tasks and stress. Contributions of Anne4Care included companionship, help with daily tasks, and opportunities to communicate in multiple languages. On the other hand, some participants expressed anxiety toward the use of Anne4Care. Furthermore, the platform required an internet connection at home and Anne4Care could not be used outside the home. CONCLUSIONS Although older adult immigrants living with dementia had no previous experience with digital assistive technology specifically, the acceptance of the digital personal assistant, called Anne4Care, by older adult immigrants living with dementia was rather high. The digital assistant can be further developed to allow for interactive conversations and for use outside of one's home. Participation of end users during various stages of the development, refinement, and implementation of health technology innovations is of utmost importance to maximize technology acceptance.
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Affiliation(s)
- Marloes Bults
- Technology, Health & Care Research Group, Saxion University of Applied Sciences, Enschede, Netherlands
| | - Catharina Margaretha van Leersum
- Department of Technology, Policy, and Society, Faculty of Behavioural, Management and Social Sciences, University of Twente, Enschede, Netherlands
- Faculty of Humanities, Open University, Heerlen, Netherlands
| | | | - Egbert Siebrand
- Research Group Ethics and Technology, Saxion University of Applied Sciences, Enschede, Netherlands
| | - Zohrah Malik
- Technology, Health & Care Research Group, Saxion University of Applied Sciences, Enschede, Netherlands
| | - Lili Liu
- School of Public Health Sciences, Faculty of Health, University of Waterloo, Waterloo, ON, Canada
| | - Antonio Miguel-Cruz
- School of Public Health Sciences, Faculty of Health, University of Waterloo, Waterloo, ON, Canada
- Department of Occupational Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada
- GRRIT Hub Glenrose Rehabilitation Research, Innovation & Technology, Glenrose Rehabilitation Hospital, Edmonton, AB, Canada
| | - Jan Seerp Jukema
- Smart Health Research Group, Saxion University of Applied Sciences, Enschede, Netherlands
| | - Marjolein Elisabeth Maria den Ouden
- Technology, Health & Care Research Group, Saxion University of Applied Sciences, Enschede, Netherlands
- Care & Technology Research Group, Regional Community College of Twente, Hengelo, Netherlands
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Rodríguez-Martínez A, Amezcua-Aguilar T, Cortés-Moreno J, Jiménez-Delgado JJ. Qualitative Analysis of Conversational Chatbots to Alleviate Loneliness in Older Adults as a Strategy for Emotional Health. Healthcare (Basel) 2023; 12:62. [PMID: 38200967 PMCID: PMC10779105 DOI: 10.3390/healthcare12010062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 12/21/2023] [Accepted: 12/24/2023] [Indexed: 01/12/2024] Open
Abstract
This article presents an exploration of conversational chatbots designed to alleviate loneliness among older adults. In addition to technical evaluation, it delves into effective communication between these systems and this demographic group, considering linguistic nuances, communicative preferences, and specific emotional needs. The intrinsic importance of chatbots as innovative solutions in combating loneliness is highlighted, emphasizing their ability to be understanding and empathetic allies, contributing to emotional well-being and socialization. The article explores how improved emotional well-being can positively impact the health and quality of life of older adults. The methodology, rooted in triangulation between a literature review and qualitative research through interviews and focus groups with older adults, provides a comprehensive insight into the findings. Ethical, technical, and design considerations such as privacy, autonomy, technology adaptation, and usability are also addressed. The article concludes with practical recommendations for developing user-friendly interfaces that encourage the active participation of older adults in chatbots. This holistic approach not only analyzes the technical effectiveness of chatbots in mitigating loneliness in older adults but delves into human, ethical, and practical aspects, enriching the understanding and implementation of these agents for social and emotional support.
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Affiliation(s)
- Antonia Rodríguez-Martínez
- Department of Psychology, University of Jaén, Campus las Lagunillas s/n, 23071 Jaén, Spain; (A.R.-M.); (J.C.-M.)
| | - Teresa Amezcua-Aguilar
- Department of Psychology, University of Jaén, Campus las Lagunillas s/n, 23071 Jaén, Spain; (A.R.-M.); (J.C.-M.)
| | - Javier Cortés-Moreno
- Department of Psychology, University of Jaén, Campus las Lagunillas s/n, 23071 Jaén, Spain; (A.R.-M.); (J.C.-M.)
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Yutong T, Yan Z, Qingyun C, Lixue M, Mengke G, Shanshan W. Information and Communication Technology Based Integrated Care for Older Adults: A Scoping Review. Int J Integr Care 2023; 23:2. [PMID: 37033366 PMCID: PMC10077997 DOI: 10.5334/ijic.6979] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Accepted: 03/09/2023] [Indexed: 04/05/2023] Open
Abstract
Background Integrated care is an important initiative to respond positively to the ageing of society and information and communication technology(ICT) plays an important role in facilitating the integration of functional and normative health and social care. The scoping review aims to synthesize evidence on the experience and practice of ICT-based implementation of integrated care for older adults. Methods This study followed the research framework developed by Arksey and O'malley for the scoping review and systematically searched for relevant studies published between 1 January 2000 and 30 March 2022 from nine electronic databases, three specialist journals, three key institutional websites, 11 integrated care project websites, google scholar and references of the studies to be included. Two reviewers independently screened and extracted data and used thematic analysis to sort out and summarize the core elements, hindrances and facilitators of ICT-based integrated care. Results A total of 77 studies were included in this study, including 36 ICT-based practice models of integrated care with seven core elements of implementation including single entry point, comprehensive geriatric assessment, personalized care planning, multidisciplinary case conferences, coordinated care, case management and patient empowerment, which generally had a positive effect on improving quality of life, caregiver burden and primary care resource utilization for older adults, but effectiveness evaluations remained Heterogeneity exists. The barriers and facilitators to ICT-based implementation of integrated care were grouped into four themes: demand-side factors, provider factors, technology factors and system factors. Conclusion The implementation of ICT-based integrated care for the elderly is expected to improve the health status of both the supply and demand of services, but there is still a need to strengthen the supply of human resources, team training and collaboration, ICT systems and financial support in order to promote the wider use of ICT in integrated care.
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Perez H, Miguel-Cruz A, Daum C, Comeau AK, Rutledge E, King S, Liu L. Technology Acceptance of a Mobile Application to Support Family Caregivers in a Long-Term Care Facility. Appl Clin Inform 2022; 13:1181-1193. [PMID: 36257602 PMCID: PMC9771689 DOI: 10.1055/a-1962-5583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2022] [Accepted: 10/15/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Family caregivers are unpaid individuals who provide care to people with chronic conditions or disabilities. Family caregivers generally do not have formal care-related training. However, they are an essential source of care. Mobile technologies can benefit family caregivers by strengthening communication with care staff and supporting the monitoring of care recipients. OBJECTIVE We conducted a mixed-method study to evaluate the acceptance and usability of a mobile technology called the Smart Care System. METHODS Using convenience sampling, we recruited 27 family caregivers to evaluate the mobile Smart Care System (mSCS). In the quantitative phase, we administered initial and exit questionnaires based on the Unified Theory of Acceptance and Use of Technology. In the qualitative phase, we conducted focus groups to explore family caregivers' perspectives and opinions on the usability of the mSCS. With the quantitative data, we employed univariate, bivariate, and partial least squares analyses, and we used content analysis with the qualitative data. RESULTS We observed a high level of comfort using digital technologies among participants. On average, participants were caregivers for an average of 6.08 years (standard deviation [SD] = 6.63), and their mean age was 56.65 years (SD = 11.62). We observed a high level of technology acceptance among family caregivers (7.69, SD = 2.11). Behavioral intention (β = 0.509, p-value = 0.004) and facilitating conditions (β = 0.310, p-value = 0.049) were statistically significant and related to usage behavior. In terms of qualitative results, participants reported that the mobile application supported care coordination and communication with staff and provided peace of mind to family caregivers. CONCLUSION The technology showed high technology acceptance and intention to use among family caregivers in a long-term care setting. Facilitating conditions influenced acceptance. Therefore, it would be important to identify and optimize these conditions to ensure technology uptake.
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Affiliation(s)
- Hector Perez
- Faculty of Health, University of Waterloo, Waterloo, Ontario, Canada
| | - Antonio Miguel-Cruz
- Faculty of Health, University of Waterloo, Waterloo, Ontario, Canada
- Faculty of Rehabilitation Medicine, University of Alberta. Edmonton, Alberta, Canada
- Glenrose Rehabilitation Research, Innovation & Technology (GRRIT) Hub, Glenrose Rehabilitation Hospital. Edmonton, Alberta, Canada
| | - Christine Daum
- Faculty of Health, University of Waterloo, Waterloo, Ontario, Canada
- Faculty of Rehabilitation Medicine, University of Alberta. Edmonton, Alberta, Canada
| | - Aidan K. Comeau
- Faculty of Rehabilitation Medicine, University of Alberta. Edmonton, Alberta, Canada
| | - Emily Rutledge
- Faculty of Health, University of Waterloo, Waterloo, Ontario, Canada
| | - Sharla King
- Faculty of Education, University of Alberta. Edmonton, Alberta, Canada
| | - Lili Liu
- Faculty of Health, University of Waterloo, Waterloo, Ontario, Canada
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Lan YL, Chen HC. Telehealth care system for chronic disease management of middle-aged and older adults in remote areas. Health Informatics J 2022; 28:14604582221141835. [DOI: 10.1177/14604582221141835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022]
Abstract
Background With the global spread of the coronavirus disease pandemic, governments have become more interested in applying telehealth technology in 2020. Objective This study integrates the technology acceptance model and information system success model to explore the influence of satisfaction, attitudes, and continued use of telehealth systems among middle-aged and older people in remote areas. Methods The study participants were patients over 40 years (inclusive) who lived in remote townships in eastern Taiwan, were diagnosed with diabetes or hypertension, and used the telehealth care system. In total, 545 questionnaires were returned, resulting in a recovery rate of 99%. Results Accepting the hypothesized structural equation model, this study found that information, system, and service quality were influenced by the mediating effect of perceived ease of use and the perceived usefulness of the technology acceptance model. The use of telehealth care systems among chronic patients increased significantly.
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Affiliation(s)
- Yu Li Lan
- Tzu Chi University of Science and Technology, Hualien, Taiwan
| | - Hsing Chu Chen
- Department of Public Health, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan
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Miguel Cruz A, Lopez Portillo HP, Daum C, Rutledge E, King S, Liu L. Technology Acceptance and Usability of a Mobile Application to Support the Workflow of Health Care Aides who Provide Services to older adults residing in a care facility: A Pilot Mixed Methods Study (Preprint). JMIR Aging 2022; 5:e37521. [PMID: 35583930 PMCID: PMC9161048 DOI: 10.2196/37521] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 03/30/2022] [Accepted: 04/26/2022] [Indexed: 01/01/2023] Open
Abstract
Background Health care aides are unlicensed support personnel who provide direct care, personal assistance, and support to people with health conditions. The shortage of health care aides has been attributed to recruitment challenges, high turnover, an aging population, the COVID-19 pandemic, and low retention rates. Mobile apps are among the many information communication technologies that are paving the way for eHealth solutions to help address this workforce shortage by enhancing the workflow of health care aides. In collaboration with Clinisys EMR Inc, we developed a mobile app (Mobile Smart Care System [mSCS]) to support the workflow of health care aides who provide services to older adult residents of a long-term care facility. Objective The purpose of this study was to investigate the technology acceptance and usability of a mobile app in a real-world environment, while it is used by health care aides who provide services to older adults. Methods This pilot study used a mixed methods design: sequential mixed methods (QUANTITATIVE, qualitative). Our study included a pre– and post–paper-based questionnaire with no control group (QUAN). Toward the end of the study, 2 focus groups were conducted with a subsample of health care aides (qual, qualitative description design). Technology acceptance and usability questionnaires used a 5-point Likert scale ranging from disagree (1) to agree (5). The items included in the questionnaires were validated in earlier research as having high levels of internal consistency for the Unified Theory of Acceptance and Use of Technology constructs. A total of 60 health care aides who provided services to older adults as part of their routine caseloads used the mobile app for 1 month. Comparisons of the Unified Theory of Acceptance and Use of Technology constructs’ summative scores at pretest and posttest were calculated using a paired t test (2-tailed). We used the partial least squares structural regression model to determine the factors influencing mobile app acceptance and usability for health care aides. The α level of significance for all tests was set at P≤.05 (2-tailed). Results We found that acceptance of the mSCS was high among health care aides, performance expectancy construct was the strongest predictor of intention to use the mSCS, intention to use the mSCS predicted usage behavior. The qualitative data support the quantitative findings and showed health care aides’ strong belief that the mSCS was useful, portable, and reliable, although there were still opportunities for improvement, especially with regard to the mSCS user interface. Conclusions Overall, these results support the assertion that mSCS technology acceptance and usability are high among health care aides. In other words, health care aides perceived that the mSCS assisted them in addressing their workflow issues.
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Affiliation(s)
- Antonio Miguel Cruz
- Glenrose Rehabilitation Research, Innovation & Technology, Glenrose Rehabilitation Hospital, Edmoton, AB, Canada
- Department of Occupational Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada
- Faculty of Health, University of Waterloo, Waterloo, ON, Canada
| | | | - Christine Daum
- Department of Occupational Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada
- Faculty of Health, University of Waterloo, Waterloo, ON, Canada
| | - Emily Rutledge
- Faculty of Health, University of Waterloo, Waterloo, ON, Canada
| | - Sharla King
- Educational Psychology, Faculty of Education, Edmonton, AB, Canada
| | - Lili Liu
- Faculty of Health, University of Waterloo, Waterloo, ON, Canada
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