1
|
Trần TB, Ambrens M, Nguyễn J, Coleman E, Gilanyi Y, Letton M, Pandit A, Lock L, Thom JM, Sen S, Lambert K, Arnold R. Preferences of people with chronic kidney disease regarding digital health interventions that promote healthy lifestyle: qualitative systematic review with meta-ethnography. BMJ Open 2024; 14:e082345. [PMID: 38802278 PMCID: PMC11131123 DOI: 10.1136/bmjopen-2023-082345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 04/25/2024] [Indexed: 05/29/2024] Open
Abstract
OBJECTIVES Diet and physical activity are crucial for people with chronic kidney disease (CKD) to maintain good health. Digital health interventions can increase access to lifestyle services. However, consumers' perspectives are unclear, which may reduce the capacity to develop interventions that align with specific needs and preferences. Therefore, this review aims to synthesise the preferences of people with CKD regarding digital health interventions that promote healthy lifestyle. DESIGN Qualitative systematic review with meta-ethnography. DATA SOURCES Databases Scopus, CENTRAL, MEDLINE, CINAHL and SPORTDiscus were searched between 2000 and 2023. ELIGIBILITY CRITERIA Primary research papers that used qualitative exploration methods to explore the preferences of adults with CKD (≥18 years) regarding digital health interventions that promoted diet, physical activity or a combination of these health behaviours. DATA EXTRACTION AND SYNTHESIS Two independent reviewers screened title, abstract and full text. Discrepancies were resolved by a third reviewer. Consumers' quotes were extracted verbatim and synthesised into higher-order themes and subthemes. RESULTS Database search yielded 5761 records. One record was identified following communication with a primary author. 15 papers were included. These papers comprised 197 consumers (mean age 51.0±7.2), including 83 people with CKD 1-5; 61 kidney transplant recipients; 53 people on dialysis. Sex was reported in 182 people, including 53% male. Five themes were generated regarding consumers' preferences for digital lifestyle interventions. These included simple instruction and engaging design; individualised interventions; virtual communities of care; education and action plans; and timely reminders and automated behavioural monitoring. CONCLUSION Digital health interventions were considered an important mechanism to access lifestyle services. Consumers' preferences are important to ensure future interventions are tailored to specific needs and goals. Future research may consider applying the conceptual framework of consumers' preferences in this review to develop and evaluate the effect of a digital lifestyle intervention on health outcomes. PROSPERO REGISTRATION NUMBER CRD42023411511.
Collapse
Affiliation(s)
- Thái Bình Trần
- School of Medical, Indigenous and Health Sciences, University of Wollongong Faculty of Science Medicine and Health, Wollongong, New South Wales, Australia
- Department of Renal Medicine, Concord Repatriation General Hospital, Concord, New South Wales, Australia
| | - Meghan Ambrens
- Falls, Balance and Injury Research Centre, Neuroscience Research Australia, Randwick, New South Wales, Australia
- School of Population Health, University of New South Wales Faculty of Medicine, Sydney, New South Wales, Australia
| | - Jennifer Nguyễn
- Department of Renal Medicine, Concord Repatriation General Hospital, Concord, New South Wales, Australia
- School of Health Sciences, University of New South Wales Faculty of Medicine, Sydney, New South Wales, Australia
| | - Eve Coleman
- Falls, Balance and Injury Research Centre, Neuroscience Research Australia, Randwick, New South Wales, Australia
- School of Health Sciences, University of New South Wales Faculty of Medicine, Sydney, New South Wales, Australia
| | - Yannick Gilanyi
- School of Health Sciences, University of New South Wales Faculty of Medicine, Sydney, New South Wales, Australia
- Centre for Pain IMPACT, Neuroscience Research Australia, Randwick, New South Wales, Australia
| | - Meg Letton
- School of Medical, Indigenous and Health Sciences, University of Wollongong Faculty of Science Medicine and Health, Wollongong, New South Wales, Australia
- Falls, Balance and Injury Research Centre, Neuroscience Research Australia, Randwick, New South Wales, Australia
| | - Anurag Pandit
- School of Health Sciences, University of New South Wales Faculty of Medicine, Sydney, New South Wales, Australia
| | - Logan Lock
- School of Health Sciences, University of New South Wales Faculty of Medicine, Sydney, New South Wales, Australia
| | - Jeanette M Thom
- School of Health Sciences, The University of Sydney Faculty of Medicine and Health, Sydney, New South Wales, Australia
- Sydney Musculoskeletal Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Shaundeep Sen
- Department of Renal Medicine, Concord Repatriation General Hospital, Concord, New South Wales, Australia
- Concord Clinical School, The University of Sydney Faculty of Medicine and Health, Sydney, New South Wales, Australia
| | - Kelly Lambert
- School of Medical, Indigenous and Health Sciences, University of Wollongong Faculty of Science Medicine and Health, Wollongong, New South Wales, Australia
- Illawarra Shoalhaven Local Health District, Wollongong, New South Wales, Australia
| | - Ria Arnold
- School of Medical, Indigenous and Health Sciences, University of Wollongong Faculty of Science Medicine and Health, Wollongong, New South Wales, Australia
- Department of Renal Medicine, Concord Repatriation General Hospital, Concord, New South Wales, Australia
- School of Health Sciences, University of New South Wales Faculty of Medicine, Sydney, New South Wales, Australia
| |
Collapse
|
2
|
Lindroos A, Douglas-Smith N. Exploring informal caregivers' well-being during COVID-19 through online discussion forums. Scand J Caring Sci 2024; 38:104-113. [PMID: 37522268 DOI: 10.1111/scs.13199] [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: 01/19/2023] [Revised: 06/29/2023] [Accepted: 07/12/2023] [Indexed: 08/01/2023]
Abstract
BACKGROUND COVID-19 has increased pressures on caregivers, disruptions to health services and increased health concerns during COVID-19. Reports have been made on informal carers' increased workload and limited support services during the pandemic. AIMS This study aimed to explore how informal caregivers experienced their well-being during COVID-19 through online discussion forums. MATERIALS AND METHODS A reflexive thematic analysis characterised by theoretical flexibility, organic inductive coding processes and theme development was conducted on online discussion forums. The method highlighted theme reviewing which was done twice to encourage data reflection. The project was conducted on a novel topic which was a new area of research interest. Semantic coding where participants' words were used directly in the interpretation and construction of themes was used. RESULTS In the theme 'Locked in or locked away' caregivers worried about continuing care at home, due to limited freedom and worries of hiring help during a pandemic. Some expressed worries about visitation rights and grief of not being present with a loved one if they would reside in a care home. The theme 'Nothing left to give' suggested that COVID-19 exasperated caregivers' loneliness, social isolation and increased responsibilities and challenges with other roles. Bitterness, resentment and anger were felt towards lack of social support and workload. Theme 'Celebrating a virtual way of life' described how caregivers used online forums when other support services were disrupted. DISCUSSION We discuss the role of informal caregiver that was described as all-encompassing during COVID-19. We highlight the importance of advanced planning for care home transitions and the use of online forums as a form of support. We suggest further exploration into informal caregivers' role balancing. CONCLUSION COVID-19 seemed to affect informal caregivers negatively, but they reframed their situations and sought online support. With COVID-19-related restrictions and increased workload, COVID-19 added an all-or-nothing aspect to care home transition decisions.
Collapse
Affiliation(s)
- Anni Lindroos
- Psychology Division, School of Education and Social Sciences, University of the West of Scotland, Paisley, UK
| | - Nicola Douglas-Smith
- Psychology Division, School of Education and Social Sciences, University of the West of Scotland, Paisley, UK
| |
Collapse
|
3
|
McGarrigle CA, Ward M, Kenny RA. An investigation of what protective individual- and community-level factors are associated with life satisfaction in middle-aged and older family carers in Ireland. Front Public Health 2023; 11:1207523. [PMID: 37637804 PMCID: PMC10457003 DOI: 10.3389/fpubh.2023.1207523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 07/11/2023] [Indexed: 08/29/2023] Open
Abstract
Background Family care plays an essential role in providing care in society. However, caring can cause stress, and mental and physical responses to caring vary widely. Different outcomes for carers may reflect different approaches or adaptability to caring and their ability to maintain or recover their mental health and wellbeing following an adverse event (psychosocial resilience). We aim to identify factors that may promote psychosocial resilience, conceptualized as maintaining or recovering subjective wellbeing and operationalized as satisfaction with life, among carers. Methods Data were from 6 Waves (2009-2021) of The Irish Longitudinal Study on Aging (TILDA), a prospective biennial nationally representative longitudinal study of older adults aged ≥50 in Ireland. Family caregiving was assessed in Waves 3-6. Participants were asked if they cared for someone, their relationship to the recipient, and the number of hours per week that they provided care. We used growth mixture modeling to identify latent trajectories of satisfaction with life (SWL) before and after caring was initiated. Regression modeling was then used to identify protective factors (at the individual, family, and community levels) associated with resilient trajectories. Results Overall, 731 (12.2%) participants became carers during follow-up. We identified three trajectories in SWL in carers following initiation of caring, namely, Resilient-Stable (81%), Resilient-Recovery (12%), and Non-recovery (6%). Membership in Resilient-Stable and Resilient-Recovery trajectories was associated with fewer depressive symptoms (OR = 0.86, 95% CI 0.78, 0.94) and chronic conditions (OR = 0.21, 95% CI 0.06, 0.74), larger social networks (OR = 2.03, 95% CI 1.06, 3.86), more close friends and relatives (OR = 1.15, 95% CI 1.01, 1.32), and caring for someone other than a child (OR = 0.19, 95% CI 0.07, 0.51) compared to the Non-recovery group. Conclusion Becoming a family carer was associated with a decline in SWL over time in some carers. However, most carers either did not experience a decline in SWL or recovered their SWL over time. We found that both individual and community-level supports may be protective for carers' wellbeing. These results will inform the priorities for social and community-level services and support for older carers and contribute to the design of new projects and programs to meet these needs.
Collapse
Affiliation(s)
- Christine A. McGarrigle
- The Irish Longitudinal Study on Ageing (TILDA), School of Medicine, Trinity College Dublin, The University of Dublin, Dublin, Ireland
| | - Mark Ward
- The Irish Longitudinal Study on Ageing (TILDA), School of Medicine, Trinity College Dublin, The University of Dublin, Dublin, Ireland
| | - Rose Anne Kenny
- The Irish Longitudinal Study on Ageing (TILDA), School of Medicine, Trinity College Dublin, The University of Dublin, Dublin, Ireland
- St James's Hospital, Mercer's Institute for Successful Ageing, Dublin, Ireland
| |
Collapse
|
4
|
Yu Y, Xiao L, Ullah S, Meyer C, Wang J, Pot AM, Shifaza F. The Experiences of Informal Caregivers of People With Dementia in Web-Based Psychoeducation Programs: Systematic Review and Metasynthesis. JMIR Aging 2023; 6:e47152. [PMID: 37247218 DOI: 10.2196/47152] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 04/19/2023] [Accepted: 05/01/2023] [Indexed: 05/30/2023] Open
Abstract
BACKGROUND Informal caregivers of people living with dementia experience a higher level of physical and mental stress compared with other types of caregivers. Psychoeducation programs are viewed as beneficial for building caregivers' knowledge and skills and for decreasing caregiver stress. OBJECTIVE This review aimed to synthesize the experiences and perceptions of informal caregivers of people with dementia when participating in web-based psychoeducation programs and the factors that enable and impede informal caregivers' engagement in web-based psychoeducation programs. METHODS This review followed the Joanna Briggs Institute protocol of systematic review and meta-aggregation of qualitative studies. We searched 4 English databases, 4 Chinese databases, and 1 Arabic database in July 2021. RESULTS A total of 9 studies written in English were included in this review. From these studies, 87 findings were extracted and grouped into 20 categories. These categories were further synthesized into 5 findings: web-based learning as an empowering experience, peer support, satisfactory and unsatisfactory program content, satisfactory and unsatisfactory technical design, and challenges encountered in web-based learning. CONCLUSIONS High-quality and carefully designed web-based psychoeducation programs offered positive experiences for informal caregivers of people living with dementia. To meet broader caregiver education and support needs, program developers should consider information quality and relevancy, the support offered, individual needs, flexibility in delivery, and connectedness between peers and program facilitators.
Collapse
Affiliation(s)
- Ying Yu
- College of Nursing and Health Sciences, Flinders University, South Australia, Australia
| | - Lily Xiao
- College of Nursing and Health Sciences, Flinders University, South Australia, Australia
| | - Shahid Ullah
- College of Medicine and Public Health, Flinders University, Bedford Park, South Australia, Australia
| | - Claudia Meyer
- Bolton Clarke Research Institute, Melbourne, Victoria, Australia
- Ageing and Independent Living Research Centre, Monash University, Melbourne, Victoria, Australia
- Centre for Health Communication and Participation, La Trobe University, Melbourne, Victoria, Australia
| | - Jing Wang
- Faculty of Nursing, Health Science Center, Xi'an Jiao tong University, Xi'an, Shanxi, China
| | - Anne Margriet Pot
- Erasmus School of Health Policy & Management, Erasmus University Amsterdam, Amsterdam, Netherlands
- Optentia, North-West University, Vanderbijlpark, South Africa
| | - Fathimath Shifaza
- College of Nursing and Health Sciences, Flinders University, South Australia, Australia
| |
Collapse
|
5
|
Musich S, Wang SS, Kraemer S, Yeh CS. The association of psychological protective factors with caregiver mental health outcomes. Geriatr Nurs 2023; 50:174-180. [PMID: 36791542 DOI: 10.1016/j.gerinurse.2023.01.020] [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: 01/04/2023] [Revised: 01/19/2023] [Accepted: 01/20/2023] [Indexed: 02/15/2023]
Abstract
The primary objectives were to investigate the association of resilience, purpose-in-life, and social connections in additive combinations with mental health outcomes of caregivers: 1) reduced levels of loneliness and/or depression; and 2) higher levels of positive perception of aging and quality of life. The study sample was identified from adults age ≥65, who had completed a survey during May-June 2018 or May-June 2019, and self-identified as caregivers (N=1,015; 15.4%). Resilience, purpose-in-life, and social connections were dichotomized as high/low; then counted with equal weighting 0 to 3. Among caregiver respondents, 24%, 29%, 32%, and 15% had 0, 1, 2, or 3 of these protective factors, respectively. As the number of protective factors increased, loneliness and depression decreased and positive perception of aging and quality of life increased. Caregiver interventions that include a focus on psychological protective factors may help to buffer caregiving-related stress thereby improving mental health and quality of life.
Collapse
Affiliation(s)
- Shirley Musich
- Research for Aging Populations, Optum Labs, 315 E. Eisenhower Parkway, Suite 305, Ann Arbor, MI 48108, 248-626-0082.
| | - Shaohung S Wang
- Research for Aging Populations, Optum Labs, 315 E. Eisenhower Parkway, Suite 305, Ann Arbor, MI 48108, 248-626-0082
| | - Sandra Kraemer
- Medicare & Retirement, UnitedHealthcare Alliances, PO Box 9472, Minneapolis, MN 55440, 952-931-5866
| | - Charlotte S Yeh
- AARP Services, Inc., 601 E. Street, N.W., Washington, D.C. 20049, 202-434-7531
| |
Collapse
|
6
|
Kamalpour M, Eden R, Syed RA, Buys L, Tariq A, Watson J. What older adults do in online communities when they co-create and co-destruct value. INTERNATIONAL JOURNAL OF QUALITY AND SERVICE SCIENCES 2021. [DOI: 10.1108/ijqss-03-2020-0043] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
This study aims to explain the value co-creation and co-destruction practices of older adults in an online community (OC).
Design/methodology/approach
Adopting practice theory and service-dominant logic as a theoretical perspective, this paper examined an OC of older adults by conducting an inductive thematic analysis of the interactions of the participants in the community.
Findings
The analysis revealed older adults engage with three value co-creation plus one value co-destruction practices in the OC including, communal coping practices, happiness creation practices, social capital generation practices and disparaging practices for older adults.
Research limitations/implications
Illustrated in a conceptual model, this study extends previous work evidencing OCs serve as a platform for value co-creation and value co-destruction activities in the context of older adults. Further, it suggests OCs facilitate resilience of older adults through value co-creation practices. Recognition of value co-destruction in OCs is critical as it is detrimental to the resilience of older adults. This study provides the needed foundation to advance knowledge on the use of OCs by older adults and suggests future research directions.
Practical implications
Identifying co-creation and co-destruction practices of older adults in OCs enables service providers (e.g. caregivers) to engage better in online value co-creation practices. Further, the findings of this study address one of the main priorities of service science to investigate the impact of value co-creation on well-being.
Originality/value
Despite the significant engagement of older adults in OCs, there is a lack of enough knowledge in the literature regarding value co-creation and co-destruction practices of older adults in OCs. This study addressed this gap by explaining how older adults co-create and co-destruct value in online spaces.
Collapse
|
7
|
Tan JY, Tam WSW, Goh HS, Ow CC, Wu XV. Impact of sense of coherence, resilience and loneliness on quality of life amongst older adults in long-term care: A correlational study using the salutogenic model. J Adv Nurs 2021; 77:4471-4489. [PMID: 34142732 DOI: 10.1111/jan.14940] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Revised: 05/14/2021] [Accepted: 05/24/2021] [Indexed: 11/28/2022]
Abstract
AIMS This study aimed to identify the predicting factors of quality of life (QoL) from a set of psychosocial, sociodemographic and clinical variables amongst older adults in a long-term care setting. DESIGN A cross-sectional, descriptive correlational study. METHOD The study was conducted in a nursing home and a day care centre from July to December 2019. Two hundred older adults were recruited. Guided by the salutogenic model, the sense of coherence (SOC) scale, Connor-Davidson resilience scale, de Jong Gierveld loneliness scale and World Health Organization quality of life instrument-older adults (WHOQOL-OLD) were used. The sociodemographic and clinical profiles of participants were collected. Descriptive statistics, Pearson product-moment correlation coefficient, independent-samples t test, one-way analysis of variance and stepwise regression were utilised in the analysis. RESULTS The mean score for WHOQOL-OLD was 94.42 ± 19.55. The highest mean score was observed in the "Death and Dying" facet, while the lowest mean scores were reflected in the "Autonomy" and "Intimacy" facets of QoL. Regardless of resident type, most QoL scores were similar across different variables. Based on the stepwise regression, higher manageability and meaningfulness in SOC, higher resilience, lower social loneliness, lower emotional loneliness and hearing impairments are significantly associated with higher QoL. CONCLUSION Manageability, meaningfulness and resilience should be enhanced while ameliorating feelings of loneliness to improve the QoL amongst older adults receiving long-term care. Age, marital status, educational level, care arrangement, body mass index, performance in activities of daily living, comorbidities and hearing and mobility impairments could influence QoL and thus warrant more attention. IMPACT Future interventions can be conducted in group sessions to facilitate social interaction and alleviate loneliness. More resources should be allocated to enhance older adults' care arrangements and coping mechanisms to provide them with the support, as they face challenges in daily life due to mobility impairment and other restrictions.
Collapse
Affiliation(s)
- Jia Yi Tan
- Singapore General Hospital, Singapore, Singapore
| | - Wai San Wilson Tam
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Hongli Sam Goh
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | | | - Xi Vivien Wu
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| |
Collapse
|