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Bird K, Bohanna I, McDonald M, Wapau H, Blanco L, Cullen J, McLucas J, Forbes S, Vievers A, Wason A, Strivens E, Barker R. A good life for people living with disability: the story from Far North Queensland. Disabil Rehabil 2024; 46:1787-1795. [PMID: 37161860 DOI: 10.1080/09638288.2023.2205172] [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: 09/28/2022] [Accepted: 04/14/2023] [Indexed: 05/11/2023]
Abstract
PURPOSE People with disability in regional, rural and remote Australia have poorer service access compared to people from metropolitan areas. There is urgent need for reform. This study's aim was to explore the needs and aspirations of people with lived experience of disability in Far North Queensland (FNQ) to inform a new service framework. MATERIALS AND METHODS Twenty-five individuals with diverse experience of disability were engaged in semi-structured interviews. Participants were recruited from four sites that differed geographically, culturally, and socioeconomically. Using an inductive then deductive thematic approach to data analysis, statements of needs and aspirations were compiled and aligned with three pre-determined vision statements. RESULTS Needs and aspirations aligned well with the vision statements which were to: feel "included, connected, safe and supported"; have "opportunities to choose one's own life and follow one's hopes and dreams"; and have "access to culturally safe services close to home." To realise this vision in FNQ, support to navigate and coordinate services across sectors is essential. CONCLUSION People of FNQ of all abilities, need and aspire to experience "a good life" like their fellow Australians. Any new service model must focus on providing service navigation and co-ordination amid the complexities of service delivery in FNQ.
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Affiliation(s)
- Katrina Bird
- James Cook University, College of Healthcare Sciences, Cairns, QLD, Australia
| | - India Bohanna
- James Cook University, College of Healthcare Sciences, Cairns, QLD, Australia
| | - Malcolm McDonald
- Australian Institute of Tropical Health and Medicine, James Cook University, Cairns, QLD, Australia
| | - Hylda Wapau
- Torres and Cape Hospital and Health Service, Bamaga, QLD, Australia
| | - Leisyle Blanco
- James Cook University, College of Healthcare Sciences, Cairns, QLD, Australia
| | | | - Jan McLucas
- Former Senator and Co-Chair FNQ Connect Consumer Reference Group, QLD, Australia
| | - Sue Forbes
- Co-Chair FNQ Connect Consumer Reference Group, QLD, Australia
| | - Anita Vievers
- Centacare FNQ & Catholic Early Learning and Care, Cairns, QLD, Australia
| | - Alan Wason
- Mulungu Aboriginal Corporation Primary Health Care, Mareeba, QLD, Australia
| | - Edward Strivens
- Cairns and Hinterland Hospital and Health Service, Older Persons Sub-Acute and Rehabilitation, Cairns, QLD, Australia
| | - Ruth Barker
- James Cook University, College of Healthcare Sciences, Cairns, QLD, Australia
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Vicente C, Fernandes S, Romão A, Fernandes JB. Current trends in psychotherapies and psychosocial interventions for people with dementia: a scoping review of randomized controlled trials. Front Psychiatry 2024; 15:1286475. [PMID: 38317762 PMCID: PMC10838973 DOI: 10.3389/fpsyt.2024.1286475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 01/09/2024] [Indexed: 02/07/2024] Open
Abstract
An outcome of dementia is a progressive decline in cognitive function. Implementing psychotherapies and psychosocial interventions is crucial for bolstering cognitive abilities, promoting independence, and elevating the quality of life for individuals with dementia. This review aims to identify current trends in psychotherapies and psychosocial interventions for people with dementia. A Scoping review was developed based on the framework proposed by Arksey and O'Malley. The literature search was conducted on electronic databases, including Scopus, Cochrane Central Register of Controlled Trials, MEDLINE, CINAHL, Nursing & Allied Health Collection, and MedicLatina. Executed in June 2023, the search focused on articles published in English, Portuguese, and Spanish between 2013 and 2023. Through this search, 1409 articles were initially identified. After selecting and analyzing the reports, sixteen trials were included in this review. Eight distinct categories were identified, covering different strategies. These categories run from computerized game-based cognitive training and reminiscence therapy to compensatory and restorative strategies, memory and attention training, calculation training, dual-task training, counseling, and personalized goal attainment. The findings of this scoping review highlight the diverse landscape of psychotherapies and psychosocial interventions for people with dementia.
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Affiliation(s)
- Célia Vicente
- Department of Nursing, Hospital Garcia de Orta, Almada, Portugal
- Nurs Lab, Caparica, Almada, Portugal
| | - Sónia Fernandes
- Nurs Lab, Caparica, Almada, Portugal
- Egas Moniz Center for Interdisciplinary Research (CiiEM), Egas Moniz School of Health & Science, Caparica, Almada, Portugal
| | - Ana Romão
- Nurs Lab, Caparica, Almada, Portugal
- Egas Moniz Center for Interdisciplinary Research (CiiEM), Egas Moniz School of Health & Science, Caparica, Almada, Portugal
| | - Júlio Belo Fernandes
- Nurs Lab, Caparica, Almada, Portugal
- Egas Moniz Center for Interdisciplinary Research (CiiEM), Egas Moniz School of Health & Science, Caparica, Almada, Portugal
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Backhouse T, Killett A, Mioshi E, Khondoker M. What are the factors associated with people with advanced dementia refusing assistance with personal care? Int J Geriatr Psychiatry 2023; 38:e5857. [PMID: 36490270 PMCID: PMC10107826 DOI: 10.1002/gps.5857] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Accepted: 11/21/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND People with dementia sometimes refuse assistance with personal care activities such as washing or dressing. We aimed to investigate the factors associated with refusals of care in advanced dementia. METHODS A cross-sectional study using informant-based measures. Participants were people with advanced dementia and their caregivers (family carers or care-home staff) (n = 260, 130 dyads) in the UK. Mixed effects linear models were used to examine the effects of neuropsychiatric behaviours, ability with activities of daily living, professional input, co-morbidities, psychotropic medications, environment modifications, and caregiver factors including type and training status on refusals of care. The Refusal of Care Informant Scale was used, range 1-13; higher scores indicate more refusal behaviours. RESULTS Higher independence in activities of daily living was associated with less refusal behaviours (coefficient = -0.11, p < 0.001 [95% confidence interval -0.15, -0.07]). Higher agitation was associated with more refusal behaviours (0.11, p < 0.001 [0.06, 0.15]). No other statistically significant differences were found. There was no demonstrable evidence of differences in number of refusals of care between family and care-home caregivers or between dementia-trained or -untrained caregivers. CONCLUSIONS Results suggest refusals of care have similar prevalence regardless of caregiver type (family or care home) or dementia training status, indicating that current dementia training has no impact on refusals of care or may not be implemented as intended. Improving independence in activities of daily living and reducing agitations may help prevent refusals of care. To establish causality, future research should consider embedding these factors into interventions targeting refusal of care.
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Affiliation(s)
- Tamara Backhouse
- School of Health SciencesUniversity of East AngliaNorwichNorfolkUK
| | - Anne Killett
- School of Health SciencesUniversity of East AngliaNorwichNorfolkUK
| | - Eneida Mioshi
- School of Health SciencesUniversity of East AngliaNorwichNorfolkUK
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Mendez KJW, Labrique AB, Budhathoki C, Sadak T, Tanner EK, Cotter VT, Han HR. Use of mobile applications and health technologies among dementia caregivers with chronic conditions: A cross-sectional study. Digit Health 2023; 9:20552076231181213. [PMID: 37361436 PMCID: PMC10286551 DOI: 10.1177/20552076231181213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 05/24/2023] [Indexed: 06/28/2023] Open
Abstract
Objective Almost 80% of people, who are caring for someone with dementia, have one or more chronic conditions and require self-management support. New technologies offer promising solutions; however, little is known about what technologies caregivers use for their health or in general. This study aimed to describe the prevalence of mobile application (app) and health-related technology use among caregivers who have chronic conditions and care for someone with dementia. Methods A cross-sectional study was conducted with 122 caregivers recruited online and from communities in the Baltimore-metropolitan area. Data were collected with online surveys and computer-assisted telephone interviews. Descriptive and inferential statistics were used to analyze survey data. Results Study participants were primarily female (95 of 122, 77.9%), middle-aged (average 53 years, standard deviation (SD) 17), well educated (average 16 years, SD 3.3), an adult child of the person with dementia (53 of 122, 43.4%), and had 4 chronic conditions on average (SD 2.6). Over 90% of caregivers used mobile apps (116 of 122), spending a range of 9 to 82 min on each app. Most caregivers reported using social media apps (96 of 116, 82.8%), weather apps (96 of 116, 82.8%), and/or music or entertainment apps (89 of 116, 76.7%). Among caregivers using each app type, more than half of caregivers used social media (66 of 96, 69%), games (49 of 74, 66%), weather (62 of 96, 65%), and/or music or entertainment apps (51 of 89, 57%) daily. Caregivers also used several technologies to support their own health-the most common being websites, mobile devices, and health-related mobile apps. Conclusion This study supports the feasibility of using technologies to promote health behavior change and support self-management among caregivers.
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Affiliation(s)
| | - Alain Bernard Labrique
- International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | | | - Tatiana Sadak
- University of Washington School of Nursing, Seattle, WA, USA
| | | | | | - Hae-Ra Han
- Johns Hopkins School of Nursing, Baltimore, MD, USA
- Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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Kagwa AS, Konradsen H, Kabir ZN. Value co-creation with family caregivers to people with dementia through a tailor-made mHealth application: a qualitative study. BMC Health Serv Res 2022; 22:1362. [PMCID: PMC9667833 DOI: 10.1186/s12913-022-08704-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Accepted: 10/19/2022] [Indexed: 11/17/2022] Open
Abstract
Abstract
Background
Digitalization has been recognized as an efficient and cost-effective solution to address the increasing need for care due to the ageing population and the rise in people with dementia. This has subsequently increased the need to also care for family caregivers in community settings. Another benefit of digitalization is the introduction of new service concepts within service-dominant logic namely, value co-creation, which is changing the dynamics in healthcare, transitioning from a provider-centric to a customer-centric approach. The literature indicates that this transition is a slow process in healthcare due to the complex service context consisting of multi-stakeholders, with a fragmented decision-making process. This has resulted in limited research on how individuals co-create value through technology. The study aimed to explore how family caregivers to people with dementia living at home, as consumers of healthcare services co-create value in a multi-stakeholder context through a tailormade mHealth application.
Methods
A qualitative explorative design was used. Data were collected through semi-structured interviews with 12 family caregivers of people with dementia living at home. The data were analyzed deductively using qualitative content analysis.
Results
The findings show how family caregivers to people with dementia as healthcare consumers, engaged with a mHealth application and other actors in their service network through different levels of value co-creation activities.
Conclusion
This paper showed a willingness among family caregivers to people with dementia living at home, who mostly consisted of older people, to implement new technology to assist them with their caregiving tasks. The different value co-creation activities adopted by the family caregivers generated different levels of experiential value such as support, knowledge, and increased access to healthcare.
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Backhouse T, Jeon YH, Killett A, Mioshi E. How do family carers and care-home staff manage refusals when assisting a person with advanced dementia with their personal care? DEMENTIA 2022; 21:2458-2475. [PMID: 36053711 PMCID: PMC9583289 DOI: 10.1177/14713012221123578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Background and objectives Caregivers may encounter, or inadvertently cause, refusals of care by a care
recipient. Managing refusals of care can be challenging and have potential
negative consequences. We aimed to examine caregivers’ (care-home staff and
family carers) experiences of managing refusals of personal care in advanced
dementia. Research design and methods One-to-one semi-structured interviews with 12 care assistants from six care
homes and 20 family carers who were physically assisting a person with
advanced dementia with their personal care in the UK. Interviews were audio
recorded and transcribed verbatim, with data analysed using qualitative
content analysis. Findings Core to the caregiver experience of refusals of care was
knowing the person. This underpinned
five key themes identified as caregivers’ strategies used in preventing or
managing refusals of care: (1) finding the right moment to care; (2) using
specific communication strategies; (3) being tactful: simplifying, leaving,
or adapting care; (4) having confidence in care; and (5) seeking support
from others when safety is at risk. Discussion and implications Different caregiver relationships with the person with dementia influenced
how they managed refusals of care. Refusals of care can place caregivers in
tough situations with tensions between providing care when it is seemingly
not wanted and leaving care incomplete. Both caregiver groups require
support such as coaching, mentoring and/or advice from other health and
social care practitioners to manage difficult personal care interactions
before crisis points occur.
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Affiliation(s)
- Tamara Backhouse
- School of Health Sciences, 83726University of East Anglia, Norwich, Norfolk, UK
| | - Yun-Hee Jeon
- Sydney Nursing School, 4334The University of Sydney, Sydney, NSW, Australia
| | - Anne Killett
- School of Health Sciences, 83726University of East Anglia, Norwich, Norfolk, UK
| | - Eneida Mioshi
- School of Health Sciences, 83726University of East Anglia, Norwich, Norfolk, UK
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Ottaviani AC, Monteiro DQ, Ferreira Campos CR, Barham EJ, Oliveira D, da Cruz KCT, Corrêa L, de Souza Orlandi F, Zazzetta MS, Gratão ACM, Pavarini SCI. ISupport-Brasil: Preliminary results of the usability and acceptability assessment by caregivers of people who have dementia. Front Med (Lausanne) 2022; 9:981748. [PMID: 36059826 PMCID: PMC9433833 DOI: 10.3389/fmed.2022.981748] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 08/04/2022] [Indexed: 11/14/2022] Open
Abstract
Objective To assess usability and acceptability of iSupport-Brasil (iSupport-BR) to virtually support family caregivers of people who have dementia. Materials and methods In the first stage, nine caregivers/former caregivers assessed the interface of the platform that hosts iSupport-BR. In the second stage, 10 caregivers assessed acceptability of the platform and answered the System Usability Scale (SUS), which varies from 0 to 100 points. A descriptive analysis of the quantitative data was performed, as well as a thematic analysis on the open questions. All the ethical aspects were respected. Results The results of the first stage indicated a user-friendly interface of the system and relevant content of the program, with 55.6 and 77.8% of the participants assigning the maximum grade to these questions, respectively. Of the five possible points, the system's mean score was 3.7. In Stage 2, 80% of the caregivers rated the program as very useful and 100% would recommend it to other caregivers. Perception of the program's usability by the SUS scale was excellent (M = 86.5 ± 11.5). Conclusion This research allowed elaborating the final version of iSupport-BR, considering usability and acceptability of the platform and the program for computers/notebooks, being a pioneer in evaluating it for use in smartphones. Future research studies will have to assess the effects of iSupport-BR on the caregivers' mental health.
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Affiliation(s)
- Ana Carolina Ottaviani
- Department of Gerontology, Universidade Federal de São Carlos, São Carlos, São Paulo, Brazil
| | - Diana Quirino Monteiro
- Department of Gerontology, Universidade Federal de São Carlos, São Carlos, São Paulo, Brazil
| | | | - Elizabeth Joan Barham
- Postgraduate Programme in Psychology, Universidade Federal de São Carlos, São Carlos, São Paulo, Brazil
- Department of Psychology, Universidade Federal de São Carlos, São Carlos, São Paulo, Brazil
| | - Déborah Oliveira
- Department of Psychiatry, School of Medicine, Universidade Federal de São Paulo, São Paulo, São Paulo, Brazil
| | | | - Larissa Corrêa
- Postgraduate Programme in Nursing, Universidade Federal de São Carlos, São Carlos, São Paulo, Brazil
| | - Fabiana de Souza Orlandi
- Department of Gerontology, Universidade Federal de São Carlos, São Carlos, São Paulo, Brazil
- Postgraduate Programme in Nursing, Universidade Federal de São Carlos, São Carlos, São Paulo, Brazil
| | - Marisa Silvana Zazzetta
- Department of Gerontology, Universidade Federal de São Carlos, São Carlos, São Paulo, Brazil
- Postgraduate Programme in Nursing, Universidade Federal de São Carlos, São Carlos, São Paulo, Brazil
| | - Aline Cristina Martins Gratão
- Department of Gerontology, Universidade Federal de São Carlos, São Carlos, São Paulo, Brazil
- Postgraduate Programme in Nursing, Universidade Federal de São Carlos, São Carlos, São Paulo, Brazil
| | - Sofia Cristina Iost Pavarini
- Department of Gerontology, Universidade Federal de São Carlos, São Carlos, São Paulo, Brazil
- Postgraduate Programme in Nursing, Universidade Federal de São Carlos, São Carlos, São Paulo, Brazil
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Dorell Å, Konradsen H, Kallström AP, Kabir ZN. “A friend during troubled times”: Experiences of family caregivers to persons with dementia when receiving professional support via a mobile app. PLoS One 2022; 17:e0271972. [PMID: 35917295 PMCID: PMC9345357 DOI: 10.1371/journal.pone.0271972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Accepted: 07/11/2022] [Indexed: 11/19/2022] Open
Affiliation(s)
- Åsa Dorell
- Department of Neurobiology, Care Sciences and Society, NVS, Karolinska Institutet, Stockholm, Sweden
- * E-mail:
| | - Hanne Konradsen
- Department of Neurobiology, Care Sciences and Society, NVS, Karolinska Institutet, Stockholm, Sweden
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Department of Gastroenterology, Herley and Gentofte Hospital, Herlev, Denmark
| | - Ana Paula Kallström
- Department of Neurobiology, Care Sciences and Society, NVS, Karolinska Institutet, Stockholm, Sweden
| | - Zarina Nahar Kabir
- Department of Neurobiology, Care Sciences and Society, NVS, Karolinska Institutet, Stockholm, Sweden
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Garnett A, Northwood M, Ting J, Sangrar R. Mobile Health Interventions to Support Caregivers of Older Adults: An Equity-Focused Systematic Review. JMIR Aging 2022; 5:e33085. [PMID: 35616514 PMCID: PMC9308083 DOI: 10.2196/33085] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 04/11/2022] [Accepted: 05/23/2022] [Indexed: 12/31/2022] Open
Abstract
Background Informal caregivers, hereafter referred to as caregivers, provide support to older adults so that they can age safely at home. The decision to become a caregiver can be influenced by individual factors, such as personal choice, or societal factors such as social determinants of health, including household income, employment status, and culture-specific gender roles. Over time, caregivers’ health can be negatively affected by their caregiving roles. Although programs exist to support caregivers, the availability and appropriateness of services do not match caregivers’ expressed needs. Research suggests that supportive interventions offered through mobile health (mHealth) technologies have the potential to increase caregivers’ access to supportive services. However, a knowledge gap remains regarding the extent to which social determinants of health are considered in the design, implementation, and evaluation of mHealth interventions intended to support the caregivers of older adults. Objective This study aimed to conduct a systematic review to determine how health equity is considered in the design, implementation, and evaluation of mHealth interventions for caregivers of older adults using Cochrane Equity’s PROGRESS-Plus (place of residence, race, ethnicity, culture, language, occupation, gender, religion, education, social capital, socioeconomic status–plus age, disability, and sexual orientation) framework and synthesize evidence of the impacts of the identified caregiver-focused mHealth interventions. Methods A systematic review was conducted using 5 databases. Articles published between January 2010 and June 2021 were included if they evaluated or explored the impact of mHealth interventions on the health and well-being of informal caregivers of older adults. mHealth interventions were defined as supportive services, for example, education, that caregivers of older adults accessed via mobile or wireless devices. Results In total, 28 articles met the inclusion criteria and were included in the review. The interventions evaluated sought to connect caregivers with services, facilitate caregiving, and promote caregivers’ health and well-being. The PROGRESS-Plus framework factors were mainly considered in the results, discussion, and limitations sections of the included studies. Some PROGRESS-Plus factors such as sexual orientation, religion, and occupation, received little to no consideration across any phase of the intervention design, implementation, or evaluation. Overall, the findings of this review suggest that mHealth interventions were positively received by study participants. Such interventions have the potential to reduce caregiver burden and positively affect caregivers’ physical and mental health while supporting them as caregivers. The study findings highlight the importance of making support available to help facilitate caregivers’ use of mHealth interventions, as well as in the use of appropriate language and text. Conclusions The successful uptake and spread of mHealth interventions to support caregivers of older adults will depend on creating opportunities for the inclusive involvement of a broad range of stakeholders at all stages of design, implementation, and evaluation.
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Affiliation(s)
- Anna Garnett
- Western University, FIMS Nursing Building, Rm 2306, London, CA
| | | | - Justine Ting
- Western University, FIMS Nursing Building, Rm 2306, London, CA
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Wang AH, Newman K, Martin LS, Lapum J. Beyond instrumental support: Mobile application use by family caregivers of persons living with dementia. DEMENTIA 2022; 21:1488-1510. [PMID: 35414298 PMCID: PMC9237854 DOI: 10.1177/14713012211073440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
In recent years, there has been a rapid increase in technology use in dementia caregiving, particularly the use of mobile applications (apps) which are highly accessible, cost-effective and intuitive. Yet, little is known about the experiences of family caregivers of persons living with dementia who use apps to support caregiving activities. This is of particular concern given that limited understandings of the user experience in designing technology have often led to end-users experiencing barriers in technology adoption and use. Using a qualitative descriptive approach, the purpose of the study was to explore the experiences of family caregivers of persons living with dementia on using apps in their caregiving roles. A purposive sample of five family caregivers in Ontario, Canada participated in two interviews each, with the second interview informed by photo-elicitation methods. Thematic analysis of the collected data revealed a central overarching theme, Connecting to support through apps in my, your and our lives, which explicated how apps played an important role in the lives of the caregiver, the care recipient and both together as a dyad. Three core themes also emerged: Adapting apps to meet individual needs of the dyad, Minimising the impact of the condition on the person and the family and Determining the effectiveness of apps. The findings highlighted that the value of apps extends beyond their mere functionality and their ability to help with care provision as they are also able to promote richer interpersonal connections, enhance personhood and sustain family routines. This research advances our understanding of the impact of app use in caregiving and provides direction for future research, policy, education, practice and app development.
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Affiliation(s)
- Angel H Wang
- Daphne Cockwell School of Nursing, 7984Ryerson University, Toronto, Ontario M5B 2K3, Canada
| | - Kristine Newman
- Daphne Cockwell School of Nursing, 7984Ryerson University, Toronto, Ontario M5B 2K3, Canada
| | - Lori Schindel Martin
- Daphne Cockwell School of Nursing, 7984Ryerson University, Toronto, Ontario M5B 2K3, Canada
| | - Jennifer Lapum
- Daphne Cockwell School of Nursing, 7984Ryerson University, Toronto, Ontario M5B 2K3, Canada
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Mendez KJW, Budhathoki C, Labrique AB, Sadak T, Tanner EK, Han HR. Factors Associated With Intention to Adopt mHealth Apps Among Dementia Caregivers With a Chronic Condition: Cross-sectional, Correlational Study. JMIR Mhealth Uhealth 2021; 9:e27926. [PMID: 34463637 PMCID: PMC8441609 DOI: 10.2196/27926] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2021] [Revised: 04/26/2021] [Accepted: 06/04/2021] [Indexed: 12/19/2022] Open
Abstract
Background In the United States, nearly 80% of family caregivers of people with dementia have at least one chronic condition. Dementia caregivers experience high stress and burden that adversely affect their health and self-management. mHealth apps can improve health and self-management among dementia caregivers with a chronic condition. However, mHealth app adoption by dementia caregivers is low, and reasons for this are not well understood. Objective The purpose of this study is to explore factors associated with dementia caregivers’ intention to adopt mHealth apps for chronic disease self-management. Methods We conducted a cross-sectional, correlational study and recruited a convenience sample of dementia caregivers. We created a survey using validated instruments and collected data through computer-assisted telephone interviews and web-based surveys. Before the COVID-19 pandemic, we recruited dementia caregivers through community-based strategies, such as attending community events. After nationwide closures due to the pandemic, the team focused on web-based recruitment. Multiple logistic regression analyses were used to test the relationships between the independent and dependent variables. Results Our sample of 117 caregivers had an average age of 53 (SD 17.4) years, 16 (SD 3.3) years of education, and 4 (SD 2.5) chronic conditions. The caregivers were predominantly women (92/117, 78.6%) and minorities (63/117, 53.8%), experienced some to extreme income difficulties (64/117, 54.7%), and were the child or child-in-law (53/117, 45.3%) of the person with dementia. In logistic regression models adjusting for the control variables, caregiver burden (odds ratio [OR] 1.3, 95% CI 0.57-2.8; P=.57), time spent caregiving per week (OR 1.7, 95% CI 0.77-3.9; P=.18), and burden of chronic disease and treatment (OR 2.3, 95% CI 0.91-5.7; P=.08) were not significantly associated with the intention to adopt mHealth apps. In the final multiple logistic regression model, only perceived usefulness (OR 23, 95% CI 5.6-97; P<.001) and the interaction term for caregivers’ education and burden of chronic disease and treatment (OR 31, 95% CI 2.2-430; P=.01) were significantly associated with their intention to adopt mHealth apps. Perceived ease of use (OR 2.4, 95% CI 0.67-8.7; P=.18) and social influence (OR 1.8, 95% CI 0.58-5.7; P=.31) were not significantly associated with the intention to adopt mHealth apps. Conclusions When designing mHealth app interventions for dementia caregivers with a chronic condition, it is important to consider caregivers’ perceptions about how well mHealth apps can help their self-management and which app features would be most useful for self-management. Caregiving factors may not be relevant to caregivers’ intention to adopt mHealth apps. This is promising because mHealth strategies may overcome barriers to caregivers’ self-management. Future research should investigate reasons why caregivers with a low education level and low burden of chronic disease and treatment have significantly lower intention to adopt mHealth apps for self-management.
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Affiliation(s)
| | - Chakra Budhathoki
- School of Nursing, Johns Hopkins University, Baltimore, MD, United States
| | - Alain Bernard Labrique
- Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States
| | - Tatiana Sadak
- School of Nursing, University of Washington, Seattle, WA, United States
| | - Elizabeth K Tanner
- School of Nursing, Johns Hopkins University, Baltimore, MD, United States
| | - Hae Ra Han
- School of Nursing, Johns Hopkins University, Baltimore, MD, United States.,Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States
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Gullslett MK, Nilsen ER, Dugstad J. Next of kin's experiences with and attitudes towards digital monitoring technology for ageing people with dementia in residential care facilities. A qualitative study based on the voices of next of kin and care providers. Scand J Caring Sci 2021; 36:1094-1103. [PMID: 34121217 DOI: 10.1111/scs.13009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2020] [Accepted: 04/30/2021] [Indexed: 11/29/2022]
Abstract
AIM To explore next of kin's experiences and attitudes regarding information surrounding the introduction and use of technology to monitor residential home residents with dementia. BACKGROUND As our population ages, conditions increase health care and societal challenges. Digitalisation and welfare technology are important for developing health services for the ageing population; adapting information-sharing and communication about these pics with those involved, such as next of kin, will become increasingly important for developing appropriate services. DESIGN This qualitative study has an exploratory and interpretative approach, using in-depth interviews based on a hermeneutical-phenomenological perspective. METHODS During the process of implementing a variety of residential care monitoring technologies, data were collected primarily via semi-structured, in-depth interviews with care providers and next of kin. In addition to the individual interviews, one focus group interview was carried out with care providers. RESULTS Next of kin are a heterogeneous group who need differing types of information - and different styles of communication - to convey information about their relatives in residential care. General attitudes among the next of kin towards welfare technology were positive. Three analytic themes that illustrate the next of kin concerns emerged: (1) concern for safety, autonomy and ethics; (2) resistance and optimism towards technology; (3) information about the use of monitoring technology. CONCLUSION Digital monitoring technology is increasingly being implemented in residential care. Next of kin are salient in this context. Accordingly, best practices for informing and communicating in a collaborative process must be developed. While some next of kin have resources and are able to be highly engaged, others are unable or unwilling to be active participants in their family members' lives. It is critical that care providers are aware that next of kin are a heterogeneous group. Our proposed profiles may prove helpful for giving the right information and attention to next of kin, and this may improve residential care services. RELEVANCE TO CLINICAL PRACTICE These findings may aid in the tailoring of information and communication systems to individual next of kin's needs and in improving residential care services.
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Affiliation(s)
- Monika K Gullslett
- Department of Nursing and Health Sciences, University of Southeastern Norway (USN), Kongsberg, Norway
| | - Etty R Nilsen
- Department of Nursing and Health Sciences, University of Southeastern Norway (USN), Kongsberg, Norway
| | - Janne Dugstad
- Department of Nursing and Health Sciences, University of Southeastern Norway (USN), Kongsberg, Norway
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Chelberg GR, Neuhaus M, Mothershaw A, Mahoney R, Caffery LJ. Mobile apps for dementia awareness, support, and prevention - review and evaluation. Disabil Rehabil 2021; 44:4909-4920. [PMID: 34034601 DOI: 10.1080/09638288.2021.1914755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
PURPOSE This review aimed to document the characteristics and appraise the quality of dementia applications (apps) to support persons living with dementia and their caregivers. MATERIALS AND METHODS Systematic searches of the Australian-based Google Play Store, Apple App Store, and relevant websites sought apps with dementia or Alzheimer's information, support for caregivers and persons living with dementia, or prevention content. Apps were screened and subsequently appraised via the mobile application review system (MARS). RESULTS The majority of the final 75 dementia apps were free to download, but were only available on a single platform. Persons involved in caregiving were the primary audience. App content focused on dementia information, practical caregiving, and communication tips. Language options in addition to English were limited and few apps offered ongoing support. MARS appraisal identified few apps with good "Overall Quality" scores. Apps that were more comprehensive trended towards higher MARS scores. CONCLUSIONS A composite lack of standardised quality indicators and commercial drivers of the marketplace present significant barriers for consumers seeking meaningful dementia information and support. Persons living with dementia and their caregivers would significantly benefit from social and organisational services that assist with navigating the app marketplace.Implications for rehabilitationThere is significant opportunity for quality digital innovations, including apps, to support home-based, independent dementia care.A composite lack of standardised quality indicators and commercial drivers of the app marketplace present significant barriers for persons living with dementia and their caregivers who seek apps with dementia information and support.Social and organisational services can support the dementia community through assistance with navigating the app marketplace for quality dementia information and support.
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Affiliation(s)
- Georgina R Chelberg
- Centre for Online Health - Centre for Health Services Research, The University of Queensland, Brisbane, Australia.,Australian E-Health Research Centre (AEHRC), Commonwealth Scientific and Industrial Research Organisation (CSIRO), Canberra, Australia
| | - Maike Neuhaus
- Centre for Online Health - Centre for Health Services Research, The University of Queensland, Brisbane, Australia
| | - Adam Mothershaw
- Centre for Online Health - Centre for Health Services Research, The University of Queensland, Brisbane, Australia
| | - Ray Mahoney
- Australian E-Health Research Centre (AEHRC), Commonwealth Scientific and Industrial Research Organisation (CSIRO), Canberra, Australia.,School of Public Health, The University of Queensland, Brisbane, Australia
| | - Liam J Caffery
- Centre for Online Health - Centre for Health Services Research, The University of Queensland, Brisbane, Australia
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Rathnayake S, Moyle W, Jones C, Calleja P. Co-design of an mHealth application for family caregivers of people with dementia to address functional disability care needs. Inform Health Soc Care 2020; 46:1-17. [DOI: 10.1080/17538157.2020.1793347] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Sarath Rathnayake
- Menzies Health Institute Queensland, Griffith University, Nathan, Australia
- School of Nursing and Midwifery, Griffith University, Brisbane, Australia
- Department of Nursing, University of Peradeniya, Kandy, Sri Lanka
| | - Wendy Moyle
- Menzies Health Institute Queensland, Griffith University, Nathan, Australia
- School of Nursing and Midwifery, Griffith University, Brisbane, Australia
| | - Cindy Jones
- Menzies Health Institute Queensland, Griffith University, Nathan, Australia
- Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Australia
| | - Pauline Calleja
- Menzies Health Institute Queensland, Griffith University, Nathan, Australia
- School of Nursing and Midwifery, Griffith University, Brisbane, Australia
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Brites ADS, Caldas CP, Motta LBD, Carmo DSD, Sztajnberg A, Stutzel MC. Mobile Care System for Older Adults: perceptions about its use in caring for people with dementia. REVISTA BRASILEIRA DE GERIATRIA E GERONTOLOGIA 2020. [DOI: 10.1590/1981-22562020023.190277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Abstract Objective: To analyze the perceptions of caregivers and health professionals about a mobile application used for the caring and social support of people with dementia. Method: A qualitative study was performed on the experience of implementing a Mobile Care System for Older Adults (Sistema Móvel de Assistência ao Idoso, SMAI) in the routine of caregivers of people with dementia, treated at an outpatient clinic for cognitive disorders. Data were obtained through the application of questionnaires about the characteristics of caregivers and the Zarit scale to assess the level of burden. An Activities of Daily Living Questionnaire (ADLQ) was applied for functional evaluation. The perception of caregivers and professionals were collected through the audio recording of focus groups and analyzed according to the thematic-categorical analysis technique. Results: Twenty caregivers and five health professionals participated in the focus groups. Categories that emerged from the study revealed themes related to users’ experiences, communication, medication management, feelings of caregivers, patient management strategies, impact of dementia on caregivers’ lives, illness of caregivers and application evaluation. Conclusion: Interventions using mobile applications can help improve communication and social support in the care of dementia. The experience with the SMAI and its applications represented an innovative opportunity for both family caregivers and healthcare professionals.
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Affiliation(s)
- André da Silva Brites
- Universidade do Estado do Rio de Janeiro, Brazil; Universidade do Estado do Rio de Janeiro, Brazil
| | - Celia Pereira Caldas
- Universidade do Estado do Rio de Janeiro, Brazil; Universidade do Estado do Rio de Janeiro, Brazil
| | - Luciana Branco da Motta
- Universidade do Estado do Rio de Janeiro, Brazil; Universidade do Estado do Rio de Janeiro, Brazil
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