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de Siqueira Silva Í, de Araújo AJ, Lopes RH, Silva CRDV, Xavier PB, de Figueirêdo RC, Brito EWG, Lapão LV, Martiniano CS, de Araújo Nunes VM, da Costa Uchôa SA. Digital home care interventions and quality of primary care for older adults: a scoping review. BMC Geriatr 2024; 24:507. [PMID: 38858634 PMCID: PMC11163791 DOI: 10.1186/s12877-024-05120-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Accepted: 05/29/2024] [Indexed: 06/12/2024] Open
Abstract
BACKGROUND Population aging is forcing the transformation of health care. Long-term care in the home is complex and involves complex communication with primary care services. In this scenario, the expansion of digital health has the potential to improve access to home-based primary care; however, the use of technologies can increase inequalities in access to health for an important part of the population. The aim of this study was to identify and map the uses and types of digital health interventions and their impacts on the quality of home-based primary care for older adults. METHODS This is a broad and systematized scoping review with rigorous synthesis of knowledge directed by the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). The quantitative data were analyzed through descriptive statistics, and the qualitative data were analyzed through basic qualitative content analysis, considering the organizational, relational, interpersonal and technical dimensions of care. The preliminary results were subjected to consultation with stakeholders to identify strengths and limitations, as well as potential forms of socialization. RESULTS The mapping showed the distribution of publications in 18 countries and in the Sub-Saharan Africa region. Older adults have benefited from the use of different digital health strategies; however, this review also addresses limitations and challenges, such as the need for digital literacy and technological infrastructure. In addition to the impacts of technologies on the quality of health care. CONCLUSIONS The review gathered priority themes for the equitable implementation of digital health, such as access to home caregivers and digital tools, importance of digital literacy and involvement of patients and their caregivers in health decisions and design of technologies, which must be prioritized to overcome limitations and challenges, focusing on improving quality of life, shorter hospitalization time and autonomy of older adults.
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Affiliation(s)
- Ísis de Siqueira Silva
- Postgraduate in Collective Health, Federal University of Rio Grande Do Norte, Natal, Brazil.
| | | | | | | | - Pedro Bezerra Xavier
- Postgraduate in Health Sciences, Federal University of Rio Grande Do Norte, Natal, Brazil
| | | | | | - Luís Velez Lapão
- WHO Collaborating Center on Health Workforce Policy and Planning, IHMT, Universidade Nova de Lisboa, Lisbon, Portugal
- UNIDEMI, Department of Mechanical and Industrial Engineering, Nova School of Science and Technology, Caparica, Portugal
- Laboratório Associado de Sistemas Inteligentes, Escola de Engenharia Universidade do Minho, Campus Azurém, 4800-058, Guimarães, Portugal
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Tabaeeian RA, Hajrahimi B, Khoshfetrat A. A systematic review of telemedicine systems use barriers: primary health care providers' perspective. JOURNAL OF SCIENCE AND TECHNOLOGY POLICY MANAGEMENT 2022. [DOI: 10.1108/jstpm-07-2021-0106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Purpose
The purpose of this review paper was identifying barriers to the use of telemedicine systems in primary health-care individual level among professionals.
Design/methodology/approach
This study used Scopus and PubMed databases for scientific records identification. A systematic review of the literature structured by PRISMA guidelines was conducted on 37 included papers published between 2009 and 2019. A qualitative approach was used to synthesize insights into using telemedicine by primary care professionals.
Findings
Three barriers were identified and classified: system quality, data quality and service quality barriers. System complexity in terms of usability, system unreliability, security and privacy concerns, lack of integration and inflexibility of systems-in-use are related to system quality. Data quality barriers are data inaccuracy, data timeliness issues, data conciseness concerns and lack of data uniqueness. Finally, service reliability concerns, lack of technical support and lack of user training have been categorized as service quality barriers.
Originality/value
This review identified and mapped emerging themes of barriers to the use of telemedicine systems. This paper also through a new conceptualization of telemedicine use from perspectives of the primary care professionals contributes to informatics literature and system usage practices.
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Korkmaz Yaylagul N, Kirisik H, Bernardo J, Dantas C, van Staalduinen W, Illario M, De Luca V, Apóstolo J, Silva R. Trends in Telecare Use among Community-Dwelling Older Adults: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph192416672. [PMID: 36554553 PMCID: PMC9779196 DOI: 10.3390/ijerph192416672] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 12/08/2022] [Accepted: 12/10/2022] [Indexed: 06/08/2023]
Abstract
A scoping review was conducted to map and analyze the concept of telecare services and the trends in telecare use. This scoping review was conducted according to Arksey and O'Malley's framework. A search was conducted in CINAHL (via EBSCO), ERIC, Academic Search Ultimate, and MEDLINE/PubMed databases. This scoping review considered quantitative (e.g., analytical observational studies, including prospective and retrospective cohort studies, case-control, analytical cross-sectional, and descriptive-observational studies), qualitative (e.g., phenomenology, grounded theory, ethnography, and action research), and mixed-method primary studies. Forty research articles published from 1 January 2012, to 1 January 2022 were included in this review, these studies met the eligibility criteria as all were focused on telecare and targeting older adults over 65 living at home. The reviewers coded the data in an Excel spreadsheet, including the articles' title, year, author, journal information and subject, research methods, sample size, location, and summary. Then, the researchers analyzed the conceptual definitions, measurement techniques, and findings in detail and the findings were grouped into categories. The trends around the concept of telecare are independent living, remote care, aging in place, and safety. Telecare research focuses mainly on service use, chronic illness, ethics, and cost-effectiveness. Technology acceptance among older individuals is a critical factor for telecare use. The results found in the literature about the cost-effectiveness of telecare are inconsistent.
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Affiliation(s)
- Nilufer Korkmaz Yaylagul
- Department of Gerontology, Faculty of Health Sciences, University of Akdeniz, Antalya 07070, Turkey
| | - Hande Kirisik
- Elderly Care Program, Vocational School of Haymana, University of Ankara, Ankara 06860, Turkey
| | - Joana Bernardo
- Health Sciences Research Unit: Nursing (UICISA: E), Nursing School of Coimbra (ESEnfC), 3000-076 Coimbra, Portugal
| | | | | | - Maddalena Illario
- Dipartimento di Sanità Pubblica, Università degli Studi di Napoli Federico II, 80131 Napoli, Italy
| | - Vincenzo De Luca
- Dipartimento di Sanità Pubblica, Università degli Studi di Napoli Federico II, 80131 Napoli, Italy
| | - João Apóstolo
- Health Sciences Research Unit: Nursing (UICISA: E), Nursing School of Coimbra (ESEnfC), 3000-076 Coimbra, Portugal
- Portugal Centre for Evidence Based Practice: A JBI Centre of Excellence (PCEBP), 3000-232 Coimbra, Portugal
| | - Rosa Silva
- Health Sciences Research Unit: Nursing (UICISA: E), Nursing School of Coimbra (ESEnfC), 3000-076 Coimbra, Portugal
- Portugal Centre for Evidence Based Practice: A JBI Centre of Excellence (PCEBP), 3000-232 Coimbra, Portugal
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Galavi Z, Montazeri M, Ahmadian L. Barriers and challenges of using health information technology in home care: A systematic review. Int J Health Plann Manage 2022; 37:2542-2568. [DOI: 10.1002/hpm.3492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Revised: 02/27/2022] [Accepted: 03/15/2022] [Indexed: 11/09/2022] Open
Affiliation(s)
- Zahra Galavi
- Department of Health Information Sciences Faculty of Management and Medical Information Sciences Kerman University of Medical Sciences Kerman Iran
| | - Mahdieh Montazeri
- Department of Health Information Sciences Faculty of Management and Medical Information Sciences Kerman University of Medical Sciences Kerman Iran
- Medical Informatics Research Center Institute for Futures Studies in Health Kerman University of Medical Sciences Kerman Iran
| | - Leila Ahmadian
- Department of Health Information Sciences Faculty of Management and Medical Information Sciences Kerman University of Medical Sciences Kerman Iran
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Glomsås HS, Knutsen IR, Fossum M, Christiansen K, Halvorsen K. Family caregivers' involvement in caring for frail older family members using welfare technology: a qualitative study of home care in transition. BMC Geriatr 2022; 22:223. [PMID: 35303816 PMCID: PMC8932075 DOI: 10.1186/s12877-022-02890-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Accepted: 03/02/2022] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Demographic, economic and organisational changes challenge home care services. Increased use of welfare technology and involvement of family members as co-producers of care are political initiatives to meet these challenges. However, these initiatives also involve ethical aspects. METHOD The aim of this qualitative study was to explore family caregivers' experience of involvement and possible ethical aspects of caring for frail older family members receiving home care services supported by welfare technology. This study used a qualitative explorative and descriptive design within a phenomenological-hermeneutical approach. Sixteen interviews with eighteen family caregivers were conducted. The participants were sons, daughters, siblings and spouses of frail older people receiving home care services with the support of welfare technology. Data were analysed using reflexive thematic analysis. The COREQ checklist was used. RESULTS The analysis led to five main themes. First, the family caregivers' experienced caring as meaningful but increasingly demanding concerning the changes in home care services. Second, they experienced a change in relationships, roles, tasks, and responsibilities related to more family involvement and the use of welfare technology. This also challenged their sense of autonomy. However, welfare technology helped them deal with responsibilities, especially safety. The family caregivers requested early involvement, dialogue for care decisions, more cooperation and support from health professionals. Third, the participants experienced that health professionals decided the conditions for co-production without discussion. Their need for information and knowledge about welfare technology were not met. Fourth, the family caregivers felt that the health professionals did not adequately recognise their unique knowledge of the care receiver and did not use this knowledge for customising the welfare technology to the care receiver and their families. Fifth, the family caregivers expressed concern about service and welfare technology inequality in home care services. CONCLUSIONS Co-production in the involvement of family caregivers in care is still not an integral part of home care service. Welfare technology was appreciated, but the family caregivers called for early involvement to ensure successful and safe implementation and use. More attention needs to be given to ethical concerns about the change in relations, transfer of tasks and responsibility, and risk of inequality.
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Affiliation(s)
- Heidi Snoen Glomsås
- Faculty of Health Sciences, Institute of Nursing and health promotion, Oslo Metropolitan University, Postbox 4, St. Olavs plass, N-0130 Oslo, Norway
| | - Ingrid Ruud Knutsen
- Faculty of Health Sciences, Institute of Nursing and health promotion, Oslo Metropolitan University, Postbox 4, St. Olavs plass, N-0130 Oslo, Norway
| | - Mariann Fossum
- Faculty of Health and Sport Sciences, Institute of Health and Nursing Science, University of Agder, Postboks 422, N-4604 Kristiansand, Norway
| | - Karin Christiansen
- Faculty of Health Sciences, Research Centre for Health and Welfare Technology, VIA University College, Hedeager 2, DK-8200 Aarhus, Denmark
| | - Kristin Halvorsen
- Faculty of Health Sciences, Institute of Nursing and health promotion, Oslo Metropolitan University, Postbox 4, St. Olavs plass, N-0130 Oslo, Norway
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Duncan MH, Erickson JM, Chang D, Toor R, Ratzliff ADH. Psychiatry's Expanded Integration into Primary Care. Psychiatr Clin North Am 2022; 45:71-80. [PMID: 35219443 DOI: 10.1016/j.psc.2021.11.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Integrated behavioral care, and in particular, the collaborative care model, has been working to improve access and treatment for people with mental health disorders. Integrated care allows for adaptable, scalable, and sustainable practice that addresses the mental health needs of the public. During the pandemic several challenges emerged to delivering integrated care. This disruption happened at a systems level, team-based care level, scope of care level, and patient access level. This article looks through the lens of those various levels to identify and some of the lessons learned to help build a more resilient and flexible integrated care program.
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Affiliation(s)
- Mark H Duncan
- Department of Psychiatry and Behavioral Sciences, University of Washington, 4225 Roosevelt Way Northeast, Street 306, Seattle, WA 98105, USA.
| | - Jennifer M Erickson
- Department of Psychiatry and Behavioral Sciences, University of Washington, 4225 Roosevelt Way Northeast, Street 306, Seattle, WA 98105, USA
| | - Denise Chang
- Department of Psychiatry and Behavioral Sciences, University of Washington, 4225 Roosevelt Way Northeast, Street 306, Seattle, WA 98105, USA
| | - Ramanpreet Toor
- Department of Psychiatry and Behavioral Sciences, University of Washington, 4225 Roosevelt Way Northeast, Street 306, Seattle, WA 98105, USA
| | - Anna D H Ratzliff
- Department of Psychiatry and Behavioral Sciences, University of Washington, 4225 Roosevelt Way Northeast, Street 306, Seattle, WA 98105, USA
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Fredriksen E, Thygesen E, Moe CE, Martinez S. Digitalisation of municipal healthcare collaboration with volunteers: a case study applying normalization process theory. BMC Health Serv Res 2021; 21:410. [PMID: 33933092 PMCID: PMC8088692 DOI: 10.1186/s12913-021-06429-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Accepted: 04/23/2021] [Indexed: 01/06/2023] Open
Abstract
Background Increasing use of volunteers in healthcare requires structured collaboration between healthcare services and volunteers. The aim of this research was to explore critical issues and strategies in the implementation process of a digital solution for collaboration with and coordination of volunteers in municipal healthcare services. Methods Qualitative data collection was used to study implementation of a digital system for collaboration with volunteers in three Norwegian municipalities. Three rounds of interviews were conducted with healthcare employees from a volunteer centre and from municipality healthcare units in three municipalities: before implementation, and 6 and 12 months after deployment. Observations of healthcare employees training and use of the system were also done. Results An inductive analysis resulted in eleven themes that were grouped based on the four constructs of the normalisation process theory (NPT), plus two themes that fall outside those constructs. Coherence (understanding of the intervention) was high among the employees prior to the intervention. They expected the system to meet several of their needs and increase efficiency, structure and overview. In addition, they expected the system to benefit recruitment strategies along with their matching processes. Cognitive participation (engagement and commitment towards the intervention): employees from two of the municipalities reported absence of leadership and management guidance during the process, management of expectations and clarification of their roles. In the third, there was high engagement and management involvement in the implementation process. Collective action (whether the intervention is carried out): the employees reported time-consuming preparations. Engagement varied between the municipalities. There was a lack of commitment in two due to ongoing reorganisation, in these, the system was partly or not implemented. The third municipality implemented and fully piloted the system. Reflexive monitoring (appraisal towards the system and its impact on practice): the employees learned throughout testing of the system and realised that there were several benefits that could improve their working routines. Conclusion Crucial aspects for implementation of the digital tool for collaboration with volunteers include having structure “in place”, establishing policies for involving volunteers, defining clear roles and expectations and involving management and key people (“champions”) to drive the implementation. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-021-06429-w.
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Affiliation(s)
- Erica Fredriksen
- Faculty of Health and Sport Sciences, University of Agder, PB 422, 4604, Kristiansand, Norway.
| | - Elin Thygesen
- Faculty of Health and Sport Sciences, University of Agder, PB 422, 4604, Kristiansand, Norway
| | - Carl E Moe
- Faculty of Social Sciences, University of Agder, PB 422, 4604, Kristiansand, Norway
| | - Santiago Martinez
- Faculty of Health and Sport Sciences, University of Agder, PB 422, 4604, Kristiansand, Norway
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Agreli H, Huising R, Peduzzi M. Role reconfiguration: what ethnographic studies tell us about the implications of technological change for work and collaboration in healthcare. BMJ LEADER 2021. [DOI: 10.1136/leader-2020-000224] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
New technologies including digital health and robotics are driving the evolution of healthcare. At the same time, healthcare systems are transitioning from a multiprofessional model approach of healthcare delivery to an interprofessional model. The concurrence of these two trends may represent an opportunity for leaders in healthcare because both require renegotiation of the complex division of work and enhanced interdependency. This review examines how the introduction of new technologies alters the role boundaries of occupations and interdependencies among health occupations. Based on a scoping review of ethnographic studies of technology implementation in a variety of contexts (from primary care to operating room) and of diverse technologies (from health informatics systems to robotics), we develop the concept of role reconfiguration to capture simultaneous adjustments of multiple, interdependent roles during technological change. Ethnographic and qualitative studies provide rich, detailed accounts of what people actually do and how their work and role is changed (or not) when a new technology arrives. Through a synthesis of these studies, we develop a typology of four types of role reconfiguration: negotiation, clarification, enlargement and restriction. We discuss leadership challenges in managing role reconfiguration and formulate four leadership priorities. We suggest that leaders: redesign roles proactively, paying attention to interdependencies; offer opportunities for collective learning about new technologies; ensure that knowledge of new technologies is distributed across roles and prepare to address resistance.
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Sanerma P, Miettinen S, Paavilainen E, Åstedt-Kurki P. A client-centered approach in home care for older persons - an integrative review. Scand J Prim Health Care 2020; 38:369-380. [PMID: 33201752 PMCID: PMC7781976 DOI: 10.1080/02813432.2020.1841517] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE To describe and synthesize client-centered care and service in home care for older persons. METHODS The study was an integrative review using the guidelines for literature reviews by the Joanna Briggs Institute. The research process followed the Whittemore and Knafl framework and PRISMA toolkit in the selection of eligible articles. The CINAHL, Medline, Scopus, Web of Science and Social Sciences abstracts were searched for articles published between January 2007 and May 2020 according to previously designed search strategies. In total, 24 articles were deemed relevant for an analysis using a thematic analysis. RESULTS The analysis resulted in four themes with sub-themes which revealed that client-centered care and service in home care consist of: 1) Clients' involvement in their own care; self-care, decision-making, satisfactory daily life, 2) Family members' and care partners' participation in care; family members' and care partners' commitment to care, family members' and care partners' competence in care, 3) Communication and co-operation; communication models, empowerment, partnership, and 4) Evidence-based service competence; delivery and organization of services, implementation of services, versatile clinical skills, quality outcomes and personnel wellbeing. CONCLUSIONS According to the results, achieving client-centered care and service in home care requires the realization of all of the above aspects. The practice of nursing must better identify all dimensions of client-centered care and take these into account in the delivery of home care services. KEY POINTS Client-centeredness is a fundamental value and the basis of nursing and care in home care provided for older persons This paper: deepens and structures the concept of client-centered care in the context of home care. assists professionals to understand the factors behind client-centered care within the home care environment. provides deeper understanding of the roles of the older person, family members, and the service system in developing client-centered services in home care for older persons.
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Affiliation(s)
- Päivi Sanerma
- Department of Health Sciences, Faculty of Social sciences, University of Tampere, Tampere, Finland
- Hamk Smart Reseach Unit, Hamk University of Applied Sciences, Hämeenlinna, Finland
- CONTACT Päivi Sanerma ; Department of Health Sciences, Faculty of Social Sciences, University of Tampere, 100, Tampere, PL, 33014, Finland; Hamk Smart Reseach Unit, Hamk University of Applied Sciences, 230, Hämeenlinna, PL, 13100, Finland
| | - Sari Miettinen
- Hamk Smart Reseach Unit, Hamk University of Applied Sciences, Hämeenlinna, Finland
- Information Services Unit, Research Unit, The Social Insurance Institution of Finland, Helsinki, Finland
| | - Eija Paavilainen
- Department of Health Sciences, Faculty of Social sciences, University of Tampere, Tampere, Finland
| | - Päivi Åstedt-Kurki
- Department of Health Sciences, Faculty of Social sciences, University of Tampere, Tampere, Finland
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