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Hickling LM, Allani S, Cella M, Scott W. A systematic review with meta-analyses of the association between stigma and chronic pain outcomes. Pain 2024:00006396-990000000-00605. [PMID: 38776178 DOI: 10.1097/j.pain.0000000000003243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 12/22/2023] [Indexed: 05/24/2024]
Abstract
ABSTRACT Stigma is common in people experiencing chronic pain and there are indications that it may adversely affect pain outcomes. However, to date, there is no systematic review exploring the impact of stigma on chronic pain-related outcomes. This systematic review and meta-analysis aimed to examine the association between stigma and key chronic pain outcomes and differences in stigma between pain conditions. Seven databases were searched for studies reporting a measure of association between stigma and at least one pain outcome in adults with chronic pain. Studies were screened by 2 independent researchers. Nineteen studies met eligibility criteria and data were extracted, quality-assessed, and narratively synthesised and meta-analysed where possible. Meta-analyses of bivariate cross-sectional correlations demonstrated significant positive correlations between stigma and pain intensity, disability, and depression, with small to moderate effects. Data from 2 prospective studies and those only reporting multivariate analyses that were not included in meta-analyses further supported these findings. There was some evidence that individuals who experience pain conditions with less clear pathophysiology may report greater stigma, although more research is needed. The review highlights that there is a growing number of studies on stigma in the pain field showing an adverse association between stigma and chronic pain outcomes.
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Affiliation(s)
- Lauren M Hickling
- King's College London, Department of Psychology, Institute of Psychiatry, Psychology, and Neuroscience, London, United Kingdom
- South London and Maudsley NHS Foundation Trust, London, United Kingdom
| | - Selsebil Allani
- King's College London, Department of Psychology, Institute of Psychiatry, Psychology, and Neuroscience, London, United Kingdom
| | - Matteo Cella
- King's College London, Department of Psychology, Institute of Psychiatry, Psychology, and Neuroscience, London, United Kingdom
- South London and Maudsley NHS Foundation Trust, London, United Kingdom
| | - Whitney Scott
- King's College London, Department of Psychology, Institute of Psychiatry, Psychology, and Neuroscience, London, United Kingdom
- INPUT Pain Management Unit, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom
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Bults M, van Leersum CM, Olthuis TJJ, Siebrand E, Malik Z, Liu L, Miguel-Cruz A, Jukema JS, den Ouden MEM. Acceptance of a Digital Assistant (Anne4Care) for Older Adult Immigrants Living With Dementia: Qualitative Descriptive Study. JMIR Aging 2024; 7:e50219. [PMID: 38639994 PMCID: PMC11069095 DOI: 10.2196/50219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 01/15/2024] [Accepted: 02/21/2024] [Indexed: 04/20/2024] Open
Abstract
BACKGROUND There is a need to develop and coordinate dementia care plans that use assistive technology for vulnerable groups such as immigrant populations. However, immigrant populations are seldom included in various stages of the development and implementation of assistive technology, which does not optimize technology acceptance. OBJECTIVE This study aims to gain an in-depth understanding of the acceptance of a digital personal assistant, called Anne4Care, by older adult immigrants living with dementia in their own homes. METHODS This study used a qualitative descriptive research design with naturalistic inquiry. A total of 13 older adults participated in this study. The participants were invited for 2 interviews. After an introduction of Anne4Care, the first interview examined the lives and needs of participants, their expectations, and previous experiences with assistive technology in daily life. Four months later, the second interview sought to understand facilitators and barriers, suggestions for modifications, and the role of health care professionals. Three semistructured interviews were conducted with health care professionals to examine the roles and challenges they experienced in the use and implementation of Anne4Care. Content analysis, using NVivo11, was performed on all transcripts. RESULTS All 13 participants had an immigration background. There were 10 male and 3 female participants, with ages ranging from 52 to 83 years. Participants were diagnosed with an early-stage form of dementia or acquired brain injury. None of the older adult participants knew or used digital assistive technology at the beginning. They obtained assistance from health care professionals and family caregivers who explained and set up the technology. Four themes were found to be critical aspects of the acceptance of the digital personal assistant Anne4Care: (1) use of Anne4Care, (2) positive aspects of Anne4Care, (3) challenges with Anne4Care, and (4) expectations. Assistance at first increased the burden on health care professionals and families. After the initial effort, most health care professionals and families experienced that Anne4Care reduced their tasks and stress. Contributions of Anne4Care included companionship, help with daily tasks, and opportunities to communicate in multiple languages. On the other hand, some participants expressed anxiety toward the use of Anne4Care. Furthermore, the platform required an internet connection at home and Anne4Care could not be used outside the home. CONCLUSIONS Although older adult immigrants living with dementia had no previous experience with digital assistive technology specifically, the acceptance of the digital personal assistant, called Anne4Care, by older adult immigrants living with dementia was rather high. The digital assistant can be further developed to allow for interactive conversations and for use outside of one's home. Participation of end users during various stages of the development, refinement, and implementation of health technology innovations is of utmost importance to maximize technology acceptance.
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Affiliation(s)
- Marloes Bults
- Technology, Health & Care Research Group, Saxion University of Applied Sciences, Enschede, Netherlands
| | - Catharina Margaretha van Leersum
- Department of Technology, Policy, and Society, Faculty of Behavioural, Management and Social Sciences, University of Twente, Enschede, Netherlands
- Faculty of Humanities, Open University, Heerlen, Netherlands
| | | | - Egbert Siebrand
- Research Group Ethics and Technology, Saxion University of Applied Sciences, Enschede, Netherlands
| | - Zohrah Malik
- Technology, Health & Care Research Group, Saxion University of Applied Sciences, Enschede, Netherlands
| | - Lili Liu
- School of Public Health Sciences, Faculty of Health, University of Waterloo, Waterloo, ON, Canada
| | - Antonio Miguel-Cruz
- School of Public Health Sciences, Faculty of Health, University of Waterloo, Waterloo, ON, Canada
- Department of Occupational Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada
- GRRIT Hub Glenrose Rehabilitation Research, Innovation & Technology, Glenrose Rehabilitation Hospital, Edmonton, AB, Canada
| | - Jan Seerp Jukema
- Smart Health Research Group, Saxion University of Applied Sciences, Enschede, Netherlands
| | - Marjolein Elisabeth Maria den Ouden
- Technology, Health & Care Research Group, Saxion University of Applied Sciences, Enschede, Netherlands
- Care & Technology Research Group, Regional Community College of Twente, Hengelo, Netherlands
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Daniels K, Bonnechère B. Harnessing digital health interventions to bridge the gap in prevention for older adults. Front Public Health 2024; 11:1281923. [PMID: 38259780 PMCID: PMC10800474 DOI: 10.3389/fpubh.2023.1281923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 12/18/2023] [Indexed: 01/24/2024] Open
Affiliation(s)
- Kim Daniels
- Department of PXL – Healthcare, PXL University of Applied Sciences and Arts, Hasselt, Belgium
- REVAL Rehabilitation Research Center, Faculty of Rehabilitation Center, Hasselt University, Diepenbeek, Belgium
| | - Bruno Bonnechère
- Department of PXL – Healthcare, PXL University of Applied Sciences and Arts, Hasselt, Belgium
- REVAL Rehabilitation Research Center, Faculty of Rehabilitation Center, Hasselt University, Diepenbeek, Belgium
- Technology-Supported and Data-Driven Rehabilitation, Data Science Institute, Hasselt University, Diepenbeek, Belgium
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Eost-Telling C, Yang Y, Norman G, Hall A, Hanratty B, Knapp M, Robinson L, Todd C. Digital technologies to prevent falls in people living with dementia or mild cognitive impairment: a rapid systematic overview of systematic reviews. Age Ageing 2024; 53:afad238. [PMID: 38219225 PMCID: PMC10788098 DOI: 10.1093/ageing/afad238] [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: 06/14/2023] [Revised: 09/27/2023] [Indexed: 01/16/2024] Open
Abstract
OBJECTIVE Falls are a common cause of potentially preventable death, disability and loss of independence with an annual estimated cost of £4.4bn. People living with dementia (PlwD) or mild cognitive impairment (MCI) have an increased fall risk. This overview evaluates evidence for technologies aiming to reduce falls and fall risk for PlwD or MCI. METHODS In October 2022, we searched five databases for evidence syntheses. We used standard methods to rapidly screen, extract data, assess risk of bias and overlap, and synthesise the evidence for each technology type. RESULTS We included seven systematic reviews, incorporating 22 relevant primary studies with 1,412 unique participants. All reviews had critical flaws on AMSTAR-2: constituent primary studies were small, heterogeneous, mostly non-randomised and assessed as low or moderate quality. Technologies assessed were: wearable sensors, environmental sensor-based systems, exergaming, virtual reality systems. We found no evidence relating to apps. Review evidence for the direct impact on falls was available only from environmental sensors, and this was inconclusive. For wearables and virtual reality technologies there was evidence that technologies may differentiate PlwD who fell from those who did not; and for exergaming that balance may be improved. CONCLUSIONS The evidence for technology to reduce falls and falls risk for PlwD and MCI is methodologically weak, based on small numbers of participants and often indirect. There is a need for higher-quality RCTs to provide robust evidence for effectiveness of fall prevention technologies. Such technologies should be designed with input from users and consideration of the wider implementation context.
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Affiliation(s)
- Charlotte Eost-Telling
- National Institute for Health and Care Research (NIHR) Older People and Frailty Policy Research Unit, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester M13 9PL, UK
- Division of Nursing, Midwifery and Social Work, School of Health Sciences, The University of Manchester, Manchester M13 9PT, UK
- National Institute for Health and Care Research (NIHR) Applied Research Collaboration Greater Manchester, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester M13 9PL, UK
| | - Yang Yang
- National Institute for Health and Care Research (NIHR) Older People and Frailty Policy Research Unit, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester M13 9PL, UK
- Division of Nursing, Midwifery and Social Work, School of Health Sciences, The University of Manchester, Manchester M13 9PT, UK
| | - Gill Norman
- Division of Nursing, Midwifery and Social Work, School of Health Sciences, The University of Manchester, Manchester M13 9PT, UK
- National Institute for Health and Care Research (NIHR) Applied Research Collaboration Greater Manchester, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester M13 9PL, UK
| | - Alex Hall
- National Institute for Health and Care Research (NIHR) Older People and Frailty Policy Research Unit, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester M13 9PL, UK
- Division of Nursing, Midwifery and Social Work, School of Health Sciences, The University of Manchester, Manchester M13 9PT, UK
| | - Barbara Hanratty
- National Institute for Health and Care Research (NIHR) Older People and Frailty Policy Research Unit, Population Health Sciences Institute, Newcastle University, Newcastle-upon-Tyne NE4 5PL, UK
| | - Martin Knapp
- National Institute for Health and Care Research (NIHR) Older People and Frailty Policy Research Unit, Care Policy and Evaluation Centre, London School of Economics and Political Science, London WC2A 2AE, UK
| | - Louise Robinson
- National Institute for Health and Care Research (NIHR) Older People and Frailty Policy Research Unit, Population Health Sciences Institute, Newcastle University, Newcastle-upon-Tyne NE4 5PL, UK
| | - Chris Todd
- National Institute for Health and Care Research (NIHR) Older People and Frailty Policy Research Unit, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester M13 9PL, UK
- Division of Nursing, Midwifery and Social Work, School of Health Sciences, The University of Manchester, Manchester M13 9PT, UK
- National Institute for Health and Care Research (NIHR) Applied Research Collaboration Greater Manchester, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester M13 9PL, UK
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Brem AK, Kuruppu S, de Boer C, Muurling M, Diaz-Ponce A, Gove D, Curcic J, Pilotto A, Ng WF, Cummins N, Malzbender K, Nies VJM, Erdemli G, Graeber J, Narayan VA, Rochester L, Maetzler W, Aarsland D. Digital endpoints in clinical trials of Alzheimer's disease and other neurodegenerative diseases: challenges and opportunities. Front Neurol 2023; 14:1210974. [PMID: 37435159 PMCID: PMC10332162 DOI: 10.3389/fneur.2023.1210974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Accepted: 05/26/2023] [Indexed: 07/13/2023] Open
Abstract
Alzheimer's disease (AD) and other neurodegenerative diseases such as Parkinson's disease (PD) and Huntington's disease (HD) are associated with progressive cognitive, motor, affective and consequently functional decline considerably affecting Activities of Daily Living (ADL) and quality of life. Standard assessments, such as questionnaires and interviews, cognitive testing, and mobility assessments, lack sensitivity, especially in early stages of neurodegenerative diseases and in the disease progression, and have therefore a limited utility as outcome measurements in clinical trials. Major advances in the last decade in digital technologies have opened a window of opportunity to introduce digital endpoints into clinical trials that can reform the assessment and tracking of neurodegenerative symptoms. The Innovative Health Initiative (IMI)-funded projects RADAR-AD (Remote assessment of disease and relapse-Alzheimer's disease), IDEA-FAST (Identifying digital endpoints to assess fatigue, sleep and ADL in neurodegenerative disorders and immune-mediated inflammatory diseases) and Mobilise-D (Connecting digital mobility assessment to clinical outcomes for regulatory and clinical endorsement) aim to identify digital endpoints relevant for neurodegenerative diseases that provide reliable, objective, and sensitive evaluation of disability and health-related quality of life. In this article, we will draw from the findings and experiences of the different IMI projects in discussing (1) the value of remote technologies to assess neurodegenerative diseases; (2) feasibility, acceptability and usability of digital assessments; (3) challenges related to the use of digital tools; (4) public involvement and the implementation of patient advisory boards; (5) regulatory learnings; and (6) the significance of inter-project exchange and data- and algorithm-sharing.
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Affiliation(s)
- Anna-Katharine Brem
- Department of Old Age Psychiatry, King’s College London, Institute of Psychiatry, Psychology and Neuroscience, London, United Kingdom
- University Hospital of Old Age Psychiatry, University of Bern, Bern, Switzerland
| | - Sajini Kuruppu
- Department of Old Age Psychiatry, King’s College London, Institute of Psychiatry, Psychology and Neuroscience, London, United Kingdom
| | - Casper de Boer
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC Location VUmc, Amsterdam, Netherlands
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, Netherlands
| | - Marijn Muurling
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC Location VUmc, Amsterdam, Netherlands
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, Netherlands
| | | | | | - Jelena Curcic
- Novartis Institutes for Biomedical Research (NIBR), Basel, Switzerland
| | - Andrea Pilotto
- Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
- Laboratory of Digital Neurology and Biosensors, University of Brescia, Brescia, Italy
- Neurology Unit, Department of Continuity of Care and Frailty, ASST Spedali Civili Brescia Hospital, Brescia, Italy
| | - Wan-Fai Ng
- Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
- NIHR Newcastle Biomedical Research Centre and Clinical Research Facility, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
| | - Nicholas Cummins
- Department of Biostats and Health Informatics, King’s College London, Institute of Psychiatry, Psychology and Neuroscience, London, United Kingdom
| | | | | | - Gul Erdemli
- Novartis Pharmaceuticals Corporations, Cambridge, MA, United States
| | - Johanna Graeber
- Institute of General Practice, University Medical Center Schleswig-Holstein, Kiel University, Kiel, Germany
| | | | - Lynn Rochester
- Faculty of Medical Sciences, Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
- National Institute for Health and Care Research (NIHR) Newcastle Biomedical Research Centre (BRC), Newcastle University and The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
| | - Walter Maetzler
- Department of Neurology, University Hospital Schleswig-Holstein and Kiel University, Kiel, Germany
| | - Dag Aarsland
- Department of Old Age Psychiatry, King’s College London, Institute of Psychiatry, Psychology and Neuroscience, London, United Kingdom
- Centre for Age-Related Medicine, Stavanger University Hospital, Stavanger, Norway
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Ten Years of TeleHealth and Digital Healthcare: Where Are We? Healthcare (Basel) 2023; 11:healthcare11060875. [PMID: 36981532 PMCID: PMC10048333 DOI: 10.3390/healthcare11060875] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 03/14/2023] [Accepted: 03/15/2023] [Indexed: 03/19/2023] Open
Abstract
Due to the development of the technological innovation of devices, availability of increasingly performing networks, improvement of the digitization processes, and the push to greater diffusion determined by the COVID-19 pandemic, Digital Healthcare (DH), also referred to as Digital Health [...]
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Impact of COVID-19 Pandemic on Rate of Cognitive Impairment Screening Among the Elderly by Activity of Daily Living in Indochina: A Preliminary Report. Dement Neurocogn Disord 2023; 22:43-45. [PMID: 36814703 PMCID: PMC9939573 DOI: 10.12779/dnd.2023.22.1.43] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 01/26/2023] [Accepted: 01/26/2023] [Indexed: 02/17/2023] Open
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