Exploring the use of assistive products to promote functional independence in self-care activities in the bathroom

The experiences of the elderly regarding the use of rehabilitation assistive technologies: a directed qualitative content analysis

PURPOSE

The elderly population faces reduced levels of health and performance, which necessitates the use of rehabilitation assistive technologies to maximize functional independence in daily activities. This study aimed to explain the experiences of the elderly regarding the use of rehabilitation assistive technologies based on the Unified Theory of Acceptance and Use of Technology.

METHODS

The present study was a qualitative study of the type of content analysis that was conducted in the city of Hamadan in 2022. Participants included 20 elderly aged 60 years or above who were selected as a purposive sample and subjected to individual semi-structured in-depth interviews. Data were analyzed using directed qualitative content analysis based on Hsieh and Shannon's approach. Data were coded using MAXQDA software (MAXQDA Analytics Pro 2020, VERBI GmbH Berlin).

RESULTS

According to the results, 260 primary codes were extracted, and they were classified into five predetermined categories of the Unified Theory of Acceptance and Use of Technology, including performance expectancy, effort expectancy, social influence, facilitating conditions, and behavioral intention, as well as two new categories of technology anxiety and perceived need for technology. After extracting 260 primary codes based on the Unified Theory of Acceptance and Use of Technology, 75 sub-categories were identified in 14 main categories.

CONCLUSION

The themes obtained from the study indicate the necessity of providing the required conditions to maintain the complete independence and health of the elderly and strengthen their morale. The results can be helpful in the development of support strategies for family members, healthcare providers, and policymakers.

Assistive technology needs, access and coverage, and related barriers and facilitators in the WHO European region: a scoping review

PURPOSE

Globally, assistive technology (AT) is used by over 1 billion people, but the prevalence of needs and access to AT in specific countries or regions is largely unknown. This scoping review summarises the evidence available on the prevalence of needs, access and coverage of AT in the World Health Organisation European Region and the barriers and facilitators to its use.

METHODS

Relevant publications were identified using a combination of two strategies: 1) a systematic search for AT publications in five scientific literature databases; and 2) consultations with 76 of the Region's AT experts.

RESULT

The search strategies yielded 103 publications, 62 of them identified by the systematic search. The included publications were predominantly from six countries, and 18 countries were unrepresented. Information on AT use for specific functional impairments was present in 57 publications: AT for hearing impairment in 14 publications; vision in 12; mobility, 12; communication, 11; self-care, 6; and cognition, 2. AT needs for vision and hearing impairment were more likely to be met (1-87% and 5-90%, respectively) compared with communication and cognition impairments (10-60% and 58%, respectively). The barriers and facilitators to AT access described were linked to accessibility, affordability and acceptability.

CONCLUSION

Data on AT prevalence and coverage are limited in both quantity and quality. Agreed-upon definitions of functional impairment and assistive product categories and standards for data collection are needed to facilitate data comparisons and to build a more representative picture of AT needs and coverage.Implications for rehabilitationComprehensive and disaggregated data concerning the prevalence of needs and coverage of AT is needed to enable the development of responsive policies and actions.The literature available on the prevalence of needs and coverage of AT in the WHO European Region is primarily focussed on a small subset of countries and comparisons between studies are limited due to the use of different data collection strategies.Evidence concerning barriers and facilitators to AT access across countries is more consistent and can be organised across the key themes of accessibility, affordability and acceptability of AT.There is a need for consensus among multiple AT actors on standardised definitions for functional impairment and assistive product categories and standards for data collection to enable a more representative picture to be built of AT needs and coverage across the WHO European Region and globally.

Accessible independent housing for people with disabilities: A scoping review of promising practices, policies and interventions

BACKGROUND

Accessible housing is imperative to enabling independent living for many people with disabilities; yet, research consistently shows how people with disabilities often lack appropriate accessible housing and are more likely to experience unaffordable, insecure, and/or poor quality housing. Therefore, the aim of this study was to understand promising practices, policies and interventions regarding accessible independent housing for people with disabilities.

METHODS

We conducted a scoping review that involved searching seven international literature databases that identified 4831 studies, 60 of which met our inclusion criteria.

RESULTS

The reviewed studies involved 18 countries over a 20-year period. Our review highlighted the following key trends: (1) removing barriers to obtaining accessible housing (e.g., advocacy, builders enhancing housing supply, subsidies and financial incentives); (2) policies influencing accessible housing; (3) interventions to enhance accessible housing (i.e., home modifications, smart homes, mobile applications and other experimental devices); and (4) the impact of accessible independent housing on health and wellbeing.

CONCLUSIONS

Our findings emphasize the importance of accessible housing for people with disabilities and the urgent need to advance accessible housing options.

Effects of Bathing Skills Training on Independence and Satisfaction of Older Adults Living in a Nursing Home: A Randomized Controlled Trial

Background

Dependence in bathing is the most common activities of daily living (ADLs) dependency among older adults. The aim of this study was to evaluate the effect of bathing skills training on the independence and satisfaction of older adults living in nursing homes.

Methods

In this randomized controlled trial, 80 participants were assigned randomly to the intervention (n = 40) and control groups (n = 40). The intervention group received 10 weekly bathing skills training sessions, with each session lasting about 60 minutes, while the control group received no direct training. The evaluation was conducted using the Modified Barthel Index (MBI) and the Canadian Occupational Performance Measure (COPM). Analysis of variance for repeated measurements was used to test the effect of intervention at the baseline, post-intervention, and follow-up.

Results

The mean improvement in the MBI was greater for the intervention group (P < 0.001; partial η2 = 0.34), which remained significant at the follow-up (P < 0.001; partial η2 = 0.41). The greater mean change of the COPM-Performance was significant in the intervention group (P < 0.001; partial η2 = 0.17), which remained significant at the follow-up (P < 0.001; partial η2 = 0.19). The greater mean improvement of the COPM-Satisfaction was observed for the intervention group (P < 0.001; partial η2 = 0.36), which remained at the follow-up (P = 0.001; partial η2 = 0.42).

Conclusion

Bathing skills training is effective in improving the ADLs independence and satisfaction in older adults living in nursing homes; thus, it is recommended to be included in the schedules of nursing homes.

Quality of life in adults with Down syndrome: A mixed methods systematic review

BACKGROUND

As the life expectancy of adults (aged ≥ 18 years) with Down syndrome increases for a plethora of reasons including recognition of rights, access, and technological and medical advances, there is a need to collate evidence about their quality of life.

OBJECTIVE

Using Schalock and Verdugo's multidimensional quality of life assessment model, this systematic review aimed to identify, synthesise and integrate the quantitative and qualitative evidence on quality of life in adults with Down syndrome via self-and proxy-reporting.

METHODS

Five databases were systematically searched: MEDLINE, CINAHL, PsycINFO, Scopus, and Web of Science to identify relevant articles published between 1980 and 2022 along with grey literature and reference lists from relevant studies. A mixed methods systematic review was performed according to the Joanna Briggs Institute methodology using the convergent integrated approach. The review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.

RESULTS

Thirty-nine studies were included: 20 quantitative, 17 qualitative, and 2 mixed methods studies. The synthesised findings were grouped into the 8 core domains of quality of life: personal development, self-determination, interpersonal relations, social inclusion, rights, emotional, physical and material well-being. Of the 39 studies, 30 (76.92%) reported on emotional well-being and 10 (25.64%) on rights. Only 7 (17.94%) studies reported that adults with Down syndrome have a good quality of life centred around self-determination and interpersonal relations. Most adults with Down syndrome wanted to become more independent, have relationships, participate in the community, and exercise their human rights. Self-reported quality of life from adults with Down syndrome was rated higher than proxy reported quality of life. Discrepancies in quality of life instruments were discovered.

CONCLUSION

This review highlighted the need for a better systematic approach to improving the quality of life in adults with Down syndrome in targeted areas. Future research is required to evaluate self-and proxy-reporting methods and culture-specific quality of life instruments that are more appropriate for adults with Down syndrome. In addition, further studies should consider including digital assistive technologies to obtain self-reported quality of life data in adults with Down syndrome.

INTERNATIONAL PROSPECTIVE REGISTER OF SYSTEMATIC REVIEWS REGISTRATION NUMBER

CRD42019140056.

Towards safety and autonomy in the home bathroom: Identifying challenges, needs and gaps

This qualitative study aims to identify challenges, needs and gaps for home care bathroom tasks and gather information that will allow for user-centered, sustainable solutions for home care in the bathroom. Twenty-one interviews were carried out with participants with the perspective of client, health care worker or care organization. The data were analyzed using qualitative content analysis and interpretive description. The findings identify important factors for enabling both independent living for clients and a sustainable work environment for the health care workers. They include adequate space, access to assistive devices and regular risk assessments to recognize changing needs. Enabling independent living is one strategy that can be used to manage the ongoing demographic change as well as the expected future labor shortage in the care sector. Changes can be made in the physical environment (the residential bathroom) in order to facilitate safer task performance for both the clients and the health care workers.

Impact of assistive devices use on levels of depression in older adults: Evidence from China

The purpose of this study is to evaluate the effect of assistive devices on the level of depression among older adults. Using data from the 2015 and 2018 waves of China Health and Retirement Longitudinal Studies (CHARLS), we analysed this effect through the PSM-DID model and verified the mechanism of the effect through Hayes' mediating effect model. The results showed that assistive devices increased depression levels in older adults. Moreover, there were significant differences among different groups of older adults. The use of assistive devices in developed areas, women, people under 75 years old, and socially active older people had a deeper impact on the level of depression. Differences in the type and number of assistive devices used also affect the level of depression in older people. Furthermore, assistive devices use in older adults increases depression levels by decreasing health satisfaction. This study provides new evidence to explore the relationship between the use of assistive devices and depression levels in older adults. Meanwhile, our research illustrates the importance of developing products and services with age-friendly technology.

Educational technology for bathing/hygiene of elders at home: contributions to career knowledge

OBJECTIVE

to build and validate an educational booklet for bathing and hygiene of elders at home.

METHODS

a methodological study, developed through data collection in literature and situational diagnosis, booklet construction, material qualification through validation by expert judges (11 nurses) and target audience (30 caregivers). Data were analyzed descriptively. The minimum content validity index of 0.80 was considered.

RESULTS

in content and appearance validation, experts assigned Content Validity Index global of 0.92, while for assessment of the material's suitability, the booklet was classified as "superior", with an average of 90%. In the validation of caregivers, the overall Content Validity Index was 1.0.

CONCLUSION

the booklet was successfully validated and can be considered in the context of health education and collaborate with an adequate and safe practice of bathing and hygiene of elders at home.