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Bikova M, Ambugo EA, Tjerbo T, Jalovcic D, Førland O. Does assistive technology contribute to safety among home-dwelling older adults? BMC Health Serv Res 2024; 24:750. [PMID: 38898457 PMCID: PMC11188293 DOI: 10.1186/s12913-024-11185-8] [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: 04/03/2024] [Accepted: 06/07/2024] [Indexed: 06/21/2024] Open
Abstract
BACKGROUND Assistive technology carries the promise of alleviating public expenditure on long-term care, while at the same time enabling older adults to live more safely at home for as long as possible. Home-dwelling older people receiving reablement and dementia care at their homes are two important target groups for assistive technology. However, the need for help, the type of help and the progression of their needs differ. These two groups are seldom compared even though they are two large groups of service users in Norway and their care needs constitute considerable costs to Norwegian municipalities. The study explores how assistive technology impacts the feeling of safety among these two groups and their family caregivers. METHODS Face-to-face, semi-structured interviews lasting between 17 and 61 min were conducted between November 2018 and August 2019 with home-dwelling older adults receiving reablement (N = 15) and dementia care (N = 10) and the family caregivers (N = 9) of these users in seven municipalities in Norway. All interviews were audio-recorded, fully transcribed, thematically coded and inductively analyzed following Clarke and Braun's principles for thematic analysis. RESULTS Service users in both groups felt safe when knowing how to use assistive technology. However, the knowledge of how to use assistive technology was not enough to create a feeling of safety. In fact, for some users, this knowledge was a source of anxiety or frustration, especially when the user had experienced the limitations of the technology. For the service users with dementia, assistive technology was experienced as disturbing when they were unable to understand how to handle it, but at the same time, it also enabled some of them to continue living at home. For reablement users, overreliance on technology could undermine the progress of their functional improvement and thus their independence. CONCLUSION For users in both service groups, assistive technology may promote a sense of safety but has also disadvantages. However, technology alone does not seem to create a sense of safety. Rather, it is the appropriate use of assistive technology within the context of interactions between service users, their family caregivers and the healthcare staff that contributes to the feeling of safety.
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Affiliation(s)
- Mariya Bikova
- Department of Health and Functioning, Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Bergen, Norway.
| | - Eliva Atieno Ambugo
- Department of Health, Social and Welfare Studies, University of South-Eastern Norway, Vestfold, Norway
| | - Trond Tjerbo
- Department of Health Management and Health Economics, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Djenana Jalovcic
- Department of Health and Functioning, Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Bergen, Norway
| | - Oddvar Førland
- Centre for Care Research, Western Norway University of Applied Sciences, Bergen, Norway
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Chang F, Östlund B, Kuoppamäki S. Domesticating Social Alarm Systems in Nursing Homes: Qualitative Study of Differences in the Perspectives of Assistant Nurses. J Med Internet Res 2023; 25:e44692. [PMID: 37145835 DOI: 10.2196/44692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 02/07/2023] [Accepted: 03/12/2023] [Indexed: 05/06/2023] Open
Abstract
BACKGROUND New social alarm solutions are viewed as a promising approach to alleviate the global challenge of an aging population and a shortage of care staff. However, the uptake of social alarm systems in nursing homes has proven both complex and difficult. Current studies have recognized the benefits of involving actors such as assistant nurses in advancing these implementations, but the dynamics by which implementations are created and shaped in their daily practices and relations have received less attention. OBJECTIVE Based on domestication theory, this paper aims to identify the differences in the perspectives of assistant nurses when integrating a social alarm system into daily practices. METHODS We interviewed assistant nurses (n=23) working in nursing homes to understand their perceptions and practices during the uptake of social alarm systems. RESULTS During the four domestication phases, assistant nurses were facing different challenges including (1) system conceptualization; (2) spatial employment of social alarm devices; (3) treatment of unexpected issues; and (4) evaluation of inconsistent competence in technology use. Our findings elaborate on how assistant nurses have distinct goals, focus on different facets, and developed diverse coping strategies to facilitate the system domestication in different phases. CONCLUSIONS Our findings reveal a divide among assistant nurses in terms of domesticating social alarm systems and stress the potential of learning from each other to facilitate the whole process. Further studies could focus on the role of collective practices during different domestication phases to enhance the understanding of technology implementation in the contexts of complex interactions within a group.
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Affiliation(s)
- Fangyuan Chang
- Department of Biomedical Engineering and Health Systems, KTH Royal Institute of Technology, Stockholm, Sweden
- Department of Design, Shanghai Jiao Tong University, Shanghai, China
| | - Britt Östlund
- Department of Biomedical Engineering and Health Systems, KTH Royal Institute of Technology, Stockholm, Sweden
| | - Sanna Kuoppamäki
- Department of Biomedical Engineering and Health Systems, KTH Royal Institute of Technology, Stockholm, Sweden
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Nord MI. Thinking like a bricoleur: New forms of rigor in research on information experience. LIBRARY & INFORMATION SCIENCE RESEARCH 2022. [DOI: 10.1016/j.lisr.2022.101197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Trento M, Franceschini M, Fornengo P, Tricarico L, Mazzeo A, Bertello S, Clerico A, Oleandri S, Chiesa M, Di Leva A, Charrier L, Cavallo F, Porta M. Ambient intelligence for long-term diabetes care (AmILCare). Qualitative analysis of patients' expectations and attitudes toward interactive technology. Endocrine 2021; 73:472-475. [PMID: 33768444 PMCID: PMC7993083 DOI: 10.1007/s12020-021-02694-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 03/11/2021] [Indexed: 11/24/2022]
Affiliation(s)
- Marina Trento
- Laboratory of Clinical Pedagogy, Department of Medical Sciences, University of Turin, Turin, Italy.
| | - Marta Franceschini
- Laboratory of Clinical Pedagogy, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Paolo Fornengo
- Laboratory of Clinical Pedagogy, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Lucia Tricarico
- Laboratory of Clinical Pedagogy, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Aurora Mazzeo
- Laboratory of Clinical Pedagogy, Department of Medical Sciences, University of Turin, Turin, Italy
| | | | | | | | - Mario Chiesa
- Links Foundation, Polytechnic University of Turin, Turin, Italy
| | - Anna Di Leva
- Laboratory of Clinical Pedagogy, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Lorena Charrier
- Department of Public Health and Paediatric Sciences, University of Turin, Turin, Italy
| | - Franco Cavallo
- Department of Public Health and Paediatric Sciences, University of Turin, Turin, Italy
| | - Massimo Porta
- Laboratory of Clinical Pedagogy, Department of Medical Sciences, University of Turin, Turin, Italy
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Thilo FJ, Hahn S, Halfens RJ, Heckemann B, Schols JM. Facilitating the use of personal safety alerting device with older adults: The views, experiences and roles of relatives and health care professionals. Geriatr Nurs 2021; 42:935-942. [PMID: 34130125 DOI: 10.1016/j.gerinurse.2021.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 05/21/2021] [Accepted: 05/24/2021] [Indexed: 11/24/2022]
Abstract
To explore relatives', community nurses' and general practitioners' perspectives and experiences in promoting Personal Safety Alerting Device (PSAD) use among community-dwelling older adults, we applied a qualitative study design. Altogether 15 focus groups and 11 semi-structured interviews were conducted. Data-analysis followed the Qualitative Analysis Guide of Leuven. PSAD use was considered to be complex. Relatives and health care professionals are involved in a negotiation process comprising three phases: A) waiting for a critical event in the older adult's everyday life; B) introducing the idea of a PSAD; C) deciding on and supporting PSAD use. In conclusion, the actors involved in PSAD use should be aware of the negotiation process, which is complex, dynamic, iterative and needs time. While nurses play a crucial role, they lack sufficient knowledge for comprehensive PSAD counselling. The negotiation process could serve as an example for other technologies in the context of aging in place.
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Affiliation(s)
- Friederike Js Thilo
- Applied Research & Development in Nursing, Department of Health Professions, Bern University of Applied Sciences, Bern, Switzerland; School CAPHRI, Department of Health Services Research, Maastricht University, Maastricht, The Netherlands.
| | - Sabine Hahn
- Applied Research & Development in Nursing, Department of Health Professions, Bern University of Applied Sciences, Bern, Switzerland.
| | - Ruud Jg Halfens
- School CAPHRI, Department of Health Services Research, Maastricht University, Maastricht, The Netherlands
| | - Birgit Heckemann
- Applied Research & Development in Nursing, Department of Health Professions, Bern University of Applied Sciences, Bern, Switzerland; Institute of Health and Care Sciences, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden; Department of Anaesthesiology, Surgery and Intensive Care, Sahlgrenska University Hospital, Gothenburg, Sweden.
| | - Jos Mga Schols
- School CAPHRI, Department of Health Services Research, Maastricht University, Maastricht, The Netherlands; School CAPHRI, Department of Family Medicine, Maastricht University, Maastricht, The Netherlands.
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Stokke R, Melby L, Isaksen J, Obstfelder A, Andreassen H. A qualitative study of what care workers do to provide patient safety at home through telecare. BMC Health Serv Res 2021; 21:553. [PMID: 34090450 PMCID: PMC8180066 DOI: 10.1186/s12913-021-06556-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Accepted: 05/17/2021] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND In health care, the work of keeping the patient safe and reducing the risk of harm is defined as safety work. In our digitised and technology-rich era, safety work usually involves a relationship between people and technologies. Telecare is one of the fastest-growing technology-domains in western health care systems. In the marketing of telecare, the expectation is that safety is implicit simply by the presence of technology in patients' homes. Whilst both researchers and health authorities are concerned with developing cost-benefit analyses and measuring effects, there is a lack of attention to the daily work needed to ensure that technologies contribute to patient safety. This paper aims to describe how patient safety in home care is addressed through and with telecare. We base our exploration on the social alarm, an established technology that care workers are expected to handle as an integrated part of their ordinary work. METHODS The study has a qualitative explorative design where we draw on empirical data from three case studies, involving five Norwegian municipalities that use social alarm systems in home care services. We analyse observations of practice and interviews with the actors involved, following King's outline of template analysis. RESULTS We identified three co-existing work processes that contributed to patient safety: "Aligning people and technologies"; "Being alert and staying calm"; and "Coordinating activities based on people and technology". Attention to these work processes exposes safety practices, and how safety is constructed in relational practices involving multiple people and technologies. CONCLUSIONS We conclude that the three work processes identified are essential if the safety alarm is to function for the end user's safety. The safety of home-dwelling patients is reliant on the person-technology interface. The efforts of care workers and their interface with technology are a central feature of creating safety in a patient's home, and in doing so, they utilise a repertoire of skills and knowledge.
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Affiliation(s)
- Randi Stokke
- Centre for Care Research, NTNU Norwegian University of Science and Technology, P.O. Box 191, 2802, Gjøvik, Norway.
| | - Line Melby
- Centre for Care Research, NTNU Norwegian University of Science and Technology, P.O. Box 191, 2802, Gjøvik, Norway
| | - Jørn Isaksen
- Faculty of Social and Health Sciences, Inland Norway University of Applied Sciences, Gudbrandsdalsvegen 350, 2624, Lillehammer, Norway
| | - Aud Obstfelder
- Centre for Care Research, NTNU Norwegian University of Science and Technology, P.O. Box 191, 2802, Gjøvik, Norway
| | - Hege Andreassen
- Centre for Care Research, NTNU Norwegian University of Science and Technology, P.O. Box 191, 2802, Gjøvik, Norway
- Centre for Women and Gender Research, UiT, The Arctic University of Norway, P.O Box 6050 Langnes, 9037, Tromsø, Norway
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Glomsås HS, Knutsen IR, Fossum M, Halvorsen K. 'They just came with the medication dispenser'- a qualitative study of elderly service users' involvement and welfare technology in public home care services. BMC Health Serv Res 2021; 21:245. [PMID: 33740974 PMCID: PMC7977566 DOI: 10.1186/s12913-021-06243-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Accepted: 03/04/2021] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Public home care for the elderly is a key area in relation to improving health care quality. It is an important political goal to increase elderly people's involvement in their care and in the use of welfare technology. The aim of this study was to explore elderly service users' experience of user involvement in the implementation and everyday use of welfare technology in public home care services. METHOD This qualitative study has an explorative and descriptive design. Sixteen interviews of service users were conducted in five different municipalities over a period of six months. The data were analysed using reflexive thematic analysis. RESULTS Service users receiving public home care service are not a homogenous group, and the participants had different wishes and needs as regards user involvement and the use of welfare technology. The analysis led to four main themes: 1) diverse preferences as regards user involvement, 2) individual differences as regards information, knowledge and training, 3) feeling safe and getting help, and 4) a wish to stay at home for as long as possible. CONCLUSION The results indicated that user involvement was only to a limited extent an integral part of public home care services. Participants had varying insight into and interest in welfare technology, which was a challenge for user involvement. User involvement must be facilitated and implemented in a gentle way, highlighting autonomy and collaboration, and with the focus on respect, reciprocity and dialogue.
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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, Department of Health and Nursing Science, University of Agder, Postboks 509, N-4898, Grimstad, Norway
| | - 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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Baudin K, Gustafsson C, Frennert S. Views of Swedish Elder Care Personnel on Ongoing Digital Transformation: Cross-Sectional Study. J Med Internet Res 2020; 22:e15450. [PMID: 32543444 PMCID: PMC7327600 DOI: 10.2196/15450] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2019] [Revised: 02/18/2020] [Accepted: 03/29/2020] [Indexed: 11/30/2022] Open
Abstract
Background Swedish municipalities are facing demographic challenges due to the growing number of older people and the resulting increased need for health care services. Welfare technologies are being launched as possible solutions for meeting some of these challenges. Objective The aim of this study was to explore the perception, experimentation, evaluation, and procurement of welfare technology practices among professionals working in municipal elder care in relation to their gender, age, and profession. Methods Data for this explorative cross-sectional study were collected from 393 responses to a web-based survey on municipal elder care in Sweden. Chi square tests were performed to determine the associations. Results The results revealed gender, age, and professional differences in perspectives of municipal elder care workers. Differences were particularly evident in attitudes toward technology, both the use of technology in general and in the workplace, and involvement and participation in decision making regarding the procurement of new welfare technologies. Men (37/53, 70%) expressed a more positive attitude toward and curiosity regarding new technologies than women (157/336, 46.7%) (P=.03). Regarding age, the younger respondents (18-24 years old) perceived the digital transformation in the workplace as “too slow” (4/4, 100%), whereas the majority of older respondents (65-74 years old) perceived it as happening at the “right pace” (4/7, 57%). The elder care personnel felt encouraged by management to explore and experiment with new welfare technologies, but never did so either for management or with patients. Even though the majority of the respondents were women, more men (4/7, 57%) were involved in the procurement process for welfare technology devices and solutions than women (98/336, 29.2%) (P<.001). Conclusions Personnel working within municipal elder care were generally very positive toward new technologies. However, both gender and age differences may influence these perspectives such as the personnel’s resistance to welfare technology and patients’ participation in welfare technology usage and deployment. Different levels of participation in the decision-making process regarding new technology deployment may negatively affect the overall digital transformation within municipal elder care.
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Affiliation(s)
- Katarina Baudin
- School of Health, Care and Social Welfare, Mälardalen University, Eskilstuna, Sweden
| | - Christine Gustafsson
- School of Health, Care and Social Welfare, Mälardalen University, Eskilstuna, Sweden
| | - Susanne Frennert
- Internet of Things and People Research Center, Department of Computer Science and Media Technology, Malmö University, Malmö, Sweden
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Stokke R, Hellesø R, Sogstad M. Hvorfor er det så vanskelig å integrere velferdsteknologii omsorgstjenesten? TIDSSKRIFT FOR OMSORGSFORSKNING 2019. [DOI: 10.18261/issn.2387-5984-2019-03-02] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Affiliation(s)
| | - Ragnhild Hellesø
- Senter for omsorgsforskning, øst, NTNU i Gjøvik
- Avdeling for sykepleievitenskap, Institutt for helse og samfunn, Universitetet i Oslo
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