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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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Tian YJA, Felber NA, Pageau F, Schwab DR, Wangmo T. Benefits and barriers associated with the use of smart home health technologies in the care of older persons: a systematic review. BMC Geriatr 2024; 24:152. [PMID: 38355464 PMCID: PMC10865618 DOI: 10.1186/s12877-024-04702-1] [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: 11/05/2022] [Accepted: 01/11/2024] [Indexed: 02/16/2024] Open
Abstract
BACKGROUND Smart home health technologies (SHHTs) have been discussed in the frame of caregiving to enable aging-in-place and independence. A systematic review was conducted in accordance with the PRISMA guidelines to gather the up-to-date knowledge on the benefits and barriers of using SHHTs in the care of older persons from the perspective of older persons and their caregivers. METHODS Ten electronic databases were reviewed for empirical peer-reviewed literature published from 01.01.2000 to 31.12.2021 in English, German, and French reporting on experimental, qualitative, quantitative, and other empirical study designs were included. Included studies contained user-feedback from older persons over 65 years of age or their caregivers (formal and informal). We used an extraction document to collect relevant data from all included studies and applied narrative synthesis to analyze data related to benefits and barriers of SHHTs. RESULTS 163 empirical peer-reviewed articles were included, the majority of those published between 2014 and 2021. Five first-order categories of benefits and five of barriers were found with individual sub-themes. SHHTs could be useful in the care context where continuous monitoring is needed. They improve self-management and independent living of older persons. Barriers currently exist with respect to ease of usability, social acceptance, and cost. CONCLUSIONS SHHTs could be useful in the care context but are not without concerns. Researchers and policy makers can use the information as a starting point to better understand how the roles and outcomes of SHHTs could be improved for the care of older persons, while caregivers of older adults could use our findings to comprehend the scope of SHHTs and to decide when and where such technology could best address their individual family needs. Limitations lie in the possible exclusion of relevant articles published outside the inclusion criteria as well as the fact that due to digital divide, our review represents opinions of those who could and wanted to participate in the included 163 studies. TRIAL REGISTRATION This review has been registered as PROSPERO CRD42021248543. A protocol was completed in March 2021 with the PRISMA-P guidance. We have extended the review period from 2000 to 2020 since the registration of the protocol to 2000-2021.
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Affiliation(s)
| | | | - Félix Pageau
- Centre d'excellence sur le vieillissement de Québec, VITAM- Research Center on Sustainable Health, Laval University, Quebec City, QC, Canada
- Division of Geriatrics, Department of Medicine, Laval University, Quebec City, QC, Canada
| | - Delphine Roulet Schwab
- School of nursing sciences, La Source, HES-SO University of Applied Sciences and Arts of Western Switzerland, Lausanne, Switzerland
| | - Tenzin Wangmo
- Institute for Biomedical Ethics, University of Basel, Basel, 4056, Switzerland
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Dicianno BE, Salh A, Morris L, Xiang Y, Ding D. Rehabilitation clinicians' use of mainstream wireless technologies in practice: a scoping review. Disabil Rehabil Assist Technol 2024:1-19. [PMID: 38349177 PMCID: PMC11323212 DOI: 10.1080/17483107.2024.2316891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 02/06/2024] [Indexed: 08/16/2024]
Abstract
PURPOSE This scoping review was conducted to understand the barriers, facilitators, and education and training needs of rehabilitation clinicians in their use of mainstream wireless technologies (MWT) to support people with disabilities and older adults. It was also conducted to understand the functional skills of clients that were targeted with MWT use. MATERIALS AND METHODS This scoping review was reported using PRISMA-ScR (Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews) and the Population (or Participants)/Concept/Context) framework. We searched PubMed; ProQuest to access APA PsycINFO; Web of Science Core Collection; and EBSCOhost to access Cumulated Index to Nursing and Allied Health Literature (CINAHL), Ovid MEDLINE ALL, and Education Resources Information Center (ERIC). Articles published between 2015-2022 were retrieved. RESULTS A total of 90 articles were included. Most interventions were apps, smartphones, and tablets; were geared toward adults; and targeted motor, cognitive and speech skills. An infographic on barriers and facilitators was generated as a decision support tool for clinicians when implementing MWT. The topic, format, timing, and source of information clinicians need are also delineated. CONCLUSION MWT such as apps, smartphones and tablets are being used by rehabilitation clinicians to address motor, cognitive, and speech skills, most commonly in adults. Clinicians voice a need for more education and training. Barriers and facilitators exist at the clinician-, technology-, client-, institution-, and policy levels.Implications For RehabilitationA total of 90 articles from 2015-2022 were included in this scoping reviewMost interventions were apps, smartphones, and tablets; were geared toward adults; and targeted motor, cognitive and speech skills.An infographic was generated as a decision support tool for clinicians when implementing mainstream wireless technologies in clinical practice.Clinicians' education and training needs with regard to mainstream wireless technologies are broad. Materials on a variety of topics, in different formats, from multiple sources are needed.This review also discusses implications of findings on policy, technology development, and future research.
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Affiliation(s)
- Brad E. Dicianno
- Department of Physical Medicine and Rehabilitation, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
- Human Engineering Research Laboratories, VA Pittsburgh Healthcare System, Pittsburgh, PA, USA
- Department of Rehabilitation Science and Technology, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA, USA
| | - Angad Salh
- College of Osteopathic Medicine, KS City University, Kansas City, MO, USA
| | - Lindsey Morris
- Human Engineering Research Laboratories, VA Pittsburgh Healthcare System, Pittsburgh, PA, USA
- Department of Rehabilitation Science and Technology, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA, USA
| | - Yifan Xiang
- Department of Rehabilitation Science and Technology, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA, USA
| | - Dan Ding
- Human Engineering Research Laboratories, VA Pittsburgh Healthcare System, Pittsburgh, PA, USA
- Department of Rehabilitation Science and Technology, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA, USA
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Tian YJ(A, Jotterand F, Wangmo T. Remote Technologies and Filial Obligations at a Distance: New Opportunities and Ethical Challenges. Asian Bioeth Rev 2023; 15:479-504. [PMID: 37808448 PMCID: PMC10555987 DOI: 10.1007/s41649-023-00256-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 08/02/2023] [Accepted: 08/07/2023] [Indexed: 10/10/2023] Open
Abstract
The coupled growth of population aging and international migration warrants attention on the methods and solutions available to adult children living overseas to provide distance caregiving for their aging parents. Despite living apart from their parents, the transnational informal care literature has indicated that first-generation immigrants remain committed to carry out their filial caregiving obligations in extensive and creative ways. With functions to remotely access health information enabled by emergency, wearable, motion, and video sensors, remote monitoring technologies (RMTs) may thus also allow these international migrants to be alerted in sudden changes and remain informed of their parent's state of health. As technological solutions for caregiving, RMTs could allow independent living for older persons while any unusual deviations from normal health patterns are detected and appropriately supported. With a vignette of a distance care arrangement, we engage with concepts such as filial piety, in-absentia caregiving distress, and the social exchange theory, as well as the upholding of shifting cultural ideals to illustrate the complex dynamic of the satisfaction and quality of the informal caregiving relationship. This paper extends the traditional ethical issues in technology-aided caregiving, such as autonomy, privacy, and justice, to be considered within the context of distance care. We also posit newer ethical considerations such as consent in power imbalances, harm to caregivers, and stigma. These known and new ethical issues aim to encourage further ethically conscious design and use of RMTs to support distance care for older persons.
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Affiliation(s)
| | - Fabrice Jotterand
- Institute for Biomedical Ethics, University of Basel, Basel, Switzerland
- Center for Bioethics and Medical Humanities, Medical College of Wisconsin, Milwaukee, USA
| | - Tenzin Wangmo
- Institute for Biomedical Ethics, University of Basel, Basel, Switzerland
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Felber NA, Tian YJ, Pageau F, Elger BS, Wangmo T. Mapping ethical issues in the use of smart home health technologies to care for older persons: a systematic review. BMC Med Ethics 2023; 24:24. [PMID: 36991423 PMCID: PMC10061702 DOI: 10.1186/s12910-023-00898-w] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Accepted: 03/02/2023] [Indexed: 03/31/2023] Open
Abstract
Abstract
Background
The worldwide increase in older persons demands technological solutions to combat the shortage of caregiving and to enable aging in place. Smart home health technologies (SHHTs) are promoted and implemented as a possible solution from an economic and practical perspective. However, ethical considerations are equally important and need to be investigated.
Methods
We conducted a systematic review according to the PRISMA guidelines to investigate if and how ethical questions are discussed in the field of SHHTs in caregiving for older persons.
Results
156 peer-reviewed articles published in English, German and French were retrieved and analyzed across 10 electronic databases. Using narrative analysis, 7 ethical categories were mapped: privacy, autonomy, responsibility, human vs. artificial interactions, trust, ageism and stigma, and other concerns.
Conclusion
The findings of our systematic review show the (lack of) ethical consideration when it comes to the development and implementation of SHHTs for older persons. Our analysis is useful to promote careful ethical consideration when carrying out technology development, research and deployment to care for older persons.
Registration
We registered our systematic review in the PROSPERO network under CRD42021248543.
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Concheiro-Moscoso P, Groba B, Martínez-Martínez FJ, Miranda-Duro MDC, Nieto-Riveiro L, Pousada T, Pereira J. Use of the Xiaomi Mi Band for sleep monitoring and its influence on the daily life of older people living in a nursing home. Digit Health 2022; 8:20552076221121162. [PMID: 36060611 PMCID: PMC9434673 DOI: 10.1177/20552076221121162] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Accepted: 08/08/2022] [Indexed: 11/15/2022] Open
Abstract
Background: Lower quantity and poorer sleep quality are common in
most older adults, especially for those who live in a nursing home. The use of
wearable devices, which measure some parameters such as the sleep stages, could
help to determine the influence of sleep quality in daily activity among nursing
home residents. Therefore, this study aims to analyse the influence of sleep and
its changes concerning the health status and daily activity of older people who
lived in a nursing home, by monitoring the participants for a year with Xiaomi
Mi Band 2. Methods: This is a longitudinal study set in a nursing
home in [Details omitted for double-anonymized peer reviewed]. The Xiaomi Mi
Band 2 will be used to measure biomedical parameters and different assessment
tools will be administered to participants for evaluating their quality of life,
sleep quality, cognitive state, and daily functioning. Results: A
total of 21 nursing home residents participated in the study, with a mean age of
86.38 ± 9.26. The main outcomes were that sleep may influence daily activity,
cognitive state, quality of life, and level of dependence in activities of daily
life. Moreover, environmental factors and the passage of time could also impact
sleep. Conclusions: Xiaomi Mi Band 2 could be an objective tool to
assess the sleep of older adults and know its impact on some factors related to
health status and quality of life of older nursing homes residents. Trial
Registration: NCT04592796 (Registered 16 October 2020) Available on:
https://clinicaltrials.gov/ct2/show/NCT04592796.
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Affiliation(s)
- Patricia Concheiro-Moscoso
- CITIC, TALIONIS group, Elviña Campus, Universidade da Coruña (University of A Coruña), Spain
- Faculty of Health Sciences, Oza Campus, Universidade da Coruña (University of A Coruña), Spain
| | - Betania Groba
- CITIC, TALIONIS group, Elviña Campus, Universidade da Coruña (University of A Coruña), Spain
- Faculty of Health Sciences, Oza Campus, Universidade da Coruña (University of A Coruña), Spain
| | - Francisco José Martínez-Martínez
- CITIC, TALIONIS group, Elviña Campus, Universidade da Coruña (University of A Coruña), Spain
- Instituto de Biomedicina de València (CSIC), Valencia, Spain
| | - María del Carmen Miranda-Duro
- CITIC, TALIONIS group, Elviña Campus, Universidade da Coruña (University of A Coruña), Spain
- Faculty of Health Sciences, Oza Campus, Universidade da Coruña (University of A Coruña), Spain
| | - Laura Nieto-Riveiro
- CITIC, TALIONIS group, Elviña Campus, Universidade da Coruña (University of A Coruña), Spain
- Faculty of Health Sciences, Oza Campus, Universidade da Coruña (University of A Coruña), Spain
| | - Thais Pousada
- CITIC, TALIONIS group, Elviña Campus, Universidade da Coruña (University of A Coruña), Spain
- Faculty of Health Sciences, Oza Campus, Universidade da Coruña (University of A Coruña), Spain
| | - Javier Pereira
- CITIC, TALIONIS group, Elviña Campus, Universidade da Coruña (University of A Coruña), Spain
- Faculty of Health Sciences, Oza Campus, Universidade da Coruña (University of A Coruña), Spain
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