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Hoe J, Profyri E, Kemp C, Manela M, Webster L, Anthony J, Costafreda S, Arrojo F, Souris H, Livingston G. Risk assessment for people living with dementia: a systematic review. Int Psychogeriatr 2024; 36:263-288. [PMID: 38053362 DOI: 10.1017/s1041610223004398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/07/2023]
Abstract
OBJECTIVE This systematic review identified key components of risk assessment for people with dementia, examined attitudes toward risk identification and risk assessment, and appraised existing risk assessment tools. METHODS Systematic searches of five databases on two platforms (EBSCO, OVID) and gray literature databases (Open Grey, Base) were conducted. Studies were screened for inclusion based on predetermined eligibility criteria and quality assessed using the Mixed Methods Appraisal Tool. Findings were tabulated and synthesized using thematic synthesis. RESULTS Our review found people with dementia, their family carers, and healthcare professionals differed in how risk is conceptualized, with views being shaped by media perceptions, personal experiences, socio-cultural influences, dementia knowledge, and dementia severity. We found that mobilization (causing falls inside and getting lost outside) is the most frequently identified risk factor. Our findings show people with dementia are generally risk-tolerant, while healthcare professionals may adopt risk-averse approaches because of organizational requirements. We found factors that disrupt daily routines, living and caring arrangements, medication management, and unclear care pathways contribute toward adverse risk events. We discovered that most studies about risk and risk assessment scales did not consider insight of the person with dementia into risks although this is important for the impact of a risk. No risk instrument identified had sufficient evidence that it was useful. CONCLUSION Accurate risk assessment and effective communication strategies that include the perspectives of people with dementia are needed to enable risk-tolerant practice. No risk instrument to date was shown to be widely acceptable and useful in practice.
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Affiliation(s)
- Juanita Hoe
- Geller Institute of Ageing and Memory, University of West London, London, UK
- School of Health Sciences, University of London, London, UK
| | - Elena Profyri
- School of Health Sciences, University of London, London, UK
| | - Charlotte Kemp
- School of Health Sciences, University of London, London, UK
| | - Monica Manela
- UCL Division of Psychiatry, University College London, Maple House, London, UK
| | - Lucy Webster
- UCL Division of Psychiatry, University College London, Maple House, London, UK
- Centre for Health Services Studies, University of Kent, Canterbury, Kent, UK
| | - Justine Anthony
- School of Health Sciences, University of London, London, UK
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, Leicestershire, UK
| | - Sergi Costafreda
- UCL Division of Psychiatry, University College London, Maple House, London, UK
- Camden, and Islington NHS Foundation Trust, St Pancras Hospital, London, UK
| | - Frank Arrojo
- Alzheimer's Society Research Network, Alzheimer's Society, London, UK
| | - Helen Souris
- Camden, and Islington NHS Foundation Trust, St Pancras Hospital, London, UK
- Dementia Clinical Network, NHS England and NHS Improvement (London Region, London, UK
| | - Gill Livingston
- UCL Division of Psychiatry, University College London, Maple House, London, UK
- Camden, and Islington NHS Foundation Trust, St Pancras Hospital, London, UK
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Kim AJ, An KO, Yang J, Rho ER, Shim J, Eun SD. Predicting adoption of the assistive technology open platform: extended unified theory of acceptance and use of technology. Disabil Rehabil Assist Technol 2024:1-13. [PMID: 38357965 DOI: 10.1080/17483107.2023.2300050] [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: 05/08/2023] [Accepted: 12/21/2023] [Indexed: 02/16/2024]
Abstract
PURPOSE The Assistive Technology (AT) Open Platform supports people with disabilities, older people, and developers in co-creating new assistive products outside the business realm. To address dissatisfaction with and non-adoption of commercial assistive products, the National Rehabilitation Centre in South Korea created an AT Open Platform as an open-source AT sharing platform to research and develop appropriate assistive technology suitable for users' needs. The emerging concept of AT Open Platform is new for both assistive product users and developers in South Korea. The Extended Unified Theory of Acceptance and Use of Technology (UTAUT2) was utilised to understand the factors influencing the adoption of the AT Open Platform and to gain further insights on its design and future use. MATERIALS AND METHODS Interviews were conducted with six potential AT Open Platform users to develop a questionnaire for predicting behavioural intention. Subsequently, we surveyed 175 potential users to validate the UTAUT2. RESULTS The results revealed that behavioural intention was significantly predicted by social influence, performance expectancy, facilitating conditions, and hedonic motivation. CONCLUSIONS The AT Open Platform should focus on both online and offline platforms to educate and facilitate the co-creation of ATs for assistive product users and makers. This study, which targeted assistive product users and developers, has significant implications for policymakers and future research in using and adopting the AT Open Platform as it reflects the actual voices of the platform's stakeholders.
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Affiliation(s)
- Agnes Jihae Kim
- Graduate School of Science and Technology Policy, Korea Advanced Institute of Science and Technology (KAIST), Daejeon, Republic of Korea
| | - Kwang-Ok An
- Assistive Technology Research Team for Independent Living, National Rehabilitation Center, Seoul, Republic of Korea
| | - Jisun Yang
- Department of Psychology, Yonsei University, Seoul, Republic of Korea
| | - Eun-Rea Rho
- Assistive Technology Research Team for Independent Living, National Rehabilitation Center, Seoul, Republic of Korea
| | - Jaewoo Shim
- Assistive Technology Research Team for Independent Living, National Rehabilitation Center, Seoul, Republic of Korea
| | - Seon-Deok Eun
- Assistive Technology Research Team for Independent Living, National Rehabilitation Center, Seoul, Republic of Korea
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3
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Schneider C, Nißen M, Kowatsch T, Vinay R. Impact of digital assistive technologies on the quality of life for people with dementia: a scoping review. BMJ Open 2024; 14:e080545. [PMID: 38341210 PMCID: PMC10862336 DOI: 10.1136/bmjopen-2023-080545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Accepted: 01/11/2024] [Indexed: 02/12/2024] Open
Abstract
BACKGROUND Digital assistive technologies (DATs) have emerged as promising tools to support the daily life of people with dementia (PWD). Current research tends to concentrate either on specific categories of DATs or provide a generic view. Therefore, it is of essence to provide a review of different kinds of DATs and how they contribute to improving quality of life (QOL) for PWD. DESIGN Scoping review using the framework proposed by Arksey and O'Malley and recommendations from Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews. DATA SOURCES Cochrane, Embase, PubMed, Scopus and Web of Science (January 2013 to May 2023). ELIGIBILITY CRITERIA FOR SELECTING STUDIES Completed scientific literature with a primary focus on DATs for PWD, perspectives of caregivers, family members or healthcare workers in relation to a PWD, people living in diverse settings and all severities of dementia. DATA EXTRACTION AND SYNTHESIS Screening and data extraction were conducted, followed by quantitative and qualitative analyses using thematic analysis principles and Digital Therapeutics Alliance categories for DAT grouping. RESULTS The literature search identified 6083 records, with 1056 duplicates. After screening, 4560 full texts were excluded, yielding 122 studies of different designs. The DATs were categorised into digital therapeutics (n=109), patient monitoring (n=30), digital diagnostics (n=2), care support (n=2) and health system clinical software (n=1). These categories were identified to impact various aspects of QOL: preserving autonomy, engagement, and social interaction, health monitoring and promotion, improving activities of daily living, improving cognition, maintaining dignity, managing behavioural and psychological symptoms of dementia and safety/surveillance. CONCLUSIONS Various DATs offer extensive support, elevating the QOL of PWD. Digital therapeutics are predominantly used for ageing-in-place and independent living through assistance with daily tasks. Future research should focus on less-represented digital health technology categories, such as care support, health & wellness or software solutions. Observing ongoing DAT developments and their long-term effects on QOL remains essential.
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Affiliation(s)
- Charlotte Schneider
- Department of Management, Technology and Economics, ETH Zürich, Zurich, Switzerland
| | - Marcia Nißen
- University of St. Gallen, St. Gallen, Switzerland
| | - Tobias Kowatsch
- Department of Management, Technology and Economics, ETH Zürich, Zurich, Switzerland
- Institute of Technology Management, University of St. Gallen, St. Gallen, Switzerland
- Institute for Implementation Science in Health Care, University of Zurich, Zurich, Switzerland
| | - Rasita Vinay
- Institute of Biomedical Ethics and History of Medicine, University of Zurich, Zurich, Switzerland
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4
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Lee AR, McDermott O, Orrell M. Understanding Barriers and Facilitators to Online and App Activities for People Living With Dementia and Their Supporters. J Geriatr Psychiatry Neurol 2023; 36:366-375. [PMID: 36597870 PMCID: PMC10394950 DOI: 10.1177/08919887221149139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 11/28/2022] [Accepted: 12/14/2022] [Indexed: 01/05/2023]
Abstract
BACKGROUND Stigma often surrounds people with dementia when it comes to use of computer technology, although evidence does not always support this. More understanding is needed to investigate attitudes and experience in relation to computer technology use among those living with dementia and their readiness to use it to support self-management. METHODS An online self-report questionnaire was completed by adults living with a dementia diagnosis and those living with them. Questions explored how long the participants had been using computer technology; how regularly they used it; the popularity of common communication apps; and whether they were interested in using an app to support their independence. RESULTS 47 participants with dementia and 62 supporters responded to the questionnaire. There were no obvious differences between those with dementia and supporters when it came to regular technology usage and both groups showed positive attitudes to the use of it for independence in dementia. CONCLUSIONS There was active use of computer technology among this population. Benefits were shown to include communication, increasing individuals' understanding of dementia diagnoses, and enabling independent activities for both those with dementia and supporters.
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Affiliation(s)
- Abigail R. Lee
- Mental Health and Clinical Neurosciences, Institute of Mental Health, University of Nottingham, Nottingham, UK
| | - Orii McDermott
- Mental Health and Clinical Neurosciences, Institute of Mental Health, University of Nottingham, Nottingham, UK
| | - Martin Orrell
- Mental Health and Clinical Neurosciences, Institute of Mental Health, University of Nottingham, Nottingham, UK
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5
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Horn BL, Albers EA, Mitchell LL, Jutkowitz E, Finlay JM, Millenbah AN, Seifert GJ, Hedin DS, Knutson MJ, Kramer KM, Mikal JP. Can Technology-Based Social Memory Aids Improve Social Engagement? Perceptions of a Novel Memory Aid for Persons With Memory Concerns. J Appl Gerontol 2023; 42:399-408. [PMID: 36274581 PMCID: PMC9957785 DOI: 10.1177/07334648221134869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Social withdrawal and isolation are frequently experienced among people with cognitive impairment, Alzheimer's disease, and Alzheimer's disease related dementias. Few assistive technologies exist to support persons with memory concerns' (PWMC) continuing social engagement. This study aimed to understand PWMC and family caregivers' initial perspectives on the feasibility and utility of a wearable technology-based social memory aid. We recruited 20 dyads, presented the memory aid, and conducted semi-structured interviews from June to August 2020 over Zoom video conferencing. Interviews were transcribed and analyzed using thematic analysis. Overall, participants anticipated the technology could reduce socializing-related stress now and in the future for both members of the care dyad. However, certain features of the memory aid (e.g., visitors must have the app), could limit utility, and participants provided recommendations to enhance the tool. Our findings will inform future technology-enabled social memory aid development for PWMC and family caregivers.
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Affiliation(s)
- Brenna L. Horn
- Division of Health Policy and Management, School of Public
Health, University of Minnesota, 420 Delaware St S.E., Minneapolis, MN 55455
| | - Elizabeth A. Albers
- Division of Health Policy and Management, School of Public
Health, University of Minnesota, 420 Delaware St S.E., Minneapolis, MN 55455
| | - Lauren L. Mitchell
- Department of Psychology, Emmanuel College, 400 The Fenway,
Boston, MA 02115
| | - Eric Jutkowitz
- Department of Health Services, Policy and Practice, Brown
University School of Public Health, 121 S Main St, 6th Fl, Providence, RI
02903,Center of Innovation in Long Term Services and Supports,
Providence VA Medical Center, 830 Chalkstone Ave, Providence, RI 02908
| | - Jessica M. Finlay
- Social Environment and Health Program, Institute for Social
Research, University of Michigan, 426 Thompson Street, Ann Arbor, MI, 48104
| | - Ashley N. Millenbah
- Division of Health Policy and Management, School of Public
Health, University of Minnesota, 420 Delaware St S.E., Minneapolis, MN 55455
| | - Gregory J. Seifert
- Advanced Medical Electronics, 6901 E. Fish Lake Rd., Suite
190, Maple Grove, Minnesota, 55369
| | - Daniel S. Hedin
- Advanced Medical Electronics, 6901 E. Fish Lake Rd., Suite
190, Maple Grove, Minnesota, 55369
| | - Matthew J. Knutson
- Minnesota HealthSolutions Corp., 861 E. Hennepin Ave.,
Suite 440, Minneapolis, MN, 55414
| | - Kevin M. Kramer
- Minnesota HealthSolutions Corp., 861 E. Hennepin Ave.,
Suite 440, Minneapolis, MN, 55414
| | - Jude P. Mikal
- Division of Health Policy and Management, School of Public
Health, University of Minnesota, 420 Delaware St S.E., Minneapolis, MN 55455
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Daly-Lynn J, Ryan A, McCormack B, Martin S. Stakeholder's experiences of living and caring in technology-rich supported living environments for tenants living with dementia. BMC Geriatr 2023; 23:62. [PMID: 36726077 PMCID: PMC9889957 DOI: 10.1186/s12877-023-03751-2] [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: 12/22/2021] [Accepted: 01/12/2023] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND Technology innovation provides an opportunity to support the rising number of people living with dementia globally. The present study examines experiences of people who have dementia and live in technology enriched supported care models. Additionally, it explores caregiver's attitudes towards technology use with the housing scheme. METHODS A qualitative research design was adopted, and eight housing schemes consented to take part in the study. A technology audit was undertaken in addition to participant interviews and caregiver survey. Seven peer researchers conducted semi-structured interviews with 22 people living with dementia. Interviews were analysed using thematic analysis. Informal and formal caregivers were invited to complete a survey to capture their attitudes towards technology use. A total of 20 informal and 31 formal caregiver surveys were returned. All surveys were input into Survey Monkey and downloaded into excel for analysis. Closed questions were analysed using descriptive statistics and open-ended questions were organised into themes and described descriptively. RESULTS The technology audit identified that technologies were in place from as early as 2002. Technology heterogeneity of, both passive and active devices, was found within the housing schemes. Technologies such as wearable devices were reportedly used according to need, and mobile phone use was widely adopted. The themes that developed out of the tenant interviews were: Attitudes and Engagement with Technology; Technology Enhancing Tenants Sense of Security; Seeking Support and Digital Literacy; and Technology Enabled Connection. A lack of awareness about living alongside technology was a major finding. Technologies enabled a sense of reassurance and facilitated connections with the wider community. The interaction with technology presented challenges, for example, remembering passwords, access to Wi-Fi and the identification of its use in an emergency. The caregiver survey reported a range of facilitators and barriers for the use of technology within care. Both types of caregivers held relatively similar views around the benefits of technology, however their views on issues such as privacy and consent varied. Safety was considered more important than right to privacy by family caregivers. CONCLUSIONS The present study provides new insight into stakeholder's experiences of living, working and caregiving alongside technology in supported living environments. As the generation of people living with dementia become more tech savvy, harnessing everyday technologies to support care could enable holistic care and support the transition through the care continuum. Advance care planning and technology assessments are at the very core of future technology provision. It is evident that a paternalistic attitudes towards technology use could impact the multitude of benefits technology can play in both health and leisure for people living with dementia and their caregivers.
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Affiliation(s)
- Jean Daly-Lynn
- grid.12641.300000000105519715School of Health Sciences, Ulster University, Newtownabbey, Northern Ireland
| | - Assumpta Ryan
- School of Nursing, Ulster University, Magee, Northern Ireland
| | - Brendan McCormack
- grid.104846.fHead of Division of Nursing, Queen Margaret University, Scotland, UK
| | - Suzanne Martin
- grid.12641.300000000105519715School of Health Sciences, Ulster University, Newtownabbey, Northern Ireland
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7
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Zwar L, König HH, van der Leeden C, Lühmann D, Oey A, Wiese B, Weyerer S, Werle J, Fuchs A, Pentzek M, Luppa M, Löbner M, Weeg D, Mösch E, Heser K, Wagner M, Maier W, Riedel-Heller SG, Scherer M, Hajek A. Do oldest old individuals perceive receipt of informal care as a restriction or support of their autonomy? Aging Ment Health 2022; 26:1862-1873. [PMID: 34338096 DOI: 10.1080/13607863.2021.1955824] [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: 10/20/2022]
Abstract
OBJECTIVES Autonomy (defined as self-governance; not equivalent to independence) is relevant to well-being and psychological functioning. However, there is a lack of research on individuals aged >85 years and their perception of autonomy when receiving informal care. This study aims to answer the question if and how the receipt of informal care is associated with perceived autonomy of individuals aged over 85 years. METHOD A cross-sectional study was conducted with data from follow-up 9 of the AgeQualiDe study (2015/2016), which is a multi-centric prospective cohort study in Germany. The analytical sample included 570 participants aged >85 years and with a score of ≥ 19 on the Mini-Mental-State-Examination. Perceived autonomy was assessed with the Perceived Autonomy in Old Age Scale. Receipt of care was assessed as performance of at least one care task (help with basic and instrumental activities of daily living, and supervision) by relatives or friends. Sociodemographic information, mental health, functional level and receipt of professional ambulatory care were controlled for. RESULTS Unadjusted and adjusted linear regression analyses indicated a significant negative association between receipt of informal care and perceived autonomy. The results remained stable in sensitivity analyses; no significant interaction effect was found for gender or education. CONCLUSION Findings indicate that informal care recipients aged >85 years perceive lower autonomy compared to those not receiving care. Additional or other forms of support, and improving the care relationship and communication might be considered to support autonomy of care recipients aged >85 years.
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Affiliation(s)
- Larissa Zwar
- Department of Health Economics and Health Services Research, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Hans-Helmut König
- Department of Primary Medical Care, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Carolin van der Leeden
- Department of Health Economics and Health Services Research, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Dagmar Lühmann
- Department of Primary Medical Care, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Anke Oey
- Work Group Medical Statistics and IT-Infrastructure, Institute for General Practice, Hannover Medical School, Hannover, Germany
| | - Birgitt Wiese
- Work Group Medical Statistics and IT-Infrastructure, Institute for General Practice, Hannover Medical School, Hannover, Germany
| | - Siegfried Weyerer
- Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
| | - Jochen Werle
- Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
| | - Angela Fuchs
- Institute of General Practice, Medical Faculty, Heinrich-Heine-University Düsseldorf, Dusseldorf, Germany
| | - Michael Pentzek
- Institute of General Practice, Medical Faculty, Heinrich-Heine-University Düsseldorf, Dusseldorf, Germany
| | - Melanie Luppa
- Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, Leipzig, Germany
| | - Margrit Löbner
- Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, Leipzig, Germany
| | - Dagmar Weeg
- Department of Psychiatry, Technical University of Munich, Munich, Germany
| | - Edelgard Mösch
- Department of Psychiatry, Technical University of Munich, Munich, Germany
| | - Kathrin Heser
- Department of Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Bonn, Germany
| | - Michael Wagner
- Department of Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Bonn, Germany.,German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
| | - Wolfgang Maier
- Department of Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Bonn, Germany.,German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
| | - Steffi G Riedel-Heller
- Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, Leipzig, Germany
| | - Martin Scherer
- Department of Primary Medical Care, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - André Hajek
- Department of Health Economics and Health Services Research, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Yuan F, Sadovnik A, Zhang R, Casenhiser D, Paek EJ, Zhao X. A simulated experiment to explore robotic dialogue strategies for people with dementia. J Rehabil Assist Technol Eng 2022; 9:20556683221105768. [PMID: 35692231 PMCID: PMC9174559 DOI: 10.1177/20556683221105768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 05/22/2022] [Indexed: 11/16/2022] Open
Abstract
Introduction Persons with dementia (PwDs) often show symptoms of repetitive questioning, which brings great burdens on caregivers. Conversational robots hold promise of helping cope with PwDs’ repetitive behavior. This paper develops an adaptive conversation strategy to answer PwDs’ repetitive questions, follow up with new questions to distract PwDs from repetitive behavior, and stimulate their conversation and cognition. Methods We propose a general reinforcement learning model to interact with PwDs with repetitive questioning. Q-learning is exploited to learn adaptive conversation strategy (from the perspectives of rate and difficulty level of follow-up questions) for four simulated PwDs. A demonstration is presented using a humanoid robot. Results The designed Q-learning model performs better than random action selection model. The RL-based conversation strategy is adaptive to PwDs with different cognitive capabilities and engagement levels. In the demonstration, the robot can answer a user’s repetitive questions and further come up with a follow-up question to engage the user in continuous conversations. Conclusions The designed Q-learning model demonstrates noteworthy effectiveness in adaptive action selection. This may provide some insights towards developing conversational social robots to cope with repetitive questioning by PwDs and increase their quality of life.
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Affiliation(s)
- Fengpei Yuan
- Department of Mechanical, University of Tennessee, Knoxville, TN, USA
| | - Amir Sadovnik
- Department of Electrical Engineering and Computer Science, University of Tennessee, Knoxville, TN, USA
| | - Ran Zhang
- Department of Electrical and Computer Engineering, Miami University, Oxford, OH, USA
| | - Devin Casenhiser
- Department of Audiology and Speech Pathology, University of Tennessee Health Science Center, Knoxville, TN, USA
| | - Eun Jin Paek
- Department of Audiology and Speech Pathology, University of Tennessee Health Science Center, Knoxville, TN, USA
| | - Xiaopeng Zhao
- Department of Mechanical, University of Tennessee, Knoxville, TN, USA
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9
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Land LPW, Chenoweth L, Zhang YG. Exploring Adoption and Satisfaction with Self-Service Health Technology in Older Age: Perspectives of Healthcare Professionals and Older People. Healthcare (Basel) 2022; 10:healthcare10040738. [PMID: 35455917 PMCID: PMC9032905 DOI: 10.3390/healthcare10040738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Revised: 04/14/2022] [Accepted: 04/14/2022] [Indexed: 01/25/2023] Open
Abstract
(1) Background. A range of self-service technologies (SST) have been adapted to support the health of older people. Factors involved in older people’s and health professionals’ perceptions of SST in older age were investigated. (2) Methods. Customer Dominant Logic guided this prospective mixed-methods study, including surveys with people 70 years and over and health professionals and individual semi-structured interviews in a sample of survey respondents. Survey data were descriptively analysed, while interview themes were derived inductively. (3) Results. Surveyed (n = 12) people 70 years and over placed higher value, expressed more positive user experience, were more satisfied and had greater recognition of the benefits of SST, compared with (n = 10) health professionals (p = 0.001), who considered them to be inferior to traditional healthcare. All seven interviewees agreed that despite accessibility issues and complexity, they valued SST support of older people’s health, thereby confirming the relevance of Customer Dominant Logic in SST offerings. (4) Conclusions. Since older participants were positive and satisfied in using SSTs that are health-supporting, health professionals have a role in encouraging and assisting older people in their use. This requires targeted SST education for health professionals, and more accessible, user-friendly SST and technological support for older people.
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Affiliation(s)
- Lesley Pek Wee Land
- UNSW Business, UNSW Sydney, Kensington, NSW 2052, Australia; (L.P.W.L.); (Y.G.Z.)
| | - Lynn Chenoweth
- Centre for Healthy Brain Ageing (CHeBA), UNSW Sydney, Kensington, NSW 2052, Australia
- Correspondence:
| | - Yukun Grant Zhang
- UNSW Business, UNSW Sydney, Kensington, NSW 2052, Australia; (L.P.W.L.); (Y.G.Z.)
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10
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Knox L, McDermott C, Hobson E. Telehealth in long-term neurological conditions: the potential, the challenges and the key recommendations. J Med Eng Technol 2022; 46:506-517. [PMID: 35212580 DOI: 10.1080/03091902.2022.2040625] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Long-term neurological conditions (LTNCs) cause physical and psychological symptoms that have a significant impact on activities of daily living and quality of life. Multidisciplinary teams are effective at providing treatment for people with LTNCs; however, access to such services by people with disabilities can be difficult and as a result, good quality care is not universal. One potential solution is telehealth. This review describes the potential of telehealth to support people with LTNCs, the challenges of designing and implementing these systems, and the key recommendations for those involved in telehealth to facilitate connected services that can benefit patients, carers and healthcare professionals. These recommendations include understanding the problems posed by LTNCs and the needs of the end-user through a person-centred approach. We discuss how to work collaboratively and use shared learning, and consider how to effectively evaluate the intervention at every stage of the development process.
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Affiliation(s)
- Liam Knox
- Department of Neuroscience, University of Sheffield, Sheffield, UK
| | - Christopher McDermott
- Department of Neuroscience, University of Sheffield, Sheffield, UK.,Department of Neuroscience, Sheffield Teaching Hospitals, Sheffield, UK
| | - Esther Hobson
- Department of Neuroscience, University of Sheffield, Sheffield, UK.,Department of Neuroscience, Sheffield Teaching Hospitals, Sheffield, UK
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11
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Yuan F, Anderson JG, Wyatt TH, Lopez RP, Crane M, Montgomery A, Zhao X. Assessing the Acceptability of a Humanoid Robot for Alzheimer’s Disease and Related Dementia Care Using an Online Survey. Int J Soc Robot 2022. [DOI: 10.1007/s12369-021-00862-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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12
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Zaman SB, Khan RK, Evans RG, Thrift AG, Maddison R, Islam SMS. Exploring Barriers to and Enablers of the Adoption of Information and Communication Technology for the Care of Older Adults With Chronic Diseases: Scoping Review. JMIR Aging 2022; 5:e25251. [PMID: 34994695 PMCID: PMC8783284 DOI: 10.2196/25251] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 05/10/2021] [Accepted: 09/26/2021] [Indexed: 02/06/2023] Open
Abstract
Background Information and communication technology (ICT) offers considerable potential for supporting older adults in managing their health, including chronic diseases. However, there are mixed opinions about the benefits and effectiveness of ICT interventions for older adults with chronic diseases. Objective We aim to map the use of ICT interventions in health care and identified barriers to and enablers of its use among older adults with chronic disease. Methods A scoping review was conducted using 5 databases (Ovid MEDLINE, Embase, Scopus, PsycINFO, and ProQuest) to identify eligible articles from January 2000 to July 2020. Publications incorporating the use of ICT interventions, otherwise known as eHealth, such as mobile health, telehealth and telemedicine, decision support systems, electronic health records, and remote monitoring in people aged ≥55 years with chronic diseases were included. We conducted a strengths, weaknesses, opportunities, and threats framework analysis to explore the implied enablers of and barriers to the use of ICT interventions. Results Of the 1149 identified articles, 31 (2.7%; n=4185 participants) met the inclusion criteria. Of the 31 articles, 5 (16%) mentioned the use of various eHealth interventions. A range of technologies was reported, including mobile health (8/31, 26%), telehealth (7/31, 23%), electronic health record (2/31, 6%), and mixed ICT interventions (14/31, 45%). Various chronic diseases affecting older adults were identified, including congestive heart failure (9/31, 29%), diabetes (7/31, 23%), chronic respiratory disease (6/31, 19%), and mental health disorders (8/31, 26%). ICT interventions were all designed to help people self-manage chronic diseases and demonstrated positive effects. However, patient-related and health care provider–related challenges, in integrating ICT interventions in routine practice, were identified. Barriers to using ICT interventions in older adults included knowledge gaps, a lack of willingness to adopt new skills, and reluctance to use technologies. Implementation challenges related to ICT interventions such as slow internet connectivity and lack of an appropriate reimbursement policy were reported. Advantages of using ICT interventions include their nonpharmacological nature, provision of health education, encouragement for continued physical activity, and maintenance of a healthy diet. Participants reported that the use of ICT was a fun and effective way of increasing their motivation and supporting self-management tasks. It gave them reassurance and peace of mind by promoting a sense of security and reducing anxiety. Conclusions ICT interventions have the potential to support the care of older adults with chronic diseases. However, they have not been effectively integrated with routine health care. There is a need to improve awareness and education about ICT interventions among those who could benefit from them, including older adults, caregivers, and health care providers. More sustainable funding is required to promote the adoption of ICT interventions. We recommend involving clinicians and caregivers at the time of designing ICT interventions.
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Affiliation(s)
- Sojib Bin Zaman
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Melbourne, Australia
| | - Raihan Kabir Khan
- Department of Health Sciences, James Madison University, Harrisonburg, VA, United States
| | - Roger G Evans
- Cardiovascular Disease Program, Biomedicine Discovery Institute, Monash University, Melbourne, Australia.,Department of Physiology, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia
| | - Amanda G Thrift
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Melbourne, Australia
| | - Ralph Maddison
- Institute for Physical Activity and Nutrition, School of Exercise & Nutrition Sciences, Deakin University, Geelong, Australia
| | - Sheikh Mohammed Shariful Islam
- Institute for Physical Activity and Nutrition, School of Exercise & Nutrition Sciences, Deakin University, Geelong, Australia
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Shin MH, McLaren J, Ramsey A, Sullivan JL, Moo L. Titrating Support: Stakeholder Perspectives on Improving a Mobile Telepresence Robot for People with Alzheimer's Disease and Related Dementias (Preprint). JMIR Aging 2021; 5:e32322. [PMID: 35503518 PMCID: PMC9115649 DOI: 10.2196/32322] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 12/30/2021] [Accepted: 03/25/2022] [Indexed: 12/02/2022] Open
Abstract
Background By 2050, nearly 13 million Americans will have Alzheimer disease and related dementias (ADRD), with most of those with ADRD or mild cognitive impairment (MCI) receiving home care. Mobile telepresence robots may allow persons with MCI or ADRD to remain living independently at home and ease the burden of caregiving. The goal of this study was to identify how an existing mobile telepresence robot can be enhanced to support at-home care of people with MCI or ADRD through key stakeholder input. Objective The specific aims were to assess what applications should be integrated into the robot to further support the independence of individuals with MCI or ADRD and understand stakeholders’ overall opinions about the robot. Methods We conducted in-person interviews with 21 stakeholders, including 6 people aged >50 years with MCI or ADRD living in the community, 9 family caregivers of people with MCI or ADRD, and 6 clinicians who work with the ADRD population. Interview questions about the robot focused on technology use, design and functionality, future applications to incorporate, and overall opinions. We conducted a thematic analysis of the data obtained and assessed the patterns within and across stakeholder groups using a matrix analysis technique. Results Overall, most stakeholders across groups felt positively about the robot’s ability to support individuals with MCI or ADRD and decrease caregiver burden. Most ADRD stakeholders felt that the greatest benefits would be receiving help in emergency cases and having fewer in-person visits to the doctor’s office. Caregivers and clinicians also noted that remote video communication with their family members using the robot was valuable. Adding voice commands and 1-touch lifesaving or help buttons to the robot were the top suggestions offered by the stakeholders. The 4 types of applications that were suggested included health-related alerts; reminders; smart-home–related applications; and social, entertainment, or well-being applications. Stakeholders across groups liked the robot’s mobility, size, interactive connection, and communication abilities. However, stakeholders raised concerns about their physical stability and size for individuals living in smaller, cluttered spaces; screen quality for those with visual impairments; and privacy or data security. Conclusions Although stakeholders generally expressed positive opinions about the robot, additional adaptations were suggested to strengthen functionality. Adding applications and making improvements to the design may help mitigate concerns and better support individuals with ADRD to live independently in the community. As the number of individuals living with ADRD in the United States increases, mobile telepresence robots are a promising way to support them and their caregivers. Engaging all 3 stakeholder groups in the development of these robots is a critical first step in ensuring that the technology matches their needs. Integrating the feedback obtained from our stakeholders and evaluating their effectiveness will be important next steps in adapting telepresence robots.
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Affiliation(s)
- Marlena H Shin
- Center for Healthcare Organization and Implementation Research, Veterans Affairs Boston Healthcare System, Boston, MA, United States
| | - Jaye McLaren
- New England Geriatric Research Education and Clinical Center, Veterans Affairs Bedford Healthcare System, Bedford, MA, United States
| | | | - Jennifer L Sullivan
- Center of Innovation in Long-Term Services and Supports, Veterans Affairs Providence Healthcare System, Providence, RI, United States
- School of Public Health, Brown University, Providence, RI, United States
| | - Lauren Moo
- New England Geriatric Research Education and Clinical Center, Veterans Affairs Bedford Healthcare System, Bedford, MA, United States
- Center for Healthcare Organization and Implementation Research, Veterans Affairs Bedford Healthcare System, Bedford, MA, United States
- Harvard Medical School, Boston, MA, United States
- Department of Neurology, Massachusetts General Hospital, Boston, MA, United States
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Albers EA, Mikal J, Millenbah A, Finlay J, Jutkowitz E, Mitchell L, Horn B, Gaugler JE. Technology Use Among Persons with Memory Concerns and Their Caregivers in the United States During the COVID-19 Pandemic: A Qualitative Study (Preprint). JMIR Aging 2021; 5:e31552. [PMID: 35134748 PMCID: PMC8972107 DOI: 10.2196/31552] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 01/15/2022] [Accepted: 02/07/2022] [Indexed: 11/13/2022] Open
Abstract
Background Objective Methods Results Conclusions
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Affiliation(s)
- Elizabeth A Albers
- Division of Health Policy and Management, School of Public Health, University of Minnesota, Minneapolis, MN, United States
| | - Jude Mikal
- Division of Health Policy and Management, School of Public Health, University of Minnesota, Minneapolis, MN, United States
| | - Ashley Millenbah
- Division of Health Policy and Management, School of Public Health, University of Minnesota, Minneapolis, MN, United States
| | - Jessica Finlay
- Social Environment and Health Program, Institute for Social Research, University of Michigan, Ann Arbor, MI, United States
| | - Eric Jutkowitz
- Department of Health Services, Policy and Practice, School of Public Health, Brown University, Providence, RI, United States
| | - Lauren Mitchell
- Department of Psychology, Emmanuel College, Boston, MA, United States
| | - Brenna Horn
- Division of Health Policy and Management, School of Public Health, University of Minnesota, Minneapolis, MN, United States
| | - Joseph E Gaugler
- Division of Health Policy and Management, School of Public Health, University of Minnesota, Minneapolis, MN, United States
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Franciosi EB, Tan AJ, Kassamali B, Leonard N, Zhou G, Krueger S, Rashighi M, LaChance A. The Impact of Telehealth Implementation on Underserved Populations and No-Show Rates by Medical Specialty During the COVID-19 Pandemic. Telemed J E Health 2021; 27:874-880. [PMID: 33826411 DOI: 10.1089/tmj.2020.0525] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
A unique and sudden need for virtual medical visits created by the coronavirus disease 2019 (COVID-19) pandemic has led to an unprecedented expansion of telemedicine across nearly all medical specialties in the United States. In addition to providing essential medical services during the pandemic, telemedicine has the potential to expand health care access to underserved populations by eliminating traditional barriers to care such as transportation needs, distance from specialty providers, and approved time off from work. However, the literature regarding telehealth accessibility for low-income, non-English-speaking, and minority patients remains limited. Through a cross-sectional analysis comparing 2019 clinic visits with 2020 telehealth visits at the UMass Memorial Medical Center, we demonstrate specialty-specific changes in patient demographics, including a younger population, fewer non-English-speaking patients, and a relative preservation of minority, Medicaid, and Medicare patients among telehealth visits in comparison to clinic visits. We also demonstrate that nonsurgical specialties had significantly lower no-show rates and the greatest number of telehealth visits. Overall, our findings highlight the potential shortcomings of telemedicine in servicing non-English-speaking patients, while maintaining that it is an important tool with the potential to improve access to health care, particularly in nonprocedural specialties.
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Affiliation(s)
- Ellen B Franciosi
- Department of Dermatology, University of Massachusetts Medical School, Worcester, Massachusetts, USA
| | - Alice J Tan
- Department of Dermatology, University of Massachusetts Medical School, Worcester, Massachusetts, USA
| | - Bina Kassamali
- Department of Dermatology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Nicholas Leonard
- Department of Dermatology, University of Massachusetts Medical School, Worcester, Massachusetts, USA
| | - Guohai Zhou
- Center for Clinical Investigation, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Steven Krueger
- Department of Dermatology, University of Massachusetts Medical School, Worcester, Massachusetts, USA
| | - Mehdi Rashighi
- Department of Dermatology, University of Massachusetts Medical School, Worcester, Massachusetts, USA
| | - Avery LaChance
- Department of Dermatology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
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Irazoki E, Sánchez-Gómez MC, Contreras-Somoza LM, Toribio-Guzmán JM, Martín-Cilleros MV, Verdugo-Castro S, Jenaro-Río C, Franco-Martín MA. A Qualitative Study of the Cognitive Rehabilitation Program GRADIOR for People with Cognitive Impairment: Outcomes of the Focus Group Methodology. J Clin Med 2021; 10:jcm10040859. [PMID: 33669716 PMCID: PMC7922357 DOI: 10.3390/jcm10040859] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Revised: 02/13/2021] [Accepted: 02/15/2021] [Indexed: 12/17/2022] Open
Abstract
In recent years, technology has been implemented in the field of interventions for older adults. GRADIOR 4.5 is a cognitive software within the wide variety of available multimedia programs that support healthcare professionals in cognitive assessment and neuropsychological rehabilitation. The study aimed to evaluate the new version of GRADIOR (v4.5) based on the experience of people with mild cognitive impairment (MCI), people with dementia (PWD), and healthcare professionals. A qualitative study using the focus group methodology was carried out involving 13 people with MCI, 13 PWD, and 11 healthcare professionals. An analysis of the content and the level of feedback was performed. The study showed that GRADIOR 4.5 might be sufficiently adapted to PWD and people with MCI. Participants were motivated to use GRADIOR 4.5, showed high acceptability of the software, and a positive attitude towards technology. However, healthcare professionals suggested significant improvements to the software. GRADIOR 4.5 appeared to be a promising intervention that, because of its positive experience and acceptability, could be systematically implemented to complement cognitive rehabilitation interventions for older adults with MCI and dementia. Finally, it is advisable to consider the suggestions gathered in this study for future developments.
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Affiliation(s)
- Eider Irazoki
- Department of Personality, Evaluation and Psychological Treatments, Faculty of Psychology, Campus Ciudad Jardín, University of Salamanca, Avenida de la Merced, 109, 37005 Salamanca, Spain; (L.M.C.-S.); (C.J.-R.); (M.A.F.-M.)
- Department of Research and Development, INTRAS Foundation, Carretera de la Hiniesta 137, 49024 Zamora, Spain;
- Correspondence:
| | - Mª Cruz Sánchez-Gómez
- Department of Didactic, Organization and Research Method, University of Salamanca, Paseo Canalejas, 169, 37008 Salamanca, Spain; (M.C.S.-G.); (M.V.M.-C.); (S.V.-C.)
| | - Leslie María Contreras-Somoza
- Department of Personality, Evaluation and Psychological Treatments, Faculty of Psychology, Campus Ciudad Jardín, University of Salamanca, Avenida de la Merced, 109, 37005 Salamanca, Spain; (L.M.C.-S.); (C.J.-R.); (M.A.F.-M.)
- Department of Research and Development, INTRAS Foundation, Carretera de la Hiniesta 137, 49024 Zamora, Spain;
| | - José Miguel Toribio-Guzmán
- Department of Research and Development, INTRAS Foundation, Carretera de la Hiniesta 137, 49024 Zamora, Spain;
| | - Mª Victoria Martín-Cilleros
- Department of Didactic, Organization and Research Method, University of Salamanca, Paseo Canalejas, 169, 37008 Salamanca, Spain; (M.C.S.-G.); (M.V.M.-C.); (S.V.-C.)
| | - Sonia Verdugo-Castro
- Department of Didactic, Organization and Research Method, University of Salamanca, Paseo Canalejas, 169, 37008 Salamanca, Spain; (M.C.S.-G.); (M.V.M.-C.); (S.V.-C.)
| | - Cristina Jenaro-Río
- Department of Personality, Evaluation and Psychological Treatments, Faculty of Psychology, Campus Ciudad Jardín, University of Salamanca, Avenida de la Merced, 109, 37005 Salamanca, Spain; (L.M.C.-S.); (C.J.-R.); (M.A.F.-M.)
| | - Manuel A. Franco-Martín
- Department of Personality, Evaluation and Psychological Treatments, Faculty of Psychology, Campus Ciudad Jardín, University of Salamanca, Avenida de la Merced, 109, 37005 Salamanca, Spain; (L.M.C.-S.); (C.J.-R.); (M.A.F.-M.)
- Department of Psychiatry, Rio Hortega University Hospital, Calle Dulzaina, 2, 47012 Valladolid, Spain
- Department of Psychiatry, Zamora Hospital, Calle Hernán Cortés, 40, 49071 Zamora, Spain
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