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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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Wynn M, Garwood-Cross L, Vasilica C, Davis D. Digital nursing practice theory: A scoping review and thematic analysis. J Adv Nurs 2023; 79:4137-4148. [PMID: 36971282 DOI: 10.1111/jan.15660] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 03/03/2023] [Accepted: 03/16/2023] [Indexed: 03/29/2023]
Abstract
AIMS This scoping review aims to identify existing theories associated with digital nursing practice to add a lens on the future use of digital technologies by nurses. DESIGN A review of theories related to digital technology in nursing practice was conducted following the framework described by Arksey and O'Malley. All published literature until 12th May 2022 was included. DATA SOURCES Seven databases were utilized including Medline, Scopus, CINAHL, ACM Digital Library, IEEE Xplore, BNI and Web of Science. A Google Scholar search was also performed. REVIEW METHODS The search terms included (nurs* AND [digital OR technol* OR e-health or ehealth or digital health or telemedicine or telehealth] AND theory). RESULTS The database searches yielded 282 citations. After screening, nine articles were included in the review. These described eight distinct nursing theories. CONCLUSION The focuses of the theories included the role of technology in society and nursing. How technology should be developed to support nursing practice, health consumers' use of nursing informatics, the use of technology as an expression of caring and the preservation of humanness and the relationship between human persons and non-human actants and the creation of nursing technologies as caring in addition to existing technologies. Three themes were identified including the role of technology as an agent within the patient environment; nurse interactions with technology to achieve 'knowing' of patients and the necessity of technological competence among nurses. Then, using Actor Network Theory (ANT), a zoom-out lens to map the concepts was proposed (The Lens for Digital Nursing [LDN]). This study is the first to add a new theoretical lens on digital nursing. IMPACT This study provides the first synthesis of key concepts of nursing theories to add a theoretical lens to digital nursing practice. This can be used in a functional capacity to zoom-in different entities. No patient or public contribution was made in this study due to it being an early scoping study on a currently understudied area of nursing theory.
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Huang H, Chen Z, Cao S, Xiao M, Xie L, Zhao Q. Adoption Intention and Factors Influencing the Use of Gerontechnology in Chinese Community-Dwelling Older Adults: A Mixed-Methods Study. Front Public Health 2021; 9:687048. [PMID: 34604153 PMCID: PMC8484701 DOI: 10.3389/fpubh.2021.687048] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Accepted: 08/11/2021] [Indexed: 11/13/2022] Open
Abstract
Objective: To explore the Chinese community-dwelling intention of older adults to adopt gerontechnology and its influencing factors. Design: A mixed-methods sequential explanatory design with an inductive approach was employed. In phase 1, a self-made questionnaire was administered from August 2018 to December 2019. Multifactor logistic regression was used to analyze the adoption intention and factors influencing the use of gerontechnology. In phase 2, participants completed a semistructured interview to explore the adoption intention of a specific form of gerontechnology, Smart Aged Care Platform, from May to July 2020. Setting: Twelve communities in three districts of Chongqing, China. Participants: Community-dwelling older adults were included. Results: A total of 1,180 older adults completed the quantitative study; two-thirds of them (68.7%) showed adoption intention toward gerontechnology. Nineteen participants (10 users and nine nonusers) completed the qualitative study and four themes were explored. Through a summarized understanding of the qualitative and quantitative data, a conceptual model of influencing factors, namely, predictive, enabling, and need factors, was constructed. Conclusions: This study reveals that most Chinese community-dwelling older adults welcome the emergence of new technologies. However, there was a significant difference in the adoption intention of gerontechnology in Chinese community-dwelling older adults based on their sociodemographic and psychographic characteristics. Our findings extend previous technology acceptance models and theories and contribute to the existing resource base.
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Affiliation(s)
- Huanhuan Huang
- First Clinical College, Chongqing Medical University, Chongqing, China.,Department of Nursing, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Zhiyu Chen
- First Clinical College, Chongqing Medical University, Chongqing, China.,Department of Orthopedic, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Songmei Cao
- First Clinical College, Chongqing Medical University, Chongqing, China.,Department of Nursing, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Mingzhao Xiao
- Department of Urology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Liling Xie
- Department of Nursing, The First Branch of First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Qinghua Zhao
- Department of Nursing, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
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Varey S, Dixon M, Hernández A, Mateus C, Palmer TM, Milligan C. The role of combinatorial health technologies in supporting older people with long-term conditions: Responsibilisation or co-management of healthcare? Soc Sci Med 2020; 269:113545. [PMID: 33339684 DOI: 10.1016/j.socscimed.2020.113545] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 11/11/2020] [Accepted: 11/19/2020] [Indexed: 10/22/2022]
Abstract
Neoliberalism, austerity and health responsibilisation are increasingly informing policies and practices designed to encourage older patients to take responsibility for the management of their own healthcare. Combined with an ageing population, novel ways to address the increasing healthcare needs of older people have become a priority, with the emergence in recent years of new models of integrated care enhanced by combinatorial health technologies (CHTs). This paper presents qualitative findings from the evaluation of one programme, the Lancashire and Cumbria Innovation Alliance (LCIA) Test Bed, a programme funded by NHS England and conducted in England between 2016 and 2018. Drawing on data from patients, family carers, and staff members involved in the programme, this paper explores the extent to which CHTs, as part of the LCIA Test Bed programme, contributed to health responsibilisation amongst older people with complex health conditions. Through this programme, we find that relationships between patients, family carers and healthcare professionals combined to create a sense of reassurance and shared responsibility for all parties. Our findings suggest the need for a more nuanced approach to responsibilisation and self-management for older people living with complex health conditions. By focusing on co-management - and recognising the potential of CHTs to facilitate this approach - there is potential to increase patient confidence in managing their health condition, reduce carer burden, and enhance clinician satisfaction in their work roles. While neoliberal agendas are focused on self-management and self-responsibility of one's own health care, with technology as a facilitator of this, our findings suggest that the successful use of CHTs for older people with complex health conditions may instead be rooted in co-management. This paper argues that co-management may be a more successful model of care for patients, carers and clinicians.
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Affiliation(s)
- Sandra Varey
- Centre for Ageing Research, Division of Health Research, Lancaster University, Lancaster, LA1 4AT, UK.
| | - Mandy Dixon
- Northern Health Science Alliance Ltd., Weightmans LLP, Hardman Square, No 1 Spinningfields, Manchester, M3 3EB, UK.
| | - Alejandra Hernández
- Centre for Ageing Research, Division of Health Research, Lancaster University, Lancaster, LA1 4AT, UK.
| | - Céu Mateus
- Health Economics, Division of Health Research, Lancaster University, Lancaster, LA1 4AT, UK.
| | - Tom M Palmer
- MRC Integrative Epidemiology Unit and Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 2BN, UK.
| | - Christine Milligan
- Centre for Ageing Research, Division of Health Research, Lancaster University, Lancaster, LA1 4AT, UK.
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Bilodeau A, Potvin L. Unpacking complexity in public health interventions with the Actor-Network Theory. Health Promot Int 2018; 33:173-181. [PMID: 27492825 DOI: 10.1093/heapro/daw062] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2016] [Accepted: 07/03/2016] [Indexed: 11/14/2022] Open
Abstract
This article proposes a sociologically informed theoretical and methodological framework to address the complexity of public health interventions (PHI). It first proposes three arguments in favour of using the Actor-Network Theory (ANT) for the framework. ANT: (1) deals with systems made of human and non-human entities and proposes a relational view of action; (2) provides an understanding of the intervention-context interactions and (3) is a tool for opening the intervention's black box. Three principles derived from ANT addressing theoretical problems with conceptualisation of PHI as complex systems are proposed: (1) to focus on the process of connecting the network entities instead of their stabilised form; (2) both human and non-human entities composing networks have performative capacities and (3) network and intervention shape one another. Three methodological guidelines are further derived: (1) the researcher's task consists in documenting the events that transform the network and intervention; (2) events must be ordered chronologically to represent the intervention's evolution and (3) a broad range of data is needed to capture complex interventions' evolution. Using ANT as a guide, this paper helps reconcile technicist and social views of PHI and provides a mean to integrate process and effect studies of interventions.
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Affiliation(s)
- Angèle Bilodeau
- École de Santé Publique, Université de Montréal, 7101 avenue du Parc, Montréal (Québec), Canada, H3C3J7.,Institut de Recherche en Santé Publique de l'Université de Montréal.,Centre de Recherche Léa-Roback sur les Inégalités Sociales de Santé de Montréal
| | - Louise Potvin
- École de Santé Publique, Université de Montréal, 7101 avenue du Parc, Montréal (Québec), Canada, H3C3J7.,Institut de Recherche en Santé Publique de l'Université de Montréal.,Centre de Recherche Léa-Roback sur les Inégalités Sociales de Santé de Montréal
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Children's Imaginaries of Human-Robot Interaction in Healthcare. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15050970. [PMID: 29757221 PMCID: PMC5982009 DOI: 10.3390/ijerph15050970] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/22/2018] [Revised: 05/08/2018] [Accepted: 05/09/2018] [Indexed: 11/17/2022]
Abstract
This paper analyzes children’s imaginaries of Human-Robots Interaction (HRI) in the context of social robots in healthcare, and it explores ethical and social issues when designing a social robot for a children’s hospital. Based on approaches that emphasize the reciprocal relationship between society and technology, the analytical force of imaginaries lies in their capacity to be embedded in practices and interactions as well as to affect the construction and applications of surrounding technologies. The study is based on a participatory process carried out with six-year-old children for the design of a robot. Imaginaries of HRI are analyzed from a care-centered approach focusing on children’s values and practices as related to their representation of care. The conceptualization of HRI as an assemblage of interactions, the prospective bidirectional care relationships with robots, and the engagement with the robot as an entity of multiple potential robots are the major findings of this study. The study shows the potential of studying imaginaries of HRI, and it concludes that their integration in the final design of robots is a way of including ethical values in it.
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"Grandma, You Should Do It--It's Cool" Older Adults and the Role of Family Members in Their Acceptance of Technology. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2015; 12:15470-85. [PMID: 26690188 PMCID: PMC4690935 DOI: 10.3390/ijerph121214999] [Citation(s) in RCA: 66] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/24/2015] [Accepted: 12/02/2015] [Indexed: 12/04/2022]
Abstract
Despite its potential, the acceptance of technology to support the ability to live independently in one’s own home, also called aging in place, is not optimal. Family members may play a key role in technology acceptance by older adults; however, it is not well understood why and how they exert influence. Based on open interviews with 53 community-dwelling older adults, this paper describes the influence of family members, including spouses, on the use of various types of consumer electronics by older adults as was reported by themselves. Such a broad focus enables understanding the use of technology as was reported by older adults, instead of its intended use. Our study reveals that the influence of each family member has its own characteristics. The influence of technology acceptance is a natural and coincidental part of the interaction with spouses and grandchildren in which entertainment and pleasure are prominent. This is also partly true for the influence of children, but their influence also is intentional and driven by concerns. Our study indicates the importance of including all family members when implementing technology in the lives of older adults. Besides information for children about the use(fullness) of devices, it is worthwhile to give grandchildren an important role, because older adults easily adopt their enthusiasm and it might eventually lighten the burden on children.
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Harvey J, Dopson S, McManus RJ, Powell J. Factors influencing the adoption of self-management solutions: an interpretive synthesis of the literature on stakeholder experiences. Implement Sci 2015; 10:159. [PMID: 26566623 PMCID: PMC4644277 DOI: 10.1186/s13012-015-0350-x] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2015] [Accepted: 11/10/2015] [Indexed: 11/10/2022] Open
Abstract
Background In a research context, self-management solutions, which may range from simple book diaries to complex telehealth packages, designed to facilitate patients in managing their long-term conditions, have often shown cost-effectiveness, but their implementation in practice has frequently been challenging. Methods We conducted an interpretive qualitative synthesis of relevant articles identified through systematic searches of bibliographic databases in July 2014. We searched PubMed (Medline/NLM), Web of Science, LISTA (EBSCO), CINAHL, Embase and PsycINFO. Coding and analysis was inductive, using the framework method to code and to categorise themes. We took a sensemaking approach to the interpretation of findings. Results Fifty-eight articles were selected for synthesis. Results showed that during adoption, factors identified as facilitators by some were experienced as barriers by others, and facilitators could change to barriers for the same adopter, depending on how adopters rationalise the solutions within their context when making decisions about (retaining) adoption. Sometimes, when adopters saw and experienced benefits of a solution, they continued using the solution but changed their minds when they could no longer see the benefits. Thus, adopters placed a positive value on the solution if they could constructively rationalise it (which increased adoption) and attached a negative rationale (decreasing adoption) if the solution did not meet their expectations. Key factors that influenced the way adopters rationalised the solutions consisted of costs and the added value of the solution to them and moral, social, motivational and cultural factors. Conclusions Considering ‘barriers’ and ‘facilitators’ for implementation may be too simplistic. Implementers could instead iteratively re-evaluate how potential facilitators and barriers are being experienced by adopters throughout the implementation process, to help adopters to retain constructive evaluations of the solution. Implementers need to pay attention to factors including (a) cost: how much resource will the intervention cost the patient or professional; (b) moral: to what extent will people adhere because they want to be ‘good’ patients and professionals; (c) social: the expectations of patients and professionals regarding the interactive support they will receive; (d) motivational: motivations to engage with the intervention and (e) cultural: how patients and professionals learn and integrate new skills into their daily routines, practices and cultures.
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Affiliation(s)
- J Harvey
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Observatory Quarter, Woodstock road, Oxford, OX2 6GG, UK.
| | - S Dopson
- Saïd Business School, University of Oxford, Park End Street, Oxford, OX1 1HP, UK.
| | - R J McManus
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Observatory Quarter, Woodstock road, Oxford, OX2 6GG, UK.
| | - J Powell
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Observatory Quarter, Woodstock road, Oxford, OX2 6GG, UK.
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Use or non-use of gerontechnology--a qualitative study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2013; 10:4645-66. [PMID: 24084674 PMCID: PMC3823313 DOI: 10.3390/ijerph10104645] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/21/2013] [Revised: 09/12/2013] [Accepted: 09/22/2013] [Indexed: 11/16/2022]
Abstract
This study employed a qualitative approach to explore the attitudes and experiences of older people towards using gerontechnology, and to determine the underlying reasons that might account for their use and non-use of gerontechnology. Four focus group discussions and 26 individual interviews were undertaken. Qualitative data were analyzed using NVivo software and were categorized using coding and grounded theory techniques. The result indicated that old people in Hong Kong had an overall positive attitude toward technology. Positive attitudes were most frequently related to enhanced convenience and advanced features. Negative attitudes were most frequently associated with health risks and social problems arising from using technology (e.g., social isolation and addiction). Usage of technology is driven by outcome expectations and social influences, and supported by facilitators, whereas non-use of gerontechnology relates to the personal (e.g., health and functional capacities), technological (e.g., cost and complexity), and environmental barriers experienced. Use of gerontechnology is a synthesis of person, technology, and environment. To encourage non-users to adopt technology, there is a need to remove barriers at personal, technological, and environmental levels.
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