Factors Associated with the Acceptance of New Technologies for Ageing in Place by People over 64 Years of Age

A Social Work Analysis of Facilitators of and Barriers to Adopting Technology in Older Adults: A Systematic Literature Review

Increasing concern within social work about delivering comprehensive and high-quality care to older adults necessitates exploring their interest in information and communication technologies. The aim is to determine, via a systematic review using the PRISMA method, how the scientific literature on older adults' technology experiences through the lens of the Technology Acceptance Model (TAM). The review differentiates between enabling factors and barriers that influence older adults' use and acceptance of technology from their own perspective. It provides social workers with a comprehensive overview of use of technologies and identify general guidelines to enhance older adults' personal and communal autonomy.

Digitalization of Activities of Daily Living and Its Influence on Social Participation for Community-Dwelling Older Adults: A Scoping Review

Everyday technology (ET) has been defined as the broad set of devices and artefacts that are currently present in people's lives both inside and outside of the home. A subgroup within ET is known as everyday information and communication technologies (EICTs). The main characteristic of these technologies is that they can facilitate or disrupt the engagement of individuals in their daily activities. This scoping review aims to identify what is known about how ET can function as facilitators or barriers to occupations, such as the social participation of older adults. The proposed scoping review was conducted in accordance with the Joanna Briggs Institute (JBI) methodology for scoping reviews. The review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Review (PRISMA-ScR) guidelines and checklist. The scoping review was conducted across five online databases (PubMed, Scopus, Web of Science, MEDLINE and PsycoINFO [EBSCO]) to identify published, peer-reviewed records. Studies were screened by two independent reviewers against the inclusion criteria. This review considered studies concerning the use of ET or EICTs in community-dwelling adults aged over 60 years, with or without cognitive impairment or dementia. All of the articles were in English, and reviews were not included. Eleven papers were selected and showed that despite the increasing demand for technologies of daily life and the digitalization of society and processes, according to our research, few studies addressed the limitations in the social participation of older adults. In conclusion, ET can provide a way to promote and maintain the personal autonomy for older adults in community dwellings. However, cognitive impairment hinders the use of electronic technologies and increases perceived problems.

The Path From Awareness to Action: Exploring Diabetic Patients' Awareness and Attitudes and Barriers to Utilization of Artificial Pancreas in the Beheira Governorate, Egypt

Background and objective There is scarce data on diabetic patients' awareness, attitude, and barriers to utilization regarding the artificial pancreas. In light of this, the current study aimed to explore the awareness, attitudes, and perceived barriers to utilization of the artificial pancreas experienced by diabetic patients. Methods A cross-sectional study design was employed to achieve the aim of the study. The study was conducted in Damanhur city, the Beheira Governorate, Egypt. The convenience sampling technique was used to include 385 diabetic patients. The researchers designed an interview questionnaire comprising four parts to collect data about knowledge, attitudes, and barriers to utilization. Results The findings showed that 61% of the participants had a satisfactory level of overall knowledge. Regarding overall attitude, 64.1% of participants exhibited a positive attitude toward the artificial pancreas. The data indicated that 37.7% of participants identified the associated high cost as a significant barrier. Additionally, 23.3% expressed concerns about the lack of healthcare provider support, 21.5% had reservations regarding maintenance, and 17.5% felt limited by their technical skills. Conclusions The study revealed a notable satisfactory level of knowledge and attitudes among about two-thirds of participants regarding the artificial pancreas. Concerns about the high cost emerged as a predominant barrier followed by a lack of healthcare provider support. Empowering both healthcare providers and patients through ongoing educational initiatives can play a pivotal role in fostering a positive attitude and addressing concerns related to artificial pancreas technology.

Examining technology-assisted rehabilitation for older adults' functional mobility: a network meta-analysis on efficacy and acceptability

Technological advancements facilitate feedback adaptation in rehabilitation through virtual reality (VR) exergaming, serious gaming, wearables, and telerehabilitation for older adults fall prevention. Although studies have evaluated these technologies, no comparisons of their effectiveness have been conducted to date. Thus, this study aims to assess the differences in effectiveness of these interventions on balance and functional mobility in the older adults. A systematic review and network meta-analysis (NMA) were conducted to identify the most effective interventions for improving balance and functional mobility in adults aged 60 and over. The search was conducted in five databases (PubMed, Embase, Cochrane Central Register of Controlled Trials, Scopus, and Web of Science) up to June 10, 2023. The eligibility criteria were: (1) older adults, (2) functional mobility, balance, or gait as the primary outcome, (3) new technology intervention, and (4) randomized study design. New technology interventions were classified into five categories: exergaming with balance platforms or motion capture technologies, other serious gaming, interventions with wearables, and telerehabilitation. Additionally, two categories of control interventions (conventional exercises and no treatment) were extracted. The NMA was performed for the aggregated results of all outcomes, and separately for clinical functional scales, functional mobility, and gait speed results. Fifty-two RCTs with 3081 participants were included. Exergaming with motion capture was found to be statistically significant in producing a better effect than no treatment in the analysis of the functional mobility with an SMD of -0.70 (P < 0.01). The network meta-analysis revealed that exergaming with motion capture offers greater therapeutic benefits for functional mobility and balance compared to no treatment control. The effectiveness of this approach is similar to that of conventional exercises. Further RCTs are needed to provide a more definitive conclusion, particularly with respect to the effectiveness of serious games, telerehabilitation, and interventions with wearables.

Physicians' perceptions of electronic prescribing of controlled medications in the West Bank, Palestine: A pre-implementation assessment

BACKGROUND

In Palestine, prescribing controlled medications is still done on paper. Despite valuable regulatory efforts, there is a high risk of undetected abuse and "doctor shopping". These problems can be addressed with electronic prescribing of controlled medicines (EPCM). User adoption is essential to the successful implementation of any technology. Therefore, it is crucial to determine the perception of end users at an early stage. This topic has never been addressed in Palestine. Our study aims to investigate the perception of Palestinian physicians towards the introduction of EPCM.

METHODS

This cross-sectional study was conducted among Palestinian physicians in the West Bank who are familiar with controlled medications prescribing. Data were collected using a self-administered questionnaire based on the Unified Theory of User Acceptance and Use of Technology (UTAUT) from a convenience sample of 300 physicians. Data were analyzed using SPSS version 26. Bivariate analysis and binary and multivariate logistic regression were performed to identify factors associated with physicians' perceptions of ECPM.

RESULTS

Most physicians expressed their willingness to use EPCM, with an acceptance rate of 85%. This perception was significantly affected by performance expectancy, effort expectancy and trust. None was moderated by age, gender, or experience with electronic prescribing. Age and specialization level were independent factors significantly influencing the intention to use EPCM. The level of current workflow challenges did not correlate with the intent to use EPCM.

CONCLUSION

Palestinian physicians will accept EPCM. Based on the results of this study, it is recommended that the following be considered: ensuring maximum efficiency of the system, selecting user-friendly interfaces and high-security measures to prevent system breaches.

The Use of a Technology Acceptance Model (TAM) to Predict Patients' Usage of a Personal Health Record System: The Role of Security, Privacy, and Usability

Personal health records (PHR) systems are designed to ensure that individuals have access and control over their health information and to support them in being active participants rather than passive ones in their healthcare process. Yet, PHR systems have not yet been widely adopted or used by consumers despite their benefits. For these advantages to be realized, adoption of the system is necessary. In this study, we examined how self-determination of health management influences individuals' intention to implement a PHR system, i.e., their ability to actively manage their health. Using an extended technology acceptance model (TAM), the researchers developed and empirically tested a model explaining public adoption of PHRs. In total, 389 Saudi Arabian respondents were surveyed in a quantitative cross-sectional design. The hypotheses were analysed using structural equation modelling-partial least squares (SEM-PLS4). Results indicate that PHR system usage was influenced by three major factors: perceived ease of use (PEOU), perceived usefulness (PU), and security towards intention to use. PHR PEOU and PHR intention to use were also found to be moderated by privacy, whereas usability positively moderated PHR PEOU and PHR intention to use and negatively moderated PHR PU and PHR intention to use. For the first time, this study examined the use of personal health records in Saudi Arabia, including the extension of the TAM model as well as development of a context-driven model that examines the relationship between privacy, security, usability, and the use of PHRs. Furthermore, this study fills a gap in the literature regarding the moderating effects of privacy influence on PEOU and intention to use. Further, the moderating effects of usability on the relationship between PEOU, PU, and intention to use. Study findings are expected to assist government agencies, health policymakers, and health organizations around the world, including Saudi Arabia, in understanding the adoption of personal health records.

Mobility restriction and barrier-reduced housing among people aged 65 or older in Germany: Do those who need it live in barrier-reduced residences?

Introduction

Older people spend a lot of time at home and in the area near where they live. Housing conditions ensure their ability to participate in social life, especially when they suffer from mobility restrictions. Barrier-free access to the residence and to rooms within the residence is a key condition for their everyday mobility. As a result, this is what we define as minimal criteria for barrier-reduced residences. This article examines the extent to which people aged 65 and over (including people with mobility issues) live in barrier-reduced housing and what factors influence the chance of living in such residences.

Data and method

Cross-sectional data from the German Ageing Survey (DEAS) 2020/21 (persons aged 65 and over, n = 2,854) were used. The DEAS is a representative cross-sectional and longitudinal survey of the population aged 40 and over in Germany. In our analyses, we used logistic regression models to investigate the probability of living in a barrier-reduced residence. We defined housing as barrier-reduced when the apartment/house and the rooms inside it can be reached without steps or stairs. As explanatory variable, we considered mobility restrictions, defined as limited ability to climb a flight of stairs. In addition, the model includes other individual factors (age, gender, equivalized household income), regional factors (living in East vs. West Germany, in urban vs. rural region) and moving to the current residence after the age of 65.

Results and discussion

Of all individuals aged 65 or older, 19.3 percent live in a barrier-reduced residence. Also, of mobility-restricted elders, only 21.4 percent have such residences. The logistic regression results show that mobility restrictions are associated with a higher probability of living in a barrier-reduced residence. Compared to the lowest income group, older people in the highest income group are more likely to live in barrier-reduced housing. East Germans and people in urban areas are less likely to live in a barrier-reduced home. The likelihood of barrier-reduced living is higher among seniors who moved into their current residence after age 65. No significant differences were found for age groups and gender. The findings show that not enough seniors have barrier-reduced access to their homes and rooms, even if they suffer from mobility restrictions. Preventing functional restrictions must therefore also include improvements in the residential environment, especially in disadvantaged residential areas.

Health Emergencies, Falls, and Use of Communication Technologies by Older People with Functional and Social Frailty: Ageing in Place in Deprived Areas of Italy

Frail older people ageing alone in place need help to perform daily living activities, especially when functional limitations are increasing and formal/informal supports are lacking. This context represents a risk of experiencing health emergencies, in particular falls. It is thus important to understand how seniors manage these potential difficulties and who helps them. The present study aimed to explore these dimensions in Italy, where 120 qualitative interviews were carried out in 2019 within the "Inclusive ageing in place" (IN-AGE) research project, involving frail older people living alone at home. A content analysis was conducted. Results showed that seniors need to manage health emergencies regarding heart and breathing problems but mainly episodes of falls are reported, with consequent fractures and fear of falling again. In several cases, the use of a mobile phone was crucial in order to seek for help, and the first to intervene were children, in addition to some neighbors. Some seniors also referred their ability to call independently the General Practitioner (GP) or the emergency room, in order to not disturb family members. These findings highlight new useful insights for policy makers, regarding health emergencies prevention and management measures to put in place, especially concerning falls, and the support provided by communication technologies.

Frail Older People Ageing in Place in Italy: Use of Health Services and Relationship with General Practitioner

Functional limitations, chronic diseases and frailty often occur in later life. These aspects become very challenging when older people age alone in place, thus needing support in the activities of daily living, and in this context, it is important they can access and use health services. The present study aimed to explore these issues in Italy. In 2019, 120 qualitative interviews were carried out within the “Inclusive Ageing in Place” (IN-AGE) project, involving frail older people living at home in three Italian regions (Lombardy, Marche, and Calabria). A content analysis and some quantifications of main statements are presented. Results showed that the majority of seniors report poor self-rated health (SRH), suffer from many chronic diseases, and mainly use the General Practitioner (GP) and Medical Specialists (MSs), even though long waiting list in the public sector and high costs in the private one act as barriers to access health services. Complaints regarding GPs mainly refer to the almost exclusive provision of prescriptions and the lack of home visits. Some regional peculiarities highlighted a better overall context in the north than in the south, especially with regards to the public health sector. These results can provide useful insights for policy makers, in order to deliver health services assuring frail, older people the continuity of assistance needed at home.

Caring for Frail Older People Living Alone in Italy: Future Housing Solutions and Responsibilities of Family and Public Services, a Qualitative Study

When frail older people age alone in place, with increasing functional limitations, they require support in performing daily living activities. In this respect, it is important to assess their preferences in terms of future housing solutions, and their opinions/orientations on the care responsibilities of both family and public services. The present study aimed to explore these aspects in Italy. Qualitative interviews were carried out in 2019 within the “Inclusive ageing in place” (IN-AGE) research project, involving 120 frail older people who lived at home in three Italian regions (Lombardy, Marche, and Calabria). A content analysis was conducted, and some quantifications of interviewees’ statements were provided. The results revealed that the majority of seniors prefer ageing at home, at least with a personal care assistant (PCA), whereas moving to a nursing home is typically deemed as a last option. Moreover, they considered the family to be primarily responsible for taking care of them, even with the support of public services. In addition, some territorial differences emerged. Strengthening an integrated model of long-term care (LTC) for older people, where both formal and informal supports allow frail older people to age at home, seems thus a good overall policy solution to pursue, with interventions based also on the needs and preferences of both seniors and their respective families.

Exploring Usability and Patient Attitude towards a Smart Hospital Service with the Technology Acceptance Model

The demand for health care has increased with the development of global technology and the rise of public health awareness, and smart service systems have also been introduced to medical care to relieve the pressure on hospital staff. However, the survey found that patients' willingness to use smart services at the time of consultation has not improved. The main research purpose of this study was to understand the willingness of patients from various groups to use smart medical service systems and to explore the influencing factors on patients' use of smart service systems in hospitals through the technology acceptance model. This study distributed questionnaires in the outpatient area of National Taiwan University Hospital Yunlin Branch, and a total of 202 valid questionnaires were obtained. After related research and regression analysis, it was found that patients paid more attention to the benefits and convenience brought by smart services. If patients believed that smart services were trustworthy and beneficial to themselves, their usage intention and attitude would be positive. The results of this study are summarized by the following four points: (1) Designed according to the cultural conditions of different regions; (2) think about design from the patient's perspective; (3) strengthen the explanation and promotion of smart services; and (4) add humanized care and design. This study could be used as a reference for hospitals to improve their service quality and systems in the future.