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Watson J, Hanna K, Talbot C, Hansen M, Cannon J, Caprioli T, Gabbay M, Komuravelli A, Eley R, Tetlow H, Giebel C. A systematic review of digital access to post-diagnostic health and social care services for dementia. Int J Geriatr Psychiatry 2024; 39:e6119. [PMID: 39004777 DOI: 10.1002/gps.6119] [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: 03/26/2024] [Accepted: 06/17/2024] [Indexed: 07/16/2024]
Abstract
OBJECTIVES For many people with dementia and unpaid carers, using technology for care and support has become essential. Rapid proliferation of technology highlights the need to understand digital access to health and social care services for dementia. This mixed-methods systematic review aims to explore digital access to health and social care services for dementia, from the perspective of people with dementia and unpaid carers. METHODS Nine electronic databases were searched in May 2023 for qualitative, quantitative, or mixed-method studies, published in English or German, focused on experiences of using technology-delivered health and social care services for people with dementia and unpaid carers. After removal of duplicates and screening, 44 empirical papers were included. RESULTS From the 44 studies, findings were grouped into five categories, highlighting experiences for people with dementia and unpaid carers: (1) Adapting to technology, (2) Inequalities and variations in outcomes, (3) Impact on caring, (4) Impact on health, and (5) Impact on relationships. Proliferation of technology in care access emphasised the need for quick adaptation to technology and examination of its impact. The impact of such service delivery has evidenced mixed findings. There were improvements in the health and wellbeing of people with dementia and unpaid carers, and benefits for their dyadic relationship. However, using technology for health and social care access is not always possible and is often reliant on unpaid carers for support. Lower tech-literacy, lack of equipment or money to buy equipment and poor internet connection can impact the potential for positive outcomes. CONCLUSIONS Technology can bring great benefits: social inclusion, improved service access and care. However, using technology in service delivery in dementia needs careful thought. Professionals and service providers need to be cognizant of the complex nature of dementia, and the benefits and challenges of hybrid service delivery.
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Affiliation(s)
- James Watson
- Department of Primary Care & Mental Health, University of Liverpool, Liverpool, UK
| | - Kerry Hanna
- School of Health Sciences, University of Liverpool, Liverpool, UK
| | - Catherine Talbot
- Ageing and Dementia Research Centre, Bournemouth University, Bournemouth, UK
| | - Marcus Hansen
- Faculty of Business and Law, Liverpool John Moores University, Liverpool, UK
| | | | - Thais Caprioli
- Department of Primary Care & Mental Health, University of Liverpool, Liverpool, UK
- NIHR Applied Research Collaboration North West Coast, Liverpool, UK
| | - Mark Gabbay
- Department of Primary Care & Mental Health, University of Liverpool, Liverpool, UK
- NIHR Applied Research Collaboration North West Coast, Liverpool, UK
| | | | - Ruth Eley
- Together in Dementia Everyday (TIDE), Liverpool, UK
| | - Hilary Tetlow
- NIHR Applied Research Collaboration North West Coast, Liverpool, UK
- Together in Dementia Everyday (TIDE), Liverpool, UK
- Service User Reference Forum (SURF), Liverpool, UK
| | - Clarissa Giebel
- Department of Primary Care & Mental Health, University of Liverpool, Liverpool, UK
- NIHR Applied Research Collaboration North West Coast, Liverpool, UK
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Damant J. Unpaid carers of people with dementia and information communication technology: Use, impact and ideas for the future. DEMENTIA 2024; 23:779-799. [PMID: 38664990 PMCID: PMC11163843 DOI: 10.1177/14713012241249793] [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] [Indexed: 06/11/2024]
Abstract
OBJECTIVES Several 100,000s of people living with dementia in the UK are cared for at home by a spouse or relative. Few studies have considered the ICT needs and experiences of unpaid carers. This study explores the types of ICT unpaid carers use, the ways they use ICT, the impact of ICT-use, and their ideas for how ICT could be more supportive of their role as a carer. METHODS Six focus groups with 32 unpaid carers of people living with dementia discussed their experiences of - and barriers to - using ICT. Transcripts were analysed thematically according to three types of ICT (mainstream, accessible and formal) and five functions (supporting domestic tasks, care management, monitoring, communication and information and education). RESULTS Participants predominantly used mainstream ICT devices such as laptops and smartphones and internet-enabled applications including videoconferencing and social media platforms to support their daily activities and assist them in their caring role. A few participants discussed using accessible devices such as memory clocks and formal telecare and care-phone services for care management and monitoring functions. Participants' ideas for improvements centred on personalised communication applications that facilitate remote interactions and promote persons living with dementia's independence. Others expressed concerns about the growing need to use ICT to access formal care services and the inadequacy of the ICT infrastructure in some care homes. CONCLUSIONS Unpaid carers mostly turn to readily available mainstream ICT to support their personal and care activities. Further research is required to understand the social impact of the increasing reliance of ICT across health, social and residential care service sectors. Improved cooperation between unpaid carers, technology developers and care services providers could align ICT development to the needs and experiences of families living with dementia and assist unpaid carers with identifying ICTs that optimally support their personal circumstances.
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Affiliation(s)
- Jacqueline Damant
- Care Policy and Evaluation Centre of the London School of Economics and Political Science, London, UK
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Giebel C, Gabbay M, Shrestha N, Saldarriaga G, Reilly S, White R, Liu G, Allen D, Zuluaga MI. Community-based mental health interventions in low- and middle-income countries: a qualitative study with international experts. Int J Equity Health 2024; 23:19. [PMID: 38308294 PMCID: PMC10835969 DOI: 10.1186/s12939-024-02106-6] [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: 03/20/2023] [Accepted: 01/13/2024] [Indexed: 02/04/2024] Open
Abstract
BACKGROUND Mental health services are scarce in low- and middle-income countries (LMICs), and designing and implementing effective interventions can be difficult. The aim of this international study was to explore the key lessons for developing, implementing, and evaluating community-based mental health and well-being interventions in LMICs, with an additional focus on older adults. METHODS Research and clinical experts in developing and implementing psychosocial community-based interventions in LMICs were interviewed remotely between October 2021 and January 2022. Participants were recruited via existing global health networks and via published literature searches. Participants were asked about their experiences of developing and implementing interventions, and about key barriers and facilitators during the process. Interviews lasted up to 45 min, and data were analysed using combined inductive and deductive thematic analysis. RESULTS Sixteen global mental health experts participated. Five themes with different sub-themes were generated: Mechanisms and contexts; Barriers; Facilitators; Public and stakeholder involvement; Looking through an ageing lens. The development and delivery of mental health interventions in LMICs are facilitated through integration into existing health infrastructures and working with existing job roles as delivery agents. Public and stakeholder involvement are crucial at all stages of development through to implementation to focus on meeting local needs and sustaining participant motivation. Logistical barriers of transport, resources, and location need to be addressed, emphasising local sustainability. CONCLUSIONS This study provides important insights for how the development, implementation, and evaluation of community-based mental health and well-being interventions in LMICs can be optimised, and can complement general guidance into complex interventions developments.
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Affiliation(s)
- Clarissa Giebel
- Department of Primary Care & Mental Health, University of Liverpool, Liverpool, UK.
- NIHR Applied Research Collaboration North West Coast (ARC NWC), Liverpool, UK.
| | - Mark Gabbay
- Department of Primary Care & Mental Health, University of Liverpool, Liverpool, UK
- NIHR Applied Research Collaboration North West Coast (ARC NWC), Liverpool, UK
| | - Nipun Shrestha
- Trials Centre, NHMRC Clinical, University of Sydney, Sydney, Australia
| | | | - Siobhan Reilly
- Centre for Applied Dementia Studies, Faculty of Health Studies, University of Bradford, Bradford, UK
| | - Ross White
- School of Psychology, Queen's University Belfast, Belfast, UK
| | - Ginger Liu
- NIHR Applied Research Collaboration North West Coast (ARC NWC), Liverpool, UK
| | - Dawn Allen
- NIHR Applied Research Collaboration North West Coast (ARC NWC), Liverpool, UK
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Muurling M, de Boer C, Hinds C, Atreya A, Doherty A, Alepopoulos V, Curcic J, Brem AK, Conde P, Kuruppu S, Morató X, Saletti V, Galluzzi S, Vilarino Luis E, Cardoso S, Stukelj T, Kramberger MG, Roik D, Koychev I, Hopøy AC, Schwertner E, Gkioka M, Aarsland D, Visser PJ. Feasibility and usability of remote monitoring in Alzheimer's disease. Digit Health 2024; 10:20552076241238133. [PMID: 38601188 PMCID: PMC11005503 DOI: 10.1177/20552076241238133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 02/22/2024] [Indexed: 04/12/2024] Open
Abstract
Introduction Remote monitoring technologies (RMTs) can measure cognitive and functional decline objectively at-home, and offer opportunities to measure passively and continuously, possibly improving sensitivity and reducing participant burden in clinical trials. However, there is skepticism that age and cognitive or functional impairment may render participants unable or unwilling to comply with complex RMT protocols. We therefore assessed the feasibility and usability of a complex RMT protocol in all syndromic stages of Alzheimer's disease and in healthy control participants. Methods For 8 weeks, participants (N = 229) used two activity trackers, two interactive apps with either daily or weekly cognitive tasks, and optionally a wearable camera. A subset of participants participated in a 4-week sub-study (N = 45) using fixed at-home sensors, a wearable EEG sleep headband and a driving performance device. Feasibility was assessed by evaluating compliance and drop-out rates. Usability was assessed by problem rates (e.g., understanding instructions, discomfort, forgetting to use the RMT or technical problems) as discussed during bi-weekly semi-structured interviews. Results Most problems were found for the active apps and EEG sleep headband. Problem rates increased and compliance rates decreased with disease severity, but the study remained feasible. Conclusions This study shows that a highly complex RMT protocol is feasible, even in a mild-to-moderate AD population, encouraging other researchers to use RMTs in their study designs. We recommend evaluating the design of individual devices carefully before finalizing study protocols, considering RMTs which allow for real-time compliance monitoring, and engaging the partners of study participants in the research.
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Affiliation(s)
- Marijn Muurling
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC location VUmc, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, The Netherlands
| | - Casper de Boer
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC location VUmc, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, The Netherlands
| | - Chris Hinds
- Nuffield Department of Population Health, University of Oxford Big Data Institute, Oxford, UK
| | - Alankar Atreya
- Nuffield Department of Population Health, University of Oxford Big Data Institute, Oxford, UK
| | - Aiden Doherty
- Nuffield Department of Population Health, University of Oxford Big Data Institute, Oxford, UK
| | - Vasilis Alepopoulos
- Information Technologies Institute, Center for Research and Technology Hellas (CERTH-ITI), Thessaloniki, Greece
| | | | - Anna-Katharine Brem
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Department of Old Age Psychiatry, University Hospital of Old Age Psychiatry, University of Bern, Bern, Switzerland
| | - Pauline Conde
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Sajini Kuruppu
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Xavier Morató
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Valentina Saletti
- Laboratory Alzheimer's Neuroimaging & Epidemiology, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Samantha Galluzzi
- Laboratory Alzheimer's Neuroimaging & Epidemiology, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Estefania Vilarino Luis
- Centre de la mémoire, Université de Genève (UNIGE), Hôpitaux Universitaires de Genève, Geneva, Switzerland
| | - Sandra Cardoso
- Faculdade de Medicina da, Universidade de Lisboa, Lisbon, Portugal
| | - Tina Stukelj
- Department of Neurology, University Medical Center Ljubljana and Medical faculty, University of Ljubljana, Ljubljana, Slovenia
| | - Milica Gregorič Kramberger
- Department of Neurology, University Medical Center Ljubljana and Medical faculty, University of Ljubljana, Ljubljana, Slovenia
- Division of Clinical Geriatrics, Department of Neurobiology, Department of Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Dora Roik
- Department of Geriatric Psychiatry, Central Institute for Mental Health, Medical Faculty Mannheim, University of Heidelberg, Heidelberg,
Germany
| | - Ivan Koychev
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - Ann-Cecilie Hopøy
- Department of Old Age Psychiatry, Centre for Age-Related Medicine, Stavanger University Hospital, Stavanger, Norway
| | - Emilia Schwertner
- Division of Clinical Geriatrics, Department of Neurobiology, Department of Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
- Faculty of Psychology, SWPS University of Social Sciences and Humanities, Krakow, Poland
| | - Mara Gkioka
- Laboratory of Neurodegenerative Diseases, Center for Interdisciplinary Research and Innovation (CIRI – AUTh), Balkan Center, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Dag Aarsland
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Department of Old Age Psychiatry, Centre for Age-Related Medicine, Stavanger University Hospital, Stavanger, Norway
| | - Pieter Jelle Visser
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC location VUmc, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, The Netherlands
- Division of Clinical Geriatrics, Department of Neurobiology, Department of Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
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Pessoa Lima D, Rosa ID. People affected by dementia had mixed experiences of using technology during COVID-19. Evid Based Nurs 2023; 26:162. [PMID: 37116981 DOI: 10.1136/ebnurs-2022-103635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/11/2023] [Indexed: 04/30/2023]
Affiliation(s)
- Danielle Pessoa Lima
- Faculdade de Medicina, Centro de Ciências da Saúde, Universidade de Fortaleza, Fortaleza, Ceará, Brazil
- Serviço de Geriatria, Departamento de Clínica Médica, Hospital Universitário Walter Cantídio, Universidade Federal do Ceará, Fortaleza, Ceará, Brazil
| | - Isabele Dantas Rosa
- Serviço de Geriatria, Departamento de Clínica Médica, Hospital Universitário Walter Cantídio, Universidade Federal do Ceará, Fortaleza, Ceará, Brazil
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Emerson MR, Dinkel D, Watanabe-Galloway S, Torous J, Johnson DJ. Adaptation of digital navigation training for integrated behavioral health providers: Interview and survey study. Transl Behav Med 2023; 13:612-623. [PMID: 37086443 DOI: 10.1093/tbm/ibad016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/23/2023] Open
Abstract
Despite effective treatment options, people who experience mental health conditions often do not receive needed care. E-mental health, for instance the use of mobile apps, is emerging as a way to increase access to and extend care. However, little formal training is available to increase the digital literacy level among behavioral healthcare providers (BHPs), seeking to employ such technology. The purpose of this study was to explore the acceptability and usability of an adapted in-person Digital Navigation Training (DNT) curriculum into e-Learning modules focused on the integrated environment for BHPs. BHP confidence to serve as digital navigators was also explored. E-Learning modules were adapted from an existing in-person DNT. A purposeful sampling strategy was used to recruit BHPs (n = 8) to complete the modules. Acceptability, usability, and confidence were assessed via survey and semi-structured interviews. Descriptive statistics were calculated for survey data and qualitative data were analyzed using a directed content analysis approach. BHPs who completed the training (n = 8) felt the modules were usable, enjoyed the structure, and felt the amount of time to complete the modules was acceptable. All participants thought the structure of the training worked well and enjoyed learning new information. While participants' confidence in their digital navigation skills increased, they desired more information and/or experience with screening apps prior to increasing their use of apps within their care. E-Learning modules were an acceptable method of educating BHPs with digital navigation skills. Future research is needed to explore incentives needed for training along with if participating in these modules can increase use of quality mobile apps to augment care within BHP treatment plans.
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Affiliation(s)
- Margaret R Emerson
- College of Nursing, University of Nebraska Medical Center, Omaha, NE 68154, USA
| | - Danae Dinkel
- College of Education, Health, and Human Sciences, University of Nebraska at Omaha, Omaha, NE 68182, USA
| | | | - John Torous
- Department of Psychiatry at Beth Israel Deaconess Medical Center, Boston, 02115 MA, USA
| | - David J Johnson
- Department of Psychiatry & Behavioral Science, Mercer University School of Medicine, Atlanta, GA 30341, USA
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Lion KM, Murfield J, Sriram D, Sung B, Cook G, Estai M, Jones C, Klein B, Liddle J, Pu L, Moyle W, Collaborative TA. Technology in aged care: a qualitative survey of academic, research, and technology industry professionals. Contemp Nurse 2023; 59:311-322. [PMID: 37537756 DOI: 10.1080/10376178.2023.2242978] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 07/26/2023] [Indexed: 08/05/2023]
Abstract
AIMS AND OBJECTIVES The study's aim was two-fold: (1) to explore the experiences and perceptions of industry, academic, and research professionals concerning technologies used within aged care; and (2) to identify needs-led priorities for the future development and application of technologies within aged care. BACKGROUND Global population ageing requires a recalibration of aged care policies, systems, and services to promote and support healthy ageing. It is expected that technology will play an important role in this regard. This study qualitatively assessed the landscape of technology use in aged care from the perspective of industry, academic, and research professionals. DESIGN A purposefully designed cross-sectional survey collecting experiences, perspectives, and barriers about technology through open responses. METHODS Using convenience sampling, thirty-five participants completed an online survey between April and October 2020. A descriptive qualitative content analysis approach was used to analyse the written responses. Reporting of findings followed the EQUATOR's Standards for Reporting Qualitative Research checklist. RESULTS Four themes were identified that characterised the use of technologies within aged care: (1) User Perceptions and Attitudes: wariness and reluctance to technology; (2) Systemic Issues within Aged Care: Under-resourced with opportunities for innovation; (3) Technology-Related Barriers: Equity, costs, privacy, integration, and interoperability and (4) Research Priorities: Co-design and integration of technology. CONCLUSIONS The existing technology does not meet the needs of older people, aged care personnel and the system in general, which prevents its successful implementation and uptake.
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Affiliation(s)
- Katarzyna M Lion
- Menzies Health Institute Queensland, Griffith University, Brisbane, QLD, Australia
- Australian Aged Care Technologies Collaborative, Griffith University, Brisbane, qld, Australia
| | - Jenny Murfield
- Menzies Health Institute Queensland, Griffith University, Brisbane, QLD, Australia
- Australian Aged Care Technologies Collaborative, Griffith University, Brisbane, qld, Australia
- School of Nursing & Midwifery, Menzies Health Institute Queensland, Griffith University, Health Sciences (N48), 170 Kessels Road, Nathan, Brisbane, QLD 4111, Australia
- Food & Mood Centre, The Institute for Mental and Physical Health and Clinical Translation (IMPACT), School of Medicine, Deakin University, Melbourne, Australia
| | - Deepa Sriram
- Menzies Health Institute Queensland, Griffith University, Brisbane, QLD, Australia
| | - Billy Sung
- Australian Aged Care Technologies Collaborative, Griffith University, Brisbane, qld, Australia
- School of Management and Marketing, Curtin University, Perth, WA, Australia
| | - Glenda Cook
- Australian Aged Care Technologies Collaborative, Griffith University, Brisbane, qld, Australia
- Department of Nursing, Midwifery and Health, Northumbria University, Newcastle upon Tyne, UK
| | - Mohamed Estai
- Australian Aged Care Technologies Collaborative, Griffith University, Brisbane, qld, Australia
- The Australian eHealth Research Centre, CSIRO, Perth, WA, Australia
| | - Cindy Jones
- Menzies Health Institute Queensland, Griffith University, Brisbane, QLD, Australia
- Australian Aged Care Technologies Collaborative, Griffith University, Brisbane, qld, Australia
- Faculty of Health Sciences & Medicine, Bond University, Gold Coast, QLD, Australia
| | - Barbara Klein
- Research Centre FUTURE AGING, Faculty of Health and Social Work, Frankfurt University of Applied Sciences, Frankfurt am Main, Germany
| | - Jacki Liddle
- Australian Aged Care Technologies Collaborative, Griffith University, Brisbane, qld, Australia
- School of Information Technology and Electrical Engineering, University of Queensland, Brisbane, QLD, Australia
| | - Lihui Pu
- Menzies Health Institute Queensland, Griffith University, Brisbane, QLD, Australia
- Australian Aged Care Technologies Collaborative, Griffith University, Brisbane, qld, Australia
- School of Nursing & Midwifery, Menzies Health Institute Queensland, Griffith University, Health Sciences (N48), 170 Kessels Road, Nathan, Brisbane, QLD 4111, Australia
| | - Wendy Moyle
- Menzies Health Institute Queensland, Griffith University, Brisbane, QLD, Australia
- Australian Aged Care Technologies Collaborative, Griffith University, Brisbane, qld, Australia
- School of Nursing & Midwifery, Menzies Health Institute Queensland, Griffith University, Health Sciences (N48), 170 Kessels Road, Nathan, Brisbane, QLD 4111, Australia
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Giebel C, Reilly S, Gabbay M, Dickinson J, Tetlow H, Hogan H, Griffiths A, Cooper C. Dementia care navigation: A systematic review on different service types and their prevalence. Int J Geriatr Psychiatry 2023; 38:e5977. [PMID: 37526320 DOI: 10.1002/gps.5977] [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] [Received: 01/17/2023] [Accepted: 07/12/2023] [Indexed: 08/02/2023]
Abstract
BACKGROUND Dementia Care Navigators (DCNs) are professionals without clinical training, who provide individualised emotional and practical support to people living with dementia, working alongside clinical services. Navigator services have been implemented but the service offered vary without a consistent overview provided. The aim of this narrative systematic review was to describe and compare existing service formats, and to synthesise evidence regarding their implementation and impacts. METHODS The review was registered on PROSPERO [CRD42021292518]. Three electronic databases were searched and included studies reported on a DCN service, defined as a service in which non-clinically trained workers provide personalised advice and support to people with dementia and/or carers in the community. Two independent reviewers screened abstracts and titles and read through full papers for inclusion. Risk of bias was assessed using the Standard Quality Assessment QualSyst. RESULTS We included 14 papers reporting on six studies. All services were US-based and only varied by integration and training provided. Studies reported different degrees of impact on service utilisation and on symptoms and mental well-being of people with dementia and their carers, with too little evidence to draw substantial/meaningful conclusions and studies employing different outcome measures. One study evidenced greater impacts on people with more advanced dementia compared to earlier stages. CONCLUSIONS DCN services have the potential to effectively provide non-clinical support to people with dementia and carers from the point of diagnosis. Further research from countries other than the USA, focusing on the impact on social care and social support service access and utilisation, and utilising similar established outcome measures are required.
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Affiliation(s)
- Clarissa Giebel
- Department of Primary Care & Mental Health, University of Liverpool, Liverpool, UK
- NIHR Applied Research Collaboration North West Coast, Liverpool, UK
| | - Siobhan Reilly
- Centre for Applied Dementia Studies, University of Bradford, Bradford, UK
| | - Mark Gabbay
- Department of Primary Care & Mental Health, University of Liverpool, Liverpool, UK
- NIHR Applied Research Collaboration North West Coast, Liverpool, UK
| | - Julie Dickinson
- NIHR Applied Research Collaboration North West Coast, Liverpool, UK
| | - Hilary Tetlow
- NIHR Applied Research Collaboration North West Coast, Liverpool, UK
| | | | - Alys Griffiths
- Department of Primary Care & Mental Health, University of Liverpool, Liverpool, UK
| | - Claudia Cooper
- Centre of Psychiatry and Mental Health, Wolfson Institute of Population Health, Queen Mary University London, London, UK
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9
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Bradley L, Shanker S, Murphy J, Fenge LA, Heward M. Effectiveness of digital technologies to engage and support the wellbeing of people with dementia and family carers at home and in care homes: A scoping review. DEMENTIA 2023:14713012231178445. [PMID: 37235791 DOI: 10.1177/14713012231178445] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Use of digital technologies to support meaningful engagement of people with dementia and carers increased during the COVID-19 pandemic. The purpose of this scoping review was to determine the effectiveness of digital technologies in supporting the engagement and wellbeing of people with dementia and family carers at home and in care homes. Studies published in peer reviewed literature were identified across four databases (CINAHL, Medline, PUBMED, PsychINFO). Sixteen studies met the inclusion criteria. Findings indicate that digital technologies can potentially support the wellbeing of people with dementia and family carers, although only a few studies had measured impact on wellbeing, as many were reporting on technology at proof-of-concept stage rather than commercially ready products. Moreover, current studies lacked meaningful involvement of people with dementia, family carers, and care professionals in the design of the technology. Future research should bring together people with dementia, family carers, care professionals and designers to coproduce digital technologies with researchers and evaluate them using robust methodologies. Codesign should start early in the intervention development phase and continue until implementation. There is a need for real world applications that nurture social relationships by focusing on how digital technologies can support more personalised, adaptive forms of care. Developing the evidence base to identify what makes digital technologies effective in supporting the wellbeing of people with dementia is crucial. Future interventions should therefore consider the needs and preferences of people with dementia, their families, and professional carers, as well as the suitability and sensitivity of wellbeing outcome measures.
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Affiliation(s)
- Lyndsey Bradley
- Ageing and Dementia Research Centre, Faculty of Health & Social Sciences, Bournemouth University, Bournemouth, UK
| | - Shanti Shanker
- Ageing and Dementia Research Centre, Faculty of Health & Social Sciences, Bournemouth University, Bournemouth, UK
| | - Jane Murphy
- Ageing and Dementia Research Centre, Faculty of Health & Social Sciences, Bournemouth University, Bournemouth, UK
| | - Lee-Ann Fenge
- Centre for Seldom Heard Voices, Faculty of Health & Social Sciences, Bournemouth University, Bournemouth, UK
| | - Michelle Heward
- Ageing and Dementia Research Centre, Faculty of Health & Social Sciences, Bournemouth University, Bournemouth, UK
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Ahmed MS, Kornblum D, Oliver D, Fusar-Poli P, Patel R. Associations of remote mental healthcare with clinical outcomes: a natural language processing enriched electronic health record data study protocol. BMJ Open 2023; 13:e067254. [PMID: 36764723 PMCID: PMC9923317 DOI: 10.1136/bmjopen-2022-067254] [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] [Indexed: 02/12/2023] Open
Abstract
INTRODUCTION People often experience significant difficulties in receiving mental healthcare due to insufficient resources, stigma and lack of access to care. Remote care technology has the potential to overcome these barriers by reducing travel time and increasing frequency of contact with patients. However, the safe delivery of remote mental healthcare requires evidence on which aspects of care are suitable for remote delivery and which are better served by in-person care. We aim to investigate clinical and demographic associations with remote mental healthcare in a large electronic health record (EHR) dataset and the degree to which remote care is associated with differences in clinical outcomes using natural language processing (NLP) derived EHR data. METHODS AND ANALYSIS Deidentified EHR data, derived from the South London and Maudsley (SLaM) National Health Service Foundation Trust Biomedical Research Centre (BRC) Case Register, will be extracted using the Clinical Record Interactive Search tool for all patients receiving mental healthcare between 1 January 2019 and 31 March 2022. First, data on a retrospective, longitudinal cohort of around 80 000 patients will be analysed using descriptive statistics to investigate clinical and demographic associations with remote mental healthcare and multivariable Cox regression to compare clinical outcomes of remote versus in-person assessments. Second, NLP models that have been previously developed to extract mental health symptom data will be applied to around 5 million documents to analyse the variation in content of remote versus in-person assessments. ETHICS AND DISSEMINATION The SLaM BRC Case Register and Clinical Record Interactive Search (CRIS) tool have received ethical approval as a deidentified dataset (including NLP-derived data from unstructured free text documents) for secondary mental health research from Oxfordshire REC C (Ref: 18/SC/0372). The study has received approval from the SLaM CRIS Oversight Committee. Study findings will be disseminated through peer-reviewed, open access journal articles and service user and carer advisory groups.
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Affiliation(s)
- Muhammad Shamim Ahmed
- Department of Psychosis Studies, Division of Academic Psychiatry, Institute of Psychiatry Psychology and Neuroscience, London, UK
| | - Daisy Kornblum
- NIHR Maudsley Biomedical Research Centre, South London and Maudsley Mental Health NHS Trust, London, UK
| | - Dominic Oliver
- Department of Psychosis Studies, Division of Academic Psychiatry, Institute of Psychiatry Psychology and Neuroscience, London, UK
- Department of Psychiatry, University of Oxford, Oxford, UK
- NIHR Oxford Health Biomedical Research Centre, Oxford, UK
| | - Paolo Fusar-Poli
- Department of Psychosis Studies, Division of Academic Psychiatry, Institute of Psychiatry Psychology and Neuroscience, London, UK
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Rashmi Patel
- NIHR Maudsley Biomedical Research Centre, South London and Maudsley Mental Health NHS Trust, London, UK
- Department of Psychological Medicine, Division of Academic Psychiatry, Institute of Psychiatry Psychology and Neuroscience, London, UK
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