Social transformation and social isolation of older adults: Digital technologies, nursing, healthcare

An exploration of factors involved in the roll out of a digital application in breast services: A case study approach

INTRODUCTION

Acceptance of new technologies in health care, by those who use them as part of their role, is challenging with confounding contextual factors surrounding the acceptance of technology. As healthcare is rapidly digitising, stakeholder groups should be included in each stage of evaluation and implementation to allow opportunities to influence and contribute to digital health policies. This research employed a case study methodology to initiate an exploration into the factors associated with implementing a digital application into a mammography service. It examined the initial implementation and subsequent impact of the rollout of a digital application (VA) within a breast service in South Australia.

METHODS

Stakeholders' opinions on team performance and feedback mechanisms of the digital application were evaluated through a staff questionnaire distributed through an online survey JISC.

RESULTS

The incorporation of digitised technology into a service is evidently met with challenges. Although there is potential value in utelising automated feedback for workflow improvement and patient services, it appears imperative to provide targeted and developmental resources for educational development and staff well-being during the implementation phase.

CONCLUSION

This case study approach delves into key discussion areas and serves as the initial insight into the implementation of a digital application. It could be regarded as a foundational reference for future evaluations of digital applications.

IMPLICATIONS FOR PRACTICE

Research around digital fluency within the radiography profession requires further consideration. Under-utilisation or resistance may result in missed opportunities to enhance patient experiences and care outcomes and support staff wellbeing. Therefore, continued engagement and the encouragement of user feedback during the implementation phase are crucial to demonstrate future acceptance of digital applications in clinical settings.

Qualitative Analysis of Conversational Chatbots to Alleviate Loneliness in Older Adults as a Strategy for Emotional Health

This article presents an exploration of conversational chatbots designed to alleviate loneliness among older adults. In addition to technical evaluation, it delves into effective communication between these systems and this demographic group, considering linguistic nuances, communicative preferences, and specific emotional needs. The intrinsic importance of chatbots as innovative solutions in combating loneliness is highlighted, emphasizing their ability to be understanding and empathetic allies, contributing to emotional well-being and socialization. The article explores how improved emotional well-being can positively impact the health and quality of life of older adults. The methodology, rooted in triangulation between a literature review and qualitative research through interviews and focus groups with older adults, provides a comprehensive insight into the findings. Ethical, technical, and design considerations such as privacy, autonomy, technology adaptation, and usability are also addressed. The article concludes with practical recommendations for developing user-friendly interfaces that encourage the active participation of older adults in chatbots. This holistic approach not only analyzes the technical effectiveness of chatbots in mitigating loneliness in older adults but delves into human, ethical, and practical aspects, enriching the understanding and implementation of these agents for social and emotional support.

Digitizing nursing: A theoretical and holistic exploration to understand the adoption and use of digital technologies by nurses

BACKGROUND

With healthcare undergoing rapid digitalization, the effective integration of new technologies is crucial for nursing professionals, who form the largest group in the healthcare workforce. However, barriers within the nursing profession may impede digitalization efforts, leading to under utilization of available technologies and missed opportunities for enhancing healthcare quality and population health.

AIMS

This article aims to investigate the adoption and use of digital technologies by nurses, considering how key demographics, such as gender, age, and voluntariness of technology use, interact to influence their acceptance and utilization of these technologies.

METHODS

Employing the Unified Theory of Acceptance and Use of Technology (UTAUT) as a framework, we conducted a discursive exploration, supplemented by a literature review from diverse academic sources. Keywords related to UTAUT, digitalization, nursing practice and technology adoption were searched on PubMed, CINAHL and Google Scholar. Additionally, UK government and professional regulator reports were examined to understand current recommendations concerning digital technologies in nursing practice and the profession's demography. Searches focused on moderating factor domains, and the last search was conducted on 26 April 2023.

RESULTS

The study revealed that the successful implementation of digital technologies in nursing practice requires a nuanced understanding of the nursing workforce's characteristics and preferences. Gender, age and voluntariness of technology use were found to intersect and influence nurses' acceptance and utilization of digital tools.

DISCUSSION

By applying UTAUT in the context of nursing, this study highlights the importance of tailored implementation strategies for digital technologies. A technologically deterministic perspective is insufficient; instead, consideration of social factors specific to nursing is essential for successful adoption.

CONCLUSION

To maximize the benefits of digitalization in healthcare, it is imperative to address the barriers faced by nursing professionals. A comprehensive understanding of how key demographics impact technology adoption will inform targeted strategies, enhancing the engagement of nurses with digital tools and fostering innovation in healthcare practices. Further research and primary data are needed, but this study lays the foundation for future advancements in digital healthcare integration for nursing professionals.

RELEVANCE TO CLINICAL PRACTICE

The issues highlighted in this article are relevant to nurse leaders and those responsible for implementing technologies within nursing contexts. They are also relevant to technology developers who may benefit from considering the evidence associated with the moderating demographic factors highlighted in this article. Without a holistic approach to the implementation of technology, challenges associated with the use of digital technology by nurses are likely to persist. By considering the moderating demographic factors highlighted within the UTAUT (age, gender, voluntariness of use and experience) nurse leaders and technology developers may have greater success obtaining greater clinical outcomes from digital technology. This work was completed in 2022.

NO PATIENT OR PUBLIC CONTRIBUTION

Due to the focus of this article being one on professional challenges within the nursing profession, no involvement from patients or the public was sought.

Older adults' experiences of social isolation and loneliness: Can virtual touring increase social connectedness? A pilot study

The present pilot study explored the research aim of understanding how independent-living older adults experience social isolation and loneliness and whether virtual tour digital technology can increase social connectedness (N = 10). Through triangulation of interviews, experiences, and feedback, this study contributes to the knowledge base on the well-being of our ageing populations and how digital technologies, specifically virtual tourism, can aid in this process. The key findings reveal that the participants in our study were moderately lonely but were open to embracing more digital technology, sharing how it is instrumental in facilitating social connection and life administration. Participating in virtual tour experiences was well accepted as participants expressed enjoyment, nostalgia, and interest in future use. However, its contribution to increasing social connections needs to be clarified and requires further investigation. Several future research and education directions are provided.

Information Cocoons on Short Video Platforms and Its Influence on Depression Among the Elderly: A Moderated Mediation Model

Background

As the elderly increasingly engage with new media, particularly short video platforms, concerns are arising about the formation of "information cocoons" that limit exposure to diverse perspectives. While the impact of these cocoons on society has been investigated, their effects on the mental well-being of the elderly remain understudied. Given the prevalence of depression among the elderly, it is crucial to understand the potential link between information cocoons and depression among older adults.

Methods

The study examined the relationships between information cocoons and depression, loneliness, and family emotional support among 400 Chinese elderly people. The statistical software package SPSS was used to establish a moderated mediation model between information cocoons and depression.

Results

Information cocoons directly predicted depression among the elderly participants. Family emotional support moderated the first half and the second half of the mediation process, whereby information cocoons affected the depression of the elderly through loneliness. Specifically, in the first half of the mediation process, when the level of information cocoons was lower, the role of family emotional support was more prominent. In the second half of the process, when the level of family emotional support was higher, such support played a more protective role in the impact of loneliness on depression.

Discussion

The findings of this study have practical implications for addressing depression among the elderly population. Understanding the influence of information cocoons on depression can inform interventions aimed at promoting diverse information access and reducing social isolation. These results will contribute to the development of targeted strategies to improve the mental well-being of older adults in the context of evolving media landscapes.

Digital Inclusion, Cultural Capital, and Health Status of Urban and Rural Residents: An Empirical Study Based on 2017 CGSS Database

China is committed to using digital technology to drive urban-rural integration in health care. This study aims to explore the effect of digital inclusion on health status with the mediating role of cultural capital and the digital health disparities between urban and rural residents in China. Using data from the 2017 Chinese General Social Survey (CGSS), the present study adopted an ordinary least squares (OLS) robust standard error regression model to investigate the impact of digital inclusion on health status. In addition, causal step regression (CSR) and bootstrapping methods were combined to test the mediating effect of cultural capital. The results showed that, first, digital inclusion was related to positive and significant effects on resident health status. Second, cultural capital played a mediating role in the relationship between digital inclusion and health status. Third, urban residents gained more health benefits from digital inclusion than rural residents. Additionally, common method variance (CMV) tests, endogenous tests, and a propensity score matching (PSM) analysis showed that the above conclusions remained robust. The government should therefore focus not only on promoting the population's health by utilizing digital inclusion but also on accelerating digital health equity between urban and rural areas by developing such strategies as a digital infrastructure expansion schedule and digital literacy education and training programs.

The new role of nursing in digital inclusion: Reflections on smartphone use and willingness to increase digital skills among Chinese older adults

OBJECTIVE

This study explores the willingness of older adults to use smartphones and improve their digital skills and encourages nursing to actively participate in bridging the digital divide.

METHODS

Subject analysis was used to conduct qualitative research, and 23 older adults were interviewed.

RESULTS

We identified four themes: (1) the current situation of smartphone use; (2) the digital dilemma of smartphone use; (3) social support for digital skills; and (4) the willingness to learn digital skills. Older adults in China are willing to accept and use smartphones for simple operations, and peer learning may be an effective way to improve their digital skills.

CONCLUSION

Community support is necessary to develop the digital skills of older adults with smartphones and reduce the digital divide to the greatest extent possible. Nursing may play a role in promoting digital inclusion for older adults.

Behavioral Patterns of Supply and Demand Sides of Health Services for the Elderly in Sustainable Digital Transformation: A Mixed Methods Study

The aging transformation of digital health services faces issues of how to distinguish influencing factors, redesign services, and effectively promote measures and policies. In this study, in-depth interviews were conducted, and grounded theory applied to open coding, main axis coding, and selective coding to form concepts and categories. Trajectory equifinality modeling clarified the evolution logic of digital transformation. Based on the theory of service ecology, a digital health service aging model was constructed from the “macro–medium–micro” stages and includes governance, service, and technology transformation paths. The macro stage relies on organizational elements to promote the institutionalization of management and guide the transformation of governance for value realization, including the construction of three categories: mechanism, indemnification, and decision-making. The meso stage relies on service elements to promote service design and realize service transformation that is suitable for aging design, including the construction of three categories: organization, resources, and processes. The micro stage relies on technical elements to practice experiencing humanization, including the construction of three categories: target, methods, and evaluation. These results deepen the understanding of the main behaviors and roles of macro-organizational, meso-service, and micro-technical elements in digital transformation practice and have positive significance for health administrative agencies to implement action strategies.

Empirical Study of Virtual Reality to Promote Intergenerational Communication: Taiwan Traditional Glove Puppetry as Example

Based on glove puppetry, a traditional cultural pursuit of Taiwan, this study designed a virtual reality (VR) intergenerational game to bring together the elderly and young participants. In the game, a system of cooperation and sharing was constructed which would lead to an exchange between experience and knowledge of traditional culture and digital technology and result in intergenerational interaction and communication learning. Through interviews with eight subjects after the empirical study, this study explored the operation and experience of this game, the perception of interaction and dialogue, and the cultural heritage and learning. According to the research findings, VR game cultural elements and technology learning positively influence intergenerational relations and communication. Key factors of VR intergenerational games include the following: (1) the game content must be attractive for the elderly; (2) the operating procedure of the game and affordance of the interface for the elderly must be simplified; and (3) the game must establish a sense of achievement for players.

Use of Digital Tools, Social Isolation, and Lockdown in People 80 Years and Older Living at Home

The COVID-19 crisis and associated lockdowns have exposed the extent of social isolation among older adults (OAs). Currently, the French government and medical, social, and charitable organizations are working to find means of limiting the multiple psychological and physical consequences of social isolation on the health of OAs. One proposal is to help the elderly become more comfortable using digital tools (DTs). However, the ability of DTs to reduce social isolation is disputed in the literature. This study aimed to collect the views of OAs on social isolation; to identify the determinants of the use or not of DTs, in particular in the context of a lockdown; and the role of DTs in the strategy to reduce social isolation. This qualitative study was based on 27 semi-structured individual interviews with OAs ≥ 80 years, in Côte-d’Or and Haute-Marne (French departments), from March to May 2021. A total of 96.3% of participants had already owned one or more DTs (mobile phone, tablet, or computer) for several years. The lockdown had not prompted the population to equip themselves more. The most common reason for using DTs was to maintain contact with relatives, and 63% of the participants said that DTs have a positive impact in reducing social isolation. However, there is a significant need for assistance and training in their use, especially since many services are now offered online. The participants suggested that the key to minimizing social isolation remained the maintenance of social contacts. In conclusion, DTs appear to be useful for helping the elderly maintain social links with relatives and, therefore, have a strategic place in the reduction of social isolation. However, these tools should not replace in-person interactions.

Reimagining quarantine: Assuring hopefulness in nursing and healthcare

This article aimed to explore issues of concern related to quarantine, its social consequences and influences, challenging its effects on human behavioral expressions during social isolation. The advent of the coronavirus disease 2019 (COVID-19) pandemic impacted human lives in multifarious ways, threatening the meaning of normalcy. Quarantine, lockdown, isolation, and other terms reflecting conditions limiting human freedoms have become synonymous in importance to safety, security, and survival. To understand human defiance in the face of maintaining limited mobility during the COVID-19 pandemic, reimagining situations of "unfreedoms" is explained as thinking of changes to inspire and improve the meaning of living lives meaningfully. During the pandemic, issues regarding healthcare practices and social behaviors focused much attention on interactive challenges that enhance ways to mitigate the spread of contagious diseases. Illuminating these issues, discussing concerns and highlighting recommendations to engage in alternative approaches and practices, heightens the declaration of efficiency of quarantine outcomes and effectiveness. Implications are proposed with the hope that they may lead the way forward in exercising contemporary healthcare practices.

Living alone and using social media technologies: The experience of Filipino older adults during the COVID-19 pandemic

Prolonged implementation of lockdowns during the coronavirus disease 2019 (COVID-19) pandemic has resulted in older adults living alone in social isolation. The purpose of the study was to describe the meaning of the experience of Filipino older adults, who are living alone and using social media technologies during the COVID-19 pandemic. Eight participants who met the inclusion criteria were interviewed using the snowball selection technique. Transcribed interviews were read while also listening to the recorded interviews and highlighting significant words, phrases, and statements. An iterative process of analysis using van Manen's phenomenological approach identified thematic structures and categories revealing life-worlds of corporeality, relationality, temporality, spatiality, and materiality. The five general essences of flourishing, communicating, struggling, journeying and empowering, described the meaning of living alone and using social media technologies among older adults during the pandemic. The experience was expressed as "flourishing despite struggling to communicate, while journeying and empowering oneself and others." Older adults in isolation struggled to communicate with others however, with social technologies opportunities were opened for them in securing needed food, safety and security, maintaining their health, and their social connectedness. Despite the physical isolation and living arrangements during the pandemic, the use of social media technologies sustained older persons' well-being.