Usability of multimedia technology to help caregivers prepare for a crisis

Technology and Caregiving: Emerging Interventions and Directions for Research

An array of technology-based interventions has increasingly become available to support family caregivers, primarily focusing on health and well-being, social isolation, financial, and psychological support. More recently the emergence of new technologies such as mobile and cloud, robotics, connected sensors, virtual/augmented/mixed reality, voice, and the evermore ubiquitous tools supported by advanced data analytics, coupled with the integration of multiple technologies through platform solutions, have opened a new era of technology-enabled interventions that can empower and support family caregivers. This paper proposes a conceptual framework for identifying and addressing the challenges that may need to be overcome to effectively apply technology-enabled solutions for family caregivers. The paper identifies a number of challenges that either moderate or mediate the full use of technologies for the benefit of caregivers. The challenges include issues related to equity, inclusion, and access; ethical concerns related to privacy and security; political and regulatory factors affecting interoperability and lack of standards; inclusive/human-centric design and issues; and inherent economic and distribution channel difficulties. The paper concludes with a summary of research questions and issues that form a framework for global research priorities.

Use of a dementia training designed for nurse aides to train other staff

Problematic resident behaviors may escalate in long-term care facilities (LTCs). If nurse aides (NAs) are not nearby, the nearest staff to intervene may be non-direct care workers (NDCWs), who have little or no dementia training. This pilot research tested Internet dementia-training program, designed for NAs, on NDCWs in a LTC setting. Sixty-eight NDCWs participated, filling out two baseline surveys at 1-month intervals and a posttest survey after training. The surveys included video-situation testing, items addressing psychosocial constructs associated with behavior change, and measures training-acceptance. Paired t tests showed significant positive effects on measures of knowledge, attitudes, self-efficacy, and behavioral intentions, with small-moderate effect sizes. Nursing staff as well as non-health care workers showed improved scores, and the web-site training program was well received by all participants. These results suggest that Internet training may allow staff development coordinators to conserve limited resources by cross-training of different job categories with the same program.

Mental illness training for licensed staff in long-term care

Licensed care staff working in long-term care facilities may be poorly prepared to work with residents with mental illness. This research reports on the program evaluation of Caring Skills: Working with Mental Illness, a training program delivered on the Internet. It was tested with a randomized treatment-control design, with an eight-week follow-up. The training provided video-based behavioral skills and knowledge training. Measures included video situations testing and assessment of psycho-social constructs including empathy and stigmatization. ANCOVA analysis at 4-weeks posttest showed significant positive effects with medium-large effect sizes, which were largely maintained at the 8-week follow-up. The training was well-received by the users.

Internet training to respond to aggressive resident behaviors

PURPOSE

This research evaluated an individualized Internet training designed to teach nurse aides (NAs) strategies to prevent or, if necessary, react to resident aggression in ways that are safe for the resident as well as the caregiver.

DESIGN AND METHODS

A randomized treatment and control design was implemented, with baseline, 1-, and 2-month assessments for 158 NAs. The training involved 2 weekly visits. The Internet intervention was a behaviorally focused and video-based training that included content on skills for safely dealing with physical aggression. Measures included video situation testing and assessment of psychosocial constructs associated with behavior change.

RESULTS

Analysis of covariance showed positive results for knowledge, attitudes, self-efficacy, and empathy, with medium-large effect sizes maintained after 2 months. The training was well received by participants.

IMPLICATIONS

Internet training is a viable approach to shape appropriate NA reactions to aggressive resident behaviors. This format has future potential because it offers fidelity of presentation and automated documentation, with minimal supervision.

Mental illness training for long term care staff

OBJECTIVES

Mental illness is prevalent among nursing home residents, but staff are not well trained to deal with it. This research evaluated an Internet mental illness training program designed for certified direct care workers, ie, nurse aides (NAs). Pilot research was also conducted to explore effects and acceptance of the same program with a sample of licensed health professionals (LHPs).

DESIGN

Trial 1: Pre-post randomized treatment and control design for NAs; Trial 2: Quasi-experimental pre-post within-subjects design for LHPs.

SETTING

Both studies were conducted on the Internet.

PARTICIPANTS

Trial 1: n = 70 NAs; Trial 2: n = 16 LHPs.

INTERVENTION

Internet-based behavioral skills training and knowledge building, using video modeling with mastery learning instructional design.

MEASUREMENTS

Video situations testing and assessment of psychosocial constructs associated with behavior change; follow-up interviews with a sample of treatment NAs.

RESULTS

Trial 1: Multivariate analysis of covariance analysis showed positive results (P = .003) for knowledge, attitudes, self-efficacy, and behavioral intention, with medium-large effect sizes. The training was well received by the users. Trial 2: Paired t tests showed significant effects on 5 of 6 outcome measures, with medium-large effect sizes, and it was well received by the LHP sample.

CONCLUSIONS

Internet training can be an effective approach to help staff work with residents with mental illness. In this research, it showed significant positive effects and was well received by NAs and by LHPs.

Online training in sports concussion for youth sports coaches

The purpose of this study was to evaluate ACTive: Athletic Concussion Training using Interactive Video Education, an interactive e-learning program designed to train community coaches of youth ages 10-18 in effective sports concussion prevention and management practices. Seventy-five youth sports coaches from across the country completed the study over the Internet. Results of a randomized control trial demonstrated significant differences between treatment and control participants on measures of (a) knowledge about sports concussion, management, and prevention; (b) attitudes about the importance of preventing sports concussion; and (c) intention and self-efficacy in sports concussion management and prevention. The results suggest that ACTive is an effective method of training youth sports coaches who are in an important position to reduce risks associated with sports concussion.

An internet tool to normalize grief

This research evaluated the efficacy of a psycho-educational Internet self-help tool to educate and support recently (1-6 months) bereaved individuals. The goal of the website was to help users normalize their grief to enhance their adaptive adjustment. A randomized controlled trial evaluated the gains in social cognitive theory constructs and state anxiety. Compared to the control group (N = 34), treatment participants (N = 33) reported significant multivariate gains (eta-square = .191). Significant program effects were obtained on all three outcome measures: attitude (eta-square = .177), self-efficacy (eta-square = .106), and state anxiety (eta-square = .083). These findings suggest the potential efficacy of an Internet-based grief support tool to enhance adaptive adjustment of the bereaved.

One size doesn't fit all: bringing telehealth services to special populations

Telehealth applications and information communication technologies can be customized and scaled to meet the healthcare service needs of a wide variety of special populations. Categorization of those special groups can be viewed from a spectrum of perspectives such as by gender, age, culture, families, communities, chronic conditions, or particular types of locations, as well as when addressing a specific or unique health need. The emergence of innovations in the use of a range of technologies and connectivity offers exciting new approaches to the integration of telehealth aimed at improving quality and continuity of care to better meet the needs of special populations.

Internet training for nurse aides to prevent resident aggression

OBJECTIVES

Evaluate Internet training to help nurse aides decrease resident aggression.

DESIGN

Randomized treatment and control design; pre-post assessment.

SETTING

The study was conducted entirely on the Internet.

PARTICIPANTS

Nurse aides; N = 62.

INTERVENTION

Internet-based interactive training using video modeling and mastery learning instructional design.

MEASUREMENTS

Video situations testing and assessment of psychosocial constructs associated with behavior change; follow-up interviews with a sample of treatment participants.

RESULTS

MANCOVA analysis showed positive results (P = .001) for knowledge, attitudes, self-efficacy, and behavioral intention, with large effect sizes; it was well received by the users.

CONCLUSIONS

Interactive training is an effective approach to shaping appropriate staff reactions to aggressive resident behaviors. The training can effectively be delivered on the Internet. In this research, it was both valued and well received by study participants.

Quality of life, psychosocial well-being, and sexual satisfaction in women with polycystic ovary syndrome

Polycystic ovary syndrome (PCOS) is a common endocrine disorder characterized by chronic anovulation and hyperandrogenism. PCOS is one of the leading causes of infertility and manifests with hirsutism, acne, and obesity. To investigate its impact on health-related quality of life and sexuality, 50 women with PCOS and 50 controls were evaluated with standardized questionnaires (36-item short-form health survey, symptom checklist revised, and life satisfaction questionnaire). The impact of hirsutism, obesity, and infertility was assessed using five-point rating scales, and sexual satisfaction was analyzed with visual analog scales. Patients showed greater psychological disturbances on the symptom checklist revised dimensions, obsessive-compulsive, interpersonal sensitivity, depression, anxiety, aggression, and psychoticism, along with a lower degree of life satisfaction in the life satisfaction questionnaire scales health, self, and sex. Health-related quality of life measured with the 36-item short-form health survey revealed significantly decreased scores for physical role function, bodily pain, vitality, social function, emotional role function, and mental health in patients with PCOS. Although patients had the same partner status and frequency of sexual intercourse, they were significantly less satisfied with their sex life and found themselves less attractive. Most of the differences were not affected by correction for body weight. In conclusion, PCOS causes a major reduction in the quality of life and severely limits sexual satisfaction.