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Anttila M, Koivisto J, Luoma ML, Anttila H. How to adopt technologies in home care: a mixed methods study on user experiences and change of home care in Finland. BMC Health Serv Res 2023; 23:1342. [PMID: 38042800 PMCID: PMC10693073 DOI: 10.1186/s12913-023-10368-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: 08/07/2023] [Accepted: 11/22/2023] [Indexed: 12/04/2023] Open
Abstract
BACKGROUND There is a need for better adoption of technology to meet the needs of home care professionals, older people, and informal caregivers. METHODS Mixed methods were used to describe and analyse quantitative and qualitative data in a Finnish governmental programme called KATI. The study was three-fold: it 1) listed what kinds of technologies were piloted and deployed in a national study, 2) provided information from the perspectives of home care professionals about requirements to use technology by using focus-group interviews, and 3) assessed experiences of how the adoption of technology changes work and work processes over time by using repeated surveys. Informants in interviews (n = 25) and surveys (n = 90) were home care professionals, who also described the perspectives of older people and informal caregivers. The conceptual models framing the study were adapted from the Technology Acceptance Model and DirVA PROVE-IT. RESULTS There were 80 technology pilots, in which variety of technologies were followed in home care. Familiarity with, commitment to and understanding of technology benefits were considered to be requirements for the technology to be used. The adoption of technology provided new skills and information about older people's wellbeing, realisation of treatment and new possibilities in home care. It developed new procedures to focus on older people's needs and motivated professionals by gained concrete aid. It enabled them to leave out some concrete procedures as unnecessary. On the other hand, there were also pessimistic and negative experiences when technology use provided nothing new or did not change anything. CONCLUSIONS The adoption of technology is dependent on the technology and its integration into the prevailing service practice. When they both work, it is possible to leave out unnecessary procedures in care, allocate resources and save time. It is possible to be aware of older people's safety and how they cope at home, find new ways to get involved in older people's lives, gain insight, and make changes at work. Continuous on-site training, modifications in service practices and communication throughout organisations is needed.
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Affiliation(s)
- Minna Anttila
- Finnish Institute for Health and Welfare, Helsinki, Finland.
| | - Juha Koivisto
- Finnish Institute for Health and Welfare, Helsinki, Finland
| | | | - Heidi Anttila
- Finnish Institute for Health and Welfare, Helsinki, Finland
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Aksin OZ, Bilgic B, Guner P, Gunes ED, Kuscu K, Ormeci EL, Sayin S, Eser HY. Caregiver support and burden drive intention to engage in a peer-to-peer exchange of services among caregivers of dementia patients. Front Psychiatry 2023; 14:1208594. [PMID: 37484665 PMCID: PMC10359163 DOI: 10.3389/fpsyt.2023.1208594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 06/21/2023] [Indexed: 07/25/2023] Open
Abstract
Introduction The number of people diagnosed with dementia is increasing, creating significant economic burden globally. With the progression of the disease, patients need a caregiver whose wellbeing is important for continuous care. Providing respite as a service, through sharing the responsibility of caregiving or support for the caregiver, is a costly initiative. A peer-to-peer online support platform for dementia caregivers, motivated by the sharing economy, putting exchange of knowhow, resources, and services at its center, has the potential to balance cost concerns with a search for respite. The aim of this research is to assess caregivers' intention to engage in peer-to-peer exchange. Methods A survey including sociodemographic, technology use, and caregiving variables, structured questionnaires (Zarit caregiver burden, WHO brief quality of life scale, ADCS-ADL and chronic stress scale) were administered, January 2018-May 2019, in the dementia outpatient clinic of a university hospital, to a convenience sample of n = 203 individuals identifying themselves as primary caregivers. A path analysis exploring the drivers of an intention to engage in peer-to-peer service exchange was conducted. Results In the path model, caregivers experiencing higher caregiver burden showed higher intention to engage (0.079, p < 0.001). Disease stage had no effect while patient activities of daily living, chronic social role related stressors of the caregiver and general quality of life were significant for the effect on the caregiver burden. Existing household support decreased the caregiver burden, affecting the intention to engage. Caregivers who can share more know-how demonstrate a higher intention to engage (0.579, p = 0.021). Caregiver technology affinity (0.458, p = 0.004) and ability and openness to seek professional help for psychological diagnoses (1.595, p = 0.012) also increased intention to engage. Conclusion The model shows caregiver burden to be a major driver, along with caregiver characteristics that reflect their technology affinity and openness to the idea of general reciprocity. Existing support for obtaining knowhow and exchanging empathy have a direct effect on the intention to engage. Given the scarcity of caregiver support in the formal care channels, the identified potential of enlarging informal support via a peer-to-peer exchange mechanism holds promise.
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Affiliation(s)
- O. Zeynep Aksin
- College of Administrative Sciences and Economics, Koc University, Istanbul, Türkiye
| | - Basar Bilgic
- Department of Neurology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Türkiye
| | - Perihan Guner
- Department of Nursing, Faculty of Health Sciences, Istanbul Bilgi University, Istanbul, Türkiye
| | - Evrim D. Gunes
- College of Administrative Sciences and Economics, Koc University, Istanbul, Türkiye
| | - Kemal Kuscu
- Department of Psychiatry, School of Medicine, Koc University, Istanbul, Türkiye
| | | | - Serpil Sayin
- College of Administrative Sciences and Economics, Koc University, Istanbul, Türkiye
| | - Hale Yapici Eser
- Department of Psychiatry, School of Medicine, Koc University, Istanbul, Türkiye
- Research Center for Translational Medicine, Koc University, Istanbul, Türkiye
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Collins TL, Cardella A, Gordon S. The Impact of Assistive Technology on Quality of Life of Home-Dwelling People with Parkinson's Disease. Home Healthc Now 2023; 41:214-220. [PMID: 37417573 DOI: 10.1097/nhh.0000000000001187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/08/2023]
Abstract
Parkinson's disease (PD) is the fastest growing neurological disease worldwide with more than 8.5 million people diagnosed. Assistive technologies for people with PD support the user to maximize independence. The purpose of this integrative literature review was to critique and synthesize the literature on the impact of assistive technologies on quality of life of home-dwelling individuals with PD. A literature search for studies on assistive technologies for people with PD with a primary outcome measure of quality of life was conducted. Of 156 articles screened for eligibility, 6 met selection criteria, including 4 quantitative studies, 1 qualitative study, and 1 mixed-method. Levels of evidence were scored as a percentage of quality criteria met, from 60% to 100% using the Mixed Methods Appraisal Tool. Using home monitoring devices was associated with significant improvements in walking, especially during freezing of gait. Evidence supports the use of assistive technologies including voice-activated technology, home automation, and home monitoring devices. Further research is needed to determine the effect of assistive technology on quality of life.
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Baik D, McIlvennan CK, Baker C, Coats H. Caregiving experiences of older family caregivers of persons with heart failure: A mixed methods study. Geriatr Nurs 2022; 48:51-57. [PMID: 36126441 PMCID: PMC10990471 DOI: 10.1016/j.gerinurse.2022.08.015] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Revised: 08/24/2022] [Accepted: 08/26/2022] [Indexed: 12/16/2022]
Abstract
Older family caregivers of persons with heart failure (HF-FCGs) are an understudied and vulnerable population, who are at heightened risk for age-related physical and cognitive declines. We explored caregiving experiences of older HF-FCGs and examined levels of their caregiver burden, psychological distress, caregiving self-efficacy and quality of life (QoL) using descriptive mixed methods. We conducted telephone-based surveys and semi-structured interviews (N=13). Low levels of caregiver burden, psychological distress, and high levels of caregiving self-efficacy and QoL were reported. Through qualitative interviews, three qualitative themes emerged: (1) Impact of Being a Caregiver, (2) Managing Caregiver Distress, and (3) Embracing the Caregiver Role. Psychological distress was the most frequently reported. Physical, psychological, and social distress experienced by older HF-FCGs might be offset by their coping strategies and willingness to accept their caregiver role. FCG-centered support programs that help older HF-FCGs develop and apply their own coping strategies should be considered.
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Affiliation(s)
- Dawon Baik
- College of Nursing, University of Colorado, 13120 E. 19th Ave., Aurora, CO 80045, USA.
| | | | - Christina Baker
- College of Nursing, University of Colorado, 13120 E. 19th Ave., Aurora, CO 80045, USA
| | - Heather Coats
- College of Nursing, University of Colorado, 13120 E. 19th Ave., Aurora, CO 80045, USA
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Hvalič‐Touzery S, Dolničar V, Prevodnik K. Factors influencing informal carers' acceptance of assistive telecare systems in the pre- and post-implementation phase: A scoping study. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e1484-e1504. [PMID: 35574935 PMCID: PMC9541532 DOI: 10.1111/hsc.13840] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 03/15/2022] [Accepted: 04/22/2022] [Indexed: 06/15/2023]
Abstract
Assistive telecare systems (ATSs) have great potential to be beneficial for informal carers (ICs) providing long-term care to older people (OP). However, little is known about ATS acceptance among ICs. This scoping study aims to investigate various factors that influence the ICs' acceptance of ATSs over time in the pre- and post-implementation phases. A five-stage scoping study was conducted. A systematic search of five bibliographic databases (Science Direct, Scopus, CINAHL, PubMED and Proquest Social Sciences Database) was conducted in September 2020, supplemented by a round of grey literature searches. Using the established selection criteria, 37 publications published between 2000 and September 2020 were included. The data were analysed with Atlas.ti 8 using content-based analysis and a combination of deductive and inductive approaches. The results show that work on understanding acceptance of ATS only gained wider attention after 2010. Seven key factors of ATS acceptance were identified: benefits and concerns about ATS, care situation, the influence of the OP, carer characteristics, perceived need to use and social influence. Several subfactors were also found. The post-intervention acceptance factors were found to be more nuanced than the pre-implementation factors, indicating that first-hand experience with ATSs enabled study participants to provide a more tangible, extensive and in-depth overview of the various ATS acceptance factors. This scoping review is useful for ATS developers, providers, health and social care scholars and practitioners, policy makers and commissioners, all of whom seek to improve and facilitate the provision of long-term care in the community.
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Affiliation(s)
- Simona Hvalič‐Touzery
- Faculty of Social Sciences, Centre for Social InformaticsUniversity of LjubljanaLjubljanaSlovenia
| | - Vesna Dolničar
- Faculty of Social Sciences, Centre for Social InformaticsUniversity of LjubljanaLjubljanaSlovenia
| | - Katja Prevodnik
- Faculty of Social Sciences, Centre for Social InformaticsUniversity of LjubljanaLjubljanaSlovenia
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Mejía ST, Su TT, Lan Q, Zou A, Griffin A, Sosnoff JJ. The Context of Caring and Concern for Falling Differentiate Which Mobile Fall Technology Features Chinese Family Caregivers Find Most Important. J Appl Gerontol 2021; 41:1175-1185. [PMID: 34852205 DOI: 10.1177/07334648211053857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Falls are not only a leading cause of death and disability, but also a strain on the capacity for caregivers to provide care. This study examined how the context of caregiving relates to the importance of caregiver-defined mobile fall prevention feature sets. A sample of 266 family caregivers, recruited from a Chinese social media platform, reported care for an older adult and interest in mobile fall prevention technology features. Factor analysis identified three caregiver-defined feature sets: automatic fall response, digitized fall prevention tools, and social features. Multiple regression showed caregivers' concern about falling was the most robust predictor of a feature set's importance. Poisson regression revealed that caregiver concern and assistance with instrumental activities of daily living were associated with rating more features as important. Our findings suggest that caregivers are interested in mobile fall prevention technologies that support older adults' independence while also alleviating concerns about falling.
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Affiliation(s)
- Shannon T Mejía
- Department of Kinesiology and Community Health, 14589University of Illinois at Urbana-Champaign, Champaign, IL, USA
| | - Tai-Te Su
- Department of Kinesiology and Community Health, 14589University of Illinois at Urbana-Champaign, Champaign, IL, USA
| | - Qingyi Lan
- Department of Kinesiology and Community Health, 14589University of Illinois at Urbana-Champaign, Champaign, IL, USA
| | - Ajiang Zou
- Sports Humanities Department, 66444Shenyang Sport University Shenyang, China
| | - Aileen Griffin
- Department of Kinesiology and Community Health, 14589University of Illinois at Urbana-Champaign, Champaign, IL, USA
| | - Jacob J Sosnoff
- Department of Physical Therapy, Rehabilitation Science, and Athletic Training, University of Kansas Medical Center, Kansas City, KS, USA
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Baik D, Song J, Tark A, Coats H, Shive N, Jankowski C. Effects of Physical Activity Programs on Health Outcomes of Family Caregivers of Older Adults with Chronic Diseases: A Systematic Review. Geriatr Nurs 2021; 42:1056-1069. [PMID: 34261027 DOI: 10.1016/j.gerinurse.2021.06.018] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Revised: 06/11/2021] [Accepted: 06/14/2021] [Indexed: 01/11/2023]
Abstract
This systematic review was conducted to analyze and capture the most recent trends in physical activity interventions for family caregivers of older adults with chronic disease as found in randomized clinical trials over the last 10 years (2010-2020). We used PubMed, CINAHL, Embase, PsycInfo, and the Cochrane Library. We synthesized participants' demographics, physical activity interventions and family caregivers' health outcomes. The Cochrane Collaboration Risk of Bias Tool was used to assess risk of bias of the included studies. Sixteen studies were included and most studies (n = 11) had a moderate risk of bias. Physical activity programs with mixed modes (e.g., aerobic and resistance exercise), mixed delivery methods (e.g., in-person and telephone) and mixed settings (e.g., supervised gym-based sessions and unsupervised home-based sessions) were used most frequently. Physical activity interventions significantly improved psychological health but had inconsistent effects on physical health. This review provides current trends and research findings that suggest types of physical activity interventions and components that improve family caregivers' health and wellness.
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Affiliation(s)
- Dawon Baik
- University of Colorado, College of Nursing, 13120 E 19th Ave., Aurora, CO 80045, United States.
| | - Jiyoun Song
- Columbia University, School of Nursing, 560 W 168th street, New York, NY 10032, United States
| | - Aluem Tark
- University of Iowa, College of Nursing, 50 Newton Road Iowa City, Iowa City, Iowa, IA 52242, United States
| | - Heather Coats
- University of Colorado, College of Nursing, 13120 E 19th Ave., Aurora, CO 80045, United States
| | - Nadia Shive
- University of Colorado, College of Nursing, 13120 E 19th Ave., Aurora, CO 80045, United States
| | - Catherine Jankowski
- University of Colorado, College of Nursing, 13120 E 19th Ave., Aurora, CO 80045, United States
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Leslie M, Gray RP, Khayatzadeh-Mahani A. What is 'care quality' and can it be improved by information and communication technology? A typology of family caregivers' perspectives. Scand J Caring Sci 2020; 35:220-232. [PMID: 32168399 DOI: 10.1111/scs.12837] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Accepted: 02/11/2020] [Indexed: 11/30/2022]
Abstract
INTRODUCTION With governments worldwide reducing their involvement in the provision of institutional long-term elder care, community-based family caregivers (FCs) have become a key element in policies aimed at improving the quality of healthcare systems and maintaining their financial sustainability. This paper uses data from focus groups with FCs providing care to older adults to describe their approaches to and priorities for achieving care quality and sustainability as they work with formal health and social care systems. It describes FCs' views on information and communications technology (ICT) as potential supports for achieving these care quality and sustainability goals. METHODS We held 10 focus groups from May 2017 to August 2018 and recruited 25 FCs through a mix of convenience and snowball sampling strategies. We employed an inductive approach and used qualitative thematic content analysis methods to examine and interpret the resulting data. We used NVIVO 12 software for data analysis. RESULTS Quality of care - as delivered by both FCs themselves, and formal health and social care systems - was a major preoccupation for our participants. They saw communications quality as a key aspect of the broader concept of care quality. Our data analysis produced a typology of communications quality from the FC perspective. Analysis of our data also revealed ICT development opportunities and available products in key areas. CONCLUSIONS Our findings suggest that the formal care system providers could be more caregiver-oriented in their communications by engaging FCs in the decision-making process and allowing them to express their own concerns and goals. The implication of our findings for those seeking to develop policies and ICT products in support of FCs is that these should focus on human relationships and seek to expand facilitative communications.
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Affiliation(s)
- Myles Leslie
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.,School of Public Policy, University of Calgary, Calgary, AB, Canada
| | | | - Akram Khayatzadeh-Mahani
- School of Public Policy, University of Calgary, Calgary, AB, Canada.,Health Services Management Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
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