Integrated care for older people based on information and communication technology: a scoping review protocol

Unraveling the subjective well-being of formal and informal caregivers for people with dementia: a comparative analysis

BACKGROUND

Both formal and informal caregivers play pivotal roles in long-term dementia care, demonstrating a shared dedication to providing comprehensive care and support for individuals with dementia. These two caregiver groups exhibit both similarities and differences in their caregiving experiences, contributing to variations in subjective well-being outcomes. However, limited research has compared the psychological well-being and self-rated health of these two caregiver groups, or explored the influencing factors. This knowledge gap hinders the development of targeted interventions and support strategies tailored to different caregiving contexts and informs supportive policymaking.

METHODS

A cross-sectional survey was conducted among 440 caregivers of individuals with dementia, including 229 informal caregivers and 211 formal caregivers. Psychological well-being was assessed using the short version of Ryff's Psychological Well-being Scale, while self-rated health was measured using a summative item from a validated instrument. Caregiving appraisal and coping were evaluated separately using the Chinese version of the Caregiving Appraisal Scale and Ways of Coping Questionnaire. Descriptive statistics, t-tests, Chi-square tests, and multivariate stepwise regression analyses were employed for data analysis.

RESULTS

Formal caregivers exhibited significantly better psychological well-being and self-rated health compared to informal caregivers. Moreover, formal caregivers reported more positive caregiving appraisals than their informal counterparts. However, there was no statistical difference in coping strategies between the two groups. The psychological well-being of informal caregivers was primarily influenced by coping (standardized β = 0.309) and caregiving mastery (standardized β = 0.270). For formal caregivers, their psychological well-being was mainly influenced by caregiving satisfaction (standardized β = 0.267) and caregiving intensity (standardized β = 0.242). Both informal (standardized β = 0.354) and formal caregivers' (standardized β = 0.156) self-rated health were influenced by passive coping.

CONCLUSIONS

This study provides valuable insights for developing tailored interventions and support systems aimed at improving the psychological well-being and self-rated health of informal and formal caregivers of people with dementia. To enhance the psychological well-being of informal caregivers, interventions targeting improvements in coping skills and caregiving mastery can be designed; while for formal caregivers, interventions focusing on enhancing caregiving satisfaction and effective coping strategies may be beneficial. Improving the passive coping and caregiving appraisals may help improve the self-rated health of both groups.

Effectiveness of information and communication technology-based integrated care for older adults: a systematic review and meta-analysis

Background

Information and communication technology (ICT) is a key factor in advancing the implementation of integrated care for older adults in the context of an aging society and the normalization of epidemics. This systematic review aims to comprehensively evaluate the effectiveness of ICT-based integrated care for older adults to provide input for the construction of intelligent integrated care models suitable for the context of an aging population in China.

Methods

A systematic review and meta-analysis were conducted using PubMed, Web of Science Core Collection, Scopus, MEDLINE, EBSCO, EMBASE, CINAHL with full text, ProQuest, and Cochrane Library databases, along with the Google Scholar search engine, for papers published between January 1, 2000, and July 25, 2022, to include randomized controlled trials and quasi-experimental studies of ICT-based integrated care for older adults. Two reviewers independently performed literature screening, quality assessment (JBI standardized critical appraisal tool), and data extraction. The results were pooled using a random effects model, and narrative synthesis was used for studies with insufficient outcome data.

Results

We included 32 studies (21 interventions) with a total of 30,200 participants (14,289 in the control group and 15,911 in the intervention group). However, the quality of the literature could be improved. The meta-analysis results showed that ICT-based integrated care significantly improved the overall perceived health status of older adults (n=3 studies, MD 1.29 (CI 0.11 to 2.46), no heterogeneity) and reduced the number of emergency department visits (n=11 studies, OR 0.46 (CI 0.25 to 0.86), high heterogeneity) but had no significant effect on improving quality of life, mobility, depression, hospital admissions and readmissions, or mortality in older adults, with a high degree of study heterogeneity. Narrative analysis showed that the overall quality of care, primary care service use, and functional status of older adults in the intervention group improved, but the cost-effectiveness was unclear.

Conclusions

ICT-based integrated care is effective in improving health outcomes for older adults, but the quality and homogeneity of the evidence base need to be improved. Researchers should develop intelligent integrated care programs in the context of local health and care welfare provision systems for older adults, along with the preferences and priorities of the older adults.

Conceptualizing Interprofessional Digital Communication and Collaboration in Health Care: Protocol for a Scoping Review

BACKGROUND

Effective communication and collaboration among health professionals are essential prerequisites for patient-centered care. However, interprofessional teams require suitable structures and tools to efficiently use their professional competencies in the service of high-quality care appropriate to the patient's life situation. In this context, digital tools potentially enhance interprofessional communication and collaboration and lead to an organizationally, socially, and ecologically sustainable health care system. However, there is a lack of studies systematically assessing the critical factors for successfully implementing tools for digitally supported interprofessional communication and collaboration in the health care setting. Furthermore, an operationalization of this concept is missing.

OBJECTIVE

The aim of the proposed scoping review is to (1) identify factors influencing the development, implementation, and adoption processes of digital tools for interprofessional communication in the health care sector and (2) analyze and synthesize the (implicit) definition, dimensions, and concepts of digitally supported communication and collaboration among health care professionals in the health care setting. Studies focusing on digital communication and collaboration practices among health care professionals, including medical doctors and qualified medical assistants, in any health care setting will be included in this review.

METHODS

To address these objectives, an in-depth analysis of heterogeneous studies is needed, which is best achieved through a scoping review. Within this proposed scoping review, which adheres to the Joanna Briggs Institute methodology, 5 databases (SCOPUS, CINAHL, PubMed, Embase, and PsycInfo) will be searched for studies assessing digital communication and collaboration among various health care professionals in different health care settings. Studies focusing on health care providers or patient interaction through digital tools and non-peer-reviewed studies will be excluded.

RESULTS

Key characteristics of the studies included will be summarized through descriptive analysis, using diagrams and tables. We will synthesize and map the data and conduct a qualitative in-depth thematic analysis of definitions and dimensions of interprofessional digital communication and collaboration among health care and nursing professionals.

CONCLUSIONS

Results from this scoping review may help in establishing digitally supported collaborations between various stakeholders in the health care setting and successfully implementing new forms of interprofessional communication and collaboration. This could facilitate the transition to better coordinated care and encourage the development of digital frameworks.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

PRR1-10.2196/45179.

Digital health interventions and quality of home-based primary care for older adults: A scoping review protocol

Introduction

The use of digital health interventions has expanded, particularly in home-based primary care (HBPC), following the increase in the older adult population and the need to respond to the higher demand of chronic conditions, weakness and loss of autonomy of this population. There was an even greater demand with COVID-19 and subsequent isolation/social distancing measures for this risk group. The objective of this study is to map and identify the uses and types of digital health interventions and their reported impacts on the quality of HBPC for older adults worldwide.

Methods and analysis

This is a scoping review protocol which will enable a rigorous, transparent and reliable synthesis of knowledge. The review will be developed from the theoretical perspective of Arksey and O'malley, with updates by Levac and Peters and respective collaborators based on the Joanna Briggs Institute manual, and guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR). Data from white literature will be extracted from multidisciplinary health databases such as: the Virtual Health Library, LILACS, MEDLINE/PubMed, Scopus, Web of Science, Cinahl and Embase; while Google Scholar will be used for gray literature. No date limit or language restrictions will be determined. The quantitative data will be analyzed through descriptive statistics and qualitative data through thematic analysis. The results will be submitted to stakeholder consultation for preliminary sharing of the study and will later be disseminated through publication in open access scientific journals, scientific events and academic and community journals. The full scoping review report will present the main impacts, challenges, opportunities and gaps found in publications related to the use of digital technologies in primary home care.

Discussion

The organization of this protocol will increase the methodological rigor, quality, transparency and accuracy of scoping reviews, reducing the risk of bias.