Perspectives on the popularization of smart senior care to meet the demands of older adults living alone in communities of Southwest China: A qualitative study

The smart senior care demand in China in the context of active ageing: a qualitative study with multiple perspectives

Background

With the rapid population aging in China, smart senior care is urgently demanded. Therefore, it is necessary to comprehensively consider people's demand for smart senior care for its better development. This study aimed to explore the needs and expectations of relevant stakeholders of smart senior care in China in the context of active aging.

Methods

This is a qualitative descriptive study, in which 21 semi-structured interviews were conducted between October 2021 and March 2022. A total of seven community-dwelling older adults, seven smart senior care managers, and seven providers were selected using purposeful sampling. Interviews were transcribed, translated into English, and analyzed by the thematic analysis method.

Results

Four major themes and 12 subcategories were identified in the data: "challenges of smart senior care" (low acceptance of users; high cost vs. low purchasing power; low coverage of smart devices and applications), "meet the demands of users" (strong medical care needs; meticulous life care needs; extensive social interaction needs), "multi-body participation" (online and offline integration; government's broader role; cooperative gaming), and "all-around guarantee" (legal guarantee, technological empowerment, network security guarantee).

Conclusion

To develop smart senior care in China in the context of active aging, it is essential to clarify the current issues and challenges faced by relevant stakeholders of smart senior care. To better develop smart senior care, we need to meet the health, life, and social care need of users, through multi-body participation and all-around guarantee.

Development and application of a questionnaire on the smart care needs of older adults living in long-term care communities

Considering the current global aging of society, the demand for promoting smart care-a technology based care and knowledge system-among older adults living in long-term care (LTC) communities highlights the urgent need to assess the smart care needs of older adults. This study developed a questionnaire applicable to this context, tested it, and initially applied its reliability. We assessed the questionnaire's discriminant validity, content validity, consistency reliability, folding half reliability, and test-retest reliability, using a cross-sectional survey (260 older adults). Using a different cross-sectional participant group (418 older adults), we validated the factor analysis of the finalized questionnaire and its preliminary application. The results showed that the total mean score of the smart care needs of older adults in LTC communities was 67.55±13.81 (a medium level). We ultimately assessed the questionnaire to be a reliable tool for assessing the smart care needs of older adults in LTC communities.

Influence of Policy Awareness and Satisfaction With Service on the Willingness to Engage in Rural Elderly Medical and Nursing Care Service Programs in Rural China

BACKGROUND

In rural China, the participation of residents in elderly medical and nursing care service programs is notably low. To understand the reasons behind this underutilization or reluctance to use such services, an empirical study is warranted.

DESIGN

This study adopts a cross-sectional research design, utilizing survey data collected between January and March 2023.

SAMPLE

Retired elderly individuals aged 50 and above who were permanent residents of LS Town.

MEASUREMENTS

The survey collects data concerning several key aspects of the older adult population, including their fundamental demographic information, awareness levels regarding integrated medical and nursing care services offered by local township health clinics, their current enrollment status in family doctor contract services, and their propensity to subscribe to such healthcare arrangements.

RESULTS

The findings indicate a significant positive relationship between awareness of the integrated medical and elderly care nursing model and the willingness of rural older adults to adopt these services. Furthermore, satisfaction with the services also directly influences the willingness to engage with these services.

CONCLUSION

This study contributes to the existing body of knowledge by highlighting the significance of policy dissemination and enhancing service quality as pivotal strategies for governments and health service organizations to foster increased uptake of these services among the rural elderly population.

Demand, utilization, and supply of community smart senior care services for older people in China

Objective

Although smart senior care services offer numerous benefits, they have not yet gained widespread acceptance among the general populace, particularly seniors. Numerous related issues have surfaced, with the structural imbalance between supply and demand being most prominent. Currently, there is a lack of research distinguishing between the various categories of demand for smart ageing services and the associated behaviors of older individuals. In this study, we aimed to identify the types of demand and utilization of smart senior care services among Chinese older adults to understand their diverse characteristics and the factors that facilitate certain behaviors. We also analyzed the imbalance between supply and demand for smart senior care services and explored the factors influencing it, thereby providing a reference for optimizing smart senior services.

Methods

We conducted a cross-sectional study from January to March 2023 and analyzed 1037 valid questionnaires. Three types of smart senior care services were investigated: intelligent information, intelligent consultation, and intelligent monitoring. We identified the demand, utilization, and supply of these services among older individuals. Latent class analysis (LCA) was used to differentiate the heterogeneity of older adults in terms of service demand and utilization. Factors influencing service preferences were analyzed using binary logistic regression based on Andersen's behavioral model.

Results

Based on the LCA findings, service demand, and utilization were divided into two categories: positive demand (desire to use the services) or negative demand, and taking action or negative action to use the services. The persons with high demand but low utilization comprised the largest number of older people in this study (69.35%). The results indicated that the number of children (odds ratio (OR) = 1.491), community-provided smart devices (OR = 1.700), number of chronic diseases (OR = 1.218), and self-care capacity (OR = 0.214) are associated with positive demand. Meanwhile, pre-retirement employment, income sources, community device provided, community promotion, region, and self-care ability were significant predictors (p < 0.05) of taking action to use the services. In terms of community supply outcome, income situation had a significant effect on intelligent information services. Income sources were associated with intelligent information and intelligent monitoring services. Pre-retirement employment and housing type variables showed effect on IC services. Community promotion and self-care ability were associated with all three types of service supply (p < 0.05).

Conclusion

Older adults expressed a strong demand for smart ageing services; however, difficulties using smart technology remain a serious problem. Further investigation of how family support contributes to the perception and use of care services for older people is needed. Specific policies, such as financial assistance, should be established to support service use. Communities should expand their support and promotion of smart ageing services, focusing on enhancing digital health literacy among seniors to facilitate product utilization. Furthermore, personalized recommendations and applications tailored to the physical conditions of older adults are essential.

Factors influencing utilization of healthcare services for internal migrant older adults in Xuzhou, China: based on Anderson's model

Background

As population migration increases and the aging process accelerates, the number of migrant older adults is growing significantly. This trend presents a substantial challenge to urban health services in regions experiencing an influx of older adults individuals. Consequently, examining the healthcare service utilization of the migrant older adults population is crucial to promote healthy aging.

Methods

A multi-stage random sampling method was employed to select a study population of 568 migrant older adults individuals, aged 60 years and above, residing in urban Xuzhou City. Multivariate logistic regression analysis, based on Anderson's model, was conducted to explore the factors influencing outpatient and inpatient health service utilization among this population.

Results

Among the 568 migrants, 73 (12.9%) had received outpatient services within the past 2 weeks, while 109 (19.2%) had received inpatient services within the past year. Migrant older adults with education level, time to health centers, and self-assessed health status negatively influenced the outpatient services utilization among migrant older adults. Possession of pension insurance, convenience to visit, sick for the past 2 weeks, and health services need positively influenced the outpatient services utilization among migrant older adults. Furthermore, age, possession of pension insurance and health insurance, convenience to visit, number of chronic diseases, sick for the past 2 weeks, and healthcare service need positively influenced inpatient service utilization among migrant older adults. Education level, self-assessed health status, and time to health centers negatively influenced the inpatient services utilization among migrant older adults.

Conclusion

The overall utilization of healthcare services by migrant older adults in Xuzhou remains inadequate. Addressing this issue requires enhanced medical policy support and assistance, stronger health education initiatives, and improved social integration for the older adults. Additionally, efforts should be made to reduce their financial burdens and improve the accessibility of healthcare services.

Analysis of demand and influencing factors for smart senior care among older adults in underdeveloped regions of western China: a case study of Lanzhou

Introduction

With the rapid development of artificial intelligence and Internet-of-Things technology, internal support systems among families are gradually weakening, which can no longer satisfy the current demands of older adults. In this context, smart senior care has become a new development direction. However, existing studies on the demand for smart senior care are primarily concentrated in economically developed provinces and mega-cities in eastern China; their research results or conclusions may not apply to underdeveloped areas in the Western region. Therefore, our study selects Lanzhou as a representative city in an underdeveloped western region to investigate the demand of older adults for smart senior care and analyze the influencing factors.

Methods

This cross-sectional study included 4,815 older adults from Lanzhou, China. A structured questionnaire was designed to investigate the demands of the older adults for smart senior care and analyze thie influencing factors. The Chi-square test was used for single factor analysis of each variable. The logistic regression model included the statistically significant variables to analyze factors influencing older adults' demand for smart senior care. A significance level of p < 0.05 was considered statistically significant.

Results

Among the surveyed older adults, 1,625 (33.75%) expressed a demand for smart senior care. The finding indicated that participants' age, level of education, marital status, monthly income, number of children, type of endowment insurance, and knowledge of smart senior care were significantly associated with their demands for smart senior care (p < 0.05). Notably, medical care emerged as the smart senior care service with the highest demand rate (79.45%).

Conclusion

In Lanzhou, older adults show a low level of knowledge but a high demand for smart senior care. Their demand is influenced by personal, family, health conditions, senior care security, and other factors. To advance smart senior care, government departments should accelerate the improvement of the laws and regulations on smart senior care while vigorously enhancing the service's publicity to raise knowledge about it. Additionally, the service contents for smart senior care should be expanded to meet the diversified demands of older adults.

An evolutionary game-based simulation study of a multi-agent governance system for smart senior care services in China

BACKGROUND

The competing interests of the government, smart senior care technology service providers, and older adults have led to a serious fragmentation of governance in China. This study aims to identify the collaboration mechanisms and evolutionary stabilization strategies for these agents.

METHODS

An evolutionary game model is developed to analyze the strategic decisions made by the government, smart senior care technology service providers, and older adults. A sensitivity analysis is conducted using data from Anhui Province, China, to verify the effects of relevant parameters on the strategy decisions of each agent.

RESULTS

The results of the simulation and sensitivity analysis indicated that, first, despite changes in the initial willingness values of the tripartite agents, the system eventually converges on 1. Second, the collaboration mechanism of the tripartite agents in the smart senior care system is related to government incentives, penalties, and subsidies, smart senior care service costs, and the additional benefits provided to smart senior care technology service providers.

CONCLUSION

The strategy decisions of the government, providers, and older adults interact with each other. To promote collaboration among the tripartite agents and improve governance effectiveness, the government should strengthen the regulations for providers, increase penalties for providers that engage in a breach of trust, provide moderate incentives and subsidies, and control smart senior care service costs.

Impact of the National Nursing Development Plan on nursing human resources in China: An interrupted time series analysis for 1978-2021

BACKGROUND

Shortages of nurses and unequal distribution of nursing staff have been huge challenges for global health services.

OBJECTIVES

The aim of our study was to evaluate the impact of the National Nursing Development Plan on nursing human resources in China.

METHODS

An interrupted time series design was used in this study. The data for this study were extracted from the National Health Statistics Yearbook from 1978 to 2021. The Ministry of Health issued the National Nursing Development Plan (2005-2010) in July 2005. Subsequently, the strategic plan was issued every 5 years: the National Nursing Development Plan (2011-2015), the National Nursing Development Plan (2016-2020), and the National Nursing Development Plan (2021-2025). This study used five indicators including 1) the number of registered nurses (RNs) in China, 2) the number of RNs per 1000 population in China, 3) the proportion of RNs in health technical personnel in China, 4) the doctor-nurse ratio and 5) the number of nurses working in primary medical institutions to evaluate the changing trend of nursing human resources in China from 1978 to 2021.

RESULTS

Interrupted time series analysis showed that after the implementation of the National Nursing Development Plan (2005-2010), the building of nurses in China was gradually strengthening, and the number of RNs in China increased by 0.198 million per year (95%CI 0.174-0.223; P < 0.001); the number of RNs per 1000 population (Coefficient = 0.139; 95%CI 0.123-0.154; P < 0.001); the proportion of RNs in the total number of health professionals in China has increased from 29.6 % to 44.6 % (Coefficient = 0.010; 95%CI 0.009-0.010; P < 0.001); in China, the doctor-nurse ratio increased by 0.024 (95%CI 0.019-0.029; P < 0.001). In 2021, the number of RNs working in primary medical institutions increased by approximately 0.86 million compared with that in 2005, and the proportion of RNs in the country increased by 1.4 %. The development of nurses is especially tilted to the primary level to meet the health and nursing needs of the primary level.

CONCLUSIONS

The implementation of the National Nursing Development Plan has greatly expanded the scale of nursing human resources in China and significantly optimized the efficiency of allocation. The implementation of the National Nursing Development Plan (2011-2015) and the National Nursing Development Plan (2016-2020) well continued the strategic plan from 2005 to 2010, further expanded the nursing workforce and further optimized the allocation efficiency.

TWEETABLE ABSTRACT

The implementation of the National Nursing Development Plan has greatly expanded the scale of nursing human resources in China and significantly optimized the efficiency of allocation.