scholarly journals Engaging older people in an internet platform for cardiovascular risk self-management: a qualitative study among Dutch HATICE participants

BMJ Open ◽  
2018 ◽  
Vol 8 (1) ◽  
pp. e019683 ◽  
Author(s):  
Tessa van Middelaar ◽  
Cathrien R L Beishuizen ◽  
Juliette Guillemont ◽  
Mariagnese Barbera ◽  
Edo Richard ◽  
...  
Keyword(s):  
Primary Care ◽  
Older People ◽  
Computer Literacy ◽  
The Elderly ◽  
Self Management ◽  
Daily Routine ◽  
Semistructured Interview ◽  
User Friendliness ◽  
Increased Risk ◽  
Internet Platform

ObjectivesTo study older peoples’ experiences with an interactive internet platform for cardiovascular self-management, to assess which factors influence initial and sustained engagement. To assess their views on future use within primary care.DesignQualitative semistructured interview study, with thematic analysis.SettingPrimary care in the Netherlands.ParticipantsPeople ≥65 years with an increased risk of cardiovascular disease who used the ‘Healthy Ageing Through Internet Counselling in the Elderly’ internet platform with remote support of a coach. Participants were selected using a purposive sampling method based on gender, age, level of education, cardiovascular history, diabetes, duration of participation and login frequency.ResultsWe performed 17 interviews with 20 participants, including three couples. In the initial phase, platform engagement was influenced by perceived computer literacy of the participants, user-friendliness, acceptability and appropriateness of the intervention and the initial interaction with the coach. Sustained platform use was mainly facilitated by a relationship of trust with the coach. Other facilitating factors were regular automatic and personal reminders, clear expectations of the platform, incorporation into daily routine, social support and a loyal and persistent attitude. Perceived lack of change in content of the platform could work both stimulating and discouraging. Participants supported the idea of embedding the platform into the primary care setting.ConclusionsHuman support is crucial to initial and sustained engagement of older people in using an interactive internet platform for cardiovascular self-management. Regular reminders further facilitate sustained use, and increased tailoring to personal preference is recommended. Embedding the platform in primary healthcare may enhance future adoption.Trial registration numberISRCTN48151589; Pre-results.

scholarly journals Apps for Older People’s Pain Self-Management: Perspectives of Primary Care and Allied Health Clinicians

Pain Medicine ◽  
2019 ◽  
Vol 21 (4) ◽  
pp. 686-694 ◽  
Author(s):  
Priyanka Bhattarai ◽  
Toby Newton-John ◽  
Jane L Phillips
Keyword(s):  
Primary Care ◽  
Older People ◽  
Older Patients ◽  
Allied Health ◽  
Management Strategies ◽  
Data Access ◽  
Careful Consideration ◽  
Self Management ◽  
Semistructured Interview ◽  
Time Data

Abstract Background Chronic arthritic pain is one of the major causes of physical suffering and disability among older people. Primary care and allied health clinicians use various approaches to help their older clients better manage their arthritic pain. The growing uptake of technology among older people offers the potential for clinicians to integrate an arthritic pain app into their patients’ self-management plans. This study explored the perspectives of Australian primary care and allied health clinicians regarding the use of pain self-management apps to help their older patients/clients better manage their arthritic pain. Methods Qualitative design using a semistructured interview approach. Interviews were conducted via telephone with primary and allied health clinicians (N = 17) across Australia. Results The overarching theme underlying participants’ views on integration of apps into older people’s pain self-management strategy was that this approach is an idealistic but uniquely challenging endeavor. Four subthemes emerged, namely: 1) self-management apps are a potentially useful tool but require careful consideration; 2) clinicians’ involvement is crucial yet potentially onerous; 3) no single app is right for every older person with arthritic pain; and 4) patient data access is beneficial, but caution is needed for real-time data access. Discussion The predominant clinician perspective of integrating apps into their older patients/clients’ pain self-management strategies was that this approach is an idealistic but uniquely challenging endeavor. Apps were seen as having potential to support various aspects of patients’ self-management behaviors; however, there were notable concerns with regards to the challenges inherent in this approach for both clinicians and older users (patients/clients).

Development and Validation of an Interactive Internet Platform for Older People: The Healthy Ageing Through Internet Counselling in the Elderly Study

2017 ◽  
Vol 23 (2) ◽  
pp. 96-104 ◽  
Author(s):  
Susan Jongstra ◽  
Cathrien Beishuizen ◽  
Sandrine Andrieu ◽  
Mariagnese Barbera ◽  
Matthijs van Dorp ◽  
...  
Keyword(s):  
Older People ◽  
The Elderly ◽  
Healthy Ageing ◽  
Internet Platform ◽  
Development And Validation

scholarly journals Characteristics of patients receiving health assessments, care plans or case conferences by general practitioners, as part of the Enhanced Primary Care program between November 1999 and October 2001

2002 ◽  
Vol 25 (6) ◽  
pp. 120
Author(s):  
David Wilkinson ◽  
Heather McElroy ◽  
Justin Beilby ◽  
Kathy Mott ◽  
Kay Price ◽  
...  
Keyword(s):  
Primary Care ◽  
Older People ◽  
Indigenous People ◽  
Care Program ◽  
The Elderly ◽  
Care Plans ◽  
Department Of Health ◽  
Health Assessments ◽  
Case Conferences ◽  
Gender Patterns

We aimed to describe the characteristics of patients receiving health assessments (HA), care plans (CP) or case conferences (CC) through the Enhanced Primary Care (EPC) program between November 1999 and October 2001. The Commonwealth Department of Health and Ageing provided data. In all, 43%of non-Indigenous people who had a HA were aged 75-79 years and 32%were aged 80-84 years. Those having a HA at home were older (30.3% aged 85 years and above) than those having a HA in GP's rooms (20.2%85 years and above). For Indigenous people, between 12 and 17%of all HAs were done among each five-year age group between 55 and 84 years. As a group, CPs were mostly done among older people, with a higher proportion done among older women (74.2%among those 55 years and above) than older men (66.4%). Most CCs were also done among older people (60.4%55 years and above). Of the 286,250 people that had at least one EPC service, most (219,210; 76.6%)had only one. Of these, 153,624 (70.1%)had a HA. Of those having at least one EPC service, 95.7%had two services (most often a HA plus a CP). To date EPC activity has been concentrated among the elderly, gender patterns are similar, and few patients have received more than a single EPC service, which is usually a HA.

scholarly journals From “Step Away” to “Stand Down”: Tailoring a Smartphone App for Self-Management of Hazardous Drinking for Veterans

10.2196/16062 ◽  
2020 ◽  
Vol 8 (2) ◽  
pp. e16062
Author(s):  
Daniel Blonigen ◽  
Brooke Harris-Olenak ◽  
Eric Kuhn ◽  
Keith Humphreys ◽  
Christine Timko ◽  
...  
Keyword(s):  
Primary Care ◽  
Mobile App ◽  
Hazardous Drinking ◽  
Self Management ◽  
Primary Care Visit ◽  
Semistructured Interview ◽  
Veterans Health ◽  
Health Administration ◽  
Primary Care Population ◽  
Measurement Based Care

Background US military veterans who screen positive for hazardous drinking during primary care visits may benefit from a mobile app. Step Away is an evidence-based mobile intervention system for the self-management of hazardous drinking. However, Step Away was not designed for veterans, and differences between veterans and civilians could limit the reach and effectiveness of the app with this population. Objective The primary objective of this study was to repurpose Step Away to address the needs and preferences of the veteran primary care population. The Method for Program Adaptation through Community Engagement (M-PACE) model was used to guide the adaptation process. This model can serve as a generalizable approach that other researchers and intervention developers can follow to systematically tailor mobile health tools for a new population. Methods Veteran patients who screened positive for hazardous drinking during a primary care visit (n=12) and peer providers employed by the US Veterans Health Administration (n=11) were recruited to systematically review Step Away and provide feedback on its content and presentation via Web-based surveys and a semistructured interview. Participant feedback was reviewed through an iterative process by key stakeholders who adjudicated which suggested modifications to the app could enhance engagement and effectiveness with veterans while maintaining program integrity. Results Usability ratings of the individual modules of Step Away were uniformly positive across patients and peers, as was the perceived utility of the app overall. Personalized feedback on the health consequences and costs of drinking, options for customization, and the measurement-based care capabilities of the app were viewed as facilitators of engagement. Conversely, lengthy text, small font, and a lack of interactive features were viewed as potential barriers with the older primary care population. Modifications to create a veteran version of the app (Stand Down: Think Before You Drink) included altering the appearance of the app to incorporate more veteran-centric content, adding links and options for resources and activities for veterans, and reducing the amount of text and adding veteran-specific references and common concerns and triggers for drinking in this population. Conclusions The M-PACE model provided a systematic approach to repurpose Step Away to fit the needs and preferences of veteran primary care patients who engage in hazardous drinking. Stand Down may serve as an innovative, low-cost means of expanding access to care for veterans who engage in hazardous drinking.

scholarly journals Mental Disorders, Cognitive Impairment and the Risk of Suicide in Older Adults

2021 ◽  
Vol 12 ◽  
Author(s):  
Agnieszka Kułak-Bejda ◽  
Grzegorz Bejda ◽  
Napoleon Waszkiewicz
Keyword(s):  
Older Adults ◽  
Bipolar Disorder ◽  
Cognitive Impairment ◽  
Mental Disorders ◽  
Anxiety Disorders ◽  
Older People ◽  
Mood Disorders ◽  
The Elderly ◽  
Increased Risk ◽  
The World

More than 600 million people are aged 60 years and over are living in the world. The World Health Organization estimates that this number will double by 2025 to 2 billion older people. Suicide among people over the age of 60 is one of the most acute problems. The factors strongly associated with suicide are mentioned: physical illnesses, such as cancer, neurologic disorder, pain, liver disease, genital disorders, or rheumatoid disorders. Moreover, neurologic conditions, especially stroke, may affect decision-making processes, cognitive capacity, and language deficit. In addition to dementia, the most common mental disorders are mood and anxiety disorders. A common symptom of these disorders in the elderly is cognitive impairment. This study aimed to present the relationship between cognitive impairment due to dementia, mood disorders and anxiety, and an increased risk of suicide among older people. Dementia is a disease where the risk of suicide is significant. Many studies demonstrated that older adults with dementia had an increased risk of suicide death than those without dementia. Similar conclusions apply to prodromal dementia Depression is also a disease with a high risk of suicide. Many researchers found that a higher level of depression was associated with suicide attempts and suicide ideation. Bipolar disorder is the second entity in mood disorders with an increased risk of suicide among the elderly. Apart from suicidal thoughts, bipolar disorder is characterized by high mortality. In the group of anxiety disorders, the most significant risk of suicide occurs when depression is present. In turn, suicide thoughts are more common in social phobia than in other anxiety disorders. Suicide among the elderly is a serious public health problem. There is a positive correlation between mental disorders such as dementia, depression, bipolar disorder, or anxiety and the prevalence of suicide in the elderly. Therefore, the elderly should be comprehensively provided with psychiatric and psychological support.

scholarly journals General practitioners’ perceptions towards the use of digital health services for citizens in primary care: a qualitative interview study

BMJ Open ◽  
2019 ◽  
Vol 9 (5) ◽  
pp. e028251 ◽  
Author(s):  
Asbjørn Johansen Fagerlund ◽  
Inger Marie Holm ◽  
Paolo Zanaboni
Keyword(s):  
Primary Care ◽  
Health Services ◽  
General Practitioners ◽  
Computer Literacy ◽  
Large Scale ◽  
Digital Health ◽  
The Elderly ◽  
Structured Interviews ◽  
Electronic Prescription ◽  
Qualitative Interview Study

ObjectivesTo explore general practitioners’ (GPs) perceptions towards use of four digital health services for citizens: an electronic booking service to make reservations with the GP; an electronic prescription service to request renewal of maintenance drugs; a service for text-based non-clinical enquiries to the GP office and a service for text-based electronic consultation (e-consultation) with the GP.DesignA qualitative study based on semi-structured interviews.SettingPrimary care.ParticipantsNine GPs who were early adopters of the four services were interviewed.MethodOne moderator presented topics using open-ended questions, facilitated the discussion and followed up with further questions. Phone interviews were conducted, audio recorded and transcribed verbatim. Qualitative data were analysed using the framework method.ResultsThe use of digital services in primary care in Norway is growing, although the use of text-based e-consultations is still limited. Most GPs were positive about all four services, but there was still some scepticism regarding their effects. Advantages for GP offices included reduced phone load, increased efficiency, released time for medical assessments, less crowded waiting rooms and more precise communication. Benefits for patients were increased flexibility, autonomy and time and money savings. Children, the elderly and people with low computer literacy might still need traditional alternatives.ConclusionsMore defined and standardised routines, as well as more evidence of the effects, are necessary for large-scale adoption.

scholarly journals Impact of intergenerational transfers on fertility

POPULATION ◽  
2021 ◽  
Vol 24 (1) ◽  
pp. 77-89
Author(s):  
Vyacheslav Babyshev
Keyword(s):  
World War Ii ◽  
Older People ◽  
Empirical Test ◽  
Social Systems ◽  
Intergenerational Transfers ◽  
Substitution Effect ◽  
The Elderly ◽  
Economic Reason ◽  
Elderly Parents ◽  
Increased Risk

On the theoretical basis of the "generational economy" the article describes the "model of overlapping generations" and "life cycle model" as the cause of the existence of intergenerational transfers. The classification of approaches to their study is carried out. Based on the exchange model (the concept of childbearing as a long-term investment in future transfers from adult children to elderly parents) and the theory of substitutions (crowding out private transfers by public social systems), the "elderly security hypothesis" is highlighted as a possible socio-economic reason for the demographic transition. Based on the works of A. Cigno, a theoretical review of this theory is made using the concepts of ^substitution effect» and «free rider effect». According to the works of R. Fenge and B. Scheubel, the "income effect" and "price effect" are defined as the key parameters for testing this hypothesis. An overview of the existing scientific and practical works on the topic of research is made, highlighting methods and results on the following examples: Italy after World War II, Germany at the turn of the 19th and 20th centuries, Brazil in 1991-2000, Hungary in 19502006, 34 OECD countries in the 1990s and the consolidated data for 121 countries at present. The author has carried out his own empirical test of the «hypothesis of elderly security» in the countries of the world on the basis of UN and OECD statistics. Coverage, social security spending, replacement rate, mandatory premium rate, and an increased risk of poverty among older people support the safe aging theory of upward intergenerational transfers from children to parents. But the internal rate of return of pension systems and the average income of older people support the competing hypothesis of top-down intergenerational transfers from parent to child. It is concluded that, with a relatively low standard of living of population, intergenerational transfers go from children to parents, but when a certain level of national welfare is reached, the movement of transfers changes to the opposite direction.

scholarly journals From “Step Away” to “Stand Down”: Tailoring a Smartphone App for Self-Management of Hazardous Drinking for Veterans (Preprint)

2019 ◽  
Author(s):  
Daniel Blonigen ◽  
Brooke Harris-Olenak ◽  
Eric Kuhn ◽  
Keith Humphreys ◽  
Christine Timko ◽  
...  
Keyword(s):  
Primary Care ◽  
Mobile App ◽  
Hazardous Drinking ◽  
Self Management ◽  
Primary Care Visit ◽  
Semistructured Interview ◽  
Veterans Health ◽  
Health Administration ◽  
Primary Care Population ◽  
Measurement Based Care

BACKGROUND US military veterans who screen positive for hazardous drinking during primary care visits may benefit from a mobile app. Step Away is an evidence-based mobile intervention system for the self-management of hazardous drinking. However, Step Away was not designed for veterans, and differences between veterans and civilians could limit the reach and effectiveness of the app with this population. OBJECTIVE The primary objective of this study was to repurpose Step Away to address the needs and preferences of the veteran primary care population. The Method for Program Adaptation through Community Engagement (M-PACE) model was used to guide the adaptation process. This model can serve as a generalizable approach that other researchers and intervention developers can follow to systematically tailor mobile health tools for a new population. METHODS Veteran patients who screened positive for hazardous drinking during a primary care visit (n=12) and peer providers employed by the US Veterans Health Administration (n=11) were recruited to systematically review Step Away and provide feedback on its content and presentation via Web-based surveys and a semistructured interview. Participant feedback was reviewed through an iterative process by key stakeholders who adjudicated which suggested modifications to the app could enhance engagement and effectiveness with veterans while maintaining program integrity. RESULTS Usability ratings of the individual modules of Step Away were uniformly positive across patients and peers, as was the perceived utility of the app overall. Personalized feedback on the health consequences and costs of drinking, options for customization, and the measurement-based care capabilities of the app were viewed as facilitators of engagement. Conversely, lengthy text, small font, and a lack of interactive features were viewed as potential barriers with the older primary care population. Modifications to create a veteran version of the app (<i>Stand Down: Think Before You Drink</i>) included altering the appearance of the app to incorporate more veteran-centric content, adding links and options for resources and activities for veterans, and reducing the amount of text and adding veteran-specific references and common concerns and triggers for drinking in this population. CONCLUSIONS The M-PACE model provided a systematic approach to repurpose Step Away to fit the needs and preferences of veteran primary care patients who engage in hazardous drinking. Stand Down may serve as an innovative, low-cost means of expanding access to care for veterans who engage in hazardous drinking.

Mobility impairment in the elderly

2018 ◽  
Vol 11 (1) ◽  
pp. 14-19
Author(s):  
Rabia Mahmood Khan
Keyword(s):  
Primary Care ◽  
Older People ◽  
Functional Ability ◽  
Clinical Relevance ◽  
The Elderly ◽  
Clinical Disease ◽  
Screening Tools ◽  
Early Interventions ◽  
Mobility Impairment ◽  
Mobility Impairments

Decline in functional ability among the elderly is of clinical relevance as a marker of potentially treatable clinical disease. It is possible to screen older people for mobility issues and apply early interventions to prevent mobility problems and rehabilitate existing mobility impairments. This article discusses the predictors of mobility decline, available screening tools and the prevention and management of mobility impairment in primary care.

scholarly journals Reminiscence Therapy through Kidung Bali for Depression of older people living in Urban area

2021 ◽  
Vol 11 (02) ◽  
pp. 94-99
Author(s):  
Sukardin Sukardin ◽  
Hadi Suryatno ◽  
Ni Wayan Dewi Parwati ◽  
Ni Made Sumartyawati
Keyword(s):  
Older People ◽  
Urban Area ◽  
Geriatric Depression Scale ◽  
Depression Scale ◽  
The Elderly ◽  
Mean Value ◽  
Wilcoxon Test ◽  
Geriatric Depression ◽  
Reminiscence Therapy ◽  
Increased Risk

Abstract: Aging process impacted the existence of health-related problems. Depression is one of the most common health problems that occurred in older people. Effects experienced by elderly depression is an increased risk of getting various diseases. So that we need therapy as an alternative treatment for depression in the elderly. Objectives: This study aimed to determine the effect of Reminiscence therapy through Kidung Bali on the changes in depression in the elderly in Urban area. Methods: This research was a quasi-experimental study performed on 33 Elderly in Mataram. Participants were randomly selected. The Geriatric Depression Scale (GDS) questionnaire was used to collect data related to Elderly Depression. Reminiscence therapy was conducted over five days, the duration of treatment approximately 30-40 minutes each meeting. Data were analyzed using Pearson and Spearman correlation and Wilcoxon-test in SPSS 24. Results: : This study illustrated that there was a change in the Geriatric Depression Scale score.  Before giving the reminiscence therapy, a mean value was 5.67, and after being given the reminiscence therapy, the mean Value changed to 3.15. Statistical test results showed the p-value <α (0.000 <0.05).  Conclusion: It can be concluded that There was an effect of Reminiscence therapy through Kidung Bali to elderly depression in Urban area. Reminiscence therapy through Kidung Bali is an alternative option in reducing depression in the elderly. Keywords: Reminiscence therapy, Kidung Bali, Elderly, Depression.  

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