Effects of a Video-Based mHealth Program for Homebound Older Adults: Study Protocol for a Pilot Randomized Controlled Trial

Gerontology ◽  
2021 ◽  
pp. 1-8
Author(s):  
Arkers Kwan Ching Wong ◽  
Frances Kam Yuet Wong ◽  
Karen Kit Sum Chow ◽  
Siu Man Wong
Keyword(s):  
Quality Of Life ◽  
Older Adults ◽  
Randomized Controlled Trial ◽  
Daily Living ◽  
Controlled Trial ◽  
Self Care ◽  
Randomized Controlled ◽  
Homebound Older Adults ◽  
Pilot Randomized Controlled Trial

<b><i>Background:</i></b> Although homebound older adults are among the highest users of hospital services, the existing health and social services that are provided to them in the community are limited and fragmented. This study attempts to bring this group of older adults to providers’ attention by designing a health-social-oriented self-care mobile Health (mHealth) program and subjecting it to empirical testing. The aim of this study is to shift the current reactive, cure-oriented approach to a preventive and health-promoting model, empowering homebound older adults to take an active role in their health, be responsive to their care needs, and subsequently improve their holistic health. <b><i>Methods:</i></b> This is a pilot randomized controlled trial. The study is supported by 5 community centers with an estimated sample size of 68 subjects. The subjects will be randomly assigned to video-based mHealth or control groups when they (1) are aged 60 or over, (2) go outdoors less than once a week in the current 6 months, (3) live within the service areas, and (4) use a smartphone. Subjects in the video-based mHealth group will receive a 3-month program comprising 2 main interventions: nurse case management supported by a social service team and video messages covering self-care topics, delivered via smartphone. The control group will receive usual care. Data will be collected at 2 time points – pre-intervention (T1) and post-intervention (T2). The primary outcome will be self-efficacy, and secondary outcomes will include health outcomes (activities of daily living, instrumental activities of daily living, and medication adherence), perceived well-being outcomes (quality of life and depression), and health service utilization outcomes (outpatient clinic, emergency room, and hospital admission). <b><i>Discussion:</i></b> The current study will add to the knowledge gap in using mHealth supported by a health-social team to enhance quality of life and self-care and meet the needs of these particularly vulnerable older adults.

Challenges of Telemonitoring Programs for Complex Chronic Conditions: A Randomized Controlled Trial with an Embedded Qualitative Study (Preprint)

2021 ◽  
Author(s):  
Patrick Ware ◽  
Amika Shah ◽  
Heather Joan Ross ◽  
Alexander Gordon Logan ◽  
Phillip Segal ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Randomized Controlled Trial ◽  
Decision Support ◽  
Chronic Conditions ◽  
Controlled Trial ◽  
Self Care ◽  
Randomized Controlled ◽  
Complex Patients ◽  
Secondary Outcomes

BACKGROUND Despite the growing prevalence of people with complex conditions and evidence of the positive impact of telemonitoring for single conditions, little research exists on the use of telemonitoring in this population, particularly those with multiple chronic conditions (MCCs). OBJECTIVE This randomized controlled trial (RCT) and embedded qualitative study aimed to evaluate the impact and experiences of patients and healthcare providers (HCPs) using a telemonitoring system with decision support to manage complex patients, including those with MCCs, compared to the standard of care. METHODS A pragmatic 6-month RCT sought to recruit 146 patients with a diagnosis of heart failure (HF), uncontrolled hypertension (HT), and/or insulin requiring diabetes (DM) from outpatient specialty settings in Toronto, Canada. Participants were randomized into the control and telemonitoring groups with the latter being instructed to take readings relevant to their condition(s). The telemonitoring system contained an algorithm that generated decision support in the form of actionable self-care directives to patients and alerts to HCPs. The primary outcome was health status as measured by the SF-36. Secondary outcomes included anxiety and depression, self-efficacy in chronic disease management, and self-reported healthcare utilization. HF-related quality of life and self-care measures were also collected from patients followed for HF. Within- and between-group change scores were analyzed for statistical significance (P<.05). A convenience sample of HCPs and patients in the intervention group were interviewed about their experiences RESULTS A total of 96 patients were recruited and randomized. Recruitment was terminated early due to implementation challenges and the onset of COVID-19. No significant within- and between-group differences were found for the main primary and secondary outcomes. However, a within-group analysis of HF patients found improvements in self-care maintenance (P=.036) and physical quality of life (P= .046). Opinions expressed by the 5 HCPs and 13 patients interviewed differed based on the condition(s) monitored. Although HF patients reported benefitting from actionable self-care guidance and meaningful interactions with their HCPs, patient and HCP users of the DM and HT modules did not think telemonitoring improved the clinical management of those conditions to the same degree. These differing experiences were largely attributed to the siloed nature of specialty care, and the design of the decision support whereby it was indicated that fluctuations in HT and DM patient status typically required less urgent intervention compared to HF. CONCLUSIONS Consistent with previous studies, we recommend that future research conceive telemonitoring as a program and that self-management and clinical decision support are necessary, but not sufficient components of such programs for complex patients with lower acuity. We conclude that a multidisciplinary model of care that includes care coordination must accompany telemonitoring systems which may best be operationalized through novel models of care, such as nurse-led models. CLINICALTRIAL ClinicalTrials.gov NCT03127852, ISRCTN (41238563) INTERNATIONAL REGISTERED REPORT RR2-10.2196/resprot.8367

scholarly journals Effectiveness of a Randomized Controlled Trial of Individual Reminiscence Therapy on Cognition, Mood and Quality of Life in Azorean Older Adults with Neurocognitive Disorders

2021 ◽  
Vol 10 (22) ◽  
pp. 5395
Author(s):  
Susana I. Justo-Henriques ◽  
Enrique Pérez-Sáez ◽  
João L. Alves Apóstolo ◽  
Janessa O. Carvalho
Keyword(s):  
Quality Of Life ◽  
Older Adults ◽  
Randomized Controlled Trial ◽  
Controlled Trial ◽  
Neurocognitive Disorders ◽  
Cognitive Stimulation ◽  
Reminiscence Therapy ◽  
Randomized Controlled ◽  
Multicenter Randomized Controlled Trial

Reminiscence therapy (RT) is a form of cognitive stimulation therapy that incorporates discussion of past activities, events, and experiences to stimulate individual memories; it has had some success in treating persons with neurocognitive disorders. This research aims to evaluate the ability of individual RT, using a simple reminiscence format, to improve the overall cognitive function, memory, executive functions, emotional status, and quality of life in older adults with neurocognitive disorders who received social care and support services. A multicenter randomized controlled trial was completed in the Azores archipelago (an independent region of Portugal) using repeated measures (pre-intervention, post-intervention, and follow-up). The intervention group underwent individual RT sessions, twice weekly for 13 weeks, while the control group completed regular activities administered as part of their program. Results did not reveal any significant differences between the intervention and control groups. While results did not reveal significant effects, a number of historical and contextual factors are considered as possible explanations for the lack of effects—namely, data collection occurring during the COVID-19 global pandemic, participant cohort effects, and therapist heterogeneity.

The Effect of Spiritual Self-care Training on the Quality of Life of Mothers of Preterm Infants: A Randomized Controlled Trial

2018 ◽  
Vol 59 (2) ◽  
pp. 714-724 ◽  
Author(s):  
Zohreh Sekhavatpour ◽  
Tayebe Reyhani ◽  
Mohammad Heidarzade ◽  
Seied Mehdi Moosavi ◽  
Seied Reza Mazlom ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Randomized Controlled Trial ◽  
Preterm Infants ◽  
Controlled Trial ◽  
Self Care ◽  
Randomized Controlled ◽  
Mothers Of Preterm Infants ◽  
Care Training ◽  
Spiritual Self
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