scholarly journals Mobile Care System for Older Adults: perceptions about its use in caring for people with dementia

2020 ◽  
Vol 23 (1) ◽  
Author(s):  
André da Silva Brites ◽  
Celia Pereira Caldas ◽  
Luciana Branco da Motta ◽  
Danielli Santos do Carmo ◽  
Alexandre Sztajnberg ◽  
...  
Keyword(s):  
Social Support ◽  
Older Adults ◽  
Focus Groups ◽  
Health Professionals ◽  
Medication Management ◽  
Management Strategies ◽  
Cognitive Disorders ◽  
Functional Evaluation ◽  
People With Dementia ◽  
Care System

Abstract Objective: To analyze the perceptions of caregivers and health professionals about a mobile application used for the caring and social support of people with dementia. Method: A qualitative study was performed on the experience of implementing a Mobile Care System for Older Adults (Sistema Móvel de Assistência ao Idoso, SMAI) in the routine of caregivers of people with dementia, treated at an outpatient clinic for cognitive disorders. Data were obtained through the application of questionnaires about the characteristics of caregivers and the Zarit scale to assess the level of burden. An Activities of Daily Living Questionnaire (ADLQ) was applied for functional evaluation. The perception of caregivers and professionals were collected through the audio recording of focus groups and analyzed according to the thematic-categorical analysis technique. Results: Twenty caregivers and five health professionals participated in the focus groups. Categories that emerged from the study revealed themes related to users’ experiences, communication, medication management, feelings of caregivers, patient management strategies, impact of dementia on caregivers’ lives, illness of caregivers and application evaluation. Conclusion: Interventions using mobile applications can help improve communication and social support in the care of dementia. The experience with the SMAI and its applications represented an innovative opportunity for both family caregivers and healthcare professionals.

scholarly journals Medication management strategies used by older adults with heart failure: A systems-based analysis

2017 ◽  
Vol 17 (5) ◽  
pp. 418-428 ◽  
Author(s):  
Robin S Mickelson ◽  
Richard J Holden
Keyword(s):  
Heart Failure ◽  
Older Adults ◽  
Medication Adherence ◽  
Ad Hoc ◽  
Qualitative Content Analysis ◽  
Medication Management ◽  
Management Strategies ◽  
Cognitive Engineering ◽  
Behavioral Adaptations ◽  
Future Patient

Background: Older adults with heart failure use strategies to cope with the constraining barriers impeding medication management. Strategies are behavioral adaptations that allow goal achievement despite these constraining conditions. When strategies do not exist, are ineffective or maladaptive, medication performance and health outcomes are at risk. While constraints to medication adherence are described in literature, strategies used by patients to manage medications are less well-described or understood. Aim: Guided by cognitive engineering concepts, the aim of this study was to describe and analyze the strategies used by older adults with heart failure to achieve their medication management goals. Methods: This mixed methods study employed an empirical strategies analysis method to elicit medication management strategies used by older adults with heart failure. Observation and interview data collected from 61 older adults with heart failure and 31 caregivers were analyzed using qualitative content analysis to derive categories, patterns and themes within and across cases. Results: Data derived thematic sub-categories described planned and ad hoc methods of strategic adaptations. Stable strategies proactively adjusted the medication management process, environment, or the patients themselves. Patients applied situational strategies (planned or ad hoc) to irregular or unexpected situations. Medication non-adherence was a strategy employed when life goals conflicted with medication adherence. The health system was a source of constraints without providing commensurate strategies. Conclusions: Patients strived to control their medication system and achieve goals using adaptive strategies. Future patient self-mangement research can benefit from methods and theories used to study professional work, such as strategies analysis.

scholarly journals The Use of Wearable Activity Trackers Among Older Adults: Focus Group Study of Tracker Perceptions, Motivators, and Barriers in the Maintenance Stage of Behavior Change (Preprint)

2018 ◽  
Author(s):  
Anastasia Kononova ◽  
Lin Li ◽  
Kendra Kamp ◽  
Marie Bowen ◽  
R.V. Rikard ◽  
...  
Keyword(s):  
Physical Activity ◽  
Social Support ◽  
Older Adults ◽  
Focus Groups ◽  
Short Term ◽  
Activity Tracker ◽  
Activity Trackers ◽  
Maintenance Stage ◽  
Wearable Activity Trackers

BACKGROUND Wearable activity trackers offer the opportunity to increase physical activity through continuous monitoring. Viewing tracker use as a beneficial health behavior, we explored the factors that facilitate and hinder long-term activity tracker use, applying the transtheoretical model of behavior change with the focus on the maintenance stage and relapse. OBJECTIVE The aim of this study was to investigate older adults’ perceptions and uses of activity trackers at different points of use: from nonuse and short-term use to long-term use and abandoned use to determine the factors to maintain tracker use and prevent users from discontinuing tracker usage. METHODS Data for the research come from 10 focus groups. Of them, 4 focus groups included participants who had never used activity trackers (n=17). These focus groups included an activity tracker trial. The other 6 focus groups (without the activity tracker trial) were conducted with short-term (n=9), long-term (n=11), and former tracker users (n=11; 2 focus groups per user type). RESULTS The results revealed that older adults in different tracker use stages liked and wished for different tracker features, with long-term users (users in the maintenance stage) being the most diverse and sophisticated users of the technology. Long-term users had developed a habit of tracker use whereas other participants made an effort to employ various encouragement strategies to ensure behavior maintenance. Social support through collaboration was the primary motivator for long-term users to maintain activity tracker use. Short-term and former users focused on competition, and nonusers engaged in vicarious tracker use experiences. Former users, or those who relapsed by abandoning their trackers, indicated that activity tracker use was fueled by curiosity in quantifying daily physical activity rather than the desire to increase physical activity. Long-term users saw a greater range of pros in activity tracker use whereas others focused on the cons of this behavior. CONCLUSIONS The results suggest that activity trackers may be an effective technology to encourage physical activity among older adults, especially those who have never tried it. However, initial positive response to tracker use does not guarantee tracker use maintenance. Maintenance depends on recognizing the long-term benefits of tracker use, social support, and internal motivation. Nonadoption and relapse may occur because of technology’s limitations and gaining awareness of one’s physical activity without changing the physical activity level itself.

scholarly journals Smartphone Apps to Support Falls Rehabilitation Exercise: App Development and Usability and Acceptability Study

10.2196/15460 ◽  
2020 ◽  
Vol 8 (9) ◽  
pp. e15460
Author(s):  
Helen Hawley-Hague ◽  
Carlo Tacconi ◽  
Sabato Mellone ◽  
Ellen Martinez ◽  
Claire Ford ◽  
...  
Keyword(s):  
Older Adults ◽  
Focus Groups ◽  
Goal Setting ◽  
Health Professionals ◽  
Well Being ◽  
Design Stage ◽  
Home Exercise ◽  
Smartphone Apps ◽  
Implementation Phase ◽  
App Development

Background Falls have implications for older adults’ health and well-being. Strength and balance interventions significantly reduce the risk of falls. However, patients do not always perform the unsupervised home exercise needed for fall reduction. Objective This study aims to develop motivational smartphone apps co-designed with health professionals and older adults to support patients to perform exercise proven to aid fall reduction and to explore the apps’ usability and acceptability with both health professionals and patients. Methods There were 3 phases of app development that included analysis, design, and implementation. For analysis, we examined the literature to establish key app components and had a consultation with 12 older adults attending a strength and balance class, exercise instructors, and 3 fall services. For design, we created prototype apps and conducted 2 patient and public involvement workshops, one with 5 health professionals and the second with 8 older adults from an exercise group. The apps were revised based on the feedback. For implementation, we tested them with one fall service and their patients for 3 weeks. Participatory evaluation was used through testing, semistructured interviews, and focus groups to explore acceptability and usability. Focus groups were conducted with the service that tested the apps and two other services. Qualitative data were analyzed using the framework approach. Results On the basis of findings from the literature and consultations in the analysis phase, we selected Behavior Change Techniques, such as goal setting, action planning, and feedback on behavior, to be key parts of the app. We developed goals using familiar icons for patients to select and add while self-reporting exercise and decided to develop 2 apps, one for patients (My Activity Programme) and one for health professionals (Motivate Me). This enabled health professionals to guide patients through the goal-setting process, making it more accessible to nontechnology users. Storyboards were created during the design phase, leading to prototypes of “Motivate Me” and “My Activity Programme.” Key changes from the workshops included being able to add more details about the patients’ exercise program and a wider selection of goals within “Motivate Me.” The overall app design was acceptable to health professionals and older adults. In total, 7 patients and 3 health professionals participated in testing in the implementation phase, with interviews conducted with 6 patients and focus groups, with 3 teams (11 health professionals). Barriers, facilitators, and further functionality were identified for both apps, with 2 cross-cutting themes around phone usability and confidence. Conclusions The motivational apps were found to be acceptable for older adults taking part in the design stage and patients and health professionals testing the apps in a clinical setting. User-led design is important to ensure that the apps are usable and acceptable.

scholarly journals One-to-One and Group-Based Teleconferencing for Falls Rehabilitation: Usability, Acceptability, and Feasibility Study (Preprint)

2020 ◽  
Author(s):  
Helen Hawley-Hague ◽  
Carlo Tacconi ◽  
Sabato Mellone ◽  
Ellen Martinez ◽  
Lorenzo Chiari ◽  
...  
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Focus Group ◽  
Focus Groups ◽  
Health Professionals ◽  
Health Care Professionals ◽  
Public Involvement ◽  
Patient And Public Involvement ◽  
Feasibility Testing ◽  
One To One

BACKGROUND Falls have implications for the health of older adults. Strength and balance interventions significantly reduce the risk of falls; however, patients seldom perform the dose of exercise that is required based on evidence. Health professionals play an important role in supporting older adults as they perform and progress in their exercises. Teleconferencing could enable health professionals to support patients more frequently, which is important in exercise behavior. OBJECTIVE This study aims to examine the overall concept and acceptability of teleconferencing for the delivery of falls rehabilitation with health care professionals and older adults and to examine the usability, acceptability, and feasibility of teleconferencing delivery with health care professionals and patients. METHODS There were 2 stages to the research: patient and public involvement workshops and usability and feasibility testing. A total of 2 workshops were conducted, one with 5 health care professionals and the other with 8 older adults from a community strength and balance exercise group. For usability and feasibility testing, we tested teleconferencing both one-to-one and in small groups on a smartphone with one falls service and their patients for 3 weeks. Semistructured interviews and focus groups were used to explore acceptability, usability, and feasibility. Focus groups were conducted with the service that used teleconferencing with patients and 2 other services that received only a demonstration of how teleconferencing works. Qualitative data were analyzed using the framework approach. RESULTS In the workshops, the health care professionals thought that teleconferencing provided an opportunity to save travel time. Older adults thought that it could enable increased support. Safety is of key importance, and delivery needs to be carefully considered. Both older adults and health care professionals felt that it was important that technology did not eliminate face-to-face contact. There were concerns from older adults about the intrusiveness of technology. For the usability and feasibility testing, 7 patients and 3 health care professionals participated, with interviews conducted with 6 patients and a focus group with the health care team. Two additional teams (8 health professionals) took part in a demonstration and focus group. Barriers and facilitators were identified, with 5 barriers around reliability due to poor connectivity, cost of connectivity, safety concerns linked to positioning of equipment and connectivity, intrusiveness of technology, and resistance to group teleconferencing. Two facilitators focused on the positive benefits of increased support and monitoring and positive solutions for future improvements. CONCLUSIONS Teleconferencing as a way of delivering fall prevention interventions can be acceptable to older adults, patients, and health care professionals if it works effectively. Connectivity, where there is no Wi-Fi provision, is one of the largest issues. Therefore, local infrastructure needs to be improved. A larger usability study is required to establish whether better equipment for delivery improves usability. CLINICALTRIAL

scholarly journals Smartphone Apps to Support Falls Rehabilitation Exercise: App Development and Usability and Acceptability Study (Preprint)

2019 ◽  
Author(s):  
Helen Hawley-Hague ◽  
Carlo Tacconi ◽  
Sabato Mellone ◽  
Ellen Martinez ◽  
Claire Ford ◽  
...  
Keyword(s):  
Older Adults ◽  
Focus Groups ◽  
Goal Setting ◽  
Health Professionals ◽  
Well Being ◽  
Design Stage ◽  
Home Exercise ◽  
Smartphone Apps ◽  
Implementation Phase ◽  
App Development

BACKGROUND Falls have implications for older adults’ health and well-being. Strength and balance interventions significantly reduce the risk of falls. However, patients do not always perform the unsupervised home exercise needed for fall reduction. OBJECTIVE This study aims to develop motivational smartphone apps co-designed with health professionals and older adults to support patients to perform exercise proven to aid fall reduction and to explore the apps’ usability and acceptability with both health professionals and patients. METHODS There were 3 phases of app development that included analysis, design, and implementation. For analysis, we examined the literature to establish key app components and had a consultation with 12 older adults attending a strength and balance class, exercise instructors, and 3 fall services. For design, we created prototype apps and conducted 2 patient and public involvement workshops, one with 5 health professionals and the second with 8 older adults from an exercise group. The apps were revised based on the feedback. For implementation, we tested them with one fall service and their patients for 3 weeks. Participatory evaluation was used through testing, semistructured interviews, and focus groups to explore acceptability and usability. Focus groups were conducted with the service that tested the apps and two other services. Qualitative data were analyzed using the framework approach. RESULTS On the basis of findings from the literature and consultations in the analysis phase, we selected Behavior Change Techniques, such as goal setting, action planning, and feedback on behavior, to be key parts of the app. We developed goals using familiar icons for patients to select and add while self-reporting exercise and decided to develop 2 apps, one for patients (My Activity Programme) and one for health professionals (Motivate Me). This enabled health professionals to guide patients through the goal-setting process, making it more accessible to nontechnology users. Storyboards were created during the design phase, leading to prototypes of “Motivate Me” and “My Activity Programme.” Key changes from the workshops included being able to add more details about the patients’ exercise program and a wider selection of goals within “Motivate Me.” The overall app design was acceptable to health professionals and older adults. In total, 7 patients and 3 health professionals participated in testing in the implementation phase, with interviews conducted with 6 patients and focus groups, with 3 teams (11 health professionals). Barriers, facilitators, and further functionality were identified for both apps, with 2 cross-cutting themes around phone usability and confidence. CONCLUSIONS The motivational apps were found to be acceptable for older adults taking part in the design stage and patients and health professionals testing the apps in a clinical setting. User-led design is important to ensure that the apps are usable and acceptable.

scholarly journals One-to-One and Group-Based Teleconferencing for Falls Rehabilitation: Usability, Acceptability, and Feasibility Study

10.2196/19690 ◽  
2021 ◽  
Vol 8 (1) ◽  
pp. e19690
Author(s):  
Helen Hawley-Hague ◽  
Carlo Tacconi ◽  
Sabato Mellone ◽  
Ellen Martinez ◽  
Lorenzo Chiari ◽  
...  
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Focus Group ◽  
Focus Groups ◽  
Health Professionals ◽  
Health Care Professionals ◽  
Public Involvement ◽  
Patient And Public Involvement ◽  
Feasibility Testing ◽  
One To One

Background Falls have implications for the health of older adults. Strength and balance interventions significantly reduce the risk of falls; however, patients seldom perform the dose of exercise that is required based on evidence. Health professionals play an important role in supporting older adults as they perform and progress in their exercises. Teleconferencing could enable health professionals to support patients more frequently, which is important in exercise behavior. Objective This study aims to examine the overall concept and acceptability of teleconferencing for the delivery of falls rehabilitation with health care professionals and older adults and to examine the usability, acceptability, and feasibility of teleconferencing delivery with health care professionals and patients. Methods There were 2 stages to the research: patient and public involvement workshops and usability and feasibility testing. A total of 2 workshops were conducted, one with 5 health care professionals and the other with 8 older adults from a community strength and balance exercise group. For usability and feasibility testing, we tested teleconferencing both one-to-one and in small groups on a smartphone with one falls service and their patients for 3 weeks. Semistructured interviews and focus groups were used to explore acceptability, usability, and feasibility. Focus groups were conducted with the service that used teleconferencing with patients and 2 other services that received only a demonstration of how teleconferencing works. Qualitative data were analyzed using the framework approach. Results In the workshops, the health care professionals thought that teleconferencing provided an opportunity to save travel time. Older adults thought that it could enable increased support. Safety is of key importance, and delivery needs to be carefully considered. Both older adults and health care professionals felt that it was important that technology did not eliminate face-to-face contact. There were concerns from older adults about the intrusiveness of technology. For the usability and feasibility testing, 7 patients and 3 health care professionals participated, with interviews conducted with 6 patients and a focus group with the health care team. Two additional teams (8 health professionals) took part in a demonstration and focus group. Barriers and facilitators were identified, with 5 barriers around reliability due to poor connectivity, cost of connectivity, safety concerns linked to positioning of equipment and connectivity, intrusiveness of technology, and resistance to group teleconferencing. Two facilitators focused on the positive benefits of increased support and monitoring and positive solutions for future improvements. Conclusions Teleconferencing as a way of delivering fall prevention interventions can be acceptable to older adults, patients, and health care professionals if it works effectively. Connectivity, where there is no Wi-Fi provision, is one of the largest issues. Therefore, local infrastructure needs to be improved. A larger usability study is required to establish whether better equipment for delivery improves usability.

Social Support and Depression in LGB Middle-Aged and Older Adults With Internalized Homophobia

2012 ◽  
Author(s):  
Jonathan J. W. Mueller ◽  
Nicole D. Ng ◽  
Hilary Sluis ◽  
Louis Y. Stephenson ◽  
Wendy Ratto ◽  
...  
Keyword(s):  
Social Support ◽  
Older Adults ◽  
Internalized Homophobia ◽  
Middle Aged

Māori Research(er) in Three Poems

2018 ◽  
Vol 2 (1) ◽  
pp. 35
Author(s):  
Jacquie Kidd
Keyword(s):  
Palliative Care ◽  
Health Literacy ◽  
Cultural Identity ◽  
Focus Groups ◽  
Health Professionals ◽  
Bell Hooks ◽  
Face To Face ◽  
The Third ◽  
Ruth Behar ◽  
Seeking Help

These three poems re-present the findings from a research project that took place in 2013 (Kidd et al. 2018, Kidd et al. 2014). The research explored what health literacy meant for Māori patients and whānau when they accessed palliative care. Through face-to-face interviews and focus groups we engaged with 81 people including patients, whānau, bereaved loved ones, support workers and health professionals. The poems are composite, written to bring some of our themes to life. The first poem is titled Aue. This is a Māori lament that aligns to English words such as ‘oh no’, or ‘arrgh’, or ‘awww’. Each stanza of the poem re-presents some of the stories we heard throughout the research. The second poem is called Tikanga. This is a Māori concept that encompasses customs, traditions and protocols. There are tikanga rituals and processes that guide all aspects of life, death, and relationships. This poem was inspired by an elderly man who explained that he would avoid seeking help from a hospice because ‘they leave tikanga at the door at those places’. His choice was to bear his pain bravely, with pride, within his cultural identity. The third poem is called ‘People Like Me’. This is an autoethnographical reflection of what I experienced as a researcher which draws on the work of scholars such as bell hooks (1984), Laurel Richardson (1997) and Ruth Behar (1996). These and many other authors encourage researchers to use frustration and anger to inform our writing; to use our tears to fuel our need to publish our research.

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