Web 2.0 Chronic Disease Self-Management for Older Adults: A Systematic Review

IntroductionIn response to the burden of chronic disease among older adults, different chronic disease self-management tools have been created to optimise disease management. However, these seldom consider all aspects of disease management are not usually developed specifically for seniors or created for sustained use and are primarily focused on a single disease. We created an eHealth self-management application called ‘KeepWell’ that supports seniors with complex care needs in their homes. It incorporates the care for two or more chronic conditions from among the most prevalent high-burden chronic diseases.Methods and analysisWe will evaluate the effectiveness, cost and uptake of KeepWell in a 6-month, pragmatic, hybrid effectiveness–implementation randomised controlled trial. Older adults age ≥65 years with one or more chronic conditions who are English speaking are able to consent and have access to a computer or tablet device, internet and an email address will be eligible. All consenting participants will be randomly assigned to KeepWell or control. The allocation sequence will be determined using a random number generator.Primary outcome is perceived self-efficacy at 6 months. Secondary outcomes include quality of life, health background/status, lifestyle (nutrition, physical activity, caffeine, alcohol, smoking and bladder health), social engagement and connections, eHealth literacy; all collected via a Health Risk Questionnaire embedded within KeepWell (intervention) or a survey platform (control). Implementation outcomes will include reach, effectiveness, adoption, fidelity, implementation cost and sustainability.Ethics and disseminationEthics approval has been received from the North York General Hospital Research and Ethics Board. The study is funded by the Canadian Institutes of Health Research and the Ontario Ministry of Health. We will work with our team to develop a dissemination strategy which will include publications, presentations, plain language summaries and an end-of-grant meeting.Trial registration numberNCT04437238.

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The Situated Influence of Chronic Pain Perception on Chinese Older Adults’ Self-Management in Home Care

Geriatrics ◽

10.3390/geriatrics3040064 ◽

2018 ◽

Vol 3 (4) ◽

pp. 64

Author(s):

Fang Liu ◽

Min Tong

Keyword(s):

Older Adults ◽

Chronic Pain ◽

Chronic Disease ◽

Pain Perception ◽

Community Dwelling ◽

Self Management ◽

Chinese Older Adults ◽

Care Experience ◽

Management Capacity ◽

Important Others

Background and objective: Worldwide, 26 million older adults die from chronic disease, and chronic pain is typically a part of the experience of chronic disease. This study explores the perception of chronic pain for home-dwelling Chinese older adults and its influence on (1) self-management ability and (2) management and reduction of chronic pain. Methods: Adopting a qualitative study design, we conducted in-depth interviews with 10 Chinese community-dwelling older adults who experience chronic pain. Half of our informants perceive chronic pain, whereas the other half, diagnosed with Alzheimer’s disease, do not report that they perceive chronic pain. Data were analyzed with inductive thematic analysis. Results: Chronic pain perception plays important roles in (1) defining the challenge of self-management, (2) connecting previous caretaking experience, (3) adjusting the identity of self-management, (4) acquiring support from important others and (5) re-planning self-management arrangements. Conclusion: Pain perception helps to motivate Chinese older adults to face health challenges and regain self-management capacity through adjustments in self-identity and care experience with the support of important others. Pain perception can consolidate the situation of independent living of older adults. It helps to motivate Chinese older adults to face health challenges and regain self-management capacity.

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Implementation and evaluation of the chronic-disease self-management program among Chinese immigrant older adults in the U.S.

Geriatric Nursing ◽

10.1016/j.gerinurse.2014.07.002 ◽

2014 ◽

Vol 35 (6) ◽

pp. 448-450 ◽

Cited By ~ 5

Author(s):

XiaoRong Wang ◽

Heather K. Hardin ◽

Lei Zhou ◽

Lei Fang ◽

Pan Shi ◽

...

Keyword(s):

Older Adults ◽

Chronic Disease ◽

Management Program ◽

Self Management ◽

Chinese Immigrant ◽

The U.S

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Health Outcomes After Disaster for Older Adults With Chronic Disease: A Systematic Review

The Gerontologist ◽

10.1093/geront/gnz123 ◽

2019 ◽

Vol 60 (7) ◽

pp. e535-e547 ◽

Cited By ~ 3

Author(s):

Sue Anne Bell ◽

Jennifer Horowitz ◽

Theodore J Iwashyna

Keyword(s):

Systematic Review ◽

Older Adults ◽

Health Care ◽

Chronic Disease ◽

Access To Health Care ◽

Disease Process ◽

Outcome Data ◽

Care Utilization ◽

Chronic Obstructive ◽

Weather And Climate

Abstract Background and Objectives This review synthesizes the current literature surrounding chronic disease outcomes after weather- and climate-related disasters among older adults. The associations between exposure of older adults to weather- and climate-related disasters and the primary outcomes of diabetes, end-stage renal disease (ESRD), congestive heart failure (CHF), and chronic obstructive pulmonary disease (COPD) were examined. Research Design and Methods A systematic review of studies reporting on clinical outcomes of four chronic diseases after disaster exposure was performed. Under the direction of an informationist, the databases PubMed, Scopus, EMBASE, and Web of Science (Science and Social Science Citation Index) were searched from inception to July 2019. Results Of 5,229 citations identified, 17 articles met the study criteria. Included articles were retrospective observational in nature and focused on earthquakes (24%, n = 4), hurricane (41%, n = 7), and wildfire (35%, n = 6) disasters. Outcome data by disease process included COPD (35%, n = 6), ESRD (41%, n = 7), CHF (24%, n = 4), and diabetes (29%, n = 5). Three main categories were identified: access to health care, postdisaster health care utilization, and study rigor. The age-stratified analyses reported in this review found multiple instances where disasters have limited or insignificant effects on older adults relative to younger populations. Discussion and Implications Disaster research faces unique methodological challenges, and there remains a need for data-driven conclusions on how best to care for older adults before, during, and after disasters. To encourage consistent dialogue among studies, we advocate for the use of rigorous and standardized scientific methodology to examine the health impacts of disasters on adults with chronic disease.

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Chronic Disease Self-Management Among Iranian Older Adults: A Scoping Review

Journal of Applied Gerontology ◽

10.1177/0733464819832198 ◽

2019 ◽

Vol 39 (8) ◽

pp. 922-930 ◽

Cited By ~ 1

Author(s):

Aein Zarrin ◽

Nima Tourchian ◽

George A. Heckman

Keyword(s):

Physical Activity ◽

Older Adults ◽

Chronic Disease ◽

Scoping Review ◽

Self Management ◽

Cochrane Library ◽

Self Monitoring ◽

Care Models ◽

Language Objectives ◽

Main Components

Background: Implementing care models that emphasize chronic disease self-management (CDSM) strategies may be an effective approach to the growing prevalence of chronic conditions in Iran. We, therefore, conducted a scoping review on CDSM among older Iranians to identify existing gaps and opportunities to improve chronic disease care. Method: We conducted a search in CINAHL, EMBASE, MEDLINE/PubMed, and Cochrane library. Selected articles were charted based on year of publication, language, objectives, methods, target chronic disease(s), sample demographics, self-management type, and key findings. Results: We selected 73 articles. The main components of CDSM addressed were social support, education, physical activity, nutrition, self-monitoring, spirituality, and financial support. Older Iranians reported low levels of physical activity. Conclusion: Enhancing the quality of CDSM research and provision of coaching to enhance older adults’ social and mental health are among the main strategies to enhance CDSM among the Iranian older population.

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