Qualitative Analysis of the Cognition and Flow (CoGFlowS) Study: An Individualized Approach to Cognitive Training for Dementia Is Needed

2021 ◽  
pp. 1-17
Author(s):  
Lucy Beishon ◽  
Victoria Haunton ◽  
Hari Subramaniam ◽  
Elizabeta B. Mukaetova-Ladinska ◽  
Ronney B. Panerai ◽  
...  
Keyword(s):  
Cognitive Training ◽  
Controlled Trial ◽  
Cognitive Disorders ◽  
Health Belief ◽  
Analytical Framework ◽  
Structured Interviews ◽  
Home Based ◽  
Individualized Approach ◽  
Belief Model ◽  
Severity Of Dementia

Background: Cognitive training (CT) may have benefits for both healthy older adults (HC) and those with early cognitive disorders [mild cognitive impairment (MCI) and dementia]. However, few studies have qualitatively evaluated home-based, computerized CT programs. Objective: We present the qualitative arm of a feasibility randomized controlled trial evaluating a CT program for HC and people living with MCI or dementia. Methods: Participants underwent semi-structured interviews after 12 weeks of CT. Where possible, participants were interviewed with their carers. The interview schedule and analysis were underpinned by the health belief model. Interviews were audio-recorded, transcribed, open-coded, and categorized into themes. The analytical framework was developed, and themes were condensed under five major categories: benefits, barriers, threat, self-efficacy, and cues to action. Results: 37 participants underwent interviews. CT was feasible and acceptable to participants. Benefits included: enjoyment, improved awareness, benchmarking cognitive function, reassurance of abilities and giving back control. Barriers were more prevalent among those with dementia: problems with technology, frustration, conflict between patients and carers, apathy and lack of insight, anxiety or low mood, and lack of portability. HC and MCI perceived the severity of dementia risk as high, partially mitigated by CT. Participants living with dementia valued a more individualized approach to training, accounting for baseline characteristics. Conclusion: CT was a feasible intervention for HC and people living with dementia and MCI. Benefits were present, but the identified barriers need to be addressed for CT to be implemented successfully.

407 QUALITATIVE ASSESSMENT OF COGNITIVE TRAINING FOR PEOPLE LIVING WITH DEMENTIA: AN INDIVIDUALISED APPROACH IS NEEDED AUTHORS

2021 ◽  
Vol 50 (Supplement_2) ◽  
pp. ii1-ii4
Author(s):  
L Beishon ◽  
V Haunton ◽  
H Subramaniam ◽  
E Mukaetova-Ladinska ◽  
R Paneraia ◽  
...  
Keyword(s):  
Older Adults ◽  
Cognitive Function ◽  
Cognitive Training ◽  
Perceived Risk ◽  
Randomised Trial ◽  
Health Belief ◽  
Analytical Framework ◽  
Qualitative Assessment ◽  
Structured Interviews ◽  
Healthy Older Adults

Abstract Background Cognitive training (CT) may be beneficial in mild cognitive impairment (MCI) and early dementia. However, few studies have qualitatively evaluated CT programmes in dementia. The aim of this analysis was to explore the benefits and barriers to a home-based computerised CT programme for healthy older adults, and people living with MCI or dementia. Methods This was a nested qualitative study within a larger feasibility randomised trial of CT. Participants underwent semi-structured interviews after 12 weeks of CT. Where possible, participants were interviewed with their carers. The interview schedule and analysis were underpinned by the health belief model. Interviews were audio-recorded, transcribed, open-coded, and categorised into themes. The analytical framework was developed, and themes were condensed under four major categories: benefits and efficacy, barriers, threat, and behaviour. Results 37 participants underwent interviews (10 healthy older adults, 4 MCI, 5 dementia, 9 patient-carer dyads [2 MCI, 7 dementia]). CT was feasible and acceptable to participants. Benefits included: enjoyment, improved awareness, benchmarking cognitive function, reassurance of abilities, and giving back control. Barriers were more prevalent amongst those with dementia: problems with technology, frustration, conflict between patients and carers, apathy and lack of insight, anxiety or low mood, and lack of portability. Perceived risk susceptibility of dementia varied between participants. Healthy older adults and MCI perceived the severity of dementia risk as high, which was only partially mitigated by CT. Participants living with dementia valued a more individualised approach to training, accounting for baseline characteristics. For people living with dementia, maintenance was as valued as improvement of cognitive function. Conclusions CT was a feasible intervention for healthy older adults, and people living with dementia and MCI. Benefits were present, but the identified barriers need to be addressed for CT to be implemented successfully.

scholarly journals Reluctance to Accept Palliative Care and Recommendations for Improvement: Findings From Semi-Structured Interviews With Patients and Caregivers

2021 ◽  
pp. 104990912110126
Author(s):  
Valeria Cardenas ◽  
Anna Rahman ◽  
Yujun Zhu ◽  
Susan Enguidanos
Keyword(s):  
Palliative Care ◽  
Controlled Trial ◽  
Insurance Coverage ◽  
Healthcare Providers ◽  
Health Condition ◽  
Insurance Companies ◽  
Structured Interviews ◽  
Care Services ◽  
Home Based ◽  
Palliative Care Services

Background: Despite some insurance plans now paying for home-based palliative care, recent reports have suggested that insurance coverage for palliative care may be insufficient in expanding patient access to home-based palliative care. Aim: To identify patients’ and caregivers’ perceived barriers to home-based palliative care and their recommendations for overcoming these barriers. Design: We conducted a qualitative study using semi-structured individual interviews. Our interview protocol elicited participants’ perspectives on home-based palliative care services; positive and negative aspects of the palliative program explanation; and suggestions for improving messaging around home-based palliative care. Setting/Participants: Twenty-five participants (patients, proxies, and their caregivers) who were eligible for a randomized controlled trial of home-based palliative care were interviewed by telephone. Results: Themes related to home-based palliative care referral barriers included reluctance to have home visits, enrollment timing, lack of palliative care knowledge, misconceptions about palliative care, and patients’ self-perceived health condition. Themes related to recommendations for overcoming these obstacles included ensuring that palliative care referrals come from healthcare providers or insurance companies and presenting palliative care services more clearly. Conclusion: Findings reinforce the need for additional palliative care education among patients with serious illness (and their caregivers) and the importance of delivering palliative care information and referrals from trusted sources.

scholarly journals Factors Associated With the Experience of Cognitive Training Apps for the Prevention of Dementia: Cross-sectional Study Using an Extended Health Belief Model

10.2196/31664 ◽  
2022 ◽  
Vol 24 (1) ◽  
pp. e31664
Author(s):  
Jaegyeong Lee ◽  
Jung Min Lim
Keyword(s):  
Health Belief Model ◽  
Cognitive Training ◽  
Online Survey ◽  
Mobile Apps ◽  
Health Belief ◽  
Female Gender ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Factors Associated ◽  
Belief Model

Background The prevalence and economic burden of dementia are increasing dramatically. Using information communication technology to improve cognitive functions is proven to be effective and holds the potential to serve as a new and efficient method for the prevention of dementia. Objective The aim of this study was to identify factors associated with the experience of mobile apps for cognitive training in middle-aged adults. We evaluated the relationships between the experience of cognitive training apps and structural variables using an extended health belief model. Methods An online survey was conducted on South Korean participants aged 40 to 64 years (N=320). General characteristics and dementia knowledge were measured along with the health belief model constructs. Statistical analysis and logistic regression analysis were performed. Results Higher dementia knowledge (odds ratio [OR] 1.164, P=.02), higher perceived benefit (OR 1.373, P<.001), female gender (OR 0.499, P=.04), and family history of dementia (OR 1.933, P=.04) were significantly associated with the experience of cognitive training apps for the prevention of dementia. Conclusions This study may serve as a theoretical basis for the development of intervention strategies to increase the use of cognitive training apps for the prevention of dementia.

scholarly journals The unbooked maternity patient in an academic hospital in Durban

Curationis ◽  
1992 ◽  
Vol 15 (3) ◽  
Author(s):  
R. Gcaba ◽  
H.B. Brookes
Keyword(s):  
Health Services ◽  
Service Failure ◽  
Health Belief ◽  
Interaction Model ◽  
Academic Hospital ◽  
Structured Interviews ◽  
Case Study Methodology ◽  
Study Methodology ◽  
Belief Model ◽  
The Health Belief Model

This paper examines the unbooked maternity patient in an academic hospital in Durban, Natal; This hospital is the biggest hospital serving the underprivileged population of this area. Of the 16000 annual deliveries in this hospital, about 12% are unbooked patients. The health belief model of Rosenstock, as interpreted by Mikhail and Cox’s interaction model of client health behaviour were used as a theoretical framework for this research. A qualitative case study methodology was undertaken and semi-structured interviews were conducted with unbooked mothers who had utilized appropriate health services in a previous pregnancy. The aim of such interviews was to explore reasons given by mothers for non-use of facilities in the current pregnancy. The basic trends reflected in the findings regarding non-utilization of health services were client instability, health service failure and socio-cultural constraints, The study is innovative and addresses the problem from a social-cultural and midwifery perspective.

scholarly journals The circuits of healthcare: Understanding healthcare seeking behaviour—A qualitative study with tuberculosis patients in Lisbon, Portugal

PLoS ONE ◽  
2021 ◽  
Vol 16 (12) ◽  
pp. e0261688
Author(s):  
Rafaela M. Ribeiro ◽  
Philip J. Havik ◽  
Isabel Craveiro
Keyword(s):  
Health System ◽  
Health Belief ◽  
System Delay ◽  
Structured Interviews ◽  
Tuberculosis Patients ◽  
Healthcare Seeking ◽  
Health System Delay ◽  
Services Delivery ◽  
Belief Model ◽  
Diagnostic Delays

Background Understanding health delivery service from a patient´s perspective, including factors influencing healthcare seeking behaviour, is crucial when treating diseases, particularly infectious ones, like tuberculosis. This study aims to trace and contextualise the trajectories patients pursued towards diagnosis and treatment, while discussing key factors associated with treatment delays. Tuberculosis patients’ pathways may serve as indicator of the difficulties the more vulnerable sections of society experience in obtaining adequate care. Methods We conducted 27 semi-structured interviews with tuberculosis patients attending a treatment centre in a suburban area of Lisbon. We invited nationals and migrant patients in active treatment to participate by sharing their illness experiences since the onset of symptoms until the present. The Health Belief Model was used as a reference framework to consolidate the qualitative findings. Results By inductive analysis of all interviews, we categorised participants’ healthcare seeking behaviour into 4 main types, related to the time participants took to actively search for healthcare (patient delay) and time the health system spent to diagnose and initiate treatment (health system delay). Each type of healthcare seeking behaviour identified (inhibited, timely, prolonged, and absent) expressed a mindset influencing the way participants sought healthcare. The emergency room was the main entry point where diagnostic care cascade was initiated. Primary Health Care was underused by participants. Conclusions The findings support that healthcare seeking behaviour is not homogeneous and influences diagnostic delays. If diagnostic delays are to be reduced, the identification of behavioural patterns should be considered when designing measures to improve health services’ delivery. Healthcare professionals should be sensitised and perform continuous capacity development training to deal with patients´ needs. Inhibited and prolonged healthcare seeking behaviour contributes significantly to diagnostic delays. These behaviours should be detected and reverted. Timely responses, from patients and the healthcare system, should be promoted.

scholarly journals An exploratory study of the acceptability of indoor residual spraying for malaria control in upper western Ghana

2020 ◽  
Author(s):  
Vitalis Mwinyuri Suuron ◽  
Lillian Mwanri ◽  
George Tsourtos ◽  
Ebenezer Owusu-Addo
Keyword(s):  
Malaria Control ◽  
Cultural Beliefs ◽  
Indoor Residual Spraying ◽  
Health Belief ◽  
Realist Evaluation ◽  
Evaluation Framework ◽  
World Health ◽  
Structured Interviews ◽  
Endemic Region ◽  
Belief Model

Abstract Background: Despite the implementation of the World Health Organisation’s recommended indoor residual spraying (IRS) intervention in the upper west region of Ghana to reduce malaria morbidity and mortality, the uptake of this intervention remains low. This study explores the facilitators and barriers to the acceptability and community uptake of indoor residual spraying in a highly endemic region of Ghana. Methods: The health belief model (HBM) and realist evaluation framework were used to inform the study. A qualitative enquiry was conducted between April to October 2016. Data were collected through focus group discussions and semi-structured interviews with program stakeholders including community members, AngloGold Ashanti malaria control (AGA Mal) spray operators, and AGA Mal officials. Results: A total of 101 people participated in the study. Considerable barriers to community acceptance of indoor residual spraying (IRS) were found, including, dislike of spray insecticides, inadequate information, religious and cultural beliefs, perceived low efficacy of IRS, difficulties with packing, unprofessional conduct of IRS spray operators, and other operational barriers to spraying. Facilitators of IRS uptake included a perceived effectiveness of IRS in preventing malaria and reducing mosquito bites, incidental benefits, respect for authority, training and capacity building, and sensitization activities. Conclusion: The numerous barriers to indoor residual spraying acceptance and implications show that acceptance levels could be improved. However, measures are required to address householders’ concerns and streamline operational barriers to increase community uptake of indoor residual spraying.

scholarly journals Application of Freire’s Adult Education Model for Modifying the Psychological Constructs of Health Belief Model in Self-medication Behaviors of Elderly: a randomized controlled trial

2020 ◽  
Author(s):  
Katayon Bakhtiar ◽  
Arash Ardalan ◽  
Marzieh Araban ◽  
Farzad Ebrahimzadeh ◽  
Mohammad Almasian ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Adult Education ◽  
Health Belief Model ◽  
Controlled Trial ◽  
Health Belief ◽  
Self Medication ◽  
Psychological Constructs ◽  
Randomized Controlled ◽  
Education Model ◽  
Belief Model

Abstract Background: As people age, they are more likely to engage in self-medication and suffer from its adverse effects. The present study aimed to modifying knowledge, psychological constructs of Health Belief Model (HBM), and self-medication behaviors using Freire’s Adult Education Model (FAEM) among elderlies in Khorramabad, Iran, from 2017 to 2018. Methods: This research was of a prospective randomized controlled trial conducted on 132 elderly individuals older than 60 who were referred from health care centers. The participants were selected using multistage sampling method and randomly divided into two groups of intervention and control. The data collection instruments included a questionnaire which was designed based on both HBM and the self-medication behaviors questionnaires. The phases of the adult education approach were used to modify the psychological constructs of HBM and self-medication behaviors. Data were analyzed using SPSS software version 20 with a significance level of 0.05. Descriptive statistical tests, the chi-squared test, paired t-test, independent t-test, and univariate modeling were employed for this purpose. Results: The mean age of the elderly was 66.28 ± 7.18 years. There was no significant difference between groups in terms of self-medicating. Unawareness of the effects of medicines were the most important causes of self-medication (p=0.50). The two groups were not significantly different in terms of knowledge, HBM constructs, and self-medication behaviors (p>0.05). However, they came up to be considerably different for the above variables after the intervention was completed (p<0.05). When the findings were adjusted for the effects of confounding variables, there were significant differences between almost all constructs of HBM and their behaviors (p < 0.05). However, the perceived barrier modality of HBM did not reach to a significant level of difference between two groups. Conclusion: The psychological constructs of HBM were affected at the phases of listening to the problem and reflecting on it. Self-medication was tempered at the action-reflection phase with shared creation and evaluation of the action plan geared towards the achievement of the behavioral objectives. The results might be of importance for healthcare professionals involved incare of older patients.

scholarly journals Feasibility of a Cognitive Training Game in Parkinson’s Disease: The Randomized Parkin’Play Study

2020 ◽  
Vol 83 (4) ◽  
pp. 426-432 ◽  
Author(s):  
Sjors C.F. van de Weijer ◽  
Annelien A. Duits ◽  
Bastiaan R. Bloem ◽  
Nienke M. de Vries ◽  
Roy P.C. Kessels ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Cognitive Training ◽  
Controlled Trial ◽  
Intervention Group ◽  
Waiting List ◽  
Control Group ◽  
Positive Effects ◽  
Home Based ◽  
Global Cognition

Cognitive training (CT) shows modest positive effects on cognitive function in patients with Parkinson’s disease (PD). Gamification may enhance adherence to traditional CT, but this has not been studied yet. Here, we investigated the feasibility of a gamified CT. We performed a randomized controlled trial including PD patients with mild cognitive impairment. Participants were randomly allocated to a 12-week home-based gamified CT intervention or waiting-list control group. Assessments were performed at baseline and at weeks 12 and 24. Forty-one patients were included (21 intervention and 20 waiting-list controls). Sixty-three percent of the intervention group trained >50% of the recommended sessions, while 81% voluntarily continued training after 12 weeks. After 24 weeks, 87.5% graded the game to be satisfactory. Global cognition scores improved after 24 weeks. Home-based gamified CT shows acceptable feasibility in patients with PD, and we observed preliminary indications for efficacy. Larger trials are needed to establish this efficacy.

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