scholarly journals A Smart Home System for Information Sharing, Health Assessments, and Medication Self-Management for Older People: Protocol for a Mixed-Methods Study

10.2196/12447 ◽  
2019 ◽  
Vol 8 (4) ◽  
pp. e12447 ◽  
Author(s):  
Margaretha Norell Pejner ◽  
Wagner Ourique de Morais ◽  
Jens Lundström ◽  
Hélène Laurell ◽  
Ingela Skärsäter
2018 ◽  
Author(s):  
Margaretha Norell Pejner ◽  
Wagner Ourique de Morais ◽  
Jens Lundström ◽  
Hélène Laurell ◽  
Ingela Skärsäter

BACKGROUND Older adults often want to stay in a familiar place, such as their home, as they get older. This so-called aging in place, which may involve support from relatives or care professionals, can promote older people’s independence and well-being. The combination of aging and disease, however, can lead to complex medication regimes and difficulties for care providers in correctly assessing the older person's health. In addition, the organization of health care is fragmented, which makes it difficult for health professionals to encourage older people to participate in their own care. It is also a challenge to perform adequate health assessments and to engage in appropriate communication between health care professionals. OBJECTIVE The purpose of this paper is to describe the design for an integrated home-based system that can acquire and compile health-related evidence for guidance and information-sharing among care providers and care receivers in order to support and promote medication self-management among older people. METHODS The authors used a participatory design approach for this mixed-methods project, which was divided into four phases. Phase I, Conceptualization, consists of the conceptualization of a system to support medication self-management, objective health assessments, and communication between health care professionals. Phase II, Development of a System, consists of building and bringing together the conceptualized systems from Phase I. Phase III, Pilot Study, and Phase IV, Full-Scale Intervention, are described briefly. RESULTS Participants in Phase I were people who were involved in some way in the care of older adults and included older adults themselves, relatives of older adults, care professionals, and industrial partners. With input from Phase I participants, we identified two relevant concepts for promoting medication self-management, both of which related to systems that participants believed could provide guidance for the older adults themselves, relatives of older adults, and care professionals. The systems will also encourage information-sharing between care providers and care receivers. The first is the concept of the Intelligent Age-Friendly Home (IAFH), defined as an integrated residential system that evolves to sense, reason, and act in response to individuals’ needs, preferences, and behaviors as these change over time. The second concept is the Medication safety, Objective assessments of health-related behaviors, and Personalized medication reminders (MedOP) system, a system that would be supported by the IAFH, and which consists of three related components: one that assesses health behaviors, another that communicates health data, and a third that promotes medication self-management. CONCLUSIONS The participants in this project were older adults, relatives of older adults, care professionals, and our industrial partners. With input from the participants, we identified two main concepts that could comprise a system for health assessment, communication, and medication self-management: the IAFH and the MedOP system. These concepts will be tested in this study to determine whether they can facilitate and promote medication self-management among older people. INTERNATIONAL REGISTERED REPOR DERR1-10.2196/12447


2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Stijn Crutzen ◽  
Tessa van den Born-Bondt ◽  
Petra Denig ◽  
Katja Taxis

Abstract Background Hypoglycaemia is a common and potentially avoidable adverse event in people with type 2 diabetes (T2D). It can reduce quality of life, increase healthcare costs, and reduce treatment success. We investigated self-management issues associated with hypoglycaemia and self-identified causes of hypoglycaemia in these patients. Methods In this mixed methods study qualitative semi-structured interviews were performed, which informed a subsequent quantitative survey in T2D patients. All interviews were audio recorded, transcribed verbatim and coded independently by two coders using directed content analysis, guided by the Theoretical Domains Framework. Descriptive statistics were used to quantify the self-management issues and causes of hypoglycaemia collected in the survey for the respondents that had experienced at least one hypoglycaemic event in the past. Results Sixteen participants were interviewed, aged 59–84 years. Participants perceived difficulties in managing deviations from routine, and they sometimes lacked procedural knowledge to adjust medication, nutrition or physical activity to manage their glucose levels. Grief and loss of support due to the loss of a partner interfered with self-management and lead to hypoglycaemic events. Work ethic lead some participant to overexerting themselves, which in turn lead to hypoglycaemic events. The participants had difficulties preventing hypoglycaemic events, because they did not know the cause, suffered from impaired hypoglycaemia awareness and/or did not want to regularly measure their blood glucose. When they did recognise a cause, they identified issues with nutrition, physical activity, stress or medication. In total, 40% of respondents reported regular stress as an issue, 24% reported that they regularly overestimated their physical abilities, and 22% indicated they did not always know how to adjust their medication. Around 16% of patients could not always remember whether they took their medication, and 42% always took their medication at regular times. Among the 83 respondents with at least one hypoglycaemic event, common causes for hypoglycaemia mentioned were related to physical activity (67%), low food intake (52%), deviations from routine (35%) and emotional burden (28%). Accidental overuse of medication was reported by 10%. Conclusion People with T2D experience various issues with self-managing their glucose levels. This study underlines the importance of daily routine and being able to adjust medication in relation to more physical activity or less food intake as well as the ability to reduce and manage stress to prevent hypoglycaemic events.


2018 ◽  
Vol 39 (7) ◽  
pp. 1528-1551 ◽  
Author(s):  
CLAIRE PRESTON ◽  
STEPHEN MOORE

ABSTRACTThe drive to deliver services addressing loneliness in older people by telephone and online makes it increasingly relevant to consider how the mode of communication affects the way people interact with services and the capacity of services to meet their needs. This paper is based on the qualitative strand of a larger mixed-methods study of a national phoneline tackling loneliness in older people in the United Kingdom. The research comprised thematic analysis of four focus groups with staff and 42 semi-structured interviews with callers. It explored the associations between telephone-delivery, how individuals used the services and how the services were able to respond. To understand these associations, it was useful to identify some constituent characteristics of telephone communication in this context: namely its availability, reach and non-visual nature. This enabled various insights and comparison with other communication media. For example, the availability of the services attracted people seeking frequent emotional support but this presented challenges to staff. More positively, the ability of the services to connect disparate individuals enabled them to form different kinds of satisfying relationships. The evolution of mixed communication forms, such as internet-based voice communication and smartphone-based visual communication, makes analysis at the level of a technology's characteristics useful. Such a cross-cutting perspective can inform both the design of interventions and assessment of their suitability for different manifestations of loneliness.


10.2196/33506 ◽  
2021 ◽  
Vol 10 (9) ◽  
pp. e33506
Author(s):  
Anna Hatzioannou ◽  
Andreas Chatzittofis ◽  
Virginia Sunday Koutroubas ◽  
Evridiki Papastavrou ◽  
Maria Karanikola


2020 ◽  
Vol 55 (S1) ◽  
pp. 41-42
Author(s):  
S. Robinson ◽  
M. Zocchi ◽  
D. Netherton ◽  
A. Ash ◽  
C. Purington ◽  
...  

2018 ◽  
Vol 68 ◽  
pp. 146-152 ◽  
Author(s):  
Susanne M. van Hooft ◽  
Yvonne N. Becqué ◽  
Jolanda Dwarswaard ◽  
AnneLoes van Staa ◽  
Roland Bal

2019 ◽  
Vol 3 (s1) ◽  
pp. 44-45
Author(s):  
Nessa E Ryan

OBJECTIVES/SPECIFIC AIMS: 1. To assess feasibility (efficacy, safety, acceptability) of the menstrual cup for managing urinary incontinence among women with obstetric fistula 2. To examine pre-implementation facilitators and barriers (including appropriateness) among additional stakeholders METHODS/STUDY POPULATION: Sequential explanatory mixed methods study whereby repeated measures clinical trial results are explained by subsequent interviews with additional women with OF on coping and stigma and other stakeholders on perceptions of fistula self-management. RESULTS/ANTICIPATED RESULTS: Of the 32 patients screened, 11 were eligible (100% consent rate). At baseline, mean (±SD) leakage in ml was 63.2 (±49.2) (95% CI: 30.2-96.3) over two hours, while the mean leakage over two hours of use of the cup was 16.8 (±16.5) (95% CI: 5.7-27.9). The mean difference of 46.4 (±52.1) ml with use of the cup (95% CI: 11.4-81.4) was statistically significant (p = 0.02). With the cup, women experienced an average 61.0% (±37.4) (95% CI: 35.9-86.2) leakage reduction, a difference 10/11 users (91.0%) perceived in reduced leakage. One participant, reporting four previous surgical attempts, experienced a 78.7% leakage reduction. Acceptability was high–women could easily insert (8/11), remove (8/11), and comfortably wear (11/11) the cup and most (10/11) would recommend it. No adverse effects attributable to the intervention were observed on exam, although some women perceived difficulties with insertion and removal. Data collection tools were appropriate with slight modification advised. Interviews highlighted that women were already using various active coping and resistance strategies but lacked access to tools to support coping. Additional stakeholders reported the innovation was a simple, low-cost device that is an appropriate fit with ongoing fistula programming. Pre-implementation facilitators include the clear relative advantage to existing self-management strategies, the potential to build upon existing partnerships to implement, and a tension for change to address surgical gaps. Barriers included additional stakeholder’s perceptions of low user acceptability and appropriateness in some cases and the need for additional study data to inform decision making for practice and policy. DISCUSSION/SIGNIFICANCE OF IMPACT: The innovation is efficacious, acceptable, adds to current coping strategies, and fits within existing fistula programs. Stakeholders’ pre-implementation perceptions highlight the importance of partnerships and the need for an evidence base related to effectiveness, acceptability, and cost. Challenges to address include access to resources within these contexts (water, soap, and safe space to empty cup) and development of a culturally appropriate counseling message. Future research warranted.


PLoS ONE ◽  
2019 ◽  
Vol 14 (3) ◽  
pp. e0213835 ◽  
Author(s):  
Bob Erens ◽  
Kirstin R. Mitchell ◽  
Lorna Gibson ◽  
Jessica Datta ◽  
Ruth Lewis ◽  
...  

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