scholarly journals Learning and Use of eHealth Among Older Adults Living at Home in Rural and Nonrural Settings: Systematic Review (Preprint)

2020 ◽  
Author(s):  
Ella Airola

BACKGROUND Care policies emphasize deinstitutionalization and <i>aging in place</i> in response to demographic changes. Different eHealth technologies are one way to achieve this aim. However, there is a need to better understand older adults’ needs for eHealth services, and thus, these health solutions require further exploration. OBJECTIVE The purpose of this systematic literature review is to appraise, synthesize, and summarize the literature on older adults’ (aged ≥60 years) eHealth learning and use in real home settings, particularly in rural and remote areas, with a focus on the social and cultural context. METHODS A systematic search was conducted in January 2020 using 4 academic databases. The studies by means of qualitative thematic analysis to identify the barriers, enablers, and support practices involved in the domestication process were examined. In addition, we identified the various meanings attached to eHealth technologies for older adults living in rural and remote areas. RESULTS In total, 31 empirical studies published between 2010 and 2020 were included in this review. A total of 17 articles included participants from rural and remote areas. The most regularly reported barriers related to older adults’ learning to use and use of eHealth were health-related difficulties, such as cognitive impairment or impaired hearing. The most reported enabler was the support provided for older adults in learning and use of eHealth. Support mainly comprised older adults’ own digital competences, which were distributed with their social network. It was found that eHealth technology is needed for rural and remote areas to facilitate access and reduce logistical barriers to health care services. CONCLUSIONS The literature review provided information and practical implications for designers, health care providers, and policy makers. On the basis of these findings, eHealth technologies should be easy to use, and adequate support should be provided to older adults for use.

Sexual Health ◽  
2007 ◽  
Vol 4 (4) ◽  
pp. 288
Author(s):  
M. B. Skinner ◽  
R. Muller ◽  
S. Bialasiewicz ◽  
J. Debattista

Background: The progress in chlamydia testing/management seems to have stalled in Australia over the last years with persistent high prevalences observed in known risk groups. A novel approach is needed to lower the barriers to testing especially in those who are socially isolated and/or live in rural or remote locations. Aim: To develop, implement and evaluate a novel approach to chlamydia testing in the form of a 'self-collection testing kit' that is easily accessible, confidential, free of charge, easy to use, and allows for home self-collection of specimens, their transportation by regular mail and the central management (notification, treatment and follow-up) of results. Methods: The developed 'kit' consists of all necessary items and instructions to obtain a sample. A network of 'kit' distribution sites at locations frequented by the target population has been established in urban as well as rural and remote areas. The 'kits' can also be requested via an advertised website and a 1800 phone number. Specimens are returned via reply paid mail. A centralised system for the management of results and follow up of individuals has been developed. Test results are conveyed to participants by the method of their choice including email, SMS and phone. Treatment is organised via a network of health care providers in various locations. Results/Discussion: First promising results and experiences from the implementation phase of this novel approach to chlamydia testing will be presented covering distribution and uptake of 'kits', return of specimens as well as management and follow up. If eventually proven successful, this approach to chlamydia testing will provide significant opportunities for increasing access to testing across Australia especially in rural and remote areas. An extension to gonorrhoea testing is possible. This project is supported by the 'National Chlamydia Pilot Program' funding of innovative chlamydia projects.


2012 ◽  
Vol 17 (1) ◽  
pp. 11-16
Author(s):  
Lynn Chatfield ◽  
Sandra Christos ◽  
Michael McGregor

In a changing economy and a changing industry, health care providers need to complete thorough, comprehensive, and efficient assessments that provide both an accurate depiction of the patient's deficits and a blueprint to the path of treatment for older adults. Through standardized testing and observations as well as the goals and evidenced-based treatment plans we have devised, health care providers can maximize outcomes and the functional levels of patients. In this article, we review an interdisciplinary assessment that involves speech-language pathology, occupational therapy, physical therapy, and respiratory therapy to work with older adults in health care settings. Using the approach, we will examine the benefits of collaboration between disciplines, an interdisciplinary screening process, and the importance of sharing information from comprehensive discipline-specific evaluations. We also will discuss the importance of having an understanding of the varied scopes of practice, the utilization of outcome measurement tools, and a patient-centered assessment approach to care.


2021 ◽  
Vol 8 ◽  
Author(s):  
Cheng Wang ◽  
Peizhen Zhao ◽  
Mingzhou Xiong ◽  
Joseph D. Tucker ◽  
Jason J. Ong ◽  
...  

Background: Sexual health among older adults is a major public health concern globally. The syphilis burden is increasing in older adults in China. This study aimed to describe factors associated with syphilis infection and diagnosis among older adults in China during a 16 year period.Methods: Using 16 years of data (2004–2019) from the syphilis case report system of Guangdong, China, we compared data from older adults (aged ≥50 years) with those from younger people (aged 15–49 years). We compared the two age group with the Chi-square test for difference, and Joinpoint regression models to assess the temporal trends.Results: During the study period, 242,115 new syphilis diagnoses were reported in older adults. The mean notification rate of new diagnoses was 64.1 per 100,000 population across the entire 16-year period, which significantly increased over time (average annual percent change [AAPC] 16.2%, 95% CI 13.7–18.7). Syphilis diagnoses increased significantly over time among less developed cities and older women. In 2019, compared with younger adults, newly diagnosed older adults were more likely to be male, native to reporting city, had unknown transmission routes, and were diagnosed late.Conclusion: Our findings call for an urgent need to deliver more targeted prevention interventions for older adults, such as strengthen awareness among health care providers, and integration of syphilis services and primary health care for older adults.


2019 ◽  
Vol 25 (4) ◽  
pp. 506-532 ◽  
Author(s):  
Nadine Henriquez ◽  
Kathryn Hyndman ◽  
Kathryn Chachula

Research has identified the need for improved cultural competence of health care providers regarding the lesbian, gay, bisexual, transgender, and queer (LGBTQ) community’s needs. This article articulates the teaching approach and methodology of an unfolding LGBTQ family case study for undergraduate nursing students. This method provided a forum for exploration of personal biases and gender-affirming techniques, and addressed the challenges of aging for a transgender woman and family within the context of societal stigma and discrimination. Students gained knowledge concerning shifts in family structures and understanding of the nurses’ role encouraging inclusiveness and equitable access in health care settings, advocating for vulnerable populations, and addressing specific health concerns for transgender older adults. Student responses demonstrated increased knowledge of family diversity, and critical thought regarding the intersectionality of discrimination and aging. The findings revealed the case study methodology facilitated student understanding of the unique health and social issues for LGBTQ older adults within a family context.


2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S687-S687
Author(s):  
Paul Stolee ◽  
Jacobi B Elliott ◽  
Kerry Byrne ◽  
Joanie Sims-Gould ◽  
Catherine Tong ◽  
...  

Abstract For older adults with complex health conditions, transitions between care settings are common and a major risk to quality of care and patient safety. Care transition interventions have shown positive impacts on continuity of care and health service use, however, most require additional human resources (e.g., transition coach), focus on one transition or “handoff”, and provide support for individual patients without addressing underlying challenges of health system integration. We sought to develop a framework for system-level enhancements to care transitions for older adults. We report a secondary framework analysis of an ethnographic investigation (the “InfoRehab” project) of care transitions for older persons who had experienced a hip fracture. The ethnographic study involved interviews, observations, and document reviews for 23 patients, 19 family caregivers, and 92 health care providers. Data were collected at each transition point (1-4/patient) along the care continuum, at three Canadian sites (large urban, mid-size urban, rural). Our framework analysis followed the approach described by Gale et al. (2013), using as cases 12 peer-reviewed papers which had reported InfoRehab results. Two researchers coded findings from each paper, then developed an analytical framework of eight themes by consensus; these include: patient involvement and choice, family caregiver involvement, patient complexity, health care provider coordination, information sharing, documentation, system constraints, and relationships. NVivo 11 was used to index findings into these themes and to generate a matrix. We are working with system stakeholders, including patients and caregivers, to apply this framework in the development of improved systems for care transitions.


CJEM ◽  
2019 ◽  
Vol 21 (S1) ◽  
pp. S54-S55
Author(s):  
E. Mercier ◽  
A. Nadeau ◽  
A. Brousseau ◽  
M. Emond ◽  
J. Lowthian ◽  
...  

Introduction: This systematic scoping review aims to synthetize the available evidence on the epidemiology, risk factors, clinical characteristics, screening tools, prevention strategies, interventions and knowledge of health care providers regarding elder abuse in the emergency department (ED). Methods: A systematic literature search was performed using three databases (Medline, Embase and Cochrane Library). Grey literature was scrutinized. Studies were considered eligible when they were observational studies or randomized control trials reporting on elder abuse in the prehospital and/or ED setting. Data extraction was performed independently by two researchers and a qualitative approach was used to synthetize the findings. Results: A total of 443 citations were retrieved from which 58 studies published between 1988 and 2018 were finally included. Prevalence of elder abuse following an ED visit varied between 0.01% and 0.03%. Reporting of elder abuse to proper law authorities by ED physicians varied between 2% to 50% of suspected cases. The most common reported type of elder abuse detected was neglect followed by physical abuse. Female gender was the most consistent factor associated with elder abuse. Cognitive impairment, behavioral problems and psychiatric disorder of the patient or the caregiver were also associated with physical abuse and neglect as well as more frequent ED consultations. Several screening tools have been proposed, but ED-based validation is lacking. Literature on prehospital- or ED-initiated prevention and interventions was scarce without any controlled trial. Health care providers were poorly trained to detect and care for older adults who are suspected of being a victim of elder abuse. Conclusion: Elder abuse in the ED is an understudied topic. It remains underrecognized and underreported with ED prevalence rates lower than those in community-dwelling older adults. Health care providers reported lacking appropriate training and knowledge with regards to elder abuse. Dedicated ED studies are required.


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