Influential Factors for Older Users’ Acceptance of eHealth Services: an Integrated Acceptance Framework (IAF) (Preprint)

2021 ◽  
Author(s):  
Jiyeon Yu ◽  
Angelica de Antonio ◽  
Elena Villalba-Mora
Keyword(s):  
Systematic Review ◽  
Older Adults ◽  
New Technologies ◽  
Meta Analysis ◽  
Health Condition ◽  
Influential Factors ◽  
Current Status ◽  
Five Dimensions ◽  
The Impact ◽  
Acceptance Factors

BACKGROUND eHealth and Telehealth play a crucial role in assisting older adults who visit hospitals frequently or who live in nursing homes and can benefit from staying at home while being cared for. Adapting to new technologies can be difficult for older people. Thus, to better apply these technologies to older adults’ lives, many studies have analyzed acceptance factors for this particular population. However, there is not yet a consensual framework to be used in further development and the search for solutions. OBJECTIVE This paper presents an Integrated Acceptance Framework (IAF) for the older user’s acceptance of eHealth, based on 43 studies selected through a systematic review. METHODS We conducted a four-step study. First, through a systematic review from 2010 to 2020 in the field of eHealth, the acceptance factors and basic data for analysis were extracted. Second, we carried out a thematic analysis to group the factors into themes to propose and integrated framework for acceptance. Third, we defined a metric to evaluate the impact of the factors addressed in the studies. Last, the differences amongst the important IAF factors were analyzed, according to the participants’ health conditions, verification time, and year. RESULTS Through the systematic review, 731 studies were founded in 5 major databases, resulting in 43 selected studies using the PRISMA methodology. First, the research methods and the acceptance factors for eHealth were compared and analyzed, extracting a total of 105 acceptance factors, which were grouped later, resulting in the Integrated Acceptance Framework. Five dimensions (i.e., personal, user-technology relational, technological, service-related, environmental) emerged with a total of 23 factors. Also, we assessed the quality of the evidence. And then, we conducted a stratification analysis to reveal the more appropriate factors depending on the health condition and the assessment time. Finally, we assess which are the factors and dimensions that are recently becoming more important. CONCLUSIONS The result of this investigation is a framework for conducting research on eHealth acceptance. To elaborately analyze the impact of the factors of the proposed framework, the criteria for evaluating the evidence from the studies that have extracted factors are presented. Through this process, the impact of each factor in the IAF has been presented, in addition to the framework proposal. Moreover, a meta-analysis of the current status of research is presented, highlighting the areas where specific measures are needed to facilitate e-Health acceptance.

Self-compassionate Aging: A Systematic Review

2018 ◽  
Vol 59 (4) ◽  
pp. e311-e324 ◽  
Author(s):  
Lydia Brown ◽  
Jeff C Huffman ◽  
Christina Bryant
Keyword(s):  
Systematic Review ◽  
Older Adults ◽  
Psychological Symptoms ◽  
Meta Analysis ◽  
Later Life ◽  
Well Being ◽  
Physical Symptoms ◽  
Search Term ◽  
Self Compassion ◽  
The Impact

Abstract Abstract Background and Objectives There is considerable heterogeneity in experiences of aging, with some experiencing greater well-being and adapting more successfully to the challenges of aging than others. Self-compassion is a modifiable psychological skill that might help explain individual differences in well-being and adjustment in later life. The aim of this study was to systematically review the literature on self-compassion and well-being outcomes in studies of older adults aged 65 and older. Research Design and Methods This systematic review was conducted according to PRISMA guidelines, using databases PsycINFO, Medline, and Embase. The search term self-compassion was paired with terms relating to well-being, psychological symptoms, and adjustment. Meta-analysis was used to synthesize results on the relationship between self-compassion and four outcomes including depression, anxiety, hedonic well-being, and eudaimonic well-being. Results Eleven studies met inclusion criteria for this review. Meta-analysis revealed that self-compassion was associated with lower levels of depression (r = −.58, 95% CI [−.66, −.48]) and anxiety (r = −.36, 95% CI [−.60, −.07]), and higher levels of hedonic (r = .41, 95% CI [.15, .62]) and eudaimonic (r = .49, 95% CI [.41, .57]) well-being. Further, three studies found self-compassion weakened the impact of physical symptoms on well-being outcomes. Discussion and Implications We found preliminary evidence that self-compassion is associated with well-being outcomes in older adults, and that self-compassion may buffer the psychological sequelae of health symptoms in later life. Higher quality studies with uniform outcome measures are needed to replicate and extend these results.

scholarly journals The Impact of Protein Supplementation on Appetite and Energy Intake in Healthy Older Adults: A Systematic Review with Meta-Analysis

2020 ◽  
Author(s):  
Sana Ben-Harchache ◽  
Helen M Roche ◽  
Clare A Corish ◽  
Katy M Horner
Keyword(s):  
Systematic Review ◽  
Older Adults ◽  
Longitudinal Studies ◽  
Energy Intake ◽  
Energy Content ◽  
Meta Analysis ◽  
Protein Supplementation ◽  
Cochrane Library ◽  
Healthy Older Adults ◽  
The Impact

ABSTRACT Protein supplementation is an attractive strategy to prevent loss of muscle mass in older adults. However, it could be counterproductive due to adverse effects on appetite. This systematic review and meta-analysis aimed to determine the effects of protein supplementation on appetite and/or energy intake (EI) in healthy older adults. MEDLINE, The Cochrane Library, CINAHL, and Web of Science were searched up to June 2020. Acute and longitudinal studies in healthy adults ≥60 y of age that reported effects of protein supplementation (through supplements or whole foods) compared with control and/or preintervention (for longitudinal studies) on appetite ratings, appetite-related peptides, and/or EI were included. Random-effects model meta-analysis was performed on EI, with other outcomes qualitatively reviewed. Twenty-two studies (9 acute, 13 longitudinal) were included, involving 857 participants (331 males, 526 females). In acute studies (n = 8), appetite ratings were suppressed in 7 out of 24 protein arms. For acute studies reporting EI (n = 7, n = 22 protein arms), test meal EI was reduced following protein preload compared with control [mean difference (MD): −164 kJ; 95% CI: −299, −29 kJ; P  = 0.02]. However, when energy content of the supplement was accounted for, total EI was greater with protein compared with control (MD: 649 kJ; 95% CI: 438, 861 kJ; P < 0.00001). Longitudinal studies (n = 12 protein arms) showed a higher protein intake (MD: 0.29 g ⋅ kg−1 ⋅ d−1; 95% CI: 0.14, 0.45 g ⋅ kg−1 ⋅ d−1; P < 0.001) and no difference in daily EI between protein and control groups at the end of trials (MD: −54 kJ/d; 95% CI: −300, 193 kJ/d; P  = 0.67). While appetite ratings may be suppressed with acute protein supplementation, there is either a positive effect or no effect on total EI in acute and longitudinal studies, respectively. Therefore, protein supplementation may represent an effective solution to increase protein intakes in healthy older adults without compromising EI through appetite suppression. This trial was registered at PROSPERO as https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42019125771 (CRD42019125771).

scholarly journals The Effect of Exercise on the Older Adult’s Blood Pressure Suffering Hypertension: Systematic Review and Meta-Analysis on Clinical Trial Studies

2020 ◽  
Vol 2020 ◽  
pp. 1-19
Author(s):  
Mohsen Kazeminia ◽  
Alireza Daneshkhah ◽  
Rostam Jalali ◽  
Aliakbar Vaisi-Raygani ◽  
Nader Salari ◽  
...  
Keyword(s):  
Systematic Review ◽  
Blood Pressure ◽  
Older Adults ◽  
Treatment Plan ◽  
Meta Analysis ◽  
Intervention Group ◽  
The Elderly ◽  
Before And After ◽  
Cochran Test ◽  
The Impact

Background. Senescence refers to spontaneous and progressive irreversible degenerative changes in which both the physical and psychological power diminish significantly. Hypertension is the most common cardiovascular disease in the elderly. Several studies have been conducted regarding the effect of exercise on reducing the blood pressure of the elderly, which have found contradictory results. One of the uses of meta-analysis study is responding to these assumptions and resolving the discrepancies. Accordingly, the aim of the present study is to determine the impact of exercise on the blood pressure of older adults. Method. In this research, in order to find electronic published papers from 1992 to 2019, the papers published in both domestic and foreign databases including SID, MagIran, IranMedex, IranDox, Gogole Scholar, Cohrane, Embase, Science Direct, Scopus, PubMed, and Web of Science (ISI) were used. Heterogeneity index between the studies was determined based on Cochran test Q(c) and I2. Considering existence of heterogeneity, random effects model was employed to estimate the standardized subtraction of the mean exercise test score for reduction of blood pressure in the older adults across the intervention group before and after the test. Results. In this meta-analysis and systematic review, eventually 69 papers met the inclusion criteria. The total number of participants was 2272 in the pre- and postintervention groups when examining the systolic changes and 2252 subjects in the pre- and postintervention groups when inspecting the diastolic changes. The standardized mean difference in examining the systolic changes before the intervention was 137.1 ± 8.09 and 132.98 ± 0.96 after the intervention; when exploring the diastolic changes, the pre- and postintervention values were 80.3 ± 0.85 and 76.0 ± 6.56, respectively, where these differences were statistically significant (P<0.01). Conclusion. The results of this study indicated that exercise leads to significant reduction in both systolic and diastolic blood pressure. Accordingly, regular exercise can be part of the treatment plan for hypertensive elderly.

scholarly journals The Effect of Chair-Based Exercise on Physical Function in Older Adults: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 18 (4) ◽  
pp. 1902
Author(s):  
Natalie Klempel ◽  
Nicole E. Blackburn ◽  
Ilona L. McMullan ◽  
Jason J. Wilson ◽  
Lee Smith ◽  
...  
Keyword(s):  
Physical Activity ◽  
Systematic Review ◽  
Older Adults ◽  
Physical Function ◽  
Handgrip Strength ◽  
Meta Analysis ◽  
Later Life ◽  
Risk Of Bias ◽  
Exercise Programmes ◽  
The Impact

Physical activity is an important determinant of health in later life. The public health restrictions in response to COVID-19 have interrupted habitual physical activity behaviours in older adults. In response, numerous exercise programmes have been developed for older adults, many involving chair-based exercise. The aim of this systematic review was to synthesise the effects of chair-based exercise on the health of older adults. Ovid Medline, EMBASE, CINAHL, AMED, PyscInfo and SPORTDiscus databases were searched from inception to 1 April 2020. Chair-based exercise programmes in adults ≥50 years, lasting for at least 2 weeks and measuring the impact on physical function were included. Risk of bias of included studies were assessed using Cochrane risk of bias tool v2. Intervention content was described using TiDieR Criteria. Where sufficient studies (≥3 studies) reported data on an outcome, a random effects meta-analysis was performed. In total, 25 studies were included, with 19 studies in the meta-analyses. Seventeen studies had a low risk of bias and five had a high risk of bias. In this systematic review including 1388 participants, results demonstrated that chair-based exercise programmes improve upper extremity (handgrip strength: MD = 2.10; 95% CI = 0.76, 3.43 and 30 s arm curl test: MD = 2.82; 95% CI = 1.34, 4.31) and lower extremity function (30 s chair stand: MD 2.25; 95% CI = 0.64, 3.86). The findings suggest that chair-based exercises are effective and should be promoted as simple and easily implemented activities to maintain and develop strength for older adults.

scholarly journals A systematic review and meta-analysis of the impact of GLP-1 receptor agonists and SGLT-2 inhibitors on cardiovascular outcomes in biologically healthy older adults

2021 ◽  
Author(s):  
William D Strain ◽  
Jonathan Griffiths
Keyword(s):  
Systematic Review ◽  
Older Adults ◽  
Weight Loss ◽  
Meta Analysis ◽  
Major Adverse Cardiovascular Events ◽  
Receptor Agonists ◽  
Central Registry ◽  
Glucagon Like Peptide 1 ◽  
Poor Outcomes ◽  
The Impact

Background: Unintentional weight loss is a hallmark of frailty and is associated with poor outcomes in older adults with type 2 diabetes. As such, the role of pharmacological therapies that facilitate weight loss – namely, sodium- glucose co-transporter-2 (SGLT-2) inhibitors and glucagon-like peptide-1 (GLP-1) receptor agonists – remains uncertain in fitter older adults. We performed a systematic review and meta-analysis to evaluate these agents on major adverse cardiovascular events (MACE) in older adults eligible for participation in cardiovascular outcome trials.Methods: A literature search was performed in MEDLINE, EMBASE, CINAHL, Cochrane Central Registry of Controlled Trials (CENTRAL) and CNKI from inception to 29 June 2020. A class-specific meta-analysis was conducted in older adults (>65 years at recruitment) and compared with the similar analysis in younger (<65 years) adults.Results: Of 761 unique studies identified, nine met the criteria for inclusion, five using GLP-1 receptor agonists and four with SGLT-2 inhibitors. GLP-1 receptor agonists in older adults were associated with a 15.3% (OR 0.847 (95% CI 0.788 to 0.910)) reduction in MACE events, similar to the 16% benefit seen in younger adults. The use of SGLT-2 inhibitors reduced MACE in older participants by 16.9% (OR 0.831 (95% CI 0.699 to 0.989)), numerically superior to the impact in younger patients (OR 0.936 (95% CI 0.787 to 1.113).Conclusions: GLP-1 receptor agonists and SGLT-2 inhibitors reduced MACE outcomes in older adults who were eligible to participate in clinical trials. Whereas this is reassuring for the biologically robust, it should not be extrapolated to frail older adults without further investigation.

scholarly journals Trauma-focused treatments for depression. A systematic review and meta-analysis

PLoS ONE ◽  
2021 ◽  
Vol 16 (7) ◽  
pp. e0254778
Author(s):  
Sarah K. Dominguez ◽  
Suzy J. M. A. Matthijssen ◽  
Christopher William Lee
Keyword(s):  
Systematic Review ◽  
Depressive Symptoms ◽  
Publication Bias ◽  
Effect Size ◽  
Meta Analysis ◽  
Health Condition ◽  
Current Evidence ◽  
Primary Concern ◽  
Imagery Rescripting ◽  
The Impact

Background Trauma-focused treatments (TFTs) have demonstrated efficacy at decreasing depressive symptoms in individuals with PTSD. This systematic review and meta-analysis evaluated the effectiveness of TFTs for individuals with depression as their primary concern. Methods A systematic search was conducted for RCTs published before October 2019 in Cochrane CENTRAL, Pubmed, EMBASE, PsycInfo, and additional sources. Trials examining the impact of TFTs on participants with depression were included. Trials focusing on individuals with PTSD or another mental health condition were excluded. The primary outcome was the effect size for depression diagnosis or depressive symptoms. Heterogeneity, study quality, and publication bias were also explored. Results Eleven RCTs were included (n = 567) with ten of these using EMDR as the TFT and one using imagery rescripting. Analysis suggested these TFTs were effective in reducing depressive symptoms post-treatment with a large effect size [d = 1.17 (95% CI: 0.58~ 1.75)]. Removal of an outlier saw the effect size remain large [d = 0.83 (95% CI: 0.48~ 1.17)], while the heterogeneity decreased (I2 = 66%). Analysis of the 10 studies that used EMDR also showed a large effect [d = 1.30 (95% CI: 0.67~1.91)]. EMDR was superior to non trauma-focused CBT [d = 0.66 (95% CI: 0.31~1.02)] and analysis of EMDR and imagery rescripting studies suggest superiority over inactive control conditions [d = 1.19 (95% CI: 0.53~ 1.86)]. Analysis of follow-up data also supported the use of EMDR with this population [d = 0.71 (95% CI: 1.04~0.38)]. No publication bias was identified. Conclusions Current evidence suggests that EMDR can be an effective treatment for depression. There were insufficient RCTs on other trauma-focused interventions to conclude whether TFTs in general were effective for treating depression. Larger studies with robust methodology using EMDR and other trauma-focused interventions are needed to build on these findings.

The impact of exercise on the cognitive functioning of healthy older adults: A systematic review and meta-analysis

2014 ◽  
Vol 16 ◽  
pp. 12-31 ◽  
Author(s):  
Michelle E. Kelly ◽  
David Loughrey ◽  
Brian A. Lawlor ◽  
Ian H. Robertson ◽  
Cathal Walsh ◽  
...  
Keyword(s):  
Systematic Review ◽  
Older Adults ◽  
Cognitive Functioning ◽  
Meta Analysis ◽  
Healthy Older Adults ◽  
The Impact
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