Aims and objectives To identify key areas of competence for digitalisation in healthcare settings, describe healthcare professionals’ competencies in these areas and identify factors related to their competence. Background Digitalisation requires changes in healthcare practices, policies and actions to revise job expectations and workflows. The aspects of patient safety and integration of digitalisation into the professional context necessitate an assessment of healthcare professionals’ competencies in digitalisation. Design Systematic review. Methods A systematic review was conducted following Center of Reviews and Dissemination guidelines, including application of a PRISMA statement. Four databases—CINAHL (EBSCO), MEDLINE (Ovid), Web of Science and Academic Search Premiere (EBSCO)—were searched for relevant original peer‐reviewed studies published between 2012–2017. Twelve were chosen for final analysis: five quantitative studies and seven qualitative studies, which were, respectively, subjected to narrative and thematic synthesis. Results Key competence areas regarding digitalisation from a healthcare perspective identified encompass knowledge of digital technology and the digital skills required to provide good patient care, including associated social and communication skills, and ethical considerations of digitalisation in patient care. Healthcare professionals need the motivation and willingness to acquire experience of digitalisation in their professional context. Collegial and organisational support appear to be essential factors for building positive experiences of digitalisation for healthcare professionals. Conclusion Healthcare organisations should both pay attention to the social environment of a workplace and create a positive atmosphere if they want to improve the response to digitalisation. The successful implementation of new technology requires organisational and collegial support. Relevance to clinical practice Recommendations for clinical practice include the following: development of competence in digitalisation by healthcare professionals when using technological equipment to minimise errors; provision of sufficient resources, equipment and room for technology usage; and provision of regular education that considers the participants’ competencies.
Aim was to explore the health-related quality of life (HRQoL) and related factors among older adults with visual impairment (VI). A total of 39 independently living subjects aged ⩾65 years (83 ± 6.5), referred to the Low Vision Center of the Oulu University Hospital, Finland during one year participated in the study. The participants had low vision or blindness as defined by the World Health Organization (WHO). The 15D, a generic HRQoL instrument, was used to assess the HRQoL, and an ophthalmic examination was performed to assess vision. A population-based control group ( n = 1074) was available for comparison. The mean 15D index scores for the participants and the control group were 0.768 ( SD = 0.089) and 0.827 ( SD = 0.044), respectively, ( p < .002). In the dimensions of move ( p < .05), see ( p < .001), breath ( p < .05), usual activities ( p < .001), depression ( p < .05), and distress ( p < .05), the study participants scored statistically significantly lower than the control group. However, the participants had better mental function scores (0.856 vs 0.773, p < .05). Among the participants, there was no difference in the 15D by gender (men 0.755, women 0.774, p > .05), habitation (alone 0.768, with someone 0.770, p > .05), or age ( r = –.084), nor did the extent of low vision appear to affect the 15D index in this material. The older adults with VI had poorer 15D index score than Finnish population of equal age, but they scored better in the dimension of mental function. Mental skills may indeed be crucial for independent living despite VI.
This study describes the self-estimated functional ability of older adults with visual impairments (VI) living at home prior to and after 24 months of individual low vision rehabilitation (LVR) according to the International Classification of Functioning, Disability and Health (ICF) framework. The LVR was carried out according to regular standard of care in Finland. The study provides knowledge that is relevant for improving both LVR as well as other services for older adults living with VI. Thirty-nine older adults with VI initially participated in the study with 28 remaining for the follow-up at 24 months of LVR. Data were collected by an orally administered questionnaire including items from the Oldwellactive Wellness Profile instrument. Data were analyzed using the marginal homogeneity test, and the outcomes were divided into four categories according to the ICF framework. Comparisons between the baseline and 2-year follow-up revealed statistically significant decreases in daily functions, including going outdoors ( p = .011), washing oneself ( p = .016), taking care for personal hygiene ( p = .046), dressing ( p = .034), preparing meals ( p = .041), and doing heavy housework ( p = .046), following 2 years of received LVR. A statistically significant increase in the need for help was also observed during the study period ( p = .025). The independence of older adults with VI decreased, and the need for external services or help increased during 24 months after the onset of receiving LVR. Visual problems were shown to widely affect functional ability. Activities and participation dimension together with loneliness are most affected and need attention in individual LVR.
Background/Objective: Low vision rehabilitation (LVR) services aim to help people of all ages with visual impairment (VI) to maintain and improve their quality of life and well-being. However, knowledge about elderly people’s subjective experiences of the usefulness as well as their expectations of LVR is very limited. The aim of this study was therefore to produce new knowledge that can be utilized in the development and improvement of LVR processes and services in order to better support well-being and quality of life, and encourage the ‘active aging’ of elderly people with VI.Methods: Qualitative research methods were used. The data was collected from elderly people with VI (n = 35) by unstructured telephone interviews one year after the onset of individual LVR. The data was analyzed by inductive content analysis.Results: Numerous and varied expectations were expressed for LVR, showing mainly hopes for vision improvement and the need for services and support. The impact of medical care on vision outcome was mentioned in relation to the perceived benefits of LVR. LVR was generally considered useful in terms of overall well-being and quality of life, the main practical benefits being the provision of different visual aids and assistive devices.Conclusions: The results proved the concept, process and multi-sided nature of LVR to be incompletely perceived by the participants in the study. In light of this, we argue that there is a need for improved communication between people with VI and medical staff when discussing the nature and the realistic possibilities of LVR; care should be taken to distinguish it from medical care. The benefits of LVR in enabling independence in daily tasks were commonly recognized, however.
Worldwide demographic changes have led to an increased share of older people in the population (Ritchie & Roser, 2019), which is also increasing the number of older people in need of long-term care.In Finland, and in other European countries, safe aging at homewith support from additional nursing and home help services-is a national goal that has shifted the focus of long-term care for older people from residential care to home care (Boerma & Genet, 2012; Finnish Institute for Health and Welfare, 2020a). Finland's National Programme on Aging 2030 focusses on preventive measures to improve the functional ability of older people and risk groups (Ministry of Social Affairs and Health, 2020). Vision is a major factor that affects an older person's functioning and living at home. However, up-to-date information on the visual performance of home-dwelling older people receiving home care is not available. In 2019, over 100,000 home-dwelling older people (>65 years of age) received regular home care services in Finland. This represents approximately 8% of this age group (Saukkonen et al., 2020).Although several studies have shown that visual impairment (VI) affects functional ability, overall well-being and quality of
The aim of this study was to describe the well-being supportive home environment of elderly people (n=37) with visual impairment (VI) and its relationship with health-related quality of life (HRQoL). Data were collected during home visits six (6) months after the commencement of individual low vision rehabilitation (LVR) process. A structured well-being supportive environment instrument and a general HRQoL instrument were administered.Background variables had no detectable effect on the HRQoL. The HRQoL correlated significantly with the symbolic environment living-related fears and feelings of general restrictiveness. The participants generally saw their home environment to be comfortable and supportive of well-being, but many felt that their life was too much restricted to home environment.
Visual impairments (VI) burden particularly the aging population globally. To ensure healthy aging despite disability, the health care systems must provide effective low-vision rehabilitation services (LVR) for those in need. Low-vision rehabilitation counseling (LVRC) requires specialized multidisciplinary teamwork and has not been studied in detail among the elderly. This study aims to provide a comprehensive picture of individual LVRC actions and introduce a LVRC classification to use for attempts to improve the LVRC processes. This study employed a qualitative follow-up design. Data describing the individual LVRC processes in a prospective cohort of elderly patients with VI ( n = 39) were collected individually over 2 years during the years 2016–2019. The data were analyzed through deductive content analysis. The analyzed LVRC provided assistive devices, services, and home modifications, but problems related to independent movement in the living environment, psychosocial burdens, adaptation to disability, and learning new compensatory skills received less attention. To ensure effective LVRC, the multiprofessional team providing the rehabilitation should emphasize goal-setting and continuous assessment. LVRC should be seen as a process of adaptation, adherence, and learning. LVRC should support and promote older adults to participate and function to their full potential in the modern society, which includes utilizing digital technologies.
Background and aim: Visual impairment (VI) problems are increasing as the global aging population grows. Mobile devices have become essential to interacting with friends and society. Because the visually impaired are no exception, it would be useful to determine the functionalities that best support the independence of people with VI.The currently available functionalities and applications were analysed to provide insight about which features the visually impaired value most. Materials and methods:A Webropol survey with structured and open-ended questions was carried out. The participants ( n=26) were asked about their use of mobile applications and opinions regarding the usefulness of certain applications in promoting independent functioning. An instrument was developed for this study based on previous literature, and its quality was assured through an expert panel evaluation and pretesting. The collected data were analysed statistically and by inductive content analysis.Results: A majority of the participants were active users of mobile devices. Substantial variation was observed in the evaluations of how useful various applications are to different everyday tasks. The participants suggested numerous improvements, such as additional customisation, to the current mobile devices and applications• Implications for Rehabilitation:• People with VI benefit from the use of mobile devices in the same way that the population with normal vision does, and mobile devices and applications can be pivotal to supporting their independence.• The participants offered innovative ideas and suggestions for how mobile devices and applications could be designed to better meet the needs of the visually impaired.
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