No abstract
Much hope is placed in the use of assistive technologies (AT) to support older adults and retain their independence and quality of life. AT could also be a way to help fulfill the increasing requirements of caring for an aging population. While many devices are freely available, successful and broad adoption is progressing slowly. In a qualitative analysis, we investigated the popularity of AT and the willingness to and obstacles for use. Eleven older adults aged 62–85 participated in three groups, each focusing on a specific age-related case example. Using content analysis, statements have been categorized into three levels: the affected person, their surroundings, and supportive devices. Information (knowledge, consultation) was the topic spoken about the most (n=101), followed by statements focusing on everyday life and the use of assistive devices (n=99). Comments on economic topics carried the least weight (n=28). The biggest obstacles for the reluctant adoption of AT don’t seem to be acceptance issues but rather a lack of knowledge of AT and where to get counseling. Thus, the provision and promotion of coherent information material and accessible consultation for users and relatives should be prioritized. AT training for healthcare professionals can provide further opportunities.
Background The use of assistive technologies (ATs) to support older people has been fueled by the demographic change and technological progress in many countries. These devices are designed to assist seniors, enable independent living at home or in residential facilities, and improve quality of life by addressing age-related difficulties. Objective We aimed to evaluate the effectiveness of ATs on relevant outcomes with a focus on frail older adults. Methods A systematic literature review of randomized controlled trials evaluating ATs was performed according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. The Ovid Medline, PsycINFO, SocIndex, CINAHL (Cumulative Index to Nursing and Allied Health Literature), CENTRAL (Cochrane Central Register of Controlled Trials), and IEEEXplore databases were searched from January 1, 2009, to March 15, 2019. ATs were included when aiming to support the domains autonomy, communication, or safety of older people with a mean age ≥65 years. Trials performed within a laboratory setting were excluded. Studies were retrospectively categorized according to the physical frailty status of participants. Results A total of 19 trials with a high level of heterogeneity were included in the analysis. Six device categories were identified: mobility, personal disease management, medication, mental support, hearing, and vision. Eight trials showed significant effectiveness in all or some of the primary outcome measures. Personal disease management devices seem to be the most effective, with four out of five studies showing significant improvement of disease-related outcomes. Frailty could only be assessed for seven trials. Studies including participants with significant or severe impairment showed no effectiveness. Conclusions Different ATs show some promising results in well-functioning but not in frail older adults, suggesting that the evaluated ATs might not (yet) be suitable for this subgroup. The uncertainty of the effectiveness of ATs and the lack of high-quality research for many promising supportive devices were confirmed in this systematic review. Large studies, also including frail older adults, and clear standards are needed in the future to guide professionals, older users, and their relatives. Trial Registration PROSPERO CRD42019130249; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=130249
Zusammenfassung. Hintergrund: Befragungen von pflegenden Angehörigen von Menschen im Projekt MoCaB (Mobile Care Backup) zeigen, dass u. a. ein Mangel an Krankheitswissen und Unwissen über pflegerische Handlungsoptionen als belastend erlebt werden. Zielsetzung und Fragestellung: Ziel ist es, pflegende Angehörige in ihrer Häuslichkeit zu unterstützen. Dazu werden pflegerelevantes Wissen und Anleitungen zur Selbstpflege situationsgerecht über eine mobile Applikation (MoCaB-App) bereitgestellt. Methoden: Das Kernelement der mobilen Applikation, die personalisierte Wissensvermittlung in Dialogform, wird in einem partizipativen Verfahren mit potenziellen Nutzerinnen und Nutzern entwickelt. Das relevante evidenzbasierte Pflegewissen wurde im Experten-Review-Verfahren gesichtet und für die Zielgruppe der pflegenden Angehörigen aufbereitet. Ergebnisse: Bislang wurden 86 pflegerelevante Themen identifiziert und formuliert. Die Usability-Testungen mit potenziellen Anwenderinnen und Anwendern zeigen, dass die Inhalte selbst, die sprachliche Aufbereitung und die Darbietung über die MoCaB-App gut angenommen werden. Ausblick: In einem nächsten Schritt wird die App im häuslichen Setting mit pflegenden Angehörigen getestet, um ggf. weitere Überarbeitungsbedarfe zu identifizieren.
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