An app for supporting older people receiving home care – usage, aspects of health and health literacy: a quasi-experimental study

Abstract

Background During the last decade, there has been an increase in studies describing use of mHealth, using smartphones with apps, in the healthcare system by a variety of populations. Despite this, few interventions including apps are targeting older people receiving home care. Developing mobile technology to its full potential of being interactive in real time remains a challenge. The current study is part of a larger project for identifying and managing health concerns via an app by using real-time data. The aim of the study was to describe older people’s usage of an app and to evaluate the impact of usage on aspects of health and health literacy over time. Methods A quasi-experimental design was employed. Seventeen older people self-reported health concerns via Interaktor twice a week for 3-months and answered questionnaires at baseline, the end of the intervention and at a 6–month follow-up. Logged data on app usage and data on Sense of Coherence, Health Index, Nutrition Form for the Elderly, Geriatric Depression Scale-20, Swedish Communicative and Critical Health Literacy and Swedish Functional Health Literacy were collected and analysed using descriptive and non-parametric inferential statistics. Results The median usage of the app as intended was 96%. Pain was one of the most reported health concerns and was also the health concern that triggered an alert (n = 33). The older people’s communicative and critical health literacy improved significantly over time. Regarding the scores of Sense of Coherence, Health Index, Nutritional Form for the Elderly, Geriatric Depression Scale-20 and Swedish Functional Health Literacy scale, there were no significant differences over time. Conclusions The high app usage showed that an app may be a suitable tool for some older people living alone and receiving home care. The results indicate that the usage of Interaktor can support older people by significantly improving their communicative and critical health literacy. Aspects of health were not shown to be affected by the usage of the app. Further research with larger sample is needed for evaluation the effect on health literacy, and which aspects of health of importance to support by an app.

Suffering and Salutogenesis: A Conceptual Analysis of Lessons for Psychiatry From Existential Positive Psychology (PP2.0) in the Setting of the COVID-19 Pandemic

“…In principle, the integration of PP2.0 into a broader salutogenic framework for psychological intervention, particularly in the context of COVID-19, has many advantages over conventional approaches. The development of a formal therapeutic model or manual for such an intervention would require further inputs from a wide range of stakeholders, including (1) direct perspectives from persons affected by the pandemic across countries and cultures (Alipour et al, 2020;Mazumder et al, 2021); (2) discussions with healthcare workers handling mental health issues during the pandemic, to outline their perceptions of the "conventional" psychiatric approach and the limitations thereof (Bommersbach et al, 2021); (3) expert opinions from specialists already involved in interventions based on a salutogenic, PP2.0, or person-centered approach (Christodoulou et al, 2018;Wong, 2020); (4) inputs from local community and spiritual leaders, to identify those aspects of meaningfulness and coherence that are culturally relevant and could foster resilience (Thompkins et al, 2020); (5) the perspectives of social science experts and policy makers on which systemic interventions could foster a SOC and strengthen resistance resources (Christodoulou et al, 2018;Alvarez et al, 2020); (6) specific advice from experts in information technology, in order to devise optimal strategies on adapting salutogenic-PP2.0 principles to interventions delivered via mobile or social media platforms (Goransson et al, 2020), and (7) careful planning of intervention trials in collaboration with experts in biostatistics and research methodology, to avoid the methodological flaws that affected earlier studies in this field (Alvarez et al, 2020). It is hoped that the preliminary steps outlined in this paper are of use not only to researchers, but to clinicians and those involved in formulating policies to help those most affected by the COVID-19 pandemic.…”

Using a Mobile Application for Health Communication to Facilitate a Sense of Coherence: Experiences of Older Persons with Cognitive Impairment

“…Meaningfulness indicates how meaningful these challenges are viewed. SOC has previously been applied as a framework for analysis to understand older persons’ use of mobile applications from a quantitative approach [ 19 ]. However, qualitative research that targets the use of mobile technologies by older persons with CI and that employs SOC as a theoretical model remains scarce [ 20 ].…”

Study on the Types of Elderly Intelligent Health Management Technology and the Influencing Factors of Its Adoption

“…Chung, Goransson, Lee, et al conducted following similar research, examining an app that supports cognitive behavioral therapy for insomnia [24]. Another app helps the elderly receive home care [25], and a health management app uses mobile health technology and health games [26]. Thus, apps can provided different services in different aspects of daily health care and physical health of the elderly.…”

“…The encouragement of medical staff has played an important role in the use of health information technology by the elderly [25] Training…”

“…The elderly describe that trust, which makes them feel modern and acknowledged as valued people. In conclusion, the home care nurses may have played a role in inspiring the elderly to use the app [25]. Irizarry et al proved that both high and low health literacy groups felt that specific task-based training was necessary [5].…”