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Developing and evaluating an interactive app to support self-care among older persons receiving home care
Örebro University, School of Health Sciences.ORCID iD: 0000-0001-6215-2032
2019 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The proportion of older persons worldwide is growing. With older age, complex health problems may occur and the need for home care increases. To support older persons to maintain health and self-care, innovative ways need to be developed. The aim of the project was to develop and evaluate an interactive app among older persons receiving home care. The project had several phases: i) to define and understand the problem ii) develop the intervention iii) develop and optimise evaluation. Qualitative and quantitative methods were employed. Data were collected through a scoping review, interviews with healthcare experts, older persons and nursing assistants (study I); interviews with older persons (studies II, III); focus groups with homecare nurses (study II). Questionnaires at baseline, end of intervention and 6-month follow-up; with instruments to assess aspects of health, health literacy, self-care, and a study specific question regarding sense of security were used (studies III-IV). Logged data from reported health concerns, alerts, and notes were collected (study IV). Data were analysed using qualitative content analysis (study I), thematic analysis (study II), qualitative content analysis with directed approach (study III) and descriptive and inferential statistics (studies III, IV). Results: Important aspects for health and self-care from the older persons’ perspectives were described as: frame of mind, having relationships and social activities, physical ability and concerns, and maintaining self-care (I). These results were included in the app as questions with self-care advice, graphs and alerts to homecare nurses. The app use was described as an enabler for learning (II). The older persons showed improved communicative and critical health literacy at the 6- month follow-up (IV). They described an increased sense of security (II and III), which decreased at the 6-month follow-up (III). They expressed increased self-confidence (II) and support in self-care, but reported a decrease in self-care ability at the 6-month follow-up (III). App usage was high, with the health concern pain triggering the most alerts (IV). Their aspects of health were unchanged at the three assessments points (IV). In this context using an app may increase older persons’ participation in their care. The results show that for some older persons, an app can be implemented as a tool for support in conventional home care.

Place, publisher, year, edition, pages
Örebro: Örebro University , 2019. , p. 97
Series
Örebro Studies in Medicine, ISSN 1652-4063 ; 189
Keywords [en]
Health concerns, mHealth, older persons, self-care
National Category
Other Health Sciences
Identifiers
URN: urn:nbn:se:oru:diva-71507ISBN: 978-91-7529-276-2 (print)OAI: oai:DiVA.org:oru-71507DiVA, id: diva2:1279365
Public defence
2019-03-29, Örebro universitet, Forumhuset, Hörsal F, Fakultetsgatan 1, Örebro, 13:00 (Swedish)
Opponent
Supervisors
Available from: 2019-01-16 Created: 2019-01-16 Last updated: 2019-04-10Bibliographically approved
List of papers
1. Perspectives of health and self-care among older persons: to be implemented in an interactive interactive information and communication technology-platform
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2017 (English)In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 26, no 23-24, p. 4745-4755Article in journal (Refereed) Published
Abstract [en]

AIM AND OBJECTIVES: To acquire knowledge regarding the contents to be implemented in an interactive ICT-platform perceived to be relevant to health and self-care among older persons based on the literature, healthcare professionals and the older persons themselves.

BACKGROUND: The growing ageing population places demands on the healthcare system to promote healthy ageing and to strengthen the older person's self-care ability. This requires innovative approaches to facilitate communication between the older person and healthcare professionals, and to increase the older person's participation in their care. An information and communication technology-platform (ICT-platform) could be used for this purpose, but the content needs to be relevant to both the older persons and the healthcare professionals.

DESIGN: Descriptive qualitative design.

METHODS: This study was based on three samplings: a scoping review of the literature (n=20 articles), interviews with healthcare professionals (n=5), and a secondary analysis of interviews with older persons (n=8) and nursing assistants (n=7). The data were analysed using qualitative content analysis.

RESULTS: Four areas were identified to be of relevance to older persons' perceived health: frame of mind, having relationships and social activities, physical ability and concerns, and maintaining self-care. Self-care was described in the literature and by the healthcare professionals more than by the older persons.

CONCLUSIONS: The results show a concordance in the data samplings that give a clear indication of the areas relevant to older persons' health and self-care that can be integrated in an interactive ICT-platform for use in regular daily care assessments. Descriptions of self-care was limited indicating a possible gap in knowledge that requires further research.

RELEVANCE TO CLINICAL PRACTICE: Areas relevant to older persons' health and self-care could be used for regular assessment to support and promote healthy ageing.

Place, publisher, year, edition, pages
John Wiley & Sons, 2017
Keywords
Health status, information-communication technology, nursing care, older persons, qualitative content analysis, self-care
National Category
Nursing
Research subject
Nursing Science
Identifiers
urn:nbn:se:oru:diva-56862 (URN)10.1111/jocn.13827 (DOI)000416319600087 ()28334519 (PubMedID)
Note

Funding Agencies:

Faculty of Medicine and Health, School of Health Sciences, Örebro University  

School of Health and Welfare, Halmstad University 

Available from: 2017-03-28 Created: 2017-03-28 Last updated: 2019-02-27Bibliographically approved
2. Testing an app for reporting health concerns: Experiences from older people and home care nurses
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2018 (English)In: International Journal of Older People Nursing, ISSN 1748-3735, E-ISSN 1748-3743, Vol. 13, no 2, article id e12181Article in journal (Refereed) Published
Abstract [en]

AIMS AND OBJECTIVES: To explore the experiences of using an app among older people with home-based health care and their nurses.

BACKGROUND: Few information and communication technology innovations have been developed and tested for older people with chronic conditions living at home with home-based health care support. Innovative ways to support older people's health and self-care are needed.

DESIGN: Explorative qualitative design.

METHODS: For 3 months to report health concerns, older people receiving home-based health care used an interactive app, which included direct access to self-care advice, graphs and a risk assessment model that sends alerts to nurses for rapid management. Interviews with older people (n = 17) and focus group discussions with home care nurses (n = 12) were conducted and analysed using thematic analysis.

RESULTS: The findings reveal that a process occurs. Using the app, the older people participated in their care, and the app enabled learning and a new way of communication. The interaction gave a sense of security and increased self-confidence among older people. The home care nurses viewed the alerts as appropriate for the management of health concerns. However, all participants experienced challenges in using new technology and had suggestions for improvement.

CONCLUSIONS: The use of an app appears to increase the older people's participation in their health care and offers them an opportunity to be an active partner in their care. The app as a new way to interact with home care nurses increased the feeling of security. The older people were motivated to learn to use the app and described potential use for it in the future.

IMPLICATIONS FOR PRACTICE: The use of an app should be considered as a useful information and communication technology innovation that can improve communication and accessibility for older people with home-based health care.

Place, publisher, year, edition, pages
John Wiley & Sons, 2018
Keywords
App, health concerns, older people, security, self-confidence, thematic analysis
National Category
Nursing Geriatrics
Identifiers
urn:nbn:se:oru:diva-63300 (URN)10.1111/opn.12181 (DOI)000434118100005 ()29210218 (PubMedID)2-s2.0-85037995107 (Scopus ID)
Note

Funding Agencies:

Faculty of Medicine and Health, School of Health Sciences, Örebro University  

School of Health and Welfare, Halmstad University  

Karolinska Institutet 

Available from: 2017-12-11 Created: 2017-12-11 Last updated: 2019-02-27Bibliographically approved
3. Self-care ability and sense of security among older persons when using an app as a tool for support
Open this publication in new window or tab >>Self-care ability and sense of security among older persons when using an app as a tool for support
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(English)Manuscript (preprint) (Other academic)
National Category
Other Health Sciences
Identifiers
urn:nbn:se:oru:diva-72808 (URN)
Available from: 2019-02-26 Created: 2019-02-26 Last updated: 2019-02-27Bibliographically approved
4. Evaluating an app for older people: interaction, health and health literacy, a quasi-experimental study
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(English)Manuscript (preprint) (Other academic)
National Category
Other Health Sciences
Identifiers
urn:nbn:se:oru:diva-72809 (URN)
Available from: 2019-02-26 Created: 2019-02-26 Last updated: 2019-02-27Bibliographically approved

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Göransson, Carina

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