ObjectiveTo provide high-quality elderly care, digital health technologies (DHTs) can potentially assist in reaching the full capacity of comprehensive geriatric assessments (CGAs) to improve communication and data transfer on patients' medical and treatment plan information and health decision-making. This systematic review aimed to describe the evidence on the feasibility and usability, efficacy and effectiveness, and implementation outcomes of DHTs developed to facilitate the administration of CGAs for long-term care settings or community care and to describe their technical features and components. MethodsA search strategy was conducted in three databases, targeting studies evaluating the DHTs facilitating the administration of CGAs used in long-term care settings or community care. Studies in English and Spanish published up to 5 April 2023 were considered. ResultsFour DHTs supporting the administration of the CGAs were identified. Limited information was found on the technical features and required hardware. Some of the barriers identified regarding usability can be overcome with novel technologies; however, training of health professionals on the assessments and staff knowledge regarding the purpose of the data collected are not technology related and need to be addressed. ConclusionsBarriers regarding usability were related to experienced difficulties navigating the software, unstable network connectivity, and length of the assessment. Feasibility obstacles were associated with the lack of training to use the DHT, availability and accessibility to hardware (e.g. laptops), and lack of insight into the clinical benefits of collected data. Further research must focus on these areas to improve the implementation and usefulness of these DHTs.
Background: Health systems are in the need for novel approaches to tackle the challenges from the demographic transition to ageing populations. An effective approach to face these challenges is integrated care delivery. Implementing Comprehensive Geriatric Assessments (CGAs) in Health Ageing might be highly relevant to incorporate this approach. However, this implementation should be supported by Digital Health Interventions (DHIs) in order to reach their full capacity. Research Objective: To identify the DHIs facilitating the administration of CGAs used in long-term care and home care settings and provide an insight on their characteristics and stage of maturity and evaluation. Method: A search strategy was conducted in PubMed, CINAHL, and Web of Science, targeting studies evaluating the DHIs facilitating the administration of CGAs used in long-term care and home care settings. Studies in English and Spanish and published up to July 26, 2021 were considered. Preliminary results of the ongoing study: A total of four papers describing three digital platforms supporting the administration of the CGAs were identified. Information on implementation reported less completion of some sections affecting the CGAs outcomes, assessments mostly being the responsibility of nurses, and missing data related with less quality of care. Limitations and barriers regarding their usability and feasibility were also identified. Conclusion: The inclusion of safe data storage, automatic notifications for assessment completion, automatic calculation of final outcomes, and facilitation of multidisciplinary assessments, were identified as key features to enhance the implementation of digital platforms facilitating the administration of CGAs. Nonetheless, information regarding technical features and hardware information of the digital platforms was scarce. This project is part of the Marie Skłodowska Curie Actions Innovative Training Network H2020-MSCA-ITN, under grant agreement number 813196
Technology integration in the field of mental health helps prevent cognitive decline in patients. If older users do not adopt service-based Information and Communication Technologies, they will face problems in managing their daily lives. The main objective of our work is to analyze the usability of the Long Lasting Memories program among mental health professionals. This study sample consisted of 23 participants: psychologists (52.2 % ) and qualified assistants (47.8 % ). Once the intervention with the program had concluded, the participants answered a usability questionnaire with different variables. Questions relating to aspects such as the ease of use of the program, its satisfaction and sustainability were included in the questionnaire. From the point of view of the professional in charge of the intervention, the degree of usability is high.
Integrated care delivery is regarded as the most effective way of care provisioning to tackle challenges of dementia care, such as uncoordinated care, risk of hospitalizations, care planning and unmet needs. As Comprehensive Geriatric Assessments (CGAs) incorporate the key principles of integrated care, implementing CGAs in care practice might be highly relevant. However, this implementation should be supported by Digital Health Interventions in order to reach the full CGA capacity.To present the state-of-the-art evidence on available CGAs for long-term and home care, and digital platforms supporting the administration of CGAs.Two search strategies were conducted in PubMed, CINAHL, and Web of Science. One focused on the validity and reliability of available CGAs for long-term and home care settings, and the second search comprised digital platforms that support CGAs. Studies in English and Spanish and published up to July 30, 2020 were considered.A total of 73 studies reporting on the validity/reliability of 14 different CGAs, and five papers describing four digital platforms supporting CGAs were identified. Most of the CGAs covered a wide range of domains, evidence for good to excellent validity and reliability was reported for various instruments. Digital platforms showed some limitations and barriers regarding their usability and feasibility.Foremost, strong evidence of good to excellent validity and reliability was found for the Resident Assessment Instrument-Minimum Data Set (RAI-MDS) and subsequent updated instruments, similar results have been reported for multiple countries. For this reason, we recommend the use of its latest versions for long-term care facilities and home care, the interRAI LTCF and interRAI HC. Regarding the digital platforms supporting CGAs, the inclusion of safe data storage, automatic notifications for assessment completion, individualized profile reports, automatic calculation of final outcomes, and facilitation of multidisciplinary assessments, were identified as key features to enhance their implementation. This project is part of the Marie Skłodowska Curie Actions Innovative Training Network H2020-MSCA-ITN, under grant agreement number 813196.
BACKGROUND:Affective symptoms are considered a risk factor or prodromal symptom for dementia. Recent reviews indicate that depressive symptoms predict progression from mild cognitive impairment (MCI) to dementia, but results need to be further explored.OBJECTIVE:To investigate the effect of depressive symptoms on the development of dementia in people with MCI, and explore potential sources of between-study variability, including study setting by a systematic review and meta-analysis.METHODS:Databases were searched for prospective studies defining people with MCI at baseline, investigating dementia at follow-up and giving information about depressive symptoms. Two authors independently extracted data from the studies and rated the methodological quality. Meta-analyses were conducted using random-effect models to yield pooled risk ratios (RR). Meta-regression analyses tested differences between clinical and community-based studies and other sources of heterogeneity.RESULTS:Thirty-five studies, representing 14,158 individuals with MCI, were included in the meta-analysis. Depressive symptoms in MCI predicted dementia in 15 community-based studies (RR = 1.69, 95% CI 1.49-1.93, I2 = 0.0%), but not in 20 clinical studies (RR = 1.02, 95% CI 0.92-1.14, I2 = 73.0%). Further investigation of this effect showed that the mean age of community-based studies was significantly higher than of clinical studies but neither this nor other study characteristics explained variability in study outcomes.CONCLUSIONS:Depressive symptoms are associated with an increased risk of conversion from MCI to dementia in community-based studies. In contrast, evidence in clinical populations was insufficient with high heterogeneity.
BackgroundProvision of follow-up and care during treatment of people with suicidal intentions is a challenge for health professionals and experts in information and communications technology (ICT). Therefore, health professionals and ICT experts are making efforts to carry out these activities in collaboration by using mobile apps as a technological resource. ObjectiveThis study aimed to descriptively analyze mobile apps aimed at suicide prevention and to determine relevant factors in their design and development. In addition, it sought to analyze their impact on the support of treatment for patients at risk for suicide. MethodsWe considered 20 apps previously listed in the article “Mobile Apps for Suicide Prevention: Review of Virtual Stores and Literature” (de la Torre et al, JMIR mHealth uHealth 2017;5[10]:e130). To find the apps in this list, the most popular app stores (Android and iOS) were searched using the keyword “suicide prevention.” The research focused on publicly available app information: language, platform, and user ratings. The results obtained were statistically evaluated using 16 parameters that establish various factors that may affect the choice of the user, and the consequent support that the app can offer to a person at risk for suicide. ResultsOf the 20 mobile apps, 4 no longer appeared in the app stores and were therefore excluded. Analysis of the remaining 16 apps sampled showed the following: (1) a high percentage of the apps analyzed in the study (n=13, 82%) are provided in English language; (2) the sampled apps were last updated in 2017, when only 45% of them were updated, but the constant and progressive update of treatments should be reflected in the apps; and (3) the technical quality of these apps cannot be determined on the basis of the distribution of scores, because their popularity indices can be subjective (according to the users). User preference for a particular operating system would require further, more specific research, including study of the differences in the technical and usability aspects between both platforms and the design of medical apps. ConclusionsAlthough there are positive approaches to the use of apps for suicide prevention and follow-up, the technical and human aspects are yet to be explored and defined. For example, the design and development of apps that support suicide prevention should be strongly supported by health personnel to humanize these apps, so that the effectiveness of the treatments supported by them can be improved.
In this opportunity, we present the Development of a model to train mental health staff in the prevention of suicide. This paper describes a general model for carrying out the design, development, and conduct of training courses for health professionals using e-learning and a learning management (LMS) platform. The model presented is novel in the sense of including aspects related to the multidisciplinary nature of professionals who collaborate interactively with their knowledge and experience in the direction of adequately training medical personnel in techniques of identification and prevention of suicide. To this set of human resources described in the model, is added the ability to use effective and low-cost technologies such as the LMS platform, Moodle. The presentation of the model is enriched by the brief inclusion of its real deployment with the medical staff of the Zamora Hospital, Spain.
The integration of new technologies in the Mental Health field helps to prevent the cognitive impairment of patients and improve their quality of life. The main objective of our paper is to analyze the usability of the Long Lasting Memories program applied to Mental Health professionals. The study sample consisted of 23 participants, Mental Health professionals, of which 52.2% are psychologists and 47.8% are qualified assistants. Participants were given a usability questionnaire that included different variables once the intervention was concluded with the program. The results obtained from the questionnaire applied to the 23 participants of the study were analyzed taking into account the evaluation of use ease of the program, satisfaction and sustainability. From the results collected through the program it can be concluded that, from the professional’s point of view in charge of the intervention, the usability degree is high.
In recent years, there has been a great development of software technology in the field of psychogeriatric research, helping to improve the quality of life of the elderly and preventing cognitive deterioration associated with aging, and thus decrease the possible dependence. The main objective of the present study is to evaluate the usability of the Long Lasting Memories program in elderly people with or without cognitive impairment in a region of Spain. For the study, users were classified into three groups: subjects with no cognitive impairment, with mild cognitive impairment and mild dementia, and they were given a usability questionnaire covering different variables. Of the 157 Spanish participants in the study, 84.1 percent answered the usability questionnaire, obtaining wide acceptance in all study groups regarding the usability of the Long Lasting Memories program. Current research begins to mark a new perspective that recognizes the need to establish a preventive strategy for degenerative diseases.
This study analyzes the views of four groups of healthcare professionals who may play a role in the management of suicidal behavior. The goal was to identify key factors for suicide prevention in different areas of the healthcare system. Qualitative research was conducted using focus groups made up of different healthcare professionals who participated in the identification, management, and prevention of suicidal behavior. Professionals included were primary care physicians, psychologists, psychiatrists, and emergency physicians. 'Suicide' was amongst the most relevant terms that came up in discussions most of the times it appeared associated with words such as 'risk', 'danger', or 'harm'. In the analysis by categories, the four groups of professionals agreed that interventions in at-risk behaviors are first in importance. Prevention was the second main concern with greater significance among psychiatrists. Primary care professionals call for more time to address patients at risk for suicide and easier access to and communication with the mental health network. Emergency care professionals have a lack of awareness of their role in the detection of risk for suicide in patients who seek attention at emergency care facilities for reasons of general somatic issues. Mental health care professionals are in high demand in cases of self-harm, but they would like to receive specific training in dealing with suicidal behavior.
Background This study provides an analysis on the use of emerging technologies for the prevention of suicide in 8 different European countries. Objective The objective of this study was to analyze the potentiality of using emerging technologies in the area of suicide prevention based on the opinion of different professionals involved in suicide prevention. Methods Opinions of 3 groups of stakeholders (ie, relevant professionals in suicide field) were gathered using a specifically designed questionnaire to explore dimensions underlying perceptions of facilitating factors and barriers in relation to the use of emerging technologies for suicide prevention. Results Goal 1 involved facilitating factors for the use of emerging technologies in suicide prevention. Northern European countries, except for Belgium, attach greater relevance to those that optimize implementation and benefits. On the other hand, Southern European countries attach greater importance to professionally oriented and user-centered facilitating factors. According to different stakeholders, the analysis of these facilitating factors suggest that professionals in the field of social work attach greater relevance to those that optimize implementation and benefits. However, professionals involved in the area of mental health, policy makers, and political decision makers give greater importance to professionally oriented and user-centered facilitating factors. Goal 2 was related to barriers to the usability of emerging technologies for suicide prevention. Both countries and stakeholders attach greater importance to barriers associated with resource constraints than to those centered on personal limitations. There are no differences between countries or between stakeholders. Nevertheless, there is a certain stakeholders-countries interaction that indicates that the opinions on resource constraints expressed by different stakeholders do not follow a uniform pattern in different countries, but they differ depending on the country. Conclusions Although all countries and stakeholders agree in identifying resource constraints as the main barrier to the use of emerging technologies, factors facilitating their use in suicide prevention differ among countries and among stakeholders.
Suicide is the second cause of death in young people. The use of technologies as tools facilitates the detection of individuals at risk of suicide thus allowing early intervention and efficacy. Suicide can be prevented in many cases. Technology can help people at risk of suicide and their families. It could prevent situations of risk of suicide with the technological evolution that is increasing. This work is a systematic review of research papers published in the last ten years on technology for suicide prevention. In September 2017, the consultation was carried out in the scientific databases PubMed, ScienceDirect, PsycINFO, The Cochrane Library and Google Scholar. A general search was conducted with the terms “prevention” AND “suicide” AND "technology. More specific searches included technologies such as "Web”, “mobile”, “social networks”, and others terms related to technologies. The number of articles found following the methodology proposed was 90, but only 30 are focused on the objective of this work. Most of them were Web technologies (51.61%), mobile solutions (22.58%), social networks (12.90%), machine learning (3.23%) and other technologies (9.68%). According to the results obtained, although there are technological solutions that help the prevention of suicide, much remains to be done in this field. Collaboration among technologists, psychiatrists, patients, and family members is key to advancing the development of new technology-based solutions that can help save lives.
Introduction. The elderly population is growing driven by the increase in life expectancy, which in turn entails an increase in the number of people with chronic diseases such as dementia. The vast majority of people suffering from this illness is assisted by informal caregivers, who play a key role in fulfilling the patients' needs, promoting the possibility for people with dementia to live in their home environment. The Internet as a support tool in psychoeducational programs can significantly improve accessibility of them, becoming a currently consolidated interactive resource for the training of patients with acute and chronic diseases, and their caregivers.Population and method. A literature search of the Pubmed, PsyINFO, Scopus, SciELO and Psicodoc databases was performed to systematically review those studies related to web-based interventions for informal caregivers of people with dementia or cognitive impairment.Results. On balance, the studies show a significant improvement after the psychoeducational intervention. Specifically, the improvement in caregivers' wellbeing can be observed in the measures for self-efficacy, anxiety and depression.Conclusions. Online interventions are a promising strategy for the care of people with dementia. It would be advisable to perform further randomized trials to assess the reasons for lack of adherence to intervention, as well as usability studies to test the different software programs used.
Background New technologies are an integral component of today’s society and can complement existing suicide prevention programs. Here, we analyzed the use of new technologies in the prevention of suicide in 8 different European countries. Objective The aim of this paper was to assess the opinions of professionals in incorporating such resources into the design of a suicide prevention program for the region of Zamora in Spain. This investigation, encompassed within the European project entitled European Regions Enforcing Actions against Suicide (EUREGENAS), includes 11 regions from 8 different countries and attempts to advance the field of suicide prevention in Europe. Methods Using a specifically designed questionnaire, we assessed the opinions of 3 different groups of stakeholders regarding the use, frequency of use, facilitators, content, and format of new technologies for the prevention of suicide. The stakeholders were comprised of policy and public management professionals, professionals working in the area of mental health, and professionals related to the social area and non-governmental organizations (NGOs). A total of 416 participants were recruited in 11 regions from 8 different European countries. Results The utility of the new technologies was valued positively in all 8 countries, despite these resources being seldom used in those countries. In all the countries, the factors that contributed most to facilitating the use of new technologies were accessibility and free of charge. Regarding the format of new technologies, the most widely preferred formats for use as a tool for the prevention of suicide were websites and email. The availability of information about signs of alarm and risk factors was the most relevant content for the prevention of suicide through the use of new technologies. The presence of a reference mental health professional (MHP) was also considered to be a key aspect. The countries differed in the evaluations given to the different formats suggesting that the cultural characteristics of the country should be taken into account. Conclusions New technologies are much appreciated resources; however they are not often underused in the field of suicide prevention. The results of this exploratory study show that new technologies are indeed useful resources and should be incorporated into suicide prevention programs.
Dementia has a multifactorial etiology, but the importance of individual health and lifestyle related risk factors is often uncertain or based on few studies. The goal of this paper is to identify the major modifiable risk factors for dementia as a first step in developing an effective preventive strategy and promoting healthy late life cognitive functioning.