JMIR Aging最新文献

{"title":"Internet-Based Supportive Interventions for Family Caregivers of People With Dementia: Randomized Controlled Trial.","authors":"Yanhong Xie, Shanshan Shen, Caixia Liu, Hong Hong, Huilan Guan, Jingmei Zhang, Wanqi Yu","doi":"10.2196/50847","DOIUrl":"10.2196/50847","url":null,"abstract":"<p><strong>Background: </strong>As dementia progresses, patients exhibit various psychological and behavioral symptoms, imposing a significant burden on families and society, including behavioral and psychological symptoms of dementia. However, caregivers lack professional care knowledge and skills, making it difficult for them to effectively cope with the diverse challenges of caregiving. Therefore, it is necessary to provide caregivers with professional knowledge and skills guidance.</p><p><strong>Objective: </strong>This study aimed to analyze the impact of internet-based training on behavioral and psychological symptoms of dementia in patients, and explore how this training model affects the caregiving abilities and caregiving burden of the family caregivers of patients with dementia.</p><p><strong>Methods: </strong>Using a consecutive enrollment method, the Department of Geriatrics at Zhejiang Hospital (Zhejiang, China) recruited 72 informal caregivers of patients with dementia. These caregivers were randomly divided into an intervention group and a control group, with 36 participants in each group. The intervention group underwent caregiver skill training via a web-based platform, whereas the control group initially received face-to-face follow-up guidance and was subsequently offered web-based training after 6 months. To assess the effectiveness of the intervention program, we used the Neuropsychiatric Inventory Questionnaire (NPI-Q), the Chinese version of the Zarit Burden Interview (CZBI), and the Sense of Competence in Dementia Care Staff Scale (SCIDS) for evaluations conducted before the intervention, 3 months after the intervention, and 6 months after the intervention.</p><p><strong>Results: </strong>Between July 2019 and December 2020, a total of 66 patients successfully completed the intervention and follow-up. After 6 months of intervention, the NPI-Q score of the intervention group was 3.18 (SD 3.81), the CZBI score was 10.97 (SD 5.43), and the SCIDS score was 71.88 (SD 4.78). The NPI-Q score of the control group was 8.09 (SD 8.52), the CZBI score was 30.30 (SD 13.05), and the SCIDS score was 50.12 (SD 9.10). There were statistically significant differences in NPI-Q (P=.004), CZBI (P<.001), and SCIDS scores (P<.001) between the intervention group and the control group. Repeated measures analysis of variance showed that compared with before the intervention, there were statistically significant differences in CZBI (P<.001) and SCIDS (P<.001) scores 3 months after the intervention, while the difference in NPI-Q (P=.11) scores was not significant. The total scores of NPI-Q (P<.001), CZBI (P<.001), and SCIDS (P<.001) were significantly improved 6 months after the intervention. In addition, the results of the covariance analysis showed that after excluding the time effect, the web-based training intervention significantly reduced the NPI-Q score (-2.79, 95% CI -4.38 to -1.19; P<.001) of patients with dementia and the CZBI score (-13.52","PeriodicalId":36245,"journal":{"name":"JMIR Aging","volume":"7 ","pages":"e50847"},"PeriodicalIF":5.0,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11469337/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142376139","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Medication Self-Management for Home Care Users Receiving Multidose Drug Dispensing: Qualitative Interview Study.","authors":"Anette Vik Josendal, Trine Strand Bergmo","doi":"10.2196/57651","DOIUrl":"10.2196/57651","url":null,"abstract":"<p><strong>Background: </strong>Multidose drug dispensing (MDD) is an adherence aid where medicines are machine-dispensed in disposable unit bags, usually for a 14-day period. MDD replaces manually filled dosettes in many home care services in Norway. While evidence suggests that MDD can improve medication adherence and reduce errors, there are few studies on how patients manage MDD at home and how this affects their daily routines.</p><p><strong>Objective: </strong>The aim of the study is to identify factors influencing medication self-management behavior among MDD users living at home and explore how MDD affects medication self-management.</p><p><strong>Methods: </strong>We conducted semistructured interviews with 19 MDD users in Oslo between August 2019 and February 2020. The interviews were held at the participants' homes, and the interview transcripts were analyzed thematically.</p><p><strong>Results: </strong>All participants in the study received some form of assistance with medication management from home care services. This assistance ranged from MDD delivery every other week to actual assistance with medication administration multiple times daily. However, regardless of the level of assistance received, participants primarily managed their MDD medications themselves. Daily medication routines and knowledge about medicines varied among the participants, with some taking an active role in their medication management, while others relied on others to take responsibility. The degree of involvement seemed determined by motivation rather than capability.</p><p><strong>Conclusions: </strong>MDD can support medication self-management, but its effectiveness varies among patients. The level of medication management by MDD users is not solely determined by their actual capabilities. Factors such as interest in self-care and independence, available support, information, and cognitive capacity all play a role in determining the degree of autonomy.</p>","PeriodicalId":36245,"journal":{"name":"JMIR Aging","volume":"7 ","pages":"e57651"},"PeriodicalIF":5.0,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11468972/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142376140","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development of a 12-Week Unsupervised Online Tai Chi Program for People With Hip and Knee Osteoarthritis: Mixed Methods Study.","authors":"Shiyi Julia Zhu, Kim L Bennell, Rana S Hinman, Jenny Harrison, Alexander J Kimp, Rachel K Nelligan","doi":"10.2196/55322","DOIUrl":"10.2196/55322","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Osteoarthritis is a leading contributor to global disability. While evidence supports the effectiveness of Tai Chi in improving symptoms for people with hip/knee osteoarthritis, access to in-person Tai Chi classes may be difficult for many people. An unsupervised online Tai Chi intervention for people with osteoarthritis can help overcome accessibility barriers. The Approach to Human-Centered, Evidence-Driven Adaptive Design (AHEAD) framework provides a practical guide for co-designing such an intervention.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study aims to develop an unsupervised online Tai Chi program for people with hip/knee osteoarthritis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;An iterative process was conducted using the AHEAD framework. Initially, a panel of Tai Chi instructors and people with osteoarthritis was assembled. A literature review was conducted to inform the content of a survey (survey 1), which was completed by the panel and additional Australian Tai Chi instructors to identify Tai Chi movements for potential inclusion. Selection of Tai Chi movements was based on 3 criteria: those that were appropriate (for people with hip/knee osteoarthritis aged 45+ years), safe (to be performed at home unsupervised), and practical (to be delivered online using prerecorded videos). Movements that met these criteria were then ranked in a second survey (survey 2; using conjoint analysis methodology). Survey findings were discussed in a focus group, and the Tai Chi movements for program use were identified. A draft of the online Tai Chi program was developed, and a final survey (survey 3) was conducted with the panel to rate the appropriateness and safety of the proposed program. The final program was developed, and usability testing (think-aloud protocol) was conducted with people with knee osteoarthritis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The panel consisted of 10 Tai Chi instructors and 3 people with osteoarthritis. The literature review identified Yang Style 24 as a common and effective Tai Chi style used in hip/knee osteoarthritis studies. Surveys 1 (n=35) and 2 (n=27) produced a ranked list of 24 Tai Chi movements for potential inclusion. This list was refined and informed by a focus group, with 10 Tai Chi movements being selected for inclusion (known as the Yang Style 10 form). Survey 3 (n=13) found that 92% (n=12) of the panel members believed that the proposed draft Tai Chi program was appropriate and safe, resulting in its adoption. The final program was produced and hosted on a customized website, \"My Joint Tai Chi,\" which was further refined based on user feedback (n=5). \"My Joint Tai Chi\" is currently being evaluated in a randomized controlled trial.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;This study demonstrates the use of the AHEAD framework to develop an unsupervised online Tai Chi intervention (\"My Joint Tai Chi\") for people with hip/knee osteoarthritis. This intervention is now being tested for effectivenes","PeriodicalId":36245,"journal":{"name":"JMIR Aging","volume":"7 ","pages":"e55322"},"PeriodicalIF":5.0,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11474117/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142355730","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Developing a Life Story Intervention for Older Adults With Dementia or at Risk of Delirium Who Were Hospitalized: Multistage, Stakeholder-Engaged Co-Design Study.","authors":"Sarah J Flessa, James D Harrison, Roniela Turnigan, Megan Rathfon, Michael Chandler, Jay Newton-Small, Stephanie E Rogers","doi":"10.2196/59306","DOIUrl":"10.2196/59306","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Older adults with chronic or acute cognitive impairment, such as dementia or delirium, who are hospitalized face unique barriers to person-centered care and a higher risk for negative outcomes stemming from hospitalizations. There is a need for co-designed interventions adapted for these patients to the hospital setting to improve care and outcomes. Patient life storytelling interventions have demonstrated promise in enhancing person-centered care by improving patient-care team relationships and providing information to enable care tailored to individual needs and values.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study aims to engage patients, care partners, and clinical stakeholders in a co-design process to adapt an existing life storytelling model for use with older adults with dementia and at risk of delirium in the acute care hospital setting.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We recruited patients with dementia or at risk of delirium who were hospitalized, their care partners, clinicians, and informaticists. A 3-stage co-design process that used a mixed methods data collection approach including in-depth interviews and surveys was completed. We used content analysis to analyze qualitative data and descriptive statistics to summarize quantitative data.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;In total, 27 stakeholder informants (ie, patients, care partners, and interdisciplinary care team [IDT] members) participated. Stakeholders were unanimously interested in using patient life stories as a tool for hospital care through electronic health record (EHR) integration. Stakeholders shared potential topics for life stories to cover, including social support, information on patients' key life events, and favorite activities. Participants provided insights into the logistics of integrating life stories into acute care, including interview arrangement, story-sharing methods, and barriers and facilitators. IDT members shared preferences on EHR integration, resulting in 3 co-designed mock-ups of EHR integration options. Stakeholders shared ways to optimize future acceptability and uptake, including engaging with the care team and promoting awareness of life stories, ensuring suitability to the acute environment (eg, distilling information in an easily digestible way), and addressing concerns for patient capacity and privacy (eg, engaging care partners when appropriate). Thoughts on potential impacts of life stories were also elicited, including improving patient- and care partner-IDT member relationships; humanizing patients; increasing clinical team, patient, and caregiver satisfaction; and enabling more specific, tailored care for patients with dementia and at risk of delirium.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;This study resulted in a co-designed life storytelling intervention for patients with dementia and at risk for delirium in an acute care hospital setting. Stakeholders provided valuable information to ensure future interve","PeriodicalId":36245,"journal":{"name":"JMIR Aging","volume":"7 ","pages":"e59306"},"PeriodicalIF":5.0,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11470218/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142355729","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Extracting Critical Information from Unstructured Clinicians' Notes Data to Identify Dementia Severity Using a Rule-Based Approach: Feasibility Study.","authors":"Ravi Prakash, Matthew E Dupre, Truls Østbye, Hanzhang Xu","doi":"10.2196/57926","DOIUrl":"10.2196/57926","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;The severity of Alzheimer disease and related dementias (ADRD) is rarely documented in structured data fields in electronic health records (EHRs). Although this information is important for clinical monitoring and decision-making, it is often undocumented or \"hidden\" in unstructured text fields and not readily available for clinicians to act upon.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;We aimed to assess the feasibility and potential bias in using keywords and rule-based matching for obtaining information about the severity of ADRD from EHR data.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We used EHR data from a large academic health care system that included patients with a primary discharge diagnosis of ADRD based on ICD-9 (International Classification of Diseases, Ninth Revision) and ICD-10 (International Statistical Classification of Diseases, Tenth Revision) codes between 2014 and 2019. We first assessed the presence of ADRD severity information and then the severity of ADRD in the EHR. Clinicians' notes were used to determine the severity of ADRD based on two criteria: (1) scores from the Mini Mental State Examination and Montreal Cognitive Assessment and (2) explicit terms for ADRD severity (eg, \"mild dementia\" and \"advanced Alzheimer disease\"). We compiled a list of common ADRD symptoms, cognitive test names, and disease severity terms, refining it iteratively based on previous literature and clinical expertise. Subsequently, we used rule-based matching in Python using standard open-source data analysis libraries to identify the context in which specific words or phrases were mentioned. We estimated the prevalence of documented ADRD severity and assessed the performance of our rule-based algorithm.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;We included 9115 eligible patients with over 65,000 notes from the providers. Overall, 22.93% (2090/9115) of patients were documented with mild ADRD, 20.87% (1902/9115) were documented with moderate or severe ADRD, and 56.20% (5123/9115) did not have any documentation of the severity of their ADRD. For the task of determining the presence of any ADRD severity information, our algorithm achieved an accuracy of &gt;95%, specificity of &gt;95%, sensitivity of &gt;90%, and an F&lt;sub&gt;1&lt;/sub&gt;-score of &gt;83%. For the specific task of identifying the actual severity of ADRD, the algorithm performed well with an accuracy of &gt;91%, specificity of &gt;80%, sensitivity of &gt;88%, and F&lt;sub&gt;1&lt;/sub&gt;-score of &gt;92%. Comparing patients with mild ADRD to those with more advanced ADRD, the latter group tended to contain older, more likely female, and Black patients, and having received their diagnoses in primary care or in-hospital settings. Relative to patients with undocumented ADRD severity, those with documented ADRD severity had a similar distribution in terms of sex, race, and rural or urban residence.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Our study demonstrates the feasibility of using a rule-based matching algorithm to identif","PeriodicalId":36245,"journal":{"name":"JMIR Aging","volume":"7 ","pages":"e57926"},"PeriodicalIF":5.0,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11462099/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142308692","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development of a Dementia Case Management Information System App: Mixed Methods Study.","authors":"Huei-Ling Huang, Yi-Ping Chao, Chun-Yu Kuo, Ya-Li Sung, Yea-Ing L Shyu, Wen-Chuin Hsu","doi":"10.2196/56549","DOIUrl":"10.2196/56549","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Case managers for persons with dementia not only coordinate patient care but also provide family caregivers with educational material and available support services. Taiwan uses a government-based information system for monitoring the provision of health care services. Unfortunately, scheduling patient care and providing information to family caregivers continues to be paper-based, which results in a duplication of patient assessments, complicates scheduling of follow-ups, and hinders communication with caregivers, which limits the ability of case managers to provide cohesive, quality care.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This multiphase study aimed to develop an electronic information system for dementia care case managers based on their perceived case management needs and what they would like included in an electronic health care app.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Case managers were recruited to participate (N=63) by purposive sampling from 28 facilities representing two types of community-based dementia care centers in Taiwan. A dementia case management information system (DCMIS) app was developed in four phases. Phase 1 assessed what should be included in the app by analyzing qualitative face-to-face or internet-based interviews with 33 case managers. Phase 2 formulated a framework for the app to support case managers based on key categories identified in phase 1. During phase 3, a multidisciplinary team of information technology engineers and dementia care experts developed the DCMIS app: hardware and software components were selected, including platforms for messaging, data management, and security. The app was designed to eventually interface with a family caregiver app. Phase 4 involved pilot-testing the DCMIS app with a second group of managers (n=30); feedback was provided via face-to-face interviews about their user experience.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Findings from interviews in phase 1 indicated the DCMIS framework should include unified databases for patient reminder follow-up scheduling, support services, a health education module, and shared recordkeeping to facilitate teamwork, networking, and communication. The DCMIS app was built on the LINE (LY Corporation) messaging platform, which is the mobile app most widely used in Taiwan. An open-source database management system allows secure entry and storage of user information and patient data. Case managers had easy access to educational materials on dementia and caregiving for persons living with dementia that could be provided to caregivers. Interviews with case managers following pilot testing indicated that the DCMIS app facilitated the completion of tasks and management responsibilities. Some case managers thought it would be helpful to have a DCMIS desktop computer system rather than a mobile app.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Based on pilot testing, the DCMIS app could reduce the growing challenges of high caseloads faced by ca","PeriodicalId":36245,"journal":{"name":"JMIR Aging","volume":"7 ","pages":"e56549"},"PeriodicalIF":5.0,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11459097/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142308691","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Internet Use and Higher-Level Functional Capacity Decline Suppression in Japanese Older Adults With Low Education: JAGES 2016-2019 Longitudinal Study.","authors":"Atsuko Tajika, Atsushi Nakagomi, Yasuhiro Miyaguni, Chie Koga, Katsunori Kondo, Toshiyuki Ojima","doi":"10.2196/53384","DOIUrl":"10.2196/53384","url":null,"abstract":"<p><strong>Background: </strong>Higher-level functional capacity (HLFC) is crucial for the independent living of older adults. While internet use positively impacts the health of older adults, its effect on HLFC and how this effect varies with educational attainment remains uncertain.</p><p><strong>Objective: </strong>This longitudinal study aimed to investigate whether internet use could mitigate the risk of HLFC decline and if this benefit extends to older adults with lower levels of education.</p><p><strong>Methods: </strong>The data were sourced from the Japan Gerontological Evaluation Study (JAGES), encompassing 8050 community-dwelling adults aged 65 years and older from 2016 to 2019. The study focused on those who remained self-sufficient from 2016 to 2019, identifying participants with independent HLFC in 2016. The Tokyo Metropolitan Institute of Gerontology Index of Competence defined HLFC operationally, consisting of 3 subscales, namely instrumental activities of daily living, intellectual activity, and social role. The primary variable was the frequency of internet use in 2016; participants who reported using the internet were classified as internet users, while those who answered \"No\" were identified as nonusers. The study compared the effects of internet use on HLFC decline across educational levels of ≤9 years, 10-12 years, and ≥13 years using Poisson regression analysis adjusted for robust SE to calculate the risk ratio (RR) and 95% CI for HLFC decline in 2019.</p><p><strong>Results: </strong>After adjusting for demographic and health condition risk factors, internet use was significantly linked to a decreased risk of HLFC decline in older adults over 3 years, including those with lower educational levels. Internet users with ≤9 years of educational attainment experienced a suppressed decline in the total score (RR 0.57, 95% CI 0.43-0.76; P<.001); instrumental activities of daily living (RR 0.58, 95% CI 0.38-0.91; P=.02), intellectual activity (RR 0.60, 95% CI 0.41-0.89; P=.01), and social role (RR 0.74, 95% CI 0.56-0.97; P=.03) compared with nonusers. Participants with 10-12 years of education showed suppression rates of 0.78 (95% CI 0.63-0.98; P=.03), 0.59 (95% CI 0.39-0.90; P=.01), 0.91 (95% CI 0.63-1.31; P=.61), and 0.82 (95% CI 0.68-1.00; P=.05), respectively, and those with ≥13 years displayed suppression rates of 0.65 (95% CI 0.51-0.85; P=.001), 0.55 (95% CI 0.36-0.83; P=.01), 0.64 (95% CI 0.37-1.10; P=.11), and 0.83 (95% CI 0.64-1.08; P=.17), respectively.</p><p><strong>Conclusions: </strong>These findings indicate that internet use supports the maintenance of HLFC independence in older adults with higher education and those with lower educational levels. Encouraging internet use among older adults with lower levels of education through future policies could help narrow functional health disparities associated with educational attainment.</p>","PeriodicalId":36245,"journal":{"name":"JMIR Aging","volume":"7 ","pages":"e53384"},"PeriodicalIF":5.0,"publicationDate":"2024-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11452757/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142297320","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Requirement Analysis of Different Variants of a Measurement and Training Station for Older Adults at Risk of Malnutrition and Reduced Mobility: Focus Group Study.","authors":"Lisa Happe, Marie Sgraja, Vincent Quinten, Mareike Förster, Rebecca Diekmann","doi":"10.2196/58714","DOIUrl":"10.2196/58714","url":null,"abstract":"<p><strong>Background: </strong>Demographic change is leading to an increasing proportion of older people in the German population and requires new approaches for prevention and rehabilitation to promote the independence and health of older people. Technical assistance systems can offer a promising solution for the early detection of nutritional and physical deficits and the initiation of appropriate interventions. Such a system should combine different components, such as devices for assessing physical and nutritional status, educational elements on these topics, and training and feedback options. The concept is that the whole system can be used independently by older adults (aged ≥70 years) for monitoring and early detection of problems in nutrition or physical function, as well as providing opportunities for intervention.</p><p><strong>Objective: </strong>This study aims to develop technical and digital elements for a measurement and training station (MuTs) with an associated app. Through focus group discussions, target group requirements, barriers, and favorable components for such a system were identified.</p><p><strong>Methods: </strong>Older adults (aged ≥70 years) were recruited from a community-based setting as well as from a geriatric rehabilitation center. Focus group interviews were conducted between August and November 2022. Following a semistructured interview guideline, attitudes, requirements, preferences, and barriers for the MuTs were discussed. Discussions were stimulated by videos, demonstrations of measuring devices, and participants' ratings of the content presented using rankings. After conducting 1 focus group in the rehabilitation center and 2 in the community, the interview guide was refined, making a more detailed discussion of identified elements and aspects possible. The interviews were recorded, transcribed verbatim, and analyzed using content analysis.</p><p><strong>Results: </strong>A total of 21 older adults (female participants: n=11, 52%; mean age 78.5, SD 4.6 years) participated in 5 focus group discussions. There was a strong interest in the independent measurement of health parameters, such as pulse and hand grip strength, especially among people with health problems who would welcome feedback on their health development. Participants emphasized the importance of personal guidance and interaction before using the device, as well as the need for feedback mechanisms and personalized training for everyday use. Balance and coordination were mentioned as preferred training areas in a MuTs. New training options that motivate and invite people to participate could increase willingness to use the MuTs.</p><p><strong>Conclusions: </strong>The target group is generally open and interested in tracking and optimizing diet and physical activity. A general willingness to use a MuTs independently was identified, as well as a compelling need for guidance and feedback on measurement and training to be part of the station.</p>","PeriodicalId":36245,"journal":{"name":"JMIR Aging","volume":"7 ","pages":"e58714"},"PeriodicalIF":5.0,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11445625/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142297334","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors Influencing Malnutrition Among Older Adult Residents in the Western Region of Saudi Arabia: Sex Differential Study.","authors":"Mai Adil Ghabashi, Firas Sultan Azzeh","doi":"10.2196/55572","DOIUrl":"10.2196/55572","url":null,"abstract":"<p><strong>Background: </strong>The global population of older adults is on the rise. As people age, their physical functions gradually decline, leading to a decrease in the overall functioning of different organ systems. Due to these changes, older individuals are at a higher risk of encountering various adverse health outcomes and complications, such as malnutrition.</p><p><strong>Objective: </strong>This study aims to investigate the prevalence of malnutrition and its associated factors among older adults dwelling in the western region of Saudi Arabia. We have analyzed these factors separately for both men and women to understand any potential sex differences.</p><p><strong>Methods: </strong>A nonrandomized cross-sectional study was conducted for older adults aged ≥60 years in the western region of Saudi Arabia. Personal information was obtained through a closed questionnaire. The Mini Nutritional Assessment Short Form was used to determine the malnutrition status of older adults. Consequently, the individuals were divided into 2 groups: normal and malnourished. To assess the risk factors related to malnutrition, the odds ratio (OR) and 95% CI were determined using a binary logistic regression.</p><p><strong>Results: </strong>The prevalence of malnutrition in men and women was around 7% and 5%, respectively. Potential risk factors related to malnutrition in men were higher age (OR 1.263, 95% CI 1.086-1.468; P=.002), being widowed (OR 8.392, 95% CI 1.002-70.258; P=.049), and having dental problems (OR 9.408, 95% CI 1.863-47.514; P=.007). On the other hand, risk factors associated with malnutrition in women were lower BMI (OR 0.843, 95% CI 0.747-0.952; P=.006) and being disabled (OR 18.089, 95% CI 0.747-0.952; P=.006).</p><p><strong>Conclusions: </strong>The findings of this study provide important insights into the risk factors for malnutrition among older adults in the western region of Saudi Arabia. While the overall prevalence of malnutrition was relatively low, the analysis revealed distinct risk factors for older men and women. Interventions developed based on the identified risk factors may prove effective in addressing the issue of malnutrition within this population.</p>","PeriodicalId":36245,"journal":{"name":"JMIR Aging","volume":"7 ","pages":"e55572"},"PeriodicalIF":5.0,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11443179/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142297318","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nursing Staff's Perspectives of Care Robots for Assisted Living Facilities: Systematic Literature Review.","authors":"Katie Trainum, Jiaying Liu, Elliott Hauser, Bo Xie","doi":"10.2196/58629","DOIUrl":"10.2196/58629","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Care robots have been proposed in response to nursing shortages in assisted living facilities (ALFs) and the growing population of older adults. While the use of care robots may improve the general health and well-being of older adults, their introduction changes the work of nursing staff fundamentally, and it has implications for the entire health care system. In developing such technology, it is important to include end users, but so far, the nursing staff's perspectives have largely been ignored.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study aims to examine the literature on nursing staff's attitudes, needs, and preferences related to the use of care robots in ALFs, in order to discover gaps in the literature and guide future research.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This review follows the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) 2020 protocol. On May 12, 2023, we searched PubMed, CINAHL Plus with Full Text, PsycINFO, the IEEE Xplore Digital Library, and the ACM Digital Library using predetermined search terms. Included publications, written in English, focused on the predevelopment phase, in which information was gathered on nursing staff's attitudes, needs, and preferences regarding care robots for ALFs. Publications were excluded if they did not provide peer-reviewed empirical data. The studies' findings were summarized, coded, and analyzed into major themes using thematic analysis and narrative synthesis. Their quality was assessed using McGill University's Mixed Methods Appraisal Tool and the Joanna Briggs Institute's critical appraisal tools.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The final sample included 15 studies. Most of the studies (n=11, 73%) were rated as good quality; however, there was a general lack of reporting on important methodological decisions and sample characteristics. Nursing staff desired care robots that could assist with physically demanding tasks and reduce their workload but had mixed feelings on whether robots could or should assist with social tasks. In addition, nursing staff are concerned about the ethics of care robots, as well as about their safety, accessibility, and operability. The nursing staff's culture, qualification, and role in the facility may influence their perspectives of care robots. The studies lacked theory-driven designs and large sample sizes. Eight (53%) studies mentioned using a participatory design approach, but a lack of established criteria for what constitutes participatory design leads to varying degrees of methodological quality.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;There was consensus among nursing staff that care robots should serve as nursing assistants to reduce workload. Whether robots could or should assist with social tasks remains a question. Further research is needed to mitigate nursing staff's concerns and understand the socioecological factors that influence their perspectives of care robots and their adoption in","PeriodicalId":36245,"journal":{"name":"JMIR Aging","volume":"7 ","pages":"e58629"},"PeriodicalIF":5.0,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11443223/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142297332","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}