Expert’s View on Central Components of the Actional Model of Older People’s Coping with Health-Related Declines: A Pilot Study with Professional Caregivers

in Integrative Psychological and Behavioral Science (2023)

Abri & Boll (2022) proposed the “Actional Model of Older People´s Coping with Health-Related Declines” to explain the use of various action alternatives of older persons for dealing with diseases ... [more ▼]

Abri & Boll (2022) proposed the “Actional Model of Older People´s Coping with Health-Related Declines” to explain the use of various action alternatives of older persons for dealing with diseases, functional declines, activity limitations, and participation restrictions. It draws on a broad knowledge base: an action-theoretical model of intentional self-development, models of the use of assistive technologies (ATs) and medical services, qualitative studies on reasons for using or not-using ATs, and quantitative studies on older people’s health-related goals. The present study aims to gather evidence to further refine this model by additionally relying on expert knowledge from professional caregivers serving older people. Six experienced geriatric nurses working in mobile care services or residential care facilities were interviewed about key components of the above model in relation to 17 older people aged 70 to 95 with stroke, arthrosis, or mild dementia. The results revealed additional goals of reducing or preventing health-related discrepancies beyond those already included in the model (e.g., moving without pain, doing things alone, driving a car again, social return). Moreover, new motivating or demotivating goals for using certain action possibilities were found (e.g., to be at home, to be alone, to rest, to motivate other older people). Finally, some new factors were identified from the biological-functional (e.g., illness, fatigue), technological (e.g., pain inducing ATs, maladaptive devices), and social contexts (e.g., lack of staff time) that are likely to promote or hinder the use of certain action possibilities. Implications for refining the model and future research are discussed. [less ▲]

Subjective Reasons for Using versus not Using Assistive Technologies in Aging Population: A Meta-Synthesis of Qualitative Studies

Poster (2019, May 24)

The number of older people with limitations of activities of daily living in developing countries is predicted to increase by a factor of four between 2015 and 2050. One possibility to overcome such ... [more ▼]

The number of older people with limitations of activities of daily living in developing countries is predicted to increase by a factor of four between 2015 and 2050. One possibility to overcome such limitations is to promote the use of assistive technologies (ATs) in the aging population. Despite evident benefits of ATs in this context, the use rate is still low. To find out why this is the case, we performed systematic literature searches in PsycINFO, MEDLINE, and Google Scholar databases about subjective reasons of older people for use and non-use of these devices. We then performed a meta-synthesis of the relevant studies in order to arrive at a comprehensive view of older people’s reasons for the use or non-use of ATs. Beliefs about ease to use and reliability of AT use as well as perceived suggestion by significant others to use ATs were important reasons for using them. Beliefs about insecurity, uselessness and other attributes of ATs as well as desires to avoid burden for others were major reasons for not using of ATs. We systematized the identified subjective reasons for using versus not using as referring to (1) situation of need and demand for an AT, (2) suggestion by significant others, (3) act of using, and (4) consequences of AT use. Most of the reasons were reasons for non-use such as beliefs about negative attributes of ATs, and the consequences of their use. In contrast, desires were only rarely mentioned as reasons for use or non-use of ATs. Comparing subjective reasons of our meta-synthesis with predictors in ATs use models, we found that only 5 out of 25 identified subjective reasons have already been considered in these models. Thus, these models appear not yet to be sufficiently comprehensive. We suggest integrating the identified subjective reasons from our meta-synthesis as additional predictors in a comprehensive AT use model with an improved predictive power. [less ▲]

Comparative Evaluation of Models of Assistive Technologies’ Use

Scientific Conference (2018, July 06)

Many older people have functional limitations and are at risk of losing their ability to live autonomously. Assistive Technology (AT) could help to reduce that risk. However, many older people don’t use ... [more ▼]

Many older people have functional limitations and are at risk of losing their ability to live autonomously. Assistive Technology (AT) could help to reduce that risk. However, many older people don’t use ATs. Our presentation reviews existing models of ATs use, their applicability to specific types of AT, predictive value, fundamental elements, and critiques of such models. In systematic literature searches in PsycINFO, MEDLINE, and Google Scholar 46 papers were identified that met our inclusion criteria. 32 papers covered models of ATs use, applicability to special types of ATs, components of models, and their predictive value. 14 papers cover criticisms of models of AT use. We classified the models into two groups: The first included 11 models focusing on individuals’ mental states (e.g., beliefs, desires) as factors explaining ATs use; the second included 22 models that also considered contextual factors (e.g., social influence, physical environment) in addition to individuals’ mental states. Across both groups the most frequently included explanatory components were subjective norm and personal attitudes towards AT use, followed by perceived usefulness, perceived ease of use and then intention to use. Models were most frequently applied to information technologies followed by application to socially assistive robots. Unified Theory of Acceptance and Use of Technology 2 (UTAUT2) and an extended version of Technology Acceptance Model showed the highest amount of explained variance in intention to use (56-74%) and an extended model of UTAUT in actual use of ATs (64%). We conclude with recommendations for further improvement of AT use models. [less ▲]

Barriers and facilitators for the use of assistive technologies for activities of daily living

Scientific Conference (2018, April)

Many older people have functional impairments which increase their risk of losing the ability to live autonomously and to become dependent on care by others. However, assistive technologies (ATs) can help ... [more ▼]

Many older people have functional impairments which increase their risk of losing the ability to live autonomously and to become dependent on care by others. However, assistive technologies (ATs) can help to overcome some limitations of activities of daily living and can thus be assumed to prevent, delay or reduce the need for personal long-term care as well as the burden on caring family members (e.g., spouses, adult children). Yet, the use rate of ATs is still rather low. This paper reviews positive effects of ATs and factors that influence their use. We performed systematic literature searches in PsycINFO, MEDLINE, and Google scholar databases. We found convergent results that the use of ATs for several kinds of activities of daily living such as self-care and mobility was associated with a reduced amount of self-reported personal (in particular informal) care hours. Regarding factors of ATs use, we found that feeling loneliness, cognitive impairments, and difficulty of use were some of barriers for the use of ATs. There is converging evidence that indicators of situation of need (in particular: disabilities in preforming self-care activities) are associated with an increased use of ATs. Slight to moderate functional limitations, chronic illnesses, and home-based training were some of the facilitators for the use of ATs. We concluded with recommendations for further improvement of studies relevant to ATs use. [less ▲]

Self-care Assistive Technologies: A systematic review of studies on efficiency and factors influencing their use

Scientific Conference (2017, July 05)

A gradual decline in functional and mental capacity, as well as a growing risk of care dependency constitute major concerns of life in old age. These are expected to become more urgent in the future ... [more ▼]

A gradual decline in functional and mental capacity, as well as a growing risk of care dependency constitute major concerns of life in old age. These are expected to become more urgent in the future, because the old-age dependency ratio in the EU is projected to nearly double until 2060 due to demographic change. On the other side, there is a strong desire to maintain the autonomy of older people as long as possible. In reaction to this, there have been strong health and social policy recommendations across Europe to develop and promote the use of assistive technologies (ATs). Whereas systematic reviews already exist for several kinds of ATs, reviews about self-care ATs are still missing. Based on a systematic literature search in PsycINFO, MEDLINE, and Google Scholar databases 203 papers were identified of which 13 were included according to our selection criteria. The methodological quality of all the reviewed studies is evaluated. We reviewed findings on objective and subjective indicators of independent living as efficiency criteria as well as evidence about facilitating and inhibiting factors in the use of these technologies. Self-care ATs turned out to be efficient, with respect to care hours, independence level, and self-reported satisfaction. The actual use of these ATs was influenced by diverse personal, contextual, and device aspects. Lack of randomized control trial studies and the need for a further research about ATs in the diverse subdomains of self-care activities is revealed. Based on the findings of the current study, we generate recommendations for future research. [less ▲]