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Using Mobile Health and the Impact on Health-Related Quality of Life: Perceptions of Older Adults with Cognitive Impairment
Blekinge Institute of Technology, Faculty of Engineering, Department of Health.ORCID iD: 0000-0002-5135-0452
Blekinge Institute of Technology, Faculty of Engineering, Department of Health.
Blekinge Institute of Technology, Faculty of Engineering, Department of Health.ORCID iD: 0000-0003-4312-2246
Blekinge Institute of Technology, Faculty of Engineering, Department of Health.ORCID iD: 0000-0001-9870-8477
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2020 (English)In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 17, no 8, article id 2650Article in journal (Refereed) Published
Abstract [en]

Digital health technologies such as mobile health (mHealth) are considered to have the potential to support the needs of older adults with cognitive impairment. However, the evidence for improving health with the use of mHealth applications is of limited quality. Few studies have reported on the consequences of technology use concerning the older adults' quality of life. The purpose of this study was to describe perceptions of mHealth and its impact on health-related quality of life (HRQoL) among older adults with cognitive impairment. The study was conducted using a qualitative design with a phenomenographic approach. A total of 18 older participants with cognitive impairment were interviewed. The interviews were analyzed in order to apply phenomenography in a home-care context. The results showed variations in the older adults' perceptions that were comprised within three categories of description; Require technology literacy, Maintain social interaction, and Facilitate independent living. In conclusion, the development and design of mHealth technologies need to be tailored based on older adults´ needs in order to be understood and perceived as useful in a home-care context. For mHealth to support HRQoL, healthcare should be provided in a way that encourages various forms of communication and interaction.

Place, publisher, year, edition, pages
MDPI, 2020. Vol. 17, no 8, article id 2650
Keywords [en]
aging, cognitive impairment, health technology use, health-related quality of life, phenomenography
National Category
Nursing
Identifiers
URN: urn:nbn:se:bth-19423DOI: 10.3390/ijerph17082650ISI: 000535744100035PubMedID: 32294911Scopus ID: 2-s2.0-85083407856OAI: oai:DiVA.org:bth-19423DiVA, id: diva2:1427880
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Open access

Available from: 2020-05-03 Created: 2020-05-03 Last updated: 2022-01-11Bibliographically approved
In thesis
1. Using Mobile Health Technology to Support Health-related Quality of Life: From the Perspective of Older Adults with Cognitive Impairment
Open this publication in new window or tab >>Using Mobile Health Technology to Support Health-related Quality of Life: From the Perspective of Older Adults with Cognitive Impairment
2022 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The prevalence of cognitive impairment and illness increases with age. For older adults, maintaining or improving health-related quality of life (HRQoL) in the early stages of cognitive impairment is important to prevent consequences related to the progression of the condition. This thesis aims to identify factors affecting HRQoL and describe how mHealth technology can support HRQoL in older adults with cognitive impairment.

Four studies were conducted using quantitative and qualitative approaches. A cross-sectional design was used to identify factors affecting older adults’ HRQoL (Study I) and investigate the relationship between mHealth technology use and self-rated quality of life (QoL) (Study III). A phenomenographical design was used to describe variations in older adults’ perceptions of mHealth technology and its impact on HRQoL (Study II). A prospective longitudinal design was used to examine older adults’ HRQoL changes over time (Study IV).

Participants were selected from two longitudinal population studies using a purposive sampling strategy to include those aged 55 years and above with mild cognitive impairment or mild dementia. Data were obtained from questionnaires and semi-structured interviews. Data from the quantitative studies were analysed using statistical analysis, including descriptive and comparative analysis and regression analysis, while data from the qualitative study were examined using phenomenographical analysis in consecutive steps.

The results showed that most older adults experienced good HRQoL with regard to both physical and mental health. The likelihood of having good-to-excellent QoL increased with age and was higher among males and those with higher education levels. Those diagnosed with dementia reported poorer HRQoL. Factors associated with low HRQoL included dependency in activities of daily living, receiving informal care and feelings of loneliness and pain. The use of mHealth technology was perceived as supportive in maintaining social interactions and facilitating independent living. The technology literacy levels among the study sample varied significantly. Those who reported having moderate-to-high technical skills and using the internet regularly via mHealth technology had higher odds of experiencing good-to-excellent QoL. No significant changes were observed in the older adults’ HRQoL over time in relation to the non-use and use of a customized mHealth application.

The indicators of HRQoL are clinically relevant for the secondary prevention of dementia to help maintain good HRQoL in older adults with incipient cognitive impairment. The technology-related differences reflect the risk of digital exclusion. To improve preconditions for being digitally involved in society, societal initiatives that aim to empower the technology literacy level of older adults are needed.

Place, publisher, year, edition, pages
Karlskrona: Blekinge Tekniska Högskola, 2022
Series
Blekinge Institute of Technology Doctoral Dissertation Series, ISSN 1653-2090 ; 2022:01
Keywords
Aging, Cognitive Impairment, Cohort Studies, Dementia, Gerontechnology, Health-related Quality of Life, Independent Living, Mental Health, Mobile Health, Phenomenography, Quality of Life, Telemedicine
National Category
Nursing
Research subject
Applied Health Technology
Identifiers
urn:nbn:se:bth-22553 (URN)978-91-7295-435-9 (ISBN)
Public defence
2022-02-25, J1630, Valhallavägen 1, 371 41 Karlskrona, 13:00 (Swedish)
Opponent
Supervisors
Available from: 2022-01-12 Created: 2022-01-11 Last updated: 2022-01-26Bibliographically approved

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Christiansen, LineLindberg, CatharinaSanmartin Berglund, JohanAnderberg, PeterSkär, Lisa

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