Canada Research Chair in Shared Decision Making and Knowledge Translation, Laval University, Québec, QC, Canada.
Centre de recherche en santé durable (VITAM), Québec, QC, Canada.
JMIR Mhealth Uhealth. 2020 Jul 22;8(7):e16979. doi: 10.2196/16979.
Older adults desire to stay independent at home for as long as possible. We developed an interactive website to inform older adults and caregivers about ways to achieve this.
This study aimed to perform an in-depth exploration among potential end users about how to improve the interactive website to better inform older adults and caregivers about ways to stay independent at home.
To complement the results of a quantitative survey on the usability and acceptability of the website before implementation, we conducted a qualitative descriptive study. Using multiple recruitment strategies, we recruited a purposeful sample of older adults (aged ≥65 years) and caregivers of older adults struggling to stay independent at home. We conducted face-to-face or telephonic interviews in either English or French. In addition, we collected sociodemographic characteristics, other characteristics of participants (eg, health, digital profile, and perception of retirement homes), and experiences with using the website (factors facilitating the use of the website, barriers to its use, and suggestions for improvement). Interviews were audio recorded, transcribed verbatim, and thematically analyzed by two researchers.
We recruited 15 participants, including 5 older adults (mean age 75 years, SD 6) and 10 caregivers (mean age 57 years, SD 14). The mean interview time was 32 min (SD 14). Most older adults had either mobility or health problems or both, and many of them were receiving home care services (eg, blood pressure measurement and body care). Overall, participants found the website easy to navigate using a computer, reassuring, and useful for obtaining information. Barriers were related to navigation (eg, difficult to navigate with a cellphone), relevance (eg, no specific section for caregivers), realism (eg, some resources presented are not state funded), understandability (eg, the actors' accents were difficult to understand), and accessibility (eg, not adapted for low digital literacy). Suggestions for improvement included a needs assessment section to direct users to the support appropriate to their needs, addition of information about moving into residential care, a section for caregivers, distinction between state-provided and private support services, simpler language, expansion of content to be relevant to all of Canada, and video subtitles for the hearing impaired.
Users provided a wealth of information about the needs of older adults who were facing a loss of autonomy and about what such a website could usefully provide. The request for less generic and more personalized information reflects the wide range of needs that electronic health innovations, such as our interactive website, need to address. After integrating the changes suggested, the new website-Support for Older Adults to Stay Independent at Home (SUSTAIN)-will be implemented and made available to better assist older adults and caregivers in staying independent at home.
老年人希望尽可能长时间地独立在家。我们开发了一个互动网站,为老年人和护理人员提供有关实现这一目标的方法。
本研究旨在通过与潜在最终用户进行深入探讨,找到改进互动网站的方法,以便为老年人和护理人员提供更多关于独立在家的方法。
为了补充实施前对网站可用性和可接受性的定量调查结果,我们进行了一项定性描述性研究。通过多种招募策略,我们招募了一组有目的的老年人(年龄≥65 岁)和难以独立在家的老年人的护理人员。我们进行了面对面或电话访谈,语言为英语或法语。此外,我们还收集了参与者的社会人口统计学特征、其他特征(如健康状况、数字档案和对养老院的看法)以及使用网站的经验(使用网站的促进因素、使用网站的障碍以及改进建议)。访谈进行了录音,并由两名研究人员逐字转录和进行主题分析。
我们招募了 15 名参与者,包括 5 名老年人(平均年龄 75 岁,标准差 6 岁)和 10 名护理人员(平均年龄 57 岁,标准差 14 岁)。平均访谈时间为 32 分钟(标准差 14 分钟)。大多数老年人都有行动不便或健康问题,或者两者兼而有之,其中许多人正在接受家庭护理服务(如血压测量和身体护理)。总的来说,参与者发现该网站使用计算机进行导航很容易,令人安心,并且对获取信息很有用。障碍与导航有关(例如,使用手机导航困难)、相关性(例如,没有专门针对护理人员的部分)、现实性(例如,展示的一些资源不是由国家资助的)、可理解性(例如,演员的口音难以理解)和可访问性(例如,不适应低数字素养)。改进建议包括增加一个需求评估部分,将用户引导至适合其需求的支持;添加有关进入养老院的信息;为护理人员设立一个部分;区分国家提供的和私人提供的支持服务;使用更简单的语言;扩大内容以适用于加拿大的所有地区;为听力障碍人士提供视频字幕。
用户提供了大量有关面临自主能力丧失的老年人需求的信息,以及此类网站可以提供的有用信息。对更具体和个性化信息的需求反映了电子健康创新(例如我们的互动网站)需要满足的广泛需求。在整合了建议的更改之后,新网站——“帮助老年人独立在家”(SUSTAIN)将被实施并提供,以更好地帮助老年人和护理人员独立在家。