Kirby Pippa, Lai Helen, Horrocks Sophie, Harrison Matthew, Wilson Danielle, Daniels Sarah, Calvo Rafael A, Sharp David J, Alexander Caroline M
Department of Therapies, Imperial College Healthcare NHS Trust, London, United Kingdom.
UK Dementia Research Institute, Care Research and Technology Centre (UK DRI CR&T), London, United Kingdom.
JMIR Aging. 2024 Mar 4;7:e48292. doi: 10.2196/48292.
Technology-related research on people with dementia and their carers often aims to enable people to remain living at home for longer and prevent unnecessary hospital admissions. To develop person-centered, effective, and ethical research, patient and public involvement (PPI) is necessary, although it may be perceived as more difficult with this cohort. With recent and rapid expansions in health and care-related technology, this review explored how and with what impact collaborations between researchers and stakeholders such as people with dementia and their carers have taken place.
This review aims to describe approaches to PPI used to date in technology-related dementia research, along with the barriers and facilitators and impact of PPI in this area.
A scoping review of literature related to dementia, technology, and PPI was conducted using MEDLINE, PsycINFO, Embase, and CINAHL. Papers were screened for inclusion by 2 authors. Data were then extracted using a predesigned data extraction table by the same 2 authors. A third author supported the resolution of any conflicts at each stage. Barriers to and facilitators of undertaking PPI were then examined and themed.
The search yielded 1694 papers, with 31 (1.83%) being analyzed after screening. Most (21/31, 68%) did not make clear distinctions between activities undertaken as PPI and those undertaken by research participants, and as such, their involvement did not fit easily into the National Institute for Health and Care Research definition of PPI. Most of this mixed involvement focused on reviewing or evaluating technology prototypes. A range of approaches were described, most typically using focus groups or co-design workshops. In total, 29% (9/31) described involvement at multiple stages throughout the research cycle, sometimes with evidence of sharing decision-making power. Some (23/31, 74%) commented on barriers to or facilitators of effective PPI. The challenges identified often regarded issues of working with people with significant cognitive impairments and pressures on time and resources. Where reported, the impact of PPI was largely reported as positive, including the experiences for patient and public partners, the impact on research quality, and the learning experience it provided for researchers. Only 4 (13%) papers used formal methods for evaluating impact.
Researchers often involve people with dementia and other stakeholders in technology research. At present, involvement is often limited in scope despite aspirations for high levels of involvement and partnership working. Involving people with dementia, their carers, and other stakeholders can have a positive impact on research, patient and public partners, and researchers. Wider reporting of methods and facilitative strategies along with more formalized methods for recording and reporting on meaningful impact would be helpful so that all those involved-researchers, patients, and other stakeholders-can learn how we can best conduct research together.
针对痴呆症患者及其护理人员的技术相关研究,通常旨在使患者能够更长时间地居家生活,并防止不必要的住院治疗。为了开展以患者为中心、有效且符合伦理的研究,患者及公众参与(PPI)是必要的,尽管对于这一群体而言,可能会觉得实施起来更具难度。随着近期健康与护理相关技术的迅速发展,本综述探讨了研究人员与痴呆症患者及其护理人员等利益相关者之间的合作方式及所产生的影响。
本综述旨在描述迄今为止在与技术相关的痴呆症研究中所采用的PPI方法,以及PPI在该领域的障碍、促进因素和影响。
使用MEDLINE、PsycINFO、Embase和CINAHL对与痴呆症、技术和PPI相关的文献进行了范围综述。由两位作者筛选纳入的论文。然后由这两位作者使用预先设计的数据提取表提取数据。第三位作者协助解决每个阶段出现的任何冲突。随后对开展PPI的障碍和促进因素进行了审查并确定主题。
检索共获得1694篇论文,筛选后分析了31篇(1.83%)。大多数(21/31,68%)没有明确区分作为PPI开展的活动和研究参与者开展的活动,因此,他们的参与并不容易符合英国国家卫生与保健研究所对PPI的定义。这种混合参与大多集中在对技术原型进行审查或评估。描述了一系列方法,最常见的是使用焦点小组或联合设计研讨会。总共有29%(9/31)描述了在整个研究周期的多个阶段的参与情况,有时有共享决策权的证据。一些论文(23/31,74%)评论了有效PPI的障碍或促进因素。所确定的挑战通常涉及与认知能力严重受损者合作的问题以及时间和资源方面的压力。在有报告的情况下,PPI的影响大多被报告为积极的,包括对患者和公众合作伙伴的体验、对研究质量的影响以及为研究人员提供的学习经验。只有4篇(13%)论文使用了正式方法来评估影响。
研究人员经常让痴呆症患者和其他利益相关者参与技术研究。目前,尽管期望有高水平的参与和合作,但参与范围往往有限。让痴呆症患者及其护理人员和其他利益相关者参与,可能会对研究、患者和公众合作伙伴以及研究人员产生积极影响。更广泛地报告方法和促进策略,以及采用更正式的方法来记录和报告有意义的影响,将有所帮助,这样所有相关人员——研究人员、患者和其他利益相关者——都可以了解如何最好地共同开展研究。