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Two-year use of care robot Zora in Dutch nursing homes: an evaluation study
- Authors:
- HUISMAN Chantal, KORT Helianthe S.M.
- Journal article citation:
- Healthcare, 7(1), 2019, p.31. Online only
- Publisher:
- Molecular Diversity Preservation International and Multidisciplinary Digital Publishing Institute
The use of the Zora robot was monitored and evaluated in 14 nursing care organizations (15 locations). The Zora robot, a Nao robot with software, is designed as a social robot and used for pleasure and entertainment or to stimulate the physical activities of clients in residential care. In the first year, the aim was to monitor and evaluate how the care robot is used in daily practice. In the second year, the focus was on evaluating whether the use of Zora by care professionals can be extended to more groups and other type of clients. Interviews, questionnaires and observations were used as instruments to reveal the progress in the use of the robot and to reveal the facilitators and barriers. Care professionals experienced several barriers in the use of the robot (e.g., start-up time and software failures). The opportunity they had to discuss their experience during project team meetings was seen as a facilitator in the project. Furthermore, they mentioned that the Zora robot had a positive influence on clients as it created added value for the care professionals in having fun at work. (Edited publisher abstract)
Effectiveness and cost-effectiveness of proactive and multidisciplinary integrated care for older people with complex problems in general practice: an individual participant data meta-analysis
- Authors:
- BLOM J.W., et al
- Journal article citation:
- Age and Ageing, 47(5), 2018, pp.705-714.
- Publisher:
- Oxford University Press
Purpose: To support older people with several healthcare needs in sustaining adequate functioning and independence, more proactive approaches are needed. This purpose of this study is to summarise the (cost-) effectiveness of proactive, multidisciplinary, integrated care programmes for older people in Dutch primary care. Methods design: Individual patient data (IPD) meta-analysis of eight clinically controlled trials. Setting: Primary care sector. Interventions: Combination of (i) identification of older people with complex problems by means of screening, followed by (ii) a multidisciplinary integrated care programme for those identified. Main: Outcome activities of daily living, i.e. a change on modified Katz-15 scale between baseline and 1-year follow-up. Secondary outcomes: Quality of life (visual analogue scale 0–10), psychological (mental well-being scale Short Form Health Survey (SF)-36) and social well-being (single item, SF-36), quality-adjusted life years (Euroqol-5dimensions-3level (EQ-5D-3L)), healthcare utilisation and cost-effectiveness. Analysis: Intention-to-treat analysis, two-stage IPD and subgroup analysis based on patient and intervention characteristics. Results: Included were 8,678 participants: median age of 80.5 (interquartile range 75.3; 85.7) years; 5,496 (63.3%) women. On the modified Katz-15 scale, the pooled difference in change between the intervention and control group was −0.01 (95% confidence interval −0.10 to 0.08). No significant differences were found in the other patient outcomes or subgroup analyses. Compared to usual care, the probability of the intervention group to be cost-effective was less than 5%. Conclusion: Compared to usual care at 1-year follow-up, strategies for identification of frail older people in primary care combined with a proactive integrated care intervention are probably not (cost-) effective. (Publisher abstract)
A multi-perspective evaluation of a service robot for seniors: the voice of different stakeholders
- Authors:
- BEDAF Sandra, et al
- Journal article citation:
- Disability and Rehabilitation: Assistive Technology, 13(6), 2018, pp.592-599.
- Publisher:
- Taylor and Francis
- Place of publication:
- London
Purpose: The potential of service robots for older people is given increasing attention as the ageing population in Western countries will continue to grow as well as the demand for home care. In order to capture the experience of living with a robot at home, a multi-perspective evaluation was conducted. Methods: Older adults (n = 10) were invited to execute an actual interaction scenario with the Care-O-bot® robot in a home-like environment and were questioned about their experiences. Additionally, interviews were conducted with the elderly participants, informal carers (n = 7) and professional caregivers (n = 11). Results: Seniors showed to be more keen to accept the robot than their caregivers and relatives. However, the robot in its current form was found to be too limited and participants wished the robot could perform more complex tasks. In order to be acceptable a future robot should execute these complex tasks based on the personal preferences of the user which would require the robot to be flexible and extremely smart, comparable to the care that is delivered by a human carer. Conclusions: Developing the functional features to perform activities is not the only challenge in robot development that deserves the attention of robot developers. The development of social behaviour and skills should be addressed as well. This is possible adopting a person-centred design approach, which relies on validation activities with actual users in realistic environments, similar to those described in this paper. (Edited publisher abstract)
Effects of a comprehensive educational group intervention in older women with cognitive complaints: a randomized controlled trial
- Authors:
- HOOGENHOUT Esther M., et al
- Journal article citation:
- Aging and Mental Health, 16(1-2), January 2012, pp.135-144.
- Publisher:
- Taylor and Francis
One of the most common complaints of normal aging refers to cognitive changes. Such perceived cognitive changes can be a source of worry and frustration. This study presents a new comprehensive educational group intervention that offers psycho-education about cognitive aging and the influence of contextual factors such as negative age stereotypes, beliefs, health, and lifestyle. The intervention discusses the use of commonly applicable compensatory strategies, and includes group discussion. A randomised controlled trial was carried with a sample of 50 community-dwelling older women aged 60-75 years who reported normal age-related cognitive complaints. As the main problem of these individuals were perceived cognitive deficits without actual cognitive decrements, metacognition served as the primary outcome measure. The findings showed that the participants reported significantly fewer negative emotional reactions toward cognitive functioning. The article concludes that this comprehensive educational group intervention reduces negative emotional reactions toward cognitive functioning, and can therefore potentially contribute the well-being of an important and large group of older adults.
Evaluation of the chronic disease self-management program (CDSMP) among chronically ill older people in the Netherlands
- Authors:
- ELZIN Henrike, et al
- Journal article citation:
- Social Science and Medicine, 64(9), May 2007, pp.1832-1841.
- Publisher:
- Elsevier
Many chronically ill older patients in the Netherlands have a combination of more than one chronic disease. There is therefore a need for self-management programs that address general management problems, rather than the problems related to a specific disease. The Chronic Disease Self-Management Program (CDSMP) seems to be very suitable for this purpose. In evaluations of the program that have been carried out in the United States and China, positive effects were found on self-management behaviour and health status. However, the program has not yet been evaluated in the Netherlands. Therefore, the aim of this study was to evaluate the short-term and longer-term effects of the program among chronically ill older people in the Netherlands. One hundred and thirty-nine people aged 59 or older, with a lung disease, a heart disease, diabetes, or arthritis were randomly assigned to an intervention group (CDSMP) or a control group (care-as-usual). Demographic data and data on self-efficacy, self-management behaviour and health status were collected at three measurement moments (baseline, after 6 weeks, and after 6 months). The patients who participated rated the program with a mean of 8.5 points (range 0–10), and only one dropped out. However, the study did not yield any evidence for the effectiveness of the CDSMP on self-efficacy, self-management behaviour or health status of older patients in the Netherlands. Because the patients who participated were very enthusiastic, which was also indicated by very high mean attendance (5.6 out of 6 sessions) and only one dropout, it seems too early to conclude that the program is not beneficial for these patients.
The impact of informal caregiving for older adults on the health of various types of caregivers: a systematic review
- Authors:
- BOM Judith, et al
- Journal article citation:
- Gerontologist, 59(5), 2019, p.e629–e642.
- Publisher:
- Oxford University Press
Objective: Informal care, the provision of unpaid care to dependent friends or family members, is often associated with physical and mental health effects. As some individuals are more likely to provide caregiving tasks than others, estimating the causal impact of caregiving is difficult. This systematic literature review provides an overview of all studies aimed at estimating the causal effect of informal caregiving on the health of various subgroups of caregivers. Methodology: A structured literature search, following PRISMA guidelines, was conducted in 4 databases. Three independent researchers assessed studies for eligibility based on predefined criteria. Results from the studies included in the review were summarized in a predefined extraction form and synthesized narratively. Results: The systematic search yielded a total of 1,331 articles of which 15 are included for synthesis. The studies under review show that there is evidence of a negative impact of caregiving on the mental and physical health of the informal caregiver. The presence and intensity of these health effects strongly differ per subgroup of caregivers. Especially female, and married caregivers, and those providing intensive care appear to incur negative health effects from caregiving. Conclusion: The findings emphasize the need for targeted interventions aimed at reducing the negative impact of caregiving among different subgroups. As the strength and presence of the caregiving effect differ between subgroups of caregivers, policymakers should specifically target those caregivers that experience the largest health effect of informal caregiving. (Edited publisher abstract)
Effects of Dementia Care Mapping on well‐being and quality of life of older people with intellectual disability: a quasi‐experimental study
- Authors:
- SCHAAP Feija D., et al
- Journal article citation:
- Journal of Applied Research in Intellectual Disabilities, 32(4), 2019, pp.849-860.
- Publisher:
- Wiley
Background: The ageing of people with intellectual disability, accompanied with consequences like dementia, challenges intellectual disability‐care staff and creates a need for supporting methods, with Dementia Care Mapping (DCM) as a promising possibility. This study examined the effect of DCM on the quality of life of older people with intellectual disability. Methods: This study performed a quasi‐experimental study in 23 group homes for older people with intellectual disability in the Netherlands, comparing DCM (n = 113) with care‐as‐usual (CAU; n = 111). Using three measures, this study assessed the staff‐reported quality of life of older people with intellectual disability. Results: DCM achieved no significantly better or worse quality of life than CAU. Effect sizes varied from 0.01 to −0.22. Adjustments for covariates and restriction of analyses to people with dementia yielded similar results. Conclusion: The finding that DCM does not increase quality of life of older people with intellectual disability contradicts previous findings and deserves further study. (Edited publisher abstract)
Formal and informal care for community‐dwelling frail elderly people over time: a comparison of integrated and usual care in the Netherlands
- Authors:
- JANSE Benjamin, et al
- Journal article citation:
- Health and Social Care in the Community, 26(2), 2018, pp.e280-e290.
- Publisher:
- Wiley
While integration has become a central tenet of community‐based care for frail elderly people, little is known about its impact on formal and informal care and their dynamics over time. The aim of this study was therefore to examine how an integrated care intervention for community‐dwelling frail elderly people affects the amount and type of formal and informal care over 12 months as compared to usual care. A quasi‐experimental design with a control group was used. Data regarding formal and informal care were collected from frail elderly patients (n = 207) and informal caregivers (n = 74) with pre/post‐questionnaires. Within‐ and between‐group comparisons and multiple linear regression analyses were performed. The results showed marginal changes over time in the amount of formal and informal care in both integrated care and usual care. However, different associations between changes in formal and informal care were found in integrated and usual care. Most notably, informal caregivers provided more instrumental assistance over time if formal caregivers provided less personal care (and vice versa) in integrated care but not in usual care. These results suggest that integrated care does not necessarily change the contribution of formal or informal care, but changes the interaction between formal (personal care) and informal (instrumental) activities. Implications and recommendations for research and practice are discussed. Trial registration: Current Controlled Trials ISRNT05748494. (Publisher abstract)
Dementia case management through the eyes of informal carers: a national evaluation study
- Authors:
- FRANCKE Anneke L., et al
- Journal article citation:
- Dementia: the International Journal of Social Research and Practice, 16(5), 2017, pp.642-655.
- Publisher:
- Sage
This paper focuses on the evaluation of dementia case management in the Netherlands, as well as factors associated with positive evaluations of informal caregivers. A survey was completed by 554 informal carers. The majority of the informal carers were older (69% was 55+), and female (73%), and often concerned the partner or adult children of the person with dementia. Eighty percent indicated that the contact with the case manager facilitated their role as informal carer, while 95% or more stated that the case manager showed sufficient understanding, allowed enough space to decide together on how to approach problems in the care, took time to listen to their story, gave sufficient attention to and showed interest in their relative, took their schedule into account and/or kept appointments. Contrary to the expectations, multilevel analyses did not show association between informal caregivers’ care burden and the evaluation of case management. Neither were the period living with dementia and the number of personal contacts with the case manager associated with the evaluations of informal caregivers. However, being the partner of the patient was significantly related (p < 0.05) to a positive overall evaluation by informal carers. These results suggest that sufficient case management resources should be offered and targeted especially towards partners of people with dementia. (Publisher abstract)
Dealing with distrust and power dynamics: asymmetric relations among stakeholders in responsive evaluation
- Authors:
- BAUR Vivianne E., et al
- Journal article citation:
- Evaluation, 16(3), July 2010, pp.233-248.
- Publisher:
- Sage
Asymmetric relations among stakeholders create challenges in participatory evaluation processes. The aim of responsive evaluation is to include the issues of as many stakeholder groups as possible in the evaluation by engaging them in evaluative interaction. However, power and conflict may hinder equal and genuine communication about the value of the practices evaluated. This article discusses the use of a specific interpretation of responsive evaluation as an approach to foster dialogues among stakeholders in politically laden contexts. It aims to illustrate how asymmetric relations can be dealt with constructively, focusing on inclusion of marginalised groups, mutual learning and good dialogue. The article uses two reflective case narratives, conducted in a residential elderly care setting and in a psychiatric hospital, as examples of responsive evaluation projects in settings with marginalised groups. These case studies illustrate the changing, active roles of responsive evaluators. Both evaluation settings shed light on how to go about making social relations among stakeholders and the evaluator ‘the point’ in evaluation, and how to exploit these relations constructively in order to establish practice improvements.