Meeting own needs and supporting ability to care: Family caregivers' and health care professionals' perspectives on professional support provided through a potential mobile application.

BACKGROUND: A majority of persons with dementia in Sweden live in their own homes and are often cared for by family members. Caring for a family member may be a positive experience. It may, however, also be a negative experience as symptoms like disturbing behavior and delusions may be difficult to encounter. The burden of being a family caregiver has been shown to affect the caregivers' quality of life. OBJECTIVE: To explore stakeholders' perspectives on a potential mobile application through which family caregivers could be supported by healthcare professionals in caring for a person with dementia living at home. METHOD: Eight individual interviews with family caregivers and a focus group with eight healthcare professionals specialized in dementia care were analyzed using content analysis method. RESULTS: The findings suggest that a mobile application can support family caregivers to meet their own needs in terms of finding structure in everyday life, how to get information and support in their own pace, and how to care for themselves. The findings also suggest the necessity of accessing relevant contact networks to be supported in the ability to care for a family member with dementia. CONCLUSION: Healthcare and social services mediated support provided through user-friendly mobile application has the potential to support family caregivers both in taking care of a person with dementia and caring for themselves. Moreover, it is important that the information provided to family caregivers is personalized according to the needs of the family caregivers as the family member's dementia advances.

Facebook as a Novel Tool for Continuous Professional Education on Dementia: Pilot Randomized Controlled Trial.

BACKGROUND: Social network sites (SNSs) are widely exploited in health education and communication by the general public, including patients with various conditions. Nevertheless, there is an absence of evidence evaluating SNSs in connecting health professionals for professional purposes. OBJECTIVE: This pilot randomized controlled trial was designed to evaluate the feasibility of an intervention aiming to investigate the effects of a continuous professional education program utilizing Facebook to obtain knowledge on dementia and care for patients with dementia. METHODS: Eighty health professionals from Hong Kong were recruited for participation in the study and randomized at a 1:1 ratio by a block randomization method to the intervention group (n=40) and control group (n=40). The intervention was an 8-week educational program developed to deliver updated knowledge on dementia care from a multidisciplinary perspective, either by Facebook (intervention group) or by email (control group) from October 2018 to January 2019. The primary outcomes were the effects of the intervention, measured by differences in the means of changes in pre- and postintervention scores of knowledge assessments from the 25-item Dementia Knowledge Assessment Scale (DKAS) and formative evaluation of 20 multiple choice questions. Other outcome measurements included participant compliance, participant engagement in Facebook, satisfaction, and self-perceived uses of Facebook for continuing professional education programs. RESULTS: Significantly more intervention group participants (n=35) completed the study than the control group (n=25) (P<.001). The overall retention rate was 75% (60/80). The mean of changes in scores in the intervention group were significant in all assessments (P<.001). A significant difference in the mean of changes in scores between the two groups was identified in the DKAS subscale Communication and Behavior (95% CI 0.4-3.3, P=.02). There was no significant difference in the total DKAS scores, scores of other DKAS subscales, and multiple choice questions. Participant compliance was significantly higher in the intervention group than in the control group (P<.001). The mean numbers of participants accessing the learning materials were 31.5 (SD 3.9) and 17.6 (SD 5.2) in the intervention and control group, respectively. Polls attracted the highest level of participant engagement, followed by videos. Intervention group participants scored significantly higher in favoring the use of Facebook for the continuing education program (P=.03). Overall, participants were satisfied with the interventions (mean score 4 of a total of 5, SD 0.6). CONCLUSIONS: The significantly higher retention rate, together with the high levels of participant compliance and engagement, demonstrate that Facebook is a promising tool for professional education. Education delivered through Facebook was significantly more effective at improving participants' knowledge of how people with dementia communicate and behave. Participants demonstrated positive attitudes toward utilizing Facebook for professional learning. These findings provide evidence for the feasibility of using Facebook as an intervention delivery tool in a manner that can be rolled out into practical settings.

Relationships Between the Usage of Televisions, Computers, and Mobile Phones and the Quality of Sleep in a Chinese Population: Community-Based Cross-Sectional Study.

BACKGROUND: No study has comprehensively investigated the association between the usage of typical screen-based electronic media devices and sleep quality in a Chinese population with individuals in a wide range of ages. OBJECTIVE: This study aimed to understand the characteristics of television (TV) viewing, computer usage, and mobile phone usage in a representative Chinese population in Macau and to examine their roles in predicting the variations in sleep quality. METHODS: This cross-sectional study was an analysis of 1500 Macau residents aged 15 to 90 years based on a community-based health needs assessment study entitled, "Healthy Living, Longer Lives." Data collection was conducted in 7 districts of Macau from 2017 to 2018 through face-to-face interviews. The durations of daily TV viewing, computer usage, and mobile phone usage were recorded in a self-administered questionnaire. The Chinese version of the Pittsburgh Sleep Quality Index (PSQI) was used to assess the sleep quality. RESULTS: The prevalence of TV, computer, and mobile phone usage was 78.4% (1176/1500), 51.6% (769/1490), and 85.5% (1276/1492), respectively. The average daily hours of usage were 1.75 (1.62), 1.53 (2.26), and 2.85 (2.47) hours, respectively. Females spent more time watching TV (P=.03) and using mobile phones (P=.02) and less time on the computer (P=.04) as compared to males. Older adults were more likely to watch TV while young people spent more time using the computer and mobile phones (P for all trends<.001). The mean PSQI global score was 4.79 (2.80) among the participants. Females exhibited significantly higher PSQI scores than males (5.04 vs 4.49, respectively; P<.001). No linear association was observed between the PSQI score and the amount of time spent on the 3 electronic devices (P=.58 for PSQI-TV, P=.05 for PSQI-computer, and P=.52 for PSQI-mobile phone). Curve estimation showed significant quadratic curvilinear associations in PSQI-TV (P=.003) and PSQI-computer (P<.001) among all the participants and in PSQI-mobile phone among youths (age, 15-24 years; P=.04). After adjustment of the gender, age, body mass index, demographics, and lifestyle factors, more than 3 hours of TV viewing and 4 hours of computer usage or mobile phone usage was associated with 85% (95% CI 1.04-1.87; P=.008), 72% (95% CI 1.01-2.92; P=.045), and 53% (95% CI 1.06-2.22; P=.03) greater odds of having poor sleep quality (PSQI score>5), respectively. CONCLUSIONS: The mobile phone was the most popular screen-based electronic device used in the Macau population, especially among young people. "J" shape associations were observed between sleep quality and the duration of TV viewing, computer usage, and mobile phone usage, indicating that the extreme use of screen-based electronic devices predicted poorer sleep status, whereas moderate use would be acceptable.

A Mobile App for Identifying Individuals With Undiagnosed Diabetes and Prediabetes and for Promoting Behavior Change: 2-Year Prospective Study.

BACKGROUND: To decrease the burden of diabetes in society, early screening of undiagnosed diabetes and prediabetes is needed. Integrating a diabetes risk score into a mobile app would provide a useful platform to enable people to self-assess their risk of diabetes with ease. OBJECTIVE: The objectives of this study were to (1) assess the profile of Diabetes Risk Score mobile app users, (2) determine the optimal cutoff value of the Finnish Diabetes Risk Score to identify undiagnosed diabetes and prediabetes in the Chinese population, (3) estimate users' chance of developing diabetes within 2 years of using the app, and (4) investigate high-risk app users' lifestyle behavior changes after ascertaining their risk level from the app. METHODS: We conducted this 2-phase study among adults via mobile app and online survey from August 2014 to December 2016. Phase 1 adopted a cross-sectional design, with a descriptive analysis of the app users' profile. We used a Cohen kappa score to show the agreement between the risk level (as shown in the app) and glycated hemoglobin test results. We used sensitivity, specificity, and area under the curve to determine the optimal cutoff value of the diabetes risk score in this population. Phase 2 was a prospective cohort study. We used a logistic regression model to estimate the chance of developing diabetes after using the app. Paired t tests compared high-risk app users' lifestyle changes. RESULTS: A total of 13,289 people used the app in phase 1a. After data cleaning, we considered 4549 of these as valid data. Most users were male, and 1811 (39.81%) had tertiary education or above. Among them, 188 (10.4%) users agreed to attend the health assessment in phase 1b. We recommend the optimal value of the diabetes risk score for identifying persons with undiagnosed diabetes and prediabetes to be 9, with an area under the receiver operating characteristic curve of 0.67 (95% CI 0.60-0.74), sensitivity of 0.70 (95% CI 0.58-0.80), and specificity of 0.57 (95% CI 0.47-0.66). At the 2-year follow-up, people in the high-risk group had a higher chance of developing diabetes (odds ratio 4.59, P=.048) than the low-risk group. The high-risk app users improved their daily intake of vegetables (baseline: mean 0.76, SD 0.43; follow-up: mean 0.93, SD 0.26; t81=-3.77, P<.001) and daily exercise (baseline: mean 0.40, SD 0.49; follow-up: mean 0.54, SD 0.50; t81=-2.08, P=.04). CONCLUSIONS: The Diabetes Risk Score app has been shown to be a feasible and reliable tool to identify persons with undiagnosed diabetes and prediabetes and to predict diabetes incidence in 2 years. The app can also encourage high-risk people to modify dietary habits and reduce sedentary lifestyle.

Use of Social Network Sites for Communication Among Health Professionals: Systematic Review.

BACKGROUND: Although much research has been done investigating the roles of social network sites (SNSs) in linking patients and health professionals, there is a lack of information about their uses, benefits, and limitations in connecting health professions only for professional communication. OBJECTIVE: This review aimed to examine the utilization of SNSs for communication among health professionals in (1) frontline clinical practice, (2) professional networks, and (3) education and training to identify areas for future health communication research. METHODS: This review followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. A systematic search of the literature published in the last 10 years (January 1, 2007, to March 1, 2017) was performed in March 2017, using the following electronic databases: MEDLINE via OvidSP, EMBASE, CINAHL Complete, and InfoSci-Journals. The searches were conducted using the following defined search terms: "social media" OR "social network" OR "social network site" OR "Facebook" OR "Twitter" OR "Linkedin" OR "Instagram" OR "Weibo" OR "Whatsapp" OR "Telegram" OR "WeChat" AND "health" OR "health profession." RESULTS: Of the 6977 papers retrieved, a total of 33 studies were included in this review. They were exploratory in nature, and the majority used surveys (n=25) and interviews (n=6). All retrieved studies stated that SNSs enhanced effective communication and information sharing. SNSs were used for supporting delivering of clinical services, making referrals, and sharing information. They were beneficial to network building and professional collaboration. SNSs were novel tools to enhance educational interactions among peers, students, instructors, and preceptors. The application of SNSs came with restraints in technical knowledge, concerns on data protection, privacy and liability, issues in professionalism, and data protection. CONCLUSIONS: SNSs provide platforms facilitating efficient communication, interactions, and connections among health professionals in frontline clinical practice, professional networks, education, and training with limitations identified as technical knowledge, professionalism, and risks of data protection. The evolving use of SNSs necessitates robust research to explore the full potential and the relative effectiveness of SNSs in professional communication.

Prevalence and correlates of abuse screening items among community-dwelling Hong Kong Chinese older adults.

AIM: The present study aims to describe the prevalence of potential elder abuse, and to examine correlates of abuse screening items among Chinese community-dwelling older adults. METHODS: We analyzed the data of 3435 older persons aged ≥60 years who had first applied for the long-term care services in Hong Kong and completed the screening tool (Minimum Data Set-Home Care) in 2006. For each of the five abuse screening items ("fearful of a family member/caregiver," "unexplained injuries/broken bones/burns," "physically restrained," "unusually poor hygiene" and "neglected/abused/mistreated"), we examined its relationship with four types of factors: older person, perpetrator, relationship and environment. RESULTS: The rates of individual abuse screening items ranged from 3.9% for physically restrained to 0.03% for unexplained injures/broken bones/burns. Physically restrained was positively associated with activities of daily living impairments, instrumental activities of daily living impairments, perceived poor health, physically abusive behavior and caregiver mental health. Unusually poor hygiene was positively associated with socially inappropriate behavior and actively resisted care. "Fearful of a family member/caregiver" was positively associated with perceived poor health, conflicting relationship and mental health, and negatively with care activities. Neglected/abused/mistreated was positively associated with age and informal care, and negatively with care activities. CONCLUSIONS: We identified a number of associated factors of different abuse screening items among older adults. Our findings could inform healthcare practitioners in identifying those older persons who might be at higher risk of abuse, and provide a knowledge base on which to develop effective preventive measures in the Chinese population. Geriatr Gerontol Int 2017; 17: 150-160.