Community-Dwelling Older Adults' Readiness for Adopting Digital Health Technologies: Cross-Sectional Survey Study.

BACKGROUND: Digital health technologies offer the potential to improve the daily lives of older adults, maintain their health efficiently, and allow aging in place. Despite increasing evidence of benefits and advantages, readiness for adopting digital interventions among older people remains underexplored. OBJECTIVE: This study aims to explore the relationships between sociodemographic-, health-, and lifestyle-related factors and technology use in everyday life and community-dwelling older adults' readiness to adopt telemedicine, smartphones with texting apps, wearables, and robotics. METHODS: This was a cross-sectional, population-based survey study with a stratified probabilistic sample of adults aged 75 years or older living in South Tyrol (autonomous province of Bolzano/Bozen, Italy). A random sample of 3600 community-dwelling older adults living at home was invited to complete a questionnaire including single items (older adults' readiness to use health technology) and scales (PRISMA-7; Program of Research on Integration of Services for the Maintenance of Autonomy). Descriptive and logistic regression analyses were performed to analyze the data. RESULTS: In total, 1695 community-dwelling older adults completed the survey (for a response rate of 47%). In terms of potential digital health technology adoption, wearable devices were favored by 33.7% (n=571), telemedicine by 30.1% (n=510), smartphones and texting apps by 24.5% (n=416), and assistant robots by 13.7% (n=232). Sociodemographic-, health- and lifestyle-related factors, as well as the use of technology in everyday life, played a significant role in explaining readiness to adopt digital health technologies. For telemedicine, age ≥85 years (odds ratio [OR] 0.74, 95% CI 0.56-0.96), financial constraints (OR 0.68, 95% CI 0.49-0.95), and less than 2 hours of physical activity per week (OR 0.75, 95% CI 0.58-0.98) were associated with nonreadiness, while Italian-speaking participants (OR 1.54, 95% CI 1.16-2.05) and those regularly using computers (OR 1.74, 95% CI 1.16-2.60), smartphones (OR 1.69, 95% CI 1.22-2.35), and the internet (OR 2.26, 95% CI 1.47-3.49) reported readiness for adoption. CONCLUSIONS: Community-dwelling older adults display varied readiness toward the adoption of digital health technologies, influenced by age, mother tongue, living situation, financial resources, physical activity, and current use of technology. The findings underscore the need for tailored interventions and educational programs to boost digital health technology adoption among community-dwelling older adults.

Administrative burden in Swiss nursing homes and its association with care workers' outcomes-a multicenter cross-sectional study.

BACKGROUND: Care workers in nursing homes often perform tasks that are rather related to organizational or management activities than 'direct patient care'. 'Indirect care activities', such as documentation or other administrative tasks are often considered by care workers as a burden, as they increase overall workload and keep them away from caring for residents. So far, there is little investigation into what kind of administrative tasks are being performed in nursing homes, by which type of care workers, and to which extent, nor how administrative burden is associated with care workers' outcomes. PURPOSE: The objective of this study was to describe care workers' administrative burden in Swiss nursing homes and to explore the association with four care worker outcomes (i.e., job dissatisfaction, emotional exhaustion, intention to leave the current job and the profession). METHODS: This multicenter cross-sectional study used survey data from the Swiss Nursing Homes Human Resources Project 2018. It included a convenience sample of 118 nursing homes and 2'207 care workers (i.e., registered nurses, licensed practical nurses) from Switzerland's German- and French-speaking regions. Care workers completed questionnaires assessing the administrative tasks and burden, staffing and resource adequacy, leadership ability, implicit rationing of nursing care and care worker characteristics and outcomes. For the analysis, we applied generalized linear mixed models, including individual-level nurse survey data and data on unit and facility characteristics. RESULTS: Overall, 73.9% (n = 1'561) of care workers felt strongly or rather strongly burdened, with one third (36.6%, n = 787) reporting to spend 2 h or more during a "normal" day performing administrative tasks. Ratings for administrative burden ranged from 42.6% (n = 884; ordering supplies and managing stocks) to 75.3% (n = 1'621; filling out the resident's health record). One out of four care workers (25.5%, n = 561) intended to leave the profession, whereby care workers reporting higher administrative task burden (OR = 1.24; 95%CI: 1.02-1.50) were more likely to intend to leave the profession. CONCLUSION: This study provides first insights on care workers' administrative burden in nursing homes. By limiting care workers' burdensome administrative tasks and/or shifting such tasks from higher to lower educated care workers or administrative personnel when appropriate, nursing home managers could reduce care workers' workload and improve their job satisfaction and retention in the profession.

Evaluating Measurement Properties of the Adapted Interprofessional Collaboration Scale through Rasch Analysis.

This study aimed to evaluate the validity and reliability of the German and Italian versions of the Interprofessional Collaboration Scale (IPC scale) by applying a Rasch analysis. Data were gathered from 1182 nurses participating in a cross-sectional study in northern Italy. The scale demonstrated good reliability (Cronbach's alpha = 0.92). Item polarity of all 13 items was positive, indicating good construct validity. However, revising one item would further improve the validity of the scale. Item stability was confirmed for work experience, workplace, age range, the language version, and gender. The analysis, applying a non-classical test theory, confirmed that the IPC scale is a valid and reliable instrument to measure interprofessional collaboration between nurses and physicians.

Application of an adapted relationship scale for assessing the occurrence of six different relationships as perceived by seven health care professions in Northern Italy.

Interprofessional working relationships can influence the quality of collaborative practices, with consequences for patient safety outcomes. This article reports findings of an adapted relationship scale comprising six different relationship types, ranging from hostile to collegial, between seven health-care professions: physicians, nurses, dieticians, occupational therapists, physiotherapists, speech therapists, and psychologists. Survey data were gathered within amixed-method study aiming to explore the current status quo of interprofessional collaboration in aHealth Trust, located in Northern Italy. An online questionnaire was completed by 2,238 health professionals achieving aresponse rate of 44%. The working relationship element was answered by 1,897 respondents. The results of the survey are used as abasis for recommending strategies for advancing interprofessional collaboration in the Trust. Descriptive statistics were used to examine relationship-types, with frequency of occurrence considered. The non-parametric Mann Whitney and Kruskal Wallis tests were used to explore relationship differences among groups defined by sociodemographic variables. Participants reported overall positive relationships with other health professions. We noted variability in the occurrence of different relationship-types amongst the health professions. In particular, the six professions viewed their relationships with doctors more negatively than physicians who reported amore positive perception of their relationships with the six professions.

Do Health Professionals Sufficiently Address Patients' Disposition Toward Changing Their Nutritional and Physical Activity Habits? Findings from a Pilot Study among People with Type 2 Diabetes in Northern Italy.

The aim of our study was to evaluate the disposition of individuals with type 2 diabetes mellitus (DM2) toward changing their nutritional and physical activity habits and associated factors-particularly their perceptions about interacting and communicating with four health professions. Working with a local patients' association, we invited 364 individuals with DM2, all at least 18 years old, to complete a paper-based survey with questions addressing their experiences of interacting and communicating with general practitioners, nurses, dieticians and diabetologists and about their readiness to change targeted habits, their health literacy and their clinical status. Of the 109 questionnaires collected, 100 were eligible for descriptive and inferential statistical analysis. Regarding nutritional habits, the highest percentage of participants were at the maintenance stage (26%), whereas regarding physical activity habits the highest percentage of participants were at the preparation stage (31%). Significant differences between the habits emerged for four of the five stages and for two psychological processes. The precontemplation stage was most associated with communication-related variables, whereas the maintenance stage was associated with higher health literacy for both habits, and waist-to-height ratio was associated with several stages of change and psychological processes for physical activity habits. Considering aggregated stages (i.e., active or passive stage), significant differences were observed for all psychological processes except readiness to change nutritional habits. Logistic regression analysis revealed associations of the active stage with higher self-efficacy and lower discrepancy processes for both habits. Nutritional habits were associated with normal HbA1c values and physical activity habits with high cholesterol. Understanding the combination of the stages of change and how they relate to psychological processes can afford meaningful insights into the potential internal and external communication skills of health professions and should be examined as possible elements for a patient evaluation model.

Living on the Own Island? Aligned Collaboration Between Family Physicians, Nurses, Dieticians, and Patients With Diabetes Type 2 in an Outpatient Care Setting in Northern Italy: Findings From a Qualitative Study.

INTRODUCTION: Diabetes mellitus type 2 (DM2), one of the four most important chronic diseases worldwide, is generally considered to be preventable. However, it is not yet sufficiently clear whether an aligned collaboration between different health professions could facilitate behavioral changes to be made by patients with DM2 regarding their eating and physical activity habits. OBJECTIVE: To explore if and how far in current outpatient care for 3 health-care professions it is an objective to collaborate with each other supporting patients with DM2 in changing their eating and physical activity habits. METHODS: We conducted 18 qualitative problem centered interviews with selected family physicians, nurses, dieticians working in outpatient setting and patients with DM2, transcribed verbatim, and analyzed with qualitative content analysis. RESULTS: Issues identified ranged from description and reflection of current health-care practice, strategies, and hindrances to cope with changes of eating and physical activity behaviors as well as for health-care practice regarding interprofessional collaboration and patient-centered care up to considerations about collaboration and patient centricity (for health professionals and patients to achieve goals) and changes and ideas of "ideal care practice". DISCUSSION: The included professional groups work predominantly for themselves. Collaboration currently only takes place when individually triggered and neither structured nor organized.

Interprofessional team-based learning in basic sciences: students' attitude and perception of communication and teamwork.

OBJECTIVES: To explore whether a team-based learning strategy applied to an interprofessional course on basic science changes students' perception of communication and teamwork skills and attitudes as related to interprofessional learning. METHODS: A mixed-methods approach was utilized. The participants were selected through an opportunity sample of 33 first-semester anatomy students from occupational therapy and orthoptics programs. Students completed an interprofessional questionnaire before and after the course. The data were analyzed descriptively. Fourteen students were selected randomly for group interviews. Qualitative data was interpreted using thematic analyses. RESULTS: The pre-test scores for 'communication and teamwork skills' and 'interprofessional learning' were high with mean values of 26.58 and 34.24, respectively. The post-test scores were 27.30 and 34.27, respectively, indicating no relevant changes in students' perception and attitudes. Qualitative data suggested that team-based learning represents a valid strategy to encourage communication and teamwork skills but revealed a lack of interprofessional exchange during the course. Students reported that classroom activities must require the professional knowledge of all participating groups in order to prevent a negative attitudinal shift towards interprofessional education in the later years of their studies. CONCLUSIONS: Implementing team-based learning in basic sciences can encourage communication and teamwork among students. Mixed classes can help socialize students of different professional groups, although they carry a risk of a negative attitudinal shift towards interprofessional education. Whether, and in what ways, effective interprofessional exchange during the teaching of basic sciences can be achieved needs further investigation.

Perceptions of collaborative relationships between seven different health care professions in Northern Italy.

This article presents quantitative findings from a mixed method study that aimed to explore the status quo of interprofessional collaboration (IPC) in a Health Trust, located in a trilingual region in Northern Italy. The survey targeted seven health professions (physicians, nurses, dieticians, occupational therapists, physiotherapists, speech therapists, and psychologists). The survey was distributed online to more than 5,000 health professionals and completed by 2,238. This paper presents results on the frequency of collaboration as well as data from a multiple-group measurement scale for assessing IPC. Descriptive statistics were calculated for continuous variables while categorical data were analysed as counts and percentages. Pearson's Chi-square test and Fisher's exact test were calculated while Mann Whitney and Kruskal Wallis tests were applied to analyse statistical differences in IPC between groups according to sociodemographic variables. In general, our survey data showed that participants, perceived IPC in a positive way, even if the analysis indicated heterogeneity in the level of collaboration expressed. We also found that not all professions had an opportunity to collaborate with others. In addition, we found evidence to suggest that the way health care is organised impacted on perceptions of collaboration between the health professionals in this study. This study provides an initial insight into the perceived levels of IPC within a North Italian context. As such, it offers an account of the strengths and weaknesses of IPC from seven different professional groups based in this region of Europe.

A multiple-group measurement scale for interprofessional collaboration: Adaptation and validation into Italian and German languages.

This article presents a study that aimed to validate a translation of a multiple-group measurement scale for interprofessional collaboration (IPC). We used survey data gathered over a three month period as part of a mixed methods study that explored the nature of IPC in Northern Italy. Following a translation from English into Italian and German the survey was distributed online to over 5,000 health professionals (dieticians, nurses, occupational therapists, physicians, physiotherapists, speech therapists and psychologists) based in one regional health trust. In total, 2,238 different health professions completed the survey. Based on the original scale, three principal components were extracted and confirmed as relevant factors for IPC (communication, accommodation and isolation). A confirmatory analysis (3-factor model) was applied to the data of physicians and nurses by language group. In conclusion, the validation of the German and Italian IPC scale has provided an instrument of acceptable reliability and validity for the assessment of IPC involving physicians and nurses.

Combining traditional anatomy lectures with e-learning activities: how do students perceive their learning experience?

OBJECTIVE: The purpose of this study was to investigate how students perceived their learning experience when combining traditional anatomy lectures with preparatory e-learning activities that consisted of fill-in-the-blank assignments, videos, and multiple-choice quizzes. METHODS: A qualitative study was conducted to explore changes in study behaviour and perception of learning. Three group interviews with students were conducted and thematically analysed. RESULTS: Data was categorized into four themes: 1. Approaching the course material, 2. Understanding the material, 3. Consolidating the material, and 4. Perceived learning outcome. Students appreciated the clear structure of the course, and reported that online activities encouraged them towards a first engagement with the material. They felt that they were more active during in-class sessions, described self-study before the end-of-term exam as easier, and believed that contents would remain in their memories for a longer time. CONCLUSIONS: By adjusting already existing resources, lectures can be combined fairly easily and cost-effectively with preparatory e-learning activities. The creation of online components promote well-structured courses, can help minimize 'student passivity' as a characteristic element of lectures, and can support students in distributing their studies throughout the term, thus suggesting enhanced learning. Further research work should be designed to confirm the afore-mentioned findings through objective measurements of student learning outcomes.

The state of interprofessional collaboration in Northern Italy: a mixed methods study.

Health care systems are facing continual reorganizations in response to scientific and technological innovations as well as financial constraints. Simultaneously the rising prevalence of chronic diseases call for a kind of health care organization in which interprofessional collaboration (IPC) functions on a high level. This article describes a research project that aims to generate an empirical account of the current state of IPC in the South Tyrolean Health Trust, located in a bilingual region in northern Italy. The study will employ a sequential mixed methods' design. A survey will be followed by individual and focus group interviews. An innovative aspect of the study is that it will include participants from six different health professions (dieticians, nurses, occupational therapists, physicians, physiotherapists, and speech therapists). Qualitative data analysis will draw on the negotiated order/structural ordering approach and on the social world/arena perspective. The results are expected to generate specific recommendations to improve IPC in the South Tyrolean Health Trust and inform further research.