Search

Background Ageing in place has recently gained visibility in healthcare policies and services. Technology has the potential to facilitate independence at home. The objective of this systematic review is to identify technologies that have been rigorously evaluated for supporting the ageing in place of healthy older adults. As well we explored the methods in engagement with technology in healthy older adults. Methods Databases Pubmed, Scopus, PsycInfo and Cinahl were consulted for clinical controlled trials or randomised controlled trials between 2014 and 2019. Studies were included if they contained a technological intervention and focussed on supporting healthy older adults’ independent living. PRISMA guidelines and the risk of bias tool of the Cochrane Collaboration were applied. Results The search identified 3662 articles of which only 7 made the final analysis. Through narrative analysis, technologies were categorised into three groups: accessible communication, emergency assistance and physical and mental well-being. Patient-centredness was extensively addressed by exploring how the participants engaged in the development and evaluation of the technology and how they were trained and monitored. Conclusions Literature concerning technology to support ageing, based on controlled trials and research performed in authentic home situations, is scarce. Thus, there is a need to investigate the subject in depth. The use of a neurofeedback headband, an accessible computer system, a wristband with pedometer, a biofeedback device and an online video platform can bring added value to ageing in place for healthy older adults. A patient-centred approach for developing, implementing and evaluating technology benefits ageing in place.

As drug delivery activity to outpatients in precarious situation is rising continuously, the goal of this work was to perform an assessment of the professional practices of the care pathway of these patients, called PASS in France (permanence d'acces aux soins de sante). At first, two pharmacists did an audit of this care pathway. Then, options for improvement were suggested and established after a multidisciplinary work with pharmacists, physicians and social workers of the relevant services. Finally, after six months, those actions and their impact were evaluated. Over a three-year period, the audit showed an increase by a factor of 1.77 of the average number of prescriptions provided per year. Over the same period, the number of dispensed lines was increased by 2.2 and the annual costs were multiplied per 1.82. The pharmacy department suggested several corrective actions: at first, initiating new schedules suited to the activity; then, making adjustments in the reception zone; but also, establishing two new specific prescriptions and 89 helps cards about the most frequently delivered medications. As a result, the time dedicated to drug delivery has been cut in half while the number of pharmaceutical actions remained constant. This assessment of the professional practices showed how hard it is to formalize a transversal circuit as the PASS in hospital. The actions established had improved the organization and the drug delivery activity in the pharmacy department.

The objective is to systematically review the psychometric properties and the clinical utility of patient-reported outcome measures (PROMs) and proxy-reported outcome measures that assess health-related quality of life (HRQoL) among patients receiving enteral feeding to make recommendations for use in clinical practice and research. The purpose of this systematic review is to evaluate the psychometric properties and the clinical utility of:The research question is: What are the psychometric properties and the clinical utility of these measures? We will summarize evidence on the following properties: validity (content validity, criterion-related validity, construct validity, floor and ceiling effects), reliability (reproducibility and internal consistency) and responsiveness and clinical utility (interpretability and feasibility to complete the PROM and the proxy-reported outcome measure).

Background The aim of this study was to investigate the feasibility and reliability of the Oral Health Assessment Tool (OHAT) as used by speech pathologists, to become part of a comprehensive clinical swallowing examination. Methods A multicentre study in 132 elderly subjects was conducted by speech pathologists. The inter-rater, test–retest and intra-rater reliabilities of the OHAT were assessed in R statistics, version 3.0.1. Intraclass correlation coefficients (ICCs) were used for the total OHAT, and Kappa statistics were used for the individual categories. Results Total OHAT scores showed good inter-rater (ICC = 0.96), intra-rater (ICC ≥ 0.95) and test–retest (ICC ≥ 0.78) agreement. The inter-rater Kappa statistics were almost perfect (κ ≥ 0.83) for seven of the eight individual categories of the OHAT and perfect for ‘dental pain’ (κ = 1.00). The test–retest Kappa statistics indicated excellent agreement for ‘natural teeth’ and ‘dentures’ (κ ≥ 0.86). The intra-rater per cent agreement was excellent for all categories except ‘gums and tissues’. Conclusions This is the first study to examine the feasibility and reliability of the OHAT as used by speech pathologists. As the results showed both good feasibility and reliability, the OHAT has the potential to add to the clinical swallowing examination. However, future research investigating actual referral strategies and adaptation of care strategies following assessment with OHAT is needed.

The Swallowing Quality-of-Life questionnaire (SWAL-QoL) is considered the gold standard for assessing health-related quality of life in people with dysphagia. However, many dysphagic patients struggle to complete this questionnaire because of additional functional sequelae such as language impairment and cognitive disorders. In this study, we sought to develop an adjusted Dutch version of the SWAL-QoL (aDSWALQoL) and to evaluate its psychometric properties and feasibility compared with the original questionnaire. We developed the aDSWAL-QoL based on recommendations from previous literature. The feasibility, internal consistency, testretest reliability, and criterion validity of the aDSWAL-QoL were evaluated in 78 dysphagic patients, among whom 43 had additional language and/or cognitive impairments (DysLC). Statistical analyses were performed using SPSS 20.0. The aDSWAL-QoL had a higher degree of feasibility for the DysLC group. We obtained high Cronbachs α coefficients for total scale and for almost all subscales. Total aDSWAL-QoL scores showed excellent testretest agreement and good criterion validity with respect to the DSWAL-QoL. Almost all subscales showed significantly moderate to good testretest agreement and criterion validity. However, the psychometric properties of the Food selection subscale were inadequate. The aDSWAL-QoL is a feasible, reliable, and valid tool for use with DysLC patients. Conversion of the aDSWAL-QoL into an audio computer-assisted self-administered format should be investigated. The construct validity of the aDSWAL-QoL will be evaluated in a separate report.

Background The Swallowing Quality-of-Life Questionnaire (SWAL-QoL) is considered the gold standard for assessing health-related QoL in oropharyngeal dysphagia. The Dutch translation (DSWAL-QoL) and its adjusted version (aDSWAL-QoL) have been validated using classical test theory (CTT). However, these scales have not been tested against the Rasch measurement model, which is required to establish the structural validity and objectivity of the total scale and subscale scores. Thus, the purpose of this study was to examine the psychometric properties of these scales using item analysis according to the Rasch model. Methods Item analysis with the Rasch model was performed using RUMM2030 software with previously collected data from a validation study of 108 patients. The assessment included evaluations of overall model fit, reliability, unidimensionality, threshold ordering, individual item and person fits, differential item functioning (DIF), local item dependency (LID) and targeting. Results The analysis could not establish the psychometric properties of either of the scales or their subscales because they did not fit the Rasch model, and multidimensionality, disordered thresholds, DIF, and/or LID were found. The reliability and power of fit were high for the total scales (PSI = 0.93) but low for most of the subscales (PSI