Bonnie Poksinska and Malin Wiger
Providing high-quality and cost-efficient care of older people is an important development priority for many health and social care systems in the world. This paper suggests a…
Abstract
Purpose
Providing high-quality and cost-efficient care of older people is an important development priority for many health and social care systems in the world. This paper suggests a shift from acute, episodic and reactive hospital-centered care toward longitudinal, person-centered and proactive home-centered care. The purpose of this paper is to contribute to the knowledge of a comprehensive development strategy for designing and providing home-centered care of older people.
Design/methodology/approach
The study design is based on qualitative research with an inductive approach. The authors study development initiatives at the national, regional and local levels of the Swedish health and social care system. The data collection methods included interviews (n = 54), meeting observations (n = 25) and document studies (n = 59).
Findings
The authors describe findings related to policy actions and system changes, attempts to achieve collaboration, integration and coordination, new forms of care offerings, characteristics of work settings at home and differences in patients' roles and participation at home and in the hospital.
Practical implications
The authors suggest home-centered care as a solution for providing person-centered and integrated care of older people and give examples of how this can be achieved.
Originality/value
The authors outline five propositions for research and development related to national policies, service modularity as a solution for customized and coordinated care, developing human resources and infrastructure for home settings, expanding services that enable older people living at home and patient co-creation.
Details
Keywords
Kiran Badesha, Sarah Wilde and David L. Dawson
A rapid increase in global smartphone ownership and digital health technologies offers the potential for mobile phone applications (apps) to deliver mental health interventions…
Abstract
Purpose
A rapid increase in global smartphone ownership and digital health technologies offers the potential for mobile phone applications (apps) to deliver mental health interventions. The purpose of this paper is to bring together evidence reporting on mental health mobile apps to gain an understanding of the quality of current evidence, the positive and adverse effects of apps and the mechanisms underlying such effects.
Design/methodology/approach
A systematic search was carried out across six databases, for any systematic reviews or meta-analyses conducted up to 2020. Review quality was assessed using the Assessment of Multiple Systematic Reviews.
Findings
Across a total of 24 articles, a variety of clinical outcomes were assessed. Most compelling support was shown for apps targeting anxiety symptoms; some evidence favoured the use of apps for depression symptoms. Less evidence was available for the remaining clinical symptoms such as bipolar disorder, schizophrenia, post-traumatic stress disorder, sleep disorders and substance use. Overall, there was limited evidence pertaining to adverse effects and change mechanisms and a lack of quality reporting across a large proportion of included reviews. The included reviews demonstrate the need for further robust research before apps are recommended clinically.
Originality/value
This paper makes a valuable contribution to the current status of research and reviews investigating mental health mobile apps. Recommendations are made for improved adherence to review guidelines and to ensure risk of bias is minimised.