Influence of Lifestyle Redesign® on health, social participation, leisure and mobility of older French-Canadians

Importance: Developed in California to enable community-dwelling older adults to maintain healthy and meaningful activities, Lifestyle Redesign® is a well-known cost-effective preventive occupational therapy intervention. The impact of a newly adapted French version on older French-Canadians was, however, unknown. Objective: To explore the influence of Lifestyle Redesign on older French-Canadians’ health, social participation, leisure, and mobility. Design: A mixed-methods design included a preexperimental component (questionnaires administered before and after the intervention and 3 and 6 mo postintervention) and an exploratory descriptive qualitative clinical study. Individual semidirected interviews were digitally audiotaped and transcribed, then underwent thematic content analysis using mix extraction grids. Setting: Community. Participants: Sixteen volunteers (10 women) aged 65–90 yr (mean = 76.4, standard deviation = 7.6), 10 without and 6 with disabilities. Inclusion criteria were age ≥65 yr, normal cognitive functions, residence in a conventional or senior home, and French speaking. Intervention: French-Canadian 6-mo version of Lifestyle Redesign. Outcomes and Measures: Health, social participation, leisure, and mobility were measured using the 36-item Short Form Health Survey, Social Participation Scale, Leisure Profile, and Life-Space Assessment, as well as a semistructured interview guide. Results: The French-Canadian Lifestyle Redesign had a beneficial effect on participants’ mental health (p = .02) and interest in leisure (p = .02) and, in those with disabilities, social participation (p = .03) and attitudes toward leisure (p = .04). Participants reported positive effects on their mental health, leisure, mobility, and social participation, including frequency and quality of social interactions, and indicated that having an occupational routine fostered better health. None of the participants reported no effect. Conclusion and Relevance: The translated and culturally adapted Lifestyle Redesign is a promising occupational therapy intervention for community-dwelling older French-Canadians

Conditions and ethical challenges that could influence the implementation of technologies in nursing homes: A qualitative study

Aim: To explore the conditions that may influence the implementation of an interactive mobile application (app) and an intelligent videomonitoring system (IVS) in nursing homes (NHs) and the ethical challenges of their use. Background: There is a lack of knowledge about implementing technologies in NHs and the ethical challenges that might arise. In past studies, nursing care teams expressed the need for technologies offering clinical support. Technologies like an IVS and an app could prove useful in NHs to prevent and manage falls and responsive behaviours. Design: An exploratory qualitative study was conducted with care managers, family caregivers, and formal caregivers in five NHs. Methods: Each participant was shown a presentation of a potential app and a short video on an IVS. It was followed by an individual semi-structured interview. A conventional content analysis was performed. Findings: Potential users found it would be possible to implement these technologies in NHs even if resistance could be expected. To facilitate adoption and achieve clinical benefits, the implementation of technologies should be pilot-tested, and coaching activities should be planned. Ethical risks were considered already present in NHs even without technologies, for example, risks to privacy. Strategies were proposed, for instance, to adapt the code of ethics and procedures. Some potential prejudices about the interest and abilities of older staff, nurses’ aides, and family caregivers to use technology were identified. Conclusions: Through rigorous and ethical implementation, technologies supporting clinical care processes could benefit older people living in NHs, as well as their relatives and the staff. Implications for practice: Various strategies are proposed to successfully implement technologies. Effort should be made to avoid prejudices during implementation, and procedures should be adapted to mitigate possible ethical challenges