Table 2 Included studies Author, year,... | Emerald Publishing

Table 2

Included studies

Author, year, country	Study type	Technology	Target audience	Aim	Transition towards appropriate care	Main findings
(Aloulou et al., 2013), Singapore	Intervention study that uses an ambient assistive living solution in a nursing home	Ambient assistive living technology (ALL): a set of ubiquitous technologies – e.g. sensors, actuators, interaction devices – embedded in the living space of the patient to monitor and react to his contextual needs by providing computerized assistive services	Residents with moderate dementia & professional caregivers	To present the approach we adopted to develop and deploy a system for ambient assistive living in a nursing home and evaluate its performance and usability in real conditions	AAL technologies are used in diverse health care applications and are expected to increase efficacy and efficiency of health care providers. They target to improve the organization of health care provider, improve therapy and rehabilitation and enhance prevention and care. The authors are interested in supporting health care in nursing homes by helping residents to perform their activities of daily living and by providing support to caregivers	Technology should provide adapted assistance with different activities based on each resident’s habits and profile whilst guaranteeing privacy of patients and professional caregivers and manage multiple people in controlled areas. It should also be reconfigurable, customizable and adaptable by professional caregivers to meet unique and changing needs of residents. The tested technological system was able to detect abnormal behavior, and the systems performance was evaluated
(Anker-Hansen et al., 2022), Norway	Qualitative study using in-depth interviews with informal caregivers	Assistive technology (AT): any item, piece of equipment, product or system that is used to increase, maintain or improve the functional capabilities and independence of people with cognitive, physical or communication difficulties	Informal caregivers of nursing homes residents	To explore informal caregivers’ experiences and perspectives concerning AT in two nursing homes, through the conceptual lens of person-centeredness	The challenge for the health authorities is to develop health services that can handle the increasing need for health services, to increase the quality of care, to facilitate active ageing, and to ensure a good and dignified life for the person with dementia in collaboration with their informal caregivers. Among the strategies proposed in government guidelines for health care services to solve these challenges are increased efficiency and greater use of technology. Informal caregivers can facilitate the introduction of AT for people with dementia as they can contribute valuable insights regarding the wishes, hopes and preferences when people with dementia are unable to articulate these themselves. This is crucial for the successful implementation and use of AT to improve the quality of care.	The themes ‘slow-going transition from old to new technology’, and ‘AT promoting and degrading dignity’ showed how the informal caregivers experienced that AT both promoted and degraded the dignity of their family members. Informal caregivers were positive to the use of technology but have sparse knowledge and information about ATs in the nursing homes. They express a desire for AT to increase activity and safety, which promotes dignity, quality of life, and quality of the care for their family member. The informal caregivers want their family member to be seen, heard, and to get assistance on their own terms, even with regard to technology
(Barisch-Fritz et al., 2023), Germany	An online survey of nursing home employees	No formal definition provided	Nursing home employees (managers, nursing operations, therapy)	To (a) examine affinity for technology and technology interaction and related sociodemographic confounders, as well as detect possible requirements and boundary conditions for development and implementation of assistive technologies among nursing home employees	Digitalization and technological development are regarded as a potential solution to the growing problems of an aging society, that is, the increased need for care for older individuals in light of a shortage of care providers. The technical readiness of nursing home employees is now seen as a key factor in the successful adoption of assistive technologies	A rather high affinity for technology and technology interaction values overall was observed, particularly for nursing home employees compared to managers. Significant predictors for technology affinity and interaction may have important implications, for example the perspectives of nursing home employees and managers should be considered separately in the technological design, development, and implementation process. Furthermore, an open dialogue between all stakeholders should be encouraged to increase the probability of actual technology use
(Curtis and Brooks, 2020), UK	Appreciative inquiry methodology using interviews followed by co-creation workshops	Digital Health Technology (DHT): algorithms for analyzing health data and “intelligent” systems that can be programmed to respond to aspects of an individual’s daily life	Nursing home employees (managers and nurses), and residents and relatives	To identify the factors that enable nurses to implement DHT in nursing homes and to co-design a nurse-led stepped process supporting the effective implementation of DHT innovations in nursing homes	Digital innovation in health care, such as telehealth and telemedicine, is transforming the way services are delivered – a trend that is expected to continue at an exponential rate. The increasing number of older people in the UK means that finding efficient and cost-effective methods for addressing their health care needs is a priority for health care providers. High-quality nursing home care is increasingly required to meet older people’s multiple and complex health care needs. DHT can support management processes (communication and risk identification), potentially improving health outcomes	Three broad themes emerged: improving communication; engaging with DHT and retaining humanised care; and introducing DHT and protecting data security. Supportive leadership and a whole-team approach involving all stakeholders were required to launch and sustain DHT innovations. Ensuring data security, prioritizing care, and avoiding replacing human interaction with technology were important factors when considering DHT implementation. Participating nurses co-created a three-step process for the effective implementation of DHT innovations in nursing homes, which has the potential to release staff time, improve quality of care, and have positive effects on staff recruitment and retention
(Dorsten et al., 2009), US	A qualitative study using focus groups	Assistive technology (AT); Cognitive Orthotics, Environmental, and Advanced Integrated Sensors	Residents, informal caregivers and nursing home employees (nurses and nursing assistants, rehabilitation specialists, administrators, chief financial officers, and facility maintenance staff)	This study addresses some of the gaps in our understanding of the ethical implications of technology implementation and its user acceptance in LTC facilities since assistive technologies are emerging at a rapid rate and will be increasingly used to compensate for tremendous staffing shortages in these facilities	The graying of America poses a formidable socioeconomic challenge to the provision of acute and long-term care. In light of sobering demographic shifts and socioeconomic forecasts, there is an interest in the early detection and management of AD, as well as technological innovations that may promote “aging-in place.” This shift from institutional and clinic-based care to remote mobile health monitoring is predicted to be the next major wave in the reform of health care delivery systems, and honors the oft-stated preference of the elderly to remain independent for as long as possible, even in the face of increasing disability	Common themes identified across all focus groups centered on concerns for privacy, autonomy, cost and safety associated with implementation of novel technologies. The relative importance of each theme varied by stakeholder group as well as the perceived severity of cognitive and/or physical disability. The findings suggest that ethical issues are critical to acceptance of novel technologies by their end users, and that stakeholder groups are interdependent and require shared communication about the acceptance of these emerging technologies
(Holmes et al., 2007), US	Quasi-experimental design in dementia special care units	The Vigil monitoring system is comprised of a bed exit sensor positioned under each resident’s bed sheet, and bathroom and bedroom exit monitors and alerts caregivers via a silent pager when a high-risk resident exits his or her bed, bedroom, or bathroom according to norms that are established for each resident	Dementia residents in a special care unit in a nursing home and facility nursing staff	The Vigil system aims to reduce falls, accidents, and injuries among residents, enhancing their quality of life. By minimizing disruptive noise and light from routine rounds, it also improves residents’ sleep quality and reduces behavioral issues. Additionally, Vigil lessens the frequency of nighttime checks needed by nurses and aides, thereby reducing staff workload and time spent on direct care	Many facilities are understaffed; nursing shortages have become endemic, and public reimbursement for institutional care has been reduced. Technological innovation during the next several years can reduce costs and improve staff efficiency	Results showed that there was no significant reduction in falls and injuries, but there was a significant improvement in affective disorder in the intervention group as contrasted with the comparison group. There was no significant increase in staff-perceived burden, despite the significant increase in the amount of direct care time logged. Additional time spent in staff care was significantly related to decreased affective disorder. The findings related to Vigil are generally mixed. The question remains as to whether the improvement in affect was due to Vigil or vigilance

Author, year, country	Study type	Technology	Target audience	Aim	Transition towards appropriate care	Main findings
(Aloulou et al., 2013), Singapore	Intervention study that uses an ambient assistive living solution in a nursing home	Ambient assistive living technology (ALL): a set of ubiquitous technologies – e.g. sensors, actuators, interaction devices – embedded in the living space of the patient to monitor and react to his contextual needs by providing computerized assistive services	Residents with moderate dementia & professional caregivers	To present the approach we adopted to develop and deploy a system for ambient assistive living in a nursing home and evaluate its performance and usability in real conditions	AAL technologies are used in diverse health care applications and are expected to increase efficacy and efficiency of health care providers. They target to improve the organization of health care provider, improve therapy and rehabilitation and enhance prevention and care. The authors are interested in supporting health care in nursing homes by helping residents to perform their activities of daily living and by providing support to caregivers	Technology should provide adapted assistance with different activities based on each resident’s habits and profile whilst guaranteeing privacy of patients and professional caregivers and manage multiple people in controlled areas. It should also be reconfigurable, customizable and adaptable by professional caregivers to meet unique and changing needs of residents. The tested technological system was able to detect abnormal behavior, and the systems performance was evaluated
(Anker-Hansen et al., 2022), Norway	Qualitative study using in-depth interviews with informal caregivers	Assistive technology (AT): any item, piece of equipment, product or system that is used to increase, maintain or improve the functional capabilities and independence of people with cognitive, physical or communication difficulties	Informal caregivers of nursing homes residents	To explore informal caregivers’ experiences and perspectives concerning AT in two nursing homes, through the conceptual lens of person-centeredness	The challenge for the health authorities is to develop health services that can handle the increasing need for health services, to increase the quality of care, to facilitate active ageing, and to ensure a good and dignified life for the person with dementia in collaboration with their informal caregivers. Among the strategies proposed in government guidelines for health care services to solve these challenges are increased efficiency and greater use of technology. Informal caregivers can facilitate the introduction of AT for people with dementia as they can contribute valuable insights regarding the wishes, hopes and preferences when people with dementia are unable to articulate these themselves. This is crucial for the successful implementation and use of AT to improve the quality of care.	The themes ‘slow-going transition from old to new technology’, and ‘AT promoting and degrading dignity’ showed how the informal caregivers experienced that AT both promoted and degraded the dignity of their family members. Informal caregivers were positive to the use of technology but have sparse knowledge and information about ATs in the nursing homes. They express a desire for AT to increase activity and safety, which promotes dignity, quality of life, and quality of the care for their family member. The informal caregivers want their family member to be seen, heard, and to get assistance on their own terms, even with regard to technology
(Barisch-Fritz et al., 2023), Germany	An online survey of nursing home employees	No formal definition provided	Nursing home employees (managers, nursing operations, therapy)	To (a) examine affinity for technology and technology interaction and related sociodemographic confounders, as well as detect possible requirements and boundary conditions for development and implementation of assistive technologies among nursing home employees	Digitalization and technological development are regarded as a potential solution to the growing problems of an aging society, that is, the increased need for care for older individuals in light of a shortage of care providers. The technical readiness of nursing home employees is now seen as a key factor in the successful adoption of assistive technologies	A rather high affinity for technology and technology interaction values overall was observed, particularly for nursing home employees compared to managers. Significant predictors for technology affinity and interaction may have important implications, for example the perspectives of nursing home employees and managers should be considered separately in the technological design, development, and implementation process. Furthermore, an open dialogue between all stakeholders should be encouraged to increase the probability of actual technology use
(Curtis and Brooks, 2020), UK	Appreciative inquiry methodology using interviews followed by co-creation workshops	Digital Health Technology (DHT): algorithms for analyzing health data and “intelligent” systems that can be programmed to respond to aspects of an individual’s daily life	Nursing home employees (managers and nurses), and residents and relatives	To identify the factors that enable nurses to implement DHT in nursing homes and to co-design a nurse-led stepped process supporting the effective implementation of DHT innovations in nursing homes	Digital innovation in health care, such as telehealth and telemedicine, is transforming the way services are delivered – a trend that is expected to continue at an exponential rate. The increasing number of older people in the UK means that finding efficient and cost-effective methods for addressing their health care needs is a priority for health care providers. High-quality nursing home care is increasingly required to meet older people’s multiple and complex health care needs. DHT can support management processes (communication and risk identification), potentially improving health outcomes	Three broad themes emerged: improving communication; engaging with DHT and retaining humanised care; and introducing DHT and protecting data security. Supportive leadership and a whole-team approach involving all stakeholders were required to launch and sustain DHT innovations. Ensuring data security, prioritizing care, and avoiding replacing human interaction with technology were important factors when considering DHT implementation. Participating nurses co-created a three-step process for the effective implementation of DHT innovations in nursing homes, which has the potential to release staff time, improve quality of care, and have positive effects on staff recruitment and retention
(Dorsten et al., 2009), US	A qualitative study using focus groups	Assistive technology (AT); Cognitive Orthotics, Environmental, and Advanced Integrated Sensors	Residents, informal caregivers and nursing home employees (nurses and nursing assistants, rehabilitation specialists, administrators, chief financial officers, and facility maintenance staff)	This study addresses some of the gaps in our understanding of the ethical implications of technology implementation and its user acceptance in LTC facilities since assistive technologies are emerging at a rapid rate and will be increasingly used to compensate for tremendous staffing shortages in these facilities	The graying of America poses a formidable socioeconomic challenge to the provision of acute and long-term care. In light of sobering demographic shifts and socioeconomic forecasts, there is an interest in the early detection and management of AD, as well as technological innovations that may promote “aging-in place.” This shift from institutional and clinic-based care to remote mobile health monitoring is predicted to be the next major wave in the reform of health care delivery systems, and honors the oft-stated preference of the elderly to remain independent for as long as possible, even in the face of increasing disability	Common themes identified across all focus groups centered on concerns for privacy, autonomy, cost and safety associated with implementation of novel technologies. The relative importance of each theme varied by stakeholder group as well as the perceived severity of cognitive and/or physical disability. The findings suggest that ethical issues are critical to acceptance of novel technologies by their end users, and that stakeholder groups are interdependent and require shared communication about the acceptance of these emerging technologies
(Holmes et al., 2007), US	Quasi-experimental design in dementia special care units	The Vigil monitoring system is comprised of a bed exit sensor positioned under each resident’s bed sheet, and bathroom and bedroom exit monitors and alerts caregivers via a silent pager when a high-risk resident exits his or her bed, bedroom, or bathroom according to norms that are established for each resident	Dementia residents in a special care unit in a nursing home and facility nursing staff	The Vigil system aims to reduce falls, accidents, and injuries among residents, enhancing their quality of life. By minimizing disruptive noise and light from routine rounds, it also improves residents’ sleep quality and reduces behavioral issues. Additionally, Vigil lessens the frequency of nighttime checks needed by nurses and aides, thereby reducing staff workload and time spent on direct care	Many facilities are understaffed; nursing shortages have become endemic, and public reimbursement for institutional care has been reduced. Technological innovation during the next several years can reduce costs and improve staff efficiency	Results showed that there was no significant reduction in falls and injuries, but there was a significant improvement in affective disorder in the intervention group as contrasted with the comparison group. There was no significant increase in staff-perceived burden, despite the significant increase in the amount of direct care time logged. Additional time spent in staff care was significantly related to decreased affective disorder. The findings related to Vigil are generally mixed. The question remains as to whether the improvement in affect was due to Vigil or vigilance

Source(s): Table by authors