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Barbabella, FrancescoORCID iD iconorcid.org/0000-0002-1497-0011
Publications (10 of 61) Show all publications
Melchiorre, M. G., Papa, R., Rijken, M., van Ginneken, E., Hujala, A. & Barbabella, F. (2018). eHealth in integrated care programs for people with multimorbidity in Europe: Insights from the ICARE4EU project. Health Policy, 122(1), 53-63
Open this publication in new window or tab >>eHealth in integrated care programs for people with multimorbidity in Europe: Insights from the ICARE4EU project
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2018 (English)In: Health Policy, ISSN 0168-8510, E-ISSN 1872-6054, Vol. 122, no 1, p. 53-63Article in journal (Refereed) Published
Abstract [en]

Introduction: Care for people with multimorbidity requires an integrated approach in order to adequately meet their complex needs. In this respect eHealth could be of help. This paper aims to describe the implementation, as well as benefits and barriers of eHealth applications in integrated care programs targeting people with multimorbidity in European countries, including insights on older people 65+. Methods: Within the framework of the ICARE4EU project, in 2014, expert organizations in 24 European countries identified 101 integrated care programs based on selected inclusion criteria. Managers of these programs completed a related on-line questionnaire addressing various aspects including the use of eHealth. In this paper we analyze data from this questionnaire, in addition to qualitative information from six programs which were selected as 'high potential' for their innovative approach and studied in depth through site visits. Results: Out of 101 programs, 85 adopted eHealth applications, of which 42 focused explicitly on older people. In most cases Electronic Health Records (EHRs), registration databases with patients' data and tools for communication between care providers were implemented. Percentages were slightly higher for programs addressing older people. eHealth improves care integration and management processes. Inadequate funding mechanisms, interoperability and technical support represent major barriers. Conclusion: Findings seems to suggest that eHealth could support integrated care for (older) people with multimorbidity.

Place, publisher, year, edition, pages
Elsevier, 2018
Keywords
Multimorbidity, eHealth, Integrated care program, Older people, Europe
National Category
Nursing
Research subject
Health and Caring Sciences, Health Informatics
Identifiers
urn:nbn:se:lnu:diva-70939 (URN)10.1016/j.healthpol.2017.08.006 (DOI)000423642000007 ()28899575 (PubMedID)
Available from: 2018-02-15 Created: 2018-02-15 Last updated: 2018-02-15Bibliographically approved
Barbabella, F., Poli, A., Hanson, E., Andréasson, F., Salzmann, B., Doehner, H., . . . Lamura, G. (2018). Usage and Usability of a Web-based Program for Family Caregivers of Older People in Three European Countries: A Mixed-Methods Evaluation. Computers, Informatics, Nursing, 36(5), 232-241
Open this publication in new window or tab >>Usage and Usability of a Web-based Program for Family Caregivers of Older People in Three European Countries: A Mixed-Methods Evaluation
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2018 (English)In: Computers, Informatics, Nursing, ISSN 1538-2931, E-ISSN 1538-9774, Vol. 36, no 5, p. 232-241Article in journal (Refereed) Published
Abstract [en]

InformCare is a European Web platform that supports informal caregivers of older people by providing access to online information and professional and peer support. The aim of this study was to assess the usage and usability of a psychosocial Web-based program carried out in three European countries (Italy, Sweden, and Germany). A mixed-methods sequential explanatory design was adopted, comprising baseline and postintervention assessments, as well as combined thematic content analysis of results and focus group findings. A convenience sample of 118 caregivers was enrolled, of whom 94 used the services offered by the program at least once. The subsamples in the three countries used the platform in different ways, with a predominance of passive strategies (eg, seeking information and reading other people's comments) for Italian caregivers, and more active usage by Swedish and German caregivers. The usability assessment showed that the platform was perceived well by Italian and German caregivers, whereas technical problems affected the Swedish sample's experiences. Focus group data highlighted user satisfaction with the online support and reliability of the environment. Recommendations for practitioners are to ensure digital training for caregivers who have lower confidence in use of the Internet, to involve different healthcare professionals in the provision of professional support, and to adequately manage online community building.

Place, publisher, year, edition, pages
Lippincott Williams & Wilkins, 2018
Keywords
Caregivers, Frail elderly, Health education, Internet, Social support
National Category
Nursing
Research subject
Health and Caring Sciences, Health Informatics
Identifiers
urn:nbn:se:lnu:diva-76813 (URN)10.1097/CIN.0000000000000422 (DOI)000431738300005 ()29505433 (PubMedID)
Available from: 2018-07-11 Created: 2018-07-11 Last updated: 2018-07-11Bibliographically approved
Struckmann, V., Barbabella, F., Dimova, A. & van Ginneken, E. (2017). Integrated Diabetes Care Delivered by Patients - A Case Study from Bulgaria. International Journal of Integrated Care, 17, Article ID UNSP 6.
Open this publication in new window or tab >>Integrated Diabetes Care Delivered by Patients - A Case Study from Bulgaria
2017 (English)In: International Journal of Integrated Care, ISSN 1568-4156, E-ISSN 1568-4156, Vol. 17, article id UNSP 6Article in journal (Refereed) Published
Abstract [en]

Introduction: Increasing numbers of persons are living with multiple chronic diseases and unmet medical needs in Bulgaria. The Bulgarian 'Diabetic care' non-profit (DCNPO) programme aims to provide comprehensive integrated care focusing on people with diabetes and their co-morbidities. Methods: The DCNPO programme was selected as one of eight 'high potential' programmes in the Innovating Care for People with Multiple Chronic Conditions (ICARE4EU) project, covering 31 European countries. Data was first gathered with a questionnaire after which semi-structured interviews with project staff and participants were conducted during a site visit. Results: The programme trains diabetic patients to act as carers, case managers, self-management trainers and health system navigators for diabetic patients and their family. The programme improved care coordination and patient-centered care by offering free care delivered by a multidisciplinary team. It facilitates the collaboration between patients, volunteers, health providers and the community. Internal evaluations demonstrate reduced hospital admissions and avoidable amputations, with consequent cost savings for the health care system. Conclusion: Integrated care provided by volunteering patients can empower people suffering from diabetes and their co-morbidities and address health and social inequalities in resource-poor settings. It can also contribute to an increased trust and improved satisfaction among vulnerable patients with complex care needs.

Place, publisher, year, edition, pages
Ubiquity Press, 2017
Keywords
Integrated diabetes care, multiple chronic diseases, health and social care, volunteers, coordination of care, free care
National Category
Endocrinology and Diabetes Nursing
Research subject
Health and Caring Sciences
Identifiers
urn:nbn:se:lnu:diva-64433 (URN)10.5334/ijic.2475 (DOI)000400671100003 ()
Available from: 2017-05-29 Created: 2017-05-29 Last updated: 2018-01-31Bibliographically approved
Melchiorre, M. G., Di Rosa, M., Barbabella, F., Barbini, N., Lattanzio, F. & Chiatti, C. (2017). Validation of the Italian Version of the Caregiver Abuse Screen among Family Caregivers of Older People with Alzheimer's Disease. BioMed Research International, Article ID 3458372.
Open this publication in new window or tab >>Validation of the Italian Version of the Caregiver Abuse Screen among Family Caregivers of Older People with Alzheimer's Disease
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2017 (English)In: BioMed Research International, ISSN 2314-6133, E-ISSN 2314-6141, article id 3458372Article in journal (Refereed) Published
Abstract [en]

Introduction. Elder abuse is often a hidden phenomenon and, in many cases, screening practices are difficult to implement among older people with dementia. The Caregiver Abuse Screen (CASE) is a useful tool which is administered to family caregivers for detecting their potential abusive behavior. Objectives. To validate the Italian version of the CASE tool in the context of family caregiving of older people with Alzheimer's disease (AD) and to identify risk factors for elder abuse in Italy. Methods. The CASE test was administered to 438 caregivers, recruited in the Up-Tech study. Validity and reliability were evaluated using Spearman's correlation coefficients, principal-component analysis, and Cronbach's alphas. The association between the CASE and other variables potentially associated with elder abuse was also analyzed. Results. The factor analysis suggested the presence of a single factor, with a strong internal consistency (Cronbach's alpha = 0.86). CASE score was strongly correlated with well-known risk factors of abuse. At multivariate level, main factors associated with CASE total score were caregiver burden and AD-related behavioral disturbances. Conclusions. The Italian version of the CASE is a reliable and consistent screening tool for tackling the risk of being or becoming perpetrators of abuse by family caregivers of people with AD.

Place, publisher, year, edition, pages
HINDAWI LTD, 2017
National Category
Nursing
Research subject
Health and Caring Sciences
Identifiers
urn:nbn:se:lnu:diva-61684 (URN)10.1155/2017/3458372 (DOI)000394852100001 ()
Available from: 2017-03-24 Created: 2017-03-24 Last updated: 2018-05-31Bibliographically approved
Barbabella, F., Poli, A., Andréasson, F., Salzmann, B., Papa, R., Hanson, E., . . . Lamura, G. (2016). A web-based psychosocial intervention for family caregivers of older people: results from a mixed-methods study in three European countries. JMIR Research Protocols, 5(4), 1-16, Article ID e196.
Open this publication in new window or tab >>A web-based psychosocial intervention for family caregivers of older people: results from a mixed-methods study in three European countries
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2016 (English)In: JMIR Research Protocols, ISSN 1929-0748, E-ISSN 1929-0748, Vol. 5, no 4, p. 1-16, article id e196Article in journal (Refereed) Published
Abstract [en]

Background: Informal caregiving is the main source of care for older people in Europe. An enormous amount of responsibility and care activity is on the shoulders of family caregivers, who might experience problems in their psychological well-being and in reconciling caregiving and their personal sphere. In order to alleviate such burden, there is increasing interest and growing research in Europe on Web-based support addressing family caregivers and their needs. However, the level of development and penetration of innovative Web-based services for caregivers is still quite low and the access to traditional face-to-face services can be problematic for logistic, availability, and quality reasons.

Objective: As part of the European project INNOVAGE, a pilot study was conducted for developing and testing a Web-based psychosocial intervention aimed at empowering family caregivers of older people in Italy, Sweden, and Germany. The program offered information resources and interactive services to enable both professional and peer support.

Methods: A mixed-methods, sequential explanatory design was adopted. Caregivers’ psychological well-being, perceived negative and positive aspects of caregiving, and social support received were assessed before and after the 3-month intervention. Poststudy, a subsample of users participated in focus groups to assist in the interpretation of the quantitative results.

Results: A total of 94 out of 118 family caregivers (79.7%) from the three countries used the Web platform at least once. The information resources were used to different extents in each country, with Italian users having the lowest median number of visits (5, interquartile range [IQR] 2-8), whereas German users had the highest number (17, IQR 7-66) (P<.001). The interactive services most frequently accessed (more than 12 times) in all countries were the social network (29/73, 40%) and private messages (27/73, 37%). The pretest-posttest analysis revealed some changes, particularly the slight worsening of perceived positive values of caregiving (Carers of Older People in Europe [COPE] positive value subscale: P=.02) and social support received (COPE quality-of-support subscale: P=.02; Multidimensional Scale of Perceived Social Support subscale: P=.04), in all cases with small effect size (r range -.15 to -.18). Focus groups were conducted with 20 family caregivers and the content analysis of discussions identified five main themes: online social support, role awareness, caregiving activities, psychological well-being, and technical concerns. The analysis suggested the intervention was useful and appropriate, also stimulating a better self-efficacy and reappraisal of the caregivers’ role.

Conclusions: The intervention seemed to contribute to the improvement of family caregivers’ awareness, efficacy, and empowerment, which in turn may lead to a better self-recognition of their own needs and improved efforts for developing and accessing coping resources. A major implication of the study was the finalization and implementation of the InformCare Web platform in 27 European countries, now publicly accessible (www.eurocarers.org/informcare).

Place, publisher, year, edition, pages
JMIR Publications, 2016
Keywords
Caregivers, Frail elderly, Internet, Social support, Social networking, Health education
National Category
Health Sciences
Research subject
Health and Caring Sciences, Caring Science
Identifiers
urn:nbn:se:lnu:diva-61490 (URN)10.2196/resprot.5847 (DOI)000391042300034 ()27713113 (PubMedID)
Available from: 2017-03-21 Created: 2017-03-21 Last updated: 2018-04-17Bibliographically approved
Schmidt, A. E., Ilinca, S., Schulmann, K., Rodrigues, R., Principi, A., Barbabella, F., . . . Galenkamp, H. (2016). Fit for caring: factors associated with informal care provision by older caregivers with and without multimorbidity. European Journal of Ageing, 13(2), 103-113
Open this publication in new window or tab >>Fit for caring: factors associated with informal care provision by older caregivers with and without multimorbidity
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2016 (English)In: European Journal of Ageing, ISSN 1613-9372, E-ISSN 1613-9380, Vol. 13, no 2, p. 103-113Article in journal (Refereed) Published
Abstract [en]

Due to an increased prevalence of chronic diseases, older individuals may experience a deterioration of their health condition in older ages, limiting their capacity for social engagement and in turn their well-being in later life. Focusing on care provision to grandchildren and (older) relatives (‘informal care’) as forms of engagement, this paper aims to identify which individual characteristics may compensate for health deficits and enable individuals with multimorbidity to provide informal care. We use data from the SHARE survey (2004–2012) for individuals aged 60 years and above in 10 European countries. Logistic regression estimates for the impact of different sets of characteristics on the decision to provide care are presented separately for people with and without multimorbidity. Adapting Arber and Ginn’s resource theory, we expected that older caregivers’ resources (e.g., income or having a spouse) would facilitate informal care provision to a greater extent for people with multimorbidity compared to those without multimorbidity, but this result was not confirmed. While care provision rates are lower among individuals suffering from chronic conditions, the factors associated with caregiving for the most part do not differ significantly between the two groups. Results, however, hint at reciprocal intergenerational support patterns within families, as the very old with multimorbidity are more likely to provide care than those without multimorbidity. Also, traditional gender roles for women are likely to be weakened in the presence of health problems, as highlighted by a lack of gender differences in care provision among people with multimorbidity.

Place, publisher, year, edition, pages
Springer, 2016
Keywords
(Multi)morbidity, Extra-residential care, Grandchild care, Older people, EuropeSHARE
National Category
Gerontology, specialising in Medical and Health Sciences Sociology (excluding Social Work, Social Psychology and Social Anthropology)
Research subject
Medicine, Gerontology; Social Sciences, Sociology
Identifiers
urn:nbn:se:lnu:diva-52257 (URN)10.1007/s10433-016-0373-4 (DOI)000382024100003 ()2-s2.0-84964199558 (Scopus ID)
Available from: 2016-04-27 Created: 2016-04-27 Last updated: 2018-01-10Bibliographically approved
Campbell, J., Ikegami, N., Gori, C., Barbabella, F., D'Amico, F., Holder, H., . . . Theobald, H. (2016). How different countries allocate long-term care resources to older users: a comparative snapshot. In: Cristiano Gori, José-Luis Fernandez, Raphael Wittenberg (Ed.), Long-term care reforms in OECD countries: Successes and failures (pp. 47-76). Bristol: Policy Press
Open this publication in new window or tab >>How different countries allocate long-term care resources to older users: a comparative snapshot
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2016 (English)In: Long-term care reforms in OECD countries: Successes and failures / [ed] Cristiano Gori, José-Luis Fernandez, Raphael Wittenberg, Bristol: Policy Press, 2016, p. 47-76Chapter in book (Refereed)
Place, publisher, year, edition, pages
Bristol: Policy Press, 2016
National Category
Health Care Service and Management, Health Policy and Services and Health Economy Gerontology, specialising in Medical and Health Sciences Political Science (excluding Public Administration Studies and Globalisation Studies)
Research subject
Health and Caring Sciences; Medicine, Gerontology; Social Sciences, Political Science
Identifiers
urn:nbn:se:lnu:diva-52259 (URN)978-144731-071-6 (ISBN)
Available from: 2016-04-27 Created: 2016-04-27 Last updated: 2018-01-10Bibliographically approved
Gori, C., Barbabella, F., Campbell, J., Ikegami, N., D'Amico, F., Holder, H., . . . Theobald, H. (2016). How different countries allocate long-term care resources to older users: changes over time. In: Cristiano Gori, José-Luis Fernandez, Raphael Wittenberg (Ed.), Long-term care reforms in OECD countries: Successes and failures (pp. 77-116). Bristol: Policy Press
Open this publication in new window or tab >>How different countries allocate long-term care resources to older users: changes over time
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2016 (English)In: Long-term care reforms in OECD countries: Successes and failures / [ed] Cristiano Gori, José-Luis Fernandez, Raphael Wittenberg, Bristol: Policy Press, 2016, p. 77-116Chapter in book (Refereed)
Abstract [en]

A key policy debate in long-term care (LTC) policies across OECD countriestoday can be summarised by the following question: what measures and strategiescan be adopted to optimise resources? New policies are required for balancingfinances and access to care, with different options on the table and waiting forgovernments’ decisions.This chapter looks at changes over time in public resource allocation amongLTC users in the same OECD countries considered in the previous chapter (exceptfor Australia). As in Chapter Four, this chapter focuses exclusively on publiccare inputs, defined as those inputs that are (at least partially) publicly funded,and looks at users aged 65 and over. Chapter Four led the way to reconsideringhow public resources are allocated in different LTC systems through an in-depthanalysis of current spending. To complement that analysis, this chapter adopts along-term perspective, investigating the changes that have occurred over the last20–25 years in three crucial dimensions of resource allocation: the mix of LTCservices for older people, their intensity, and their coverage.The countries considered are representative of the OECD environment withrespect to both the overall welfare models and the models of LTC policies.Concerning the former, as Campbell et al have noted in Chapter Four, ‘wehave Sweden in social-democratic Northern Europe, Italy in familial SouthernEurope, Germany in corporatist mid-continent, Australia, the US and Englandas quite different versions of the Anglo-Saxon “residual” model, and Japan as therelatively new entry that shares aspects of all the other models.’ From the pointof view of LTC policies, the sample of countries selected represents the differentmodels in the OECD context:

• Universal coverage within a single programme: this model guarantees people access toformal services without taking into account users’ income or assets as eligibilitycriteria. It is also organised as a single system, separated or integrated with theoverall health system (Germany, Japan and Sweden).

• Mixed systems: in this case, LTC is provided through a mix of different universalprogrammes and benefits operating alongside, or a mix of universal and meanstestedLTC entitlements (England and Italy).

• Means-tested systems: under this type of scheme, LTC coverage is providedthrough safety-net programmes. In countries using this system, income and/or asset tests are used to define thresholds for eligibility to publicly fundedcare. Only those falling below a set threshold are entitled to publicly fundedservices or benefits (the US) (Colombo et al, 2011).

This chapter is organised as follows. First, it addresses the issue of resourceallocation, providing a definition of the topic and the methodology used. Themain policies implemented in each of the six countries are then examined. Finally,a comparative discussion on the trends emerging across our sample is presented,followed by a final paragraph looking ahead.

Place, publisher, year, edition, pages
Bristol: Policy Press, 2016
National Category
Health Care Service and Management, Health Policy and Services and Health Economy Gerontology, specialising in Medical and Health Sciences Political Science (excluding Public Administration Studies and Globalisation Studies)
Research subject
Health and Caring Sciences; Medicine, Gerontology; Social Sciences, Political Science
Identifiers
urn:nbn:se:lnu:diva-52260 (URN)978 144731 071 6 (ISBN)
Available from: 2016-04-27 Created: 2016-04-27 Last updated: 2018-01-10Bibliographically approved
Magnusson, L., Hanson, E., Larsson Skoglund, A., Ilett, R., Sennemark, E., Barbabella, F. & Gough, R. (2016). Kvalitet i äldreomsorg ur ett anhörigperspektiv. Kalmar: Nationellt kompetenscentrum anhöriga
Open this publication in new window or tab >>Kvalitet i äldreomsorg ur ett anhörigperspektiv
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2016 (Swedish)Report (Other academic)
Abstract [sv]

Nationellt kompetenscentrum anhöriga, Nka, har tagit fram rapporten "Kvalitet i äldreomsorg ur ett anhörigperspektiv" på uppdrag från Socialdepartementet. Rapporten ingår i den nationella kvalitetsplanen för äldreomsorgen.I rapporten framgår det tydligt att trygghet är själva förutsättningen för att kunna skapa bästa och mesta möjliga välbefinnande för anhöriga och äldre närstående. Andra viktiga byggstenar är tillhörighet, delaktighet och betydelsefullhet. Det finns också ett behov av kompetensutveckling – både i verksamheterna och hos de anhöriga. I kunskapssammanställningen framgår också att anhöriga och äldre närstående tenderar att bemötas och behandlas olika beroende på den utbildning, arbete och social position personen har. Detsamma gäller kön, etnisk tillhörighet, trosuppfattning, funktionsnedsättning, sexuell läggning och ålder. Rapporten tar upp en rad åtgärder för att utveckla kvaliteten i vården och omsorgen för äldre ur ett anhörigperspektiv.

Place, publisher, year, edition, pages
Kalmar: Nationellt kompetenscentrum anhöriga, 2016. p. 106
National Category
Nursing
Research subject
Health and Caring Sciences, Nursing
Identifiers
urn:nbn:se:lnu:diva-61365 (URN)
Note

På uppdrag av utredningen nationell kvalitetsplan för äldreomsorgen (S 2015:03)

Available from: 2017-03-14 Created: 2017-03-14 Last updated: 2017-04-11Bibliographically approved
Barbabella, F., Chiatti, C., Di Rosa, M., Lamura, G., Martin-Matthews, A., Papa, R. & Svensson, T. (2016). Launching an interdisciplinary “International Summer School on Ageing” (ISSA): Aims, methodology and outcomes. Educational gerontology, 42(4), 253-264
Open this publication in new window or tab >>Launching an interdisciplinary “International Summer School on Ageing” (ISSA): Aims, methodology and outcomes
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2016 (English)In: Educational gerontology, ISSN 0360-1277, E-ISSN 1521-0472, Vol. 42, no 4, p. 253-264Article in journal (Refereed) Published
Abstract [en]

Despite the increasing availability of gerontological training programmes, knowledge of theircontents, characteristics, methods and outcomes remains limited. However, the transitionfrom multidisciplinarity to interdisciplinary orientations is now fundamental to such training,providing participants from diverse academic orientations and professional backgrounds withopportunities to interact ‘across boundaries’. In response to recommendations of the EUFuturage Road Map for European Ageing Research (2011) concerning training and careerdevelopmentneeds of future cohorts of practitioners and scholars in aging, an InternationalSummer School on Ageing (ISSA) was developed in 2012. Its aim was to initiate the practicalimplementation of some of the capacity building goals identified by Futurage. The design andstructure of the ISSA was informed by the experience of Canada’s Summer Programme inAgeing - run by the Institute of Aging of the Canadian Institutes of Health Research – and bythe cross-border academic training activities organized by Lund University (Sweden) inScandinavian countries. As Italy has lacked a tradition of comprehensive, interdisciplinarytraining programmes in gerontology, the Italian National Institute of Health and Science onAgeing undertook to launch the inaugural ISSA. In this article, the core aims andmethodology of the ISSA are presented, together with an analysis of its main outcomes, asmeasured by participant evaluations. These are discussed in the context of internationaldebate on this topic.

National Category
Gerontology, specialising in Medical and Health Sciences
Research subject
Medicine, Gerontology
Identifiers
urn:nbn:se:lnu:diva-51001 (URN)10.1080/03601277.2015.1109402 (DOI)
Available from: 2016-03-17 Created: 2016-03-17 Last updated: 2018-01-10Bibliographically approved
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ORCID iD: ORCID iD iconorcid.org/0000-0002-1497-0011

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