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Cocreation of a Video Feedback Tool for Managing Self-Care at Home With Pairs of Older Adults: Remote Experience-Based Co-Design Study
Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. (ReAction)ORCID iD: 0000-0003-2150-3822
Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Linnaeus University, Linnaeus Knowledge Environments, Sustainable Health. Karolinska Institutet, Sweden.ORCID iD: 0000-0002-4108-391x
Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Linnaeus University, Linnaeus Knowledge Environments, Sustainable Health. Region Kalmar County, Sweden. (DISA;DISA-IDP)ORCID iD: 0000-0002-4257-282X
Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Linnaeus University, Linnaeus Knowledge Environments, Sustainable Health. University of Calgary, Canada. (DISA;DISA-IDP)ORCID iD: 0000-0001-9687-7242
2024 (English)In: JMIR Formative Research, E-ISSN 2561-326X, Vol. 8, article id e57219Article in journal (Refereed) Published
Sustainable development
SDG 3: Ensure healthy lives and promote well-being for all at all ages
Abstract [en]

Background: Involving older adults in co-design processes is essential in developing digital technologies and health care solutions to enhance self-care management at home, especially for older adults with chronic illness and their companions. Remote co-design approaches could provide technologically sustainable solutions that address their personal needs.

Objective: This study aimed to cocreate and test the usability of a video feedback tool to facilitate self-care management at home.

Methods: This experience-based co-design approach involved collaboration between 4 pairs of older adults, 4 researchers, and 2 service designers in three steps: (1) six iterative workshops (5 remote and 1 in person) to cocreate self-care exercises within an existing video feedback tool by identifying factors influencing self-care management; (2) developing and refining the self-care exercises based on suggestions from the older adults; and (3) usability testing of the cocreated exercises with the 4 pairs of older adults in their homes. Among the older adults (68-78 years), 3 adults had heart failure and 1 adult had hypertension. Data were analyzed inductively through thematic analysis and deductively using the USABILITY (Use of Technology to Engage in Adaptation by Older Adults and/or Those With Low or Limited Literacy) framework.

Results: Theidentifiedinfluencingfactorsguidingthecontentsandformatdevelopmentof2newself-careexerciseswerethat pairs of older adults support and learn from each other in performing self-care, which increases their motivation and engagement in practicing self-care at home. The usability test of the 2 new self-care exercises, “Breathing exercises” and “Picking up from the floor,” revealed that the pairs found the exercises and the video feedback component valuable for learning and understanding, for example, by comparison of performances highlighting movement variability. However, they found it difficult to manage the video feedback tool on their own, and a support structure or tailored education or training was requested.

Conclusions: This study emphasizes that the video feedback tool holds the potential to facilitate learning and understanding in self-care management, which may support motivation. The studied video feedback tool can be beneficial for pairs of older adults managing self-care at home as a complement to traditional health care services, but an accurate supporting structure is required. The effectiveness of the video feedback tool and its integration into existing health care services still need to be assessed and improved through careful design and structured support.

Place, publisher, year, edition, pages
JMIR Publications, 2024. Vol. 8, article id e57219
Keywords [en]
chronic illness, eHealth, experience-based co-design, older adults, self-care, video feedback
National Category
Nursing
Research subject
Health and Caring Sciences, Caring Science
Identifiers
URN: urn:nbn:se:lnu:diva-133150DOI: 10.2196/57219ISI: 001539268000111PubMedID: 39466305Scopus ID: 2-s2.0-85207934512OAI: oai:DiVA.org:lnu-133150DiVA, id: diva2:1908718
Projects
Stödja patienter och anhöriga i ett aktivt deltagande av egenvård i hemmetAvailable from: 2024-10-28 Created: 2024-10-28 Last updated: 2025-11-25Bibliographically approved
In thesis
1. Co-creating self-care: Experiences of self-care and usage of eHealth among older adults with chronic illness, informal carers, and healthcare professionals
Open this publication in new window or tab >>Co-creating self-care: Experiences of self-care and usage of eHealth among older adults with chronic illness, informal carers, and healthcare professionals
2025 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Aim: To explore the co-creation of self-care and the use of eHealth among older adults with chronic illness, their informal carers, and healthcare professionals. Methods: This thesis employed various qualitative methods across four studies. Study I aimed to clarify the concept of “self-care monitoring” from a patient perspective through a concept analysis based on a systematic search of peer-reviewed articles from four databases. Study II aimed to describe patients’ and informal carers’ experiences of self-care management and the use of telemonitoring applications, using semi-structured telephone interviews analyzed by qualitative content analysis. Study III aimed to co-create and test a video feedback tool for self-care at home, using an experience-based co-design approach that facilitated collaboration between pairs of older adults, researchers, and service designers through three iterative steps: workshops, development and refinement, and usability testing. Data were analyzed using thematic analysis, employing both inductive and deductive approaches. Study IV aimed to describe healthcare professionals’ experiences of motivating self-care, utilizing individual narrative interviews analyzed by a phenomenological-hermeneutic approach. Results: Study I clarified the concept of “self-care monitoring”, resulting in the definition: “Self-care monitoring is an activity that means a person has to pay attention and be confident and needs routines for tracking symptoms, signs, and action.” Study II described self-care management with telemonitoring at home, captured by the theme “Developing the capability to perform self-care with technology as both an intruder and an invited guest.” Telemonitoring supported skill acquisition and engagement with healthcare professionals but also introduced uncertainties in symptom interpretation and exclusion. Study III co-created and tested two new self-care exercises within the video feedback tool: “Breathing exercises” and “Picking up from the floor.” Older adults found the exercises and feedback valuable for learning, particularly in highlighting movement variability through performance comparison. Study IV described healthcare professionals’ experiences of motivating self-care, revealing “Co-creating sustainable self-care responsibilities” as the main theme, encompassing empowerment through mutuality, reassigning responsibility, and using oneself as a creative tool. Conclusion: This thesis highlights co-created self-care as a dynamic, empowering process shaped by collaboration, shared responsibility, and active engagement among older adults with chronic illness, informal carers, and healthcare professionals. Engagement in self-care strengthens through interactive approaches like peer support, video feedback, and telemonitoring, enhancing motivation, confidence, and adherence. Future research should focus on long-term engagement strategies and integrating eHealth into primary care to improve co-created self-care.

Place, publisher, year, edition, pages
Växjö: Linnaeus University Press, 2025. p. 125
Series
Linnaeus University Dissertations ; 562
Keywords
chronic illness, co-creation, eHealth, experiences, healthcare professionals, informal carer, older adults, peer support, primary care, qualitative, self-care
National Category
Nursing
Research subject
Health and Caring Sciences, Caring Science
Identifiers
urn:nbn:se:lnu:diva-137079 (URN)10.15626/LUD.562.2025 (DOI)978-91-8082-278-7 (ISBN)978-91-8082-279-4 (ISBN)
Public defence
2025-04-04, Weber, Universitetetsplatsen 1, Växjö, 10:00 (Swedish)
Opponent
Supervisors
Funder
The Kamprad Family FoundationForte, Swedish Research Council for Health, Working Life and WelfareLinnaeus University
Available from: 2025-03-04 Created: 2025-03-03 Last updated: 2025-05-15Bibliographically approved

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Strandberg, SusannaEkstedt, MirjamFagerström, CeciliaBackåberg, Sofia

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