Digital technologies as sources of information for patients and caregivers during COVID-19 pandemic: A cross-sectional survey

Background The emergence of the coronavirus disease 2019 (COVID-19) pandemic had a significant impact on the global economy, society, and healthcare systems. Little is known about the role of digital technologies as sources of information for patients and informal caregivers during COVID-19 pandemic. Considering the substantial information needs experienced by informal caregivers during the COVID-19 pandemic, further understanding of caregivers' use of digital technologies to access COVID-19 information is needed. Objective The aim of this study is to identify associations between informal caregiver's characteristics and the use of digital technologies to seek COVID-19 information in two countries with two different care systems: Italy (family based care system) and Sweden (universal care system) in order to determine whether factors such as demographics, socioeconomic resources, and the caregiving context may influence caregivers' use of these technologies during the pandemic. Methods A sample of 500 respondents participated in a cross-sectional survey by completing the online questionnaire. Respondents were recruited by the Italian National Institute of Health and Science on Ageing and the Swedish Family Care Competence Centre. Logistic regression model was used to investigate the association between the use of digital technologies to seek COVID-19 information and the independent variables. Results The multivariate analysis for the Italian sample indicated that female caregivers had two times the odds of use of digital technologies compared with males (p = 0.010, 95% CI 1.191 to 3.701). The odds of use were 2.3 times higher when the level of dependency of the care recipient on the caregiver is low compared with a high level of dependency (p = 0.029, 95% CI 1.090 to 4.858). In the Swedish group, respondents who spent less than 10 h per week providing care were almost three times more likely to use digital technologies as opposed to those who dedicate more than 40 h per week to care provision (p = 0.039, 95% CI 0.133 to 0.951). Caregivers in the age group 40–59 years were 2.7 times more likely to use digital technologies in comparison with those of the age group 60 +  years (p = 0.033, 95% CI 1.083 to 6.494). Perceiving a lack of awareness about available online resources that support caregivers in their role during the pandemic was the top challenge mentioned by the participants in both countries in using digital technologies to access information during the pandemic. The study revealed that the most used sources of online COVID-19 information for Italian caregivers were social media platforms and mobile apps, while in the case of the Swedish caregivers, online portals and apps published by state, regional, or municipal authorities were the most used sources. Italian participants in the study perceived less reliability in the online COVID-19 information than their Swedish counterparts. Conclusions Digital technologies are used by patients and their caregivers to seek information relevant to the pandemic. Because digital technologies are becoming a popular and accessible information source, medical professionals should consider the differences between caregivers' age groups when delivering information online. Strategies aiming to address the spread of misinformation on social media and online platforms are needed to fight infodemic. Governments should consider innovative policies that promote formal certification of online platforms and apps on the basis of their reliability. As digitalization of healthcare systems continues, efforts are needed to ensure different populations of patients and their caregivers are supported to obtain timely accurate information that meets their needs. An inclusive approach in the digitalization of healthcare systems may reduce inequalities in access to technology. Consequently, technology itself may over time become a tool in reducing such inequalities by empowering underserved or underrepresented population .

Digital technologies as sources of information for patients and caregivers during COVID-19 pandemic: A cross-sectional survey.

Background: The emergence of the coronavirus disease 2019 (COVID-19) pandemic had a significant impact on the global economy, society, and healthcare systems. Little is known about the role of digital technologies as sources of information for patients and informal caregivers during COVID-19 pandemic. Considering the substantial information needs experienced by informal caregivers during the COVID-19 pandemic, further understanding of caregivers' use of digital technologies to access COVID-19 information is needed. Objective: The aim of this study is to identify associations between informal caregiver's characteristics and the use of digital technologies to seek COVID-19 information in two countries with two different care systems: Italy (family based care system) and Sweden (universal care system) in order to determine whether factors such as demographics, socioeconomic resources, and the caregiving context may influence caregivers' use of these technologies during the pandemic. Methods: A sample of 500 respondents participated in a cross-sectional survey by completing the online questionnaire. Respondents were recruited by the Italian National Institute of Health and Science on Ageing and the Swedish Family Care Competence Centre. Logistic regression model was used to investigate the association between the use of digital technologies to seek COVID-19 information and the independent variables. Results: The multivariate analysis for the Italian sample indicated that female caregivers had two times the odds of use of digital technologies compared with males (p = 0.010, 95% CI 1.191 to 3.701). The odds of use were 2.3 times higher when the level of dependency of the care recipient on the caregiver is low compared with a high level of dependency (p = 0.029, 95% CI 1.090 to 4.858). In the Swedish group, respondents who spent less than 10 h per week providing care were almost three times more likely to use digital technologies as opposed to those who dedicate more than 40 h per week to care provision (p = 0.039, 95% CI 0.133 to 0.951). Caregivers in the age group 40-59 years were 2.7 times more likely to use digital technologies in comparison with those of the age group 60 + years (p = 0.033, 95% CI 1.083 to 6.494). Perceiving a lack of awareness about available online resources that support caregivers in their role during the pandemic was the top challenge mentioned by the participants in both countries in using digital technologies to access information during the pandemic. The study revealed that the most used sources of online COVID-19 information for Italian caregivers were social media platforms and mobile apps, while in the case of the Swedish caregivers, online portals and apps published by state, regional, or municipal authorities were the most used sources. Italian participants in the study perceived less reliability in the online COVID-19 information than their Swedish counterparts. Conclusions: Digital technologies are used by patients and their caregivers to seek information relevant to the pandemic. Because digital technologies are becoming a popular and accessible information source, medical professionals should consider the differences between caregivers' age groups when delivering information online. Strategies aiming to address the spread of misinformation on social media and online platforms are needed to fight infodemic. Governments should consider innovative policies that promote formal certification of online platforms and apps on the basis of their reliability. As digitalization of healthcare systems continues, efforts are needed to ensure different populations of patients and their caregivers are supported to obtain timely accurate information that meets their needs. An inclusive approach in the digitalization of healthcare systems may reduce inequalities in access to technology. Consequently, technology itself may over time become a tool in reducing such inequalities by empowering underserved or underrepresented populations.

Perceived deterioration in health status among older adults in Europe and Israel following the first wave of the COVID-19 pandemic.

The COVID-19 pandemic has created challenges in providing medical care for people with health conditions other than COVID-19. The study aims to assess the prevalence of older adults' reportage of decline in health relative to pre-pandemic and to identify its determinants. The study is based on the Survey of Health, Ageing and Retirement in Europe (SHARE) data collected during the pandemic. It comprised 51,778 people in twenty-seven European countries and Israel. Participants were asked about changes in their health status relative to pre-pandemic. Bivariate analysis and logistic regression were used to identify factors associated with worsening of health. Nine percent of people (average age 70 years) reported a worsening of health relative to pre-pandemic. A logistic regression revealed a significant relation of the probability of a downturn in health to forgoing, postponing, or being denied an appointment for medical care. Multiple chronic illnesses, developing COVID-19, having at least one form of psychosocial distress, higher age, and lower economic capacity were also found significantly related to the probability of a decline in health. Older adults' comprehensive health needs must be addressed even when healthcare services are under strain due to pandemic outbreaks. Policymakers should attend to the healthcare needs of people whose vulnerability to the pandemic is amplified by chronic health conditions and low socioeconomic status. Public healthcare systems may experience a massive rebound of demand for health care, a challenge that should be mitigated by delivery of healthcare services and the provision of the financial resources that they need.

Factors Worsening and Mitigating the Consequences of the COVID-19 Outbreak on the Overall Health of Informal Caregivers of Older People with Long-Term Care Needs Living in Germany and in Italy.

Population ageing and the higher prevalence of multimorbidity in later life are increasing the demand for Long-Term Care (LTC) worldwide; this has been exacerbated by the COVID-19 pandemic. As in Europe and beyond, the bulk of care for frail older people is carried out by informal caregivers. This study aimed at understanding the factors affecting the overall worsening health of informal caregivers of older people with LTC needs living in Germany and Italy during the outbreak. To this purpose, 319 informal caregivers (149 in Germany and 173 in Italy) were surveyed online in 2020-2021. A logistic regression analysis was performed by country, to obtain an adjusted estimate of the risk of worsening of caregivers' health. This risk increased by 42% for German caregivers compared to Italian ones, despite the former receiving more formal services. This may depend on different quality standards of LTC services and caregivers' expectations, and on differing policies concerning migrant care workers (MCWs) during the outbreak, who could not enter Germany and were "trapped" at care recipients' homes in Italy. Results call for in-home care reforms and policies guaranteeing more effective caregiver support, home care services and fairer working condition for MCWs in both countries.

How Many Older Informal Caregivers Are There in Europe? Comparison of Estimates of Their Prevalence from Three European Surveys.

Informal caregivers are people providing some type of unpaid, ongoing assistance to a person with a chronic illness or disability. Long-term care measures and policies cannot take place without taking into account the quantitatively crucial role played by informal caregivers. We use the European Health Interview Survey (EHIS), the European Quality of Life Survey (EQLS), and the Study on Health and Ageing in Europe (SHARE) to measure the prevalence of informal caregivers in the European population, and analyze associated socio-demographic factors. This rate ranges between about 13 percent in Portugal and Spain, and more than 22 percent in Luxembourg, Belgium, and Denmark. It declines in older age groups and, on average, is lower in men than in women in all countries studied, and lower among the poorly educated compared to those with higher levels of education. However, large variance was observed in the average share of informal caregivers for most countries between the three surveys. Our findings, estimated through the three surveys, reveal common trends, but also a series of disparities. Additional research will be needed to enable policy makers to access a richer and more harmonized body of data, allowing them to adopt truly evidence-based and targeted policies and interventions in this field.

Impact of the Outbreak of the COVID-19 Pandemic on Formal and Informal Care of Community-Dwelling Older Adults: Cross-National Clustering of Empirical Evidence from 23 Countries

The COVID-19 pandemic has been dramatically affecting the life of older adults with care needs and their family caregivers. This study illustrates how the initial outbreak of the pandemic changed the supply of formal and informal care to older adults in European countries and Israel and assesses the resilience of these countries in providing support to their older populations by means of a mix of both types of care. We subjected data from the Survey of Health, Ageing and Retirement in Europe COVID-19 period (SHARE-COVID-19) across 23 European countries (including Israel) to descriptive and cluster analyses. In the first wave of the outbreak, a significant proportion of older adults in European countries received informal help, with an increase in the frequency of informal help received from children, neighbors, friends, or colleagues and a decrease in that received from other relatives. In most countries, difficulties in receiving home care services from professional providers were reported. Seven clusters were identified, reflecting different combinations of changes in the formal/informal care provision. In most countries, informal care is more resilient than home care services that formal providers deliver. Since they are an essential source for sustainable care, their challenges related to care should be addressed. The impact of the pandemic does not follow the traditional characterization of welfare regimes. A clustering effort may yield more understanding of the priorities that future care policies should exhibit at the national level and may identify potential systems for policymakers to enhance sustainability of care for community-dwelling older adults.

Impact of the COVID-19 Pandemic on Family Carers of Older People Living with Dementia in Italy and Hungary

The COVID-19 pandemic has had a major effect on both older people with dementia and families caring for them. This paper presents the results of an online survey carried out among Italian and Hungarian family carers of people with dementia during the first pandemic wave (May–July 2020, n = 370). The research questions were the following: (1) How has the pandemic changed the lives of family carers? (2) How did government restriction measures change the availability of care-related help? (3) What other changes did families experience? Results show that about one-quarter of both subsamples experienced a deterioration in their financial status. A decline in both general and mental health was also reported. Due to “lockdown”, family carers’ burden increased substantially. Utilization of care-related help decreased, and the share of those left with no help increased in both countries. Cross-country differences emerged in terms of dementia care system, severity of the first pandemic wave, and measures put in place by governments. Findings outline the weaknesses of support structures and their country-specific vulnerabilities to a worldwide pandemic. To better protect people with dementia in the future, it is essential to strengthen their family carers, and support structures need to be re-evaluated and re-designed.