| 1. |
- Barbabella, Francesco, Dr. 1984-, et al.
(författare)
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Ecological factors associated with Emergency Department use by older people in Italy.
- 2021
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Ingår i: Aging Clinical and Experimental Research. - : Springer. - 1594-0667 .- 1720-8319. ; 33, s. 659-668
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Many studies investigated factors associated with overuse of Emergency Department (ED) by older people. However, there is little evidence of how a better access to long-term care services can affect ED visit rates. Therefore, we estimated the association between ED use and contextual (distance to closest ED), need (priority level at admission and care deprivation), predisposing (socio-economic conditions) and enabling factors (availability of health services) at the municipal level.METHODS: We investigated ED visit rates by comparing the older population (aged 75 and more) to those aged less than 75 years among 233 municipalities and 13 health districts in the Marche Region, Central Italy. Administrative data were enriched by spatial dimensions. The outcomes were analysed using t-tests and ANOVA, while OLS and multilevel regressions have been used to identify independent correlates of ED visit rates.RESULTS: Mean ED visit rate was 56.3% and 25.3% among older people and the rest of the population (< 75 years), respectively. The multivariate analysis for older people showed that the presence of an ED within the municipality and living alone were positively associated with ED use, whereas greater availability of nursing homes was negatively associated. For general population (< 75 years), distance to closest ED, economic deprivation and bigger hospitals were negatively associated with ED visits.CONCLUSIONS: Our study shows that interventions to reduce frequent ED use by older people should include the availability of long-term care facilities in the area. As population ageing is progressing, our results suggest that investing in alternative care options for older people with long-term care needs might have the beneficial impact of reducing the overall ED rates and improving quality and appropriateness of care.
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| 2. |
- Barbabella, Francesco, Dr. 1984-, et al.
(författare)
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Recruitment of Adolescent Young Carers to a Psychosocial Support Intervention Study in Six European Countries : Lessons Learned from the ME-WE Project
- 2023
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Ingår i: International Journal of Environmental Research and Public Health. - : MDPI. - 1661-7827 .- 1660-4601. ; 20:6
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Tidskriftsartikel (refereegranskat)abstract
- Young carers provide a substantial amount of care to family members and support to friends, yet their situation has not been actively addressed in research and policy in many European countries or indeed globally. Awareness of their situation by professionals and among children and young carers themselves remains low overall. Thus, young carers remain a largely hidden group within society. This study reports and analyses the recruitment process in a multi-centre intervention study offering psychosocial support to adolescent young carers (AYCs) aged 15–17 years. A cluster-randomised controlled trial was designed, with recruitment taking place in Italy, the Netherlands, Slovenia, Sweden, Switzerland and the United Kingdom exploiting various channels, including partnerships with schools, health and social services and carers organisations. In total, 478 AYCs were recruited and, after screening failures, withdrawals and initial dropouts, 217 were enrolled and started the intervention. Challenges encountered in reaching, recruiting and retaining AYCs included low levels of awareness among AYCs, a low willingness to participate in study activities, uncertainty about the prevalence of AYCs, a limited school capacity to support the recruitment; COVID-19 spreading in 2020–2021 and related restrictions. Based on this experience, recommendations are put forward for how to better engage AYCs in research.
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| 3. |
- Barbabella, Francesco, Dr. 1984-, et al.
(författare)
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Socio-economic status and social participation as predictors of quality of life of older adults with functional limitations: a cross-sectional study in Italy and Greece
- 2020
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Ingår i: Retraite et société. - : CAIRN. - 1167-4687. ; 81:1, s. 41-64
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Tidskriftsartikel (refereegranskat)abstract
- Older adults with functional limitations constitute a vulnerable group with usually lower levels of health status and quality of life (QoL). In both Italy and Greece, informal care and privately-hired care workers are common measures for providing them continuous care and support, more than public care services. This situation might increase the risk of worst QoL if older adults are not equipped with own social and economic resources for coping with daily life limitations, especially in a macro-context heavily influenced in recent years by the effects of the economic crisis. The study aimed at identifying the role of socio-economic status (SES) and social participation as predictors of QoL of older adults with functional limitations, after the Great Recession period. We used data on older adults (50+ years) from the Survey on health, ageing and retirement in Europe (Share) wave 6 (2015) for conducting a crosssectional descriptive analysis and running a hierarchical linear regression model for both Italy and Greece, with blocs of predictors concerning demographic, socio-economic, health, access to care, and social participation domains. In both countries, higher levels of SES and social participation were strongly associated with higher QoL, although good health status remained the most influential predictor of better QoL. Our results suggested that multiple social inequalities are likely to occur among most socially disadvantaged older adults and may heavily affect their QoL and social inclusion.
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| 4. |
- Di Rosa, Mirko, et al.
(författare)
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Migrant care workers in Italian households : recent trends and future perspectives
- 2017
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Ingår i: The Routledge Handbook of Social Care Work Around the World. - Abingdon, Oxon ; New York, NY : Routledge, 2018. : Routledge. - 9781315612805 - 9781472479457 ; , s. 142-155
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Bokkapitel (övrigt vetenskapligt/konstnärligt)abstract
- This chapter focuses on role played by migrant care work within the Italian long-term care (LTC) system. Italy is a country where the informal sector, and in particular the family, has traditionally represented the bulk of care provision, with public policies and interventions tending to perpetuate and take for granted this constellation. The analysis examines the increasingly important pillar of the Italian LTC system represented by care workers who are directly employed by Italian households, usually called in Italian assistenti familiari or – in a partly pejorative informal term – badanti. The impact of demographic trends on the Italian LTC system is exacerbated by a traditional lack in the coverage of formal LTC services, and more recently by the deepest economic recession since the Second World War. Families can take the chance to open up to new care and living solutions and create human capital, or they can isolate and shut down any positive possibility in the caregiving triad.
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| 5. |
- Hanson, Elizabeth, 1961-, et al.
(författare)
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Ethical Considerations When Conducting Pan-European Research with and for Adolescent Young Carers
- 2023
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Ingår i: Ethics and social welfare. - : Taylor & Francis Group. - 1749-6535 .- 1749-6543. ; 17:2, s. 125-158
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Tidskriftsartikel (refereegranskat)abstract
- Adolescent young carers (AYCs) are a sub-group of young carers who carry out significant or substantial caring tasks and assume a level of responsibility which would usually be associated with an adult. They are a potentially vulnerable group of minors because of the risk factors associated with their caring role. AYCs face a critical transition phase from adolescence to adulthood often with a lack of tailored support from service providers. The recently completed European funded ‘ME-WE’ project, which forms the focus of this paper, aimed to change the ‘status quo’ by advancing the situation of AYCs in Europe, via responsive research and knowledge translation actions. This paper outlines the participatory, co-creation approach employed in the project to optimise AYC’s involvement. It describes the ethical framework adopted by the project consortium to ensure the wellbeing of AYCs within all project activities. Ethical issues that arose in the field study work in all six countries are presented, followed by a discussion of the level of success or otherwise of the consortium to address these issues. The paper concludes with lessons learned regarding ethically responsible research with and for AYCs that are likely transferable to other vulnerable research groups and pan-European projects.
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| 6. |
- Hanson, Elizabeth, 1961-, et al.
(författare)
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Research and Innovation for and with Adolescent Young Carers to Influence Policy and Practice—The European Union Funded “ME-WE” Project
- 2022
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Ingår i: International Journal of Environmental Research and Public Health. - : MDPI. - 1661-7827 .- 1660-4601. ; 19:16
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Tidskriftsartikel (refereegranskat)abstract
- Young carers are children and adolescents who provide care to other family members or friends, taking over responsibilities that are usually associated with adulthood. There is emerging but still scarce knowledge worldwide about the phenomenon of young carers and the impact of a caring role on their health, social and personal development spheres. This paper provides an overview of the main results from the ME-WE project, which is the first European research and innovation project dedicated to adolescent young carers (AYCs) (15–17 years). The project methods relied on three main activities: (1) a systematization of knowledge (by means of a survey to AYCs, country case studies, Delphi study, literature review); (2) the co-design, implementation and evaluation of a primary prevention intervention addressing AYCs’ mental health (by means of Blended Learning Networks and a clinical trial in six European countries); (3) the implementation of knowledge translation actions for dissemination, awareness, advocacy and lobbying (by means of national and international stakeholder networks, as well as traditional and new media). Project results substantially contributed to a better understanding of AYCs’ conditions, needs and preferences, defined tailored support intervention (resilient to COVID-19 related restrictions), and significant improvements in national and European policies for AYCs.
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| 7. |
- Lamura, Giovanni, et al.
(författare)
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Implications of the use of migrant care work and web-based services on family caregivers' health
- 2019
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Ingår i: International Journal of Care and Caring. - : POLICY PRESS. - 2397-8821 .- 2397-883X. ; 3:1, s. 97-116
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Tidskriftsartikel (refereegranskat)abstract
- This article illustrates the implications of two recent trends on family carers' health: the employment of home-based migrant care workers; and the provision of web-based supports. The main factors traditionally associated with carers' health are used to analyse the results of a six-country study via a multilevel linear regression. Attention will be dedicated to the role of migrant care workers, who are often hired by private households to provide eldercare. Finally, web-based services for carers will be investigated by considering InformCare, a recently implemented European platform tested on a sample of carers from three countries (Germany, Italy and Sweden).
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| 8. |
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| 9. |
- Melchiorre, Maria Gabriella, et al.
(författare)
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eHealth for people with multimorbidity : results from the ICARE4EU project and insights from the "10 e's" by Gunther Eysenbach
- 2018
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Ingår i: PLOS ONE. - : Public Library of Science. - 1932-6203. ; 13:11, s. 1-26
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: People with multimorbidity, especially older people, have complex health and social needs, and require an integrated care approach. In this respect, eHealth could be of support. This paper aims to describe the implementation of eHealth technologies in integrated care programs for people with multimorbidity in Europe, and to analyse related benefits and barriers according to outcomes from ICARE4EU study and within the more general conceptual framework of the "10 e's" in eHealth by Gunther Eysenbach.METHODS: In 2014, ICARE4EU project identified 101 integrated care programs in 24 European countries. Expert organizations and managers of the programs completed an on-line questionnaire addressing several aspects including the adoption of eHealth. Findings from this questionnaire were analyzed, by linking in particular benefits and barriers of eHealth with the "10 e's" by Eysenbach (Efficiency, Enhancing, Evidence-based, Empowerment, Encouragement, Education, Enabling, Extending, Ethics, and Equity).RESULTS: Out of 101 programs, 85 adopted eHealth tools, of which 42 focused explicitly on older people. eHealth could improve care integration/management, quality of care/life and cost-efficiency, whereas inadequate funding represents a major barrier. The "10 e's" by Eysenbach seem to show contact points with ICARE4EU findings, in particular when referring to positive aspects of eHealth such as Efficiency and Enhancing quality of care/life, although Empowerment/Education of patients, care Equity and Ethics issues seem crucial in this respect. Encouragement of a new relationship patient-health professional, and Enabling standardized exchange of electronic information, represent further aspects impacting integration/management of care.CONCLUSIONS: Aspects of eHealth, which emerged as benefits and barriers impacting integration/management of care, as well as cost-efficiency and quality of care/life, can be identified on the basis of both ICARE4EU findings and the "10 e's" in eHealth by Eysenbach. They could represent objectives of new policies for supporting the deployment of eHealth technologies within integrated care across Europe.
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| 10. |
- Melchiorre, Maria Gabriella, et al.
(författare)
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Integrated Care Programs for People with Multimorbidity in European Countries : eHealth Adoption in Health Systems.
- 2020
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Ingår i: BioMed Research International. - : Hindawi Publishing Corporation. - 2314-6133 .- 2314-6141. ; 2020
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: eHealth applications have the potential to provide new integrated care services to patients with multimorbidity (MM), also supporting multidisciplinary care. The aim of this paper is to explore how widely eHealth tools have been currently adopted in integrated care programs for (older) people with MM in European countries, including benefits and barriers concerning their adoption, according to some basic health system characteristics.Materials and Methods: In 2014, in the framework of the ICARE4EU project, expert organizations in 24 European countries identified 101 integrated care programs. Managers of the selected programs completed an online questionnaire on several dimensions, including the use of eHealth. We analyzed data from this questionnaire, in addition to qualitative information from six innovative programs which were studied in depth through case study methodology, according to characteristics of national health systems: a national health model (financing system), overall strength of primary care (PC) (structure/service delivery process), and level of (de)centralization of health system (executive powers in a country).Results: 85 programs (out of 101) adopted at least one eHealth tool, and 42 of these targeted explicitly older people. In most cases, Electronic Health Records (EHRs) were used and some benefits emerged like improved care management and integration, although inadequate funding mechanisms represented a major barrier. The analysis by health system characteristics showed a greater adoption of eHealth applications in decentralized countries, in countries with a National Health Service (NHS) model, and in countries with a strong/medium level of PC development.Conclusions: Although in the light of some limitations, findings indicate a relation between implementation of care programs using eHealth tools and basic characteristics of health systems, with decentralization of a health system, NHS model, and strong/medium PC having a key role. However adaptations of European health systems seem necessary, in order to provide a more innovative and integrated care.
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