Methods
Study Design
This study was a descriptive pilot study design with convenience sampling, allowing for relevant data collection of older adults’ usage of a social technology medium, Sherish℠ Connect. Sherish℠ Connect is a television-based, photo-sharing application in which family and friends send photos and captions to their loved ones in a residential living facility providing a low-cost alternative to similar, more costly products such as robotic pets. Participants were residents of a residential living facility in the Midwest already utilizing Sherish℠ Connect prior to the study.
A descriptive pilot study was an optimal approach to investigate the research question. The retrospective medical records review provided insight on (a) psychotropic/depression medication dosage and frequency (referred to as medication usage) and quarterly results of the (b) Patient Health Questionnaire-9 (PHQ-9) and (c) Brief Interview for Mental Status (BIMS). Institutional Review Board (IRB) approval provided authorization for a review of medical records in the calendar quarter before the participants engaged in the intervention (pre-test). The post-test scores were recorded in the quarter immediately following one month use of the social media platform. Same quarter pre- and post-test information was not used in the study.
Sampling
The executive director of a Midwest residential healthcare facility organized the recruitment process and identified residents that qualified for the study. The administration and staff of the residential living facility obtained informed consent from Sherish℠ Connect users and their power of attorney (See Appendix A). Permanent residents over the age of 50 who had purchased Sherish℠ Connect were included in the study. Residents in short-term rehabilitation and non-residents were excluded from participating in the study. There were neither gender nor ethnic/racial constraints for this study. Each participant had the option of withdrawing at any time without consequences.
Instrumentation
Two forms of instrumentation, which included a survey and data collection tool, were reviewed by two expert clinicians to increase face validity. The instruments used during this study are described below.
Data collection instruments
A data collection tool was created by researchers to aid in the collection and organization of data on the components analyzed (See Appendix B). The components included participants’ PHQ-9 score, BIMS score, medication usage, and healthcare utilization. Data from these components were collected retrospectively, before the participants began using Sherish℠ Connect, and once more following at least one month of usage.
The PHQ-9 is a 10-item questionnaire that assesses depression and depressive symptoms. The PHQ-9 was found to have an internal consistency value of 0.854, test-retest reliability value of 0.873, and an optimal cutoff score of 11 with a sensitivity of 0.89 and specificity of 0.97 (Zhang et al., 2013). The screening assessment can be used to help with a depression diagnosis and tracking of an individual’s progress after retrieving a baseline score. A score between 0-4 indicates no depressive symptoms, 5- 9 is mild, 10-14 is moderate, 15-19 is moderately severe, and 20-27 is severe depression. The PHQ-9 is a valid and reliable tool that is utilized by the Midwest residential living facility participating in the study.
The BIMS assesses mental status by analyzing overall orientation, the ability to repeat words, and the ability to recall words. The summary of the three identified sections provides a score that can be used to understand an individual’s mental status further. The BIMS was found to have a validity of 0.906 (Saliba et al., 2012). A score between 0-7 indicates severe cognitive impairment, 8-12 moderate impairment, and scores above 13 indicate little to no impairment. The BIMS is an interviewstyle assessment that is both valid and reliable as it is currently being used to assess residents of the Midwest residential living facility participating in the study.
Survey
Following the completion of the medical records review, researchers surveyed participants that consented to this portion of the study. The surveys consisted of 15 questions that identified how participants perceived Sherish℠ Connect (See Appendix C). Questions using Likert scale-type answers were utilized to examine the participants’ perceptions and experiences regarding the Sherish℠ Connect. Each participant was surveyed individually by two researchers; one researcher facilitated the questions, and the other recorded participant responses.
Procedure
Upon obtaining consent, the executive director designated an appropriate staff member to extract data from existing medical records. Pre-test data was collected in the calendar quarter before the participant started using Sherish℠ Connect. Posttest data was collected in the quarter immediately following implementation of Sherish℠ Connect for one month or more. Data was gathered from two separate quarters. Researchers were blind to participants medical records until completion of study.
Researchers gathered data on the use and perceived impact of using Sherish℠ Connect from the survey responses. Researchers surveyed each participant while utilizing a written script and pre-established questions, which were formatted as Likert scale response options. At the conclusion of this study, researchers reviewed the medical records data and survey responses to determine if the study supports significant evidence on the effects of Sherish℠ Connect.
Table of Contents
- Introduction
- Literature Review
- Methods
- Results
- Discussion
- Conclusion
- References
- Appendix A
- Appendix B
- Appendix C