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Smart technology and the meaning in life of older adults during the Covid-19 public health emergency period: a cross-cultural qualitative study

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The exponential increase of the older segment of the population is coinciding with the growing challenges of a digital society in different socio-cultural contexts. This exploratory study aims to analyze older adult perspectives of how smart technology influenced their meaning in life during the Covid-19 Public Health Emergency period, using qualitative research at a cross-national level. Three hundred and fifty-one community-dwelling older participants aged 65-87 years were included in the study. Participants were Italian, Mexican, Portuguese and Spanish. All the narratives went through a process of content analysis. Findings of content analysis produced six themes: Meaningful relations, rewarding activities, spirituality, health and safety-related support, self-growth, and physical activity. Smart technology was important in promoting significant relations for Mexican older adults (71.3%), rewarding activities for Portuguese older adults (57.1%), spirituality for Spanish older participants (71.6%), and physical activity for Italian older adults (29.5%). This study indicated that smart technology during the Health Emergency period was important for the meaning in life of older populations, mostly by facilitating meaningful relations , rewarding activities and spirituality. Future interventions with older adults during pandemic periods should consider the diversity of themes associated with increasing older adult well-being, from a cross-cultural perspective. ARTICLE HISTORY
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International Review of Psychiatry
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Smart technology and the meaning in life of
older adults during the Covid-19 public health
emergency period: a cross-cultural qualitative
study
Sofia von Humboldt , Neyda Ma. Mendoza-Ruvalcaba , Elva Dolores Arias-
Merino , Andrea Costa , Emilia Cabras , Gail Low & Isabel Leal
To cite this article: Sofia von Humboldt , Neyda Ma. Mendoza-Ruvalcaba , Elva Dolores Arias-
Merino , Andrea Costa , Emilia Cabras , Gail Low & Isabel Leal (2020): Smart technology and the
meaning in life of older adults during the Covid-19 public health emergency period: a cross-cultural
qualitative study, International Review of Psychiatry, DOI: 10.1080/09540261.2020.1810643
To link to this article: https://doi.org/10.1080/09540261.2020.1810643
Published online: 05 Oct 2020.
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ARTICLE
Smart technology and the meaning in life of older adults during the
Covid-19 public health emergency period: a cross-cultural qualitative study
Sofia von Humboldt
a
, Neyda Ma. Mendoza-Ruvalcaba
b
, Elva Dolores Arias-Merino
c
, Andrea Costa
d
,
Emilia Cabras
e
, Gail Low
f
and Isabel Leal
a
a
William James Research Center, ISPA Instituto Universit
ario, Lisbon, Portugal;
b
Health Sciences Division, Universidad de
Guadalajara CUTONALA, Guadalajara, Mexico;
c
Public Health Department, Universidad de Guadalajara CUCS, Guadalajara, Mexico;
d
ISPA Instituto Universit
ario, Lisbon, Portugal;
e
Departamento de Educaci
on, Universidad Antonio de Nebrija, Madrid, Spain;
f
Faculty of Nursing, University of Alberta, Edmonton, Canada
ABSTRACT
The exponential increase of the older segment of the population is coinciding with the growing
challenges of a digital society in different socio-cultural contexts. This exploratory study aims to
analyze older adult perspectives of how smart technology influenced their meaning in life dur-
ing the Covid-19 Public Health Emergency period, using qualitative research at a cross-national
level. Three hundred and fifty-one community-dwelling older participants aged 6587 years
were included in the study. Participants were Italian, Mexican, Portuguese and Spanish. All the
narratives went through a process of content analysis. Findings of content analysis produced six
themes: Meaningful relations, rewarding activities, spirituality, health and safety-related support,
self-growth, and physical activity. Smart technology was important in promoting significant rela-
tions for Mexican older adults (71.3%), rewarding activities for Portuguese older adults (57.1%),
spirituality for Spanish older participants (71.6%), and physical activity for Italian older adults
(29.5%). This study indicated that smart technology during the Health Emergency period was
important for the meaning in life of older populations, mostly by facilitating meaningful rela-
tions, rewarding activities and spirituality. Future interventions with older adults during pan-
demic periods should consider the diversity of themes associated with increasing older adult
well-being, from a cross-cultural perspective.
ARTICLE HISTORY
Received 9 July 2020
Accepted 12 August 2020
KEYWORDS
Cross-cultural; meaning in
life; older adults; positive
psychology;
smart technology
Introduction
Thechangefromanindustrialtoadigitalworldwill
lead to radical changes in how we organize society. This
development is converging with another trend: a global
increase of the older population (Anderberg, 2020).
The 4th Revolution has affected our sense of priv-
acy, ownership, skills, social connections, meaning in
life and self-growth (World Health Organization,
2020). Older adults are increasingly using smart tech-
nology, however, they have not received enough
attention in the literature (Anderberg, 2020). Research
indicates that 67% of older adults in the United States
and 49% in Europe use the Internet, on average, while
43% own smartphones (Anderberg, 2020). Wang
et al. (2011) stressed that the cultural background of
older adults is important for the design of smart tech-
nology. In fact, older adults use smart technological
devices and solutions differently (e.g. personal com-
puters, smart phones and tablets, software, Internet),
on a daily basis, for communicating by e-mail, online
video/phone calls, online chatting/instant messaging,
using search engines, social networking sites, apps,
word processing and online shopping (Finn, 2020).
Moreover, higher levels of smart technology use seem
to be significant predictors of reduced loneliness,
higher levels of social support, fewer depressive symp-
toms, better self-rated health, fewer chronic illnesses,
higher life satisfaction, purpose in life and well-being
among older individuals (Finn, 2020). Additionally,
artificial intelligence and algorithms have improved
the diagnosis and treatment of older adults
(Anderberg, 2020). Assistive technologies help older
adults age in place longer, by allowing support from
telecare, smart homes, proactive service systems,
household robots, robot-assisted therapy and socially
assistive robots (Anderberg, 2020).
In this context, gerontechnology has emerged as an
answer with innovative and directed technological
CONTACT Sofia von Humboldt sofia.humboldt@gmail.com William James Center for Research, ISPA Instituto Universit
ario, Rua Jardim do
Tabaco, 34, Lisbon 1149-041, Portugal
ß2020 Institute of Psychiatry and Johns Hopkins University
INTERNATIONAL REVIEW OF PSYCHIATRY
https://doi.org/10.1080/09540261.2020.1810643
developments, which promote better living conditions
and independent living for the older population
(Anderberg, 2020). Smart gerontechnology has been
used in assisted living of older adults by directly sup-
porting independent living and social interaction
(Martel et al., 2018). Home health technologies are
mostly used for online shopping and to monitor daily
living activities, mental health, physical exercise, cog-
nitive decline and cardiovascular conditions among
older adults (Martel et al., 2018). Gerontechnology
has also facilitated social relations through the use of
adapted communication devices (Anderberg, 2020).
Furthermore, health care has benefitted from smart
gerontechnology, by monitoring, providing preventive
care and treating older adults, and by supporting
function and maintaining a good life, especially for
those living alone (Anderberg, 2020). Older adults
have highlighted positive aspects of using smart tech-
nology (e.g. easy access to information, portability
and communication, protection, user-friendliness)
(Anderberg, 2020). Conversely, research suggests that
older adults were unmotivated to use smart technol-
ogy due to feelings of inadequacy and negative com-
parison with younger generations; insufficient
interaction and social communication; excessively
complex technology; lack of clear instructions and
assistance; lack of privacy and security; and stigma
(Vaportzis et al., 2017). Furthermore, research reiter-
ates differences in use of smart technology stemming
from the cultural background of older adults
(Shirahada et al., 2019).
Meaning in life is the individual perception allow-
ing one to understand the beliefs about ones life and
activities, and the value and importance attached to
them. It is related to terms such as order, justice,
coherence, values, faith and belonging. It includes
involvement or commitment to goals or a life struc-
ture and the subsequent sense of accomplishment and
satisfaction or lack thereof (Moore et al., 2006).
Meaning in life among older people generally
depends on whether they have different positive
meanings of their present and past life experiences.
Older adults build meaning and portray a sense of
self-evolution that contributes to their living and
adopted life. This evolutionary sense of self is
reflected in how they lived their lives, faced challenges
and extreme situations, took risks and strove to main-
tain an attitude that promoted their sense of engage-
ment and purpose in life. Meaning in life is a
significant component of quality of life, contributing
to health and well-being in old age (Moore et al.,
2006). Indeed, for older adults, meaning in life is
related to a good life, well-being, health and quality
of life (Hupkens et al., 2018), and differs culturally
(Moore et al., 2006). Indeed, research reiterates that
meaning in life depends on the type of meaning, age
and culture (Hupkens et al., 2018).
In 2019, a new coronavirus (SARS-Cov-2) began to
cause respiratory illness, and older adults have a
much higher risk of mortality (about 15%) than
younger people, especially if they have comorbidities
like diabetes, hypertension, obesity, heart and respira-
tory diseases, cancer, lupus, renal insufficiency, and
other chronic conditions (Wilson et al., 2020). Health
recommendations suggest that older adults, in par-
ticular those with comorbidities, should be protected
with social distance or if necessary social isolation
(Wilson et al., 2020).
As of 30 June 2020, more than 95% of deaths due
to Covid-19 were people aged 65 years and older, and
more than half of deaths were people over 80. In add-
ition, worldwide, 8 out of 10 deaths occurred in indi-
viduals with at least one underlying comorbidity, in
particular those with cardiovascular diseases, hyper-
tension and diabetes. In Europe, about 30,000 people
died with COVID-19, where 90% of the deaths were
in Italy, Spain and France (European Centre for
Disease Prevention and Control, 2020).
Italy presented a total of 233,836 assessed cases
and 33,601 deaths from Covid-19, and 85.1% deaths
were people aged 70 or older (Ministero Della Salute,
2020). In Mexico, approximately 29,592 older adults
(13.6% from total) were infected. The number of
deaths related to Covid-19 in Mexico has still been
growing and, by June 30, there were 26,648 reported
deaths, of which 41.7% (11,132) corresponded to
older adults (Gobierno de M
exico, 2020). By end of
June 2020, there were 39,392 cases of Covid-19 in
Portugal, and about 30.6% of the infected people were
individuals over the age of 65. This countrys death
toll has been low compared to many other countries,
however, approximately 67.2% of cases are older
adults aged 80 years and older (Direc¸~
ao Geral de
Sa
ude, 2020). Furthermore, Spain had 246,272 cases
and 28,323 deaths for Covid-19, of which 86.5% were
people aged 70 years or older (European Centre for
Disease Prevention and Control, 2020).
Isolation and loneliness may lead to depression,
cognitive dysfunction, disability, cardiovascular dis-
ease and increased mortality among older adults
(Morley & Vellas, 2020). Trzebi
nski et al. (2020) indi-
cated that meaning in life, satisfaction with life and
basic hope are elements that influence thoughts and
emotions in case of mortal danger. Hence, higher
2 S. VON HUMBOLDT ET AL.
levels of meaning in life, satisfaction with life, and
sense of hope correlate with less state anxiety and
stress during COVID-19 pandemic (Trzebi
nski
et al., 2020).
The literature suggests that the experience of mean-
ing in life among older people is higher when they have
access to family and friends, more interpersonal intim-
acy, mutual aid in daily life, practice self-disclosure,
higher levels of education, emotional support, better
self-perceived health status, and are open to communi-
cation (Lewnard & Lo, 2020). In this context, smart
technology has been relevant to explore meaning in life,
personal meaning, self-growth, sense of agency and self-
management, as well as other person-centered develop-
ments in old age (Martel et al., 2018).
Smart technology has been important for confined
older adults during the Covid-19 pandemic, but we
still lack knowledge about how Covid-19 affects
meaning in life among older adults from different cul-
tures and how technology is related to their meaning
in life during the COVID-19 pandemic (Trzebi
nski
et al., 2020). In this context, this study aims to ana-
lyze older adult perspectives of how smart technology
influenced their notion of meaning in life during the
Covid-19 Public Health Emergency period (Covid-19
PHEP) in different cultures.
Methods
Four hundred people were contacted and 378 agreed
to participate in this exploratory study. In total, 351
were included in the final sample. The rest were
excluded due to lack of availability or incomplete
data, yielding an unweighted response rate of 87.8%
and a weighted response rate of 94.3%. Among the
participants, 63.0% were women, 66.7% were married
or in a relationship, 39.0% lived alone and 43.9%
attended primary school (see Table 1). Participants
were recruited in Italy, Mexico, Portugal and Spain.
Recruiting methods varied widely, including senior
universities, message boards, community centre list-
serves, social networks ads and personal emails. The
objectives of the study were described, participants
were informed that the information they provided
was to be employed for this research only and their
names were kept anonymous. Participants gave their
informed consent to provide a telephone or online
contact and answer an online questionnaire (e.g.
Skype, Survey Monkey, Zoom and Whatsapp).
Participants had to fulfil a series of inclusion crite-
ria, namely (a) age equal to or over 65 years; (b)
clearly understanding of the decision to participate in
the study; (c) no history of psychiatric or neurological
illness, or history of drug or alcohol abuse, which
might compromise cognitive function and (d) use of
smart technology (e.g. computer, tablet, Apps, artifi-
cial intelligence) during the Covid-19 PHEP.
Qualitative data were collected between 1 May and
30 June 2020. Interviews lasted approximately 15 min
and were conducted in the participants mother lan-
guage, namely Italian, Spanish or Portuguese. The
questionnaire and interview guide were translated in
three steps (forward translation, back translation and
reconciliation). All procedures were approved by the
Table 1. Sample socio-demographic and health characteristics.
Characteristics Italian 78 (22.2) Mexican 94 (26.8) Portuguese 98 (27.9) Spanish 81 (23.1) Total 351 (100.0)
Age, mean ± SD 67.4 ± 3.1 69.7 ± 2.6 76.2 ± 4.1 75.2 ± 6.4 73.4 ± 3.4
Gender, n(%)
Women 42 (53.8.0) 65 (69.1) 64 (65.3) 50 (61.7) 221 (63.0)
Men 36 (46.2) 29 (30.9) 34 (34.7) 31 (38.3) 130 (37.0)
Living status, n(%)
Alone 34 (43.6) 45 (47.9) 23 (23.5) 35 (43.2) 137 (39.1)
With children 3 (3.8) 2 (2.1) 6 (10.2) 0 (0.0) 11 (3.1)
With a partner 41 (52.6) 47 (50.0) 65 (66.3) 50 (61.7) 203 (57.8)
Education, n(%)
Primary school 39 (50.0) 41 (43.6) 33 (33.7) 41 (50.6) 154 (43.8)
Middle school 20 (25.6) 22 (23.4) 24 (24.5) 1 (1.2) 62 (17.7)
High school 36 (24.4) 31 (33.0) 41 (41.8) 27 (33.3) 135 (38.5)
Marital status, n(%)
Married or in a relationship 65 (83.3) 61 (64.9) 54 (55.1) 54 (66.7) 234 (66.7)
Not married or in relationship 13 (16.7) 33 (35.1) 44 (44.9) 27 (33.3) 117 (33.3)
Professional status, n(%)
Active 18 (23.1) 16 (17.0) 21 (21.4) 18 (22.2) 73 (20.8)
Inactive 60 (76.9) 78 (83.0) 77 (78.6) 63 (77.8) 278 (79.2)
Family annual income, n(%)
25,000 e67 (85.9) 72 (76.6) 76 (77.6) 52 (64.2) 267 (76.1)
>25,000 e11 (14.1) 22 (23.4) 22 (22.4) 29 (35.8) 84 (23.9)
Perceived health, n(%)
Good 68 (87.2) 73 (77.7) 87 (88.8) 61 (75.3) 289 (82.3)
Poor 10 (12.8) 21 (22.3) 11 (11.2) 20 (24.7) 62 (17.7)
INTERNATIONAL REVIEW OF PSYCHIATRY 3
William James Centre for Research Ethics Committee,
ISPA Instituto Universit
ario, and were in accord-
ance with the ethical standards of the 1964 Helsinki
Declaration and its subsequent amendments or com-
parable ethical standards. Support for participants was
available by phone or online, and participants were
invited to give their feedback.
Data analysis
The interviews were recorded and transcribed verba-
tim. After this phase, an in-depth reading was carried
out, with the aim of collecting material for content
analysis. After reading the interviews, the data were
distributed with the aim of generating units of mean-
ing; then codes for the units of meaning were created;
and finally categories were created from the existing
codes. In this process, the contents were named with
succinct and intuitive names and several codes were
collected that referred to the same category. The des-
ignation of each category was defined at the end of
the process (Erlingsson & Brysiewicz, 2017).
To guarantee the replicability and reliability of the
analysis, the content organization process followed
specific rules, such as the existence of exclusive codes
and the homogeneity of those codes. Finally, when
the information collected stopped providing know-
ledge and important information for the analysis, the
process was interrupted due to its theoretical satur-
ation (Erlingsson & Brysiewicz, 2017).
Throughout the study, qualitative (theoretical and
empirical) and quantitative (descriptive statistics)
analyses were performed to elaborate an interpretative
structure of the findings, of a descriptive nature
(Erlingsson & Brysiewicz, 2017). All names used in
the content analysis are pseudonyms.
Categories were subjected to an external review
and critical feedback was obtained. To guarantee the
reliability of the study, Cohens Kappa was used. The
scores showed a high level of agreement (.87 <k<
.96, p<.01).
Results
We examined six non-mutually exclusive themes that
represented the cultural diversity of narratives
reported by older participants from four nationalities
(Italian, Mexican Portuguese and Spanish) when
exploring their meaning in life through smart tech-
nology during the Covid-19 PHEP. Although partici-
pants did not always plainly use the expression
meaning in life, their narratives pointed towards
contexts clearly related with their perspectives of
meaning in life. The evidence of meaning in life
emerged in six major themes: meaningful relations,
rewarding activities, spirituality, health and safety-
related support, self-growth, and physical activity. The
information shared by each participant could have
added to different themes (see Table 2).
Theme 1: Meaningful relations
A large number of participants (n¼134) indicated
that technology helped them connect with family, col-
leagues and friends. This theme was reported mainly
by Mexican participants (nMex ¼67; nPort ¼32;
nSpan ¼24; nItal ¼11). Maria explained that smart
technology is an open door to social interrelation-
ships, at the international, national and regional level
in my city, with family and friends(Maria; female,
79 years-old). Some participants reported the feeling
of being rewarded by being able to communicate with
their significant relations. Carlos explained that being
able to communicate with many members of my fam-
ily who are in different countries, by videoconference
and WhatsApp, and with my groups of friends on a
daily basis is very rewarding(Carlos; male, 81 years-
old). Moreover, smart technologies also served as a
Table 2. Main themes found and descriptive examples.
Themes Descriptive examples
Theme 1: Meaningful relations
(n¼134)
"Is an open door to social interrelationships, at the international, national and regional level in my city, family
and friends" (Maria; female, 79 years-old)
Theme 2: Rewarding activities
(n¼121)
Internet allowed me to continue my work, volunteer with groups spread over the national territory,
participate in national and international webinars, visit museums around the world, strengthen
communication methodologies, truly a source of intellectual nourishment.(Karim; male, 66 years-old)
Theme 3: Spirituality (n¼110) I may be in quarantine, in total isolation, but I will always have God by my side. I believe that we will go
through this and in the end, we will be stronger(Alice; female, 76 years old)
Theme 4: Health and safety-related
support (n¼102)
It helped me better understand the instructions to protect myself from contracting the covid-19 infection and
that made me feel safer and stronger, more aware of myself and my limitations. I think I reached a new
level of self-concept and I know what life means to me(Diana; female, 75 years old)
Theme 5: Self-growth (n¼87) Technology made it possible to broaden the expression of my possibilities and to accompany and stimulate
the imagination. They favoured concentration as well(Sophia; female, 79 years old)
Theme 6: Physical activity (n¼54) I do Yoga through an App and it works very well for me, sometimes new situations are food to break up
myth. I thought I couldnt do it bit it was easy to use this App.(Ava; female, 75 years old)
4 S. VON HUMBOLDT ET AL.
way of companionship. Miriam reported that it is
important because it is a distraction tool and its
another way to have company when we feel so much
what it is to be alone. I can see my loved ones and
share my day with them(Miriam, female, 83 years-
old). Smart technology also permitted new relations
to be formed. As Diego verbalized: Covid-19 was not
bad to me. I met Irina online and fell in love with
her, now we are in a relationship and I reconnected
with people with whom I had not been in contact for
a long time. I cant complain(Diego, male,
68 years-old).
Theme 2: Rewarding activities
Some participants (n¼121) indicated that smart tech-
nology was also seen as an important instrument for
carrying out their activities. This theme was mostly
reported by Portuguese participants (nPort ¼56;
nSpan ¼34; nMex ¼18; nItal ¼13). Smart technology
enabled older adults to have access to relevant infor-
mation and activities, which were important for their
learning, self-fulfilment and accomplishment. Thus,
Nicole explained: Since I am in the first year of my
degree, it was thanks to intelligent technology that the
information and materials were transmitted. Probably,
without this technology, our classes would have been
paused(Nicole; female, 65 years-old). Karim added
that the internet allowed me to continue my work,
volunteer with groups spread over the national terri-
tory, participate in national and international webi-
nars, visit museums around the world, strengthen
communication methodologies, truly a source of intel-
lectual nourishment. (Karim; male, 66 years-old).
Smart technology was a means to fight monotony
by allowing a large range of activities. Hugo claimed
that It takes away my boredom, it amuses me with
podcastsand technology allowed the learning of
languages(Hugo; male, 77 years-old). Filipa verbal-
ized that there are also applications where I can be
distracted, to knit, listen to music, learn gardening
techniques, write down my thoughts, meditate, think
about myself, listen to tips for a better life and rec-
ipes(Filipa; female, 69 years-old). In addition, partici-
pants reported that the attitude towards to use of
technology changed during the pandemic: Covid-19
gave me the opportunity to experience technology
more calmly; previously I used technology for specific
purposes and now this is how I research anything I
feel like. The emergency period accelerated online
processes and it generated other challenges and situa-
tions to solve. (Oscar; male, 70 years-old)
Theme 3: Spirituality
Some participants (n¼110) indicated that new tech-
nologies helped develop a sense of spirituality. This
theme was mostly reported by Spanish participants
(nSpan ¼58; nMex ¼23; nItal ¼20; nPort ¼9). Lucilia
explained that I wake up with the Guruji and make
guided meditation daily. It has been wonderful to fol-
low his Podcast. (Lucilia; female, 79 years old). Carla
added that technology is innovative and important to
develop physically, emotionally and spiritually.
(Carla; female, 68 years old).
Spirituality was important for meaning in life and
for enduring this difficult phase in the lives of these
participants. Elena reported that It helped me to be a
better person, to live with more tranquillity and to be
grateful to God for what I have(Elena; female,
81 years old). Erica added that we have to believe in
ourselves, to have faith. It is just a phase, a test to our
spirituality. (Erica; female, 84 years old).
Some participants reported that smart technology
helped them attend religious ceremonies and keep
their faith alive: Mia verbalized, I continue to attend
masses, but now on the internet(Mia; female,
84 years old). Alice added that I may be in quaran-
tine, in total isolation, but I will always have God by
my side. I believe that we will go through this and in
the end, we will be stronger(Alice; female,
76 years old).
Theme 4: Health and safety-related support
Older participants (n¼102) indicated that health and
safety assistance were possible to maintain due to
smart technology. This theme was mostly reported by
Spanish participants (nSpan ¼67; nPort ¼17;
nSpan ¼14; nItal ¼4).
A large number of older individuals considered
information essential for their safety and health pro-
tocols, and those of their families, by adding to the
definition of their self-concept and meaning in life.
Diana reported that It helped me better understand
the instructions to protect myself from contracting
the covid-19 infection and that made me feel safer
and stronger, more aware of myself and my limita-
tions. I think I reached a new level of self-concept
and I know what life means to me. (Diana; female,
75 years old). Daniel reported that Yes, health
instructions are important, to protect us and our fam-
ilies relationships and friendships. After all, we are
part of a risk group. That made me think about how
vulnerable I became. I think about what life will
INTERNATIONAL REVIEW OF PSYCHIATRY 5
mean to me in the future and what the future will
bring me(Daniel; male, 90 years old).
Health care was reported as being facilitated by
smart technologies, since they make it easier for peo-
ple to take care of themselves. Samuel verbalzsed:
Actually It has been a great help, all the health
support and healthy lifestyle activities that have been
sent to us by City Halls Safety and Health depart-
ment(Samuel; male, 69 years old).
Some respondents shared their gratitude for efforts
from health professionals. Anabela indicated that
I thank in advance all the team that has supported us
(myself and my husband), in these difficult times.
(Anabela; female, 79 years old).
Some participants indicated that they enlarged
their perspective of life and its meaning, by staying
connected with the outside world, and, therefore,
staying updated with the news and opinions from the
exterior. These participants also shared their concern
with fake news: Knowing the reality in which we live
is essential, in order to learn. It has been very good
since it has given me a broader knowledge of the real-
ity that I am living, namely the evolution of Covid-
19. We just have to be careful with fake news
(Oswald, male, 81 years old).
Theme 5: Self-growth
Some participants (n¼87) indicated that smart
technologies allowed for self-growth and reflection
about how to achieve self-growth during the Covid-
19 PHEP. This theme was mostly reported by
Portuguese participants (nPort ¼48; nItal ¼21;
nSpan ¼12; nMex ¼6).
Difficult experiences were reported as occasions for
self-growth for these older participants and the pan-
demic gave them the opportunity to reflect about and
experience new perspectives of meaning in life. Isabel
revealed, I feel calmer now because the world has
stopped stressing me. I do not have to hurry up for
everything anymore. For me, Covid-19 has been
good. I grew up and learned a lot. I feel more at
peace. It has been a vacation all around. I have
explored the topics that interest me on Youtube, I lis-
ten to podcasts, I have time to explore important
apps. Technology has served my interests. I can taste
food, look at a flower, and do nothing but feel. What
can I ask for more?(Isabel; female, 69 years old).
Additionally, some participants focussed on how tech-
nology allowed them to explore possibilities and to
stimulate imagination: Technology made it possible
to broaden the expression of my possibilities and to
accompany and stimulate the imagination. It favored
concentration as well(Sophia; female, 79 years old).
In addition to experiences, some participants
reported that this phase also provided important life
lessons. David explained, I have been able to under-
stand the magnitude of the problem and how to sur-
vive. It has also taught me a great lesson: that we
have nothing safe in life and must be prepared psy-
chologically with a balanced and responsible attitude
in life and towards others(David, male, 65 years old).
Some participants indicated that they valued little
things and the time they had. By living some part of
their lives online, they did not waste time in non-
satisfactory activities and focussed upon the free
time they had. Laura explained that Idiscovered
that I owe much more importance than I thought to
smallthings.Inoticemoreofthem.Thelaughterof
a child, a flower blossoming, a cat that comes to my
garden every day.(Laura;female,76yearsold).Sara
added some environmental concerns: Ilearnedto
be alone and to value my life on this planet, Covid
is helping us to save the planet. The human race
had to stop and give the planet a break.(Sara;
female, 86 years old).
Some participants reported self-growth by learning
with new technologies that were available online.
Antonio said that smart technologies are novel and
very important to develop myself emotionally, physic-
ally and economically. I feel more empowered, I feel I
grew up another step. (Antonio; male, 71 years old).
Theme 6: Physical activity
The last theme was reported by 54 participants.
Participants used smart technology to continue exer-
cising, in particular those who already practiced phys-
ical activity previously. Most used Apps, YouTube
videos and podcasts. This theme was mostly reported
by Italian participants (nIta ¼23; nPort ¼14;
nSpan ¼10; nMex ¼7). Ava reported that I do Yoga
through an App and it works very well for me.
I thought I couldnt do it, but it was easy to use this
App. (Ava; female, 75 years old).
Some older participants contracted the services of a
personal trainer. Olivia verbalized, I started to have a
personal trainer and that has been fantastic. (Olivia;
female, 78 years old). Additionally, some participants
started new physical activities. Amelia referred that
I started to do Pilates and I follow my step counter
at home and in the garden, I never do less than
10,000 a day to stay healthy. To stop is to die.
(Amelia; female, 77 years old).
6 S. VON HUMBOLDT ET AL.
Senior athletes continued to train on a daily basis,
but shared the need to adapt to the contingencies of
smart technology. Jessica explained that, I exercise
through Zoom with my dance colleagues. It is not
the same, the atmosphere is lacking but it is also
an opportunity to socialise. (Jessica; female,
75 years old).
Discussion
This exploratory study aimed to fill a knowledge gap
about older adult perceptions of how smart technol-
ogy influenced their meaning in life during the
Covid-19 PHEP. Findings indicate that older adults
from different cultures perceived meaning in life in
diverse and rich manners.
Meaningful Relations was the theme most fre-
quently indicated by older adults, most of which
Mexican participants. Participants indicated that tech-
nology helped them connect with family, colleagues
and friends. The literature reiterates that smart tech-
nology helps older people socially connect, positively
benefit their well-being, self-rated health, and mental
health (Lewnard & Lo, 2020). Being connected with
others is critical to the experience of meaning in life,
but older adults often have poor social networks
(Duppen Rn et al., 2019). The most-used technology
to achieve social engagement were social networks,
but also emerging technologies, such as virtual or
augmented reality applications and virtual assistants
that make use of artificial intelligence for social con-
nectedness (Lewnard & Lo, 2020).
Home confinement was mandatory for older adults
and infected people, which may have increased the
feeling of social isolation and loneliness among older
adults, thus making individuals in advanced ages
doubt their meaning in life and lose confidence in the
value of life (Lewnard & Lo, 2020). Participants used
smart technologies for companionship and to decrease
loneliness. Research has showed that smart technology
mitigates social isolation among older adults through
four mechanisms: connecting to the outside world,
gaining social support, engaging in activities of inter-
est, and boosting self-confidence (Lewnard & Lo,
2020). Moreover, social connectedness contributes to
a meaningful life in older age (Low, von Humboldt,
Kalfoss, Wilson, & Leal, 2019; von Humboldt, 2016;
von Humboldt & Leal, 2015).
Interestingly, due to smart technology, new models
of social relations and social networks among older
adults have emerged (Lewnard & Lo, 2020). Indeed,
Ayalon and his colleagues (2020) highlighted that
older adults make proactive use of technology to
shape their social contexts.
The second most mentioned theme was Rewarding
Activities, mostly indicated by the Portuguese partici-
pants. Smart technology was an important instrument
for carrying out their activities, explore their hobbies,
learn new competences and participate in enjoyable
and distracting activities. In this way, older partici-
pants used smart technology as a means to accom-
plish rewarding activities, such as listening to
podcasts and music, learning new recipes and garden-
ing techniques with tutorials, exercising with virtual
personal trainers, among others. Indeed, smart tech-
nology can help older people pursue rewarding activ-
ities and add meaning to their lives. Accessible
information, different forms of entertainment, con-
venient and communication tools can enrich older
peoples lives, maintain cognitive skills, keep them
from feelings of emptiness and loneliness, and help
them experience meaning in life (Ayalon et al., 2020).
Spirituality was the third most mentioned theme.
Spanish older individuals were who most mentioned
this theme. Spirituality was important to give meaning
to participantslives and help them face this difficult
phase. The literature indicates a relationship between
spirituality and a good life in old age (Roman et al.,
2020). In addition, spiritual care is about providing
compassion and empathy during times of greater
stress, anguish and anxiety (Roman et al., 2020).
Spiritual care has been a factor of great importance
for holistic management of health, especially in terms
of coping with suffering, illness and death (Roman
et al., 2020). Likewise, COVID-19 led participants to
reflect on quality of life, health, well-being, meaning
in life and especially about the end of life, which cor-
roborated the literature (Lewnard & Lo, 2020).
Furthermore, participants used smart technology to
assist their spiritual and religious devotion, using
tools such as apps and websites to improve their reli-
gious education and devotional emails, and improve
their spiritual experiences. Indeed, smart technology
can facilitate participation and growth in religious
and spiritual life (Roman et al., 2020) and religious-
ness is related to a sense of meaning in life in old age
(Roman et al., 2020).
The next most indicated theme was Health and
Safety-Related Support, again mentioned especially by
Spanish participants. Older people value health-related
technology that gives them independence, safety and
protection, allows them to manage their own health,
and helps them in their daily activities (Vaportzis
et al., 2017). In this line, participants indicated that
INTERNATIONAL REVIEW OF PSYCHIATRY 7
with smart technology it was possible to maintain
assistance in health and safety. These participants felt
connected with the outside world, namely in relation
to the evolution of Covid-19. Note that the quality of
life of older adults can be improved by the use of
innovative technologies, mainly by monitoring their
health situations through remote controlled technol-
ogy; by increasing self-esteem, since they no longer
depend on other people; by reducing loneliness,
through the interaction with specific online groups;
by keeping senior individuals active through online
communication; and by providing formal medical
care and preventive care (Anderberg, 2020).
The fifth theme indicated by participants was Self-
Growth, a topic mentioned most by Portuguese par-
ticipants. Older adults use smart technology to invest
in their internal growth, which can contribute to
meaning in their lives (Morrow-Howell et al., 2020).
Smart technology can be used to expand ones mood
and wisdom, which affects meaning in life. Moreover,
older people use the Internet and social media to sup-
port informal, self-directed learning goals, to
empower themselves and to develop their inner being
(Morrow-Howell et al., 2020). Accordingly, some par-
ticipants shared that this phase provided important
life lessons, such as being in peace with themselves,
looking for meaning in daily situations, meditating,
enjoying the current moment, and being grateful.
The recent literature indicates that the use of tech-
nology to help meditate, self-help, report mood and
support mental health is beneficial for the internal
growth of older adults (Finn, 2020). In addition,
smart technology offers new opportunities for old
people in distress when traditional resources are
unreachable, unattainable or require special effort
(e.g. online therapy and counselling, online support
groups) (Finn, 2020). Furthermore, the use of smart
technology empowers older adults by engaging them
in critical thinking and decision-making, which leads
to self-efficacy and empowerment, and further triggers
their positive feelings towards themselves and their
control over life, and their self-growth and meaning
in life (Lewnard & Lo, 2020).
The last theme mentioned was Physical Activity,
and mostly indicated by the Italian participants.
There has been a major impact on physical activity
behaviour worldwide due to COVID-19, which forced
people to stay home and isolate themselves.
Technology-based exercise interventions can improve
physical activity and exercise adherence in older peo-
ple and can contribute to feelings of empowerment
and self-esteem. Moreover, smart technology
applications offer well-accepted methods to realize
exercise programmes for older adults, improving
healthy behaviours, psychological outcomes, clinical
parameters, motivation and enjoyment (Buyl et al.,
2020). Many participants continued exercising with
the help of Apps, online personal trainers, tutorials
on YouTube and others. Dancing, gymnastics and
exergaming were the most indicated physical activ-
ities. New technological tools, such as Fitbit, are
increasingly being used as an alternative to conven-
tional rehabilitation-based exercises (Buyl et al.,
2020). Research showed that older adults exposed to
exergame training are able to improve a variety of
physical functions, such as balance control, cardio-
respiratory fitness and gait speed (Buyl et al., 2020).
The present study has a number of limitations.
The number of participants was relatively small,
which limits the comparability and generalization of
findings, and there was an uneven sampling of
nationalities. Considering the cultural differences, a
more balanced distribution would be advantageous,
and a greater sample size to incorporate a broader
selection of older adults. Even though the study was
designed to be free of bias, one core area was prede-
fined. Hence, interviews tended to steer to this area,
which could have biased the findings.
Notwithstanding these limitations, this exploratory
study is valuable for a number of reasons. Firstly, it
includes a sample with four nationalities, which
allows for intercultural comparison. The user-driven
findings reveal a variety of cultural perspectives,
which contribute to knowledge about interventions
that can reduce costs and improve health and quality
of life during a pandemic. Considering that people in
different cultures show different meanings for their
experiences, qualitative research provides access to the
varying perspectives of older adultsmeaning in life.
Planning public health resources, expertise and
intervention programmes that aim to reduce frailty
and social isolation should include assessments of
meaning in life among older adults, and the attitudes
of older individuals regarding technology. Moreover,
there is a need for meaningful activities that improve
health and well-being of older adults in the commu-
nity (Duppen Rn et al., 2019).
Worldwide, the number of old people in the popu-
lation and the need to adequately help them is
increasing. Older adults may feel powerless in face of
new technologies, however an effective use of smart
technology permits their integration in current daily
life and access to a convenient and ergonomic high-
tech life (Ayalon et al., 2020). Smart technology offers
8 S. VON HUMBOLDT ET AL.
older people more ways to realize their own value
and achieve meaning in life. However, Covid-19 chal-
lenged their meaning in life by having to live through
adversity, in many cases in isolation during an unpre-
cedented period of their lives. These older participants
found ways to socially reconfigure their day-to-day
lives through smart technology and experience mean-
ing in everyday life. This use of technology supports
Peace et al. (2011) notion of option recognition,
wherein older people strategically modify their behav-
iour and living environments to maintain a sense of
connection with a living space. During COVID-19,
smart technology created affordances for the older
people in this study to live in place with a sense
of meaning.
Moreover, older participants from diverse cultures
used technology differently in developing their mean-
ing in life. Meaningful relations were reported mainly
by Mexican participants, while rewarding activities
were mostly indicated by Portuguese participants, and
spirituality was mostly reported by Spanish older
adults. Indeed, understanding how older adults per-
ceive technology is essential to facilitate implementa-
tion and maximize its potential to provide them an
independent life. Moreover, it is of utmost import-
ance to continue to reduce the gap between frail old
people, health professionals and health providers, and
new technologies, bringing together the diverse views
on technology. Although the development of smart
technology seems to entail many obstacles for older
adults, devices focussed on communication, access to
information, personal investment, entertainment,
safety and monitoring behavioural, and medical issues
can help older people find meaning in life. In brief,
the impact of this period of isolation on the future
meaning in life, well-being, both physical and emo-
tional, of older adults is still being determined. This
exploratory study adds value to the still unknown
relation between smart technology and meaning in
life among older adults from different cultures, high-
lighting the pertinence of meaningful relations,
rewarding activities spirituality, health and safety-
related support, self-growth, and physical activity in
old age.
Disclosure statement
The authors report no conflicts of interest. The authors
alone are responsible for the content and writing of
the paper.
Sponsors role: The fund approved the design and aims
of the study but did not play any role in the collection of
data, interpretation of findings, or preparation of
this article.
Funding
This work was supported by a grant from the Portuguese
Foundation for Science and Technology (FCT) [Grant no.
SFRH/BPD/116114/2016].
ORCID
Sofia von Humboldt http://orcid.org/0000-0001-
9664-6735
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Background and objectives: The COVID-19 pandemic exacerbated the public health concerns of social isolation and loneliness for older people who are vulnerable due to their health conditions and more restrictive social measures. However studies revealed that many older adults demonstrated high resilience and remained emotionally stable during the pandemic, particularly those who had a broad engagement with online technology that could compensate for their isolation. Yet, little empirical research has examined explicitly the association between online engagement and loneliness among older adults, and the role resilience played in this relationship during the pandemic. This study contributed to the literature by addressing these research gaps. Research design and methods: This study investigated the relationships between online engagement (sum of involvement in 31 online activities), resilience (sum of positive experiences and personal growth during COVID-19) and loneliness (mean of 11-items from the revised version of the UCLA loneliness scale) among community-dwelling older people (aged 60+), using national survey data from the 2020 Health and Retirement Study (HRS) collected during the COVID-19 pandemic (N = 3,552). Results and conclusion: Online engagement was negatively associated with levels of loneliness (β = -0.080, 95% CI [-0.118, -0.047]), and this association was partially mediated by levels of resilience (β = -0.023, 95% CI [-0.031, -0.016]. The findings suggested that a broad integration of online technology into daily-life may have helped older people combat loneliness during the pandemic, and resilience could be one important mechanism that linked this association.
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Implementation of the curriculum in elementary school based on the use of ICT by educators. Nowadays, ICT has developed from time to time, this requires all educators to be able to use ICT. As educators, of course, they must be able to master technology, especially for the learning process for students. This ICT learning does not only exist in public schools, but also in elementary school By learning to use ICT, and educators who use it can also master it, learning will be easier for both educators themselves and students. The purpose of this research itself refers to how the use of ICT by educators in elementary school in order to implement the competency curriculum in elementary school. The research was conducted using in-depth interviews with educators at elementary school through the WhatsApp application with a qualitative method. The results of the research are that the use of ICT for educators is quite developed, even ICT is very helpful for educators in providing material that is easily understood by students. The use of ICT in elementary school is very beneficial for educators and for students, with ICT in learning it makes it very easy for students to understand the material provided, moreover students are very happy with things that attract their attention so that the material provided will be easier to understand. The limitations of this research are that the researcher did not make a report on what percentage of educators can use ICT, as well as the extent to which educators and researchers have only studied one elementary school. Therefore, it is hoped that future researchers can conduct better and more complete research
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The attention of language learning experts conducting various research and studies to determine the effectiveness and success of Arabic learning methods. Communication strategy is one of the strategies used in learning Arabic, which focuses on communication skills. This strategy is used in an analysis that uses a literature strategy where the data is based on various significant reference sources in this discussion. The results of this study indicate that learning methods based on the communicative approach emphasize listening and speaking skills; the learning objectives to be achieved through these various methods are so that students can communicate in the target language being studied whenever and wherever that is. Suitable for language learning. Arabic language education research has reviewed a lot about learning at the elementary, middle, and high school education levels, most of which show theoretical and practical aspects. This study aims to reveal the application of PAUD Arabic education theory and look at the strategies used by teachers or schools and things that influence the initial inculcation of Arabic language learning in early Childhood by using vocabulary strategies.
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COVID-19, a health-based problem, presents the world with unprecedented challenges across all strata in society. The COVID experience, within these challenges, teach us about quality of life, health and well-being and just as important, end of life. During this time, spiritual care is a vital component of holistic health management especially in terms of coping, coming to terms with illness, suffering and ultimately death. The relationship with the transcendent or sacred has a strong influence on a people’s beliefs, attitudes, emotions, and behaviour. Populations, communities, families and individuals have always found solace through their religious or philosophical beliefs in times of personal adversity and widespread anxiety or disaster. Though spiritual care has always been located within the domain of religious beliefs, a more contemporary perspective is that spiritual care forms part of the human psyche and thus forms part of human care, health and wellbeing for families, patients and health care workers. Spiritual care is concerned with the provision of compassion and empathy during periods of heightened stress, distress and anxiety within care. This short article provides insight to the necessity of providing spiritual care as a means of coping and wellbeing for families, patients and health care workers during this COVID-19 pandemic.
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Being connected with others is fundamental for the experience of a meaningful life. Unfortunately, several older adults have poor networks/social support. The present study focuses on the experience of meaning in life as well as the loss of meaning for socially frail older adults. Results indicate that socially frail older adults experience meaning in life in different dimensions. The article argues that home-care organizations and prevention programs aimed at reducing frailty are encouraged to include evaluations of meaning in life. There is a need for meaningful activities in organizations that ameliorate social con-nectedness for community-dwelling older adults.
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As we look toward recovery from the COVID-19 pandemic, we overview challenges to be minimized, including economic setbacks, health and well-being effects, and highlighted ageism, racism, and classism. We articulate opportunities to be seized, including increased comfort with technology and online platforms; stronger family and intergenerational connections, renewed energy to combat social isolation; more respect for self-care and time management; increased awareness about the importance of advance directives; and, potentially, increased interest across disciplines to work on issues of aging society. Ongoing efforts to improve policies and programs for longer, healthier lives might now be more productive, as we communicate to consumers, public officials, and everyday citizens who may be more aware of what isn’t working, what is at stake, and what might be improved.