The use of online groups to involve older people in influencing nursing care guidance


  • Timothy B. Kelly
  • Irene Schofield
  • Jo Booth
  • Debbie Tolson



<i>involving service users</i>, <i>online groups for older people</i>, <i>gerontological nursing</i>


The drive to involve service users in policy and practice decisions is occurring on an international basis, yet meaningful involvement is not as commonplace as it should be. There are numerous barriers to meaningful involvement of service users, and groupwork offers a potentially empowering approach to helping service users influence the policy and practice decisions that impact their lives. This paper describes a model of service user involvement based on an online communities of practice approach. Twenty-one older people and carers were recruited to take part in a project aimed at influencing the policy and practice of nursing older people on a national level (Scotland). Participants were taught IT skills and worked as an online group to articulate what they thought constituted good nursing care of older people. Together they produced two statements concerning prevention of depression and ensuring adequate nutrition for older people in care. This paper reports on one aspect of a larger evaluation of the project, namely the role of groupwork in the involving model. Content analysis of the groupwork records highlights the importance of groupwork and mutual aid in achieving group goals. The combination of groupwork, service user involvement, and interactive computer technology has much potential.


Alexy, E.M. (2000) Computers and caregiving: Reaching out and redesigning interventions for homebound older adults and caregivers. <i>Holistic Nursing Practice</i>, 14, 4, 60-66\nAndrews, J., Manthorpe, J., and Watson, R. (2004) Involving older people in intermediate care. <i>Nursing and Health Care Management and Policy</i>, 46, 3, 303-310\nAudit Commission (1997) <i>The Coming of Age: Improving care services for older people</i>. London: Audit Commission\nBarnes, M. and Walker, A. (1996) Consumerism versus empowerment: A principled approach to the involvement of older service users. <i>Policy and Politics</i>, 24, 4, 375-393\nBenbunan-Fich, R., Hiltz, S.R., and Turoff, M. (2002) A comparative content analysis of face-to-face vs. asynchronous group decision making. <i>Decision Support Systems</i>, 34, 457-469\nBreton, M. (1994). On the meaning of empowerment and empowerment-oriented social work practice. <i>Social Work with Groups</i>, 17, 3, 23-37\nCzaja, S.J., and Sharit, J. (1998) Age differences in attitudes toward computers. <i>The Journals of Gerontology</i>, 53b, 5, 329-340\nChambers, P., and Pickerd, J. (2001) Involving older members of the Lifetime Project in research: A report of research in progress. <i>Education and Ageing</i>, 16, 1, 27-38\nChen, G. D., Wang, C. Y., and Ou, K. L. (2002) Using group communication to monitor web-based group learning. <i>Journal of Computer Assisted Learning</i>, 19, 401-415\nCotter, A., Meyer, J., and Roberts, S. (1998) The transition from hospital to long-term institutional care. <i>Nursing Times</i>, 94, 34, 54-66\nDavies, S. and Nolan, M. (2003) Learning from experience. <i>Quality in Ageing: Policy, practice and research</i>, 4, 4, 2-5\nDepartment of Health (1999) <i>Patient and public involvement in the new NHS</i>. London: DoH\nDewar, B.J. (2005) Beyond tokenistic involvement of older people in research: A framework for future development and understanding. <i>International Journal of Older People Nursing</i>, 14, 3a, 48-53\nDewar, B., Jones, C. and O’May, F. (2004) <i>Involving older people: Lessons for community planning</i>. Edinburgh: Scottish Executive Social Research\nDoel, M. and Sawdon, C. (1999) <i>The Essential Groupworker: Teaching and learning creative groupwork</i>. London: Jessica Kingsley Publishers\nEdwards, M. and Roberts, E. (2000) Old testament. <i>Health Service Journal</i>, 3, February, 30-31\nFlanagin, A. J., Park, H.S. and Seibold, D.R. (2004) Group performance and collaborative technology: A longitudinal and multilevel analysis of information quality, contribution equity, and members’ satisfaction in computer-mediated groups. <i>Communication Monographs</i>, 71, 3, 352-372\nGünther, V. K., Schäfer, P., Holzner, B. J. and Kemmler, G.W. (2003) Long-term improvements in cognitive performance through computer-assisted cognitive training: A pilot study in a residential home for older people. <i>Aging and Mental Health</i>, 7, 3, 200-206\nGutierrez, L. M., DeLois, K.A., and GlenMaye, L. (1995). Understanding empowerment practice: Building on practitioner-based knowledge. <i>Families in Society: The Journal of Contemporary Human Services</i>, 76, 9, 534-542\nHahm, W. and Bikson, T. (1989) Retirees using email and networked computers. <i>International Journal of Technology and Aging</i>, 2, 2, 113-123\nHealth Advisory Service (1997) <i>Services for People Who Are Elderly: Addressing the balance. The multidisciplinary assessment of elderly people and the delivery of high quality continuing care</i>. London: The Stationery Office\nHendrix, C. (2000) Computer use among elderly people. <i>Computers in Nursing</i>, 18, 2, 62-68\nIrizarry, C., West, D., and Downing, A. (2001) Use of the Internet by older rural south Australians. <i>Australasian Journal on Ageing</i>, 20, 3, 153-155\nIvory, M. (2003) Bjorn again. <i>Community Care</i>, 15 May 2003, 36-37\nKanayama, T. (2003) Ethnographic research on the experience of Japanese elderly people online. <i>New Media and Society</i>, 5, 2, 267-288\nKane, R.L., and Kane, R.A. (Eds) (2000). <i>Assessing Older Persons</i>. New York: Oxford University Press\nKelly, T.B., Lowndes, A., and Tolson, D. (2005) Advancing stages of group development: The case of virtual nursing community of practice groups. <i>Groupwork</i> 15, 2, 7-28\nKrippendorf, K. (1980) <i>Content Analysis: An introduction to its methodology</i>. Beverly Hills, CA: Sage Press\nLai, C.K.Y., Arthur, D.G., and Chau, W.W.H. (2004) Implication of Internet growth on enhancing health of disadvantaged groups in China: A global perspective. <i>International Journal of Older People Nursing</i>, 13, 6b, 68-73\n<i>Local Government Act 2003</i> (Chapter 26). Edinburgh: Stationery Office\nMackie, R.R., and Wylie, C.D. (1988) Factors influencing acceptance of computer-based innovations. in M. Helander (Ed.) <i>Handbook of Human-Computer Interaction</i>. (pp. 1081-1106) New York: Elsevier\nMacDonald C., Storkey H., and Raab G. (2001) <i>Older People in Scotland: Results from the first year of the Scottish Household Survey</i>. Edinburgh: Scottish Executive Social Research\nMcKenna, K.Y.A., and Green, A.S. (2002). Virtual group dynamics. <i>Group Dynamics: Theory research, and practice</i>, 6, 1, 116-127\nMcLeod, P.L, Baron, R.S., Marti, M.W., and Yoon, K. (1997) The eyes have it: Minority influence in face-to-face and computer-mediated group discussion. <i>Journal of Applied Psychology</i>, 82, 5, 706-718\nMeier, A. (2000) Offering social support via the Internet: A case study of an online support group for social workers. <i>Journal of Technology in Human Services</i>, 17, 2/3, 237-266\nMichinov, N., and Primois, C. (2004) Improving productivity and creativity in online groups through social comparison process: New evidence for asynchronous electronic brainstorming. <i>Computers in Human Behavior</i>, 21, 11-28\nMonnier, J., Laken, M. and Carter, C. (2002) Patient and caregiver interest in internet-based cancer services. <i>Cancer Practice</i>, 10, 6, 305-310\nNational Audit Office (2003) <i>Progress in Making E-services Accessible to All: Encouraging use by older people</i>. London: The Stationery Office\nNHSQIS (2004) <i>Working with Older People towards Prevention and Early Detection of Depression</i>. Edinburgh: NHS Quality Improvement Scotland\nNHSQIS (2005a) <i>Care Guidance for Older People: Getting sufficient nourishment when going into a hospital or care home</i>. Edinburgh: NHS Quality Improvement Scotland\nNHSQIS (2005a) <i>Care Guidance for Older People: Prevention and early detection of depression</i>. Edinburgh: NHS Quality Improvement Scotland\nNHS Scotland (2003) <i>A Partnership for Care: Scotland’s Health White Paper</i>. Edinburgh: Stationery Office\nNMPDU (2002) <i>Nutrition for Physically Frail Older People</i>. Edinburgh: Nursing and Midwifery Practice Development Unit\nNickell, G.S., and Pinto, J.N. (1986) The Computer Attitude Scale. <i>Computers in Human Behavior</i>, 2, 301-306\nO’Keefe, E., and Hogg, C. (1999) Public participation and marginalized groups: The community development model. <i>Health Expectations</i>, 2, 245-254\nPawson R., and Tilley, N. (1997) <i>Realistic Evaluation</i>. London: Sage\nPostmes, T., Spears, R., and Lea, M. (2000) The formation of group norms in computer-mediated communication. <i>Human Communication Research</i>, 26, 3, 341-371\nQuinn, A., Snowling, A., and Denicolo, P. (2003) <i>Older People’s Perspectives: Devising information, advice and advocacy services</i>. York: Joseph Rowntree Foundation\nRaynes, N.V. (1998) Involving residents in quality specification. <i>Ageing and Society</i>, 18, 1, 65-77\nRichardson, M., Weaver, C.K., and Zorn, T.E. (2005) ‘Getting on’: Older New Zealanders’ perceptions of computing. <i>New Media and Society</i>, 7, 2, 219-245\nSalamon M.J., and Conte, V.A. (1998) <i>Manual for the Life Satisfaction Scale (LSS): Formerly the Life Satisfaction in the Elderly Scale</i> (LSES). Hewlett, NY: Adult Development Center\nSchopler, J.H., Abell, M.D., and Galinsky, M.J. (1998) Technology-based groups: A review and conceptual framework for practice. <i>Social Work</i>, 43, 3, 254-267\nSchwartz, W. (1971) On the use of groups in social work practice. in W. Schwartz and S. Zalba (Eds), <i>The Practice of Group Work</i> (pp. 3-24). New York: Columbia University Press\nSelwyn, N., Gorard, S., Furlong, J., and Madden, L. (2003) Older adults’ use of information and communications technology in everyday life. <i>Ageing and Society</i>, 23, 561-582\nSherer, M. (1997) Introducing computers to frail residents of homes for the aged. <i>Educational Gerontology</i>, 23, 4, 345-358\nShreeve, M. (1999) Part of the solution. <i>Community Care</i>, 24th June, 4-5\nShulman, L. (1999) <i>The Skills Of Helping Individuals, Families, Groups and Communities</i>. Itasca, IL: F.E. Peacock\nSmokowski, P.R., Galinsky, M., and Harlow, K. (2001) Using technologies in groupwork Part II: Technology-based groups. <i>Groupwork</i>, 13, 1, 98-115\nSteinberg, D. (2004) <i>The Mutual-Aid Approach to Working with Groups Helping people help one another</i>. (2nd edition) Binghampton, NY: Haworth\nStraus, S.G., and McGrath, J.E. (1994) Does the medium matter? The interaction of task type and technology on group performance and member reactions. <i>Journal of Applied Psychology</i>, 1, 87-97\nSumner, K. (2004) Who are the real experts? <i>Community Care</i>, 29th February, 32-34\nValcke, M. (1988) Theoretical foundations and empirical arguments for group work in computer learning environments. <i>Education & Computing</i>, 4, 209-215\nWelsh Assembly Government (2003) <i>Signposts Two: Putting public and patient involvement into practice</i>. Cardiff: Welsh Assembly Government\nWenger, E. (1998) <i>Communities of Practice: Meaning and identity</i>. Cambridge: Cambridge University Press\nZornoza, A., Ripoll, P., and Pieró, J.M. (2002) Conflict management in groups that work in two different communication contexts: Face-to-face and computer-mediated communication. <i>Small Group Research</i>, 33, 5, 481-509\n




How to Cite

Kelly, T. B., Schofield, I., Booth, J., & Tolson, D. (2012). The use of online groups to involve older people in influencing nursing care guidance. Groupwork, 16(1), 69-94.