[Grief and loss in elderly people: A qualitative study regarding the user acceptance of an internet-based self-help...

The loss of a significant other is a stressful life event, especially for older people. The aim of this study was to investigate user acceptance of an internet-based self-help program for mourners aged 60 years and above. Potential access paths as well as barriers of use were to be identified from both users' and experts' perspectives.

This study is following a qualitative design. Two focus groups were formed consisting of elderly people (60+) with loss experience (N=12) and of experts from the medical care system (N=8). The focus groups were conducted using a discussion guide related to the model of the Unified Theory of Acceptance and Use of Technology (UTAUT). Focus group data were recorded by audio tape and fully transcribed. Qualitative content analysis according to Mayring (2015) was applied using MAXQDA.

The mean age of elderly participants with loss experience was 64.5 years, 50 % were women. From the user's perspective, an internet-based self-help program should comprise information regarding grieving, suggestions and motivation for behavioral activation, strengthening self-esteem, and suggestions for dealing with other feelings related to grief (such as guilt). Directions for relatives of mourners as well as faith and spirituality were important topics for users. Elderly participants felt confident to be able to use an internet-based self-help program. Processing time and topic selection should be flexible for the user. Potential access paths included general practitioners and specialists, mourning cafés, or local media. A potential barrier was seen for people who prefer a personal relationship. The average age of participants in the expert focus group was 40.1 years, 87.5 % were female. There was a high user acceptance from the perspective of health care experts with regard to the target group of elderly people (60+). Access paths were seen across all specialist groups working with elderly people (e.g., physicians, occupational therapists, nursing facilities). Lack of guidance was discussed as a potential barrier.

A key aspect and prerequisite for the use and effectiveness of an internet-based self-help intervention for mourners is user acceptance. Judgments from potential users and experts showed a high user acceptance, but also the need to address age group-specific topics for coping with grief.

Internet-based self-help interventions can be a promising add-on treatment option for elderly bereaved people. The implementation of such programs should take the access paths mentioned into account in order to inform users and experts about the intervention.